Regulations of Connecticut State Agencies (Last Updated: June 14,2023) |
Title38a Insurance Department |
SubTitle38a-478u-1_38a-478u-7. Managed Care |
Sec.38a-478u-5. Medical loss ratio
Latest version.
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For the purposes of reporting and disclosure in accordance with Sections 4 and 8 of Public Act 97-99 as amended by Public Act 97-8, June 18 Special Session, "medical loss ratio" means the ratio of incurred claims to earned premium for the prior calendar year for managed care plans issued in Connecticut. Claims shall be limited to medical expenses for services and supplies provided to enrollees and shall not include expenses for stop loss, reinsurance, enrollee educational programs or other cost containment programs or features.
(Adopted effective April 5, 1999)