Public Welfare. Part158:Issuer use of premium revenue: reporting and rebate requirements. Section158.211:Requirement in States with a higher medical loss ratio.
(a) State option to set higher minimum loss ratio. For coverage offered in a State whose law provides that issuers in the State must meet a higher MLR than that set forth in §158.210, the State's higher percentage must be substituted for the percentage stated in §158.210. If a State requires the small group market and individual market to be merged and also sets a higher MLR standard for the merged market, the State's higher percentage must be substituted for the percentage stated in §158.210 for both the small group and individual markets.