CDPHP® works hard to ensure our administrative costs are not our members’ burden, and that we spend a vast majority of your premium dollars on medical care. That’s why we are pleased to announce that CDPHP has exceeded the federal standard for medical loss ratio.
An insurance company’s medical loss ratio (MLR) is a measurement of how premium dollars are spent. The Affordable Care Act requires all health insurers to spend a proportion of premiums (80 cents of every $1) on medical benefits, which includes things like payments to your doctors, hospitals, and other medical providers, as well as coverage of your prescription drugs.
When an insurer does not meet these standards, it must rebate its customers the difference. Because CDPHP exceeds these standards, we will not be required to issue rebates.