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Medical Loss Ratio (MLR) Tracker

financial · Updated 2026-04-25

Medical Loss Ratio (MLR) Tracker

MLR = Medical Costs / Premium Revenue ACA requires: 80% individual/small group, 85% large group

Why MLR Matters

  • Higher MLR → insurer is paying more claims (good for enrollees, pressure on margins)
  • Lower MLR → insurer retains more as profit/admin
  • Post-COVID trend: MLR rising as utilization normalizes

Company MLR Comparison (FY2023 Actuals — update with 2024)

CompanyCommercial MLRMedicare MLRMedicaid MLRBlended
UnitedHealth~82%~87%~88%~84%
Elevance~84%~88%~89%~86%
Cigna~81%N/AN/A~83%
HumanaN/A~89%N/A~89%
CenteneN/A~87%~88%~88%

Sources: SEC 10-K filings — verify and update per company reports

Key Trends to Monitor

  • Medicare Advantage MLR pressure (CMS rate reductions 2024-2025)
  • Medicaid redetermination impacts (post-COVID unwinding)
  • GLP-1 drug cost escalation effect on commercial MLR
  • Behavioral health parity enforcement costs