NAIC MLR Reporting
NAIC + CMS ACA MLR ratio reporting.
Definition
MLR Reporting Form (CMS-10418) filed annually by health insurers via NAIC SIR (State Reporting Information System). Includes earned premium, incurred claims, quality improvement expenditures, federal/state taxes. If MLR below threshold -> rebate to enrollees. ACA Section 2718 compliance. Filing deadline June each year for the previous year.
Origin
Affordable Care Act 2010 Section 2718, CMS final rule December 2010, NAIC MLR Annual Form revised annually.
Usage
Mandatory for all US health insurers individual / small group / large group. CMS audit, sanctions for non-compliance.