---
kind: "section"
citation: "45 C.F.R. § 158.210"
title: "45"
number: "158.210"
heading: "Minimum medical loss ratio."
url: "https://uscodex.org/cfr/45/158.210"
---

# §158.210. Minimum medical loss ratio.


Subject to the provisions of [§ 158.211](/cfr/45/158.211.md) of this subpart:

- (a) **Large group market.** For all policies issued in the large group market in a State during the MLR reporting year, an issuer must provide a rebate to enrollees if the issuer has an MLR of less than 85 percent, as determined in accordance with this part.
- (b) **Small group market.** For all policies issued in the small group market in a State during the MLR reporting year, an issuer must provide a rebate to enrollees if the issuer has an MLR of less than 80 percent, as determined in accordance with this part.
- (c) **Individual market.** For all policies issued in the individual market in a State during the MLR reporting year, an issuer must provide a rebate to enrollees if the issuer has an MLR of less than 80 percent, as determined in accordance with this part.
- (d) **Adjustment by the Secretary.** If the Secretary has adjusted the percentage that issuers in the individual market in a specific State must meet, then the adjusted percentage determined by the Secretary in accordance with [§ 158.301](/cfr/45/158.301.md) of this part et seq. must be substituted for 80 percent in [paragraph (c)](#c) of this section.

## Notes

### Authority

Authority: 42 U.S.C. 300gg-18.

### Source

Source: 75 FR 74921, Dec. 1, 2010, unless otherwise noted.