Connecticut Administrative Code
Title 38a - Insurance Department
478u - Managed Care
Section 38a-478u-5 - Medical loss ratio

For the purposes of reporting and disclosure in accordance with Sections 4 and 8 of Public Act 97-99 as amended by Public Act 97-8, June 18 Special Session, "medical loss ratio" means the ratio of incurred claims to earned premium for the prior calendar year for managed care plans issued in Connecticut. Claims shall be limited to medical expenses for services and supplies provided to enrollees and shall not include expenses for stop loss, reinsurance, enrollee educational programs or other cost containment programs or features.