Code of Massachusetts Regulations
211 CMR - DIVISION OF INSURANCE
Title 211 CMR 147.00 - Methodology For Calculating And Reporting Medical Lass Ratios (mlrs) Of Health Benefit Plans
Section 147.03 - Methodology for Calculating and Reporting MLR

Unless otherwise determined by the Commissioner, for the purposes of M.G.L. c. 176J, § 6 and M.G.L. c. 176O, § 21, the MLR of a Health Benefit Plan shall be calculated and reported in accordance with the current NAIC methodology for calculating and reporting MLR and with reference to federal guidance. When calculating MLR, a Third-party Administrator, pharmacy benefit manager or other similar entity shall perform its calculations utilizing data from the Health Benefit Plans it administers in the Commonwealth, and, if applicable, aggregate such data.