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 147.04 - Administrative Cost Expenditure
Current through Register 1531, September 27, 2024
Unless otherwise determined by the Commissioner, the following items shall be deemed to be an Administrative Cost Expenditure for the purposes of calculating and reporting the MLR of Health Benefit Plans for M.G.L. c. 176J, § 6 and M.G.L. c. 176O, § 21:
(a) Financial administration expenses;
(b) Marketing and sales expenses;
(c) Distribution expenses;
(d) Claims operations expenses;
(e) Medical administration expenses, such as disease management, care management, utilization review and medical management activities;
(f) Network operations expenses;
(g) Charitable expenses;
(h) Board, bureau or association fees;
(i) State and federal tax expenses, including assessments; and
(j) Payroll expenses.
