Medical Loss Ratio Annual Reports, MLR Notices, and Recordkeeping Requirements (CMS-10418)

OMB 0938-1164

OMB 0938-1164

Section 2718 of the PHS Act and its implementing regulation requires health insurance issuers (issuers) offering group or individual health insurance coverage to submit an annual report to the Secretary of the Department of Health and Human Services concerning the amount the issuer spends each year on claims, quality improvement expenses, non-claims costs, Federal and State taxes, licensing and regulatory fees, the amount of earned premium for the reporting year, its medical loss ratio and any rebate it may owe to subscribers. In addition, the implementing regulation requires issuers to maintain all documents and other evidence which support the data that is provided in an issuer's annual report to the Secretary.

The latest form for Medical Loss Ratio Annual Reports, MLR Notices, and Recordkeeping Requirements (CMS-10418) expires 2020-10-31 and can be found here.

OMB Details

Annual MLR Report

Federal Enterprise Architecture: Health - Health Care Services

Form CMS-10418MLR Form InstructionsFillable FileableForm and instruction
Form CMS-10418Risk Corridors Plan Level FormFillable FileableForm
Form CMS-10418MLR Reporting FormFillable FileableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.


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