What percentage of premium dollars are insurers required to spend on healthcare services and quality improvement?

Insurers are required to spend a minimum percentage of premium dollars on healthcare services and quality improvement to ensure that a significant portion of the money collected from policyholders goes towards providing actual care rather than administrative profits or overhead. Under the Affordable Care Act (ACA), a regulation known as the Medical Loss Ratio (MLR) mandates that insurers must spend at least 80% of premium dollars on medical care for individual and small group plans, and at least 85% for large group plans.

This requirement was designed to increase transparency in how premium dollars are used and to promote the delivery of higher quality health care services. Thus, the correct answer reflects the larger category of plans, indicating that major health insurance companies are indeed required to spend at least 85% of premium revenue on healthcare services and quality improvement measures. This regulation serves to protect consumers and ensure that their investment in health insurance translates into tangible health benefits.