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MLR Rebate Calculator

Medical Loss Ratio numerator/denominator, credibility-adjustment tier, 3-year premium-weighted averaging, and rebate math per 45 CFR 158 (ACA MLR rule). Classifies member life-years into non-credible / partially-credible / fully-credible bands, computes the current-year adjusted MLR and the 3-year average against the market threshold (80% individual/small-group, 85% large-group), and applies the de minimis payment floor.

Tool URL: https://ainumbers.co/chaingraph/art-344-compute-mlr-rebate.html

post/v1/tools/compute_mlr_rebate

Request

  • Base URL: https://ainumbers.co
  • URL: https://ainumbers.co/v1/tools/compute_mlr_rebate
  • Auth: none declared

Request body

earned_premiumnumber
federal_taxes_feesnumber
incurred_claimsnumber
marketunknown required
member_life_yearsnumber
prior_year_1_adjusted_mlr_pctnumber

Percentage value

prior_year_1_earned_premiumnumber
prior_year_2_adjusted_mlr_pctnumber

Percentage value

prior_year_2_earned_premiumnumber
quality_improvement_expendituresnumber
reinsurance_recoveriesnumber
reporting_yearnumber
risk_adjustment_netnumber
risk_corridors_netnumber
state_taxes_feesnumber

Response

Successful tool execution result

adjusted_earned_premiuminteger
adjusted_incurred_claimsinteger
constants_versionstring
credibility_adjustment_pct_pointsinteger
credibility_tierstring
current_year_adjusted_mlr_pctnumber
de_minimisboolean
marketstring
member_life_yearsinteger
notestring
raw_mlr_pctnumber
rebate_amountinteger
rebate_owedboolean
rebate_pct_pointsinteger
regulatory_basisstring
reporting_yearinteger
three_yr_average_mlr_pctnumber
threshold_pctinteger
years_included_in_averageinteger

Changes

No recorded changes to this operation across all 1 revision of this API.