Coverage Atlas

Medical Loss Ratio · Missouri · 2024 reporting year · BCBS OF KC GRP · not-for-profit

BLUE Cross AND BLUE Shield OF Kansas CITY

In Missouri, over the three-year window through 2024, BLUE Cross AND BLUE Shield OF Kansas CITY spent 80.5% of individual premiums on care, 79.2% of small group premiums on care, and 86.6% of large group premiums on care (its Medical Loss Ratio). Because that fell below the floor in one market, it must rebate the shortfall to its 2024 policyholders — $851,792 in all.

79.2%
lowest 3-yr MLR (across markets)
$851,792
rebate owed to 2024 policyholders
$1385.7M
premium earned (2024)

Where each premium dollar went

The filled bar is the share of premiums spent on medical care + quality improvement — the three-year Medical Loss Ratio. The marker is the legal floor for that market (80% individual & small group, 85% large group). Below the floor, the insurer rebates the shortfall (floor − MLR), applied to that year's premium.

Individual market met the 80% floor
80.5% on care
80% floor
$61,816,919 premium earned (2024) no rebate owed
Small group market below the 80% floor → $851,792 rebate
79.2% on care
80% floor
$107,773,999 premium earned (2024) $851,792 owed back · ≈$65 per enrollee
Large group market met the 85% floor
86.6% on care
85% floor
$1,216,132,381 premium earned (2024) no rebate owed

See what BLUE Cross AND BLUE Shield OF Kansas CITYsells on the marketplace — plan footprint and premium positioning — on its company profile, or browse all Missouri marketplace plans. Complaint counts and loss ratios for BLUE Cross AND BLUE Shield OF Kansas CITY (NAIC 47171) are on its carrier quality profile.

RECORDED — the Medical Loss Ratio, the 80/85% standard, premium earned, and the rebate owed are CMS-published figures (the 2024 MLR reporting year, a three-year window through 2024; rebates are paid the following year). DERIVED — rebate as a share of premium, and the rebate per enrollee (rebate ÷ member-years).

Machine-readable: JSON-LD · Markdown · Source: CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year

What this is — and is not

This is how BLUE Cross AND BLUE Shield OF Kansas CITY spent premium dollars across its entire Missouri book in each market — it is not a measure of a specific plan's quality, your denial odds, or whether the insurer is right for you, and it is not advice. A rebate, if owed, is a rule-based payment to policyholders (a check or premium credit) the following year. To compare plans, check eligibility, and enroll, go to HealthCare.gov.