Coverage Atlas

Medical Loss Ratio · Massachusetts · 2024 reporting year · not-for-profit

Mass General Brigham Health Plan, Inc

In Massachusetts, over the three-year window through 2024, Mass General Brigham Health Plan, Inc spent 84.8% of individual premiums on care, 84.8% of small group premiums on care, and 87.6% of large group premiums on care (its Medical Loss Ratio). Because that fell below the floor in some markets, it must rebate the shortfall to its 2024 policyholders — $17,189,710 in all.

84.8%
lowest 3-yr MLR (across markets)
$17,189,710
rebate owed to 2024 policyholders
$727.0M
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 below the 88% floor → $6,433,255 rebate
84.8% on care
88% floor
$209,077,992 premium earned (2024) $6,433,255 owed back · ≈$100 per enrollee
Small group market below the 88% floor → $10,756,455 rebate
84.8% on care
88% floor
$340,700,706 premium earned (2024) $10,756,455 owed back · ≈$167 per enrollee
Large group market met the 85% floor
87.6% on care
85% floor
$177,212,225 premium earned (2024) no rebate owed

See what Mass General Brigham Health Plan, Incsells on the marketplace — plan footprint and premium positioning — on its company profile, or browse all Massachusetts marketplace plans. Complaint counts and loss ratios for Mass General Brigham Health Plan, Inc (NAIC 11109) 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 Mass General Brigham Health Plan, Inc spent premium dollars across its entire Massachusetts 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.