Medical Loss Ratio · Massachusetts · 2024 reporting year · BCBS of MA Grp · not-for-profit
Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc.
In Massachusetts, over the three-year window through 2024, Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. spent 85.0% of individual premiums on care, 85.0% of small group premiums on care, and 89.3% 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 — $43,721,415 in all.
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.
See what Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc.sells on the marketplace — plan footprint and premium positioning — on its company profile, or browse all Massachusetts marketplace plans. Complaint counts and loss ratios for Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. (NAIC 12219) 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 Massachusetts HMO Blue, 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.