{
  "@context": {
    "schema": "https://schema.org/",
    "au": "https://coverage-atlas.ryanjhunter.workers.dev/vocab/agent-native#",
    "@vocab": "https://schema.org/",
    "claims": {
      "@id": "au:claims",
      "@container": "@list"
    },
    "epistemicStatus": "au:epistemicStatus",
    "occurred": "au:occurred",
    "supported": "au:supported",
    "adjudged": "au:adjudged",
    "operative": "au:operative",
    "grounding": "au:grounding",
    "groundingType": "au:groundingType",
    "adjudicator": "au:adjudicator",
    "source": "au:source",
    "sourceUrl": "au:sourceUrl",
    "value": "au:value",
    "claimType": "au:claimType",
    "reviewStatus": "au:reviewStatus",
    "commercialInfluence": "au:commercialInfluence",
    "falsifier": "au:falsifier"
  },
  "@id": "https://coverage-atlas.ryanjhunter.workers.dev/coverage/mlr/76311-nd.jsonld",
  "@type": "schema:Dataset",
  "name": "UnitedHealthcare Insurance Company — Medical Loss Ratio & rebates (North Dakota, 2024)",
  "description": "Medical Loss Ratio and rebate outcomes for UnitedHealthcare Insurance Company (parent group: Unitedhealth GRP, as reported) in North Dakota, 2024 MLR reporting year, by market: small group 89.7%, large group 90.0%. Met the 80/20-rule floor in every market; no rebate owed. RECORDED CMS-published MLR / standard / premium / rebate; rebate-as-%-of-premium is DERIVED. A spending ratio across the whole book in a market — not plan quality or advice. CC0.",
  "license": "https://creativecommons.org/publicdomain/zero/1.0/",
  "isAccessibleForFree": true,
  "isPartOf": "https://coverage-atlas.ryanjhunter.workers.dev/",
  "rdfs:isDefinedBy": "https://coverage-atlas.ryanjhunter.workers.dev/vocab/agent-native",
  "seeAlso": "https://agenticu.ryanjhunter.workers.dev/commons/the-research-object",
  "variableMeasured": [
    {
      "@type": "PropertyValue",
      "name": "Small group MLR",
      "value": 0.897,
      "minValue": 0.8,
      "unitText": "ratio",
      "description": "89.7% of premium on care vs 80% floor; rebate $0"
    },
    {
      "@type": "PropertyValue",
      "name": "Large group MLR",
      "value": 0.9,
      "minValue": 0.85,
      "unitText": "ratio",
      "description": "90.0% of premium on care vs 85% floor; rebate $0"
    }
  ],
  "temporalCoverage": "2024",
  "measurementTechnique": "Read of CMS MLR PUF part 3 (credibility-adjusted MLR, standard, rebate) joined to the submission template header (issuer, state, market).",
  "dateModified": "2026-06-22T16:51:57.453640+00:00",
  "isBasedOn": {
    "@type": "Dataset",
    "name": "CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year",
    "url": "https://www.cms.gov/marketplace/private-health-insurance/medical-loss-ratio",
    "creator": {
      "@type": "Organization",
      "name": "Centers for Medicare & Medicaid Services (CMS)"
    }
  },
  "creator": {
    "@type": "Organization",
    "name": "Coverage Atlas",
    "url": "https://coverage-atlas.ryanjhunter.workers.dev"
  },
  "relatedLink": "https://coverage-atlas.ryanjhunter.workers.dev/coverage/carriers/79413",
  "sameAs": "https://coverage-atlas.ryanjhunter.workers.dev/coverage/companies/76311",
  "about": {
    "@type": "schema:Organization",
    "name": "UnitedHealthcare Insurance Company",
    "identifier": "76311",
    "parentOrganization": {
      "@type": "schema:Organization",
      "name": "Unitedhealth GRP"
    }
  },
  "claims": [
    {
      "@id": "https://coverage-atlas.ryanjhunter.workers.dev/coverage/mlr/76311-nd/small_group",
      "@type": "schema:Claim",
      "name": "UnitedHealthcare Insurance Company spent 89.7% of small group premiums on care in ND (2024)",
      "text": "In the North Dakota small group market, UnitedHealthcare Insurance Company's three-year credibility-adjusted Medical Loss Ratio was 89.7% against the 80% floor, on $2,242,267 of 2024 premium earned. It met the floor; no rebate owed. RECORDED CMS-published figures (occurred=true; an actual backward-looking ratio insurers report under the 80/20 rule, adjudged=TRUE — CMS published it); rebate-per-enrollee is a DERIVED sub-figure.",
      "claimType": "official_fact",
      "reviewStatus": "current",
      "commercialInfluence": false,
      "epistemicStatus": {
        "occurred": true,
        "supported": true,
        "adjudged": true,
        "operative": true
      },
      "grounding": {
        "groundingType": "SourceCitation",
        "source": "CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year",
        "sourceUrl": "https://www.cms.gov/marketplace/private-health-insurance/medical-loss-ratio",
        "value": "MLR 89.7% vs 80% floor; met (no rebate)",
        "adjudicator": {
          "name": "CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year",
          "url": "https://www.cms.gov/marketplace/private-health-insurance/medical-loss-ratio"
        }
      },
      "falsifier": "A RECORD of measured/reported events (occurred=true) from CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year; superseded when CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year publishes its next release."
    },
    {
      "@id": "https://coverage-atlas.ryanjhunter.workers.dev/coverage/mlr/76311-nd/large_group",
      "@type": "schema:Claim",
      "name": "UnitedHealthcare Insurance Company spent 90.0% of large group premiums on care in ND (2024)",
      "text": "In the North Dakota large group market, UnitedHealthcare Insurance Company's three-year credibility-adjusted Medical Loss Ratio was 90.0% against the 85% floor, on $8,520,320 of 2024 premium earned. It met the floor; no rebate owed. RECORDED CMS-published figures (occurred=true; an actual backward-looking ratio insurers report under the 80/20 rule, adjudged=TRUE — CMS published it); rebate-per-enrollee is a DERIVED sub-figure.",
      "claimType": "official_fact",
      "reviewStatus": "current",
      "commercialInfluence": false,
      "epistemicStatus": {
        "occurred": true,
        "supported": true,
        "adjudged": true,
        "operative": true
      },
      "grounding": {
        "groundingType": "SourceCitation",
        "source": "CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year",
        "sourceUrl": "https://www.cms.gov/marketplace/private-health-insurance/medical-loss-ratio",
        "value": "MLR 90.0% vs 85% floor; met (no rebate)",
        "adjudicator": {
          "name": "CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year",
          "url": "https://www.cms.gov/marketplace/private-health-insurance/medical-loss-ratio"
        }
      },
      "falsifier": "A RECORD of measured/reported events (occurred=true) from CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year; superseded when CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year publishes its next release."
    },
    {
      "@id": "https://coverage-atlas.ryanjhunter.workers.dev/coverage/mlr/76311-nd/boundary",
      "@type": "schema:Claim",
      "name": "What a Medical Loss Ratio is — and is NOT",
      "text": "A Medical Loss Ratio is a spending ratio across an issuer's WHOLE book in a market for a past period — the share of premium spent on care + quality improvement versus administration and profit. It is NOT a measure of plan quality, of your individual plan's value, or of coverage availability, and it is NOT advice. A low MLR triggers a rebate; it does not rate care.",
      "claimType": "interpretation",
      "reviewStatus": "current",
      "commercialInfluence": false,
      "epistemicStatus": {
        "occurred": false,
        "supported": true,
        "adjudged": false,
        "operative": true
      },
      "grounding": {
        "groundingType": "Interpretation",
        "source": "Coverage Atlas L5 boundary (a book-level spending ratio ≠ plan quality)",
        "sourceUrl": "https://coverage-atlas.ryanjhunter.workers.dev/",
        "value": "a book-level spending ratio, not plan quality or advice",
        "adjudicator": null
      },
      "falsifier": "occurred=FALSE (a framing, not an event) and adjudged=FALSE (an in-house reading, not an authority's verdict) — the LOWEST-warrant claim here. A flat representation would render this identically to the official facts; the four-status does not."
    }
  ],
  "hasPart": [
    {
      "@type": "schema:ItemList",
      "name": "Medical Loss Ratio by market — UnitedHealthcare Insurance Company (North Dakota, 2024)",
      "numberOfItems": 2,
      "itemListElement": [
        {
          "@type": "schema:ListItem",
          "position": 1,
          "item": {
            "Market": "Small group",
            "3-yr MLR": "89.7%",
            "Floor": "80%",
            "Met floor?": "yes",
            "Premium (2024)": "$2,242,267",
            "Rebate owed": "$0",
            "Per enrollee": "—",
            "Warrant": "RECORDED"
          }
        },
        {
          "@type": "schema:ListItem",
          "position": 2,
          "item": {
            "Market": "Large group",
            "3-yr MLR": "90.0%",
            "Floor": "85%",
            "Met floor?": "yes",
            "Premium (2024)": "$8,520,320",
            "Rebate owed": "$0",
            "Per enrollee": "—",
            "Warrant": "RECORDED"
          }
        }
      ]
    }
  ]
}