Coverage Atlas

Medical Loss Ratio · District of Columbia · 2024 reporting year · Carefirst INC GRP · not-for-profit

Group Hospitalization and Medical Services, Inc

In District of Columbia, over the three-year window through 2024, Group Hospitalization and Medical Services, Inc spent 86.7% of individual premiums on care, 86.7% of small group premiums on care, and 88.2% of large group premiums on care (its Medical Loss Ratio). It met the 80/20-rule floor in every market, so no rebate was owed.

86.7%
lowest 3-yr MLR (across markets)
$0
rebate owed to 2024 policyholders
$961.1M
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
86.7% on care
80% floor
$78,809,946 premium earned (2024) no rebate owed
Small group market met the 80% floor
86.7% on care
80% floor
$231,240,278 premium earned (2024) no rebate owed
Large group market met the 85% floor
88.2% on care
85% floor
$651,064,992 premium earned (2024) no rebate owed

See what Group Hospitalization and Medical Services, Incsells on the marketplace — plan footprint and premium positioning — on its company profile, or browse all District of Columbia marketplace plans. Complaint counts and loss ratios for Group Hospitalization and Medical Services, Inc (NAIC 53007) 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 Group Hospitalization and Medical Services, Inc spent premium dollars across its entire District of Columbia 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.