Georgia Medicare Medical Loss Ratio (MLR) Guide 2026

The Medicare Medical Loss Ratio (MLR) is the federal 85% floor requiring Medicare Advantage (MA) organizations and standalone Part D Prescription Drug Plan (PDP) sponsors to spend at least 85% of premium revenue on clinical services for enrollees and activities that improve health care quality, not on administration, marketing, sales, profit, or executive compensation.

The MLR is the single most important structural consumer protection in the Medicare Advantage and Part D programs. It answers the fundamental question every Medicare beneficiary should ask: Where do my premium dollars go? Under federal law, the answer must be: at least 85% to healthcare services and quality improvement, with no more than 15% to everything else.

For Georgia, the MLR protects hundreds of thousands of Medicare Advantage enrollees plus hundreds of thousands of Georgia standalone Part D PDP enrollees — every beneficiary whose plan must annually demonstrate to CMS that premium dollars flowed to care, not to corporate profit.

The MLR is codified at:

• Section 1857(e)(4) of the Social Security Act — Medicare Advantage MLR
• Section 1860D-12(b)(3)(D) of the Social Security Act — Part D MLR
• 42 CFR 422.2410 et seq. — MA MLR implementing regulations
• 42 CFR 423.2410 et seq. — Part D MLR implementing regulations

The MLR was created by the Affordable Care Act of 2010 (Public Law 111-148):

• Section 3201 of the ACA established the MA MLR
• Section 3209 of the ACA established the Part D MLR

CMS finalized implementing regulations in 2013, and the 85% MLR requirement became effective for contract year 2014.

The MLR is reported annually to CMS by every MA organization and Part D sponsor by May 31 of the year following the plan year. CMS publishes the MLR Data Set annually, making each plan's MLR publicly available — a transparency mechanism that allows beneficiaries, advocates, researchers, and journalists to evaluate plan efficiency.

This guide explains the federal MLR framework, the numerator and denominator definitions, the Quality Improvement Activities (QIA) that count toward the numerator, the remittance calculation for plans that fall below 85%, the multi-year penalty escalation (remittance → enrollment suspension → contract termination), the coordination with the MA bid process and Quality Star Ratings, the MLR Data Set transparency mechanism, and the Georgia-specific operational context.

The Federal MLR Framework

Statutory and regulatory authority

The MLR framework rests on two statutory grants and parallel implementing regulations:

Section 1857(e)(4) of the Social Security Act, added by Section 3201 of the Affordable Care Act of 2010, establishes the MLR requirement for Medicare Advantage organizations. The statute specifies:

• The 85% minimum MLR
• The components of the numerator (incurred claims + quality improvement)
• The components of the denominator (premium revenue less taxes and fees)
• The annual reporting requirement to CMS
• The remittance obligation for plans below 85%
• The multi-year penalty escalation

Section 1860D-12(b)(3)(D) of the Social Security Act, added by Section 3209 of the Affordable Care Act of 2010, establishes the parallel MLR requirement for standalone Part D Prescription Drug Plans. The Part D MLR mirrors the MA MLR with adjustments reflecting Part D's drug-cost-driven economics.

42 CFR 422.2410 through 42 CFR 422.2490 comprise the MA MLR implementing regulations. 42 CFR 423.2410 through 42 CFR 423.2490 comprise the Part D MLR implementing regulations. These regulations specify:

• The detailed numerator and denominator definitions
• The categorization of Quality Improvement Activities
• The MLR reporting form and content
• The audit and verification procedures
• The remittance calculation methodology
• The enrollment suspension and contract termination procedures

History: from ACA enactment to current operation

The MLR was a centerpiece of the Affordable Care Act of 2010. Congress observed that some MA and Part D plans were spending more on administration, marketing, and profit than on actual healthcare — and that without a federal floor, the trend would continue. The ACA established the 85% MLR for MA and Part D as the structural fix:

• March 23, 2010: ACA signed into law (Public Law 111-148)
• 2011-2012: CMS issued proposed MLR regulations for public comment
• May 23, 2013: CMS finalized MA MLR regulations (78 Federal Register 31283)
• 2014: MLR requirement effective for contract year 2014
• May 31, 2015: First annual MLR reports submitted to CMS (for plan year 2014)
• 2016-present: Annual MLR reporting cycle continues; CMS publishes MLR Data Set

The 85% floor has been the consistent standard since 2014. CMS has made minor methodological adjustments through the Annual Call Letter but has not changed the fundamental 85% requirement.

MLR Numerator: What counts as "spent on healthcare"

The MLR numerator is the sum of two components:

Component 1: Incurred Claims

Incurred claims are payments made (or that should be made) for clinical services furnished to enrollees during the contract year. Includes:

• Physician and provider services
• Hospital inpatient services
• Hospital outpatient services
• Skilled nursing facility (SNF) services
• Home health services
• Hospice services
• Prescription drug costs (for MA-PD and Part D plans)
• Durable medical equipment (DME)
• Behavioral health services
• Vision and dental services (if covered as supplemental benefits)
• Hearing services (if covered as supplemental benefits)
• Transportation services (if covered as supplemental benefits)

Incurred claims exclude:

• Administrative costs
• Marketing and sales costs
• Broker and agent commissions
• Executive compensation
• Profit
• General overhead

Component 2: Quality Improvement Activities (QIA)

Quality Improvement Activities are programs that improve health care quality, defined at 42 CFR 422.2430 and 42 CFR 423.2430. QIA categories include:

• Care coordination programs: Integrated care management across providers, transitions of care interventions
• Disease management programs: Diabetes management, heart failure programs, COPD programs, chronic kidney disease programs, cancer survivorship
• Patient safety initiatives: Hospital-acquired infection prevention, medication safety, fall prevention, adverse event reporting and remediation
• Provider performance improvement: Quality measurement, performance feedback, performance bonus structures, provider education
• Wellness and prevention: Health risk assessments, smoking cessation, weight management, exercise programs
• Health information technology: Electronic health records, patient portals, telehealth infrastructure, e-prescribing, health information exchange
• Care transitions: Hospital-to-home transitions, SNF-to-home transitions, ED follow-up programs
• Member outreach: Reminders for preventive screenings, medication adherence programs, member education

Importantly, QIA must be enrollee-focused and must be demonstrable improvements. Generic administrative activities (claims processing, customer service, billing) are NOT QIA. CMS audits QIA classifications during MLR reviews.

MLR Denominator: Premium revenue (with adjustments)

The MLR denominator is premium revenue with specified adjustments:

Premium revenue includes:

• CMS capitation payments to the plan
• Beneficiary premium contributions
• Risk-adjustment payments received from CMS
• Bonus payments (e.g., quality bonuses)

Premium revenue is reduced by:

• Federal taxes on premium revenue (other than income taxes)
• State taxes (premium taxes, etc.)
• Licensing and regulatory fees
• Certain other regulatory assessments

The MLR denominator is NOT reduced by administrative costs, marketing, profit, or executive compensation — those are precisely what the MLR is testing against.

MLR Formula

MLR = (Incurred Claims + Quality Improvement Activities) / (Premium Revenue – Taxes and Fees)

For a plan with $1 billion in premium revenue, $30 million in taxes and fees, $830 million in incurred claims, and $20 million in QIA:

• Numerator = $830M + $20M = $850M
• Denominator = $1,000M – $30M = $970M
• MLR = $850M / $970M = 87.6%

This plan passes the 85% MLR threshold with margin to spare.

For a plan with the same revenue and tax structure but only $750M in incurred claims and $20M in QIA:

• Numerator = $750M + $20M = $770M
• Denominator = $970M
• MLR = $770M / $970M = 79.4%

This plan fails the 85% MLR threshold by 5.6 percentage points and owes remittance.

Remittance Calculation

When a plan's MLR is below 85%, the plan must remit money to the federal government calculated as:

Remittance = Adjusted Premium Revenue × (0.85 – Actual MLR)

In the failing example above:

• Adjusted premium revenue = $970M
• 0.85 – 0.794 = 0.056
• Remittance = $970M × 0.056 = $54.3M

The plan must pay $54.3 million back to the federal government. The remittance does NOT go to enrollees as a refund (unlike commercial market MLR refunds under the ACA's individual/small group MLR provisions). The remittance goes to the Medicare Trust Fund.

Annual MLR Reporting

Every MA organization and Part D sponsor must submit an annual MLR report to CMS by May 31 of the year following the plan year. For plan year 2025, MLR reports were due May 31, 2026.

The report includes:

• Plan identification (contract ID, plan benefit package ID)
• Total premium revenue
• Total incurred claims (broken down by service category)
• Total Quality Improvement Activities (broken down by QIA category)
• Tax and fee deductions
• Calculated MLR
• Supporting documentation
• Auditor attestations (for plans above certain enrollment thresholds)

CMS reviews the reports, audits a sample, calculates remittances, and publishes the MLR Data Set publicly each year.

Multi-Year Penalty Escalation

The MLR penalty structure escalates with consecutive years of MLR failure:

The three-year enrollment suspension is the practical death knell for most plans — a plan that cannot accept new enrollees for three years typically loses substantial market share through attrition and may not recover financially. The five-year contract termination is the regulatory finishing blow.

These penalties operate as a powerful deterrent: plans take MLR compliance very seriously because falling below 85% repeatedly is existential.

Coordination with the MA Bid Process

Every Medicare Advantage organization submits an annual bid to CMS by the first Monday in June each year, specifying their proposed plan design, premium, cost-sharing, and supplemental benefits for the following plan year. The bid process is codified at 42 CFR 422.252 and related provisions.

MLR compliance is built into the bid process:

• Plans must estimate their projected MLR in the bid
• Plans must specify how the bid achieves the 85% MLR threshold
• Plans cannot bid in ways that systematically underspend on care
• Plans with a history of MLR shortfalls face heightened CMS scrutiny

The MLR effectively constrains how plans design benefits. A plan cannot, for example, offer a very rich supplemental benefit package and a low premium if the result is that the plan spends only 70% on care — that would fail MLR.

Coordination with CMS Quality Star Ratings

The CMS Quality Star Ratings measure plan performance across dozens of quality measures, including many of the same activities that count as Quality Improvement Activities for MLR purposes. The two programs are complementary:

• MLR: A floor on what fraction of premium dollars must go to care and quality
• Star Ratings: A measurement of how well the plan actually delivers care and quality

A plan that invests heavily in QIA improves both:

• MLR numerator (QIA spending counts toward 85% requirement)
• Star Ratings (QIA activities improve quality measures like preventive screenings, chronic condition management, member experience)

This creates aligned incentives: plans that invest in real quality improvement see both better MLR compliance and better Star Ratings, which drives:

• More enrollment (higher-rated plans attract more enrollees during AEP)
• Higher CMS payments (5-star plans receive bonus payments under the Quality Bonus Program)
• 5-star SEP enrollment opportunities (year-round enrollment)

MLR Transparency: The CMS MLR Data Set

CMS publishes the MLR Data Set annually, making each plan's MLR publicly available. The MLR Data Set includes:

• Contract ID and plan benefit package
• Plan name and parent organization
• State and service area
• Total premium revenue
• Total incurred claims
• Total Quality Improvement Activities
• Calculated MLR
• Whether remittance was owed and the amount

The MLR Data Set is downloadable from CMS.gov in spreadsheet format. Beneficiaries, advocates, and researchers use it to:

• Identify plans with consistently strong MLR (high efficiency)
• Identify plans with consistently weak MLR (potential quality concerns)
• Compare MLR across competing plans in the same market
• Track MLR trends over time
• Investigate plans with consecutive below-MLR years

For Georgia beneficiaries, the MLR Data Set can be a useful supplementary tool when comparing plans during AEP — alongside Star Ratings, formulary coverage, network coverage, premiums, and cost-sharing.

The Georgia MLR Context

Affected population

Georgia has a large Medicare Advantage enrollee population plus hundreds of thousands of standalone Part D PDP enrollees. Every dollar of premium revenue paid by these enrollees (and the CMS capitation payments that go with them) is subject to MLR review.

Major Georgia plans subject to MLR

The major Georgia MA insurers are subject to MLR for their Georgia operations:

• Humana
• UnitedHealthcare
• Aetna (CVS Health)
• Anthem (Elevance Health)
• Wellcare (Centene)
• Cigna
• Kaiser Permanente Georgia
• Alignment Health Plan

In addition, all standalone Part D PDPs available to Georgia beneficiaries are subject to Part D MLR:

• Wellcare Value Script
• Wellcare Classic
• Humana Walmart Value
• AARP MedicareRx Preferred
• AARP MedicareRx Saver Plus
• Cigna Saver Rx
• SilverScript Choice
• SilverScript Plus
• Plus 20-40+ other PDP options per Georgia county

Georgia MA market MLR performance

Across recent reporting cycles, the Georgia MA market has generally performed at or above the 85% MLR threshold. Plans that consistently approach the 85% floor face heightened CMS scrutiny in their annual bid review.

GeorgiaCares SHIP and MLR

GeorgiaCares SHIP at 1-866-552-4464 provides free counseling to Georgia Medicare beneficiaries, including education on MLR. Counselors can:

• Explain the MLR concept and 85% floor
• Walk beneficiaries through the CMS MLR Data Set for Georgia plans
• Help beneficiaries consider MLR alongside Star Ratings, formulary, and network during AEP plan comparison
• Refer suspected MLR-related compliance issues to the Georgia Senior Medicare Patrol

Georgia Senior Medicare Patrol and MLR

The Georgia Senior Medicare Patrol monitors MLR-adjacent issues, including:

• Plans that aggressively market low-value benefits while underspending on care
• Plans whose enrollment growth rate seems inconsistent with their claimed clinical investment
• Beneficiary reports of denied services contemporaneous with low-MLR public data
• Cross-referrals to CMS Center for Program Integrity for further investigation

14 MLR Best Practices for Georgia Beneficiaries

1. Understand that 85% is a floor, not a target. Plans can and do exceed 85%.
2. Check the CMS MLR Data Set before enrolling in a new plan, especially during AEP.
3. Look for consistent MLR performance, not just one good year. Year-over-year volatility may indicate operational issues.
4. Combine MLR data with Star Ratings for a fuller picture of plan quality.
5. Don't choose a plan solely on MLR. Network, formulary, and provider quality matter more for individual care.
6. Be skeptical of plans with low MLR + rich supplemental benefits. The math may not be sustainable.
7. Understand QIA value. Disease management programs, care coordination, and member outreach count toward MLR and improve actual care.
8. Recognize that MLR is structural, not a guarantee of individual quality. A plan with 87% MLR can still have access issues.
9. Use GeorgiaCares SHIP for free counseling on plan comparison including MLR considerations.
10. Report compliance concerns to Georgia SMP at 1-866-552-4464.
11. Know that MLR penalties escalate. Three years below 85% = enrollment suspension. Five years = contract termination.
12. Recognize the ACA's role. MLR was created by the Affordable Care Act of 2010 and reflects a structural consumer protection.
13. Track plans entering or leaving Georgia. MLR failures sometimes precede plan exits.
14. Verify your specific plan's MLR at CMS.gov rather than relying on plan marketing claims.

14 Common MLR Misunderstandings

1. "MLR is a refund to me." No. MLR remittance from MA/Part D plans goes to the Medicare Trust Fund, not to individual enrollees.
2. "Low MLR means a bad plan." Not necessarily. A plan with 84% MLR pays remittance but may still deliver good clinical care.
3. "High MLR means a great plan." Not necessarily. A plan with 95% MLR could still have access issues or formulary gaps.
4. "MLR applies to Original Medicare." No. Original Medicare is government-administered and doesn't have a plan-level MLR.
5. "MLR is the same as Star Ratings." No. They're complementary but distinct measures.
6. "My plan's marketing claims tell me the MLR." Not necessarily. Verify at CMS.gov.
7. "MLR includes plan profit." No. Profit is in the 15% non-MLR portion, NOT in the 85% MLR numerator.
8. "MLR includes broker commissions." No. Broker commissions are administrative, not clinical, and don't count toward MLR.
9. "MLR is the same as the ACA commercial market MLR." Related but different. Commercial MLR is 80%/85% with consumer refunds; MA/Part D MLR is 85% with federal remittance.
10. "MLR penalties never actually happen." They do. Plans have faced remittance, enrollment suspension, and contract termination.
11. "MLR is reported in the plan ANOC." No. MLR is reported to CMS annually, not in beneficiary-facing ANOC documents.
12. "I can sue a plan over MLR." No. MLR enforcement is regulatory (CMS), not private right of action.
13. "MLR considers individual claim denials." Not directly. MLR is plan-wide; individual denials are appealed through standard Medicare appeals processes.
14. "Higher MLR means lower premiums." Not directly. Plan premiums reflect competitive dynamics; MLR ensures premium dollars flow to care.

Worked Examples

Example 1: Fulton 67 — Atlanta beneficiary using MLR data for AEP plan comparison

Margaret, age 67, lives in Atlanta (Fulton County). During AEP 2026, she's comparing three MA-PD options for plan year 2027. She wants to consider MLR alongside other factors. She calls GeorgiaCares SHIP at 1-866-552-4464.

The counselor pulls the CMS MLR Data Set for Georgia plans and shows Margaret:

• Plan A (Humana MA-PD): MLR 88.2% (2023), 87.6% (2024), 89.1% (2025) — consistent, above 85%
• Plan B (UnitedHealthcare MA-PD): MLR 90.5% (2023), 89.8% (2024), 91.2% (2025) — consistent, well above 85%
• Plan C (Newer entrant MA-PD): MLR 84.3% (2023), 86.1% (2024) — only two years of data, one below 85% with remittance owed

The counselor explains that MLR is one factor among many. Plan B has the highest MLR but Plan A has Margaret's preferred PCP in-network. Margaret evaluates the tradeoffs and chooses Plan A, satisfied that its MLR has been consistently strong.

Lesson: MLR data informs plan comparison but doesn't drive it alone. Combine MLR with network, formulary, Star Ratings, and cost-sharing.

Example 2: DeKalb 70 — DeKalb plan remittance scenario explained

James, age 70, lives in Decatur (DeKalb County). In late 2026, James reads a news article about a Georgia MA plan that owed $42 million in remittance to the Medicare Trust Fund for plan year 2025 MLR failure. He calls GeorgiaCares to understand what this means for him as an enrollee.

The counselor explains:

• The $42M remittance is calculated as: Adjusted Premium Revenue × (0.85 – Actual MLR)
• The remittance goes to the Medicare Trust Fund, NOT to individual enrollees
• The plan must continue to operate but faces heightened CMS scrutiny
• If the plan fails MLR again next year, total consecutive below-MLR years = 2 (year 3 would trigger enrollment suspension)
• James as an existing enrollee is not directly affected — his coverage continues

The counselor recommends James monitor the plan's annual MLR going forward and consider switching during AEP if MLR continues to fail. James decides to stay for plan year 2027 but plans to compare options at next AEP.

Lesson: Plan-level MLR remittance is a regulatory event. Existing enrollees are not directly refunded but should monitor plan performance.

Example 3: Cobb 68 — Cobb beneficiary understanding QIA value in MA plan

Robert, age 68, lives in Marietta (Cobb County). His MA plan recently enrolled him in a Disease Management Program for his Type 2 diabetes, including monthly nurse check-ins, free glucose monitor, dietitian consultations, and discounted diabetic shoes. Robert wonders why the plan is "giving him so much" and whether it's marketing.

He calls GeorgiaCares. The counselor explains:

• The Disease Management Program is a Quality Improvement Activity (QIA) under MLR rules
• The plan's spending on the DMP counts toward the 85% MLR numerator
• The plan is incentivized to invest in QIA because:
  • QIA boosts MLR compliance
  • QIA improves Star Ratings (better diabetes control → higher quality scores)
  • Higher Star Ratings increase plan revenue (quality bonus payments)
  • Improved health reduces downstream claims (hospitalizations, ER visits)
• The DMP isn't "free" — it's funded by Robert's premium and CMS capitation, but it's structurally designed to improve his care
• Robert should engage with the DMP, not view it as marketing

Robert engages with the DMP and finds the nurse check-ins valuable.

Lesson: QIA programs are real clinical investments driven by MLR economics. Beneficiaries should engage rather than dismiss them as marketing.

Example 4: Worth County 72 — Worth rural beneficiary and MLR's effect on plan availability

Linda, age 72, lives in rural Worth County in south Georgia. Plan availability in Worth County is limited — only three MA plans are available. Linda wonders why metro Atlanta has 25+ plans but Worth County has only three. She calls GeorgiaCares.

The counselor explains:

• Rural markets have lower enrollment density, making it harder for plans to achieve scale
• MLR requires plans to spend 85% on care; rural plans face higher per-member administrative costs
• Plans must balance:
  • Adequate provider networks (requires partnerships with rural providers)
  • 85% MLR compliance (administrative costs spread over smaller enrollment)
  • Star Ratings (rural plans face structural quality challenges)
• Many national plans simply don't offer Worth County coverage because the economics don't work
• Original Medicare + standalone Part D PDP often provides better rural access than narrow-network MA plans

Linda decides Original Medicare with a Wellcare PDP and a Plan G Medigap policy fits her rural lifestyle better than any of the three available MA plans.

Lesson: MLR economics influence rural plan availability. Rural beneficiaries should evaluate whether Original Medicare provides better access than locally-available MA plans.

Example 5: Bibb 69 — Bibb three-consecutive-year-below-MLR enrollment suspension scenario

David, age 69, lives in Macon (Bibb County). His MA plan has reported below-85% MLR for three consecutive years (2023, 2024, 2025), triggering a three-year enrollment suspension. CMS has notified the plan it cannot accept new enrollees for plan years 2027, 2028, and 2029.

David is an existing enrollee. He calls GeorgiaCares to understand his options.

The counselor explains:

• David's coverage continues for plan year 2026 and beyond — the suspension affects new enrollment, not existing enrollees
• David has the right to disenroll during AEP or MA OEP and choose a different plan
• The enrollment suspension is publicly announced; David can review the plan's reported MLR data
• If the plan fails MLR for a fourth consecutive year, total consecutive failures = 4 (year 5 would trigger contract termination)
• David should consider switching during AEP 2026 to a plan with consistent MLR compliance

David switches to a different MA-PD plan during AEP with a 5-star quality rating and consistent MLR above 88%.

Lesson: Multi-year MLR failures eventually triggers serious regulatory consequences. Existing enrollees should monitor and switch when warranted.

Example 6: Hall 65 — Hall first AEP using MLR data alongside Star Ratings

Sarah, age 65, lives in Gainesville (Hall County). She's preparing for her first AEP after enrolling in Medicare via IEP. She wants to evaluate plans systematically using both MLR data and Star Ratings.

She calls GeorgiaCares. The counselor walks Sarah through a side-by-side comparison:

• Plan A: 5 stars, MLR 89.2% — top quality + above-floor MLR
• Plan B: 4 stars, MLR 91.5% — high MLR but slightly lower quality measures
• Plan C: 4.5 stars, MLR 86.7% — balanced quality + slight MLR margin
• Plan D: 3.5 stars, MLR 83.2% — low quality + below MLR floor with remittance

The counselor explains:

• Plan A is the strongest overall — top Star Ratings + consistent MLR above floor
• Plan B's higher MLR doesn't translate to higher Star Ratings, suggesting QIA spending isn't translating to measurable quality
• Plan C is balanced and acceptable
• Plan D is concerning — both metrics are weak

Sarah chooses Plan A and uses it for her first plan year. She plans to re-evaluate next AEP using the same MLR + Star Ratings framework.

Lesson: MLR + Star Ratings are complementary. Look for plans that perform well on both, with consistent year-over-year performance.

Frequently Asked Questions

CTA: Free Georgia MLR Resources

• Medicare: 1-800-MEDICARE (1-800-633-4227) — federal Medicare information line
• SSA Medicare: 1-800-772-1213 — Medicare enrollment
• GeorgiaCares SHIP: 1-866-552-4464 — free Medicare counseling including MLR education
• Georgia Senior Medicare Patrol: 1-866-552-4464 — MLR-related fraud detection
• Medicare Rights Center: 1-800-333-4114 — national Medicare advocacy
• Georgia DCH Member Services: 1-866-211-0950 — Medicaid coverage
• Georgia Department of Insurance: 1-800-656-2298 — state insurance regulation
• Atlanta Legal Aid: 404-377-0701 — legal assistance
• Georgia Legal Services: 1-800-498-9469 — legal assistance outside metro Atlanta
• Eldercare Locator: 1-800-677-1116 — federal eldercare referral
• 211 Georgia: 211 — local social services referral
• Patient Advocate Foundation: 1-800-532-5274 — patient advocacy
• Humana Medicare: 1-800-457-4708
• UnitedHealthcare Medicare: 1-800-721-0627
• Aetna Medicare: 1-800-282-5366
• Anthem Medicare: 1-833-919-1577
• Wellcare Medicare: 1-833-444-9088
• Cigna Medicare: 1-800-668-3813

Find personalized help navigating Medicare MLR and plan options in Georgia at brevy.com.

Last verified: 2026-05-14. MLR regulations and individual plan MLR data change annually. Always verify current values at CMS.gov MLR Data Set or by calling GeorgiaCares SHIP at 1-866-552-4464. This guide is informational and does not constitute legal, financial, or medical advice.