Medical loss ratio likely to lead to rebates: This year, health insurers must either meet the new minimum loss ratio requirements by spending at least 80 percent of premiums on care and quality improvement or offer customers rebates in 2012. Already, 75 million Americans in plans covered by this rule are benefiting from insurers’ efforts to lower administrative costs and increase the value of their coverage. We estimate, in the small group market, one million enrollees could receive rebates averaging $312 per enrollee. In the large group market, another million enrollees could receive average rebates of $166.