Group loss ratio calculator: how do your claims compare with premium?
Enter premium, paid claims and an estimate of unreported claims to see your loss ratio and the change from last year. Built for HR and finance teams preparing for a renewal.
Calculate your group loss ratio.
The unreported claims figure is an estimate. The result updates as you type.
Ask your carrier. Enter 0 if unsure.
Your estimate
A simple calculation. Carriers adjust for pooling, retention and other factors that are not shown here.
What is a loss ratio?
A loss ratio is claims divided by premium. If a group pays $750,000 in premium and claims total $600,000, the loss ratio is 80 percent. The rest of the premium covers the carrier administration, taxes, fees, risk charges and profit. A high loss ratio often leads to a larger renewal increase, and a low one to a smaller increase.
How should an employer read it?
Look at several periods, not one. Check whether a few large claims drive the result, and whether enrollment changed. Ask the carrier how credible your experience is, since small groups get less weight. The loss ratio is a starting point for the renewal conversation, which also covers trend, plan changes and market alternatives.
Common questions
What loss ratio is good?
There is no single answer. Carriers target a range that covers cost and margin, and the right range varies by market and group size. Compare your own results over time.
Is this the same as the MLR rebate rule?
No. The federal MLR rule applies to the insurer across a state market, not to one employer group. Our MLR rebate calculator covers that.
Why include IBNR?
Claims from late in the period may not yet be reported. Including an estimate gives a fairer ratio.
Can we challenge a renewal built on loss ratio?
Yes. Ask for the claim detail, compare other carriers and review plan design. We can help with each step.
Talk to us about your renewal
Book a 30-minute call and we will look at your loss ratio, the renewal and the options that fit. Visit us at 41000 Woodward Avenue, Suite 350 East, Bloomfield Hills, MI 48304, or call 248.370.8853.
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