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Text of CMS Question and Answer Regarding the Medical Loss Ratio Reporting and Rebate Requirements (PDF)
Center for Consumer Information & Insurance Oversight [CCIIO], Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS] 
[Official Guidance] July 2, 2013
"Issuers may exclude ACA assessments or fees from MLR calculations for a reporting year only if such assessments or fees were incurred in that reporting year. Issuers may not exclude ACA assessments or fees they expect to incur in future MLR reporting years." [CCIIO Technical Guidance (CCIIO 2013—0003)]
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