Ambetter from Centene is refunding over $1 billion to Missouri health insurance policyholders for underspending on care under ACA Medical Loss Ratio rules, reshaping the state's individual insurance market.

Massachusetts insurance regulators require five health insurers to refund $75.6 million to consumers for not meeting medical loss ratio standards, reinforcing regulatory oversight and consumer protections.

Oscar Health's innovative routing technology is driving claims deflation and profitability, reshaping healthcare delivery and insurance cost management in the U.S. market.