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Long-term care insurance providers.  

Insurers that do not meet the Medical Loss Ratio standard will be required to provide rebates to their customers and reduce spending on their administrative costs. 

Insurers that do not meet the Medical Loss Ratio standard will pay a tax penalty to the Federal government, n

Insurers that do not meet the Medical Loss Ratio standard will pay a tax penalty to the Health Benefits Exchange.

Insurers that do not meet the Medical Loss Ratio standard will only be required to reduce their spending on administrative costs.