The affordable care act specifies that 80% of premiums must be spent on medical expenses. If not, the consumer gets a rebate at the end of the year.
See e.g. https://www.investopedia.com/terms/m/medical-cost-ratio.asp
See e.g. https://www.investopedia.com/terms/m/medical-cost-ratio.asp
Refer to: https://fas.org/sgp/crs/misc/R42735.pdf