SMVaddadi/propensity-data-cms-mlr-puf

cms_mlr_puf — mirror

A convenience mirror of a public dataset, pushed by propensity.data.hf_mirror so that benchmark runs do not depend on a flaky upstream origin.

This is a mirror, not a grant of rights

Copyright and licence remain with the original source named below. Mirroring moves bytes; it does not and cannot change the terms they arrived under. If you intend to redistribute this further, or to use it commercially, read the original terms — not this card, and not the license: field above, which is our best reading and may be wrong.

Provenance

• Source: Medical Loss Ratio Public Use File, Centers for Medicare & Medicaid Services, Center for Consumer Information and Insurance Oversight, MLR reporting years 2011-2024. Public domain as a matter of US law: 17 U.S.C. 105 denies copyright to works of the United States Government, and the reported figures are uncopyrightable facts in any case. Declared other + us-public-domain, not cc0-1.0: CC0 is a waiver only a rights holder can execute and CMS has executed nothing. Note this is a DIFFERENT notice position from the sibling cms_marketplace_puf mirror -- the Exchange-PUF agreement is measurably absent from this release -- so the two were assessed separately. DERIVED DATA: renamed, pivoted, state vocabularies normalised and roll-up rows dropped. Not presented as CMS data. WHAT THIS IS: the health-insurance counterpart to CAS Schedule P -- premium earned, claims incurred, quality-improvement expense and rebates filed side by side as a statutory return under ACA section 2718, at the grain 45 C.F.R. 158.120 mandates (one report per state an issuer is licensed in, aggregated separately by individual / small group / large group market). 320,589 rows x 55 columns, 14 reporting years, 4,741 issuer-state entities, 8 co-observed outcomes. The published file is keyed by a LINE-ITEM LOOKUP, so this mirror is PIVOTED: 4,021,349 raw rows become 320,589. The licence contrast with CAS Schedule P is itself the point -- CAS forbids derivative works and AI training; this is a federal work with no copyright at all. SEVEN MEASURED CAVEATS. (1) 75% OF NON-NULL PREMIUM VALUES ARE EXACTLY ZERO -- CMS writes 0.00 for segments an issuer does not sell, so non-null is NOT presence, and the panel that actually wrote business is 72,126 rows, not 320,589. (2) Issuer ROLL-UP pseudo-entities share the id space (7,225 header rows marked 'Grand Total'); they are dropped here, and testing for a null HIOS id is NOT safe because four roll-ups carry one. (3) business_state used TWO VOCABULARIES -- full state names through 2016, postal codes from 2017 -- so 57 values per release become 113 stacked, 2,460 of 4,203 issuers look multi-state, and every issuer-state series is cut in half at 2017. Normalised here to a 1:1 4,741 pairs. (4) Two derived totals LEAK: the part-1 and part-2 incurred-claims columns are the same quantity twice, and total allowable QIA expenses is the exact sum of its five components. (5) 454 line-item codes carry 569 names and 745 descriptions, so the pivot keys on the CODE and never the label. (6) Only 74 of 111 line-item codes exist in all fourteen years; no bridge is fabricated. (7) Leading zeros are real -- federal EIN, NAIC group code and AM Best number all carry them -- so id columns are strings. WHAT THIS IS NOT: not claim-level or microdata (every row is an annual aggregate over an issuer's book in one state and market, so there is no personal-data question at all); NO adjudication outcomes -- nothing records a claim admitted or declined; not a price (premium over member months is average revenue per member month, not a rate); and several market segments are residual buckets rather than comparable markets.
• Origin URL: https://www.cms.gov/marketplace/resources/data/medical-loss-ratio-data-systems-resources
• Loader: propensity.data.public_loaders.load_cms_mlr_puf
• Extract: full pull from origin
• Reported source: cms_mlr_puf
• Rows pushed: 320,589
• Columns: 55

Licence and redistribution

• Licence as found: other (us-public-domain)
• Redistribution verdict: open
• Basis: OPEN on 17 U.S.C. 105 grounds, and the plan's UNVERIFIED premise is confirmed rather than contradicted -- it is the premise that is right and the verdict that changes, because the basis is a statute and not a sentence CMS wrote. The MLR Public Use File is compiled and published by the Center for Consumer Information and Insurance Oversight at the Centers for Medicare & Medicaid Services from reports issuers are COMPELLED to file under ACA section 2718 (42 U.S.C. 300gg-18(a)), implemented at 45 C.F.R. part 158 subpart A, which is titled 'Disclosure and Reporting'. 17 U.S.C. 105 denies copyright protection to any work of the United States Government, and the compilation is such a work; the reported figures are in any case uncopyrightable facts (Feist Publications v. Rural Telephone Service, 499 U.S. 340 (1991)). MEASURED ABSENCE OF ANY NOTICE, 2026-11-10. (1) The release page https://www.cms.gov/marketplace/resources/data/medical-loss-ratio-data-systems-resources (HTTP 200, 206,946 bytes, 18,570 characters of extracted text) contains ZERO occurrences of 'licen', 'copyright', 'disclaim' or 'public domain'. (2) THE EXCHANGE-PUF AGREEMENT WAS NOT TRANSFERRED ONTO THIS RELEASE, exactly as the plan says: of the 27 PDF links on that page, none matches disclaim/agree/terms/licen, and the string 'exchange-pufs' occurs 0 times, so _cms_marketplace_schema.AGREEMENT_URL is not incorporated here by reference and is not relied on. (3) The bundled documentation carries nothing either: MLR_DataDictionaryPUF.pdf for 2024 (21 pages, 32,263 chars), 2014 (23 pages, 27,854 chars) and 2011 (50 pages, 72,767 chars), plus the 54-page 2014 reporting form instructions, contain ZERO occurrences of 'copyright', 'disclaimer', 'terms of use', 'public domain', 'restrict', 'proprietary' or 'confidential'; the only matches for 'licen' are 'licensed to offer health insurance', i.e. regulatory licensure, not a copyright grant. (4) CMS's own reachable web-policy page, cms.gov/about-cms/web-policies-important-links/web-policies/privacy (HTTP 200, 215,842 bytes), contains no copyright, reuse or public-domain statement; the two candidate content-reuse URLs under /about-cms/web-policies-important-links/ return HTTP 404 and hhs.gov returns HTTP 403 to a non-browser client, so there is no agency sentence to quote. (5) The governing regulation imposes no confidentiality: 45 C.F.R. part 158, read in full from the eCFR API (ecfr.gov/api/versioner/v1/full/2025-11-01/title-45.xml?part=158, HTTP 200, 116,917 characters), contains ZERO occurrences of 'confidential', 'proprietary', 'trade secret' or 'Freedom of Information'. (6) Access is anonymous: all fourteen ZIPs return HTTP 200 unauthenticated with 'access-control-allow-origin: *' and no interstitial, no clickwrap and no acceptance mechanism, so there is nothing for ClickwrapNotAcceptedError to refuse. RECORDED AS THE WEAKNESS: unlike CFPB, CMS publishes no affirmative public-domain sentence for this family, so this is the same 'OPEN (presumptive)' footing as ssbci_capital -- statute plus measured absence of a restrictive notice. No availability sentence is quoted as a grant. WHAT TRAVELS WITH A REDISTRIBUTION: the publisher and release page; the statutory basis (17 U.S.C. 105) rather than a CC0 label; the retrieval date and the per-year URL, because the 2011-2018 files sit on the legacy /cciio/ path under three different naming schemes and CMS has reissued files on the same URL (the 2024 ZIP's Last-Modified is 2025-11-21); and a statement that the frame is DERIVED -- this loader renames, pivots, normalises two state vocabularies and drops the issuer roll-up rows, so it must not be presented as CMS data. Card convention: license 'other' + license_name 'us-public-domain', never 'cc0-1.0', because CC0 is a waiver only a rights holder can execute and CMS has executed nothing. No personal data: every row is a corporate regulatory filing.

This is US-government material and therefore in the public domain as a matter of US law. The frontmatter says other rather than cc0-1.0 on purpose: CC0 is a waiver that only a rights holder can execute, and we are not the rights holder. Claiming it would be the same error that makes much of this Hub's licence metadata untrustworthy.

Citation

Centers for Medicare & Medicaid Services, Center for Consumer Information and Insurance Oversight (2026). Medical Loss Ratio Public Use File, MLR reporting years 2011-2024. Retrieved 2026-11-10 from https://www.cms.gov/marketplace/resources/data/medical-loss-ratio-data-systems-resources. US federal government work; no copyright under 17 U.S.C. 105. These data have been RENAMED, PIVOTED AND FILTERED by propensity.data.public_loaders._cms_mlr_puf (issuer roll-up rows dropped, full state names mapped to postal codes) and are NOT presented as CMS data.

Loading

from propensity.data.hf_mirror import load_mirrored

result = load_mirrored("cms_mlr_puf", org="SMVaddadi")
result.frame.head()

load_mirrored falls back to the original loader (origin, then its own offline replica) if this mirror is unreachable, so it is safe to depend on.