The ACA requires insurance companies to notify customers regarding the proportion of premiums spent on medical care and quality improvement. Effective in 2011, insurers were required to spend at least 80% of total premium dollars collected on medical care and quality improvement; insurers that do not meet the 80/20 MLR must pay rebates to their customers in 2012. On February 16, 2012, CMS posted proposed notices for insurers to send to consumers regarding compliance with the MLR standard.