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October 18, 2011 at 11:21 AM
Two states say they need to set the minimum medical loss ratio (MLR) for the individual markets at 65%, rather than 80%, to keep those markets stable.
The Center for Consumer Information and Insurance Oversight (CCIIO) announced today that it has deemed the MLR relief applications from Florida and Michigan to be complete.
Commenters who want to weigh in on the applications have until Oct. 27 to do so.
CCIIO, an arm of the U.S. Department of Health and Human Services (HHS), now has received a total of 17 state and territory MLR relief applications and is still in the process of reviewing 4 of the applications for completeness.
States and territories are going through the relief process in response to a provision in the Patient Protection and Affordable Care Act of 2010 (PPACA) that now requires health insurers to spend at least 85% of large group revenue and 80% of individual and small group revenue on health care and quality improvement efforts. If MLR levels fall below the cut-offs, a company must pay rebates to its customers.
The state MLR relief filings give interesting individual group health insurance market snapshots.
