CMS to Keep Collecting Mini-Med Reports

Managers of expat plans argued that those plans ought to be exempted from the MLR rules because the cost of developing provider networks, paying claims overseas, and helping insureds with tasks such as translation increases the percentage of revenue that an expat plan must spend on administration.

CMS and its parent, the U.S. Department of Health and Human Services (HHS), is requiring major medical plans to file reports describing spending on claims, quality improvement expenses, non-claims costs, and federal and state taxes and licensing or regulatory fees. Each issuer also must report on earned premium revenue.

CMS has created an MLR waiver program for the mini-med and expat plans, to help them stay in business while adapting to PPACA, but, in exchange, CMS is requiring those plans to file their operating performance reports on a quarterly basis.

For purposes of applying the MLR rules, CMS is classifying plans with total annual benefits limits of $250,000 or less as mini-med plans.

When CMS proposed continuing the data collection on its own website, it received just two comments letter, CMS officials say.

Comments on the OMB clearance request are due Dec. 19.