The Centers for Medicare & Medicaid Services is wrapping up work on the medical loss ratio reporting form and rebate program for the 2013 reporting year.
Carriers will have to use form CMS-10418 later this year to see if they have to send enrollees MLR rebates.
The Patient Protection and Affordable Care Act forces carriers to spend at least 85 percent of large group revenue and 80 percent of individual policy and small-group revenue on health care and quality improvement efforts.
Carriers that miss the MLR targets are supposed to use rebates or other forms of compensation to make up for the gap.
The 2013 plan year reports are due June 1.
Brokers want the government to exclude broker compensation from the calculations. CMS continues to classify producer comp as a “non-claims cost.”