HHS Issues Final MLR Regulations on your Health Insurance

The Department of Health and Human Services issued final rules implementing changes to the medical loss ratio requirements for health insurers under the Affordable Care Act. 

Why is this important to you? Because the MLR (medical loss ratio) will determine how much money will be reimbursed to health insurance policyholders in the event that your insurance carrier has overcharged you.

Simply, if your insurance company collects more money from you than you use in claims, based on what the law will allow (PPACA), they are obligated by the law to reimburse you ( or your employer).

It may also mean the end of having an independent broker help you select an insurance plan, as it ( the regulations) eliminates any exclusions for broker commissions, so brokers may have no choice but to charge a rate to their clients for their services.

Interim final regulations had been issued in November 2010 requiring insurance carriers, as of 2011, to account for claims and administrative costs, and to satisfy MLR thresholds or provide rebates. 

The final rules address several technical issues that have arisen in implementing the MLR provision. 

Read the complete release here: http://totalbenefits.biz/wordpress/?p=410