Medical Loss Ratio
The MLR requirements were designed to limit the amount that a health insurance company can spend on administrative costs. Specifically, the MLR requirement states that 80% of all premium dollars must go to medical care, with the remaining 20% going to administrative costs. While NAHU agrees with the goal of providing consumers with more value for healthcare dollars spent, the PPACA MLR requirements significantly and negatively impact access to health insurance agents and brokers by wrongfully including agent and broker commissions in with administrative costs, at the very time our economy is the weakest and health insurance purchasers have the most need for help. Bi-partisan legislation has been introduced into the 113th Congress by Senator Mary Landrieu (D-LA), with co-sponsors Mark Begich (D-AK), Johnny Isackson (R-GA) and Lisa Murkowski (R-AK) to remove independent health insurance agents and brokers from PPACA’s Medical Loss Ratio requirements.
Resources
NAHU’s Issue Summary on MLR
NAHU has developed an issue summary highlighting the negative impact MLR has on independent health insurance agents and brokers.
Myths and Realities of PPACA’s Medical Loss Ratio Requirements
Economic Impact of MLR
This paper examines exactly how the Medical Loss Ratio requirements of PPACA impact independent health insurance agents and brokers.