Medical Loss Ratio Rebate Requirements Released

Medical Loss Ratio Requirements

The Affordable Care Act is slowly but surely trickling into our lives. This month one of the sleeping giants of the law was further detailed in an Interim Final Rule. The “medical loss ratio” requires health insurance companies to spend 80% of money we pay in premiums on our health benefits. Larger group insurers will see 85% ratios required. If the insurers do not meet this ratio, you will receive a rebate.

This interim final rule with comment period revises the regulations implementing medical loss ratio (MLR) requirements for health insurance issuers under the Public Health Service Act in order to establish rules governing the distribution of rebates by issuers in group markets for non-Federal governmental plans.”

The effective date for the rule is January 3, 2012. Comment period end no later than 5 p.m. on February 6, 2012. The amendments to Part 158 generally apply beginning January 1, 2012, to health insurance issuers offering group health insurance coverage.

Related Rule:  Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act

Check out Kaiser Health News, they have compiled a variety of articles on the rules.