Posts Tagged - ‘insurance commissioners’

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State Health Insurance Commissioners To Rule on Medical Loss Ratios

Thursday, October 21st, 2010

Image: turtlemom4bacon under CC 3.0

All eyes are on Orlando today, but not because of anything Mickey Mouse has done. Rather, it is a meeting of several states’ insurance commissioners. Their topic: coming up with the rules that insurers will have to abide by post-healthcare reform.

Specifically, they are responsible for calculating minimum medical loss ratios. MLRs are also known as the percentage of premiums spent on providing health care, as opposed to profits and administrative expenses. Proponents of the limits believe that they will result in more affordable health insurance for consumers. However, some are worried that the new rules will make some niches and entire markets–such as small groups–less appealing, and that people will become uninsured as a result.

The group’s recommendations will become effective next year. Although the already-determined limits are 85% for large group plans and 80% for small groups and individuals, the commissioners will consider tax exemptions and a longer phasing-in period. Most significantly, they will help determine what counts as a medical expense. Insurers obviously want a wider definition of qualified medical costs.

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Obama Warns Insurers Against Circumventing Healthcare Reform

Tuesday, June 22nd, 2010

Image: cliff1066™ under CC 3.0

Health insurance companies are preparing for the impact reform will have on them. Some of this preparation is gaining negative attention from President Obama–namely, increasing their rates severely before healthcare reform takes effect and significantly limits their ability to do so. Since the law will keep them from increasing rates solely for profit-maximizing purposes, they ideally want to have the highest floor before it becomes effective.

Today, he is holding a meeting at the White House to drive this point home further. Although the federal government doesn’t gain direct control over regulating health insurance plans, it gains more oversight responsibility. Their worst-case scenario is that insurers increase their rates before provisions begin taking effect this summer, while blaming the legislation for forcing them to make those moves.

The president of industry lobbying group America’s Health Insurance Plans, as well as executives from 13 health insurers and several state insurance commissioners, will attend the meeting. It is unclear whether it will have any actual impact on their actions. Some believe the summit is more of a political move, intended to protect Democrats against blowback in the midterm elections.

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