Health Insurance Medical Loss Ratio and Exchanges

The Department of Health and Human Services (HHS) has released two new sets of guidelines: the long-awaited regulations governing the Affordable Care Act provision on Medical Loss Ratio (MLR) and the first of a series of guidance and rules to aid states in complying with a health care reform law to set up insurance exchanges by 2014. The MLR regulations, which go into effect in January 2011, require that large group plans spend at least 85 percent and small group and individual health insurance plans at least 80 per cent of premiums on clinical services and activities related to quality of care. Insurers who don’t meet the standards in 2011 will be required to issue rebates for that amount in 2012. We are now evaluating the new regulations and you will be hearing more about both in the near future. Health insurance quotes

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