NAIC's Task Force Releases Draft Bill
The National Association of Insurance Commissioners’ (NAIC) Professional Health Insurance Advisors Task Force released a draft bill on Thursday that would pull brokers’ fees out of the Medical Loss Ratio (MLR) calculation.
More specifically, Section 2718 of the proposed bill states:
“(a) CLEAR ACCOUNTING FOR COSTS. – A health insurance issuer offering group or individual health insurance coverage (including a grandfathered health plan) shall, with respect to each plan year, submit to the Secretary a report concerning the ratio of the incurred loss (or incurred claims) plus the loss adjustment expense (or change in contract reserves) to earned premiums. Such report shall include the percentage of total premium revenue, after accounting for collections or receipts for risk adjustment and risk corridors and payments of reinsurance, that such coverage expends –
(1) on reimbursement for clinical services provided to enrollees under such coverage;
(2) for activities that improve health care quality; and
(3) on all other non-claims costs, including an explanation of the nature of such costs, and excluding Federal and State taxes, licensed independent insurance producer remuneration, and licensing or regulatory fees.”
Florida Insurance Commissioner Kevin McCarty requests comments of the draft to be sent to his office by March 14, one week prior to NAIC’s national meeting.
BenefitMall strongly supports this language and will comment as such to Commissioner McCarty.
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