The Department of Health and Human Services issued a statement last week, saying the agency will exercise the discretion of Secretary Kathleen Sebelius under new health reform law to address the special circumstances of limited benefit plans in medical loss ratio calculations.
Federal MLR requirements have not officially been issued, and recommendations from the National Association of Insurance Commissioners are due by Dec 31.
The MLR guidance issue is of great concern to companies employing a high proportion of part-time, seasonal and temporary workers who are enrolled in limited medical benefit (mini-med) plans because they are ineligible for coverage under their employer's regular group health care plan. Most of these mini-med plans don't meet a 2011 requirement that they spend 80 percent to 85 percent of premiums on medical benefits instead of administration expenses.
Complete your profile to continue reading and get FREE access to BenefitsPRO, part of your ALM digital membership.
Your access to unlimited BenefitsPRO content isn’t changing.
Once you are an ALM digital member, you’ll receive:
- Breaking benefits news and analysis, on-site and via our newsletters and custom alerts
- Educational webcasts, white papers, and ebooks from industry thought leaders
- Critical converage of the property casualty insurance and financial advisory markets on our other ALM sites, PropertyCasualty360 and ThinkAdvisor
Already have an account? Sign In Now
© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.
