The Medical Loss Ratio is very critical to the health insurance industry. This MLR is going to have a huge effect on carriers profits and how they operate. In fact we could see some carriers drop out of certain markets reducing the already limited choices of carriers. The HHS has to clarify the laws on  the MLR. These laws going into effect as of Jan1st 2010 so we are getting down to the wire on explantions.

The National Association of Insurance and Financial Advisors (NAIFA) has again partnered with The Council of Insurance Agents & Brokers (CIAB), the Independent Insurance Agents & Brokers of America (IIABA), and the National Association of Health Underwriters to provide comments to the Department of Health and Human Services regarding the development of Medical Loss Ratios (MLRs) in section 2718 of the Public Health Service Act.

The groups are concerned that the narrow MLR definitions would adversely impact spending on such important health plan activities as case management, wellness, disease management, and fraud and abuse prevention programs, among others.

The group asserts, “It is important to spend time clearly defining clinical series and administrative costs to allow insurance carriers to provide an array of services that will improve the health of Americans and provide them the health care they deserve – effectively and efficiently – including the important services provided by licensed health insurance agents, brokers, and benefits consultants.”

Read the group’s full comment letter on the development of Medical Loss Ratios at www.naifa.org/advocacy/documents/05172010_2718.pdf.

About NAIFA: The National Association of Insurance and Financial Advisors comprises more than 700 state and local associations representing the interests of approximately 200,000 agents and their associates nationwide. NAIFA members focus their practices on one or more of the following: life insurance and annuities, health insurance and employee benefits, multiline, and financial advising and investments. The Association’s mission is to advocate for a positive legislative and regulatory environment, enhance business and professional skills, and promote the ethical conduct of its members