NU Online News Service, Oct. 1, 3:35 p.m. EDT
WASHINGTON--The Department of Health and Human Services last night issued a statement that it will allow great flexibility to employers in applying medical loss ratio (MLR) standards to certain health plans under the health care reform law.
The issue is of concern to health insurance agents and brokers, especially as it affects mini-med plans, which provide limited health care benefits to certain employees, such as part-time workers employed by large corporations.
The law's MLR provisions will require 85 percent of large group premiums and 80 percent of individual and small group coverage premiums to be spent on medical care and quality improvement activities. Carriers and plans that spend too little are supposed to pay rebates.
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