New Bill Will Modify Medical Loss Ratios

The U.S. House of Representatives Energy and Commerce Committee has approved H.R. 1206, the Access to Professional Health Insurance Advisors Act, with a 26-14 vote. The bill will modify the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers, who provide professional insurance and guidance to the poor, the elderly and small-business owners who do not wholly understand their health insurance options, from administrative cost calculations for purposes of calculating the medical-loss ratio (MLR) of a health insurance plan.

The provision on MLR requires the secretary of Health and Human Services, when a state requests an adjustment of a medical-loss ratio, to defer to the state’s findings and determinations as to whether enforcing the required medical-loss ratio may destabilize the individual or small group markets for health insurance.