The Florida Office of Insurance Regulation (OIR) recently conducted a public hearing with the Florida Health Insurance Advisory Board (FHIAB) to review the impact of the federal Medical Loss Ratio (MLR) requirements. The medical loss ratio requirements, which go into effect on Jan. 1, 2011, require health insurance companies nationally to utilize a specific percentage of the premium dollar for medical coverage.
At the meeting, the state officially adopted a resolution to request a waiver from the federal government regarding implementation of the MLR requirement.
“I am concerned that the Medical Loss Ratio requirements included in the Affordable Care Act could cause disruptions in the Florida health insurance marketplace,” said Insurance Commissioner Kevin McCarty. “I am especially concerned about how the MLR requirements will affect the role of health care agents who are critically necessary to help consumers in this increasingly complicated health care landscape.”
McCarty was one of 34 insurance commissioners from around the nation to meet with President Obama on this issue at the White House on Sept. 22, 2010.
During the hearing several members of industry testified including representatives from Aetna, AvMed Health Plans, Golden Rule (a subsidiary of UnitedHealthcare), and U.S. Health Plans. According to OIR, they claimed that the MLR requirements would create impediments to new competitors, a misalignment of costs (as individual health plans are more expensive in earlier years), and significant disruptions in the marketplace.
A representative from the National Association of Insurance and Financial Advisors warned the new MLR requirements would cause an exodus of agents from the marketplace, leaving consumers without advisors to assist them in navigating changes in the health care system.
But consumer advocate groups, including the Florida Alliance for Retired Americans, encouraged the state to implement the MLR requirements as Congress intended, arguing they could be an important tool to help control health care costs.
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