How Long to Read Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (ACA): Issues for Congress

How Long Does it Take to Read Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (ACA): Issues for Congress?

It takes the average reader and 32 minutes to read Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (ACA): Issues for Congress by Suzanne M. Kirchhoff

Assuming a reading speed of 250 words per minute. Learn more

Description

The 2010 Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) requires certain health insurers to provide rebates to their customers for each year that the insurers do not meet a set financial target called a medical loss ratio (MLR). At its most basic, a MLR measures the share of a health care premium dollar spent on medical benefits, as opposed to company expenses such as overhead or profits. For example, if total premiums collected are $100,000, and $85,000 is spent on medical care, the MLR would be 85%. The ACA sets the minimum required MLR at 80% for the individual and small group markets and at 85% for the large group market. In general, the higher the MLR, the more value a policyholder receives for his or her premium payment. Congress imposed the MLR in an effort to provide “greater transparency and accountability around the expenditures made by health insurers and to help bring down the cost of health care.” Insurers that fail to meet these minimum standards must provide rebates to policyholders. The Department of Health and Human Services (HHS), with input from state insurance commissioners who are the main regulators of health insurance, issued rules for implementing the provisions. These rules provided greater details for calculating the MLR and issuing rebate payments. ACA allows companies to include quality improvements along with medical benefits when calculating the MLR. In addition, state and local taxes and some licensing fees are subtracted (i.e., disregarded) from expenses in the MLR formula. ACA's requirements are different from those imposed by state laws, which generally compare only medical claims to premiums. Though a number of states have their own MLRs, the ACA is now the minimum standard that must be met nationwide by certain health insurers. About 12.8 million U.S. consumers were due more than $1.1 billion in ACA MLR rebate payments in August 2012, for an average award of $151 per qualifying household. Employers or insurers can provide the rebates, which are based on activity in 2011, via a check, an electronic deposit in a bank account, a reduction in future insurance premiums in the amount of the rebate, or by spending the funds for the benefit of employees. About 66.7 million people were insured by covered companies that met or exceeded MLR standards for 2011, and will not receive rebates. The MLR is based on the aggregate performance of a health plan, not individual policy history. Even if a beneficiary had no medical claims during a given year, he or she would not receive a rebate if the broader plan met the MLR requirements. In addition, many Americans were enrolled in health plans that were not covered by the ACA MLR provisions in 2011. The ACA MLR provisions cover only fully funded health plans, which are plans where insurance companies assume the full risk for medical expenses incurred. The requirements do not extend to self-funded plans, which are health care plans offered by businesses in which the employer assumes the risk for, and pays for, medical care. Non-profit insurers and some Medicare Advantage plans were not covered by the ACA MLR standards in 2012, though the MLR provisions will be phased in during 2013 and 2014, respectively. In addition, some states won special exceptions for individual insurance policies, based on a HHS determination that meeting the MLR requirement would harm a state's insurance market. Several issues have been raised about the MLR provisions since the ACA was enacted. These include considerations regarding the treatment of insurance agent and broker bonuses and commissions, the impact of the MLR on insurers that provide high deductible plans, and special rules for non-profit health insurers.

How long is Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (ACA): Issues for Congress?

Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (ACA): Issues for Congress by Suzanne M. Kirchhoff is 32 pages long, and a total of 8,064 words.

This makes it 11% the length of the average book. It also has 10% more words than the average book.

How Long Does it Take to Read Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (ACA): Issues for Congress Aloud?

The average oral reading speed is 183 words per minute. This means it takes and 44 minutes to read Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (ACA): Issues for Congress aloud.

What Reading Level is Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (ACA): Issues for Congress?

Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (ACA): Issues for Congress is suitable for students ages 8 and up.

Note that there may be other factors that effect this rating besides length that are not factored in on this page. This may include things like complex language or sensitive topics not suitable for students of certain ages.

When deciding what to show young students always use your best judgement and consult a professional.

Where Can I Buy Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (ACA): Issues for Congress?

Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act (ACA): Issues for Congress by Suzanne M. Kirchhoff is sold by several retailers and bookshops. However, Read Time works with Amazon to provide an easier way to purchase books.

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