Insurance Journal
As insurance brokers feared, the Obama Administration has not exempted broker commissions from the formula for the medical loss ratio that health insurers must adhere to beginning in 2011.
Brokers say they may ask Congress to intervene if the medical loss ratio (MLR) formula is not altered to protect their fees and commissions.
The MLR requirement is part of the Patient Protection and Affordable Care Act and requires health insurers to spend 80 to 85 percent of consumers’ premiums on direct care for patients. The intention is to limit the share of premiums that insurers spend on administrative costs and profits, including executive salaries, overhead and marketing.