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Your Health Insurance Company May Owe You Money

June 3, 2013  /  Insurers, Medical Loss Ratio

In all the talk about death panels, mandates, and insurance exchanges, it’s easy to miss how the Affordable Care Act tries to limit health insurance premiums.  The rule, known as the medical loss ratio, requires insurers to spend at least 80 cents of every premium dollar on medical care.

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Insurer Excellus reports exceeding MLR Requirements on health care spending

June 3, 2013  /  Medical Loss Ratio

Excellus BlueCross BlueShield announced Monday it exceeded federal and state standards by $330 million in 2012 in dollars spent on medical benefits for its members.

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How the Medical Loss Ratio Requirement Could Increase Health Insurance Premiums And Insurer Profits at Taxpayer Expense

April 28, 2013  /  Medical Loss Ratio

One of the most highly touted features of the health reform law is a section requiring health insurers to maintain a minimum Medical Loss Ratio (MLR) the dollar value of medical payments as a percentage of premium revenue, the difference going to administrative costs and profit. The goal of this provision is to encourage insurers […]

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Agency Proposes New Medicare Ratios

March 1, 2013  /  Insurers, Medical Loss Ratio, Medicare

The Department of Health and Human Services has proposed a rule meant to ensure Medicare providers are spending more money on patient care than administrative expenses.

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White House unveils awaited Affordable Care Act profit margin rule

February 17, 2013  /  Medical Loss Ratio

A proposed federal rule to cap profit margins for certain health insurance plans and prescription drug benefit programs is now available for review.

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Kaiser Analysis: Estimated Health Insurance Rebates under the Health Reform Law Total $1.3 Billion Dollars in 2012

April 26, 2012  /  Medical Loss Ratio

Consumers and businesses are expected to receive an estimated $1.3 billion by this August in rebates from health insurers who spent more on administrative expenses and profits than allowed by the Affordable Care Act (ACA), finds a new analysis from the Kaiser Family Foundation of the latest estimates provided by insurers to state insurance commissioners. […]

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Medical Loss Ratio Review

February 1, 2012  /  Medical Loss Ratio

The Affordable Care Act (ACA) includes several provisions that change the way private health insurance is regulated in an effort to provide better value to consumers and increase transparency. One such provision – the Medical Loss Ratio (or MLR) requirement – limits the portion of premium dollars health insurers may spend on administration, marketing, and […]

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