HHS and MLR

[Winter_123]

Not sure if this has been posted but here it is anyway.

Medical News: HHS Releases New Insurance Rule - in Washington-Watch, Reform from MedPage Today

 

[0b1kanobee]

I thinks the government should have a GLR so we know how much tax money and revenue actually gets put towards benefits of government. When you think about it, it is sickening just how out of hand it is. It's one corrupt system now for sure no matter what party is at the helm.

 

[CHUMPS FROM OXFORD]

Interesting.

 

[AllenChicago]

Looks to be almost exactly what the NAIC presented to HHS in October. Sebelius sat on it for a month just to make herself look important. Since there's no "phase-in" as insurance companies hoped for, they will have to gear up for compliance over the next 30 days...during the holiday season. Kathleen Sebelius is ___________(fill in the blank).
-AC

 

[YouGotMyMoney]

In reference to this:

"Few Americans understand how much of the money that they pay for health insurance in fact ends up paying for health insurance bureaucracy instead of healthcare," said Tim Jost, a consumer representative with the National Association of Insurance Commissioners (NAIC).

Sebelius noted that some insurers currently spend less than 60% of their revenue on medical care.

I say this:

Matthew 7:5


You hypocrite, first take the plank out of your own eye, and then you will see clearly to remove the speck from your brother's eye.

 

[TXINSURANCE]

Poorly written article with typos.

 

[BalancedPlan]

Looks like it's pretty much a definite that our commissions are not going to be a pass through.

The "Big I" or Independant Insurance Agents and Brokers of America. Has called on HHS and Congress to address this today. Fearing that if this ruling stays the law, it will have a devastating effect on the marketplace. They also said that if the HHS fails to fix this before the rule is final, they hope that Congress can step in and revise the MLR formula through the legislative process.

Somehow I doubt that.

 

[somarco]

The Spectator had this take, along with comments from Michael Cannon at Cato.

Also, it's no accident that the requirements were set at 85 percent and 80 percent. Last December, the Congressional Budget Office issued a memo saying that if the requirements were set any higher than that, health insurers would have to be considered part of the federal budget -- driving up the cost estimate of ObamaCare. As the CBO put it, referencing proposals for even more stringent requirements, "this further expansion of the federal government's role in the health insurance market would make such insurance an essentially governmental program, so that all payments related to health insurance policies should be recorded as cash flows in the federal budget." At the time, the Cato Institute's Michael Cannon pointed to the memo as a "smoking gun," revealing that Democrats had deliberately hidden the true cost of ObamaCare by making sure the CBO wouldn't factor in the cost of the private sector mandates imposed by the legislation.

As church lady says, "isn't that special".

 

[jbage007]

that is special, and interesting, but I don't get it? why would more stringent requirements make health insurers part of the federal budget???

------
in any event, if you read the original posted article, there is a reference to a potential "rebate" due consumers of about $164; that is, if the 80/85% requirement is not met

so let me get this straight.

I'm being asked to take an $80,000 per year hit just so some insurance company doesn't have to send a rebate of $164 to some goofball policyholder???

Now THAT is precious.

This whole MLR thing is over a hundred bucks?????

You have GOT to be kidding me.

Has anyone bothered to figure up how much it will cost an insurance company to compute then process millions of rebate checks in such a puny amount? Ha! What a bunch of baloney-heads.

 

[somarco]

But wait, there's more!

HHS estimates about $1.4 billion in refund checks or about $164 per insured.

How much does it cost to do this?

The carrier has to track premiums and claims and conduct an end of the year accounting and (presumably) report back to HHS.

Then they have to figure out who was insured during the year, how much their pro-rata share is, and mail them a check.

If this is a group plan and the employer gets a refund check they have to amend their return to show less premiums paid (after rebate) and pro-rate the amount between their cost and the employee cost.

Then they have to track down every employee covered during the year and, if they are no longer employed, have to send them a check for their share of the rebate.

Only Washington could come up with something so convoluted and claim this is good for the taxpayer.