HHS and MLR

[ABC]

We are in the hurt locker! This was my worst fear.

If we are lucky each state will ask for a MLR waiver and so we can stay in business and hope the congress can revise the MLR.

 

[JAngelson79]

Re: Financial Reform and Fiduciary Standard Coming too

We all knew that this was coming down the pike. Regardless of which part controls Congress for now a repeal is impossible. And has been mentioned on here a number of times, once entitlement programs are rolled out they ain't taken back. Just the way it is here. So, I for one am making sure to build a block with life, med supps, DI, and supplemental coverages. While we can. Financial reform is going to end up having us have to conform to the same fiduciary standard as is imposed on investment advisors and reps. If there is "no load" insurance product available that we can sell to the client we have to sell it. How long do you think it will take the carriers to realize that they can put out products with no commissions or dramatically scaled back commissions and sell those! Direct to consumers. It might be time to get the hell out of dodge and by dodge I mean the place that used to be the USA.

Justin

 

[AgentOrange]

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.

Check out this excerpt from a Politico article about our commissions, its not "pass through" for this year but there is a waiver provision ...

State insurance commissioners also worry that the provision encourages insurers to cut back on insurance agents' and brokers' commissions, which could drive them out of business just as consumers have to learn to navigate a new insurance market. In response to that concern, states will be able to ask HHS for a waiver to deal with the commissions separately.

POLITICO Forums:Health care: W.H. outlines insurer spending rules - POLITICO.com

 

[somarco]

If agents are gone, or non-existent, that means more staffing in home offices AND the DOI to field all the service calls that we take for "free".

 

[AllenChicago]

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.

The reporting requirements, rebate calculations, printing of checks and postage will add to the administrative cost of a company, thereby inducing the HHS to demand that they rebate even more money...a second round of checks! Then a third.. a fourth...etc..

With all the new regulations that negatively affect corporate bottom lines, place freezes on Senior's Cost of Living Adjustments, Strips money from Medicare Doctors and Strips People at airports, our government is stirring up some serious internal threats. Bin Laden will seem like an angel in comparison to the anarchy our government is brewing within its own citizenry.
-AC

 

[Franz Kafka]

Bin Laden will seem like an angel in comparison to the anarchy our government is brewing within its own citizenry.
-AC

An anarchy, a revolution, a civil war ... whatever it may be ... we need something soon ... I don't want my children growing up here being subject to all those taxes.

 

[AllenChicago]

An anarchy, a revolution, a civil war ... whatever it may be ... we need something soon ... I don't want my children growing up here being subject to all those taxes.

Don't worry..it's coming. And it will be FAST if the government allows the "Bush Tax Cuts" as they're called, to expire on December 31st. The average worker (Family earning $70K annually) will see an additional $56 per week deducted from the paycheck by Uncle Sam Obama. It would be the match that ignites the powder keg.

-ac

 

[ijerome]

Allen, where did you get your figures? Another maybe...if?? So far I think you are the only tax expert to put this out.

 

[ins.dave]

Don't worry..it's coming. And it will be FAST if the government allows the "Bush Tax Cuts" as they're called, to expire on December 31st. The average worker (Family earning $70K annually) will see an additional $56 per week deducted from the paycheck by Uncle Sam Obama. It would be the match that ignites the powder keg.

-ac

PLEASE ...

 

[somarco]

About those "rebate" checks . . .

Starting in 2011 health insurance companies will have to track premiums, claims, and administrative fee's and provide a year end accounting on how much was spent on each item. This report will go to HHS but most likely also to the IRS.


If the health insurance company failed to meet the mandated MLR they must issue refund checks, and 1099's, to all covered participants. That cost will be factored into their overhead which means even less for customer service.


The checks that go out to businesses are quite complicated. Starting in 2012 business owners will start to receive refund checks for premium overcharges if things go as planned. The money received by the business means a possible amended business tax return, but it also means each business must pro-rate the refund over each individual that was a plan participant during the year and issue refund checks to those individuals.


If the premium was deducted by the employee on a pre-tax basis that means an amended return for them, and even more work for the IRS.


So far it seems as if the only winners in this deal is the IRS.


These checks and the headache that goes with this grand scheme will hit in 2012. How many businesses, both large and small, will decide to terminate health insurance plans rather than continue doing battle with the government?


All of this hits in 2012, which coincidentally happens to be an election year . . .