Did you really think Shebullus (pronounced "she bull us"), would allow her old state of Kansas where she was Insurance commish to avoid PPACA that she's in charge of implementing?
Looks like Kansasites will be getting a refund. From my experience, Goldenrule/UHC has the best network negotiated rates, and it might be reflected in that 62% number below. But what incentive will a company have to negotiate lower rates, when they need to pay out more to providers to meet the MLR?
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Four of eight insurance issuers fell below the 80 percent standard in 2010, HHS said: Coventry (72.6 percent), Humana (70.8 percent), Time (68 percent) and Golden Rule (62 percent). The companies all are profitable and can afford to pay rebates, Larsen said. The companies at or above 80 percent were Blue Cross Blue Shield of Kansas (88.8 percent) and of Kansas City (79.4 percent), Aetna (85.1 percent) and Reserve (109.5 percent; adjusted for its small size).
Twenty percent of premium dollars may be spent on administrative costs such as marketing, advertising and agents' commissions.
Praeger said that some companies will be able to make a case that some of their administrative costs improve health care and therefore can fall into the 80 percent rather than the 20 percent category.
One argument against the 80/20 rule is that commissions of independent agents will be cut. Larsen said that might be one way companies meet the requirement, but he said HHS did not have any evidence that this was going to hurt people's access to insurance. "We value the role agents play," he said.
Read more here: Feds reject Kansas' request to cut amount insurers must devote to health care | Wichita Eagle
Looks like Kansasites will be getting a refund. From my experience, Goldenrule/UHC has the best network negotiated rates, and it might be reflected in that 62% number below. But what incentive will a company have to negotiate lower rates, when they need to pay out more to providers to meet the MLR?
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Four of eight insurance issuers fell below the 80 percent standard in 2010, HHS said: Coventry (72.6 percent), Humana (70.8 percent), Time (68 percent) and Golden Rule (62 percent). The companies all are profitable and can afford to pay rebates, Larsen said. The companies at or above 80 percent were Blue Cross Blue Shield of Kansas (88.8 percent) and of Kansas City (79.4 percent), Aetna (85.1 percent) and Reserve (109.5 percent; adjusted for its small size).
Twenty percent of premium dollars may be spent on administrative costs such as marketing, advertising and agents' commissions.
Praeger said that some companies will be able to make a case that some of their administrative costs improve health care and therefore can fall into the 80 percent rather than the 20 percent category.
One argument against the 80/20 rule is that commissions of independent agents will be cut. Larsen said that might be one way companies meet the requirement, but he said HHS did not have any evidence that this was going to hurt people's access to insurance. "We value the role agents play," he said.
Read more here: Feds reject Kansas' request to cut amount insurers must devote to health care | Wichita Eagle
