Rockefeller MLR Report & Public Comments to HHS

[ABC]

Great topic
Its going to be an interesting battle.

To try to find something positive out of this MLR BS
If I could tell a small group that if you run well that you will be eligible for a premium reimbursement sounds good.
Is this a case by case situation or state blocks?


Look at UHC individual block running at 70% MLR. That is a very good block. They have plenty of room to keep brokers in the equation. I know understand how they can do all the bonus programs.

There is no way the carriers are going to give correct MLR.
They will start to BS and state that the network discount on claims does not apply and so on.

What is keeping the carriers from just raising their premiums. Then they can sit on the money and earn interest before refunding it.

Lets see these loss ratios after GI.

 

[somarco]

If I could tell a small group that if you run well that you will be eligible for a premium reimbursement sounds good.

Dividend refund plans went away 30 years ago. Never made much sense. If the carrier made money, they gave it back. If they lost, they gave out a rate increase and hoped the client stayed long enough to at least break even.

I had a client in the late 70's where I delivered a refund check and a rate increase in the same meeting. That was fun trying to explain.

Lets see these loss ratios after GI.

Look at loss ratio's on COBRA, risk pools, small groups (5 lives and under) and in the GI states now. You have your answer.

 

[ABC]

Somarco
You can still get the premium refund on large group.
500+ lives. Just have to ask for it.

Dividend refund plans went away 30 years ago. Never made much sense. If the carrier made money, they gave it back. If they lost, they gave out a rate increase and hoped the client stayed long enough to at least break even.

I had a client in the late 70's where I delivered a refund check and a rate increase in the same meeting. That was fun trying to explain.



Look at loss ratio's on COBRA, risk pools, small groups (5 lives and under) and in the GI states now. You have your answer.

 

[somarco]

I suppose there are still 500+ life groups that are not on "minimum premium" plans or ASO but haven't run across any in years. The dividend refund plans are nothing more than overcharging up front in hopes of a refund on the back end.

Still doesn't make much sense to me.

 

[dgoldenz]

I suppose there are still 500+ life groups that are not on "minimum premium" plans or ASO but haven't run across any in years. The dividend refund plans are nothing more than overcharging up front in hopes of a refund on the back end.

Still doesn't make much sense to me.

Sounds like whole life. Just saying.