Final Regulations on Medical Loss Ratio Issued
The structure of the MLR is not changing, and the final regulations address technical issues in how to calculate and report the MLR and how to distribute rebates to enrollees. The changes in the new rule include the following:
• Rather than having insurers send checks that could be taxed, workers in group health plans can receive tax-free rebates.
• Increased transparency will allow consumers to receive a notice of the amount of the rebate but also what the health insurer's MLR means.
• A change to a quality improvement definition will promote insurer improvements in defining or coding of medical conditions for a limited window of time.
• Mini-med and expatriate plans are being phased down.
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