CMS Limits Reporting Requirements for Plans that Meet Medical Loss Ratio Standard
In December 2011, CMS published an interim final rule and a final rule with comment that established notice requirements applicable to health insurance issuers who owed rebates for failure to meet the applicable MLR standard, and addressed the treatment of mini-med and expatriate policies with regards to MLR requirements. At that time, CMS invited comments regarding (a) whether insurers who met or exceeded the MLR standard in a given year should be required to provide notice to policyholders and stakeholders, and (b) whether issuers should be required to include in their notices information about the issuer’s MLR from the previous year.
After reviewing submitted comments, CMS released amendments to the regulations that:
- Creates a “simple straightforward notice requirement” for health insurers that meet or exceed the MLR standards set in PPACA;
- Only requires the above notice be sent for the 2011 reporting year; and
- Does not require issuers to provide information on the prior year MLR in their notice.
The rule notes that information about a specific insurer’s past years MLR will be available on the HHS website.
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