As many of you are aware, Be Well Insurance Solutions has made it a priority to keep you, our clients, prospects and friends, informed regarding the Patient Protection and Affordability Care Act (PPACA), also known as Healthcare Reform or the Affordable Care Act (ACA).
Recently, the Department of Health and Human Services (HHS) made the decision to dismiss the National Association of Insurance Commissioners (NAIC) recommendation to include Insurance Agents/Brokers in the Medical Loss Ratio (MLR).
So what does this mean and how will it affect you?
MLR is included in the PPACA framework, which means that 80-85% of every dollar must be spent directly on your healthcare. The other 15-20% is left for the carriers to spend on their administrative costs.The NAIC was specifically charged by Congress to craft the MLR guidelines for PPACA and present their recommendations to the HHS. On November 11, 2011, the NAIC recommended that Health Insurance producers, agents/brokers, be included in the 20% portion of the MLR.
On December 2, 2011, HHS issued a final rule and an interim rule addressing a variety of issues relative to the PPACA medical loss ratio (MLR) requirements. Unfortunately, HHS did nothing to mitigate the adverse effects the MLR rule is currently having on the ability of insurance producers to serve the demands and needs of the health care consumers.
According to the current definition, health insurance brokers’ commissions are considered an administrative cost and must make up no more than 15-20% of healthcare premiums. This has many industry analysts worried that brokers’ revenues will dry up as this will leave little for carriers to spend on administrative functions and force health insurance brokers out of business; which in turn means less protection for Americans needing health care coverage.
Health Insurance Brokers offer their clients valuable services that are currently built into the cost of their premiums. If brokers are no longer compensated by the carriers, the cost of the services we currently offer our clients will have to be passed on directly to our clients through consulting and added fees, which many small to midsize business owners cannot afford. Especially in these challenging economic times!
For this reason, the National Association of Health Underwriters and Be Well Insurance Solutions ask you to urge your Congress members to Support HR1206.
In addition, we are also asking you to personally mail a letter on your company letterhead explaining what health insurance agents and brokers do for you. SAMPLE Letter- We need our broker–KLG edits-so
Attached is a sample letter, but feel free to write a letter in your own words. Completed letters can be emailed to SOliverez@BeWellInsruance.com or faxed to (408) 615-1280.
To learn more about MLR requirements, please visit: http://bit.ly/wB2R0R
Please make sure all letters are delivered on or Before January 19th, 2012, to the below email or Fax, and I will deliver them personally when I am visiting with your Congressmen and Senators.
If you should need any further clarification regarding this Call To Action! Please do not hesitate to email or call Sylvia Oliverez at: SOliverez@BeWellInsurance.com or (408) 667-2602.
Thank you in advance for your time and support!