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NAIC Draft on Medical Loss Ratios Open for Comment

Janice Simmons, for HealthLeaders Media, September 28, 2010

In a letter last week to Health and Human Services Secretary Kathleen Sebelius, Iowa Insurance Commission Susan Voss said that Iowa has had some of the lowest health insurance rates in the country, with a market that includes a large health insurance carrier and several smaller insurance carriers in the individual market. However, the state is already seeing carriers with small numbers of insurers in the individual market "announce their intent to cease business in our state," Voss said.

Among the rules included in the draft that may be welcome news for health insurers are provisions that would allow them to include spending on wellness programs and healthcare hotlines as expenses—but only in instances where the focus is on improving the quality of care. Insurers also would be permitted under the draft guidelines to exclude most federal and state taxes from MLR calculations—except for those federal income taxes on investment income and capital gains.

Following the public comment period, the draft must be approved by additional NAIC committees and then voted on by the membership of the NAIC at its annual meeting later in October. That version will then be sent to Sebelius' office.


Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.

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