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TX Strikes Out on MLR Waiver Request

Margaret Dick Tocknell, for HealthLeaders Media, January 30, 2012

In the appeal denial letter Larsen noted that the appeal provided "no evidence that insurers would be unwilling to enter the market due to their inability to meet the 80% MLR standard," or that the new standard was responsible for driving several insurers from the market.

"Evidence presented by the (Office of Insurance Regulation's) application suggests that these six issuers' withdrawals were not caused by the 80% MLR standard," says the letter. In regards to the agent and broker workforce, Larsen states in the letter that no evidence was presents that "consumers would be unable to access agents and brokers absent an adjustment to the MLR standard."

"We are disappointed to learn about HHS' determination made on January 19. The Office continues to be concerned about the impact the MLR ratios have had, and will continue to have on the individual health insurance market in Florida," Jack McDermott, spokesperson for the Florida Office of Insurance Regulation, told HealthLeaders Media in an e-mail exchange.

Florida will have another chance to convince CMS that its needs relief from the MLR standards. Any state that wants to can begin filing requests now to adjust the 2012 MLR standard. However, to use 2011 data as the basis for the request states may need to wait until after April 1, when most issuers will file their supplemental health care exhibits with the National Association of Insurance Commissioners.


Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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1 comments on "TX Strikes Out on MLR Waiver Request"


Robert Luedecke, MD (2/3/2012 at 10:32 AM)
It is no secret that Governor Perry is opposed to any idea introduced by Democrats. The Texas Medical Association has been trying for many years to get exactly this sort of transparency in the insurance industry. This legislation is a major good for all the people of Texas in giving them more information to help the free enterprise system work more efficiently and should be implemented without delay.