Insurance producers are fighting the Patient Protection and Affordable Care Act’s (PPACA) element that excludes commissions from the calculations of the minimum medical loss ratio.
The PPACA states that health insurance companies in the large group market must spend a minimum of 85 percent of premiums on healthcare services, and those in the small group and individual markets much spend at least 80 percent on healthcare services.
Broker and agent groups are battling on Capitol Hill to remove their commissions from the requirement. They had hoped that the cause would be supported by a recent recommendation made by the National Association of Insurance Commissioners.
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This month, though, the Department of Health and Human Services eliminated that chance by promoting a final regulation that does not remove commissions from the calculation. This leaves Capitol Hill as the final opportunity for insurance agents and brokers to influence the changes.
The Access to Professional Health Insurance Advisors Act of 2011 was introduced in March by Rep. Mike Rogers (R-Mich). H.R. 1206 currently has 140 co-sponsors, and will change the Public Health Service Act so that it no longer includes remunerations received by licensed independent insurance producers for a health insurance plan’s calculations of the medical loss ratio’s administrative cost elements.
The changes from this proposal would also alter the definition of an independent insurance producer, so that it would include insurance consultants, limited insurance reps, insurance agents and brokers, and other people who need licenses in order to solicit, service, negotiate, sell, effect, renew, procure, or bind insurance policies, or people who provide counsel, advice, professional opinions, or other services connected to insurance.