• Center on Health Equity & Access
  • Clinical
  • Health Care Cost
  • Health Care Delivery
  • Insurance
  • Policy
  • Technology
  • Value-Based Care

Final Medical Loss Ratio Rule Rebuffs Insurance Agents

Article

The Obama administration issued a rule today that is sure to disappoint insurance agents: Fees paid to brokers and agents won’t count as medical care, under limits imposed on insurers in the 2010 federal health law.

That’s key because under the health law, insurers must spend at least 80 percent of their premium revenue on medical care and quality improvement — or issue rebates to consumers. The target is 85 percent for large-group issuers.

Brokers had lobbied hard to have their fees exempted from the calculation of administrative costs, which also includes such expenses as marketing and executive salaries, saying that without such a move, commissions will be cut and agents could lose their jobs, leaving consumers without as much access to brokers who help them choose health insurance.

Read the full report at: http://capsules.kaiserhealthnews.org/index.php/2011/12/final-medical-loss-ratio-rule-rebuffs-insurance-agents/

Click here to see the full MLR final rule and a related interim rule or read the HHS fact sheet.

Source: Kaiser Health News

Related Videos
5 experts are featured in this series.
Keith Ferdinand, MD, professor of medicine and the Gerald S. Berenson Chair in Preventative Cardiology, Tulane University School of Medicine
1 expert is featured in this series.
1 expert is featured in this series.
Robin Glasco, Spencer Stuart
Edgardo S. Santos, MD, FACP, FASCO
Related Content
© 2025 MJH Life Sciences
AJMC®
All rights reserved.