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Health and Human Services Not Budging on Medical Loss Ratio

Health and Human Services Not Budging on Medical Loss Ratio

The U.S. Department of Health and Human Services has informed the Florida Office of Insurance Regulation that it will not reverse its decison to impose a medical loss ratio requirement of 80% on health insurers.  The Florida Office of Insurance Regulation has been concerned for many months that imposing this medical loss ratio will be damaging to Florida’s health insurance market, hurting agents and threatening the availability of coverage options.  The OIR urged the Department of Health and Human Services to rethink the way it calculates the medical loss ratio or to phase in its requirements.  The agency denied that request, OIR followed by filing an appeal.  The appeal, however, met the same fate as the initial request–  the Department of Health and Human Services sent a letter last week expressing its view that Florida has not demonstrated the ratio would hurt the insurance market or limit access to agents.   Accordingly, the agency informed the OIR that it will not modify its prior decision.