Press Release

Florida Insurance Commissioner Kevin McCarty along with lead regulators from other states voted unanimously to approve the National Association of Insurance Commissioners' (NAIC) recommended language (blanks proposal) for the Medical Loss Ratio (MLR) definition under the federal Affordable Care Act on Tuesday, August 17. Due to the definition of medical expenses, health insurance agent premiums were not included in the definition of medical losses. Commissioner McCarty has expressed serious concerns that an immediate adoption of the MLR ratios without accommodating the needs of health insurance agents will negatively impact the selection process for health insurance in the small group and individual markets.

 

Commissioner McCarty co-sponsored a resolution that was adopted by the NAIC demonstrating the NAIC's commitment to keeping agents as an integral part of the health insurance selection process for small businesses and individuals. (See: OIR – August 17 News Release). In addition, Florida also sponsored a charge adopted by the Health Insurance and Managed Care (B) Committee, instructing the NAIC to continue to work on other methods, possibly through a model law or statute, that will retain the role of health insurance agents within the framework of the federal law, and within the framework of the MLR definition.

 

Even though the Office is coordinating its efforts with the NAIC, the Office is not waiting for the NAIC to take action. Florida has been proactive in considering legislative changes prior to action on the national level.  In May 2010, the Office along with the Florida Health Insurance Advisory Board, conducted a public hearing in Orlando on the MLR issue. The Office has scheduled another hearing on the MLR issue in Tallahassee for September 24. The Office intends to take information from this hearing to craft legislation that preserves the role of health insurance agents in Florida.

 

The process of implementation is ongoing. Although the NAIC has adopted recommended MLR language -- the most pivotal question is the implementation date, not the actual language. The NAIC is in the process of writing a letter to the Secretary of Health and Human Services (HHS) recommending a three-year transition period for implementing the MLR standards under the federal law to minimize disruption in the marketplace. The Commissioner supports this transition period.  A transition period may also give the NAIC and HHS (and the state of Florida) time to adequately resolve the health insurance agent issue prior to full implementation of the MLR standards.