Small Businesses Demand Value for Premiums

One of the key provisions of the Affordable Care Act passed in 2010 was something called a minimum Medical Loss Ratio (MLR) requirement. This requirement establishes a basic level of value for premiums. Insurers either meet that standard or, if they fail to, owe rebates to their customers.

If this requirement had been in effect in 2010, health insurance customers would have received rebates of almost $2 billion from insurers who failed to meet the value for premiums standard. That’s some serious money back in the pockets of small business owners who've paid too much for health care – and a serious incentive for insurers to hold premiums down and increase value in the future.

Predictably, these new requirements have come under attack by industry groups that want to roll them back and allow insurers to continue doing "business as usual." The latest attack is an attempt to remove agent and broker commissions and fees from the value for premiums calculation.

What would that mean for small businesses? This change would wipe out $1.2 billion – more than half – of the potential rebates in the 2010 estimates. And, it would undermine the incentive for insurers to hold premiums down going forward.

The Main Street Alliance submitted a letter to a task force of the National Association of Insurance Commissioners (NAIC) on June 28 outlining the small business case for protecting the value for premiums requirement and implementing the new minimum medical loss ratio standards without changes.

Read MSA’s letter here