Insurance agents, brokers shouldn't be except from MLR

Sen. Jay Rockefeller (D-W. Va.) has joined a growing number of people calling on the nation's insurance commissioners to oppose draft legislation that would exempt insurance agents from new restrictions on administrative spending, reports The Hill’s Healthwatch.

Insurance agents and brokers are currently lumped into administrative expenses when calculating the medical-loss ratio, but the NAIC has proposed legislation that would count them toward care dollars.

The National Association of Health Underwriters and Florida Insurance Commissioner Kevin McCarty are lobbying NAIC members to endorse the exemption, reports the New York Times Prescriptions blog. While NAHU has presented its proposal to the NAIC and others as a simple "administrative" fix, Rockefeller says, it would actually make an unprecedented change to the method NAIC and the health insurance industry use to calculate medical-loss ratios.

He said he shares NAIC's "appreciation for the valuable work that licensed insurance agents and brokers do on behalf of their customers," and "recognizes the valuable role agents and brokers play in helping American consumers and businesses purchase health insurance." But "I cannot support a proposal that would allow agents, brokers and health insurance companies to retain the estimated $1 billion in benefits that American consumers will receive next year thanks to the health care reform law," Rockefeller says.

The purpose of the MLR provision is to encourage insurers to deliver healthcare services to customers in a more efficient and cost-effective way. Rockefeller added that he's encouraged that the health reform law is prompting many insurers that were previously not meeting these targets to conduct a long-overdue review of their business operations and make changes that will result in higher-quality care and lower premiums for their customers, reports the National Underwriter.

To learn more:
- read The Hill’s Healthwatch story
- see the New York Times blog
- view the National Underwriter piece

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