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Administration seeks comments to get ready for health reform expense ratio and related regulations


The Departments of Labor, Treasury and Health and Human Services have issued a Federal Register notice requesting public comment on a series of questions concerning new Section 2718 of the Public Health Service Act, enacted as part of the Patient Protection and Affordable Care Act which became law on March 23rd.

The questions involve new requirements requiring reporting of individual and group market expense ratio information by insurance carriers, payment of rebates to enrollees if an issuer's clinical and quality improvement expense ratios do not satisfy statutory thresholds and establishment of key definitions required for administration of the new requirements. Another provision conditions qualification of certain non-profit health insurers for special tax deductions on the insurer maintaining a specified ratio of claim services reimbursement to total premium revenue.

The notice seeks public comment on a broad range of questions about current industry and state regulatory practices bearing on the subjects addressed by the new legislative requirements and also solicits comments on any issue under Section 2718 that commenters wish to address. Comments are due by May 14th.

Please contact for more information.