ENSURING VALUE AND LOWER PREMIUMS

[FreakinDJ]

H.R.3200

SEC. 116. ENSURING VALUE AND LOWER PREMIUMS.

(a) In General- A qualified health benefits plan shall meet a medical loss ratio as defined by the Commissioner. For any plan year in which the qualified health benefits plan does not meet such medical loss ratio, QHBP offering entity shall provide in a manner specified by the Commissioner for rebates to enrollees of payment sufficient to meet such loss ratio.

(b) Building on Interim Rules- In implementing subsection (a), the Commissioner shall build on the definition and methodology developed by the Secretary of Health and Human Services under the amendments made by section 161 for determining how to calculate the medical loss ratio. Such methodology shall be set at the highest level medical loss ratio possible that is designed to ensure adequate participation by QHBP offering entities, competition in the health insurance market in and out of the Health Insurance Exchange, and value for consumers so that their premiums are used for services.

http://thomas.loc.gov/cgi-bin/query/F?c111:1:./temp/~c111djd8uq:e28880:

Does this mean they can no longer claim the Army of Health Insurance Co. Beurocrats and Lawyers who work feverishly to Deny Your Claim as "Operatiing Cost"

No wonder the Health Insurance Companies are fighting this so hard

[xchrom]

1. initially -- yes -- but i am confident

that the corporations will work very hard to swamp this.

[FreakinDJ]

3. But would not the Profit/Loss disclosures be public record

and of course as outlined in this section they can only claim actual payouts of medical expenses as losses.

So immediately one would think logical human beings would begin rating Health Insurance Cos. by their "Profit/Loss Ratio"

[strategery blunder]

2. Or just "persuade" the appointment of an insurance toadie for Commissioner.

You know, kind of how like Wall Street got Geithner in.

The Commissioner then defines a medical loss ratio requirement that is so low as to be meaningless.