Healthcare Business News

Ga. seeks medical-loss ratio waiver

By Jessica Zigmond
Posted: March 16, 2011 - 3:00 pm ET

Georgia has become the latest state to ask HHS for a waiver from the health reform law's requirement that at least 80% of policyholder insurance premium dollars be spent on direct medical costs.

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Georgia Insurance Commissioner Ralph Hudgens said he will request a waiver from the medical-loss ratio standard for 2011, 2012 and 2013 so no harm comes to Georgia residents with health issues who are currently insured in the individual market; so the phase-in period gives insurers time to adjust their business models to compete in the federal system, if it is found constitutional; and to help preserve consumer access to agents or brokers who facilitate the purchase of individual health policies.

“I am concerned that the Obama administration has a fundamental distrust of the role that brokers and agents play in the orderly delivery of health insurance,” Hudgens said in a news release. “It appears to me that the current law is engineered to eliminate the agent from the marketplace by reducing the commissions that can be paid on the sale of a health insurance policy.”

Last week, Maine became the first state to receive such an exemption from HHS. New Hampshire, Kentucky and Nevada still have requests pending with the agency.

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