Technical Guidance Regarding Medical Loss Ratio

The agencies issue CCIIO Technical Guidance 2012-002: Questions and Answers Regarding the Medical Loss Ratio regulation.

Document Excerpt

This Bulletin provides MLR guidance on the following topics:

• Applicability of the Medical Loss Ratio to Certain Types of Plans

• Employer Groups of One

• Counting Employees for Determining Market Size

• Individual Association Policies

• Offering Policyholders a “Premium Holiday”

• Reinsurance and Reporting

• Exchange User Fees

• States With a Higher Medical Loss Ratio Standard

 “Mini-Med” Experience – Application of the Adjustment

• Form of Rebate



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