If you love lingo, acronyms, transparency and perhaps a bit of jargon, then this post may be for you. If you love not getting screwed by insurance companies, then this post is definitely for you.
Let the health care reform wonkiness begin!
Short version: new rules announced today will require insurance companies to spend at least 80 to 85 of your health insurance premiums on actual medical care. Rather than spending a ton of money on administrative costs, executive salaries, overhead and marketing or hording profits, insurance companies now have to spend money on direct care for patients and efforts to improve care quality. And if they don’t, you get a rebate.
This is happening because of the health care reform law that passed this year.
Long version: Re-read the short version. And for the jargon and acronym lovers, this regulation is called “medical loss ratio” or MLR. According to the Department of Health and Human Services (HHS!), the MLR regulation outlines disclosure and reporting requirements, details how insurance companies will calculate their MLR and provide rebates, and how changes can be made to the MLR standard to guard against market destabilization. So starting in 2011, we be able to see how insurance companies spend the money you pay on premiums.
Finally, MLR is fine as a name (and sounds great as a concept), but couldn’t HHS have called this regulation the “Spend My Health Care Money on Actual Health Care or Give Me My Money Back” rule, even if SMHCMOAHCOGMMMB is a bit of a mouthful? Just a thought.




