The Affordable Care Act’s Medical Loss Ratio (MLR) requirements passed on November 22, 2010 in accordance with The National Association of Insurance Commissioners (NAIC) and the Department of Health and Human Services (DHHS).

If Medical Loss Ratios are not adhered to there will be ramifications –this affects all plans, including yours…

Those plans that fail to meet the MLR mandates will be required to rebate their members the difference.

MLRs require health plans to report yearly to the DHHS, detailing what percentages of their premium go towards three critical areas - clinical services, quality initiatives and all other non-claims costs. In preparation for 2010, health plans in the individual and small group market must spend 80 percent of their premium dollars on health care and quality endeavors.

Attend this Summit to learn critical information pertaining to the requirements and key tactics to help prepare your plan for the transition:

• Breakdown MLRs percentages state by state
• Define what constitutes as quality and care initiatives versus non-claim costs
• Best methods for avoiding fraud due to changing guidelines
• Review the role of small, expatriate and mini-med plans
• Hear what others in the industry are doing to prepare and adjust to the requirements
• Strategies for collecting, analyzing and presenting mandated data
• Who owns the MLR process in the organization?
• Integrating departments for consistent measures
• How will quality scores impact this realm? 
• Identifying additional product lines to supplement for profit loss