State wins health insurance provision waiver
Federal officials have granted Maine's request to waive a provision of the health care reform law that would direct how insurance companies spend policyholders' premiums.
Insurance Superintendent Mila Kofman last July asked the federal Department of Health and Human Services to waive the provision that requires 80% of health insurance premiums be spent on patient care, an increase over Maine's requirement of 65%. Kofman argued the provision could lead MegaLife Insurance, just one of three companies offering individual premiums in Maine, to pull out of the state's individual market. The decision from DHHS Administrator Steven Larson waives the modification to the medical loss ratio until the end of 2013, according to the Bangor Daily News. MegaLife covers about 14,000 Mainers.
The new medical loss ratio is part of the Affordable Care Act and goes into effect for policies written or renewed this year, and also includes an 85% loss ratio for large group plans.
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