January 9, 2012
In This Issue
Supreme Court Gets Busy
HHS Denies Two More State MLR Waiver Requests
New Guidance Released For Employers on Health Benefit Informational W-2 Reporting
HHS Announced Final Limited Medical Benefit Plan Waiver Totals
Capitol Conference 2012
Professional Development Survey
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HHS Denies Two More State MLR Waiver Requests

Last week, HHS told two more state insurance departments, those in Kansas and Oklahoma, that their requests for adjustments to PPACA’s medical loss ratio (MLR) standards for individual market insurers were denied. Ten states or jurisdictions have now had their MLR adjustment requests turned down by the federal government. Waiver petitions by insurance commissioners from Delaware, Florida, Guam, Indiana, Louisiana, Michigan and North Dakota were all turned down by HHS in 2011.  

The only state to receive the exact adjustment it requested to date is Maine, which was the first state to apply for one in 2010.HHS also approved modified adjustment requests for Georgia, Iowa, Kentucky and Nevada earlier in 2011. However, the federal government has not approved any state adjustment requests since the National Association of Insurance Commissioner voted on November 22 to formally ask both HHS and Congress to modify PPACA’s MLR requirements to accommodate producer compensation arrangements.  HHS has yet to make a determination on adjustment requests submitted by North Carolina, Texas and Wisconsin earlier last year. The states of Florida and Louisiana are both currently in the process of appealing their adverse waiver determination decisions. 

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