Industry agent groups are disappointed over a federal decision to include producer commissions as part of non-claims costs within medical loss ratio calculation.
The Department of Health and Human Services released Monday final interim rules for MLR calculations required by the Affordable Care Act. The trade organizations were hoping these regulations would give flexibility to count commissions as a pass-through expense excluded from the MLR calculation.
Instead, agents' and brokers' commissions and fees will be classified as part of insurer costs that count as non-claims expenses — expenditures that are not used to adjust premiums, incurred claims or activities that improve quality care.
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