The Center for Consumer Information and Insurance Oversight is giving health insurers advice that could cut the insurers' earnings this year and increase the size of the rebate checks going out to enrollees.
Teresa Miller, acting director of the CCIIO oversight group, issued her advice — contained in CCIIO Technical Guidance (CCIIO 2013-0003) – after looking at how insurers should handle fees related to the Patient Protection and Affordable Care Act when they are calculating PPACA medical loss ratios and MLR rebate payment amounts.
The PPACA requires health insurers to spend at least 85 percent of large-group health insurance revenue and 80 percent of individual and small-group health insurance revenue on health care or quality improvement efforts or else make up the difference by sending rebates to the enrollees.
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