The National Association of Insurance Commissioners filed a letter to Health and Human Services Secretary Kathleen Sebelius on Wednesday, highlighting issues that have come up as they get closer to concluding work on medical loss ratio definitions.

Health care reform promises to change the landscape dramatically for brokers and carriers alike. In fact, many argue that the two need each more than ever before if they're going to survive this brave new world of health insurance.

When it comes to complying with health care reform, meeting medical loss ratio requirements, acquiring and retaining the best risk, establishing cost-effective distribution channels and working with exchanges are U.S. payers' top priorities.