Not affiliated with The United States Office of Personnel Management or any government agency

Not affiliated with The United States Office of Personnel Management or any government agency

MEDICAL LOSS RATIO

MEDICAL LOSS RATIOThere are often words and phrases tossed about when we hear talk of benefits and other things that matter to us we don’t completely understand.  Medical Loss Ratio is one of those items very important in understanding overall our Federal Employees Health Benefits (FEHB) Plan.  According to the Centers for Medicare

and Medicaid Services (CMS), many insurance companies spend a large portion of premium fees paid by consumers on administrative concerns such as executive salaries, perks, overhead and marketing.

The Affordable Care Act (ACA) is requiring more accountability and transparency from insurance companies.  The Act requires that insurance companies meet a minimum spending standard on medical care or provide rebates to their enrollees when they fail to meet the standard.

The largest portion of the premium paid mandates that spending is for clinical services and quality improvement where 80 percent at a minimum or 85 percent of the premium is spent on medical care.  Again, failing to meet that standard will compel  insurance companies to make rebates to consumers.  The provision rebate became effective in 2012.  Insurance companies  also due to the Act are held to stricter regulations when it comes to premium increases passed on to consumers.

P. S.  Always Remember to Share What You Know.

Dianna Tafazoli

Here is my Bio details:
Prospective clients will hire the best,
most credible professional they can find.

The more Expertise and Authority you demonstrate,
the more Trust you will earn, the more business you will win.

Contact John Faith

Search for Public Sector Retirement Expert.

Receive the Best advice.

PSR Experts can help you determine if Public Sector Retirement is right for you or if you should look for alternatives.

The Best Advice creates
the best results.

Recent Articles

More Articles by John Faith

ORGANIZATIONS THAT GIVE DISCOUNTS TO VETERANS

ORGANIZATIONS THAT GIVE DISCOUNTS TO VETERANS – by Dianna Tafazoli We can never think of enough ways to honor Veterans...

New Orleans

NEW ORLEANS IS CLEANING HOUSE – by Dianna Tafazoli

Image Credits New Orleans Mayor Mitch Landrieu decided with a vote from the New Orleans City Council on December 17,...

retirement benefits

INTRODUCING MR. CYBER SECURITY by Dianna Tafazoli

Clifton Triplett is the Cyber Advisor in the Office of Personnel Management. Mr. Triplett comes from SteelePointe Partners, a global...

Search For Public Sector Retirement Expert

Receive the Best advice.

PSR Experts can help you determine if
Public Sector Retirement is right for you or if you should
look for alternatives.

The Best Advice creates

the best results.

Subscribe to our Newsletter

"*" indicates required fields

Our Readers Deserve The Best PSHB and USPS Health Benefits Guidance

Licensed insurance agents who understand PSHB, Medicare, and USPS Health Benefits Plan are encouraged to apply for a free listing.

This field is for validation purposes and should be left unchanged.

Book Phone Consultation

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Get In Touch

Stay up to date on the latest information about Public Sector Retirement.

The Best Advice Creates The Best