I received notification from my Health Maintenance Organization (HMO) regarding Medical Loss Ratio. It informed me that I do not qualify for the refund based on the Medical Loss Ratio requirement. I received this notice based on compliance with the federal health care reform legislation.
The Affordable Care Act – “Obamacare” – requires health insurers in the individual and small group markets to spend at least 80 percent of the premiums they receive on health care services and activities to improve health care quality (in the large group market, this amount is 85 percent). This is referred to as the Medical Loss Ratio – MLR rule or the 80/20 rule. If a health insurer does not spend at least 80 percent of the premiums it receives on health care services and activities to improve health care quality, the insurer must rebate the difference.
Attorney General Rob McKenna participated in a lawsuit to overturn the Affordable Care Act. This shows his disdain for the majority of Washingtonians, especially those with pre-existing medical conditions, women with reproductive health issues and children who are now able to receive extended coverage through their parents’ insurer. McKenna intends to be compliant with the national tea party agenda. Wake up, Washington.