Monday, July 25, 2011

Iowa Receives Federal Waiver for

Medical Loss Ratio Implementation

Companies allowed adjustment in target numbers

(DES MOINES) July 25, 2011– Iowa received a response on Friday, July 21 to its request

for a waiver allowing an adjustment to some transitional Medical Loss Ratio (MLR)

provisions of the Affordable Care Act in Iowa.

The response from the Department of Health and Human Services (HHS) was that the

request was granted, although with a modification of the proposed target proposed by

Insurance Commissioner Susan Voss when she made the request.

The original request had been for a 2011 standard of 60% MLR standard to be used, but

the HHS response instead sets the standard to be Medical Loss Ratio (MLR) standard to

be met in 2011 as 67% of premium, and in 2012 as 75% of premium. The final standard

of 80% will be implemented in 2013 and beyond. The adjustment was requested and

granted in recognition of the inability of some Iowa companies selling individual policies

to remain in the market under the initial requirements.

The complete letter from HHS granting the waiver can be found here.

About the Iowa Insurance Division

The Iowa Insurance Division (IID) has general control, supervision and direction over all

insurance and securities business transacted in the state, and enforces Iowa’s laws and

regulations. The IID investigates consumer complaints and prosecutes companies,

agents and brokers engaging in unfair trade practices. Consumers with insurance or

securities‐related questions or complaints may contact the IID toll free at 877‐955‐1212

or visit the division on the web at