Login or Sign Up To Comment

ZIP Code: 
Related Topics

Bill - HR3200

This Document was obtained from The Library of Congress Thomas System as of July 14th, 2009

SEC. 116. ENSURING VALUE AND LOWER PREMIUMS.

[a] In General- A qualified health benefits plan shall meet a medical loss ratio as defined by the Commissioner. For any plan year in which the qualified health benefits plan does not meet such medical loss ratio, QHBP offering entity shall provide in a manner specified by the Commissioner for rebates to enrollees of payment sufficient to meet such loss ratio.

[b] Building on Interim Rules- In implementing subsection [a], the Commissioner shall build on the definition and methodology developed by the Secretary of Health and Human Services under the amendments made by section 161 for determining how to calculate the medical loss ratio. Such methodology shall be set at the highest level medical loss ratio possible that is designed to ensure adequate participation by QHBP offering entities, competition in the health insurance market in and out of the Health Insurance Exchange, and value for consumers so that their premiums are used for services.

Table of Contents >>>