HHS-MLR Interim Final Rule

Bookmark and Share

The ACA requires that carriers covering large employers spend at least 85 percent of premiums paid on claims or quality improvements, and carriers covering small group and individual insurers spend 80 percent, or refund the difference to policyholders, beginning in 2012. However, the ACA gave the Kathleen Sebelius, Secretary of Health and Human Services (HHS), the authority to waive the requirement if states can demonstrate that fulfilling it would destabilize the individual market. On December 1, 2010, HHS published an interim final rule, giving states the opportunity to apply for waivers.