Bookmark and Share

April 2011 St@teside

New Hampshire's and Nevada's Applications for Medical Loss Ratio Waiver Completed

New Hampshire and Nevada began their application process for a medical loss ratio (MLR) waiver on January 12 and February 9, respectively. The U.S. Department of Health and Human Services (HHS) deemed New Hampshire’s application complete on March 14 and Nevada’s on April 25.

The public has submitted comments on New Hampshire’s MLR standard waiver to HHS. A decision is expected no later than mid-May.

In his letter, the New Hampshire Insurance Commissioner Roger Sevigny, requested that HHS lower the state’s MLR requirement to 70 percent through 2014. Currently the MLR for the individual market is 65 percent. New Hampshire’s request is based on these facts:

  • the state’s individual market is dominated by a single insurance carrier;
  • the size of the individual market makes it unattractive to insurance carriers; and
  • several of the smaller carriers stated their intention to refrain from participating in the market when New Hampshire’s Insurance Department issued a Bulletin prohibiting carriers in the individual market from refusing to issue child-only individual health insurance plans.

In response to the state’s application, consumer groups as well as the New Hampshire Hospital Association have submitted letters in opposition to the state’s request for a waiver to the 80 percent MLR standard. The letters express doubt that the implementation of the 80 percent MLR standard requirement would destabilize the individual market, as the New Hampshire application warns. Furthermore, the letters note that the 80 percent MLR standard is needed to incentivize insurers to provide their customers a better value for their premium dollar. The New Hampshire Hospital Association’s letter urges HHS to provide an incremental phase-in of the MLR standard, if the agency decides to grant the waiver request.

On March 8, Maine became the first state to be granted a waiver from the MLR standard. Seven other states and one territory have also submitted applications for a waiver from the MLR standard; they are: Florida, Georgia, Guam, Iowa, Kentucky, Louisiana, Nevada, and North Dakota.