IA-HHS Approves MLR Waiver

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Iowa’s Department of Insurance requested an adjustment of the 80 percent MLR to a 60% MLR standard for 2011, 70% for 2012, and 75% for 2013.

Three of Iowa’s dominant issuers (represent 88 percent of individual market), Wellmark, Time and American Family, are not expected to be impacted by the 80 percent MLR standard.

Three smaller issuers in the state could owe rebates in 2011 based on their 2010 financial results--Golden Rule, Coventry, and American Republic--have MLRs of 48 percent to 68 percent. Some or all of these three issuers could be impacted by meeting an 80 percent standard and could withdraw from the market, potentially leaving roughly 15,000 enrollees without coverage.

Iowa was granted an alternative adjustment of 67% for 2011, 75% for 2012, and 80% thereafter.  T