11/8/11 HHS/The Center for Consumer Information and Insurance Oversight (CCIIO) approved Georgia's request for a waiver which will allow insurers in the state to phase in the ACA's medical loss ratio (MLR) requirements.

The ACA allows the Secretary to adjust the medical loss ratio (MLR) standard for a state if it is determined that meeting the 80% MLR standard may destabilize the individual insurance market. In order to qualify for this adjustment, a state must demonstrate that requiring insurers in its individual market to meet the 80% MLR has a likelihood of destabilizing the individual market and result in fewer choices for consumers. As part of the ACA, if insurers fall short of the standards in 2011, they'll have to issue rebates for that amount in 2012.  

The Georgia Department of Insurance requested an adjustment of the MLR standard to 65%, 70%, and 75% for 2011, 2012, and 2013, respectively. HHS determined it will phase in the spending requirements in Georgia, though not at the same levels the state requested, adjusting the rates in 2011 and 2012 but requiring the 80% statutory standard beginning in 2013. Georgia is the 6th state to be granted such a waiver. HHS has approved waivers for five other states including Iowa, Kentucky, Maine, Nevada, and New Hampshire. In July HHS denied North Dakota's request for a waiver. In September HHS denied Delaware's request. The other states that have applied and are awaiting determinations include: Kansas, Indiana, Louisiana, Florida, Michigan, Texas, Oklahoma, North Carolina and Wisconsin.

For more information on states and the MLR requirements visit the Center for Consumer Information and Insurance Oversight (CCIIO) website at: http://cciio.cms.gov/programs/marketreforms/mlr/index.html 

11/7/2011 In a report released by the Treasury Inspector General for Tax Administration, as of mid-May 2011, only 228,000 of an estimated 4.4 million eligible taxpayers claimed the Small Business Health Care Tax Credit. The credit, created under §1421 of the ACA, is available to small businesses that pay at least one-half of the cost of health insurance coverage for their employees. The IRS has stated that it plans to hold focus groups to understand why the claiming rate was so low. In Massachusetts, 74.1% of all small businesses were eligible for the tax credit in 2010. This represents approximately 81,300 small businesses. The Treasury Report does not include state specific numbers of businesses that have claimed the tax credit. 

For the Treasury report, click here: http://www.treasury.gov/tigta/auditreports/2011reports/201140103fr.pdf.