Posted on 29 Mar 2011
The National Association of Professional Insurance Agents (PIA) has endorsed the Access to Professional Health Insurance Advisors Act of 2011 (H.R. 1206) sponsored by Reps. Mike Rogers (R-Mich.) and John Barrow (D-Ga.). The legislation clarifies that producer compensation will not be considered as part of medical loss ratio (MLR) calculations under the healthcare reform law enacted last year.
Preliminary regulations issued by the federal Department of Health and Human Services (HHS) counted producer compensation within medical loss ratio (MLR) calculations, administrative expenses limited to 15% or 20% under the Patient Protection and Affordable Care Act (PPACA). This action threatens the ability of consumers to utilize the services of licensed professional insurance agents as they navigate the complexities of a health insurance system that is undergoing significant changes. It also undermines congressional intent.
“Congress specifically included licensed health insurance agents and brokers as an integral part of the healthcare delivery system under PPACA,” said PIA National Director of Federal Affairs Mike Becker. “PIA believes that HHS should not be permitted to exclude agents from the marketplace through regulation, especially when the underlying legislation specifically included agents. H.R. 1206 fixes this by specifically removing agent and broker compensation from MLR calculations.”
“Purchasing health insurance is not like purchasing other products and services,” PIA stated in comments filed for a March 27 hearing by the National Association of Insurance Commissioners (NAIC). “If you make a poor choice, you may not be aware of the consequences of your decision until it’s too late. Many consumers who will be most negatively affected by the loss of licensed, trained health insurance agents are the elderly and small business owners who don’t fully understand all the options available to them.”
PIA members from around the country will urge lawmakers to pass H.R. 1206 during their annual Federal Legislative Summit March 30-31 in Washington, D.C.