The Department of Health and Human Services (“HHS”) issued a bulletin on November 5, 2010 stating it will promulgate regulations “in the near future” that will include a special methodology for applying the Patient Protection and Affordable Care Act’s (PPACA’s) medical-loss ratio requirements to limited benefit health plans (“mini-med plans”). Starting in 2011, PPACA requires small group and individual insurance plans to spend at least 80 percent of the premiums collected on medical claims or quality improvements, and large group plans to spend at least 85 percent. Plans that spend less than those amounts will have to refund the difference to policyholders beginning in 2012. According to the bulletin, the methodology will apply at least through 2011.
17 Nov '10