{[ promptMessage ]}

Bookmark it

{[ promptMessage ]}

Pay its customers medical claims and activities that

Info iconThis preview shows pages 2–3. Sign up to view the full content.

View Full Document Right Arrow Icon
pay its customers' medical claims and activities that improve the quality of care; the company has a medical loss ratio of 80%. A medical loss ratio of 80% indicates that the insurer is using the remaining 20 cents of each premium dollar to pay overhead expenses, such as marketing, profits, salaries, administrative costs, and agent commissions. The Affordable Care Act sets minimum medical loss ratios for different markets, as do some state laws”. So this Law is going to essentially force the payers on the insurance policies to provide 80% of payments for medical services paid directly on behalf of the member with the intention of improving the quality of care. Payers who focus their attention on larger groups have a requirement of spending 85% towards quality and care enhancements for the member. The Affordable Care Act laws do not apply to grandfathered or self-insured policies. The healthcare Act has its good and bad points. The legislator helped bring this law to life because this branch can create new rules, and rid of those that are not necessary. The Act has a
Background image of page 2

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Image of page 3
This is the end of the preview. Sign up to access the rest of the document.

{[ snackBarMessage ]}