Pay its customers medical claims and activities that

Info icon This 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
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 ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern