NAIC Definition of Small Group Plans An Issue in Medical Loss Ratio Deliberations

How expansively small group health insurance plans are defined is a major issue to be decided by state insurance regulators during an upcoming Oct. 14 conference call.

A decision to define small group plans to include more employees would result in insurers spending a smaller share of premium dollars on medical expenses than they would have to otherwise.

At an Oct. 4 conference call meeting, several National Association of Insurance Commissioners’ work groups approved standards for the so-called medical loss ratio that would define small group plans as having up to 50 employees. Under the medical loss ratio provision of ...