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PIA Healthcare Priority Introduced

With the reform of the Affordable Care Act stalled, PIA has been working to address issues related to healthcare that have been detrimental to independent agents, particularly agent compensation...
December 11, 2017

With the reform of the Affordable Care Act (ACA) stalled, PIA has been working to address issues related to healthcare that have been detrimental to independent agents, particularly agent compensation.

The ACA implemented a requirement called the medical loss ratio (MLR). The MLR is designed to limit the amount that a health insurance company can spend on administrative costs. PIA agrees with this goal; however, the MLR requirement has been interpreted in a way that has resulted in unstable reductions to agent compensation. As a result, many agents have been forced out of the health insurance market, leaving consumers without guidance in selecting health plans.

To address this issue, PIA has been working with the U.S. Department of Health and Human Services (HHS) to exempt agent compensation as an administrative cost in the MLR formula. Our efforts were delayed with the resignation of Tom Price as HHS secretary, but we’ve recently been working with allies to address this through the regulatory process.

At the same time, PIA has also been working to have reintroduced legislation we’ve supported in previous years, the Access to Professional Health Insurance Advisors Act. On Dec. 7, Rep. Billy Long (R-MO) introduced such legislation, H.R. 4575, to exempt agent compensation from the administrative portion of the MLR formula. PIA National sent a letter of support to Rep. Long. We expect Senate legislation to be introduced as well in the coming weeks.

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