Returning the premium for payment over the MLR should be done though Pre-Tax bank accounts and the funds directed into these accounts to be used for contributions, cobra payments, co-pays, deductibles and all IRS approved FSA expenses.
If the funds go in pre-tax, they should be returned to the contributor on a pre-tax basis into these accounts.
To suggest that an employer could use these funds in the future is potentially taking a terminated employees contribution and applying it towards a new hire's premium, which should be illegal.
The employer would not have to allocate this in any way but back into this side account that each individual would have via payroll.
This is fair and just and less confusing than what has been offered as a suggestion.
Lastly, please read my comments on Essential Beneifts, which explains the idea of 6 different plans (A-F) so individuals do not have to purchase covered for EVERYTHING, but only what they believe they need and can afford. Also features a chart with financial incentives for Health lifestyles and Preventive Well Visits reducing premium.
There is also a document on Safe Harbor and the most important, a document submitted at the Federal Plaza meeting in NYC on The Role of the Agent and Broker, with many issues addressed under the PPACA.
Thank you,
Gail HIller-Lee
NAIFA-NYS Working Committee on Healthcare
This is comment on Rule
Medical Loss Ratio Rebate Requirements for Non-Federal Governmental Plans
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