Medical Loss Ratio and Rebate Calculations

Submitted by Administrator on Thu, 04/19/2012 - 3:22pm

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Course Title: Medical Loss Ratio and Rebate Calculations

Description: Comprehensive discussion of the MLR and rebate calculation Annual Reporting Form for Plan Years 2011, 2012 and 2013.

Topic: NAIC and Federal reporting requirements under the Patient Protection and Affordable Care Act (PPACA)

Level: Update

CPE Credits: 2.0 hours

Prerequisites: None, although an understanding of the NAIC Supplemental Health Care Exhibit would be helpful.

NASBA publication/revision date: March 2012

Learning Objectives:

Upon successful completion, the learner should:

  • Be aware of the NAIC Model Regulation for Uniform Definitions and Standardized Methodologies for Calculation of the Medical Loss Ratio for Plan Years 2011, 2012 and 2013 per Section 2718 (b) of the Public Health Service Act
  • Be aware of the relevant provisions of the Department of Health and Human Services’ rules implementing the Medical Loss Ratio (MLR) and rebate requirements under the Patient Protection and Affordable Care Act (PPACA)
  • Have an understanding of how to complete the Centers for Medicare & Medicaid Services (CMS) MLR annual reporting form and calculate the applicable rebates for comprehensive health plans

Outline:

  • Course content and learning objectives
  • Overview of the Patient Protection and Affordable Care Act's Medical Loss Ratio (MLR) Requirements
  • NAIC MLR/Rebate Model Regulation
  • HHS Regulations and Other Resources
  • Levels of Aggregation for MLR Calculations
  • Details of the MLR and Rebate Calculation Forms for 2011 through 2013
    • Data carried from the Supplemental Health Care Exhibit
    • Items included in the MLR numerator and denominator
    • Claims development in the forms
    • Credibility adjustments
    • Multi-year experience in the 2012 and 2013 calculations
    • Rebate calculations
  • Payment of the Rebates

DateTimeCost
May 17, 201211:00AM$200 (first attendee)
$180 (each additional attendee)		Webinar already held.
(Registration closes 2 hours prior to the starting time.)

Note: All times are US Eastern. What time is it now?.


System Requirements:
  • Windows 95 or Higher
  • Internet Explorer 5.0 or Higher
  • 800 x 600 or higher screen resolution
  • Macromedia Flash Player 5 or Higher
  • Acrobat Reader