The Insurance Record - November 4, 2010

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THE VOICE OF TEXAS INSURANCE RE C O R D INSURANCE

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WASHINGTON—During a joint session on Oct. 21, the executive and plenary committees of the National Association of Insurance Commissioners (NAIC) voted to adopt a model regulation containing the definitions and methodologies for calculating medical loss ratios as required by the Patient Protection and Affordable Care Act (PPACA).

Happy With Their Work
“I commend the work of our regulators and staff as we
considered a number of very challenging issues [moving]
through the committee process. The committee model reg-
ulation on MLR passed with only technical amendments,
which is a testament to our inclusive and transparent pro-
cess,” said Jane L. Cline, NAIC president and West Virginia
insurance commissioner. “It is with a great deal of pride we
present these recommendations to the secretary.”

Required Recommendations

The PPACA signed into law on March 23, 2010, requires that beginning in 2011, insurance companies meet new medical loss ratio requirements designed to ensure that premium dollars go to health care. The law requires that the NAIC provide recommendations for the definitions and calculations of these ratios to HHS by Dec. 31, 2010.

NAIC: Not My Job

In coordination with the anticipated completion of the mod- continued on page 20

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In This Issue

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AUSTIN—Texas Mutual Insurance Co. announced that a Travis County district court sentenced Joffrey Majors of Parker, Texas, on workers’ compensation fraud-related charges. The court sentenced Majors to four years’ deferred adjudication and ordered him to pay $100,000 to Texas Mutual.

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by Jerry LeCompte

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Majors operated Ameripro Drivers LLC, a temporary employment agency in Dallas. Majors was involved in a scheme to conceal the number of employees and annual payroll of Ameripro Drivers LLC from Texas Mutual.

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Because workers’ compensation insurance premium is based in part on payroll,

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