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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-
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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,
continued on page 5
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