Health Care Corner: Tips by Monty Dise

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The Affordable Care Act (ACA) requires health insurance companies to adhere to a strict accounting methodology known as the Medical Loss Ratio or “MLR.” MLR requires health insurance companies to spend at least 80 to 85 percent of their premium dollars to reimburse medical provider expenses and to improve the quality of care, leaving 15 to 20 percent to pay their overhead costs. If a carrier’s overhead is higher than the threshold percentage, the carrier is required to send rebate checks back to their customers. Please contact me with any questions.

Monty Dise, President  Asset Protection Group, Inc.  mdise@apgroupinc.com  804-423-7700