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Medical Loss Ratio

Kentucky Request for an Adjustment of the Medical Loss Ratio Standard

The Affordable Care Act allows the Secretary to adjust the medical loss ratio standard for a State if it is determined that meeting the 80 percent medical loss ratio standard may destabilize the individual market.  In order to qualify for this adjustment, a State must demonstrate that requiring insurers in its individual market to meet the 80 percent MLR has a likelihood of destabilizing the individual market and could result in fewer choices for consumers. This page contains materials related to this State’s application for an adjustment to the MLR standard for the individual market. 

A State’s request for an adjustment to the MLR standard is a public document.  The Secretary invites public comment regarding a State’s request.  All public comments must be submitted electronically by midnight on the 10th calendar day after the posting of a complete State request. When the application is deemed complete, the webpage will be updated to reflect the deadline for public comment on the State’s application.  

To submit a comment regarding this adjustment application, please email MLRAdjustments@hhs.gov.  Please include Kentucky in the email subject line.

State:   Kentucky

Application Status:     undergoing review for completeness

Comments Due:          TBD

Application Materials:

Persons using assistive technology may not be able to fully access information in this file. For assistance, please email MLRAdjustments@hhs.gov.

  • MLR Adjustment Request
    This document contains Kentucky’s request to adjust the MLR standard to 65 percent, 70 percent, and 75 percent in 2011, 2012, and 2013, respectively (received by HHS on 02/16/11).
  • Enrollees, Premium, and Market Share Information
    This file contains information on number of enrollees, premiums earned, and individual market share by issuer in the Kentucky individual market (received by HHS on 02/16/11).
  • Financial Information by Issuer
    This file contains financial information on three issuers in the Kentucky individual market (received by HHS on 02/16/11).
  • Dale Hyers Opinion
    This file contains the expert opinion of Dale Hyers, a consultant to the Kentucky Department of Insurance, regarding the implementation of the 80 percent MLR standard in Kentucky’s individual market (received by HHS on 02/16/11).
  • American Academy of Actuaries Letter
    This file is an April 28, 2010 letter from the American Academy of Actuaries Medical Loss Ratio Regulation Work Group to the NAIC regarding potential disruption of individual markets (received by HHS on 02/16/11).
  • Issues Regarding Minimum Loss Ratios
    This file is a February 2010 issue document regarding minimum loss ratios written by the American Academy of Actuaries (received by HHS on 02/16/11).
  • Rate Filing Requirements
    This file describes Kentucky’s health benefit plan rate filing requirements (received by HHS on 02/16/11).
  • Commissioner’s Rate Filing Approval Authority
    This file describes the Kentucky Commissioner’s authority to approve or disapprove rate filings (received by HHS on 02/16/11).
  • Renewal or Continuation Requirements
    This file describes Kentucky’s renewal or continuation requirements for health benefit plans (received by HHS on 02/16/11).
  • Premium Rate Guidelines
    This file describes the premium rate guidelines for individual, small group, and association plans in Kentucky (received by HHS on 02/16/11).
  • Kentucky Access Premiums
    This file describes how premium rates under the Kentucky Access program are established (received by HHS on 02/16/11).
  • Kentucky Access Eligibility
    This file describes how eligibility for the Kentucky Access program is determined (received by HHS on 02/16/11).
  • History of Kentucky Health Insurance Market
    This file describes the history of Kentucky’s accident and health insurance market since 1990 (received by HHS on 02/16/11).
  • Kentucky Health Insurance Market Report – Part 1
    This file contains part 1 of 3 of the Kentucky Department of Insurance’s 1997 Market Report on Health Insurance (received by HHS on 02/16/11).
  • Kentucky Health Insurance Market Report – Part 2
    This file contains part 2 of 3 of the Kentucky Department of Insurance’s 1997 Market Report on Health Insurance (received by HHS on 02/16/11).
  • Kentucky Health Insurance Market Report– Part 3
    This file contains part 3 of 3 of the Kentucky Department of Insurance’s 1997 Market Report on Health Insurance (received by HHS on 02/16/11).