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Medical Loss Ratio

Iowa Request for an Adjustment of the Medical Loss Ratio Standard

The Affordable Care Act allows the Secretary to adjust the Medical Loss Ratio (MLR) 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. 

State: Iowa

Application Status: HHS determination issued

Application Determination: 

Application Materials:

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

  1. MLR Adjustment Request (PDF – 270 KB)
    This document contains Iowa’s request to adjust the MLR standard to 60 percent, 70 percent, and 75 percent in 2011, 2012, and 2013, respectively (received by HHS on 03/21/11).
  2. HHS Request for Additional Information (PDF – 30 KB)
    This document is an April 19, 2011 letter from the Acting Director of the Office of Oversight to Iowa requesting additional information in order for Iowa’s application to be deemed complete.
  3. HHS Follow-up Letter (PDF – 27 KB)
    This document is an April 19, 2011 letter from the Acting Director of the Office of Oversight to Iowa requesting additional information regarding Iowa’s application, which is separate and distinct from the request for information for completeness.
  4. Iowa Response to HHS Request for Additional Information (PDF – 204 KB)
    This document is a letter from Iowa to the Acting Director of the Office of Oversight with responses to CCIIO’s April 19, 2011 letter requesting additional information (received by HHS on 05/06/11).
  5. Iowa Response to HHS Follow-up Letter (PDF – 139 KB)
    This document is a letter from Iowa to the Acting Director of the Office of Oversight with responses to CCIIO’s April 19, 2011 follow-up letter (received by HHS on 05/06/11).
  6. Financial Information by Issuer (XLS – 51 KB)
    This file contains financial data by issuer (received by HHS on 05/06/11).
  7. HHS Letter Deeming Iowa’s Application Complete (PDF – 31 KB)
    This document is a May 27, 2011 letter from the Acting Director of the Office of Oversight to Iowa deeming Iowa’s application complete, requesting clarifications regarding Iowa’s May 6, 2011 responses, and indicating the start of the HHS review period.
  8. Iowa Response to Additional Questions in HHS Letter Deeming Iowa’s Application Complete (PDF - 93 KB)
    This document is a letter from Iowa to the Acting Director of the Office of Oversight with responses to follow-up questions in CCIIO’s May 27, 2011 letter (received by HHS on 06/06/11).
  9. Enrollees, Premium, and Market Share Information (XLS – 48 KB)
    This file contains updated information on the number of enrollees, premiums earned, and individual market share by issuer in the Iowa individual market (received by HHS on 06/06/11).
  10. 2010 Supplemental Health Care Exhibits – The following files contain data from Part 1 of the 2010 Supplemental Health Care Exhibit for each issuer insuring more than 300 enrollees in the Iowa individual market (received by HHS on 06/06/11).
  11. HHS Letter to Iowa Extending the 30 Day Review Period for an Additional 30 days (PDF – 42 KB)
    This document is a June 24, 2011 letter from the Acting Director of the Office of Oversight to Iowa exercising the Secretary’s discretion to extend the 30-day review period for an additional 30 days.

Public Comments:

1. Iowa Consumer Groups Public Comment (PDF – 29 KB)

This file is a public comment from the Child and Family Policy Center, Iowa Citizen Action Network, Iowa Citizens for Community Improvement, Iowa Main Street Alliance, SEIU IA, and Center for Rural Affairs regarding Iowa’s request for an adjustment to the MLR standard.