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Medical Loss Ratio

Louisiana 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: Louisiana

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 Cover Letter (PDF – 82 KB)
    This document is a cover letter to the State of Louisiana’s request for an adjustment to the MLR standard (received by HHS on 03/29/11).
  2. MLR Adjustment Request (PDF – 122 KB)
    This document contains Louisiana’s request to adjust the MLR standard to 70 percent in 2011 and 75 percent in 2012 (received by HHS on 03/29/11).
  3. HHS Request for Additional Information  (PDF – 51 KB)
    This document is an April 18, 2011 letter from the Acting Director of the Office of Oversight to Louisiana requesting additional information in order for Louisiana’s application to be deemed complete.
  4. HHS Follow-up Letter  (PDF – 49 KB)
    This document is an April 19, 2011 letter from the Acting Director of the Office of Oversight to Louisiana requesting additional information and clarifications regarding Louisiana’s application, which is separate and distinct from the request for information needed for Louisiana’s application to be complete.
  5. Louisiana Response to HHS Follow-up Letter  (PDF – 112 KB)
    This document is a letter from Louisiana 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 04/29/11).
  6. Louisiana Response to HHS Request for Additional Information  (PDF – 98 KB)
    This document is a letter from Louisiana to the Acting Director of the Office of Oversight with responses to CCIIO’s April 18, 2011 letter requesting additional information (received by HHS on 05/25/11).
  7. Supporting Data by Issuer  (XLS – 81 KB)
    This document contains enrollee, premium, market share, and financial data by issuer in the Louisiana individual market (received by HHS on 05/25/11).
  8. HHS Second Follow-up Letter  (PDF – 70 KB)
    This document is a July 1, 2011 letter from the Acting Director of the Office of Oversight to Louisiana requesting additional information and clarifications regarding the information Louisiana submitted on April 29 and May 25, 2011.
  9. HHS Second Follow-up Timeframe Inquiry  (PDF – 43 KB)
    This document is an August 30, 2011 email from the Office of Oversight to Louisiana requesting an estimate of the timeframe for receiving Louisiana’s responses to CCIIO’s July 1, 2011 letter.
  10. Louisiana Response to HHS Second Follow-up Letter  (PDF – 125 KB)
    This document is a letter from Louisiana to the Acting Director of the Office of Oversight with responses to CCIIO’s July 1, 2011 letter requesting additional information (received by HHS on 09/01/11).
  11. 2010 Supplemental Health Care Exhibits – The following files contain data from the 2010 Supplemental Health Care Exhibit for each issuer with at least 1,000 life-years in the Louisiana individual market (received by HHS on 09/08/11).
  12. HHS Letter Deeming Louisiana's Application Complete  (PDF – 53 KB)
    This document is a September 28, 2011 letter from the Acting Director of the Office of Oversight to Louisiana deeming Louisiana’s application complete and indicating the start of the HHS review period.
  13. Louisiana Response to Additional Question in HHS Letter Deeming Louisiana’s Application Complete  (PDF – 41 KB)
    This document is a letter from Louisiana to the Acting Director of the Office of Oversight with responses to follow-up question in CCIIO’s September 28, 2011 letter (received by HHS on 10/05/11).
  14. MLR Calculation  (XLS – 14 KB)
    This file contains issuers’ revisions to CCIIO’s MLR and rebate calculations (received by HHS on 10/05/11).
  15. HHS Letter to Louisiana Extending the 30 Day Review Period for an Additional 30 days  (PDF – 73 KB).
    This document is an October 28, 2011 letter from the Acting Director of the Office of Oversight to Louisiana exercising the Secretary’s discretion to extend the 30-day review period for an additional 30 days.
  16. Louisiana Request for Reconsideration  (PDF – 127 KB)
    This document is a letter from Louisiana to the Director of the Center for Consumer Information and Insurance Oversight requesting reconsideration of the HHS determination (received by HHS on 12/08/11).

Public Comment:

  1. Louisiana Consumer Healthcare Coalition Public Comment  (PDF – 175 KB)
    This file is a public comment from the Louisiana Consumer Healthcare Coalition regarding Louisiana’s request for an adjustment to the MLR standard (received by HHS on 10/09/11).