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Medical Loss Ratio

Michigan 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: Michigan

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 – 594 KB)
    This document contains Michigan’s request to adjust the MLR standard to 65 percent, 70 percent, and 75 percent for 2011, 2012, and 2013, respectively (received by HHS on 07/28/11).
  2. Financial Information by Issuer (XLS – 38 KB)
    This document contains enrollee, premium, market share, and financial data by issuer in the Michigan individual market (received by HHS on 07/28/11).
  3. Michigan MLR Adjustment Request Status Inquiry  (PDF – 62 KB)
    This document is an email from Michigan to the Acting Director of the Office of Oversight inquiring about the status of Michigan’s request for adjustment to the MLR standard (received by HHS on 08/18/11)
  4. Representatives Camp and Upton Letter  (PDF – 988 KB)
    This document is an August 4, 2011 letter from Representatives Dave Camp and Fred Upton to the Secretary requesting that the Secretary grant Michigan's request for adjustment to the MLR standard  (received by HHS on 08/18/11).
  5. HHS Follow-up Letter  (PDF – 74 KB)
    This document is an August 29, 2011 letter from the Acting Director of the Office of Oversight to Michigan requesting additional information and clarifications regarding Michigan’s application.
  6. Michigan Response to HHS Follow-up Letter  (PDF – 328 KB)
    This document is an October 4, 2011 letter from Michigan to the Acting Director of the Office of Oversight with responses to CCIIO's August 29, 2011 letter requesting additional information (received by HHS on 10/04/11).
  7. Financial Information by Issuer – Revised  (XLS – 47 KB)
    This file contains updated enrollee, premium, market share, and financial data by issuer in the Michigan individual market (received by HHS on 10/04/11).
  8. 2010 Supplemental Health Care Exhibits  (XLS – 290 KB)
    This file contains the 2010 Supplemental Health Care Exhibits for select issuers in the Michigan individual market (received by HHS on 10/04/11).
  9. HHS Letter Deeming Michigan's Application Complete  (PDF – 66 KB)
    This document is an October 17, 2011 letter from the Acting Director of the Office of Oversight to Michigan deeming Michigan’s application complete and indicating the start of the HHS review period.
  10. HHS Letter to Michigan Extending the 30 Day Review Period for An Additional 30 Days (PDF – 54KB)
    This document is a November 16, 2011 letter from the Acting Director of the Office of Oversight to Michigan exercising the Secretary’s discretion to extend the 30-day review period for an additional 30 days.
  11. Representatives Levin and Dingell Letter (PDF - 120 KB)
    This document is a November 17, 2011 letter from Representatives Sander M. Levin and John Dingell to the Secretary regarding Michigan's request for an adjustment to the MLR standard (received by HHS on 11/18/11).
  12. Michigan Supplemental Information  (PDF – 96 KB)
    This document is a November 18, 2011 email from Michigan to HHS with additional information in support of Michigan’s application (received by HHS on 11/18/11).
  13. American Enterprise Group Letter  (PDF – 36 KB)
    This document is an October 20, 2011 letter from the American Enterprise Group to Michigan notifying Michigan that American Republic and World are withdrawing from all individually underwritten comprehensive major medical insurance markets (received by HHS on 11/18/11).
  14. Michigan Supplemental Information  (PDF – 66 KB)
    This file contains a November 28, 2011 email from the Office of Oversight to Michigan requesting additional information, and a December 13, 2011 email from Michigan to the Office of Oversight providing the requested information.
  15. BCBS Rates  (PDF – 1MB)
    This file contains enrollment, benefit level, and premium rate information for BCBS of Michigan (received by HHS on 12/13/11).
  16. Alliance Rates  (PDF – 15 KB)
    This file contains enrollment, benefit level, and premium rate information for Alliance Health & Life Ins. Co. (received by HHS on 12/13/11).
  17. Priority Health Rates  (PDF – 51 KB)
    This file contains enrollment, benefit level, and premium rate information for Priority Health Ins. Co. (received by HHS on 12/13/11).

Public Comments:

  1. Michigan Consumers for Healthcare Advancement Public Comment  (PDF – 967 KB)
    This document is a public comment from the Michigan Consumers for Healthcare Advancement regarding Michigan’s request for an adjustment to the MLR standard (received by HHS on 08/04/11).
  2. Michigan Universal Health Care Access Network Public Comment  (PDF – 95 KB)
    This file is a public comment from the Michigan Universal Health Care Access Network regarding Michigan’s request for an adjustment to the MLR standard (received by HHS on 08/20/11).
  3. Michigan Legal Services Public Comment  (PDF – 176 KB)
    This file is a public comment from the Michigan Legal Services regarding Michigan’s request for an adjustment to the MLR standard (received by HHS on 08/29/11).
  4. Michigan Legal Services Public Comment Exhibit  (PDF – 73 KB)
    This file contains 2009 premium, claims, and MLRs for issuers in the Michigan small group market, submitted with the Michigan Legal Services public comment regarding Michigan’s request for an adjustment to the MLR standard (received by HHS on 08/29/11).
  5. Michigan League for Human Services Public Comment  (PDF – 95 KB)
    This file is a public comment from the Michigan League for Human Services regarding Michigan’s request for an adjustment to the MLR standard (received by HHS on 09/27/11).
  6. The Ezekiel Project Public Comment  (PDF – 83 KB)
    This file is a public comment from The Ezekiel Project regarding Michigan’s request for an adjustment to the MLR standard (received by HHS on 10/24/11).
  7. NAIFA-Michigan Public Comment  (PDF – 18 KB)
    This file is a public comment from the National Association of Insurance and Financial Advisors – Michigan regarding Michigan’s request for an adjustment to the MLR standard (received by HHS on 10/25/11).
  8. NorthWest Lansing Healthy Communities Initiative  (PDF – 69 KB)
    This file is a public comment from the NorthWest Lansing Healthy Communities Initiative regarding Michigan’s request for an adjustment to the MLR standard (received by HHS on 10/26/11).
  9. MAHU Public Comment  (PDF – 73 KB)
    This file is a public comment from the Michigan Association of Health Underwriters regarding Michigan’s request for an adjustment to the MLR standard (received by HHS on 10/26/11).
  10. Michigan Association of Insurance Agents Public Comment  (PDF – 135 KB)
    This file is a public comment from the Michigan Association of Insurance Agents regarding Michigan’s request for an adjustment to the MLR standard (received by HHS on 10/27/11).
  11. Michigan Protect Your Care Public Comment  (PDF – 127 KB)
    This file is a public comment from Michigan Protect Your Care regarding Michigan’s request for an adjustment to the MLR standard (received by HHS on 10/27/11).
  12. Urban Neighborhood Initiatives Public Comment  (PDF – 82 KB)
    This file is a public comment from the Urban Neighborhood Initiatives regarding Michigan’s request for an adjustment to the MLR standard (received by HHS on 10/27/11).
  13. Interfaith Health & Hope Coalition Public Comment  (PDF – 16 KB)
    This file is a public comment from the Interfaith Health & Hope Coalition regarding Michigan’s request for an adjustment to the MLR standard (received by HHS on 10/27/11).
  14. Michigan AFSCME Council 25 Public Comment  (PDF – 233 KB)
    This file is a public comment from the Michigan Council 25 of the American Federation of State, County, and Municipal Employees, AFL-CIO regarding Michigan’s request for an adjustment to the MLR standard (received by HHS on 10/27/11).
  15. Consumer Public Comments  (PDF – 376 KB)
    This file contains 101 public comments from Michigan consumers regarding Michigan’s request for an adjustment to the MLR standard (received by HHS between 10/02/11 and 11/03/11).
  16. Michigan Consumers Petition Cover Letter by Michigan Universal Health Care Access Network  (PDF – 213 KB)
    This file is a cover letter to the petition by Michigan consumers requesting that HHS deny Michigan’s request for an adjustment to the MLR standard, with additional comments from the Michigan Universal Health Care Access Network and (received by HHS on 10/27/11).
  17. Michigan Consumers Petition  (PDF – 555 KB)
    This file is a petition by Michigan consumers requesting that HHS deny Michigan’s request for an adjustment to the MLR standard (received by HHS on 10/27/11).