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Medical Loss Ratio

Oklahoma 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: Oklahoma

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 – 124 KB)
    This document contains Oklahoma’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 09/01/11).
  2. Financial Information by Issuer  (XLS – 53 KB)
    This document contains enrollee, premium, market share, and financial data by issuer in the Oklahoma individual market (received by HHS on 09/01/11).
  3. Independent Insurance Agents of Oklahoma Letter  (PDF – 72 KB)
    This document is an August 23, 2011 letter from the Independent Insurance Agents of Oklahoma regarding Oklahoma’s request for an adjustment to the MLR standard  (received by HHS on 09/01/11).
  4. Oklahoma State Association of Health Underwriters Letter  (PDF – 49 KB)
    This document is an August 19, 2011 letter from the Oklahoma State Association of Health Underwriters regarding Oklahoma’s request for an adjustment to the MLR standard  (received by HHS on 09/01/11).
  5. HHS Follow-up Letter (PDF – 64 KB)
    This document is a September 26, 2011 letter from the Acting Director of the Office of Oversight to Oklahoma requesting additional information and clarifications regarding Oklahoma’s application.
  6. Oklahoma Response to HHS Follow-up Letter (PDF – 615 KB)
    This document is an October 18, 2011 letter from Oklahoma with responses to CCIIO's September 26, 2011 letter requesting additional information (received by HHS on 10/18/11).
  7. Oklahoma Insurance Department Questionnaire  (PDF – 23 KB)
    This file contains the blank questionnaire sent by the Oklahoma Insurance Department to issuers in the Oklahoma individual market in the process of preparing Oklahoma’s request for an adjustment to the MLR standard (received by HHS on 10/18/11).
  8. 2010 Supplemental Health Care Exhibits  (PDF – 8.9 MB)
    This file contains the 2010 Supplemental Health Care Exhibits for select issuers in the Oklahoma individual market (received by HHS on 10/18/11).
  9. HHS Letter Deeming Oklahoma's Application Complete (PDF - 216 KB)
    This document is a November 28, 2011 letter from the Acting Director of the Office of Oversight to Oklahoma deeming Oklahoma's application complete and indicating the start of the HHS review period.
  10. Oklahoma Response to Additional Question in HHS Letter Deeming Oklahoma’s Application Complete  (PDF – 78 KB)
    This document is a letter from Oklahoma to the Acting Director of the Office of Oversight with responses to follow-up question in CCIIO’s November 28, 2011 letter (received by HHS on 12/02/11)
  11. American Enterprise Group Letter 1   (PDF – 757 KB)
    This document is an October 20, 2011 letter from the American Enterprise Group to Oklahoma notifying Oklahoma that American Republic and World are withdrawing from all individually underwritten comprehensive major medical insurance markets (received by HHS on 12/02/11).
  12. American Enterprise Group Letter 2   (PDF – 7 KB)
    This document is an addendum to the October 20, 2011 letter from the American Enterprise Group to Oklahoma (received by HHS on 12/02/11).
  13. HHS Letter to Oklahoma Extending the 30 Day Review Period for an Additional 30 days (PDF – 199 KB)
    This document is a December 28, 2011 letter from the Acting Director of the Office of Oversight to Oklahoma exercising the Secretary’s discretion to extend the 30-day review period for an additional 30 days.

Public Comments:

  1. Oklahoma Congressional Delegation Letter   (PDF – 178 KB)
    This document is a September 9, 2011 letter from the Oklahoma Congressional delegation to the Secretary in support of Oklahoma’s request for an adjustment to the MLR standard (received by HHS on 09/15/11).
  2. Consumer Watchdog Public Comment   (PDF – 197 KB)
    This file is a public comment from Consumer Watchdog regarding Oklahoma’s request for an adjustment to the MLR standard (received by HHS on 12/07/11).
  3. Oklahoma Policy Institute Public Comment   (PDF – 2.4 MB)
    This file is a public comment from the Oklahoma Policy Institute regarding Oklahoma’s request for an adjustment to the MLR standard (received by HHS on 12/08/11).
  4. National Patient Advocate Foundation Public Comment   (PDF – 496 KB)
    This file is a public comment from the National Patient Advocate Foundation regarding Oklahoma’s request for an adjustment to the MLR standard (received by HHS on 12/08/11).