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Comment Letter by the Medical Loss Ratio Regulation Work Group of the American Academy of Actuaries to CMS on Medical Loss Ratio Requirements for the Medicare Advantage and the Medicare Prescription Drug Benefit Programs (PDF)

"CMS has made a concerted effort , in developing regulations implementing Section 1857(e)(4) of the Social Security Act, to closely mirror the regulations implementing the commercial health insurance MLR provisions enacted under Section 2718 of the Public Health Service Act. Consistency between the Medicare MLR regulation and the commercial MLR regulation is an appropriate approach . Our comments focus on a few areas in which further clarification would be helpful or for which we wanted to provide some additional thoughts based on our experience with the commercial MLR regulation."

Comment Letter by the Medical Loss Ratio Regulation Work Group of the American Academy of Actuaries, to HHS on MLR Reporting Aspects of Proposed Contraceptive Mandate Rules (PDF)

"[I]n situations in which ['zero premium contraceptive-only'] policies are issued to individuals whose underlying comprehensive medical coverage is provided via a self-funded group health plan ..., the issuer (or an affiliate) would be eligible to receive adjustments to any federally facilitated exchange (FFE) user fees it might owe ... All else being equal, a lower level of FFE user fees would lead to higher reported premiums for MLR purposes, a lower reported MLR value, and a potentially higher level of customer rebates."

American Academy of Actuaries Comment Letter to CMS on Medical Loss Ratio Report for Medicare Advantage Plans and Prescription Drug Plans (PDF)

"[F]or consistency in MLR reporting not only among issuers, but also between the commercial and Medicare markets, we encourage CMS to state explicitly within the instructions for the Medicare MLR report that the following questions [from previously-issued FAQs] apply to Medicare MLR as well. If guidance on any of these items for Medicare MLR is not to remain consistent with the applicable guidance for commercial plans, it would be helpful for CMS to provide an explanation of the differences, possibly through a notice of rulemaking process with an opportunity for public comment." [FAQs cited in this letter were issued by CCIIO on May 13, 2011, July 18, 2011, and February 10, 2012.]