Phase 1: Enactment & build · Step 1.11

Rewrite insurance & benefits law

Effective in stages with each enrollment wave · Congress; DOL EBSA; Treasury; state insurance commissionersDiscuss this step

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Task 1.11.2 of 6

Define 'supplementary coverage' (non-covered services only) and regulate it under state insurance law; require a minimum 85% medical loss ratio.

Who does it

Congress / NAIC

When

Month 12

Trade-off

An 85% minimum loss ratio protects buyers of supplementary coverage but may drive small insurers out of the market.

Part of: Rewrite insurance & benefits law

Amend ERISA, the tax code, and the ACA so that employer plans and private insurance cannot duplicate UHP benefits, and so supplementary insurance is regulated.

This step changes 10 existing laws, programs, or institutions. See the list.