Wednesday, July 27, 2011

MLR Revisited

In the law, there's an aphorism that goes "he who is his own lawyer has a fool for a client."

I would argue that as regards insurance, and especially health insurance, "he who is his own agent has a fool for a client."

[Click here for a detailed explication of why this is so. HGS]

Basically, the agent is the interface between the carrier and the client, and serves as both advisor to and advocate for the latter. Over the years, we've recounted countless experiences where agents have helped clients, both large and small, out of a bind.

Remember also that deleting the agent from the equation represents little, if any, real savings: after all, carriers still have to pay for Customer Service (such as it is) and marketing. If anything, I suspect that most agents who ultimately decide to "stay in" will move to a fee-only model, and clients without access to professional advice and advocacy are the ones who will be most hurt.

And that's one of the effects of the Medical Loss Ratio (MLR) provision in ObamaCare©. By mandating a specific disbursement threshold, agents' commissions go away, making it impossible for us to continue servicing existing clients, let alone obtaining new ones.

Of course, that's easy for me to say; after all, I have a vested interest in the outcome. What if I told you, though, that Senator Mary Landrieu (D-LA), who voted for ObamaCare© so that she (and we) could see what's actually in it, is having second thoughts about doing away with us? In a letter to HHS Secretary Shecantbeserious, Ms Landrieu writes:

"(A) certain provision regarding [ObamaCare©]'s MLR requirements is unintentionally* harming an important sector of the small business community - health insurance agents and brokers - and may also harm other small businesses that rely on their services."

[ed: it's far from clear that this was, in fact, "unintentional"]

So, contra Mr Rockefeller, agents do in fact bring value to the table.

But then, we already knew that.

[Hat Tip: FoIB P Paule]
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