Despite years of lobbying efforts by broker advocacy organizations, the American Health Care Act makes no mention of removing broker commissions from the Affordable Care Act’s medical loss ratio provision. While not the desired outcome, agent groups believe there is still an opportunity to remove brokers from the MLR provision through regulatory action in the near future.

As written in the ACA, the MLR requires health plans to spend a minimum of 80% of premiums on medical claims (85% in the large group market) and rebate any excessive overhead to enrollees. As a result, most insurance companies have slashed agent commissions, in many cases by 50%, according to the National Association of Insurance & Financial Advisors. NAIFA says 80% of its members surveyed have seen decreased commissions since the MLR went into effect.

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