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Bills & Legislation | California Association of Health Underwriters

Legislative White Papers -

The Adverse Effects of Medical Loss Ratio (MLR) and Agent Compensation Calculations on the Consumers of Health Insurance

Support of SB 2288 and HR 1206



We welcome the opportunity to comment on SB 2288 and H.R. 1206.


We strongly support the goals of reducing health care costs, improving health outcomes for patients and providing better value for health care consumers. We are extremely concerned that MLR definitions would adversely impact spending on such important health plan activities as case management, wellness, disease management, and fraud and abuse prevention programs, among others. These important aspects of medical care and health plan coverage were given heightened emphasis by Congress in the PPACA because they both improve care quality and also help contain medical treatment costs. If they are somehow diminished due to narrow MLR definitions and enforcement, the quality of health care delivery for consumers will deteriorate and health care costs will surely increase.


Who we are:

The San Diego Association of Health Underwriters (SDAHU) is an organization with over 250 licensed agents, brokers, consultants and benefit professionals in the county of San Diego, CA. We are one of over 200 chapters nationwide with more than 100,000 licensed agents serving the need of large and small group employers, families and individuals guiding them through the complexities of searching, enrolling, and purchasing the best value health plans.

SDAHU believes that “activities that improve health care quality” should be defined broadly enough to include activities that:

  1. Relate directly to the individual patient’s care.
  2. Provide tools to educate and inform patients about their current or future care and potential alternative cost savings.
  3. Prevent unnecessary and inappropriate care.
  4. Ensure a minimum level of health care quality.

All of these activities work to improve the quality of health care and to enhance access to quality care.  Read more...







Copyright © 2015 San Diego Association of Health Underwriters 
P: 858.883.2486  I  F: 858-630-3793  I E: sdahu1@yahoo.com

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