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View Diary: Devil in the Details 2: AHIP took a left hook to the liver (41 comments)

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  •  Language (0+ / 0-)

    It would certainly make more sense as a moving average, but the way it's worded it sounds like year 4 is capped at the average of years 1, 2, and 3, which by definition are each capped at 85%.  

    Maybe it's late?

    •  The 80%/85% cap starts 2011 (1+ / 0-)
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      OK- here is how it works: the 80/85 cap comes into effect 2011. From 2011 to 2013- every year the insurer will have to calculate their loss ratio based on that year's payout/premium. However, starting in 2014, they calculate the loss ratio using a 3 year running average: 3years' payout/3years' premium.
      Read that language in 2718(b)(1)(B) carefully- it's gobbledegook but once you read it slowly it will make sense.

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