Maine MLR Waiver
March 2011
Waiver issued to the state of Maine from the Department of Health and Human Services exempting the state's insurance companies with complying with a provision in the health care law that determines the percentage of premiums that insurers must spend on medical services. According to the letter issued by HHS, "we agree with the reasoning that led to the [State of Maine Bureau of Insurance, or MBI] conclusion that application of the 80 percent MLR standard in Maine has a reasonable likelihood of destabilizing the Maine individual health insurance market. We have determined that an adjustment of the MLR to 65 percent is warranted under the particular circumstances presented in the MBI application. While we conclude that such an adjustment is appropriate for three years, the adjustment to 65 percent for the third year is granted on the condition that the MBI provide CCIIO with updated data in 2012 that indicate a continued need for such an adjustment. This letter explains the basis of our decision, which is rooted in the particular circumstances of the Maine insurance market."
Maine MLR Waiver