Examples of MLR reporting year in a sentence
In addition, the State provides the following clarifications: The MLR calculation shall be performed separately for each MLR reporting year.
The calculation must fully comply with 42 CFR 438.8. In addition, the State provides the following clarifications: The MLR calculation shall be performed separately for each MLR reporting year.
Line 2.7 – Rebates paid MLR rebates paid during the MLR reporting year.
Except where inapplicable, the reserve included in these lines should be based on past experience, modified to reflect current conditions, such as changes in exposure Line 2.3 – Direct claim liability prior year (year preceding the MLR reporting year) 12/31 Column – liability as of 12/31 of the year preceding the MLR reporting year, as reported to the regulatory authority in the issuer’s State of domicile or as reported on the NAIC SHCE filing for the year preceding the MLR reporting year.
Line 2.8 – Estimated rebates unpaid at the end of the previous MLR reporting year Amount should equal Line 2.9 from the previous MLR reporting form.Line 2.9 – Estimated rebates unpaid at the end of the MLR reporting year MLR rebates estimated but unpaid as of the end of the MLR reporting year.
Include: Experience rating refunds and State premium refunds paid or received during the MLR reporting year.
In addition, the report must include claim reserves associated with claims incurred during the MLR reporting year, the change in contract reserves, reserves for contingent benefits and the claim portion of lawsuits, and any experience rating refunds paid or received.
In addition, the State provides the following clarifications: ▪ The MLR calculation shall be performed separately for each MLR reporting year.
Include: PCORI fees attributed to applicable policies during the MLR reporting year.
Include: • Unpaid claims, including claims reported in the process of adjustment, percentage withholds from payments made to contracted providers, recoverable for anticipated coordination of benefits (COB) and subrogation (including third party liability) • Incurred but not reported – report claims incurred only during the MLR reporting year and not reported by 3/31 of the following year.