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News: 2011 Press Release

For Release: January 25, 2011
Media Calls Only: 916-492-3566
Insurance Commissioner Jones Announces Approval Of Emergency Regulation

Insurance Commissioner Dave Jones today announced that the Office of Administrative Law (OAL) approved his request for an emergency regulation to give him the authority to enforce the 80% Medical Loss Ratio (MLR) in the individual market established under the Patient Protection and Affordable Care Act (PPACA) that went into effect on January 1, 2011. The MLR is defined as the percentage of premium revenues an insurer pays for medical services, as opposed to insurer profits, marketing, and overhead.

 "The OAL's ruling to approve the emergency regulation I proposed on my first day in office is an important step in ensuring that consumers are getting the best deal possible for their premium dollars," Commissioner Jones said. "This emergency regulation will give me the legal authority to enforce the new federal 80% medical loss ratio for the individual health insurance market in California, even if Congress prevents the federal Department of Health and Human Services from enforcing it. I will be watching very closely to make sure health insurers comply."

Today's development represents the fulfillment of a commitment Commissioner Jones made at his inauguration when he signed a "Notice of Emergency Regulation" to begin this process. Under PPACA, as of January 1st, health insurers in the individual market are required to maintain a medical loss ratio of 80%.

To view the documents indicating OAL's approval and filing, please click here.

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The California Department of Insurance, established in 1868, is the largest consumer protection agency in California, regulating the $123 billion insurance marketplace. In 2012 the California Department of Insurance received more than 160,000 calls from consumers and helped recover over $64 million in claims and premiums. Please visit the Department of Insurance web site at www.insurance.ca.gov. Non-media inquiries should be directed to the Consumer Hotline at 800.927.HELP. Out-of-state callers, please dial 213.897.8921. Telecommunications Devices for the Deaf (TDD), please dial 800.482.4833.

If you are a member of the public wishing information, please visit our Consumer Services.

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