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State Insurance Commissioners on Thursday unanimously approved tough new rules that require many health insurance companies to spend more of every dollar of premium for consumers to new federal health law provides that at least 80 percent premium. Revenue should be allocated to health care and activities that improve the quality of health care for patients -. Not retained as profits or to pay the compensation and administrative costs of legislation, adopted at a meeting of the National Association of Insurance Commissioners in Orlando, Florida, described how the calculations are carried out, specifying what counts as medical care and what expenses are classified as administrative.

Kaiser Health News During the debate leading to recommendations, the insurers prompted the broadest possible definition of what constitutes medical expenses, including things like the cost of paying claims, signing medical or running their networks centers telephone customer service. The final recommendations are narrower, which is what has urged consumer groups. The commissioners would, for example, insurers to include many of the costs of quality improvement, together with payments to doctors, nurses, hospitals and other medical providers, but estimates of the costs not the costs of fraud or billing control efforts.

It is also recommended that the insurers may deduct federal and state taxes, but pay no taxes on investment income (Appleby, 10/21). Some political cost items such as medical bills were clearly identified from the outset as medical expenses. Insurance advertising and overhead is quickly put into the administrative category. However, many other elements, such as nurse hotlines, some federal taxes, commissions of insurance agents and programs to improve coordination of care, fell into a gray area and were subject to hours of debate. Under the final regulation, insurers can categorize a series of activities in health spending, such as quality improvement

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