Current through Register 1527, August 2, 2024
Section 147.04 - Administrative Cost ExpenditureUnless otherwise determined by the Commissioner, the following items shall be deemed to be an Administrative Cost Expenditure for the purposes of calculating and reporting the MLR of Health Benefit Plans for M.G.L. c. 176J, § 6 and M.G.L. c. 176O, § 21:
(a) Financial administration expenses;(b) Marketing and sales expenses;(c) Distribution expenses;(d) Claims operations expenses;(e) Medical administration expenses, such as disease management, care management, utilization review and medical management activities;(f) Network operations expenses;(h) Board, bureau or association fees;(i) State and federal tax expenses, including assessments; andAmended by Mass Register Issue 1351, eff. 11/3/2017.