Health and Human Services (HHS) issued interim final rules regarding the Medical Loss Ratio (MLR) calculations required by the Affordable Care Act. The rules include agent and broker commissions as part of the costs in the MLR calculation and do not allow for commissions to be excluded from the MLR calculation. 

The interim rules are effective on January 1, 2011, but HHS is seeking comments on the regulation and will issue further guidance and a final rule later this year. 

The interim rules allow states to seek waivers from the MLR requirements.