Compliance & Regulation

For years, loss ratio flexibility was one of the defining advantages of supplemental health products. Carriers had real latitude in how they structured pricing and rate filings across accident, critical illness, and indemnity plans — room to build sustainable margins while still expanding access. That latitude is narrowing. State regulators are raising the bar on loss ratio scrutiny without changing a single rule on paper. And the pressure doesn’t stop at the carrier. Plan fiduciaries — the brokers and administrators making placement and design decisions — are now squarely exposed too.