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BCBSM/BCN needs employee counts from customers to comply with reform law

January 21, 2013

The federal Patient Protection and Affordable Care Act requires that health insurance carriers annually report Medical Loss Ratio (MLR).

In order to report the MLR for the 2013 period, BCBSM and BCN must know the average number of employees that underwritten groups had in the 2012 calendar year. This count must include all active (nonretiree) employees, even part-time and seasonal workers, regardless of their eligibility for benefits.

A few questions were added to this year’s survey to help the Blues with the filing and rebate process, including information about the group health plan type and if the customer is the sole owner of the business (e.g. sole proprietor or a sole shareholder).

Beginning on Feb. 1, a letter will be mailed (PDF) and survey form (PDF) to approximately 31,000 customers in the fully insured group markets to ask for total employee counts.

It’s very important that you return the survey by March 8, 2013. Please complete and return the survey as soon as possible.

It is vital that the most accurate numbers be reported. This information is critical in helping to determine whether BCBSM or BCN has met the minimum thresholds and if rebates must be issued to comply. There are significant federal penalties for not complying with the law, including a penalty of $100 per responsible entity per day per violation per individual.

Insured groups must complete this survey form to supply the information by March 8, 2013. In early March, a follow-up letter will be sent (PDF) to those who don’t respond.

MLR survey questions? Contact

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