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Blues need information from you to comply with reform law

April 17, 2014

The Affordable Care Act requires that health insurance carriers annually report medical loss ratio.  In order to do so for 2014, BCBSM and BCN must know the average number of employees that full-insured groups had in the 2013 calendar year. This count must include all active (non-retiree) employees, even their part-time and seasonal employees, regardless of their eligibility for benefits.

Beginning on May 19, 2014, BCBSM and BCN will contact approximately 30,000 customers in the small and middle group markets by mail to ask for your total employee count.  If your plan is insured by BCBSM or BCN, either through an association sponsored plan like that of SBAM or directly insured, please watch for this mailing.

It’s very important that you return the survey to BCBSM by June 13, 2014.  It’s 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 required by the ACA and if rebates must be issued to come into compliance. There are significant federal penalties for both insurers and employers that fail to comply with the law, including a penalty of $100 per responsible entity per day per individual for each violation.

Will the Blues intend to issue rebates this year? As a part of the Blues ongoing commitment to serving their customers, they have traditionally met and exceeded the required MLR minimums, assuring that customers like you receive value for their premium dollars.

According to their recent filing with the National Association of Insurance Commissioners, BCBSM and BCN are projecting that they will not be required to issue rebates this year; however, the HHS filing in June will determine whether a rebate must be issued by the Blues. Plans required to issue rebates must do so by Aug. 1, 2014. If the Blues issue rebates, they will pass along more information after the June filing.

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