Jan 12, 2023
The Affordable Care Act (ACA) requires Blue Shield and other health insurance carriers to spend a minimum percentage of plan members' premium on medical expenses, known as the Medical Loss Ratio (MLR). This week, Blue Shield will be sending out MLR employer surveys requesting the following information from clients to help calculate the MLR for 2022, as required by the ACA.
- The average number of employees for their business in calendar year 2021.
- Whether their business is wholly owned by one individual and his/her spouse.
- Whether they are a non-governmental or non-ERISA plan.
Employer groups will be given the option of submitting their group information via an online survey or by faxing their completed form to (855) 895-3497. Employer groups must submit their information by March 31, 2023.
Non-ERISA employers who return their MLR survey via fax will receive an attestation form via mail that they will need to return back to Blue Shield in early 2023.
Non-governmental, non-ERISA plan employers who submit their information using the online survey will be able to automatically attest that any future rebates they receive will be allocated to their subscribers in one of the three ways outlined by the ACA. (Note that the vast majority of employer plans are covered by ERISA).
To support your clients, we ask you to strongly encourage them to submit their information by March 31, 2023 via Blue Shield's online survey or by faxing back the print survey form. To access the online survey, please use the Group ID and following web key: #44n50c.
If you have any questions regarding the MLR Employer Survey, please contact the Blue Shield MLR team at MLRAssist@blueshieldca.com or call (800) 325-5166.
