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Blues need information from customers to comply with reform law

The federal Patient Protection and 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 underwritten 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, we’re contacting approximately 30,000 customers in the small and middle group markets by mail to ask them for their total employee counts.

It’s very important that customers return their survey by June 13, 2014. You can help by encouraging them to complete it as soon as possible and return it to us.

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 and if we must issue rebates to come into compliance. There are significant federal penalties for 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.

You may receive questions from groups as to whether or not the Blues intend to issue rebates this year. As a part of our ongoing commitment to serving our members, we’ve traditionally met and exceeded the required MLR minimums, assuring that customers receive value for their premium dollars.

According to our recent filing with the National Association of Insurance Commissioners, we’re projecting that BCBSM or BCN won’t 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 we're issuing rebates, we’ll pass along more information after the June filing.

Groups must complete this form to supply the information to us by June 13, 2014. To answer additional questions you may have regarding the medical loss ratio provision of the ACA, we developed this FAQ.

Questions regarding the survey? Contact

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