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Volume 7, Issue 2 • January 16, 2013

► Blue Alert 

Blues need employee counts from customers to comply with reform law

The federal Patient Protection and Affordable Care Act requires that health insurance carriers annually reportMedical Loss Ratio.

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 their part-time and seasonal workers, regardless of their eligibility for benefits.

We added a few additional questions to this year’s survey to help the Blues with the filing and rebate process. We ask 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, we’ll mail a letter (PDF) and survey form (PDF) to approximately 31,000 customers in the fully insured group markets to ask for their total employee counts.

It’s very important that customers return the survey by March 8, 2013. You can help by encouraging them to complete the survey as soon as possible and return it to us.

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 we must issue rebates 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.

Groups must complete this survey form to supply the information to us by March 8, 2013. In early March, we will send a follow-up letter (PDF) to customers who don’t respond.

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