If you sponsor an Anthem group health insurance plan, keep your eye on the mail.

Medical Loss Ratio (MLR) surveys will be going out soon.
The Affordable Care Act (ACA) requires insurers to categorize group health plans as either small or large – based upon the number of full-time equivalent (FTE) employees they have.  Because the insurers only have data on the employees enrolled in your health plan, they need to survey employers to capture all employees affected by the calculations.  This includes full-time, part-time and seasonal employees.  The information gathered is vital for the insurer to determine the different thresholds established by the ACA.

The data collected will be used to determine whether or not the insurer will be required to issue rebates to either category, so it is important that their calculations be as accurate as possible.  Employers who do not respond to the survey will be categorized based upon the number of employees enrolled in their plan on average for 2014.

By the end of May, Anthem will begin sending the surveys to all fully-insured group clients.  For more details on the survey, read this Frequently Asked Questions (FAQ).

For additional information on MLR’s and other health insurance questions, please feel free to contact me at: