Jan 27, 2025
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).
Later this week, Blue Shield will send out MLR employer surveys (to groups with <150 employees) requesting the information below to help calculate the MLR for 2024, as required by the ACA:
- The average number of employees for their business in calendar year 2023 .
- Whether their business is wholly owned by one individual and their spouse.
- Whether they are a non-governmental or non-ERISA plan. Note: Most employers are covered by ERISA
As a reminder, when calculating 2024 MLR rebates owed, 2023 information is used for statistical sampling purposes. If any rebates are owed, these will be issued by September 30, 2025.
The deadline to submit information is March 31, 2025.
To support your clients, Blue Shield asks you to encourage them to submit information via the online survey. To access the online survey, please use the Group ID and the following web key: #44n50c
Employer groups also have the option to submit information by completing the print survey form and faxing to (855) 895-3497.
Please note:
Non-ERISA employers who return their MLR survey via fax will receive an attestation form via mail that they will need to return to Blue Shield in early 2025.
Blue Shield appreciates your help in collecting the information needed to help them meet the MLR requirement. Please review the MLR FAQs for more information. If you have any questions regarding the MLR Employer Survey, please contact MLRAssist@blueshieldca.com or call us at (800) 325-5166.
