BlueCross BlueShield of South Carolina

Medical Loss Ratio Rebate Survey

August 30, 2011

Under the Patient Protection and Affordable Care Act (PPACA), health insurance carriers are required to report their medical loss ratios (MLR) to state and federal agencies annually. Based on the size of an employer’s business, the MLR requirement differs between 80 percent and 85 percent. If MLR results are below the requirements, carriers must issue rebates to members and employers.

We have begun notifying groups that they must complete a simple, six-question survey related to the MLR rebate. This survey is required. We will use the supplied information to determine if a group is “small” or “large” for MLR purposes.

The survey includes the following six questions:

• What is your organization or company’s name?
• What is your client number? (Shown on the upper-right corner of your bill)
• What is your group contact’s name?
• What is your group contact’s email address?
• How many full-time employees in your organization/company were eligible for health insurance in 2010? (This number represents the 2010 average of all full-time employees, defined as working at least 30 hours per week, 48 weeks per year as well as retirees, COBRA, and State Continuation employees, if applicable.)
• How many employees did you have in 2010? (In other words, all 2010 W-2 recipients)