Dear <John Q. Employer>,
As we put the health care reform law into action, we do our best to keep you posted on our progress. And, from time to time, we need your help. This is one of those times.
We simply need to know how to categorize your group based on the number of employees you had, on average, in 2010. To help you answer this question, we've provided a worksheet on the back of this page. Please do not return the worksheet to us.
Here’s why we need you to answer the survey question:
The health care reform law’s medical loss ratio (MLR) rules say we need to categorize groups as small or large based on number of employees.
We have data about how many are enrolled in your health plan, but we don’t know how many employees you have.
Issuers have to meet different MLR thresholds for small and large groups. So if the MLR requirement results in rebates, the way you’re categorized could have an impact on your rebate amount.
We’ll use your survey response only to categorize your group for 2011 calendar year MLR reporting.
Please respond by September 30, 2011 in the way that’s most convenient for you:
Online: Go to hcrsurvey.anthem.com/PURLXXXXXXXXXXXXXXXXXXXXXXX.
By mail: Check one of the boxes on the survey below and return it in the enclosed envelope.
Be sure to include your email address so we can provide you with timely information about this and other requirements of health care reform.
If you do not reply to this survey, we will categorize your group as small or large for
2011 MLR reporting based on the number of enrollees in our health plan and applicable state-specific laws and regulations.
We’re committed to making health care reform work for you and your employees. Over the next few months, you will receive more information from us about the MLR requirement. If you have questions about this survey, call us at 866-214-6623, or refer to the FAQs at hcrsurvey.anthem.com/PURLXXXXXXXXXXXXXXXXXXXXXXX. For all other questions, contact your broker or account manager.
Thank you,
<Anthem Blue Cross and Blue Shield> Compliance Department
Definitions
JMedical loss ratio (MLR)—The portion of premium (less federal and state taxes and licensing or regulatory fees) spent on medical care and quality programs for the members covered under your plan.
JFull-time equivalency —A way of counting part-time and seasonal workers by adding their total hours and dividing by a number. For example, two employees who work 20 hours a week would count as 1.33 full-time equivalents based on a 30-hour work week.
