The Medical Loss Ratio (MLR) minimum standard requires that health-insurance companies spend a certain percentage of premium dollars on medical claims and activities that improve health-care quality. Rebates are due to payers if insurers fail to meet minimum loss ratios of 80 percent in the small group market and 85 percent in the large group market. For each calendar year, Capital BlueCross and its affiliates will calculate and pay rebates, if required, to eligible groups prior to August 1st of the following calendar year.
To help us determine rebate eligibility for the next calendar year we ask that our group customers complete a short informational questionnaire. The specific information being requested is listed below. Each is explained in further detail within the questionnaire.
- Your current Federal tax identification number and current W-9 Federal tax name of your company;
- Your Plan Classification, as defined by ERISA and;
- Your group size as determined by the average number of individuals employees by your company for the prior calendar year.
Thank you in advance for providing the information needed to process rebates. To learn more about MLR and its impact, visit the Capital BlueCross Health Care Reform website. If you have any questions, contact our support team at 1.888.267.2242.