May 2022

Annually, Blue KC surveys groups to meet ACA requirements that apply differently based on whether an employer is determined to be a large or small employer.

One important example is the requirement that insurance companies report their medical loss ratio (MLR) to a federal agency and pay rebates if certain MLR targets are not met. Rebates are paid based on whether the targets are met for the individual market, the small group market, and the large group market.

Insurance companies are also required to comply with certain rating and benefit requirements for small employer insurance products. To comply with the ACA’s requirements, Blue KC collects data from an authorized employee (e.g., group administrator or benefits coordinator) via a short form regarding the number of individuals employed by their company. This data will help determine if a group will be classified as small (50 or fewer employees) or large (51 or more employees).

Please note, if the group size has changed since the last time the group completed the form, Blue KC may need to make modifications to the group’s insurance coverage to ensure compliance. We will notify you of any such changes for any applicable groups.

Important items of note:

  • Blue KC will email groups May 23 with a link to the MLR Employer Size Form. The email will come from Jenny Housley with the subject line “Blue KC MLR Employer Size Form – Potential Rebate”. We will send emails based on existing contact information on file.
  • Based on the information provided, the group will be categorized as small or large for the purposes of applying the ACA requirements.
  • About a week after the first email, Blue KC will send an email reminder to nonresponders.
  • Beginning June 1, Blue KC will send a letter and the form to nonresponding groups and groups for whom we do not have email addresses. View a sample letter, email, FAQ, and Employer Size Form.
  • Responses are due June 30.

If you have questions, please contact your Blue KC representative.