Each year, to meet ACA requirements, Blue KC surveys employer groups for the purpose of classifying them as large or small groups. ACA requirements apply differently based on group size.
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 that requests the number of individuals employed by their company. This data helps 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 applicable groups of such changes.
Important items of note:
- Blue KC will email groups at the end of May 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 non-responders.
- Beginning July 15, Blue KC will send a letter and the form to non-responding 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.
*2023 updates to this sample letter forthcoming.