Employer Group Size information required to fulfill federal regulation

Dear Customer,

Independence Blue Cross (Independence) and its affiliates are required by federal regulations to contact you for information regarding your employee count size, as outlined under Medicare Secondary Payer (MSP) and Medical Loss Ratio (MLR) guidelines.

The Centers for Medicare & Medicaid Services (CMS) uses MSP information to determine whether we or Medicare are the primary payer of claims for your Medicare-eligible employees.

The Affordable Care Act includes a provision that requires a health insurer’s MLR be above a minimum level. If an insurer’s MLR is below this minimum level, the insurer must return some of the paid premiums to the employer.

What you need to do

Please complete this survey within 10 days of receipt of the MSP/MLR letter. You will need your Company ID (provided to you on the letter) to complete the form.

Your failure to submit the worksheet may result in the receipt of a demand letter from CMS and/or the imposition of fines or penalties on you or us.

The information included with this letter is not intended to serve as legal advice. Please consult with your legal counsel if you have any questions regarding MSP or MLR rules/regulations.

If you have any questions, please call your broker or account executive. If you do not know who your account executive or broker is, call 1-800-ASK-BLUE. We value your business and thank you.

Customer Service