EmblemHealth Requesting Group Size Information
To comply with provisions of the federal Affordable Care Act and certain other laws and regulations, we are requesting some important information from your clients concerning group size. You will find details about this request in the attached letter that we sent to groups on March 16.
Why We Are Asking for This Information
The federal health care reform law's Medical Loss Ratio (MLR) provision stipulates the percentage
of premium that insurers must spend on medical care and activities that improve quality. If our costs are lower than the minimum required to be spent on these services, we issue groups a rebate.
The rebate is based in part on whether a group is classified as small
To do this, we need to know each year the average number of employees in your clients'
What Your Clients Must Do
To help us submit accurate information to the government, we are asking your clients to fill
If you have any questions, please contact your EmblemHealth representative.
|Group Health Incorporated (GHI), GHI HMO Select, Inc. (GHI HMO), HIP Health Plan of New York (HIP), HIP Insurance Company of New York and EmblemHealth Services Company, LLC are EmblemHealth companies. EmblemHealth Services Company, LLC provides administrative services to the EmblemHealth companies.|