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Blue Shield and other health insurance carriers are required by The Affordable Care Act (ACA) to spend a minimum percentage of plan members' premium on medical expenses, known as the Medical Loss Ratio (MLR). Blue Shield will send out MLR employer surveys (to groups with <150 employees) requesting information to help calculate the MLR for 2025, as required by the ACA. If any rebates are owed, these will be issued by September 30, 2026.

1.    The average number of employees for their business in calendar year 2024.

2.    Whether their business is wholly owned by one individual and their spouse.

3.    Whether they are a non-governmental or non-ERISA plan.

Note: Most employers are covered by ERISA As a reminder, when calculating 2025 MLR rebates owed, 2024 information is used for statistical sampling purposes.

The deadline to submit information is March 31, 2026.

For More Information or Help Quoting Blue Shield, Please Contact Your Dickerson Sales Rep.