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NJ Office - 973-257-5558


8/1/11 -Horizon Brief Notes MLR - Average Employee Counts for Medical Loss Ratio (MLR) reporting due August 19, 2011. The Affordable Care Act (ACA) established new rules related to medical loss ratios (MLRs) effective January 1, 2011. The ACA requires health insurance companies to provide premium rebates to enrollees when they do not meet certain MLRs for fully insured business in the individual and small and large group markets. To determine MLRs and potential rebates due, the law requires health insurance companies to obtain the average number of employees during the preceding calendar year for each employer group. To comply with federal requirements, Horizon Blue Cross Blue Shield of New Jersey is collecting from fully insured group customers with 200 and fewer enrollees, their average number of employees in calendar year 2010. The information is due by August 19, 2011.