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*This email is intended for producers in Pennsylvania
Highmark Annual Group Client MSP/MLR Employee Count Collection Online Survey
We wanted to make you aware that on 4/30/21-5/1/21, Highmark sent a letter to all group clients (small, mid-large, regional, and national markets) that had active Highmark medical and/or drug coverage in 2020 in western, central, and/or northeastern Pennsylvania.
The letter will direct all clients to complete a mandatory on-line Medicare Secondary Payer and Medical Loss Ratio (MSP/MLR) survey. This survey must be completed by May 24, 2021.
About the MSP/MLR survey
All group clients must complete the survey with their 2020 employee count information to ensure Highmark has accurate data on file.
Note: Clients can also elect to receive their contract (and contract updates) online only, in lieu of paper, by completing the "Acknowledgement" at the end of the MSP/MLR survey.
Highmark is required to verify employee counts annually to comply with Medical Loss Ratio and Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007.
Medicare Secondary Payer (MSP)
The Centers for Medicare & Medicaid Services use MSP information to determine whether Highmark or Medicare is the primary payer of claims for your Medicare-eligible employees. The information you provide will assist with timely and accurate processing of your claims and help to avoid unanticipated costs for your employees in the future.
Medical Loss Ratio (MLR)
The Affordable Care Act requires Highmark and other insurers to spend a certain percentage of premium revenue on medical expenses and activities to improve health care. This percentage is called the MLR. If we do not meet the required MLR for a given calendar year, we will be required to pay rebates to policyholders. The information you provide will assist with determining your employer size and whether your organization is eligible for a rebate.
Questions?
If you have any questions, please contact your Highmark Client Manager or Highmark Sales Executive.
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