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This email is intended for producers with business in Central PA, Western PA, & Northeastern PA.
HIGHMARK ANNUAL GROUP CLIENT MSP/MLR EMPLOYEE COUNT COLLECTION ONLINE SURVEY
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We wanted to make you aware that on or about April 12, 2024, 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 2023 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 June 20, 2024.
About the MSP/MLR survey
All group clients must complete the survey with their 2023 employee count information to ensure Highmark has accurate data on file.
If you still need to submit the survey you can access it here.
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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Highmark Inc. is an independent licensee of the Blue Cross Blue Shield Association. Insurance or benefit administration may be provided by or through Highmark Inc. or one of its affiliated Blue companies. Highmark Inc. d/b/a Highmark Blue Shield and certain of its affiliated Blue companies serve Blue Shield members in the 21 counties of central Pennsylvania. As a partner in joint operating agreements, Highmark Blue Shield also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Inc. or certain of its affiliated Blue companies serve Blue Cross Blue Shield members in the 29 counties of western Pennsylvania, 13 counties in northeast Pennsylvania, the state of West Virginia plus Washington County, Ohio, and the entire state of Delaware. Highmark Blue Cross Blue Shield of Western New York is a trade name of Highmark Western and Northeastern New York Inc., an independent licensee of the Blue Cross Blue Shield Association. Highmark Blue Shield of Northeastern New York (Highmark BSNENY) is a trade name of Highmark Western and Northeastern New York Inc., an independent licensee of the Blue Cross Blue Shield Association.
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This email and any attachments contain important information about Highmark, including its products, customers and business
processes, and may include information which Highmark considers to be confidential and proprietary ("the Highmark Information").
The Highmark Information is intended solely for the use of the individual or entity to which it is addressed, including employees of that
entity with a need to access such information. Unauthorized use, disclosure or copying of the Highmark Information, including the
posting of such information on a website or social media sites that can be accessed by third parties, is strictly prohibited.
® Highmark is a registered mark of Highmark Inc.
© 2016 Highmark Inc., All Rights Reserved
120 Fifth Avenue Pittsburgh, PA 15222 USA
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