Highmark's MSP and MLR

This email is intended for producers with business in Delaware, New York, Pennsylvania, and West Virginia.

Highmark's Annual Medicare Secondary Payer (MSP) and Medical Loss Ratio (MLR) Employee Count Survey is still live.

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. We first communicated this process in April 2025, and a copy of the producer blast can be found here.

What do I need to know?

We're sending a second letter to all clients that had active Highmark medical and/or drug coverage at any time during the previous calendar year (2024) and who didn't complete the initial survey. The letter will direct clients to complete the mandatory on-line Medicare Secondary Payer and Medical Loss Ratio (MSP/MLR) survey. All group clients must complete the survey with their 2024 employee count information to ensure Highmark has accurate data on file. The survey must be completed by September 15, 2025. (If your client(s) previously completed the online survey, they can disregard this second notice.)

New this year: A link to the online survey is posted in the Highmark Employer Portal under the 'What's New' section.

What do I need to do?

Inform your clients about this second mailing and the survey requirement, and guide them to the Employer Portal to complete the survey by September 15, 2025..If your client(s) previously completed the online survey, no action is needed.

Questions?

Copies of the client letters are attached for reference. Please contact your Highmark Client Manager with any questions.

Attachment(s)
2025 MSP/MLR Letter (Delaware, Pennsylvania, and West Virginia)2025 MSP/MLR Letter (New York)

Benefits and/or benefit administration may be provided by or through the following entities, which are independent licensees of the Blue Cross Blue Shield Association:
Western and Northeastern PA: Highmark Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Choice Company, Highmark Health Insurance Company, Highmark Coverage Advantage Inc., Highmark Benefits Group Inc., First Priority Health, First Priority Life or Highmark Senior Health Company.
Central and Southeastern PA: Highmark Inc. d/b/a Highmark Blue Shield, Highmark Benefits Group Inc., Highmark Health Insurance Company, Highmark Choice Company or Highmark Senior Health Company.
PA: Your plan may not cover all your health care expenses. Read your plan materials carefully to determine which health care services are covered. For more information, call the number on the back of your member ID card or, if not a member, call 866-459-4418.
Delaware: Highmark BCBSD Inc. d/b/a Highmark Blue Cross Blue Shield.
West Virginia: Highmark West Virginia Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Health Insurance Company or Highmark Senior Solutions Company. Visit https://www.highmarkbcbswv.com/networkaccessplan to view the Access Plan required by the Health Benefit Plan Network Access and Adequacy Act. You may also request a copy by contacting us at the number on the back of your ID card.
Western NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Cross Blue Shield.
Northeastern NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Shield.
Highmark Blue Cross Blue Shield and Highmark Blue Shield are Medicare Advantage HMO, PPO, and/or Part D plans with a Medicare contract. Enrollment in these plans depends on contract renewal.
All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration and/or to one or more of its affiliated Blue companies.

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processes, and may include information which Highmark considers to be confidential and proprietary ("the Highmark Information").
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entity with a need to access such information. Unauthorized use, disclosure or copying of the Highmark Information, including the
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