Welcome to Blue Shield of California Employer Connection - ESS

Medical Loss Ratio Employer Survey

Thank you for responding to the Medical Loss Ratio (MLR) employer survey communication from Blue Shield of California. As part of the Affordable Care Act opens in new window , health insurance companies are required to report their MLR to state and federal agencies. The MLR rebate calculation is based on group size as determined by the average number of employees for your business in the prior calendar year.
Find My Company
* required
Enter your Blue Shield of California Group Number and Web Key as included in the communication we sent regarding your company's MLR information.


Company Information
* required
Company Name:
If the Company Name is not correct, please do not submit your information online. Use the fax-back option
that was included in the MLR employer information communication.
* Average number of employees in 2020
  • * Is your business a sole proprietorship?
  • * If yes, does the business cover employees other than the owner and/or their spouse or registered domestic partner under the same policy/plan?
  • * Is your group plan classified under federal
    law as a non-ERISA plan (i.e. "Church Plan")?
  • Federal law requires that we receive assurance that any future rebates will be used in certain ways to benefit your enrollees. If we do not receive this assurance, rebates (including any portion that would go to your group) will be paid directly to your subscribers.

    Rebate Distribution Confirmation

    As a Non-ERISA employer, you must check the box(es) below to agree that, if your group is eligible for a rebate, you will allocate the rebate according to one of these three federal rules of the Affordable Care Act (ACA):

    (1) To reduce the subscribers' portion of the annual premium for the subsequent policy year for all subscribers covered under any group health policy offered by the plan;

    (2) To reduce the subscribers' portion of the annual premium for the subsequent policy year for only those subscribers covered by the group health policy on which the rebate was based; or

    (3) To provide a cash refund only to subscribers that were covered by the group health policy on which the rebate is based.





  • * Is your group plan for a government entity other
    than federal (i.e. states and municipalities)?
Name
By submitting your company's information, you are stating that, to the best of your knowledge, the information accurately reflects the number of employees in your company for the period requested.
The average employee count should include any employee who received a W-2 for the given year, whether full time,part time, or seasonal, regardless of whether the employee enrolled in health coverage.Retirees and 1099 contractors should not be included.
A sole proprietorship consists of only "one" individual; ownership by more than one person creates a partnership. (Note: A husband and wife can be classified as a sole proprietorship. A business conducted by registered domestic partners must be classified as a partnership.)
A majority of employer plans are subject to the Employee Retirement Income Security Act of 1974 (ERISA). However, if your group medical insurance plan is NOT subject to ERISA, please indicate so by selecting the "yes" option, otherwise, select "no".

Examples of health plans that are probably NOT regulated by ERISA include plans that are sponsored by 1) churches and/or religious organizations; 2) school systems and/or school boards; 3) local government entities such as municipalities, counties, and public utilities; and 4) Native American tribes or reservations or entities.

If your group plan is for a non-federal government plan, please indicate by selecting the "yes" or "no" option.

Discard info?

Looking up the Group Number will clear any data previously entered. Do you want to proceed with the lookup?

Your company's information has already been submitted for this reporting year. Submitting another response for the same reporting year will replace any previously submitted response.

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