News & Updates
Annually UnitedHealthcare mails a survey to customer employer groups with 5 to 150 subscribers. This important survey determines accurate employee counts based upon the “preceding calendar year.” Unless the business was not in operation in the prior calendar year, UHC will always look for the number of employees from the prior year.
Accuracy is extremely important because it affects Medical Loss Ratio (MLR), Essential Health Benefit requirements, Employer Mandate and how an employer group is rated (adjusted community rating).
Each state has its own method of determining an employer group’s size. It may be a definition based upon – eligible, average total number of employees (ATNE) or full time equivalent employees (FTE). MLR is always based upon ATNE count. Small Business Health Options Program is always based upon FTE count; however, rating may be based upon either eligible, ATNE or FTE depending on the state.