Annual Group Size Survey Underway

Sep 15, 2016

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.

Why is the Employee Count Survey Important?

Based on the rules under the Affordable Care Act, for rating purposes insurers are required to use the preceding calendar year employer size for any quotes for the current year. This is true for quotes for new as well as renewing customers. For example, rates quoted in 2016 MUST use the size of the employer from 2015 NOT the size of the employer in 2016.

Please encourage your clients to complete this important survey when it is mailed. And remember, for rating, to use the preceding calendar year employer size as required by the state and federal law.

For questions, please contact a member of your b&p Sales Team - 888.722.3373.