Medical Loss Ratio (MLR) annual survey process underway at Health Net

BrokerCharts1Ensuring we are compliant with all government and regulatory requirements is a top priority at Health Net.

Currently, we are working to comply with the Medical Loss Ratio (MLR) provision of the Affordable Care Act (ACA) which requires all health care insurers to spend a certain percentage of premium revenue on medical expenses.

If the MLR requirements are not met, premium rebates must be issued in the following MLR reporting year.

We want you to know that we are sending a survey to employer groups who had Health Net coverage in 2017 and asking them to provide us with their 2017 average number of employees. It is crucial that those groups who receive a letter provide us with this information so they can be accurately categorized for MLR purposes.

Employee count

The required calculation is simply the average monthly number of employees (not the number of people enrolled in, or eligible for, the health plan) in the business during the prior calendar year.

Any employee who received a W-2 in 2017 – including full-time, part-time and seasonal workers – should be counted.  The employee count should not include retirees or 1099 contractors.

Deadline is March 1, 2018 

This is a time-sensitive process, and it’s important that your employer group clients respond to our letter as soon as possible.

If your clients do not submit their employee averages by March 1, 2018, their group size will be categorized based upon our current records, which may impact the MLR calculation and affect any possible premium rebate.

How to submit information

Employer groups can submit their employee count information online at

The following will be needed to collect the information:

  • Policyholder ID: «PHID»
  • Policyholder name: «GROUP»

If you have any questions or would like further details, please contact your dedicated Health Net sales representative.




Related Reading

Bret Smith