Medical Loss Ratio 2019 Rebates to DMHC Small Business plans (100 or less employees)

Blue Shield of California is to refund part of the premiums they receive, as required by the Affordable Care Act, if they do not spend at least 80% of the premiums for small groups on healthcare services, such as doctors and hospital bills, and activities to improve healthcare quality, such as efforts to improve patient safety.

Employer groups who are eligible for 2019 MLR rebates will be notified by letter by September 30, 2020.

Blue Shield of California Small Business Plans (DMHC regulated)
Subscribers and eligible employers enrolled in health plans from Blue Shield of California (Blue Shield), with 100 or fewer employees, will receive rebates by September 30, 2020. Blue Shield missed the 80 percent target by 1.0% of premiums for its Small Business Plans in 2019.

The below employer groups and subscribers will not receive 2019 rebates, as Blue Shield met or exceeded the MLR targets for those health plans.

  • Individual and Family subscribers with Blue Shield and Blue Shield of California Life & Health Insurance Company (Blue Shield Life) plans.
  • Large groups with Blue Shield and Blue Shield Life plans