Health Plan Reports and Results
Listed below are four areas of public information submitted by health plans as required to maintain licensure and accreditation. For more information or to view these documents click on the links below.
1. Quality Assurance - Aside from investigating individual complaints, the Department of Health uses the Quality Assurance Examination and Targeted Examination as two vehicles to ensure legal compliance.
2. Financial Reporting - Health Plans also need to show evidence of financial solvency and are required to submit Financial Statements, copies of their IRS Form 990, executive compensation, as well as a financial examination by the Department of Commerce.
3. HEDIS - Each plan compiles statistics on quality, access and other performance markers as determined by the NCQA. These statistics are compiled in the same manner by each plan and allows consistent comparison between plans or to measure improvements from year to year.
4. Enrollment - Each plan submits enrollment information on a yearly basis. These reports also break down the enrollment populations by product and age.
5. Complaints - Comparison Stats, summaries and processes.
Click Here to view a report summary for each plan.
For more information, or to file a complaint, contact MCS section at (651) 201-5100 or 1-800-657-3916.