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File a Complaint
File a Complaint
Information on filing a complaint and requesting an Independent Medical Review
Independent Medical Review/Complaint Forms
Printable Independent Medical Review/Complaint Forms that can be either mailed or faxed to the DMHC Help Center
How to File a Complaint with Your Health Plan
Information on filing a grievance or complaint with your Health Plan
Independent Medical Review and Complaint Reports
Reports on Independent Medical Review outcomes, and reports on complaints and arbitration decisions
Provider Complaint Against a Plan
Submit a provider complaint
Frequently Asked Questions
Frequently asked questions for enrollees and providers
Health Care in California
Health Care in California
Helpful information on health care, health coverage, enrollee rights and how to best use your coverage
Choose the Right Plan
Information on benefits, costs and quality
Low or No-Income Options and The Uninsured
How to gain coverage through Covered California or Medi-Cal
Types of Coverage
Information on group and individual coverage
Types of Plans
Information on HMO, PPO, POS, EPO, Medi-Cal managed care and Medicare Advantage
I'm Insured, Now What?
Information on understanding and using your coverage
Get the Best Care
Information on emergency and urgent care, mental health care, prescription drugs, preventive care, pregnancy care and clinical trials
Your Health Care Rights
Information on enrollees’ rights
Resources for Health Care Providers
Prescription drug prior authorization request form and other resources for providers
Resource List
Contact information for health care-related organizations, useful terms and fact sheets
Premium Rate Review
Proposed rate increases for individual or small group health plans
Data & Research
Data & Research
Premium rate information, financial information, medical and financial survey reports, complaint reports, enforcement actions, and other information
Search Independent Medical Review Decisions
Database containing Independent Medical Review decisions
Archived Documents
Archived communications from the DMHC
Health Plan Dashboard
Health Plan Dashboard
View or compare health plan information. The health plan dashboard features health plan contact information, enrollment data, complaint and IMR data, enforcement actions, and financial data.
DMHC Dashboard
View aggregated data for health plans licensed by the DMHC.
Enforcement Actions
View aggregated enforcement action data.
Consumer Complaints and IMRs
View aggregated health plan complaint and Independent Medical Review data.
Financial Stability
View aggregated health plan enrollment and financial data.
Licensing & Reporting
Licensing & Reporting
Health plan licensing information and information on reporting to the DMHC
Health Plan Licensing
How to obtain a license
Filing and Reporting Process
How to file reports with the DMHC
Submit Health Plan Filings
Submit quarterly grievance reports, timely access reports, block transfer filings, and arbitration decisions
Risk Bearing Organizations
Submit risk bearing organization reports
Health Plan Compliance/Medical Survey
View health plan survey reports and technical assistance guides
View Financial Examination Reports
View health plan financial examination reports
Submit Financial Reports
Submit financial reports, financial solvency reports, claims settlement practices, dispute resolution reports, and premium rate filings.
Pharmacy Benefit Manager Registration
Information about Pharmacy Benefit Manager Registration
Individual and Small Group Product Filings
View information about Individual and Small Group Product Filings
Employee Assistance Program
Information about Employee Assistance Programs
About the DMHC
About the DMHC
Learn about the DMHC’s mission, vision and organizational structure
Contact Us
DMHC contact information
Leadership Team
Leadership team biographies
Career Opportunities
Job openings at the DMHC
Strategic Plan 2015 - 2019
Learn about DMHC's Strategic Plan 2015 – 2019
Request for Public Records
Request information and public records maintained by the DMHC
DMHC Public Meetings
View the agendas, presentations, and other DMHC public meetings materials.
DMHC Reports
DMHC legislative, public and annual reports
Newsroom
Media relations contact information, press releases and recent articles
Laws & Regulations
The Knox-Keene Health Care Service Plan Act, regulations, administrative decisions, Director’s Letters, and other information.
Opportunities to Participate
Comment on draft regulations or participate in the rulemaking process
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File a Complaint
Independent Medical Review/Complaint Forms
How to File a Complaint with Your Health Plan
Independent Medical Review and Complaint Reports
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Submit a Provider Complaint
Emergency Services Independent Dispute Resolution Process
Non Emergency Services Independent Dispute Resolution Process
Frequently Asked Questions
Health Care in California
Choose the Right Plan
Low or No-Income Options and The Uninsured
Types of Coverage
Types of Plans
Keep Your Health Coverage (COBRA)
Individual Conversion Plans (HIPAA)
I'm Insured, Now What?
Get the Best Care
Care of Illness
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Emergency and Urgent Care
Mental Health Care
Prescription Drugs
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Pregnancy Care
Your Health Care Rights
Continuity of Care
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You and Your Doctor
Referrals and Approvals
Disability Access
Disability Specialist Contact Form
Physical Access to Care - Fact Sheet
Hearing Disabilities - Fact Sheet
Hearing-Deaf - Fact Sheet
Vision - Fact Sheet
Getting Health Care Benefits and Services - Fact Sheet
Timely Access to Care
Resources for Health Care Providers
Resource List
Useful Terms
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Premium Rate Review
What is Premium Rate Review?
Rate Review Process
Health Care Costs
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Data & Research
Search Independent Medical Review Decisions
Archived Documents
Health Plan Dashboard
DMHC Dashboard
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Summary of Benefit & Coverage (SB388)
All Plan Letters
Filing and Reporting Process
eFile Guide
Submit Health Plan Filings
Timely Access Compliance and Annual Network Reporting
Quarterly Grievance Report
Block Transfer Filings
Arbitration Decisions
Language Assistance Filing Checklists
Risk Bearing Organizations
Submit RBO
RBO – Financial Report Results
RBO Frequently Asked Questions
Health Plan Compliance/Medical Survey
View Financial Examination Reports
Submit Financial Reports
Pharmacy Benefit Manager Registration
Individual and Small Group Product Filings
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Financial Solvency Standards Board Archive
Opportunities to Participate
Consumer Participation Program - Frequently Asked Questions
Applications for an Award to Participate
Need Help with Your Health Plan?
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