Information on filing a complaint and requesting an Independent Medical Review

Printable Independent Medical Review/Complaint Forms that can be either mailed or faxed to the DMHC Help Center

Information on filing a grievance or complaint with your Health Plan

Reports on Independent Medical Review outcomes, and reports on complaints and arbitration decisions

Submit a provider complaint

Frequently asked questions for enrollees and providers

Helpful information on health care, health coverage, enrollee rights and how to best use your coverage

Information on benefits, costs and quality

How to gain coverage through Covered California or Medi-Cal

Information on group and individual coverage

Information on HMO, PPO, POS, EPO, Medi-Cal managed care and Medicare Advantage

Information on understanding and using your coverage

Information on emergency and urgent care, mental health care, prescription drugs, preventive care, pregnancy care and clinical trials

Information on enrollees’ rights

Prescription drug prior authorization request form and other resources for providers

Contact information for health care-related organizations, useful terms and fact sheets

Proposed rate increases for individual or small group health plans

Premium rate information, financial information, medical and financial survey reports, complaint reports, enforcement actions, and other information

Database containing Independent Medical Review decisions

Archived communications from the DMHC

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.

View aggregated data for health plans licensed by the DMHC.

View aggregated enforcement action data.

View aggregated health plan complaint and Independent Medical Review data.

View aggregated health plan enrollment and financial data.

Health plan licensing information and information on reporting to the DMHC

How to obtain a license

How to file reports with the DMHC

Submit quarterly grievance reports, timely access reports, block transfer filings, and arbitration decisions

Submit risk bearing organization reports

View health plan survey reports and technical assistance guides

View health plan financial examination reports

Submit financial reports, financial solvency reports, claims settlement practices, Assembly Bill 72 (AB 72) and dispute resolution reports, and premium rate filings.

View information about Individual and Small Group Product Filings

Information about Employee Assistance Programs