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Use the health plan dashboard to 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.

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View the DMHC Dashboard for a comprehensive look at DMHC health plan data.

What's New

RFP No. 17MC-SA009 – External Party Review Services

Thursday, December 14, 2017

The Department of Managed Health Care (DMHC), Office of Financial Review (OFR) is soliciting proposals for External Party Review services to oversee the Corrective Action Plan (CAP) Process when a Risk-Bearing Organization (RBO) contracted by a health plan fails to satisfactorily meet established grading criteria. The services provided may include some or all of the following: overseeing development, implementation and completion of the CAP Process and activities explicitly described in the California Code of Regulations (CCR), Title 28, Section 1300.75.4.8.

DMHC Fines Blue Shield of CA and Care 1st Health Plan $457,500 for Consumer Grievance Violations

Friday, December 8, 2017

(Sacramento) – The California Department of Managed Health Care (DMHC) has taken enforcement actions including a $322,500 fine against California Physicians' Service (Blue Shield of California) and a $135,000 fine against Care 1st Health Plan for failing to identify, timely process, and resolve consumer grievances. The plans have also failed to fully and timely provide information to the Department during the investigation of these consumer complaints.

“The health plan grievance and appeals process is structured to ensure that consumer complaints are resolved in a timely manner, and that consumers are made aware of their right to appeal to the DMHC,” said DMHC Director Shelley Rouillard. “Blue Shield of California and Care 1st Health Plan must improve their grievance and appeals systems to better address consumer complaints and protect the health care rights of their enrollees.”

DMHC Fines Anthem Blue Cross $5 Million for Systemic Grievance System Violations

Wednesday, November 15, 2017

(Sacramento) – The California Department of Managed Health Care (DMHC) has taken enforcement action including a $5 million fine against Blue Cross of California (Anthem Blue Cross) for systemic grievance system violations. Anthem Blue Cross has demonstrated a pattern and practice of failing to identify, timely process and resolve enrollees’ grievances. Anthem Blue Cross has also failed to fully and timely provide information to the Department during the investigation of member complaints.

“The grievance process is fundamental to protecting consumers’ health care rights and ensuring consumers receive the care they need,” said DMHC Director Shelley Rouillard. “Anthem Blue Cross’ failures to comply with the law surrounding grievance and appeals rights are longstanding, ongoing and unacceptable. The plan must correct the deficiencies in their grievance and appeals system and comply with the law.”

DMHC Director Rouillard Issues Statement on Federal Regulations Regarding Contraception Coverage

Friday, October 6, 2017

(Sacramento) – California Department of Managed Health Care (DMHC) Director Shelley Rouillard issued the following statement today following the release of new federal regulations regarding contraception coverage.

“We are reviewing the details of the new federal regulations and possible impacts to Californians enrolled in plans licensed by the DMHC,” said DMHC Director Shelley Rouillard. “However, it is important to note that California has a long history of expanding timely access to birth control to prevent unintended pregnancy. California has enacted laws that promote gender equity and women’s health, and state regulated health plans must cover contraceptives for women without cost sharing with very narrow exceptions offered for religious employers as defined in California law.”

Financial Solvency Standards Board Meeting

Friday, October 6, 2017

The Department of Managed Health Care invites you to the Financial Solvency Standards Board (FSSB) public meeting on October 18, 2017. For more information please click here.

2016 Annual Report and Infographic

Monday, June 12, 2017

The Department of Managed Health Care 2016 annual report and infographic are now available online. Both of these documents highlight the DMHC’s activities during 2016 and include key statistics about the Department.

DMHC 2016 Annual Report

2016 Infographic

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