2019 SLAA Report

Amicus Curiae Brief: Centinela Freeman Emergency Medical Associates vs. Health Net of California, Inc.

Notice of Errata for Amicus Curiae Brief

Ten Year Report on Health Care Consumer Protections - The year 2010 marks a major milestone for consumers and the managed care industry in California -- the ten-year anniversary of the establishment of the DMHC. This report details the significant consumer protection laws and policies established by the DMHC over the past ten years.

Implementation of Department Review of Prescription Drug Benefits

DMHC/CDI Consistency in Consumer Protection (SB 1913)

DMHC issues amended Order of Approval for the Notice of Material Modification to Blue Cross of CA Knox-Keene License.  
This amended order supersedes the Order of Approval issued on July 23, 2004, concerning the same transaction.

• Statement by Director Ehnes
• Fact Sheet
• Correspondence to Blue Cross of California
• Amended Order of Approval
• Blue Cross of California Undertakings
• Exhibit A to Undertakings

Report to Senate Insurance Committee and Assembly Health Committee Pursuant to Health and Safety Code section 1367.03(j)

Filing Suggestions: Exhibits F, L, and M

Compliance with Section 1366.35(i): Disclosure of the Availability of HIPAA Coverage; Model Language for Use in Evidences of Coverage

Implementation of the Claim Settlement Practices and Dispute Mechanisms Regulations

Plan Disclosure of Personal Health Information to the Department of Managed Health Care

Cancellation of Enrollment

Revised Financial Reporting Forms

Signature Requirements for Reports

Unilateral Amendments to Contracts

Updated Information On The Financial Reporting Forms And Web Portal

Advisory Regarding Exempt Employee Assistance Program

• Memo
• Notice (MS Word)

Exclusion of Coverage for Certain Pharmaceuticals

Required Disclosures and Conditions of Binding Arbitration

Confidentiality of Enrollee Social Security Numbers

Restrictions on out of area maternity services

Delta Dental Purchase of Interest in Moda FAQ

Update: The DMHC approved Delta Dental’s purchase of an interest in Moda on Thursday, February 21, 2019.

Delta Dental of California (Delta Dental) filed notice with the Department of Managed Health Care (DMHC) on September 6, 2018, to purchase a 49.5 percent interest in Moda, Inc, (Moda) an Oregon insurance company. Moda is currently owned by Oregon Dental Services (Delta Dental Plan of Oregon).

Delta Dental is a DMHC-licensed plan and reported approximately 25,043,000 dental enrollees as of September 30, 2018. Moda is not a DMHC-licensed plan.

This FAQ provides information on the DMHC’s authority and review of this filing.