Monday, July 15, 2013


DMHC Finds Covered California Proposed Health Plan Rates Not Unreasonable

(Sacramento) – The California Department of Managed Health Care (DMHC) announced today that the proposed rates for individual health plans to be offered through Covered California are not unreasonable. As required by law, DMHC actuaries conducted a thorough review of the premium rates proposed by 13 Qualified Health Plans that will offer coverage beginning January 1, 2014. The actuaries evaluated the plans’ justification for the proposed rates, including anticipated medical and administration costs, utilization trends and profits.

"DMHC actuaries carefully reviewed the proposed rate filings from each of 13 Qualified Health Plans that will offer coverage in the individual market through Covered California. Upon close scrutiny, the DMHC found that the plans have justified their proposed premium rates," said DMHC Director Brent Barnhart.

The DMHC reviewed proposed premiums for the following individual Covered California Qualified Health Plans:

  • Alameda Alliance for Health Valley Health Plan
  • L.A. Care Health Plan
  • Contra Costa Health Services
  • Anthem Blue Cross of California
  • Ventura County Health Care Plan
  • Molina Healthcare
  • Health Net
  • Blue Shield of California
  • Western Health Advantage
  • Sharp HealthCare
  • Kaiser Permanente
  • Chinese Community Health Plan

Since January 2011, the DMHC has saved Californians approximately $53 million through its health plan rate review program. Under existing state law, proposed rates and increases for individual or small group health plans must be filed with the DMHC. The department's actuaries perform an in-depth review of all proposed rate increases to ensure that the proposed rate changes are justified by underlying medical costs and trends.

For more information on premium rate review, visit

About the DMHC

The DMHC regulates managed care health plans in California, protects the rights of approximately 20 million health plan enrollees, educates consumers on their health care rights and responsibilities, and preserves the financial stability of the managed health care system. Since 2000, the department has helped more than 1 million Californians resolve health plan problems through its Help Center. Information and assistance is available 24/7 at or by calling 1-888-466-2219.