Data & Research | Reports, Filings, Financial Information, Enforcement Actions

Data & Research

Providing information to the public is an important part of the consumer protection services provided by the DMHC. Search our databases and read our reports to gain a better understanding of California’s health care delivery systems.

 

Health Plan Dashboard


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.

Select a health plan by using the search window above or choose from a list of all plans.

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

Premium Rate Review

Financial Information

Health Plan Information

Health Plan Compliance Information

  • List of Pending Health Plan Applications - Applications for a health plan license submitted to the Department and under Knox-Keene Act review.
  • Medical Survey Reports - California managed care law (Knox-Keene Health Care Service Plan Act) requires the Department to conduct a routine medical survey of each licensed full service and specialty health plan at least once every three years.
  • Search Enforcement Actions - Search for enforcement actions, which have been adjudicated since July 1, 2000, in the Enforcement Action Database.
  • Timely Access Reports - Summary of health and mental health plan compliance with the timely access regulations.

Provider Related Information

  • Quarterly Claims Settlement Practices Report
    Shows health plans and capitated providers that did not reimburse at least 95% of claims on a timely basis. The information is provided for the past five quarters.
  • Provider Complaint / Dispute Issues Statistics - The Department of Managed Health Care's Provider Complaint Unit tracks and trends provider complaints submitted by California providers. The posted statistical information reflects the provider complaint activity for each calendar year quarter.

Disputes and Resolutions

  • Arbitration Decisions - Each health plan which uses arbitration to settle disputes with its members must file with the Department a copy of any written arbitration decision.
  • Independent Medical Review and Complaint Resolutions - The Department publishes an annual report that details the number and types of complaints or grievances received during the calendar year, including Independent Medical Review (IMR) data.
  • Search for Independent Medical Review cases - The IMR program was created by the California Legislature, and provides a vital service for California health plan members. In our database, you’ll find all IMR decisions since the program began on January 1, 2001.