The following reports are published by the DMHC and made available to the public.
Timely Access Report
The Timely Access Report summarizes provider appointment availability data that health plans submitted to the DMHC. The charts within this report show provider responses to appointment availability requests.
Measurement Year 2022
Measurement Year 2021
Measurement Year 2020
Measurement Year 2019
Measurement Year 2018
Measurement Year 2017
Measurement Year 2016
Measurement Year 2015
Measurement Year 2014
Prescription Drug Cost Transparency Report
Senate Bill (SB) 17 (2017) requires health plans and health insurers that file rate information with the DMHC or the California Department of Insurance (CDI) to annually report specific information related to the costs of covered prescription drugs. This report looks at the impact of the cost of prescription drugs on health plan premiums in the commercial market.
Measurement Year 2023
Measurement Year 2022
Measurement Year 2021
Measurement Year 2020
Measurement Year 2019
Measurement Year 2018
Measurement Year 2017
Health Plan Aggregate Premium Rate Report
Senate Bill (SB) 546 (Leno, 2015) requires health plans to submit aggregate rate information for products in the large group market with the DMHC by October 1, 2016, and annually thereafter. SB 17 (Hernandez, 2017) added an additional requirement for health plans in the large group market to submit specific prescription drug cost information.
Assembly Bill (AB) 2118 (Kalra, 2020), as codified in Health and Safety Code section 1385.043, requires health plans that offer commercial products in the individual and small group market to report to the DMHC specified information, including premiums, cost sharing, benefits, enrollment, and trend factors by October 1, 2021, and annually thereafter.
The report summarizes aggregate rate information and weighted average rate changes across the individual, small group, and large group markets.
Measurement Year 2024
Measurement Year 2023
Measurement Year 2022
Measurement Year 2021
Measurement Year 2020
Measurement Year 2019
Measurement Year 2018
Measurement Year 2017
Measurement Year 2016
Enrollment Summary Reports
Full service health plans are required to annually report the number of enrollees and covered lives that receive coverage under specified policies, as of December 31st of the prior year. Additionally, plans that provide coverage through a multiple employer welfare arrangement (MEWA) are required to report the name of each MEWA and the number of covered persons in each MEWA as of December 31 of the prior year. The Enrollment Summary Report summarizes the information reported by the health plans.
Health Equity and Quality Committee Recommendations Report
The DMHC convened a Health Equity and Quality Committee to make recommendations to the Department for standard health equity and quality measures, including annual benchmark standards for assessing equity and quality in health care delivery required by Assembly Bill (AB) 133 (2021). This report documents the recommendations developed by the Committee, which met over eight months in a series of public meetings.
Behavioral Health Investigation Reports
The DMHC received approval from the 2020-21 state budget to conduct focused Behavioral Health Investigations of all full-service commercial health plans regulated by the Department to further evaluate health plan compliance with California laws and to assess whether enrollees have consistent access to medically necessary behavioral health services.
Transgender, Gender Diverse, or Intersex (TGI) Health Care Quality Standards and Training Curriculum Working Group Report
The DMHC convened the Transgender, Gender Diverse, or Intersex (TGI) Health Care Quality Standards and Training Curriculum Working Group to make recommendations to the Department, as required by Senate Bill (SB) 923 (2022). The Working Group’s purpose was to develop a quality standard for patient experience to measure cultural competency related to the TGI community and recommend a trans-inclusive training curriculum to be used by health care plan staff who are in direct contact with enrollees in the delivery of health care services. This report documents the recommendations developed by the Working Group, which met nine times from April 2023-February 2024, in addition to hosting four statewide listening sessions in Fall 2023.