Medical Loss Ratio Information
The Centers for Medicare and Medicaid Services provide Medical Loss Ratio data on their website:
https://www.cms.gov/apps/mlr/mlr-search.aspx
Select a reporting year, select “California”, and then enter the legal name of the company you’re interested in:
- “Aetna Health of California Inc.”
- “Blue Cross Of California” for Anthem BlueCross
- “California Physicians' Service” for Blue Shield of California
- “Chinese Community Health Plan” for CCHP Health Plan
- “Health Net Of California, Inc.” for Health Net CA
- “Kaiser Foundation Health Plan, Inc.” for Kaiser Permanente
- “Local Initiative Health Authority for Los Angeles County” for LA Care Health Plan
- “Molina Healthcare of California” for Molina Healthcare
- “Oscar Health Plan of California” for Oscar (No Data Prior to 2015)
- “Santa Clara County” for Valley Health Plan
- “Sharp Health Plan”
- “Western Health Advantage”
Health Net Life annual financial statements discuss Medical Loss Ratio and can be found on the CDI website:
https://interactive.web.insurance.ca.gov/companyprofile/companyprofile?event=financialStatementEvent&doFunction=annualStatementsHome
From the left toolbar:
- Company Profile — Select “Company Search”
- Company Name — Type in “Health Net Life Insurance Company” for Health Net Life
- “Get Company” — Select button
- Search Results — Select Health Net Life Insurance Company with “NAIC Number” 66141
- Financial Statements PDF’s — Select “Annual Statements”
- Annual Financial Statements – Select a year
- Choice of statements are displayed.
Consumer Information
- Information on Cost-Sharing and Payments With Respect To Out-of-Network Coverage
- Enrollee Rights Information Under Title I of the Affordable Care Act
Quality Ratings
Claims
Data and Enrollment
- Data on Enrollment
- Data on Disenrollment
- Data on Rating Practices
- Data on Denied Claims
- Data on Appeals
Financial Information
Rate Booklet
- 2023 Regional Rate Sheets
- 2022 Regional Rate Sheets
- 2021 Regional Rate Sheets
- Covered California's Health Insurance Companies and Plan Rates for 2022
- 2020 Health Plan Rate Booklet
- 2019 Health Plan Rate Booklet
- 2021 Family Dental Rate Booklet
- 2020 Family Dental Rate Booklet
Contracts
- 2017-2023_QDP_Issuer_Model_Contract_8.1.22.pdf
- 2023-2025_QHP_IND_Att-1_Appendix-A_8-1-22_Clean_7-19_v
- 2023-2025_QHP_IND_Att-2_Performance-Standards-with-Penalties_8-1-22
- 2023-2025_QHP_IND_Att-3_Performance-Standards-and-Expectations_8-1-22
- 2023-2025_QHP_IND_Att-4_8-1-22_Clean
- 2023_QHP_IND_Att-5_Off-Exchange Silver_8-1-22
- 2023-2025 QHP_IND_Model-Contract_Final_Clean_8-1-22
- 2023-2025_ QHP_CCSB_Attachment-1_Clean_8-1-22
- 2023-2025_CCSB_Att-2_Performance-Standards-With-Penalties_8-1-22
- 2023-2025_CCSB_Att 3_Performance-Standards-and-Expectations_8-1-22
- 2023-2025_QHP_CCSB_Model-Contract_8-1-22
- 2023_Attachment-5_CCSB
- QHP Individual Market Model Contract for 2017-2022 - Amended for 2022
- QHP Individual Market Attachment 7 for 2017-2022 - Amended for 2022
- QHP Individual Market Attachment 14 for 2017-2022 - Amended for 2022
- QDP Model Contract for 2017-2022 - Amended for 2022
- QDP Attachment 3 for 2017-2022 - Amended for 2022
- QDP Attachment 7 for 2017-2022 - Amended for 2022
- QDP Attachment 14 for 2017-2022 - Amended for 2022
- CCSB QHP Model Contract for 2017-2022 - Amended for 2022
- CCSB Attachment 3 for 2017-2022 - Amended for 2022
- CCSB Attachment 7 for 2017-2022 - Amended for 2022
- CCSB Attachment 14 for 2017-2022 - Amended for 2022