Health Plan Quality Ratings
Covered California’s quality ratings show how our health plans compare on helping members get the right medical care, and on member-reported experiences of care and service.
Covered California has been reporting quality ratings since day one. These ratings play an important role in helping Californians get better care at affordable prices. California health plans perform well in most areas: Several Covered California plans earned very high or top ratings, and half of the plans are rated three-star or higher on members’ getting the right medical care. But the performance standards set by the highest-performing plans tells us that some plans can do better.
Covered California is working with its health insurance companies to improve the quality and overall value of the coverage they offer. Key efforts include seeing that every member is matched to a primary care clinician; connecting the sickest enrollees with health care organizations that have demonstrated superior-quality care; identifying and eliminating gaps in good care across populations of people who differ by ethnicity, race or income; and advancing health care technology to improve care and eliminate unsafe practices.
Click on the following link to be taken directly to the Health Plan Quality Ratings for 2019.
- Information on Cost-Sharing and Payments With Respect To Out-of-Network Coverage
- Enrollee Rights Information Under Title I of the Affordable Care Act
Data and Enrollment
- QHP Model Contract for 2017-2019 – Amended for 2019
- QDP Model Contract for 2017-2019 – Amended for 2019
- CCSB Model Contract for 2017-2019 – Amended for 2019
- Attachment 7 for 2017-2019 - Amended for 2019
- QHP Model Contract 2017-2019 – Amended for 2017 and 2018
- QDP Model Contract 2017-2019 – Amended for 2017 and 2018
- CCSB Model Contract 2017-2019 – Amended for 2017 and 2018
- Attachment 7 –
Amended for 2017 and 2018
- QHP Model Contract for 2017-2019
- QDP Model Contract for 2017-2019
- CCSB Model Contract for 2017-2019