Plan Management & Delivery Systems Reform
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Edit December 8th Meeting
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December 8th, 2022: Plan Management Advisory Group Meeting and Webinar
Edit November 10th Meeting
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November 10th, 2022: Plan Management Advisory Group Meeting and Webinar
Edit October 13th Meeting
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October 13th, 2022: Plan Management Advisory Group Meeting and Webinar
Edit September 29th Meeting
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September 29th, 2022: QDP Issuer Model Contract Refresh Workgroup Meeting
Edit August 16th Meeting
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August 16th, 2022: QDP Issuer Model Contract Refresh Workgroup Meeting
Edit July 7th Meeting
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July 7th, 2022: QDP Issuer Model Contract Refresh Workgroup Meeting
Edit June 9th Meeting
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June 9th, 2022: Plan Management Advisory Group Meeting and Webinar
Edit June 2nd Meeting
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June 2nd, 2022: QDP Issuer Model Contract Refresh Workgroup Meeting
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May 12th, 2022: Plan Management Advisory Group Meeting and Webinar
Edit May 5th Meeting
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May 5th, 2022: QDP Issuer Model Contract Refresh Workgroup Meeting
Edit April 7th Meeting
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April 7th, 2022: Plan Management Advisory Group Meeting and Webinar
Edit April 7th Meeting
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April 7th, 2022: QDP Issuer Model Contract Refresh Workgroup Meeting and Webinar
Edit February 10th Meeting
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February 10th, 2022: Plan Management Advisory Group Meeting and Webinar
Edit January 13th Meeting
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January 13th, 2022: Plan Management Advisory Group Meeting and Webinar
Edit December 9th Meeting
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December 9th, 2021: Plan Management Advisory Group Meeting and Webinar
Edit November 10th Meeting
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November 10th, 2021: Plan Management Advisory Group Meeting and Webinar
Edit October 14th Meeting
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October 14th, 2021: Plan Management Advisory Group Meeting and Webinar
Edit September 9th Meeting
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September 9th, 2021: Plan Management Advisory Group Meeting and Webinar
Edit September 2nd Meeting
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September 2nd, 2021: Attachment 7 Refresh Workgroup Meeting and Webinar
Edit August 12th Meeting
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August 12th, 2021: Attachment 7 Refresh Workgroup Meeting and Webinar
- Agenda
- Presentation
- Webinar Recording is unavailable
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July 8th, 2021: Attachment 7 Refresh Workgroup Meeting and Webinar
Edit June 10th Meeting
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June 10th, 2021: Plan Management Advisory Group Meeting and Webinar
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June 3rd, 2021: Attachment 7 Refresh Workgroup Meeting and Webinar
Edit May 6th Meeting
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May 6th, 2021: Attachment 7 Refresh Workgroup Meeting and Webinar
Edit April 1st Meeting
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April 1st, 2021: Attachment 7 Refresh Workgroup Meeting and Webinar
Edit March 11th Meeting
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March 11th, 2021: Plan Management Advisory Group Meeting and Webinar
Edit January 7th Meeting
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January 7th, 2021: Plan Management Advisory Group Meeting and Webinar
Edit December 10th Meeting
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December 10th, 2020: Plan Management Advisory Group Meeting and Webinar
Edit November 12th Meeting
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November 12th, 2020: Plan Management Advisory Group Meeting and Webinar
Edit October 8th Meeting
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October 8th, 2020: Plan Management Advisory Group Meeting and Webinar
Edit September 10th Meeting
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September 10th, 2020: Plan Management Advisory Group Meeting and Webinar
Edit August 13th Meeting
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August 13th, 2020: Plan Management Advisory Group Meeting and Webinar
Edit July 9th Meeting
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July 9th, 2020: Plan Management Advisory Group Meeting and Webinar
Edit June 12th Meeting
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June 12th, 2020: Quality Rating System Reporting for Measurement Year 2019 Due To COVID-19 – Data Submission Instructions
Edit May 14th Meeting
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May 14th, 2020: Quality Rating System Reporting for Measurement Year 2019 Due To COVID-19
Edit May 14th Meeting
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May 14th, 2020: Plan Management Advisory Group Meeting and Webinar
Edit March 19th Meeting
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March 19th, 2020: Plan Management Advisory Group Meeting and Webinar
Edit March 5th Meeting
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March 5th, 2020: Attachment 7 Refresh Workgroup Meeting and Webinar
Edit January 9th Meeting
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January 9th, 2020: Plan Management Advisory Group Meeting and Webinar
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December 5th, 2019: Attachment 7 Refresh Workgroup Meeting and Webinar
Edit November 14th Meeting
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November 14th, 2019: Plan Management Advisory Group Meeting and Webinar
Edit November 6th Meeting
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November 6th, 2019: Attachment 7 Refresh Workgroup Meeting and Webinar
Edit October 10th Meeting
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October 10th, 2019: Plan Management Advisory Group Meeting and Webinar
Edit October 3rd Meeting
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October 3rd, 2019: Attachment 7 Refresh Workgroup Meeting and Webinar
Edit September 24 Meeting
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September 24, 2019: Attachment 7 Refresh Workgroup Meeting and Webinar
Edit July 31 Meeting
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July 31, 2019: Attachment 7 Refresh Workgroup Meeting and Webinar
Edit September 3rd Meeting
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September 3rd, 2019: Plan Management Advisory Group - Update
Edit July 18th Meeting
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July 18th, 2019: Plan Management Advisory Group Meeting and Webinar
Edit May 9th Meeting
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May 9th, 2019: Plan Management Advisory Group Meeting and Webinar
Edit March 7th Meeting
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March 7th, 2019: Plan Management Advisory Group Meeting and Webinar
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February 14th, 2019: Plan Management Advisory Group Meeting and Webinar
- Agenda
- Presentation Slides
- Proposed Covered California 2020 Dental Copay Schedule
- Proposed Covered California 2020 Dental Benefit Plan Designs and Endnotes
- Proposed 2020 Patient-Centered Benefit Play Design – Side-by-Side Comparison
- Proposed 2020 Patient-Centered Benefit Plan Designs
The proposed 2020 Patient-Centered Benefit Plan Designs presented during the February 14th meeting are final and there will be no further changes to the endnotes. -
January 10th, 2019: Plan Management Advisory Group Meeting and Webinar
Edit Qualified Health Meeting
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Qualified Health Plan Quarterly Certification Application for Plan Year 2019 Covered California Small Business Marketplace
Archives (2018 and Prior)
Quality Transformation Initiative
Resources
- Plan Management Advisory Group Proposed 2022 Dates
- 2021 Plan Management Advisory Charter and Membership
2024-2026 QDP Issuer Contract Refresh
- 2024-2026 QDP Issuer Model Contract CLEAN_Final Draft
- 2024-2026 QDP Issuer Model Contract REDLINE_Final Draft.pdf
- 2024-2026 QDP Attachment 1 Contract_ Final Draft
- 2024-2026 QDP Contract Att 2 Performance Standards with Penalties_Final Draft
- 2024-2026 QDP Contract Att 3 Performance Standards and Expectations_Final Draft
2024 QHP Issuer Contract Amendment CCSB
- 2024 QHP_CCSB_Attachment_1_Amendment_Draft_Redline_11-10-22
- 2024 QHP_CCSB_Attachment_1_Amendment_Draft_Clean_11-10-22
- 2024_QHP_CCSB_Attachment_ 2_ Amendment_Draft_ Redline_11-10-22
- 2024_QHP_CCSB_Attachment_ 2_ Amendment_Draft_ Clean_11-10-22
- 2024_QHP_CCSB_Amendment_Draft_Redline_10-19-22
2024 QHP Issuer Contract Amendment Individual
- 2024 QHP_IND_Attachment _1_Amendment_Draft_Redline_11-10-22
- 2024 QHP_IND_Attachment _1_Amendment_Draft_Clean_11-10-22
- 2024_QHP_IND_Attachment_2_ Amendment_Redline_11-10-22
- 2024_QHP_IND_Attachment_2_ Amendment_Clean_11-10-22
- 2024_QHP_IND_Attachment_4_Amendment_Draft_Redline_11-10-22
- 2024_QHP_IND_Attachment_4_Amendment_Draft_Clean_11-10-22
- 2024_QHP_IND_Amendment_Draft_Redline_10-19-22
2023-25 Contract Refresh
- 25-2-2 Policy Methodology 6-10-22
- 2023-2025 QHP_IND_Model Contract_ Final Proposed_ Redline_4-19-22
- 2023-2025 QHP_IND_Model Contract_Final Proposed_Clean_4-19-22
- 2023-2025 QHP_IND_Model Contract Crosswalk_3-3-22
- Response to Comments- Cycle 3- QHP IND- Model Contract
- 2023-2025_QHP_IND_Attachment_1_4-19-22_Redline
- 2023-2025_QHP_IND_Attachment_1_4-19-22_Clean
- Response to Comments-Cycle 3-IND Attachment 1
- 2023-2025_QHP Att 2-Performance Standards with Penalties-Clean- 4-19-22
- 2023-2025_QHP Att 2-Performance Standards with Penalties-Redline- 4-19-22
- Response to Comments- Cycle 3 - QHP IND Attachment 2 – 4-19-22
- 2023-2025_QHP Att 3-Performance Standards and Expectations-Clean- 4-19-22
- 2023-2025_QHP Att 3-Performance Standards and Expectations -Redline- 4-19-22
- Response to Comments- Cycle 3 - QHP IND Attachment 3 – 4-19-22
- 2023-2025 QHP_CCSB_Model Contract_ Final Proposed_ Redline_4-19-22
- 2023-2025 QHP_CCSB_Model Contract_ Final Proposed_ Clean_4-19-22
- 2023-2025 QHP_CCSB_Model Contract Crosswalk_4-19-22
- Response to Comments_Cycle 3_QHP CCSB Model Contract
- 2023-2025_QHP_CCSB_Attachment_1_ Clean_4-19-22
- 2023-2025_QHP_CCSB_Attachment_1_ Redline_4-19-22
- Response to Comments-Cycle 3-CCSB Attachment 1
- 2023-2025_CCSB Att 2-Performance Standards with Penalties-Clean- 4-19-22
- 2023-2025_CCSB Att 2-Performance Standards with Penalties-Redline- 4-19-22
- Response to Comments- Cycle 3 - QHP CCSB Attachment 2 – 4-19-22
- 2023-2025_CCSB Att 3-Performance Standards and Expectations-Clean- 4-19-22
- 2023-2025_CCSB Att 3-Performance Standards and Expectations-Redline- 4-19-22
- Response to Comments- Cycle 3 - QHP CCSB Attachment 3 – 4-19-22
- 2017-2023_QDP Model Contract A7_Clean_04-19-22
- 2017-2023_QDP Model Contract A7_Redline_4-19-22
- 2023-2025 QHP_CCSB_Model Contract_Redline_1-28-22
- 2023-2025 QHP_CCSB_Model Contract_Clean_1-28-22
- 2017-2023 QDP_Model Contract_Redline_1-28-22
- 2017-2023 QDP_Model Contract_Clean_1-28-22
- 2023-2025 QHP_IND_Model Contract Crosswalk_1-28-22
- 2023-2025 QHP_IND_Model Contract_Redline_1-28-22
- 2023-2025 QHP_IND_Model Contract_Clean_1-28-22
- Response to Comments- Cycle 2- QHP IND- Model Contract
- Response to Comments- Cycle 2- QDP- Model Contract
- 2023-2025_QHP_IND_Attachment_1_Redline_ 1-24-22
- 2023-2025_QHP_IND_Attachment_1_Clean_ 1-24-22
- Response to Comments- Cycle 2- QHP IND Attachment 1
- 2023-2025_QHP Att 2-Performance Standards with Penalties-Redline-1-24-22
- 2023-2025_QHP Att 2-Performance Standards with Penalties-Clean-1-24-22
- Response to Comments- Cycle 2- QHP IND Attachment 2
- 2023-2025_QHP Att 3-Performance Standards and Expectations -Redline-1-24-22
- 2023-2025_QHP Att 3-Performance Standards and Expectations-Clean-1-24-22
- Response to Comments- Cycle 2- QHP IND Attachment 3
- 2023-2025_CCSB_Attachment_1_Redline_ 1-24-22
- 2023-2025_CCSB_Attachment_1_Clean_ 1-24-22
- Response to Comments- Cycle 2- CCSB QHP Attachment 1
- 2023-2025_CCSB Att 2-Performance Standards with Penalties-Redline-1-24-22
- 2023-2025_CCSB Att 2-Performance Standards with Penalties-Clean-1-24-22
- 2023-2025_CCSB Att 3-Performance Standards and Expectaions-Redline-1-24-22
- 2023-2025_CCSB Att 3-Performance Standards and Expectations-Clean-1-24-22
- Response to Comments- Cycle 2- CCSB QHP Attachment 3
- 2017-2023 QDP Contract Attachment 7 and 14 REDLINE 1-24-22
- Response to Comments- Cycle 2- QDP Attachment 7 and 14
- CoveredCA - Contracting to Promote Quality & Equity 11-10-2021
- 2023-2025 CCSB Att 3 – Performance Standards and Expectations-Redline-11-18-21
- 2023-2025 CCSB Att 3 – Performance Standards and Expectations-Clean-11-18-21
- Response to Comment_Cycle 1_QHP_CCSB_Attachment 1
- 2023-2025 CCSB Attachment 1_Redline_Draft 11-18-21
- 2023-2025 CCSB Attachment 1_Clean_Draft 11-18-21
- Response to Comments- Cycle 1- CCSB Att 2
- 2023-2025 CCSB Att 2-Performance Standards With Penalties-Redline-11-18-21
- 2023-2025 CCSB Att 2-Performance Standards With Penalties-Clean-11-18-21
- Response to Comments- Cycle 1- QHP Att 2
- 2023-2025 QHP Att 2- Performance Standards with Penalties- Redline -11-18-21
- 2023-2025 QHP Att 2- Performance Standards with Penalties- Clean -11-18-21
- Response to Comments – Cycle 1 – QHP Att 3
- 2023-2025 QHP Att 3- Performance Standards and Expectations- Redline-11-18-21
- 2023-2025 QHP Att 3- Performance Standards and Expectations- Clean - 11-18-21
- Response to Comment_Cycle 1_QHP_IND_Attachment 1
- Attachment 7_2023-25_Summary of Changes_Crosswalk
- Proposed 2023-2025 Attachment 1 QHP IND Redline_11-8-21
- Proposed 2023-2025 Attachment 1 QHP IND Clean-11-8-21
- Response to Comment Cycle1_QHP Model Contract IND_Final
- 2023 IND QHP Model Contract_Draft_Redline_11-3-21
- 2023 IND QHP Model Contract_Draft_Clean_11-3-21
- Response to Comment Cycle 1_QHP Model Contract CCSB_Final
- 2023 CCSB QHP Model Contract_Draft_Redline_11.3.21
- 2023 CCSB QHP Model Contract_Draft_Clean_11.3.21
- 2017-2023 QDP Issuer Model Contract A7 REDLINE_11-3-21
- 2017-2023 QDP Issuer Model Contract A7 CLEAN POST_11-3-21
- Response to Comment Cycle 1_QDP A7 A14 FINAL
- 2017-2023 QDP Contract Attach 14 A7 REDLINE_11-3-21
- 2017-2023 QDP Contract Attach 14 A7 CLEAN_11-3-21
- Response to Comment Cycle 1_QDP
- 2017-2023 QDP Contract Attach 7 A7 REDLINE_11-3-21
- 2017-2023 QDP Contract Attach 7 A7 CLEAN_11-3-21
- 2023-2025 QHP Att X-Performance Standards with Penalties - DRAFT - 10-15-21
- 2023-2025 QHP Att X-Performance Standards and Expectations - DRAFT -10-15-21
- 2022 to 2023-2025 CCSB Att 7 Crosswalk – 10-21-21
- 2023-2025 CCSB Att 7 – Draft 10-21-21
- Draft_2023-2025_QHP Attachment X- Performance Standards and Expectations
- Draft_2023-2025_QHP Attachment X- Performance Standards with Penalties
- Proposed_2017-2023_QDP_Attachment 14_Redline_9.17.21
- Proposed_2017-2023_QDP_Attachment 7_Redline_9.17.21
- Draft_2023_QHP_ IND_Attachment_7_09.10.21
- Attachment_7_2023-2025_Summary of Changes_Crosswalk
- Proposed 2017-2023 QDP Issuer Model Contract_Redline
- Proposed_2023 CCSB QHP Model Contract _Clean_9.2.21
- Proposed_2023 CCSB QHP Model Contract_Redline_9.2.21
- Proposed_2023 QHP IND Model Contract_Clean_8.31.21
- Proposed_2023 QHP IND Model Contract_Redline_8.31.21
2022 Contract Amendment
- Proposed 2022 Attachment 14 QHP IND Clean_3-18-21
- Proposed 2022 Attachment 14 QHP IND Redline
- Proposed 2022 QDP Issuer Model Contract A6 CLEAN_3-18-21
- Proposed 2022 QDP Issuer Model Contract A6 REDLINE
- Proposed 2022 Attachment 7 QDP Contract A6 CLEAN_3-18-21
- Proposed 2022 Attachment 7 QDP Contract A6 REDLINE
- Proposed 2022 Attachment 14 QDP Contract A6 CLEAN_3-18-21
- Proposed 2022 Attachment 14 QDP Contract A6 REDLINE
- Response to Comment_QDP Attachment 14_3-18-21
- 2022 Qualified Dental Plan Second Public Comment Period Clean
- 2022 Qualified Dental Plan Second Public Comment Period Redline
- Proposed 2022 Attachment 7 QHP IND Clean_3-18-21
- Proposed 2022 Attachment 7 QHP IND Redline_3-18-21
- Response to Comment_IND Attachment 7_3-18-21
- Proposed 2022 Attachment 14 QHP IND Clean_3-18-21
- Proposed 2022 Attachment 14 QHP IND Redline
- Response to Comment_IND Attachment 14_3-18-21
- Proposed 2022 Attachment 7 QHP CCSB CLEAN_3-18-21
- Proposed 2022 Attachment 7 QHP CCSB REDLINE
- Response to Comment_CCSB Attachment 7_3-18-21
- 2022 CCSB Qualified Health Plan Second Public Comment Period Clean
- 2022 CCSB Qualified Health Plan Second Public Comment Period Redline
- Proposed 2022 Attachment 14 QHP CCSB CLEAN_3-18-21
- Proposed 2022 Attachment 14 QHP CCSB REDLINE
- 2022 IND QHP Model Contract Jan 2021 Clean
- 2022 IND QHP Model Contract Jan 2021 Redline
- Draft 2022 QHP Model Contract First Round Comments
- 2022 Attachment 7 Draft Jan 2021 Clean
- 2022 Attachment 7 Draft Jan 2021 Redline
- Draft 2022 Attachment 7 First Round Comments
- 2022 Attachment 14 Draft Jan 2021 Clean
- Draft 2022 Attachment 14 Amendment – Redline
- Draft 2022 Attachment 14 First Round Comments
- Draft 2022 Attachment 7 Amendment
Health Equity & Quality Transformation Refresh Resources
- NCQA Multicultural Health Care Distinction
- NCQA Multicultural Health Care Distinction Crosswalk
- URAC Comments to Covered California on HMA Report
- National Accreditation Bodies and Fit for Covered California
- Covered California’s First Five Years: Improving Access, Affordability and Accountability
- Covered California Holding Health Plans Accountable for Quality and Delivery System Reform
- Chart Pack for Covered California Reports
- Issuer and Public Comments to Inform Attachment 7 Refresh
- Current Best Evidence and Performance Measures for Improving Quality of Care and Delivery System Reform
- Recommended Measures for Covered California by PricewaterhouseCoopers
- Health Purchaser Strategies for Improving Quality of Care and Delivery System Reform
Benefit Plan Designs
- 2023 Standard Benefit Plan Designs - Updated September 2022
- 2023 Standard Benefit Plan Designs
- 2022 Standard Benefit Plan Designs
- 2021 Standard Benefit Plan Designs
- 2020 Standard Benefit Plan Designs
- 2019 Standard Benefit Plan Designs
- 2023 Dental Standard Benefit Plan Designs
- 2022 Dental Standard Benefit Plan Designs
- 2023 Dental Copay Schedule
- 2022 Dental Copay Schedule
Final QHP and QDP Issuer Model 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
- QHP Model Contract for 2017-2021 - Amended for 2021
- QDP Model Contract for 2017-2021 - Amended for 2021
- CCSB Model Contract for 2017-2021 - Amended for 2021
- CCSB Attachment 3 for 2017-2021 – Amended for 2021
- CCSB Attachment 7 for 2017-2021 – Amended for 2021
- CCSB Attachment 14 for 2017-2021 – Amended for 2021
- Attachment 7 for the Individual Market 2017-2021 - Amended for 2021
- Attachment 14 for for the Individual Market2017-2021 - Amended for 2021
- QHP Model Contract for 2017-2020 - Amended for 2020
- QDP Model Contract for 2017-2020 - Amended for 2020
- CCSB Model Contract for 2017-2020 - Amended for 2020
- Attachment 7 for 2017-2020 - Amended for 2020
- Attachment 14 for 2017-2020 - Amended for 2020
- 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
- Attachment 14 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
Certification
Additional Stakeholder Links
Provider Data Submission Support Documents
- Covered California Provider Data Submission Guide V1.12
- Covered California Provider Data Submission Schedule 2022
Essential Community Providers
- Covered California's Essential Community Provider Page
- Covered California's Essential Community Provider List