Large Calif. Health Plans See Rise in Complaints, Drop in Total Enrollment
The number of complaints filed with California's Department of Managed Health Care against large health insurers increased by 9% in 2009, even though the number of Californians enrolled in HMOs declined that year, Payers & Providers reports. Large health plans were defined as those with 400,000 or more policyholders.
In 2009, policyholders filed 4,274 complaints against large health plans, up from the 3,864 complaints filed in 2008. During that time, enrollment in large plans fell by 105,000 to about 15.52 million.
Among smaller health plans -- those with enrollment below 400,000 -- complaints decreased by 42%, from 212 in 2008 to 123 last year. In 2009, enrollment in the smaller health plans declined by 22.6% to 2.86 million.
Many of the complaints were filed against:
- Blue Shield of California, which received 799 complaints in 2009, up from 675 in 2008; and
- Kaiser Foundation Health Plan, which received 1,809 complaints in 2009, up from 1,516 the previous year.
The Kaiser plan received the most complaints, accounting for 40% of the total number of complaints filed against California's large health insurers. Â
Decrease in Complaints
Anthem Blue Cross saw its total complaints drop from 1,046 in 2008 to 935 in 2009.
Both Health Net and PacifiCare also saw modest decreases in complaints.
Type of Complaints
Complaints involving coordination of care increased by about 22.7% in 2009, according to Payers & Providers.
Most other categories of complaints had more modest increases (Payers & Providers, 9/16).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.