The Regulators
Who regulates the health care products you buy? It’s a combination of State and Federal. The State has the biggest part and you should look to them first to understand if your problem falls in their court or in the Federal realm. If you have a problem with the health plan, start with the health plan’s grievance and appeal process. If this fails then you turn to the regulators for help. Remember that a good broker can help with this entire process.
Department Of Managed
Health Care (DMHC) - http://www.dmhc.ca.gov (888) HMO-2219 or (800)
400-0815.
California recently changed the agency that is responsible for regulating
the Managed Care Plans. These include HMO’s and POS plans. Have a
Problem with Your HMO? Get Help: http://www.dmhc.ca.gov/gethelp/
Department of Insurance http://www.insurance.ca.gov/ This agency is responsible for regulating the "Health Insurance Plans" and not the "Managed Care Plans"
Financial Rating Organizations
On these sites you will be able to check the financial health in the various health care companies.
- A.M. Best
- Fitch Ratings
- Moody's Investors
Service
- Standard
& Poor's Insurance Ratings
- Weiss Ratings, Inc.