HMO Complaints for Calendar Year 2009
| Basic Service HMOs | Total Complaints (Closed Cases) | Justified Complaints | Enrollment | Ratio of Justified Complaints per 10,000 Enrollees |
|---|---|---|---|---|
| AETNA HEALTH INC. | 209 | 49 | 210,003 | 2.33 |
| AMERIGROUP TEXAS, INC. | 84 | 2 | 504,656 | 0.04 |
| ARCADIAN HEALTH PLAN, INC. | 51 | 2 | 28,962 | 0.69 |
| BLUE CROSS AND BLUE SHIELD OF TEXAS, A DIVISION OF | 182 | 32 | 7,733,536 | 0.04 |
| BRAVO HEALTH TEXAS, INC. | 168 | 13 | 16,155 | 8.05 |
| CIGNA HEALTHCARE OF TEXAS, INC. | 32 | 12 | 29,331 | 4.09 |
| COMMUNITY FIRST HEALTH PLANS, INC. | 6 | 1 | 112,340 | 0.09 |
| COMMUNITY HEALTH CHOICE, INC. | 4 | 1 | 149,857 | 0.07 |
| COOK CHILDREN'S HEALTH PLAN | 6 | 0 | 72,793 | 0.00 |
| EL PASO FIRST HEALTH PLANS, INC. | 3 | 1 | 57,532 | 0.17 |
| EVERCARE OF TEXAS, L.L.C. | 151 | 9 | 98,156 | 0.92 |
| HUMANA HEALTH PLAN OF TEXAS, INC. | 143 | 31 | 186,151 | 1.67 |
| MERCY HEALTH PLANS OF MISSOURI, INC. | 3 | 0 | 36,896 | 0.00 |
| MOLINA HEALTHCARE OF TEXAS, INC. | 12 | 0 | 39,574 | 0.00 |
| PACIFICARE OF TEXAS, INC. | 461 | 18 | 152,446 | 1.18 |
| PARKLAND COMMUNITY HEALTH PLAN, INC., A PROGRAM OF | 10 | 0 | 167,789 | 0.00 |
| PHYSICIANS HEALTH CHOICE OF TEXAS, LLC | 44 | 0 | 18,033 | 0.00 |
| SCOTT AND WHITE HEALTH PLAN | 70 | 28 | 157,255 | 1.78 |
| SELECTCARE HEALTH PLANS, INC. | 26 | 2 | 5,479 | 3.65 |
| SELECTCARE OF TEXAS, L.L.C. | 234 | 6 | 44,747 | 1.34 |
| SETON HEALTH PLAN, INC. | 1 | 1 | 17,201 | 0.58 |
| SHA, L.L.C. | 58 | 7 | 80,979 | 0.86 |
| SUPERIOR HEALTHPLAN, INC. | 30 | 11 | 300,893 | 0.37 |
| TEXAS CHILDREN'S HEALTH PLAN, INC. | 6 | 1 | 243,673 | 0.04 |
| TEXAS HEALTHSPRING, LLC | 68 | 6 | 49,587 | 1.21 |
| UNICARE HEALTH PLANS OF TEXAS, INC. | 12 | 3 | 39,640 | 0.76 |
| UNITED HEALTHCARE OF TEXAS, INC. | 83 | 8 | 7,278 | 10.99 |
| VALLEY BAPTIST HEALTH PLAN, INC. | 7 | 1 | 19,686 | 0.51 |
| Average: | 77 | 9 | 377,880 | 1.48 |
| Single & Limited Service HMOs | Total Complaints (Closed Cases) | Justified Complaints | Enrollment | Ratio of Justified Complaints per 10,000 Enrollees |
|---|---|---|---|---|
| AETNA DENTAL INC. | 5 | 0 | 323,044 | 0.00 |
| ALPHA DENTAL PROGRAMS, INC. | 14 | 5 | 72,679 | 0.69 |
| CIGNA DENTAL HEALTH OF TEXAS, INC. | 4 | 2 | 178,829 | 0.11 |
| MANAGED DENTALGUARD, INC. | 4 | 2 | 66,992 | 0.30 |
| NATIONAL PACIFIC DENTAL, INC. | 8 | 4 | 156,512 | 0.26 |
| SAFEGUARD HEALTH PLANS, INC. | 8 | 4 | 134,724 | 0.30 |
| UNITED CONCORDIA DENTAL PLANS OF TEXAS, INC. | 3 | 3 | 4,160 | 7.21 |
| UNITED DENTAL CARE OF TEXAS, INC. | 1 | 0 | 86,302 | 0.00 |
| VALUEOPTIONS OF TEXAS, INC. | 2 | 0 | 388,148 | 0.00 |
| Average: | 5 | 2 | 156,821 | 0.98 |
Count includes Record Only and CHIP
For more information contact:
Last updated: 08/30/2010
