HMO Complaints for Calendar Year 2008
| Basic Service HMOs | Total Complaints (Closed Cases) | Justified Complaints | Enrollment | Ratio of Justified Complaints per 10,000 Enrollees |
|---|---|---|---|---|
| AETNA HEALTH INC. | 283 | 71 | 223,470 | 3.18 |
| AMERIGROUP TEXAS, INC. | 72 | 1 | 454,920 | 0.02 |
| ARCADIAN HEALTH PLAN, INC. | 4 | 0 | 25,241 | 0.00 |
| BLUE CROSS AND BLUE SHIELD OF TEXAS, A DIVISION OF | 244 | 55 | 868,906 | 0.63 |
| BRAVO HEALTH TEXAS, INC. | 14 | 0 | 11,184 | 0.00 |
| CIGNA HEALTHCARE OF TEXAS, INC. | 43 | 10 | 47,222 | 2.12 |
| COMMUNITY FIRST HEALTH PLANS, INC. | 2 | 0 | 96,727 | 0.00 |
| COMMUNITY HEALTH CHOICE, INC. | 5 | 0 | 142,162 | 0.00 |
| COOK CHILDREN'S HEALTH PLAN | 4 | 0 | 56,327 | 0.00 |
| DRISCOLL CHILDREN'S HEALTH PLAN | 7 | 0 | 44,125 | 0.00 |
| EVERCARE OF TEXAS, L.L.C. | 47 | 1 | 98,922 | 0.10 |
| HUMANA HEALTH PLAN OF TEXAS, INC. | 94 | 40 | 171,842 | 2.33 |
| MERCY HEALTH PLANS OF MISSOURI, INC. | 1 | 1 | 54,871 | 0.18 |
| MOLINA HEALTHCARE OF TEXAS, INC. | 4 | 1 | 30,828 | 0.32 |
| PACIFICARE OF TEXAS, INC. | 165 | 16 | 146,140 | 1.09 |
| PARKLAND COMMUNITY HEALTH PLAN, INC., A PROGRAM OF | 16 | 3 | 148,007 | 0.20 |
| PHYSICIANS HEALTH CHOICE OF TEXAS, LLC | 4 | 0 | 12,250 | 0.00 |
| SCOTT AND WHITE HEALTH PLAN | 37 | 10 | 180,738 | 0.55 |
| SELECTCARE HEALTH PLANS, INC. | 1 | 0 | 2,793 | 0.00 |
| SELECTCARE OF TEXAS, L.L.C. | 59 | 2 | 42,120 | 0.47 |
| SETON HEALTH PLAN, INC. | 2 | 0 | 15,042 | 0.00 |
| SHA, L.L.C. | 93 | 37 | 104,321 | 3.55 |
| SUPERIOR HEALTHPLAN, INC. | 57 | 20 | 277,582 | 0.72 |
| TEXAS CHILDREN'S HEALTH PLAN, INC. | 40 | 2 | 215,157 | 0.09 |
| TEXAS HEALTHSPRING, LLC | 7 | 0 | 43,863 | 0.00 |
| UNITED HEALTHCARE OF TEXAS, INC. | 84 | 26 | 9,459 | 27.49 |
| UTMB HEALTH PLANS, INC. | 1 | 0 | 688 | 0.00 |
| VALLEY BAPTIST HEALTH PLAN, INC. | 3 | 1 | 12,470 | 0.80 |
| Average: | 47 | 10 | 126,335 | 1.57 |
| Single & Limited Service HMOs | Total Complaints (Closed Cases) | Justified Complaints | Enrollment | Ratio of Justified Complaints per 10,000 Enrollees |
|---|---|---|---|---|
| AETNA DENTAL INC. | 9 | 5 | 527,332 | 0.09 |
| ALPHA DENTAL PROGRAMS, INC. | 7 | 2 | 74,887 | 0.27 |
| CIGNA DENTAL HEALTH OF TEXAS, INC. | 6 | 1 | 218,129 | 0.05 |
| DENTICARE, INC. | 1 | 0 | 98,354 | 0.00 |
| MANAGED DENTALGUARD, INC. | 2 | 0 | 67,861 | 0.00 |
| NATIONAL PACIFIC DENTAL, INC. | 2 | 0 | 142,519 | 0.00 |
| SAFEGUARD HEALTH PLANS, INC. | 5 | 2 | 136,614 | 0.15 |
| UNITED CONCORDIA DENTAL PLANS OF TEXAS, INC. | 3 | 1 | 4,404 | 2.27 |
| UNITED DENTAL CARE OF TEXAS, INC. | 2 | 0 | 91,645 | 0.00 |
| VALUEOPTIONS OF TEXAS, INC. | 1 | 0 | 330,293 | 0.00 |
| Average: | 4 | 1 | 169,204 | 0.28 |
Count includes Record Only and CHIP
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Last updated: 08/30/2010
