Who oversees health insurance in California?
In California, health insurance is regulated by the California Department of Insurance (CDI). Our mission is to protect consumers, foster a vibrant and stable insurance marketplace, and enforce laws related to health insurance and the health insurance code fairly and impartially.
Which of these entities is considered a covered entity?
Covered entities are defined in the HIPAA rules as (1) health plans, (2) health care clearinghouses, and (3) health care providers who electronically transmit any health information in connection with transactions for which HHS has adopted standards.
Who regulates HMOs in California?
The Department of Managed Health Care (DMHC) is the lead organization in California overseeing managed care or HMOs. The DMHC licenses and regulates California health plans under authority granted in The Knox-Keene Health Care Service Plan Act of 1975 and as subsequently amended.
What does the California Department of Insurance do?
All of CDI's functions, including overseeing insurer solvency, licensing agents and brokers, conducting market conduct reviews, resolving consumer complaints, and investigating and prosecuting insurance fraud, are to protect consumers.