Complaints Reported by Covered California for 2015
Covered California is the state's health insurance marketplace.
The following table includes information about State Fair Hearings held on Covered California issues. Covered California reported this 2014 complaint information to OPA for the annual Complaint Data Report.
|2015 Covered California State Fair Hearings|
(conducted by the Department of Social Services)
|Most Common Reasons for Fair Hearings
- Denial of coverage (70%)
- Eligibility determination issues (18%)
- Cancellation (13%)
|Most Common Results from the Fair Hearing
- Complaint withdrawn (45%)
- Compromise settlement or resolution (18%)
- Covered California position overturned (17%)
- No action required (16%)
- Covered California position upheld (5%)
|Number of Days the Fair Hearing Process Usually Takes
||Between 49-69 days|
- There is a faster review process for complainants with an urgent health issue.