NCQA Health Insurance Plan
See all Health Insurance Plan Ratings
NCQA’s Health Insurance Plan Ratings 2015–2016 lists private, Medicare, and Medicaid health insurance plans based on their combined HEDIS®, CAHPS® and NCQA Accreditation standards scores.
The NCQA Accreditation status used in these ratings are as of June 30, 2015.
With NCQA’s permission, Consumer Reports references the NCQA Health Insurance Plan Ratings on its Web site and in the November issue of Consumer Reports magazine, ensuring that this valuable information reaches millions of consumers.
NCQA’s Health Insurance Plan Ratings 2015–2016 uses the new Ratings methodology which classifies plans into scores from 1-5 in 0.5 increments–-a system similar to CMS’ Five-Star Quality Rating System.
Information for Health Plans
The 2015 Schedule for NCQA’s Health Insurance Plan Ratings:
Ratings Project Announcement - April
Message sent to: HEDIS and Accreditation staff, medical director, CEO, marketing manager
This notification alerts plans that NCQA will rate plans in 2015.
Plan Data Confirmation - Late May
(Action Required) Confirmation of the HEDIS and CAHPS submissions and other information used (e.g., display name, states, Accreditation status) to calculate ratings. Plans have 5 business days to confirm.
HEDIS and CAHPS Submission - June 15
This submission deadline is as defined in the HEDIS Vol. 2 Technical Specifications.
Projected Ratings Notification - August 4
(Action Required) Confirmation of Accreditation status and overall rating or 1 of 3 reasons a rating cannot be calculated:
- Partial Data Reported – The plan submitted HEDIS data but not CAHPS data (or vice versa); or the plan earned an NCQA Accreditation status that does not require HEDIS.
- No Data Reported – Plan did not submit data or opted not to report data publicly.
- Low Enrollment – Plan did not submit data or opted not to report data publicly, and the organization's enrollment is less than 8,000 members.
Plans have until August 13 to confirm.
Final Ratings Notification - Early September
A private release of the final ratings to all health plans.
NCQA Releases Ratings - September 17
Final Ratings Posted on NCQA.org - Embargo on plan rating-related promotions ends 6:00 p.m. ET; plans may begin advertising their ratings at this point.
Late September / Early October
Final ratings will be referenced at consumerreports.org and in the November issue of Consumer Reports magazine.
Contact NCQA’s Health Insurance Plan Ratings Help Desk at my.ncqa.org if you have questions.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).