NCQA’s Health Plan Ratings 2021

Plan Confirmation—Late May

• (Action Required) Confirmation of HEDIS/CAHPS submissions and other information used (e.g., organization name, states, Accreditation status) to calculate ratings. Plans have 10 business days to confirm.

HEDIS and CAHPS Submission—June 15

• This submission deadline is defined in the HEDIS Volume 2 Technical Specifications.

Projected Ratings—Early August

• (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 did not submit CAHPS data (or vice versa); or the plan earned an NCQA Accreditation status that does not require submission of HEDIS data.
  • No Data Reported: The plan did not submit data or opted not to report data publicly.
  • Low Enrollment: The plan did not submit data or opted not to report data publicly, and its enrollment is fewer than 15,000 members.
• Plans have 10 business days to confirm their information.

Final Ratings—Early September

• A private release of final ratings to all plans. 

NCQA Releases Ratings—September 15

• Final ratings posted on the Health Plan Report Card.
• Embargo on plan rating-related promotions ends at 6pm ET; plans may begin advertising their ratings at this point.

Questions? Contact NCQA’s Health Plan Ratings Help Desk at  my.ncqa.org.