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California's PPO health insurers get low marks

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A state evaluation gives ratings of poor to Anthem Blue Cross, Blue Shield of California, Health Net, UnitedHealthcare and Cigna in that category. Aetna performs slightly better.
Most major health insurers in California do a poor job of paying claims and providing customer service for members in preferred provider organization plans, according to a new state survey.

The evaluation by the California Department of Insurance comes as many workers assess their healthcare options this month before enrolling for another year of insurance benefits through PPO plans that serve 2.5 million people statewide.

In the quality report card, Anthem Blue Cross, Blue Shield of California, Health Net Inc., UnitedHealthcare and Cigna Corp.received the lowest possible ratings -- poor -- for customer service. Aetna Inc. earned a slightly better rating of fair.

Most of those insurers also garnered marks of fair for the ease and speed with which members see doctors and get medical care. UnitedHealthcare earned a grade of good.

No insurer received the top overall rating: excellent.

The insurers said they welcomed the scrutiny even as they defended their own efforts to improve customer satisfaction and streamline care.

But California Insurance Commissioner Steve Poizner called the findings "atrocious," saying insurers "must step up and improve the quality" of their healthcare services in a marketplace that generates $17 billion a year in revenue.

"This is hopefully a wake-up call for insurance companies," Poizner said Thursday. "They are simply underperforming. People should be concerned."

By Duke Helfand, Los Angeles Times
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