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HIPAA and Conversion Benefit Summaries, Rates and Health Plan Websites

You can view the benefit summaries (also called matrices) and the rate charts filed by the health plans that offer Individual Conversion plans or HIPAA plans. The benefit summaries can help you compare benefits. The rate charts show the monthly premium cost or rate for each type of coverage by rating group (for example, subscriber or main member only, subscriber and number of dependents), subscriber age, and geographic area. In reviewing the rate charts, be advised that the Department does not approve Conversion or HIPAA rates. The calculation of these rates is determined by statute, and health plans are required to file rates with the Department that comply with the law.

The DMHC updates these summaries at least once a year.

To Find a Benefit Summary (Matrix) or Rate Chart

  1. Click on a health plan below to view a list of Matrices (summaries) and Rate Charts.
  2. Select the Matrix or Rate Chart you wish to see.
  3. Please contact the health plan for more detailed information about the terms of coverage, eligibility (including eligibility for dependents), benefits, rates, and service areas. Also contact the plan for a copy of the evidence of coverage (booklet that describes the benefits). The contact information for each plan is provided in the matrix.

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