Potential Partners for Community-Based Organizations in the California Health Care Landscape

Transcription

1 Potential Partners for Community-Based Organizations in the California Health Care Landscape By Jennifer Rak and Sally Rodriguez Preparing Community-Based Providers For Successful Health Care Partnerships August 2012 While efforts are underway to improve care transitions and coordination, there is a dearth of information on how best to build partnerships between community-based long-term services and healthcare systems. Both sectors are tackling the issue of care coordination and good care transitions, but have been doing so in silos. To better understand specific opportunities for these partnerships in California, the Foundation developed this series of background briefs. Recent policy changes put in motion by the Affordable Care Act (ACA) are shifting health care payment incentives in order to hold providers accountable for quality and cost of care. The shift towards value-based reimbursement has produced a variety of new payment policies, demonstration programs, and newlycreated agencies tasked with improving care coordination and reducing costs. Many of these policies and programs specifically target improvements in care transitions, or the transfer of patients from one site of care to another location. For example, the ACA reduces Medicare payments for hospitals with higher than expected readmissions for patients with specified conditions (i.e., patients returning to the hospital within 30 days of a hospitalization to treat heart failure, heart attack, or pneumonia). The ACA also authorized new programs that promote care coordination more broadly and set up two new federal offices tasked with integrating care for dual eligibles and testing innovative new models of payment and care delivery. These programs, policies, and demonstrations encourage providers to consider how better to ensure successful care transitions, reduced rehospitalizations, and improved care coordination. Hospitals, post-acute care providers, provider networks, and insurers will need assistance as they shift towards integrated care delivery and consider their options for providing care transition services. Community-based organizations (CBOs) will be important partners to these entities as they begin offering a broader range of integrated care delivery services. Ongoing and upcoming care coordination and/or transition initiatives and programs include: Accountable Care Organizations (ACOs): Section 3022 of the ACA created the Medicare Shared Savings Program to govern ACOs, which are provider-based networks that bear financial risk for Medicare beneficiaries health care and have the opportunity to share savings gained through better care coordination. The Centers for Medicare and Medicaid Services (CMS) began accepting applications in October Community-based Care Transitions program: Section 3026 of the ACA authorized a 5-year program beginning in 2011 to test the efficacy of care transition models among high-risk Medicare beneficiaries. Under the program, hospitals with high readmission rates will partner with CBOs that provide 1

2 August 2012 Potential Partners in the California Health Care Landscape care transition services; CMS will pay CBOs an all-inclusive rate, per eligible discharge, for care transitions services provided. Though CMS has already approved applications from some CBOs, additional applications are being accepted and reviewed on a rolling basis. The Bundled Payments initiative: Authorized by section 3023 of the ACA, this payment demonstration tests a fundamental change in the way Medicare pays for services; CMS will link payments for multiple services (e.g., acute care, postacute care, outpatient services) across a full episode of care. Providers applying to participate in the first iteration of this demonstration have been asked to define the bundle under one of four models (two models for hospital inpatient services only, one inpatient and post-acute care model, and a post-acute care only model) and to set a price/target savings for each bundle. Initiatives focused on dual eligibles: the new Medicare-Medicaid Coordination Office, authorized by Section 2602 of the ACA, is tasked with integrating Medicare and Medicaid services and payment for individuals eligible for both programs; a state demonstration to integrate the programs is underway. under these programs, to be strong partners for CBOs in delivering Long-Term Services and Supports. Hospitals in California Most evidence-based care transition models rely on the successful engagement of hospitals; the assessment and discharge processes are often the key targets of care transition interventions. Accordingly, recent policy changes attempt to hold hospitals accountable for one of the adverse outcome indicators associated with poor care transitions: readmissions to the hospital. While the readmissions penalty under the ACA is perhaps the most imminent care transitions policy affecting hospitals, there are many other ongoing or upcoming initiatives related to care coordination that will necessitate the involvement of hospitals. California s mix of very urban to very rural counties is reflected by the variation in the number of hospitals in each county (shown in Map 1). This paper will focus on the opportunities of each of these programs within the health care sector in California. Five key segments from the sector will be included in the discussion: Hospitals, Medicare Advantage Plans, Dual Eligible Special Needs Plans and Demonstrations, Accountable Care Organizations and Major Medical Groups. Each of these players has the potential, 2

3 August 2012 Potential Partners in the California Health Care Landscape MAP 1 Number of Hospitals in California s Counties Number of Hospitals per, 2012 Over to 35 6 to 10 2 to 5 1 Source: Billian s HealthDATA 2012 Note: No data were available for the counties colored grey. The following table provides basic information for the top 25 hospitals in California, as measured by number of discharges. In subsequent tables within this report, the same 25 hospitals will be profiled; for a full table of hospitalspecific data, see Appendix

4 August 2012 Potential Partners in the California Health Care Landscape TABLE 1 Number of Beds, Discharges, and Patient Revenue for the Top 25 Discharging Hospitals in California Hospitals Hospital Name Total Beds Discharges Patient Revenue ($) Cedars-Sinai Medical Center Los Angeles ,756 8 billion Northridge Hospital Medical Center Los Angeles , billion Community Regional Medical Center Los Angeles -USC Medical Center Kaiser Permanente Sacramento Medical Center Fresno , billion Los Angeles , billion Sacramento ,392 Not available Scripps Mercy Hospital Diego , billion Loma Linda University Medical Center , billion Huntington Hospital Los Angeles , billion UCSF Medical Center Francisco , billion Sutter Memorial Hospital Sacramento , billion University of California-Davis Medical Center Hoag Memorial Hospital Presbyterian Sacramento , billion Orange , billion Sharp Grossmont Hospital Diego , billion Kaiser Permanente Diego Medical Center Diego ,668 Not available Sharp Memorial Hospital Diego , billion Kaiser Permanente Fontana Medical Center Kaiser Permanente Los Angeles Medical Center ,412 Not available Los Angeles ,133 Not available Antelope Valley Hospital Los Angeles , billion Citrus Valley Medical Center- InterCommunity Campus Los Angeles , billion St. Agnes Medical Center Fresno , billion 4

5 August 2012 Potential Partners in the California Health Care Landscape Hospital Name Total Beds Discharges Patient Revenue ($) Torrance Memorial Medical Center Los Angeles , billion Los Angeles Harbor-UCLA Medical Center Long Beach Memorial Medical Center Los Angeles , billion Los Angeles , billion Stanford Hospital & Clinics ta Clara , billion UCSD Medical Center-Hillcrest Diego , billion Source: Billian s HealthDATA, Discharge data were not available for all hospitals; this list is based on available data. California Hospitals: Reliance on Public Payers California s hospitals vary in their proportion of Medicare and Medicaid revenue to total revenue, which can include revenue from Medicare, Medicaid, private insurers, out-ofpocket payments, charitable donations, and other sources. Hospitals that derive a higher percentage of their revenue from Medicare may be more sensitive to the aforementioned policy changes. Map 2 displays the percent of California hospital patient days covered by either Medicare or Medicaid. 5

6 August 2012 Potential Partners in the California Health Care Landscape MAP 2 California Hospitals: Patient Days Covered by Medicare or Medicaid Patient Days Covered by Medicare or Medicaid, per, % or higher 60% to 69% 50% to 59% 40% to 49% 30% to 39% Less than 30% Source: Billian s HealthDATA 2012 Note: No data were available for the counties colored grey. California Hospitals: Quality Quality measurement in the context of health care delivery is a rapidly evolving field and its development is being fueled in part by policy initiatives that will depend on robust quality measurement to determine accurate reimbursement. Historically, hospitals have been required to submit to oversight and onsite quality assurance processes by various agencies like the Joint Commission, but recent years have seen a rapid development of clinical data-based quality measures as well as other dimensions of quality measurement, such as patient experience surveys and 6

7 August 2012 Potential Partners in the California Health Care Landscape adverse outcome measures, i.e. hospitalacquired conditions (HACs) measures. CMS makes certain quality information available to the public on its Quality Care Finder website, which includes a module called Hospital Compare. The visibility of this and other quality information about hospitals increases both the public s awareness of hospital performance as well as the pressure on hospitals to provide high quality care. The following tables display California hospitals performance on three key quality measures. Table 2 displays hospitals readmission rates associated with the 3 ACA-specified conditions, and Table 3 shows the percent of patients rating their hospital a 9 or 10 overall (on a scale of 1 to 10, where 1 is the worst rating) on a standardized patient experience survey, and percent of patients receiving care instructions and other information upon discharge. TABLE 2 Unadjusted Readmission Rates Associated with ACA-Specified Conditions, National Average and the Top 25 Discharging Hospitals in California. Hospital Name Heart Attack Heart Failure Pneumonia National Average % 24.8% 18.4% Cedars-Sinai Medical Center 19.2% 23.5% 16.9% Northridge Hospital Medical Center 19.6% 24.1% 17.8% Community Regional Medical Center 20.5% 26.3% 19.9% Los Angeles -USC Medical Center 20% 25.1% 20.3% Kaiser Permanente Sacramento Medical Center N/A 25.9% 19.4% Scripps Mercy Hospital 20.4% 23.3% 18% Loma Linda University Medical Center 21.2% 24.7% 20.2% Huntington Hospital 20.4% 23% 18.6% UCSF Medical Center 20.6% 25.2% 17.7% Sutter Memorial Hospital 19.1% 24.8% 17.5% University of California-Davis Medical Center 19.9% 27.4% 18.3% Hoag Memorial Hospital Presbyterian 18% 24.1% 17.6% Sharp Grossmont Hospital 19% 23.3% 19.5% Kaiser Permanente Diego Medical Center 2 N/A N/A N/A Sharp Memorial Hospital 18.4% 23.8% 17.8% Kaiser Permanente Fontana Medical Center 2 N/A N/A N/A 7

8 August 2012 Potential Partners in the California Health Care Landscape Hospital Name Heart Attack Heart Failure Pneumonia Kaiser Permanente Los Angeles Medical Center 2 N/A N/A N/A Antelope Valley Hospital 22% 28.5% 20.0 Citrus Valley Medical Center-InterCommunity Campus 18.3% 22.1% 17.2% St. Agnes Medical Center 19.3% 25.1% 18.4% Torrance Memorial Medical Center 19.5% 23% 20.5% Los Angeles Harbor-UCLA Medical Center 22.3% 25.4% 17.8% Long Beach Memorial Medical Center 18.4% 21.7% 18.3% Stanford Hospital & Clinics 17.9% 23.8% 16.4% UCSD Medical Center-Hillcrest 17.9% 24.8% 18.8% Source: Billian s HealthDATA. Discharge data were not available for all California hospitals; this list is based on available data. 1 National averages are derived from Hospital Outcome of Care Measures at Data.Medicare.Gov. 2 No 30-day readmission rate data were available N/A = Not Available TABLE 3 Patients Giving Highest Hospital Rating and Receiving Instructions upon Discharge for the Top 25 California Hospitals Hospital Name Percent Rating Hospital 9 or 10 1 Percent Receiving Instructions at Discharge Cedars-Sinai Medical Center 76% 78% Northridge Hospital Medical Center 60% 78% Community Regional Medical Center 65% 80% Los Angeles -USC Medical Center 68% 78% Kaiser Permanente Sacramento Medical Center 68% 83% Scripps Mercy Hospital 65% 81% Loma Linda University Medical Center 75% 84% Huntington Hospital 79% 81% UCSF Medical Center 75% 84% Sutter Memorial Hospital 67% 84% University of California-Davis Medical Center 67% 83% 8

9 August 2012 Potential Partners in the California Health Care Landscape Hospital Name Percent Rating Hospital 9 or 10 Percent Receiving Instructions at Discharge Hoag Memorial Hospital Presbyterian 80% 83% Sharp Grossmont Hospital 70% 82% Kaiser Permanente Diego Medical Center 66% 85% Sharp Memorial Hospital 81% 84% Kaiser Permanente Fontana Medical Center 67% 83% Kaiser Permanente Los Angeles Medical Center 74% 82% Antelope Valley Hospital 58% 77% Citrus Valley Medical Center-InterCommunity Campus 63% 79% St. Agnes Medical Center 70% 80% Torrance Memorial Medical Center 70% 80% Los Angeles Harbor-UCLA Medical Center 63% 77% Long Beach Memorial Medical Center 69% 76% Stanford Hospital & Clinics 74% 84% UCSD Medical Center-Hillcrest 69% 83% Source: Hospital Compare, Centers for Medicare and Medicaid Services. Accessed at: California Hospitals: Medicare Reimbursement. There are significant variations in the average Medicare payments received by California s hospitals. Table 4 below displays information about Medicare payments for beneficiaries in the last two years of life. 9

10 August 2012 Potential Partners in the California Health Care Landscape TABLE 4 Medicare Per Capita Spending Data for Beneficiaries with Serious Chronic Illnesses in the Last Two Years of Life, , for the Top 25 Discharging Hospitals in California Hospital Name Per Capita Medicare Reimbursement Total Inpatient Outpatient SNF Home Health Cedars-Sinai Medical Center $117,615 $72,049 $20,031 $11,848 $7,694 Northridge Hospital Medical Center $84,569 $47,662 $11,664 $13,210 $5,890 Community Regional Medical Center $59,613 $37,413 $7,920 $8,128 $1,819 Los Angeles -USC Medical Center Kaiser Permanente Sacramento Medical Center NA NA NA NA NA NA NA NA NA NA Scripps Mercy Hospital $78,254 $41,449 $10,405 $15,739 $3,059 Loma Linda University Medical Center $82,164 $49,417 $11,302 $11,294 $2,797 Huntington Hospital $80,216 $42,622 $11,516 $13,987 $5,326 UCSF Medical Center $89,695 $58,931 $13,887 $8,256 $3,628 Sutter Memorial Hospital $59,386 $34,007 $9,996 $8,332 $2,329 University of California-Davis Medical Center Hoag Memorial Hospital Presbyterian $73,179 $47,269 $10,706 $7,397 $1,926 $82,111 $36,415 $21,047 $12,081 $4,522 Sharp Grossmont Hospital $66,505 $32,563 $9,129 $14,921 $2,296 Kaiser Permanente Diego Medical Center NA NA NA NA NA Sharp Memorial Hospital $66,279 $33,330 $11,234 $10,953 $2,722 Kaiser Permanente Fontana Medical Center Kaiser Permanente Los Angeles Medical Center NA NA NA NA NA NA NA NA NA NA Antelope Valley Hospital $79,228 $44,882 $11,523 $12,195 $3,645 Citrus Valley Medical Center- InterCommunity Campus $84,842 $44,499 $10,561 $19,347 $4,

11 August 2012 Potential Partners in the California Health Care Landscape Hospital Name Per Capita Medicare Reimbursement Total Inpatient Outpatient SNF Home Health St. Agnes Medical Center $57,458 $28,392 $13,007 $8,819 $2,007 Torrance Memorial Medical Center $72,266 $37,419 $12,345 $11,751 $3,388 Los Angeles Harbor-UCLA Medical Center Long Beach Memorial Medical Center $97,965 $64,683 $16,370 $7,183 $4,283 $90,555 $46,988 $ $11,821 $21,665 $4,172 Stanford Hospital & Clinics $79,591 $47,447 $16,402 $7,667 $2,837 UCSD Medical Center-Hillcrest $78,293 $45,575 $11,166 $11,078 $2,861 Source: The Dartmouth Atlas of Health Care, accessed at: All data reflect feefor-service Medicare beneficiaries with chronic illnesses who are in the last two years of life. Medicare pays the same base rate for procedures and treatments, but service utilization may vary among hospitals due to differences in patient mix and hospital practices. N/A = Not available California s hospitals span the continuums of small to large and rural to urban. Given the ACA s readmissions penalty, new financing arrangements tying payment to quality, and the many initiatives related to care transitions and care coordination, hospitals both large and small have an increasing interest in monitoring the care of their patients more broadly, from admission, to discharge to post-acute care. Due to the Medicare readmissions payment penalty, and to the extent that hospitals participate in new financing arrangements that encourage improved quality and cost-effectiveness, hospitals are now at greater financial risk. Many of California s hospitals may not be fully equipped to respond to these shifting incentives and may comprise a large pool of potential customers for CBOs that provide the models and tools to improve care transitions and/or coordination. Medicare Advantage Plans in California The Medicare Advantage (MA) program allows Medicare beneficiaries to receive their Medicare benefits from private plans that are approved by the Centers for Medicare and Medicaid Services (CMS). The types of plans that beneficiaries can enroll in include health maintenance organizations (HMOs) and preferred provider organizations (PPOs). 1 MA plans provide all Medicare-covered benefits, including hospital services (Medicare Part A), and physician services (Medicare Part B). Most MA plans, known as MAprescription drug (MA-PD) plans, also cover prescription drugs under Medicare Part D. Despite significant payment reductions enacted by the Affordable Care Act (ACA) for MA 11

12 August 2012 Potential Partners in the California Health Care Landscape plans, the MA program has remained steady in its popularity and growth. Nationwide, the number of MA plans, including MA-PD plans, increased between 2011 and MA enrollment rose by nearly 10 percent, from 12.2 million in 2011 to 13.3 million in Twentyseven (27.0) percent of all Medicare beneficiaries are currently enrolled in an MA plan. 2 The MA program has an exceptionally strong presence in California, with over 1.8 million (36.4 percent) of the state s Medicare beneficiaries enrolled in an MA plan. Over 90 percent of MA enrollees in California are enrolled in plans offered by one of the top ten plan sponsors. In fact, nearly half of California s MA enrollees are in plans offered by Kaiser, and nearly another 20 percent are enrolled in UnitedHealth plans. Table 5 lists the top ten MA plan sponsors in California. Nationally, UnitedHealth, Humana, and Kaiser, in that order, are the top three MA sponsors by enrollment, covering over 40 percent of all MA enrollees (over 5 million enrollees). TABLE 5 Top MA Parent Organizations by Number of California Enrollees, 2012 Parent Organization Number of California Enrollees Percentage of Total California Enrollees (N = 1,807,489) Kaiser Foundation Health Plan, Inc. 827, % UnitedHealth Group, Inc. 334, % Health Net, Inc. 137, % SCAN Health Plan 114, % WellPoint, Inc. 104, % California Physicians' Service 61, % Aetna Inc. 29, % Easy Choice Health Plan Inc. 27, % Humana Inc. 26, % Care1st Health Plan 22, % Source: Avalere Health analysis of CMS Medicare Advantage/Part D ct and Data. Monthly by ct/plan/state/, March

13 August 2012 Potential Partners in the California Health Care Landscape At least one MA plan is available in every California county, and most have several operating MA plans. Map 3 shows the counties with high numbers of MA enrollees (which will differ from the counties with high percentage of beneficiaries enrolled the most populous counties will generally have the highest numbers of MA enrollees). Map 3 shows the number of MA enrollees in each California county. MAP 3 Number of MA Enrollees by, 2012 Number of MA Enrollees, March ,000 or more 10,000 to 99,999 1,000 to 9, to to 99 Source: Avalere Health analysis of CMS Medicare Advantage/Part D ct and Data. Monthly by ct/plan/state/, March

14 August 2012 Potential Partners in the California Health Care Landscape There is, however, considerable variation at the county level in the percentage enrolled in MA plans, as shown in Map 4. MAP 4 Medicare beneficiaries enrolled in MA % MA, March % or greater 20.00% to 39.99% 5.00% to 19.99% Less than 5.00% Source: Avalere Health analysis of CMS Medicare Advantage/Part D ct and Data. Monthly by ct/plan/state/, March

15 August 2012 Potential Partners in the California Health Care Landscape Map 5 shows the number of participating MA plans per county in California. MA plans in many California counties face significant competition for enrollees and are likely to be continually seeking ways to attract more enrollees with better care services and quality. MAP 5 Number of MA Plans per, 2012 Number of MA Plans, March or more 10 to 19 5 to 9 1 t o 4 Source: Avalere Health analysis of CMS Medicare Advantage/Part D ct and Data. Monthly by ct/plan/state/, March

16 August 2012 Potential Partners in the California Health Care Landscape MA Plan Quality Now Linked to Plan Payments CMS uses a star rating system to evaluate the quality of MA plans, and the rating scale ranges from one star, representing poor performance and plan quality, to five stars, representing highest performance and quality. CMS has published the MA plan star ratings on the Medicare.gov website for a number of years to provide Medicare beneficiaries with plan quality information to consider when making enrollment decisions. However, the ACA reduced payments to MA plans and for the first time, directly tied payments to MA plans to their performance on the star ratings. The ACA directed CMS to increase payment benchmarks for MA plans with ratings of four or more stars beginning in Only a fraction of plans would have qualified for bonuses under these requirements, covering only about 30 percent of MA enrollees. However, to ease MA plans transition to the new quality-based payment system and to test a graduated bonus system, CMS launched a demonstration that expanded bonus payment eligibility to MA plans with three or more stars for Under this demonstration, a significant majority of MA plans (covering nearly 90 percent of MA enrollees) qualify for the bonuses. In 2015, only 4- and 5-star plans will be eligible for bonuses, as required by the ACA. CMS scores MA plans on a number of measures that gauge the plans performance in several areas, including access to screenings, management of chronic conditions, responsiveness to beneficiaries, handling of complaints and appeals, and quality of customer service. For prescription drug coverage plans, CMS evaluates adequacy of customer service, quality of members experiences, management of complaints and appeals, and drug pricing transparency. Overall star ratings are then calculated by averaging the individual measure scores, which are weighted differently. CMS weights outcomes measures three times as much as process measures, and the agency weights patient experience and access measures 1.5 times as much as process measures. For MA-PD plans, the overall star rating also includes performance on the prescription drug measures. In line with its recent focus on quality improvement and value-based purchasing within Medicare, CMS has announced its intention to strengthen the star ratings over time, increasing the focus on outcomes measures while limiting the inclusion of administrative and process measures. For 2012, CMS added a measure assessing plans ability to minimize hospital readmissions and to improve medication adherence. In 2013, CMS plans to introduce a measure assessing care coordination based on beneficiary responses to the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. Additionally, CMS is considering a measure on the use of highly rated hospitals by plan members and a measure based on the evaluation of a plan sponsor s Chronic Care Improvement Program (CCIP) and Quality Improvement Project (QIP), for possible inclusion in the star ratings in future years. Beginning January 1, 2012, MA plans must newly report encounter, or utilization, data to CMS, which is likely to help CMS to construct and adopt more outcomes-based measures. While MA plans may focus immediate efforts on boosting scores for process measures that 16

17 August 2012 Potential Partners in the California Health Care Landscape they have direct control over (such as those assessing the quality of customer service), improving scores on measures regarding care transitions services is likely also a goal for MA plans moving forward. As such, plans may welcome working with community-based organizations to improve their members care transition processes within their network of providers and facilities to increase their measure scores and overall star ratings. A much higher percentage of California MA plans are rated high-quality than is the case nationally. As a result, California MA enrollees are more likely than MA enrollees nationally to have at least one high-quality plan from which to choose. The following table summarizes the distribution of plans and enrollment among the star rating categories for California and the U.S. TABLE 6 Plan by Star Rating for California and the United States, s Plans Enrollees California U.S. California U.S. 4 to 5 stars 41.90% 17.88% 57.33% 27.78% 3.5 stars 36.41% 24.20% 31.72% 32.75% 3 stars 9.42% 31.60% 3.73% 25.15% 2.5 stars 4.44% 12.68% 3.46% 7.91% 2 stars 0% 0.94% 0% 0.25% Not enough data for rating 1.75% 2.18% 0.91% 0.96% Plan too new to be measured 3.30% 5.77% 2.42% 3.01% Source: Avalere Health analysis of CMS Part C and D Performance Data Part C & D Medicare Plan Ratings Data, April 2, Values do not add to 100 percent because certain types of MA plans (1876 cost, employer/union only, and national Program of All-Inclusive Care for the Elderly [PACE] plans) do not receive overall star ratings. 17

18 August 2012 Potential Partners in the California Health Care Landscape Map 6 displays the percentage of MA enrollees in 4 to 5-star plans in each county. MAP 6 4- to 5-Star MA Plan by, 2012 % of MA Enrollees in 4 to 5-Star Plans, by county 80% or greater 60.00% to 79.99% 40.00% to 59.99% 20.00% to 39.99% Less than 19.99% Source: Avalere Health analysis of CMS Part C and D Performance Data Part C & D Medicare Plan Ratings Data, April 2,

19 August 2012 Potential Partners in the California Health Care Landscape Dual Eligible Special Needs Plans Dual eligible special needs plans (D-SNPs) are a type of special needs plan (SNP), which are specialized MA plans that serve a select population of Medicare beneficiaries. The D-SNPs provide managed care to beneficiaries who are eligible for both Medicare and Medicaid (dual eligibles). The D-SNP program was originally authorized by the Medicare Prescription Drug Improvement and Modernization Act (MMA) of 2003, and it is currently only authorized through the end of However, D-SNP reauthorization is highly likely in light of federal and state policymakers recent focus on efforts to manage these high-cost patients through better care coordination. There are currently 1.2 million Medicare beneficiaries enrolled in D-SNPs nationally and over 162,000 enrolled in California. As many D-SNPs currently designate their Medicaid benefits as supplemental benefits, CMS aims to allow D-SNPs flexibility to design supplemental benefits that improve the integration of Medicare and Medicaid benefits. CMS identified as the most appropriate supplemental benefits under this initiative several care transition-related services like non-skilled in-home support services, in-home food delivery, supports for caregivers, and adult day care services. This new benefit flexibility is likely to create additional opportunities for community-based organizations to partner with D-SNPs to provide such supplemental benefits. Table 7 provides an overview of the popularity and the quality of D-SNPs currently operating in California. In an effort to ensure that these plans are coordinating care between programs for their enrollees, Congress established a requirement that beginning in calendar year (CY) 2013, all sponsors of D-SNPs must contract with the Medicaid agencies of the states in which they operate. Sponsors will not be permitted to create new D-SNPs without such contracts, and existing D-SNPs that fail to obtain a contract will not be allowed to operate. California recently released guidance for D-SNPs on fulfilling this requirement. For CY 2013, CMS announced a proposal to increase flexibility in the types of benefits certain highly integrated D-SNPs can offer to enrollees. CMS will allow qualifying D-SNPs that meet high integration and performance standards to offer supplemental benefits beyond what MA plans are permitted to offer. 19

20 August 2012 Potential Partners in the California Health Care Landscape TABLE 7 California s D-SNP Plans, 2012 ct Name Plan Name Geographic Area Star Rating Alameda Alliance Joint Powers Authority (JPA) Care1st Health Plan Care1st Health Plan Care1st Health Plan Care1st Health Plan Alliance CompleteCare Care1st TotalDual Plan Care1st TotalDual Plan Care1st TotalDual Plan Care1st TotalDual Plan Alameda 4,413 3/5 stars Los Angeles 3,240 3/5 stars Orange 147 3/5 stars 107 3/5 stars Diego 2,019 3/5 stars CareMore Health Plan CareMore Connect Los Angeles and Orange Counties (partial) /5 stars Central Health Plan of California, Inc. Central Health Medi- Medi Plan Los Angeles and Partial 3, /5 stars Chinese Community Health Plan CCHP Senior Select Program Francisco 3, /5 stars Community Health Group CommuniCare Advantage Diego 1,049 Not enough data Easy Choice Health Plan Inc. Easy Choice Freedom Plan Los Angeles, Orange, Riverside and Counties 8, /5 stars Health Net of California Health Net Seniority Plus Amber I Los Angeles, Kern, Orange, Riverside and Counties 1, /5 stars Health Net of California Health Net Seniority Plus Amber II Parts of So. Cal., Alameda,, Francisco 12, /5 stars IEHP Health Access IEHP Medicare DualChoice Riverside and Counties 6,789 3/5 stars Kaiser Foundation HP, Inc. Kaiser Foundation HP, Inc. Senior Advantage Medicare Medi-Cal Plan South Senior Advantage Medicare Medi-Cal Plan North Southern California 31,566 5 stars Northern California 29,081 5 stars 20

21 August 2012 Potential Partners in the California Health Care Landscape ct Name Plan Name Geographic Area Star Rating L. A. Care Health Plan L.A. Care Health Plan Medicare Advantage Los Angeles 2, /5 stars MD Care, Inc. Preferred Dual SNP Los Angeles, Orange, Riverside and Counties 2, /5 stars Molina Healthcare of California Molina Healthcare of California Molina Medicare Options Plus Molina Medicare Options Plus Southern California 4, /5 stars Sacramento 1, /5 stars Orange Health Authority OneCare Orange 13,318 4/5 stars Partnership Healthplan of California PartnershipAdvantage Napa, Solano, and Yolo Counties 7,271 4/5 stars Mateo Health Commission Scan Health Plan Scan Health Plan Scan Health Plan Scan Health Plan Scan Health Plan Scan Health Plan Scan Health Plan UnitedHealthcare of California UnitedHealthcare of California HPSM CareAdvantage SCAN Connections (HMO SNP) SCAN Connections (HMO SNP) SCAN Connections (HMO SNP) SCAN Connections at Home SCAN Connections at Home SCAN Connections at Home SCAN Connections (HMO SNP) UnitedHealthcare Dual Complete UnitedHealthcare Dual Complete Mateo 8, /5 stars Los Angeles 2,923 4/5 stars Riverside 1,005 4/5 stars 666 4/5 stars Los Angeles 1,462 4/5 stars Riverside 565 4/5 stars 295 4/5 stars Joaquin /5 stars Los Angeles 1, /5 stars Orange /5 stars UnitedHealthcare of California UnitedHealthcare Dual Complete Riverside and Counties 1, /5 stars Source: Avalere Health analysis of CMS Part C and D Performance Data, 2012 Part C & D Medicare Plan Ratings Data, April 2,

22 August 2012 Potential Partners in the California Health Care Landscape Dual Eligibles Demonstrations The ACA established the Medicare-Medicaid Coordination Office (the Dual Eligibles Office) to better align and coordinate benefits between Medicare and Medicaid for dual eligibles. In April 2011, the Dual Eligibles Office awarded grants of $1 million each to 15 states, including California, to support state efforts to develop and test coordinated, integrated care approaches for dual eligibles. All 15 states proposed to contract with managed care organizations or integrated provider networks to coordinate care for dual eligibles. In August 2011, CMS released a letter to all state Medicaid directors that identified two financial alignment models that states could use in proposals to improve coordination of care for dual eligibles, including a fully capitated model which would involve a three-way contract between CMS, a state, and one or more health plans or a managed fee-for-service (FFS) model with the state eligible for shared savings. Twentyeight states are expected to release proposals to participate in this demonstration. In April 2012, California released its draft proposal to coordinate care for dual eligibles in four counties: Los Angeles, Diego, Orange, and Mateo counties, where approximately 535,000 of the state s total 1.1 million dual eligibles reside. The state also announced the health plans that are eligible to participate in the demonstration in the four counties: L.A. Care, Health Net, Care1st, Community Health Group, Molina, CalOptima, and Health Plan of Mateo. Many of these plans are current D-SNP sponsors and are likely be interested in improving care transitions for their particularly vulnerable dually eligible members. Governor Jerry Brown recently proposed expanding the demonstration to up to 8 additional counties and approximately 201,000 additional dual eligibles. Accountable Care Organizations are Forming In April 2012, CMS announced the first 27 Medicare Shared Savings Program participants. These new ACOs will enroll almost 375,000 beneficiaries across 18 states and be eligible for shared savings depending on their performance on 33 quality measures. Nine of the 27 participants are partnerships between local providers and a wholly owned subsidiary of Universal American, an MA plan sponsor committed to creating ACO partnerships. Although none of the Medicare Shared Savings Program ACOs in California (AppleCare Medical ACO, LLC, and Premier ACO Physician Network) is in partnership with Universal American, more plans are expected to engage with physicians in managing ACOs based on their experience in managed care. Additionally, in December 2011, CMS and the Center for Medicare & Medicaid Innovation (the Innovation Center) announced the organizations selected to participate in the Pioneer ACO Model. The Pioneer ACO Model is designed for ACOs that have experience in coordinating patient care under financial risksharing contracts and are positioned to move from a fee-for-service financial model to a population-based payment model. California s MA providers will play a role in the Pioneer ACO program. For example, Orange s Monarch Healthcare, a physician-led independent practice association, was one of the 32 organizations selected to participate in the Pioneer ACO Model. Monarch s network includes the Monarch Health Plan, 22

23 August 2012 Potential Partners in the California Health Care Landscape a California-licensed health plan bearing full risk for over 11,000 MA beneficiaries. As ACOs are expected to be fully financially responsible for care coordination and transitions for their members, ACOs would also be a likely partner for community-based organization in care transitions initiatives. Major Medical Groups in California The variety of ongoing care coordination, quality improvement, and payment realignment initiatives are driving physicians and other providers to seek arrangements with larger, more integrated provider networks and groups. California does not allow direct employment of physicians by entities other than professional corporations, which has historically limited hospital and physician integration. Recently, however, hospitals and health systems have developed other mechanisms for formal arrangements, such as medical foundations or exclusively contracted medical groups. Among these medical groups, there is wide variation in the use of care management models, contracted organizations, quality measurement, and financial incentives. 3 Due to the emphasis that many new initiatives place on care coordination and integration, medical groups with integrated delivery networks are well-positioned to participate. Specifically, California s dual eligible integration demonstration and the Medicare ACO program require that applicants provide a comprehensive set of services to all enrollees. Medical groups are best-positioned to offer such services, and many in California are actively strengthening their networks and offerings as they apply to participate in these new programs. Several medical groups applied for CMS Pioneer ACO program; Table 8 lists the provider organizations that were recently selected as participants. TABLE 8 California Providers Selected by CMS for the Pioneer ACO Program, as of June Organization Brown & Toland Physicians HealthCare Partners Medical Group Heritage ACO California Monarch HealthCare PrimeCare Medical Network Sharp HealthCare Service Area Francisco Bay Area Los Angeles and Orange Counties Southern, Central, and Coastal California Orange and Riverside Counties Diego 23

24 August 2012 Potential Partners in the California Health Care Landscape Six of California s largest provider organizations are described below. Four of these groups are participants in the Pioneer ACO program, and the others have experience setting up ACO-like programs. HealthCare Partners According to its publicly available annual report, HealthCare Partners is one of the largest single providers of pre-paid health care for seniors in California. Founded in 1992, HealthCare Partners provides health care services to both HMO enrollees and fee-forservice patients with contracts with most major HMOs and PPOs serving the Los Angeles area. The full service area includes Los Angeles, Pasadena/the Gabriel Valley, South Bay, Long Beach, the Fernando and ta Clarita Valleys, and Orange. HealthCare Partners Medical group (staff model) employs more than 700 physicians and provides care through a network of more than 50 medical offices. In addition, the HealthCare Partners Independent Physician Association (IPA) contracts with physicians in the community to provide more access to physician care; more than 900 physicians and 3,000 specialists are available to patients served by the staff model medical group as well as the IPA. Notably, HealthCare Partners Medical Group announced in December 2011 that it was selected to participate in the Pioneer ACO demonstration. 4 Brown & Toland Physicians Based in Francisco, Brown & Toland is a physician-owned and governed independent practice association of more than 800 community physicians serving 300,000 enrollees. Per the 2010 annual report, Brown & Toland serves about 115,000 HMO and 175,000 PPO participants; in Francisco, Brown & Toland serves about 15,000 MA enrollees through contracts with HealthNet, UnitedHealth, and SCAN Health Plan. Brown & Toland has an operating income of $6.8 million, and was selected to participate in the Pioneer ACO demonstration. 5 Hill Physicians Medical Group Per its 2010 Annual Report, Hill Physicians Medical Group is the largest Independent Physician Association in Northern California. Founded in 1984, Hill Physicians serves more than 310,000 patients via a provider network of more than 3,500 physicians and other practitioners. The service area includes the East Bay, Francisco, Sacramento, and Joaquin, and Hill Physicians contracts with 12 health plans, including Aetna of California, Anthem/Blue Cross of California, CIGNA Healthcare of California, Health Net Medicare, United Healthcare West, SCAN Health Plan, and others. In 2010, Hill Physicians reported $455 million in revenue, with a net income $5.4 million. Notably, Hill Physicians participated in a virtual ACO initiative in Sacramento with Catholic Healthcare West (CHW) and Blue Shield of California. The initiative yielded positive results; average length of stay decreased by 12% and hospital readmission rates decreased by 22%. 6 Sharp HealthCare Sharp HealthCare is an integrated health care delivery system based serving the Diego area. The system includes Sharp Community Medical Group, an Independent Physician Association (IPA) and Sharp Rees-Stealy Medical Group, a Multispecialty Group Staff Model, and operates four acute-care hospitals, 24

25 August 2012 Potential Partners in the California Health Care Landscape three specialty hospitals, two affiliated medical groups and a health plan, as well as other facilities and services. 7 Sharp contracts with 2,600 physicians. In addition, Sharp HealthCare operates Sharp Health Plan, the only commercial health plan based in Diego. Sharp hospitals also hold six capitated commercial HMO contracts and one capitated senior HMO contract. In fiscal year 2009, Sharp reported net revenues of $2.1 billion. Scripps Health Scripps Health is a private, nonprofit health system in Diego, California that includes four acute-care hospitals on five campuses, more than 2,600 affiliated physicians, and outpatient care network, home health care and associated support services. Scripps Health was established more than 80 years ago in the community of La Jolla but now extends from Chula Vista to Oceanside, with more than 20 primary and specialty care outpatient centers. 8 Scripps average daily inpatient census is 831 patients. Heritage Provider Network Heritage Provider Network provides programs and services designed specifically for the managed care environment. Founded in 1995, Heritage has expanded to include Southern and Central California and currently has 500,000 patients in its panel. Affiliated Medical Groups include Bakersfield Family Medical Center, Coastal Communities Physician Network, Desert Oasis Health Care, High Desert Medical Group, Heritage Victor Valley Medical Group, Lakeside Medical Group, Regal Medical Group, Sierra Medical Group, and Affiliated Doctors of Orange. Heritage contracts with 11 health plans, including Aetna, Anthem, CIGNA, HealthNet, SCAN Health Plan, United Healthcare, and others. Notably, in December 2011, that Heritage Provider Network was selected to participate in the Pioneer ACO demonstration. 9 Table 9 displays general information about these medical groups. TABLE 9 Publicly-Available Information about Selected California Medical Groups Medical Group Service Area Patients Physicians Income ACO? Health Care Partners Los Angeles and Southern CA 575, MDs/3,000 specialists (IPA) Not available Yes: Pioneer Brown & Toland Francisco area 300, MDs Operating income $6.8 million Yes: Pioneer Hill Physicians Northern CA 310,000 3,500 MDs + specialists Net income $5.4 million Virtual ACO Sharp Diego NA 2,600 MDs Scripps Diego NA 2,600 MDs Net revenue: $2.1 billion Revenue: $2.3 billion Yes: Pioneer ACO-like Integrated Delivery Network Heritage Provider Network Southern and Central CA 500,000 2,100 MDs, 30,000 specialists Not available Yes: Pioneer Source: Annual reports, fact sheets, and other information within medical groups websites. 25

26 August 2012 Potential Partners in the California Health Care Landscape Conclusion Hospitals, insurers, physicians, medical groups, and other health care entities are increasingly responding to the shift away from fragmented, siloed care delivery towards coordinated, integrated care. New payment arrangements and policies, discussed in this paper, that encourage high-quality coordinated care will put unprepared providers at risk of lost patients and revenue. As providers and insurers determine how best to thrive in this new policy and financial environment, CBOs offering evidence-based care coordination expertise and service models have an excellent opportunity to develop partnerships and provide services to a larger customer base. Author Bios Jennifer Rak, Senior Manager at Avalere Health, provides policy analysis and strategic advice on Medicare legislation and regulation and health insurance market reform. In particular, she focuses on policy and payment issues related to the Medicare Advantage and Part D programs. Prior to joining Avalere, Jennifer was an executive director in the Federal Programs Health Policy department at America s Health Insurance Plans (AHIP), a national trade association, where she worked with members on policy developments impacting plans participating in the Medicare program. She analyzed key implementation issues arising from health reform relating to Medicare Advantage, Medicare Part D, state Exchanges and the Medicaid program. She also worked as an associate in the law firm of Cooper and Dunham, LLC doing patent prosecution and IP strategy for biotech applications. Jennifer holds a B.A. from Reed College, a J.D. from Case Western Reserve University with a focus in health law, and a M.P.H. from Emory University. Sally Rodriguez, Senior Manager at Avalere Health, provides research and analytic support to clients on Medicaid and long-term care policy issues, focusing on longterm care reform. Prior to joining Avalere, Sally worked as an Analyst for the Government Accountability Office (GAO), producing Congressionally-requested reports that analyzed domestic health policies and programs. Prior to GAO, Sally conducted survey research for the Center for the Study of Services and worked for a Washington, DC-based policy consultant. Sally holds a B.S. in Health Promotion Disease Prevention Studies from the University of Southern California and received her M.P.H. with a concentration in policy from the George Washington University. 26

27 August 2012 Potential Partners in the California Health Care Landscape References 1. MA plans also include private fee-for-service (PFFS), cost, and demonstration MA-PD plans, which together represent only approximately 15 percent of all MA plan offerings in Avalere Health. Analysis of CMS MA State/ Penetration File. April 2012; 3. Burtley, Cleo et al. Physician-Hospital Integration 2012: How Health Care Reform Is Reshaping California s Delivery System, California Health Care Foundation; MEDIA%20LIBRARY%20Files/PDF/P/PDF%20PhysicianHospIntegration.pdf 4. HealthCare Partners. About HealthCare Partners; aboutus.asp 5. Brown & Toland Physicians Annual Report; Documents/en/about/Annual%20Report% pdf 6. Hill Physicians Medical Group. More Than Ever: Strength in Numbers Annual Report; Sharp HealthCare. About Sharp; 8. Scripps. Transforming Results: 2010 Annual Report; 9. Heritage Provider Network. About Us; For more information contact: The SCAN Foundation Erin C. Westphal, MSG, Program Officer 3800 Kilroy Airport Way, Suite 400, Long Beach, CA (888) [email protected] Follow us on Twitter Find us on Facebook

28 Appendix 1: California Hospitals: General Information, Readmissions, and Quality Indicators Hospital Name Discharges Total Beds Patient Revenue Patient Days: Medicare Patient Days: Medicaid Rates: Heart Attack Rates: Heart Failure Rates: Pneumonia Patients Rating the Hospital 9 or 10 Percent Providing Info Upon Discharge Cedars-Sinai Medical Center Los Angeles 58, $ 7,994,336, % 39.1% 19.2% 23.5% 16.9% 76% 78% Northridge Hospital Medical Center Los Angeles 35, $ 1,576,529, % 30.7% 19.6% 24.1% 17.8% 60% 78% Community Regional Medical Center Fresno 35, $ 2,474,693, % 16.6% 20.5% 26.3% 19.9% 65% 80% Los Angeles -USC Medical Center Los Angeles 35, $ 1,870,786, % 6.0% 20.0% 25.1% 20.3% 68% 78% Kaiser Permanente Sacramento Medical Center Sacramento 32, N/A 5.7% 5.7% 0.0% 25.9% 19.4% 68% 83% Scripps Mercy Hospital Diego 32, $ 2,067,850, % 29.8% 20.4% 23.3% 18.0% 65% 81% Loma Linda University Medical Center 31, $ 3,948,648, % 22.4% 21.2% 24.7% 20.2% 75% 84% Huntington Hospital Los Angeles 29, $ 1,906,879, % 34.6% 20.4% 23.0% 18.6% 79% 81% UCSF Medical Center Francisco 29, $ 5,946,735, % 21.8% 20.6% 25.2% 17.7% 75% 84% Sutter Memorial Hospital Sacramento 29, $ 2,815,201, % 21.1% 19.1% 24.8% 17.5% N/A N/A University of California-Davis Medical Center Sacramento 29, $ 5,219,460, % 28.6% 19.9% 27.4% 18.3% 67% 83% Hoag Memorial Hospital Presbyterian Orange 28, $ 1,840,576, % 31.1% 18.0% 24.1% 17.6% 80% 83% Sharp Grossmont Hospital Diego 28, $ 2,219,714, % 32.6% 19.0% 23.3% 19.5% 70% 82% Kaiser Permanente Diego Medical Center-Kaiser Foundation Diego 27, N/A 2.0% 2.0% 0.0% 0.0% 0.0% 66% 85% Sharp Memorial Hospital Diego 27, $ 2,923,962, % 27.7% 18.4% 23.8% 17.8% 81% 84% Kaiser Permanente Fontana Medical Center 25, N/A 3.0% 3.0% 0.0% 0.0% 0.0% 67% 83% Kaiser Permanente Los Angeles Medical Center Los Angeles 25, N/A 2.0% 2.0% 0.0% 0.0% 0.0% 74% 82% Antelope Valley Hospital Los Angeles 25, $ 1,058,085, % 27.2% 22.0% 28.5% 20.0% 58% 77% Citrus Valley Medical Center- InterCommunity Campus Los Angeles 24, $ 1,087,968, % 27.4% 18.3% 22.1% 17.2% 63% 79% St. Agnes Medical Center Fresno 24, $ 1,646,872, % 48.1% 19.3% 25.1% 18.4% 70% 80% Torrance Memorial Medical Center Los Angeles 24, $ 2,163,972, % 34.6% 19.5% 23.0% 20.5% 70% 80% Los Angeles Harbor-UCLA Medical Center Los Angeles 24, $ 1,748,063, % 7.1% 22.3% 25.4% 17.8% 63% 77% Long Beach Memorial Medical Center Los Angeles 23, $ 1,777,416, % 33.5% 18.4% 21.7% 18.3% 69% 76% Stanford Hospital & Clinics ta Clara 23, $ 6,705,342, % 34.6% 17.9% 23.8% 16.4% 74% 84%

29 Hospital Name Discharges Total Beds Patient Revenue Patient Days: Medicare Patient Days: Medicaid Rates: Heart Attack Rates: Heart Failure Rates: Pneumonia Patients Rating the Hospital 9 or 10 Percent Providing Info Upon Discharge UCSD Medical Center-Hillcrest Diego 23, $ 2,122,691, % 24.4% 17.9% 24.8% 18.8% 69% 83% Riverside Regional Medical Center Riverside 23, $ 1,408,000, % 10.4% 0.0% 26.5% 20.0% 69% 81% Arrowhead Regional Medical Center 23, $ 1,247,067, % 13.6% 19.7% 26.7% 18.2% 62% 76% Kaiser Foundation Hospital-Anaheim Orange 22, N/A 1.7% 1.7% 0.0% 0.0% 0.0% 75% 84% ta Clara Valley Medical Center ta Clara 22, $ 2,120,397, % 11.0% 19.1% 21.8% 18.1% 57% 74% Mission Hospital-Mission Viejo Campus Orange 21, $ 1,563,353, % 33.2% 19.6% 25.1% 17.8% 76% 81% Pomona Valley Hospital Medical Center Los Angeles 21, $ 2,236,923, % 18.1% 18.9% 21.5% 19.6% 81% 85% California Pacific Medical Center- Pacific Campus Francisco 21,756 1,254 $ 2,700,935, % 28.8% 21.6% 24.4% 18.0% 68% 76% Kaiser Permanente ta Clara Medical Center ta Clara 21, N/A 1.7% 1.7% 0.0% 24.0% 0.0% 75% 84% Kaweah Delta Medical Center Tulare 21, $ 1,425,647, % 41.0% 18.0% 22.4% 17.9% 67% 80% Saddleback Memorial Medical Center- Laguna Hills Campus Orange 20, $ 1,278,829, % 32.0% 20.0% 21.7% 16.2% 62% 78% Providence Little Company of Mary Medical Center Torrance Los Angeles 20, $ 1,674,858, % 39.7% 19.8% 24.7% 18.8% 73% 79% Palomar Medical Center Diego 20, $ 1,239,684, % 14.8% 19.3% 21.1% 19.7% 60% 77% Memorial Medical Center Stanislaus 20, $ 2,259,148, % 33.1% 18.5% 25.9% 20.5% 73% 84% Centinela Hospital Medical Center Los Angeles 20, $ 1,428,045, % 41.5% 20.6% 26.8% 21.1% 61% 77% Doctors Medical Center of Modesto Stanislaus 20, $ 2,678,660, % 26.3% 18.9% 24.4% 18.9% 64% 82% St. Francis Medical Center Los Angeles 20, $ 1,136,355, % 17.2% 19.4% 23.7% 18.9% 65% 75% John Muir Medical Center Walnut Creek 20, $ 2,735,927, % 44.2% 19.8% 22.8% 16.3% 74% 82% Riverside Community Hospital Riverside 19, $ 1,769,159, % 28.7% 19.7% 25.6% 20.0% 60% 81% Tri-City Medical Center Diego 19, $ 1,014,868, % 38.1% 17.4% 21.5% 17.5% 55% 81% Mercy Juan Medical Center Sacramento 19, $ 1,783,037, % 16.6% 19.0% 26.6% 18.0% 64% 84% Alta Bates Summit Medical Center- Alta Bates Campus Alameda 19,488 1,094 $ 2,246,542, % 18.4% 19.5% 26.4% 17.9% 69% 80% Rancho Springs Medical Center Riverside 19, $ 712,206, % 23.8% 20.4% 24.7% 20.3% 0% 0% White Memorial Medical Center Los Angeles 19, $ 1,571,274, % 26.8% 19.9% 24.4% 19.8% 74% 79% Eisenhower Medical Center Riverside 18, $ 2,108,120, % 59.9% 17.1% 23.6% 16.4% 72% 81%

30 Hospital Name Discharges Total Beds Patient Revenue Patient Days: Medicare Patient Days: Medicaid Rates: Heart Attack Rates: Heart Failure Rates: Pneumonia Patients Rating the Hospital 9 or 10 Percent Providing Info Upon Discharge Joaquin Community Hospital Kern 18, $ 1,090,855, % 36.4% 20.1% 25.7% 17.1% 69% 83% Glendale Adventist Medical Center Los Angeles 18, $ 1,773,816, % 52.6% 19.9% 24.6% 16.6% 61% 76% El Camino Hospital ta Clara 18, $ 2,018,776, % 32.5% 17.8% 24.0% 19.4% 75% 83% Kaiser Permanente Oakland Medical Center Alameda 18, N/A 4.4% 4.4% 0.0% 24.9% 19.7% 51% 81% Mercy General Hospital Sacramento 17, $ 2,044,146, % 30.6% 19.1% 24.0% 18.4% 67% 84% Providence St. Joseph Medical Center Los Angeles 17, $ 2,338,744, % 43.7% 21.3% 24.7% 17.0% 75% 79% Presbyterian Intercommunity Hospital Los Angeles 17, $ 2,081,061, % 34.7% 18.0% 23.2% 15.8% 80% 80% Valley Presbyterian Hospital Los Angeles 17, $ 871,610, % 26.4% 19.0% 24.7% 18.3% 61% 74% Fountain Valley Regional Hospital & Medical Center Orange 17, $ 1,596,808, % 28.1% 19.1% 25.1% 16.8% 62% 78% Antonio Community Hospital 17, $ 1,107,691, % 26.9% 18.1% 23.6% 15.0% 68% 80% Citrus Valley Medical Center-Queen of the Valley Campus Los Angeles 17, $ 661,125, % 22.6% N/A N/A N/A N/A N/A Providence Holy Cross Medical Center Los Angeles 17, $ 1,884,127, % 30.2% 20.7% 24.4% 16.1% 73% 80% ta Barbara Cottage Hospital ta Barbara 17, $ 1,219,970, % 33.4% 16.6% 19.0% 14.5% 74% 85% Scripps Memorial Hospital-La Jolla Diego 17, $ 1,555,052, % 35.6% 17.2% 22.2% 18.3% 74% 81% Bakersfield Memorial Hospital Kern 17, $ 1,121,777, % 29.0% 20.5% 23.5% 21.1% 71% 81% St. Bernardine Medical Center 16, $ 1,258,313, % 21.9% 21.5% 24.3% 19.5% 66% 76% California Hospital Medical Center Los Angeles 16, $ 857,861, % 12.4% 22.0% 25.6% 19.7% 59% 72% Ventura Medical Center Ventura 16, $ 843,851, % 12.5% 0.0% 25.4% 17.5% 68% 79% Desert Regional Medical Center Riverside 16, $ 1,891,537, % 25.7% 20.4% 26.3% 19.1% 68% 83% St. Joseph's Medical Center Joaquin 16, $ 1,661,254, % 48.2% 19.6% 23.1% 18.2% 62% 79% Good Samaritan Hospital ta Clara 16, $ 2,154,502, % 28.6% 17.7% 25.7% 17.4% 64% 80% University of California-Irvine Medical Center Orange 16, $ 2,507,651, % 22.4% 21.9% 27.0% 18.5% 70% 84% Rady Children's Hospital Diego Diego 16, $ 1,332,031, % 0.2% N/A N/A N/A N/A N/A Sutter Roseville Medical Center Placer 16, $ 1,241,463, % 30.7% 16.7% 23.6% 17.2% 78% 82% St. Joseph Hospital Orange 16, $ 2,365,214, % 27.0% 18.5% 23.2% 15.7% 74% 83%

31 Hospital Name Discharges Total Beds Patient Revenue Patient Days: Medicare Patient Days: Medicaid Rates: Heart Attack Rates: Heart Failure Rates: Pneumonia Patients Rating the Hospital 9 or 10 Percent Providing Info Upon Discharge St. Jude Medical Center Orange 16, $ 1,552,193, % 35.8% 17.1% 21.7% 17.1% 70% 86% Methodist Hospital of Southern California Los Angeles 15, $ 915,213, % 53.2% 17.1% 23.9% 15.7% 65% 75% St. Mary Medical Center 15, $ 968,628, % 28.7% 21.3% 28.4% 19.7% 65% 79% Kaiser Permanente Riverside Medical Center Riverside 15, N/A 1.9% 1.9% 0.0% 0.0% 0.0% 71% 83% Kaiser Permanente Hayward Medical Center Alameda 15, N/A 2.7% 2.7% 0.0% 0.0% 0.0% 62% 84% Kaiser Permanente Baldwin Park Medical Center Los Angeles 15, N/A 2.8% 2.8% 0.0% 0.0% 0.0% 74% 84% ta Monica-UCLA Medical Center Los Angeles 15, $ 1,044,025, % 33.0% 20.8% 24.9% 18.1% 68% 77% Francisco General Hospital Francisco 14, $ 1,581,838, % 14.4% 22.1% 25.8% 18.5% 56% 83% Kaiser Permanente South Bay Medical Center Los Angeles 14, N/A 4.1% 4.1% 0.0% 0.0% 0.0% 70% 84% Sharp Chula Vista Medical Center Diego 14, $ 1,247,346, % 24.9% 20.3% 23.7% 15.1% 70% 83% Miller Children's Hospital Los Angeles 14, $ 878,688, % 0.3% N/A N/A N/A N/A N/A Kaiser Permanente Walnut Creek Medical Center 14, N/A 2.7% 2.7% 0.0% 0.0% 0.0% 64% 84% Hollywood Presbyterian Medical Center Los Angeles 14, $ 1,066,664, % 28.1% 20.8% 30.1% 18.5% 59% 72% Good Samaritan Hospital Los Angeles 14, $ 1,310,428, % 36.5% 19.8% 25.5% 16.7% 65% 73% St. John's Health Center Los Angeles 14, $ 966,165, % 42.8% 20.0% 24.2% 16.9% 66% 80% Olive View-UCLA Medical Center Los Angeles 14, $ 662,030, % 5.5% 0.0% 24.8% 19.9% 62% 77% Enloe Medical Center Butte 14, $ 1,301,351, % 59.1% 20.6% 25.0% 20.2% 60% 83% Orange Coast Memorial Medical Center Orange 13, $ 797,169, % 19.7% 19.2% 22.4% 17.7% 59% 74% Children's Hospital Central California Madera 13, $ 900,188, % 0.1% N/A N/A N/A N/A N/A Mills-Peninsula Medical Center Mateo 13, $ 1,480,349, % 30.4% 18.3% 19.1% 14.1% 73% 82% Kaiser Foundation Hospital-Panorama City Medical Center Los Angeles 13, N/A 1.4% 1.4% 0.0% 0.0% 0.0% 77% 82% Los Robles Hospital & Medical Center Ventura 13, $ 1,260,971, % 53.5% 18.6% 22.6% 16.9% 66% 82% Community Memorial Hospital Ventura 13, $ 1,296,762, % 23.7% 21.7% 24.1% 18.1% 58% 79% KFH Francisco Medical Center Francisco 13, N/A 2.4% 2.4% 20.2% 25.5% 0.0% 65% 82% Mercy Medical Center-Redding Shasta 13, $ 1,158,846, % 48.1% 18.6% 19.0% 17.5% 67% 82%

32 Total Beds Patient Days: Medicare Patient Days: Medicaid Rates: Heart Attack Rates: Heart Failure Rates: Pneumonia Patients Rating the Hospital 9 or 10 Percent Providing Info Upon Discharge Hospital Name Discharges Patient Revenue Alta Bates Summit Medical Center- Summit Campus Alameda 13, $ 1,904,691, % 45.6% 20.4% 23.2% 20.0% 69% 86% Washington Hospital Alameda 13, $ 1,784,823, % 46.2% 21.2% 25.6% 20.3% 60% 85% Downey Regional Medical Center Los Angeles 13, $ 942,940, % 32.6% 18.2% 26.5% 15.9% 59% 77% Anaheim Regional Medical Center Orange 12, $ 993,124, % 26.3% 20.0% 23.8% 16.2% 58% 78% O'Connor Hospital ta Clara 12, $ 1,543,679, % 42.7% 17.7% 28.2% 19.4% 57% 77% Providence Tarzana Medical Center Los Angeles 12, $ 1,350,306, % 49.1% 0.0% 0.0% 0.0% 55% 72% Lucile Packard Children's Hospital ta Clara 12, $ 2,441,028, % 0.4% N/A N/A N/A N/A N/A Hemet Valley Medical Center Riverside 12, $ 509,435, % 33.2% 21.7% 25.5% 19.6% 40% 72% Marian Medical Center ta Barbara 12, $ 795,993, % 37.6% 19.6% 23.0% 17.6% 54% 80% Salinas Valley Memorial Healthcare System Monterey 12, $ 877,961, % 45.3% 17.5% 25.5% 15.9% 65% 80% Kaiser Permanente West Los Angeles Medical Center Los Angeles 12, N/A 3.7% 3.7% 0.0% 0.0% 0.0% 72% 83% Kaiser Permanente South Sacramento Medical Center Sacramento 12, N/A 5.5% 5.5% 0.0% 0.0% 0.0% 66% 85% Children's Hospital of Orange Orange 12, $ 1,169,999, % 0.0% N/A N/A N/A N/A N/A Henry Mayo Newhall Memorial Hospital Los Angeles 12, $ 1,055,348, % 36.8% 21.0% 25.0% 18.0% 59% 74% Rideout Memorial Hospital Yuba 12, $ 738,491, % 44.7% 20.0% 22.3% 18.0% 45% 73% Kaiser Permanente Woodland Hills Medical Center Los Angeles 12, N/A 1.7% 1.7% 0.0% 0.0% 0.0% 73% 84% Mercy Hospitals of Bakersfield- Truxton Campus Kern 12, $ 893,725, % 32.3% 20.7% 24.3% 19.2% 64% 80% Redlands Community Hospital 12, $ 713,640, % 16.5% 19.9% 24.0% 18.8% 68% 80% ta Rosa Memorial Hospital Sonoma 12, $ 1,513,914, % 45.9% 16.6% 20.9% 17.3% 62% 81% St. John's Regional Medical Center Ventura 12, $ 932,257, % 40.3% 19.1% 23.4% 18.9% 67% 80% Scripps Green Hospital Diego 12, $ 1,185,838, % 33.6% 17.0% 25.0% 18.0% 80% 82% Kaiser Permanente Jose Medical Center ta Clara 11, N/A 5.7% 5.7% 0.0% 23.1% 18.8% 65% 84% Kern Medical Center Kern 11, $ 619,486, % 7.0% 0.0% 0.0% 18.3% 51% 71% Regional Medical Center 11, $ 532,858, % 18.4% 0.0% 25.6% 17.4% 68% 81% Dominican Hospital ta Cruz 11, $ 1,189,656, % 43.1% 19.0% 23.7% 16.4% 62% 80%

33 Total Beds Patient Days: Medicare Patient Days: Medicaid Rates: Heart Attack Rates: Heart Failure Rates: Pneumonia Patients Rating the Hospital 9 or 10 Percent Providing Info Upon Discharge Hospital Name Discharges Patient Revenue Kaiser Permanente Vallejo Medical Center Solano 11, N/A 6.3% 6.3% 0.0% 23.9% 17.0% 68% 83% Community Hospital of the Monterey Peninsula Monterey 11, $ 968,850, % 57.0% 18.2% 23.3% 15.6% 75% 81% Community Hospital of 11, $ 755,551, % 13.9% 0.0% 25.9% 18.4% 57% 78% Children's Hospital Los Angeles Los Angeles 11, $ 1,112,662, % 0.3% N/A N/A N/A N/A N/A Sharp Mary Birch Hospital for Women Diego 11, $ 481,429, % 0.3% 0.0% 0.0% 0.0% N/A N/A Dameron Hospital Joaquin 11, $ 969,517, % 27.5% 20.7% 26.3% 19.2% 57% 80% Western Medical Centers-ta Ana Orange 11, $ 691,715, % 14.2% 19.9% 23.6% 15.7% 69% 77% Garfield Medical Center Los Angeles 11, $ 1,188,055, % 36.3% 19.7% 27.4% 18.5% 56% 79% Children's Hospital & Research Center Alameda 10, $ 1,000,140, % 0.1% N/A N/A N/A N/A N/A Glendale Memorial Hospital & Health Center Los Angeles 10, $ 957,878, % 43.1% 20.6% 26.9% 19.6% 62% 80% Mercy Medical Center Merced Merced 10, $ 739,273, % 28.2% 19.5% 25.0% 18.0% 66% 80% Emanuel Medical Center Stanislaus 10, $ 851,685, % 29.9% 18.9% 24.9% 18.1% 65% 83% Western Medical Center-Anaheim Orange 10, $ 275,842, % 19.1% 19.0% 23.8% 21.3% 65% 76% St. Mary Medical Center Los Angeles 10, $ 800,636, % 29.7% 20.5% 24.3% 17.9% 67% 78% Regional Medical Center- Jose ta Clara 10, $ 1,788,818, % 48.4% 20.4% 27.0% 20.5% 54% 79% Paradise Valley Hospital Diego 10, $ 451,929, % 45.4% 19.8% 22.7% 19.3% 59% 76% Alameda Medical Center- Highland Hospital Alameda 9, $ 944,285, % 8.0% 0.0% 28.1% 18.2% 60% 78% Hoag Hospital Irvine Orange 9, $ 588,639, % 18.0% 20.0% 21.7% 17.4% N/A N/A Marin General Hospital Marin 9, $ 1,119,073, % 43.9% 17.4% 22.8% 15.8% 65% 77% Adventist Medical Center-Hanford Kings 9, $ 681,612, % 43.8% 21.3% 25.2% 16.0% 61% 84% Los Alamitos Medical Center Orange 9, $ 971,163, % 41.4% 19.5% 23.0% 17.5% 67% 78% Scripps Memorial Hospital-Encinitas Diego 9, $ 641,604, % 33.7% 17.6% 23.6% 17.3% 68% 80% Sequoia Hospital Mateo 9, $ 1,040,099, % 38.7% 18.2% 22.6% 19.2% 70% 79% Scripps Mercy Hospital-Chula Vista Diego 9, $ 310,011, % 41.7% N/A N/A N/A N/A N/A Eden Medical Center Alameda 9, $ 853,250, % 35.2% 21.9% 25.4% 17.7% 67% 84%

34 Hospital Name Discharges Total Beds Patient Revenue Patient Days: Medicare Patient Days: Medicaid Rates: Heart Attack Rates: Heart Failure Rates: Pneumonia Patients Rating the Hospital 9 or 10 Percent Providing Info Upon Discharge Alvarado Hospital Diego 9, $ 724,785, % 38.5% 18.8% 24.7% 16.9% 57% 79% Clovis Community Medical Center Fresno 9, $ 481,254, % 20.2% 20.1% 22.6% 19.5% 66% 85% Manteca Medical Center Joaquin 9, N/A 1.7% 1.7% 0.0% 0.0% 0.0% 70% 82% Beverly Hospital Los Angeles 9, $ 275,410, % 32.9% 19.1% 25.6% 15.1% 54% 71% Shasta Regional Medical Center Shasta 9, $ 783,207, % 55.9% 19.6% 20.9% 17.4% 64% 81% Whittier Hospital Medical Center Los Angeles 8, $ 590,690, % 17.5% 18.6% 23.2% 14.5% 54% 73% John Muir Medical Center Concord 8, $ 1,557,641, % 46.5% 19.1% 22.5% 16.8% 73% 84% Parkview Community Hospital Riverside 8, $ 519,036, % 22.5% 21.2% 24.8% 18.8% 48% 70% Kaiser Permanente ta Rosa Medical Center Sonoma 8, N/A 2.7% 2.7% 0.0% 0.0% 0.0% 70% 85% John F. Kennedy Memorial Hospital Riverside 8, $ 624,008, % 24.0% 19.2% 26.1% 19.3% 58% 78% Keck Hospital of USC Los Angeles 8, $ 1,818,910, % 42.3% 20.1% 22.6% 19.2% 73% 77% Corona Regional Medical Center Riverside 8, $ 515,072, % 43.5% 20.5% 24.1% 20.7% 49% 77% Oroville Hospital Butte 8, $ 520,292, % 45.4% 20.8% 25.1% 22.0% 45% 71% Methodist Hospital of Sacramento Sacramento 8, $ 743,295, % 17.0% 19.8% 26.3% 16.9% 60% 82% Joaquin General Hospital Joaquin 8, $ 499,198, % 9.3% 20.3% 24.6% 20.4% 57% 77% St. Vincent Medical Center Los Angeles 8, $ 915,873, % 59.3% 18.7% 24.2% 16.2% 63% 78% Seton Medical Center Mateo 8, $ 1,545,045, % 25.6% 19.9% 26.4% 18.2% 59% 80% Los Angeles Community Hospital Los Angeles 8, $ 355,269, % 28.0% 0.0% 25.5% 19.2% 37% 60% Queen of the Valley Medical Center Napa 8, $ 1,029,177, % 42.1% 18.6% 21.6% 17.2% 74% 83% West Hills Hospital & Medical Center Los Angeles 8, $ 912,020, % 48.7% 19.9% 26.0% 17.9% 58% 80% Kaiser Permanente Antioch Medical Center 8, N/A 4.6% 4.6% 0.0% 0.0% 0.0% 76% 86% Sierra View District Hospital Tulare 7, $ 554,544, % 29.5% 19.5% 24.0% 19.5% 50% 78% Lodi Memorial Hospital Joaquin 7, $ 1,015,093, % 46.3% 19.9% 23.0% 16.3% 67% 80% Sutter Delta Medical Center 7, $ 604,135, % 41.2% 20.3% 22.8% 20.1% 65% 75% Gabriel Valley Medical Center Los Angeles 7, $ 759,103, % 39.4% 19.4% 28.2% 18.4% 55% 79% Natividad Medical Center Monterey 7, $ 657,906, % 18.2% 0.0% 25.2% 17.0% 72% 81%

35 Hospital Name Discharges Total Beds Patient Revenue Patient Days: Medicare Patient Days: Medicaid Rates: Heart Attack Rates: Heart Failure Rates: Pneumonia Patients Rating the Hospital 9 or 10 Percent Providing Info Upon Discharge Inland Valley Medical Center Riverside 7, $ 155,543, % 23.3% N/A N/A N/A N/A N/A Pacific Alliance Medical Center Los Angeles 7, $ 162,861, % 28.8% 20.4% 25.0% 19.5% 50% 75% ValleyCare Medical Center-Livermore Campus Alameda 7, $ 971,898, % 46.7% 18.6% 23.0% 18.0% N/A N/A Desert Valley Hospital 7, $ 403,167, % 35.3% 19.7% 26.0% 19.8% 58% 77% Kaiser Permanente Fresno Medical Center Fresno 7, N/A 3.1% 3.1% 0.0% 0.0% 0.0% 72% 82% Lakewood Regional Medical Center Los Angeles 7, $ 794,876, % 35.8% 20.8% 25.6% 16.5% 61% 79% Pomerado Hospital Diego 7, $ 449,975, % 20.4% 20.2% 22.6% 16.5% 64% 79% Providence Little Company of Mary Medical Center Pedro Los Angeles 7, $ 818,845, % 19.4% 0.0% 25.8% 20.5% 73% 79% Kaiser Permanente Redwood City Medical Center Mateo 7, N/A 4.1% 4.1% 0.0% 0.0% 0.0% 61% 84% Brotman Medical Center Los Angeles 7, $ 538,867, % 50.3% 20.4% 27.8% 18.6% 45% 64% West Anaheim Medical Center Orange 7, $ 409,071, % 59.4% 19.8% 26.6% 17.1% 61% 78% Garden Grove Hospital & Medical Center Orange 7, $ 405,895, % 31.6% 20.1% 23.8% 19.2% 58% 79% Pacific Hospital of Long Beach Los Angeles 7, $ 475,176, % 29.8% 0.0% 24.4% 19.4% 58% 76% Olympia Medical Center Los Angeles 6, $ 978,999, % 65.9% 21.8% 28.0% 19.3% 66% 75% St. Rose Hospital Alameda 6, $ 692,839, % 40.7% 20.3% 26.5% 19.4% 56% 74% Mission Community Hospital Los Angeles 6, $ 181,560, % 40.9% 0.0% 26.7% 21.0% 53% 76% Chino Valley Medical Center 6, $ 253,133, % 37.3% 20.6% 23.9% 16.0% 58% 79% Victor Valley Community Hospital 6, $ 254,089, % 18.1% 20.7% 28.4% 18.9% 50% 76% St. Joseph Hospital Humboldt 6, $ 648,259, % 49.1% 21.4% 23.6% 16.0% 58% 82% Hollywood Community Hospital Los Angeles 6, $ 171,435, % 40.3% 0.0% 25.0% 17.4% 46% 76% El Centro Regional Medical Center Imperial 6, $ 472,399, % 20.0% 19.9% 25.1% 16.1% 61% 84% Memorial Hospital of Gardena Los Angeles 6, $ 438,212, % 17.7% 0.0% 27.0% 20.8% 52% 70% Fremont Medical Center Sutter 6, $ 123,144, % 39.0% N/A N/A N/A N/A N/A Bellflower Medical Center Los Angeles 6, $ 177,908, % 26.1% 0.0% 26.1% 17.8% 60% 79% UCSF Medical Center at Mount Zion Francisco 6, $ 339,592, % 56.0% N/A N/A N/A N/A N/A

36 Hospital Name Discharges Total Beds Patient Revenue Patient Days: Medicare Patient Days: Medicaid Rates: Heart Attack Rates: Heart Failure Rates: Pneumonia Patients Rating the Hospital 9 or 10 Percent Providing Info Upon Discharge Verdugo Hills Hospital Los Angeles 6, $ 338,459, % 52.1% 19.6% 23.5% 17.8% 67% 76% Pioneers Memorial Hospital Imperial 6, $ 305,148, % 30.4% 21.4% 27.3% 17.4% 61% 77% Coastal Communities Hospital Orange 6, $ 273,206, % 22.4% 0.0% 23.8% 18.4% 67% 72% Doctors Medical Center of Pablo 6, $ 706,859, % 41.4% 20.8% 25.0% 19.3% 45% 73% Feather River Hospital Butte 6, $ 782,458, % 73.1% 18.8% 24.0% 17.4% 69% 86% Sierra Vista Regional Medical Center Luis Obispo 5, $ 645,744, % 26.0% 18.5% 22.0% 17.3% 65% 88% St. Mary's Medical Center Francisco Francisco 5, $ 836,911, % 55.6% 17.9% 25.0% 18.8% 66% 82% Sutter Medical Center of ta Rosa Sonoma 5, $ 484,385, % 29.2% 18.4% 20.0% 16.6% 69% 82% Kaiser Permanente Rafael Medical Center Marin 5, N/A 3.0% 3.0% 0.0% 0.0% 0.0% 67% 86% Kaiser Permanente South Francisco Medical Center Mateo 5, N/A 4.4% 4.4% 0.0% 0.0% 0.0% 67% 83% Kaiser Permanente Hospital Moreno Valley Riverside 5, N/A 10.8% 10.8% 0.0% 26.1% 18.6% 67% 80% Watsonville Community Hospital ta Cruz 5, $ 650,296, % 30.1% 20.7% 24.1% 16.7% 73% 84% Palmdale Regional Medical Center Los Angeles 5, $ 458,279, % 45.0% 22.9% 26.5% 19.4% 69% 78% Marshall Medical Center El Dorado 5, $ 738,065, % 57.8% 20.5% 26.3% 16.5% 66% 82% Simi Valley Hospital Ventura 5, $ 461,587, % 54.9% 19.0% 23.2% 20.0% 64% 82% Los Angeles Metropolitan Medical Center Los Angeles 5, $ 216,964, % 52.6% 0.0% 25.3% 19.4% N/A N/A Luis Twin Cities Community Hospital Obispo 5, $ 594,439, % 51.1% 20.3% 23.3% 17.6% 61% 82% Foothill Presbyterian Hospital Los Angeles 5, $ 233,503, % 32.6% 19.5% 24.2% 18.3% 69% 78% Tulare Regional Medical Center Tulare 5, $ 250,981, % 19.9% 19.0% 26.0% 20.3% 50% 71% St. Helena Hospital Napa Valley Napa 5, $ 711,828, % 46.0% 19.5% 22.7% 17.1% 73% 84% NorthBay Medical Center Solano 5, $ 1,117,411, % 22.1% 20.2% 24.1% 19.6% 69% 85% Sierra Nevada Memorial Hospital Nevada 5, $ 364,220, % 67.3% 18.4% 24.7% 17.5% 66% 84% Silver Lake Medical Center-Downtown Campus Los Angeles 5, $ 187,812, % 33.4% 0.0% 25.4% 18.0% 55% 75% Pacifica Hospital of the Valley Los Angeles 5, $ 179,465, % 13.9% 0.0% 26.2% 19.7% 64% 74% Montclair Hospital Medical Center 5, $ 191,518, % 17.7% 0.0% 25.1% 0.0% 61% 75%

37 Hospital Name Discharges Total Beds Patient Revenue Patient Days: Medicare Patient Days: Medicaid Rates: Heart Attack Rates: Heart Failure Rates: Pneumonia Patients Rating the Hospital 9 or 10 Percent Providing Info Upon Discharge Madera Community Hospital Madera 5, $ 206,519, % 19.6% 19.5% 23.0% 17.5% 62% 81% Sutter Solano Medical Center Solano 5, $ 508,430, % 34.2% 20.3% 27.6% 20.7% 64% 84% Luis French Hospital Medical Center Obispo 4, $ 514,957, % 44.3% 18.7% 22.0% 18.3% 72% 83% Ramon Regional Medical Center 4, $ 638,509, % 34.9% 20.1% 25.7% 18.1% 63% 82% Sonora Regional Medical Center Tuolumne 4, $ 623,877, % 37.4% 18.9% 22.7% 16.4% 60% 82% St. Francis Memorial Hospital Francisco 4, $ 754,924, % 38.5% 19.9% 21.2% 17.3% 63% 80% Mercy Hospital of Folsom Sacramento 4, $ 442,031, % 32.1% 0.0% 25.1% 21.0% 61% 82% Marina del Rey Hospital Los Angeles 4, $ 443,966, % 44.9% 19.5% 23.6% 18.4% 57% 71% Monterey Park Hospital Los Angeles 4, $ 376,453, % 28.0% 20.6% 26.8% 20.1% 56% 75% La Palma Intercommunity Hospital Orange 4, $ 193,570, % 55.4% 20.9% 25.8% 19.2% 63% 76% Sherman Oaks Hospital Los Angeles 4, $ 256,683, % 45.8% 20.4% 26.7% 17.7% 49% 70% Mission Hospital-Laguna Beach Campus Orange 4, $ 268,925, % 26.9% 0.0% 26.0% 18.3% 0% 0% Dimas Community Hospital Los Angeles 4, $ 267,967, % 30.5% 0.0% 22.8% 17.6% 63% 82% Menifee Valley Medical Center Riverside 4, $ 201,129, % 39.1% 20.9% 25.7% 19.7% 51% 72% Woodland Healthcare Yolo 4, $ 449,101, % 37.9% 0.0% 21.8% 18.2% 71% 88% Huntington Beach Hospital Orange 4, $ 201,651, % 56.6% 20.7% 23.6% 17.5% 52% 75% Placentia-Linda Hospital Orange 4, $ 353,820, % 30.9% 20.1% 23.4% 16.4% 69% 83% Bakersfield Heart Hospital Kern 4, $ 307,433, % 64.6% 18.1% 26.1% 17.2% 77% 81% Sutter Auburn Faith Hospital Placer 4, $ 330,296, % 46.6% 0.0% 20.3% 16.6% 69% 87% East Los Angeles Doctors Hospital Los Angeles 4, $ 220,929, % 18.8% 0.0% 22.7% 18.4% 68% 80% Eden Medical Center- Leandro Hospital Campus Alameda 4, $ 345,845, % 54.2% 22.2% 27.0% 20.5% N/A N/A Community Hospital of Long Beach Los Angeles 4, $ 290,548, % 44.0% 19.9% 24.7% 19.6% 67% 78% Sutter Tracy Community Hospital Joaquin 3, $ 377,756, % 41.8% 0.0% 25.7% 18.3% 71% 84% Doctors Hospital of Manteca Joaquin 3, $ 637,569, % 44.8% 19.3% 24.7% 17.5% 62% 82% Good Samaritan Hospital Kern 3, $ 63,287, % 33.3% 0.0% 25.0% 18.2% 61% 82% Alhambra Hospital Medical Center Los Angeles 3, $ 302,287, % 43.1% 22.7% 24.3% 19.5% 59% 81%

38 Hospital Name Discharges Total Beds Patient Revenue Patient Days: Medicare Patient Days: Medicaid Rates: Heart Attack Rates: Heart Failure Rates: Pneumonia Patients Rating the Hospital 9 or 10 Percent Providing Info Upon Discharge Coast Plaza Doctors Hospital Los Angeles 3, $ 144,860, % 38.3% 0.0% 26.8% 18.9% 47% 72% Rancho Los Amigos National Rehabilitation Center Los Angeles 3, $ 426,561, % 9.0% 0.0% 0.0% 0.0% 73% 83% Community Hospital of Huntington Park Los Angeles 3, $ 195,051, % 24.6% 0.0% 25.3% 19.1% N/A N/A St. Luke's Hospital Francisco 3, $ 518,040, % 21.5% 0.0% 24.3% 17.4% 61% 79% Greater El Monte Community Hospital Los Angeles 3, $ 238,516, % 17.8% 0.0% 27.8% 17.2% 53% 76% Ukiah Valley Medical Center Mendocino 3, $ 241,604, % 35.7% 19.4% 25.1% 19.2% 69% 81% Mateo Medical Center Mateo 3, $ 337,302, % 2.9% 0.0% 0.0% 16.5% 67% 73% El Camino Hospital ta Clara 3, $ 379,094, % 41.4% 0.0% 24.8% 16.0% N/A N/A TriCity Regional Medical Center Los Angeles 3, $ 286,937, % 50.0% 0.0% 22.4% 16.3% 61% 77% St. Elizabeth Community Hospital Tehama 3, $ 265,377, % 58.7% 20.7% 25.3% 17.0% 70% 82% College Hospital Mesa Orange 3, $ 92,164, % 8.5% 0.0% 0.0% 0.0% 58% N/A St. John's Pleasant Valley Hospital Ventura 3, $ 358,947, % 32.5% 21.0% 23.0% 16.2% 61% 76% St. Louise Regional Hospital ta Clara 3, $ 401,596, % 43.5% 21.4% 21.0% 18.0% 64% 79% Hi-Desert Medical Center 3, $ 199,510, % 16.2% 0.0% 23.4% 17.8% 58% 74% Delano Regional Medical Center Kern 3, $ 186,933, % 14.0% 0.0% 25.2% 18.0% 61% 79% Sutter Davis Hospital Yolo 3, $ 253,415, % 18.9% 0.0% 24.4% 17.4% 81% 85% Anaheim General Hospital Orange 3, $ 220,632, % 32.7% 0.0% 24.3% 18.3% N/A N/A Saddleback Memorial Medical Center Clemente Campus Orange 3, $ 97,728, % 59.8% N/A N/A N/A N/A N/A Temple Community Hospital Los Angeles 3, $ 153,950, % 52.3% 20.9% 24.9% 16.9% 59% 72% Petaluma Valley Hospital Sonoma 3, $ 323,005, % 49.1% 19.4% 23.7% 15.6% 69% 80% Gorgonio Memorial Hospital Riverside 3, $ 149,783, % 35.4% 20.1% 22.1% 20.3% 45% 80% Sharp Coronado Hospital & Healthcare Center Diego 2, $ 242,738, % 10.6% 0.0% 26.1% 19.2% 82% 89% Hazel Hawkins Memorial Hospital Benito 2, $ 212,861, % 23.5% 0.0% 26.1% 18.6% 51% 75% Ridgecrest Regional Hospital Kern 2, $ 153,558, % 41.8% 0.0% 22.8% 19.1% 49% 78% Alameda Hospital Alameda 2, $ 278,877, % 22.6% 20.6% 27.9% 19.1% 57% 79% Encino Hospital Medical Center Los Angeles 2, $ 200,256, % 45.3% 18.8% 24.7% 18.9% 56% 75%

39 Hospital Name Discharges Total Beds Patient Revenue Patient Days: Medicare Patient Days: Medicaid Rates: Heart Attack Rates: Heart Failure Rates: Pneumonia Patients Rating the Hospital 9 or 10 Percent Providing Info Upon Discharge Fallbrook Hospital Diego 2, $ 183,285, % 29.2% 0.0% 24.4% 20.4% 62% 81% VacaValley Hospital Solano 2, $ 519,482, % 49.7% 19.7% 25.6% 17.3% N/A N/A Luis Arroyo Grande Community Hospital Obispo 2, $ 244,567, % 57.4% 18.7% 21.9% 16.8% 56% 83% Adventist Medical Center-Selma Fresno 2, $ 133,277, % 12.9% N/A N/A N/A N/A N/A Sutter Coast Hospital Del Norte 2, $ 202,551, % 24.3% 20.3% 23.6% 16.9% 65% 87% Barstow Community Hospital 2, $ 257,455, % 37.5% 20.1% 28.3% 18.3% 57% 82% Fresno Heart & Surgical Hospital Fresno 2, $ 219,642, % 62.2% 20.0% 24.4% 0.0% 84% 88% Lompoc Valley Medical Center ta Barbara 2, $ 82,420, % 13.5% 0.0% 24.0% 16.7% 61% 76% Fresno Surgical Hospital Fresno 2, $ 224,920, % 40.5% 0.0% 0.0% 0.0% 90% 90% Adventist Medical Center-Reedley Fresno 2, $ 60,657, % 21.9% 0.0% 22.0% 17.6% 59% 76% Barton Memorial Hospital El Dorado 2, $ 226,627, % 21.8% 0.0% 23.8% 19.2% 65% 85% Sutter Amador Hospital Amador 2, $ 181,206, % 41.0% 0.0% 23.1% 14.3% 73% 86% Chapman Medical Center Orange 2, $ 168,010, % 21.3% 0.0% 27.3% 19.6% 59% 77% Sutter Lakeside Hospital Lake 1, $ 181,007, % 52.9% 0.0% 0.0% 0.0% 66% 87% East Valley Hospital Medical Center Los Angeles 1, $ 92,921, % 69.1% 20.0% 22.9% 15.4% 52% 73% Chinese Hospital Francisco 1, $ 175,072, % 42.9% 0.0% 25.1% 19.5% 42% 87% Mad River Community Hospital Humboldt 1, $ 129,872, % 63.7% 20.0% 22.1% 16.5% 62% 83% George L. Mee Memorial Hospital Monterey 1, $ 170,552, % 9.2% 0.0% 24.0% 17.2% 65% 85% ta Paula Hospital Ventura 1, $ 31,910, % 15.8% N/A N/A N/A N/A N/A Tahoe Forest Hospital Nevada 1, $ 139,054, % 24.0% 0.0% 23.8% 16.1% 86% 86% St. Helena Hospital Clearlake Lake 1, $ 192,578, % 27.5% 0.0% 27.3% 16.9% 45% 76% Novato Community Hospital Marin 1, $ 228,087, % 56.7% 18.9% 20.5% 15.9% 74% 85% Sutter Maternity & Surgery Center ta Cruz 1, $ 119,738, % 7.4% 0.0% 0.0% 0.0% 91% 87% Redwood Memorial Hospital Humboldt 1, $ 127,404, % 48.1% 0.0% 25.4% 18.5% N/A N/A Palo Verde Hospital Riverside 1, $ 83,233, % 19.3% 0.0% 25.5% 20.3% N/A N/A Memorial Hospital Los Banos Merced 1, $ 177,565, % 16.7% 0.0% 24.3% 18.8% 70% 83%

40 Hospital Name Discharges Total Beds Patient Revenue Patient Days: Medicare Patient Days: Medicaid Rates: Heart Attack Rates: Heart Failure Rates: Pneumonia Patients Rating the Hospital 9 or 10 Percent Providing Info Upon Discharge Sonoma Valley Hospital Sonoma 1, $ 135,978, % 69.1% 19.2% 22.6% 16.7% 58% 84% Mark Twain St. Joseph's Hospital Calaveras 1, $ 123,261, % 45.4% 0.0% 26.1% 19.3% 68% 80% Los Angeles Orthopaedic Hospital Los Angeles 1, $ 68,746, % 15.7% N/A N/A N/A N/A N/A Fairchild Medical Center Siskiyou 1, $ 98,887, % 41.1% 0.0% 20.9% 16.4% 70% 85% Oak Valley Hospital Stanislaus 1, $ 166,953, % 8.6% 0.0% 26.8% 18.1% 59% 80% Goleta Valley Cottage Hospital ta Barbara 1, $ 173,920, % 13.2% 0.0% 23.8% 16.8% 75% 86% Frank R. Howard Memorial Hospital Mendocino 1, $ 120,811, % 58.8% 0.0% 24.3% 16.8% 78% 89% Mercy Medical Center-Mount Shasta Siskiyou 1, $ 89,415, % 18.4% 19.2% 26.2% 15.4% 78% 87% Banner Lassen Medical Center Lassen 1, $ 81,592, % 33.9% 0.0% 24.7% 18.8% 71% 85% Mendocino Coast District Hospital Mendocino 1, $ 88,003, % 52.8% 0.0% 24.2% 16.4% 70% 84% Thousand Oaks Surgical Hospital Ventura 1, $ 140,203, % 26.7% 0.0% 0.0% 0.0% N/A N/A Coalinga Regional Medical Center Fresno 1, $ 40,293, % 4.7% 0.0% 25.2% 18.7% 66% 78% Palm Drive Hospital Sonoma 1, $ 83,937, % 59.7% 0.0% 21.9% 16.3% 73% 84% Kindred Hospital-Ontario 1, $ 166,960, % 72.5% N/A N/A N/A N/A N/A Colusa Regional Medical Center Colusa 1, $ 61,200, % 35.6% 0.0% 25.5% 18.1% 60% 79% Stanislaus Surgical Hospital Stanislaus $ 196,130, % 38.0% 0.0% 0.0% 0.0% 89% 87% Vista Hospital of South Bay Los Angeles $ 155,311, % 96.0% 0.0% 0.0% 17.9% N/A N/A Northern Inyo Hospital Inyo $ 87,800, % 33.0% 0.0% 24.8% 16.1% 68% 82% Ojai Valley Community Hospital Ventura $ 104,014, % 15.5% 19.5% 22.9% 17.5% 63% 81% Kern Valley Healthcare District Kern $ 69,065, % 10.5% 0.0% 24.3% 20.6% N/A N/A Kindred Hospital-Los Angeles Los Angeles $ 164,604, % 70.7% N/A N/A N/A N/A N/A Biggs-Gridley Memorial Hospital Butte $ 41,213, % 28.0% 0.0% 23.9% 16.9% N/A N/A USC Norris Cancer Hospital Los Angeles $ 247,391, % 47.4% 0.0% 0.0% 0.0% N/A N/A Sutter Surgical Hospital-North Valley Sutter $ 53,647, % 48.6% N/A N/A N/A 84% 86% Colorado River Medical Center $ 23,113, % 39.6% 0.0% 24.5% 19.7% N/A N/A Mammoth Hospital Mono $ 79,033, % 8.0% 0.0% 0.0% 0.0% N/A N/A

41 Hospital Name Discharges Total Beds Patient Revenue Patient Days: Medicare Patient Days: Medicaid Rates: Heart Attack Rates: Heart Failure Rates: Pneumonia Patients Rating the Hospital 9 or 10 Percent Providing Info Upon Discharge Kindred Hospital- Diego Diego $ 75,590, % 79.9% N/A N/A N/A N/A N/A Mayers Memorial Hospital District Shasta $ 31,625, % 3.5% 0.0% 23.5% 17.0% N/A N/A Healdsburg District Hospital Sonoma $ 84,007, % 30.5% 0.0% 22.3% 18.1% 67% 86% Eastern Plumas Health Care Plumas $ 41,124, % 20.9% 0.0% 24.0% 17.6% N/A N/A Veterans Home of California- Yountville Napa 499 1,167 $ 72,990, % 0.8% 0.0% 0.0% 17.5% N/A N/A Kindred Hospital- Francisco Bay Area Alameda $ 125,410, % 55.4% N/A N/A N/A N/A N/A Plumas District Hospital Plumas $ 37,522, % 32.2% 0.0% 23.2% 16.6% N/A N/A Trinity Hospital Trinity $ 24,792, % 18.5% 0.0% 24.2% 16.8% N/A N/A Bear Valley Community Healthcare District $ 29,539, % 8.4% 0.0% 0.0% 0.0% 76% 87% Menlo Park Surgical Hospital Mateo $ 36,008, % 6.0% 0.0% 0.0% 0.0% 91% 86% Vista Hospital of Riverside Riverside $ 122,094, % 87.1% N/A N/A N/A N/A N/A Corcoran District Hospital Kings $ 15,813, % 29.8% 0.0% 26.3% 0.0% 50% 55% Mountains Community Hospital $ 26,512, % 9.0% 0.0% 0.0% 19.0% N/A N/A Glenn Medical Center Glenn $ 28,068, % 32.7% 0.0% 24.2% 18.9% N/A N/A ta Ynez Valley Cottage Hospital ta Barbara $ 29,448, % 66.0% 0.0% 23.8% 18.2% 82% 84% Motion Picture & Television Hospital Los Angeles $ 97,915, % 3.1% 0.0% 25.9% 17.0% 85% 77% Patients Hospital of Redding Shasta $ 24,966, % 23.0% 0.0% 0.0% 0.0% 94% 91% Miracle Mile Medical Center Los Angeles $ 52,025, % 31.0% 0.0% 0.0% 0.0% 83% 81% John C. Fremont Healthcare District Mariposa $ 23,706, % 24.5% 0.0% 24.7% 18.2% N/A N/A Seneca Healthcare District Hospital Plumas $ 23,745, % 30.5% N/A N/A N/A N/A N/A Doctors Hospital of West Covina Los Angeles $ 38,514, % 4.4% 0.0% 0.0% 0.0% 80% 89% Tehachapi Valley Healthcare District Kern $ 35,602, % 7.6% 0.0% 0.0% 0.0% N/A N/A Modoc Medical Center Modoc $ 27,817, % 20.9% 0.0% 0.0% 18.1% N/A N/A Laguna Honda Hospital & Rehabilitation Center Francisco $ 209,963, % 1.6% 0.0% 0.0% 16.8% 48% N/A Jerold Phelps Community Hospital Humboldt $ 6,287, % 23.7% 0.0% 0.0% 0.0% N/A N/A Surprise Valley Healthcare District Modoc $ 3,548, % 14.3% 0.0% 0.0% 0.0% N/A N/A

42 Hospital Name Discharges Total Beds Patient Revenue Patient Days: Medicare Patient Days: Medicaid Rates: Heart Attack Rates: Heart Failure Rates: Pneumonia Patients Rating the Hospital 9 or 10 Percent Providing Info Upon Discharge Seton Medical Center-Coastside Mateo $ 24,755, % 3.4% N/A N/A N/A N/A N/A Sources: Billian s HealthDATA, Accessed April 2012 at: Hospital Compare, Centers for Medicare and Medicaid Services. Accessed April 2012 at:

43 Appendix 2: California's Medicare Advantage Plans: General Information,, and Quality Ratings California Alameda IBT Voluntary Employee Benefits Trust Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 42 #N/A Alameda Union Pacific Railroad Employees Health Employer/Union Only Direct Systems ct PDP The UPREHS Prime Medicare Plan (Employer PDP) 18 #N/A Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage LA, Orange Co stars Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 22 5 stars Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage B Only North 23 5 stars Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma 60 5 stars Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North stars Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Marin Mateo 45 5 stars Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa stars Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Diego 11 5 stars Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage ta Clara 59 5 stars Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced Stanis 16 5 stars Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced SnJoaq 27 5 stars Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Basic SnJoaq 11 5 stars Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 25 5 stars Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 26 5 stars Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars Alameda Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part B Only with D 21 5 stars Alameda UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Alameda UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Alameda UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Alameda UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Alameda Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Alameda Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars

44 Alameda Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Green out of 5 stars Alameda Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Alameda Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Amber II out of 5 stars Alameda Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Alameda Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Alameda Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Alameda Chinese Hospital Association HMO/HMOPOS CCHP Senior Program out of 5 stars Alameda UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 12 3 out of 5 stars Alameda UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) out of 5 stars Alameda MVP Health Care, Inc. Local PPO Kodak USA Care Rx (PPO) out of 5 stars Alameda On Lok, Inc. National PACE On Lok Lifeways (Dual Eligibles) (PACE) 91 #N/A Alameda Center For Elders Independence National PACE Center for Elders Independence - Part D (PACE) 390 #N/A Alameda Health Plan of Mateo HMO/HMOPOS HPSM CareAdvantage out of 5 stars Alameda Health Net, Inc. Local PPO Health Net Violet (PPO) out of 5 stars Alameda Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Alameda Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Alameda WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 50 3 out of 5 stars Alameda Kaiser Foundation Health Plan, Inc Cost 450 Alameda Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Alameda Alameda Alliance for Health HMO/HMOPOS Alliance CompleteCare out of 5 stars Alameda WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 919 Plan too new to be measured Alameda Blue Cross Blue Shield of Michigan Local PPO Medicare Plus Blue PPO Employer CY (PPO) out of 5 stars Amador Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma stars Amador Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North 25 5 stars Amador Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa 16 5 stars Amador Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 17 5 stars Amador Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Amador Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D 14 5 stars Amador UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Amador UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 27 3 out of 5 stars Amador Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Amador Kaiser Foundation Health Plan, Inc Cost 13 Amador WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 24 Plan too new to be measured Butte IBT Voluntary Employee Benefits Trust Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 24 #N/A Butte Union Pacific Railroad Employes Health Employer/Union Only Direct Systems ct PDP The UPREHS Prime Medicare Plan (Employer PDP) 80 #N/A Butte Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 34 5 stars

45 Butte Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma 32 5 stars Butte Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North 15 5 stars Butte Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 12 5 stars Butte Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Butte Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D 13 5 stars Butte UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 54 3 out of 5 stars Butte Universal American Corp. PFFS Today's Options Premier 400 (PFFS) out of 5 stars Butte Universal American Corp. PFFS Today's Options Premier Plus 250A (PFFS) out of 5 stars Butte Universal American Corp. PFFS Today's Options Premier Plus 450D (PFFS) out of 5 stars Butte Universal American Corp. PFFS Today's Options Premier 200 (PFFS) out of 5 stars Butte Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Butte Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Butte Kaiser Foundation Health Plan, Inc Cost 17 Butte Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Butte WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 28 Plan too new to be measured Calaveras Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 65 5 stars Calaveras Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma 32 5 stars Calaveras Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Marin Mateo 12 5 stars Calaveras Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa 21 5 stars Calaveras Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 16 5 stars Calaveras Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage ta Clara 20 5 stars Calaveras Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced Stanis 13 5 stars Calaveras Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced SnJoaq 54 5 stars Calaveras Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Basic SnJoaq 11 5 stars Calaveras Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 13 5 stars Calaveras Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Calaveras UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 31 3 out of 5 stars Calaveras UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Essential (PFFS) 73 3 out of 5 stars Calaveras UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Rx (PFFS) out of 5 stars Calaveras Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Colusa Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 25 5 stars Colusa UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Essential (PFFS) 17 3 out of 5 stars

46 Colusa UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Rx (PFFS) out of 5 stars Employer/Union Only Direct IBT Voluntary Employee Benefits Trust ct PDP IBT VEBA (Employer PDP) 25 #N/A Union Pacific Railroad Employes Health Employer/Union Only Direct Systems ct PDP The UPREHS Prime Medicare Plan (Employer PDP) 15 #N/A Health Services 1876 Cost 480 California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Kaiser Permanente Senior Advantage LA, Orange Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Co stars Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 62 5 stars Kaiser Permanente Senior Advantage B Only North Kaiser Foundation Health Plan, Inc. HMO/HMOPOS 17 5 stars Kaiser Permanente Senior Advantage Sac., Sonoma Kaiser Foundation Health Plan, Inc. HMO/HMOPOS 53 5 stars Senior Advantage Medicare Medi-Cal Plan North Kaiser Foundation Health Plan, Inc. HMO/HMOPOS stars Kaiser Permanente Senior Advantage Marin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Mateo 27 5 stars Kaiser Permanente Senior Advantage Alam., SF, Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Napa stars Kaiser Permanente Senior Advantage Kaiser Foundation Health Plan, Inc. HMO/HMOPOS stars Kaiser Permanente Senior Advantage ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS 22 5 stars Kaiser Permanente Senior Advantage Enhanced Kaiser Foundation Health Plan, Inc. HMO/HMOPOS SnJoaq 11 5 stars Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 14 5 stars Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 28 5 stars Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars

47 Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Green out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Amber II out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 29 3 out of 5 stars UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) out of 5 stars MVP Health Care, Inc. Local PPO Kodak USA Care Rx (PPO) out of 5 stars On Lok, Inc. National PACE On Lok Lifeways (Dual Eligibles) (PACE) 12 #N/A Center For Elders Independence National PACE Center for Elders Independence - Part D (PACE) 37 #N/A SCAN Health Plan HMO/HMOPOS SCAN Classic out of 5 stars SCAN Health Plan HMO/HMOPOS SCAN Options out of 5 stars Health Net, Inc. Local PPO Health Net Violet (PPO) out of 5 stars Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 31 3 out of 5 stars PARTNERSHIP HEALTHPLAN OF CALIFORNIA HMO/HMOPOS PartnershipAdvantage 22 4 out of 5 stars Kaiser Foundation Health Plan, Inc Cost 379 Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Alameda Alliance for Health HMO/HMOPOS Alliance CompleteCare 33 3 out of 5 stars WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 11 Plan too new to be measured

48 Blue Cross Blue Shield of Michigan Local PPO Medicare Plus Blue PPO Employer CY (PPO) out of 5 stars Del Norte Universal American Corp. PFFS Today's Options Premier Plus 450B (PFFS) out of 5 stars Del Norte UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Essential (PFFS) 72 3 out of 5 stars Del Norte UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Rx (PFFS) out of 5 stars El Dorado Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage LA, Orange Co stars El Dorado Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma stars El Dorado Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North stars El Dorado Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa 30 5 stars El Dorado Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 13 5 stars El Dorado Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage ta Clara 12 5 stars El Dorado Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars El Dorado Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars El Dorado Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars El Dorado UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars El Dorado UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars El Dorado UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 50 3 out of 5 stars El Dorado Health Net, Inc. Local PPO Health Net Violet (PPO) out of 5 stars El Dorado Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars El Dorado Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars El Dorado Kaiser Foundation Health Plan, Inc Cost 27 El Dorado Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars El Dorado WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 72 Plan too new to be measured Fresno IBT Voluntary Employee Benefits Trust Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 17 #N/A Fresno Humana Inc. HMO/HMOPOS Humana Gold Plus H Not enough data to calculate overall rating Fresno Humana Inc. HMO/HMOPOS Humana Gold Plus H (HMO-POS) 1113 Not enough data to calculate overall rating Fresno California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Fresno Aetna Inc. HMO/HMOPOS Aetna Medicare Select Plan out of 5 stars Fresno Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage LA, Orange Co stars Fresno Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North stars Fresno Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced Fresno stars Fresno Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Basic Fresno stars

49 Fresno Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Fresno Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 16 5 stars Fresno Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Fresno Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars Fresno UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Fresno UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Fresno UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Fresno UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Fresno Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Fresno Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Fresno Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Fresno UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 81 3 out of 5 stars Fresno Highmark Inc. Local PPO FreedomBlue PPO MA Pennsylvania (PPO) out of 5 stars Fresno Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Fresno Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Fresno Kaiser Foundation Health Plan, Inc Cost 18 Humboldt Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 19 5 stars Humboldt UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 14 3 out of 5 stars Humboldt UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Essential (PFFS) 77 3 out of 5 stars Humboldt UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Rx (PFFS) out of 5 stars Humboldt Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Humboldt Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Humboldt WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 16 Plan too new to be measured Imperial California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Imperial Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage LA, Orange Co stars Imperial Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Diego 24 5 stars Imperial Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 19 5 stars Imperial UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Imperial UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Imperial Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart Plan out of 5 stars Imperial WellPoint, Inc. HMO/HMOPOS Blue Cross Senior Secure Plan I 18 3 out of 5 stars Imperial Easy Choice Health Plan Inc. HMO/HMOPOS Easy Choice Best Plan out of 5 stars Imperial SCAN Health Plan HMO/HMOPOS SCAN Options 29 4 out of 5 stars Imperial WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 46 Plan too new to be measured Imperial WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 267 Plan too new to be measured Kern IBT Voluntary Employee Benefits Trust Employer/Union Only Direct IBT VEBA (Employer PDP) 12 #N/A

50 ct PDP Kern DMBA (Deseret Mutual Benefit Administrators) Employer/Union Only Direct ct PFFS Deseret Secure (Employer PFFS) 11 #N/A Kern California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Kern Aetna Inc. HMO/HMOPOS Aetna Medicare Select Plan out of 5 stars Kern Aetna Inc. HMO/HMOPOS Aetna Medicare Plan w/rx CY out of 5 stars Kern Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage LA, Orange Co stars Kern Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Inland Empire 13 5 stars Kern Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan South stars Kern Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced Kern stars Kern Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Basic Kern stars Kern Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Kern Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Kern Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 17 5 stars Kern Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars Kern UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Kern UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Essential out of 5 stars Kern UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Kern UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Kern UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Kern Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Green out of 5 stars Kern Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Amber I out of 5 stars Kern Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Amber II out of 5 stars Kern Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Ruby out of 5 stars Kern Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Kern Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Kern Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Kern WellPoint, Inc. HMO/HMOPOS Blue Cross Senior Secure Plan I out of 5 stars Kern WellPoint, Inc. HMO/HMOPOS Senior Secure 83 3 out of 5 stars Kern Universal Care, Inc HMO/HMOPOS Brand New Day out of 5 stars Kern UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 42 3 out of 5 stars Kern SCAN Health Plan HMO/HMOPOS SCAN Classic out of 5 stars Kern SCAN Health Plan HMO/HMOPOS SCAN Classic 15 4 out of 5 stars Kern Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Kern Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Kern Golden Empire Managed Care HMO/HMOPOS GEMCare Medicare Plus out of 5 stars

51 Kern Golden Empire Managed Care HMO/HMOPOS GEMCARE Medicare Plus ES Plan out of 5 stars Kern Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Kern WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 26 Plan too new to be measured Kern WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 42 Plan too new to be measured Kings Humana Inc. HMO/HMOPOS Humana Gold Plus H Not enough data to calculate overall rating Kings Humana Inc. HMO/HMOPOS Humana Gold Plus H (HMO-POS) 255 Not enough data to calculate overall rating Kings Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North 22 5 stars Kings Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced Fresno stars Kings Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Basic Fresno 28 5 stars Kings Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 11 5 stars Kings Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Kings Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D 11 5 stars Lake IBT Voluntary Employee Benefits Trust Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 11 #N/A Lake Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 84 5 stars Lake Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma stars Lake Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North 13 5 stars Lake Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Marin Mateo 21 5 stars Lake Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa 20 5 stars Lake Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 17 5 stars Lake Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 12 5 stars Lake Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Lake Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D 13 5 stars Lake UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 17 3 out of 5 stars Lake Universal American Corp. PFFS Today's Options Premier 400 (PFFS) out of 5 stars Lake Universal American Corp. PFFS Today's Options Premier Plus 250A (PFFS) out of 5 stars Lake Universal American Corp. PFFS Today's Options Premier Plus 450D (PFFS) out of 5 stars Lake Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Lake Kaiser Foundation Health Plan, Inc Cost 28 Lassen Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 13 5 stars Los Angeles IBT Voluntary Employee Benefits Trust Employer/Union Only Direct IBT VEBA (Employer PDP) 76 #N/A Los Angeles Commonwealth of PA Pub Schools Retirement System ct PDP Employer/Union Only Direct ct PDP PSERS HOP (Employer PDP) 23 #N/A

52 Los Angeles Los Angeles DMBA (Deseret Mutual Benefit Administrators) Union Pacific Railroad Employes Health Systems Employer/Union Only Direct ct PFFS Employer/Union Only Direct ct PDP Deseret Secure (Employer PFFS) 39 #N/A The UPREHS Prime Medicare Plan (Employer PDP) 82 #N/A Los Angeles Humana Inc. HMO/HMOPOS Humana Gold Plus H Los Angeles Humana Inc. HMO/HMOPOS Humana Gold Plus H Los Angeles Humana Inc. HMO/HMOPOS Humana Gold Plus H (HMO-POS) 100 Not enough data to calculate overall rating Not enough data to calculate overall rating Not enough data to calculate overall rating Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Dual Complete out of 5 stars Los Angeles CIGNA HMO/HMOPOS Cigna Medicare Select Plus Rx-Standard out of 5 stars Los Angeles California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Los Angeles California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Los Angeles California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 30 4 out of 5 stars Los Angeles California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus Choice Plan 66 4 out of 5 stars Los Angeles California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus Choice Plan out of 5 stars Los Angeles California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 16 4 out of 5 stars Los Angeles California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 13 4 out of 5 stars Los Angeles California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Los Angeles California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 49 4 out of 5 stars Los Angeles Aetna Inc. HMO/HMOPOS Aetna Medicare Select Plan out of 5 stars Los Angeles Aetna Inc. HMO/HMOPOS Aetna Medicare Select Plan out of 5 stars Los Angeles Aetna Inc. HMO/HMOPOS Aetna Medicare Select Plan out of 5 stars Los Angeles Aetna Inc. HMO/HMOPOS Aetna Medicare Plan out of 5 stars Los Angeles Aetna Inc. HMO/HMOPOS Aetna Medicare Plan w/rx CY out of 5 stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage B Only South 22 5 stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage LA, Orange Co stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage LA, Orange Co stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma 24 5 stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Inland Empire stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan South stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan South stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North 48 5 stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, 32 5 stars

53 Napa Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 16 5 stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Ventura stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced Kern 23 5 stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Diego 80 5 stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 78 5 stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 76 5 stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 25 5 stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars Los Angeles Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part B Only with D 19 5 stars Los Angeles Altamed Health Services Corporation National PACE AltaMed Senior BuenaCare (PACE) 721 #N/A Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Premier out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Dual Complete out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Dual Complete out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Dual Complete out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Essential out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS Sharp SecureHorizons Plan by UnitedHealthcare out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Los Angeles WellPoint, Inc. HMO/HMOPOS CareMore Value Plus out of 5 stars Los Angeles WellPoint, Inc. HMO/HMOPOS CareMore Value Plus out of 5 stars

54 Los Angeles WellPoint, Inc. HMO/HMOPOS CareMore Connect out of 5 stars Los Angeles WellPoint, Inc. HMO/HMOPOS CareMore Reliance out of 5 stars Los Angeles WellPoint, Inc. HMO/HMOPOS CareMore Reliance out of 5 stars Los Angeles WellPoint, Inc. HMO/HMOPOS CareMore Touch out of 5 stars Los Angeles WellPoint, Inc. HMO/HMOPOS StartSmart with CareMore out of 5 stars Los Angeles WellPoint, Inc. HMO/HMOPOS CareMore Value Plus out of 5 stars Los Angeles WellPoint, Inc. HMO/HMOPOS CareMore Reliance out of 5 stars Los Angeles WellPoint, Inc. HMO/HMOPOS CareMore Heart out of 5 stars Los Angeles WellPoint, Inc. HMO/HMOPOS CareMore Breathe out of 5 stars Los Angeles WellPoint, Inc. HMO/HMOPOS CareMore ESRD out of 5 stars Los Angeles WellPoint, Inc. HMO/HMOPOS CareMore ESRD out of 5 stars Los Angeles InterValley Health Plan HMO/HMOPOS Inter Valley Health Plan Service To Seniors out of 5 stars Los Angeles InterValley Health Plan HMO/HMOPOS Inter Valley Health Plan Total Fit out of 5 stars Los Angeles InterValley Health Plan HMO/HMOPOS Inter Valley Health Plan Desert Preferred Choice 11 4 out of 5 stars Los Angeles Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Green out of 5 stars Los Angeles Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Amber I out of 5 stars Los Angeles Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Amber I out of 5 stars Los Angeles Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Amber II out of 5 stars Los Angeles Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Amber II out of 5 stars Los Angeles Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart Plan out of 5 stars Los Angeles Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart Plan out of 5 stars Los Angeles Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Ruby Plan out of 5 stars Los Angeles Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Ruby Plan out of 5 stars Los Angeles Health Net, Inc. HMO/HMOPOS Salud con Health Net Medicare Advantage out of 5 stars Los Angeles Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart Plan out of 5 stars Los Angeles Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Los Angeles Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Los Angeles Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Los Angeles Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Los Angeles Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Los Angeles WellPoint, Inc. HMO/HMOPOS Blue Cross Senior Secure Plan I 35 3 out of 5 stars Los Angeles WellPoint, Inc. HMO/HMOPOS Blue Cross Senior Secure Plan I out of 5 stars Los Angeles WellPoint, Inc. HMO/HMOPOS Blue Cross Senior Secure Plan I 42 3 out of 5 stars Los Angeles WellPoint, Inc. HMO/HMOPOS Senior Secure out of 5 stars Los Angeles Universal Care, Inc HMO/HMOPOS Brand New Day out of 5 stars Los Angeles Universal Care, Inc HMO/HMOPOS Brand New Day HMO Extra Care 21 3 out of 5 stars Los Angeles UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 64 3 out of 5 stars Los Angeles UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) out of 5 stars Los Angeles Medical Associates Clinic 1876 Cost Medical Associates SmartPlan (Cost) 12 0

55 Los Angeles Golden State Medicare Health Plan HMO/HMOPOS Golden State Medicare Health Plan, Golden 68 Not enough data to calculate overall rating Los Angeles L.A. Care Health Plan HMO/HMOPOS L.A. Care Health Plan Medicare Advantage (HMO SNP) out of 5 stars Los Angeles L.A. Care Health Plan HMO/HMOPOS L.A. Care Health Plan Medicare Advantage (HMO SNP) out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS Senior Dimensions Southern Nevada (HMO-POS) out of 5 stars Los Angeles Humana Inc. HMO/HMOPOS Humana Gold Plus H out of 5 stars Los Angeles WellPoint, Inc. Local PPO Anthem Medicare Preferred Core (PPO) 20 Not enough data to calculate overall rating Los Angeles WellPoint, Inc. Local PPO Empire MediBlue Freedom (PPO) out of 5 stars Los Angeles MVP Health Care, Inc. Local PPO Kodak USA Care Rx (PPO) out of 5 stars Los Angeles Honored Citizens Choice Health Plan HMO/HMOPOS Citizens Choice Healthplan out of 5 stars Los Angeles Honored Citizens Choice Health Plan HMO/HMOPOS Citizens Choice Healthplan out of 5 stars Los Angeles Highmark Inc. Local PPO FreedomBlue PPO MA Pennsylvania (PPO) out of 5 stars Los Angeles Highmark Inc. Local PPO FreedomBlue PPO MA-PD Pennsylvania (PPO) out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Los Angeles Easy Choice Health Plan Inc. HMO/HMOPOS Easy Choice Freedom Plan out of 5 stars Los Angeles Easy Choice Health Plan Inc. HMO/HMOPOS Easy Choice Freedom Plan out of 5 stars Los Angeles Easy Choice Health Plan Inc. HMO/HMOPOS Easy Choice Plus Plan out of 5 stars Los Angeles Easy Choice Health Plan Inc. HMO/HMOPOS Easy Choice Best Plan out of 5 stars Los Angeles Easy Choice Health Plan Inc. HMO/HMOPOS Easy Choice Best Plan out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Classic 60 4 out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Classic 21 4 out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Classic out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Classic out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Classic out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Classic 21 4 out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Classic 24 4 out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Connections 56 4 out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Connections out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Options 27 4 out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Options 50 4 out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Options 59 4 out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS My Choice (HMO-POS) out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS Heart First 14 4 out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Connections at Home 34 4 out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Connections at Home out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Employer Group out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Employer Group out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Employer Group 11 4 out of 5 stars

56 Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Employer Group out of 5 stars Los Angeles CalOptima HMO/HMOPOS OneCare 24 4 out of 5 stars Los Angeles Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Los Angeles Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Los Angeles WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) out of 5 stars Los Angeles INLAND EMPIRE HEALTH PLAN HMO/HMOPOS IEHP Medicare DualChoice 30 3 out of 5 stars Los Angeles Central Health Plan of California HMO/HMOPOS Central Health Medicare Plan out of 5 stars Los Angeles Central Health Plan of California HMO/HMOPOS Central Health Medicare Plan out of 5 stars Los Angeles Central Health Plan of California HMO/HMOPOS Central Health Medi-Medi Plan out of 5 stars Los Angeles Central Health Plan of California HMO/HMOPOS Central Health Medi-Medi Plan out of 5 stars Los Angeles Molina Healthcare, Inc., HMO/HMOPOS Molina Medicare Options Plus out of 5 stars Los Angeles Molina Healthcare, Inc., HMO/HMOPOS Molina Medicare Options Plus out of 5 stars Los Angeles Molina Healthcare, Inc., HMO/HMOPOS Molina Medicare Options out of 5 stars Los Angeles AIDS Healthcare Foundation HMO/HMOPOS Positive Healthcare Partners 784 Not enough data to calculate overall rating Los Angeles AIDS Healthcare Foundation HMO/HMOPOS Positive Healthcare Partners 11 Not enough data to calculate overall rating Los Angeles Care1st Health Plan HMO/HMOPOS Care1st TotalDual Plan 90 3 out of 5 stars Los Angeles Care1st Health Plan HMO/HMOPOS Care1st TotalDual Plan out of 5 stars Los Angeles Care1st Health Plan HMO/HMOPOS Care1st AdvantageOptimum Plan out of 5 stars Los Angeles Care1st Health Plan HMO/HMOPOS Care1st AdvantageOptimum Plan out of 5 stars Los Angeles Care1st Health Plan HMO/HMOPOS Care1st AdvantageOptimum Plan 11 3 out of 5 stars Los Angeles Care1st Health Plan HMO/HMOPOS Care1st TotalAdvantage Plan out of 5 stars Los Angeles Kaiser Foundation Health Plan, Inc Cost 351 Los Angeles Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Los Angeles Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Los Angeles Humana Inc. HMO/HMOPOS Advantage I MAPD out of 5 stars Los Angeles Humana Inc. HMO/HMOPOS Advantage I MAPD out of 5 stars Los Angeles Humana Inc. HMO/HMOPOS Advantage Select MA out of 5 stars Los Angeles Humana Inc. HMO/HMOPOS Preferred Dual SNP out of 5 stars Los Angeles Humana Inc. HMO/HMOPOS Preferred Dual SNP out of 5 stars Los Angeles UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare MedicareComplete out of 5 stars Los Angeles WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) Plan too new to be measured Los Angeles WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 46 Plan too new to be measured Los Angeles WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 23 Plan too new to be measured Los Angeles WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 15 Plan too new to be measured Los Angeles WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 14 Plan too new to be measured Los Angeles WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 1399 Plan too new to be measured Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Healthy at Home 73 4 out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Healthy at Home out of 5 stars

57 Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Healthy at Home 49 4 out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Healthy at Home 16 4 out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Healthy at Home 16 4 out of 5 stars Los Angeles SCAN Health Plan HMO/HMOPOS SCAN Classic 18 3 out of 5 stars Los Angeles Blue Cross Blue Shield of Michigan Local PPO Medicare Plus Blue PPO Employer CY (PPO) out of 5 stars Madera Humana Inc. HMO/HMOPOS Humana Gold Plus H Not enough data to calculate overall rating Madera Humana Inc. HMO/HMOPOS Humana Gold Plus H (HMO-POS) 314 Not enough data to calculate overall rating Madera California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Madera Aetna Inc. HMO/HMOPOS Aetna Medicare Select Plan out of 5 stars Madera Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North stars Madera Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced Fresno stars Madera Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Basic Fresno stars Madera Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Madera Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Madera Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D 62 5 stars Madera UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Madera UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Madera UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Madera UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Madera UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 18 3 out of 5 stars Marin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 15 5 stars Marin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma stars Marin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North stars Marin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Marin Mateo stars Marin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa 54 5 stars Marin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 24 5 stars Marin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Marin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Marin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars Marin Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Marin UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 34 3 out of 5 stars Marin On Lok, Inc. National PACE On Lok Lifeways (Dual Eligibles) (PACE) 26 #N/A

58 Marin Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Marin Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Marin Kaiser Foundation Health Plan, Inc Cost 118 Marin WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 11 Plan too new to be measured Marin Blue Cross Blue Shield of Michigan Local PPO Medicare Plus Blue PPO Employer CY (PPO) out of 5 stars Mariposa Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced Fresno 34 5 stars Mariposa Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 46 5 stars Mendocino Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 42 5 stars Mendocino Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma 74 5 stars Mendocino Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North 20 5 stars Mendocino Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Marin Mateo 12 5 stars Mendocino Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa 23 5 stars Mendocino Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 17 5 stars Mendocino Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Mendocino UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Mendocino UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Essential (PFFS) 26 3 out of 5 stars Mendocino UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Rx (PFFS) out of 5 stars Mendocino Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Mendocino Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Mendocino PARTNERSHIP HEALTHPLAN OF CALIFORNIA HMO/HMOPOS PartnershipAdvantage 27 4 out of 5 stars Merced IBT Voluntary Employee Benefits Trust Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 20 #N/A Merced Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 21 5 stars Merced Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North 16 5 stars Merced Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage ta Clara 53 5 stars Merced Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced Stanis 23 5 stars Merced Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 14 5 stars Merced Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 84 5 stars Merced UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Merced UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Merced UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 11 3 out of 5 stars Merced Universal American Corp. PFFS Today's Options Premier 400 (PFFS) out of 5 stars Merced UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Essential (PFFS) out of 5 stars

59 Merced UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Rx (PFFS) out of 5 stars Merced Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Modoc Universal American Corp. PFFS Today's Options Premier 400 (PFFS) out of 5 stars Modoc UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Essential (PFFS) 17 3 out of 5 stars Modoc UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Rx (PFFS) out of 5 stars Monterey IBT Voluntary Employee Benefits Trust Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 29 #N/A Monterey Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 31 5 stars Monterey Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Marin Mateo 12 5 stars Monterey Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa 15 5 stars Monterey Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage ta Clara 50 5 stars Monterey Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 11 5 stars Monterey Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 63 5 stars Monterey UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 31 3 out of 5 stars Monterey Universal American Corp. PFFS Today's Options Premier Plus 250A (PFFS) out of 5 stars Monterey Universal American Corp. PFFS Today's Options Premier Plus 450E (PFFS) out of 5 stars Monterey Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Monterey Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Monterey Kaiser Foundation Health Plan, Inc Cost 13 Monterey Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Monterey WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 12 Plan too new to be measured Napa Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 28 5 stars Napa Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma 32 5 stars Napa Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North stars Napa Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa stars Napa Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 78 5 stars Napa Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Napa Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars Napa UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 25 3 out of 5 stars Napa Universal American Corp. PFFS Today's Options Premier 400 (PFFS) out of 5 stars Napa Universal American Corp. PFFS Today's Options Premier Plus 450B (PFFS) out of 5 stars Napa Universal American Corp. PFFS Today's Options Premier Plus 250A (PFFS) out of 5 stars Napa Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Napa PARTNERSHIP HEALTHPLAN OF CALIFORNIA HMO/HMOPOS PartnershipAdvantage out of 5 stars Napa Kaiser Foundation Health Plan, Inc Cost 86

60 Nevada California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Nevada California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 32 4 out of 5 stars Nevada Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano stars Nevada Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma stars Nevada Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North 17 5 stars Nevada Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Marin Mateo 13 5 stars Nevada Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa 18 5 stars Nevada Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 14 5 stars Nevada Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage ta Clara 15 5 stars Nevada Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 12 5 stars Nevada Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Nevada UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Nevada UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Nevada UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Nevada UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Nevada UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Nevada Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart Plan out of 5 stars Nevada Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Nevada UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 63 3 out of 5 stars Nevada Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Nevada Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Nevada Kaiser Foundation Health Plan, Inc Cost 27 Nevada WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 19 Plan too new to be measured Orange IBT Voluntary Employee Benefits Trust Employer/Union Only Direct IBT VEBA (Employer PDP) 20 #N/A Orange Orange Orange Commonwealth of PA Pub Schools Retirement System DMBA (Deseret Mutual Benefit Administrators) Union Pacific Railroad Employes Health Systems ct PDP Employer/Union Only Direct ct PDP Employer/Union Only Direct ct PFFS Employer/Union Only Direct ct PDP PSERS HOP (Employer PDP) 18 #N/A Deseret Secure (Employer PFFS) 27 #N/A The UPREHS Prime Medicare Plan (Employer PDP) 25 #N/A Orange Humana Inc. HMO/HMOPOS Humana Gold Plus H Orange Humana Inc. HMO/HMOPOS Humana Gold Plus H (HMO-POS) 209 Not enough data to calculate overall rating Not enough data to calculate overall rating Orange California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Orange California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 17 4 out of 5 stars

61 Orange California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus Choice Plan out of 5 stars Orange California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 13 4 out of 5 stars Orange California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Orange California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 83 4 out of 5 stars Orange Aetna Inc. HMO/HMOPOS Aetna Medicare Select Plan out of 5 stars Orange Aetna Inc. HMO/HMOPOS Aetna Medicare Select Plan out of 5 stars Orange Aetna Inc. HMO/HMOPOS Aetna Medicare Plan out of 5 stars Orange Aetna Inc. HMO/HMOPOS Aetna Medicare Plan w/rx CY out of 5 stars Orange Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage LA, Orange Co stars Orange Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Inland Empire stars Orange Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan South stars Orange Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North 16 5 stars Orange Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced Kern 11 5 stars Orange Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Diego 57 5 stars Orange Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Orange Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Orange Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 25 5 stars Orange Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Orange Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars Orange UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Orange UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Premier out of 5 stars Orange UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Orange UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Dual Complete out of 5 stars Orange UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Essential out of 5 stars Orange UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Orange UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Orange UnitedHealth Group, Inc. HMO/HMOPOS Sharp SecureHorizons Plan by UnitedHealthcare out of 5 stars Orange UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Orange UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Orange UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Orange WellPoint, Inc. HMO/HMOPOS CareMore Value Plus out of 5 stars Orange WellPoint, Inc. HMO/HMOPOS CareMore Connect out of 5 stars

62 Orange WellPoint, Inc. HMO/HMOPOS CareMore Reliance out of 5 stars Orange WellPoint, Inc. HMO/HMOPOS CareMore Touch out of 5 stars Orange WellPoint, Inc. HMO/HMOPOS StartSmart with CareMore out of 5 stars Orange WellPoint, Inc. HMO/HMOPOS CareMore Heart out of 5 stars Orange WellPoint, Inc. HMO/HMOPOS CareMore Breathe out of 5 stars Orange WellPoint, Inc. HMO/HMOPOS CareMore ESRD out of 5 stars Orange Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Green out of 5 stars Orange Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Amber I out of 5 stars Orange Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Amber II out of 5 stars Orange Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart Plan out of 5 stars Orange Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Ruby Plan out of 5 stars Orange Health Net, Inc. HMO/HMOPOS Salud con Health Net Medicare Advantage out of 5 stars Orange Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart Plan out of 5 stars Orange Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Orange Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Orange Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Orange WellPoint, Inc. HMO/HMOPOS Blue Cross Senior Secure Plan I out of 5 stars Orange WellPoint, Inc. HMO/HMOPOS Blue Cross Senior Secure Plan I 11 3 out of 5 stars Orange WellPoint, Inc. HMO/HMOPOS Senior Secure out of 5 stars Orange Universal Care, Inc HMO/HMOPOS Brand New Day out of 5 stars Orange UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 27 3 out of 5 stars Orange UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) out of 5 stars Orange Golden State Medicare Health Plan HMO/HMOPOS Golden State Medicare Health Plan, Golden 710 Not enough data to calculate overall rating Orange UnitedHealth Group, Inc. HMO/HMOPOS Senior Dimensions Southern Nevada (HMO-POS) out of 5 stars Orange WellPoint, Inc. Local PPO Empire MediBlue Freedom (PPO) out of 5 stars Orange MVP Health Care, Inc. Local PPO Kodak USA Care Rx (PPO) out of 5 stars Orange Honored Citizens Choice Health Plan HMO/HMOPOS Citizens Choice Healthplan out of 5 stars Orange Highmark Inc. Local PPO FreedomBlue PPO MA Pennsylvania (PPO) out of 5 stars Orange Highmark Inc. Local PPO FreedomBlue PPO MA-PD Pennsylvania (PPO) out of 5 stars Orange Easy Choice Health Plan Inc. HMO/HMOPOS Easy Choice Freedom Plan out of 5 stars Orange Easy Choice Health Plan Inc. HMO/HMOPOS Easy Choice Plus Plan out of 5 stars Orange Easy Choice Health Plan Inc. HMO/HMOPOS Easy Choice Best Plan out of 5 stars Orange SCAN Health Plan HMO/HMOPOS SCAN Classic 19 4 out of 5 stars Orange SCAN Health Plan HMO/HMOPOS SCAN Classic 96 4 out of 5 stars Orange SCAN Health Plan HMO/HMOPOS SCAN Classic out of 5 stars Orange SCAN Health Plan HMO/HMOPOS SCAN Classic 16 4 out of 5 stars Orange SCAN Health Plan HMO/HMOPOS SCAN Options out of 5 stars Orange SCAN Health Plan HMO/HMOPOS SCAN Options 55 4 out of 5 stars Orange SCAN Health Plan HMO/HMOPOS SCAN Options 24 4 out of 5 stars

63 Orange SCAN Health Plan HMO/HMOPOS My Choice (HMO-POS) out of 5 stars Orange SCAN Health Plan HMO/HMOPOS SCAN Employer Group out of 5 stars Orange SCAN Health Plan HMO/HMOPOS SCAN Employer Group out of 5 stars Orange SCAN Health Plan HMO/HMOPOS SCAN Employer Group out of 5 stars Orange CalOptima HMO/HMOPOS OneCare out of 5 stars Orange Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Orange Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Orange WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 15 3 out of 5 stars Orange INLAND EMPIRE HEALTH PLAN HMO/HMOPOS IEHP Medicare DualChoice 18 3 out of 5 stars Orange Central Health Plan of California HMO/HMOPOS Central Health Medicare Plan out of 5 stars Orange Care1st Health Plan HMO/HMOPOS Care1st AdvantageOptimum Plan 14 3 out of 5 stars Orange Care1st Health Plan HMO/HMOPOS Care1st TotalDual Plan out of 5 stars Orange Care1st Health Plan HMO/HMOPOS Care1st AdvantageOptimum Plan out of 5 stars Orange Kaiser Foundation Health Plan, Inc Cost 52 Orange Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Orange Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Orange Humana Inc. HMO/HMOPOS Advantage I MAPD out of 5 stars Orange Humana Inc. HMO/HMOPOS Preferred Dual SNP out of 5 stars Orange WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 107 Plan too new to be measured Orange WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 6471 Plan too new to be measured Orange WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 19 Plan too new to be measured Orange WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 456 Plan too new to be measured Orange SCAN Health Plan HMO/HMOPOS SCAN Healthy at Home 38 4 out of 5 stars Orange SCAN Health Plan HMO/HMOPOS SCAN Healthy at Home out of 5 stars Orange SCAN Health Plan HMO/HMOPOS SCAN Healthy at Home 13 4 out of 5 stars Orange Blue Cross Blue Shield of Michigan Local PPO Medicare Plus Blue PPO Employer CY (PPO) out of 5 stars Placer IBT Voluntary Employee Benefits Trust Employer/Union Only Direct IBT VEBA (Employer PDP) 11 #N/A Placer Union Pacific Railroad Employes Health Systems ct PDP Employer/Union Only Direct ct PDP Placer Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Placer Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Placer Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Placer Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Placer Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Placer Kaiser Foundation Health Plan, Inc. HMO/HMOPOS The UPREHS Prime Medicare Plan (Employer PDP) 13 #N/A Kaiser Permanente Senior Advantage LA, Orange Co. Kaiser Permanente Senior Advantage Sac., Sonoma Senior Advantage Medicare Medi-Cal Plan North Kaiser Permanente Senior Advantage Marin Mateo Kaiser Permanente Senior Advantage Alam., SF, Napa Kaiser Permanente Senior Advantage 12 5 stars stars stars 11 5 stars 16 5 stars 12 5 stars

64 Placer Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage ta Clara 21 5 stars Placer Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Placer Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Placer Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 13 5 stars Placer Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars Placer UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Placer UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Placer UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Placer UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Placer UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Placer UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Placer Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Green out of 5 stars Placer Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart Plan out of 5 stars Placer Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart Plan out of 5 stars Placer Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Placer Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Placer Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Placer UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 96 3 out of 5 stars Placer MVP Health Care, Inc. Local PPO Kodak USA Care Rx (PPO) out of 5 stars Placer Health Net, Inc. Local PPO Health Net Violet (PPO) out of 5 stars Placer Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Placer Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Placer Kaiser Foundation Health Plan, Inc Cost 90 Placer Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Placer Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Placer WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 54 Plan too new to be measured Placer Blue Cross Blue Shield of Michigan Local PPO Medicare Plus Blue PPO Employer CY (PPO) out of 5 stars Plumas Union Pacific Railroad Employes Health Employer/Union Only Direct Systems ct PDP The UPREHS Prime Medicare Plan (Employer PDP) 67 #N/A Plumas Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma 11 5 stars Plumas Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 25 5 stars Plumas UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Essential (PFFS) 11 3 out of 5 stars Plumas UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Rx (PFFS) out of 5 stars Plumas Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Riverside IBT Voluntary Employee Benefits Trust Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 16 #N/A Riverside DMBA (Deseret Mutual Benefit Administrators) Employer/Union Only Direct Deseret Secure (Employer PFFS) 25 #N/A

65 Riverside Riverside Union Pacific Railroad Employes Health Systems Oklahoma State and Educ Employees Group Ins Board ct PFFS Employer/Union Only Direct ct PDP Employer/Union Only Direct ct PDP The UPREHS Prime Medicare Plan (Employer PDP) 20 #N/A OK State and Education Emp Group Ins Board (Employer PDP) Riverside Humana Inc. HMO/HMOPOS Humana Gold Plus H Riverside Humana Inc. HMO/HMOPOS Humana Gold Plus H (HMO-POS) #N/A Not enough data to calculate overall rating Not enough data to calculate overall rating Riverside California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 66 4 out of 5 stars Riverside California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 21 4 out of 5 stars Riverside California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Riverside California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Riverside California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 25 4 out of 5 stars Riverside Aetna Inc. HMO/HMOPOS Aetna Medicare Select Plan out of 5 stars Riverside Aetna Inc. HMO/HMOPOS Aetna Medicare Select Plan out of 5 stars Riverside Aetna Inc. HMO/HMOPOS Aetna Medicare Plan out of 5 stars Riverside Aetna Inc. HMO/HMOPOS Aetna Medicare Plan w/rx CY out of 5 stars Riverside Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage LA, Orange Co stars Riverside Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma 12 5 stars Riverside Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Inland Empire stars Riverside Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan South stars Riverside Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North 11 5 stars Riverside Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Ventura 12 5 stars Riverside Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Diego stars Riverside Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Riverside Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Riverside Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 38 5 stars Riverside Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 76 5 stars Riverside Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars Riverside UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Riverside UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Premier out of 5 stars Riverside UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Riverside UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Value out of 5 stars Riverside UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Premier out of 5 stars

66 Riverside UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Dual Complete out of 5 stars Riverside UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Essential out of 5 stars Riverside UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Riverside UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Riverside UnitedHealth Group, Inc. HMO/HMOPOS Sharp SecureHorizons Plan by UnitedHealthcare out of 5 stars Riverside UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Riverside UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Riverside UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Riverside WellPoint, Inc. HMO/HMOPOS CareMore Value Plus out of 5 stars Riverside WellPoint, Inc. HMO/HMOPOS CareMore Reliance out of 5 stars Riverside WellPoint, Inc. HMO/HMOPOS CareMore Touch out of 5 stars Riverside WellPoint, Inc. HMO/HMOPOS CareMore Value Plus out of 5 stars Riverside WellPoint, Inc. HMO/HMOPOS CareMore Diabetes out of 5 stars Riverside InterValley Health Plan HMO/HMOPOS Inter Valley Health Plan Service To Seniors out of 5 stars Riverside InterValley Health Plan HMO/HMOPOS Inter Valley Health Plan Total Fit out of 5 stars Riverside InterValley Health Plan HMO/HMOPOS Inter Valley Health Plan Desert Preferred Choice out of 5 stars Riverside Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Green out of 5 stars Riverside Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Amber I out of 5 stars Riverside Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Amber II out of 5 stars Riverside Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Amber CHF out of 5 stars Riverside Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart Plan out of 5 stars Riverside Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Ruby Plan out of 5 stars Riverside Health Net, Inc. HMO/HMOPOS Salud con Health Net Medicare Advantage out of 5 stars Riverside Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart Plan out of 5 stars Riverside Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Riverside Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Riverside Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Riverside WellPoint, Inc. HMO/HMOPOS Blue Cross Senior Secure Plan I out of 5 stars Riverside WellPoint, Inc. HMO/HMOPOS Senior Secure 62 3 out of 5 stars Riverside Universal Care, Inc HMO/HMOPOS Brand New Day out of 5 stars Riverside UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 48 3 out of 5 stars Riverside UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) out of 5 stars Riverside UnitedHealth Group, Inc. HMO/HMOPOS Senior Dimensions Southern Nevada (HMO-POS) out of 5 stars Riverside WellPoint, Inc. Local PPO Empire MediBlue Freedom (PPO) out of 5 stars Riverside MVP Health Care, Inc. Local PPO Kodak USA Care Rx (PPO) out of 5 stars

67 Riverside Honored Citizens Choice Health Plan HMO/HMOPOS Citizens Choice Healthplan out of 5 stars Riverside Easy Choice Health Plan Inc. HMO/HMOPOS Easy Choice Freedom Plan out of 5 stars Riverside Easy Choice Health Plan Inc. HMO/HMOPOS Easy Choice Best Plan out of 5 stars Riverside SCAN Health Plan HMO/HMOPOS SCAN Classic 26 4 out of 5 stars Riverside SCAN Health Plan HMO/HMOPOS SCAN Classic 58 4 out of 5 stars Riverside SCAN Health Plan HMO/HMOPOS SCAN Classic 42 4 out of 5 stars Riverside SCAN Health Plan HMO/HMOPOS SCAN Classic out of 5 stars Riverside SCAN Health Plan HMO/HMOPOS SCAN Classic 20 4 out of 5 stars Riverside SCAN Health Plan HMO/HMOPOS SCAN Connections out of 5 stars Riverside SCAN Health Plan HMO/HMOPOS SCAN Options 16 4 out of 5 stars Riverside SCAN Health Plan HMO/HMOPOS SCAN Options out of 5 stars Riverside SCAN Health Plan HMO/HMOPOS SCAN Options 37 4 out of 5 stars Riverside SCAN Health Plan HMO/HMOPOS My Choice (HMO-POS) 20 4 out of 5 stars Riverside SCAN Health Plan HMO/HMOPOS SCAN Connections at Home out of 5 stars Riverside SCAN Health Plan HMO/HMOPOS SCAN Employer Group 57 4 out of 5 stars Riverside SCAN Health Plan HMO/HMOPOS SCAN Employer Group out of 5 stars Riverside SCAN Health Plan HMO/HMOPOS SCAN Employer Group 52 4 out of 5 stars Riverside CalOptima HMO/HMOPOS OneCare 12 4 out of 5 stars Riverside Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Riverside Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Riverside WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 35 3 out of 5 stars Riverside INLAND EMPIRE HEALTH PLAN HMO/HMOPOS IEHP Medicare DualChoice out of 5 stars Riverside Central Health Plan of California HMO/HMOPOS Central Health Medicare Plan out of 5 stars Riverside Molina Healthcare, Inc., HMO/HMOPOS Molina Medicare Options Plus out of 5 stars Riverside Molina Healthcare, Inc., HMO/HMOPOS Molina Medicare Options out of 5 stars Riverside Care1st Health Plan HMO/HMOPOS Care1st TotalDual Plan 11 3 out of 5 stars Riverside Care1st Health Plan HMO/HMOPOS Care1st AdvantageOptimum Plan out of 5 stars Riverside SCAN Health Plan HMO/HMOPOS VillageHealth (HMO-POS SNP) 369 Not enough data to calculate overall rating Riverside Kaiser Foundation Health Plan, Inc Cost 41 Riverside Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Riverside Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Riverside Humana Inc. HMO/HMOPOS Advantage I MAPD out of 5 stars Riverside Humana Inc. HMO/HMOPOS Advantage Select MA out of 5 stars Riverside Humana Inc. HMO/HMOPOS Preferred Dual SNP out of 5 stars Riverside WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 91 Plan too new to be measured Riverside WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 36 Plan too new to be measured Riverside WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 1908 Plan too new to be measured Riverside WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 140 Plan too new to be measured Riverside SCAN Health Plan HMO/HMOPOS SCAN Healthy at Home 11 4 out of 5 stars

68 Riverside SCAN Health Plan HMO/HMOPOS SCAN Healthy at Home 26 4 out of 5 stars Riverside SCAN Health Plan HMO/HMOPOS SCAN Healthy at Home out of 5 stars Riverside SCAN Health Plan HMO/HMOPOS SCAN Healthy at Home 11 4 out of 5 stars Riverside SCAN Health Plan HMO/HMOPOS SCAN Classic 11 3 out of 5 stars Riverside Blue Cross Blue Shield of Michigan Local PPO Medicare Plus Blue PPO Employer CY (PPO) out of 5 stars Sacramento IBT Voluntary Employee Benefits Trust Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 33 #N/A Sacramento Union Pacific Railroad Employes Health Employer/Union Only Direct Systems ct PDP The UPREHS Prime Medicare Plan (Employer PDP) 46 #N/A Sacramento California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 54 4 out of 5 stars Sacramento Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage LA, Orange Co stars Sacramento Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 72 5 stars Sacramento Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma stars Sacramento Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan South 18 5 stars Sacramento Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North stars Sacramento Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Marin Mateo 18 5 stars Sacramento Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa 43 5 stars Sacramento Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 21 5 stars Sacramento Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Diego 13 5 stars Sacramento Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage ta Clara 30 5 stars Sacramento Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced SnJoaq 21 5 stars Sacramento Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Sacramento Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 26 5 stars Sacramento Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Sacramento Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 60 5 stars Sacramento Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars Sacramento Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part B Only with D 22 5 stars Sacramento UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Sacramento UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Sacramento UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Sacramento UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Sacramento UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars

69 Sacramento UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Sacramento UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Sacramento Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Sacramento Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Green out of 5 stars Sacramento Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart Plan out of 5 stars Sacramento Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart Plan out of 5 stars Sacramento Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Sacramento Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Sacramento Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Sacramento UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 23 3 out of 5 stars Sacramento UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 98 3 out of 5 stars Sacramento MVP Health Care, Inc. Local PPO Kodak USA Care Rx (PPO) out of 5 stars Sacramento Sutter Health Sacramento Sierra Region National PACE Sutter SeniorCare (PACE) 198 #N/A Sacramento Health Net, Inc. Local PPO Health Net Violet (PPO) out of 5 stars Sacramento Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Sacramento Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Sacramento WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 33 3 out of 5 stars Sacramento PARTNERSHIP HEALTHPLAN OF CALIFORNIA HMO/HMOPOS PartnershipAdvantage 95 4 out of 5 stars Sacramento Molina Healthcare, Inc., HMO/HMOPOS Molina Medicare Options Plus out of 5 stars Sacramento Molina Healthcare, Inc., HMO/HMOPOS Molina Medicare Options out of 5 stars Sacramento Care1st Health Plan HMO/HMOPOS Care1st AdvantageOptimum Plan 11 3 out of 5 stars Sacramento Kaiser Foundation Health Plan, Inc Cost 239 Sacramento Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Sacramento Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Sacramento WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 414 Plan too new to be measured Sacramento WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 356 Plan too new to be measured Sacramento Blue Cross Blue Shield of Michigan Local PPO Medicare Plus Blue PPO Employer CY (PPO) out of 5 stars Benito IBT Voluntary Employee Benefits Trust Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 20 #N/A Benito Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 24 5 stars Benito Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage ta Clara 77 5 stars Benito Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 64 5 stars Benito Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Employer/Union Only Direct IBT Voluntary Employee Benefits Trust ct PDP IBT VEBA (Employer PDP) 21 #N/A Union Pacific Railroad Employes Health Employer/Union Only Direct Systems ct PDP The UPREHS Prime Medicare Plan (Employer PDP) 24 #N/A Not enough data to calculate overall Humana Inc. HMO/HMOPOS Humana Gold Plus H rating Humana Inc. HMO/HMOPOS Humana Gold Plus H (HMO-POS) 316 Not enough data to calculate overall

70 rating California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 69 4 out of 5 stars California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 18 4 out of 5 stars Aetna Inc. HMO/HMOPOS Aetna Medicare Select Plan out of 5 stars Aetna Inc. HMO/HMOPOS Aetna Medicare Select Plan out of 5 stars Aetna Inc. HMO/HMOPOS Aetna Medicare Plan w/rx CY out of 5 stars Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage LA, Orange Co stars Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 12 5 stars Kaiser Foundation Health Plan, Inc. Kaiser Foundation Health Plan, Inc. Kaiser Foundation Health Plan, Inc. Kaiser Foundation Health Plan, Inc. HMO/HMOPOS HMO/HMOPOS HMO/HMOPOS HMO/HMOPOS Kaiser Permanente Senior Advantage Inland Empire Senior Advantage Medicare Medi-Cal Plan South Kaiser Permanente Senior Advantage Enhanced Kern Kaiser Permanente Senior Advantage Diego stars stars 12 5 stars 47 5 stars Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 21 5 stars Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 78 5 stars Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Dual Complete out of 5 stars UnitedHealth Group, Inc. UnitedHealth Group, Inc. HMO/HMOPOS HMO/HMOPOS AARP MedicareComplete SecureHorizons Essential AARP MedicareComplete SecureHorizons Plan out of 5 stars out of 5 stars

71 UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars WellPoint, Inc. HMO/HMOPOS CareMore Value Plus out of 5 stars WellPoint, Inc. HMO/HMOPOS CareMore Reliance out of 5 stars WellPoint, Inc. HMO/HMOPOS CareMore Touch out of 5 stars WellPoint, Inc. HMO/HMOPOS CareMore Value Plus out of 5 stars WellPoint, Inc. HMO/HMOPOS CareMore Reliance out of 5 stars WellPoint, Inc. HMO/HMOPOS StartSmart with CareMore out of 5 stars WellPoint, Inc. HMO/HMOPOS CareMore Breathe out of 5 stars WellPoint, Inc. HMO/HMOPOS CareMore ESRD out of 5 stars WellPoint, Inc. HMO/HMOPOS CareMore Heart out of 5 stars InterValley Health Plan HMO/HMOPOS Inter Valley Health Plan Service To Seniors out of 5 stars InterValley Health Plan HMO/HMOPOS Inter Valley Health Plan Total Fit out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Green out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Amber I out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Amber II out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Amber CHF out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart Plan out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Ruby Plan out of 5 stars Health Net, Inc. HMO/HMOPOS Salud con Health Net Medicare Advantage out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart Plan out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars

72 Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars WellPoint, Inc. HMO/HMOPOS Blue Cross Senior Secure Plan I out of 5 stars WellPoint, Inc. HMO/HMOPOS Senior Secure 61 3 out of 5 stars Universal Care, Inc HMO/HMOPOS Brand New Day out of 5 stars UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 27 3 out of 5 stars UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 77 3 out of 5 stars MVP Health Care, Inc. Local PPO Kodak USA Care Rx (PPO) out of 5 stars Honored Citizens Choice Health Plan HMO/HMOPOS Citizens Choice Healthplan out of 5 stars Easy Choice Health Plan Inc. HMO/HMOPOS Easy Choice Freedom Plan out of 5 stars Easy Choice Health Plan Inc. HMO/HMOPOS Easy Choice Best Plan out of 5 stars SCAN Health Plan HMO/HMOPOS SCAN Classic 86 4 out of 5 stars SCAN Health Plan HMO/HMOPOS SCAN Classic 22 4 out of 5 stars SCAN Health Plan HMO/HMOPOS SCAN Classic 16 4 out of 5 stars SCAN Health Plan HMO/HMOPOS SCAN Classic out of 5 stars SCAN Health Plan HMO/HMOPOS SCAN Connections out of 5 stars SCAN Health Plan HMO/HMOPOS SCAN Options 11 4 out of 5 stars SCAN Health Plan HMO/HMOPOS SCAN Options 61 4 out of 5 stars SCAN Health Plan HMO/HMOPOS SCAN Options out of 5 stars SCAN Health Plan HMO/HMOPOS My Choice (HMO-POS) 18 4 out of 5 stars SCAN Health Plan HMO/HMOPOS SCAN Connections at Home out of 5 stars SCAN Health Plan HMO/HMOPOS SCAN Employer Group 26 4 out of 5 stars SCAN Health Plan HMO/HMOPOS SCAN Employer Group 66 4 out of 5 stars SCAN Health Plan HMO/HMOPOS SCAN Employer Group 25 4 out of 5 stars

73 CalOptima HMO/HMOPOS OneCare 13 4 out of 5 stars Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 19 3 out of 5 stars INLAND EMPIRE HEALTH PLAN HMO/HMOPOS IEHP Medicare DualChoice out of 5 stars Central Health Plan of California HMO/HMOPOS Central Health Medicare Plan out of 5 stars Central Health Plan of California HMO/HMOPOS Central Health Medi-Medi Plan out of 5 stars Molina Healthcare, Inc., HMO/HMOPOS Molina Medicare Options Plus out of 5 stars Molina Healthcare, Inc., HMO/HMOPOS Molina Medicare Options out of 5 stars Care1st Health Plan HMO/HMOPOS Care1st TotalDual Plan 14 3 out of 5 stars Care1st Health Plan HMO/HMOPOS Care1st AdvantageOptimum Plan 18 3 out of 5 stars Care1st Health Plan HMO/HMOPOS Care1st TotalDual Plan out of 5 stars Care1st Health Plan HMO/HMOPOS Care1st AdvantageOptimum Plan out of 5 stars SCAN Health Plan HMO/HMOPOS VillageHealth (HMO-POS SNP) 225 Kaiser Foundation Health Plan, Inc Cost 60 Not enough data to calculate overall rating Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Humana Inc. HMO/HMOPOS Advantage I MAPD out of 5 stars Humana Inc. HMO/HMOPOS Preferred Dual SNP out of 5 stars WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 52 Plan too new to be measured WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 847 Plan too new to be measured WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 91 Plan too new to be measured SCAN Health Plan HMO/HMOPOS SCAN Healthy at Home 14 4 out of 5 stars SCAN Health Plan HMO/HMOPOS SCAN Healthy at Home out of 5 stars Blue Cross Blue Shield of Michigan Local PPO Medicare Plus Blue PPO Employer CY (PPO) out of 5 stars

74 Diego Diego Diego Diego IBT Voluntary Employee Benefits Trust Commonwealth of PA Pub Schools Retirement System DMBA (Deseret Mutual Benefit Administrators) Oklahoma State and Educ Employees Group Ins Board Employer/Union Only Direct ct PDP Employer/Union Only Direct ct PDP Employer/Union Only Direct ct PFFS Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 11 #N/A PSERS HOP (Employer PDP) 21 #N/A Deseret Secure (Employer PFFS) 20 #N/A OK State and Education Emp Group Ins Board (Employer PDP) Diego Humana Inc. HMO/HMOPOS Humana Gold Plus H Diego Humana Inc. HMO/HMOPOS Humana Gold Plus H (HMO-POS) #N/A Not enough data to calculate overall rating Not enough data to calculate overall rating Diego UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete out of 5 stars Diego CIGNA HMO/HMOPOS Cigna Medicare Select Plus Rx-Standard out of 5 stars Diego California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 14 4 out of 5 stars Diego California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 16 4 out of 5 stars Diego Aetna Inc. HMO/HMOPOS Aetna Medicare Select Plan out of 5 stars Diego Aetna Inc. HMO/HMOPOS Aetna Medicare Select Plan out of 5 stars Diego Aetna Inc. HMO/HMOPOS Aetna Medicare Plan w/rx CY out of 5 stars Diego Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage LA, Orange Co stars Diego Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 14 5 stars Diego Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma 20 5 stars Diego Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Inland Empire stars Diego Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan South stars Diego Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North 17 5 stars Diego Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa 12 5 stars Diego Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Diego stars Diego Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Diego Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Diego Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 42 5 stars Diego Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 42 5 stars Diego Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars Diego Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part B Only with D 12 5 stars Diego UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Diego UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Diego UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Value out of 5 stars

75 Diego UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Premier out of 5 stars Diego UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Essential out of 5 stars Diego UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Diego UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Diego UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Diego UnitedHealth Group, Inc. HMO/HMOPOS Sharp SecureHorizons Plan by UnitedHealthcare out of 5 stars Diego UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Diego UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Diego UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Diego Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Diego Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Ruby out of 5 stars Diego Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Ruby Plan out of 5 stars Diego Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Green out of 5 stars Diego Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Amber II out of 5 stars Diego Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart Plan out of 5 stars Diego Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart Plan out of 5 stars Diego Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Diego Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Diego Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Diego WellPoint, Inc. HMO/HMOPOS Blue Cross Senior Secure Plan I out of 5 stars Diego WellPoint, Inc. HMO/HMOPOS Senior Secure 40 3 out of 5 stars Diego UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 42 3 out of 5 stars Diego UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) out of 5 stars Diego WellPoint, Inc. Local PPO Empire MediBlue Freedom (PPO) out of 5 stars Diego MVP Health Care, Inc. Local PPO Kodak USA Care Rx (PPO) out of 5 stars Diego Highmark Inc. Local PPO FreedomBlue PPO MA-PD Pennsylvania (PPO) out of 5 stars Diego UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete Plan out of 5 stars Diego SCAN Health Plan HMO/HMOPOS SCAN Signature out of 5 stars Diego SCAN Health Plan HMO/HMOPOS SCAN Classic out of 5 stars Diego SCAN Health Plan HMO/HMOPOS SCAN Classic 30 4 out of 5 stars Diego SCAN Health Plan HMO/HMOPOS SCAN Classic 17 4 out of 5 stars Diego SCAN Health Plan HMO/HMOPOS SCAN Options 28 4 out of 5 stars Diego SCAN Health Plan HMO/HMOPOS SCAN Employer Group 31 4 out of 5 stars Diego Health Net, Inc. Local PPO Health Net Violet (PPO) out of 5 stars Diego Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Diego Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars

76 Diego WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 25 3 out of 5 stars Diego Community Eldercare of Diego National PACE St. Paul's PACE (PACE) 137 #N/A Diego Molina Healthcare, Inc., HMO/HMOPOS Molina Medicare Options Plus out of 5 stars Diego Molina Healthcare, Inc., HMO/HMOPOS Molina Medicare Options out of 5 stars Diego Care1st Health Plan HMO/HMOPOS Care1st TotalDual Plan out of 5 stars Diego Care1st Health Plan HMO/HMOPOS Care1st AdvantageOptimum Plan out of 5 stars Diego Kaiser Foundation Health Plan, Inc Cost 125 Diego Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Diego Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Diego Community Health Group HMO/HMOPOS CommuniCare Advantage 1038 Not enough data to calculate overall rating Diego WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 8103 Plan too new to be measured Diego WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 87 Plan too new to be measured Diego Blue Cross Blue Shield of Michigan Local PPO Medicare Plus Blue PPO Employer CY (PPO) out of 5 stars Francisco California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Francisco California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Kaiser Permanente Senior Advantage LA, Orange Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Francisco Co stars Francisco Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 12 5 stars Kaiser Permanente Senior Advantage B Only North Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Francisco 19 5 stars Kaiser Permanente Senior Advantage Sac., Sonoma Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Francisco 29 5 stars Kaiser Permanente Senior Advantage Inland Empire Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Francisco 16 5 stars Senior Advantage Medicare Medi-Cal Plan North Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Francisco stars Kaiser Permanente Senior Advantage Marin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Francisco Mateo stars Kaiser Permanente Senior Advantage Alam., SF, Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Francisco Napa stars Kaiser Permanente Senior Advantage Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Francisco 38 5 stars Kaiser Permanente Senior Advantage ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Francisco 19 5 stars Francisco Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Francisco Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 34 5 stars Francisco Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 19 5 stars

77 Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Green out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Amber II out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Chinese Hospital Association HMO/HMOPOS CCHP Senior Program out of 5 stars Chinese Hospital Association HMO/HMOPOS CCHP Senior Select Program out of 5 stars Chinese Hospital Association HMO/HMOPOS CCHP Senior Program Employer-Only Plan out of 5 stars UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 33 3 out of 5 stars On Lok, Inc. National PACE On Lok Lifeways (Dual Eligibles) (PACE) 826 #N/A SCAN Health Plan HMO/HMOPOS SCAN Classic out of 5 stars SCAN Health Plan HMO/HMOPOS SCAN Options out of 5 stars Health Plan of Mateo HMO/HMOPOS HPSM CareAdvantage out of 5 stars Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars PARTNERSHIP HEALTHPLAN OF CALIFORNIA HMO/HMOPOS PartnershipAdvantage 26 4 out of 5 stars

78 Francisco Kaiser Foundation Health Plan, Inc Cost 169 Francisco Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Francisco Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Francisco WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 863 Plan too new to be measured Joaquin IBT Voluntary Employee Benefits Trust Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 39 #N/A Joaquin Union Pacific Railroad Employes Health Employer/Union Only Direct Systems ct PDP The UPREHS Prime Medicare Plan (Employer PDP) 88 #N/A Joaquin California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Joaquin California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 16 4 out of 5 stars Joaquin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma 31 5 stars Joaquin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North stars Joaquin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa 39 5 stars Joaquin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 21 5 stars Joaquin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage ta Clara 27 5 stars Joaquin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced Stanis 23 5 stars Joaquin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced SnJoaq stars Joaquin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Basic SnJoaq stars Joaquin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Joaquin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Joaquin Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars Joaquin Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Joaquin Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Ruby out of 5 stars Joaquin Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Joaquin Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Joaquin Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Joaquin UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 48 3 out of 5 stars Joaquin Highmark Inc. Local PPO FreedomBlue PPO MA-PD Pennsylvania (PPO) out of 5 stars Joaquin Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Joaquin Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Joaquin SCAN Health Plan HMO/HMOPOS SCAN Classic out of 5 stars Joaquin SCAN Health Plan HMO/HMOPOS SCAN Connections out of 5 stars

79 Joaquin SCAN Health Plan HMO/HMOPOS SCAN Options out of 5 stars Joaquin Care1st Health Plan HMO/HMOPOS Care1st AdvantageOptimum Plan out of 5 stars Joaquin Care1st Health Plan HMO/HMOPOS Care1st AdvantageOptimum Plan 15 3 out of 5 stars Joaquin Kaiser Foundation Health Plan, Inc Cost 41 Joaquin Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Joaquin Alameda Alliance for Health HMO/HMOPOS Alliance CompleteCare 14 3 out of 5 stars Luis Obispo California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Luis Obispo California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 13 4 out of 5 stars Luis Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage LA, Orange 25 5 stars Obispo Luis Obispo Luis Obispo Luis Obispo Luis Obispo Luis Obispo Luis Obispo Luis Obispo Luis Obispo Luis Obispo Luis Obispo Luis Obispo Luis Obispo Luis Obispo Luis Obispo Luis Obispo Luis Obispo Mateo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Co. Kaiser Permanente Senior Advantage ta Clara 11 5 stars Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 47 5 stars Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 42 5 stars UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 12 3 out of 5 stars UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 71 3 out of 5 stars WellPoint, Inc. Local PPO Empire MediBlue Freedom (PPO) out of 5 stars Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Golden Empire Managed Care HMO/HMOPOS Physicians Choice Medicare Plus out of 5 stars Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 49 Plan too new to be measured IBT Voluntary Employee Benefits Trust Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 16 #N/A

80 Mateo California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Mateo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage LA, Orange Co stars Mateo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage B Only North 24 5 stars Mateo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma 44 5 stars Mateo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Inland Empire 11 5 stars Mateo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North stars Mateo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Marin Mateo stars Mateo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa stars Mateo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 27 5 stars Mateo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage ta Clara 69 5 stars Mateo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Mateo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 14 5 stars Mateo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Mateo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 21 5 stars Mateo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars Mateo UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Mateo UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Mateo UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Mateo UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Mateo Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Mateo Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Mateo Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Mateo Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Green out of 5 stars Mateo Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Mateo Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Mateo Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Mateo Chinese Hospital Association HMO/HMOPOS CCHP Senior Program out of 5 stars Mateo UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 82 3 out of 5 stars Mateo MVP Health Care, Inc. Local PPO Kodak USA Care Rx (PPO) out of 5 stars Mateo On Lok, Inc. National PACE On Lok Lifeways (Dual Eligibles) (PACE) 22 #N/A Mateo Health Plan of Mateo HMO/HMOPOS HPSM CareAdvantage out of 5 stars Mateo Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Mateo Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Mateo Kaiser Foundation Health Plan, Inc Cost 196

81 Mateo Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Mateo WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 11 Plan too new to be measured Mateo WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 729 Plan too new to be measured Mateo Blue Cross Blue Shield of Michigan Local PPO Medicare Plus Blue PPO Employer CY (PPO) out of 5 stars ta Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage LA, Orange 25 5 stars Barbara ta Barbara ta Barbara ta Barbara ta Barbara ta Barbara ta Barbara ta Barbara ta Barbara ta Barbara ta Barbara ta Barbara ta Barbara ta Barbara ta Barbara ta Barbara ta Barbara ta Barbara ta Barbara ta Barbara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Co. Senior Advantage Medicare Medi-Cal Plan South 12 5 stars Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 29 5 stars UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Ruby out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Green out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars WellPoint, Inc. HMO/HMOPOS Senior Secure 12 3 out of 5 stars UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 40 3 out of 5 stars Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Golden Empire Managed Care HMO/HMOPOS Physicians Choice Medicare Plus out of 5 stars Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 29 Plan too new to be measured WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 35 Plan too new to be measured ta Clara IBT Voluntary Employee Benefits Trust Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 50 #N/A ta Clara DMBA (Deseret Mutual Benefit Administrators) Employer/Union Only Direct Deseret Secure (Employer PFFS) 12 #N/A

82 ct PFFS ta Clara California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 18 4 out of 5 stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage LA, Orange Co stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 16 5 stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage B Only North 25 5 stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma 49 5 stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan South 11 5 stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Marin Mateo 80 5 stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa 66 5 stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 30 5 stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Diego 18 5 stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced Fresno 12 5 stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage ta Clara stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced Stanis 13 5 stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced SnJoaq 20 5 stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 11 5 stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 30 5 stars ta Clara Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars ta Clara UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars ta Clara UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars ta Clara UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars ta Clara WellPoint, Inc. HMO/HMOPOS CareMore Value Plus out of 5 stars ta Clara WellPoint, Inc. HMO/HMOPOS StartSmart with CareMore out of 5 stars ta Clara WellPoint, Inc. HMO/HMOPOS CareMore Touch out of 5 stars ta Clara WellPoint, Inc. HMO/HMOPOS CareMore Breathe out of 5 stars ta Clara WellPoint, Inc. HMO/HMOPOS CareMore Diabetes out of 5 stars ta Clara WellPoint, Inc. HMO/HMOPOS CareMore Heart out of 5 stars ta Clara Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars

83 ta Clara Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars ta Clara Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Green out of 5 stars ta Clara Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Ruby out of 5 stars ta Clara Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars ta Clara Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars ta Clara Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars ta Clara UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) out of 5 stars ta Clara MVP Health Care, Inc. Local PPO Kodak USA Care Rx (PPO) out of 5 stars ta Clara On Lok, Inc. National PACE On Lok Lifeways (Dual Eligibles) (PACE) 84 #N/A ta Clara SCAN Health Plan HMO/HMOPOS SCAN Classic out of 5 stars ta Clara SCAN Health Plan HMO/HMOPOS SCAN Options out of 5 stars ta Clara Health Plan of Mateo HMO/HMOPOS HPSM CareAdvantage out of 5 stars ta Clara Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars ta Clara Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars ta Clara Care1st Health Plan HMO/HMOPOS Care1st AdvantageOptimum Plan out of 5 stars ta Clara Kaiser Foundation Health Plan, Inc Cost 311 ta Clara Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars ta Clara Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars ta Clara WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 816 Plan too new to be measured ta Clara Blue Cross Blue Shield of Michigan Local PPO Medicare Plus Blue PPO Employer CY (PPO) out of 5 stars ta Cruz IBT Voluntary Employee Benefits Trust Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 28 #N/A ta Cruz California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 17 4 out of 5 stars ta Cruz Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano stars ta Cruz Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma 21 5 stars ta Cruz Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North 14 5 stars ta Cruz Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Marin Mateo 11 5 stars ta Cruz Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa 19 5 stars ta Cruz Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage ta Clara stars ta Cruz Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 27 5 stars ta Cruz Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars ta Cruz UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars ta Cruz UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars ta Cruz UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars ta Cruz Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Ruby out of 5 stars ta Cruz Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Green out of 5 stars ta Cruz Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars

84 ta Cruz Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars ta Cruz Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars ta Cruz UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 23 3 out of 5 stars ta Cruz Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars ta Cruz Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars ta Cruz Kaiser Foundation Health Plan, Inc Cost 12 Shasta IBT Voluntary Employee Benefits Trust Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 29 #N/A Shasta Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 12 5 stars Shasta Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma 18 5 stars Shasta Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa 13 5 stars Shasta Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 74 5 stars Shasta UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Shasta UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 50 3 out of 5 stars Shasta Arcadian Management Services Inc. HMO/HMOPOS Arcadian Community Care - Plus out of 5 stars Shasta Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Shasta WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 18 Plan too new to be measured Siskiyou Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 22 5 stars Siskiyou UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Essential (PFFS) out of 5 stars Siskiyou UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Rx (PFFS) out of 5 stars Solano IBT Voluntary Employee Benefits Trust Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 17 #N/A Solano Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano stars Solano Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma 33 5 stars Solano Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North stars Solano Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa 49 5 stars Solano Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 44 5 stars Solano Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage ta Clara 12 5 stars Solano Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Solano Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Solano Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 13 5 stars Solano Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars Solano Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Solano Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Green out of 5 stars Solano Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Solano Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars

85 Solano Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Solano UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 20 3 out of 5 stars Solano UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 25 3 out of 5 stars Solano MVP Health Care, Inc. Local PPO Kodak USA Care Rx (PPO) out of 5 stars Solano PARTNERSHIP HEALTHPLAN OF CALIFORNIA HMO/HMOPOS PartnershipAdvantage out of 5 stars Solano Kaiser Foundation Health Plan, Inc Cost 153 Solano Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Sonoma Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma stars Sonoma Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North stars Sonoma Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Marin Mateo 59 5 stars Sonoma Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa 44 5 stars Sonoma Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 17 5 stars Sonoma Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage ta Clara 11 5 stars Sonoma Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Sonoma Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 12 5 stars Sonoma Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Sonoma Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 21 5 stars Sonoma Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars Sonoma UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Sonoma UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Sonoma UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Sonoma UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Sonoma Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Green out of 5 stars Sonoma Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Sonoma Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Sonoma Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Sonoma Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Sonoma UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 11 3 out of 5 stars Sonoma UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 67 3 out of 5 stars Sonoma MVP Health Care, Inc. Local PPO Kodak USA Care Rx (PPO) out of 5 stars Sonoma Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Sonoma Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Sonoma Kaiser Foundation Health Plan, Inc Cost 124 Sonoma Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars

86 Sonoma WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 1205 Plan too new to be measured Sonoma Blue Cross Blue Shield of Michigan Local PPO Medicare Plus Blue PPO Employer CY (PPO) out of 5 stars Stanislaus IBT Voluntary Employee Benefits Trust Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 25 #N/A Stanislaus Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma 11 5 stars Stanislaus Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North stars Stanislaus Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa 18 5 stars Stanislaus Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage ta Clara 14 5 stars Stanislaus Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced Stanis stars Stanislaus Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Basic Stanis stars Stanislaus Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced SnJoaq 19 5 stars Stanislaus Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Stanislaus Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Stanislaus Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars Stanislaus UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Stanislaus UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Stanislaus UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Stanislaus UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Stanislaus UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Stanislaus WellPoint, Inc. HMO/HMOPOS CareMore Value Plus out of 5 stars Stanislaus WellPoint, Inc. HMO/HMOPOS StartSmart with CareMore out of 5 stars Stanislaus WellPoint, Inc. HMO/HMOPOS CareMore Breathe out of 5 stars Stanislaus WellPoint, Inc. HMO/HMOPOS CareMore Diabetes out of 5 stars Stanislaus WellPoint, Inc. HMO/HMOPOS CareMore Heart out of 5 stars Stanislaus WellPoint, Inc. HMO/HMOPOS CareMore EGWP MAPD out of 5 stars Stanislaus Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Stanislaus Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Stanislaus Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Stanislaus Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Stanislaus UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 29 3 out of 5 stars Stanislaus Highmark Inc. Local PPO FreedomBlue PPO MA-PD Pennsylvania (PPO) out of 5 stars Stanislaus Care1st Health Plan HMO/HMOPOS Care1st AdvantageOptimum Plan 61 3 out of 5 stars Stanislaus Care1st Health Plan HMO/HMOPOS Care1st AdvantageOptimum Plan out of 5 stars Stanislaus Kaiser Foundation Health Plan, Inc Cost 20

87 Stanislaus Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Stanislaus WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 156 Plan too new to be measured Sutter Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma stars Sutter Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North 13 5 stars Sutter Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 91 5 stars Sutter UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 17 3 out of 5 stars Tehama Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 16 5 stars Tehama Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 35 5 stars Tehama UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Tehama Universal American Corp. PFFS Today's Options Premier Plus 450E (PFFS) out of 5 stars Tehama Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Trinity UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Essential (PFFS) 32 3 out of 5 stars Trinity UnitedHealth Group, Inc. PFFS UnitedHealthcare MedicareDirect Rx (PFFS) out of 5 stars Tulare IBT Voluntary Employee Benefits Trust Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 22 #N/A Tulare Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage LA, Orange Co stars Tulare Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North 35 5 stars Tulare Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced Kern 21 5 stars Tulare Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced Fresno stars Tulare Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Basic Fresno 30 5 stars Tulare Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 25 5 stars Tulare Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 86 5 stars Tulare UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Tulare UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Tulare UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Tulare UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 14 3 out of 5 stars Tulare WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 41 Not enough data to calculate overall rating Tulare Arcadian Management Services Inc. HMO/HMOPOS Arcadian Community Care - Plus out of 5 stars Tulare Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Tulare WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 18 Plan too new to be measured Tuolumne Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 59 5 stars Tuolumne Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma 11 5 stars Tuolumne Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Alam., SF, Napa 12 5 stars

88 Tuolumne Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 17 5 stars Tuolumne Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage ta Clara 23 5 stars Tuolumne Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Enhanced Stanis 26 5 stars Tuolumne Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 17 5 stars Tuolumne Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Tuolumne UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 38 3 out of 5 stars Tuolumne Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Ventura IBT Voluntary Employee Benefits Trust Employer/Union Only Direct ct PDP IBT VEBA (Employer PDP) 11 #N/A Ventura California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus 13 4 out of 5 stars Ventura California Physicians' Service HMO/HMOPOS Blue Shield 65 Plus out of 5 stars Ventura Aetna Inc. HMO/HMOPOS Aetna Medicare Select Plan out of 5 stars Ventura Aetna Inc. HMO/HMOPOS Aetna Medicare Select Plan out of 5 stars Ventura Aetna Inc. HMO/HMOPOS Aetna Medicare Plan out of 5 stars Ventura Aetna Inc. HMO/HMOPOS Aetna Medicare Plan w/rx CY out of 5 stars Ventura Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage LA, Orange Co stars Ventura Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan South stars Ventura Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Ventura stars Ventura Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Ventura Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Ventura Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 14 5 stars Ventura Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 34 5 stars Ventura Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D stars Ventura UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Ventura UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons out of 5 stars Ventura UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Ventura UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Ventura UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Ventura Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart Plan out of 5 stars Ventura UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 68 3 out of 5 stars Ventura MVP Health Care, Inc. Local PPO Kodak USA Care Rx (PPO) out of 5 stars Ventura SCAN Health Plan HMO/HMOPOS SCAN Classic out of 5 stars Ventura SCAN Health Plan HMO/HMOPOS SCAN Classic 44 4 out of 5 stars Ventura SCAN Health Plan HMO/HMOPOS SCAN Employer Group 22 4 out of 5 stars Ventura Aetna Inc. Local PPO Aetna Medicare Plan (PPO) out of 5 stars Ventura Aetna Inc. Local PPO Aetna Medicare Plan w/rx CY (PPO) out of 5 stars Ventura WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) out of 5 stars

89 Ventura Golden Empire Managed Care HMO/HMOPOS Physicians Choice Medicare Plus out of 5 stars Ventura Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Ventura Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Ventura WellPoint, Inc. Local PPO Anthem Medicare Preferred Standard (PPO) 4145 Plan too new to be measured Ventura WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 110 Plan too new to be measured Ventura Blue Cross Blue Shield of Michigan Local PPO Medicare Plus Blue PPO Employer CY (PPO) out of 5 stars Yolo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Solano 13 5 stars Yolo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma stars Yolo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North stars Yolo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage 28 5 stars Yolo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Yolo Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D 94 5 stars Yolo UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Yolo UnitedHealth Group, Inc. HMO/HMOPOS AARP MedicareComplete SecureHorizons Plan out of 5 stars Yolo UnitedHealth Group, Inc. HMO/HMOPOS UnitedHealthcare Group Medicare Advantage out of 5 stars Yolo Health Net, Inc. HMO/HMOPOS Health Net Healthy Heart out of 5 stars Yolo Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Green out of 5 stars Yolo Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Yolo Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Yolo Health Net, Inc. HMO/HMOPOS Health Net Seniority Plus Employer out of 5 stars Yolo UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 13 3 out of 5 stars Yolo PARTNERSHIP HEALTHPLAN OF CALIFORNIA HMO/HMOPOS PartnershipAdvantage out of 5 stars Yolo Molina Healthcare, Inc., HMO/HMOPOS Molina Medicare Options Plus out of 5 stars Yolo Humana Inc. Local PPO Humana Employer Sponsored (PPO) out of 5 stars Yolo WellPoint, Inc. Local PPO Anthem Medicare Preferred (PPO) 13 Plan too new to be measured Yuba Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage Sac., Sonoma stars Yuba Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Senior Advantage Medicare Medi-Cal Plan North 30 5 stars Yuba Kaiser Foundation Health Plan, Inc. HMO/HMOPOS Kaiser Permanente Senior Advantage stars Yuba Kaiser Foundation Health Plan, Inc. HMO/HMOPOS FEHB Part AB with D 13 5 stars Yuba UnitedHealth Group, Inc. Local PPO UnitedHealthcare Group Medicare Advantage (PPO) 11 3 out of 5 stars Source: Avalere Health analysis of CMS Medicare Advantage/Part D ct and Data. Monthly by ct/plan/state/, March Available at: Reports/MCRAdvPartDEnrolData/Downloads/CPSC 2012_03.zip.