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Health Plan Licensing

All licensed health care service plans must maintain compliance with all applicable managed care laws. Below, you’ll find valuable information about how to obtain and maintain a license to operate a health care service plan under the Knox-Keene Act.

Obtain A License

The sections of the law below pertain to health care service plan licensing requirements and will need to be reviewed by the applicant before a pre-filing conference is scheduled.

Relevant Laws

  • Knox-Keene Act (KKA) - Article 3. Licensing and Fees, sections 1349 to 1356.2
  • California Code of Regulations (CCR) - 1300.51 to 1300.52.4
  • Section 1345(f)(1). This is the definition of a health care service plan, the legal entity that DMHC is authorized to license and regulate. 
  • Application for License - 1300.51

See Laws and regulations relating to health care service plans in California.

Resources

For more information please contact the Licensing Division at 916-324-9046.

Licensing Contacts for Plans

The section below contains contact information specific to a health care service plan maintaining its license in California. This list should not be used to contact the plan for questions regarding a plan's services or benefits.

Electronic Fund Transfer

The Electronic Fund Transfer (EFT) program is a method that allows health plans to make an Automated Clearing House (ACH) Debit transaction to pay DMHC invoices. This program allows plans to electronically transfer funds from its bank account to the DMHC bank account. The plan will maintain total control to initiate a transaction by specifying the amount and date of its withdrawal.

If your health plan administrator has authorized you to make payments for your health plan, log into the Web Portal to make payments.

If you need assistance, contact us at (916) 445-2282 between the hours of 8:00 a.m. to 4:30 p.m. (Pacific Standard Time, Monday through Friday, excluding holidays).

Licensing Contacts for Plans

The section below contains contact information specific to a health care service plan maintaining its license in California. This list should not be used to contact the plan for questions regarding a plan's services or benefits.

Licensing Contact Information by Plan

Pending Knox-Keene Applications
View pending applications and the breakdown of active health plans.