Executive Summary

In California, most private health coverage plans are regulated by one of two regulators. California’s Department of Managed Health Care (DMHC) licenses most fully-insured health maintenance organization (HMO) plans in California, including most Covered California plans, and many private individual, small, and large group plans. The DMHC also regulates Blue Cross and Blue Shield fully-insured preferred provider organization (PPO) products in the state. The California Department of Insurance (CDI) regulates most fully-insured PPO products in California, other than the Blue Shield and Blue Cross PPOs regulated by DMHC, which includes some Covered California plans as well as other private individual market, small-group, and large-group plans. Both regulators have instructed their health plans to allow enrollees to access services by telehealth during the COVID-19 emergency in California. Their guidance is described in more detail in this fact sheet.