Basic Service HMOs

Total Number of Complaints (Closed Cases)

Number of Justified Complaints

Enrollment (September 1999)

Ratio of Justified Complaints Per 10,000 Enrollees

1

Aetna U.S. Healthcare of North Texas, Inc.

166

78

121,557

6.42

2

Aetna U.S. Healthcare, Inc.

129

61

155,681

3.92

3

Amcare Health Plans of Texas, Inc.

22

15

8,234

18.22

4

Americaid Texas, Inc.

10

2

67,800

0.29

5

Amerihealth HMO of Texas, Inc.

40

27

0

NA

6

Amerihealth of Texas, Inc.

15

9

51,379

1.75

7

Amil International (Texas), Inc.

12

3

12,458

2.41

8

Cigna Healthcare of Texas, Inc.

232

86

563,468

1.53

9

Community First Health Plans, Inc.

6

4

32,761

1.22

10

Community Health Choice, Inc.

73

41

19,438

21.09

11

Comprehensive Health Services of Texas, Inc.

509

503

0

NA

12

Exclusive Healthcare, Inc.

10

4

0

NA

13

Harris Methodist Texas Health Plan, Inc.

283

121

312,676

3.87

14

Healthfirst HMO, Inc.

16

1

17,078

0.59

15

Healthsource North Texas, Inc.

7

4

0

NA

16

Humana Health Plan of Texas, Inc.

552

317

277,162

11.44

17

Kaiser Foundation Health Plan of Texas

38

22

0

NA

18

Memorial Sisters of Charity HMO, L.L.C.

85

54

94,123

5.74

19

Mercy Health Plans of Missouri, Inc.

2

1

7,459

1.34

20

Methodist Care, Inc.

22

12

55,609

2.16

21

Metrowest Health Plan, Inc.

1

1

1,390

7.19

22

Nylcare Health Plans of the Gulf Coast, Inc.

704

343

406,056

8.45

23

Nylcare Health Plans of the Southwest, Inc.

445

240

206,906

11.60

24

One Health Plan of Texas, Inc.

84

35

34,592

10.12

25

Pacificare of Texas, Inc.

725

415

181,044

22.92

26

PCA Health Plans of Texas, Inc.

369

261

94,703

27.56

27

Presbyterian Health Plan, Inc.

6

3

14,003

2.14

28

Prudential Health Care Plan, Inc.

550

314

540,751

5.81

29

Rio Grande HMO, Inc.

153

89

159,784

5.57

30

Scott and White Health Plan

20

3

150,354

0.20

31

Seton Health Plan, Inc.

4

3

8,380

3.58

32

SHA, L.L.C.

65

26

98,799

2.63

33

Texas Health Choice, L.C.

233

170

120,043

14.16

34

Unicare of Texas Health Plans, Inc.

4

1

0

NA

35

United Healthcare of Texas, Inc.

436

223

296,861

7.51

36

Universal Healthplan, Inc.

1

1

264

37.88

37

Wellcare Health Plans of Texas, L.L.C.

500

478

6,436

742.70

38

West Texas Health Plans, L.C.

6

4

17,941

2.23

Average for Basic Service HMOs

26.16

Single & Limited Service HMOs

Total Number of Complaints (Closed Cases)

Number of Justified Complaints

Enrollment (September 1999)

Justified Complaints Per 10,000 Enrollees

39

AECC Total Vision Health Plan of Texas, Inc.

2

1

407,935

0.02

40

Aetna U.S. Healthcare Dental Plan, Inc.

2

1

31,899

0.31

41

Alpha Dental Programs, Inc.

3

3

50,143

0.60

42

Cigna Dental Health of Texas, Inc.

10

6

296,977

0.20

43

Denticare, Inc.

3

2

133,992

0.15

44

ECCA Managed Vision Care, Inc.

1

1

273,303

0.04

45

Magellan Behavioral Health of Texas, Inc.

3

1

592,592

0.02

46

MNM-1997, Inc.

1

1

2,883

3.47

47

Nylcare Dental Plans of the Southwest, Inc.

6

2

36,749

0.54

48

Parliament Dental Plans, Inc.

2

1

16,079

0.62

49

Pearle Vision Managed Care - HMO of Texas, Inc.

3

3

217,850

0.14

50

Prudential Dental Maintenance Org., Inc.

38

17

536,649

0.32

51

Safeguard Health Plans, Inc.

15

8

224,946

0.36

52

Spectera Dental, Inc.

3

2

167,974

0.12

53

United Concordia Dental Plans of Texas, Inc.

1

1

0

NA

54

United Dental Care of Texas, Inc.

20

8

236,885

0.34

55

Value Behavioral Health of Texas, Inc.

2

1

5,500

1.82

Average for Single & Limited Service HMOS

0.53

Total for all HMOs

6,650

4,034

61%