Medi-Cal Managed Care Enrollment/Disenrollment Reports

The following reports provide information pertaining to enrollments and disenrollments in the counties serviced by Health Care Options (HCO).  These reports are currently used by the Department of Health Care Services, Health Plans, and other interested parties.

Due to a new system implementation, the reports dated July 2009 as well as all future reports, will have an updated format. If you have any questions, please email Health Care Options Branch at hcoreports@dhcs.ca.gov.

• Monthly Enrollment Reports (COPS-11)
  These reports provide a summary of all medical/dental enrollments processed for a month.
• Default Report (COPS-12)
  These reports display defaults for each county, zip-code, and language for a month.
• Monthly Disenrollment Reports (COPS-17)
  These reports display totals of all accepted medical and dental disenrollments by reason, county and plan for a month.
• Approved Emergency Disenrollments by Reason and Plan (COPS-19)
  These reports display the approved emergency disenrollments by reason and by plan. Beginning February 2009 Exemption Summary Reports have been separated into individual reports (COPS-20).
• Exception to Plan Enrollment Summary Report (COPS-20)
  The purpose of this report is to provide a summary of exception volume over the reporting period.  Data is grouped by reason, county, and plan.  Prior to February 2009 this report was combined with the Approved Emergency Disenrollments by Reason and Plan (COPS-19). 
• HCO Monthly Plan Enrollment Status Reports (COPS-25) 
  These reports compare the current enrollment levels for each health plan, to the enrollment levels from the previous month, and to its capitated enrollment ceiling.
• Exception Production Activity Report (COPS-37)
  The purpose of the Exception Production Activity Report is to describe the volume and time disposition of contact Exception types.