Managed Care Industry ESG Material Mapping

HC-MC-240a.1Medical Loss Ratio (MLR)

HC-MC-240a.2Total amount of rebates accrued and paid due to non-compliance with the Patient Protection and Affordable Care Act for Medical Loss Ratio (MLR)

HC-MC-240a.3Percentage of proposed rate increases receiving “not unreasonable” designation from Health and Human Services (HHS) review or state review

HC-MC-230a.1Description of policies and practices to secure customers’ protected health information (PHI) records and other personally identifiable information (PII)

HC-MC-230a.2(1) Number of data breaches, (2) percentage involving (a) personally identifiable information (PII) only and (b) protected health information (PHI), (3) number of customers affected in each category, (a) PII only and (b) PHI

HC-MC-230a.3Total amount of monetary losses as a result of legal proceedings associated with data security and privacy

HC-MC-260a.1Percentage of enrollees in wellness programs by type (1) diet and nutrition, (2) exercise, (3) stress management, (4) mental health, (5) smoking or alcohol cessation, or (6) other

HC-MC-260a.3Number of customers receiving care from Accountable Care Organizations or enrolled in Patient-Centered Medical Home programs

HC-MC-250a.1Average Medicare Advantage plan rating for each of the following plan types (1) HMO, (2) local PPO, (3) regional PPO, (4) PFFS, and (5) SNP

HC-MC-250a.2Enrollee retention rate by plan type, including (1) HMO, (2) local PPO, (3) regional PPO, (4) PFFS, and (5) SNP

HC-MC-250a.3Percentage of claims denied that were appealed by customers and ultimately reversed

HC-MC-250a.4Plan enrollee grievance rate