1. Harvard Pilgrim Health Care (HMO/POS)

States: MA, ME

www.harvardpilgrim.org

Now in its sixth year, the "NCQA's Health Insurance Plan Rankings" is based on combined scores for health plans in Healthcare Effectiveness Data and Information Set, commonly called HEDIS; the Consumer Assessment of Healthcare Providers and Systems, or CAHPS, and NCQA Accreditation standards scores. Consumers and employers assess plans prior to annual enrollment periods.

The report is published annually and ranks health plans in three categories: Medicare, Medicaid and Private (Commercial).

Out of 390 private health insurance plans, Harvard Pilgrim ranked No. 1, with near perfect ratings for prevention services.

Nonprofit Harvard Pilgrim Health Care's full-service health benefits company was founded by physicians more than 40 years ago. The company's service model touts direct contact with members across three states to explain and discuss benefits.

"Harvard Pilgrim continues to top the nation's best health plan rankings because we make health care work better," says Eric Schultz, president and CEO. "We do it by continuously delivering superior customer service to our members while addressing health care affordability and the total cost of care - it's the heart and soul of our company and is true to our mission of better health for the communities we serve."

The health plan was also recognized this year as the highest-ranked health insurance plan for overall member satisfaction in the New England region according to the J.D. Power and Associates 2011 Member Health Insurance Plan Study.

2. Tufts Associated Health Maintenance Organization (HMO/POS)

States: MA, NH, RI

www.tufts-healthplan.com

Headquartered in Massachusetts, Tufts Health Plan was founded in 1979 as a nonprofit health maintenance organization (HMO). The plan has New England's highest enrollment in consumer-driven health plans, according to its website, and has had the highest enrollment in the state in Medicare Advantage plans.

This is the eighth consecutive year that Tufts Health Plan has been ranked among the top health plans by NCQA.

Its Medicare Advantage HMO product, Tufts Medicare Preferred, was ranked eighth in the nation, maintaining its place among the top 10 highest ranked Medicare plans in the nation.

Since 1999, these products have achieved “Excellent” accreditation status from NCQA, which is the highest possible achievement for consumer protection, quality improvement and clinical effectiveness.

For a list of all private health insurance plan rankings click here.

3. Capital Health Plan (HMO)

States: FL

www.capitalhealth.com

Created in 1982, nonprofit Capital Health Plan is a local HMO focused solely on serving the area surrounding Tallahassee, providing coverage to 118,000 members. Its Medicare Advantage is ranked highest in the nation according to NCQA’s Health Insurance Plan Rankings 2010-2011.

“It is a great honor to be ranked among the top plans in the country,” said Dr. Nancy Van Vessem, Capital Health Plan chief medical officer. “We are constantly working to improve the quality of our programs and CHP is proud to be recognized by the NCQA.”

Capital Health Plan is the only plan in Florida that has earned high rankings consecutively for the past six years, according to John Hogan, CEO of Capital Health Plan.

For a list of all private health insurance plan rankings click here.

4. Tufts Health Plan (PPO)

States: MA, NH, RI

www.tuftshealthplan.com

This is the first year that the NCQA has included preferred provider organizations (PPOs) in the rankings, instead of only HMOs, so the pool included almost twice as many plans as last year.

In January 2009, Tufts Health Plan entered the Rhode Island health insurance market with its PPO suite of plans. The PPO plan offers a network of 25,000 providers and 90 hospitals.

For a list of all private health insurance plan rankings click here.

5. Harvard Pilgrim Health Care of New England (HMO/POS)

States: NH

www.harvardpilgrim.org

Harvard Pilgrim's HMO/POS in Massachusetts and Maine was ranked No. 1 in this year's NCQA Health Insurance Plan Rankings.

For a list of all private health insurance plan rankings click here.

6. Kaiser Foundation Health Plan of Colorado (HMO)

States: CO

www.kp.org

Kaiser also nabbed the top four Medicare plans in the country this year. Top honors went to Kaiser Permanente Northern California, Kaiser Permanente Southern California, Kaiser Permanente Colorado and Kaiser Permanente Northwest.

The six largest Kaiser Permanente plans rated in the top 10 percent for all commercial plans in the country. The two smaller plans rated in the top 20 percent.

"We are proud and deeply honored by being recognized among the top Commercial, Medicare and Medicaid health plans this year," said Jed Weissberg, MD, senior vice president, Hospitals, Quality and Care Delivery Excellence, Kaiser Permanente. "Our high standing in this year's report underscores Kaiser Permanente's deep commitment for sustained improvement; the dedicated work of our physicians, nurses and care teams; and the value of our cutting-edge electronic health record in helping to support the relentless drive toward the highest quality health care possible."

For a list of all private health insurance plan rankings click here.

7. Group Health Cooperative of South Central Wisconson (HMO)

States: WI

www.ghcscw.com

Group Health Cooperative of South Central Wisconsin was recognized for having the highest ranking in quality among all managed health care organizations in Wisconsin.

2011 marks the sixth consecutive year that GHC-SCW was listed among the nation’s top 10 health plans, as well as the sixth consecutive year listed as Wisconsin’s top health plan

According to its website, Group Health Cooperative of South Central Wisconsin (GHC-SCW) is a nonprofit managed health care organization that provides the entire spectrum of health care services, including insurance, primary care and specialty care.

For a list of all private health insurance plan rankings click here.

The heart of GHC-SCW is in its nationally-ranked Primary Care Clinics, which integrate with the insurance arm of the organization to provide quality care with value-added services. GHC-SCW is also paired with several networks, which allow our members to access a variety of primary and specialty care options, depending on the insurance plan the member is enrolled in and the network he or she selects.

8. Geisinger Health Plan (HMO/POS)

States: PA

www.thehealthplan.com

With headquarters in Danville, Pa., Geisinger Health Plan has more than 270,000 members, and serves the health-care needs of members in 43 counties throughout central and northeastern Pennsylvania.

Started in 1985, the plan has steadily evolved into one of the nation's largest rural HMOs. According to its website, Geisinger Health Plans's roots evolved from a rural, prepaid health plan offered as a pilot program in 1972 to Geisinger Medical Center employees and residents of the five counties that surrounded the hospital. The five counties included Montour, Columbia, Northumberland, Snyder and Union.

In 1985, the Health Plan received its Certificate of Authority to operate an HMO under the authority of the Pennsylvania Health Maintenance Act of 1973.

For a list of all private health insurance plan rankings click here.

9. Harvard Pilgrim Health Care (PPO)

States: MA

www.harvardpilgrim.org

Out of 390 private health insurance plans, Harvard Pilgrim ranked No. 1, with near perfect ratings for prevention services. The "NCQA's Health Insurance Plan Rankings" report is published annually and ranks health plans in three categories: Medicare, Medicaid and Private (Commercial).

For a list of all private health insurance plan rankings click here.

10. Health New England (HMO/POS)

States: MA

www.healthnewengland.com

Health New England is a managed care organization serving western Massachusetts since 1985.The plan serves more than 100,000 members and 5,000 employers.

The HMO/POS also received the highest rating in customer service in 2008 from the National Committee for Quality Assurance among 160 commercial HMO/POS health plans surveyed in the United States.

For a list of all private health insurance plan rankings click here.

Instant Insights /

Top 10 private health plans

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