HMO/HMOPOS · observed 2026 → 2026 · 75 months of CPSC history · 13 active CY 2026 plans.
| Plan | Category | Premium | MOOP | ★ | Counties | Enrollment |
|---|---|---|---|---|---|---|
| HealthSun MediSun Full Dual Extra (HMO D-SNP) H5431/026 · Dual-Eligible | SNP | $0 | $3,450 | 4.5 | 2 | 22,065 |
| HealthSun VitalCare (HMO C-SNP) H5431/021 · Chronic or Disabling Condition | SNP | $0 | $1,900 | 4.5 | 2 | 15,101 |
| HealthSun MediSun Extra (HMO D-SNP) H5431/019 · Dual-Eligible | SNP | $0 | $3,450 | 4.5 | 2 | 14,028 |
| HealthSun HealthAdvantage Plus (HMO) H5431/017 | MA-PD | $0 | $3,450 | 4.5 | 1 | 7,129 |
| HealthSun HealthAdvantage Plus (HMO) H5431/018 | MA-PD | $0 | $3,450 | 4.5 | 1 | 2,536 |
| HealthSun HealthAdvantage Plan (HMO) H5431/001 | MA-PD | $0 | $1,500 | 4.5 | 1 | 1,937 |
| HealthSun HealthAdvantage Plan (HMO) H5431/012 | MA-PD | $0 | $2,500 | 4.5 | 1 | 1,290 |
| HealthSun HealthAdvantage Plus (HMO) H5431/020 | MA-PD | $0 | $3,450 | 4.5 | 1 | 802 |
| HealthSun VitalCare (HMO C-SNP) H5431/022 · Chronic or Disabling Condition | SNP | $0 | $2,450 | 4.5 | 1 | 629 |
| HealthSun MediSun Full Dual Plus (HMO D-SNP) H5431/025 · Dual-Eligible | SNP | $0 | $3,450 | 4.5 | 1 | 611 |
| HealthSun MediSun Plus (HMO D-SNP) H5431/016 · Dual-Eligible | SNP | $0 | $3,450 | 4.5 | 1 | 581 |
| HealthSun MediMax (HMO) H5431/006 | MA-PD | $0 | $3,450 | 4.5 | 2 | 391 |
| HealthSun HealthAdvantage Plan (HMO) H5431/013 | MA-PD | $0 | $3,450 | 4.5 | 1 | 331 |
| ID | Measure | ★ |
|---|---|---|
| C01 | Breast Cancer Screening | 5.0 |
| C02 | Colorectal Cancer Screening | 5.0 |
| C03 | Annual Flu Vaccine | 1.0 |
| C04 | Improving or Maintaining Physical Health | — |
| C05 | Improving or Maintaining Mental Health | — |
| C06 | Monitoring Physical Activity | 5.0 |
| C07 | Special Needs Plan (SNP) Care Management | 5.0 |
| C08 | Care for Older Adults – Medication Review | 5.0 |
| C09 | Care for Older Adults – Pain Assessment | 4.0 |
| C10 | Osteoporosis Management in Women who had a Fracture | 3.0 |
| C11 | Diabetes Care – Eye Exam | 5.0 |
| C12 | Diabetes Care – Blood Sugar Controlled | 3.0 |
| C13 | Kidney Health Evaluation for Patients with Diabetes | 5.0 |
| C14 | Controlling High Blood Pressure | 5.0 |
| C15 | Reducing the Risk of Falling | 5.0 |
| C16 | Improving Bladder Control | — |
| C17 | Medication Reconciliation Post-Discharge | 4.0 |
| C18 | Plan All-Cause Readmissions | 4.0 |
| C19 | Statin Therapy for Patients with Cardiovascular Disease | 5.0 |
| C20 | Transitions of Care | 2.0 |
| C21 | Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions | 4.0 |
| C22 | Getting Needed Care | 4.0 |
| C23 | Getting Appointments and Care Quickly | 4.0 |
| C24 | Customer Service | 4.0 |
| C25 | Rating of Health Care Quality | 5.0 |
| C26 | Rating of Health Plan | 5.0 |
| C27 | Care Coordination | 4.0 |
| C28 | Complaints about the Health Plan | 4.0 |
| C29 | Members Choosing to Leave the Plan | 4.0 |
| C30 | Health Plan Quality Improvement | 2.0 |
| C31 | Plan Makes Timely Decisions about Appeals | 5.0 |
| C32 | Reviewing Appeals Decisions | 5.0 |
| C33 | Call Center – Foreign Language Interpreter and TTY Availability | 5.0 |
| D01 | Call Center – Foreign Language Interpreter and TTY Availability | 5.0 |
| D02 | Complaints about the Drug Plan | 4.0 |
| D03 | Members Choosing to Leave the Plan | 4.0 |
| D04 | Drug Plan Quality Improvement | 1.0 |
| D05 | Rating of Drug Plan | 5.0 |
| D06 | Getting Needed Prescription Drugs | 4.0 |
| D07 | MPF Price Accuracy | 5.0 |
| D08 | Medication Adherence for Diabetes Medications | 4.0 |
| D09 | Medication Adherence for Hypertension (RAS antagonists) | 4.0 |
| D10 | Medication Adherence for Cholesterol (Statins) | 3.0 |
| D11 | MTM Program Completion Rate for CMR | 5.0 |
| D12 | Statin Use in Persons with Diabetes (SUPD) | 5.0 |