Contract
H4005

Triple-S Advantage · 2027 Star Ratings

TRIPLE S ADVANTAGE, INC. · Local CCP

Parent: Guidewell Mutual Holding Corporation

Summary ratings

Overall
4.5
2026: 3.5+1.0
Part C · health plan
4.5
2026: 3.5+1.0
Part D · drug plan
5.0
2026: 4.5+0.5

2027 footprint

Members, Sep 2026
5,890
2027 plans
1
Open to all ($0 premium)
1 (1)
Counties
78
Special needs plans
None
Drug coverage
Yes
PR

Domain stars

Domain20272026Change
HD1Staying Healthy: Screenings, Tests and Vaccines4.03.0+1.0
HD2Managing Chronic (Long Term) Conditions4.03.0+1.0
HD3Member Experience with Health Plan4.03.0+1.0
HD4Member Complaints and Changes in the Health Plan's Performance5.04.0+1.0
HD5Health Plan Customer ServiceNot enough data availableNot enough data available—
DD1Drug Plan Customer Service5.04.0+1.0
DD2Member Complaints and Changes in the Drug Plan's Performance5.04.0+1.0
DD3Member Experience with the Drug Plan5.05.0±0
DD4Drug Safety and Accuracy of Drug Pricing3.04.0−1.0

Part C measures · health plan

Measure2027 result2027 starsvs 2026
C01Breast Cancer Screening80%4.0±0
C02Colorectal Cancer Screening80%4.0new spec
C03Annual Flu Vaccine63%3.0+2
C04Improving or Maintaining Physical Health72%3.0−1
C05Improving or Maintaining Mental Health87%5.0+2
C06Monitoring Physical Activity63%5.0+1
C07Special Needs Plan (SNP) Care ManagementPlan not required to report measure—
C08Care for Older Adults – Medication ReviewPlan not required to report measure—
C09Care for Older Adults - Functional Status AssessmentPlan not required to report measure—
C10Osteoporosis Management in Women who had a FractureNot enough data available—
C11Diabetes Care – Eye Exam90%5.0±0
C12Diabetes Care – Blood Sugar Controlled91%4.0+1
C13Kidney Health Evaluation for Patients with Diabetes73%4.0+1
C14Controlling High Blood Pressure91%5.0±0
C15Reducing the Risk of Falling64%3.0−1
C16Improving Bladder Control54%5.0+2
C17Plan All-Cause Readmissions12%2.0±0
C18Statin Therapy for Patients with Cardiovascular Disease86%3.0±0
C19Transitions of Care65%3.0+1
C20Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions59%2.0±0
C21Getting Needed Care792.0±0
C22Getting Appointments and Care Quickly802.0+1
C23Customer Service914.0+1
C24Rating of Health Care Quality915.0±0
C25Rating of Health Plan915.0±0
C26Care Coordination863.0+1
C27Complaints about the Health Plan0.045.0±0
C28Members Choosing to Leave the Plan4%5.0±0
C29Health Plan Quality ImprovementMedicare shows only a Star Rating for this topic5.0+2
C30Plan Makes Timely Decisions about AppealsNot enough data available—
C31Reviewing Appeals DecisionsNot enough data available—
C32Call Center – Foreign Language Interpreter and TTY Availability98%4.0±0

Part D measures · drug plan

Measure2027 result2027 starsvs 2026
D01Call Center – Foreign Language Interpreter and TTY Availability100%5.0+1
D02Complaints about the Drug Plan0.045.0±0
D03Members Choosing to Leave the Plan4%5.0±0
D04Drug Plan Quality ImprovementMedicare shows only a Star Rating for this topic4.0+1
D05Rating of Drug Plan915.0±0
D06Getting Needed Prescription Drugs914.0−1
D07MPF Price Accuracy1005.0±0
D08Medication Adherence for Diabetes Medications89%3.0±0
D09Medication Adherence for Hypertension (RAS antagonists)90%4.0+1
D10Medication Adherence for Cholesterol (Statins)84%2.0±0
D11Statin Use in Persons with Diabetes (SUPD)89%3.0−1
D12Concurrent Use of Opioids and Benzodiazepines (COB)14%3.0—
D13Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)7%4.0—

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