For the seventh straight year, the Kaiser Foundation Health Plan earned the highest rating for customer satisfaction in California, according to an annual survey issued Monday by market research firm J.D. Power.

"Kaiser set the curve in the state of California," said Rick Johnson, head of J.D. Power's health care evaluation practice.

Kaiser scored 756 points out of a possible 1,000, followed by Cigna and UnitedHealthcare with 674 and 667 points, respectively. The average score for health plans in California was 680 points.

J.D. Power, which is best known for its automotive market research, has measured customer satisfaction with their health insurance for the past eight years.

"J.D. Power thinks that health care is a critical issue," Johnson said. "Now more than ever, consumers need to be heard when it comes to their health care."

The plans are evaluated for six key factors, including benefits and coverage; provider choice; information and communication; claims processing; cost; and customer service.

Nationally, all plans scored an average of 669 points for overall customer satisfaction.

Johnson said Kaiser received high marks for "helping people understand their coverage," as well as its ability to convey information that helps members manage their health.

Judy Coffey, Kaiser Permanente's senior vice president and area manager in Sonoma and Marin counties, said Kaiser's large network of physicians and integrated health care delivery model are among the reasons for its high scores in California.

"These J.D. Power satisfaction ratings provide important information to people in our communities, and we're proud to be recognized by our members and patients," Coffey said Monday.

For the first time this year, J.D. Power examined customer satisfaction with the cost of their health plan.

The study found that 55 percent of members nationally said the price of their health insurance increased in 2013. Also, nearly half of all health plan members in the country said their plan does not offer the most common types of health and wellness discount/incentive programs.

Members wait eight days, on average, for communication from their provider after they've submitted pre-approval requests, Johnson said. Health plans must figure out ways to more quickly communicate pre-approvals and costs, he said.

Johnson said the goal of the study is to "help bring the voice of the consumer to the different health plans so they can really better understand how to serve their members and potentially communicate in a way that they can get even more members."

The survey, conducted in December and January, is based on responses from more than 34,000 members of 136 commercial health plans across 18 regions in the United States.