Didn't spend a lot of time on the site and wasn't able to make much sense of their rating system. It almost looks like they rate more based on lifestyle considerations than health conditions. I would expect those counties with a high percent of seniors to have higher rates. Not sure how to determine that. I would also expect factors like obesity, smoking and drinking, exercise and some others to have an impact. California compares favorably in most categories but still has higher premiums than most. California also has fewer seniors in the counties I checked. For the most part, it looks like Californians have healthier lifestyles. So based on my quick look it would appear that cost of doing business might be one of the overriding factor.