Coverage gaps · as of August 2026

Where this insurance registry is thin

According to the NAIC complaint index and CMS marketplace claim-denial public files, these are the coverage unevennesses in the PlainInsurer corpus, counts and rates only, not recommendations.

215
Insurers graded
67%
With CMS denial rows
20
States with no denial rows
8.4%
With MA prior-auth rows

Registry read

144 of 215 graded insurers carry CMS claim-denial rows (67%); 20 states have no marketplace denial rows at all in this extract; 30 states clear the map floor of 50,000 claims.

215
NAIC complaint-index carriers
144
CMS denial carriers
18
MA prior-auth carriers

Coverage by data layer

Each layer is a distinct public source. Percentages are of graded insurers in this database. Derivation in plain terms: methodology.

Layer Insurers Share of graded set
NAIC complaint index 215 100%
CMS claim-denial data 144 67%
Per-state / per-line breakdown 72 33.5%
Medicare Advantage prior-auth 18 8.4%

States with no CMS denial rows

These 20 jurisdictions have zero rows in the CMS marketplace denial extract loaded here. Auto-expenditure maps may still cover them via NAIC auto files.

CA, CO, CT, GA, ID, KY, ME, MD, MA, MN, NV, NJ, NM, NY, PA, RI, VT, VA, WA, DC.

National average auto expenditure (NAIC): $1191/year · highest state average: Florida ($1864). See auto rates.

Extremes in the denial extract

  • Highest average marketplace denial rate among qualifying states: Alaska at 32.0%.
  • Lowest average marketplace denial rate among qualifying states: South Dakota at 7.9%.
  • Highest denial rate among large marketplace health insurers in this extract: CareSource North Carolina Co. at 37.0%.

Full national figures: statistics · rankings · research · compare.

Every figure on PlainInsurer comes directly from NAIC MCAS and CMS Transparency in Coverage data; no editor types in numbers. Coverage counts are DISTINCT company_id rows joined to each public source table; state denial gaps use DISTINCT state from denial_rates with no claim floor. See our editorial standards or methodology, or report an error. Data current as of August 2026. Grades measure only the published complaint/denial data; we don't recommend any insurer or policy.