Reputation grade
D
Peer-relative, A–F
Insurer profile · CVS Health · NAIC + CMS
Aetna Health Inc. (a PA corp.)
Aetna Health Inc. (a PA corp.)'s complaint record, claim-denial rate and reputation grade, drawn from published NAIC complaint data and CMS Transparency in Coverage.
- D
- Reputation grade
- 18.6%
- Claims denied
- 3
- States (CMS data)
The verdict
Aetna Health Inc. (a PA corp.) earns a D reputation grade - a worse-than-average record versus peers, according to CMS Transparency in Coverage filings, 18.6% of its marketplace claims were denied across 3 states.
- D
- reputation grade
- 18.6%
- claims denied (CMS)
NAIC complaint index
N/A
1.0 = market average; lower is better
Claim denial rate
18.6%
CMS, 3 states
Graded on 1 of 3 measures: claim denials. The score is rescaled across the measures available, so it is not directly comparable with a carrier graded on more of them.
How we calculated this grade →These claim figures are from plan year 2025, not 2026. Aetna Health Inc. (a PA corp.) does not appear in the CMS Transparency in Coverage file for plan year 2026, so the most recent figures CMS has published for this insurer are the ones shown here. Illinois carriers left that file when the state moved to its own health-insurance marketplace for 2026; other insurers stop appearing when they exit the individual marketplace. The numbers below are unchanged and still describe the period they cover. They are simply not current-year, and are excluded from every national and state average on this site. See our methodology.
Aetna Health Inc. (a PA corp.) - claim denial rate by state
- DE
DE: 31.3% denied (22,590 of 72,242 claims)
31 % of claims denied
- IL
IL: 24.4% denied (45,153 of 185,335 claims)
24 % of claims denied
- NC
NC: 18.3% denied (1,693,812 of 9,237,233 claims)
18 % of claims denied
What this shows Denial rates vary by state plan and network. Across 3 reporting states, Aetna Health Inc. (a PA corp.) denied 18.6% of marketplace claims on average.
Among states with enough reported claims to compare, Aetna Health Inc. (a PA corp.)'s highest marketplace denial rates in this dataset are in Delaware (31.3%), Illinois (24.4%), and North Carolina (18.3%). State-level rates reflect the specific plans Aetna Health Inc. (a PA corp.) offers there and how each state's regulators and utilization-review rules apply, not necessarily the carrier's national practice.
CMS marketplace filing
Reported appeal outcomes for Aetna Health Inc. (a PA corp.)
711
appeals filed
321
overturned (reported outcomes)
45.1%
of appeals with a reported outcome
The largest state samples are North Carolina (658 filed, 295 overturned) and Illinois (53 filed, 26 overturned); 2 states contribute to the profile total.
CMS reports an overturn outcome for 711 of these 711 filed appeals; missing outcomes are excluded from the percentage. These filing totals are not a prediction for an individual appeal. View the CMS source ↗
What the data shows for Aetna Health Inc. (a PA corp.)
Aetna Health Inc. (a PA corp.), part of CVS Health, carries a D reputation grade in PlainInsurer's dataset, with a composite score of 35.1 (higher means more consumer friction relative to size). It does not yet carry enough NAIC complaint history for a normalized complaint index.
On the claims side, CMS Transparency-in-Coverage filings show Aetna Health Inc. (a PA corp.) denied 18.6% of marketplace claims across 3 reporting states - a moderate rate that still varies by plan design and network.
See where Aetna Health Inc. (a PA corp.) sits against every reporting carrier in the claim-denial rate ranking.
Source: NAIC Consumer Information Source complaint data (2024). Source: CMS Transparency in Coverage PUF (PY2025), cms.gov.
Aggregates only, not advice. Full terms on the disclaimer.
Other D-graded carriers in PlainInsurer's dataset include Globe Life and Primerica Life Insurance, and the closest overall composite score to Aetna Health Inc. (a PA corp.)'s 35.1 belongs to Health Options, Inc. (35.1), each rescaled across the measures that carrier reports.
Aetna Health Inc. (a PA corp.) is part of the CVS Health family, alongside Aetna (CVS Health), Aetna Health Inc. (a FL corp.), Banner Health and Aetna Health Plan Inc., Aetna Life Insurance Company, and 1 more in PlainInsurer's dataset -- a shared parent doesn't mean shared performance, so check each subsidiary's own record before assuming they behave alike.
Other D-graded insurers
Carriers with the same peer-relative reputation grade
| Insurer | Grade |
|---|---|
| Globe Life | D |
| Primerica Life Insurance | D |
| Liberty Mutual Homeowners | D |
| GEICO | D |
| Farmers Insurance | D |
Closest composite score to Aetna Health Inc. (a PA corp.)
Carriers with the nearest overall composite score (35.1)
| Insurer | Composite score |
|---|---|
| Health Options, Inc. | 35.1 |
| Molina Healthcare of Texas, Inc. | 34.1 |
| Molina Healthcare of Wisconsin, Inc. | 36.2 |
| Community Health Choice, Inc. | 33.5 |
| Cigna HealthCare of Texas, Inc. | 36.8 |
Questions about Aetna Health Inc. (a PA corp.)
What does Aetna Health Inc. (a PA corp.)'s grade mean?
Aetna Health Inc. (a PA corp.) received a grade of D, indicating a worse-than-average record versus peers.
How many complaints does Aetna Health Inc. (a PA corp.) have?
NAIC's public bulk data does not include a complaint-volume estimate for Aetna Health Inc. (a PA corp.) - the carrier may be new, small, or file under a parent company. Absence of an estimate is missing data, not evidence of zero complaints.
How do I file a complaint against Aetna Health Inc. (a PA corp.)?
File against Aetna Health Inc. (a PA corp.) through your state's Department of Insurance or the NAIC consumer portal at naic.org.
Is Aetna Health Inc. (a PA corp.) a good insurance company?
PlainInsurer's D grade for Aetna Health Inc. (a PA corp.) reflects a worse-than-average record versus peers relative to peers on published complaint and denial data.
What types of insurance does Aetna Health Inc. (a PA corp.) offer?
Detailed line-of-business data isn't currently available for Aetna Health Inc. (a PA corp.). The carrier is licensed in 0 states.
Source: NAIC published complaint index + CMS Transparency in Coverage PY2025 Complaint index, reputation grade and per-state claim denial rates for Aetna Health Inc. (a PA corp.) · 2024
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Download the data behind this page
The full PlainInsurer extract, covering every insurer including Aetna Health Inc. (a PA corp.), is available as CSV and JSON. Underlying federal data is public domain; see our methodology for the compilation and grading method.
Data: NAIC published complaint index (2024) · CMS Transparency in Coverage PUF PY2025. Not affiliated with NAIC or CMS.
Every figure on PlainInsurer comes directly from NAIC MCAS and CMS Transparency in Coverage data; no editor types in numbers. See our editorial standards or methodology, or report an error. Data current as of 2026-08-11. Grades measure only the published complaint/denial data; we don't recommend any insurer or policy.