Insurer profile · Centene · NAIC + CMS
Ambetter of North Carolina Inc.
Ambetter of North Carolina Inc.'s complaint record, claim-denial rate and reputation grade, drawn from published NAIC complaint data and CMS Transparency in Coverage.
- C
- Reputation grade
- 21.0%
- Claims denied
- 1
- States (CMS data)
The verdict
Ambetter of North Carolina Inc. earns a C reputation grade - a record near the industry median, according to CMS Transparency in Coverage filings, 21.0% of its marketplace claims were denied across 1 state.
- C
- reputation grade
- 21.0%
- claims denied (CMS)
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 →NAIC CIS filing desk
NAIC NAIC C · 49.7
GRADE-C · INDEX-UNK · DENIAL-ELEV · RANK-UNK · PHOTO-SOLO · LINES-0 · BOOK-MID
- GRADE-C C · 49.7
- INDEX-UNK Index blank
- DENIAL-ELEV 21.0% denied
- RANK-UNK Rank pending
- PHOTO-SOLO No peer gap
- LINES-0 No lines
- BOOK-MID 3/7 fields
Instrument codes from this carrier’s NAIC Consumer Information Source filing: grade band, complaint index, CMS denial band, corpus rank, photo-finish peer, line book, and field completeness. Not an official NAIC rating.
CMS marketplace filing
Reported appeal outcomes for Ambetter of North Carolina Inc.
The reported appeals on this profile come from North Carolina (1,238 filed, outcome not reported).
CMS reports an overturn outcome for 0 of these 1,238 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 NAIC filing desk shows for Ambetter of North Carolina Inc.
Ambetter of North Carolina Inc.'s filing desk summarizes the NAIC complaint record and any CMS marketplace denial data on file.
See where Ambetter of North Carolina Inc. sits against every reporting carrier in the claim-denial rate ranking. Appeal notes for Ambetter of North Carolina.
Nationwide insurers with similar scores or complaint volume
Two corpus-wide peer sets for Ambetter of North Carolina Inc.: nearest national-scale carriers by composite score and by NAIC complaint volume. These are cross-market neighborhoods, not the corporate-family list or same-grade chips above.
Similar composite score
Nearest carriers by composite score (49.7 here). Floored at 50+ complaints and 5+ states.
Ambetter of North Carolina Inc. is part of the Centene family, alongside Ambetter (Centene), Centene Corporation (WellCare), Ambetter of Magnolia Inc., Ambetter Health of Louisiana, Inc., 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.
Questions about Ambetter of North Carolina Inc.
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Source: NAIC published complaint index + CMS Transparency in Coverage PY2026 Complaint index, reputation grade and per-state claim denial rates for Ambetter of North Carolina Inc. · 2024
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The full PlainInsurer extract, covering every insurer including Ambetter of North Carolina Inc., 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 PY2026. 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.