Reputation grade
B
Peer-relative, A–F
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.
- B
- Reputation grade
- 15.3%
- Claims denied
- 1
- States (CMS data)
The verdict
Ambetter of North Carolina Inc. earns a B reputation grade — a better-than-average record versus peers, CMS records show 15.3% of its marketplace claims denied across 1 state.
- B
- reputation grade
- 15.3%
- claims denied (CMS)
Grades are peer-relative within PlainInsurer's dataset. A high complaint ratio is not proof of wrongdoing — larger insurers draw more complaints by volume, which the index normalises.
NAIC complaint data Grade B CMS denial data · 1 states 0 states
NAIC complaint index
N/A
1.0 = market average; lower is better
Claim denial rate
15.3%
CMS, 1 states
Reputation grade B (composite score 72.3) — A=Excellent, F=Failing. Based on NAIC complaint ratios and CMS denial data.
What the data shows for Ambetter of North Carolina Inc.
Ambetter of North Carolina Inc., part of Centene, carries a B reputation grade in PlainInsurer's dataset, with a composite score of 72.3 (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 Ambetter of North Carolina Inc. denied 15.3% of marketplace claims across 1 reporting state — a moderate rate that still varies by plan design and network.
The practical implication: complaint and denial data give a comparative view of how Ambetter of North Carolina Inc. treats policyholders relative to peers, but they cannot predict your individual claim experience. Compare the grade against named alternatives in your state, and weigh price, coverage terms and state licensing before any purchase. Source: NAIC Consumer Information Source complaint data (2024). Source: CMS Transparency in Coverage PUF (PY2025), cms.gov.
Use this data wisely. Complaint and denial figures reflect regulatory filings, not individual claim outcomes. A high complaint ratio is not proof of illegal behaviour. This page is informational and is not financial, legal, or insurance advice — verify coverage decisions with your insurer or a licensed agent.
Frequently asked questions
What does Ambetter of North Carolina Inc.'s grade mean?
Ambetter of North Carolina Inc. received a grade of B, indicating a better-than-average record versus peers. PlainInsurer grades insurers on a curve relative to the ~200 carriers in our dataset, using the NAIC complaint index (normalized by premium volume), CMS claim denial rates, and Medicare Advantage prior-authorization data where available.
How many complaints does Ambetter of North Carolina Inc. have?
Ambetter of North Carolina Inc. has 0 confirmed complaints on record across 0 states, based on published NAIC complaint data. Raw counts favour smaller insurers — PlainInsurer uses the complaint index (complaints relative to premium volume, where 1.0 is the market average) to compare carriers fairly.
How do I file a complaint against Ambetter of North Carolina Inc.?
Contact your state's Department of Insurance — every state has an insurance commissioner's office that accepts consumer complaints online, by phone, or by mail. The NAIC also runs a central complaint portal at naic.org. Document your policy number, claim number, dates, and the specific issue before filing.
Is Ambetter of North Carolina Inc. a good insurance company?
It depends on your coverage needs, state, and budget. PlainInsurer's B grade reflects a better-than-average record versus peers relative to peers. Always compare quotes from multiple carriers and check complaint data for your specific state and line of coverage.
What types of insurance does Ambetter of North Carolina Inc. offer?
Detailed line-of-business data isn't currently available for Ambetter of North Carolina Inc.. The carrier is licensed in 0 states.
What to do with this
How to act on Ambetter of North Carolina Inc.'s complaint and denial record.
- Compare this carrier side-by-side with another before you buy. Compare insurers
- See how every insurer in your state ranks on complaints and denials. Browse by state
- Denied a claim? Learn the internal and external appeal process. Appeal a denial
Complaint ratios normalise by premium volume so larger carriers are not penalised for writing more policies.
Source: NAIC published complaint index + CMS Transparency in Coverage PY2025 Complaint index, reputation grade and per-state claim denial rates for Ambetter of North Carolina Inc. · 2024 NAIC complaint index aggregates state-DOI consumer complaints, normalized against premium volume (1.0 = market average). Denial rates from CMS Transparency in Coverage PY2025. Reputation grade is PlainInsurer's peer-relative methodology applied to this public data.
Data: NAIC published complaint index (2024) · CMS Transparency in Coverage PUF PY2025. Not affiliated with NAIC or CMS. Read our methodology.