Avera Health Plans, Inc.

Avera Health Plans, Inc. appears in PlainInsurer's regulatory database with 0 justified complaints on file across 0 states . The company's composite score of 98.3 translates to a reputation grade of A — this score combines NAIC complaint ratios, available CMS claim denial data, and Medicare Advantage prior authorization metrics where applicable. Lower composite scores indicate fewer consumer problems relative to company size; higher scores indicate more.

Looking at business mix, Avera Health Plans, Inc. does not have a detailed line-of-business breakdown available in the current NAIC filings. A normalized complaint score is not yet available for this insurer. On the health side, the insurer's denial score of 98.3 comes from CMS Transparency in Coverage PY2025 filings, which disclose claim approval and denial rates at the plan level.

For consumers evaluating Avera Health Plans, Inc., the practical implication is this: complaint ratio and denial data give a comparative view of how this insurer treats policyholders relative to peers, but they cannot predict your individual claim experience. The current A grade suggests fewer consumer problems than at most insurers of similar size, which is a positive signal — though coverage terms, price, and state-specific licensing still matter for any purchase decision. This page is not financial, legal, or insurance advice — verify all coverage terms with a licensed agent and consult your state's Department of Insurance for dispute or complaint procedures.