Insurer profile · NAIC + CMS

CareSource West Virginia Co.

CareSource West Virginia Co.'s complaint record, claim-denial rate and reputation grade, drawn from published NAIC complaint data and CMS Transparency in Coverage.

F
Reputation grade
30.5%
Claims denied
1
States (CMS data)

The verdict

CareSource West Virginia Co. earns a F reputation grade — a significantly worse record than peers, CMS records show 30.5% of its marketplace claims denied across 1 state.

F
reputation grade
30.5%
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 F CMS denial data · 1 states 0 states

Reputation grade

F

Peer-relative, A–F

NAIC complaint index

N/A

1.0 = market average; lower is better

Claim denial rate

30.5%

CMS, 1 states

Reputation grade F (composite score 16.4) — A=Excellent, F=Failing. Based on NAIC complaint ratios and CMS denial data.

FFF
Reputation grade F (composite score 16.4) — A=Excellent, F=Failing. Based on NAIC complaint ratios and CMS denial data.

What the data shows for CareSource West Virginia Co.

CareSource West Virginia Co. carries a F reputation grade in PlainInsurer's dataset, with a composite score of 16.4 (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 CareSource West Virginia Co. denied 30.5% of marketplace claims across 1 reporting state — an elevated rate that warrants checking the plan's appeal-success record before enrolling.

The practical implication: complaint and denial data give a comparative view of how CareSource West Virginia Co. 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 CareSource West Virginia Co.'s grade mean?
CareSource West Virginia Co. received a grade of F, indicating a significantly worse record than 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 CareSource West Virginia Co. have?
CareSource West Virginia Co. 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 CareSource West Virginia Co.?
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 CareSource West Virginia Co. a good insurance company?
It depends on your coverage needs, state, and budget. PlainInsurer's F grade reflects a significantly worse record than 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 CareSource West Virginia Co. offer?
Detailed line-of-business data isn't currently available for CareSource West Virginia Co.. The carrier is licensed in 0 states.

What to do with this

How to act on CareSource West Virginia Co.'s complaint and denial record.

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 CareSource West Virginia Co. · 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.