Reputation grade
B
Peer-relative, A–F
Insurer profile · NAIC + CMS
Medica Community Health Plan
Medica Community Health Plan's complaint record, claim-denial rate and reputation grade, drawn from published NAIC complaint data and CMS Transparency in Coverage.
- B
- Reputation grade
- 18.5%
- Claims denied
- 1
- States (CMS data)
The verdict
Medica Community Health Plan earns a B reputation grade - a better-than-average record versus peers, according to CMS Transparency in Coverage filings, 18.5% of its marketplace claims were denied across 1 state.
- B
- reputation grade
- 18.5%
- claims denied (CMS)
NAIC complaint index
N/A
1.0 = market average; lower is better
Claim denial rate
18.5%
CMS, 1 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 →Other B-graded carriers in PlainInsurer's dataset include UnitedHealthcare and Travelers Insurance, and the closest overall composite score to Medica Community Health Plan's 64.9 belongs to Progressive Insurance (64.4), each rescaled across the measures that carrier reports.
Other B-graded insurers
Carriers with the same peer-relative reputation grade
| Insurer | Grade |
|---|---|
| UnitedHealthcare | B |
| Travelers Insurance | B |
| Humana Health | B |
| John Hancock Life | B |
| Openly Insurance | B |
Closest composite score to Medica Community Health Plan
Carriers with the nearest overall composite score (64.9)
| Insurer | Composite score |
|---|---|
| Progressive Insurance | 64.4 |
| MetLife | 64.4 |
| Florida Health Care Plan, Inc. | 65.4 |
| Network Health Plan | 65.9 |
CMS marketplace filing
Reported appeal outcomes for Medica Community Health Plan
227
appeals filed
124
overturned (reported outcomes)
54.6%
of appeals with a reported outcome
The reported appeals on this profile come from Wisconsin (227 filed, 124 overturned).
CMS reports an overturn outcome for 227 of these 227 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 Medica Community Health Plan
Medica Community Health Plan carries a B reputation grade in PlainInsurer's dataset, with a composite score of 64.9 (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 Medica Community Health Plan denied 18.5% of marketplace claims across 1 reporting state - a moderate rate that still varies by plan design and network.
See where Medica Community Health Plan 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 (PY2026), cms.gov.
Aggregates only, not advice. Full terms on the disclaimer.
Questions about Medica Community Health Plan
What does Medica Community Health Plan's grade mean?
Medica Community Health Plan received a grade of B, indicating a better-than-average record versus peers.
How many complaints does Medica Community Health Plan have?
NAIC's public bulk data does not include a complaint-volume estimate for Medica Community Health Plan - 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 Medica Community Health Plan?
File against Medica Community Health Plan through your state's Department of Insurance or the NAIC consumer portal at naic.org.
Is Medica Community Health Plan a good insurance company?
PlainInsurer's B grade for Medica Community Health Plan reflects a better-than-average record versus peers relative to peers on published complaint and denial data.
What types of insurance does Medica Community Health Plan offer?
Detailed line-of-business data isn't currently available for Medica Community Health Plan. The carrier is licensed in 0 states.
Source: NAIC published complaint index + CMS Transparency in Coverage PY2026 Complaint index, reputation grade and per-state claim denial rates for Medica Community Health Plan · 2024
Share, download, and related pages for Medica Community Health Plan
Download the data behind this page
The full PlainInsurer extract, covering every insurer including Medica Community Health Plan, 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.