Insurer profile · NAIC + CMS

Oscar Health Plan, Inc.

Oscar Health Plan, Inc.'s complaint record, claim-denial rate and reputation grade, drawn from published NAIC complaint data and CMS Transparency in Coverage.

F
Reputation grade
34.6%
Claims denied
1
States (CMS data)

The verdict

Oscar Health Plan, Inc. earns a F reputation grade - a significantly worse record than peers, according to CMS Transparency in Coverage filings, 34.6% of its marketplace claims were denied across 1 state.

F
reputation grade
34.6%
claims denied (CMS)

Reputation grade

F

Peer-relative, A–F

NAIC complaint index

N/A

1.0 = market average; lower is better

Claim denial rate

34.6%

CMS, 1 states

FFF
Reputation grade F (composite score 9.7) - A=Excellent, F=Failing. Based on NAIC complaint ratios and CMS denial data.

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 →

CMS marketplace filing

Reported appeal outcomes for Oscar Health Plan, Inc.

4,434
appeals filed
918
overturned (reported outcomes)
20.7%
of appeals with a reported outcome

The reported appeals on this profile come from Arizona (4,434 filed, 918 overturned).

CMS reports an overturn outcome for 4,434 of these 4,434 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 Oscar Health Plan, Inc.

Oscar Health Plan, Inc. carries a F reputation grade in PlainInsurer's dataset, with a composite score of 9.7 (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 Oscar Health Plan, Inc. denied 34.6% of marketplace claims across 1 reporting state - an elevated rate that warrants checking the plan's appeal-success record before enrolling.

See where Oscar Health Plan, Inc. 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.

Other F-graded carriers in PlainInsurer's dataset include Kemper Auto and Root Insurance, and the closest overall composite score to Oscar Health Plan, Inc.'s 9.7 belongs to Oscar Health Plan of North Carolina, Inc (10.3), each rescaled across the measures that carrier reports.

Other F-graded insurers

Carriers with the same peer-relative reputation grade

Insurer Grade
Kemper Auto F
Root Insurance F
Dairyland Insurance (Sentry) F
Hippo Insurance F
Esurance (Allstate) F

Closest composite score to Oscar Health Plan, Inc.

Carriers with the nearest overall composite score (9.7)

Insurer Composite score
Oscar Health Plan of North Carolina, Inc 10.3
Community First Insurance Plans 8.1
AmeriHealth Caritas North Carolina, Inc. 11.4
UnitedHealthcare of Ohio, Inc. 7.6
Cigna HealthCare of Illinois, Inc. 11.9

Questions about Oscar Health Plan, Inc.

What does Oscar Health Plan, Inc.'s grade mean?
Oscar Health Plan, Inc. received a grade of F, indicating a significantly worse record than peers.
How many complaints does Oscar Health Plan, Inc. have?
NAIC's public bulk data does not include a complaint-volume estimate for Oscar Health Plan, Inc. - 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 Oscar Health Plan, Inc.?
File against Oscar Health Plan, Inc. through your state's Department of Insurance or the NAIC consumer portal at naic.org.
Is Oscar Health Plan, Inc. a good insurance company?
PlainInsurer's F grade for Oscar Health Plan, Inc. reflects a significantly worse record than peers relative to peers on published complaint and denial data.
What types of insurance does Oscar Health Plan, Inc. offer?
Detailed line-of-business data isn't currently available for Oscar Health Plan, Inc.. 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 Oscar Health Plan, Inc. · 2024

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The full PlainInsurer extract, covering every insurer including Oscar Health Plan, Inc., is available as CSV and JSON. Underlying federal data is public domain; see our methodology for the compilation and grading method.

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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.