Reputation grade
F
Peer-relative, A–F
Insurer profile · NAIC + CMS
Oscar Health Plan of North Carolina, Inc
Oscar Health Plan of North Carolina, Inc's complaint record, claim-denial rate and reputation grade, drawn from published NAIC complaint data and CMS Transparency in Coverage.
- F
- Reputation grade
- 31.2%
- Claims denied
- 1
- States (CMS data)
The verdict
Oscar Health Plan of North Carolina, Inc earns a F reputation grade - a significantly worse record than peers, according to CMS Transparency in Coverage filings, 31.2% of its marketplace claims were denied across 1 state.
- F
- reputation grade
- 31.2%
- claims denied (CMS)
NAIC complaint index
N/A
1.0 = market average; lower is better
Claim denial rate
31.2%
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 →CMS marketplace filing
Reported appeal outcomes for Oscar Health Plan of North Carolina, Inc
875
appeals filed
320
overturned (reported outcomes)
36.6%
of appeals with a reported outcome
The reported appeals on this profile come from North Carolina (875 filed, 320 overturned).
CMS reports an overturn outcome for 875 of these 875 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 of North Carolina, Inc
Oscar Health Plan of North Carolina, Inc carries a F reputation grade in PlainInsurer's dataset, with a composite score of 10.3 (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 Oscar Health Plan of North Carolina, Inc denied 31.2% 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 of North Carolina, 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 of North Carolina, Inc's 10.3 belongs to Oscar Health Plan, Inc. (9.7), 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 of North Carolina, Inc
Carriers with the nearest overall composite score (10.3)
| Insurer | Composite score |
|---|---|
| Oscar Health Plan, Inc. | 9.7 |
| AmeriHealth Caritas North Carolina, Inc. | 11.4 |
| Cigna HealthCare of Illinois, Inc. | 11.9 |
| Banner Health and Aetna Health Plan Inc. | 12.4 |
| Community First Insurance Plans | 8.1 |
Questions about Oscar Health Plan of North Carolina, Inc
What does Oscar Health Plan of North Carolina, Inc's grade mean?
Oscar Health Plan of North Carolina, Inc received a grade of F, indicating a significantly worse record than peers.
How many complaints does Oscar Health Plan of North Carolina, Inc have?
NAIC's public bulk data does not include a complaint-volume estimate for Oscar Health Plan of North Carolina, 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 of North Carolina, Inc?
File against Oscar Health Plan of North Carolina, Inc through your state's Department of Insurance or the NAIC consumer portal at naic.org.
Is Oscar Health Plan of North Carolina, Inc a good insurance company?
PlainInsurer's F grade for Oscar Health Plan of North Carolina, 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 of North Carolina, Inc offer?
Detailed line-of-business data isn't currently available for Oscar Health Plan of North Carolina, 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 of North Carolina, Inc · 2024
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The full PlainInsurer extract, covering every insurer including Oscar Health Plan of North Carolina, Inc, 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.