Insurer profile · NAIC + CMS
Oscar Insurance Company
Oscar Insurance Company's complaint record, claim-denial rate and reputation grade, drawn from published NAIC complaint data and CMS Transparency in Coverage.
- F
- Reputation grade
- 29.8%
- Claims denied
- 8
- States (CMS data)
The verdict
Oscar Insurance Company earns a F reputation grade - a significantly worse record than peers, according to CMS Transparency in Coverage filings, 29.8% of its marketplace claims were denied across 8 states.
- F
- reputation grade
- 29.8%
- claims denied (CMS)
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 →NAIC CIS filing desk
NAIC NAIC F · 16.2
GRADE-F · INDEX-UNK · DENIAL-HOT · RANK-UNK · PHOTO-SOLO · LINES-0 · BOOK-MID
- GRADE-F F · 16.2
- INDEX-UNK Index blank
- DENIAL-HOT 29.8% denied
- RANK-UNK Rank pending
- PHOTO-SOLO No peer gap
- LINES-0 No lines
- BOOK-MID 3/7 fields
Instrument codes from this carrier’s NAIC Consumer Information Source filing: grade band, complaint index, CMS denial band, corpus rank, photo-finish peer, line book, and field completeness. Not an official NAIC rating.
Oscar Insurance Company - claim denial rate by state
- IA
IA: 34.4% denied (225,302 of 655,352 claims)
34 % of claims denied
- KS
KS: 32.4% denied (123,477 of 380,721 claims)
32 % of claims denied
- MI
MI: 32.4% denied (20,731 of 63,957 claims)
32 % of claims denied
- TX
TX: 29.8% denied (1,050,350 of 3,521,352 claims)
30 % of claims denied
- MO
MO: 28.3% denied (189,300 of 668,238 claims)
28 % of claims denied
- TN
TN: 28.0% denied (251,752 of 898,028 claims)
28 % of claims denied
- OK
OK: 25.6% denied (95,687 of 374,292 claims)
26 % of claims denied
- NE
NE: 24.9% denied (12,230 of 49,177 claims)
25 % of claims denied
What this shows Denial rates vary by state plan and network. Across 8 reporting states, Oscar Insurance Company denied 29.8% of marketplace claims on average.
Among states with enough reported claims to compare, Oscar Insurance Company's highest marketplace denial rates in this dataset are in Iowa (34.4%), Kansas (32.4%), and Michigan (32.4%). State-level rates reflect the specific plans Oscar Insurance Company offers there and how each state's regulators and utilization-review rules apply, not necessarily the carrier's national practice.
CMS marketplace filing
Reported appeal outcomes for Oscar Insurance Company
The largest state samples are Texas (38,325 filed, 9,061 overturned), Tennessee (9,553 filed, 3,657 overturned), and Iowa (7,284 filed, 2,167 overturned); 8 states contribute to the profile total.
CMS reports an overturn outcome for 70,947 of these 70,947 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 NAIC filing desk shows for Oscar Insurance Company
Oscar Insurance Company's filing desk summarizes the NAIC complaint record and any CMS marketplace denial data on file.
See where Oscar Insurance Company sits against every reporting carrier in the claim-denial rate ranking. Appeal notes for Oscar Insurance.
Nationwide insurers with similar scores or complaint volume
Two corpus-wide peer sets for Oscar Insurance Company: nearest national-scale carriers by composite score and by NAIC complaint volume. These are cross-market neighborhoods, not the corporate-family list or same-grade chips above.
Similar composite score
Nearest carriers by composite score (16.2 here). Floored at 50+ complaints and 5+ states.
Questions about Oscar Insurance Company
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Source: NAIC published complaint index + CMS Transparency in Coverage PY2026 Complaint index, reputation grade and per-state claim denial rates for Oscar Insurance Company · 2024
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The full PlainInsurer extract, covering every insurer including Oscar Insurance Company, 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.