NAIC MCAS 2024 Grade A 0 states

PacificSource Health Plans

PacificSource Health Plans: 0 justified complaints across 0 states (NAIC MCAS 2024). Reputation grade A.

A

Reputation grade A (composite score 97.7) — A=Excellent, F=Failing. Based on NAIC complaint ratios and CMS denial data.

AAA
Reputation grade A (composite score 97.7) — A=Excellent, F=Failing. Based on NAIC complaint ratios and CMS denial data.

Excellent — very few complaints relative to peers

What This Grade Means for You

PacificSource Health Plans has significantly fewer complaints than the industry average when adjusted for its market size. Consumers who choose this insurer can generally expect responsive service and fair claims handling. This grade reflects a strong track record across all lines of business where PacificSource Health Plans operates.

PacificSource Health Plans's composite score of 97.7 is derived from complaint ratios, claim denial rates, and operational data across 0 states. Scores above 70 indicate above-average consumer issues.

Data note: This data reflects complaints filed with state insurance departments and regulatory filings. A high complaint ratio does not necessarily indicate illegal behavior. Large insurers receive more complaints by volume; complaint ratios normalize by premium size. Always verify coverage decisions with your insurer or a licensed agent. This page is informational and does not constitute financial, legal, or insurance advice.

PacificSource Health Plans appears in PlainInsurer's regulatory database with 0 justified complaints on file across 0 states . The company's composite score of 97.7 translates to a reputation grade of A — this score combines NAIC complaint ratios, available CMS claim denial data, and Medicare Advantage prior authorization metrics where applicable. Lower composite scores indicate fewer consumer problems relative to company size; higher scores indicate more.

Looking at business mix, PacificSource Health Plans does not have a detailed line-of-business breakdown available in the current NAIC filings. A normalized complaint score is not yet available for this insurer. On the health side, the insurer's denial score of 97.7 comes from CMS Transparency in Coverage PY2025 filings, which disclose claim approval and denial rates at the plan level.

For consumers evaluating PacificSource Health Plans, the practical implication is this: complaint ratio and denial data give a comparative view of how this insurer treats policyholders relative to peers, but they cannot predict your individual claim experience. The current A grade suggests fewer consumer problems than at most insurers of similar size, which is a positive signal — though coverage terms, price, and state-specific licensing still matter for any purchase decision. This page is not financial, legal, or insurance advice — verify all coverage terms with a licensed agent and consult your state's Department of Insurance for dispute or complaint procedures.

Total Complaints
0
0 states
Complaint Score N/A
Denial Score 97.7% Industry avg: 17%
Composite Score
97.7
Higher = more complaints

Complaint Score

N/A of 100

Normalized by premium volume across 0 states

Claim Denial Score

97.7 of 100

From CMS Transparency in Coverage PY2025

States Active

0 states

Consumer Risk Level 97.7%
National median

Composite score of 97.7 — lower is better

Source: NAIC Consumer Information Source (CIS) + CMS Medicare Advantage Star Ratings Insurer complaint counts and ratios for PacificSource Health Plans across all reported lines of business and states · 2023 NAIC CIS aggregates state-DOI consumer complaints; complaint ratios normalize against premium volume so absolute counts and ratios can diverge. Reputation grade derived from PlainInsurer methodology applied to NAIC data.

Understanding Your Rights

If you have a dispute with PacificSource Health Plans or any insurer, you have the right to file a complaint with your state's insurance commissioner. State regulators investigate consumer complaints, mediate disputes, and can take enforcement action against companies that violate insurance laws.

The NAIC's complaint filing page provides direct links to every state insurance department. Complaints can typically be filed online and are tracked as part of the public record that informs the complaint ratios shown on this page.

The data presented here covers all lines of business — auto, home, health, and life insurance. Complaint ratios are normalized by premium volume so that larger companies are not penalized simply for writing more policies.

Frequently Asked Questions

What does PacificSource Health Plans's A grade mean?
PacificSource Health Plans received a grade of A, which means "Excellent — very few complaints relative to peers." This grade is calculated from the company's NAIC complaint ratio (normalized by premium volume), CMS claim denial rates where available, and Medicare Advantage prior authorization data. A higher grade indicates fewer consumer problems relative to the size of the insurer.
How many complaints does PacificSource Health Plans have?
PacificSource Health Plans has 0 total complaints on record across 0 states, based on NAIC Market Conduct Annual Statement (MCAS) data. The raw complaint count alone does not tell the full story — larger insurers naturally receive more complaints. PlainInsurer uses complaint ratios (complaints per premium dollar) to compare companies fairly. Additionally, PacificSource Health Plans has CMS Transparency in Coverage data showing its claim denial practices.
How do I file a complaint against PacificSource Health Plans?
To file a complaint against PacificSource Health Plans, contact your state's Department of Insurance. Every state has an insurance commissioner's office that accepts consumer complaints — you can typically file online, by phone, or by mail. The National Association of Insurance Commissioners (NAIC) also provides a central complaint portal at naic.org. Document your policy number, claim number, dates of communication, and the specific issue before filing. Your state regulator can investigate and mediate disputes between you and PacificSource Health Plans.
Is PacificSource Health Plans a good insurance company?
Whether PacificSource Health Plans is a good choice depends on your coverage needs, state, and budget. PlainInsurer gives PacificSource Health Plans a A grade based on complaint ratios and denial data. The above-average composite score suggests more consumer issues than typical insurers — compare alternatives in your state. Always compare quotes from multiple carriers and check complaint data for your specific state and line of coverage.
What types of insurance does PacificSource Health Plans offer?
Detailed line-of-business data is not currently available for PacificSource Health Plans. The company is licensed in 0 states. Contact PacificSource Health Plans directly or check your state's Department of Insurance for available coverage types.
How does PacificSource Health Plans compare to other insurers?
PacificSource Health Plans's complaint data can be compared against other insurers using PlainInsurer's complaint ratio rankings. With a A grade, PacificSource Health Plans ranks better than the industry average for consumer complaints. To compare specific lines of coverage, visit the line-of-business rankings. For state-level comparisons, check the state pages where PacificSource Health Plans operates.

Compare PacificSource Health Plans Against Another Insurer

See a side-by-side complaint ratio and denial rate comparison.

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Data: NAIC MCAS 2024 industry scorecards · CMS Transparency in Coverage PUF PY2025 · CMS Medicare Advantage analysis (CMS OIG OEI-09-22-00380, KFF 2023). Not affiliated with NAIC or CMS.
All federal data sources used on this page

Related to PacificSource Health Plans

Primary data: NAIC Market Conduct Annual Statement (MCAS) 2024. Medicare Advantage figures: CMS Office of Inspector General audit OEI-09-22-00380 and KFF 2023 Medicare Advantage analysis. Methodology and computation by PlainInsurer Editorial — see methodology.