Insurer profile · NAIC + CMS

Providence Health Plan

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

A
Reputation grade
8.3%
Claims denied
1
States (CMS data)

The verdict

Providence Health Plan earns a A reputation grade - far fewer consumer problems than peers of its size, according to CMS Transparency in Coverage filings, 8.3% of its marketplace claims were denied across 1 state.

A
reputation grade
8.3%
claims denied (CMS)
AAA
Reputation grade A (composite score 95.1) - 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 →

NAIC CIS filing desk

NAIC NAIC A · 95.1

GRADE-A · INDEX-UNK · DENIAL-MID · RANK-UNK · PHOTO-SOLO · LINES-0 · BOOK-MID

  • GRADE-A A · 95.1
  • INDEX-UNK Index blank
  • DENIAL-MID 8.3% 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.

CMS marketplace filing

Reported appeal outcomes for Providence Health Plan

301
appeals filed
217
overturned (reported outcomes)
72.1%
of appeals with a reported outcome

The reported appeals on this profile come from Oregon (301 filed, 217 overturned).

CMS reports an overturn outcome for 301 of these 301 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 Providence Health Plan

Providence Health Plan's filing desk summarizes the NAIC complaint record and any CMS marketplace denial data on file.

See where Providence Health Plan sits against every reporting carrier in the claim-denial rate ranking. Appeal notes for Providence Health Plan.

Nationwide insurers with similar scores or complaint volume

Two corpus-wide peer sets for Providence Health Plan: 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 (95.1 here). Floored at 50+ complaints and 5+ states.

Aggregates only, not advice. Full terms on the disclaimer.

Questions about Providence Health Plan

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

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The full PlainInsurer extract, covering every insurer including Providence Health Plan, 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.