Reputation grade
A
Peer-relative, A–F
Insurer profile · NAIC + CMS
Sanford Health Plan
Sanford 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
- 6.6%
- Claims denied
- 2
- States (CMS data)
The verdict
Sanford Health Plan earns a A reputation grade - far fewer consumer problems than peers of its size, according to CMS Transparency in Coverage filings, 6.6% of its marketplace claims were denied across 2 states.
- A
- reputation grade
- 6.6%
- claims denied (CMS)
Grades are peer-relative within PlainInsurer's dataset. A high complaint ratio is not proof of wrongdoing, larger insurers draw more complaints by volume, which the index normalises.
NAIC complaint index
N/A
1.0 = market average; lower is better
Claim denial rate
6.6%
CMS, 2 states
Reputation grade A (composite score 96.6) - A=Excellent, F=Failing. Based on NAIC complaint ratios and CMS denial data.
Other A-graded carriers in PlainInsurer's dataset include Lincoln National Life and Principal Financial, and the closest overall composite score to Sanford Health Plan's 96.6 belongs to HealthPartners Insurance Company (95.5).
Other A-graded insurers
Carriers with the same peer-relative reputation grade
| Insurer | Grade |
|---|---|
| Lincoln National Life | A |
| Principal Financial | A |
| TIAA Life | A |
| Mutual of Omaha | A |
| USAA Homeowners | A |
Closest composite score to Sanford Health Plan
Carriers with the nearest overall composite score (96.6)
| Insurer | Composite score |
|---|---|
| HealthPartners Insurance Company | 95.5 |
| PacificSource Health Plans | 97.7 |
| Kaiser Foundation Health Plan, Inc. | 94.9 |
| Avera Health Plans, Inc. | 98.3 |
| Priority Health | 94.4 |
Among states with enough reported claims to compare, Sanford Health Plan's highest marketplace denial rates in this dataset are in North Dakota (6.6%) and South Dakota (6.5%). State-level rates reflect the specific plans Sanford Health Plan 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 Sanford Health Plan
393
appeals filed
255
overturned (reported outcomes)
64.9%
of appeals with a reported outcome
The largest state samples are South Dakota (258 filed, 169 overturned) and North Dakota (135 filed, 86 overturned); 2 states contribute to the profile total.
CMS reports an overturn outcome for 393 of these 393 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 Sanford Health Plan
Sanford Health Plan carries a A reputation grade in PlainInsurer's dataset, with a composite score of 96.6 (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 Sanford Health Plan denied 6.6% of marketplace claims across 2 reporting states - a moderate rate that still varies by plan design and network.
In short: complaint and denial data show how Sanford Health Plan compares to peers, not what your own claim experience will be. Weigh price, coverage terms and state licensing before any purchase. Source: NAIC Consumer Information Source complaint data (2024). Source: CMS Transparency in Coverage PUF (PY2025), cms.gov.
Use this data wisely. Complaint and denial figures reflect regulatory filings, not individual claim outcomes. A high complaint ratio is not proof of illegal behaviour. This page is informational and is not financial, legal, or insurance advice, verify coverage decisions with your insurer or a licensed agent.
What to do with this
How to act on Sanford Health Plan's complaint and denial record.
- Compare this carrier side-by-side with another before you buy. Compare insurers
- See how every insurer in your state ranks on complaints and denials. Browse by state
- Denied a claim? Learn the internal and external appeal process. Appeal a denial
Complaint ratios normalise by premium volume so larger carriers are not penalised for writing more policies.
Frequently asked questions
What does Sanford Health Plan's grade mean?
Sanford Health Plan received a grade of A, indicating far fewer consumer problems than peers of its size. PlainInsurer grades insurers on a curve relative to the ~200 carriers in our dataset, using the NAIC complaint index (normalized by premium volume), CMS claim denial rates, and Medicare Advantage prior-authorization data where available.
How many complaints does Sanford Health Plan have?
NAIC's public bulk data does not include a complaint-volume estimate for Sanford 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 Sanford Health Plan?
Contact your state's Department of Insurance, most accept complaints online, by phone, or by mail. The NAIC also runs a central portal at naic.org. Document your policy number, claim number, dates, and the issue before filing.
Is Sanford Health Plan a good insurance company?
It depends on your coverage needs, state, and budget. PlainInsurer's A grade reflects far fewer consumer problems than peers of its size relative to peers. Always compare quotes from multiple carriers and check complaint data for your specific state and line of coverage.
What types of insurance does Sanford Health Plan offer?
Detailed line-of-business data isn't currently available for Sanford Health Plan. The carrier is licensed in 0 states.
Source: NAIC published complaint index + CMS Transparency in Coverage PY2025 Complaint index, reputation grade and per-state claim denial rates for Sanford Health Plan · 2024 NAIC complaint index aggregates state-DOI consumer complaints, normalized against premium volume (1.0 = market average). Denial rates from CMS Transparency in Coverage PY2025. Reputation grade is PlainInsurer's peer-relative methodology applied to this public data.
Download the data behind this page
The full PlainInsurer extract, covering every insurer including Sanford Health Plan, 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 PY2025. 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 2026-07-28. Grades measure only the published complaint/denial data; we don't recommend any insurer or policy.