Reputation grade
C
Peer-relative, A–F
Insurer profile · NAIC + CMS
Sunshine State Health Plan
Sunshine State Health Plan's complaint record, claim-denial rate and reputation grade, drawn from published NAIC complaint data and CMS Transparency in Coverage.
- C
- Reputation grade
- 19.7%
- Claims denied
- 1
- States (CMS data)
The verdict
Sunshine State Health Plan earns a C reputation grade - a record near the industry median, according to CMS Transparency in Coverage filings, 19.7% of its marketplace claims were denied across 1 state.
- C
- reputation grade
- 19.7%
- claims denied (CMS)
NAIC complaint index
N/A
1.0 = market average; lower is better
Claim denial rate
19.7%
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 →Other C-graded carriers in PlainInsurer's dataset include Liberty Mutual and Aetna (CVS Health), and the closest overall composite score to Sunshine State Health Plan's 58.4 belongs to The Hartford Auto (58.0), each rescaled across the measures that carrier reports.
Other C-graded insurers
Carriers with the same peer-relative reputation grade
| Insurer | Grade |
|---|---|
| Liberty Mutual | C |
| Aetna (CVS Health) | C |
| Allstate Property | C |
| AIG Homeowners | C |
| Allstate Insurance | C |
Closest composite score to Sunshine State Health Plan
Carriers with the nearest overall composite score (58.4)
| Insurer | Composite score |
|---|---|
| The Hartford Auto | 58.0 |
| Highmark BCBSD Inc. | 58.9 |
| University of Utah Health Insurance Plans | 57.8 |
| Blue Cross Blue Shield of Texas | 59.5 |
| SelectHealth, Inc. | 57.3 |
CMS marketplace filing
Reported appeal outcomes for Sunshine State Health Plan
437
appeals filed
0
overturned (reported outcomes)
N/A
of appeals with a reported outcome
The reported appeals on this profile come from Florida (437 filed, outcome not reported).
CMS reports an overturn outcome for 0 of these 437 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 Sunshine State Health Plan
Sunshine State Health Plan carries a C reputation grade in PlainInsurer's dataset, with a composite score of 58.4 (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 Sunshine State Health Plan denied 19.7% of marketplace claims across 1 reporting state - a moderate rate that still varies by plan design and network.
See where Sunshine State Health Plan 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.
Questions about Sunshine State Health Plan
What does Sunshine State Health Plan's grade mean?
Sunshine State Health Plan received a grade of C, indicating a record near the industry median.
How many complaints does Sunshine State Health Plan have?
NAIC's public bulk data does not include a complaint-volume estimate for Sunshine State 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 Sunshine State Health Plan?
File against Sunshine State Health Plan through your state's Department of Insurance or the NAIC consumer portal at naic.org.
Is Sunshine State Health Plan a good insurance company?
PlainInsurer's C grade for Sunshine State Health Plan reflects a record near the industry median relative to peers on published complaint and denial data.
What types of insurance does Sunshine State Health Plan offer?
Detailed line-of-business data isn't currently available for Sunshine State 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 Sunshine State Health Plan · 2024
Share, download, and related pages for Sunshine State Health Plan
Download the data behind this page
The full PlainInsurer extract, covering every insurer including Sunshine State 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 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.