Insurer profile · UPMC · NAIC + CMS
UPMC Health Plan
UPMC 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
- 0.71
- Complaint index
- 1
- States active
The verdict
UPMC Health Plan earns a A reputation grade - far fewer consumer problems than peers of its size, according to the NAIC's published complaint index, its ratio runs 0.71, below the 1.0 market average.
- A
- reputation grade
- 0.71
- NAIC complaint index
Graded on 2 of 3 measures: NAIC complaints, prior authorisation. 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 40401 A · 77.6
GRADE-A · INDEX-LOW · DENIAL-NONE · RANK-UPPER · PHOTO-FINISH · LINES-1 · BOOK-RICH
- GRADE-A A · 77.6
- INDEX-LOW 0.71
- DENIAL-NONE No CMS file
- RANK-UPPER #18/72
- PHOTO-FINISH Independence Blue Cr… · B
- LINES-1 1 line
- BOOK-RICH 6/7 fields
Nearest complaint-index peer: Independence Blue Cross (±0.01 index pts)
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.
Complaint-index neighbourhood around UPMC Health Plan
Quietest and hottest poles plus nearest index peers, not a full NAIC corpus board reprint.
UPMC Health Plan - complaint index neighbourhood
- Northwestern Mutual… · quietest 0
Northwestern Mutual… · quietest
0 complaint index
- Chubb Property · near 1
Chubb Property · near
1 complaint index
- UPMC Health Plan · this carrier 1
UPMC Health Plan · this carrier
1 complaint index
- Independence Blue Cr… · near 1
Independence Blue Cr… · near
1 complaint index
- State Farm Fire & Ca… · near 1
State Farm Fire & Ca… · near
1 complaint index
- John Hancock Life · near 1
John Hancock Life · near
1 complaint index
- Gainsco Insurance · hottest
Gainsco Insurance · hottest
4 complaint index
What this shows According to PlainInsurer's dataset, UPMC Health Plan has a lower (better) NAIC complaint index than 75% of the 72 rated insurers it tracks and ranks #2 of 18 carriers by complaint ratio in Health Insurance (Individual).
Where UPMC Health Plan sits on complaints
- Best in data 0
Lowest complaint index in PlainInsurer's dataset: 0.23
0 complaint index
- Market avg 1
Market average complaint index = 1.0 (NAIC benchmark)
1 complaint index
- UPMC Health Plan 1
UPMC Health Plan: complaint index 0.71
1 complaint index
- Worst in data
Highest complaint index in PlainInsurer's dataset: 3.87
4 complaint index
What this shows UPMC Health Plan's complaint index of 0.71 is 29% below the 1.0 market average for a carrier of its size.
UPMC Health Plan vs. the full rated-insurer dataset
71% Among the most affordable more affordable than 75% of 72 rated insurers
Each bar is a band; taller bars hold more rated insurers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
Source NAIC published complaint index (2024) · 2024
Scale vs. complaint-adjusted score
Complaint record by line of business
| Line | Est. complaints | Complaint index | States active |
|---|---|---|---|
| Health Insurance (Individual) | ~98 | 0.71 | 1 |
Health insurance market share
National ranking by direct written premiums, NAIC 2024
What the NAIC filing desk shows for UPMC Health Plan
According to PlainInsurer's dataset, UPMC Health Plan has a lower (better) NAIC complaint index than 75% of the 72 rated insurers it tracks and ranks #2 of 18 carriers by complaint ratio in Health Insurance (Individual).
UPMC Health Plan is outside the CMS marketplace file, but the claim-denial rate ranking shows what that data reports for the carriers it does cover. How complaint indexes place UPMC Health Plan.
Nationwide insurers with similar scores or complaint volume
Two corpus-wide peer sets for UPMC 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 (77.6 here). Floored at 50+ complaints and 5+ states.
Similar complaint volume
Nearest carriers by NAIC complaint count (98 here). Deduped against the score peers so the two sets stay distinct.
Questions about UPMC Health Plan
What does UPMC Health Plan's grade mean?
How many complaints does UPMC Health Plan have?
How do I file a complaint against UPMC Health Plan?
Is UPMC Health Plan a good insurance company?
What types of insurance does UPMC Health Plan offer?
Verify UPMC Health Plan
UPMC Health Plan is filed with the NAIC under company number 40401. Search that number directly in the NAIC's own public consumer-information tool to cross-check this page against the primary source.
Verify on NAIC Consumer Information SourceSource: NAIC published complaint index data Complaint index, reputation grade for UPMC Health Plan · 2024
Share, download, and related pages for UPMC Health Plan
Download the data behind this page
The full PlainInsurer extract, covering every insurer including UPMC 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). 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.