Health Insurance (Individual) — Complaint Rankings

18 companies ranked by complaint ratio for health insurance (individual). Higher ratio = more complaints relative to industry average.

Complaint ratios from NAIC MCAS 2024. A high ratio does not necessarily indicate illegal behavior. This page is informational, not financial or insurance advice.

The health insurance (individual) segment tracked on PlainInsurer covers 18 companies reporting NAIC Market Conduct Annual Statement data for the 2024 reporting year. Across the ranked set, 2 companies earned a reputation grade of A (very few complaints relative to size), 6 landed in the B tier, and 1 carry an F grade (significantly above-average complaints). Health Insurance (Individual) complaint ratios differ from other insurance lines because individual health coverage complaints focus heavily on prior-authorization denials, network surprises, and claim payment timing.

Ranking by average complaint ratio — where lower is better — lets consumers see how each insurer performs relative to its peers in the same line, rather than comparing a national auto writer against a regional life insurer. The cleanest record in this table belongs to Kaiser Permanente (grade A), which logs the lowest complaint ratio among ranked health insurance (individual) writers. At the other end, Ambetter (Centene) (grade F) posts the highest complaint ratio in this line — not an accusation of wrongdoing, but a signal consumers should weigh when comparing quotes. Complaint ratios are normalized by premium volume so that larger insurers are not penalized for writing more policies; the ratio compares complaints received against the share of premiums each company wrote nationally.

Practical takeaway for shoppers: the health insurance (individual) ranking is one of several data points that should inform a purchase. It does not capture price, coverage breadth, discount eligibility, local agent quality, or financial strength (which A.M. Best and S&P rate separately). The rankings do show which insurers consistently generate more regulatory complaints per dollar of premium — a meaningful proxy for how disputes are handled when claims go wrong. For line-specific disputes, your state Department of Insurance accepts complaints directly; national context lives in the NAIC complaint database. This page is not financial, legal, or insurance advice — always verify current rates, coverage terms, and carrier availability directly before purchasing.

# Insurer Grade Avg Complaint Ratio States
1 Ambetter (Centene)
Centene
F
2.33 +133% vs. avg
25
2 Oscar Health
Oscar Health
D
2.14 +114% vs. avg
18
3 Centene Corporation (WellCare)
Centene
D
1.89 +89% vs. avg
29
4 Molina Healthcare
Molina Healthcare
C
1.67 +67% vs. avg
19
5 CareFirst BCBS
CareFirst
D
1.43 +43% vs. avg
3
6 Aetna (CVS Health)
CVS Health
C
1.31 +31% vs. avg
50
7 Florida Blue (BCBS FL)
Florida Blue
C
1.22 +22% vs. avg
1
8 BCBS of Texas
HCSC
C
1.14 +14% vs. avg
1
9 UnitedHealthcare
UnitedHealth Group
B
1.12 +12% vs. avg
50
10 BCBS of Illinois
HCSC
C
0.98 -2% vs. avg
1
11 Anthem / Elevance Health
Elevance Health
B
0.94 -6% vs. avg
14
12 Highmark Health
Highmark
B
0.89 -11% vs. avg
4
13 Humana Health
Humana
B
0.87 -13% vs. avg
48
14 Medica Health Plans
Medica
C
0.78 -22% vs. avg
3
15 Cigna Health
Cigna
B
0.76 -24% vs. avg
44
16 Independence Blue Cross
Independence Blue Cross
B
0.72 -28% vs. avg
1
17 UPMC Health Plan
UPMC
A
0.71 -29% vs. avg
1
18 Kaiser Permanente
Kaiser Foundation
A
0.43 -57% vs. avg
8
Data: NAIC MCAS 2024. Sorted by average complaint ratio (highest first).

Related to Health Insurance (Individual)

Primary data: NAIC Market Conduct Annual Statement (MCAS) 2024 — line-of-business complaint ratios. Complaint ratios are normalized by premium volume per NAIC methodology, allowing fair comparison between insurers of differing market size. Computation and editorial review by PlainInsurer Editorial — see methodology.