Rankings · NAIC + CMS

Insurance company rankings

Best and worst U.S. insurers by complaint record and claim-denial rate, plus state-level rankings, all from public NAIC and CMS data.

30
Carriers ranked
32%
Top state denial (Alaska)

Where to start

Three lenses on insurer accountability: which carriers draw the most complaints for their size, which health plans deny the most claims, and how costs and denials vary state by state.

20
worst-rated listed
10
best-rated listed
32%
highest state denial (Alaska)

Rankings are peer-relative within our dataset; denial rates are measured directly from CMS marketplace filings. A high ranking is a signal to investigate, not a legal judgment. Data as of August 2026.

Lowest composite scores (most consumer friction)

Bottom 10 carriers, lower score = more consumer friction for their size

composite score

What this shows The composite blends NAIC complaint index, claim-denial rate and prior-authorization data, normalized by premium volume; a lower score means more relative friction.

Source PlainInsurer, NAIC + CMS As of 2024

Highest composite scores (best records)

Top 10 best-rated carriers

composite score

What this shows Higher scores mean fewer consumer problems relative to size.

Source PlainInsurer, NAIC + CMS As of 2024

Highest state claim-denial rates

Top 10 states by marketplace claim-denial rate

% of claims denied

What this shows Aggregate marketplace denial rates from CMS filings; states with their own exchanges are excluded.

Source CMS Transparency in Coverage PY2026 As of 2025

States by claim denial rate

States ranked by aggregate marketplace claim-denial rate (CMS TiC PY2026, states with ≥100,000 claims)

# State Claim denial rate ClaimsIssuers
1 Alaska 32.0% 1.0M2
2 Hawaii 27.0% 0.7M2
3 West Virginia 23.3% 3.3M2
4 Arizona 23.2% 8.8M6
5 Tennessee 22.8% 25.9M5
6 Florida 22.7% 86.0M11
7 Iowa 22.4% 5.2M3
8 Indiana 22.3% 7.7M3
9 Alabama 22.1% 20.5M3
10 Ohio 22.0% 18.7M10
11 Nebraska 21.8% 2.0M3
12 North Carolina 20.5% 25.8M7
13 Kansas 20.5% 7.0M6
14 Delaware 20.4% 2.3M3
15 Texas 20.1% 136.4M14

Use the rankings

Rankings are a starting point, drill into a carrier or state before you decide.

Rankings reflect complaint and denial data, not financial strength or legal status. Informational only.

Data: NAIC published complaint index (2024) · CMS Transparency in Coverage PY2026. Rankings are relative across the insurer population. Not affiliated with NAIC or CMS.

Download ranking source extracts: complaint-index.csv and marketplace-denial-rates.csv.