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
36%
Top state denial (Alabama)

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
36%
highest state denial (Alabama)

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.

Highest composite complaint scores

Top 10 carriers, higher = 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.

Source PlainInsurer, NAIC + CMS As of 2024

Lowest composite scores (best records)

Top 10 best-rated carriers

composite score

What this shows Lower 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 PY2025 As of 2025

States by claim denial rate

States ranked by aggregate marketplace claim-denial rate (CMS TiC PY2025, states with ≥100,000 claims)

# Insurer Claim denial rate ClaimsIssuers
1 Alabama 35.5% 15.3M3
2 Alaska 27.0% 0.8M1
3 Arizona 24.5% 10.1M7
4 Indiana 24.2% 4.7M3
5 Oklahoma 23.8% 11.0M6
6 Hawaii 23.8% 0.7M2
7 Ohio 22.1% 13.6M11
8 Tennessee 22.0% 17.6M5
9 Florida 21.9% 114.1M13
10 Texas 21.9% 111.9M15
11 Illinois 20.5% 16.0M10
12 Iowa 20.3% 5.4M3
13 Utah 19.8% 9.0M5
14 South Carolina 19.8% 17.3M4
15 North Carolina 19.7% 35.6M9

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 PY2025. Rankings are relative across the insurer population. Not affiliated with NAIC or CMS.