Health Insurance Company Complaint Ratios

Health Insurance Company Complaint Ratios for Individual/Family Policies in Colorado

Information from the Colorado Division of Insurance

The following is from the Colorado Division of Insurance website, http://www.dora.state.co.us/insurance/, edited to contain only health insurance company complaint ratio information on carriers offering individual/family business in Colorado.

The consumer complaint ratios of Colorado health insurance companies illustrates how some health insurance companies generate more complaints per $1 million of premium than others. The ratios provide helpful information to consumers interested in evaluating their health insurance company, and to state regulators in targeting companies requiring closer review. In the table below, a complaint ratio of 4.40, for example, means the company had approximately 4.40 complaints per $1 million worth of business. Total complaint numbers are also listed, together with premium volume and market share. For the purposes of this report, a complaint is defined as written correspondence expressing a grievance against an insurer or carrier; no judgment is made in the ratios as to whether the complaint is justified. The report includes health insurance companies with five (5) or more complaints or at least one tenth of a percent (.1%) of the premium volume in a particular line of insurance. In this manner, the report looks at those companies with significant numbers of complaints but also provides information on a number of health insurance companies in Colorado. Large differences can be seen among competing companies; small differences should not be considered meaningful. Consumers are cautioned against relying only on complaint ratios when evaluating these companies; premiums, benefits, financial condition, and level of service should all be considered as well.

Please Note: The companies included in this report are responsible for reconciling documented complaints and reporting discrepancies to the Colorado Division of Insurance; however, not all of the companies have performed this review. Therefore, this report may contain unconfirmed information.

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All numbers have been rounded to two (2) decimal places.

  2010 Complaint Ratio

Total Complaints from 1/1/10 - 12/31/10

Premium ($Million) 2010 Market Share A.M. Best Rating
0.00 0
103.64
1.39%
A
0.31 98
831.54
11.16%
A
market share too low -
<0.10%
A-
0.03 3
249.83
3.35%
A
0.50 26
79.49
1.07%
A-
0.16 27
299.98
4.03%
A-
0.06 50
1484.65
19.93%
B++
0.47 2
12.64
0.17%
B++
(Healthmarkets)
market share too low -
-
<0.10%

B++
(Healthmarkets)

0.10 7
130.36
1.75%
B++
0.40 1
7.47
0.10%
A
0.08 54
1083.17
14.54%
 
0.38 5
20.86
0.28%
A-
  2009 Complaint Ratio

Total Complaints from 1/1/09 - 12/31/09

Premium ($Million) 2009 Market Share A.M. Best Rating
0.07 6
169.30
2.33%
A
0.23 112
839.10
11.55%
A
market share too low -
<0.10%
A-
0.13 4
29.97
0.41%
A
0.51 22
69.30
0.95%
A-
0.16 29
311.37
4.28%
A-
0.06 45
1331.55
18.32%
B++
0.95 9
17.91
0.25%
B++
(Healthmarkets)
market share too low -
-
<0.10%

B++
(Healthmarkets)

0.21 17
104.40
1.44%
B++
0.68 1
8.85
0.12%
A
0.07 36
957.04
13.17%
 
0.69 9
20.43
0.28%
A-
  2008 Complaint Ratio

Total Complaints from 1/1/08 - 12/31/08

Premium ($Million) 2008 Market Share A.M. Best Rating
0.06 9
153.14
2.17%
A
0.13 1
7.68
0.11%
A (United Healthcare)
0.18 102
798.50
11.29%
A
2.80 4
2.14
0.03%
A-
0.06 1
46.50
0.66%
A
0.40 18
62.99
0.89%
A-
Golden Rule Insurance Co. (United Healthcare)
0.39 15
58.30
0.82%
A (United Healthcare)
0.13 28
309.17
4.37%
A-
0.24 3
21.19
0.30%
B++
1.23 26
22.74
0.32%
B++
(Healthmarkets)
0.38 2
7.85
0.11%

B++
(Healthmarkets)

PacifiCare Life Assurance Co. (United Healthcare) *Pacifcare is no longer writing individual health insurance in Colorado
0.07 10
160.54
2.27%
A (United Healthcare)
0.10 7
110.46
1.56%
B++
1.02 9
10.78
0.15%
A
0.62 8
22.44
0.32%
A-
  2007 Complaint Ratio

Total Complaints from 1/1/07 - 12/31/07

Premium ($Million) 2007 Market Share A.M. Best Rating
0.05 7
153.62
2.29%
A
0.28 3
10.73
0.16%
A (United Healthcare)
0.61 404
661.13
9.87%
A
2.02 6
2.97
0.04%
A-
0.51 37
72.68
1.09%
A-
Golden Rule Insurance Co. (United Healthcare)
0.29 16
54.29
0.81%
A (United Healthcare)
0.14 39
285.43
4.26%
A
0.59 19
31.96
0.48%
B++
0.73 22
29.94
0.45%
bbb+
(update)
0.83 9
10.79
0.16%
bb+
(update)
PacifiCare Life Assurance Co. (United Healthcare) *Pacifcare is no longer writing individual health insurance in Colorado
0.89 98
110.51
1.65%
A (United Healthcare)
0.08 9
113.36
1.69%
B++
1.02 12
11.80
0.18%
A+
0.41 9
22.02
0.33%
A-
  2006 Complaint Ratio

Total Complaints from 1/1/06 - 12/31/06

Premium ($Million) 2006 Market Share A.M. Best Rating
0.06 6
96.03
1.54%
A
0.52 7
13.49
0.22%
A (United Healthcare)
0.23 127
554.47
8.90%
A
3.13 11
3.51
0.06%
A-
0.87 5
5.74
0.09%
A+ (Zurich)
0.38
2
5.33
0.09%
A-
0.57 47
81.95
1.32%
A-
Golden Rule Insurance Co. (United Healthcare)
0.29 15
51.54
0.83%
A (United Healthcare)
0.12 27
220.67
3.54%
A
3.28 2
0.61
0.01%
N/A
0.37 10
27.13
0.44%
B++
0.63 26
41.38
0.66%
A- (HealthMarkets)
0.74 10
13.55
0.22%
A- (HealthMarkets)
PacifiCare Life Assurance Co. (United Healthcare) *Pacifcare is no longer writing individual health insurance in Colorado
0.10 37
372.48
5.98%
A (United Healthcare)
0.04 5
117.74
1.89%
B++
.72 8
11.05
0.18%
A+
0.71 11
15.51
0.25%
A-
  2005 Complaint Ratio

Total Complaints from 1/1/05 - 12/31/05

Premium ($Million) 2005 Market Share A.M. Best Rating
0.08 8
95.33
1.62%
0.31 4
12.84
0.22%
0.20 101
507.31
8.61%
2.34 8
3.42
0.06%
1.45 11
7.60
0.13%
1.06 (2004 data)
5
4.72
0.17%
0.86 67
78.22
1.33%
Golden Rule Insurance Co. (United Healthcare)
0.40 20
50.34
0.85%
0.32 37
115.66
1.96%
0.26 4
15.67
0.27%
0.51 22
43.38
0.74%
1.02 16
15.71
0.27%
0.06 54
865.93
14.70%
0.05 5
99.31
1.69%
1.43 11
7.69
0.13%
0.63 6
9.46
0.16%
  2004 Complaint Ratio

Total Complaints from 1/1/04 - 12/31/04

Premium ($Million) 2004 Market Share A.M. Best Rating
0.13 9
70.02
2.48%
0.07 1
13.85
0.49%
0.32 145
450.86
15.94%
0.82 3
3.65
0.13%
3.87 38
9.81
0.35%
1.06
5
4.72
0.17%
0.78 58
74.05
2.62%
0.32 15
46.25
1.63%
0.27 33
121.26
4.29%
1.20 10
8.33
0.29%
1.61 65
40.30
0.74%
1.02 16
15.71
1.42%
0.08 10
133.13
4.71%
0.23 15
6613
2.34%
1.18 9
7.63
0.27%
0.67 6
8.90
0.31%

No complaint data was compiled in 2002 or 2003

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

No complaint data was compiled in 2002 or 2003

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  2001 Complaint Ratio

Total Complaints from 1/1/01 - 12/31/01

Premium ($Million) 2001 Market Share A.M. Best Rating
0.23 8
34.24
1.70%
N/A N/A
N/A
N/A
0.58 190
328.42
16.00%
N/A N/A
N/A
N/A
N/A N/A
N/A
N/A
N/A
N/A
N/A
N/A
0.99 37
37.31
1.80%
0.86 16
18.67
0.90%
0.01 2
180.79
8.80%
0.11 60
561.07
23.86%
1.03 22
21.39
1.00%
1.72 24
13.98
0.70%
0.27 93
348.36
14.82%
Rocky Mountain Healthcare Options, Inc. (Rocky Mountain Health Maintenance
Organization, Incorporated)
0.10 17
172.74
7.35
1.63 12
7.38
0.40%
2.55 56
21.99
1.10%

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