Anthem Health Plans, Inc — health Insurance Complaints
Analysis of 2,127 health insurance complaints filed against Anthem Health Plans, Inc, based on public NAIC and state DOI data.
Key Statistics
- health Complaints: 2,127
- Total Complaints (All Types): 3,072
- health Share: 69.2%
- AI Risk Score: 50/100
health Complaint Issues
| Issue Type | Complaints | % of Total |
|---|---|---|
| Claim denial | 748 | 35.2% |
| Provider or network dispute | 290 | 13.6% |
| Delayed payment | 214 | 10.1% |
| Unfair settlement | 149 | 7.0% |
| Coverage dispute | 122 | 5.7% |
| Claim Procedure | Claim Handling | 79 | 3.7% |
| Premium or billing dispute | 67 | 3.1% |
| External Review | Claim Handling | 60 | 2.8% |
| Co-pay, Deductible, and Co-Insurance Issues | Claim Handling | Company Position Substantiated | 37 | 1.7% |
| Policy cancellation | 30 | 1.4% |
| Other | 27 | 1.3% |
| CPT Code Issue | Claim Handling | 24 | 1.1% |
| Claim Handling Other | Claim Handling | Claim Settled | 20 | 0.9% |
| Misleading sales | 16 | 0.8% |
| Co-pay, Deductible, and Co-Insurance Issues | Claim Handling | 14 | 0.7% |
| Claim Handling Other | Claim Handling | Company Position Substantiated | 12 | 0.6% |
| Co-pay, Deductible, and Co-Insurance Issues | Claim Handling | Company Position Overturned | 11 | 0.5% |
| Policy Service | PolicyHolder Service | 9 | 0.4% |
| Authorization Dispute | Claim Handling | 9 | 0.4% |
| Co-pay, Deductible, and Co-Insurance Issues | Claim Handling | Claim Settled | 7 | 0.3% |
| CPT Code Issue | Claim Handling | Company Position Substantiated | 6 | 0.3% |
| Delivery of Policy | PolicyHolder Service | Company Position Substantiated | 6 | 0.3% |
| UR Procedure | Claim Handling | 6 | 0.3% |
| Prompt Pay | Claim Handling | Company Position Overturned | 6 | 0.3% |
| Policy Service Other | PolicyHolder Service | 5 | 0.2% |
| Claim Handling Other | Claim Handling | 5 | 0.2% |
| Delivery of Policy | PolicyHolder Service | 5 | 0.2% |
| Claim Procedure | Claim Handling | Claim Settled | 5 | 0.2% |
| Claim Procedure | Claim Handling | Company Position Substantiated | 5 | 0.2% |
| Recoupment | Claim Handling | Company Position Substantiated | 4 | 0.2% |
| Medically Necessary | Claim Handling | 4 | 0.2% |
| Co-pay, Deductible, and Co-Insurance Issues | Claim Handling | Question of Fact/Contract/Provision/Legal Issue | 4 | 0.2% |
| Policy Service | PolicyHolder Service | Company Position Substantiated | 4 | 0.2% |
| Medically Necessary | Claim Handling | Company Position Substantiated | 4 | 0.2% |
| CPT Code Issue | Claim Handling | Claim Settled | 3 | 0.1% |
| Policy Service Other | PolicyHolder Service | Company Position Substantiated | 3 | 0.1% |
| Recoupment | Claim Handling | 3 | 0.1% |
| Recoupment | Claim Handling | Claim Settled | 3 | 0.1% |
| Recoupment | Claim Handling | Question of Fact/Contract/Provision/Legal Issue | 3 | 0.1% |
| Coordination of Benefit | Claim Handling | Claim Settled | 3 | 0.1% |
| Coordination of Benefit | Claim Handling | 3 | 0.1% |
| Preventive Care | Claim Handling | Company Position Substantiated | 3 | 0.1% |
| Coordination of Benefits | Claim Handling | 2 | 0.1% |
| Unprofessional Conduct by Insurer | PolicyHolder Service | 2 | 0.1% |
| Surrender Problems | PolicyHolder Service | Company Position Substantiated | 2 | 0.1% |
| Usual, Customary, Reasonable (UCR) Charges | Claim Handling | 2 | 0.1% |
| CT Continuation 38a-512a | Underwriting | 2 | 0.1% |
| Mandated Benefit | Claim Handling | 2 | 0.1% |
| Lapsed | PolicyHolder Service | 2 | 0.1% |
| Recoupment | Claim Handling | Company Position Overturned | 2 | 0.1% |
| Authorization Dispute | Claim Handling | Company Position Substantiated | 2 | 0.1% |
| Usual & Customary Fees | Claim Handling | Question of Fact/Contract/Provision/Legal Issue | 2 | 0.1% |
| Refusal to Insure | Underwriting | Question of Fact/Contract/Provision/Legal Issue | 2 | 0.1% |
| Claim Recoding/Bundling | Claim Handling | Company Position Substantiated | 2 | 0.1% |
| Coordination of Benefits | Claim Handling | Claim Settled | 2 | 0.1% |
| Coordination of Benefits | Claim Handling | Company Position Overturned | 2 | 0.1% |
| Coordination of Benefit | Claim Handling | Company Position Substantiated | 2 | 0.1% |
| Usual, Customary, Reasonable (UCR) Charges | Claim Handling | Company Position Substantiated | 2 | 0.1% |
| UR Case Management | Claim Handling | 2 | 0.1% |
| Inadequate Reimbursement/Rates | PolicyHolder Service | 1 | 0.0% |
| Claim Handling Other | Claim Handling | Insufficient Information | 1 | 0.0% |
| Policy Service | PolicyHolder Service | Insufficient Information | 1 | 0.0% |
| Unsatisfactory Offer | Claim Handling | 1 | 0.0% |
| Class Action | PolicyHolder Service | No Action Requested/Required | 1 | 0.0% |
| Prompt Pay | Claim Handling | Company Position Substantiated | 1 | 0.0% |
| Quality of Care | PolicyHolder Service | No Action Requested/Required | 1 | 0.0% |
| UR INTERNAL/EXTERNAL APPEAL PROCEDURE | Claim Handling | 1 | 0.0% |
| Inadequate Reimbursement/Rates | PolicyHolder Service | Question of Fact/Contract/Provision/Legal Issue | 1 | 0.0% |
| Fraud | Claim Handling | 1 | 0.0% |
| Access to Fee Schedule/Rates | PolicyHolder Service | Company Position Substantiated | 1 | 0.0% |
| Mandated Benefit | Claim Handling | Company Position Substantiated | 1 | 0.0% |
| Appeal Non-Compliance | Claim Handling | Company Position Overturned | 1 | 0.0% |
| Access to Fee Schedule/Rates | PolicyHolder Service | 1 | 0.0% |
| Policy Service | PolicyHolder Service | Claim Settled | 1 | 0.0% |
| Claim Handling Other | Claim Handling | Company Position Overturned | 1 | 0.0% |
| Policy Service | PolicyHolder Service | Referred to Outside Agency/Dept | 1 | 0.0% |
| Emergency Services | Claim Handling | 1 | 0.0% |
| Policy Service | PolicyHolder Service | Company Position Overturned | 1 | 0.0% |
| Fraud | Claim Handling | No Action Requested/Required | 1 | 0.0% |
| Claim Recoding/Bundling | Claim Handling | 1 | 0.0% |
| Unprofessional Conduct | PolicyHolder Service | Claim Settled | 1 | 0.0% |
| Mental Health Parity | Claim Handling | 1 | 0.0% |
| Claim Recoding/Bundling | Claim Handling | No Jurisdiction | 1 | 0.0% |
| Policy Information | PolicyHolder Service | 1 | 0.0% |
| Other | Claim Handling | Question of Fact/Contract/Provision/Legal Issue | 1 | 0.0% |
| Continuity of Care | PolicyHolder Service | 1 | 0.0% |
| Usual, Customary, Reasonable (UCR) Charges | Claim Handling | Question of Fact/Contract/Provision/Legal Issue | 1 | 0.0% |
| Usual & Customary Fees | Claim Handling | 1 | 0.0% |
| Delivery of Policy | PolicyHolder Service | Question of Fact/Contract/Provision/Legal Issue | 1 | 0.0% |
| Primary Care Physician Referral | Claim Handling | Company Position Substantiated | 1 | 0.0% |
| Unprofessional Conduct | PolicyHolder Service | 1 | 0.0% |
| Company Position Overturned | 1 | 0.0% |
| Policy Information | PolicyHolder Service | Question of Fact/Contract/Provision/Legal Issue | 1 | 0.0% |
| Primary Care Physician Referral | Claim Handling | Claim Settled | 1 | 0.0% |
| Notice Requirements | PolicyHolder Service | Company Position Substantiated | 1 | 0.0% |
| Claims Other | Claim Handling | Company Position Substantiated | 1 | 0.0% |
| Carrier Never Received Claim | Claim Handling | Question of Fact/Contract/Provision/Legal Issue | 1 | 0.0% |
| Other | Claim Handling | 1 | 0.0% |
| Preventive Care | Claim Handling | 1 | 0.0% |
| Claim Procedure | Claim Handling | No Action Requested/Required | 1 | 0.0% |
| Claim Recoding/Bundling | Claim Handling | Claim Settled | 1 | 0.0% |
| Notice Requirements | PolicyHolder Service | 1 | 0.0% |
| No Insurance | Underwriting | 1 | 0.0% |
| Fraud | Claim Handling | Claim Reopened | 1 | 0.0% |
| Policy Information | PolicyHolder Service | No Action Requested/Required | 1 | 0.0% |
| Authorization Dispute | Claim Handling | Company Position Overturned | 1 | 0.0% |
| Dependent Age | Underwriting | Claim Settled | 1 | 0.0% |
| Co-pay, Deductible, and Co-Insurance Issues | Claim Handling | Insufficient Information | 1 | 0.0% |
| Claim Procedure | Claim Handling | Question of Fact/Contract/Provision/Legal Issue | 1 | 0.0% |
| Continuity of Care | PolicyHolder Service | Company Position Substantiated | 1 | 0.0% |
| Usual, Customary, Reasonable (UCR) Charges | Claim Handling | Company Position Overturned | 1 | 0.0% |
| Coordination of Benefit | Claim Handling | Question of Fact/Contract/Provision/Legal Issue | 1 | 0.0% |
| CPT Code Issue | Claim Handling | Question of Fact/Contract/Provision/Legal Issue | 1 | 0.0% |
| Coordination of Benefits | Claim Handling | Question of Fact/Contract/Provision/Legal Issue | 1 | 0.0% |
health Complaints by State
| State | Complaints |
|---|---|
| Connecticut | 2,127 |
Recent health Complaints Against Anthem Health Plans, Inc
- health Complaint #CT-7085708-eb5318ae — Connecticut (2026-05-14)
- health Complaint #CT-7085676-eb5318ae — Connecticut (2026-05-14)
- health Complaint #CT-7085596-f3a0d1d4 — Connecticut (2026-05-13)
- health Complaint #CT-7085562-8d41cdc8 — Connecticut (2026-05-12)
- health Complaint #CT-7085540-8d41cdc8 — Connecticut (2026-05-12)
- health Complaint #CT-7085529-8d41cdc8 — Connecticut (2026-05-12)
- health Complaint #CT-7085526-8d41cdc8 — Connecticut (2026-05-12)
- health Complaint #CT-7085473-517b165f — Connecticut (2026-05-10)
- health Complaint #CT-7085470-517b165f — Connecticut (2026-05-10)
- health Complaint #CT-7085463-f1db792a — Connecticut (2026-05-08)
Frequently Asked Questions
How many health complaints does Anthem Health Plans, Inc have?
Anthem Health Plans, Inc has 2127 health insurance complaints on file, according to NAIC and state DOI data.
What are the most common health complaint issues with Anthem Health Plans, Inc?
The most common health complaint issues for Anthem Health Plans, Inc are: Claim denial (748), Provider or network dispute (290), Delayed payment (214), Unfair settlement (149), Coverage dispute (122).
Which states have the most health complaints against Anthem Health Plans, Inc?
The states with the most health complaints against Anthem Health Plans, Inc are: Connecticut (2127).
health Complaints by State
Anthem Health Plans, Inc Complaints by State
- Anthem Health Plans, Inc Complaints in California
- Anthem Health Plans, Inc Complaints in Texas
- Anthem Health Plans, Inc Complaints in New York
- Anthem Health Plans, Inc Complaints in Florida
- Anthem Health Plans, Inc Complaints in Illinois
- Anthem Health Plans, Inc Complaints in Pennsylvania
- Anthem Health Plans, Inc Complaints in Ohio
- Anthem Health Plans, Inc Complaints in Georgia
- Anthem Health Plans, Inc Complaints in North Carolina
- Anthem Health Plans, Inc Complaints in New Jersey