SENDERO HEALTH PLANS, INC. — health Insurance Complaints
Analysis of 390 health insurance complaints filed against SENDERO HEALTH PLANS, INC., based on public NAIC and state DOI data.
Key Statistics
- health Complaints: 390
- Total Complaints (All Types): 390
- health Share: 100.0%
- NAIC Complaint Ratio: 12.99
- AI Risk Score: 90/100
health Complaint Issues
| Issue Type | Complaints | % of Total |
|---|---|---|
| Delayed payment | 106 | 27.2% |
| Claim denial | 96 | 24.6% |
| Premium or billing dispute | 77 | 19.7% |
| Cust Srvc Policy Holder Srvcs | Information Furnished | 19 | 4.9% |
| Usual And Customary | Contract Language/Legal Issue | 9 | 2.3% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue | 6 | 1.5% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue | 5 | 1.3% |
| Provider or network dispute | 4 | 1.0% |
| Coverage dispute | 3 | 0.8% |
| Usual And Customary | Contract Language/Legal Issue; Corrective Action Taken; Additional Monies Received | 3 | 0.8% |
| Unsatisfactory Settle/Offer | Information Furnished | 3 | 0.8% |
| Unsatisfactory Settle/Offer; Usual And Customary | Company Position Upheld | 3 | 0.8% |
| Cust Service Claim Handling | Information Furnished; Corrective Action Taken | 2 | 0.5% |
| Cust Srvc Policy Holder Srvcs | Information Furnished; Complaint Withdrawn | 2 | 0.5% |
| Usual And Customary | Corrective Action Taken; Additional Monies Received; Contract Language/Legal Issue | 2 | 0.5% |
| Usual And Customary | Additional Monies Received; Corrective Action Taken; Contract Language/Legal Issue | 2 | 0.5% |
| Misleading sales | 2 | 0.5% |
| Policy cancellation | 2 | 0.5% |
| Cust Srvc Policy Holder Srvcs; Unauthorized Acts | Information Furnished; Question of Fact; Contract Language/Legal Issu | 1 | 0.3% |
| Access to Care; Cust Srvc Policy Holder Srvcs | Contract Language/Legal Issue; Information Furnished; Corrective Action | 1 | 0.3% |
| Cust Service Claim Handling | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 1 | 0.3% |
| Unfair settlement | 1 | 0.3% |
| Cust Service Claim Handling; Maximum Out of Pocket | Contract Language/Legal Issue; Information Furnished; Corrective Ac | 1 | 0.3% |
| Prior Authorization | Information Furnished; Corrective Action Taken | 1 | 0.3% |
| Cust Srvc Policy Holder Srvcs; Prior Authorization | Information Furnished; Question of Fact | 1 | 0.3% |
| Health Privacy; Insurer Fraud | Contract Language/Legal Issue; Information Furnished | 1 | 0.3% |
| Commissions | Information Furnished; Question of Fact; Company Position Upheld | 1 | 0.3% |
| Unsatisfactory Settle/Offer | Information Furnished; Corrective Action Taken; Additional Monies Received | 1 | 0.3% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Information Furnished; Corrective Action Taken | 1 | 0.3% |
| Cust Srvc Policy Holder Srvcs | Corrective Action Taken; Information Furnished | 1 | 0.3% |
| Cust Srvc Policy Holder Srvcs | Complaint Withdrawn; Information Furnished | 1 | 0.3% |
| Cust Srvc Policy Holder Srvcs; Identification Card Issue | Information Furnished | 1 | 0.3% |
| Maximum Out of Pocket | Corrective Action Taken; Information Furnished | 1 | 0.3% |
| Maximum Out of Pocket; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished | 1 | 0.3% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Company Position Upheld; Corrective Action Taken | 1 | 0.3% |
| Recoupment Of Claims Payment | Information Furnished; Claim Settled | 1 | 0.3% |
| Cust Service Claim Handling; Essential Health Benefit; Maximum Out of Pocket; Unsatisfactory Settle/Offer | Corrective A | 1 | 0.3% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Additional Monies Received; Corrective | 1 | 0.3% |
| Maximum Out of Pocket; Mental Health Parity; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Fu | 1 | 0.3% |
| Usual And Customary | Corrective Action Taken; Additional Payment Expected; Contract Language/Legal Issue | 1 | 0.3% |
| Usual And Customary | Corrective Action Taken; Contract Language/Legal Issue; Additional Payment Expected | 1 | 0.3% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken; Contract Language/Legal Issue; Additional Pa | 1 | 0.3% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Company Position Upheld; Contract Language/Legal Issue | 1 | 0.3% |
| Cust Service Claim Handling; Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Policy Not In Force | 1 | 0.3% |
| Other | Claim Settled | 1 | 0.3% |
| Unsatisfactory Settle/Offer | Claim Settled | 1 | 0.3% |
| Maternity and Newborn Care; Unsatisfactory Settle/Offer | Information Furnished; Contract Language/Legal Issue | 1 | 0.3% |
| Maternity and Newborn Care | Contract Language/Legal Issue | 1 | 0.3% |
| Usual And Customary | Contract Language/Legal Issue; Information Furnished | 1 | 0.3% |
| Unsatisfactory Settle/Offer; Usual And Customary | Corrective Action Taken | 1 | 0.3% |
| Unsatisfactory Settle/Offer | Information Furnished; Company Position Upheld | 1 | 0.3% |
| Other | No Jurisdiction; Information Furnished | 1 | 0.3% |
| Claims Reimb/Bal Bill Problems; Hlth Care Svcs Covg/Copay/Lmts | Information Furnished; Contract Language/Legal Issue | 1 | 0.3% |
| Unsatisfactory Settle/Offer | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 1 | 0.3% |
| Enrllmt/Canc/Rnwl Of Enrollee | Corrective Action Taken; Information Furnished; Consumer Withdraw | 1 | 0.3% |
| Claims Reimb/Bal Bill Problems; Cust Service Claim Handling; Hlth Care Svcs Covg/Copay/Lmts; PPACA-Preventive Health Svc | 1 | 0.3% |
| Agent/Agency Contrct Termin; Commissions | No Jurisdiction; Contract Language/Legal Issue; Information Furnished | 1 | 0.3% |
| Unsatisfactory Settle/Offer; Usual And Customary | Contract Language/Legal Issue; Information Furnished | 1 | 0.3% |
| Cust Service Claim Handling | Information Furnished | 1 | 0.3% |
| Not Within TDI Jurisdiction | Contract Language/Legal Issue; No Jurisdiction | 1 | 0.3% |
| Enrllmt/Canc/Rnwl Of Enrollee | Corrective Action Taken; Information Furnished | 1 | 0.3% |
| Access to Care | Information Furnished | 1 | 0.3% |
health Complaints by State
| State | Complaints |
|---|---|
| Texas | 390 |
Recent health Complaints Against SENDERO HEALTH PLANS, INC.
- health Complaint #TX-454414-1d2d27f5 — Texas (2026-04-22)
- health Complaint #TX-453838-52703a4d — Texas (2026-04-16)
- health Complaint #TX-450574-92e606ef — Texas (2026-03-18)
- health Complaint #TX-448156-e2a49f79 — Texas (2026-02-20)
- health Complaint #TX-446447-8aa285d7 — Texas (2026-02-02)
- health Complaint #TX-445447-7f69561c — Texas (2026-01-21)
- health Complaint #TX-445399-5eaa0c5c — Texas (2026-01-21)
- health Complaint #TX-443612-92e606ef — Texas (2026-01-02)
- health Complaint #TX-442788-8e9ddb26 — Texas (2025-12-18)
- health Complaint #TX-442279-6464b1e7 — Texas (2025-12-15)
Frequently Asked Questions
How many health complaints does SENDERO HEALTH PLANS, INC. have?
SENDERO HEALTH PLANS, INC. has 390 health insurance complaints on file, according to NAIC and state DOI data.
What are the most common health complaint issues with SENDERO HEALTH PLANS, INC.?
The most common health complaint issues for SENDERO HEALTH PLANS, INC. are: Delayed payment (106), Claim denial (96), Premium or billing dispute (77), Cust Srvc Policy Holder Srvcs | Information Furnished (19), Usual And Customary | Contract Language/Legal Issue (9).
Which states have the most health complaints against SENDERO HEALTH PLANS, INC.?
The states with the most health complaints against SENDERO HEALTH PLANS, INC. are: Texas (390).
health Complaints by State
SENDERO HEALTH PLANS, INC. Complaints by State
- SENDERO HEALTH PLANS, INC. Complaints in California
- SENDERO HEALTH PLANS, INC. Complaints in Texas
- SENDERO HEALTH PLANS, INC. Complaints in New York
- SENDERO HEALTH PLANS, INC. Complaints in Florida
- SENDERO HEALTH PLANS, INC. Complaints in Illinois
- SENDERO HEALTH PLANS, INC. Complaints in Pennsylvania
- SENDERO HEALTH PLANS, INC. Complaints in Ohio
- SENDERO HEALTH PLANS, INC. Complaints in Georgia
- SENDERO HEALTH PLANS, INC. Complaints in North Carolina
- SENDERO HEALTH PLANS, INC. Complaints in New Jersey