Payers that deny the most ACA claims

In the report, published Feb. 9, researchers analyzed transparency data for exchange plans offered on Healthcare.gov. 

Payers that denied more than a third of in-network claims in 2021 include: 

• Meridian Health Plan (Mich.) 
• Absolute Total Care (S.C.) 
• Celtic Insurance (Fla., Ill., Ind., Mo., N.H., Tenn., Texas) 
• Ambetter Insurance (Ga., Miss., N.C.) 
• Optimum Choice (Va.) 
• Buckeye Community Health Plan (Ohio) 
• Health Net (Ariz.) 
• UnitedHealthcare (Ariz.) 

The researchers compared the denial rates for payers who received more than 5 million in-network claims in 2021. 

Here’s how they stacked up: 

1. Celtic Insurance Company (Fla.) — 41.9 percent of claims denied 
2. BCBS Alabama — 22.6 percent of claims denied 
3. BCBS Texas — 20.1 percent of claims denied 
4. USAble Mutual Insurance Company (Ark.) — 18.2 percent of claims denied 
5. BCBS South Carolina — 17.3 percent of claims denied 
6. BCBS Illinois — 16.5 percent of claims denied 
7. BCBS Oklahoma — 16.2 percent of claims denied
8. HealthKeepers (Va.) — 15.8 percent of claims denied
9. BCBS North Carolina — 13.7 percent of claims denied
10. Health Options (Fla.) — 13.3 percent of claims denied 
11. SelectHealth (Utah) — 12.9 percent of claims denied 
12. BCBS Florida — 10.7 percent of claims denied 
13. Oscar Insurance (Fla.) — 6.6 percent of claims denied 
14. Bright Health (Fla.) — 5.7 percent of claims denied 

Read more here.