No Surprises Act Arbitration Lawsuits: Which Health Insurers Doctors Sue Most

Scope: a record counts as a suit against a health insurer when its first-named defendant (the IDB defendant field, cut off at 30 characters) begins with one of the following name stems, matched in this order. Horizon: HORIZON or the misspelling HORZION followed by BLUE, CROSS, SHIELD, BCBS or HEALTH (not Horizon Pharma, not Blue Horizon). Anthem/Elevance: ANTHEM, ELEVANCE, EMPIRE BLUE, EMPIRE HEALTH. Aetna: AETNA, MERITAIN. Cigna: CIGNA, HEALTHSPRING. UnitedHealthcare: UNITED HEALTH or UNITEDHEALTH, UMR, UNITED MEDICAL RESOURCES, OXFORD HEALTH, GOLDEN RULE INS (not OptumRx, a pharmacy benefit manager, and not OptumCare, a physician group). Other Blue Cross Blue Shield companies: BLUE CROSS or BLUE SHIELD anywhere in the name, or a name beginning with BCBS, HIGHMARK, PREMERA, REGENCE, CAREFIRST, WELLMARK, HEALTH CARE SERVICE CO, CALIFORNIA PHYSICIANS or LOUISIANA HEALTH SERVIC. Humana: HUMANA. Other health plans, benefit funds and administrators: HEALTH PLAN, WELFARE FUN, BENEFIT FUN or BENEFIT PLA anywhere in the name (stems shortened because names are cut off) (this includes union and employer health funds such as the National Benefit Fund of the SEIU health care workers' union in New York, but not pension funds), or a name beginning with EMBLEM, OSCAR HEALTH, AMBETTER, CENTENE, WELLCARE, MOLINA HEALTH, KAISER FOUNDATION, KAISER PERMANENTE, HEALTHFIRST, AMERIHEALTH, HEALTH NET, SUPERIOR HEALTH, SELECTHEALTH, UNIVERA, AULTCARE, PARAMOUNT INSURANCE, SENTARA HEALTH, ASCENSION PERSONALIZED CARE, EMPOWER HEALTHCARE SOLUTIONS, FREEDOM LIFE, NIPPON LIFE, AVMED, GEISINGER, SUMMACARE, EMI HEALTH, MCLAREN HEALTH ADVANTAGE, MEDICAL MUTUAL OF OHIO, CDPHP, ALLIANCE HEALTH AND LIFE, or one of the plan administrators ALLIED BENEFIT, MEDCOST, INSURANCE DESIGN ADMIN, ALLEGIANCE BENEFIT, WEBTPA, AMERICAN PLAN ADMIN, (THE) LOOMIS COMPANY, LEADING EDGE ADMIN, INTEGRA ADMINISTRATIVE, ASR HEALTH BENEFITS, MAESTRO HEALTH, CONSOCIATE HEALTH, ELCO ADMINISTRATIVE, MAGNACARE, ASC BENEFIT, ASSURED BENEFIT, BENEFIT PLAN ADMIN, FCE BENEFIT, WH ADMINISTRATORS, HEALTHCOMP, HEALTHSMART, INDEPENDENCE ADMINISTRATORS, INSURANCE MANAGEMENT SERVICES, MARPAI, OPTIMED HEALTH, PHOENIX ADMINISTRATORS, S&S HEALTHCARE, TOTAL PLAN CONCEPTS, TRUSTMARK HEALTH. Not counted: claims repricing and payment vendors such as Zelis and MultiPlan, that union itself (its name contains UNITED HEALTHCARE but does not begin with it), people or law firms whose names merely contain an insurer's name, property, casualty, reinsurance and other life insurers, and government agencies. Matching is case-insensitive; the space inside BLUE CROSS, BLUE SHIELD, UNITED HEALTH, EMPIRE BLUE and HEALTH PLAN is optional, and repeated spaces count as one. Subsidiaries are grouped with their parent as listed above; each record counts once, in the first group it matches.

Calculation: cases are assigned to the federal fiscal year (October through September) of their filing date. To check the data against the judiciary's own statistics, we counted federal question arbitration cases in fiscal 2025: 1,577 nationwide and 987 in the District of New Jersey, which matches the published nationwide figure of the Administrative Office of the U.S. Courts and is within 0.10% of its New Jersey figure. Shares by insurer use all cases against health insurers in that fiscal year as the denominator.