{
  "dataset": "Most frequently disputed non-initiating parties, second half of 2025",
  "period": {
    "start": "2025-07-01",
    "end": "2025-12-31",
    "label": "H2 2025"
  },
  "source": {
    "publisher": "U.S. Departments of Health and Human Services, Labor, and the Treasury",
    "document": "Supplemental Background on Federal Independent Dispute Resolution Public Use Files, July 1, 2025 – December 31, 2025, and the accompanying Federal IDR Supplemental Tables for 2025 Q3 and 2025 Q4",
    "sourceFormat": "XLSX",
    "sourceUpdated": "2026-07-22",
    "sourceUrl": "https://www.cms.gov/initiatives/no-surprise-billing/overview/policies-resources/independent-dispute-resolution-reports",
    "note": "Figures are transcribed from the published federal tables. Nothing here is estimated, modelled or adjusted. Where a value is a sum of the two quarters, the field name says so.",
    "table": "Table 9 — Top 10 Non-Initiating Parties or their Representatives"
  },
  "fields": {
    "party": "Non-initiating party or representative, as named by CMS. The term is the Departments' own and carries no finding about conduct.",
    "disputes_h2_2025": "Sum of the quarters in which the party appears in the table",
    "self_insured": "Disputes where the plan is a partly or fully self-insured employer plan. ERISA prevents states from regulating these, so they go through the federal process regardless of state law.",
    "fully_insured": "Disputes involving a fully insured private group health plan",
    "individual_market": "Disputes involving an individual health insurance issuer",
    "fehb": "Disputes involving a Federal Employees Health Benefits carrier",
    "non_federal_government": "Disputes involving a state or local government plan. ERISA does not reach these.",
    "church": "Disputes involving a church plan",
    "no_issuer_response": "Disputes where the issuer did not respond and the plan type was never established",
    "quarters_present": "Which quarters the party appears in. Table 9 is a per-quarter top ten and its membership changed between Q3 and Q4 2025, so a party present in only one quarter has a one-quarter total."
  },
  "note": "Summing two quarterly top-ten lists blindly would understate any party present in only one of them. Rows here are summed by name and the quarters_present field states the basis.",
  "rows": [
    {
      "party": "UnitedHealthcare",
      "disputes_h2_2025": 338429,
      "self_insured": 214490,
      "fully_insured": 81319,
      "individual_market": 8857,
      "fehb": 31,
      "non_federal_government": 29353,
      "church": 71,
      "no_issuer_response": 4308,
      "quarters_present": "q3+q4"
    },
    {
      "party": "BCBS Texas",
      "disputes_h2_2025": 237947,
      "self_insured": 168843,
      "fully_insured": 28586,
      "individual_market": 18933,
      "fehb": 13943,
      "non_federal_government": 39,
      "church": 5,
      "no_issuer_response": 7598,
      "quarters_present": "q3+q4"
    },
    {
      "party": "Aetna",
      "disputes_h2_2025": 185954,
      "self_insured": 138739,
      "fully_insured": 10680,
      "individual_market": 4059,
      "fehb": 4052,
      "non_federal_government": 26741,
      "church": 3,
      "no_issuer_response": 1680,
      "quarters_present": "q3+q4"
    },
    {
      "party": "Claritev (fka Multiplan)",
      "disputes_h2_2025": 144697,
      "self_insured": 125902,
      "fully_insured": 14634,
      "individual_market": 2484,
      "fehb": 91,
      "non_federal_government": 109,
      "church": 25,
      "no_issuer_response": 1452,
      "quarters_present": "q3+q4"
    },
    {
      "party": "Anthem",
      "disputes_h2_2025": 112804,
      "self_insured": 62945,
      "fully_insured": 5462,
      "individual_market": 180,
      "fehb": 3438,
      "non_federal_government": 37045,
      "church": 3,
      "no_issuer_response": 3731,
      "quarters_present": "q3+q4"
    },
    {
      "party": "ClearHealth Strategies",
      "disputes_h2_2025": 95628,
      "self_insured": 81497,
      "fully_insured": 1087,
      "individual_market": 8914,
      "fehb": 2911,
      "non_federal_government": 4,
      "church": 0,
      "no_issuer_response": 1215,
      "quarters_present": "q3+q4"
    },
    {
      "party": "Cigna",
      "disputes_h2_2025": 44931,
      "self_insured": 35909,
      "fully_insured": 5933,
      "individual_market": 2063,
      "fehb": 5,
      "non_federal_government": 297,
      "church": 7,
      "no_issuer_response": 717,
      "quarters_present": "q3+q4"
    },
    {
      "party": "BCBS Arizona",
      "disputes_h2_2025": 22932,
      "self_insured": 19765,
      "fully_insured": 554,
      "individual_market": 1619,
      "fehb": 885,
      "non_federal_government": 0,
      "church": 0,
      "no_issuer_response": 109,
      "quarters_present": "q3+q4"
    },
    {
      "party": "Centene",
      "disputes_h2_2025": 19197,
      "self_insured": 3146,
      "fully_insured": 1312,
      "individual_market": 12195,
      "fehb": 0,
      "non_federal_government": 4,
      "church": 0,
      "no_issuer_response": 2540,
      "quarters_present": "q3+q4"
    },
    {
      "party": "BCBS Florida",
      "disputes_h2_2025": 7849,
      "self_insured": 48,
      "fully_insured": 3549,
      "individual_market": 91,
      "fehb": 0,
      "non_federal_government": 0,
      "church": 0,
      "no_issuer_response": 4161,
      "quarters_present": "q3"
    },
    {
      "party": "BCBS Illinois",
      "disputes_h2_2025": 6471,
      "self_insured": 4315,
      "fully_insured": 464,
      "individual_market": 1262,
      "fehb": 408,
      "non_federal_government": 0,
      "church": 0,
      "no_issuer_response": 22,
      "quarters_present": "q4"
    }
  ]
}