The top ten health insurance providers in the USA

 Many private healthcare insurance experts may be found in the USA. However, as noted by the Insurance Information Institute, life/annuity and property/casualty insurers also issue similar coverage, which is typically referred to as accident and health insurance.

Direct written premiums for accident and health insurance rose from $680 billion in 2011 to $1.25 trillion in 2020, an increase of about 84%. According to the National Association of Insurance Commissioners, the top ten insurers combined wrote 55.3% of the US market (NAIC). Although that is not unexpected given that health insurance is one of the most popular forms of insurance, that is a sizable figure.

Here are the top 10 accident and health insurance groups according to NAIC's 2020 data:

1. UnitedHealth

Direct Written Premiums - 176.7 billion USD

Share of the market – 14.1%.

The main competencies of UnitedHealth Group, a diverse health and wellness firm, are clinical knowledge, cutting-edge technology, and data and health information.

Through two unique platforms, UnitedHealth Group provides customers and consumers with services in the US and more than 130 other countries: UnitedHealthcare offers healthcare coverage and benefits services, while Optum offers informational and technologically enhanced health services. The company conducts almost 1.1 trillion transactions yearly and invests more than $4 billion in technology and innovation.

 

2. Kaiser Foundation

Direct Written Premiums – 104.2 billion USD

Share of the market – 8.3%.

A non-profit provider of healthcare, Kaiser Foundation Health Plan, Inc. The company provides services in dermatology, oncology, allergies, audiology, cardiology, hospice, dermatology, occupational therapy, pain management, pediatric rehabilitation, and pharmacy. Patients in the US are served by the business.

 

3. Anthem INC

Direct Written Premiums – 76.9 billion USD

Share of the market – 6.2%.

Health benefits provider Anthem, Inc. is dedicated to enhancing people's lives, strengthening communities, and streamlining the healthcare system. Through its connected businesses, Anthem provides services to approximately 106 million customers, 42 million of whom are covered by its family of health insurance policies. It strives to be the most creative, beneficial, and open-minded partner.

A variety of HMOs, PPOs, network-based dental products, hybrid and speciality products, and health plan services have been developed by the group's associated health plans that combine appealing features for customers with efficient cost-control strategies. To suit their unique needs, both individual members and corporate groups can choose between basic and comprehensive programs. Flexible spending accounts and COBRA management are only two of the many associated specialist products and additional services offered.

 

4. Centene Crop

Direct Written Premiums – 75 billion USD

Share of the market – 6%.

Fortune 500 firm Centene Corporation is a diverse, international healthcare provider that offers a range of services to government-sponsored healthcare programs with an emphasis on the uninsured and underinsured. It has more than 25 million managed care members and operates in 50 states as well as three overseas markets.

A variety of health insurance options are offered by Centene, which also manages neighborhood health programs. Additionally, it enters into agreements with other healthcare and business organizations to provide specialty services, such as care management software, correctional healthcare services, in-home healthcare services, managed vision, specialty pharmacy, and telehealth services. These services range from behavioral health, dental benefits, life and health, and pharmacy benefits management.

 

5. Humana

Direct Written Premiums – 73.9 billion USD

Share of the market – 5.9%.

The cultural tenet of Humana is to support members in achieving their optimal health by offering individualized, straightforward, whole-person healthcare experiences. Humana develops cutting-edge tools and solutions to assist people in living their healthiest lives on their terms - when and when they need it. This is done in recognition of the fact that each person's, family's, and community's healthcare requirements continue to grow.

6. CVS

Direct Written Premiums – 69 billion USD

Share of the market – 5.5%.

The mission of CVS Health, a leader in healthcare innovation, is to assist individuals in achieving better health. It pioneers a new approach to complete health through its health plans, services, and community pharmacists.

With over 9,900 retail locations, almost 1,100 walk-in clinics, a pharmacy benefits manager with about 100 million plan members, a diversified healthcare benefits company with about 23.4 million medical members, a senior pharmacy care business serving over one million patients annually, expanding specialty pharmacy services, and a stand-alone Medicare Part D prescription drug plan, CVS has a wide range of services.

7. HCSC

Direct Written Premiums – 42 billion USD

Share of the market – 3.4%.

The biggest US customer-owned health insurance provider is Health Care Service Corporation (HCSC), a mutual legal reserve corporation. The corporation employs more than 23,000 employees in more than 60 local offices and provides services to more than 16 million members throughout five states (Illinois, Montana, New Mexico, Oklahoma, and Texas).

Through its affiliates and subsidiaries, including Dearborn Group, Dental Network of America, HCSC Insurance Service Company, Medecision, Availity, Prime Therapeutics, and TriWest Healthcare Alliance, HCSC provides a comprehensive range of life and health insurance products as well as related services.

 

8. Cigna Health

Direct Written Premiums – 31.8 billion USD

Share of the market – 2.5%.

The Cigna Corporation is a multinational provider of health services with more than 165 million patient and customer contacts across more than 30 nations. Healthcare insurance for individuals and families, dental insurance plans, Medicare plans, Medicare supplementary plans, other supplemental insurance, and overseas health insurance are among its insurance plans and goods.

 

9. Molina Healthcare, Inc.

Direct Written Premiums – 21.4 billion USD

Share of the market – 1.7%.

For eligible people and families, Molina Healthcare, a Fortune 500 firm, exclusively concentrates on government-sponsored healthcare programs. The business has agreements with state governments and functions as a health plan, offering people and families a wide range of high-quality healthcare services.

California, Florida, Illinois, Michigan, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Washington, Wisconsin, and Puerto Rico are among the states where Molina offers health insurance. The business also provides a Medicare product, and several states have chosen it to participate in dual demonstration programs to coordinate treatment for those who qualify for both Medicaid and Medicare.

 

10. Independence Health Group

Direct Written Premiums – 20.1 billion USD

Share of the market – 1.6%.

Independence Health Group, with its corporate headquarters in Philadelphia, and its affiliates provide healthcare services to over 10 million people in 27 states and the District of Columbia. Southeast Pennsylvania is home to a fourth of its client base. The business offers services to a range of employer types, including small and midsize businesses and multinational firms.

Commercial, Medicare and Medicaid coverage, pharmacy benefits management, workers' compensation, and third-party benefits administration are a few of the services the insurer provides. The business holds a Blue Cross and Blue Shield Association independent license.

 

How to find a Top health insurance company in the U.S.A.

 

Employers must make a big decision about whether to offer health insurance, but it can be difficult to know where to begin, especially for small firms without an HR department or benefits specialist to guide them.

Establishing a formal health benefit plan, however, is well worth the time and work. Offering an employer-sponsored health insurance plan has several benefits, including assisting in employee attraction and retention, differentiating your company, and promoting a content and healthy staff.

In this post, we'll identify the top 20 health insurance providers in the country and discuss non-traditional group health insurance plans for employers who are looking for alternatives.

Listing health insurance companies by market share

If you want to give excellent health benefits, knowing which health insurance carriers are reliable and provide a variety of products and providers is a smart place to start.

To be clear, the amount of the market share neither ensures the company will maintain its position throughout the year nor does it necessarily correlate with the quality of the product or medical treatment.

Nevertheless, market share size is a reliable indicator of a company's ability to compete, its financial stability, and the security of its structural foundation, and insurers with bigger market shares have higher direct written premium amounts.

How much money in premiums do health insurance companies get?

The CDC estimated that there were roughly 85 million COVID-19 cases in the U.S. during the COVID-19 pandemic. As a result, the health sector recorded an approximately 14% rise in health benefit claims, or $92 billion, which was a significant increase from previous years.

In the United States, health insurers received over $890 billion in total net premiums, according to the 2021 NAIC Health Insurance Report1. Over 2020, American consumers' premium expenditure increased by 8%.

In the previous year, United Health, which comes in first on the list below, wrote nearly $195 billion in premiums. But Massachusetts' Blue Cross Blue Shield only wrote $8.4 billion. However, over the previous year, both of these businesses experienced growth.

Due to delayed treatment during the previous year, deteriorating health conditions, and the need for care from older and higher-risk patients, the health sector anticipates further increases in the number of medical services required.

A health plan and other perks that will support required medical treatments in the upcoming years can help firms of all sizes better entice and keep their best workers.

Why health stipends and HRAs may be preferable for small companies

During the COVID-19 pandemic, the CDC reported nearly 85 million COVID-19 cases throughout the U.S. As a result, the health industry reported almost a 14% increase—equalling $92 billion—in health benefit claims, which was a big jump compared to prior years.

According to the 2021 NAIC Health Insurance Report¹, U.S. health insurers earned approximately $890 billion in total net premiums. This was an 8% increase in premium spending from U.S. consumers over 2020.

United Health, which takes the top spot in our list above, wrote roughly $195 billion in premiums over the past year. Blue Cross Blue Shield of Massachusetts, however, only wrote $8.4 billion. However, both of these companies saw an increase over the last year.

Going forward, the health industry expects continuing increases in medical services needed due to delayed treatment over the past year, worsening health conditions, and older and higher-risk patients needing care.

Considering this, employers of all sizes can better attract and retain their employees by offering a health plan and other additional benefits that will support necessary medical services in the coming years.

Why health stipends and HRAs may be preferable for small companies

Small and medium enterprises may find it challenging to budget for group health insurance due to increased premium costs. Employers who cannot afford a typical health benefit plan, however, have more options. One of the choices is health reimbursement agreements (HRAs).

An HRA is a health benefit that pays employees tax-free reimbursement for out-of-pocket medical expenses including prescription drugs and copays. By establishing an allowance, employers may better control their spending, and employees will have greater control over their health benefits.

Four health benefit plan choices that could be suitable for you and your employees are discussed below.

Qualified small employer HRA

Small business Employers without a group health insurance coverage and with less than 50 full-time equivalent employees (FTEs) may offer qualified small employer HRAs (QSEHRAs) as a health benefit. Employers can select a benefit that suits their budget, and employees can choose an insurance plan that meets their needs and make purchases to meet their specific medical requirements.

The flexible allowance allows for tax-free repayment of out-of-pocket expenses such as health insurance premiums. The full list of expenses provided by the federal government in IRS Publication 502 is available in our interactive expense tool if you're wondering what expenses are qualified for reimbursement.

Individual coverage HRA

The individual coverage HRA (ICHRA), like the QSEHRA, is a health benefit that enables employees to receive tax-free reimbursement for individual health insurance premiums as well as other medical services and costs.

But as long as the ICHRA isn't made available to employees who are covered by your group plan, it can be used as a stand-alone benefit or provided alongside a group health insurance plan and is accessible to enterprises of all sizes.

Employers can adapt the ICHRA to their needs by setting various allowance levels in accordance with the 11 employee classes. To access the benefit, employees need just opt in or out of it before it starts and certify at the start of each month that they are still protected by individual health insurance.

Integrated HRA

The integrated HRA is for you if you want to keep your workplace health insurance or switch to a high-deductible health plan (HDHP) to reduce your rates.

For employers of all sizes offering a group health insurance plan that want to supplement their benefit in addition to standard insurance, there is an integrated HRA, also known as a group coverage HRA (GCHRA). It's a tax-free reimbursement mechanism for employers who desire more control over the price of their health benefits, much like QSEHRA and ICHRA.

Integrated HRAs provide several special advantages over regular HRAs. A predetermined deductible, an unrestricted allowance amount, and a cost-sharing percentage are all options for employers to designate for employees. There are seven employee classes that you can use to tailor your integrated HRA, similar to ICHRAs.

Once the benefit is created, employees can start getting reimbursed for eligible out-of-pocket expenses that their group health insurance plan doesn't fully cover.

Health stipend

A health stipend is an additional approach to provide your staff flexible perks. The fact that health stipends are less federally regulated than other conventional health benefits, such as HRAs, makes them useful. Stipends could therefore be simpler to administer, especially for small employers. This type of incentive is available to businesses of all sizes, though.

Stipends are fixed sums of money that employers offer their staff to spend on whatever they see fit, like a health insurance plan and other medical costs. The amount given is viewed as additional compensation that was added to your employees' paychecks. The sum becomes taxable at the end of the year as a result, but your employees will have a wider range of options for how to use their overall stipend money.

How PeopleKeep can assist you in offering benefits to employees

HRAs and stipends are great ways to offer a health benefit, but you might worry about how to handle their administration. Fortunately, PeopleKeep's HRA administration software and stipend software can assist you in efficiently administering your employee benefits.

Employers can manage their benefits on a straightforward and efficient platform thanks to PeopleKeep. So that you don't have to, our team of professionals concentrates on the minutiae, such as paperwork review and compliance.

PeopleKeep has all you need to bring cheap and comprehensive benefits to your compensation package, from aiding in benefit design to award-winning employee assistance.

Conclusion

While there are many alternatives for organizations to give a typical group health benefit due to the large number of health insurance providers, it's crucial to take other, more flexible health benefit options into consideration. You can easily start providing extra benefits by using HRAs and health stipends instead of plunging into the management of group benefits. Additionally, they provide your staff the freedom to select the health plan that's best for them.

We would be happy to assist you in getting started if you are an employer thinking about offering an HRA or stipend at your business. We will get you moving by scheduling a call with a personal benefits counselor at PeopleKeep.

The top 25 health insurance providers in the US are listed below in descending order of market share size:

01. United Health

02. Kaiser Foundation

03. Anthem Inc.

04. Centene Corporation

05. Humana

06. CVS Health

07. Health Care Service Corporation (HCSC)

08. CIGNA

09. Molina Healthcare

10. Independence Health Group

11. Guidewell Mutual Holding

12. California Physicians’ Service

13. Highmark Group

14. Blue Cross Blue Shield of California

15. Blue Cross of Michigan

16. Blue Cross Blue Shield of New Jersey

17. Caresource

18. UPMC Health System

19. Blue Cross Blue Shield of North Carolina

20. Carefirst Inc.

21. Metropolitan

22. Health Net of California

23. Local Initiative Health Authority

24. Point32Health

25. Blue Cross Blue Shield of Massachusetts