In the US, there are a host of private healthcare insurance specialists. However, life/annuity and property/casualty insurers also write this coverage, often referred to as accident and health insurance, as outlined by the Insurance Information Institute.
In 2020, the accident and health insurance industry’s direct written premiums reached $1.25 trillion, up by almost 84% from $680 billion in 2011. The largest 10 insurers collectively wrote 55.3% of the total US market, according to the National Association of Insurance Commissioners (NAIC).
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Based on NAIC’s 2020 data, here are the top 10 accident and health insurance groups:
Direct Written Premiums: $176.7 billion
Market Share: 14.1%
A diversified health and well-being company, UnitedHealth Group’s core capabilities are clinical expertise, advanced technology, and data and health information.
UnitedHealth Group serves clients and consumers in the US and more than 130 other countries through two distinct platforms: UnitedHealthcare provides healthcare coverage and benefits services, while Optum provides information and technology-enabled health services. The group invests more than $4 billion in technology and innovation and processes approximately 1.1 trillion transactions annually.
2. Kaiser Foundation
Direct Written Premiums: $104.2 billion
Market Share: 8.3%
Kaiser Foundation Health Plan, Inc. operates as a non-profit healthcare organization. The organization offers allergy, audiology, cardiology, dermatology, oncology, hospice, laboratory, nephrology, occupational therapy, pain management, pediatric rehabilitation, and pharmacy services. The company serves patients in the US.
3. Anthem, Inc.
Direct Written Premiums: $76.9 billion
Market Share: 6.2%
Anthem, Inc. is a health benefits company that is committed to improving lives and communities and making healthcare simpler. Anthem, through its affiliated companies, serves more than 106 million people, including over 42 million within its family of health plans. It aims to be the most innovative, valuable, and inclusive partner.
The group’s affiliated health plans have created various HMOs, PPOs, network-based dental products, various hybrid and specialty products, and health plan services that combine the attributes consumers find attractive with effective cost control techniques. Individual members and employer groups can select from basic and comprehensive plans to meet their specific needs. A wide range of related specialty products and other services is also available, including flexible spending accounts and COBRA administration.
4. Centene Corp
Direct Written Premiums: $75 billion
Market Share: 6%
Centene Corporation, a Fortune 500 company, is a diversified, multinational healthcare company providing a portfolio of services to government-sponsored healthcare programs, focusing on uninsured and underinsured individuals. It operates in 50 states and three international markets and has more than 25 million managed care members.
Centene operates local health plans and provides a range of health insurance solutions. Also, it contracts with other healthcare and commercial organizations to offer specialty services, ranging from behavioral health, dental benefits, life and health, and pharmacy benefits management to care management software, correctional healthcare services, in-home health services, managed vision, specialty pharmacy, and telehealth services.
Direct Written Premiums: $73.9 billion
Market Share: 5.9%
Humana’s cultural foundation is aligned to helping members achieve their best health by providing personalized, simplified, whole-person healthcare experiences. Recognizing that each person, family, and community’s healthcare needs continue to evolve, Humana creates innovative solutions and resources to help people live their healthiest lives on their terms – when and where they need it.
Direct Written Premiums: $69 billion
Market Share: 5.5%
CVS Health is a healthcare innovation company with a purpose to help people on their path to better health. Through its health services, plans, and community pharmacists, it pioneers a new approach to total health.
CVS has more than 9,900 retail locations, nearly 1,100 walk-in medical clinics, a pharmacy benefits manager with about 100 million plan members, a diversified healthcare benefits company serving about 23.4 million medical members, a dedicated senior pharmacy care business serving more than one million patients per year, expanding specialty pharmacy services, and a standalone Medicare Part D prescription drug plan.
Direct Written Premiums: $42 billion
Market Share: 3.4%
Health Care Service Corporation (HCSC), a mutual legal reserve company, is the largest customer-owned healthcare insurance company in the US. The company serves more than 16 million members across five states – Illinois, Montana, New Mexico, Oklahoma, and Texas – and employs more than 23,000 people in over 60 local offices.
HCSC offers a wide variety of life and health insurance products and related services through its affiliates and subsidiaries, including Dearborn Group, Dental Network of America, HCSC Insurance Service Company, Medecision, Availity, Prime Therapeutics, and TriWest Healthcare Alliance.
8. Cigna Health
Direct Written Premiums: $31.8 billion
Market Share: 2.5%
Cigna Corporation is a global health service organization with more than 165 million customer and patient relationships in over 30 countries and jurisdictions. Its insurance plans and products include healthcare insurance for individuals and families, dental insurance plans, Medicare plans, Medicare supplemental plans, other supplemental insurance, and international health insurance.
9. Molina Healthcare, Inc.
Direct Written Premiums: $21.4 billion
Market Share: 1.7%
Molina Healthcare, a Fortune 500 company, exclusively focuses on government-sponsored healthcare programs for qualified individuals and families. The company contracts with state governments and serves as a health plan providing a wide range of quality healthcare services to individuals and families.
Molina provides health plans in California, Florida, Illinois, Michigan, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Washington, Wisconsin, and Puerto Rico. The company also offers a Medicare product and has been selected in many states to join in dual demonstration projects to manage the care for those eligible for Medicaid and Medicare.
10. Independence Health Group
Direct Written Premiums: $20.1 billion
Market Share: 1.6%
Philadelphia-headquartered Independence Health Group, along with its subsidiaries, serves about 10 million clients in 27 states and the District of Columbia. A quarter of its customer network is based in southeastern Pennsylvania. The company serves various employer groups, from small and midsize enterprises to national corporations.
Among the services the insurer offers are commercial, Medicare and Medicaid coverage, pharmacy benefits management, workers’ compensation, and third-party benefits administration. The company is an independent licensee of the Blue Cross and Blue Shield Association.
(Updated August 23, 2021)