Offering or enrolling in health insurance is a significant decision for employers and individuals. It can be overwhelming to know where to start, especially if you’re a small business without an HR team or a benefits specialist to help. But, putting in the time and research to set up a formal health benefit plan is well worth the effort.
There are several advantages to offering an employer-sponsored health insurance plan, including helping to retain and attract employees, making your business stand out, and contributing toward a happy and healthy workforce.
In this article, we’ll list the top 25 health insurance companies in the United States by market share and provide alternative coverage options if you want to offer something more cost-effective and flexible than traditional group health plans.
Takeaways from this blog post:
Health insurers in the U.S. earned approximately $1 trillion in total net earned premiums in 2022, with UnitedHealth leading in premium writing at $221 billion.
Multiple Blue Cross Blue Shield-affiliated companies rank on the list of insurers by market share.
Health reimbursement arrangements (HRAs) are more flexible option for providing health benefits to employees than traditional group coverage.
What is traditional group health insurance?
Employers comparing health insurers are most likely looking to secure a group health plan. So, let’s review those types of policies before diving into the top health insurance companies in the U.S.
With traditional group health insurance, employers choose a group medical plan for their organization and offer coverage to their employees and eligible dependents at a reduced rate. Most insurers require employers to meet a 70% minimum participation rate to receive coverage.
Insurance carriers offer various plan types, such as health maintenance organizations (HMOs) and preferred provider organizations (PPOs). A covered person will be responsible for paying their portion of the premium plus meeting their annual deductible before their insurer begins sharing the cost of their medical claims.
Employers can buy a group health policy directly from an insurance carrier, licensed agent, or broker. Small businesses can purchase a policy on the Small Business Health Options (SHOP) marketplace and apply for the Small Business Health Care Tax Credit to save on premiums1.
The cost of group health insurance varies, but rates generally increase annually. The average annual premium for group health insurance in 2023 was $8,435 for self-only coverage and $23,968 for family coverage. Of those amounts, employers contributed $7,034 to their employees’ self-only plans and $17,393 to their family plans2.
While their familiarity makes them a popular choice for employers and employees, their high costs may be too much for smaller businesses to afford.
Group coverage isn’t the only way to purchase health coverage. Individuals can also purchase their own health insurance policies from the Health Insurance Marketplace or state exchanges. Many of the same group carriers available offer individual health insurance plans.
Rank
Company
Market share in 2022
1.
UnitedHealth Group (including UnitedHealthcare)
15.34%
2.
Elevance Health Inc. (formerly Anthem)
7.16%
3.
Centene Corp.
6.68%
4.
Kaiser Foundation (Kaiser Permanente)
6.18%
5.
Humana
6.03%
6.
CVS Health (including Aetna Health)
5.82%
7.
Health Care Services Corporation (HCSC)
3.53%
8.
Cigna Health
2.39%
9.
Molina Healthcare Inc.
1.99%
10.
GuideWell (including Florida Blue)
1.84%
11.
Independence Health Group Inc.
1.76%
12.
California Physician's Service
1.40%
13.
Highmark Group
1.32%
14.
Blue Cross of California
1.15%
15.
Blue Cross Blue Shield of Michigan
1.11%
16.
Blue Cross Blue Shield of New Jersey
1.11%
17.
Caresource
0.93%
18.
UPMC Health System
0.90%
19.
Blue Cross Blue Shield of North Carolina
0.79%
20.
Carefirst Inc.
0.70%
21.
Metropolitan
0.69%
22.
Point32Health Inc.
0.63%
23.
Health Net of California, Inc.
0.63%
24.
Local Initiative Health Authority
0.61%
25.
Blue Cross Blue Shield of Massachusetts
0.60%
