125 Largest Health Insurance Companies in the USA

 

125 Largest Health Insurance Companies in the USA- According to National Association of Insurance Commissioners (NAIC), there are 125 Largest Health Insurance Companies in the USA in 2024. This data is obtained from the market share data report entitled “2024 Market Share Reports For the Top 125 Accident and Health Insurance Groups and Companies by State and Countrywide” published by NAIC in 2025.

Principally, many people still use health insurance to guarantee human health. Many activities and unpredictable risks can harm people’s health. So, to reduce the unpredictable cost of diseases, many people still trust the insurance companies providing a wide range of insurance products to deal with it.

Particularly, The United States of America (USA) which has more than 300 million people is one of the main markets of insurance industries especially health insurance. Many insurance companies launched and had the product of insurance health to help the USA’s People. Theoretically, health insurance or medical insurance, is an insurance which can help people in paying for covered medical expenses such as doctor visits, hospital stays, prescription drugs, preventive care, surgeries, and others. Commonly, insured or policyholders pay a monthly premium to a health insurer provider or company, and in return, they agree to cover a portion of your medical costs in accordance with the contractual agreement.

Commonly in the United States of America, there are two main categories of health insurance, namely Public (Government-Funded) Health Insurance and Private (Commercial) Health Insurance. Public (Government-Funded) Health Insurance is healtcare programs funded and managed by the U.S. federal or state governments. Some of the health insurance program/ types including Medicare (a government-funded health insurance program which covers citizens and permanent residents of the United States who are 65 or older of its age), Medicaid (a joint federal and state health insurance program that provides free or low-cost health coverage to millions of low-income American people), TRICARE (the health care and insurance program for the U.S. uniformed services, providing coverage for active duty members, retirees, their families, and survivors). Meanwhile, private (commercial) health insurance is a health coverage plan purchased through a private company, either directly by an individual or family, or through an employer. This type of health insurance products include Employer-Sponsored Insurance (ESI) (health insurance plan provided by an organization to its employees and their dependents), Individual and Family Plans (Marketplace Plans) (this is purchased directly from insurers or through the Health Insurance Marketplace), Short-Term Health Insurance (a temporary medical plan that provides limited coverage for a set period, typically for a few months up to one year), Supplemental Insurance (health insurance coverage for specific needs for example, dental, vision, accident, or critical illness). 

Many health insurance companies in the USA have different and diversified health insurance products offering to their customers and members. Here is the rank of 125 Largest Health Insurance Companies in the USA in 2024. Maybe, some of us know and use their products or services.

 

The Rank of 125 Largest Health Insurance Companies in the USA Based on Direct Written Premium of 2024

 

Rank	Name of Health Insurance Companies	Direct Written Premium in 2024	Market Share in 2024
		(in US Dollar (USD))	(%)
1	UnitedHealth Group	269,447,881,665	16.05%
2	CVS Health	121,241,225,625	7.22%
3	Centene Corporation	113,189,361,223	6.74%
4	Humana Inc.	110,551,486,273	6.59%
5	Elevance Health, Inc.	108,175,955,040	6.44%
6	Kaiser Permanente	100,962,892,071	6.01%
7	Health Care Service Corporation	64,072,623,801	3.82%
8	The Cigna Group	41,923,050,893	2.50%
9	Molina Healthcare Inc Grp	35,843,695,533	2.14%
10	GuideWell	30,710,428,568	1.83%
11	The Independence Holding Company	29,149,142,721	1.74%
12	Highmark Group	21,666,100,762	1.29%
13	Blue Cross Blue Shield of Michigan	19,832,448,239	1.18%
14	Blue Cross of California	17,437,036,000	1.04%
15	Blue Cross Blue Shield of New Jersey	17,412,099,600	1.04%
16	UPMC Health System Group	15,107,215,498	0.90%
17	Blue Cross and Blue Shield of North Carolina	13,513,016,548	0.80%
18	Health Net, LLC	12,975,070,059	0.77%
19	CareSource Group	11,969,332,374	0.71%
20	CareFirst BlueCross BlueShield	11,265,607,713	0.67%
21	L.A. Care Health Plan	10,728,493,654	0.64%
22	Metropolitan Group	10,560,814,946	0.63%
23	Health Net Community Solutions, Inc.	10,265,726,358	0.61%
24	BlueCross BlueShield of Tennessee (BCBST) Group	10,091,117,498	0.60%
25	Blue Cross Blue Shield of Massachusetts	9,730,517,444	0.58%
26	Oscar Health Insurance	8,777,881,588	0.52%
27	Blue Cross and Blue Shield of Minnesota	8,743,679,114	0.52%
28	Point32Health	8,732,291,236	0.5296
29	Blue Cross and Blue Shield of Alabama	8,217,761,003	0.49%
30	Inland Empire Health Plan (IEHP)	8,110,109,179	0.48%
31	Сambia Health Solutions	7,971,450,239	0.4796
32	Corewell Health Group	7,569,669,257	0.4596
33	UHC Of California	7,223,049,000	0.4396
34	Sentara Health	7,126,365,991	0.42%
35	Healthfirst	6,911,730,501	0.4196
36	EmblemHealth	6,811,366,420	0.4196
37	BlueCross BlueShield of South Carolina	6,773,052,339	0.4096
38	Lifetime Healthcare Companies	6,552,263,551	0.39%
39	Unum Insurance	6,459,225,973	0.3896
40	Medica Health Plans	6,362,549,110	0.3896
41	UCare	6,274,782,775	0.3796
42	Blue Cross Of California Partnership	6,090,054,000	0.3696
43	Mutual Of Omaha Grp	5,796,882,197	0.3596
44	Partnership Health of California	5,608,959,006	0.3396
45	Sun Life Financial	5,485,020,466	0.3396
46	Orange County Нealth	5,372,963,894	0.3296
47	Aflac Group	5,331,667,957	0.3296
48	Guardian Life Group	5,210,536,470	0.3196
49	Boston Medical Center Нealth Plan	5,206,741,299	0.3196
50	Premera Вlue Cross	5,184,044,779	0.31%
51	Louisiana Health Services Group	5,016,164,212	0.3096
52	Wellmark Insurance	4,925,844,040	0.2996
53	SCAN Health Plan	4,915,839,000	0.2996
54	Independence Holding Company (IHC)	4,798,746,043	0.2996
55	Health Partners	4,640,079,457	0.28%
56	Hawaii Medical Service Association	4,417,859,494	0.26%
57	Presbyterian Healthcare Services	4,261,892,501	0.25%
58	Tokio Marine Holdings Inc	4,135,760,608	0.25%
59	Heritage Provider Network, Inc.	4,107,346,959	0.24%
60	Medical Card System Inc Group	4,043,019,552	0.24%
61	The Hartford Insurance	4,028,658,143	0.24%
62	PacificSource Health Plans	4,025,442,250	0.24%
63	Geisinger Health System	3,866,463,564	0.23%
64	MVP Health	3,836,045,193	0.23%
65	Optum Health Plan of California	3,790,354,647	0.23%
66	Medical Mutual of Ohio Group	3,696,314,212	0.22%
67	Lincoln National Group	3,585,298,210	0.21%
68	Devoted Health Group	3,275,249,205	0.20%
69	Arkansas Blue Cross and Blue Shield	3,230,354,865	0.19%
70	Blue Cross Blue Shield of Arizona	3,180,966,107	0.19%
71	Delta Dental of California	3,126,724,000	0.19%
72	McLaren Health Care	3,030,203,333	0.18%
73	VSP Vision Care	2,982,849,808	0.18%
74	New York Life Insurance Group	2,904,719,736	0.17%
75	Voya Financial	2,836,967,254	0.17%
76	CDPHP	2,828,012,137	0.17%
77	Principal Financial Group	2,779,618,731	0.17%
78	Health Share of Oregon	2,759,775,499	0.16%
79	Texas Children's Health Plan	2,754,372,545	0.16%
80	Harris Health	2,743,822,957	0.16%
81	Blue Shield of California	2,705,810,973	0.16%
82	Baylor Scott & White Health	2,672,269,029	0.16%
83	Meiji Yasuda Life Insurance	2,670,958,108	0.16%
84	T J University	2,626,986,329	0.16%
85	Chg Foundation	2,543,429,025	0.15%
86	Providence Health Group	2,484,228,337	0.15%
87	Providence Health Assurance	2,484,207,335	0.15%
88	Independent Health	2,469,960,694	0.15%
89	Dentegra Insurance	2,462,196,693	0.15%
90	Alignment Health Plan	2,432,785,088	0. 14%
91	Blue Cross and Blue Shield of Kansas City	2,366,545,627	0. 14%
92	Alameda Alliance for Health	2,365,626,008	0. 14%
93	Henry Ford Health System	2,354,255,090	0. 14%
94	Renaissance Benefits	2,348,030,179	0. 14%
95	Blue Cross and Blue Shield of Kansas	2,344,072,805	0. 14%
96	Santa Clara County Health Authority	2,307,165,220	0. 14%
97	Gundersen Health System	2,307,079,305	0. 14%
98	Fresno-Kings-Madera Regional Health	2,298,416,987	0. 14%
99	Capital Blue Cross	2,275,467,931	0. 14%
100	Kern Family Health Care	2,236,408,000	0.13%
101	Gemstone Holdings	2,225,463,794	0.13%
102	Blue Cross Blue Shield of Rhode Island	2,222,811,370	0.13%
103	Mass General Brigham Health Plan	2,215,443,706	0.13%
104	Elderplan Inc	2,008,605,623	0.12%
105	Santa Cruz-Monterey-Merced Managed Medical Care	1,996,786,969	0.12%
106	Carle Holding Co	1,977,414,794	0.12%
107	Neighborhood Health Plan of Rhode Island	1,939,864,382	0.12%
108	Blue Cross and Blue Shield of Nebraska	1,925,576,834	0.11%
109	Prudential Financial	1,748,757,808	0.10%
110	The Fallon Group	1,727,974,867	0.10%
111	Allstate Insurance	1,722,308,969	0.10%
112	First Medical Health Plan	1,681,971,106	0.10%
113	Santa Barbara San Luis Obispo Region	1,666,209,320	0.10%
114	Chubb Ltd	1,661,056,071	0.10%
115	Blue Cross Blue Shield of North Dakota	1,642,276,053	0.10%
116	Community Health Network	1,619,595,393	0.10%
117	Northwestern Mutual	1,589,097,528	0.09%
118	San Joaquin County Health Commission	1,576,666,594	0.09%
119	Delta Dental of Oregon	1,536,837,417	0.09%
120	Mississippi Insurance Group	1,490,850,135	0.09%
121	Fidelity Services Group	1,488,845,138	0.09%
122	Security Health Plan	1,484,635,890	0.09%
123	Ameritas Mutual Holding Company	1,465,762,525	0.09%
124	Sumitomo Life Insurance	1,463,843,984	0.09%
125	CNO Financial Group	1,436,163,338	0.09%
Total Health Insurance Industry in the USA		1,678,715,813,877	100.00%
Source: NAIC, 2025

 

All of the health insurance companies ranked based on the Direct Written Premium (DWP) obtained from National Association of Insurance Commissioners (NAIC). Theoretically, Direct Written Premium (DWP) is the total amount of premiums an insurance company receives from policyholders in a specific period, before calculating for any premiums that may be ceded to other insurers for reinsurance.

 

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 The Histogram Rank of 15 Largest Health Insurance Companies in the USA Based on Direct Written Premium

 

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Brief Description of 20 Largest Health Insurance Companies in the USA in 2024

 

 

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1. UnitedHealth Group

UnitedHealth Group is one of the largest health insurance companies in the USA that was founded in 1977 by Richard Burke. Commonly, UnitedHealth Group provides insurance services under UnitedHealthcare and healthcare products under Optum. Operationally, UnitedHealth Group has had a central office in Minnetonka, Minnesota and has grown with has around 400,000 team members. As of now, UnitedHealth Group has partnerships with more than 1.7 million physicians and care professionals and over 7,000 hospitals and care facilities in the USA. Specifically, in the USA insurance market, some health insurance services provided by UnitedHealth Group include Health insurance plans, Medicare plans, Medicaid plan, Dental, vision and supplemental plans.

Financially, in 2024, according to its annual report, UnitedHealth Group has total assets around USD 298 billion and total liabilities reaching USD 195 billion. Furthermore, in terms of business performance in 2024, the UnitedHealth Group also successfully generated total revenue around USD 400 billion and reported gaining a net income of USD 15 billion. Specifically, in the health insurance industry in the USA market, UnitedHealth Group successfully gained a direct written premium of around USD 269,447 million in 2024.

 

2. CVS Health    

CVS Health Corporation is a diversified health solutions company. Historically, this company was founded in 1963 by Stanley Goldstein, Sidney Goldstein, and Ralph Hoagland. As of December 31, 2024, CVS Health Corporation had more than 9,000 retail locations, more than 1,000 walk-in and primary care medical clinics, a leading pharmacy benefits manager with approximately 90 million plan members and expanding specialty pharmacy solutions, and a dedicated senior pharmacy care business serving more than 800,000 patients per year.  Specifically, some set of business of CVS Health include

●       CVS Pharmacy

A large retail pharmacy chain with thousands of locations across the U.S. that provide prescription services, over-the-counter products, and general merchandise.

●       CVS Caremark

A leading pharmacy benefit manager (PBM) that manages prescription drug benefits for employers, insurance companies, and other plan sponsors.

●       Aetna

A health insurance company that CVS Health acquired in 2018. It offers a variety of health plans, including medical, pharmacy, and Medicare plans.

●       MinuteClinic

Walk-in medical clinics located inside select CVS Pharmacy stores, providing care for minor illnesses and injuries.

●       Oak Street Health

A network of value-based primary care centers for older adults, acquired by CVS Health in 2023.

●       Coram

A leading provider of specialty infusion therapy, including home infusion and nutrition therapy.

●       Omnicare

Omnicare is a leading national provider of pharmacy services to the long-term care market, which includes skilled nursing facilities and independent and assisted living communities.

●       Signify Health

Signify Health®, a part of CVS Health, provides In-Home Health Evaluations (IHE) to health plan members– helping to bridge gaps in care.

Specifically, In the health insurance industry of the USA, CVS Health provides some insurance products including Commercial Health Coverage, Medicare, Medicaid, Vision and Dental Management, Medical Management. Financially, in the year 2024, according to its annual report, the total assets of CVS Health Corporation reached USD 253 billion with total liabilities of around USD 177 billion. In terms of business performance in 2024, CVS Health Corporation successfully gained total revenue of USD 372 billion with net income reaching USD 4.5 billion. Furthermore, in the health insurance business in the USA market, according to the NAIC report, CVS Group successfully gained a direct written premium of around USD 121,241 million in 2024.

 

3. Centene Corporation Group        

Centene Corporation is a health insurance and pharmacy company which was founded by Elizabeth Brinn as the Health Services Managed in Milwaukee, Wisconsin, in 1984. To date, Centene Corporation has several employees, reaching 60,500 people and managed to reach 28 million of care members. In terms of health insurance products, Centene offers some health insurance products in the USA including Medicaid and Medicare members (including Medicare Prescription Drug Plans) as well as individuals and families served by the Health Insurance Marketplace.

Financially, in 2024, Centene Corporation has total revenue of USD 163 billion with net income of USD 3.31 billion. In terms of financial position, total assets of Centene Corporation reached USD 82.4 billion and total equity reached USD 26.4 billion. Specifically, in the health insurance market at USA, Centene Corporation collected a direct written premium of USD 113,189 million in the year of 2024.

 

4. Humana Inc. 

Founded in Louisville, Kentucky, in 1961 by David A. Jones Sr. and Wendell Cherry, Humana's operations are divided into three main segments: Retail (focused on government-sponsored plans like Medicare Advantage), Healthcare Services (including clinics, pharmacy, and home healthcare), and Group and Specialty (providing employer health and wellness plans). In the health insurance industry, Humana provides some health insurance products in Medicare, Dental, Vision, Medicaid, and others.

Financially, according to its annual report of 2024, Humana Inc has total assets of around USD 46 billion with total liabilities of around USD 30 billion. In terms of business performance, Humana inc successfully gained total revenue of around USD 117 billion with successfully earning net income of around USD 1.2 billion. Specifically, in the health insurance industry, Humana Inc successfully collected direct written premium in 2024 reaching USD 110,551 million.

 

5. Elevance Health

Headquarters in Indianapolis, Indiana, Elevance Health, formerly known as Anthem, Inc. (2014–2022), is a health company serving approximately 45.7 million medical members through all affiliated health plans as of December 31, 2024. Based on the business conditions, Elevance Health have organized some brand portfolio including:

• Anthem Blue Cross/Anthem Blue Cross and Blue Shield — represents Anthem-branded and affiliated Blue Cross and/or Blue Shield licensed plans

• Wellpoint — unites select non-BCBSA licensed Medicare, Medicaid and commercial plans under the Wellpoint name; and

• Carelon — this brand brings together healthcare related services and capabilities, including our CarelonRx and Carelon Services businesses, under a single brand name.

Financially, according to its annual report for 2024, Elevance Health has total assets of around USD 116 billion with total liabilities of around USD 75.4 billion. In terms of business performance in 2024, Elevance Health has gained total revenue of around USD 177 billion with net income of around USD 5.97 billion. Specifically, in the health insurance industry in the USA market, Elevance Health collected Direct Written Premium in 2024 of around USD 108,175 million.

 

6. Kaiser Permanente        

Founded in 1945, Kaiser Permanente still has headquarters in Oakland, California, and this company divides its business into Kaiser Foundation Health Plan, Inc., Kaiser Foundation Hospitals and its subsidiaries, and The Permanente Medical Groups. As of 2024, Kaiser Permanente has 12.6 million members, 40 Hospitals, 608 Medical offices, 25,270 physicians, 76,279 nurses, and 242,914 employees.

Financially, according to its annual report of 2024, Kaiser Permanente successfully gained total Revenue of around USD 115.2 billion and earned operating income of USD 569 million. In terms of the health insurance industry in the USA market, Kaiser Permanente collected direct written premiums in 2024 reaching USD 100,962 million.

 

7. Health Care Service Corporation    

As one of the largest customer-owned health insurers in the United States, Health Care Service Corporation (HCSC) served 23.2 million members with prudent management of nearly $123 billion of medical spend in 2024. Financially, in the year of 2024, Health Care Service Corporation gained total revenue around USD 62.8 billion and successfully earned net income of around USD 0.65 billion. Specifically, in the USA’s health insurance market, Health Care Service Corporation collected direct written premium in 2024 reaching USD 64,072 million.

 

8. Cigna Health Group  

Cigna is a multinational healthcare and insurance company. Operationally, this company has a primary office in Bloomfield, Connecticut, United States of America. Historically, this company was founded in 1982 because of the merger between Connecticut General Life Insurance Company (CG) and INA Corporation. As of December 2024, along with business development, the total global workforce of Cigna is approximately 73,500 colleagues striving to serve approximately 182 million customer and patient relationships in more than 30 countries and jurisdictions. Specifically, in doing its business, Cigna has two growth platforms, namely Evernorth Health Services® and Cigna Healthcare®.

 

Financially, in 2024, Financially, according to the annual report in 2024, Cigna has total assets recorded at USD 155 billion, while total liabilities reached USD 114 billion. In terms of business conditions, Cigna successfully gained total revenue of around USD 247 billion with a net income of USD 3.4 billion. Moreover, in the health insurance business at the USA market, according to the NAIC report, Cigna Health Group gained a direct premium written around 41,923 million in 2024.

 

 9. Molina Healthcare Inc Grp    

Molina Healthcare, Inc., provides managed healthcare services under the Medicaid and Medicare programs, and through the state insurance marketplaces. Historically, Molina was founded in 1980 as a provider organization serving low-income families in Southern California and reincorporated in Delaware in 2002. As of December 2024, Molina Healthcare served approximately 5.5 million members located across 21 states.

Financially, according to its annual report of 2024, Molina Healthcare has total assets of around USD 15.6 billion with total liabilities USD 11.1 billion. In terms of business performance in 2024, Molina Healthcare successfully collected total revenue of USD 40.6 billion and net income of around USD 1.1 billion. Specifically, in the health insurance industry in the USA market, Molina Healthcare successfully collected direct written premiums in 2024 reaching USD 35,843 million.

 

10.GuideWell   

GuideWell, formally GuideWell Mutual Holding Corporation (holding company for Florida Blue), is a mutual insurance holding company primarily focused on health insurance in Florida. Historically, It was created in 2013 by a reorganization initiated by Florida Blue, a member company of the Blue Cross Blue Shield Association.

Along with business development, GuideWell has around 18,000 employees. In terms of business performance in 2024, total revenue of GuideWell reached USD 32.4 billion with net income of around Net income USD 211 million. Specifically, according to the NAIC report in 2024, GuideWell successfully collected Direct Written Premium in 2024 reaching USD 30,710 million.

 

11. The Independence Holding Company  

The IHC Group or Independence Holding Company is a company that is engaged in underwriting, administering and/or distributing group and individual specialty benefit products, including disability, supplemental health, pet, and group life insurance through its subsidiaries since 1980. Structurally, The IHC Group owns three insurance companies, namely  Standard Security Life Insurance Company of New York, Madison National Life Insurance Company, Inc. and Independence American Insurance Company, and IHC Specialty Benefits, Inc., a technology-driven insurance sales and marketing company that creates value for insurance producers, carriers and consumers (both individuals and small businesses). Financially, in the health insurance industry in the USA, Independence Holding Company or IHC collected direct written premium in 2024 reaching USD 29,149 million.

 

12.Highmark Group 

Highmark is an American nonprofit healthcare company and integrated delivery network based in Pittsburgh. Basically, Highmark has some insurance products to many types of its customers including individual & family, medicare, medicaid, and employer. Along with business development, Highmark remains among the largest Blue Plans in the USA with approximately 7 million members spreading across Pennsylvania, Delaware and West Virginia, along with Western and Northeastern New York. Financially, in 2024, according to the NAIC report of 2025, Highmark Group successfully gained direct written Premium in 2024 reaching USD 21,666 million.

 

13. Blue Cross Blue Shield of Michigan      

Blue Cross Blue Shield of Michigan is a nonprofit corporation with independent licenses of the Blue Cross Blue Shield Association. Basically, Blue Cross Blue Shield of Michigan provides health insurance in Michigan. Along with business development, Blue Cross Blue Shield of Michigan serves 830,000 members across Michigan. In terms of financial conditon, according to its annual report of 2024, Blue Cross Blue Shield of Michigan has total assets of USD 24.2 billion with total liabilities USD 18.5 billion. In the business, Blue Cross Blue Shield of Michigan suffered a net loss of around USD 1.2 billion. Specifically, in the health insurance industry in the USA, Blue Cross Blue Shield of Michigan collected Direct Written Premium in 2024 reaching USD 19,832 million.

 

14. Blue Cross of California        

Blue Cross of California or commonly known as Anthem Blue Cross, is the for-profit subsidiary company of Elevance Health Inc. Basically, Anthem Blue Cross holds the Blue Cross license for California under the Blue Cross Blue Shield Association (BCBSA) and offers Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Medicare, Medicaid, and employer health plans. Financially, in 2024, Blue Cross of California (Anthem Blue Cross) collected Direct Written Premium in 2024 reaching USD 17,437 million in the USA’s health insurance industry.

 

15. Blue Cross Blue Shield of New Jersey  

Horizon Blue Cross Blue Shield of New Jersey or known as Horizon BCBSNJ is nonprofit health services corporation and the only licensed member of the Blue Cross Blue Shield Association (BCBSA) operating under the Blue Cross Blue Shield branding in New Jersey. Operationally, its headquarters are in Newark, New Jersey. Commonly, Horizon Blue Cross Blue Shield of New Jersey provides a wide range of health insurance products including individual/family plans, employer group plans, Medicare supplements and Medicare Advantage, Medicaid and other state-programs via subsidiaries. Along with business development, Horizon Blue Cross Blue Shield of New Jersey has served around 3.7-4 million members throughout New Jersey. Financially, in the health insurance industry in the USA market, Horizon Blue Cross Blue Shield of New Jersey collected direct written premium in 2024 reaching USD 17,412 million.

 

16. UPMC Health System Group         

Headquartered in Pittsburgh, Pennsylvania, UPMC (University of Pittsburgh Medical Center) is a health care provider and insurer, affiliated with the University of Pittsburgh Schools of Health Sciences. Commonly, UPMC has more than 40 hospitals and 800 doctors' offices and outpatient centers Across Pennsylvania, In Maryland and New York and serves more than 4 million members. Commonly, types of health insurance products offered by UPMC include Commercial/Employer Group Plans, Individual & Family Plans, Medicare Advantage & Related Plans, Medicaid / Medical Assistance & CHIP, Special Needs & Behavioral Health Plans, Additional Services (Workers’ Comp, Employee Assistance, Wellness Programs).  Financially, UPMC Health System Group collected direct written premium in 2024 reaching USD 15,107 million.

 

17. Blue Cross and Blue Shield of North Carolina          

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is a nonprofit health insurance company based in North Carolina and the Blue Cross Blue Shield licensee for North Carolina. Historically, it was founded in 1933 and still has its headquarters in Chapel Hill/Durham region with major operations in Durham and Winston-Salem. Along with business development, Blue Cross and Blue Shield of North Carolina can serve around 4.3 million members. Commonly, Blue Cross NC offers a wide array of insurance products and related health services. Some of their major product categories include Individual & Family Health Plans, Employer/ Business Health Coverage, Medicare Plans, Dental, Vision, International/Travel, Additional Products. Financially, in the health insurance industry in the USA market, Blue Cross and Blue Shield of North Carolina collected direct written premiums in 2024 reaching USD 13,513 million.

 

18. Health Net, LLC   

Health Net, LLC is a health insurance / managed-care company based in California and becomes the subsidiary of Centene Corporation.  Commonly, Health Net offers health plans to individuals, families, employer groups, Medicare and Medicaid populations. Financially, according to the NAIC report, in the USA’s health insurance industry, Health Net collected a direct written premium in 2024 reaching USD 12,975 million.

 

19. CareSource Group        

CareSource is a non-profit managed care organization headquartered in Dayton, Ohio. Historically, it was founded in 1989 and today, CareSource serves over 2 million members in 14 states. Commonly, in the health insurance industry, CareSource offers a variety of health insurance plans including Medicaid, Dual Need Special Plans, Marketplace, and TRICARE Prime Demo. Financially, in the year 2024, CareSource Group successfully collected direct written premiums in 2024 reaching USD 11,969 million.

 

20. CareFirst BlueCross BlueShield   

CareFirst BlueCross BlueShield (CF BCBS) is a nonprofit health insurance provider and an independent licensee of the Blue Cross Blue Shield Association serving 3.5 million individuals and groups in Maryland and the Washington metropolitan area. Commonly, CareFirst BlueCross BlueShield offers a broad portfolio of health-insurance and related health services products including Individual & Family Plans, Group / Employer Plans, Medicare & Medicaid Products, and others. Financially, specifically in the health insurance industry in the USA, CareFirst BlueCross BlueShield gained direct written premiums in 2024 reaching USD 11,265 million.

 

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Bibliography of 20 Largest Health Insurance Companies in the USA in 2024

National Association of Insurance Commissioners. 2025. Combined Accident and Health Insurance Market Share Reports. Accessed via https://content.naic.org/sites/default/files/publication-msr-hb-accident-health.pdf  on September 5th, 2025.

CVS Group. 2025. Annual Report 2024. Accessed via https://investors.cvshealth.com/investors/financial-information/annual-reports-archive/ on April 10th, 2025.

UnitedHealth Group. 2025. Annual Report 2024. Accessed via https://www.unitedhealthgroup.com/investors/financial-reports.html on April 10th, 2025.

Cigna Healthcare Group. 2025. Annual Report 2024. Accessed via https://investors.thecignagroup.com/financials/annual-reports/default.aspx  on April 10th, 2025.

Centene Corp Group. 2025. Annual Report 2024. Accessed via https://investors.centene.com/all-filings  on April 10th, 2025.

Humana Inc. 2025. Annual Report 2024. Accessed via https://humana.gcs-web.com/financial-information/annual-reports on October 28th, 2025.

Elevance Health, Inc. 2025. Annual Report 2024. Accessed via https://ir.elevancehealth.com/annual-reports/   on October 28th, 2025.

Kaiser Permanente. 2025. Annual Report 2024. Accessed via https://about.kaiserpermanente.org/expertise-and-impact/annual-reports on October 28th, 2025.

Health Care Service Corporation. 2025. Annual Report 2024. Accessed via https://www.hcsc.com/  on October 28th, 2025.

The Cigna Group. 2025. Annual Report 2024. Accessed via https://investors.thecignagroup.com/overview/default.aspx  on October 28th, 2025.

Molina Healthcare Inc Grp. 2025. Annual Report 2024. Accessed via https://www.molinahealthcare.com/   on October 28th, 2025.

GuideWell. 2025. Annual Report 2024. Accessed via https://www.guidewell.com/  on October 28th, 2025.

The Independence Holding Company. 2025. Annual Report 2024. Accessed via https://hsaforamerica.com/ihc-group/   on October 28th, 2025.

Highmark Group. 2025. Annual Report 2024. Accessed via https://www.highmark.com/ on October 28th, 2025.

Blue Cross Blue Shield of Michigan. 2025. Annual Report 2024. Accessed via https://www.bcbsm.com/ on October 28th, 2025. 

Blue Cross Of California. 2025. Annual Report 2024. Accessed via https://www.anthem.com/ca   on October 28th, 2025.

Blue Cross Blue Shield of New Jersey. 2025. Annual Report 2024. Accessed via https://www.horizonblue.com/ on October 28th, 2025.

UPMC Health System Group. 2025. Annual Report 2024. Accessed via https://www.upmc.com/   on October 28th, 2025.

Blue Cross and Blue Shield of North Carolina. 2025. Annual Report 2024. Accessed via https://www.bluecrossnc.com/  on October 28th, 2025. 

Health Net, LLC. 2025. Annual Report 2024. Accessed via https://www.healthnet.com/content/healthnet/en_us.html on October 28th, 2025.

CareSource Group. 2025. Annual Report 2024. Accessed via https://www.caresource.com/   on October 28th, 2025.

CareFirst BlueCross BlueShield. 2025. Annual Report 2024. Accessed via https://individual.carefirst.com/individuals-families/home.page on October 28th, 2025.