6 Largest Health Insurance Companies in the US

Introduction

 

With the onset of the pandemic and the worldwide disruption in the economic health of nations, the quotation “health is wealth” is more relatable today than ever. 

 

Health insurance, just like other types of insurance, is meant to protect oneself and one’s loved ones from unforeseen circumstances. Healthcare costs have continued to skyrocket in recent years coupled with several innovations in the same. It is therefore essential for a person to be ready for all kinds of tail events (or events that have a low probability of occurring but if occurred may present the person with significant damage) while dealing with health. A medical emergency can become a financial emergency in no time. 

 

Based on the essence of medical distress and the corresponding possibility of financial distress, this blog seeks to explore the 6 largest health insurance companies in the United States. The companies have been listed by their respective percentage-wise contribution to the health insurance market in the United States in descending order.

 

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The percentage-wise market share allocation is taken from the ValuePenguin website which includes the distribution of the health insurance companies by membership, by state and by revenue as well. 

 

1. Anthem (11%):

 

Symbol: NYSE: ANTM 

 

Anthem, Inc. , through its subsidiaries, operates as a health benefits company in the United States. The Company operates through four segments: Commercial & Specialty Business, Government Business, IngenioRx and Other. 

 

The company offers a spectrum of network-based managed care health benefit plans to large and small groups, individuals, Medicaid, and Medicare markets. Its managed care plans include preferred provider organizations; health maintenance organizations; point-of-service plans; indemnity plans and other hybrid plans, including consumer-driven health plans; and hospital only and limited benefit products.

 

It also provides an array of managed care services to self-funded customers, including claims processing, underwriting, stop loss insurance, actuarial services, provider network access, medical cost management, disease management, wellness programs and other administrative services.

 

In addition, it offers an array of specialty and other insurance products and services, such as pharmacy benefits management, dental, vision, life and disability insurance benefits, radiology benefit management, and analytics-driven personal health care. 

 

As of December 31, 2020, it served 43 million medical members through its affiliated health plans. The company was formerly known as WellPoint, Inc. and changed its name to Anthem, Inc. 

 

2. Centene (10%):

 

Symbol: NYSE:CNC

 

Centene Corporation operates as a multi-national healthcare enterprise that provides programs and services to under-insured and uninsured individuals in the United States. It operates through two segments: Managed Care and Specialty Services.

 

Centene offers affordable and high-quality products to nearly 1 in 15 individuals in the United States, including Medicaid and Medicare members (including Medicare Prescription Drug Plans) as well as individuals and families served by the Health Insurance Marketplace, the TRICARE program, and individuals in correctional facilities. 

 

The TRICARE program is a partnership of Health Net Federal Services (HNFS) (a wholly-owned subsidiary of Centene Corporation) with the Department of Defense to provide healthcare services to those who serve and their family members. It contributes to about 3 million managed care members.

 

Additionally, Centene provides education and outreach programs to inform and assist members in accessing appropriate healthcare services.

 

As of December 31, 2020, Centene has more than 25 million managed care members and 69,000 employees. Centene Corporation was founded in 1984 and is headquartered in St. Louis, Missouri.

 

3. UnitedHealth (9%):

 

Symbol: NYSE:UNH

 

UnitedHealth Group Incorporated operates as a diversified health care company in the United States. It operates through four segments: UnitedHealthcare, OptumHealth, OptumInsight, and OptumRx. 

 

• The UnitedHealthcare segment offers consumer-oriented health benefit plans and services.  

• The OptumHealth segment provides access to networks of care provider specialists, health management services, care delivery, consumer engagement, and financial services. 

• The OptumInsight segment offers software and information products, advisory consulting arrangements, and managed services outsourcing contracts.

• The OptumRx segment provides pharmacy care services and programs, including retail network contracting, home delivery, etc.

 

In addition, UnitedHealth Group Incorporated has a partnership with the University of California, San Francisco to expand the mental health workforce in California. UnitedHealth Group Incorporated was incorporated in 1977 and is based in Minnetonka, Minnesota.

 

4. Humana (8%):

 

Symbol: NYSE:HUM

 

Humana Inc., together with its subsidiaries, operates as a health and well-being company in the United States. It operates through Retail, Group and Specialty, and Healthcare Services segments.

 

• The Retail segment consists of Medicare benefits, including dental, vision, and other supplemental health and financial protection products.

• The Group and Specialty segment contains employer group fully-insured commercial medical products and specialty health insurance benefits marketed to individuals and groups, including dental, vision, military services and other supplemental health & voluntary insurance benefits.

• The Healthcare Services segment includes services offered to its health plan members, as well as to third parties, including pharmacy solutions, provider services, home-based services and clinical programs, as well as services and capabilities to manage population health.

• The Individual Commercial segment includes Individual Commercial products marketed under the HumanaOne brand.

 

As of December 31, 2020, the company had approximately 17 million members in medical benefit plans, as well as approximately 5 million members in specialty products. Humana Inc. was incorporated in 1964 and is headquartered in Louisville, Kentucky.

 

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5. HCSC (6%):

Unlike the top 4 health insurance providers in the United States, Health Care Service Corporation (HCSC) is a customer-owned company. It is not listed on the stock exchanges, rather is owned by its policyholders which gives it more freedom to operate in the healthcare space.

 

Health Care Service Corporation is an independent licensee of the Blue Cross and Blue Shield Association (BCBS). The Blue Cross Blue Shield Association is a national association of 35 independent, community-based and locally operated Blue Cross Blue Shield companies.

 

The Association owns and manages the Blue Cross and Blue Shield trademarks and names in more than 170 countries around the world. The Association also grants licenses to independent companies to use the trademarks and names in exclusive geographic areas. 

 

HCSC affiliates and subsidiaries include the Dearborn Group, Medecision and Dental Network of America. HCSC, along with its subsidiaries offers group life, disability and dental solutions, as well as a wide range of other individual solutions. 

 

The company was founded in 1936. As per the company’s website, HCSC serves nearly 17 million members across five states and employs nearly 24,000 people in over 60 local offices in the United States. 

 

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6. CVS Health (5%):

 

Symbol: NYSE:CVS

 

CVS Health Corporation is a provider of healthcare services in the United States. It operates in the Pharmacy Services segment, the Retail/LTC segment and the Health Care Benefits segment.

 

• The Pharmacy Services segment offers pharmacy benefit management solutions, including plan design and administration, formulary management, retail pharmacy network management, mail order pharmacy, specialty pharmacy and infusion, clinical, and disease and medical spend management services. .

• Its Retail/LTC segment sells prescription and over-the-counter drugs, consumer health and beauty products, and personal care products; and provides health care services through its MinuteClinic walk-in medical clinics.

• The company's Health Care Benefits segment offers traditional, voluntary, and consumer-directed health insurance products and related services.

 

The company has a significant presence across the country, both online and offline. It employs over 300,000 people across the United States, of which about 40,000 include medical healthcare providers including physicians, pharmacists, nurses and nurse practitioners.

 

The company was formerly known as CVS Caremark Corporation and changed its name to CVS Health Corporation in September 2014. CVS Health Corporation was founded in 1963 and is headquartered in Woonsocket, Rhode Island.

 

Final Note

 

This blog explored the 6 largest players in the health insurance sector in the US. The companies discussed in this blog have a rich historical presence in the US and together contribute to about half of the total market share in the health insurance sector in the US.

 

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