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Kaiser Permanente is the largest health insurance company in the U.S., followed by two Blue Cross Blue Shield companies (Elevance Health and HCSC), according to S&P Global Market Intelligence.
While some of these large health insurance companies are household names, others might seem obscure to the average consumer. What is the best health insurance company isn’t necessarily the biggest, but here is the list of the 50 largest health insurance companies in the U.S., and a deeper look at each of the top five.
50 Largest Health Insurance Companies in the U.S. Overall
| Rank | Health insurance company | Total health plan enrollment in 2021 | ||||
|---|---|---|---|---|---|---|
| 1 | Kaiser Permanente | 12.81% | 8,228,765 | |||
| 2 | Elevance Health (Anthem) | 7.27% | 4,670,236 | |||
| 3 | HCSC (including BCBS plans) | 6.88% | 4,419,293 | |||
| 4 | UnitedHealth Group | 6.70% | 4,306,492 | |||
| 5 | Centene Corp. | 6.17% | 3,962,897 | |||
| 6 | CVS Health Corp. (Aetna) | 4.01% | 2,574,348 | |||
| 7 | GuideWell (Florida Blue) | 3.88% | 2,491,019 | |||
| 8 | Blue Cross Blue Shield of Michigan | 2.08% | 1,337,400 | |||
| 9 | Highmark | 1.61% | 1,035,585 | |||
| 10 | Blue Cross of North Carolina | 1.40% | 897,649 | |||
| 11 | Humana | 1.38% | 887,612 | |||
| 12 | Blue Cross and Blue Shield of Alabama | 1.26% | 810,745 | |||
| 13 | Blue Cross Blue Shield of Massachusetts | 1.24% | 794,909 | |||
| 14 | Molina Healthcare | 1.21% | 778,269 | |||
| 15 | Independence Health Group | 1.21% | 774,155 | |||
| 16 | CareFirst | 1.20% | 773,007 | |||
| 17 | Tufts Health | 1.14% | 733,482 | |||
| 18 | Horizon Blue Cross Blue Shield of New Jersey | 1.07% | 684,988 | |||
| 19 | Bright Health | 0.95% | 609,981 | |||
| 20 | Blue Shield of California | 0.95% | 608,388 | |||
| 21 | Oscar Insurance | 0.89% | 573,833 | |||
| 22 | Regence | 0.89% | 570,109 | |||
| 23 | Blue Cross Blue Shield of South Carolina | 0.87% | 559,021 | |||
| 24 | Intermountain Healthcare | 0.87% | 557,622 | |||
| 25 | Medica | 0.86% | 551,986 | |||
| 26 | Priority Health | 0.82% | 529,585 | |||
| 27 | Cigna Corp. | 0.80% | 511,335 | |||
| 28 | Excellus Health | 0.76% | 485,599 | |||
| 29 | Wellmark | 0.74% | 476,632 | |||
| 30 | EmblemHealth | 0.74% | 474,949 | |||
| 31 | Blue Cross & Blue Shield of Louisiana | 0.73% | 466,813 | |||
| 32 | Premera Blue Cross | 0.72% | 465,280 | |||
| 33 | BlueCross BlueShield of Tennessee | 0.69% | 446,079 | |||
| 34 | UPMC Health Plan | 0.66% | 422,050 | |||
| 35 | HealthPartners | 0.66% | 421,333 | |||
| 36 | Hawaii Medical Service Assn. | 0.65% | 417,150 | |||
| 37 | Arkansas BlueCross BlueShield | 0.62% | 397,702 | |||
| 38 | Blue Cross & Blue Shield of Kansas City | 0.50% | 320,136 | |||
| 39 | Medical Mutual of Ohio | 0.48% | 308,476 | |||
| 40 | University Health Care | 0.41% | 266,296 | |||
| 41 | First Medical Health Plan | 0.41% | 260,438 | |||
| 42 | Blue Cross Blue Shield of Arizona | 0.40% | 254,119 | |||
| 43 | Blue Cross and Blue Shield of Minnesota | 0.39% | 250,704 | |||
| 44 | CareSource | 0.34% | 220,020 | |||
| 45 | Blue Cross & Blue Shield of Mississippi | 0.33% | 214,358 | |||
| 46 | MVP Health Care | 0.32% | 207,547 | |||
| 47 | Capital Blue Cross | 0.29% | 184,151 | |||
| 48 | Blue Cross of Idaho | 0.29% | 183,064 | |||
| 49 | PacificSource | 0.26% | 170,034 | |||
| 50 | Providence St. Joseph Health | 0.26% | 169,476 | |||
| Source: S&P Global Market Intelligence. Enrollment numbers are based on commercial group and individual health insurance members and do not include Medicare or Medicaid. | ||||||
Kaiser Permanente
Kaiser Permanente serves members in eight states and the District of Columbia. It offers the following types of plans:
- Individual health insurance
- Employer-sponsored health insurance
- Medicare Advantage
- Medicaid, including Medi-Cal
Kaiser Permanente is an integrated health system that includes both health care providers and insurance coverage.
The company specializes in a care model that encourages teams of experts to collaborate across departments and specialties, such as cancer care, cardiac care, maternity and pediatrics. The company says this helps speed the process of diagnosis, treatment and recovery.
Elevance Health (Anthem)
Elevance Health—formerly known as Anthem—features the brands of Anthem and Wellpoint, which includes multiple Blue Cross Blue Shield plans.
Elevance offers the following types of plans:
- Individual health insurance
- Employer-sponsored health insurance
- Medicare Advantage
- Medicaid
- Supplemental insurance
HCSC
Health Care Service Corp. is the largest customer-owned health insurer in the U.S. and serves members in five states. It operates Blue Cross Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma and Texas.
HCSC offers the following types of plans:
- Individual health insurance
- Employer-sponsored health insurance
- Medicare Advantage
- Medicare supplement
- Medicaid
HCSC affiliates and subsidiaries offer other types of coverage, including group life, disability and dental insurance.
UnitedHealth Group
UnitedHealth Group, parent company for UnitedHealthcare, offers Affordable Care Act (ACA) marketplace coverage to individuals and families in 18 states.
UnitedHealthcare offers the following types of plans:
- Individual health insurance
- Employer-sponsored health insurance
- Medicare Advantage
- Medicaid
- Short-term health insurance
- Supplemental insurance
UnitedHealthcare has partnerships with more than 1.3 million medical providers and 6,500 hospitals and other types of care facilities in the U.S.
Centene Corp.
Centene, which includes subsidiaries like Ambetter, Health Net, Fidelis Care and Wellcare, serves members in all 50 states. Centene offers the following types of plans:
- Individual health insurance
- Employer-sponsored health insurance
- Medicare Advantage
- Medicaid
Centene is the largest Medicaid managed care organization, with plans in four of the largest Medicaid states: California, Florida, New York and Texas.
Featured Health Insurance Partners
1
Aetna
Coverage area
Offers plans in all 50 states and Washington, D.C.
Number of providers in network
About 1.2 million
2
Blue Cross Blue Shield
Coverage area:
Offers plans in all 50 states and Washington, D.C.
Number of providers in network
About 1.7 million
Physician copays start at
$10
2
Blue Cross Blue Shield
On Healthcare Marketplace's Website
3
Cigna
Coverage area
Offers plans in all 50 states and Washington, D.C.
Number of providers in network
About 1.5 million
Physician copays start at
$0
10 Largest Individual Health Insurance Companies in the U.S.
Here are the biggest health insurance companies for individual health insurance and ACA marketplace plans.
| Rank | Health insurance company | Total health enrollment in 2021 | ||||
|---|---|---|---|---|---|---|
| 1 | Centene Corp. | 13.26% | 2,198,277 | |||
| 2 | GuideWell (Florida Blue) | 8.19% | 1,357,872 | |||
| 3 | Kaiser Permanente | 6.96% | 1,153,784 | |||
| 4 | Elevance Health (Anthem) | 5.99% | 992,700 | |||
| 5 | HCSC (including BCBS plans) | 5.80% | 962,051 | |||
| 6 | Molina Healthcare | 4.69% | 778,269 | |||
| 7 | Bright Health | 3.57% | 592,669 | |||
| 8 | Oscar Health | 3.42% | 567,838 | |||
| 9 | Blue Cross of North Carolina | 2.74% | 453,981 | |||
| 10 | Independence Health Group | 1.83% | 303,881 | |||
| Source: S&P Global Market Intelligence | ||||||
10 Largest Group Health Insurance Companies in the U.S.
Group health insurance is how most people get health insurance before they reach Medicare age. Here are the biggest health insurance companies in the group health insurance market.
| Rank | Health insurance company | Total health enrollment in 2021 | ||||
|---|---|---|---|---|---|---|
| 1 | Kaiser Permanente | 14.85% | 7,074,981 | |||
| 2 | UnitedHealth Group | 8.42% | 4,010,946 | |||
| 3 | Elevance Health (including Anthem and Wellpoint) | 7.72% | 3,677,536 | |||
| 4 | HCSC (including BCBS plans) | 7.26% | 3,457,242 | |||
| 5 | CVS Health Corp. (Aetna) | 5.13% | 2,444,988 | |||
| 6 | Centene Corp. | 3.70% | 1,764,620 | |||
| 7 | Blue Cross Blue Shield of Michigan | 2.46% | 1,172,597 | |||
| 8 | GuideWell (Florida Blue) | 2.38% | 1,133,147 | |||
| 9 | Humana | 1.86% | 887,610 | |||
| 10 | Highmark | 1.84% | 876,856 | |||
| Source: S&P Global Market Intelligence | ||||||
Largest Health Insurance Companies by State
The largest health insurance companies vary by state. In some states, national insurers like UnitedHealthcare dominate, while in other states a Blue Cross/Blue Shield plan will have the largest membership. Here are the biggest health insurance companies by state for group and individual health insurance members.
| State | Largest health insurance company membership | |
|---|---|---|
| Alabama | Blue Cross & Blue Shield of Alabama | |
| Alaska | Premera Blue Cross | |
| Arizona | Blue Cross Blue Shield of Arizona | |
| Arkansas | Arkansas BlueCross BlueShield | |
| California | Kaiser Permanente | |
| Colorado | Kaiser Permanente | |
| Connecticut | Elevance Health (Anthem) | |
| Delaware | Highmark | |
| District of Columbia | CareFirst | |
| Florida | Guidewell (Florida Blue) | |
| Georgia | Elevance Health (Anthem) | |
| Hawaii | Hawaii Medical Service Assn. | |
| Idaho | Blue Cross of Idaho | |
| Illinois | HCSC (Blue Cross Blue Shield of Illinois) | |
| Indiana | Elevance Health (Anthem) | |
| Iowa | Wellmark | |
| Kansas | Blue Cross & Blue Shield of Kansas City | |
| Kentucky | Elevance Health (Anthem) | |
| Louisiana | Blue Cross & Blue Shield of Louisiana | |
| Maine | Elevance Health (Anthem) | |
| Maryland | CareFirst | |
| Massachusetts | Blue Cross Blue Shield of Massachusetts | |
| Michigan | Blue Cross Blue Shield of Michigan | |
| Minnesota | HealthPartners | |
| Mississippi | Blue Cross & Blue Shield of Mississippi | |
| Missouri | Blue Cross & Blue Shield of Kansas City | |
| Montana | HCSC (Blue Cross Blue Shield of Montana) | |
| Nebraska | Blue Cross & Blue Shield of Nebraska | |
| Nevada | UnitedHealth Group | |
| New Hampshire | Elevance Health (Anthem) | |
| New Jersey | Horizon Blue Cross Blue Shield of New Jersey | |
| New Mexico | HCSC (Blue Cross & Blue Shield of New Mexico) | |
| New York | UnitedHealth Group | |
| North Carolina | Blue Cross of North Carolina | |
| North Dakota | Blue Cross Blue Shield of North Dakota | |
| Ohio | Elevance Health (Anthem) | |
| Oklahoma | HCSC (Blue Cross and Blue Shield of Oklahoma) | |
| Oregon | Kaiser Permanente | |
| Pennsylvania | Highmark | |
| Rhode Island | Blue Cross & Blue Shield of Rhode Island | |
| South Carolina | Blue Cross Blue Shield of South Carolina | |
| South Dakota | Wellmark | |
| Tennessee | BlueCross BlueShield of Tennessee | |
| Texas | HCSC (Blue Cross and Blue Shield of Texas) | |
| Utah | Intermountain Healthcare | |
| Vermont | BlueCross BlueShield of Vermont | |
| Virginia | Elevance Health (Anthem) | |
| Washington | Kaiser Permanente | |
| West Virginia | Highmark | |
| Wisconsin | University Health Care | |
| Wyoming | Blue Cross Blue Shield of Wyoming | |
| Source: S&P Capital IQ, combining commercial group and individual health insurance members | ||
Find The Best Health Insurance Companies Of 2024
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Largest Health Insurance Companies FAQ
What is the biggest individual health insurance company?
Centene Corp. has the most individual health insurance members in the U.S. with 13.26% of the market share. For comparison, No. 2 GuideWell (Florida Blue) has just 8.19%.
Overall, Centene ranks No. 5 among health insurance companies when combining group and individual commercial health insurance policies, with 6.17% of the market.
Centene says nearly one in 15 people in the U.S. use its products. It is the No. 1 provider of plans on the health insurance marketplace.
What is the largest insurer for group health insurance?
Kaiser Permanente is the biggest group health insurance company in the U.S. It has 14.85% of the group health insurance market, considerably ahead of No. 2 UnitedHealth Group (8.42%).
Kaiser Permanente is also the biggest overall health insurer, with 12.81% of the total health insurance market.
Kaiser Permanente’s provider network includes 23,656 physicians, 65,005 nurses, 734 medical offices and 39 hospitals.
Should you choose the largest health insurance company?
There are perks to choosing a large health insurance company. Big insurers may have large networks of health care providers and hospitals, increasing your range of choices.
However, the size of a health insurer should not be the only criteria you look at when choosing health insurance. Some other things to keep in mind include:
- How much will you pay in premiums and cost-sharing such as deductibles?
- Are your doctors in the health plan’s network?
- How does the insurer rank in terms of customer satisfaction?
As with any type of insurance product, the right choice is the one that best suits your individual wants and needs.
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