Top 10 Health Insurance Companies by Market Share
Health insurance is a very competitive field however no single health care company dominates the market; market share is more evenly distributed between all companies. Some companies will naturally hold a larger share of the market than others but overall health insurance market share is pretty diverse. The following statistics are based on a list made by National Association of Insurers Commissioners (NAIC) in 2010. The report reflects the national average of health insurance companies; the popularity of a certain company may fluctuate tremendously from one state to the next.
There are several types of health insurance policy, including HMO, PPO and POS policies. Each functions differently, and many insurers carry multiple types of plan. Because of the wide variance between policies, it’s important to understand the difference between these plans so you can choose the best policy to suit your needs.
HMO Health Insurance Plans
HMO stands for Health Maintenance Organization, and it is the cheapest type of insurance policy in most cases. HMOs work with a network of doctors to provide inexpensive health care. Whenever you are sick or need to visit a doctor, you must use a medical provider in the HMO’s network. You pay a predetermined set rate for any type of healthcare you receive, but the company has the right to refuse payment for treatments deemed experimental or unnecessary. While HMO’s are inexpensive, many people do not like the lack of flexibility that they provide.
PPO Health Insurance Plans
PPO policies are perhaps the most common, especially among employer-provided group health policies. PPO stands for preferred provider, and these policies do utilize a network of doctors similar to that offered by an HMO. The difference is that PPO providers are not affiliated with the insurance company directly the way they would be through an HMO, and patients can choose to use a provider outside of the network if they wish. Providers from outside of the network will be more expensive and the insurance coverage will not pay for the full cost of the visit, but the option is available if you need it.
POS Health Insurance Plans
POS policies, also known as point-of-service policies, provide a hybrid of the two previous policies. They are not as common in all areas, but are a better option in rural communities where a preferred provider may not be available to all individuals. These policies allow you flexibility in what provider to choose, but do focus primarily upon utilizing a preferred doctor for the majority of your needs.
In addition to choosing what type of policy you obtain, you can also personalize your health insurance policy by selecting how much coverage you need and what deductible you wish to pay. For individual policies, you may have more options than if you have an employer-provided group plan, but you should always have at least a little flexibility in choosing your coverage. This will allow you some control over your policy’s expense.
Who Are the Top 10 Health Insurance Companies?
#1 – United Health Group
With over 84 million policies in force, United Healthcare owns 13.6 percent of the market share. It is headquartered in Minnetonka, Minnesota, and services nine separate companies. The largest insurance provider in the country, United has annual revenue of about $80 billion. Part of the reason for the company’s size is its relationship with Medicare; United offers Medicare supplement and Part C coverage, both endorsed by AARP. Because of the number of retirees currently relying on Medicare for healthcare, Medicare coverage makes up a huge portion of the market. United Health Group also sells numerous group health plans for companies and government organizations.
Not only is United a large provider of insurance, it is also a hugely influential company in regards to insurance legislature. It provides substantial funding toward political action committees toward the improvement of health insurance, and lobbied extensively to limit the Healthcare Reform Act in 2010.
#2 – WellPoint, Inc.
WellPoint and Anthem merged together in 2004, becoming the leading commercial health insurance company in the country. Despite its youth as a company, WellPoint already operates in all 50 states and continues to grow its policies. WellPoint currently insures 54 million people, holding an 8.34 percent market share. This company is the largest member of the Blue Cross and Blue Shield network. WellPoint has reported an annual revenue of $56.3 billion.
WellPoint is popular for its extremely affordable healthcare coverage. In order to maintain its low costs, the company works closely with low-cost healthcare providers. It is also politically active and maintains relationships with several non-profit organizations that provide health education in communities nationwide, believing as a company that education and wellness is the best form of preventative medicine.
#3 – Kaiser Foundation Group
Possibly the best-known HMO in the country, The Kaiser Foundation was actually founded as a hospital management organization before it spread to providing health insurance. As of 2010, Kaiser held a 7.45 percent market share and reported revenue of $48.4 billion annually. Kaiser also has a large privately-administered healthcare organization, the largest on this list. Kaiser Permanente is actually a non-profit organization of healthcare providers, allowing customers access to extremely affordable healthcare.
Kaiser provides both private and group plans, although coverage is not available in all states. While many people do not like the structure of an HMO, it is undoubtedly an affordable care option for many and meets the needs of its insured customers in most cases.
#4 – Humana Group
Like United Healthcare, Humana insurance provides group employer and Medicare supplemental policies. Like Kaiser, Humana also began as a healthcare organization before spreading into insurance specifically. Humana makes the top five insurance companies in the country with a revenue of $26.6 billion and a 4.11 percent market share. Located in Louisville, Kentucky, Humana provides policies in all 50 states as well as Puerto Rico.
Humana offers coverage through both group and individual health insurance plans. In addition to its insurance policies, Humana has maintained several hospitals since 1974. United Healthcare attempted to buy the company, but the purchase fell through and Humana still operates independently while occasionally partnering with other insurance companies to extend coverage across the country.
#5 – Aetna Group
A major provider of employer group health insurance, Aetna holds 7.46 percent of the market share and reports annual revenues of $28.1 billion. It is one of the most common providers of insurance for employers, providing coverage to some of the largest industries in the country. Aetna’s popularity is due in large part to its affordable pricing and the coverage it offers.
Aetna’s roots as a company lie with Aflac, now a popular provider of supplemental insurance, in the 19th century as a life insurance provider. Aetna split from Aflac in 1859 and eventually became one of the first health insurance companies in the country.
#6 – Health Care Service Corporation
In addition to health insurance, the HCSC also offers life insurance and other related products. It is a member of the Blue Cross and Blue Shield organization and is customer-owned, meaning that policyholders also carry shares in the company. HCSC has an annual revenue of around $18.3 billion and holds 2.82 percent of the market share. In addition to standard health insurance, HCSC places a heavy focus on preventative medicine, and offers several wellness activities.
Only 10 percent of the policies sold by HCSC are to private individuals; instead, the company focuses mostly on providing employer-based group plans. In addition to health plans, HCSC also offers vision and dental plans as well as a mental health coverage that can be added to the policy.
#7 – Highmark Group
Holding 2.11 percent of the market share and insuring over 13 million policyholders, Highmark is a huge company in its home state of Pennsylvania. As a member of the Blue Cross and Blue Shield network, Highmark manages to bring in $12.9 billion each year despite operating in a single state. It is the largest insurance company by market share to operate in a single state.
In addition to regular group and private plans, Highmark also provides Medicare supplement insurance to qualifying members. Highmark is involved in several charity initiatives promoting healthy lifestyles and disease prevention. The company has won numerous awards, including one for Workplace Fitness Innovation, as well as being recognized by the American Heart Association.
#8 – CIGNA Health Group
CIGNA was founded in 1792, making it the oldest health insurance providers in the country. It’s also one of the largest providers worldwide. CIGNA was founded in Philadelphia but has spread out nationally. It now pulls in $18 billion each year.
CIGNA does not offer direct insurance coverage. Instead, it sells policies through subsidiaries and through employer group plans. The company is moving its headquarters to Connecticut, where its presence will create hundreds of new jobs and help to stimulate the economy as well as spread its policies.
#9 – Coventry Corp. Group
Servicing nearly 11 million customers, Coventry has a yearly revenue of $13.1 billion and holds 1.69 percent of the market share. It is an extremely diverse company, providing HMOs, PPOs, POSs, directed health and retiree programs. This extreme diversity makes the company a leader in the country and earns it a position in the top 10 list of providers. At one time, Coventry also handled medicare supplemental insurance. It no longer offers these policies, however, in order to focus on its other products.
Another thing that makes Coventry insurance unique in the market is that it tailors its policies to the size of the business ordering insurance. This means that it can offer specialized policies to suit the needs and budget of any given company that orders a group health plan. This flexibility helps to promote its popularity among small businesses and large corporations alike.
#10 – Blue Shield of California
You may have noticed that Blue Cross and Blue Shield has appeared several times on the list, and for good reason. Rather than providing service from a single unified company, Blue Cross and Blue Shield is an organization spread out across several states. In California alone, Blue Shield carries 9.5 million policies and holds 1.47 percent of the market share. Collectively, however, Blue Cross/Blue Shield holds an 11 percent market share, making it the second-largest insurance provider in the country.
Does Size Matter?
When it comes to health insurance, the size of your company doesn’t necessarily mean that the company is the best choice for your needs. On the one hand, a large market share indicates customer satisfaction and overall corporate health. On the other hand, health insurance is often provided by employers at a corporate level or otherwise offered without an alternate choice, so the most popular company is not necessarily the best for your needs.
There are also dozens of smaller companies that may be more popular locally. If you’re searching for a private health insurance policy, you would do well to obtain quotes from numerous companies and reading individual reviews of any company that you like. By looking at multiple insurance providers, you can obtain the best policy to suit your needs regardless of the provider’s size.