These are the top 25 property/casualty insurance companies in the US
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Top 25 Health Insurance Companies in America

Offering health insurance is a big decision for employers, but knowing where to start can be overwhelming, especially for small businesses that don’t have full human resources staff.

However, taking the time and research to establish formal health benefits is well worth the effort. There are many benefits to offering an employer-sponsored health insurance plan to help retain and attract employees, help your business stand out, and build a happy and healthy workforce.

Understanding which health insurance companies are reliable with a wide range of products and providers is a good place to start. Below are listed the top 25 health insurance companies in the United States in descending order by size of market share. This list is a great place to start your research on your path to providing great health benefits.

Top 25 U.S. health insurance companies listed by market share

  1. United Health
  2. Kaiser Foundation
  3. Anthem Inc
  4. Centene Corporation
  5. Humana
  6. CVS
  7. Health Care Service Corporation (HCSC)
  8. CIGNA
  9. Molina Healthcare
  10. Independence Health Group
  11. Guidewell Mutual Holding
  12. California Physicians Service
  13. Highmark Group
  14. Blue Cross Blue Shield of Michigan
  15. Blue Cross of California
  16. Blue Cross Blue Shield of New Jersey
  17. Caresource
  18. UPMC Health System
  19. Health Net of California
  20. Carefirst Inc.
  21. Blue Cross Blue Shield of North Carolina
  22. Metropolitan
  23. Local Initiative Health Authority
  24. Blue Cross Blue Shield of Massachusetts
  25. Blue Cross Blue Shield of Tennessee

To clarify, the size of the market share is not necessarily related to the quality of the product or service, nor does it guarantee that the company will maintain its position throughout the year. This list reflects the data collected by the end of 2020. If you are shopping for an individual health insurance policy, we recommend that you visit our blog to help you find one.

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Health insurance companies won big profits from consumers


According to the NAIC Health Insurance Report, in 2020, US health insurance companies earned about $816.2 billion in net premiums. Compared to 2019, premium spending for US consumers increased by 11%.

With the increase in premium prices, budgeting for a group health insurance plan can be difficult. However, there are now more options for small to medium-sized businesses that cannot afford a group health insurance plan. A health reimbursement arrangement (HRA) is one of those options.

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Why health reimbursement arrangements are a better option for small employers

HRA is a health benefit that is used to reimburse employees tax-free, medical expenses and health insurance premiums. Employers are able to manage their budget by setting an allowance and give their employees more flexibility and freedom over their health benefits to suit their needs.

PeopleKeep provides an HRA administration software for businesses of all sizes to quickly and easily administer their HRA benefits. This enables employers to provide a simple, effective solution to manage benefits while we focus on details such as documentation review and compliance.

If you are looking for an alternative to expensive group health insurance policies, HRA enables your employees to choose the most suitable policy for their needs. Below are three types of HRAs that PeopleKeep offers that may be right for you.

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Qualified Small Employer HRA

A Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) is a health benefit for employers with fewer than 50 full-time equivalent employees. Employers can determine an allowance that works for their budget and employees can choose an insurance policy that works best for them and purchase an insurance policy that best suits their individual medical needs.

The allowance is flexible and can be used to receive tax-free reimbursement for health insurance premiums and other out-of-pocket medical expenses. Use our interactive spending tool that includes a complete list of reimbursable expenses under IRS Publication 502.

Individual Coverage HRA

Similar to QSEHRA, Individual Coverage HRA (ICHRA) is a health benefit that can be used to pay employees personal health insurance premiums and other medical expenses tax-free. However, it is available to employers of all sizes and can be used on its own or in combination with group health insurance.

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If they choose to, employers can set different allowance amounts based on family status, making the ICHRA customizable. All employees must decide whether to opt out of benefits before they begin and certify at the beginning of each month that

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