Top 25 health insurance companies in the U.S.

Offering and enrolling in the health insurance is an significant decision for the employers and candidates. It can be overwhelming to know that where to start, especially if you’re a small business without an HR team or a benefits specialist to help them. But, putting in the time and research to set up a formal health benefit plan is well worth the effort taken.

There are several advantages to offering an employer sponsored health insurance plan, including the helping to retain and attract the employees, making your business stand out, and contributing the toward a happy and healthy workforce.

In this article, we’ll list the top 25 health insurance companies in the United States by market share and provide alternative coverage options, if you want to offer something more cost-effective and flexible than traditional group health plans.

Employers comparing health insurers are most likely looking to secure a group health plan. So, let’s review those types of policies before diving into the top health insurance companies in the U.S.

With traditional group health insurance, employers choose a group medical plan for their organization and offer coverage to their employees and eligible dependents at a reduced rate. Most insurers require employers to meet a 70% minimum participation rate to receive coverage.

Insurance carriers offer various plan types, such as health maintenance organizations (HMOs) and preferred provider organizations (PPOs). A covered person will be responsible for paying their portion of the premium plus meeting their annual deductible before their insurer begins sharing the cost of their medical claims.

Employers can buy a group health policy directly from an insurance carrier, licensed agent, or broker. Small businesses can purchase a policy on the Small Business Health Options (SHOP) marketplace and apply for the Small Business Health Care Tax Credit to save on premiums1.

The cost of group health insurance varies, but rates generally increase annually. The average annual premium for group health insurance in 2023 was $8,435 for self-only coverage and $23,968 for family coverage. Of those amounts, employers contributed $7,034 to their employees’ self-only plans and $17,393 to their family plans2.

While their familiarity makes them a popular choice for employers and employees, their high costs may be too much for smaller businesses to afford.

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

If you’re interested in offering a group health plan or you’re an individual looking to purchase a plan on the exchanges, understanding which health insurance companies are credible and provide a wide range of products and medical providers is an excellent place to start searching for coverage.

Below are the top 25 health insurance companies in the United States listed by market share size in descending order, according to NAIC3.

Conclusion

While the number of health insurance companies offers employers many ways offer a traditional group health benefit, it’s essential to consider other, more flexible options.

HRAs are an easy way to offer an affordable health benefit without diving head-first into the waters of group plan administration. They also give your employees the autonomy to choose the right health policy for them. If you’re an employer considering an HRA, we would love to help you get started.