Choosing health insurance is a major decision for individuals, families, and businesses. For small companies without HR staff or a benefits advisor, the process can seem overwhelming. However, investing the time to establish a structured health benefit plan can bring long-term rewards.

For employers, offering health coverage can help attract and retain employees, maintain a competitive edge, and contribute to a healthier, more satisfied workforce. This guide outlines the top 25 health insurance companies in the USA by market share and explores alternative options for more budget-friendly and flexible health benefits.

What Is Traditional Group Health Insurance?

Traditional group health insurance is a common choice for businesses. Employers select a plan for their teams and offer coverage to employees and their eligible dependents at reduced rates. Most insurers require businesses to meet a 70% minimum participation rate for plan approval. If too few employees enroll, the plan may not be available.

Available plan options include:

• Health Maintenance Organizations (HMOs)
• Preferred Provider Organizations (PPOs)
• Exclusive Provider Organizations (EPOs)
• Point-of-Service Plans (POS)

Employees are responsible for part of the premium and must meet their annual deductible before the insurer covers claims. Companies can purchase group plans directly through insurance providers, brokers, or marketplaces like the Small Business Health Options Program (SHOP). Small businesses may qualify for tax credits to offset the cost.

On average in 2024, group health insurance premiums were:

• $8,951 annually for individual coverage
• $25,572 annually for family coverage

Employers typically contributed:

• $7,584 toward individual plans
• $19,276 toward family plans

While group health plans are familiar and widely used, they can be expensive for smaller companies and may not be the best fit for everyone. Alternatives like individual plans or reimbursement programs can provide more flexibility and affordability.

Top 25 Health Insurance Companies in the USA

When exploring health insurance options, knowing which companies dominate the market can help guide your search. Market share reflects a company’s size and financial standing, which can indicate its reliability and resources.

Here are the top 25 health insurance companies in the USA by market share, as reported by NAIC:

1. UnitedHealth Group (16.37%)
2. Elevance Health (Anthem) (7.08%)
3. Centene Corp. (6.76%)
4. Humana (6.61%)
5. CVS Health (Aetna) (6.43%)
6. Kaiser Foundation (6.19%)
7. Health Care Services Corp. (HCSC) (3.65%)
8. Cigna Health (2.64%)
9. Molina Healthcare (2.04%)
10. GuideWell (Florida Blue) (1.91%)
11. Independence Health Group (1.85%)
12. Highmark Group (1.32%)
13. Blue Cross Blue Shield of Michigan (1.20%)
14. Blue Cross Blue Shield of New Jersey (1.11%)
15. UPMC Health System (0.95%)
16. Blue Cross Blue Shield of North Carolina (0.82%)
17. Caresource (0.77%)
18. Health Net of California (0.75%)
19. Local Initiative Health Authority (0.73%)
20. Carefirst Inc. (0.72%)
21. Metropolitan (0.65%)
22. Blue Cross Blue Shield of Massachusetts (0.61%)
23. Blue Cross Blue Shield of Tennessee (0.61%)
24. Point32Health (0.57%)
25. Health Net Community Solutions (0.55%)

Market share size doesn’t guarantee quality or provider network size, but it highlights competitive and financially stable companies.

Premium Revenue of Health Insurance Companies

Health insurers in the U.S. earned around $1.08 trillion in premiums in 2023, an 8% increase from 2022. Leading the list, UnitedHealth Group collected approximately $248 billion in premiums, while Health Net Community Solutions earned $8.35 billion.

This growth in spending reflects rising healthcare costs, inflation, and greater demand for medical services. Employers can stay competitive by offering a range of health benefits, including wellness programs, to support employees’ needs.

Alternatives for Small Businesses: HRAs and Health Stipends

Small businesses often face challenges with high premiums and participation requirements for group plans. Health Reimbursement Arrangements (HRAs) and health stipends provide flexible and cost-effective solutions.

Individual Coverage HRA (ICHRA)

An ICHRA reimburses employees tax-free for personal health insurance premiums and medical expenses. Employers can tailor allowances for different employee classes and offer it as a standalone benefit or alongside a group plan. Employees must have qualified health coverage to participate.

Qualified Small Employer HRA (QSEHRA)

Designed for businesses with fewer than 50 full-time employees, a QSEHRA allows employers to set budgets for tax-free reimbursements. Employees can use these funds for insurance premiums and medical costs. Minimum essential coverage (MEC) is required to qualify.

Integrated HRA

For employers retaining group health plans, an integrated HRA (or Group Coverage HRA) helps cover out-of-pocket expenses like deductibles and coinsurance. Employers can customize allowance amounts and cost-sharing terms to control expenses.

Health Stipends

Health stipends are taxable benefits that give employees flexibility to spend on healthcare needs, including insurance premiums and supplemental plans. While stipends don’t satisfy Affordable Care Act (ACA) requirements for larger employers, they’re easy to implement and work well for smaller organizations.

The Best Health Insurance for Visitors to the USA

Visitors to the U.S. often need health insurance tailored to their short-term stays. Policies for international travelers can cover medical emergencies, hospitalization, and other unexpected health needs. Many insurers from the top 25 list also offer visitor-specific plans with flexible options, ensuring travelers have access to necessary care during their visit.

Conclusion

Choosing the right health insurance can make a significant impact, whether for a business or individual. While traditional group plans are widely used, alternatives like HRAs and stipends offer flexibility and cost savings. For visitors to the USA, exploring specialized health plans ensures access to tailored solutions for their stay.

Understanding your options and exploring the best health insurance companies in the USA can simplify the process. Whether you’re a small business owner, individual, or traveler, the right coverage can provide peace of mind and financial security. AI Blogging System.