Top 10 health insurance companies in the US

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Top 10 health insurance companies in the US

In the US, there are a host of private healthcare insurance specialists. However, life/annuity and property/casualty insurers also write this coverage, often referred to as accident and health insurance, as outlined by the Insurance Information Institute.

In 2020, the accident and health insurance industry’s direct written premiums reached $1.25 trillion, up by almost 84% from $680 billion in 2011. The largest 10 insurers collectively wrote 55.3% of the total US market, according to the National Association of Insurance Commissioners (NAIC). That is a huge number, although it is not surprising when you consider that health insurance is one of the most common types of insurance.

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Based on NAIC’s 2020 data, here are the top 10 accident and health insurance groups:

1. UnitedHealth

Direct Written Premiums: $176.7 billion
Market Share: 14.1%

A diversified health and well-being company, UnitedHealth Group’s core capabilities are clinical expertise, advanced technology, and data and health information.

UnitedHealth Group serves clients and consumers in the US and more than 130 other countries through two distinct platforms: UnitedHealthcare provides healthcare coverage and benefits services, while Optum provides information and technology-enabled health services. The group invests more than $4 billion in technology and innovation and processes approximately 1.1 trillion transactions annually.

2. Kaiser Foundation

Direct Written Premiums: $104.2 billion
Market Share: 8.3%

Kaiser Foundation Health Plan, Inc. operates as a non-profit healthcare organization. The organization offers allergy, audiology, cardiology, dermatology, oncology, hospice, laboratory, nephrology, occupational therapy, pain management, pediatric rehabilitation, and pharmacy services. The company serves patients in the US.

Read next: Here are the basic insurance terms everyone should know

3. Anthem, Inc.

Direct Written Premiums: $76.9 billion
Market Share: 6.2%

Anthem, Inc. is a health benefits company that is committed to improving lives and communities and making healthcare simpler. Anthem, through its affiliated companies, serves more than 106 million people, including over 42 million within its family of health plans. It aims to be the most innovative, valuable, and inclusive partner.

The group’s affiliated health plans have created various HMOs, PPOs, network-based dental products, various hybrid and specialty products, and health plan services that combine the attributes consumers find attractive with effective cost control techniques. Individual members and employer groups can select from basic and comprehensive plans to meet their specific needs. A wide range of related specialty products and other services is also available, including flexible spending accounts and COBRA administration.

Centene Corporation, a Fortune 500 company, is a diversified, multinational healthcare company providing a portfolio of services to government-sponsored healthcare programs, focusing on uninsured and underinsured individuals. It operates in 50 states and three international markets and has more than 25 million managed care members.

Centene operates local health plans and provides a range of health insurance solutions. Also, it contracts with other healthcare and commercial organizations to offer specialty services, ranging from behavioral health, dental benefits, life and health, and pharmacy benefits management to care management software, correctional healthcare services, in-home health services, managed vision, specialty pharmacy, and telehealth services.

5. Humana

Direct Written Premiums: $73.9 billion
Market Share: 5.9%

Humana’s cultural foundation is aligned to helping members achieve their best health by providing personalized, simplified, whole-person healthcare experiences. Recognizing that each person, family, and community’s healthcare needs continue to evolve, Humana creates innovative solutions and resources to help people live their healthiest lives on their terms – when and where they need it.

6. CVS

Direct Written Premiums: $69 billion
Market Share: 5.5%

CVS Health is a healthcare innovation company with a purpose to help people on their path to better health. Through its health services, plans, and community pharmacists, it pioneers a new approach to total health.

CVS has more than 9,900 retail locations, nearly 1,100 walk-in medical clinics, a pharmacy benefits manager with about 100 million plan members, a diversified healthcare benefits company serving about 23.4 million medical members, a dedicated senior pharmacy care business serving more than one million patients per year, expanding specialty pharmacy services, and a standalone Medicare Part D prescription drug plan.


Direct Written Premiums: $42 billion
Market Share: 3.4%

Health Care Service Corporation (HCSC), a mutual legal reserve company, is the largest customer-owned healthcare insurance company in the US. The company serves more than 16 million members across five states – Illinois, Montana, New Mexico, Oklahoma, and Texas – and employs more than 23,000 people in over 60 local offices.

HCSC offers a wide variety of life and health insurance products and related services through its affiliates and subsidiaries, including Dearborn Group, Dental Network of America, HCSC Insurance Service Company, Medecision, Availity, Prime Therapeutics, and TriWest Healthcare Alliance.

8. Cigna Health

Direct Written Premiums: $31.8 billion
Market Share: 2.5%

Cigna Corporation is a global health service organization with more than 165 million customer and patient relationships in over 30 countries and jurisdictions. Its insurance plans and products include healthcare insurance for individuals and families, dental insurance plans, Medicare plans, Medicare supplemental plans, other supplemental insurance, and international health insurance.

9. Molina Healthcare, Inc.

Direct Written Premiums: $21.4 billion
Market Share: 1.7%

Molina Healthcare, a Fortune 500 company, exclusively focuses on government-sponsored healthcare programs for qualified individuals and families. The company contracts with state governments and serves as a health plan providing a wide range of quality healthcare services to individuals and families.

Molina provides health plans in California, Florida, Illinois, Michigan, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Washington, Wisconsin, and Puerto Rico. The company also offers a Medicare product and has been selected in many states to join in dual demonstration projects to manage the care for those eligible for Medicaid and Medicare.

10. Independence Health Group

Direct Written Premiums: $20.1 billion
Market Share: 1.6%

Philadelphia-headquartered Independence Health Group, along with its subsidiaries, serves about 10 million clients in 27 states and the District of Columbia. A quarter of its customer network is based in southeastern Pennsylvania. The company serves various employer groups, from small and midsize enterprises to national corporations.

Among the services, the insurer offers are commercial, Medicare and Medicaid coverage, pharmacy benefits management, workers’ compensation, and third-party benefits administration. The company is an independent licensee of the Blue Cross and Blue Shield Association.

What are the largest auto insurance companies?

State Farm is the number one auto insurance company in the country in terms of market share and premiums written, followed by Geico, Progressive, and Allstate. When looking at the rankings of the top auto insurance companies in the United States, most of the names are recognizable due to their national television advertising campaigns.

Yet the 10 largest insurance companies in the U.S., listed below, offer different insurance rates, customer claims experiences, and features. For shoppers looking for cheap rates, we always recommend getting a free online insurance quote to find the best price from multiple insurers.

Premiums wrote in billions
Market share percentage
1 State Farm $40.4 16%
2 Geico $33.9 14%
3 Progressive $33.2 13%
4 Allstate $25.9 10%
5 USAA $15.8 6%
6 Farmers $12.2 5%
7 Liberty Mutual $11.8 5%
8 Nationwide $5.8 2%
9 American Family $5.2 2%
10 Travelers $4.9 2%

1. State Farm

State Farm is a great auto insurance company for anyone who wants a local agent, a personalized experience and cheaper-than-average rates.

Average annual premium: $1,310
Market share: 16%
Premiums written: $40.4 bn
ValuePenguin rating: 4.5/5
J.D. Power customer satisfaction score: 892
Read our 3full State Farm review
State Farm is the largest auto insurance company in the U.S. and owns 16% of the total available market share. Over 15% of dollars spent on private passenger auto premiums in the country go to State Farm.

The company currently employs approximately 60,000 employees and has nearly 19,000 agents. State Farm operates as a mutual insurance company, meaning that its policyholders own it.

Among the largest widely available car insurers in this list, State Farm offered the cheapest car insurance rates in most of the U.S.

2. Geico

Geico is one of the cheapest auto insurance companies. It offers national availability and an easy shopping experience.

Average annual premium: $1,917
Market share: 14%
Premiums written: $33.9 bn
ValuePenguin rating: 4/5
J.D. Power customer satisfaction score: 881
Read our full Geico review
Geico, known for its advertisements featuring an animated gecko, has served as an underwriter to more than 16 million auto policies, which insure more than 24 million vehicles. The company's size allows it to employ more than 40,000 people across nine regional offices, three service centers and three claims centers.

Geico's original customer base consisted of U.S. government employees and military personnel. Today, the insurance company's customer base has expanded to include people in the private sector.

According to our research of the largest auto insurance carriers, Geico is the best insurer for college students.

3. Progressive

Progressive offers especially competitive rates to drivers with previous accidents. However, claims satisfaction ratings and coverage options are average.

Average annual premium: $2,036
Market share: 13%
Premiums written: $33.2 bn
ValuePenguin rating: 3/5
J.D. Power customer satisfaction score: 862
Read our full Progressive review
Progressive — the third-biggest insurance company in the country — was established in 1937. The company offers the ability to buy auto insurance in-person, online or by phone. Alternatively, customers can sign up through independent insurance agents.

The company employs more than 35,000 people and has over 400 offices. Progressive is a publicly traded company.

4. Allstate

Allstate typically has better-than-average claims satisfaction ratings, but higher rates. However, the insurer offers a variety of discounts that can make policies more affordable for customers.

Average annual premium: $2,349
Market share: 10%
Premiums written: $25.9 bn
ValuePenguin rating: 3/5
J.D. Power customer satisfaction score: 870
Read our full Allstate review
Established in 1931, Allstate is the second-largest publicly traded property and casualty insurance company in America. Like State Farm, Allstate has a roster of local agents ready to serve your needs. The company currently employs more than 46,000 people.

Esurance, a subsidiary of Allstate, operates in the same space. According to Allstate, the Esurance brand targets self-directed and brand-sensitive customers, while Allstate is geared toward customers who want local and personal service.

USAA is one of the best auto insurers in the country. You'll enjoy extremely competitive rates, great customer service and speedy claims responses from USAA. The only downside is USAA's restricted membership.

Average annual premium: $1,170
Market share: 6%
Premiums written: $15.8 bn
ValuePenguin rating: 4.5/5
J.D. Power customer satisfaction score: 909
Read our full USAA review
USAA was founded by 25 Army officers who decided to insure each other's vehicles in 1922. Today, the company serves millions of members associated with the U.S. military, including current and former service members, family of service members and cadets or midshipmen.

USAA is headquartered in San Antonio. The corporate campus' length extends three-quarters of a mile. USAA is the largest private company located in San Antonio.

Because of its focus on the U.S. armed forces, USAA is our top pick for the best and cheapest car insurance for veterans and military service members.

6. Farmers

Farmers offers decent discounts, coverage options and great customer service. However, Farmers' expensive rates may be a negative for some shoppers.

Average annual premium: $2,521
Market share: 5%
Premiums written: $12.2 bn
ValuePenguin rating: 3.5/5
J.D. Power customer satisfaction score: 893
Read our full Farmers review
Farmers began as an insurance company providing coverage to farmers' vehicles. Since then, it has evolved to become the seventh-largest insurance company in the country.

It’s hard to find an insurance company that offers more products than Farmers. It offers auto insurance, pet insurance and even investment products, among other insurance products. Farmers employs nearly 13,000 people, underwriting more than 19 million policies across all 50 states.

7. Liberty Mutual

Liberty Mutual's rates vary by location more than the typical insurer, and customers rank the company's claims satisfaction process as below average.

Market share: 5%
Premiums written: $11.8 bn
ValuePenguin rating: 3.5/5
J.D. Power customer satisfaction score: 876
Read our full Liberty Mutual review
Liberty Mutual is one of the largest insurance companies in the U.S. and has been around for over 100 years. It has a large international presence, with operations in 17 countries. The company sells property and casualty, health and life insurance policies.

You can get Liberty Mutual auto insurance through its call center, website, a local Liberty Mutual agent or broker, or representatives from its network of regional subsidiaries. One thing to note about Liberty Mutual's coverage is that the company guarantees rates for a year.

8. Nationwide

Nationwide is below average for affordability, and its customer reviews tend to lean negative. Nationwide offers standard coverages and discounts you’d expect from a large national insurer.

Average annual premium: $2,127
Market share: 2%
Premiums written: $5.8 bn
ValuePenguin rating: 4/5
J.D. Power customer satisfaction score: 876
Read our full Nationwide review
Nationwide offers financial services, commercial lines and personal lines in all 50 states. The company has contributed more than $430 million to nonprofit organizations since 2000.

Nationwide has a motto called "On Your Side" that influences how auto insurance claims are handled, and how policies and premiums are determined. The company also recommends getting an annual checkup to ensure policyholders understand their benefits and coverage, as well as new discounts or changes to keep premiums affordable. Nationwide calls this consultation its "On Your Side" review.

Among this list of the largest car insurance companies, Nationwide offers the best deals for customers looking to bundle their home and auto insurance policies.

9. American Family

American Family is a solid choice for auto insurance. The company offers decent rates, which have the potential to be great when policyholders take advantage of some of its many discounts.

Average annual premium: $1,755
Market share: 2%
Premiums written: $5.2 bn
ValuePenguin rating: 3.5/5
J.D. Power customer satisfaction score: 889
Read our full American Family review

American Family was initially established to insure farmers. In the 1930s, the company expanded and began to focus on insuring non-farmers as well. Today, the company is one of the biggest insurance companies in the U.S., and the largest insurer by market share in Wisconsin.

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