First Research US Industry Profile

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Health Insurance Carriers
SIC Codes: 6321, 6324
NAICS Codes: 524114
Last Quarterly Update: 10/14/2019
Companies in this industry underwrite health and medical insurance policies and administer group hospitalization plans, HMOs, and PPOs. Major companies include Aetna, Anthem, CIGNA, Humana, and UnitedHealth Group (all based in the US), as well as AEGON (the Netherlands), Allianz (Germany), and BUPA (UK).
Worldwide, demand for private health insurance is rising, especially in developing countries such as India and China, but also in countries with comprehensive government-provided health care. Private health insurance expenditures exceed $1.1 trillion annually, according to BCC Research.
The US health insurance carriers industry includes about 6,700 establishments (single-location companies and units of multi-location companies) with combined annual revenue of about $900 billion.
Competitive Landscape
Demand for health insurance products is driven by cost of medical care. The profitability of individual companies depends on efficient operations and the ability to enter favorable contracts with health care providers. Large companies and organizations have advantages in negotiating contracts with providers. Small companies can compete successfully by specializing in types of coverage or populations. The US industry is concentrated: the 50 largest companies generate about 80% of revenue.
Health payment reform efforts have altered the competitive landscape for health insurance companies around the globe. The Affordable Care Act (ACA) mandated health care coverage availability for all Americans beginning in 2014; the law also eliminated some common exclusions, such as pre-existing conditions. Managed care companies compete for customers in new government-run health exchanges, where small companies and individuals can buy health care coverage. Many state Medicaid programs offer expanded coverage under ACA provisions. The proportion of people in the US covered by insurance rose from nearly 86.7% in 2013 to 91.2% in 2017 as millions of people gained coverage. Penalties for not having health coverage will be eliminated in 2019, but other components including individual marketplaces, Medicaid expansion, and consumer protections remain intact. The law also aims to tighten coverage and payment rates, including through reductions in Medicare and Medicaid reimbursements.
Products, Operations & Technology
Major products offered by US health insurance carriers include health maintenance organization (HMO), preferred provider organization (PPOs), point-of-service ... plus:
Sales & Marketing
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Finance & Regulation
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Regional & International Issues
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Human Resources
Also includes the following chapters:
Quarterly Industry Update
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Industry Indicators
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Business Challenges
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Trends and Opportunities
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Call Preparation Questions
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Financial Information
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Industry Forecast
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Industry Websites
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Glossary of Acronyms

Historical Profiles (PDF format)

04/15/2019
01/21/2019
10/15/2018
07/16/2018
04/16/2018
01/15/2018
10/02/2017
07/03/2017
04/03/2017
01/02/2017
09/26/2016
06/27/2016
03/28/2016
12/21/2015
09/21/2015
06/22/2015
03/23/2015
12/22/2014
09/29/2014
07/07/2014
04/14/2014
01/20/2014
10/14/2013
07/22/2013
04/29/2013
02/04/2013
10/29/2012
08/06/2012
05/21/2012
02/27/2012
11/07/2011
08/08/2011
04/25/2011
01/24/2011
10/18/2010
07/19/2010
04/12/2010
01/04/2010