Health Insurance Carriers
Brief Excerpt from Industry Overview Chapter:
Companies in this industry underwrite health and medical insurance policies and administer group hospitalization plans, health maintenance organization (HMO), and preferred provider organization (PPO). Major companies include Aetna, Anthem Blue Cross and Blue Shield, Cigna, Humana, and UnitedHealthcare (all based in the US); as well as Aegon (the Netherlands); Allianz (Germany); and Bupa (UK).
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 85% of revenue.
PRODUCTS, OPERATIONS & TECHNOLOGY
Major products offered by US health insurance carriers include health maintenance organization (HMO), preferred provider organization (PPO), point-of-service (POS), and indemnity benefit plans, according to Healthcare.gov and eHealth Insurance. Of the approximately 90% of Americans covered by health insurance, about 68% are covered by private health insurance and about 34% by government. More than 9% of the US population are not covered by any health insurance in 2019, according to the American Community Survey (ACS). Most private policies are employer-based.
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