World’s Top 10 Largest Insurance Companies You Should Know

There are countless insurance companies offering various products and services. While many specialize in specific types of coverage, others provide a range of insurance options. The largest companies typically offer comprehensive coverage, including life, property, casualty, health, and business insurance. Some of these firms have even expanded into healthcare and financial services.

This list features companies that are publicly traded in the U.S. or Canada, either directly or via ADRs. Some international companies may report earnings every six months, which could result in longer reporting delays. The data here is current as of February 18, 2024, with figures sourced from Google Finance.

Here are the 10 largest insurance companies ranked by their 12-month trailing revenue (TTM).

1. UnitedHealth Group (UNH)

  • Revenue (TTM): $94.4 billion
  • Net Income (TTM): $5.5 billion
  • Market Cap: $482.4 billion
  • 1-Year Trailing Total Return: 4.5%
  • Exchange: New York Stock Exchange

UnitedHealth Group, a leader in the healthcare and insurance industry, provides a broad range of health insurance and related services. Its diverse offerings and strong market presence make it one of the most valuable insurance companies worldwide.

2. Berkshire Hathaway Inc. (BRK.B)

  • Revenue (TTM): $93.2 billion
  • Net Income (TTM): -$12.8 billion
  • Market Cap: $879.4 billion
  • 1-Year Trailing Total Return: 31.7%
  • Exchange: New York Stock Exchange

Berkshire Hathaway, led by Warren Buffett, is a giant in the insurance and investment sectors. Despite recent net income losses, the company’s vast portfolio, including insurance, utilities, and diverse investments, keeps it at the forefront of the industry. Its strong returns over the past year underscore its resilience and appeal to investors.

3. CVS Health Corp (CVS)

  • Revenue (TTM): $89.4 billion
  • Net Income (TTM): $2.3 billion
  • Market Cap: $97.03 billion
  • 1-Year Trailing Total Return: -12.9%
  • Exchange: New York Stock Exchange

While CVS is widely recognized for its medical supplies and pharmacy services, it also owns Aetna, a major insurance provider, acquired in 2018. This strategic move aimed to “transform the consumer health experience and build healthier communities.” Over time, CVS has evolved into a comprehensive healthcare provider, offering insurance, pharmaceuticals, and health and wellness products. The company operates more than 8,300 locations, employs over 300,000 people, and served over 5.5 million patients in its MinuteClinics and HealthHubs in 2022.

4. The Cigna Group (CI)

  • Revenue (TTM): $49.0 billion
  • Net Income (TTM): $1.4 billion
  • Market Cap: $99.8 billion
  • 1-Year Trailing Total Return: 13.3%
  • Exchange: New York Stock Exchange

The Cigna Group positions itself as a global healthcare benefit provider, organized into two main segments: Evernorth Health Services and Cigna Healthcare. Evernorth oversees several pharmaceutical and pharmacy solutions, including Express Scripts, Inside Rx, and ScreenRx, which enhance medication management and access. Meanwhile, Cigna Healthcare focuses on health insurance, serving the Group’s clients, the U.S. government, and individual consumers. Through this structure, Cigna delivers integrated healthcare solutions on a global scale.

5. Elevance Health Inc. (ELV)

  • Revenue (TTM): $42.9 billion
  • Net Income (TTM): $1.3 billion
  • Market Cap: $120.5 billion
  • 1-Year Trailing Total Return: 3.6%
  • Exchange: New York Stock Exchange

Elevance Health serves around 47 million members across the United States, offering health insurance plans for individuals, groups, Medicaid, and Medicare. As a key partner of the U.S. federal government, it also administers the Federal Employees Health Benefits Program. The company operates through three segments: the Commercial & Specialty Business segment, which covers employer and individual health plans; the Government Business segment, focusing on Medicaid and Medicare; and the CarelonRx segment, which manages pharmacy benefits.

6. Centene (CNC)

  • Revenue (TTM): $35.2 billion
  • Net Income (TTM): $469 million
  • Market Cap: $42.1 billion
  • 1-Year Trailing Total Return: 7.3%
  • Exchange: New York Stock Exchange

Centene is a major insurance provider for the federal government and holds the title of the largest Medicare insurer in the U.S. The company also offers a range of specialized healthcare services through various providers, including behavioral health, clinical healthcare, data analytics, pharmacy solutions, and vision and dental services. Centene provides Medicaid coverage across multiple states and regions, underscoring its broad role in government-sponsored healthcare.

7. Ping An Insurance (PNGAY)

  • Revenue (TTM): $28.8 billion
  • Net Income (TTM): $2.3 billion
  • Market Cap: $99.8 billion
  • 1-Year Trailing Total Return: -97.1%
  • Exchange: OTC

Ping An Insurance is a leading China-based company that provides both insurance and financial services. It offers a variety of products, including life and non-life insurance, which encompasses health, auto, casualty, and property coverage. In addition to its insurance offerings, Ping An also provides banking services and investment management. The company is known for its significant investments in technology development to enhance its services and operations.

8. Allianz (ALIZY)

  • Revenue (TTM): $26.5 billion
  • Net Income (TTM): $2.2 billion
  • Market Cap: $103.9 billion
  • 1-Year Trailing Total Return: 14.4%
  • Exchange: OTC

Allianz is a global insurance and asset management company based in Germany, serving over 122 million customers across more than 70 countries. The company offers a wide range of insurance products, including property, life, and health insurance. Additionally, Allianz manages approximately €1.7 trillion (about $1.8 trillion) in assets on behalf of its clients, highlighting its strong position in both the insurance and financial sectors.

9. Humana Inc. (HUM)

  • Revenue (TTM): $26.4 billion
  • Net Income (TTM): $832 million
  • Market Cap: $44.9 billion
  • 1-Year Trailing Total Return: -28.1%
  • Exchange: New York Stock Exchange

Humana is a prominent health insurance provider based in the United States, offering plans for Medicare, Medicaid, military personnel, and individual consumers. The company operates through two main segments: Insurance and CenterWell. The Insurance segment provides medical, dental, and vision insurance, along with administrative services. Meanwhile, the CenterWell segment focuses on pharmacy services, home healthcare, and primary care solutions, enhancing its commitment to comprehensive healthcare for its members.

10. Axa S.A. (AXAHY)

  • Revenue (TTM): $22.5 billion
  • Net Income (TTM): $2.1 billion
  • Market Cap: $70.0 billion
  • 1-Year Trailing Total Return: 9.8%
  • Exchange: OTC

Axa S.A. is a global insurance and financial services company based in France, with operations extending across Europe and Asia. The company offers a range of products, including property and casualty, health, and life insurance. Axa also manages approximately €932 billion in assets, showcasing its strong presence in both the insurance and financial sectors. With a focus on providing comprehensive coverage and financial solutions, Axa continues to be a key player in the global insurance market.

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