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Top 10 Biggest Insurance Companies

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There are thousands of insurance companies providing products and services in the insurance sector. Most of them specialize in specific types of insurance, while others offer multiple types. The biggest ones generally offer all types of insurance, such as life, property and casualty, health, and business insurance. Some have expanded in health care services and financial services.

This list is limited to companies that are publicly traded in the U.S. or Canada, either directly or through ADRs. Some foreign companies may report semiannually and so may have longer lag times. All figures were current as of Feb. 18, 2024, and were sourced from Google Finance.

These are the 10 Biggest Insurance Companies by 12-Month Trailing Revenue (TTM).

#1: United Health 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

United Health Group is a combination of United Health Care, its insurance business, and Optum, its health services business. United employs roughly 400,000 people and provides insurance and services for about 152 million customers and 6,400 hospitals and other facilities.12

#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 is a holding company that owns numerous subsidiaries, a significant portion of which are insurance companies. It is one of the largest companies in the world by market capitalization and is owned by famed investor Warren Buffet. Some of its insurance subsidiaries are Geico, General Re, MLMIC Insurance, United States Liability Insurance, and National Indemnity.3

#3: CVS Health Corp Group (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 well known for its medical supplies and pharmacies, it owns Aetna, an insurance provider. It acquired Aetna in 2018 in its attempts to “…transform the consumer health experience and build healthier communities…” Over the years, CVS has built itself into an all-inclusive healthcare solutions provider, able to offer insurance, pharmaceuticals, and health and wellness products and services. The company employs over 300,000 people in 8,300 locations and served over 5.5 million in its MinuteClinics and HealthHubs in 2022.4

#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 refers to itself as a global healthcare benefit provider. It is composed of two operational segments: Evernorth Health Services and Cigna Healthcare. Evernorth is the parent organization for several pharmaceutical and pharmacy solutions like Express Scripts, Inside Rx, and ScreenRx. Cigna Healthcare is the Group’s insurance segment, which provides health insurance for the Group, the U.S. Government, and consumers.5

#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 is a health insurance provider that serves about 47 million members. The company provides plans for individuals and groups, Medicaid, and Medicare. It is also the U.S. federal government’s health benefits manager and administers the Federal Employees Health Benefits Program.6

Elevance has three operational segments—its Commercial & Specialty Business segment, the Governments Business segment, and the CarelonRx segment, which manages pharmacy benefits.6

#6: Centene (CNC)

• Revenue (TTM): $35.2 billion
• Net Income (TTM): $469.0 Million
• Market Cap: $42.1 Billion
• 1-Year Trailing Total Return: 7.3%
• Exchange: New York Stock Exchange

Centene is a leading insurance provider for the federal government and is the largest Medicare insurer in the U.S.7 Through specialty providers, Centene offers behavioral health services, clinical healthcare, data analytics, pharmacy solutions, vision and dental services, and Medicaid in different states and regions.8

#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 China-based insurance and financial services company offering life and non-life insurance products. Its non-life insurance products include health, auto, casualty, property insurance, and banking. It also provides investment management services and invests heavily in technology development.9

#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 an international insurance and asset management provider headquartered in Germany. It serves more than 122 million people in over 70 countries. It provides property, life, and health insurance and manages about €1.7 trillion ($1.8 trillion) in assets for its customers.10

#9: Humana Inc. (HUM)

• Revenue (TTM): $26.4 billion
• Net Income (TTM): $832.0 Million
• Market Cap: $44.9Billion
• 1-Year Trailing Total Return: -28.1%
• Exchange: New York Stock Exchange

Humana is a U.S.-based health insurance provider. It provides plans for Medicare, Medicaid, military personnel, and consumers. Humana has two operating segments, Insurance and CenterWell. The Insurance segment offers medical, dental, and vision insurance and administrative services. The CenterWell segment offers pharmacy, home, and primary care solutions.11

#10: Axa Sa (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 Sa is an international insurance and financial services company that provides property and casualty, health, and life insurance products and manages about €932 billion in assets. It is headquartered in and operates out of France, Europe, and Asia.12

The Axa Group. “Univeral Registration Document 2022,” Pages 14-21.