Top 10 Largest Insurance Companies in USA (.PDF + .PPTX)

Today we will discuss about the Top 10 Largest Insurance Companies in USA with PPT, PDF, Table and Infographic so Lets Picking the right insurance company isn’t just about finding the cheapest premium – it’s about trusting a company to be there when life goes sideways. The United States is home to the world’s largest insurance market, generating over $1.2 trillion in premiums in 2024 alone. From protecting your car and home to covering your health and your family’s future, insurance companies play a quiet but critical role in every American’s financial life. But with hundreds of carriers competing for your business, one question keeps coming up – who are actually the biggest and most trusted players in the game?

In this guide, we break down the Top 10 Largest Insurance Companies in the USA based on the latest 2024–2025 and 2026 data from the NAIC, AM Best, and the Insurance Information Institute. Whether you’re shopping for a new policy, comparing providers, or just curious about who dominates the industry – you’re in the right place. Let’s dive in.

Why Size Matters – and How to Read These Rankings

The United States insurance market is the largest in the world, generating over $1.2 trillion in net earned premiums in 2024 – a 9% year-over-year increase. From health insurance to auto coverage, life protection to commercial risk, the 10 companies in this article collectively insure the majority of American households, businesses, and government programs.

Before diving in, an important clarification: ‘largest’ in insurance means different things depending on the metric. The same company can simultaneously be #1 in market capitalization, #4 in direct premiums written, and #1 in total assets – and all three facts would be accurate. This article uses direct premiums written (DPW) as the primary ranking, per NAIC and Insurance Information Institute (III) standards, because DPW most directly reflects how much insurance business a company actually writes. We supplement with market cap (Feb 2025) and total assets (Jan 2026) to give you the full picture.

The 2024–2025 rankings in this article are updated to reflect the latest available data – corrected from earlier versions to match what Google’s AI Mode and current NAIC data show. You will notice some familiar names (UnitedHealth, State Farm), some surprises (Centene Corporation, Kaiser Permanente), and some companies whose rankings differ significantly depending on which metric you use (Berkshire Hathaway is #4 by DPW but #1 by assets).

Top 10 Largest Insurance Companies in USA (PPT SLIDES)

The 3 Ways to Rank: Side-by-Side Data

Here is how the current data breaks down across the three most important ranking metrics for 2024–2025:

Market Capitalization – Top 10 (February 2025)

Total Assets – Top 5 (January 2026)

Sector Leaders – Direct Premiums Written (2024)

Top 10 at a Glance – Direct Premiums Written Ranking (2024)

Detailed Company Profiles: The Top 10 Largest U.S. Insurance Companies

#1. UnitedHealth Group

Largest U.S. Health Insurer by Revenue, Membership & Market Cap

UnitedHealth Group stands at the pinnacle of the American insurance industry – and by virtually every metric, it is not close. It holds the #1 market cap among all U.S. insurers at approximately $255.75 billion as of February 2025, leads the health insurance sector with 16.05% market share, and wrote approximately $269.4 billion in direct health premiums in 2024. No other health insurer is in the same conversation.

The company operates through two deeply integrated segments. UnitedHealthcare – the insurance arm – serves more than 50 million members across employer-sponsored plans, individual health coverage, Medicare Advantage, and Medicaid programs across all 50 states. Optum – the health services and technology platform – runs OptumRx (pharmacy benefits), OptumHealth (care delivery clinics and physician groups), and OptumInsight (data analytics and AI). In 2025, Optum itself generates more revenue than most standalone health insurers.

Why UnitedHealth Cannot Be Caught

The genius of UnitedHealth’s model is vertical integration. While competitors focus on selling insurance and outsourcing everything else, UnitedHealth owns the entire ecosystem: the insurance plan, the pharmacy, the physician groups, the analytics, and the data. Optum reported over $226 billion in revenue in 2023 alone – dwarfing the total revenue of companies like Humana or Kaiser Permanente as standalone businesses.

Key Products: Employer health plans, individual & family coverage, Medicare Advantage, Medicaid managed care, pharmacy benefits (OptumRx), care delivery clinics.

Competitive Edge: Vertical integration through Optum, 50M+ member scale, #1 market cap, deepest government program relationships in the industry.

#2. State Farm

America’s Largest Auto, Homeowners & P&C Insurer

State Farm is the undisputed dominant force in personal lines insurance – and the numbers are staggering. In 2024, State Farm wrote approximately $108.9 billion in Property & Casualty direct premiums (10.34% P&C market share), led private passenger auto insurance with an 18.90% market share (~$67.7B in premiums), and topped homeowners insurance with 18.20% share (~$31.5B). It has held the #1 auto insurance position for decades and shows no signs of relinquishing it.

As a mutual company – owned by its policyholders rather than public shareholders – State Farm operates with a fundamentally different incentive structure than rivals like Progressive or Allstate. There are no quarterly earnings calls to manage, no Wall Street analysts to appease. Profits build surplus and serve policyholders, which is one reason State Farm holds an A++ Superior AM Best rating alongside Berkshire Hathaway – the highest possible financial strength designation.

19,000 Agents: The Distribution Advantage

State Farm’s network of approximately 19,000 independent captive agents gives it an unmatched local presence in communities across America. In an industry increasingly focused on digital-direct sales, State Farm’s agent model continues to deliver superior retention rates. Customers who buy through an agent renew at significantly higher rates than those who purchase online – a retention advantage that directly translates to long-term profitability.

Key Products: Auto insurance, homeowners, renters, life insurance, commercial, farm & ranch, health, banking.

Competitive Edge: 18.9% private auto share (largest in U.S.), A++ AM Best rating, mutual company stability, 19,000-agent network.

#3. Elevance Health (formerly Anthem)

Largest Blue Cross Blue Shield Affiliate – 46 Million Members

Elevance Health – rebranded from Anthem in 2022 – is the largest Blue Cross Blue Shield affiliated health insurer in the nation and one of the most important healthcare companies in America. Serving approximately 46 million members across health, pharmacy, dental, vision, and behavioral health products, Elevance represents a cornerstone of employer-sponsored health coverage in the United States.

The rebrand from Anthem to Elevance Health was a strategic signal: the company is transitioning from a traditional insurance carrier to a ‘whole health company’ – one that manages not just medical claims but behavioral health, social determinants of health, and care coordination across the full spectrum of a person’s wellbeing.

Carelon: Competing with Optum

Elevance’s Carelon health services division – encompassing pharmacy benefits, behavioral health, and care management – is the company’s answer to UnitedHealth’s Optum. Carelon serves both Elevance members and external clients, creating a B2B revenue stream that diversifies Elevance beyond pure insurance. With $74.12 billion in market cap, investors are pricing in this services growth story alongside the core insurance business.

Key Products: Commercial health insurance, Medicare Advantage, Medicaid managed care, dental, vision, behavioral health, pharmacy (Carelon).

Competitive Edge: Blue Cross Blue Shield national network, Carelon integrated services platform, massive Medicaid footprint in 14 states.

#4. Berkshire Hathaway (incl. GEICO)

#1 in Total Assets – $1.15 Trillion Insurance Conglomerate

Berkshire Hathaway is a different kind of insurance company entirely. While it ranks #4 by direct premiums written in 2024, it is the undisputed #1 insurer in the world by total assets – holding approximately $1.15 trillion in non-banking assets as of January 2026. That asset base is the financial foundation upon which Warren Buffett has built one of history’s greatest investment empires.

Berkshire’s insurance operations span three major units: GEICO – the second-largest private passenger auto insurer in the U.S. with 28+ million policyholders and a low-cost direct model; Berkshire Hathaway Reinsurance Group (BHRG) – one of the world’s leading reinsurers providing catastrophic coverage to other insurers; and General Re – a global specialty reinsurer. Together, these units write billions in annual premiums.

The Legendary Insurance Float

What makes Berkshire’s insurance operation unique is not the underwriting – it is the float. Float is the money collected in premiums before claims are paid, and Berkshire’s float has exceeded $160 billion. Buffett uses this float to invest in stocks, bonds, and entire businesses, generating investment returns that effectively make Berkshire’s insurance profitable even when underwriting results are break-even. No other insurer runs this model at this scale.

Key Products: GEICO auto, homeowners, commercial, reinsurance (BHRG), specialty lines (General Re), life & health.

Competitive Edge: $1.15T in assets, $160B+ investment float, A++ AM Best, Warren Buffett capital allocation.

#5. Progressive Corporation

#3 by Market Cap – Fastest-Growing Major P&C Insurer in 2024

Progressive Corporation is the most dynamic growth story in American insurance right now. It holds the #3 market cap among all U.S. insurance companies at approximately $119.40 billion as of February 2025 – an extraordinary valuation for a company focused almost entirely on auto and property insurance. In 2024, Progressive recorded the highest year-over-year market share increase in the entire Property & Casualty sector, growing by 0.67% – a massive move in a mature market.

Progressive is the #1 commercial auto insurer in the United States with 15.10% market share and approximately $10.8 billion in commercial auto direct premiums. It is also the second-largest private passenger auto insurer. This combination makes Progressive the dominant force in auto insurance underwriting across both personal and commercial lines.

The Data Moat: Why Progressive Keeps Winning

Progressive’s competitive advantage is its data science infrastructure. The Snapshot telematics program prices auto insurance based on actual driving behavior – not demographics. Progressive has collected more telematics data per policyholder than any other U.S. auto insurer, giving it pricing precision that competitors have spent years trying to replicate. Combined with the iconic Flo advertising campaign and a superior direct-to-consumer digital platform, Progressive’s growth momentum shows no signs of slowing.

Key Products: Personal auto, commercial vehicle, motorcycle, boat, RV, homeowners.

Competitive Edge: #3 U.S. insurer by market cap, #1 commercial auto, Snapshot telematics, fastest YoY growth in P&C sector (2024).

Also read: Top 10 Largest Insurance Companies in the World 2026 .PPTX

#6. Centene Corporation

The Government Healthcare Specialist – Largest Medicaid MCO in America

Centene Corporation is one of the most important insurance companies in America that most people have never heard of – unless they are among the 28 million Americans it serves. While UnitedHealth dominates commercial and employer health insurance, Centene dominates government-sponsored healthcare: Medicaid managed care, the ACA Health Insurance Marketplace, Medicare, and TRICARE military health programs.

As the largest Medicaid managed care organization in the United States, Centene operates in all 50 states and D.C., managing Medicaid populations on behalf of state governments. Medicaid now covers over 90 million low-income Americans – making it the single largest health insurance program in the country by enrollment – and Centene has positioned itself as the premier operator in this vast government market.

Multiple Government Programs, One Company

Centene’s diversification across government health programs is a structural advantage. It operates through Ambetter Health (ACA Marketplace plans for individuals), WellCare (Medicare Advantage and Part D), HealthNet (managed care in California), and multiple state-branded Medicaid plans. This multi-brand, multi-program model means Centene can serve a person at every stage of their government health insurance journey – from Medicaid in childhood through Medicare in retirement.

Key Products: Medicaid managed care, ACA Marketplace (Ambetter), Medicare Advantage (WellCare), TRICARE, behavioral health, pharmacy.

Competitive Edge: #1 Medicaid MCO in the U.S., 50-state footprint, government program specialization across all major segments.

#7. Humana

16% Medicare Advantage Market Share – Built for America’s Seniors

Humana has executed one of the most successful strategic transformations in insurance history – pivoting from a broad health insurer into America’s premier Medicare Advantage specialist. According to 2025 data from Mark Farrah Associates, UnitedHealthcare commands 28.7% of the Medicare Advantage market while Humana holds 16.0%, together controlling nearly 45% of this massive and rapidly growing segment.

The strategic logic is powerful: approximately 10,000 Baby Boomers turn 65 every single day in the United States, and Medicare Advantage enrollment surpassed 50% of all eligible Medicare beneficiaries for the first time in 2024. Humana has structured its entire company – from insurance plans to physician clinics to pharmacy services – around serving this demographic.

CenterWell: The Senior Health Model

Humana’s CenterWell Primary Care centers are purpose-built physician clinics specifically designed for Medicare-age patients, focused on prevention, chronic disease management, and care coordination. By owning the primary care relationship, Humana closes the loop between insurance coverage and care delivery – improving outcomes while reducing unnecessary hospital admissions. This model has become one of the most studied examples of value-based care in the industry.

Key Products: Medicare Advantage, Medicare Supplement, Medicare Part D, Medicaid, TRICARE, CenterWell primary care.

Competitive Edge: 16.0% MA market share (#2 nationally), CenterWell integrated care model, aging U.S. population structural tailwind.

#8. CVS Health (Aetna)

The Most Integrated Health Ecosystem in America

CVS Health – through its landmark $69 billion acquisition of Aetna in 2018 – has assembled the most vertically integrated health care model in the United States. Aetna brings 37 million insurance members across commercial, Medicare Advantage, and Medicaid plans. CVS brings 9,000+ pharmacy and MinuteClinic locations plus Caremark, one of the largest pharmacy benefits managers in the country. The combination creates a health coverage and care delivery ecosystem that would take competitors decades and hundreds of billions to replicate.

Google’s current search data lists CVS Health (Aetna) at #8 in the top 10 largest U.S. insurance companies, reflecting Aetna’s massive insurance footprint combined with CVS’s distribution power. The combined entity’s approximately $358 billion in total revenue makes it one of the largest companies in the world by any measure.

HealthHUBs and MinuteClinics: Reinventing Access

CVS’s HealthHUB concept is transforming pharmacy locations into primary care access points – offering chronic disease management, mental health support, lab testing, and clinical consultations alongside prescriptions. For Aetna insurance members, this network of 9,000+ in-network locations creates an accessibility advantage that standalone insurers cannot match. As healthcare consumerism grows, this ‘insurance + pharmacy + clinic’ model grows more powerful every year.

Key Products: Commercial health plans, Medicare Advantage, Medicaid, dental, pharmacy benefits (Caremark), retail health (MinuteClinic, HealthHUB).

Competitive Edge: Insurance + pharmacy + care delivery integration, 9,000+ physical touchpoints, Caremark PBM scale.

#9. Kaiser Permanente

America’s Largest Not-for-Profit Integrated Health System

Kaiser Permanente is unlike any other company on this list – and that difference is its greatest strength. While every other top 10 insurer sells coverage and then reimburses external providers for care, Kaiser Permanente IS both the insurer and the healthcare system. Its 40+ hospitals, 700+ medical offices, and 23,000+ physicians operate as one unified, coordinated system. The insurance premium and the doctor’s visit are part of the same organization.

As a not-for-profit integrated managed care consortium, Kaiser does not answer to shareholders. Surplus revenue is reinvested into care quality, physician salaries, facilities, and technology. This mission-driven model consistently produces some of the highest clinical quality scores and member satisfaction ratings of any health plan in the country, according to NCQA (National Committee for Quality Assurance) annual rankings.

Why Integration Beats Everything

In Kaiser’s model, a member’s primary care doctor, specialist, pharmacist, lab, and hospital are all connected through a single unified electronic medical record. There are no referral delays from insurer approval processes, no out-of-network surprises, and no information gaps when a patient moves between care settings. This coordination produces better outcomes at lower cost than fragmented fee-for-service systems – which is the fundamental promise of managed care that few organizations actually deliver.

Kaiser intentionally limits its geographic footprint to California, Oregon, Washington, Colorado, Georgia, Hawaii, Maryland, Virginia, and D.C. – focusing on depth of integration rather than national breadth, knowing that the model only works when both insurance and care delivery are tightly controlled.

Key Products: Integrated HMO health plans, Medicare Advantage, Medicaid, dental, vision, mental health – all within Kaiser’s own provider network.

Competitive Edge: Not-for-profit mission, fully integrated care delivery, highest NCQA quality ratings, zero insurer-vs-provider conflict.

#10. MetLife

#1 Life & Annuity Insurer – $687.5 Billion in Total Assets

MetLife closes the top 10 with a distinction that no other company on this list holds: it is the #1 life and annuity insurer in the United States by direct premiums written, capturing 8.60% market share with approximately $97.7 billion in Life/Annuity DPW in 2024. Its $687.5 billion in total assets as of January 2026 place it third among all U.S. insurers – trailing only Berkshire Hathaway ($1.15T) and Prudential Financial ($721.1B).

Founded in 1868 – 155 years of continuous operation – MetLife carries a depth of brand trust that most financial services companies cannot claim. The famous Snoopy advertising campaign made life insurance feel accessible and human for generations of American families, and that emotional resonance continues to drive brand loyalty today.

The Workplace Benefits Machine

MetLife’s primary U.S. growth engine is employer-sponsored group benefits: group life insurance, dental, vision, disability, and accident & health coverage distributed directly through American employers. MetLife is the largest provider of employee benefit products in the country, reaching approximately 90 million U.S. customers through their workplaces. This B2B distribution model generates highly stable, recurring revenue that is remarkably resilient through economic cycles.

Internationally, MetLife’s strong positions in Asia and Latin America provide growth opportunities and portfolio diversification that purely domestic U.S. insurers simply cannot access – making MetLife one of the few genuinely global insurance franchises in the world.

Key Products: Group life, dental, vision, disability, accident & health, individual life, annuities, retirement solutions, global employee benefits.

Competitive Edge: #1 life/annuity market share, $687.5B in assets, dominant workplace distribution, 155+ years of brand trust, global diversification.

How to Choose the Right Insurance Company?

With 10 excellent options across different insurance segments, how do you choose? The answer depends entirely on what coverage you need:

For Health Insurance

If you get coverage through an employer, the choice may be made for you – but if you have options, compare UnitedHealth, Elevance, Aetna, and Cigna on network breadth in your area, premium cost, and deductible structure. For government programs: Centene (Medicaid), Humana or UnitedHealth (Medicare Advantage), or Kaiser Permanente (if you live in a Kaiser service area and value integration).

For Auto Insurance

State Farm, Progressive, and GEICO (Berkshire) are the top three for most drivers. Get quotes from all three – pricing differences of 20–40% for identical coverage are common. Progressive’s Snapshot program rewards safe drivers with the largest discounts. State Farm’s agents provide the best service for complex situations. GEICO’s digital platform is fastest for straightforward policies.

For Life Insurance

MetLife, Prudential, and Northwestern Mutual lead in group and individual life. For employer-sponsored group life, MetLife is the dominant provider. For individual permanent life policies, compare Northwestern Mutual and New York Life. For term life at the lowest cost, compare multiple quotes through an independent broker.

Always Verify Financial Strength

Regardless of coverage type, only purchase insurance from carriers with at least an A- AM Best rating. Berkshire Hathaway (GEICO) and State Farm hold A++ – the industry maximum. Progressive and Allstate hold A+. UnitedHealth, MetLife, Elevance, Aetna, Cigna, and Kaiser Permanente hold A. Centene and Humana hold A-. All are safe, sound choices.

(2025–2026) Trends Every Insurance Consumer Should Know

Medicare Advantage Now Covers More Than Half of Medicare Enrollees

For the first time in 2024, Medicare Advantage enrollment exceeded 50% of all eligible Medicare beneficiaries. UnitedHealth (28.7%) and Humana (16.0%) dominate this market. Expect continued aggressive competition – and better benefits – as these giants battle for seniors’ enrollment.

Homeowners Premium Surge: +10.9% Year-Over-Year

Per NAIC mid-year 2025 reports, homeowners insurance premiums increased 10.9% year-over-year as carriers absorbed climate-related losses from wildfires, hurricanes, and flooding. State Farm and others have pulled back from California and Florida. If you live in a high-risk state, start shopping early and consider state-backed FAIR Plan options.

Progressive: Fastest-Growing Major P&C Insurer in 2024

Progressive’s 0.67% year-over-year P&C market share gain in 2024 was the highest in the sector. Its combination of telematics-based pricing, digital distribution, and commercial auto leadership is creating a widening gap with rivals.

Health Insurance Market Hits $1.2 Trillion

The U.S. health insurance market grew approximately 9% in 2024, reaching $1.2 trillion in net earned premiums. Rising medical costs, Medicaid redetermination disruptions, and Medicare Advantage expansion all contributed to this growth.

FAQ:

Which is the #1 largest insurance company in the USA in 2025?

By market capitalization (~$255.75B) and health insurance market share (16.05%), UnitedHealth Group is #1. By total assets ($1.15 trillion), Berkshire Hathaway is #1. By auto and homeowners insurance market share, State Farm is #1. The ‘largest’ title depends on which metric you use – UnitedHealth Group is most commonly cited as the overall largest by revenue and market cap.

What is the largest auto insurance company in the USA?

State Farm is the largest private passenger auto insurer in the United States with 18.90% market share and approximately $67.7 billion in auto DPW in 2024. Progressive leads commercial auto with 15.10% market share.

Which insurer has the best AM Best financial rating?

Only two companies on this top 10 list hold A++ (Superior) ratings – the highest possible: Berkshire Hathaway (GEICO) and State Farm. Progressive and Allstate hold A+ (Superior). All others hold A or A-, all of which indicate excellent financial strength.

Who leads Medicare Advantage in 2025?

UnitedHealthcare leads with 28.7% Medicare Advantage market share, followed by Humana at 16.0%, according to Mark Farrah Associates 2025 data. Together, they control nearly 45% of the entire Medicare Advantage market.

What is Direct Premiums Written (DPW)?

Direct Premiums Written is the total premiums an insurance company charges policyholders before passing any portion to reinsurers. It is the insurance industry’s standard size metric, used by the NAIC and Insurance Information Institute, because it reflects how much insurance business a company is actively underwriting – as opposed to total revenue, which includes non-insurance activities.

Is Kaiser Permanente available everywhere in the USA?

No. Kaiser Permanente operates in eight states plus Washington D.C.: California, Oregon, Washington, Colorado, Georgia, Hawaii, Maryland, and Virginia. It intentionally limits its geographic footprint to maintain the deep care integration that drives its quality advantage. If you live outside these areas, Kaiser is not an option for primary coverage.

Conclusion: The 10 Companies That Define American Insurance

The 10 largest insurance companies in the United States collectively represent the financial backbone of American risk management. They pay out billions in auto accident claims, cancer treatments, life insurance benefits, and property replacement every single day. Understanding who they are, what they specialize in, and how they are ranked empowers you to make smarter, more informed coverage decisions.

The most important takeaway from this guide: there is no single ‘best’ insurance company for everyone. UnitedHealth Group dominates health insurance. State Farm dominates auto and homeowners. MetLife dominates life insurance. Humana dominates Medicare Advantage. Centene dominates Medicaid. Berkshire Hathaway dominates total assets. Match the company to your coverage need – and always verify current financial strength ratings before you buy.

These rankings reflect the best available data as of 2024–2025 and 2026. For the most current information, always check the NAIC Consumer Information Source (content.naic.org), AM Best (ambest.com), and each company’s official website before making any coverage decisions.

Disclaimer: This article is for informational purposes only. Insurance rankings, premiums, and ratings change frequently. Always verify details directly with insurers and consult a licensed insurance professional before purchasing coverage.

Sources: NAIC, Insurance Information Institute (III), AM Best, Mark Farrah Associates, Fortune 500, company 2023–2024 annual reports.