2025 State-Level Accident and Health Insurance Data for the Broader Insurance Industry

September 10, 2026

The U.S. Accident and Health (A&H) insurance market produced nearly $1.6 trillion in premium revenue in 2025, maintaining its status as one of the largest and most significant segments of the insurance industry. These results are based on insurer filings submitted to the National Association of Insurance Commissioners (NAIC), through the Accident and Health Policy Experience Exhibit (AHPEE) which is included in annual statutory financial statements. Available through Mark Farrah Associates' (MFA's) Health Coverage Portal™, AHPEE data enables insurers to analyze and benchmark premiums, claims, covered lives, member months, and policy counts across multiple A&H insurance segments at both the national and state levels. In this latest Business Strategy Report, Mark Farrah Associates (MFA) highlights key trends and insights derived from its analysis of 2025 AHPEE market data.

• Historically, the health insurance conversation has been centered on government-sponsored coverage, including Medicare Advantage, Medicare Part D (PDP), Medicare Supplement, Medicaid, and S-CHIP. Collectively, these programs represented the largest segment of the Accident and Health (A&H) insurance market in 2025, generating more than $978.2 billion in premiums, an increase of 16.4% from $840.4 billion in 2024. Enrollment totaled 111.7 million lives, a slight decline of 0.4% from 112.1 million lives in the prior year. Medicaid enrollment declined following federal policy changes implemented under the 2025 reconciliation law (One Big Beautiful Bill Act), which tightened eligibility and renewal requirements and led to the loss of coverage for beneficiaries.
   
• Government programs and comprehensive major medical coverage, including the Federal Employees Health Benefits Program (FEHBP), group plans (small group, large group, and association and trust business), and individual plans purchased on or off the exchanges, operate under extensive regulatory requirements. As a result, both segments reported high medical loss ratios (MLRs) in 2025, with government programs reaching 90.0% and major medical coverage totaling 91.2%. These ratios increased from 89.2% and 87.6%, respectively, in 2024. The year-over-year increase in MLRs reflects a larger share of premium revenue being spent on medical claims, which contributed to lower underwriting profitability compared to the prior year.
   
• Non-Comprehensive (Non-Comp) medical insurance remained one of the most profitable A&H segments in 2025, with a loss ratio of 75.1%. Enrollment declined to 514.8 million covered lives from 530.0 million in 2024. The category includes disability, long-term care (LTC), accident, named disease, limited benefit, and student health plans, and continues to be one of the lowest-cost segments at just $19 premium per member per month (PMPM).
   
• Ancillary products, including dental and vision coverage, reported an 81.5% loss ratio in 2025 and remained a low-cost segment, with average premiums of $20 PMPM.
   
• Administrative Services Only (ASO) was the second-largest A&H segment by covered lives in 2025. The category includes ASO and Administrative Services Contract arrangements, along with Credit and Stop Loss products.[i]

About the Data

The data used in this analysis brief was obtained from Mark Farrah Associates' (MFA’s) Health Coverage Portal™ database and sourced from insurance companies reporting through the NAIC (National Association of Insurance Commissioners) via the Accident and Health Policy Experience Exhibit (AHPEE). This analysis may exclude a small number of plans that have not yet filed 2025 Annual data. Within MFA’s Health Coverage Portal™, the A&H Policy Experience Exhibit by State table presents premiums, claims, lives, member months, and number of policies for multiple health insurance segments, as mentioned above. This table does not include data for plans regulated by the California Department of Managed Health Care (CA DMHC) and not all health insurers are required to file with the state insurance departments. This table presents data for NAIC plans licensed as Fraternal, Life, Property, & Health. MFA’s A&H tables exclude non-health related segments, such as life, property, or flood policies.

In 2021, the AHPEE was modified to provide state insurance regulators with additional data and improve consistency across the annual financial statements. In 2022, all types of insurers were required to report data at the state level, based on the location of the contract. The state-level A&H insurance data first became available in 2022, and MFA’s Health Coverage Portal™ currently includes state-level data for 2022 through 2025. Historically, this information was only available based on the domicile of the insurer; the AHPEEs prior to 2022 are available but not directly comparable with more recent data.

About Mark Farrah Associates (MFA)

Mark Farrah Associates (MFA) is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Our product portfolio includes Health Coverage Portal™, County Health Coverage™, 5500 Employer Health ^plus, ASO Employer Health ^plus, Medicare Business Online™, Medicare Benefits Analyzer™, and Health Plans USA™. For more information about these products, refer to the product pages and brochures available under the Our Products section of the website (www.markfarrah.com) or call 724-338-4100.

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