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5-Year Market Share Trend Averages 45% for Top Commercial Risk Insurers


February 21, 2024



The 5 leading commercial risk health insurers by market share have represented an average of 45% of the total commercial risk market over the past 5 years. Commercial risk is composed of Individual, Group fully insured business, and the Federal Employee Health Benefits Program. This market increased to 72.2 million enrollees as of September 30, 2023, after declining between 3Q19 and 3Q22. Additionally, the leading healthcare insurers each experienced membership changes that resulted in variations of market share.

  • Kaiser continued to lead the commercial risk market with nearly 9.1 million members in 3Q23, a decrease of nearly 319,000 since 3Q19. Its national market share for this segment has declined 0.6% over the last 5 years.
  • UnitedHealth ended 3Q23 with over 7.3 million members, a net decrease of 1.0 million commercial risk members since 3Q19.
  • Elevance also experienced declining market share, and a drop in enrollment of 353,000 from 3Q19 to 3Q23.
  • HCSC and Centene both increased market share in the commercial risk segment, gaining 638,000 and 1.7 million members, respectively, in the last five years. The majority or membership growth for both entities was in Texas. For HCSC, both group risk and individual markets saw significant growth. Centene’s commercial risk growth primarily came from the Individual market.
  • Centene’s gains over the last five years outpaced CVS Health, making it the fifth largest commercial risk insurer in the country.

About the Data

The data used in this analysis brief was obtained from Mark Farrah Associates' Health Coverage Portal™ database. It is important to note Individual, non-group membership, reported by some carriers may include CHIP (Children’s Health Insurance Program). Findings reflect enrollment reported by carriers with business in the U.S. and U.S. territories. Data sources include the NAIC (National Association of Insurance Commissioners), and the CA DMHC (California Department of Managed Health Care).

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™, Medicare Business Online™, Medicare Benefits Analyzer™, 5500 Employer Health PLUS, and Health Plans USA™. For more information about these products, refer to the informational videos and brochures, available under the Our Products section of the website ( or call 724-338-4100.

Healthcare Business Strategy is a FREE brief that presents analysis of important issues and developments affecting healthcare business today. If you would like to be added to our email distribution list, please submit your email address to the " Subscribe to MFA Briefs " section at the bottom of this page. Mark Farrah Associates will continue to analyze and report on important health insurance segment performance and related topics. Stay tuned for future analysis briefs with valuable insights about the health care industry.

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