Non-Medical Expenditures of Health Insurance Companies, 2019-2023


May 9, 2024



  • Expenditures on “Salaries & Wages” grew by over $4 billion (B) in 2023, an increase of 7.9% compared to 2022. Insurers spent $41.8B on the same category in 2019, compared to $54.6B in 2023 (a 30.8% increase).
  • “Outsourced Services” expenses, including electronic data processing (EDP), claims, and other services, increased by over $5.8B since 2019, a 37.6% growth. The line item’s largest annual increase occurred most recently, from 2022 to 2023, where it grew by over $2B, or 10.5%.
  • “Commissions” expenditures grew by 62.4% (almost $6.5B) since 2019, with the largest increase being in the 2022 filings: nearly $2.1B in growth (a 15.7% increase), compared to $1.1B in 2020, $1.7B in 2021, and $1.6B in 2023.
  • “Other Expenses” includes line-items such as Legal Fees & Expenses (down $161.7 million, or -18%, from 2022), Marketing & Advertising (up $182.6 million, or 5%), and Auditing, Actuarial, and Consulting Fees (up $566.8 million, or 7.6%, since 2022). Since 2019, Marketing & Advertising spending has increased by 50.8%, or roughly $1.3B; Auditing, Actuarial, and Consulting Fees, in that same time, grew by 50.2%, or approximately $2.7B.
  • “Taxes, Licenses, and Fees,” excluding federal income taxes and representing 15% of health insurance companies’ non-medical expenses in 2023, increased by 46.1%, just over $5.8B, from 2019 to 2023. The biggest change was from “State Premium Taxes,” which accounted for $2.4 billion of that growth during the period.

About the Data

The data used in this analysis brief was obtained from Mark Farrah Associates' Health Coverage Portal™ database and sourced from health insurance companies reporting through the NAIC (National Association of Insurance Commissioners) via the Annual Analysis of Expenses – Underwriting and Investment Exhibit: Part 3. This analysis excludes a small number of plans that have not yet filed 2023 annual 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, Medicare Business Online™, Medicare Benefits Analyzer™, 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 to the "Subscribe to MFA Briefs" section at the bottom of this page.

Request Information

Thank you for your interest. Please send us your email and we will contact you
within 1-2 business days.