Non-Medical Expenditures of Health Insurance Companies, 2021-2025

May 14, 2026

• Accounting for 46.6% of health insurance companies’ non-medical expenses in 2025, expenditures on “Salaries & Wages” grew by nearly $5.6 billion (B) in 2025, an increase of 9.6% compared to 2024 [i]. Insurers spent $46.3B on this category in 2021, compared to $63.9B in 2025 (a 38.1% increase).
   
• “Commissions” expenditures grew by 42.1% (over $5.5B) since 2021, with the largest increase being in the 2022 filings with nearly $2.1B in growth (a 15.7% increase). Prior to 2025, the category had grown by over 10% each year since 2020; however, 2025 is the first year that the expenditure was less than the prior year, down $51.4 million (M), or -0.3%.
   
• “Taxes, Licenses, and Fees,” excluding federal income taxes and representing 15.3% of non-medical expenses in 2025, increased by 31.1%, or about $5B, from 2021 to 2025. The segment saw its largest shift in 2022, where filings showed an increase of over $2.3B.
   
• “Outsourced Services” expenses, including electronic data processing (EDP), claims, and other services, increased by nearly $4.9B since 2021, a 27.6% growth. The line item’s largest annual increase occurred from 2022 to 2023, where it grew by nearly $2.2B, or 11.4%.
   
• “Other Expenses” includes line-items such as Legal Fees & Expenses (up $442M, or 65.3%, from 2021), Group Service & Administration Fees (up $893M, or 24.3%, from 2021), and Postage, Express, & Telephone Fees (up $308M, or 16.4%, from 2021).

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.

[i] Only carriers required to file the NAIC Annual Health Blank (form) file the Annual Analysis of Expenses exhibit. Life, Accident & Health (LA&H) insurers are increasingly required to file the NAIC Health Blank if they pass the Health Statement Test, which determines if a company is predominantly engaged in health business. Cigna Health & Life Insurance Company, one of the largest commercial health plans in the country, began filing the Health Blank in 2025.

Note: This analysis excludes a small number of plans that have not yet filed 2025 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™, Medicare Business Online™, Medicare Benefits Analyzer™, 5500 Employer Health ^PLUS, 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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