Leading Commercial Risk Health Insurers Market Share Averages 45% Over the Past 5 Years

February 2, 2023

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 declined from 73.4 million to 70.4 million enrollees between 3Q18 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 over 9.2 million members in 3Q22, a decrease of nearly 181,000 since 3Q18, with a slight gain in market share due to the overall market decline.
• Elevance also experienced a slight gain in market share, despite a drop in enrollment of 143,025.
• UnitedHealth ended 3Q22 with over 7.3 million members, a net decrease of 1.5 million members and a corresponding decrease in market share of -1.6%.
• HCSC was the only leading commercial risk insurer to gain membership in the last five years, adding 574,000 members, and experiencing a 1.1% uptick in market share. Most of its growth was in Texas.
• CVS’ market share declined -1.1% in the last five years, continuing the trajectory Aetna was on before its acquisition by CVS in 2019. Since 2015, the combined company has lost over 3.4 million commercial risk members. However, CVS did report a net gain of over 52,000 members between 3Q22 and 3Q21, a positive sign of improvement.

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