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.

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