Major Health Insurers Collect Big Premiums But Don't Pay Claims
Date
1/28/2025 4:16:34 AM
(
MENAFN- PR Newswire)
Nationwide Payers of health Insurance Benefits: 10 Worst Payout Ratios |
Company1 |
Earned Premiums2 ($millions) |
Health Benefits2 ($millions) |
Payout Ratio (%) |
Centene Corporation |
21,347 |
11,498 |
53.9 % |
Molina Healthcare |
1,862 |
1,296 |
69.6 % |
CareSource |
1,280 |
946 |
73.9 % |
Oscar Health |
6,352 |
4,722 |
74.3 % |
Prosano |
1,392 |
1,045 |
75.1 % |
BlueCross BlueShield of Tennessee |
2,359 |
1,803 |
76.4 % |
UnitedHealth Group Incorporated |
17,159 |
13,405 |
78.1 % |
Elevance Health |
17,070 |
13,547 |
79.4 % |
Louisiana Health Service & Indemnity |
2,687 |
2,136 |
79.5 % |
Cambia Health Solutions |
3,140 |
2,514 |
80.1 % |
1Combines subsidiaries domiciled in various states. Excludes groups with combined earned premiums of under $500 million. 2Includes both group and individual policies. Source: Each subsidiary's statutory filings with NAIC for 2024 Q1, Q2 and Q3. |
Based on each company's filings for the first three quarters of 2024, Weiss found that UnitedHealth Group earned $17.2 billion in premiums, paying out $13.4 billion in health benefits, or only 78.1% of the premiums.
Meanwhile, Centene Corporation, which earned $21.3 billion in health premiums, paid out $11.5 billion in benefits, or just 53.9% of premiums.
Elevance Health, also a major player, collected $17.1 billion in health premiums, paying out only $13.5 billion in benefits (79.4%).
Others among the worst 10 payers include Molina Healthcare (with a payout ratio of 69.6%), CareSource (73.9%) and Oscar Health (74.3%).
Weiss added: "Some companies say that denying a large number of health claims is 'just the nature of the business.' But the facts show that it's certainly possible to do a lot better job for customers and still make a profit."
Indeed, Kaiser Foundation Health Plan has paid out 91.7% of the money it's collected in premiums, University Health Care has paid out 92.7%, and Goodlife Partners has paid out 97.6%.
Multiple factors contribute to these payout percentages. But to help consumers evaluate how much they're likely to get from their health insurance company for their premium dollars, Weiss recommends they follow this link .
Contact: Nicole Brown
[email protected]
727-900-5293
SOURCE Weiss Ratings
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