Top health insurers: The ultimate guide for agents

Where can I work as a health insurance agent?

Choosing where to build your career in health insurance, whether as an agent, underwriter, or another industry representative, can be both promising and challenging. The job market includes prominent industry leaders such as UnitedHealth, Elevance Health, and Aetna, each offering a wide range of health insurance jobs and employing a significant portion of the workforce in the field. Yet, with over 1,000 health insurance companies operating nationwide, there's no shortage of opportunities to discover your ideal employer.

To streamline your search for the best places to work, we've compiled a comprehensive list of 100 top health insurance companies to work for in the U.S. Our guide features key data points, including company revenue, number of employees, headquarters location, and Glassdoor rating. You'll also find up-to-date links to each organization's career portal, delivering direct access to thousands of health insurance job listings all in one place.

Our curated list highlights both major national health insurance providers and a diverse range of regional carriers across the U.S. For those interested in fast-paced, corporate workplaces, companies like Cigna or Prudential (which offers supplemental health plans) may appeal thanks to their ambitious culture and scale. Others may prefer smaller, locally focused employers known for their tight-knit teams and community impact. The companies listed vary significantly in their organizational structure, ranging from large, for-profit institutions that offer extensive group, individual, or family insurance plans to nonprofit organizations focused on delivering government-funded coverage.

Pursuing a position with a leading health insurer can offer meaningful professional growth for both experienced professionals and those just starting out. The diverse array of health insurance jobs available ensures that every professional can find their ideal setting, whether your goal is sales, support, or specialized policy roles. Beyond simply listing employment opportunities, we provide you with detailed company insights, enabling you to confidently pursue the best fit within the American health insurance landscape. Explore further to discover top health insurance companies by revenue, learn where employers are ranked as the best places to work, and find all the resources you need to launch or accelerate your career in this thriving industry.

What are the top 5 health insurance companies by revenue?

As mentioned above, the U.S. health insurance industry is dominated by top health insurance companies with substantial market shares. These leaders exert a heavy influence on healthcare costs, the breadth of services available, and career opportunities across the sector. If you currently have health insurance, there's a strong likelihood that your coverage is provided by one of the top health insurance companies in the nation. The top five health insurance companies by total revenue in 2024 were:

• UnitedHealth Group: $400 billion
• CVS Health (Aetna): $373 billion
• Cigna Group: $247 billion
• Elevance Health: $177 billion
• Centene: $163 billion

These top health insurance companies command a significant presence in the industry. In 2023, one in five Americans with health insurance was enrolled in a plan from either UnitedHealth or Elevance Health. This impressive reach encompasses commercial health insurance, government-sponsored options, and supplemental coverage, including Medicare Advantage plans.

It's important to note that the revenue figures for these leading health insurers reflect total earnings from all business segments, not just insurance operations: for instance, UnitedHealth's insurance subsidiary, UnitedHealthcare, reported a revenue of $298 billion in 2024, while Aetna, part of CVS Health, earned $131 billion in insurance-specific revenue. For those interested, financials and premium totals for the insurance segment of publicly traded companies are available through corporate reports and filings with the Securities and Exchange Commission (SEC).

The reach and impact of these top health insurance companies go far beyond standard coverage. As some of the largest vertically integrated healthcare conglomerates in the U.S., these parent companies manage a network of subsidiaries, ranging from regional health insurers to Pharmacy Benefit Managers (PBMs) that set prescription formularies for plan members. Beyond their core health insurance offerings, UnitedHealth operates hospitals and clinics nationwide, while CVS Health is well-known for its extensive pharmacy chains. Centene stands out among the leading insurers, focusing primarily on individuals enrolled in Medicaid and Medicare programs.

Collectively, these top health insurance companies drive market trends, shape access to healthcare, and maintain a lasting influence throughout the American healthcare system.

Where are the top health insurance companies located?

The majority of the top health insurance companies featured on our list are headquartered in California, with 10 out of the 100 leading providers based in the state. California serves as the home base for Kaiser Permanente, consistently recognized as one of the top health insurance companies and a major healthcare organization nationwide. In addition to ranking among the nation's highest-grossing healthcare groups, Kaiser also operates an extensive network of hospitals and health clinics throughout the U.S.. Notably, Kaiser Permanente achieved the highest U.S. market share among health insurance companies in 2023, which can largely be attributed to California's substantial insured population. Following closely behind California, New York is also home to several key market players, with 9 top health insurance companies, and Texas houses 5 major providers.

Many top health insurance companies maintain extensive offices and facilities that extend far beyond their headquarters, establishing a significant footprint in markets across the country. While large regional and national firms wield considerable influence, not every company on this list can claim the household recognition of the so-called "Big Five" insurers. Several health insurance carriers primarily serve members in specific states or regions, sometimes catering to unique populations.

What's the average number of employees at top health insurance companies?

The companies on the list vary significantly in size, ranging from massive operations with hundreds of thousands of employees to smaller offices with fewer than a hundred staff. According to recent employment data, the average number of employees at these companies is nearly 26,000, although the presence of giants like UnitedHealth and Cigna skews this figure.

The median number of employees is approximately 4,000, which is still a substantial figure. While sizable corporations make up the bulk of the list, there are still options for agents interested in working at smaller, more tight-knit companies with an impressive revenue stream.

What are the best health insurance companies to work for?

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The average Glassdoor rating for the companies on the list is 3.9 out of 5 stars, indicating that employee satisfaction at the businesses provided is generally high. According to aggregated user reviews, the health insurance firms with the highest ratings on Glassdoor are:

CommunityCare Oklahoma

• Headquarters location: Tulsa, OK
• Number of employees: 450
• Glassdoor rating: 5/5

CommunityCare, founded in 1993 through a partnership between Saint Francis Hospital and St. John Medical Center, is Oklahoma's largest locally owned health plan. The company offers small group and individual coverage, Medicare Advantage, workers' compensation, and employee assistance programs. CommunityCare has grown into a trusted provider, consistently recognized for quality, customer satisfaction, and community impact.

American Fidelity Assurance

• Headquarters location: Oklahoma City, OK
• Number of employees: 2,000
• Glassdoor rating: 4.4/5

American Fidelity Assurance specializes in supplemental health insurance and annuities for education employees, healthcare providers, auto dealerships, and municipal workers. It has maintained an A+ rating from A.M. Best since 1982 and has been mentioned on Fortune's "100 Best Companies to Work For" list 15 times.

Alliant Health Plans

• Headquarters location: Dalton, GA
• Number of employees: 360
• Glassdoor rating: 4.4/5

Alliant Health Plans, a Georgia-based Provider Sponsored Health Care Corporation (PSHCC), has provided high-quality, affordable health insurance for over 25 years. Founded by community physicians and hospitals, Alliant offers fully-insured individual, family, and group plans on and off the marketplace across most Georgia counties, and is expanding into 11 counties in southern Tennessee in 2025. Alliant's network includes over 24,000 providers, ensuring members access to quality care tailored to regional needs.

Blue Cross Blue Shield of North Carolina

• Headquarters location: Durham, NC
• Number of employees: 5,000
• Glassdoor rating: 4/5

Blue Cross and Blue Shield of North Carolina (Blue Cross NC), headquartered in Durham, is a fully taxed, not-for-profit insurer serving more than 4.3 million members with over 5,000 employees nationwide. It is an independent licensee of the Blue Cross Blue Shield Association (BCBSA), which represents 33 companies covering more than 115 million people across the U.S.

Capital District Physicians' Health Plan (CDPHP)

• Headquarters location: Latham, NY
• Number of employees: 1,300
• Glassdoor rating: 4/5

Founded in 1984 by doctors, CDPHP is a member-focused health plan serving 36 counties in New York, offering a wide range of affordable, high-quality coverage options. Guided by a 15-member board with eight physicians, CDPHP emphasizes preventive care, wellness programs, and community health initiatives to support overall well-being. CDPHP is committed to health equity, aiming to address disparities and ensure inclusive, accessible care for all members.

Arkansas Blue Cross Blue Shield

• Headquarters location: Little Rock, AK
• Number of employees: 3,200
• Glassdoor rating: 4/5

Arkansas Blue Cross and Blue Shield is a not-for-profit mutual insurance company and an Independent Licensee of the Blue Cross and Blue Shield Association. Founded in 1948, it is the largest health insurer in Arkansas, employing over 3,200 people. As a mutual insurer, nearly all premiums are returned to members as benefits, with the remainder supporting operations and reserves. Arkansas Blue Cross emphasizes community involvement, financial stability, and long-term value, with a mission to enhance the health, financial security, and overall well-being of its members.

As alluded to before, bigger does not always mean "better," depending on your employment preferences and priorities. Companies with higher employee satisfaction tend to be smaller businesses that serve members in a single state or a few states, providing insight that can help guide your job search. Note that because these organizations typically employ fewer people, Glassdoor ratings may be less reliable than those of companies with larger employee bases and more active profiles. Compensation is another important factor to consider, as smaller providers may not offer the same base salary or high commission potential due to their limited size. Furthermore, agents must be licensed to sell insurance products in specific service areas for regional insurers, while large companies offer more flexibility.

Still, these companies share an approach that is mission-driven, personalized, and member-centered: you're likely to build deep, meaningful connections with clients as a part of one of these firms. A smaller client base can allow these companies to better attend to the needs of and build trust within their communities, and it's reasonable to assume that this attention extends to employees. For more information about individual company culture and benefits, you can explore their Glassdoor profiles, which are linked in the directory below.

Top health insurance companies: The complete list

Below is our updated list of top health insurance companies to work for in the U.S., evaluated based on revenue, employee size, and Glassdoor ratings. Please note that not all carriers disclose annual financial data, so in some cases, revenue numbers are based on available estimates. Each company listing includes a brief overview of the agency, along with direct links to their official website and designated job board, making it easy for you to explore current health insurance jobs and career opportunities in your area. Discover new possibilities and take the next step in your health insurance career here:

Whether you're interested in entry-level health insurance jobs or aiming to climb the career ladder at a top company, positions at these organizations offer outstanding professional growth and development opportunities. Be sure to consider what former and current employees share about these insurers to gain insights into company culture, employee support, and available benefits packages as you move along in your job search.

What job opportunities are available at health insurance companies?

Health insurance companies offer a diverse range of jobs across various fields. Traditional roles include insurance sales agents, actuaries, claim adjusters, and customer service representatives. There are also numerous opportunities for marketing, technology, and finance professionals, especially at corporate offices. Company listings will have the most up-to-date information about available roles and qualifications. Agent roles are at the core of a firm's business and sales operations, as they interact directly with consumers to promote and transact the company's suite of insurance products.

How do you become an insurance agent?

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To become a licensed health insurance agent, you must first obtain your health insurance license or a combined life and health insurance license, depending on your state's regulations. Although there are no formal education prerequisites for taking the insurance license exam, pursuing a Bachelor's degree or completing relevant coursework in business, finance, or accounting is highly recommended. Building a strong understanding of financial concepts, insurance products, and market principles will not only help you succeed on your insurance exam but also prepare you with critical knowledge for your career as an insurance agent.

How do you get a health insurance license?

The general steps to obtaining a life and health insurance license or health insurance license are as follows:

1. Complete a state-approved prelicensing course (typically 20-40 hours) to prepare for your life and health insurance exam or other required insurance exam.
2. Register online for the appropriate insurance license exam and pay the necessary fee.
3. Pass the state-administered exam, usually requiring a minimum score of 70% or higher.
4. Undergo a background check as part of the insurance license application process.
5. Submit your completed application to your state's board.

After you receive your insurance license, you'll be qualified to pursue roles in health insurance sales, advise individuals and businesses on coverage options, and begin your career as a licensed insurance agent. This credential is the first step toward helping clients navigate their business, individual, and family health insurance needs.

How much do insurance agents make?

In May 2024, the median salary for insurance agents in the U.S. was $60,370, according to the Bureau of Labor Statistics, reflecting competitive compensation for those entering this field. The job outlook for insurance agents remains promising, with a projected growth rate of 4% through 2034, mirroring the national average for all occupations and suggesting steady demand for licensed professionals.

For those specializing in health insurance, salary potential can be even higher. Data from ZipRecruiter shows that the average annual salary for health insurance agents reached $85,888 as of June 2025. Top earners in this sector reported yearly incomes up to $132,500, while those in the 75th percentile earned approximately $100,000 per year. It's important to note that actual insurance agent salaries vary by region and employer, with the local cost of living impacting overall earnings.

What is a captive vs. independent agent?

There are several different types of insurance agents, classified primarily by the relationship they have with insurance carriers. The primary distinction among the various types of insurance agents is whether they are "captive" or independent. Captive agents work exclusively for a single insurance company, meaning they can only offer policies from that particular provider. These agents benefit from in-depth company training and strong marketing support, often receiving both a base salary and a commission. An insurance agent employed directly by any of the companies above would be considered a captive agent.

Independent insurance agents represent multiple insurance companies, enabling them to offer clients a broad range of insurance products at various price points. Independent agents can operate their own businesses, manage their schedules and administrative responsibilities, and generally rely on commissions as their primary source of income. This flexibility allows independent agents to provide customers with tailored policy choices and access to competitive quotes. An independent insurance agent can potentially sell policies from any of the listed companies, depending on their location and licensing.

Health insurance FAQs

For those new to the world of health insurance, jargon and technicalities can make it difficult to understand. Health insurance is complex, but there are certain key elements you should know before pursuing a career in this field or before shopping for policies for yourself. Below are some commonly asked questions with straightforward responses to help you familiarize yourself with the basics of healthcare coverage.

How does health insurance work?

The standard health insurance framework requires paying a monthly premium to maintain active coverage. When a policyholder or their covered dependents need medical care, health insurance can cover eligible portions of services, substantially reducing out-of-pocket costs for insured individuals.

Most plans include a deductible, meaning the insured must pay a specific amount before their policy contributes to health insurance claims for covered services. Opting for a lower deductible typically results in higher monthly premium payments. Similarly, most health insurance policies feature a copayment, which is a fixed amount that policyholders must pay each time they submit a claim for certain covered treatments. Lower copays generally translate to higher premiums. Insurers may also provide a list of preferred in-network providers, typically offering greater discounts for visits and treatment before deductibles are met compared to out-of-network providers. However, some insurance arrangements will not cover out-of-network treatment.

How do you get health insurance?

Health insurance coverage in the U.S. can be obtained in one of many ways:

• Gaining coverage through work through an employee-sponsored plan
• Purchasing insurance as an individual from the Health Insurance Marketplace or through a private company directly
• Qualifying for government programs like Medicaid (reserved for those below a certain income threshold) or Medicare (available to everyone over the age of 64)
• Obtaining coverage through a parent (up until age 26), spouse, or other family member

Policyholders can sign up for insurance or change their benefit options during the annual open enrollment period. Policies are usually renewed or updated once a year, although some exceptions may apply.

What are the different types of health insurance plans?

Providers can offer a wide range of plans, with many companies providing a variety of EPO, HMO, PPO, and supplemental options. These plans differ based on network coverage and out-of-pocket costs:

• Exclusive Provider Organization (EPO): A managed care plan where health insurance claims are paid only if the insured uses services within the plan's network, except in emergencies.
• Health Maintenance Organization (HMO): Limits coverage and approved health insurance claims to care delivered in-network, requiring membership in a specific region or service area. Fully integrated care and preventive wellness are hallmarks of an HMO plan.
• Point of Service (POS): Reduces out-of-pocket expenses for health insurance claims submitted within the provider network; specialist visits may require referrals from a primary care provider.
• Preferred Provider Organization (PPO): Pays higher percentages on in-network health insurance claims but does allow out-of-network care, simply at a greater cost without needing prior referrals.

What does health insurance cover?

Comprehensive health insurance can make a broad range of medical services more affordable, with many plans covering the following:

• Yearly physical examinations
• Inpatient hospital treatment
• Emergency room visits and associated care
• Brand-name and generic prescription drugs approved by the FDA
• Preventive care, such as immunizations and screenings
• Behavioral and mental health services
• Chronic illness management and long-term care, often covered under Long Term Care (LTC) insurance
• Various other medical procedures and costs, including treatment from a specialist (with a proper referral if needed). These may be included in a plan or reimbursable through an employer-funded Flexible Spending Account (FSA).

What does health insurance not cover?

Health insurance claims may be denied in the following situations:

• Out-of-network expenses: Depending on the coverage, out-of-network may not be included in a healthcare plan.
• Cosmetic procedures: Claims for elective plastic surgery or specific dermatologic treatments are often excluded from standard health insurance coverage.
• Fertility treatments: Although some states require coverage for fertility procedures, employers may restrict these benefits, and related health insurance claims may not be approved under specific company plans.
• Dental and eye care: Many health insurance policies exclude claims for dental work and vision care. Additional policies or riders (also known as add-ons or supplements to plans) may be required to cover these services.
• Off-label prescriptions: Drugs prescribed for a condition that's different from what a person suffers from (for example, using anti-seizure medication to treat insomnia) may not be honored by insurers.
• New technology in products or services: When medical devices, drugs, or advanced tests are introduced, insurance companies may deny health insurance claims until there is sufficient evidence proving these innovations substantially benefit patients or improve health outcomes.
• Insufficient information or documentation: Providers and policyholders are required to submit documents that detail and justify medical expenses and bills to determine payment amounts. If claims are incomplete, coverage may be denied.

Insurance agents do not assess claims themselves, but they can serve as a helpful point of contact in the event that one of their clients is denied coverage. Agents should always inform policyholders of the rights and limitations of any plan they purchase to avoid denials or support appeals down the line.