Top 10 Largest Insurance Companies by 12-Month Trailing Revenue

Top 10 Largest Insurance Companies by 12-Month Trailing Revenue

When investing in insurance companies, it’s essential to understand their market positions, financial performance, and where their stocks are traded. Some of the companies on this list are traded over-the-counter (OTC) in the U.S., which can involve higher trading costs, potentially reducing returns. Below are the top 10 largest insurance companies based on their 12-month trailing revenue (TTM).

1. United Health Group (UNH)

• Revenue (TTM): $94.4 billion
• Net Income (TTM): $5.5 billion
• Market Cap: $482.4 billion
• 1-Year Trailing Total Return: 4.5%
• Exchange: New York Stock Exchange

United Health Group operates through two primary segments: United Health Care (insurance services) and Optum (health services). The company employs approximately 400,000 people and offers insurance and health services to around 152 million customers and 6,400 facilities globally.

2. Berkshire Hathaway Inc. (BRK.B)

• Revenue (TTM): $93.2 billion
• Net Income (TTM): -$12.8 billion
• Market Cap: $879.4 billion
• 1-Year Trailing Total Return: 31.7%
• Exchange: New York Stock Exchange

Berkshire Hathaway is a multinational holding company led by Warren Buffett, with significant interests in insurance through subsidiaries such as Geico, General Re, and National Indemnity. Despite its recent net income loss, it remains one of the largest companies globally by market cap.

3. CVS Health Corp (CVS)

• Revenue (TTM): $89.4 billion
• Net Income (TTM): $2.3 billion
• Market Cap: $97.03 billion
• 1-Year Trailing Total Return: -12.9%
• Exchange: New York Stock Exchange

CVS Health, known for its pharmacies and medical supplies, acquired Aetna in 2018 to expand its healthcare offerings. This acquisition positioned CVS as a comprehensive healthcare provider, offering insurance, pharmaceuticals, and wellness services across its extensive network.

4. The Cigna Group (CI)

• Revenue (TTM): $49.0 billion
• Net Income (TTM): $1.4 billion
• Market Cap: $99.8 billion
• 1-Year Trailing Total Return: 13.3%
• Exchange: New York Stock Exchange

Cigna operates through two main segments: Evernorth Health Services and Cigna Healthcare. Evernorth focuses on pharmaceutical and pharmacy solutions, while Cigna Healthcare provides a broad range of insurance services, including plans for the U.S. government and individual consumers.

5. Elevance Health Inc. (ELV)

• Revenue (TTM): $42.9 billion
• Net Income (TTM): $1.3 billion
• Market Cap: $120.5 billion
• 1-Year Trailing Total Return: 3.6%
• Exchange: New York Stock Exchange

Elevance Health is a major player in the health insurance sector, serving approximately 47 million members. The company offers a variety of insurance plans, including individual, group, Medicaid, and Medicare options, and administers the Federal Employees Health Benefits Program.

6. Centene (CNC)

• Revenue (TTM): $35.2 billion
• Net Income (TTM): $469 million
• Market Cap: $42.1 billion
• 1-Year Trailing Total Return: 7.3%
• Exchange: New York Stock Exchange

Centene is a leading provider of government-sponsored insurance programs, including Medicaid and Medicare. It also offers a range of healthcare services through its specialty providers, including behavioral health, pharmacy solutions, and vision and dental services.

7. Ping An Insurance (PNGAY)

• Revenue (TTM): $28.8 billion
• Net Income (TTM): $2.3 billion
• Market Cap: $99.8 billion
• 1-Year Trailing Total Return: -97.1%
• Exchange: OTC

Ping An Insurance is one of China's largest insurance and financial services companies. It offers a broad spectrum of insurance products, including life, health, auto, and property insurance, along with investment management services and significant investments in technology.

8. Allianz (ALIZY)

• Revenue (TTM): $26.5 billion
• Net Income (TTM): $2.2 billion
• Market Cap: $103.9 billion
• 1-Year Trailing Total Return: 14.4%
• Exchange: OTC

Allianz is a global insurance and asset management provider headquartered in Germany. It serves over 122 million customers across more than 70 countries, offering a wide range of insurance products and managing approximately €1.7 trillion in assets.

9. Humana Inc. (HUM)

• Revenue (TTM): $26.4 billion
• Net Income (TTM): $832 million
• Market Cap: $44.9 billion
• 1-Year Trailing Total Return: -28.1%
• Exchange: New York Stock Exchange

Humana is a U.S.-based company offering various insurance products, including Medicare, Medicaid, and coverage for military personnel. It operates through two segments: Insurance, which provides medical, dental, and vision coverage, and CenterWell, which offers pharmacy, home, and primary care services.

10. Axa Sa (AXAHY)

• Revenue (TTM): $22.5 billion
• Net Income (TTM): $2.1 billion
• Market Cap: $70.0 billion
• 1-Year Trailing Total Return: 9.8%
• Exchange: OTC

Axa Sa is an international insurance and financial services company headquartered in France. It provides a variety of insurance products, including property, casualty, health, and life insurance, while managing around €932 billion in assets.