Major Health Insurers Collect Big Premiums But Don't Pay Claims

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January 28, 2025 4:00 AM EST

 Centene, UnitedHealth, and Elevance Health Are Among the Worst

PALM BEACH GARDENS, Fla., Jan. 28, 2025 /PRNewswire/ -- Weiss Ratings, the nation's only independent insurance company rating agency, released data today on health insurers that have paid far less in health insurance benefits than they've collected in premiums from consumers.

Major Health Insurers Collect Big Premiums But Don't Pay Claims.

Dr. Martin D. Weiss, founder of Weiss Ratings said, "UnitedHealthcare has been prominent in the news due to the recent assassination of its CEO and its notorious health insurance denials. But the UnitedHealth Group isn't the only one. Nor is it the worst among the largest players."

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

Cision View original content to download multimedia:https://www.prnewswire.com/news-releases/major-health-insurers-collect-big-premiums-but-dont-pay-claims-302361532.html

SOURCE Weiss Ratings


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