Health Insurance Financial Models
Premiums are set before an insurer knows exactly how much care its members will need. If treatment costs rise faster than expected, membership growth can amplify the shortfall. Forecasting earnings therefore depends on the gap between premium revenue and medical claims, not enrolment alone.
UnitedHealth Group
UnitedHealth Group is a diversified health care company operating through two distinct but complementary platforms: UnitedHealthcare (health benefits) and Optum (health services).
CVS Health
CVS Health is a vertically integrated health solutions company that operates across the entire healthcare spectrum, providing health insurance, pharmacy benefit management, and retail pharmacy services.
Cigna
The Cigna Group is a global health company that operates a massive pharmacy benefit manager (PBM) and a major commercial health insurance business.
Elevance Health
Elevance Health (formerly Anthem) is one of the largest managed healthcare companies in the United States, serving approximately 45.2 million medical members as of December 2025.
Centene
Centene Corporation is a leading managed care organisation (MCO) focused primarily on government-sponsored healthcare programmes, serving uninsured and under-insured individuals.
Humana
Humana is a managed healthcare company in the United States focused on government-sponsored programmes, particularly Medicare Advantage, operating as both a health insurance risk-bearing entity and a direct provider of healthcare services.
