[lotsofpulp]

These are all the publicly listed health insurers in the US, with public financials, so the numbers come from the 10-Q and 10-K reports filed with the SEC.

Note that the first one, United Health, has slightly higher profit margins than the rest because UNH has an enormous business selling healthcare itself, not just insurance (they own a lot of doctor groups and outpatient clinics and employ a lot of doctors and nurses).

https://www.macrotrends.net/stocks/charts/UNH/unitedhealth-g...

https://www.macrotrends.net/stocks/charts/ELV/elevance-healt...

https://www.macrotrends.net/stocks/charts/CI/cigna-group/pro...

https://www.macrotrends.net/stocks/charts/CVS/cvs-health/pro...

https://www.macrotrends.net/stocks/charts/HUM/humana/profit-...

https://www.macrotrends.net/stocks/charts/CNC/centene/profit...

https://www.macrotrends.net/stocks/charts/MOH/molina-healthc...

The other big insurers will be Kaiser Foundation Health Plan and various plans franchised with Blue Cross Blue Shield, but they are all non profit.

https://projects.propublica.org/nonprofits/organizations/941...

[nradov]

Some Blue Cross Blue Shield Association members are for-profit corporations now.

As for UnitedHealth Group, much of their profit comes from a large software business which is separate from their insurance, care delivery, and PBM businesses. If that software business was spun out it would be one of the 20 largest US tech companies.

[lotsofpulp]

> Some Blue Cross Blue Shield Association members are for-profit corporations now.

In this list, I couldn’t find a single for profit BCBS licensee other than Elevance. They all seem to be mutuals/member owned/non profit.

https://en.wikipedia.org/wiki/Blue_Cross_Blue_Shield_Associa...

> As for UnitedHealth Group, much of their profit comes from a large software business which is separate from their insurance, care delivery, and PBM businesses. If that software business was spun out it would be one of the 20 largest US tech companies.

Interesting, I didn’t know UNH sold software!

[inferiorhuman]

  In this list, I couldn’t find a single for profit BCBS licensee
  other than Elevance.

Keep in mind Anthem/Elevance absorbed a bunch of licensees. So, for instance, Empire BCBS was for-profit but as of 2024 is part of Elevance.

At a quick glance Highmark and Wellmark are for-profit. And I believe the South Carolina licensee is as well. Mind you a few of the "non-profit" BCBS licensees have been sued over claims that they ought not be considered not-for-profit.

[lotsofpulp]

Highmark is non profit:

https://projects.propublica.org/nonprofits/organizations/821...

Wellmark is a mutual insurance company (profits go back to policyholders, seems not comparable to a for profit insurance business, and for this discussion, is not going to have a profit margin that results in higher costs to policyholders):

https://en.wikipedia.org/wiki/Wellmark_Blue_Cross_Blue_Shiel...

https://en.wikipedia.org/wiki/Mutual_insurance

>Mind you a few of the "non-profit" BCBS licensees have been sued over claims that they ought not be considered not-for-profit.

I see no successful lawsuits, though. Still seems like Elevance is the only for profit BCBS licensee.

>In 2014, BC/BS of Illinois (Health Care Service Corporation) was sued over its nonprofit status. The lawsuit was dismissed, with prejudice, and the dismissal ruling was upheld on appeal.[62] Similar suits occurred with similar results in other states such as Oregon.[63]

[inferiorhuman]

To be clear if Elevance is the only remaining for-profit BCBS licensee it's because they bought the others.

Highmark got labeled as for-profit on its Wikipedia entry likely because they own a variety of for-profit companies including e.g. Highmark BCBSD Inc. and Celtic Hospice LLC.

https://projects.propublica.org/nonprofits/organizations/453...

[lotsofpulp]

But Highmark, the parent organization, is still a non profit. Based on their revenue and expenses on their 990 going back a decade, the entire organization is not delivering profit to any owners, it’s just spending money earned in its for profit subsidiaries elsewhere in its org.

Specifics aside, I think it is conclusively shown that no health insurance / managed care organization earns a ton of profit margin. No one is going to become billionaire rich by starting up a managed care organization, because they will spend almost all they earn.

It’s such a low profit margin business, that Buffett, Dimon, and Bezos abandoned it:

https://www.healthcarefinancenews.com/news/haven-disbands-en...