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The following list highlights the top 20 payors by incurred claims, excluding payor subsidiaries. The included payors account for over $244.7 billion in incurred claims for 2018.

The payor with the highest incurred claims was Kaiser Permanente Health Plans with over $44.7 billion— 18.3% of the claims represented on the list. Along with ranking first in incurred claims, Kaiser Permante Health Plans also ranked first in Total Direct Premium Earned as well as Covered Lives, representing nearly one million more covered lives than the next appearing payor on the list, UnitedHealthcare.

Top 20 Payors by Total Incurred Claims

  Payor Name Definitive ID Firm Type State Total Incurred Claims Total Direct Premium Earned Covered Lives
1 Kaiser Permanente Health Plans 583130 Payor CA $44,793,463,188 $50,967,482,045 9,315,959
2 UnitedHealthcare  583151 Payor MN $33,646,659,210 $42,407,097,381 8,411,196
3 Anthem Blue Cross & Blue Shield  575957 Payor IN $30,828,168,717 $37,912,630,126 5,998,133
4 Health Care Service Corporation Group 853221 Payor IL $23,344,341,956 $28,791,218,833 4,640,496
5 Aetna 552393 Payor CT $14,421,172,501 $17,261,224,006 2,937,201
6 Florida Blue 552479 Payor FL $12,650,947,868 $16,413,720,389 2,397,800
7 Blue Shield of California 552477 Payor CA $11,543,656,846 $14,396,749,939 2,554,513
8 Cigna 552436 Payor CT $9,612,601,243 $11,888,734,873 2,018,658
9 Centene Corporation 575895 Payor MO $9,323,269,672 $13,078,998,545 2,007,398
10 CareFirst BlueCross BlueShield 575917 Payor MD $7,021,843,816 $8,569,792,777 1,352,504
11 BlueCross BlueShield of Michigan Group 552472 Payor MI $6,361,872,944 $8,021,179,225 1,472,320
12 BlueCross BlueShield of North Carolina 552474 Payor NC $5,729,711,943 $7,594,149,939 999,377
13 BlueCross BlueShield of Massachusetts Group 575753 Payor MA $5,535,104,329 $6,268,845,492 991,330
14 Horizon Blue Cross Blue Shield of New Jersey 553215 Payor NJ $5,292,994,621 $6,464,122,800 866,131
15 Highmark 552480 Payor PA $5,288,279,430 $6,358,909,401 1,055,488
16 Humana Group 552481 Payor KY $4,531,650,263 $5,532,888,939 1,004,987
17 BlueCross BlueShield of Alabama 575911 Payor AL $4,177,378,804 $4,954,535,997 894,405
18 Independence Blue Cross Group 575058 Payor PA $3,981,845,684 $5,469,323,862 841,593
19 EmblemHealth 583128 Payor NY $3,482,799,310 $4,171,848,142 578,625
20 Regence 583141 Payor OR $3,168,590,921 $3,879,547,646 740,762

Fig 1 Data from Definitive Healthcare's Payor Database; financial data is from CMS’ Consumer Information and Oversight (CCIIO) Medical Loss Ratio reports. The most recent data is from calendar year CY 2018.