How a not-for-profit insurer made the Fortune 500

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GuideWell, the parent company of Florida Blue and several health services companies, was ranked on the Fortune 500 for the first time. 

Guidewell, a not-for-profit mutual holding company, was ranked No. 136 on the list. 

In a June 25 LinkedIn post GuideWell CEO Pat Geraghty said the ranking was a “testament to our evolution as a leading health solutions company.” 

The annual Fortune 500 ranks the largest companies in the U.S. by revenue. GuideWell reports its financial results using generally accepted accounting principles, which makes it eligible for the list, Jim Boyman, vice president of GuideWell Health, wrote on LinkedIn

GuideWell brought in $32.9 billion in revenue in 2024, according to Fortune. 

The largest for-profit insurers rank in the top 50 on the Fortune 500. UnitedHealth Group, the nation’s largest insurer, rose to No. 3 on the 2025 list, ranking only behind Walmart and Amazon. 

“As a not-for-profit organization, we’re driven by a different purpose. Unlike a publicly traded company, we don’t answer to shareholders,” Mr. Geraghty wrote. “This allows us to focus on what matters most: Helping people and communities achieve better health.” 

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