The largest commercial insurer in every state | 2024

Blue Cross Blue Shield companies have the largest market share among commercial insurers in the majority of states, according to the American Medical Association's annual "Competition in Health Insurance" report. 

The report, published Nov. 19, found that 95% of metropolitan areas have "highly concentrated" commercial health insurance markets.

In 11 states, one insurer controlled more than half of the commercial insurance market. 

Here is the largest insurer in commercial and exchange markets in every state: 

Alabama 

Blue Cross Blue Shield of Alabama

Market share: 86% 

 

Alaska 

Premera Blue Cross

Market share: 46% 

 

Arizona

UnitedHealth Group

Market share: 28% 

 

Arkansas 

Blue Cross Blue Shield of Arkansas

Market share: 45% 

 

California

Kaiser Permanente

Market share: 37% 

 

Colorado 

UnitedHealth Group

Market share: 24% 

 

Connecticut 

Elevance Health

Market share: 37% 

 

Delaware 

Highmark Blue Cross Blue Shield

Market share: 56% 

 

District of Columbia 

CareFirst Blue Cross Blue Shield

Market share: 22% 

 

Florida

Florida Blue

Market share: 36% 

 

Georgia 

Elevance Health

Market share: 33% 

 

Hawaii

Hawaii Medical Service Association (Blue Cross Blue Shield) 

Market share: 63% 

 

Idaho

Blue Cross of Idaho

Market share: 42% 

 

Illinois

Health Care Service Corp.

Market share: 63% 

 

Indiana

Elevance Health

Market share: 56% 

 

Iowa

Wellmark Blue Cross Blue Shield 

Market share: 47% 

 

Kansas

Blue Cross Blue Shield of Kansas

Market share: 45% 

 

Kentucky

Elevance Health

Market share: 67% 

 

Louisiana

Louisiana Blue

Market share: 66% 

 

Maine

Elevance Health

Market share: 43% 

 

Maryland

CareFirst BlueCross BlueShield 

Market share: 43% 

 

Massachusetts 

Blue Cross Blue Shield of Massachusetts

Market share: 35% 

 

Michigan 

Blue Cross Blue Shield of Michigan 

Market share: 67% 

 

Minnesota 

Blue Cross Blue Shield of Minnesota

Market share: 38% 

 

Mississippi 

Blue Cross Blue Shield of Mississippi

Market share: 50%

 

Missouri 

Elevance Health

Market share: 29% 

 

Montana 

Health Care Service Corp. 

Market share: 50% 

 

Nebraska

Blue Cross Blue Shield of Nebraska

Market share: 45% 

 

Nevada 

UnitedHealth Group

Market share: 36% 

 

New Hampshire 

Elevance Health 

Market share: 48% 

 

New Jersey 

Horizon Blue Cross Blue Shield 

Market share: 39% 

 

New Mexico

Health Care Service Corp. 

Market share: 48% 

 

New York 

UnitedHealth Group 

Market share: 26% 

 

North Carolina 

Blue Cross Blue Shield of North Carolina 

Market share: 48% 

 

North Dakota 

Blue Cross Blue Shield of North Dakota

Market share: 48% 

 

Ohio

Elevance Health

Market share: 31% 

 

Oklahoma 

Health Care Service Corp. 

Market share: 57% 

 

Oregon 

Cambia Health Solutions (Regence BlueCross BlueShield) 

Market share: 21% 

 

Pennsylvania 

Highmark Blue Cross Blue Shield 

Market share: 31%

 

Rhode Island 

Blue Cross Blue Shield of Rhode Island 

Market share: 42% 

 

South Carolina

Blue Cross Blue Shield of South Carolina

Market share: 59% 

 

South Dakota 

Avera Health

Market share: 33% 

 

Tennessee 

Blue Cross Blue Shield of Tennessee 

Market share: 42% 

 

Texas 

Health Care Service Corp. 

Market share: 44% 

 

Utah 

Intermountain Health (Select Health) 

Market Share: 46% 

 

Vermont 

Blue Cross Blue Shield of Vermont 

Market share: 57% 

 

Virginia

Elevance Health

Market share: 43% 

 

Washington 

Kaiser Permanente

Market share: 21% 

 

West Virginia

Highmark Blue Cross Blue Shield

Market share: 52% 

 

Wisconsin 

UnitedHealth Group 

Market share: 27% 

 

Wyoming 

Cigna

Market share: 40%

 

Read the full report here.  

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