Cost of Growth: Brokerages and P&C Outpace Health Insurers in Tight Profit Race, SEC Filings Show

To cap Insurance Business magazine’s 2024 deep dive into the first three quarters of 2024, this report closely examines the US’s top 20 insurance providers by market capitalization for the entire year 2024. In particular, this report is concerned with those top-ranking public companies’ performance for shareholders and scrutinizes trends in diluted earnings-per-share over time.

Ground-level information for the US’s top insurance providers, a total of 86, is featured in IB+’s latest dashboard of SEC data, Annual Financial Insights of Top US Insurance Businesses by Market Cap. The new dashboard includes individual and aggregate data for the 2021–2024 period on public providers’ expenses, premiums, net earnings, diluted earnings per share, and other financial metrics.

Industry Trends

Despite a robust rise in earned premiums, the US’s largest public insurance providers are facing a profitability squeeze: Surging expenses have outpaced revenue gains.

Between 2021 and 2024, the US’s top 20 insurance providers by market cap saw earned average premiums rise 26 percent to $32.1 million. This average premium growth for the top 20 providers market cap, up from 2021’s $25.3 million, is marginally superior to that of the remaining 66 providers included in IB+’s latest dashboard. During the same years, those lower ranking providers’ average earned premiums rose by 16 percent to $2.3 million.

However, expenses of the US’s top 20 insurance providers largely outpaced the growth of premiums. Between 2021 and 2024, those top providers' average expenses rose 31 percent, reaching $73.7 million.

This contributed to the net earnings of the US’s top 20 insurance providers declining by 14 percent, from 2021’s average $4.1 million to 2024’s average $3.5 million. The industry’s remaining and lower-ranked 66 insurance providers saw average expenses rise 28 percent to $3.8 million, and net earnings steeper decline by 36 percent, from an average of $560,000 to just $350,000.

These cost trends have plainly favored the US’s top 20 insurance providers by market cap. In 2024, the top 20 providers claimed a remarkable three quarters of net earnings from all 86 US providers, up substantially from 2021’s 69 percent share of the industry's net earnings.

Public insurers’ premium growth failing to match that of their expenses, brought to attention in the trends of IB+’s most recent dashboard, is consistent with market research. In his March 2025 report on the broader US finance and insurance industry, Demetrios Berdousis, an analyst for the global market research firm IBISWorld, pinpointed numerous factors adding costs across every line of the US insurance business.

Chief among them are natural disasters, their anticipated increase in five-year frequency, and the resulting impact on claim financing and ability to cover risky regions. “For example, the wildfires in California in 2025 resulted in substantial claims for property damage and losses, cutting into profit margins for insurance companies,” wrote Berdousis in March 2025’s “Finance and Insurance in the US” IBISWorld report.

Beyond this, IBISWorld points to formidable regulatory and technology environments as added expenses to the insurance industry, evident in IB+’s latest dashboard data. The 2010 Dodd-Frank Wall Street Reform and subsequent Consumer Financial Protection Act has increased insurance company expenses by imposing stricter regulatory oversight, enhanced reporting requirements, and the creation of the Federal Insurance Office, which adds compliance costs and operational burdens as insurance companies grow. Likewise, evolving financial technology requires insurance companies to increasingly invest in competitive opportunities as well as protections against cyberattack.

The rapid evolution of public regulation and private technology, certainly regarding cryptocurrency or AI, are heed worthy additions to all insurance company expenses. IBISWorld projects the finance and insurance industry’s revenue to grow 2.5 percent between 2025 and 2030, 1.3 percentage points fewer than growth from 2020 to 2025. Between 2021 and 2024, the total net earnings of all 86 insurance providers included in IB+’s latest dashboard fell from $118.4 million to $92.8 million.

Business Segments

Last year's top 20 public US insurance providers by market cap are diverse across business segments. The largest share, nine out of 20, primarily deal in property, casualty, and direct insurance. Progressive Insurance is this business category’s standout, ranking second by market capitalization overall. P&C’s next top providers rank further down the top 20 list, and include The Travelers Companies (ranked seventh overall), Allstate, American International Group, and The Hartford.

As a group, between 2021 and 2024, P&C’s top insurance providers fared better than all top providers together, when compared with their trends above. During that period, top P&C providers’ premiums rose 29 percent to $27 million from $21 million, while net earnings declined by only 3 percent from $3 million to $2.9 million. Over the past five years, P&C has benefited from the profits of a hardening cycle, which was further supported by reduced interest rates and the subsequently improved financial market. However, according to IBISWorld, P&C insurance revenue is forecasted to expand 2 percent between 2025 and 2030, somewhat less than the projected revenue growth of the finance and insurance industry on the whole during the same time.

The top 20 US insurance providers by market cap also include five health and medical insurance providers. Among them is the topmost insurance provider ranked by market capitalization overall, UnitedHealth, closely followed by Elevance Health (ranked fourth overall), Cigna (sixth), Humana (14th), and Centene (15th).

The performance of these health and medical insurance providers was directly in line with the top 20 overall companies outlined above. Between 2021 and 2024, the premiums of Elevance Health, Cigna, and Humana rose 26 percent, while net earnings declined 14 percent. United and Centene did not publicly report premiums earned.

Between 2025 and 2030, health and medical insurance revenue growth is expected to be 2.7 percent, marginally better than the finance and insurance industry overall. This positive growth is due to the forecasted rise in US employment and wages, which should boost employer-sponsored and private healthcare spending, according to IBISWorld.

The last noteworthy business segment portion of the top 20 insurance providers by market cap are insurance brokerages: Marsh & McLennan Companies (ranked third overall), Arthur J. Gallagher (fifth), and Brown & Brown (12th).

These companies – which sell and service insurance policies on behalf of clients and generally earn commissions, not premiums – have performed remarkably well compared to peers directly serving P&C and health insurance. Between 2021 and 2024, these three brokerages posted a 31 percent increase in total revenue, while all insurance providers’ revenue rose 28 percent. In stark contrast to other business segments, the brokerages’ net earnings did not decline but instead rose by an astonishing 40 percent to $2.1 million from $1.5 million.

Like P&C providers, brokerages have benefitted from a hardening insurance cycle and a favorable financing environment. Brokerages are unique, however, for reaping opportunity when inflation and interest rates were high and consumers favored niche or less expensive insurance products, opposed to expensive property or healthcare. According to IB+’s latest dashboard, brokerages and their business model appear to be gaining profit while other business segments are weighed down by higher expenses.

Diluted Earnings Per Share

The examination of the insurance industry at large and individual business segments above, taken from the SEC’s 2024 filing data disposed across IB+ Annual Financial Insights of Top US Insurance Businesses by Market Cap, reveals a depression of insurance profits under mounting expenses.

Another statistic, however, is central to the performance of publicly traded companies and spells good news for insurance providers and their investors. This statistic is diluted earnings per share, the measure of a company’s profit divided by all possible outstanding shares, which gives a conservative yet comprehensive view of per-share profitability.

Despite less earnings and more expenses, between 2021 and 2024, total earnings per share across the top 20 providers by market cap rose from $370 to $398.

That was a strong recovery from the group earnings per share of just $130.50 in 2022 and $319 in 2023, signaling the top providers’ strong return across its market capitalization. Likewise, across all 86 insurance companies included in IB+’s latest dashboard, total diluted earnings per share rose to $594 in 2024 from a sharp dip in the two years prior. US interest rates are expected to continue to fall in the near future, which should support investments in relatively riskier assets such as the insurance stock market.

What follows is a brief description of the top 20 insurance providers ordered by market capitalization, and how their diluted earnings per share trends relate to their performance within their business segment at large:

Top 20 insurance providers by market capitalization:

1. UnitedHealth
Market Capitalization: $431,000,000,000

• UnitedHealth reported a revenue rise of $112.6 million from 2021 to 2024, underscoring its dominance in the health insurance space amid growing US insurance expenditures.
• However, net earnings declined by $2.8 million, consistent with regulatory costs and sector-wide pricing pressures.
• Diluted earnings per share declined 14.2 percent from $18.08 in 2021 to $15.51 in 2024, reflecting the broader struggle of health insurers to convert topline growth into per-share profitability.

2. Progressive
Market Capitalization: $166,000,000,000

• Progressive’s premiums rose by $26.4 million between 2021 and 2024, fueled by strong underwriting gains and a hardening property and casualty (P&C) cycle.
• Net earnings surged $5.1 million, one of the strongest real earnings increases among peers.
• This translated into a remarkable 154 percent EPS increase from $5.66 to $14.40 in 2024, making Progressive a standout in converting premium momentum into shareholder value.

3. Marsh & McLennan Companies
Market Capitalization: $117,000,000,000

• Marsh & McLennan added $4.6 million in revenue over three years, with net earnings increasing by just $917,000.
• Diluted EPS rose from $6.13 to $8.18, a fair 33.4 percent increase supported by strong growth for insurance brokerages.

4. Elevance Health
Market Capitalization: $90,587,267,072

• Elevance Health, a major health insurance player, grew its premiums by $26.7 million from 2021 to 2024.
• Still, net earnings dipped slightly by $178,000, in line with rising sectoral compliance and technology costs.
• Nevertheless, diluted earnings per share edged up from $24.73 to $25.68, a modest 3.8 percent improvement that reflects Elevance’s operational stability in a turbulent regulatory environment.

5. Arthur J. Gallagher & Co.
Market Capitalization: $86,934,208,512

• Arthur J. Gallagher saw a $3.3 million boost in revenue and a $556,000 increase in net earnings between 2021 and 2024. Like other brokerages, it capitalized on a hardening insurance cycle and shifting customer preferences.
• EPS rose sharply, by 48 percent from $4.37 to $6.50, validating the brokerage sector’s high-margin growth potential amid broader industry disruption.

6. Cigna
Market Capitalization: $84,826,505,216

• Cigna expanded premiums by $4.8 million during the three-year period, though net earnings declined by $1.9 million, likely due to tighter margins in employer-sponsored healthcare.
• Likewise, this healthcare provider’s diluted EPS fell from $15.75 to $12.12, offering performance below that of other healthcare insurers.

7. The Travelers Companies
Market Capitalization: $59,132,669,952

• Travelers posted a $11 million premiums earned increase and a $1.3 million gain in net earnings, supported by robust underwriting during a favorable P&C cycle.
• Diluted EPS rose an impressive 48 percent from $14.49 to $21.47, indicative of healthy operations and resilience unique within the P&C business segment.

8. MetLife
Market Capitalization: $58,878,537,728

• MetLife recorded a $3.7 million rise in premiums with a $2.4 million decrease in net earnings.
• Diluted EPS fell 22 percent from $7.70 to $5.94 across the giant insurers’ wealth of shares, suggesting stalled capital deployment and cost management in a subdued growth environment for life and group insurance.

9. Allstate
Market Capitalization: $53,681,016,832

• Allstate’s premiums expanded by $14.2 million and net earnings rose by $3 million, reaching $4.5 million, which highlights exceptional performance in the volatile personal insurance lines.
• The firm’s diluted EPS rocketed from $4.96 to $16.99, a 242 percent gain for investors and the second largest relative increase among the top 20 insurance providers by 2024’s market cap.

10. American International Group
Market Capitalization: $49,098,305,536

• American International Group reported that premiums earned fell by $7.7 million between 2021 and 2024, reflecting structural shifts in its underwriting strategy and broader sector headwinds.
• Net earnings declined by $11.7 million over the same period, posting a negative $1.4 million turnover in 2024.
• Diluted earnings per share thus declined from $11.9 to $-2.17, a change that underscores ongoing profitability challenges in the current insurance landscape and imminent capitalization changes for AIG. The drop in diluted EPS reflects the shift from strong profits to a net loss in 2024. Since diluted EPS directly mirrors total earnings divided by all potential shares, it turns negative when the company posts a loss.

11. Prudential Financial
Market Capitalization: $40,710,000,640

• Prudential Financial reported that premiums earned rose by $8.9 million between 2021 and 2024, reflecting structural shifts in its underwriting strategy.
• Net earnings declined by $6 million over the same period.
• Diluted earnings per share declined from $19.51 to $7.50, 61 percent, among the greatest relative performance drops for shareholders that underscores ongoing profitability challenges in the current insurance landscape.

12. Brown & Brown  
Market Capitalization: $34,240,385,024

• Brown & Brown reported that revenue rose by $1.6 million between 2021 and 2024.
• Net earnings grew by $406,000.
• Diluted earnings per share increased from $2.07 to $3.46, marking a 67 percent increase that underscores fairly disciplined capital management and the recent success of insurance brokerages.

13. The Hartford
Market Capitalization: $34,086,625,280

• The Hartford reported that premiums earned rose by $4.6 million between 2021 and 2024. Net earnings grew by $740,000 over the same period.
• Diluted earnings per share surged from $1.47 in 2021 to $10.35 in 2024, an impressive 604 percent increase driven by equally impressive earning growth. This is likely aided by effective capital management, reduced share count, or disciplined expense control.

14. Humana  
Market Capitalization: $31,640,358,912

• Humana’s premiums increased by $32.3 million, yet net earnings fell by $1.7 million, further reflecting sector-wide cost burdens in healthcare.
• Diluted EPS declined sharply for this healthcare insurer, down 55 percent from $22.67 to $9.98, signaling profit compression unique to this provider despite robust top-line expansion.

15. Centene 
Market Capitalization: $28,854,878,208

• Centene’s revenues rose by $37 million, while net earnings improved by $1.95 million, aided by scale and disciplined growth in public programs.
• Diluted EPS climbed from $2.28 to $6.31, a 177 percent gain and among the strongest shareholder returns in the group.

16. Markel
Market Capitalization: $24,653,314,048

• Markel posted a $1.9 million premium increase and a modest yet important $165,000 rise in earnings.
• Its diluted EPS rose from $176.51 to $199.32, up 13 percent, driven largely by a lean share count and measured gains in underwriting and investment performance. That lean share count also contributes to this list’s greatest earnings per share.

17. W. R. Berkley
Market Capitalization: $24,168,071,168

• Premiums rose by $3.4 million and net earnings by $734,000 between 2021 and 2024.
• Diluted earnings per share increased from $2.44 to $4.36, reflecting strong growth in per-share profitability. This rise suggests not only solid earnings expansion but also effective management of share dilution, allowing gains to flow through to shareholders more efficiently than many peers.

18. Erie Indemnity
Market Capitalization: $23,673,956,352

• Erie added $1.1 million in revenue and grew net earnings by $302,000, supported by strong fee-based income.
• Diluted EPS surged from $5.69 to $11.48, a 102 percent rise and the highest relative increase among the brokers, highlighting disciplined operations, capital efficiency, and brokerage attractiveness.

19. Cincinnati Financial
Market Capitalization: $23,220,402,176

• Cincinnati Financial’s diluted EPS fell to $14.53 from $18.10, a 24 percent drop, despite premium growth of $2.4 million, pointing to elevated loss ratios and reserve strain in a volatile P&C market.

20. Principal Financial Group
Market Capitalization: $20,254,097,408

• Principal gained $2 million in premiums but posted a net earnings dip, albeit by $9,200.
• Diluted EPS nudged up 15 percent to $6.68 from $5.79, suggesting modest returns amid cost pressures in retirement and asset management lines.

The latest IB+ dashboard offers a panoramic view of the forces reshaping the US insurance sector, where rising premiums have failed to offset the growing drag of expenses, and profitability has increasingly hinged on segment-specific strategies and shareholder value metrics such as diluted earnings per share.

As the industry braces for continued regulatory tightening, technological upheaval, and climate-driven volatility, the performance gaps between brokers, P&C providers, and health insurers are becoming more pronounced.

For stakeholders seeking clarity in this complex financial landscape, the Annual Financial Insights of the Top US Insurance Businesses by Market Cap serves as a critical tool that delivers granular data on premiums, expenses, earnings, and EPS trends from 2021 to 2024 across 86 public insurance providers. These insights serve as a timely lens on who is gaining ground, who is falling behind, and where the market’s next faultlines may emerge.