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Companies that primarily engage in the underwriting, marketing, and distribution of accident and health, sickness, disability, and other specialty or supplemental insurance to consumers and businesses.
Economies of scale in administration have pushed strong consolidation. Although managed care plans (MCPs) have proliferated at the local level, more are being sponsored by large for-profit companies that maintain separate entities in each state. Consolidation is also being pushed because large provider networks, difficult for smaller companies to assemble, are more attractive to customers. In some parts of the country, a few large companies now dominate the health insurance market, holding a combined HMO/PPO (preferred provider organization) market share of 30, 40, or sometimes even 50 percent. In Philadelphia, one insurer holds 55 percent of combined HMO/PPO market share.
The basic concept of insurance is that losses incurred by one party are paid by the other insured parties who haven't had losses. Insured parties are treated as though the risk of loss is the same for all. Insurers have found, however, that they can sufficiently assess risk to offer lower premiums to parties with lower risk. Nonsmokers, for example, are charged lower life insurance premiums than smokers. While this seems reasonable on the surface, it means that parties with a higher risk pay higher premiums, sometimes so high that they are essentially uninsurable, which is generally the case for people infected with HIV. Because of the rapid advances in medical knowledge, more people with preexisting medical conditions or genetically determined diseases may be unable to buy insurance, a prospect that has prompted public policy debate and may lead to more legislative action.
Hoover's has developed its own industry classifications to better serve its customers. These classifications are mapped to the North American Industry Classification System (NAICS) and the older U.S. Standard Industrial Classification (SIC) system. The Accident & Health Insurance maps to a number of NAICS codes including:
Using the 2002 Census Bureau Economic Census, Hoover's has generated an industry financial summary for the Accident & Health Insurance industry.