This report captures the latest 12 months (LTM) of payer performance through Q2 2025. Drawing on NAIC Financial Statement Filings, the analysis highlights financial patterns among national and regional payers, along with the associated implications for provider negotiations, product strategy, and capital allocation.

While Q2 2025 data may seem slightly lagged, it offers the most current and comprehensive view of available payer performance. All health insurers, including regional carriers and provider-sponsored health plans (PSHPs) that are not subject to traditional public company reporting, must file quarterly financial statements with the NAIC by early June, which is three months after Q2’s closing. This consistent reporting requirement ensures broad visibility across payer types, even in the absence of public disclosures.

Here are three takeaways from ECG’s Q2 2025 Health Plan Quarterly Report:

• Anthem and UnitedHealthcare were the only plan categories to report pretax operating margins above 3%. Other national affiliates realized a margin of 1.8%, and all other plan categories operated at a loss.
• Regional plans experienced the largest increase in their medical cost ratios (400 basis points), inferring rising utilization and medical costs within this health plan category.
• Cigna continues to see the most significant financial fluctuations as it shifts its revenue and strategic focus away from covered lives and toward its healthcare services platform, Evernorth Health Services. This trend is expected to continue following the divestiture of Cigna’s Medicare Advantage business to Health Care Service Corporation, a transaction that was completed on March 19, 2025.

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