Ranking · Plan year 2024 · Top 100
Largest fully insured employer health plans
Updated Download this list (CSV)
Employers whose medical coverage is written by an insurance carrier, ranked by participants. Insperity Holdings, Inc. of Kingwood, Texas leads the 2024 list with medical premium of $2,519,453,592. Medical premium is earned premium on contracts coded as health coverage.
| # | Employer | Participants | Medical premium | Rate |
|---|---|---|---|---|
| 1 | Insperity Holdings, Inc. · Kingwood, TX | 211,533 | $2,519,453,592 | — |
| 2 | Paychex Business Solutions LLC · ST Petersburg, FL | 197,994 | $194,259,578 | — |
| 3 | Justworks Employment Group LLC · New York, NY | 131,268 | $70,979,312 | — |
| 4 | Vensure Employer Services, Inc. · Chandler, AZ | 47,695 | $0 | — |
| 5 | Rippling Peo 1, Inc. · San Francisco, CA | 43,065 | $0 | — |
| 6 | Geico Corporation · Washington, DC | 35,258 | $0 | — |
| 7 | Vanderbilt University Medical Center · Nashville, TN | 27,828 | $0 | — |
| 8 | Cpe HR, Inc. Grace Drulias · Burbank, CA | 26,679 | $67,837,864 | 5.7% |
| 9 | NY City District Council 37, AFSCME Afl- · New York, NY | 24,590 | $0 | — |
| 10 | Socios Buenos, LP · Atlanta, GA | 24,311 | $0 | — |
| 11 | Sephora USA, Inc. · San Francisco, CA | 16,402 | $191,258 | 0.0% |
| 12 | Guardian Independent Operator Association, Inc. · Kennesaw, GA | 15,376 | $0 | — |
| 13 | Menard, Inc. · Eau Claire, WI | 14,596 | $0 | — |
| 14 | Shands Teaching Hospital and Clinics, Inc. · Gainesville, FL | 12,540 | $0 | — |
| 15 | Brown & Brown, Inc. · Daytona Beach, FL | 12,498 | $9,055,575 | — |
| 16 | SP Plus Corporation · Chicago, IL | 11,786 | $42,446,845 | — |
| 17 | Ally Financial Inc. · Detroit, MI | 11,175 | $0 | — |
| 18 | Slalom, Inc. · Seattle, WA | 9,878 | $3,409,893 | — |
| 19 | Northwestern Mutual Field Associations · Milwaukee, WI | 9,173 | $126,872,459 | 0.0% |
| 20 | Red Lobster Restaurants, LLC · Orlando, FL | 9,064 | $0 | — |
| 21 | Board of Trustees of the MLB Lwip · New York, NY | 9,027 | $139,421,790 | 4.0% |
| 22 | Empower HR LLC · Brighton, MI | 8,955 | $0 | — |
| 23 | Communications Test Design, Inc. · West Chester, PA | 8,516 | $49,834,163 | — |
| 24 | Cooper's Hawk Intermediate Holding, LLC · Downers Grove, IL | 8,402 | $0 | — |
| 25 | Advanstaff, Inc. · Las Vegas, NV | 7,949 | $0 | — |
| 26 | Hsta Voluntary Employees' Beneficiary Association Trust · Honolulu, HI | 7,794 | $0 | — |
| 27 | Farmers Agent Group Benefits Program · Woodland Hills, CA | 7,614 | $0 | — |
| 28 | Texas Operators Association, Inc. · Houston, TX | 7,530 | $0 | — |
| 29 | Employer Flexible HR, LLC · Houston, TX | 7,214 | $0 | — |
| 30 | Mufg Bank, LTD. · New York, NY | 6,750 | $0 | — |
| 31 | Abel HR, Inc. · Cranbury, NJ | 6,671 | $0 | — |
| 32 | Gentex Corporation · Zeeland, MI | 6,492 | $0 | — |
| 33 | The Trustees of the Employee Benefits Trust · Olympia, WA | 6,400 | $0 | — |
| 34 | Amplify HR Management LLC · Northbrook, IL | 6,177 | $0 | — |
| 35 | Dot Holdings Co · MT. Sterling, IL | 6,164 | $72,072,348 | 0.3% |
| 36 | Midwest Veterinary Partners, LLC · Southfield, MI | 6,051 | $0 | — |
| 37 | Ben E. Keith Company · Fort Worth, TX | 5,947 | $4,447,426 | 0.0% |
| 38 | Moody's Corporation · New York, NY | 5,736 | $0 | — |
| 39 | Trion Solutions, Inc · Troy, MI | 5,555 | $12,551,720 | — |
| 40 | Resourcing Edge I, LLC · Rockwall, TX | 5,514 | $446,006 | — |
| 41 | MC Dean Inc · Tysons, VA | 5,344 | $0 | — |
| 42 | LBMC Employment Partners, LLC · Brentwood, TN | 5,289 | $25,748,418 | — |
| 43 | Central Transport LLC · Warren, MI | 4,883 | $0 | — |
| 44 | Consumer Data Partners LP · Atlanta, GA | 4,761 | $0 | — |
| 45 | Outreach Data Partners, LP · Atlanta, GA | 4,761 | $0 | — |
| 46 | ST Matthews Area Chamber of Commerce Inc · Louisville, KY | 4,646 | $31,737,053 | 5.8% |
| 47 | The Service Companies, Inc. · Miramar, FL | 4,602 | $0 | — |
| 48 | Ruiz Food Products, Inc. · Frisco, TX | 4,469 | $0 | — |
| 49 | Keystone Capital Management LP · Chicago, IL | 4,362 | $0 | — |
| 50 | Henderson Nevada Chamber of Commerce, Inc. · Henderson, NV | 4,131 | $0 | — |
| 51 | Saltzman, Tanis, Pittell, Levin, & Jacobson, LLC · Plantation, FL | 4,087 | $0 | — |
| 52 | Prosperity Bank · Sugar Land, TX | 4,047 | $32,092,284 | 0.8% |
| 53 | American Consumer's and Affiliates LP · Atlanta, GA | 4,025 | $0 | — |
| 54 | Nabors Industries, Inc. and Subsidiaries · Houston, TX | 3,990 | $0 | — |
| 55 | Salem Contractors Exchange · Salem, OR | 3,975 | $0 | — |
| 56 | Luma Energy Servco LLC · San Juan, PR | 3,882 | $866,795 | — |
| 57 | Chamber of Commerce Executives of Kansas, Inc. · Broken Arrow, OK | 3,825 | $25,844,067 | 0.0% |
| 58 | Hmma,llc · Montgomery, AL | 3,820 | $49,031,742 | 0.0% |
| 59 | Isc Group, LLC · Baton Rouge, LA | 3,806 | $19,512,895 | — |
| 60 | Firstsource Group U.S.A., Inc. · Louisville, KY | 3,786 | $0 | — |
| 61 | People Center, Inc. · San Francisco, CA | 3,738 | $0 | — |
| 62 | Spectrum Employer Business Cooperative · Rothschild, WI | 3,736 | $30,017,364 | 2.1% |
| 63 | Pye-Barker Fire & Safety, LLC · Alpharetta, GA | 3,643 | $0 | — |
| 64 | CVS Health Care Delivery Group of Emplyers · Woonsocket, RI | 3,455 | $0 | — |
| 65 | Academica Nevada, LLC · Las Vegas, NV | 3,430 | $0 | — |
| 66 | Infinite Computer Solutions, Inc. · Rockville, MD | 3,397 | $0 | — |
| 67 | Alternative Behavior Strategies, LLC · Encino, CA | 3,372 | $0 | — |
| 68 | The Elevance Health Companies of Puerto Rico · Indianapolis, IN | 3,359 | $10,473,714 | 0.0% |
| 69 | Kura Sushi USA, Inc. · Irvine, CA | 3,308 | $0 | — |
| 70 | Leadingage Oregon · Tigard, OR | 3,269 | $0 | — |
| 71 | Mastercorp, Inc. · Crossville, TN | 3,268 | $6,567,448 | 0.3% |
| 72 | The Corps Network · Washington, DC | 3,222 | $0 | — |
| 73 | Chevron Stations Inc. · San Ramon, CA | 3,219 | $0 | — |
| 74 | Epam Systems, Inc. · Newtown, PA | 3,181 | $0 | — |
| 75 | Optum Medical Services, PC · Eden Prairie, MN | 3,146 | $0 | — |
| 76 | Howard Industries Inc · Laurel, MS | 3,133 | $0 | — |
| 77 | Findlay Management Group - Nevada, Arizona, Utah, Idaho, Washington · Henderson, NV | 3,122 | $0 | — |
| 78 | Nevada Builders Alliance Association · Carson City, NV | 3,104 | $0 | — |
| 79 | The University of Phoenix, Inc. · Phoenix, AZ | 3,053 | $0 | — |
| 80 | Bend Chamber of Commerce · Bend, OR | 3,019 | $0 | — |
| 81 | The Simplex Group, Inc. · Miami, FL | 3,015 | $18,024,738 | 3.4% |
| 82 | Sammons Corporation · Dallas, TX | 3,007 | $0 | — |
| 83 | Rockport Administrative Services, LLC · Glendale, CA | 2,948 | $0 | — |
| 84 | Lincoln Property Company Commercial, Inc. · Dallas, TX | 2,933 | $0 | — |
| 85 | Edukids, Inc. · West Seneca, NY | 2,926 | $0 | — |
| 86 | Dovenmuehle Mortgage, Inc. · Lake Zurich, IL | 2,886 | $0 | — |
| 87 | Autism Learning Partners · Monrovia, CA | 2,838 | $0 | — |
| 88 | Links Healthcare · San Diego, CA | 2,824 | $0 | — |
| 89 | 365 Health Services, LLC · Bala Cynwyd, PA | 2,811 | $1,160,206 | — |
| 90 | Westmont Hospitality Management, LLC · Houston, TX | 2,807 | $0 | — |
| 91 | McGee Air Services, Inc. · Renton, WA | 2,792 | $0 | — |
| 92 | Kia Georgia, Inc. · West Point, GA | 2,778 | $0 | — |
| 93 | Utility Trailer Manufacturing Company, LLC · City of Industry, CA | 2,752 | $44,837,998 | — |
| 94 | Hcew Inc · City of Industry, CA | 2,752 | $44,837,998 | — |
| 95 | Rockefeller Health & Welfare Benefits Trust · New York, NY | 2,750 | $21,563,307 | — |
| 96 | National Debt Relief LLC · New York, NY | 2,746 | $459,979 | — |
| 97 | Mastronardi Produce USA · Livonia, MI | 2,721 | $0 | — |
| 98 | Prime HR Service Corp · Columbus, OH | 2,697 | $0 | — |
| 99 | Western Veterinary Partners, LLC · Denver, CO | 2,696 | $0 | — |
| 100 | The Arbor Holding Company LLC · Atlanta, GA | 2,679 | $0 | — |
Source: DOL Form 5500 and Schedule A, plan year 2024; built October 24, 2026. Names as filed; a row reflects what the employer reported, and misfilings happen. Corrections: hello@benefitsledger.com. Methodology.
Which employers buy the largest fully insured medical plans?
In plan year 2024 filings, Insperity Holdings, Inc. (Kingwood, Texas) ranks first, with medical premium of $2,519,453,592. Paychex Business Solutions LLC is second and Justworks Employment Group LLC third.
How is this list built?
Employers whose medical coverage is written by an insurance carrier, ranked by participants. Medical premium is earned premium on contracts coded as health coverage. Source: U.S. Department of Labor Form 5500 and Schedule A datasets, plan year 2024, built October 24, 2026.
Employer health plans that paid brokers the mostHighest broker commission rates on employer medical plansLargest self-funded employer health plansBiggest year-over-year increases in broker payBiggest year-over-year decreases in broker payEmployer health plans filed latest after the deadlineEmployer health plans with the largest insurance premiums