Hospital & Medical Service Plans

Hospital & Medical Service Plans

Companies classified under SIC 6324 – Hospital & Medical Service Plans design and administer health coverage products ranging from group and individual medical policies to HMOs, PPOs, Medicare Advantage, and supplemental plans for employers, unions, and government programs, as well as direct-to-consumer offerings. Their typical customers include large and mid-sized employers seeking cost control, small businesses needing turnkey benefits, and individuals and retirees looking for predictable access to hospitals, physicians, and prescription drugs. Revenue depends on accurate pricing of premiums against claims, provider network management, and tight control of administrative costs, while major risks center on adverse claim trends, regulatory shifts under the Affordable Care Act and CMS rules, cybersecurity and data privacy requirements, and state insurance capital standards. In 2024–2025, the sector is shaped by telehealth expansion, value-based reimbursement, AI-driven utilization management, and growing demand for mental health benefits. For deeper company-level insight, view live SEC filings for this industry on Earnings Feed.

Source: Earnings Feed research · Nov 23