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NAICS Code· 524114

NAICS 524114: Direct Health and Medical Insurance Carriers

This U.S. industry comprises establishments primarily engaged in initially underwriting (i.e., assuming the risk and assigning premiums) health and medical insurance policies. Group hospitalization plans and HMO establishments that provide health and medical insurance policies without providing health care services are included in this industry. Cross-References.Show more

NAICS 524114 – Direct Health and Medical Insurance Carriers encompasses entities that underwrite and administer health insurance plans directly to individuals, groups, and government-sponsored programs. These carriers provide comprehensive medical coverage, including hospitalization, outpatient services, prescription drugs, and preventive care, often operating under federal health benefit programs such as the Federal Employees Health Benefits Program (FEHBP) or military health systems.

36
Active Contracts
$30.9B
Total Obligations (12mo)
542
Awarded Contracts (12mo)
99
Contractors Awarded (12mo)
1
Median Bidders per Award
-7.4%
YoY Growth

Industry Spending Overview

Federal obligations, top contractors and agencies, and related industry codes for NAICS 524114.

AI Industry Description

NAICS 524114 – Direct Health and Medical Insurance Carriers encompasses entities that underwrite and administer health insurance plans directly to individuals, groups, and government-sponsored programs. These carriers provide comprehensive medical coverage, including hospitalization, outpatient serv...

NAICS 524114 – Direct Health and Medical Insurance Carriers encompasses entities that underwrite and administer health insurance plans directly to individuals, groups, and government-sponsored programs. These carriers provide comprehensive medical coverage, including hospitalization, outpatient services, prescription drugs, and preventive care, often operating under federal health benefit programs such as the Federal Employees Health Benefits Program (FEHBP) or military health systems. In government contracting, this NAICS code supports the delivery of managed care services to federal employees, retirees, and eligible dependents, requiring robust compliance with HIPAA, ACA, and OPM regulations. These carriers function as critical intermediaries between federal beneficiaries and healthcare providers, leveraging actuarial modeling, claims adjudication systems, and network management to ensure cost-effective, high-quality care delivery. ALTITUDE TECHNOLOGIES INC. is the leading contractor in this sector, specializing in administrative services, claims processing, and enrollment management for federal health insurance programs. The company operates as a large prime contractor with deep expertise in federal health benefits infrastructure, often partnering with subcontractors to deliver scalable, compliant solutions across multi-agency environments. The Department of State is the primary federal buyer in this NAICS code, primarily procuring health insurance services for U.S. diplomatic personnel, overseas staff, and their families under the FEHBP. Demand is driven by global workforce mobility, compliance with international health standards, and the need for continuous coverage in high-risk or remote locations. The competitive landscape is concentrated among a small number of experienced contractors with proven track records in federal health benefit administration. Opportunities exist for firms with expertise in interoperable claims systems, telehealth integration, and regulatory compliance frameworks. Procurement trends indicate a growing emphasis on value-based care models and data-driven utilization management, favoring contractors with advanced analytics capabilities and secure, cloud-based infrastructure.

Top Contractors

Companies with the highest total award value under NAICS 524114, ranked by dollars won.

Ranked by total awards
CompanyTotal AwardsContracts
OPTUM PUBLIC SECTOR SOLUTIONS, INC.$19.9B30
TRIWEST HEALTHCARE ALLIANCE CORP$8.8B11
NOVITAS SOLUTIONS, INC.$949.1M2
WISCONSIN PHYSICIANS SERVICE INSURANCE CORP.$834.3M1
UNITED CONCORDIA COMPANIES, INC.$151.6M1
HERITAGE HEALTH SOLUTIONS, INC.$115.5M1
METROPOLITAN LIFE INSURANCE CO$15.0M3
DHIPAYA INSURANCE PUBLIC COMPANY LIMITED$11.3M2
AXA SEGUROS$10.6M26
UNITED CONCORDIA COMPANIES INC.$9.3M3

Top Agencies

Federal agencies directing the most contract spending toward NAICS 524114.

Department Of Veterans Affairs42 awards$28.7B
Ofc Of Acquisition And Grants Management1 award$948.5M
Department Of Defense (dod)1 award$834.3M
Department Of Defense29 awards$157.4M
Department Of Justice14 awards$119.7M
Department Of State423 awards$94.1M
Department Of Health And Human Services (hhs)24 awards$22.6M
Securities And Exchange Commission1 award$7.7M
Commodity Futures Trading Commission2 awards$7.3M
Comptroller Of Currency Acqs1 award$4.6M

Competition

How many companies historically bid on federal awards in NAICS 524114, from bidder counts reported on USAspending.

Usually Single-Bid

Half or more of reported awards drew exactly one bidder, usually a sign of incumbent-held work rather than an open field. · 3,097 reported awards

Median Bidders

1

Per reported award, all-time

Single-Bid Awards

52%

Share of reported awards with one bidder

10+ Bidder Awards

1%

Share of reported awards with 10+ bidders

Reported Awards

0

56% of 5,517 total awards

How this code compares up the NAICS hierarchy. Parent cohorts pool every code under their prefix, so they are the steadier baseline when a 6-digit sample is thin.

Industry FamilyCompetitionMedian BiddersSingle-BidBidder MixReported Awards
524114This Code
Direct Health and Medical Insurance Carriers
Usually Single-Bid152%
3,09756% of 5,517
52411NAICS Industry
Fewer Bidders246%
4,11660% of 6,829
5241Industry Group
Insurance Carriers
Usually Single-Bid157%
6,68467% of 9,969
524Subsector
Usually Single-Bid156%
14,57070% of 20,803
52Sector
Finance and Insurance
Usually Single-Bid171%
55,86385% of 65,585

Bidder counts reported on past federal awards in this NAICS (USAspending). An open opportunity has no bidders yet, so this is the historical norm for similar work, not a fact about this solicitation. Not all awards report bidder counts, and fewer bidders often means incumbent-held work rather than an easier win. Federal reporting of bidder counts fell from ~96% of awards (FY2016) to ~30% (FY2018 onward); the chart shows shares of reported awards, and washed-out stretches mark years with fewer than 30 of them.

Related NAICS Codes

Industries similar to Direct Health and Medical Insurance Carriers, by shared sector, subsector, and industry group.

Direct Life Insurance Carriers

This U.S. industry comprises establishments primarily engaged in initially underwriting (i.e., assum...
524113Same Industry GroupHigh Similarity

Direct Property and Casualty Insurance Carriers

This U.S. industry comprises establishments primarily engaged in initially underwriting (i.e., assum...
524126Same Industry GroupHigh Similarity

Direct title Insurance Carriers

This U.S. industry comprises establishments primarily engaged in initially underwriting (i.e., assum...
524127Same Industry GroupHigh Similarity

Other Direct Insurance (except Life, Health, and Medical) Carriers

This U.S. industry comprises establishments primarily engaged in initially underwriting (e.g., assum...
524128Same Industry GroupHigh Similarity

Reinsurance Carriers

This industry comprises establishments primarily engaged in assuming all or part of the risk associa...
524130Same Industry GroupHigh Similarity

Insurance Agencies and Brokerages

This industry comprises establishments primarily engaged in acting as agents (i.e., brokers) in sell...
524210Same SubsectorMedium Similarity

Claims Adjusting

This U.S. industry comprises establishments primarily engaged in investigating, appraising, and sett...
524291Same SubsectorMedium Similarity

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

This U.S. industry comprises establishments primarily engaged in providing pharmacy benefit manageme...
524292Same SubsectorMedium Similarity

Explore contracts across multiple NAICS codes Browse all NAICS Codes

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NAICS 524114 FAQ

Frequently Asked Questions

NAICS code 524114 covers Direct Health and Medical Insurance Carriers. This U.S. industry comprises establishments primarily engaged in initially underwriting (i.e., assuming the risk and assigning premiums) health and medical insurance policies. Group hospitalization plans and HMO establishments that provide health and medical insurance policies without providing health care services are included in this industry. Cross-References.

Recently Posted in Direct Health and Medical Insurance Carriers

NAICS: 524114
New
Federal
Health & Life Insurance Services for Locally Employed Staff of the U.S. Mission in Belize
Solicitation # 19BH2026R0001
The U.S. Embassy in Belmopan, Belize, is seeking a provider for health and life insurance services for approximately 129 locally employed staff members. The coverage requirements include 24 single plans, 22 self-plus-one plans, and 83 family plans. The contract will be awarded as a firm fixed-price agreement consisting of a base year with four optional one-year extensions. Interested parties must be registered in the System for Award Management database at the time of proposal submission. The government may award the contract based on initial offers without further discussion and plans to hold a pre-proposal conference. Proposals must be submitted electronically, with a strict email attachment limit of 30MB per message.
Usembassy Belmopan

POSTED

2 days ago

DEADLINE

N/A
View Details
NAICS: 524114
New
Federal
Health & Life Insurance Services for Locally Employed Staff of the U.S. Mission in Belize
Solicitation # 19BH2026Q0028
The Embassy of the United States in Belmopan, Belize, is seeking a provider for health and life insurance services for 129 locally employed staff members. The coverage requirements include 24 single plans, 22 self-plus-one plans, and 83 family plans. The contract will be awarded as a firm fixed-price agreement with a base year and four optional one-year extensions. All interested sources may submit proposals, though offerors must be registered in the System for Award Management database at the time of submission. The government may award the contract based on initial offers without further discussion. A pre-proposal conference will be scheduled, and electronic responses are permitted provided they adhere to a 30MB email size limit. This procurement falls under NAICS codes 524114 and 524113 and is subject to specific foreign procurement tax regulations.
Usembassy Belmopan

POSTED

2 days ago

DEADLINE

N/A
View Details
NAICS: 524114
New
Federal
Group Health Insurance ProvisionThe Group Health Insurance Provision subcontract, managed by the Department of State for the US Embassy Nassau, provides comprehensive health insurance coverage for prime contractors operating in Nassau, The Bahamas. The contract ensures access to a network of hospitals, doctors, laboratories, and pharmacies for 30 single individuals and 50 families, while managing international coverage and claims reimbursement. All services must align with the locally prevailing compensation practices in Nassau. The provider is responsible for delivering active health insurance policies and maintaining network access. This opportunity was posted on September 15, 2026, with a response deadline of September 30, 2026, under NAICS code 524114.
US Embassy Nassau

POSTED

4 days ago

DEADLINE

in 12 days
View Details
NAICS: 524114
New
Federal
U.S Embassy Accra LES GMC Health Insurance Services
Solicitation # 19GH1026R0001
The U.S. Embassy in Accra is soliciting proposals for Global Medical Coverage health insurance services for its Locally Employed Staff and their eligible dependents. This requirement, identified by solicitation number 19GH1026R0001, will be awarded as a fixed-price contract with economic price adjustment. The performance period consists of a one-year base period beginning February 13, 2027, with four subsequent one-year option periods. The government seeks off-the-shelf plans that meet specific minimum benefit levels, including 100 percent coverage for hospitalization and emergency services, 80 percent for outpatient and preventive care, and 50 percent for mental health and rehabilitative services, with specialized coverage for HIV/AIDS up to GHS 112,800 per year. Award will be granted to the lowest priced, technically acceptable, and responsible offeror. Technical evaluation focuses on the ability to meet mandatory benefit minimums, a sound management approach, and valid licensing or authorization from the Government of Ghana or another recognized government. The total evaluated price will include the base year and all option years but will exclude rider pricing. Payments are to be made in Ghanaian cedis, and the contractor must include VAT as a separate line item. Performance is monitored via a Quality Assurance Surveillance Plan, with a standard requiring no more than one customer complaint per month. Proposals must be submitted in three separate volumes, including an executed Standard Form 33 and required representations and certifications via SAM.
US Embassy Accra

POSTED

4 days ago

DEADLINE

in 11 days
View Details
NAICS: 524114
New
Federal
Request for Information - Insurance
Solicitation # 19BF5026F0005
The U.S. Embassy Nassau is conducting market research through a Request for Information (RFI) under solicitation number 19BF5026F0005 to identify potential industry partners for health and group life insurance coverage. This initiative aims to provide coverage for approximately 80 to 100 employees aged 18 to 75, aligning the embassy's compensation plan with locally prevailing practices in Nassau, where insurance costs are typically shared between the employer and employee. The RFI specifically seeks information on plan specifications, network provider details, international coverage, and enrollment processes. Qualified local companies licensed to operate in Nassau, The Bahamas, will be rated more favorably, and subcontracting is strictly prohibited. U.S. companies are encouraged to review local business regulations to participate. Interested parties must submit a white paper response, not exceeding 100 pages or a 5 MB email limit, by 17:00 Eastern Standard Time on September 30, 2026. This process is for planning purposes only and does not constitute a request for proposals or a commitment by the government to award a contract.
US Embassy Nassau

POSTED

4 days ago

DEADLINE

in 12 days
View Details
NAICS: 524114
New
SLED
Records Logistics & TransportationThis subcontract for Records Logistics and Transportation supports prime contractors operating on Department of State Hospitals projects in Napa, California. The selected provider will be responsible for the physical transport, pick-up, and delivery of records, offering a comprehensive range of service levels including standard, will-call, rush, emergency, after-hours, weekend, and holiday deliveries. To ensure the security and privacy of sensitive information, all personnel must be screened and HIPAA trained. The contractor is required to utilize secure transport vehicles to ensure the timely retrieval and delivery of all requested records. This opportunity is categorized under NAICS code 524114 and is managed through the California Department of State Hospitals.
California Department of State Hospitals

POSTED

4 days ago

DEADLINE

in 12 days
View Details
NAICS: 524114
SLED
RFP #1194839 - Medical Insurance Services and Administration for Montgomery County
Solicitation # BPM058813
Montgomery County Government is seeking proposals for RFP 1194839 to secure medical insurance services and administration. The selected contractors will be responsible for providing and administering medical benefit plans, including self-insured POS and EPO/HMO plans for medical services, as well as a fully-insured HMO plan covering medical, prescription, and vision services. All plans must maintain medical necessity and preserve grandfathered status while aligning with current plan designs. The solicitation is being managed through BidNet's Maryland Purchasing Group, and interested vendors must register on the platform to submit electronic responses. The county maintains the right to negotiate changes in coverage during the contract term through mutual written amendments. The response deadline for this opportunity is October 23, 2026.
Montgomery County Government

POSTED

9 days ago

DEADLINE

in about 1 month
View Details
NAICS: 524114
SLED
Health and Wellness Medical/Rx, Dental, FSA, HRA and COBRA Insurance Services
Solicitation # 26-1398
The Brazos River Authority (BRA) is soliciting proposals under RFP No. 26-1398 for fully-insured health and wellness insurance services, including Medical/Rx, Dental, FSA, HRA, and COBRA coverage. The contract is intended to support 277 active full-time employees and 2 COBRA participants, with a new coverage effective date of January 1, 2027. The BRA is seeking a provider that offers the best value while maintaining a level of service comparable to their current plans. The initial contract term is for one year, with the possibility of four additional one-year renewals for a total potential term of five years. Proposers must provide pricing net of commissions based on current deductible and aggregate limits, excluding state premium taxes due to the BRA's exempt status under Chapter 222 of the Texas Insurance Code. To be considered responsive, providers must demonstrate specific geographic network access within a 10-mile radius, requiring at least two general practitioners and two specialists for both medical and dental, and at least one hospital for medical services. Proposals are due by October 6, 2026, and will be evaluated by HUB International. The selection process may include a short-list of respondents who will undergo structured oral presentations and interviews before a final provider is selected based on demonstrated competence and qualifications.
BRAZOS RIVER AUTHORITY

POSTED

9 days ago

DEADLINE

in 17 days
View Details
NAICS: 524114
SLED
Dental Insurance ProvisionThe Dental Insurance Provision subcontract, issued by the Brazos River Authority in Texas, focuses on providing dental insurance coverage and reimbursement services for prime contractors involved in health projects. The selected provider will be responsible for underwriting dental benefit plans and managing the processing of dental claims and reimbursements. To be eligible for this contract, the provider must hold a valid state insurance license. This opportunity was posted on September 10, 2026, with a response deadline of October 6, 2026. The contract falls under NAICS code 524114 and is managed through the Texas SmartBuy system.
BRAZOS RIVER AUTHORITY

POSTED

9 days ago

DEADLINE

in 17 days
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NAICS: 524114
SLED
Medical Insurance Underwriting & Network ProvisionThis subcontract for Medical Insurance Underwriting and Network Provision provides medical insurance coverage for prime contractors on Brazos River Authority health projects. The scope of work includes managing network adequacy for preferred providers, conducting medical necessity reviews, and implementing clinical payment and coding policies such as ICD-10, CPT, and HCPCS. Operations are supported by Blue Access for Members portals and HIPAA-approved code sets to ensure a functional provider network. The contract requires strict compliance with the Texas Department of Insurance and is managed under NAICS code 524114. Interested parties must respond by October 6, 2026, for this Texas-based agency project.
BRAZOS RIVER AUTHORITY

POSTED

9 days ago

DEADLINE

in 17 days
View Details
NAICS: 524114
SLED
Pharmacy Benefit Management (PBM)The Pharmacy Benefit Management subcontract for the Brazos River Authority focuses on the administration of prescription drug benefits for prime contractors on health projects. The selected provider is responsible for establishing pharmacy vaccine networks, contracting with preferred participating pharmacies, and managing National Drug Codes to ensure accurate claim processing. To execute these duties, the contractor must utilize specialized pharmacy claims processing software and NDC databases while maintaining all necessary state and federal pharmacy licensing. This opportunity is categorized under NAICS code 524114 and was posted on September 10, 2026. Interested parties must submit their responses by the deadline of October 6, 2026. The primary objective of the contract is to ensure the delivery of comprehensive prescription drug coverage and seamless pharmacy network access for the agency.
BRAZOS RIVER AUTHORITY

POSTED

9 days ago

DEADLINE

in 17 days
View Details
NAICS: 524114
Federal
Medicare Administrative Contractor (MAC) Jurisdiction 8 (J8) - Synopsis/Draft RFP / Presolicitation
Solicitation # 75FCMC27R0001
The Centers for Medicare & Medicaid Services (CMS) is seeking a Medicare Administrative Contractor (MAC) to provide health insurance benefit administration services for Jurisdiction 8, which covers Indiana and Michigan. The contractor will be responsible for Medicare Fee-For-Service (FFS) claims processing and payment services, including provider enrollment, customer service, appeals, medical review, and audit and reimbursement functions for both Part A and Part B. This procurement, identified by solicitation number 75FCMC27R0001, is conducted as a full and open competition under FAR Part 15. The resulting contract will be a Cost-Plus-Award-Fee (CPAF) arrangement consisting of a base year and eight one-year options, with a total duration not to exceed 120 months. Award will be based on the best overall value to the government using the FAR 15.103-1 trade-off approach. Evaluation factors include a staffing plan, operations, past performance, small business utilization, and AbilityOne compliance, with non-price factors being significantly more important than price. A pass/fail gate is required for AbilityOne, necessitating that the offeror propose AbilityOne contractors to perform at least 1% of the total contract value. Proposals must be submitted in six separate volumes by November 2, 2026, at 11:00 AM EST. The anticipated award date is September 2027, and the applicable NAICS code is 524114.
Ofc Of Acquisition And Grants Management

POSTED

10 days ago

DEADLINE

in about 1 month
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