NAICS UNIVERSITY · Free research for insurance agents

Direct Health and Medical Insurance Carriers

NAICS 524114 · United States · 2022 edition

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.

UW takeaway · AI logic + saved research

Start with the work promised to the client.

For Direct Health and Medical Insurance Carriers, clarify the services, contracts and consequences of an error. Review directors & officers liability, errors & omissions / professional liability, cyber and data breach. Confirm which professional activities and additional services the proposed coverage actually addresses.

Questions to ask

  1. What is the approximate number of covered lives and annual premium volume underwritten?
  2. Is the entity a licensed insurance carrier, HMO, or third-party administrator — or some combination?
  3. Any recent regulatory actions, market conduct examinations, or consent orders?
  4. What is the data security posture — third-party audits, SOC 2, encryption standards for PHI?
  5. Any prior D&O, E&O, or cyber claims in the past five years?
  6. For Direct Health and Medical Insurance Carriers, what should the underwriter know about recent regulatory sanctions, market conduct actions, or consent orders from state insurance departments?
  7. For Direct Health and Medical Insurance Carriers, what should the underwriter know about rapidly growing covered-lives count without commensurate administrative infrastructure?
  8. For Direct Health and Medical Insurance Carriers, what should the underwriter know about significant prior e&o or d&o claims history?

Activities described by this code

Other activities to examine

Census classification reference

For educational purposes only. AI-generated insurance research and automated logic can contain errors. Independently verify classification and coverage decisions.

Compare another operation

Insurance operations research — draft

These establishments underwrite and administer health and medical insurance policies — assuming actuarial risk, collecting premiums, and paying claims for individual and group health coverage. Day-to-day operations include policy issuance, claims adjudication, provider network management, actuarial analysis, regulatory compliance, and member services. HMO entities that sell insurance without directly delivering care may also fall here.

Questions to investigate

This insurance research was generated in April 2026. It has not received a complete human review. The October 12, 2026 audit checked codes and titles only, not descriptions or coverage assertions.

Classification workflow · Multiple-operation workflow