Federal NAICS Codes

NAICS 524114: Direct Health and Medical Insurance Carriers

Explore obligations, trends, recent awards, and incumbent contractors for NAICS 524114.

NAICS 524114 federal market metrics

Total obligations
$407.7B
Total awards
4,689 awards
Active obligations
$46.5B
Size standard
$47,000,000 receipts

What this NAICS covers

NAICS 524114 covers underwriting, issuing, and administering health and medical insurance policies, including premium billing, claims adjudication, risk management, provider network administration, and policyholder enrollment and customer service.

Federal opportunities under 524114 typically involve providing insured health benefit programs for federal beneficiaries, operating enrollment and premium collection, executing claims payment and provider contracting, maintaining compliance and reporting, and supporting beneficiary customer service and audit readiness.

FY2025 snapshot

Obligations
$33B
Awards
565
Average award
$58.4M
Change from FY2024
+13.6%

Recent awards

Search contractors

$226,762

L'AFRICAINE DES ASSURANCES

Department of State

PIID
19BN1526F0020
PSC
G007 - SOCIAL- GOVERNMENT HEALTH INSURANCE PROGRAMS

FAQ

What work fits NAICS 524114?
  • Administration and adjudication of medical claims under a funded contract where the contractor assumes defined claims risk and handles enrollment and premium collection.
  • Design and operation of managed care networks, provider credentialing, rate negotiation, and provider directory maintenance under a funded benefits arrangement.
  • Actuarial pricing, reserve management, and premium calculation for a government-funded health plan where the contractor underwrites coverage.
  • Member services, utilization management, and case management delivered as part of a contract where the contractor carries financial responsibility for covered services.
When is NAICS 524114 a weak fit?
  • Administrative third-party services without risk: contracts that only provide enrollment and claims processing while the government retains financial liability, because insurance underwriting and risk assumption are absent.
  • Employee benefits consulting with no funded plan: advisory engagements that recommend benefit designs but do not issue policies or accept claims responsibility, because premium collection and underwriting are not performed.
  • Brokerage or placement of stop-loss/reinsurance: procurement focused on arranging reinsurance or benefits placement without acting as the primary carrier, because the contractor does not assume primary member claims liability.
What solicitation language points to NAICS 524114?
  • Contract language requiring the contractor to issue policies or plan documents, collect premiums, and assume financial responsibility for covered claims.
  • Deliverables that include actuarial reports, premium rate schedules, reserve calculations, and risk-pooling or stop-loss provisions.
  • Evaluation criteria that assess insurer licenses, financial solvency, underwriting capacity, and experience accepting medical claims risk.

Put this market knowledge to work

Now that you know about NAICS 524114 - Direct Health and Medical Insurance Carriers, let Sweetspot help you find and win relevant government contracts with AI-powered tools.

Schedule a Demo
Track awards in this NAICS Find contractors winning here Get alerts for new awards Analyze recompete timing