As the Q4 earnings season comes to a close, it’s time to take stock of this quarter’s best and worst performers in the health insurance providers industry, including Cigna (NYSE: CI) and its peers.

Upfront premiums collected by health insurers lead to reliable revenue, but profitability ultimately depends on accurate risk assessments and the ability to control medical costs. Health insurers are also highly sensitive to regulatory changes and economic conditions such as unemployment. Going forward, the industry faces tailwinds from an aging population, increasing demand for personalized healthcare services, and advancements in data analytics to improve cost management. However, continued regulatory scrutiny on pricing practices, the potential for government-led reforms such as expanded public healthcare options, and inflation in medical costs could add volatility to margins. One big debate among investors is the long-term impact of AI and whether it will help underwriting, fraud detection, and claims processing or whether it may wade into ethical grey areas like reinforcing biases and widening disparities in medical care.

The 12 health insurance providers stocks we track reported a slower Q4. As a group, revenues beat analysts’ consensus estimates by 0.8% while next quarter’s revenue guidance was in line.

Amidst this news, share prices of the companies have had a rough stretch. On average, they are down 5.4% since the latest earnings results.

Cigna (NYSE: CI)

With roots dating back to 1792 and serving millions of customers across the globe, The Cigna Group (NYSE: CI) provides healthcare services through its Evernorth Health Services and Cigna Healthcare segments, offering pharmacy benefits, specialty care, and medical plans.

Cigna reported revenues of $72.5 billion, up 10.4% year on year. This print exceeded analysts’ expectations by 3.8%. Despite the top-line beat, it was still a mixed quarter for the company with an impressive beat of analysts’ revenue estimates but full-year revenue guidance slightly missing analysts’ expectations.

"In 2025, we expanded access and support, lowered costs, and improved transparency for our customers and patients," said David M. Cordani, chairman and CEO of The Cigna Group.

The market was likely pricing in the results, and the stock is flat since reporting. It currently trades at $272.18.

Is now the time to buy Cigna? Access our full analysis of the earnings results here, it’s free.

Best Q4: Clover Health (NASDAQ: CLOV)

Founded in 2014 to improve healthcare for America's seniors through technology, Clover Health (NASDAQ: CLOV) provides Medicare Advantage plans for seniors with a focus on affordable care and uses its proprietary Clover Assistant software to help physicians manage patient care.

Clover Health reported revenues of $487.7 million, up 44.7% year on year, outperforming analysts’ expectations by 4.4%. The business had a strong quarter with a solid beat of analysts’ revenue estimates and EPS in line with analysts’ estimates.

Clover Health delivered the biggest analyst estimates beat and fastest revenue growth among its peers. The company added 4,577 customers to reach a total of 113,803. Although it had a fine quarter compared its peers, the market seems unhappy with the results as the stock is down 7.3% since reporting. It currently trades at $1.99.

Is now the time to buy Clover Health? Access our full analysis of the earnings results here, it’s free.

Weakest Q4: Molina Healthcare (NYSE: MOH)

Founded in 1980 as a provider for underserved communities in Southern California, Molina Healthcare (NYSE: MOH) provides managed healthcare services primarily to low-income individuals through Medicaid, Medicare, and Marketplace insurance programs across 21 states.

Molina Healthcare reported revenues of $11.38 billion, up 8.3% year on year, exceeding analysts’ expectations by 3.7%. Still, it was a softer quarter as it posted full-year revenue guidance missing analysts’ expectations significantly and a significant miss of analysts’ full-year EPS guidance estimates.

As expected, the stock is down 19.1% since the results and currently trades at $143.14.

Read our full analysis of Molina Healthcare’s results here.

CVS Health (NYSE: CVS)

With over 9,000 retail pharmacy locations serving as neighborhood health destinations across America, CVS Health (NYSE: CVS) operates retail pharmacies, provides pharmacy benefit management services, and offers health insurance through its Aetna subsidiary.

CVS Health reported revenues of $105.7 billion, up 8.2% year on year. This result beat analysts’ expectations by 2%. Zooming out, it was a satisfactory quarter as it also produced a decent beat of analysts’ revenue estimates but a slight miss of analysts’ full-year EPS guidance estimates.

The stock is up 2.7% since reporting and currently trades at $77.84.

Read our full, actionable report on CVS Health here, it’s free.

Oscar Health (NYSE: OSCR)

Founded in 2012 to simplify the notoriously complex American healthcare system, Oscar Health (NYSE: OSCR) is a technology-focused health insurance company that offers individual and small group health plans through its cloud-native platform.

Oscar Health reported revenues of $2.81 billion, up 17.3% year on year. This number came in 10.2% below analysts' expectations. Taking a step back, it was a mixed quarter as it also logged full-year operating income guidance exceeding analysts’ expectations but a significant miss of analysts’ revenue estimates.

Oscar Health delivered the highest full-year guidance raise but had the weakest performance against analyst estimates among its peers. The stock is up 9.1% since reporting and currently trades at $13.81.

Read our full, actionable report on Oscar Health here, it’s free.

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