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NAICS Code 524114-02 Description (8-Digit)

Health Plans is a subdivision of the Direct Health and Medical Insurance Carriers industry, which involves providing health insurance coverage to individuals and groups. Health Plans offer a range of health insurance products, including HMOs, PPOs, and POS plans, as well as Medicare and Medicaid plans. These plans cover a variety of medical services, such as doctor visits, hospital stays, prescription drugs, and preventive care. Health Plans work with healthcare providers to negotiate prices and ensure that their members receive quality care at an affordable cost.

Hierarchy Navigation for NAICS Code 524114-02


Tools commonly used in the Health Plans industry for day-to-day tasks and operations.

  • Claims processing software
  • Health information exchange (HIE) platforms
  • Electronic health record (EHR) systems
  • Customer relationship management (CRM) software
  • Provider network management software
  • Health risk assessment tools
  • Disease management software
  • Telehealth platforms
  • Pharmacy benefit management (PBM) software
  • Data analytics tools

Industry Examples of Health Plans

Common products and services typical of NAICS Code 524114-02, illustrating the main business activities and contributions to the market.

  • Health Savings Account (HSA)
  • Dental Insurance
  • Vision Insurance
  • Disability Insurance
  • Long-term Care Insurance
  • Short-term Health Insurance
  • Critical Illness Insurance
  • Accident Insurance
  • Prescription Drug Plans
  • Medicare Advantage Plans

Certifications, Compliance and Licenses for NAICS Code 524114-02 - Health Plans

The specific certifications, permits, licenses, and regulatory compliance requirements within the United States for this industry.

  • Health Insurance Associate (HIA): This certification is offered by America's Health Insurance Plans (AHIP) and is designed for professionals who work in the health insurance industry. It covers topics such as health insurance basics, managed care, and healthcare reform. [/]
  • Certified Health Insurance Specialist (CHIS): This certification is offered by the National Association of Health Underwriters (NAHU) and is designed for professionals who work in the health insurance industry. It covers topics such as healthcare reform, consumer-driven health plans, and medical underwriting. []
  • Certified Employee Benefit Specialist (CEBS): This certification is offered by the International Foundation of Employee Benefit Plans (IFEBP) and is designed for professionals who work in the employee benefits industry. It covers topics such as group health insurance, retirement plans, and compensation. []
  • Health Insurance Portability and Accountability Act (HIPAA) Compliance: HIPAA is a federal law that regulates the use and disclosure of protected health information (PHI). Health plans must comply with HIPAA regulations to protect the privacy and security of their members' PHI. []
  • Affordable Care Act (ACA) Compliance: The ACA is a federal law that regulates the health insurance industry. Health plans must comply with ACA regulations, such as providing essential health benefits, covering pre-existing conditions, and offering preventive care services without cost-sharing. [/]


A concise historical narrative of NAICS Code 524114-02 covering global milestones and recent developments within the United States.

  • The Health Plans industry has a long history dating back to the early 20th century when the first health insurance policies were introduced in the United States. In 1929, the first Blue Cross plan was established in Texas, followed by the first Blue Shield plan in California in 1939. These plans were designed to provide coverage for hospital services and were initially offered to teachers and other public employees. In the 1950s, health insurance plans began to expand to cover physician services, and by the 1960s, Medicare and Medicaid were introduced to provide coverage for the elderly and low-income individuals. In recent years, the industry has seen significant changes due to the Affordable Care Act, which has expanded access to health insurance and introduced new regulations for health plans. In the United States, the Health Plans industry has undergone significant changes in recent years. The Affordable Care Act, which was signed into law in 2010, has expanded access to health insurance and introduced new regulations for health plans. The law requires health plans to cover essential health benefits, such as preventive care and prescription drugs, and prohibits insurers from denying coverage based on pre-existing conditions. The law also established health insurance marketplaces where individuals can compare and purchase health plans. In addition, the industry has seen increased consolidation, with large insurers acquiring smaller competitors to gain market share and increase bargaining power with healthcare providers. Despite these changes, the industry continues to face challenges such as rising healthcare costs and uncertainty around the future of healthcare policy in the United States.

Future Outlook for Health Plans

The anticipated future trajectory of the NAICS 524114-02 industry in the USA, offering insights into potential trends, innovations, and challenges expected to shape its landscape.

  • Growth Prediction: Stable

    The future outlook for the Health Plans industry in the USA is positive due to the increasing demand for healthcare services and the growing aging population. The industry is expected to grow due to the implementation of the Affordable Care Act, which has increased the number of people with health insurance. The industry is also expected to benefit from the increasing use of technology, such as telemedicine, which allows patients to receive medical care remotely. However, the industry may face challenges due to rising healthcare costs and regulatory changes. Overall, the Health Plans industry is expected to continue to grow in the coming years.

Industry Innovations for NAICS Code 524114-02

Recent groundbreaking advancements and milestones in the Health Plans industry, reflecting notable innovations that have reshaped its landscape.

  • Health plans are increasingly using artificial intelligence (AI) to improve patient outcomes and reduce costs. AI can be used to analyze patient data and identify potential health risks, allowing health plans to intervene before a patient's condition worsens.
  • Health plans are also using telemedicine to provide remote medical care to patients. This technology allows patients to receive medical care from the comfort of their own homes, reducing the need for in-person visits and improving access to care.
  • Health plans are partnering with retail clinics to provide convenient and affordable healthcare services to patients. Retail clinics are typically located in pharmacies or grocery stores and offer basic medical services such as vaccinations and check-ups.
  • Health plans are using data analytics to identify high-risk patients and provide them with targeted interventions. By analyzing patient data, health plans can identify patients who are at risk of developing chronic conditions and provide them with preventative care.
  • Health plans are also investing in digital health tools such as mobile apps and wearable devices to help patients manage their health. These tools can be used to track fitness goals, monitor chronic conditions, and provide patients with personalized health recommendations.

NAICS Code 524114-02 - Health Plans

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