This is the question we posed to insurers and brokerages last week and a few have now responded.
The biggest loser of the entire year is HCC, which posted a loss of $1.4bn in the fourth quarter, with its total losses of $8.6bn coming from its insurer, Cigna, and a slew of smaller players.
At the bottom end, it is not even close.
It has lost $1bn in every quarter since the second quarter of 2019, when it posted a $9.3bn loss.
It is still in a position to remain the most profitable insurer in the country, but it is now looking at losing its position.
HCC was not happy with the results and it has been targeting a $4bn loss, but the company is also considering whether to raise prices for some of its plans.
Cigna also lost $3.4b last year, but its results were better than HCC.
As the year continues to roll on, the question is how far the industry can go.
The insurers are all on the verge of breaking even, with the average loss of each being $1,100.
While the insurers are struggling, the brokerages are still on a roll.
They have posted $11bn in revenue for the year and more than half of their business comes from commissions.
If the brokerage business continues to grow, it could be able to absorb a larger slice of losses from the insurers.
But with the insurers’ loss coming from fees, this would make it harder for them to absorb losses from higher premiums, which are already hitting their margins.
“We need to continue to make smart choices on pricing to keep costs low and margins high,” Cignas chief executive, Peter Wertz, told CNBC in a statement.
“We have a long-term commitment to delivering premium growth that will support our competitive position and create value for our clients.”
The industry has already seen a decline in profits from 2018.
For the year, HCC said it saw its overall profit fall to $9bn, and its losses fell to $2.6 billion.
However, this is only down from $13.6b in 2018.