Bermuda reinsurers captured a large share of the fast-growing American health reinsurance market in 2024, according to a new report from AM Best.

Hannover Life Reassurance Bermuda Ltd ranked second among unaffiliated health reinsurers in the US, writing $14.5 billion in premium last year.

The company was also at the centre of some of the year’s largest transactions, including a $2.76 billion quota share agreement with Blue Cross Blue Shield of Michigan and a further $1.65 billion tranche with the same carrier. Hannover Re Bermuda also secured a $3.1 billion deal with Horizon Healthcare Services of New Jersey.

Other Bermudian-linked transactions included Lincoln National’s $4.94 billion affiliated deal through Lincoln Pinehurst Re, and Aetna Life Insurance Company’s $4.5 billion ceded to Hannover Re Bermuda. Meanwhile, Sun Life Assurance ceded more than $2.2 billion in stop-loss premiums to its Hamilton-based affiliate, Sun Life Financial (Bermuda) Reinsurance Ltd.

The report also pointed out Bermuda’s importance in the captive space. CVS Caremark Indemnity Ltd, a Bermudian-domiciled captive, took in $407 million of ceded premium in 2024.

Overall, American health reinsurance premiums grew 30 per cent last year to $66 billion, with high-cost claims and stop-loss coverage driving demand.

Ageing populations and increased healthcare needs have contributed to the growth of global health reinsurance in recent years, according to AM Best. However, greater claim costs, including more high-dollar claims in the US, are driving increased usage of reinsurance.

“The US health reinsurance market has grown in terms of quota share and excess of loss reinsurance arrangements,” said Jon Housel, AM Best analyst. “The volume of ceded health premium has grown significantly over the past 10 years, by more than 350 per cent during that span.”