Waterdrop Valuation Multiples

Berkshire Hathaway is a holding company with a wide array of subsidiaries engaged in diverse activities. The firm's core business segment is insurance, run primarily through Geico, Berkshire Hathaway Reinsurance Group, and Berkshire Hathaway Primary Group. Berkshire has used the excess cash thrown off from its operations to acquire Burlington Northern Santa Fe (railroad), Berkshire Hathaway Energy (utilities and energy distributors), and the companies that make up its manufacturing, service, and retailing operations (which include Precision Castparts, Lubrizol, Clayton Homes, Marmon, and IMC/ISCAR). The conglomerate is unique in that it is run on a completely decentralized basis. Berkshire is expected to generate close to $375 billion in revenue in 2025.

Johnson & Johnson is the world's largest and most diverse healthcare firm. It has two divisions: innovative medicine and medtech. These now represent all of the company's sales following the divestment of the consumer business, Kenvue, in 2023. After restructurings in 2023-24, the drug division focuses on three main therapeutic areas: immunology, oncology, and neurology. Geographically, just over half of total revenue is generated in the United States.

UnitedHealth Group is one of the largest private health insurers and provides medical benefits to about 51 million members globally, including 1 million outside the US as of December 2024. As a leader in employer-sponsored, self-directed, and government-backed insurance plans, UnitedHealth has obtained massive scale in medical insurance. Along with its insurance assets, UnitedHealth's Optum franchises help create a healthcare services colossus that spans everything from pharmaceutical benefits to providing outpatient care and analytics to both affiliated and third-party customers.

Siemens is a multi-industry company focused on the areas of automation, electrification, mobility, and healthcare. Its top three geographic regions—the United States, Germany, and China—contribute over half of group revenue. Siemens has a 71% investment in separately listed Siemens Healthineers. Recent portfolio activity included the listing of Siemens Energy, spinning out its power and gas and Siemens Gamesa business divisions in 2020.

Thermo Fisher Scientific sells scientific instruments and laboratory equipment, diagnostics consumables, and life science reagents. The firm operates through four segments as of year-end 2024 (revenue figures include some cross-segment revenue): analytical technologies (17% of sales); specialty diagnostic products (11%); life science solutions (23%); and lab products and services, which includes CRO services (the remainder).

Allianz was founded as a transport and accident insurance firm in 1890 by Carl von Thieme and Wilhelm von Finck, the founders of Munich Re. It took the company five years to expand the business into Europe and North America and subsequently list in Berlin. After World War I, individuals were confronted with the loss of wealth, life, and security and Allianz founded a life business in the 1920s. In the years after World War II, Allianz's foreign assets were seized, and it lost its foreign business. By relocating its head office from Berlin to Munich in 1948, Allianz began the long road of rebuilding its domestic business. It took 20 years for the company to reacquire its prior foreign interests, starting in Austria. It became the largest European insurer in the postwar boom era.

Abbott manufactures and markets cardiovascular and diabetes devices, adult and pediatric nutritional products, diagnostic equipment and testing kits, and branded generic drugs. Products include pacemakers, implantable cardioverter defibrillators, neuromodulation devices, coronary stents, catheters, infant formula, nutritional liquids for adults, continuous glucose monitors, and immunoassays and point-of-care diagnostic equipment. Abbott derives roughly 60% of sales outside the United States.

Intuitive develops, produces, and markets a robotic system for assisting minimally invasive surgery. It also provides the instrumentation, disposable accessories, and warranty services for the system. The company has placed more than 10,000 da Vinci systems in hospitals worldwide, with more than 6,000 installations in the US and a growing number in emerging markets.

Ping An Insurance was founded in 1988 and headquartered in Shenzhen. As an integrated financial service provider, the company offers healthcare services and integrated financial products. Ping An is China's second-largest life and P&C insurer. The company strives for an integrated financial services platform comprising life insurance, P&C insurance, banking, and other financial services. These business segments contributed 58%, 11%, 32%, and negative 4% of the company’s pretax profits, respectively, in 2024.

As the largest life insurance company in China, China Life commands about 16% market share by end-2024. The firm offers group and individual life insurance through exclusive agents, bancassurance, and other marketing platforms. While the bulk of profits stem from life insurance policies, additional operations include short-term policies such as accident and health insurance. The company is focusing on building a senior-care ecosystem and reforming a new agent team for long-term growth.

In 1984, Danaher's founders transformed a real estate organization into an industrial-focused manufacturing company. Then, through a series of mergers, acquisitions, and divestitures, Danaher now focuses primarily on manufacturing scientific instruments and consumables in the life sciences and diagnostic industries after the late 2023 divestiture of its environmental and applied solutions group, Veralto.

ACE acquired Chubb in the first quarter of 2016 and assumed the Chubb name. The combination made the new Chubb one of the largest domestic property and casualty insurers, with operations in 54 countries spanning commercial and personal P&C insurance, reinsurance, and life insurance.

Progressive underwrites private and commercial auto insurance and specialty lines; it has almost 24 million personal auto policies in force and is one of the largest auto insurers in the United States. Progressive markets its policies through independent insurance agencies in the US and Canada and directly via the internet and telephone. Its premiums are split roughly equally between the agent and the direct channel. The company also offers commercial auto policies and entered homeowners insurance through an acquisition in 2015.

Stryker designs, manufactures, and markets an array of medical equipment, instruments, consumable supplies, and implantable devices. The product portfolio includes hip and knee replacements, extremities, endoscopy systems, operating room equipment, embolic coils, hospital beds and gurneys, and orthopedic robotics. Stryker remains one of the three largest competitors in reconstructive orthopedic implants and holds the leadership position in operating room equipment. Roughly one-fourth of Stryker's total revenue currently comes from outside the United States.

Headquartered in Hong Kong, AIA is one of the largest pan-Asian insurance providers with diversifed products offerings including retirement savings plans, life insurance, and accident and health insurance. It was previously part of American International Group and went for a separate listing in Hong Kong in 2010. The firm also provides employee benefits, credit life, and pension services to corporate clients. AIA operates in 18 markets and serves the holders of more than 30 million individual policies and over 16 million participating members of group insurance schemes.

Zurich is a multiline insurer that writes business across both life and nonlife insurance and also owns Farmers Management Services. Zurich was founded in 1872 as a marine reinsurer to provide reinsurance to its parent company. The company subsequently expanded into transport and accident insurance and rode the wave of transport technology innovation that drove rising demand for insurance. One of Zurich’s early principles was that setting prices too low would result in unfair claims handling, which would be damaging to both customers and Zurich. Over the years, Zurich has sought to combine customer goodwill through claims and a sufficient premium. Zurich is one of the most successful European multilines.

One of the largest medical-device companies, Medtronic develops and manufactures therapeutic medical devices for chronic diseases. Its portfolio includes pacemakers, defibrillators, transcatheter heart valves, stents, insulin pumps, spinal fixation devices, neurovascular products, advanced energy, ablation laser therapy, and surgical tools. The company primarily markets its products to healthcare institutions and physicians in the United States, Western Europe, and Japan. Foreign sales account for roughly 50% of the company's total sales.

AXA’s origins date back to Ancienne Mutuelle, which was one of the few insurers that remained after the creation of the French social security system. With the threat of nationalization, a merger took place between Drouot and AXA (still known as Mutuelles Unies in 1982) and later Présence. Ten years later, AXA acquired North American life insurer Equitable Holdings. This was a time of expansion as AXA also bought the French insurer UAP. As markets crashed at the turn of the millennium, AXA decided to refocus its business and exited its stake in US investment bank Donaldson, Lufkin & Jenrette. A few years later the firm expanded again with the acquisition of Swiss insurer Winterthur. About five years ago, AXA started to reshape its portfolio to technical risks.

Dating back to 1879, Tokio Marine is Japan’s oldest insurance company and was its top property and casualty insurer in terms of market share for many decades. After mergers of its smaller rivals in the past few years, the company is now roughly the same size in the domestic nonlife market as MS&AD and Sompo, but it remains the most valuable listed Japanese insurer in terms of market capitalization due to its larger overseas business portfolio. The majority of its overseas business is in the US, where it has purchased four specialty insurers since 2008: Philadelphia Consolidated, Delphi Financial, HCC, and PURE.

Elevance Health remains one of the leading health insurers in the US, providing medical benefits to 46 million medical members as of June 2025. The company offers employer, individual, and government-sponsored coverage plans. Elevance differs from its peers in its unique position as the largest single provider of Blue Cross Blue Shield branded coverage, operating as the licensee for the Blue Cross Blue Shield Association in 14 states. Through acquisitions, such as the Amerigroup deal in 2012 and MMM in 2021, Elevance's reach expands beyond those states through government-sponsored programs, such as Medicaid and Medicare Advantage plans, too. It is also an emerging player in pharmacy benefit management and other healthcare services.

Marsh McLennan is a professional services firm that provides advice and solutions in the areas of risk, strategy, and human capital. The company operates through two main segments: risk and insurance services and consulting. In risk and insurance services, the firm offers services via Marsh (an insurance broker) and Guy Carpenter (a risk and reinsurance specialist). The consulting division comprises Mercer (a provider of human resource services) and Oliver Wyman (a management and economic consultancy). About half of its revenue is generated outside the US.

Marsh McLennan is a professional services firm that provides advice and solutions in the areas of risk, strategy, and human capital. The company operates through two main segments: risk and insurance services and consulting. In risk and insurance services, the firm offers services via Marsh (an insurance broker) and Guy Carpenter (a risk and reinsurance specialist). The consulting division comprises Mercer (a provider of human resource services) and Oliver Wyman (a management and economic consultancy). About half of its revenue is generated outside the US.

Munich Re was founded in 1880 by Carl Thieme amid a flurry of other reinsurance companies set up independently of primaries. In those early days, most reinsurers typically focused on a few strong customers. Thieme focused on a broader set of cedents to drive stronger growth in premiums. This coincided with a strategy of risk diversification and a preference to partner rather than take on a one-sided transfer of risk. In the 1890s, Munich Re introduced the first machinery insurance. After Thieme and Wilhelm von Fink founded Allianz, this was the main channel to sell insurance on machinery. We believe the approach of partnering with insurers and preferring to avoid one-sided risk, in conjunction with combining inspection and insurance services, remains at the heart of the firm.

Cigna primarily provides pharmacy benefit management and health insurance services. Its PBM and specialty pharmacy services, which were greatly expanded by its 2018 merger with Express Scripts, are mostly sold to health insurance plans and employers. Its largest PBM contract is with the Department of Defense (current contract through 2029), and it recently won a multiyear deal with top-tier insurer Centene. In health insurance and other benefits, Cigna primarily serves employers through self-funding arrangements, and the company operates mostly in the US with 17 million US and 2 million international medical members covered as of December 2024.

Boston Scientific produces less invasive medical devices that are inserted into the human body through small openings or cuts. It manufactures products for use in angioplasty, blood clot filtration, kidney stone management, cardiac rhythm management, catheter-directed ultrasound imaging, upper gastrointestinal tract diagnostics, interventional oncology, neuromodulation for chronic pain, and treatment of incontinence. The firm markets its devices to healthcare professionals and institutions globally. Foreign sales account for roughly 36% of the firm's total sales.

Aon is a leading global provider of insurance and reinsurance brokerage and human resources solutions. Its operations are tilted toward its brokerage operations. Headquartered in London, Aon has about 50,000 employees and operations in over 120 countries.

The roots of Generali date back to the 1830s and the Bora wind and rough seas that hit the Trieste region. Over that decade, Generali sought to expand throughout Italy, but this growth was held back by the fragmented nature of Italy. The Italian Revolution in the 1840s paved the way for easier expansion in the country. After World War I, Trieste was handed back to Italy. The dissolution of the Austro-Hungarian Empire created a fragmented Europe and a fragmented Generali. To this day, Generali remains quite a diversified company, but its core operations remain in the historical Austro-Hungarian countries of Austria, Central and Eastern Europe, Germany, and Italy. This is the case in Generali’s nonlife business, and France is also an important contributor to life and savings.

Manulife Financial is one of the Big Three Canadian life insurers. The firm provides life insurance, annuities, asset management, and wealth management products to individuals and group customers in Canada, the United States, and Asia. The Canadian business segment contributes approximately 22% of adjusted earnings. The Asia segment operates across 12 countries and contributes around 36% of earnings, with a significant presence in Hong Kong and Singapore. The US business, which primarily operates under the John Hancock brand, contributes about 23% of earnings. Manulife’s global asset and wealth management business contributes approximately 20% of its earnings and had around CAD 1.03 trillion in assets under management and administration as of the end of 2024.

Travelers offers a broad product range and participates in both commercial and personal insurance lines. Its commercial operations offer a variety of coverage types for companies of any size but concentrate on serving midsize businesses. Its personal lines are roughly evenly split between auto and homeowners insurance.

Aflac Inc offers supplemental health insurance and life insurance in the United States and Japan. In addition to its cancer policies, the company has broadened its product offerings to include accident, dental and vision, disability, and long-term-care insurance. It markets its products through independent distributors, selling the majority of its policies directly to consumers at their places of work, and also reaches out to its customers outside of their worksite through digital mediums. The company has two reportable business segments; Aflac Japan which generates the majority of the revenue, and Aflac U.S.

Samsung Life Insurance Co Ltd is engaged in the life insurance business. It provides a broad mix of insurance, savings and financial services. Its offerings include life, health and pension insurance, along with property-related coverage. It also extends credit and mortgage loans, retirement products, trust services and investment management solutions. These services support customers in protecting their finances and planning for long-term growth across life, health, assets and retirement needs.

Allstate is one of the largest US property-casualty insurers in the US. Personal auto represents the largest percentage of revenue, but the company offers homeowners insurance and other insurance products. Allstate products are sold in North America primarily by about 6,000 exclusive agents.

MetLife is one of the largest life insurers in the US by assets and provides a variety of life insurance and annuity products. It is organized into six segments: Group Benefits, Retirement and Income Solutions, Asia, Latin America, Europe/Middle East/Africa (EMEA), and MetLife Holdings (products in run-off). Group Benefits and RIS are US-based, contributing to around 48% of the firm’s 2024 adjusted earnings. The Asia segment contributes around 25% of earnings, mainly tied to Japan. The company also holds leading market positions in Mexico and Chile, with the Latin America segment contributing around 13% of 2024 earnings. The EMEA and MetLife Holdings segments contributed around 4% and 10% of 2024 earnings, respectively.

Life Insurance Corporation of India is engaged in providing life insurance in India. The company offers diversified product portfolio covering various segments across individual products and group products.

Founded in 1927 as a one-person agency, Gallagher's primary business is insurance brokerage, with a focus on serving middle-market companies. The company's risk management segment provides third-party claims adjustment to companies that choose to self-insure. Gallagher has about 56,000 employees and generates about a third of its revenue internationally, primarily in Australia, Canada, New Zealand, and the UK.

Great-West Lifeco is one of the Big Three Canadian life insurers. The firm's Canadian business contributed around 30% of adjusted earnings. The firm generates a further 32% of adjusted earnings from the United States, attributable to its recordkeeping business, Empower, and its US life insurance business. Great-West Lifeco also offers various products across European markets with a strong presence in the UK and Ireland, which collectively accounted for 20% of adjusted earnings, while the firm's reinsurance business accounts for the remainder. Great-West Lifeco had around CAD 3.5 trillion of assets under administration across its business segments at the end of September 2025.

Spun off from Baxter International in 2000, Edwards Lifesciences designs, manufactures, and markets a range of medical devices and equipment for advanced stages of structural heart disease. It has established itself as a leader across key products, including surgical tissue heart valves, transcatheter aortic valves, and transcatheter mitral and tricuspid valve technologies. The firm derives about 60% of its total sales from outside the US.

Fubon Financial Holdings Co Ltd is a full-service financial holding company. Along with its subsidiaries, the company operates in the following reportable segments: Bank business, Insurance business, Life insurance business, Securities business, and Others. It generates maximum revenue from the Life Insurance business segment, which provides a variety of life and property insurance services. In addition to its reportable businesses, the group is also engaged in financial holding, venture capital, and asset management businesses. Geographically, it generates maximum revenue from Taiwan, followed by other Asian regions, and other markets.

Siemens Healthineers is engaged in therapeutic imaging, radiotherapy, laboratory, and point-of-care diagnostics. The imaging segment (56% of sales in fiscal 2025) includes magnetic resonance imaging, computed tomography, X-ray systems, molecular imaging, and ultrasound. The Varian segment (18% of sales) offers radiotherapy and other oncology solutions. The diagnostics segment (19%) includes in vitro diagnostics and point-of-care diagnostics. The advanced therapies (now part of precision therapy) segment (9%) products are designed to support image-guided minimally invasive treatments in cardiology, interventional radiology, and surgery. The Americas represents 44% of total sales, Europe, Middle East, and Africa 32%, and Asia-Pacific, including China (11%), the remainder.

Idexx Laboratories primarily develops, manufactures, and distributes diagnostic products, equipment, and services for pets and livestock. Its key product lines include single-use canine and feline test kits that veterinarians can employ in the office, benchtop chemistry and hematology analyzers for test-panel analysis on-site, reference lab services, and tests to detect and manage disease in livestock. The firm also offers vet practice management software and consulting services to animal hospitals. Idexx derives roughly 35% of its revenue from outside the United States.

Established in 1988, China Pacific Insurance is China's third-largest life insurer and third-largest general property and casualty insurer, with headquarters in Beijing. The company strives to create an integrated financial services platform that encompasses insurance, banking, and asset management. CPIC's major shareholders are state-owned companies related to the Shanghai government.

Cathay Financial Holding Co Ltd is a financial holding company. Along with its subsidiaries, it offers a broad range of life insurance, banking, and property and casualty insurance products to individual and corporate customers in Taiwan. The group has five reportable operating segments: Banking operating segment, Life insurance operating segment, Property insurance operating segment, Securities operating segment, and Other operating segment. A majority of its revenue is generated from the Life insurance segment, which is engaged in offering traditional insurance, investment-linked insurance, and interest-sensitive annuity insurance. In addition, this segment also provides financial planning services and policy loan services. Geographically, it derives key revenue from Taiwan.

PICC Group, headquartered in Beijing, is the largest state-owned insurance group in China. It holds a 69% stake in PICC Property and Casualty, an 80% stake in PICC Life, and a 69% stake in PICC Health Insurance. The P&C subsidiary is the largest nonlife insurer in the country, with approximately one-third of market share. The life insurance and health insurance subsidiaries hold about 2.9% and 1.3% of market share, respectively. The Ministry of Finance is the largest shareholder with a 61% stake, while China's Social Security Fund is the second-largest shareholder, holding nearly 13%.

PICC P&C is headquartered in Beijing. The company is the largest nonlife insurer in China, commanding nearly 33% market share in the country. It was founded by the People's Bank of China in 1949. The company is a flagship subsidiary of the PICC Group, a state-owned insurance group, which owns 69% of PICC P&C. The company offers a wide range of nonlife insurance products, including auto, commercial property, liability, credit and surety bond, accidents and health, energy and aerospace, and agricultural insurance.

Sun Life Financial is one of the Big Three Canadian life insurers. The Canadian business contributed around 38% of adjusted earnings. In that segment, the firm provides health, life insurance, and annuity products to individual and group customers. Its US business is mostly group health and contributed about 20% of the firm's adjusted earnings in 2024. Sun Life also offers life insurance and wealth products in several Asian markets with a strong presence in Hong Kong and the Philippines. The Asia segment contributed around 18% of adjusted 2024 earnings. Its asset management business had around CAD 1.1 trillion total assets under management or administration at the end of 2024 and represents around 34% of the firm's earnings.

American International Group is one of the largest insurance and financial services firms in the world and has a global footprint. It operates through a wide range of subsidiaries that provide property, casualty, and life insurance. The company recently spun off its life insurance operations (Corebridge), but still retains a minority stake.

MS&AD is Japan’s second-biggest nonlife insurer, trailing industry leader Tokio Marine in the scale of global operations although not in Japan. Like Tokio Marine and Sompo, MS&AD has grown into a second-tier presence in the domestic life insurance market since life and non-life insurance were mutually deregulated in 1996. Overseas, it is less focused on the US market than its two Japanese rivals and more focused on emerging Asia, but its acquisition of Lloyd’s syndicate Amlin in 2017 increased its exposure to the European and North American markets. MS&AD has historical business connections with the Mitsui and Sumitomo groups (the "MS" in the company name) and has a long-term partnership with Toyota Motor that is advantageous in acquiring auto insurance customers.

Humana is one of the largest private health insurers in the US, and the firm has built a niche specializing in government-sponsored programs, with nearly all its medical membership stemming from Medicare, Medicaid, and the military's Tricare program. Beyond medical insurance, the company provides other healthcare services, including primary-care services, at-home services, and pharmacy benefit management.