(Exact name of registrant as specified in its charter) | ||
Delaware | 1-5975 | 61-0647538 | ||||||
(State or other jurisdiction of incorporation) | (Commission File Number) | (IRS Employer Identification No.) |
☐ | Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425) |
☐ | Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12) |
☐ | Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b)) |
☐ | Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c)) |
Title of each class | Trading Symbol(s) | Name of each exchange on which registered | ||||||
Common Stock | HUM | New York Stock Exchange |
Exhibit No. | Description | ||||||||||
99.1 | |||||||||||
99.2 | |||||||||||
104 | Cover Page Interactive Data File (embedded within the Inline XBRL document) |
HUMANA INC. | |||||
BY: | /s/ John-Paul W. Felter | ||||
John-Paul W. Felter | |||||
Senior Vice President, Chief Accounting Officer & Controller | |||||
(Principal Accounting Officer) |
n e w s r e l e a s e |
Exhibit 99.1
Humana Inc.
500 West Main Street
P.O. Box 1438
Louisville, KY 40202
http://www.humana.com
|
Lisa Stoner
Humana Investor Relations
(502) 580-2652
e-mail: LStamper@humana.com
|
![]() |
Consolidated income before income taxes and equity in net earnings (pretax results) In millions |
2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
Generally Accepted Accounting Principles (GAAP) | $1,262 | $1,122 | $2,876 | $2,342 | ||||||||||
Amortization associated with identifiable intangibles | 16 | 18 | 34 | 36 | ||||||||||
Put/call valuation adjustments associated with company's non-consolidating minority interest investments | 53 | (8) | 107 | (29) | ||||||||||
Transaction and integration costs | 4 | 36 | (48) | 53 | ||||||||||
Change in fair market value of publicly-traded equity securities | — | 62 | (1) | 170 | ||||||||||
Impact of exit of employer group commercial medical products business | 45 | 15 | (37) | (22) | ||||||||||
Accrual related to certain anticipated litigation expenses | 90 | — | 90 | — | ||||||||||
Charges associated with productivity initiatives related to the previously disclosed $1 billion value creation plan | — | 203 | — | 203 | ||||||||||
Adjusted (non-GAAP) | $1,470 | $1,448 | $3,021 | $2,753 | ||||||||||
Diluted earnings per share (EPS) | 2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
GAAP | $7.66 | $5.48 | $17.54 | $12.77 | ||||||||||
Amortization associated with identifiable intangibles | 0.13 | 0.14 | 0.27 | 0.28 | ||||||||||
Put/call valuation adjustments associated with company's non-consolidating minority interest investments | 0.43 | (0.06) | 0.85 | (0.23) | ||||||||||
Transaction and integration costs | 0.03 | 0.28 | (0.38) | 0.42 | ||||||||||
Change in fair market value of publicly-traded equity securities | — | 0.48 | (0.01) | 1.33 | ||||||||||
Impact of exit of employer group commercial medical products business | 0.35 | 0.11 | (0.30) | (0.17) | ||||||||||
Accrual related to certain anticipated litigation expenses | 0.72 | — | 0.72 | — | ||||||||||
Charges associated with productivity initiatives related to the previously disclosed $1 billion value creation plan | — | 1.60 | — | 1.60 | ||||||||||
Tax provision related to the then-pending sale of Kindred at Home's Hospice and Personal Care divisions | — | 1.31 | — | 1.31 | ||||||||||
Tax impact of non-GAAP adjustments | (0.38) | (0.58) | (0.37) | (0.74) | ||||||||||
Adjusted (non-GAAP) | $8.94 | $8.76 | $18.32 | $16.57 | ||||||||||
Humana Inc. Summary of Results ($ in millions, except per share amounts) |
2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
CONSOLIDATED | ||||||||||||||
Revenues | $26,747 | $23,662 | $53,489 | $47,632 | ||||||||||
Revenues - Adjusted (non-GAAP) | $25,733 | $22,540 | $51,385 | $45,402 | ||||||||||
Pretax results | $1,262 | $1,122 | $2,876 | $2,342 | ||||||||||
Pretax results - Adjusted (non-GAAP) | $1,470 | $1,448 | $3,021 | $2,753 | ||||||||||
EPS | $7.66 | $5.48 | $17.54 | $12.77 | ||||||||||
EPS - Adjusted (non-GAAP) | $8.94 | $8.76 | $18.32 | $16.57 | ||||||||||
Benefits expense ratio | 86.3 | % | 85.8 | % | 85.9 | % | 86.1 | % | ||||||
Benefits expense ratio - Adjusted (non-GAAP) | 86.1 | % | 85.7 | % | 86.0 | % | 86.2 | % | ||||||
Operating cost ratio | 11.8 | % | 13.4 | % | 11.5 | % | 12.7 | % | ||||||
Operating cost ratio - Adjusted (non-GAAP) | 11.2 | % | 12.2 | % | 11.0 | % | 11.9 | % | ||||||
Operating cash flows | $9,863 | $1,261 | ||||||||||||
Operating cash flows - Adjusted (non-GAAP) (e) | $2,861 | $1,261 | ||||||||||||
Parent company cash and short term investments | $1,109 | $800 | ||||||||||||
Debt-to-total capitalization | 41.0 | % | 45.3 | % | ||||||||||
Days in Claims Payable (DCP) | 42.6 | 46.0 | ||||||||||||
INSURANCE SEGMENT | ||||||||||||||
Revenues | $25,875 | $22,532 | $51,778 | $45,499 | ||||||||||
Revenues - Adjusted (non-GAAP) | $24,861 | $21,348 | $49,675 | $43,099 | ||||||||||
Benefits expense ratio | 86.8 | % | 86.1 | % | 86.4 | % | 86.5 | % | ||||||
Benefits expense ratio - Adjusted (non-GAAP) | 86.6 | % | 86.0 | % | 86.5 | % | 86.6 | % | ||||||
Operating cost ratio | 9.9 | % | 9.4 | % | 9.6 | % | 9.2 | % | ||||||
Operating cost ratio - Adjusted (non-GAAP) | 9.2 | % | 8.8 | % | 9.1 | % | 8.7 | % | ||||||
Income from operations | $1,031 | $1,107 | $2,358 | $2,103 | ||||||||||
Income from operations - Adjusted (non-GAAP) | $1,172 | $1,127 | $2,422 | $2,091 | ||||||||||
CENTERWELL SEGMENT | ||||||||||||||
Revenues | $4,530 | $4,527 | $9,035 | $8,892 | ||||||||||
Operating cost ratio | 92.6 | % | 91.1 | % | 92.1 | % | 90.8 | % | ||||||
Income from operations | $287 | $358 | $617 | $728 | ||||||||||
Income from operations - Adjusted (non-GAAP) (f) | $337 | $402 | $716 | $819 | ||||||||||
Diluted earnings per common share |
FY 2023 Guidance (g) |
FY 2022 | ||||||
GAAP | at least $26.91 | $22.08 | ||||||
Amortization of identifiable intangibles | 0.53 | 0.64 | ||||||
Put/call valuation adjustments associated with company's non-consolidating minority interest investments | 0.85 | 0.53 | ||||||
Transaction and integration costs | (0.38) | 0.83 | ||||||
Change in fair market value of publicly-traded equity securities | (0.01) | 0.97 | ||||||
Impact of exit of employer group commercial medical products business | 0.17 | 0.84 | ||||||
Accrual related to certain anticipated litigation expenses | 0.72 | — | ||||||
Charges associated with productivity initiatives related to the previously disclosed $1 billion value creation plan | — | 3.72 | ||||||
Net gain on the sale of Kindred at Home's (KAH) Hospice and Personal Care divisions (KAH Hospice) | — | (1.86) | ||||||
Tax impact of non-GAAP adjustments | (0.54) | (1.87) | ||||||
Adjusted (non-GAAP) – FY 2023 projected; FY 2022 reported | at least $28.25 | $25.88 |
Revenues - CONSOLIDATED (in millions) |
2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
GAAP | $26,747 | $23,662 | $53,489 | $47,632 | ||||||||||
Change in fair market value of publicly-traded equity securities | — | 62 | (1) | 170 | ||||||||||
Impact of exit of employer group commercial medical products business | (1,014) | (1,184) | (2,103) | (2,400) | ||||||||||
Adjusted (non-GAAP) | $25,733 | $22,540 | $51,385 | $45,402 |
Revenues - INSURANCE SEGMENT (in millions) |
2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
GAAP | $25,875 | $22,532 | $51,778 | $45,499 | ||||||||||
Impact of exit of employer group commercial medical products business | (1,014) | (1,184) | (2,103) | (2,400) | ||||||||||
Adjusted (non-GAAP) | $24,861 | $21,348 | $49,675 | $43,099 |
Benefit expense ratio - CONSOLIDATED | 2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
GAAP | 86.3 | % | 85.8 | % | 85.9 | % | 86.1 | % | ||||||
Impact of exit of employer group commercial medical products business | (0.2) | % | (0.1) | % | 0.1 | % | 0.1 | % | ||||||
Adjusted (non-GAAP) | 86.1 | % | 85.7 | % | 86.0 | % | 86.2 | % |
Benefit expense ratio - INSURANCE SEGMENT | 2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
GAAP | 86.8 | % | 86.1 | % | 86.4 | % | 86.5 | % | ||||||
Impact of exit of employer group commercial medical products business | (0.2) | % | (0.1) | % | 0.1 | % | 0.1 | % | ||||||
Adjusted (non-GAAP) | 86.6 | % | 86.0 | % | 86.5 | % | 86.6 | % |
Operating cost ratio - CONSOLIDATED | 2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
GAAP | 11.8 | % | 13.4 | % | 11.5 | % | 12.7 | % | ||||||
Transaction and integration costs | — | % | (0.1) | % | — | % | (0.1) | % | ||||||
Impact of exit of employer group commercial medical products business | (0.2) | % | (0.3) | % | (0.3) | % | (0.3) | % | ||||||
Accrual related to certain anticipated litigation expenses | (0.4) | % | — | % | (0.2) | % | — | % | ||||||
Charges associated with productivity initiatives related to the previously disclosed $1 billion value creation plan | — | % | (0.8) | % | — | % | (0.4) | % | ||||||
Adjusted (non-GAAP) | 11.2 | % | 12.2 | % | 11.0 | % | 11.9 | % |
Operating cost ratio - INSURANCE SEGMENT | 2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
GAAP | 9.9 | % | 9.4 | % | 9.6 | % | 9.2 | % | ||||||
Impact of exit of employer group commercial medical products business | (0.3) | % | (0.6) | % | (0.3) | % | (0.5) | % | ||||||
Accrual related to certain anticipated litigation expenses | (0.4) | % | — | % | (0.2) | % | — | % | ||||||
Adjusted (non-GAAP) | 9.2 | % | 8.8 | % | 9.1 | % | 8.7 | % |
Income from operations - INSURANCE SEGMENT | 2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
GAAP | $1,031 | $1,107 | $2,358 | $2,103 | ||||||||||
Amortization associated with identifiable intangibles | 6 | 5 | 11 | 10 | ||||||||||
Impact of exit of employer group commercial medical products business | 45 | 15 | (37) | (22) | ||||||||||
Accrual related to certain anticipated litigation expenses | 90 | — | 90 | — | ||||||||||
Adjusted (non-GAAP) | $1,172 | $1,127 | $2,422 | $2,091 |
Net cash from operating activities
(in millions)
|
YTD 2023 | YTD 2022 | ||||||
GAAP | $9,863 | $1,261 | ||||||
Timing of premium payment from CMS | (7,002) | — | ||||||
Adjusted (non-GAAP) | $2,861 | $1,261 |
Income from operations - CENTERWELL SEGMENT (in millions) |
2Q23 | 2Q22 | YTD 2023 | YTD 2022 | ||||||||||
GAAP | $287 | $358 | $617 | $728 | ||||||||||
Depreciation and amortization expense | 50 | 44 | 99 | 91 | ||||||||||
Adjusted (non-GAAP) | $337 | $402 | $716 | $819 |
n e w s r e l e a s e |
Exhibit 99.2 |
Humana Inc.
500 West Main Street
P.O. Box 1438
Louisville, KY 40202
http://www.humana.com
|
Lisa Stoner Humana Investor Relations (502) 580-2652 e-mail: LStamper@humana.com |
![]() |
Consolidated income before income taxes and equity in net earnings (pretax results) In millions |
2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
Generally Accepted Accounting Principles (GAAP) | $1,262 | $1,122 | $2,876 | $2,342 | ||||||||||
Amortization associated with identifiable intangibles | 16 | 18 | 34 | 36 | ||||||||||
Put/call valuation adjustments associated with company's non-consolidating minority interest investments | 53 | (8) | 107 | (29) | ||||||||||
Transaction and integration costs | 4 | 36 | (48) | 53 | ||||||||||
Change in fair market value of publicly-traded equity securities | — | 62 | (1) | 170 | ||||||||||
Impact of exit of employer group commercial medical products business | 45 | 15 | (37) | (22) | ||||||||||
Accrual related to certain anticipated litigation expenses | 90 | — | 90 | — | ||||||||||
Charges associated with productivity initiatives related to the previously disclosed $1 billion value creation plan | — | 203 | — | 203 | ||||||||||
Adjusted (non-GAAP) | $1,470 | $1,448 | $3,021 | $2,753 | ||||||||||
Diluted earnings per share (EPS) | 2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
GAAP | $7.66 | $5.48 | $17.54 | $12.77 | ||||||||||
Amortization associated with identifiable intangibles | 0.13 | 0.14 | 0.27 | 0.28 | ||||||||||
Put/call valuation adjustments associated with company's non-consolidating minority interest investments | 0.43 | (0.06) | 0.85 | (0.23) | ||||||||||
Transaction and integration costs | 0.03 | 0.28 | (0.38) | 0.42 | ||||||||||
Change in fair market value of publicly-traded equity securities | — | 0.48 | (0.01) | 1.33 | ||||||||||
Impact of exit of employer group commercial medical products business | 0.35 | 0.11 | (0.30) | (0.17) | ||||||||||
Accrual related to certain anticipated litigation expenses | 0.72 | — | 0.72 | — | ||||||||||
Charges associated with productivity initiatives related to the previously disclosed $1 billion value creation plan | — | 1.60 | — | 1.60 | ||||||||||
Tax provision related to the then-pending sale of Kindred at Home's Hospice and Personal Care divisions | — | 1.31 | — | 1.31 | ||||||||||
Tax impact of non-GAAP adjustments | (0.38) | (0.58) | (0.37) | (0.74) | ||||||||||
Adjusted (non-GAAP) | $8.94 | $8.76 | $18.32 | $16.57 | ||||||||||
Humana Inc. Summary of Results ($ in millions, except per share amounts) |
2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
CONSOLIDATED | ||||||||||||||
Revenues | $26,747 | $23,662 | $53,489 | $47,632 | ||||||||||
Revenues - Adjusted (non-GAAP) | $25,733 | $22,540 | $51,385 | $45,402 | ||||||||||
Pretax results | $1,262 | $1,122 | $2,876 | $2,342 | ||||||||||
Pretax results - Adjusted (non-GAAP) | $1,470 | $1,448 | $3,021 | $2,753 | ||||||||||
EPS | $7.66 | $5.48 | $17.54 | $12.77 | ||||||||||
EPS - Adjusted (non-GAAP) | $8.94 | $8.76 | $18.32 | $16.57 | ||||||||||
Benefits expense ratio | 86.3 | % | 85.8 | % | 85.9 | % | 86.1 | % | ||||||
Benefits expense ratio - Adjusted (non-GAAP) | 86.1 | % | 85.7 | % | 86.0 | % | 86.2 | % | ||||||
Operating cost ratio | 11.8 | % | 13.4 | % | 11.5 | % | 12.7 | % | ||||||
Operating cost ratio - Adjusted (non-GAAP) | 11.2 | % | 12.2 | % | 11.0 | % | 11.9 | % | ||||||
Operating cash flows | $9,863 | $1,261 | ||||||||||||
Operating cash flows - Adjusted (non-GAAP) (e) | $2,861 | $1,261 | ||||||||||||
Parent company cash and short term investments | $1,109 | $800 | ||||||||||||
Debt-to-total capitalization | 41.0 | % | 45.3 | % | ||||||||||
Days in Claims Payable (DCP) | 42.6 | 46.0 | ||||||||||||
INSURANCE SEGMENT | ||||||||||||||
Revenues | $25,875 | $22,532 | $51,778 | $45,499 | ||||||||||
Revenues - Adjusted (non-GAAP) | $24,861 | $21,348 | $49,675 | $43,099 | ||||||||||
Benefits expense ratio | 86.8 | % | 86.1 | % | 86.4 | % | 86.5 | % | ||||||
Benefits expense ratio - Adjusted (non-GAAP) | 86.6 | % | 86.0 | % | 86.5 | % | 86.6 | % | ||||||
Operating cost ratio | 9.9 | % | 9.4 | % | 9.6 | % | 9.2 | % | ||||||
Operating cost ratio - Adjusted (non-GAAP) | 9.2 | % | 8.8 | % | 9.1 | % | 8.7 | % | ||||||
Income from operations | $1,031 | $1,107 | $2,358 | $2,103 | ||||||||||
Income from operations - Adjusted (non-GAAP) | $1,172 | $1,127 | $2,422 | $2,091 | ||||||||||
CENTERWELL SEGMENT | ||||||||||||||
Revenues | $4,530 | $4,527 | $9,035 | $8,892 | ||||||||||
Operating cost ratio | 92.6 | % | 91.1 | % | 92.1 | % | 90.8 | % | ||||||
Income from operations | $287 | $358 | $617 | $728 | ||||||||||
Income from operations - Adjusted (non-GAAP) (f) | $337 | $402 | $716 | $819 | ||||||||||
Diluted earnings per common share |
FY 2023 Guidance (g) |
FY 2022 | ||||||
GAAP | at least $26.91 |
$22.08 | ||||||
Amortization of identifiable intangibles | 0.53 | 0.64 | ||||||
Put/call valuation adjustments associated with company's non-consolidating minority interest investments | 0.85 | 0.53 | ||||||
Transaction and integration costs | (0.38) | 0.83 | ||||||
Change in fair market value of publicly-traded equity securities | (0.01) | 0.97 | ||||||
Impact of exit of employer group commercial medical products business | 0.17 | 0.84 | ||||||
Accrual related to certain anticipated litigation expenses | 0.72 | — | ||||||
Charges associated with productivity initiatives related to the previously disclosed $1 billion value creation plan | — | 3.72 | ||||||
Net gain on the sale of Kindred at Home's (KAH) Hospice and Personal Care divisions (KAH Hospice) | — | (1.86) | ||||||
Tax impact of non-GAAP adjustments | (0.54) | (1.87) | ||||||
Adjusted (non-GAAP) – FY 2023 projected; FY 2022 reported | at least $28.25 | $25.88 |
Humana Inc. Summary of Results ($ in millions, except per share amounts) |
2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
CONSOLIDATED | ||||||||||||||
Revenues | $26,747 | $23,662 | $53,489 | $47,632 | ||||||||||
Revenues - Adjusted (non-GAAP) | $25,733 | $22,540 | $51,385 | $45,402 | ||||||||||
Pretax results | $1,262 | $1,122 | $2,876 | $2,342 | ||||||||||
Pretax results - Adjusted (non-GAAP) | $1,470 | $1,448 | $3,021 | $2,753 | ||||||||||
EPS | $7.66 | $5.48 | $17.54 | $12.77 | ||||||||||
EPS - Adjusted (non-GAAP) | $8.94 | $8.76 | $18.32 | $16.57 | ||||||||||
Benefits expense ratio | 86.3 | % | 85.8 | % | 85.9 | % | 86.1 | % | ||||||
Benefits expense ratio - Adjusted (non-GAAP) | 86.1 | % | 85.7 | % | 86.0 | % | 86.2 | % | ||||||
Operating cost ratio | 11.8 | % | 13.4 | % | 11.5 | % | 12.7 | % | ||||||
Operating cost ratio - Adjusted (non-GAAP) | 11.2 | % | 12.2 | % | 11.0 | % | 11.9 | % | ||||||
Operating cash flows | $9,863 | $1,261 | ||||||||||||
Operating cash flows - Adjusted (non-GAAP) (e) | $2,861 | $1,261 | ||||||||||||
Parent company cash and short term investments | $1,109 | $800 | ||||||||||||
Debt-to-total capitalization | 41.0 | % | 45.3 | % | ||||||||||
Days in Claims Payable (DCP) | 42.6 | 46.0 |
Consolidated Favorable Prior Period Development
$ in millions
Basis points (bps)
|
First Quarter |
Second Quarter |
YTD | ||||||||||||||
Prior Period Development from prior years recognized in 2023 (includes favorable development related to employer group commercial business - $23 million in 1Q; unfavorable development of $20 million in 2Q) |
$522 | $232 | $754 | ||||||||||||||
Decrease to GAAP benefits expense ratio | (200 bps) | (90 bps) | (150 bps) | ||||||||||||||
Prior Period Development from prior years recognized in 2022 (includes favorable development related to employer group commercial business - $32 million in 1Q; unfavorable development of $2 million in 2Q) |
$360 | $37 | $397 | ||||||||||||||
Decrease to GAAP benefits expense ratio | (160 bps) | (20 bps) | (90 bps) |
YTD 2023 | |||||
Total number of shares repurchased | 1,218,600 | ||||
Average price paid per share | $ | 488.12 | |||
Remaining repurchase authorization as of August 1, 2023 | $2.2 billion |
Insurance Segment Results
$ in millions
|
2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
Revenues | $25,875 | $22,532 | $51,778 | $45,499 | ||||||||||
Revenues - Adjusted (non-GAAP) | $24,861 | $21,348 | $49,675 | $43,099 | ||||||||||
Benefits expense ratio | 86.8 | % | 86.1 | % | 86.4 | % | 86.5 | % | ||||||
Benefits expense ratio - Adjusted (non-GAAP) | 86.6 | % | 86.0 | % | 86.5 | % | 86.6 | % | ||||||
Operating cost ratio | 9.9 | % | 9.4 | % | 9.6 | % | 9.2 | % | ||||||
Operating cost ratio - Adjusted (non-GAAP) | 9.2 | % | 8.8 | % | 9.1 | % | 8.7 | % | ||||||
Income from operations | $1,031 | $1,107 | $2,358 | $2,103 | ||||||||||
Income from operations - Adjusted (non-GAAP) | $1,172 | $1,127 | $2,422 | $2,091 |
in thousands |
Year-over-Year Change | YTD Change | ||||||||||||||||||||||||||||||
June 30, 2023 | June 30, 2022 | December 31, 2022 | Amount | Percent | Amount | Percent | ||||||||||||||||||||||||||
Medical Membership: | ||||||||||||||||||||||||||||||||
Individual Medicare Advantage | 5,269.1 | 4,555.1 | 4,565.6 | 714.0 | 15.7 | % | 703.5 | 15.4 | % | |||||||||||||||||||||||
Group Medicare Advantage | 509.5 | 562.5 | 565.1 | (53.0) | -9.4 | % | (55.6) | -9.8 | % | |||||||||||||||||||||||
Total Medicare Advantage | 5,778.6 | 5,117.6 | 5,130.7 | 661.0 | 12.9 | % | 647.9 | 12.6 | % | |||||||||||||||||||||||
Medicare stand-alone PDP | 2,915.3 | 3,580.7 | 3,551.3 | (665.4) | -18.6 | % | (636.0) | -17.9 | % | |||||||||||||||||||||||
Total Medicare | 8,693.9 | 8,698.3 | 8,682.0 | (4.4) | -0.1 | % | 11.9 | 0.1 | % | |||||||||||||||||||||||
State-based contracts and other | 1,330.2 | 1,053.0 | 1,137.3 | 277.2 | 26.3 | % | 192.9 | 17.0 | % | |||||||||||||||||||||||
Medicare Supplement | 294.3 | 317.4 | 313.6 | (23.1) | -7.3 | % | (19.3) | -6.2 | % | |||||||||||||||||||||||
Military | 5,939.1 | 6,017.8 | 5,959.9 | (78.7) | -1.3 | % | (20.8) | -0.3 | % | |||||||||||||||||||||||
Total excluding employer group commercial medical | 16,257.5 | 16,086.5 | 16,092.8 | 171.0 | 1.1 | % | 164.7 | 1.0 | % | |||||||||||||||||||||||
Fully-insured commercial medical | 475.5 | 595.4 | 556.3 | (119.9) | -20.1 | % | (80.8) | -14.5 | % | |||||||||||||||||||||||
ASO commercial | 395.3 | 448.1 | 430.1 | (52.8) | -11.8 | % | (34.8) | -8.1 | % | |||||||||||||||||||||||
Total employer group commercial medical | 870.8 | 1,043.5 | 986.4 | (172.7) | -16.6 | % | (115.6) | -11.7 | % | |||||||||||||||||||||||
Total Medical Membership | 17,128.3 | 17,130.0 | 17,079.2 | (1.7) | — | % | 49.1 | 0.3 | % | |||||||||||||||||||||||
Specialty Membership: | ||||||||||||||||||||||||||||||||
Dental—fully-insured | 2,294.2 | 2,463.2 | 2,416.3 | (169.0) | -6.9 | % | (122.1) | -5.1 | % | |||||||||||||||||||||||
Dental—ASO | 309.1 | 284.6 | 288.1 | 24.5 | 8.6 | % | 21.0 | 7.3 | % | |||||||||||||||||||||||
Total Dental | 2,603.3 | 2,747.8 | 2,704.4 | (144.5) | -5.3 | % | (101.1) | -3.7 | % | |||||||||||||||||||||||
Vision | 2,029.4 | 1,998.0 | 2,081.7 | 31.4 | 1.6 | % | (52.3) | -2.5 | % | |||||||||||||||||||||||
Other supplemental benefits | 408.4 | 410.6 | 408.7 | (2.2) | -0.5 | % | (0.3) | -0.1 | % | |||||||||||||||||||||||
Total Specialty Membership (h) |
5,041.1 | 5,156.4 | 5,194.8 | (115.3) | -2.2 | % | (153.7) | -3.0 | % |
CenterWell Segment Results
$ in millions
|
2Q23 | 2Q22 | YTD 2023 | YTD 2022 | ||||||||||
Revenues | $4,530 | $4,527 | $9,035 | $8,892 | ||||||||||
Operating cost ratio | 92.6 | % | 91.1 | % | 92.1 | % | 90.8 | % | ||||||
Income from operations | $287 | $358 | $617 | $728 | ||||||||||
Income from operations - Adjusted (non-GAAP) (f) | $337 | $402 | $716 | $819 |
Revenues - CONSOLIDATED
(in millions)
|
2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
GAAP | $26,747 | $23,662 | $53,489 | $47,632 | ||||||||||
Change in fair market value of publicly-traded equity securities | — | 62 | (1) | 170 | ||||||||||
Impact of exit of employer group commercial medical products business | (1,014) | (1,184) | (2,103) | (2,400) | ||||||||||
Adjusted (non-GAAP) | $25,733 | $22,540 | $51,385 | $45,402 |
Revenues - INSURANCE SEGMENT
(in millions)
|
2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
GAAP | $25,875 | $22,532 | $51,778 | $45,499 | ||||||||||
Impact of exit of employer group commercial medical products business | (1,014) | (1,184) | (2,103) | (2,400) | ||||||||||
Adjusted (non-GAAP) | $24,861 | $21,348 | $49,675 | $43,099 |
Benefit expense ratio - CONSOLIDATED | 2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
GAAP | 86.3 | % | 85.8 | % | 85.9 | % | 86.1 | % | ||||||
Impact of exit of employer group commercial medical products business | (0.2) | % | (0.1) | % | 0.1 | % | 0.1 | % | ||||||
Adjusted (non-GAAP) | 86.1 | % | 85.7 | % | 86.0 | % | 86.2 | % |
Benefit expense ratio - INSURANCE SEGMENT | 2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
GAAP | 86.8 | % | 86.1 | % | 86.4 | % | 86.5 | % | ||||||
Impact of exit of employer group commercial medical products business | (0.2) | % | (0.1) | % | 0.1 | % | 0.1 | % | ||||||
Adjusted (non-GAAP) | 86.6 | % | 86.0 | % | 86.5 | % | 86.6 | % |
Operating cost ratio - CONSOLIDATED | 2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
GAAP | 11.8 | % | 13.4 | % | 11.5 | % | 12.7 | % | ||||||
Transaction and integration costs | — | % | (0.1) | % | — | % | (0.1) | % | ||||||
Impact of exit of employer group commercial medical products business | (0.2) | % | (0.3) | % | (0.3) | % | (0.3) | % | ||||||
Accrual related to certain anticipated litigation expenses | (0.4) | % | — | % | (0.2) | % | — | % | ||||||
Charges associated with productivity initiatives related to the previously disclosed $1 billion value creation plan | — | % | (0.8) | % | — | % | (0.4) | % | ||||||
Adjusted (non-GAAP) | 11.2 | % | 12.2 | % | 11.0 | % | 11.9 | % |
Operating cost ratio - INSURANCE SEGMENT | 2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
GAAP | 9.9 | % | 9.4 | % | 9.6 | % | 9.2 | % | ||||||
Impact of exit of employer group commercial medical products business | (0.3) | % | (0.6) | % | (0.3) | % | (0.5) | % | ||||||
Accrual related to certain anticipated litigation expenses | (0.4) | % | — | % | (0.2) | % | — | % | ||||||
Adjusted (non-GAAP) | 9.2 | % | 8.8 | % | 9.1 | % | 8.7 | % |
Income from operations - INSURANCE SEGMENT | 2Q23 (a) | 2Q22 (b) | YTD 2023 (c) | YTD 2022 (d) | ||||||||||
GAAP | $1,031 | $1,107 | $2,358 | $2,103 | ||||||||||
Amortization associated with identifiable intangibles | 6 | 5 | 11 | 10 | ||||||||||
Impact of exit of employer group commercial medical products business | 45 | 15 | (37) | (22) | ||||||||||
Accrual related to certain anticipated litigation expenses | 90 | — | 90 | — | ||||||||||
Adjusted (non-GAAP) | $1,172 | $1,127 | $2,422 | $2,091 |
Net cash from operating activities
(in millions)
|
YTD 2023 | YTD 2022 | ||||||
GAAP | $9,863 | $1,261 | ||||||
Timing of premium payment from CMS | (7,002) | — | ||||||
Adjusted (non-GAAP) |
$2,861 | $1,261 |
Income from operations - CENTERWELL SEGMENT
(in millions)
|
2Q23 | 2Q22 | YTD 2023 | YTD 2022 | ||||||||||
GAAP | $287 | $358 | $617 | $728 | ||||||||||
Depreciation and amortization expense | 50 | 44 | 99 | 91 | ||||||||||
Adjusted (non-GAAP) | $337 | $402 | $716 | $819 |
Humana Inc. Full Year 2023 Projections - AS OF AUGUST 2, 2023
in accordance with GAAP unless otherwise noted
| |||||||||||
Current Guidance | Previous Guidance | Comments | |||||||||
Diluted earnings per common share | |||||||||||
GAAP: at least $26.91 |
GAAP: at least $27.88 |
||||||||||
Non-GAAP: no change |
Non-GAAP: at least $28.25 |
||||||||||
Total Revenues | |||||||||||
Consolidated |
GAAP: no change
Non-GAAP: no change
|
GAAP: $104.4 billion to $106.4 billion
Non-GAAP: $100.7 billion to $102.7 billion
|
Consolidated and segment level revenue projections include expected investment income. Segment level revenues include amounts that eliminate in consolidation. The non-GAAP Consolidated and Insurance segment ranges exclude the impact of $3.7 billion related to the employer group commercial medical business. |
||||||||
Insurance segment |
GAAP: no change
Non-GAAP: no change
|
GAAP: $101.2 billion to $102.7 billion
Non-GAAP: $97.5 billion to $99.0 billion
|
|||||||||
CenterWell segment | no change | GAAP: $18.0 billion to $18.5 billion |
|||||||||
Change in year-end medical membership from prior year-end | |||||||||||
Individual Medicare Advantage | Growth of approx. 825,000 | Growth of at least 775,000 |
|||||||||
Group Medicare Advantage | no change | Decline of approx. 60,000 | |||||||||
Medicare stand-alone PDP | Decline of approx. 700,000 | Decline of approx. 800,000 | |||||||||
State-based contracts | no change | Growth in range of 25,000 to 100,000 | State-based contracts guidance includes membership in Florida, Illinois, Kentucky, Louisiana, Ohio, South Carolina, and Wisconsin. | ||||||||
Benefit Ratio
Insurance segment
|
no change | GAAP: 86.3% to 87.3% |
Ratio calculation: benefits expense as a percent of premiums revenues. Humana does not anticipate an impact on the FY 2023 ratio as a result of the announcement to exit the employer group commercial medical business. | ||||||||
Operating Cost Ratio Consolidated |
GAAP: no change
Non-GAAP: no change
|
GAAP: 11.6% to 12.6%
Non-GAAP: 11.3% to 12.3%
|
Ratio calculation: operating costs excluding depreciation and amortization as a percent of revenues excluding investment income. The non-GAAP range reflects the announced exit of the employer group commercial medical business. | ||||||||
Segment Results | |||||||||||
Insurance segment income from operations | no change | GAAP: $3.24 billion to $3.54 billion |
No material impact to segment earnings anticipated from non-GAAP adjustments. CenterWell non-GAAP Income from Operations excludes impact of depreciation and amortization. |
||||||||
CenterWell segment Income from operations | no change |
GAAP: $1.10 billion to $1.25 billion
Non-GAAP: $1.30 billion to $1.45 billion
|
|||||||||
Effective Tax Rate | no change | GAAP: 22.9% to 23.5% |
|||||||||
Weighted Avg. Share Count for Diluted EPS | Approximately 125.0 million | 125.4 million to 126.4 million | |||||||||
Cash flows from operations | no change | GAAP: ~$4.5 billion |
|||||||||
Capital expenditures | no change | GAAP: $1.2 billion |
Humana Inc. Statistical Schedules and Supplementary Information 2Q23 Earnings Release | |||||
(S-3) - (S-4) | Consolidated Statements of Income | ||||
(S-5) | Consolidated Balance Sheets | ||||
(S-6) | Consolidated Statements of Cash Flows - YTD | ||||
(S-7) - (S-8) | Consolidating Statements of Income - Quarter | ||||
(S-9) - (S-10) | Consolidating Statements of Income - YTD | ||||
(S-11) | Membership Detail | ||||
(S-12) - (S-13) | Premiums and Services Revenue Detail | ||||
(S-14) - (S-16) | CenterWell Segment - Pharmacy Solutions, Provider Services, & Home Solutions | ||||
(S-17) | Footnotes |
For the three months ended June 30, | |||||||||||||||||
Dollar | Percentage | ||||||||||||||||
2023 | 2022 | Change | Change | ||||||||||||||
Revenues: | |||||||||||||||||
Premiums | $ | 25,495 | $ | 22,266 | $ | 3,229 | 14.5 | % | |||||||||
Services | 978 | 1,349 | (371) | -27.5 | % | ||||||||||||
Investment income | 274 | 47 | 227 | 483.0 | % | ||||||||||||
Total revenues | 26,747 | 23,662 | 3,085 | 13.0 | % | ||||||||||||
Operating expenses: | |||||||||||||||||
Benefits | 22,009 | 19,099 | 2,910 | 15.2 | % | ||||||||||||
Operating costs | 3,111 | 3,173 | (62) | -2.0 | % | ||||||||||||
Depreciation and amortization | 191 | 175 | 16 | 9.1 | % | ||||||||||||
Total operating expenses | 25,311 | 22,447 | 2,864 | 12.8 | % | ||||||||||||
Income from operations | 1,436 | 1,215 | 221 | 18.2 | % | ||||||||||||
Interest expense | 120 | 101 | 19 | 18.8 | % | ||||||||||||
Other expense (income), net | 54 | (8) | 62 | 775.0 | % | ||||||||||||
Earnings before income taxes and equity in net earnings | 1,262 | 1,122 | 140 | 12.5 | % | ||||||||||||
Provision from income taxes | 296 | 427 | (131) | -30.7 | % | ||||||||||||
Equity in net (losses) earnings (A) | (10) | 2 | 12 | 600.0 | % | ||||||||||||
Net income | 956 | 697 | 259 | 37.2 | % | ||||||||||||
Net loss (income) attributable to noncontrolling interests | 3 | (1) | 4 | 400.0 | % | ||||||||||||
Net income attributable to Humana | $ | 959 | $ | 696 | $ | 263 | 37.8 | % | |||||||||
Basic earnings per common share | $ | 7.70 | $ | 5.50 | $ | 2.20 | 40.0 | % | |||||||||
Diluted earnings per common share | $ | 7.66 | $ | 5.48 | $ | 2.18 | 39.8 | % | |||||||||
Shares used in computing basic earnings per common share (000’s) | 124,574 | 126,523 | |||||||||||||||
Shares used in computing diluted earnings per common share (000’s) | 125,109 | 127,084 |
For the six months ended June 30, | |||||||||||||||||
Dollar | Percentage | ||||||||||||||||
2023 | 2022 | Change | Change | ||||||||||||||
Revenues: | |||||||||||||||||
Premiums | $ | 51,045 | $ | 44,969 | $ | 6,076 | 13.5 | % | |||||||||
Services | 1,977 | 2,613 | (636) | -24.3 | % | ||||||||||||
Investment income | 467 | 50 | 417 | 834.0 | % | ||||||||||||
Total revenues | 53,489 | 47,632 | 5,857 | 12.3 | % | ||||||||||||
Operating expenses: | |||||||||||||||||
Benefits | 43,867 | 38,724 | 5,143 | 13.3 | % | ||||||||||||
Operating costs | 6,090 | 6,059 | 31 | 0.5 | % | ||||||||||||
Depreciation and amortization | 377 | 345 | 32 | 9.3 | % | ||||||||||||
Total operating expenses | 50,334 | 45,128 | 5,206 | 11.5 | % | ||||||||||||
Income from operations | 3,155 | 2,504 | 651 | 26.0 | % | ||||||||||||
Interest expense | 233 | 191 | 42 | 22.0 | % | ||||||||||||
Other expense (income), net | 46 | (29) | 75 | 258.6 | % | ||||||||||||
Income before income taxes and equity in net earnings | 2,876 | 2,342 | 534 | 22.8 | % | ||||||||||||
Provision for income taxes | 655 | 713 | (58) | -8.1 | % | ||||||||||||
Equity in net losses (A) | (27) | (2) | 25 | 1250.0 | % | ||||||||||||
Net income | 2,194 | 1,627 | 567 | 34.8 | % | ||||||||||||
Net loss (income) attributable to noncontrolling interests | 4 | (1) | 5 | 500.0 | % | ||||||||||||
Net income attributable to Humana | $ | 2,198 | $ | 1,626 | $ | 572 | 35.2 | % | |||||||||
Basic earnings per common share | $ | 17.62 | $ | 12.83 | $ | 4.79 | 37.3 | % | |||||||||
Diluted earnings per common share | $ | 17.54 | $ | 12.77 | $ | 4.77 | 37.4 | % | |||||||||
Shares used in computing basic earnings per common share (000’s) | 124,790 | 126,730 | |||||||||||||||
Shares used in computing diluted earnings per common share (000’s) | 125,336 | 127,279 |
June 30, | December 31, | |||||||
2023 | 2022 | |||||||
Assets | ||||||||
Current assets: | ||||||||
Cash and cash equivalents | $ | 16,214 | $ | 5,061 | ||||
Investment securities | 15,251 | 13,881 | ||||||
Receivables, net | 1,429 | 1,674 | ||||||
Other current assets | 5,865 | 5,567 | ||||||
Total current assets | 38,759 | 26,183 | ||||||
Property and equipment, net | 3,309 | 3,221 | ||||||
Long-term investment securities | 389 | 380 | ||||||
Equity method investments | 733 | 749 | ||||||
Goodwill | 9,539 | 9,142 | ||||||
Other long-term assets | 3,726 | 3,380 | ||||||
Total assets | $ | 56,455 | $ | 43,055 | ||||
Liabilities and Stockholders’ Equity | ||||||||
Current liabilities: | ||||||||
Benefits payable | $ | 10,304 | $ | 9,264 | ||||
Trade accounts payable and accrued expenses | 8,118 | 5,238 | ||||||
Book overdraft | 457 | 298 | ||||||
Unearned revenues | 7,378 | 286 | ||||||
Short-term debt | 2,022 | 2,092 | ||||||
Total current liabilities | 28,279 | 17,178 | ||||||
Long-term debt | 9,722 | 9,034 | ||||||
Other long-term liabilities | 1,563 | 1,473 | ||||||
Total liabilities | 39,564 | 27,685 | ||||||
Commitments and contingencies | ||||||||
Stockholders’ equity: | ||||||||
Preferred stock, $1 par; 10,000,000 shares authorized, none issued | — | — | ||||||
Common stock, $0.16 2/3 par; 300,000,000 shares authorized; 198,690,082 issued at June 30, 2023 | 33 | 33 | ||||||
Capital in excess of par value | 3,313 | 3,246 | ||||||
Retained earnings | 27,468 | 25,492 | ||||||
Accumulated other comprehensive loss | (1,226) | (1,304) | ||||||
Treasury stock, at cost, 74,783,332 shares at June 30, 2023 | (12,754) | (12,156) | ||||||
Total stockholders’ equity | 16,834 | 15,311 | ||||||
Noncontrolling interests | 57 | 59 | ||||||
Total equity | 16,891 | 15,370 | ||||||
Total liabilities and equity | $ | 56,455 | $ | 43,055 | ||||
Debt-to-total capitalization ratio | 41.0 | % | 42.0 | % |
For the six months ended June 30, | ||||||||
2023 | 2022 | |||||||
Cash flows from operating activities | ||||||||
Net income | $ | 2,194 | $ | 1,627 | ||||
Adjustments to reconcile net income to net cash provided by operating activities: | ||||||||
Loss on investment securities, net | 45 | 137 | ||||||
Equity in net losses | 27 | 2 | ||||||
Impairment of property and equipment | — | 140 | ||||||
Depreciation | 410 | 369 | ||||||
Amortization | 34 | 45 | ||||||
Stock-based compensation | 89 | 93 | ||||||
Deferred income taxes | — | 167 | ||||||
Changes in operating assets and liabilities, net of effect of businesses acquired and dispositions: | ||||||||
Receivables | 269 | (1,733) | ||||||
Other assets | (1,141) | (655) | ||||||
Benefits payable | 978 | 1,361 | ||||||
Other liabilities | (170) | (333) | ||||||
Unearned revenues | 7,092 | 10 | ||||||
Other, net | 36 | 31 | ||||||
Net cash provided by operating activities | 9,863 | 1,261 | ||||||
Cash flows from investing activities | ||||||||
Acquisitions, net of cash and cash equivalents acquired | (189) | (167) | ||||||
Purchases of property and equipment, net | (487) | (574) | ||||||
Purchases of investment securities | (2,737) | (3,239) | ||||||
Maturities of investment securities | 577 | 947 | ||||||
Proceeds from sales of investment securities | 811 | 1,363 | ||||||
Net cash used in investing activities | (2,025) | (1,670) | ||||||
Cash flows from financing activities | ||||||||
Receipts from contract deposits, net | 3,510 | 3,076 | ||||||
Proceeds from issuance of senior notes | 1,215 | 744 | ||||||
Repayment of senior notes | (349) | — | ||||||
Proceeds (repayment) from the issuance of commercial paper, net | 238 | (418) | ||||||
Repayment of term loan | (500) | — | ||||||
Debt issue costs | (4) | (2) | ||||||
Change in book overdraft | 159 | 65 | ||||||
Common stock repurchases | (623) | (1,028) | ||||||
Dividends paid | (211) | (191) | ||||||
Other | (120) | (11) | ||||||
Net cash provided by financing activities | 3,315 | 2,235 | ||||||
Increase in cash and cash equivalents | 11,153 | 1,826 | ||||||
Cash and cash equivalents at beginning of period | 5,061 | 3,394 | ||||||
Cash and cash equivalents at end of period | $ | 16,214 | $ | 5,220 |
Insurance | CenterWell | Eliminations/ Corporate |
Consolidated | ||||||||||||||||||||
Revenues—external customers Premiums: | |||||||||||||||||||||||
Individual Medicare Advantage | $ | 19,749 | $ | — | $ | — | $ | 19,749 | |||||||||||||||
Group Medicare Advantage | 1,732 | — | — | 1,732 | |||||||||||||||||||
Medicare stand-alone PDP | 568 | — | — | 568 | |||||||||||||||||||
Total Medicare | 22,049 | — | — | 22,049 | |||||||||||||||||||
Medicaid and other | 2,062 | — | — | 2,062 | |||||||||||||||||||
Commercial fully-insured | 950 | — | — | 950 | |||||||||||||||||||
Specialty benefits | 252 | — | — | 252 | |||||||||||||||||||
Medicare Supplement | 182 | — | — | 182 | |||||||||||||||||||
Total premiums | 25,495 | — | — | 25,495 | |||||||||||||||||||
Services revenue: | |||||||||||||||||||||||
Home solutions | — | 341 | — | 341 | |||||||||||||||||||
Pharmacy solutions | — | 216 | — | 216 | |||||||||||||||||||
Provider services | — | 190 | — | 190 | |||||||||||||||||||
Military and other | 167 | — | — | 167 | |||||||||||||||||||
Commercial ASO | 64 | — | — | 64 | |||||||||||||||||||
Total services revenue | 231 | 747 | — | 978 | |||||||||||||||||||
Total revenues—external customers | 25,726 | 747 | — | 26,473 | |||||||||||||||||||
Intersegment revenues | 15 | 3,783 | (3,798) | — | |||||||||||||||||||
Investment income | 134 | — | 140 | 274 | |||||||||||||||||||
Total revenues | 25,875 | 4,530 | (3,658) | 26,747 | |||||||||||||||||||
Operating expenses: | |||||||||||||||||||||||
Benefits | 22,127 | — | (118) | 22,009 | |||||||||||||||||||
Operating costs | 2,545 | 4,193 | (3,627) | 3,111 | |||||||||||||||||||
Depreciation and amortization | 172 | 50 | (31) | 191 | |||||||||||||||||||
Total operating expenses | 24,844 | 4,243 | (3,776) | 25,311 | |||||||||||||||||||
Income from operations | $ | 1,031 | $ | 287 | $ | 118 | $ | 1,436 | |||||||||||||||
Benefit ratio | 86.8 | % | 86.3 | % | |||||||||||||||||||
Operating cost ratio | 9.9 | % | 92.6 | % | 11.8 | % |
Insurance | CenterWell | Eliminations/ Corporate |
Consolidated | ||||||||||||||||||||
Revenues—external customers Premiums: | |||||||||||||||||||||||
Individual Medicare Advantage | $ | 16,692 | $ | — | $ | — | $ | 16,692 | |||||||||||||||
Group Medicare Advantage | 1,857 | — | — | 1,857 | |||||||||||||||||||
Medicare stand-alone PDP | 606 | — | — | 606 | |||||||||||||||||||
Total Medicare | 19,155 | — | — | 19,155 | |||||||||||||||||||
Medicaid and other | 1,556 | — | — | 1,556 | |||||||||||||||||||
Commercial fully-insured | 1,109 | — | — | 1,109 | |||||||||||||||||||
Specialty benefits | 261 | — | — | 261 | |||||||||||||||||||
Medicare Supplement |
185 | — | — | 185 | |||||||||||||||||||
Total premiums | 22,266 | — | — | 22,266 | |||||||||||||||||||
Services revenue: | |||||||||||||||||||||||
Home solutions | — | 752 | — | 752 | |||||||||||||||||||
Pharmacy solutions | — | 254 | — | 254 | |||||||||||||||||||
Provider services | — | 137 | — | 137 | |||||||||||||||||||
Military and other | 131 | — | — | 131 | |||||||||||||||||||
Commercial ASO | 75 | — | — | 75 | |||||||||||||||||||
Total services revenue | 206 | 1,143 | — | 1,349 | |||||||||||||||||||
Total revenues—external customers | 22,472 | 1,143 | — | 23,615 | |||||||||||||||||||
Intersegment revenues | 14 | 3,383 | (3,397) | — | |||||||||||||||||||
Investment income | 46 | 1 | — | 47 | |||||||||||||||||||
Total revenues | 22,532 | 4,527 | (3,397) | 23,662 | |||||||||||||||||||
Operating expenses: | |||||||||||||||||||||||
Benefits | 19,164 | — | (65) | 19,099 | |||||||||||||||||||
Operating costs | 2,105 | 4,125 | (3,057) | 3,173 | |||||||||||||||||||
Depreciation and amortization | 156 | 44 | (25) | 175 | |||||||||||||||||||
Total operating expenses | 21,425 | 4,169 | (3,147) | 22,447 | |||||||||||||||||||
Income (loss) from operations | $ | 1,107 | $ | 358 | $ | (250) | $ | 1,215 | |||||||||||||||
Benefit ratio | 86.1 | % | 85.8 | % | |||||||||||||||||||
Operating cost ratio | 9.4 | % | 91.1 | % | 13.4 | % |
Insurance | CenterWell | Eliminations/ Corporate |
Consolidated | |||||||||||||||||||||||
Revenues—external customers Premiums: | ||||||||||||||||||||||||||
Individual Medicare Advantage | $ | 39,558 | $ | — | $ | — | $ | 39,558 | ||||||||||||||||||
Group Medicare Advantage | 3,497 | — | — | 3,497 | ||||||||||||||||||||||
Medicare stand-alone PDP | 1,184 | — | — | 1,184 | ||||||||||||||||||||||
Total Medicare | 44,239 | — | — | 44,239 | ||||||||||||||||||||||
Medicaid and other | 3,971 | — | — | 3,971 | ||||||||||||||||||||||
Commercial fully-insured | 1,968 | — | — | 1,968 | ||||||||||||||||||||||
Specialty benefits | 506 | — | — | 506 | ||||||||||||||||||||||
Medicare supplement | 361 | — | — | 361 | ||||||||||||||||||||||
Total premiums | 51,045 | — | — | 51,045 | ||||||||||||||||||||||
Services revenue: | ||||||||||||||||||||||||||
Home solutions | — | 655 | — | 655 | ||||||||||||||||||||||
Pharmacy solutions | — | 458 | — | 458 | ||||||||||||||||||||||
Provider services | — | 391 | — | 391 | ||||||||||||||||||||||
Military and other | 338 | — | — | 338 | ||||||||||||||||||||||
Commercial ASO | 135 | — | — | 135 | ||||||||||||||||||||||
Total services revenue | 473 | 1,504 | — | 1,977 | ||||||||||||||||||||||
Total revenues—external customers | 51,518 | 1,504 | — | 53,022 | ||||||||||||||||||||||
Intersegment revenues | 29 | 7,531 | (7,560) | — | ||||||||||||||||||||||
Investment income | 231 | — | 236 | 467 | ||||||||||||||||||||||
Total revenues | 51,778 | 9,035 | (7,324) | 53,489 | ||||||||||||||||||||||
Operating expenses: | ||||||||||||||||||||||||||
Benefits | 44,120 | — | (253) | 43,867 | ||||||||||||||||||||||
Operating costs | 4,963 | 8,319 | (7,192) | 6,090 | ||||||||||||||||||||||
Depreciation and amortization | 337 | 99 | (59) | 377 | ||||||||||||||||||||||
Total operating expenses | 49,420 | 8,418 | (7,504) | 50,334 | ||||||||||||||||||||||
Income from operations | $ | 2,358 | $ | 617 | $ | 180 | $ | 3,155 | ||||||||||||||||||
Benefit ratio | 86.4 | % | 85.9 | % | ||||||||||||||||||||||
Operating cost ratio | 9.6 | % | 92.1 | % | 11.5 | % |
Insurance | CenterWell | Eliminations/ Corporate |
Consolidated | |||||||||||||||||||||||
Revenues—external customers Premiums: | ||||||||||||||||||||||||||
Individual Medicare Advantage | $ | 33,744 | $ | — | $ | — | $ | 33,744 | ||||||||||||||||||
Group Medicare Advantage | 3,732 | — | — | 3,732 | ||||||||||||||||||||||
Medicare stand-alone PDP | 1,245 | — | — | 1,245 | ||||||||||||||||||||||
Total Medicare | 38,721 | — | — | 38,721 | ||||||||||||||||||||||
Medicaid and other | 3,110 | — | — | 3,110 | ||||||||||||||||||||||
Commercial fully-insured | 2,249 | — | — | 2,249 | ||||||||||||||||||||||
Specialty benefits | 522 | — | — | 522 | ||||||||||||||||||||||
Medicare supplement | 367 | — | — | 367 | ||||||||||||||||||||||
Total premiums | 44,969 | — | — | 44,969 | ||||||||||||||||||||||
Services revenue: | ||||||||||||||||||||||||||
Home solutions | — | 1,478 | — | 1,478 | ||||||||||||||||||||||
Pharmacy solutions | — | 475 | — | 475 | ||||||||||||||||||||||
Provider services | — | 250 | — | 250 | ||||||||||||||||||||||
Military and other | 258 | — | — | 258 | ||||||||||||||||||||||
Commercial ASO | 152 | — | — | 152 | ||||||||||||||||||||||
Total services revenue | 410 | 2,203 | — | 2,613 | ||||||||||||||||||||||
Total revenues—external customers | 45,379 | 2,203 | — | 47,582 | ||||||||||||||||||||||
Intersegment revenues | 28 | 6,686 | (6,714) | — | ||||||||||||||||||||||
Investment income | 92 | 3 | (45) | 50 | ||||||||||||||||||||||
Total revenues | 45,499 | 8,892 | (6,759) | 47,632 | ||||||||||||||||||||||
Operating expenses: | ||||||||||||||||||||||||||
Benefits | 38,898 | — | (174) | 38,724 | ||||||||||||||||||||||
Operating costs | 4,192 | 8,073 | (6,206) | 6,059 | ||||||||||||||||||||||
Depreciation and amortization | 306 | 91 | (52) | 345 | ||||||||||||||||||||||
Total operating expenses | 43,396 | 8,164 | (6,432) | 45,128 | ||||||||||||||||||||||
Income (loss) from operations | $ | 2,103 | $ | 728 | $ | (327) | $ | 2,504 | ||||||||||||||||||
Benefit ratio | 86.5 | % | 86.1 | % | ||||||||||||||||||||||
Operating cost ratio | 9.2 | % | 90.8 | % | 12.7 | % |
Year-over-Year Change | YTD Change | |||||||||||||||||||||||||||||||||||||
June 30, 2023 | Average 2Q23 | June 30, 2022 | Amount | Percent | December 31, 2022 | Amount | Percent | |||||||||||||||||||||||||||||||
Medical Membership: | ||||||||||||||||||||||||||||||||||||||
Individual Medicare Advantage | 5,269.1 | 5,233.9 | 4,555.1 | 714.0 | 15.7 | % | 4,565.6 | 703.5 | 15.4 | % | ||||||||||||||||||||||||||||
Group Medicare Advantage | 509.5 | 509.7 | 562.5 | (53.0) | -9.4 | % | 565.1 | (55.6) | -9.8 | % | ||||||||||||||||||||||||||||
Total Medicare Advantage | 5,778.6 | 5,743.6 | 5,117.6 | 661.0 | 12.9 | % | 5,130.7 | 647.9 | 12.6 | % | ||||||||||||||||||||||||||||
Medicare stand-alone PDP | 2,915.3 | 2,925.8 | 3,580.7 | (665.4) | -18.6 | % | 3,551.3 | (636.0) | -17.9 | % | ||||||||||||||||||||||||||||
Total Medicare | 8,693.9 | 8,669.4 | 8,698.3 | (4.4) | -0.1 | % | 8,682.0 | 11.9 | 0.1 | % | ||||||||||||||||||||||||||||
State-based contracts and other | 1,330.2 | 1,350.0 | 1,053.0 | 277.2 | 26.3 | % | 1,137.3 | 192.9 | 17.0 | % | ||||||||||||||||||||||||||||
Medicare supplement | 294.3 | 294.0 | 317.4 | (23.1) | -7.3 | % | 313.6 | (19.3) | -6.2 | % | ||||||||||||||||||||||||||||
Military | 5,939.1 | 5,945.3 | 6,017.8 | (78.7) | -1.3 | % | 5,959.9 | (20.8) | -0.3 | % | ||||||||||||||||||||||||||||
Total excluding employer group commercial medical | 16,257.5 | 16,258.7 | 16,086.5 | 171.0 | 1.1 | % | 16,092.8 | 164.7 | 1.0 | % | ||||||||||||||||||||||||||||
Fully-insured commercial medical | 475.5 | 497.6 | 595.4 | (119.9) | -20.1 | % | 556.3 | (80.8) | -14.5 | % | ||||||||||||||||||||||||||||
ASO commercial | 395.3 | 401.4 | 448.1 | (52.8) | -11.8 | % | 430.1 | (34.8) | -8.1 | % | ||||||||||||||||||||||||||||
Total employer group commercial medical | 870.8 | 899.0 | 1,043.5 | (172.7) | -16.6 | % | 986.4 | (115.6) | -11.7 | % | ||||||||||||||||||||||||||||
Total Medical Membership | 17,128.3 | 17,157.7 | 17,130.0 | (1.7) | — | % | 17,079.2 | 49.1 | 0.3 | % | ||||||||||||||||||||||||||||
Specialty Membership: | ||||||||||||||||||||||||||||||||||||||
Dental—fully-insured (B) | 2,294.2 | 2,306.9 | 2,463.2 | (169.0) | -6.9 | % | 2,416.3 | (122.1) | -5.1 | % | ||||||||||||||||||||||||||||
Dental—ASO | 309.1 | 309.5 | 284.6 | 24.5 | 8.6 | % | 288.1 | 21.0 | 7.3 | % | ||||||||||||||||||||||||||||
Total Dental | 2,603.3 | 2,616.4 | 2,747.8 | (144.5) | -5.3 | % | 2,704.4 | (101.1) | -3.7 | % | ||||||||||||||||||||||||||||
Vision | 2,029.4 | 2,043.2 | 1,998.0 | 31.4 | 1.6 | % | 2,081.7 | (52.3) | -2.5 | % | ||||||||||||||||||||||||||||
Other supplemental benefits | 408.4 | 411.6 | 410.6 | (2.2) | -0.5 | % | 408.7 | (0.3) | -0.1 | % | ||||||||||||||||||||||||||||
Total Specialty Membership | 5,041.1 | 5,071.2 | 5,156.4 | (115.3) | -2.2 | % | 5,194.8 | (153.7) | -3.0 | % | ||||||||||||||||||||||||||||
June 30, 2023 | Member Mix June 30, 2023 |
June 30, 2022 | Member Mix June 30, 2022 |
|||||||||||||||||||||||||||||||||||
Individual Medicare Advantage Membership | ||||||||||||||||||||||||||||||||||||||
HMO | 2,814.9 | 53 | % | 2,624.8 | 58 | % | ||||||||||||||||||||||||||||||||
PPO/PFFS | 2,454.2 | 47 | % | 1,930.3 | 42 | % | ||||||||||||||||||||||||||||||||
Total Individual Medicare Advantage |
5,269.1 | 100 | % | 4,555.1 | 100 | % | ||||||||||||||||||||||||||||||||
Individual Medicare Advantage Membership | ||||||||||||||||||||||||||||||||||||||
Shared Risk (C) | 1,813.7 | 35 | % | 1,545.3 | 34 | % | ||||||||||||||||||||||||||||||||
Path to Risk (D) | 1,804.8 | 34 | % | 1,550.0 | 34 | % | ||||||||||||||||||||||||||||||||
Total Value-based | 3,618.5 | 69 | % | 3,095.3 | 68 | % | ||||||||||||||||||||||||||||||||
Other | 1,650.6 | 31 | % | 1,455.8 | 32 | % | ||||||||||||||||||||||||||||||||
Total Individual Medicare Advantage | 5,269.1 | 100 | % | 4,551.1 | 100 | % |
For the three months ended June 30, | Per Member per Month (I) For the three months ended June 30, |
|||||||||||||||||||||||||
Dollar | Percentage | |||||||||||||||||||||||||
2023 | 2022 | Change | Change | 2023 | 2022 | |||||||||||||||||||||
Insurance | ||||||||||||||||||||||||||
Individual Medicare Advantage | $ | 19,749 | $ | 16,692 | $ | 3,057 | 18.3 | % | $ | 1,258 | $ | 1,224 | ||||||||||||||
Group Medicare Advantage | 1,732 | 1,857 | (125) | -6.7 | % | 1,133 | 1,101 | |||||||||||||||||||
Medicare stand-alone PDP | 568 | 606 | (38) | -6.3 | % | 65 | 56 | |||||||||||||||||||
State-based contracts and other (E) | 2,062 | 1,556 | 506 | 32.5 | % | 458 | 451 | |||||||||||||||||||
Fully-insured commercial medical (F) | 950 | 1,109 | (159) | -14.3 | % | 545 | 518 | |||||||||||||||||||
Specialty benefits (G) | 252 | 261 | (9) | -3.4 | % | 18 | 18 | |||||||||||||||||||
Medicare Supplement | 182 | 185 | (3) | -1.6 | % | 206 | 194 | |||||||||||||||||||
Military and other (H) | 182 | 145 | 37 | 25.5 | % | |||||||||||||||||||||
Commercial ASO | 64 | 75 | (11) | -14.7 | % | |||||||||||||||||||||
Total | 25,741 | 22,486 | 3,255 | 14.5 | % | |||||||||||||||||||||
CenterWell | ||||||||||||||||||||||||||
Pharmacy solutions | 2,855 | 2,743 | 112 | 4.1 | % | |||||||||||||||||||||
Provider services | 1,013 | 914 | 99 | 10.8 | % | |||||||||||||||||||||
Home solutions | 662 | 869 | (207) | -23.8 | % | |||||||||||||||||||||
Total | 4,530 | 4,526 | 4 | 0.1 | % | |||||||||||||||||||||
For the six months ended June 30, | Per Member per Month (I) For the six months ended June 30, |
|||||||||||||||||||||||||
Dollar | Percentage | |||||||||||||||||||||||||
2023 | 2022 | Change | Change | 2023 | 2022 | |||||||||||||||||||||
Insurance | ||||||||||||||||||||||||||
Individual Medicare Advantage | $ | 39,558 | $ | 33,744 | $ | 5,814 | 17.2 | % | $ | 1,275 | $ | 1,238 | ||||||||||||||
Group Medicare Advantage | 3,497 | 3,732 | (235) | -6.3 | % | 1,139 | 1,106 | |||||||||||||||||||
Medicare stand-alone PDP | 1,184 | 1,245 | (61) | -4.9 | % | 67 | 58 | |||||||||||||||||||
State-based contracts and other (E) | 3,971 | 3,110 | 861 | 27.7 | % | 442 | 454 | |||||||||||||||||||
Fully-insured commercial medical (F) | 1,968 | 2,249 | (281) | -12.5 | % | 547 | 516 | |||||||||||||||||||
Specialty benefits (G) | 506 | 522 | (16) | -3.1 | % | 18 | 18 | |||||||||||||||||||
Medicare Supplement | 361 | 367 | (6) | -1.6 | % | 204 | 192 | |||||||||||||||||||
Military and other (H) | 367 | 286 | 81 | 28.3 | % | |||||||||||||||||||||
Commercial ASO | 135 | 152 | (17) | -11.2 | % | |||||||||||||||||||||
Total | 51,547 | 45,407 | 6,140 | 13.5 | % | |||||||||||||||||||||
CenterWell | ||||||||||||||||||||||||||
Pharmacy solutions | 5,712 | 5,410 | 302 | 5.6 | % | |||||||||||||||||||||
Provider services | 2,033 | 1,775 | 258 | 14.5 | % | |||||||||||||||||||||
Home solutions | 1,290 | 1,704 | (414) | -24.3 | % | |||||||||||||||||||||
Total | 9,035 | 8,889 | 146 | 1.6 | % | |||||||||||||||||||||
For the three months ended June 30, 2023 |
For the three months ended June 30, 2022 |
Year-over-Year Difference |
For the three months ended March 31, 2023 |
Sequential Difference |
|||||||||||||||||||||||||
Generic Dispense Rate | |||||||||||||||||||||||||||||
Total Medicare | 91.8 | % | 91.7 | % | 0.1 | % | 91.4 | % | 0.4 | % | |||||||||||||||||||
Mail-Order Penetration | |||||||||||||||||||||||||||||
Total Medicare | 29.9 | % | 30.7 | % | -0.8 | % | 30.3 | % | -0.4 | % | |||||||||||||||||||
For the six months ended June 30, 2023 |
For the six months ended June 30, 2022 |
Year-over-Year Difference |
|||||||||||||||
Generic Dispense Rate | |||||||||||||||||
Total Medicare | 91.4 | % | 91.7 | % | -0.3 | % | |||||||||||
Mail-Order Penetration | |||||||||||||||||
Total Medicare | 30.1 | % | 30.5 | % | -0.4 | % | |||||||||||
As of June 30, 2023 | As of June 30, 2022 | Year-over-Year Growth | |||||||||||||||||||||||||||||||||
Primary | Primary | Primary | |||||||||||||||||||||||||||||||||
Center | Care | Patients | Center | Care | Patients | Center | Care | Patients | |||||||||||||||||||||||||||
Count | Providers | Served (K) | Count | Providers | Served (K) | Count | Providers | Served | |||||||||||||||||||||||||||
De novo | 67 | 200 | 29,300 | 40 | 76 | 15,500 | 67.5 | % | 163.2 | % | 89.0 | % | |||||||||||||||||||||||
Wholly-owned | 191 | 595 | 183,900 | 182 | 543 | 163,500 | 4.9 | % | 9.6 | % | 12.5 | % | |||||||||||||||||||||||
Independent Physician Associations | 59,000 | 61,100 | (3.4) | % | |||||||||||||||||||||||||||||||
258 | 795 | 272,200 | 222 | 619 | 240,100 | 16.2 | % | 28.4 | % | 13.4 | % |
As of December 31, 2022 | YTD Growth | |||||||||||||||||||||||||
Primary | Primary | |||||||||||||||||||||||||
Center | Care | Patients | Center | Care | Patients | |||||||||||||||||||||
Count | Providers | Served (K) | Count | Providers | Served | |||||||||||||||||||||
De novo | 50 | 104 | 19,300 | 34.0 | % | 92.3 | % | 51.8 | % | |||||||||||||||||
Wholly-owned | 185 | 567 | 171,900 | 3.2 | % | 4.9 | % | 7.0 | % | |||||||||||||||||
Independent Physician Associations | 56,700 | 4.1 | % | |||||||||||||||||||||||
235 | 671 | 247,900 | 9.8 | % | 18.5 | % | 9.8 | % |
For the quarter ended June 30, 2023 |
For the quarter ended June 30, 2022 |
Year-over-Year Growth | |||||||||
Episodic Admissions (L) | 75,545 | 68,556 | 10.2 | % | |||||||
Total Admissions - Same Store (M) | 92,013 | 88,134 | 4.4 | % |
For the six months ended June 30, 2023 |
For the six months ended June 30, 2022 |
Year-over-Year Growth | |||||||||
Episodic Admissions (L) | 149,482 | 138,922 | 7.6 | % | |||||||
Total Admissions - Same Store (M) | 188,371 | 178,100 | 5.8 | % |
June 30, 2023 | June 30, 2022 | Year-over-Year Growth |
||||||||||||
Members covered by a value-based home care model (N) | 828,100 | 330,900 | 150.3% |