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FORM 10-Q
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ý
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QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15 (d) OF THE
SECURITIES EXCHANGE ACT OF 1934
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¨
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TRANSITION REPORT PURSUANT TO SECTION 13 OR 15 (d) OF THE
SECURITIES EXCHANGE ACT OF 1934
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HUMANA INC.
(Exact name of registrant as specified in its charter)
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Delaware
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61-0647538
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(State or other jurisdiction of
incorporation or organization)
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(I.R.S. Employer
Identification Number)
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Large accelerated filer
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ý
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Accelerated filer
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¨
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Non-accelerated filer
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¨
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Smaller reporting company
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¨
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Class of Common Stock
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Outstanding at
September 30, 2016 |
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$0.16 2/3 par value
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149,101,179 shares
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Page
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Part I: Financial Information
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Item 1.
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Financial Statements (Unaudited)
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Item 2.
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||
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Item 3.
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||
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Item 4.
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||
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Item 1.
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||
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Item 1A.
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||
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Item 2.
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||
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Item 3.
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||
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Item 4.
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||
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Item 5.
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Item 6.
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||
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Certifications
|
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September 30,
2016 |
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December 31,
2015 |
||||
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(in millions, except share amounts)
|
||||||
|
A
SSETS
|
|
|
|
||||
|
Current assets:
|
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|
|
||||
|
Cash and cash equivalents
|
$
|
6,769
|
|
|
$
|
2,571
|
|
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Investment securities
|
7,329
|
|
|
7,267
|
|
||
|
Receivables, less allowance for doubtful accounts of $111 in 2016
and $101 in 2015: |
765
|
|
|
1,161
|
|
||
|
Other current assets
|
4,791
|
|
|
4,712
|
|
||
|
Total current assets
|
19,654
|
|
|
15,711
|
|
||
|
Property and equipment, net
|
1,478
|
|
|
1,384
|
|
||
|
Long-term investment securities
|
2,273
|
|
|
1,843
|
|
||
|
Goodwill
|
3,272
|
|
|
3,265
|
|
||
|
Other long-term assets
|
2,789
|
|
|
2,475
|
|
||
|
Total assets
|
$
|
29,466
|
|
|
$
|
24,678
|
|
|
L
IABILITIES
AND
S
TOCKHOLDERS
’ E
QUITY
|
|
|
|
||||
|
Current liabilities:
|
|
|
|
||||
|
Benefits payable
|
$
|
5,049
|
|
|
$
|
4,976
|
|
|
Trade accounts payable and accrued expenses
|
2,933
|
|
|
2,212
|
|
||
|
Book overdraft
|
183
|
|
|
301
|
|
||
|
Unearned revenues
|
3,351
|
|
|
364
|
|
||
|
Short-term borrowings
|
300
|
|
|
299
|
|
||
|
Total current liabilities
|
11,816
|
|
|
8,152
|
|
||
|
Long-term debt
|
3,792
|
|
|
3,794
|
|
||
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Future policy benefits payable
|
2,294
|
|
|
2,151
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|
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Other long-term liabilities
|
279
|
|
|
235
|
|
||
|
Total liabilities
|
18,181
|
|
|
14,332
|
|
||
|
Commitments and contingencies
|
|
|
|
||||
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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;
198,406,586 shares issued at September 30, 2016 and 198,372,059 shares issued at December 31, 2015 |
33
|
|
|
33
|
|
||
|
Capital in excess of par value
|
2,527
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|
2,530
|
|
||
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Retained earnings
|
11,899
|
|
|
11,017
|
|
||
|
Accumulated other comprehensive income
|
112
|
|
|
58
|
|
||
|
Treasury stock, at cost, 49,305,407 shares at September 30, 2016 and
50,084,043 shares at December 31, 2015 |
(3,286
|
)
|
|
(3,292
|
)
|
||
|
Total stockholders’ equity
|
11,285
|
|
|
10,346
|
|
||
|
Total liabilities and stockholders’ equity
|
$
|
29,466
|
|
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$
|
24,678
|
|
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Three months ended
September 30, |
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Nine months ended
September 30, |
||||||||||||
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2016
|
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2015
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2016
|
|
2015
|
||||||||
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(in millions, except per share results)
|
||||||||||||||
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Revenues:
|
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||||||||
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Premiums
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$
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13,371
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$
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12,987
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$
|
40,461
|
|
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$
|
39,447
|
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Services
|
227
|
|
|
246
|
|
|
749
|
|
|
1,143
|
|
||||
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Investment income
|
96
|
|
|
130
|
|
|
291
|
|
|
338
|
|
||||
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Total revenues
|
13,694
|
|
|
13,363
|
|
|
41,501
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|
|
40,928
|
|
||||
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Operating expenses:
|
|
|
|
|
|
|
|
||||||||
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Benefits
|
10,900
|
|
|
10,896
|
|
|
33,806
|
|
|
33,153
|
|
||||
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Operating costs
|
1,759
|
|
|
1,688
|
|
|
5,253
|
|
|
5,450
|
|
||||
|
Depreciation and amortization
|
86
|
|
|
84
|
|
|
263
|
|
|
267
|
|
||||
|
Total operating expenses
|
12,745
|
|
|
12,668
|
|
|
39,322
|
|
|
38,870
|
|
||||
|
Income from operations
|
949
|
|
|
695
|
|
|
2,179
|
|
|
2,058
|
|
||||
|
Gain on sale of business
|
—
|
|
|
—
|
|
|
—
|
|
|
267
|
|
||||
|
Interest expense
|
47
|
|
|
47
|
|
|
141
|
|
|
140
|
|
||||
|
Income before income taxes
|
902
|
|
|
648
|
|
|
2,038
|
|
|
2,185
|
|
||||
|
Provision for income taxes
|
452
|
|
|
334
|
|
|
1,023
|
|
|
1,010
|
|
||||
|
Net income
|
$
|
450
|
|
|
$
|
314
|
|
|
$
|
1,015
|
|
|
$
|
1,175
|
|
|
Basic earnings per common share
|
$
|
3.01
|
|
|
$
|
2.11
|
|
|
$
|
6.80
|
|
|
$
|
7.85
|
|
|
Diluted earnings per common share
|
$
|
2.98
|
|
|
$
|
2.09
|
|
|
$
|
6.73
|
|
|
$
|
7.77
|
|
|
Dividends declared per common share
|
$
|
0.29
|
|
|
$
|
0.29
|
|
|
$
|
0.87
|
|
|
$
|
0.86
|
|
|
|
Three months ended
September 30, |
|
Nine months ended
September 30, |
||||||||||||
|
|
2016
|
|
2015
|
|
2016
|
|
2015
|
||||||||
|
|
(in millions)
|
||||||||||||||
|
Net income
|
$
|
450
|
|
|
$
|
314
|
|
|
$
|
1,015
|
|
|
$
|
1,175
|
|
|
Other comprehensive (loss) income:
|
|
|
|
|
|
|
|
||||||||
|
Change in gross unrealized investment
gains/losses |
(9
|
)
|
|
25
|
|
|
150
|
|
|
(48
|
)
|
||||
|
Effect of income taxes
|
3
|
|
|
(9
|
)
|
|
(55
|
)
|
|
18
|
|
||||
|
Total change in unrealized
investment gains/losses, net of tax |
(6
|
)
|
|
16
|
|
|
95
|
|
|
(30
|
)
|
||||
|
Reclassification adjustment for net
realized gains included in investment income |
(26
|
)
|
|
(51
|
)
|
|
(65
|
)
|
|
(88
|
)
|
||||
|
Effect of income taxes
|
10
|
|
|
19
|
|
|
24
|
|
|
32
|
|
||||
|
Total reclassification adjustment, net
of tax |
(16
|
)
|
|
(32
|
)
|
|
(41
|
)
|
|
(56
|
)
|
||||
|
Other comprehensive (loss) income, net
of tax |
(22
|
)
|
|
(16
|
)
|
|
54
|
|
|
(86
|
)
|
||||
|
Comprehensive income
|
$
|
428
|
|
|
$
|
298
|
|
|
$
|
1,069
|
|
|
$
|
1,089
|
|
|
|
For the nine months ended
September 30, |
||||||
|
|
2016
|
|
2015
|
||||
|
|
(in millions)
|
||||||
|
Cash flows from operating activities
|
|
|
|
||||
|
Net income
|
$
|
1,015
|
|
|
$
|
1,175
|
|
|
Adjustments to reconcile net income to net cash provided by
operating activities: |
|
|
|
||||
|
Gain on sale of business
|
—
|
|
|
(267
|
)
|
||
|
Net realized capital gains
|
(65
|
)
|
|
(88
|
)
|
||
|
Stock-based compensation
|
76
|
|
|
92
|
|
||
|
Depreciation
|
289
|
|
|
263
|
|
||
|
Other intangible amortization
|
59
|
|
|
72
|
|
||
|
Provision for deferred income taxes
|
54
|
|
|
13
|
|
||
|
Changes in operating assets and liabilities, net of effect of
businesses acquired and dispositions: |
|
|
|
||||
|
Receivables
|
396
|
|
|
56
|
|
||
|
Other assets
|
(419
|
)
|
|
(1,080
|
)
|
||
|
Benefits payable
|
73
|
|
|
447
|
|
||
|
Other liabilities
|
127
|
|
|
(140
|
)
|
||
|
Unearned revenues
|
2,987
|
|
|
(64
|
)
|
||
|
Other, net
|
117
|
|
|
52
|
|
||
|
Net cash provided by operating activities
|
4,709
|
|
|
531
|
|
||
|
Cash flows from investing activities
|
|
|
|
||||
|
Proceeds from sale of business
|
—
|
|
|
1,055
|
|
||
|
Acquisitions, net of cash acquired
|
(7
|
)
|
|
(38
|
)
|
||
|
Purchases of property and equipment
|
(395
|
)
|
|
(384
|
)
|
||
|
Purchases of investment securities
|
(4,533
|
)
|
|
(4,345
|
)
|
||
|
Maturities of investment securities
|
1,082
|
|
|
881
|
|
||
|
Proceeds from sales of investment securities
|
3,319
|
|
|
3,448
|
|
||
|
Net cash (used in) provided by investing activities
|
(534
|
)
|
|
617
|
|
||
|
Cash flows from financing activities
|
|
|
|
||||
|
Receipts (withdrawals) from contract deposits, net
|
350
|
|
|
(984
|
)
|
||
|
Proceeds (repayment) of commercial paper, net
|
(1
|
)
|
|
10
|
|
||
|
Change in book overdraft
|
(118
|
)
|
|
(38
|
)
|
||
|
Common stock repurchases
|
(75
|
)
|
|
(380
|
)
|
||
|
Dividends paid
|
(133
|
)
|
|
(129
|
)
|
||
|
Excess tax benefit from stock-based compensation
|
—
|
|
|
15
|
|
||
|
Proceeds from stock option exercises and other
|
—
|
|
|
20
|
|
||
|
Net cash provided by (used in) financing activities
|
23
|
|
|
(1,486
|
)
|
||
|
Increase (decrease) in cash and cash equivalents
|
4,198
|
|
|
(338
|
)
|
||
|
Cash and cash equivalents at beginning of period
|
2,571
|
|
|
1,935
|
|
||
|
Cash and cash equivalents at end of period
|
$
|
6,769
|
|
|
$
|
1,597
|
|
|
Supplemental cash flow disclosures:
|
|
|
|
||||
|
Interest payments
|
$
|
102
|
|
|
$
|
105
|
|
|
Income tax payments, net
|
$
|
851
|
|
|
$
|
1,038
|
|
|
|
Amortized
Cost
|
|
Gross
Unrealized
Gains
|
|
Gross
Unrealized
Losses
|
|
Fair
Value
|
||||||||
|
|
(in millions)
|
||||||||||||||
|
September 30, 2016
|
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and other U.S. government
corporations and agencies: |
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and agency obligations
|
$
|
659
|
|
|
$
|
2
|
|
|
$
|
—
|
|
|
$
|
661
|
|
|
Mortgage-backed securities
|
1,512
|
|
|
24
|
|
|
(1
|
)
|
|
1,535
|
|
||||
|
Tax-exempt municipal securities
|
3,157
|
|
|
73
|
|
|
(4
|
)
|
|
3,226
|
|
||||
|
Mortgage-backed securities:
|
|
|
|
|
|
|
|
||||||||
|
Residential
|
10
|
|
|
—
|
|
|
—
|
|
|
10
|
|
||||
|
Commercial
|
498
|
|
|
13
|
|
|
(8
|
)
|
|
503
|
|
||||
|
Asset-backed securities
|
187
|
|
|
1
|
|
|
—
|
|
|
188
|
|
||||
|
Corporate debt securities
|
3,223
|
|
|
268
|
|
|
(12
|
)
|
|
3,479
|
|
||||
|
Total debt securities
|
$
|
9,246
|
|
|
$
|
381
|
|
|
$
|
(25
|
)
|
|
$
|
9,602
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
December 31, 2015
|
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and other U.S. government
corporations and agencies: |
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and agency obligations
|
$
|
331
|
|
|
$
|
2
|
|
|
$
|
(1
|
)
|
|
$
|
332
|
|
|
Mortgage-backed securities
|
1,902
|
|
|
12
|
|
|
(23
|
)
|
|
1,891
|
|
||||
|
Tax-exempt municipal securities
|
2,611
|
|
|
61
|
|
|
(4
|
)
|
|
2,668
|
|
||||
|
Mortgage-backed securities:
|
|
|
|
|
|
|
|
||||||||
|
Residential
|
13
|
|
|
—
|
|
|
—
|
|
|
13
|
|
||||
|
Commercial
|
1,024
|
|
|
2
|
|
|
(41
|
)
|
|
985
|
|
||||
|
Asset-backed securities
|
264
|
|
|
1
|
|
|
(2
|
)
|
|
263
|
|
||||
|
Corporate debt securities
|
2,873
|
|
|
140
|
|
|
(55
|
)
|
|
2,958
|
|
||||
|
Total debt securities
|
$
|
9,018
|
|
|
$
|
218
|
|
|
$
|
(126
|
)
|
|
$
|
9,110
|
|
|
|
Less than 12 months
|
|
12 months or more
|
|
Total
|
||||||||||||||||||
|
|
Fair
Value |
|
Gross
Unrealized Losses |
|
Fair
Value |
|
Gross
Unrealized Losses |
|
Fair
Value |
|
Gross
Unrealized Losses |
||||||||||||
|
|
(in millions)
|
||||||||||||||||||||||
|
September 30, 2016
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
U.S. Treasury and other U.S.
government corporations and agencies: |
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
U.S. Treasury and agency
obligations |
$
|
190
|
|
|
$
|
—
|
|
|
$
|
3
|
|
|
$
|
—
|
|
|
$
|
193
|
|
|
$
|
—
|
|
|
Mortgage-backed
securities |
67
|
|
|
—
|
|
|
3
|
|
|
(1
|
)
|
|
70
|
|
|
(1
|
)
|
||||||
|
Tax-exempt municipal
securities |
1,069
|
|
|
(4
|
)
|
|
24
|
|
|
—
|
|
|
1,093
|
|
|
(4
|
)
|
||||||
|
Mortgage-backed securities:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Residential
|
—
|
|
|
—
|
|
|
5
|
|
|
—
|
|
|
5
|
|
|
—
|
|
||||||
|
Commercial
|
35
|
|
|
—
|
|
|
81
|
|
|
(8
|
)
|
|
116
|
|
|
(8
|
)
|
||||||
|
Asset-backed securities
|
35
|
|
|
—
|
|
|
68
|
|
|
—
|
|
|
103
|
|
|
—
|
|
||||||
|
Corporate debt securities
|
536
|
|
|
(6
|
)
|
|
81
|
|
|
(6
|
)
|
|
617
|
|
|
(12
|
)
|
||||||
|
Total debt securities
|
$
|
1,932
|
|
|
$
|
(10
|
)
|
|
$
|
265
|
|
|
$
|
(15
|
)
|
|
$
|
2,197
|
|
|
$
|
(25
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
December 31, 2015
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
U.S. Treasury and other U.S.
government corporations and agencies: |
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
U.S. Treasury and agency
obligations |
$
|
195
|
|
|
$
|
(1
|
)
|
|
$
|
14
|
|
|
$
|
—
|
|
|
$
|
209
|
|
|
$
|
(1
|
)
|
|
Mortgage-backed
securities |
1,484
|
|
|
(20
|
)
|
|
86
|
|
|
(3
|
)
|
|
1,570
|
|
|
(23
|
)
|
||||||
|
Tax-exempt municipal
securities |
843
|
|
|
(3
|
)
|
|
52
|
|
|
(1
|
)
|
|
895
|
|
|
(4
|
)
|
||||||
|
Mortgage-backed securities:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Residential
|
2
|
|
|
—
|
|
|
4
|
|
|
—
|
|
|
6
|
|
|
—
|
|
||||||
|
Commercial
|
626
|
|
|
(13
|
)
|
|
265
|
|
|
(28
|
)
|
|
891
|
|
|
(41
|
)
|
||||||
|
Asset-backed securities
|
258
|
|
|
(2
|
)
|
|
—
|
|
|
—
|
|
|
258
|
|
|
(2
|
)
|
||||||
|
Corporate debt securities
|
918
|
|
|
(45
|
)
|
|
63
|
|
|
(10
|
)
|
|
981
|
|
|
(55
|
)
|
||||||
|
Total debt securities
|
$
|
4,326
|
|
|
$
|
(84
|
)
|
|
$
|
484
|
|
|
$
|
(42
|
)
|
|
$
|
4,810
|
|
|
$
|
(126
|
)
|
|
|
Three months ended
September 30, |
|
Nine months ended
September 30, |
||||||||||||
|
|
2016
|
|
2015
|
|
2016
|
|
2015
|
||||||||
|
|
(in millions)
|
||||||||||||||
|
Gross realized gains
|
$
|
37
|
|
|
$
|
62
|
|
|
$
|
88
|
|
|
$
|
108
|
|
|
Gross realized losses
|
(11
|
)
|
|
(11
|
)
|
|
(23
|
)
|
|
(20
|
)
|
||||
|
Net realized capital gains
|
$
|
26
|
|
|
$
|
51
|
|
|
$
|
65
|
|
|
$
|
88
|
|
|
|
Amortized
Cost |
|
Fair
Value |
||||
|
|
(in millions)
|
||||||
|
Due within one year
|
$
|
611
|
|
|
$
|
610
|
|
|
Due after one year through five years
|
2,152
|
|
|
2,200
|
|
||
|
Due after five years through ten years
|
1,647
|
|
|
1,698
|
|
||
|
Due after ten years
|
2,629
|
|
|
2,858
|
|
||
|
Mortgage and asset-backed securities
|
2,207
|
|
|
2,236
|
|
||
|
Total debt securities
|
$
|
9,246
|
|
|
$
|
9,602
|
|
|
|
Fair Value Measurements Using
|
||||||||||||||
|
|
Fair
Value |
|
Quoted Prices
in Active Markets (Level 1) |
|
Other
Observable Inputs (Level 2) |
|
Unobservable
Inputs (Level 3) |
||||||||
|
|
(in millions)
|
||||||||||||||
|
September 30, 2016
|
|
|
|
|
|
|
|
||||||||
|
Cash equivalents
|
$
|
6,879
|
|
|
$
|
6,879
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
Debt securities:
|
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and other U.S. government
corporations and agencies: |
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and agency obligations
|
661
|
|
|
—
|
|
|
661
|
|
|
—
|
|
||||
|
Mortgage-backed securities
|
1,535
|
|
|
—
|
|
|
1,535
|
|
|
—
|
|
||||
|
Tax-exempt municipal securities
|
3,226
|
|
|
—
|
|
|
3,223
|
|
|
3
|
|
||||
|
Mortgage-backed securities:
|
|
|
|
|
|
|
|
||||||||
|
Residential
|
10
|
|
|
—
|
|
|
10
|
|
|
—
|
|
||||
|
Commercial
|
503
|
|
|
—
|
|
|
503
|
|
|
—
|
|
||||
|
Asset-backed securities
|
188
|
|
|
—
|
|
|
187
|
|
|
1
|
|
||||
|
Corporate debt securities
|
3,479
|
|
|
—
|
|
|
3,474
|
|
|
5
|
|
||||
|
Total debt securities
|
9,602
|
|
|
—
|
|
|
9,593
|
|
|
9
|
|
||||
|
Total invested assets
|
$
|
16,481
|
|
|
$
|
6,879
|
|
|
$
|
9,593
|
|
|
$
|
9
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
December 31, 2015
|
|
|
|
|
|
|
|
||||||||
|
Cash equivalents
|
$
|
2,229
|
|
|
$
|
2,229
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
Debt securities:
|
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and other U.S. government
corporations and agencies: |
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and agency obligations
|
332
|
|
|
—
|
|
|
332
|
|
|
—
|
|
||||
|
Mortgage-backed securities
|
1,891
|
|
|
—
|
|
|
1,891
|
|
|
—
|
|
||||
|
Tax-exempt municipal securities
|
2,668
|
|
|
—
|
|
|
2,663
|
|
|
5
|
|
||||
|
Mortgage-backed securities:
|
|
|
|
|
|
|
|
||||||||
|
Residential
|
13
|
|
|
—
|
|
|
13
|
|
|
—
|
|
||||
|
Commercial
|
985
|
|
|
—
|
|
|
985
|
|
|
—
|
|
||||
|
Asset-backed securities
|
263
|
|
|
—
|
|
|
263
|
|
|
—
|
|
||||
|
Corporate debt securities
|
2,958
|
|
|
—
|
|
|
2,952
|
|
|
6
|
|
||||
|
Total debt securities
|
9,110
|
|
|
—
|
|
|
9,099
|
|
|
11
|
|
||||
|
Total invested assets
|
$
|
11,339
|
|
|
$
|
2,229
|
|
|
$
|
9,099
|
|
|
$
|
11
|
|
|
|
For the three months ended September 30,
|
||||||||||||||||||||||
|
|
2016
|
|
2015
|
||||||||||||||||||||
|
|
Private
Placements |
|
Auction
Rate Securities |
|
Total
|
|
Private
Placements |
|
Auction
Rate Securities |
|
Total
|
||||||||||||
|
|
(in millions)
|
||||||||||||||||||||||
|
Beginning balance at July 1
|
$
|
6
|
|
|
$
|
3
|
|
|
$
|
9
|
|
|
$
|
6
|
|
|
$
|
5
|
|
|
$
|
11
|
|
|
Total gains or losses:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Realized in earnings
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||
|
Unrealized in other
comprehensive income |
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||
|
Purchases
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||
|
Sales
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||
|
Settlements
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||
|
Balance at September 30
|
$
|
6
|
|
|
$
|
3
|
|
|
$
|
9
|
|
|
$
|
6
|
|
|
$
|
5
|
|
|
$
|
11
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
|
For the nine months ended September 30,
|
||||||||||||||||||||||
|
|
2016
|
|
2015
|
||||||||||||||||||||
|
|
Private
Placements |
|
Auction
Rate Securities |
|
Total
|
|
Private
Placements |
|
Auction
Rate Securities |
|
Total
|
||||||||||||
|
|
(in millions)
|
||||||||||||||||||||||
|
Beginning balance at January 1
|
$
|
6
|
|
|
$
|
5
|
|
|
$
|
11
|
|
|
$
|
24
|
|
|
$
|
8
|
|
|
$
|
32
|
|
|
Total gains or losses:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Realized in earnings
|
—
|
|
|
—
|
|
|
—
|
|
|
(1
|
)
|
|
—
|
|
|
(1
|
)
|
||||||
|
Unrealized in other
comprehensive income |
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||
|
Purchases
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||
|
Sales
|
—
|
|
|
—
|
|
|
—
|
|
|
(17
|
)
|
|
(3
|
)
|
|
(20
|
)
|
||||||
|
Settlements
|
—
|
|
|
(2
|
)
|
|
(2
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||
|
Balance at September 30
|
$
|
6
|
|
|
$
|
3
|
|
|
$
|
9
|
|
|
$
|
6
|
|
|
$
|
5
|
|
|
$
|
11
|
|
|
|
September 30, 2016
|
|
December 31, 2015
|
||||||||||||
|
Risk
Corridor Settlement |
|
CMS
Subsidies/ Discounts |
|
Risk
Corridor Settlement |
|
CMS
Subsidies/ Discounts |
|||||||||
|
|
(in millions)
|
||||||||||||||
|
Other current assets
|
$
|
41
|
|
|
$
|
2,287
|
|
|
$
|
25
|
|
|
$
|
2,082
|
|
|
Trade accounts payable and accrued expenses
|
(43
|
)
|
|
(672
|
)
|
|
(47
|
)
|
|
(63
|
)
|
||||
|
Net current (liability) asset
|
(2
|
)
|
|
1,615
|
|
|
(22
|
)
|
|
2,019
|
|
||||
|
Other long-term assets
|
6
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
Other long-term liabilities
|
(40
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
Net long-term liability
|
(34
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
Total net (liability) asset
|
$
|
(36
|
)
|
|
$
|
1,615
|
|
|
$
|
(22
|
)
|
|
$
|
2,019
|
|
|
|
Premium Deficiency Reserve
|
||
|
|
(in millions)
|
||
|
Balance at January 1, 2016
|
$
|
176
|
|
|
Current period results applied to the PDR liability for the
2016 coverage year |
(178
|
)
|
|
|
Change in full year 2016 estimate recorded in benefits expense
|
208
|
|
|
|
Balance at September 30, 2016
|
$
|
206
|
|
|
|
September 30, 2016
|
|
December 31, 2015
|
||||||||||||||||||||||||
|
|
Risk Adjustment
Settlement |
|
Reinsurance
Recoverables |
|
Risk
Corridor Settlement |
|
Risk Adjustment
Settlement |
|
Reinsurance
Recoverables |
|
Risk
Corridor Settlement |
||||||||||||||||
|
|
(in millions)
|
||||||||||||||||||||||||||
|
Prior Coverage Years
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||||
|
Premiums receivable
|
$
|
54
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
126
|
|
|
$
|
—
|
|
|
$
|
—
|
|
||||
|
Other current assets
|
—
|
|
|
58
|
|
|
—
|
|
|
—
|
|
|
610
|
|
|
—
|
|
||||||||||
|
Trade accounts payable and
accrued expenses |
—
|
|
|
—
|
|
|
—
|
|
|
(223
|
)
|
|
—
|
|
|
—
|
|
||||||||||
|
Net current asset (liability)
|
54
|
|
|
58
|
|
|
—
|
|
|
(97
|
)
|
|
610
|
|
|
—
|
|
||||||||||
|
Other long-term assets
|
—
|
|
|
—
|
|
|
423
|
|
|
10
|
|
|
—
|
|
|
459
|
|
||||||||||
|
Total prior coverage years' net
asset (liability) |
54
|
|
|
58
|
|
|
423
|
|
|
(87
|
)
|
|
610
|
|
|
459
|
|
||||||||||
|
Current Coverage Year
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Trade accounts payable and
accrued expenses |
(107
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||||||
|
Other long-term assets
|
197
|
|
|
157
|
|
|
168
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||||||
|
Total 2016 coverage year net
asset |
90
|
|
|
157
|
|
|
168
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||||||
|
Total net asset (liability)
|
$
|
144
|
|
|
$
|
215
|
|
|
$
|
591
|
|
|
$
|
(87
|
)
|
|
$
|
610
|
|
|
$
|
459
|
|
||||
|
|
Retail
|
|
Group
|
|
Healthcare
Services |
|
Total
|
||||||||
|
|
(in millions)
|
||||||||||||||
|
Balance at January 1, 2016
|
$
|
1,069
|
|
|
$
|
385
|
|
|
$
|
1,811
|
|
|
$
|
3,265
|
|
|
Acquisitions
|
—
|
|
|
—
|
|
|
7
|
|
|
7
|
|
||||
|
Balance at September 30, 2016
|
$
|
1,069
|
|
|
$
|
385
|
|
|
$
|
1,818
|
|
|
$
|
3,272
|
|
|
|
|
|
September 30, 2016
|
|
December 31, 2015
|
||||||||||||||||||||
|
|
Weighted
Average Life |
|
Cost
|
|
Accumulated
Amortization |
|
Net
|
|
Cost
|
|
Accumulated
Amortization |
|
Net
|
||||||||||||
|
|
|
|
($ in millions)
|
||||||||||||||||||||||
|
Other intangible assets:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Customer contracts/
relationships |
9.8 yrs
|
|
$
|
566
|
|
|
$
|
333
|
|
|
$
|
233
|
|
|
$
|
566
|
|
|
$
|
292
|
|
|
$
|
274
|
|
|
Trade names and
technology |
8.3 yrs
|
|
104
|
|
|
66
|
|
|
38
|
|
|
104
|
|
|
54
|
|
|
50
|
|
||||||
|
Provider contracts
|
14.5 yrs
|
|
51
|
|
|
28
|
|
|
23
|
|
|
51
|
|
|
24
|
|
|
27
|
|
||||||
|
Noncompetes and
other |
8.2 yrs
|
|
32
|
|
|
28
|
|
|
4
|
|
|
32
|
|
|
26
|
|
|
6
|
|
||||||
|
Total other intangible
assets |
9.8 yrs
|
|
$
|
753
|
|
|
$
|
455
|
|
|
$
|
298
|
|
|
$
|
753
|
|
|
$
|
396
|
|
|
$
|
357
|
|
|
|
(in millions)
|
||
|
For the years ending December 31,:
|
|
||
|
2016
|
$
|
77
|
|
|
2017
|
71
|
|
|
|
2018
|
63
|
|
|
|
2019
|
52
|
|
|
|
2020
|
48
|
|
|
|
2021
|
14
|
|
|
|
|
Three months ended September 30,
|
|
Nine months ended September 30,
|
||||||||||||
|
|
2016
|
|
2015
|
|
2016
|
|
2015
|
||||||||
|
|
(dollars in millions, except per common share results; number of shares in thousands)
|
||||||||||||||
|
Net income available for common stockholders
|
$
|
450
|
|
|
$
|
314
|
|
|
$
|
1,015
|
|
|
$
|
1,175
|
|
|
Weighted average outstanding shares of common stock
used to compute basic earnings per common share |
149,417
|
|
|
148,889
|
|
|
149,321
|
|
|
149,617
|
|
||||
|
Dilutive effect of:
|
|
|
|
|
|
|
|
||||||||
|
Employee stock options
|
210
|
|
|
182
|
|
|
216
|
|
|
198
|
|
||||
|
Restricted stock
|
1,277
|
|
|
1,395
|
|
|
1,332
|
|
|
1,506
|
|
||||
|
Shares used to compute diluted earnings per common share
|
150,904
|
|
|
150,466
|
|
|
150,869
|
|
|
151,321
|
|
||||
|
Basic earnings per common share
|
$
|
3.01
|
|
|
$
|
2.11
|
|
|
$
|
6.80
|
|
|
$
|
7.85
|
|
|
Diluted earnings per common share
|
$
|
2.98
|
|
|
$
|
2.09
|
|
|
$
|
6.73
|
|
|
$
|
7.77
|
|
|
Number of antidilutive stock options and restricted stock
excluded from computation |
658
|
|
|
320
|
|
|
873
|
|
|
451
|
|
||||
|
Record
Date |
|
Payment
Date |
|
Amount
per Share |
|
Total
Amount |
||||
|
|
|
|
|
|
|
(in millions)
|
||||
|
2015 payments
|
|
|
|
|
|
|
||||
|
12/31/2014
|
|
1/30/2015
|
|
$
|
0.28
|
|
|
$
|
42
|
|
|
3/31/2015
|
|
4/24/2015
|
|
$
|
0.28
|
|
|
$
|
42
|
|
|
6/30/2015
|
|
7/31/2015
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
9/30/2015
|
|
10/30/2015
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
2016 payments
|
|
|
|
|
|
|
||||
|
12/30/2015
|
|
1/29/2016
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
3/31/2016
|
|
4/29/2016
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
6/30/2016
|
|
7/29/2016
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
10/13/2016
|
|
10/28/2016
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
|
September 30, 2016
|
|
December 31, 2015
|
||||
|
|
(in millions)
|
||||||
|
Senior notes:
|
|
|
|
||||
|
$500 million, 7.20% due June 15, 2018
|
$
|
501
|
|
|
$
|
502
|
|
|
$300 million, 6.30% due August 1, 2018
|
305
|
|
|
307
|
|
||
|
$400 million, 2.625% due October 1, 2019
|
398
|
|
|
398
|
|
||
|
$600 million, 3.15% due December 1, 2022
|
595
|
|
|
595
|
|
||
|
$600 million, 3.85% due October 1, 2024
|
595
|
|
|
595
|
|
||
|
$250 million, 8.15% due June 15, 2038
|
263
|
|
|
263
|
|
||
|
$400 million, 4.625% due December 1, 2042
|
396
|
|
|
396
|
|
||
|
$750 million, 4.95% due October 1, 2044
|
739
|
|
|
738
|
|
||
|
Total long-term debt
|
$
|
3,792
|
|
|
$
|
3,794
|
|
|
|
Retail
|
|
Group
|
|
Healthcare
Services |
|
Other
Businesses |
|
Eliminations/
Corporate |
|
Consolidated
|
||||||||||||
|
|
(in millions)
|
||||||||||||||||||||||
|
Three months ended September 30, 2016
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||
|
Revenues - external customers
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Premiums:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Individual Medicare Advantage
|
$
|
7,977
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
7,977
|
|
|
Group Medicare Advantage
|
1,067
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
1,067
|
|
||||||
|
Medicare stand-alone PDP
|
1,004
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
1,004
|
|
||||||
|
Total Medicare
|
10,048
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
10,048
|
|
||||||
|
Fully-insured
|
991
|
|
|
1,350
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
2,341
|
|
||||||
|
Specialty
|
65
|
|
|
253
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
318
|
|
||||||
|
Medicaid and other
|
652
|
|
|
2
|
|
|
—
|
|
|
10
|
|
|
—
|
|
|
664
|
|
||||||
|
Total premiums
|
11,756
|
|
|
1,605
|
|
|
—
|
|
|
10
|
|
|
—
|
|
|
13,371
|
|
||||||
|
Services revenue:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Provider
|
—
|
|
|
12
|
|
|
57
|
|
|
—
|
|
|
—
|
|
|
69
|
|
||||||
|
ASO and other
|
3
|
|
|
146
|
|
|
—
|
|
|
1
|
|
|
—
|
|
|
150
|
|
||||||
|
Pharmacy
|
—
|
|
|
—
|
|
|
8
|
|
|
—
|
|
|
—
|
|
|
8
|
|
||||||
|
Total services revenue
|
3
|
|
|
158
|
|
|
65
|
|
|
1
|
|
|
—
|
|
|
227
|
|
||||||
|
Total revenues - external customers
|
11,759
|
|
|
1,763
|
|
|
65
|
|
|
11
|
|
|
—
|
|
|
13,598
|
|
||||||
|
Intersegment revenues
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Services
|
—
|
|
|
23
|
|
|
4,708
|
|
|
—
|
|
|
(4,731
|
)
|
|
—
|
|
||||||
|
Products
|
—
|
|
|
—
|
|
|
1,580
|
|
|
—
|
|
|
(1,580
|
)
|
|
—
|
|
||||||
|
Total intersegment revenues
|
—
|
|
|
23
|
|
|
6,288
|
|
|
—
|
|
|
(6,311
|
)
|
|
—
|
|
||||||
|
Investment income
|
25
|
|
|
4
|
|
|
8
|
|
|
17
|
|
|
42
|
|
|
96
|
|
||||||
|
Total revenues
|
11,784
|
|
|
1,790
|
|
|
6,361
|
|
|
28
|
|
|
(6,269
|
)
|
|
13,694
|
|
||||||
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Benefits
|
9,771
|
|
|
1,327
|
|
|
—
|
|
|
26
|
|
|
(224
|
)
|
|
10,900
|
|
||||||
|
Operating costs
|
1,308
|
|
|
430
|
|
|
6,040
|
|
|
4
|
|
|
(6,023
|
)
|
|
1,759
|
|
||||||
|
Depreciation and amortization
|
61
|
|
|
21
|
|
|
33
|
|
|
—
|
|
|
(29
|
)
|
|
86
|
|
||||||
|
Total operating expenses
|
11,140
|
|
|
1,778
|
|
|
6,073
|
|
|
30
|
|
|
(6,276
|
)
|
|
12,745
|
|
||||||
|
Income (loss) from operations
|
644
|
|
|
12
|
|
|
288
|
|
|
(2
|
)
|
|
7
|
|
|
949
|
|
||||||
|
Interest expense
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
47
|
|
|
47
|
|
||||||
|
Income (loss) before income taxes
|
$
|
644
|
|
|
$
|
12
|
|
|
$
|
288
|
|
|
$
|
(2
|
)
|
|
$
|
(40
|
)
|
|
$
|
902
|
|
|
|
Retail
|
|
Group
|
|
Healthcare
Services |
|
Other
Businesses |
|
Eliminations/
Corporate |
|
Consolidated
|
||||||||||||
|
|
(in millions)
|
||||||||||||||||||||||
|
Three months ended September 30, 2015
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||
|
Revenues - external customers
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Premiums:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Individual Medicare Advantage
|
$
|
7,316
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
7,316
|
|
|
Group Medicare Advantage
|
1,396
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
1,396
|
|
||||||
|
Medicare stand-alone PDP
|
927
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
927
|
|
||||||
|
Total Medicare
|
9,639
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
9,639
|
|
||||||
|
Fully-insured
|
1,056
|
|
|
1,362
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
2,418
|
|
||||||
|
Specialty
|
66
|
|
|
260
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
326
|
|
||||||
|
Medicaid and other
|
592
|
|
|
6
|
|
|
—
|
|
|
6
|
|
|
—
|
|
|
604
|
|
||||||
|
Total premiums
|
11,353
|
|
|
1,628
|
|
|
—
|
|
|
6
|
|
|
—
|
|
|
12,987
|
|
||||||
|
Services revenue:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Provider
|
—
|
|
|
9
|
|
|
61
|
|
|
—
|
|
|
—
|
|
|
70
|
|
||||||
|
ASO and other
|
1
|
|
|
162
|
|
|
—
|
|
|
5
|
|
|
—
|
|
|
168
|
|
||||||
|
Pharmacy
|
—
|
|
|
—
|
|
|
8
|
|
|
—
|
|
|
—
|
|
|
8
|
|
||||||
|
Total services revenue
|
1
|
|
|
171
|
|
|
69
|
|
|
5
|
|
|
—
|
|
|
246
|
|
||||||
|
Total revenues - external customers
|
11,354
|
|
|
1,799
|
|
|
69
|
|
|
11
|
|
|
—
|
|
|
13,233
|
|
||||||
|
Intersegment revenues
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Services
|
—
|
|
|
24
|
|
|
4,558
|
|
|
—
|
|
|
(4,582
|
)
|
|
—
|
|
||||||
|
Products
|
—
|
|
|
—
|
|
|
1,271
|
|
|
—
|
|
|
(1,271
|
)
|
|
—
|
|
||||||
|
Total intersegment revenues
|
—
|
|
|
24
|
|
|
5,829
|
|
|
—
|
|
|
(5,853
|
)
|
|
—
|
|
||||||
|
Investment income
|
38
|
|
|
7
|
|
|
—
|
|
|
16
|
|
|
69
|
|
|
130
|
|
||||||
|
Total revenues
|
11,392
|
|
|
1,830
|
|
|
5,898
|
|
|
27
|
|
|
(5,784
|
)
|
|
13,363
|
|
||||||
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Benefits
|
9,777
|
|
|
1,341
|
|
|
—
|
|
|
22
|
|
|
(244
|
)
|
|
10,896
|
|
||||||
|
Operating costs
|
1,241
|
|
|
426
|
|
|
5,584
|
|
|
3
|
|
|
(5,566
|
)
|
|
1,688
|
|
||||||
|
Depreciation and amortization
|
49
|
|
|
24
|
|
|
30
|
|
|
—
|
|
|
(19
|
)
|
|
84
|
|
||||||
|
Total operating expenses
|
11,067
|
|
|
1,791
|
|
|
5,614
|
|
|
25
|
|
|
(5,829
|
)
|
|
12,668
|
|
||||||
|
Income from operations
|
325
|
|
|
39
|
|
|
284
|
|
|
2
|
|
|
45
|
|
|
695
|
|
||||||
|
Interest expense
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
47
|
|
|
47
|
|
||||||
|
Income (loss) before income taxes
|
$
|
325
|
|
|
$
|
39
|
|
|
$
|
284
|
|
|
$
|
2
|
|
|
$
|
(2
|
)
|
|
$
|
648
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
|
Retail
|
|
Group
|
|
Healthcare
Services |
|
Other
Businesses |
|
Eliminations/
Corporate |
|
Consolidated
|
||||||||||||
|
|
(in millions)
|
||||||||||||||||||||||
|
Nine months ended September 30, 2016
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||
|
Revenues - external customers
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Premiums:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Individual Medicare Advantage
|
$
|
24,054
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
24,054
|
|
|
Group Medicare Advantage
|
3,229
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
3,229
|
|
||||||
|
Medicare stand-alone PDP
|
3,058
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
3,058
|
|
||||||
|
Total Medicare
|
30,341
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
30,341
|
|
||||||
|
Fully-insured
|
3,118
|
|
|
4,044
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
7,162
|
|
||||||
|
Specialty
|
196
|
|
|
761
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
957
|
|
||||||
|
Medicaid and other
|
1,960
|
|
|
12
|
|
|
—
|
|
|
29
|
|
|
—
|
|
|
2,001
|
|
||||||
|
Total premiums
|
35,615
|
|
|
4,817
|
|
|
—
|
|
|
29
|
|
|
—
|
|
|
40,461
|
|
||||||
|
Services revenue:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Provider
|
—
|
|
|
38
|
|
|
176
|
|
|
—
|
|
|
—
|
|
|
214
|
|
||||||
|
ASO and other
|
7
|
|
|
499
|
|
|
—
|
|
|
7
|
|
|
—
|
|
|
513
|
|
||||||
|
Pharmacy
|
—
|
|
|
—
|
|
|
22
|
|
|
—
|
|
|
—
|
|
|
22
|
|
||||||
|
Total services revenue
|
7
|
|
|
537
|
|
|
198
|
|
|
7
|
|
|
—
|
|
|
749
|
|
||||||
|
Total revenues - external customers
|
35,622
|
|
|
5,354
|
|
|
198
|
|
|
36
|
|
|
—
|
|
|
41,210
|
|
||||||
|
Intersegment revenues
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Services
|
—
|
|
|
67
|
|
|
14,198
|
|
|
—
|
|
|
(14,265
|
)
|
|
—
|
|
||||||
|
Products
|
—
|
|
|
—
|
|
|
4,373
|
|
|
—
|
|
|
(4,373
|
)
|
|
—
|
|
||||||
|
Total intersegment revenues
|
—
|
|
|
67
|
|
|
18,571
|
|
|
—
|
|
|
(18,638
|
)
|
|
—
|
|
||||||
|
Investment income
|
77
|
|
|
13
|
|
|
22
|
|
|
48
|
|
|
131
|
|
|
291
|
|
||||||
|
Total revenues
|
35,699
|
|
|
5,434
|
|
|
18,791
|
|
|
84
|
|
|
(18,507
|
)
|
|
41,501
|
|
||||||
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Benefits
|
30,581
|
|
|
3,794
|
|
|
—
|
|
|
82
|
|
|
(651
|
)
|
|
33,806
|
|
||||||
|
Operating costs
|
3,825
|
|
|
1,300
|
|
|
17,894
|
|
|
12
|
|
|
(17,778
|
)
|
|
5,253
|
|
||||||
|
Depreciation and amortization
|
175
|
|
|
69
|
|
|
97
|
|
|
—
|
|
|
(78
|
)
|
|
263
|
|
||||||
|
Total operating expenses
|
34,581
|
|
|
5,163
|
|
|
17,991
|
|
|
94
|
|
|
(18,507
|
)
|
|
39,322
|
|
||||||
|
Income (loss) from operations
|
1,118
|
|
|
271
|
|
|
800
|
|
|
(10
|
)
|
|
—
|
|
|
2,179
|
|
||||||
|
Interest expense
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
141
|
|
|
141
|
|
||||||
|
Income (loss) before income taxes
|
$
|
1,118
|
|
|
$
|
271
|
|
|
$
|
800
|
|
|
$
|
(10
|
)
|
|
$
|
(141
|
)
|
|
$
|
2,038
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
|
Retail
|
|
Group
|
|
Healthcare
Services |
|
Other
Businesses |
|
Eliminations/
Corporate |
|
Consolidated
|
||||||||||||
|
|
(in millions)
|
||||||||||||||||||||||
|
Nine months ended September 30, 2015
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||
|
Revenues - external customers
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Premiums:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Individual Medicare Advantage
|
$
|
22,183
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
22,183
|
|
|
Group Medicare Advantage
|
4,188
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
4,188
|
|
||||||
|
Medicare stand-alone PDP
|
2,915
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
2,915
|
|
||||||
|
Total Medicare
|
29,286
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
29,286
|
|
||||||
|
Fully-insured
|
3,263
|
|
|
4,125
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
7,388
|
|
||||||
|
Specialty
|
195
|
|
|
795
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
990
|
|
||||||
|
Medicaid and other
|
1,742
|
|
|
16
|
|
|
—
|
|
|
25
|
|
|
—
|
|
|
1,783
|
|
||||||
|
Total premiums
|
34,486
|
|
|
4,936
|
|
|
—
|
|
|
25
|
|
|
—
|
|
|
39,447
|
|
||||||
|
Services revenue:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Provider
|
—
|
|
|
29
|
|
|
590
|
|
|
—
|
|
|
—
|
|
|
619
|
|
||||||
|
ASO and other
|
7
|
|
|
485
|
|
|
—
|
|
|
10
|
|
|
—
|
|
|
502
|
|
||||||
|
Pharmacy
|
—
|
|
|
—
|
|
|
22
|
|
|
—
|
|
|
—
|
|
|
22
|
|
||||||
|
Total services revenue
|
7
|
|
|
514
|
|
|
612
|
|
|
10
|
|
|
—
|
|
|
1,143
|
|
||||||
|
Total revenues - external customers
|
34,493
|
|
|
5,450
|
|
|
612
|
|
|
35
|
|
|
—
|
|
|
40,590
|
|
||||||
|
Intersegment revenues
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Services
|
—
|
|
|
68
|
|
|
13,357
|
|
|
—
|
|
|
(13,425
|
)
|
|
—
|
|
||||||
|
Products
|
—
|
|
|
—
|
|
|
3,654
|
|
|
—
|
|
|
(3,654
|
)
|
|
—
|
|
||||||
|
Total intersegment revenues
|
—
|
|
|
68
|
|
|
17,011
|
|
|
—
|
|
|
(17,079
|
)
|
|
—
|
|
||||||
|
Investment income
|
96
|
|
|
18
|
|
|
—
|
|
|
53
|
|
|
171
|
|
|
338
|
|
||||||
|
Total revenues
|
34,589
|
|
|
5,536
|
|
|
17,623
|
|
|
88
|
|
|
(16,908
|
)
|
|
40,928
|
|
||||||
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Benefits
|
29,781
|
|
|
3,908
|
|
|
—
|
|
|
66
|
|
|
(602
|
)
|
|
33,153
|
|
||||||
|
Operating costs
|
3,708
|
|
|
1,323
|
|
|
16,774
|
|
|
10
|
|
|
(16,365
|
)
|
|
5,450
|
|
||||||
|
Depreciation and amortization
|
140
|
|
|
69
|
|
|
112
|
|
|
—
|
|
|
(54
|
)
|
|
267
|
|
||||||
|
Total operating expenses
|
33,629
|
|
|
5,300
|
|
|
16,886
|
|
|
76
|
|
|
(17,021
|
)
|
|
38,870
|
|
||||||
|
Income from operations
|
960
|
|
|
236
|
|
|
737
|
|
|
12
|
|
|
113
|
|
|
2,058
|
|
||||||
|
Gain on sale of business
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
267
|
|
|
267
|
|
||||||
|
Interest expense
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
140
|
|
|
140
|
|
||||||
|
Income before income taxes
|
$
|
960
|
|
|
$
|
236
|
|
|
$
|
737
|
|
|
$
|
12
|
|
|
$
|
240
|
|
|
$
|
2,185
|
|
|
•
|
Our pretax results for the
three and nine months ended September 30, 2016
as compared to the
three and nine months ended September 30, 2015
reflect year-over-year improvements in pretax results in our Retail and Healthcare Services segments excluding the impact of the sale of Concentra and the continued challenges in our individual commercial medical business.
|
|
•
|
Our 2016 results through
September 30, 2016
reflect the continued implementation of our strategy to offer our members affordable health care combined with a positive consumer experience in growing markets. At the core of this strategy is our integrated care delivery model, which unites quality care, high member engagement, and sophisticated data analytics. Our approach to primary, physician-directed care for our members aims to provide quality care that is consistent, integrated, cost-effective, and member-focused, provided by both employed physicians and physicians with network contract arrangements. The model is designed to improve health outcomes and affordability for individuals and for the health system as a whole, while offering our members a simple, seamless healthcare experience. We believe this strategy is positioning us for long-term growth in both membership and earnings. We offer providers a continuum of opportunities to increase the integration of care and offer assistance to providers in transitioning from a fee-for-service to a value-based arrangement. These include performance bonuses, shared savings and shared risk relationships. At
September 30, 2016
, approximately
1,786,100
members, or
63.1%
, of our individual Medicare Advantage members were in value-based relationships under our integrated care delivery model, as compared to
1,633,100
members, or
59.3%
, at
December 31, 2015
and
1,606,100
members, or
58.7%
, at
September 30, 2015
.
|
|
•
|
For the year-to-date period, year-over-year comparisons of results are impacted by the June 1, 2015
sale of our former wholly owned subsidiary, Concentra Inc., or Concentra, to MJ Acquisition Corporation, a joint venture between Select Medical Holdings Corporation and Welsh, Carson, Anderson & Stowe XII, L.P., a private equity fund, for approximately
$1,055 million
in cash, excluding approximately
$22 million
of transaction costs.
In connection with the sale, we recognized a pretax gain, net of transaction costs, of
$270 million
, or
$1.57
per diluted common share in
2015
.
|
|
•
|
For the year-to-date period, year-over-year comparisons of results are also impacted by the recognition of a premium deficiency reserve for our individual commercial medical business for the 2016 coverage year as discussed in the Retail segment highlights. During the
nine months ended September 30, 2016
we increased the premium deficiency reserve by
$208 million
, or
$0.86
per diluted common share.
|
|
•
|
Likewise, for the year-to-date period, year-over-year comparisons of the benefit ratios are impacted by the recognition of the premium deficiency reserve for our individual commercial medical business.
|
|
•
|
We recorded transaction and integration costs in connection with the Merger of approximately
$20 million
, or
$0.12
per diluted common shares, and
$81 million
, or
$0.49
per diluted common share, during the
three and nine months ended September 30, 2016
, respectively. During the
three and nine months ended September 30, 2015
we recorded transaction costs in connection with the Merger of approximately
$11 million
, or
$0.07
per diluted common share. Certain costs associated with the Merger are not deductible for tax purposes.
|
|
•
|
As disclosed in Note 2 to the condensed consolidated financial statements included in this report, we elected to early adopt new accounting guidance related to accounting for employee share-based payments, which changes how income tax effects of employee share-based payments are recorded. We adopted this guidance prospectively effective January 1, 2016. The adoption of this new guidance resulted in the recognition of approximately $20 million of tax benefits in net income, or $0.12 per diluted common share, in the first quarter of 2016.
|
|
•
|
During the
nine months ended September 30, 2016
, operating cash flow provided by operations was
$4.7 billion
as compared to
$531 million
for the
nine months ended September 30, 2015
.
Our operating cash flows for the
nine months ended September 30, 2016
were significantly impacted by the early receipt of the Medicare
|
|
•
|
In
2016
, we paid the federal government
$916 million
for the annual non-deductible health insurance industry fee compared to our payment of
$867 million
in 2015. This fee is not deductible for tax purposes, which significantly increases our effective income tax rate. The health insurance industry fee is further described below under the section titled “Health Care Reform.”
The Consolidated Appropriations Act, 2016, enacted on December 18, 2015, included a one-time one year suspension in 2017 of the health insurer fee.
This will significantly reduce our operating costs and effective tax rate in 2017.
|
|
•
|
During the
nine months ended September 30, 2016
, we paid dividends to stockholders of
$133 million
.
|
|
•
|
On April 4, 2016, CMS announced final 2017 Medicare benchmark payment rates and related technical factors impacting the bid benchmark premiums, which we refer to as the Final Rate Notice. We believe the Final Rate Notice, together with the impact of payment cuts associated with the Health Care Reform Law, quality bonuses, risk coding modifications, Star ratings for 2017, and other funding formula changes, indicate 2017 Medicare Advantage funding decreases for us of approximately 1.3% on average. Although the overall rate adjustment is negative, geographic-specific impacts may vary significantly from this average. The beneficial effect of the temporary suspension of the health insurer fee for 2017 discussed above is not reflected in our estimate for our 2017 rate changes. We believe our 2017 Medicare Advantage plan filings, including the applicable level of rate changes, will remain competitive compared to both the combination of original Medicare with a supplement policy and Medicare Advantage products offered by our competitors. Failure to execute these strategies may result in a material adverse effect on our results of operations, financial position, and cash flows.
|
|
•
|
The achievement of Star Ratings of four or higher qualifies Medicare Advantage plans for premium bonuses. Star Ratings for the 2018 bonus year issued by CMS in October 2016 indicated that the percentage of our July 31, 2016 Medicare Advantage membership in 4-Star plans or higher declined to approximately 37% from approximately 78% of our July 31, 2015 Medicare Advantage membership. The decline in membership in 4-Star rated plans does not take into account certain operational actions we intend to take over the coming months to mitigate any potential negative impact of these published ratings on Star bonus revenues for 2018, including evaluation of our contract structures. Star results for the 2018 bonus year are not expected to materially impact our Medicare revenue or membership growth for 2017.
|
|
•
|
For the
three months ended September 30, 2016
, our Retail segment pretax income
increase
d by
$319 million
, or
98.2%
, as compared to the
three months ended September 30, 2015
and
increase
d
$158 million
, or
16.5%
, for the
nine months ended September 30, 2016
as compared to the
nine months ended September 30, 2015
. These changes reflect year-over-year improvement in results across most business lines in the segment, partially offset by the loss of a large profitable group Medicare Advantage account as discussed below. In the year-to-date period, these improved results are partially offset by a year-over-year decline in results for our individual commercial medical business as discussed in the detailed segment results of operations discussion that follows.
|
|
•
|
Our Medicare Advantage results improved year-over-year primarily due to lower utilization and favorable year-over-year comparisons of prior-period medical claims reserve development. Operational initiatives centered around expanding the number of members in our clinical programs through improved outreach efforts and member engagement, as well as optimizing the performance of existing initiatives to reduce medical cost trend. In addition our Medicare Advantage membership increased year-over-year as discussed below.
|
|
•
|
Individual Medicare Advantage membership of
2,831,700
at
September 30, 2016
increased
78,300
, or
2.8%
, from
December 31, 2015
and
94,600
members, or
3.5%
from
September 30, 2015
. Medicare stand-alone PDP membership of
4,913,400
at
September 30, 2016
increased
355,500
members, or
7.8%
, from
December 31, 2015
and
403,800
members, or
9.0%
, from
September 30, 2015
. These increases in membership reflect net membership additions for the 2016 plan year, particularly for our Medicare Advantage Health Maintenance Organization, or HMO, offerings and our Medicare stand-alone PDP Humana-Walmart plan offering.
|
|
•
|
Group Medicare Advantage membership of
353,900
at
September 30, 2016
decreased
130,200
members, or
26.9%
, from
December 31, 2015
and
127,400
members, or
26.5%
, from
September 30, 2015
, primarily reflecting
the loss of a large account that moved to a private exchange offering on January 1, 2016.
|
|
•
|
Our state-based Medicaid membership of
390,100
as of
September 30, 2016
increased
16,400
members, or
4.4%
, from
December 31, 2015
and
21,700
members, or
5.9%
, from
September 30, 2015
, primarily due to
the addition of members under our Florida Medicaid contracts.
|
|
•
|
Operating results for our individual commercial medical business compliant with the Health Care Reform Law have been challenged. As disclosed in our 2015 Form 10-K, as a result of our assessment of the profitability of our individual medical policies compliant with the Health Care Reform Law, in the fourth quarter of
2015
, we recorded a provision for probable future losses (premium deficiency reserve) for the 2016 coverage year of
$176 million
. As discussed previously, during the
nine months ended September 30, 2016
we increased the premium deficiency reserve for the 2016 coverage year by
$208 million
, primarily as a result of unfavorable current and projected claims experience. As of
September 30, 2016
, the remaining premium deficiency reserve was
$206 million
.
|
|
•
|
Individual commercial medical membership of
726,200
at
September 30, 2016
decreased
172,900
members, or
19.2%
, from
December 31, 2015
and
decreased
237,500
members, or
24.6%
, from
September 30, 2015
. These decreases primarily reflect the loss of both members in plans compliant with the Health Care Reform Law, primarily on-exchange, as well as members subscribing to plans that are not compliant with the Health Care Reform Law as discussed further in the results of operations discussion that follows. At
September 30, 2016
, individual commercial medical membership in plans compliant with the Health Care Reform Law, both on-exchange and off-exchange, was
641,400
members, a
decrease
of
116,500
members, or
15.4%
, from
December 31, 2015
and
173,000
members, or
21.2%
, from
September 30, 2015
.
|
|
•
|
For the
three and nine months ended September 30, 2016
, our Group segment pretax income
decreased
$27 million
, or
69.2%
, and increased
$35 million
, or
14.8%
, respectively, as compared to the
three and nine months ended September 30, 2015
, respectively, as discussed in the results of operations discussion that follows.
|
|
•
|
On July 21, 2016, we were notified by the Defense Health Agency that we were awarded the TRICARE East Region contract. Our current TRICARE South Region contract expires March 31, 2017. The new East Region is a combination of the current North Region and South Region.
The next generation East Region and West Region contract awards are currently subject to protests before the Government Accountability Office, or GAO, by unsuccessful bidders.
|
|
•
|
As noted previously, for the year-to-date period, year-over-year comparisons of results of operations are impacted by the completion of the sale of Concentra on June 1, 2015.
|
|
•
|
As discussed in the detailed Healthcare Services segment results of operations discussion that follows, our Healthcare Services segment pretax income increased
$4 million
, or
1.4%
, and
$63 million
, or
8.5%
, for the
three and nine months ended September 30, 2016
, respectively, as compared to the
three and nine months ended September 30, 2015
, respectively, primarily due to
incremental earnings associated with revenue growth from our pharmacy solutions and home based services businesses as they serve our growing individual Medicare membership
.
|
|
•
|
Programs to enhance the quality of care for members are key elements of our integrated care delivery model. We have accelerated our process for identifying and reaching out to members in need of clinical intervention. Medicare Advantage membership with complex chronic conditions in the Humana Chronic Care Program rose to approximately
614,700
at
September 30, 2016
, an increase of
12.2%
from
September 30, 2015
and
4.1%
from
December 31, 2015
, reflecting a greater focus on members living with the most chronic conditions. Enhanced predictive modeling capabilities and proactive clinical outreach and engagement of those members helped drive increased clinical program participation, offset by the loss of engaged members associated with the group Medicare Advantage account that termed on January 1, 2016 as discussed previously. We believe these initiatives lead to better health outcomes for our members and lower health care costs.
|
|
|
|
|
|
|
|
|
|
|||||||
|
|
For the three months ended September 30,
|
|
Change
|
|||||||||||
|
|
2016
|
|
2015
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(dollars in millions, except per common share results)
|
|
|
|||||||||||
|
Revenues:
|
|
|
|
|
|
|
|
|||||||
|
Premiums:
|
|
|
|
|
|
|
|
|||||||
|
Retail
|
$
|
11,756
|
|
|
$
|
11,353
|
|
|
$
|
403
|
|
|
3.5
|
%
|
|
Group
|
1,605
|
|
|
1,628
|
|
|
(23
|
)
|
|
(1.4
|
)%
|
|||
|
Other Businesses
|
10
|
|
|
6
|
|
|
4
|
|
|
66.7
|
%
|
|||
|
Total premiums
|
13,371
|
|
|
12,987
|
|
|
384
|
|
|
3.0
|
%
|
|||
|
Services:
|
|
|
|
|
|
|
|
|||||||
|
Retail
|
3
|
|
|
1
|
|
|
2
|
|
|
200.0
|
%
|
|||
|
Group
|
158
|
|
|
171
|
|
|
(13
|
)
|
|
(7.6
|
)%
|
|||
|
Healthcare Services
|
65
|
|
|
69
|
|
|
(4
|
)
|
|
(5.8
|
)%
|
|||
|
Other Businesses
|
1
|
|
|
5
|
|
|
(4
|
)
|
|
(80.0
|
)%
|
|||
|
Total services
|
227
|
|
|
246
|
|
|
(19
|
)
|
|
(7.7
|
)%
|
|||
|
Investment income
|
96
|
|
|
130
|
|
|
(34
|
)
|
|
(26.2
|
)%
|
|||
|
Total revenues
|
13,694
|
|
|
13,363
|
|
|
331
|
|
|
2.5
|
%
|
|||
|
Operating expenses:
|
|
|
|
|
|
|
|
|||||||
|
Benefits
|
10,900
|
|
|
10,896
|
|
|
4
|
|
|
—
|
%
|
|||
|
Operating costs
|
1,759
|
|
|
1,688
|
|
|
71
|
|
|
4.2
|
%
|
|||
|
Depreciation and amortization
|
86
|
|
|
84
|
|
|
2
|
|
|
2.4
|
%
|
|||
|
Total operating expenses
|
12,745
|
|
|
12,668
|
|
|
77
|
|
|
0.6
|
%
|
|||
|
Income from operations
|
949
|
|
|
695
|
|
|
254
|
|
|
36.5
|
%
|
|||
|
Interest expense
|
47
|
|
|
47
|
|
|
—
|
|
|
—
|
%
|
|||
|
Income before income taxes
|
902
|
|
|
648
|
|
|
254
|
|
|
39.2
|
%
|
|||
|
Provision for income taxes
|
452
|
|
|
334
|
|
|
118
|
|
|
35.3
|
%
|
|||
|
Net income
|
$
|
450
|
|
|
$
|
314
|
|
|
$
|
136
|
|
|
43.3
|
%
|
|
Diluted earnings per common share
|
$
|
2.98
|
|
|
$
|
2.09
|
|
|
$
|
0.89
|
|
|
42.6
|
%
|
|
Benefit ratio
(a)
|
81.5
|
%
|
|
83.9
|
%
|
|
|
|
(2.4
|
)%
|
||||
|
Operating cost ratio
(b)
|
12.9
|
%
|
|
12.8
|
%
|
|
|
|
0.1
|
%
|
||||
|
Effective tax rate
|
50.1
|
%
|
|
51.5
|
%
|
|
|
|
(1.4
|
)%
|
||||
|
(a)
|
Represents total benefits expense as a percentage of premiums revenue.
|
|
(b)
|
Represents total operating costs, excluding depreciation and amortization, as a percentage of total revenues less investment income.
|
|
|
|
|
|
|
|
|
|
|||||||
|
|
For the nine months ended
September 30, |
|
Change
|
|||||||||||
|
|
2016
|
|
2015
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(dollars in millions, except per common share results)
|
|
|
|||||||||||
|
Revenues:
|
|
|
|
|
|
|
|
|||||||
|
Premiums:
|
|
|
|
|
|
|
|
|||||||
|
Retail
|
$
|
35,615
|
|
|
$
|
34,486
|
|
|
$
|
1,129
|
|
|
3.3
|
%
|
|
Group
|
4,817
|
|
|
4,936
|
|
|
(119
|
)
|
|
(2.4
|
)%
|
|||
|
Other Businesses
|
29
|
|
|
25
|
|
|
4
|
|
|
16.0
|
%
|
|||
|
Total premiums
|
40,461
|
|
|
39,447
|
|
|
1,014
|
|
|
2.6
|
%
|
|||
|
Services:
|
|
|
|
|
|
|
|
|||||||
|
Retail
|
7
|
|
|
7
|
|
|
—
|
|
|
—
|
%
|
|||
|
Group
|
537
|
|
|
514
|
|
|
23
|
|
|
4.5
|
%
|
|||
|
Healthcare Services
|
198
|
|
|
612
|
|
|
(414
|
)
|
|
(67.6
|
)%
|
|||
|
Other Businesses
|
7
|
|
|
10
|
|
|
(3
|
)
|
|
(30.0
|
)%
|
|||
|
Total services
|
749
|
|
|
1,143
|
|
|
(394
|
)
|
|
(34.5
|
)%
|
|||
|
Investment income
|
291
|
|
|
338
|
|
|
(47
|
)
|
|
(13.9
|
)%
|
|||
|
Total revenues
|
41,501
|
|
|
40,928
|
|
|
573
|
|
|
1.4
|
%
|
|||
|
Operating expenses:
|
|
|
|
|
|
|
|
|||||||
|
Benefits
|
33,806
|
|
|
33,153
|
|
|
653
|
|
|
2.0
|
%
|
|||
|
Operating costs
|
5,253
|
|
|
5,450
|
|
|
(197
|
)
|
|
(3.6
|
)%
|
|||
|
Depreciation and amortization
|
263
|
|
|
267
|
|
|
(4
|
)
|
|
(1.5
|
)%
|
|||
|
Total operating expenses
|
39,322
|
|
|
38,870
|
|
|
452
|
|
|
1.2
|
%
|
|||
|
Income from operations
|
2,179
|
|
|
2,058
|
|
|
121
|
|
|
5.9
|
%
|
|||
|
Gain on sale of business
|
—
|
|
|
267
|
|
|
(267
|
)
|
|
(100.0
|
)%
|
|||
|
Interest expense
|
141
|
|
|
140
|
|
|
1
|
|
|
0.7
|
%
|
|||
|
Income before income taxes
|
2,038
|
|
|
2,185
|
|
|
(147
|
)
|
|
(6.7
|
)%
|
|||
|
Provision for income taxes
|
1,023
|
|
|
1,010
|
|
|
13
|
|
|
1.3
|
%
|
|||
|
Net income
|
$
|
1,015
|
|
|
$
|
1,175
|
|
|
$
|
(160
|
)
|
|
(13.6
|
)%
|
|
Diluted earnings per common share
|
$
|
6.73
|
|
|
$
|
7.77
|
|
|
$
|
(1.04
|
)
|
|
(13.4
|
)%
|
|
Benefit ratio
(a)
|
83.6
|
%
|
|
84.0
|
%
|
|
|
|
(0.4
|
)%
|
||||
|
Operating cost ratio
(b)
|
12.7
|
%
|
|
13.4
|
%
|
|
|
|
(0.7
|
)%
|
||||
|
Effective tax rate
|
50.2
|
%
|
|
46.2
|
%
|
|
|
|
4.0
|
%
|
||||
|
(a)
|
Represents total benefits expense as a percentage of premiums revenue.
|
|
(b)
|
Represents total operating costs, excluding depreciation and amortization, as a percentage of total revenues less investment income.
|
|
|
September 30,
|
|
Change
|
||||||||
|
|
2016
|
|
2015
|
|
Members
|
|
Percentage
|
||||
|
Membership:
|
|
|
|
|
|
|
|
||||
|
Medical membership:
|
|
|
|
|
|
|
|
||||
|
Individual Medicare Advantage
|
2,831,700
|
|
|
2,737,100
|
|
|
94,600
|
|
|
3.5
|
%
|
|
Group Medicare Advantage
|
353,900
|
|
|
481,300
|
|
|
(127,400
|
)
|
|
(26.5
|
)%
|
|
Medicare stand-alone PDP
|
4,913,400
|
|
|
4,509,600
|
|
|
403,800
|
|
|
9.0
|
%
|
|
Total Retail Medicare
|
8,099,000
|
|
|
7,728,000
|
|
|
371,000
|
|
|
4.8
|
%
|
|
Individual commercial
|
726,200
|
|
|
963,700
|
|
|
(237,500
|
)
|
|
(24.6
|
)%
|
|
State-based Medicaid
|
390,100
|
|
|
368,400
|
|
|
21,700
|
|
|
5.9
|
%
|
|
Medicare Supplement
|
217,100
|
|
|
157,100
|
|
|
60,000
|
|
|
38.2
|
%
|
|
Total Retail medical members
|
9,432,400
|
|
|
9,217,200
|
|
|
215,200
|
|
|
2.3
|
%
|
|
Individual specialty membership (a)
|
1,125,300
|
|
|
1,187,300
|
|
|
(62,000
|
)
|
|
(5.2
|
)%
|
|
(a)
|
Specialty products include dental, vision, and other supplemental health and financial protection products. Members included in these products may not be unique to each product since members have the ability to enroll in multiple products.
|
|
|
For the three months ended September 30,
|
|
Change
|
|||||||||||
|
|
2016
|
|
2015
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(in millions)
|
|
|
|||||||||||
|
Premiums and Services Revenue:
|
|
|
|
|
|
|
|
|||||||
|
Premiums:
|
|
|
|
|
|
|
|
|||||||
|
Individual Medicare Advantage
|
$
|
7,977
|
|
|
$
|
7,316
|
|
|
$
|
661
|
|
|
9.0
|
%
|
|
Group Medicare Advantage
|
1,067
|
|
|
1,396
|
|
|
(329
|
)
|
|
(23.6
|
)%
|
|||
|
Medicare stand-alone PDP
|
1,004
|
|
|
927
|
|
|
77
|
|
|
8.3
|
%
|
|||
|
Total Retail Medicare
|
10,048
|
|
|
9,639
|
|
|
409
|
|
|
4.2
|
%
|
|||
|
Individual commercial
|
882
|
|
|
978
|
|
|
(96
|
)
|
|
(9.8
|
)%
|
|||
|
State-based Medicaid
|
652
|
|
|
592
|
|
|
60
|
|
|
10.1
|
%
|
|||
|
Medicare Supplement
|
109
|
|
|
78
|
|
|
31
|
|
|
39.7
|
%
|
|||
|
Individual specialty
|
65
|
|
|
66
|
|
|
(1
|
)
|
|
(1.5
|
)%
|
|||
|
Total premiums
|
11,756
|
|
|
11,353
|
|
|
403
|
|
|
3.5
|
%
|
|||
|
Services
|
3
|
|
|
1
|
|
|
2
|
|
|
200.0
|
%
|
|||
|
Total premiums and services revenue
|
$
|
11,759
|
|
|
$
|
11,354
|
|
|
$
|
405
|
|
|
3.6
|
%
|
|
Income before income taxes
|
$
|
644
|
|
|
$
|
325
|
|
|
$
|
319
|
|
|
98.2
|
%
|
|
Benefit ratio
|
83.1
|
%
|
|
86.1
|
%
|
|
|
|
(3.0
|
)%
|
||||
|
Operating cost ratio
|
11.1
|
%
|
|
10.9
|
%
|
|
|
|
0.2
|
%
|
||||
|
|
For the nine months ended
September 30, |
|
Change
|
|||||||||||
|
|
2016
|
|
2015
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(in millions)
|
|
|
|||||||||||
|
Premiums and Services Revenue:
|
|
|
|
|
|
|
|
|||||||
|
Premiums:
|
|
|
|
|
|
|
|
|||||||
|
Individual Medicare Advantage
|
$
|
24,054
|
|
|
$
|
22,183
|
|
|
$
|
1,871
|
|
|
8.4
|
%
|
|
Group Medicare Advantage
|
3,229
|
|
|
4,188
|
|
|
(959
|
)
|
|
(22.9
|
)%
|
|||
|
Medicare stand-alone PDP
|
3,058
|
|
|
2,915
|
|
|
143
|
|
|
4.9
|
%
|
|||
|
Total Retail Medicare
|
30,341
|
|
|
29,286
|
|
|
1,055
|
|
|
3.6
|
%
|
|||
|
Individual commercial
|
2,799
|
|
|
3,038
|
|
|
(239
|
)
|
|
(7.9
|
)%
|
|||
|
State-based Medicaid
|
1,960
|
|
|
1,742
|
|
|
218
|
|
|
12.5
|
%
|
|||
|
Medicare Supplement
|
319
|
|
|
225
|
|
|
94
|
|
|
41.8
|
%
|
|||
|
Individual specialty
|
196
|
|
|
195
|
|
|
1
|
|
|
0.5
|
%
|
|||
|
Total premiums
|
35,615
|
|
|
34,486
|
|
|
1,129
|
|
|
3.3
|
%
|
|||
|
Services
|
7
|
|
|
7
|
|
|
—
|
|
|
—
|
%
|
|||
|
Total premiums and services revenue
|
35,622
|
|
|
34,493
|
|
|
$
|
1,129
|
|
|
3.3
|
%
|
||
|
Income before income taxes
|
$
|
1,118
|
|
|
$
|
960
|
|
|
$
|
158
|
|
|
16.5
|
%
|
|
Benefit ratio
|
85.9
|
%
|
|
86.4
|
%
|
|
|
|
(0.5
|
)%
|
||||
|
Operating cost ratio
|
10.7
|
%
|
|
10.8
|
%
|
|
|
|
(0.1
|
)%
|
||||
|
•
|
Retail segment pretax income was
$644 million
in the
2016 quarter
, an
increase
of
$319 million
, or
98.2%
, compared to
$325 million
in the
2015 quarter
, and was
$1.1 billion
in the
2016 period
, an
increase
of
$158 million
, or
16.5%
compared to
$960 million
in the
2015 period
. These increases were primarily driven by the year-over-year improvement in results across most business lines in the segment, partially offset by the loss of a large group Medicare Advantage account as discussed below. In addition, the increase in the 2016 period was partially offset by a year-over-year decline in results for our individual commercial medical business as discussed below.
|
|
•
|
Individual Medicare Advantage membership
increased
94,600
members, or
3.5%
, from
September 30, 2015
to
September 30, 2016
reflecting net membership additions, particularly for our HMO offerings, for the 2016 plan year.
|
|
•
|
Group Medicare Advantage membership
decreased
127,400
, or
26.5%
, from
September 30, 2015
to
September 30, 2016
reflecting
the loss of a large account that moved to a private exchange offering on January 1, 2016.
|
|
•
|
Medicare stand-alone PDP membership
increased
403,800
members, or
9.0%
, from
September 30, 2015
to
September 30, 2016
reflecting net membership additions, primarily for our Humana-Walmart plan offering, for the 2016 plan year
.
|
|
•
|
Individual commercial medical membership
decreased
237,500
members, or
24.6%
, from
September 30, 2015
to
September 30, 2016
primarily reflecting
the loss of on-exchange members due to product competitiveness, the loss of membership associated with the discontinuance of certain Health Care Reform Law compliant plans in the 2016 period, the loss of membership associated with non-payment of premiums or termination by CMS due to lack of eligibility documentation, and the loss of members subscribing to plans that are not compliant with the Health Care Reform Law.
|
|
•
|
State-based Medicaid membership
increased
21,700
members, or
5.9%
, from
September 30, 2015
to
September 30, 2016
, primarily driven by
the addition of members under our Florida Medicaid contracts.
|
|
•
|
Individual specialty membership
decreased
62,000
members, or
5.2%
, from
September 30, 2015
to
September 30, 2016
primarily due to the loss of individual commercial medical members that also had specialty coverage.
|
|
•
|
Retail segment premiums increased
$403 million
, or
3.5%
, from the
2015 quarter
to the
2016 quarter
and increased
$1.1 billion
, or
3.3%
, from the
2015 period
to the
2016 period
. These increases primarily were due to individual Medicare Advantage membership growth and increased per member premiums for certain lines of business, partially offset by declines in group Medicare Advantage and individual commercial medical membership. Average individual Medicare Advantage membership increased
3.6%
for the
2016 quarter
and
4.2%
for the
2016 period
.
|
|
•
|
The Retail segment benefit ratio
decreased
300
basis points from
86.1%
in the
2015 quarter
to
83.1%
in the
2016 quarter
and
decrease
d
50
basis points from
86.4%
in the
2015 period
to
85.9%
in the
2016 period
. These declines primarily were due to lower year-over-year Medicare Advantage utilization and favorable comparisons of prior-period medical claims reserve development. In the
2016 period
, these items were partially offset by an increase in the premium deficiency reserve associated with our 2016 individual commercial medical offerings compliant with the Health Care Reform Law
.
As previously disclosed, in the fourth quarter of 2015 we recorded a premium deficiency reserve associated with our 2016 individual commercial medical offerings compliant with the Health Care Reform Law. During the
2016 period
, we increased the premium deficiency reserve for the 2016 coverage year and recorded a change in estimate of
$208 million
with a corresponding increase in benefits expense primarily as a result of unfavorable current and projected claims experience. The increase in benefits expense associated with the recognition of the premium deficiency reserve increased the Retail segment benefit ratio by approximately
60
basis points in the
2016 period
.
|
|
•
|
The Retail segment’s benefits expense for the
2016 quarter
included
$87 million
in favorable prior-period medical claims reserve development versus
$65 million
in favorable prior-prior period medical claims reserve development in the
2015 quarter
. For the
2016 period
, the Retail segment's benefit expense included the beneficial effect of
$483 million
in favorable prior-period medical claims reserve development versus
$242 million
in the
2015 period
. Prior-period medical claims reserve development decreased the Retail segment benefit ratio by approximately
70
basis points in the
2016 quarter
versus approximately
60
basis points in the
2015 quarter
. Favorable prior-period medical claims reserve development decreased the benefit ratio by approximately
140
basis points in the
2016 period
versus approximately
70
basis points in the
2015 period
.
|
|
•
|
The Retail segment operating cost ratio of
11.1%
for the
2016 quarter
increased
20
basis points from
10.9%
for the
2015 quarter
, primarily due to the unfavorable comparison to unusually low operating expenses in the
2015 quarter
resulting from the temporary suspension of certain administrative costs and the loss of a large group Medicare Advantage account which carried a lower operating cost ratio than our individual Medicare Advantage business. The Retail segment operating cost ratio for the
2016 period
was relatively unchanged decreasing
10
basis points to
10.7%
for the
2016 period
from
10.8%
for the
2015 period
. The non-deductible health insurance industry fee impacted the operating cost ratio by
170
basis points in each of the
2016 quarter
,
2015 quarter
, and
2016 period
and by
160
basis points in the
2015 period
.
|
|
|
September 30,
|
|
Change
|
||||||||
|
|
2016
|
|
2015
|
|
Members
|
|
Percentage
|
||||
|
Membership:
|
|
|
|
|
|
|
|
||||
|
Medical membership:
|
|
|
|
|
|
|
|
||||
|
Fully-insured commercial group
|
1,131,500
|
|
|
1,167,400
|
|
|
(35,900
|
)
|
|
(3.1
|
)%
|
|
ASO
|
570,300
|
|
|
709,800
|
|
|
(139,500
|
)
|
|
(19.7
|
)%
|
|
Military services
|
3,080,900
|
|
|
3,082,700
|
|
|
(1,800
|
)
|
|
(0.1
|
)%
|
|
Total group medical members
|
4,782,700
|
|
|
4,959,900
|
|
|
(177,200
|
)
|
|
(3.6
|
)%
|
|
Group specialty membership (a)
|
5,829,900
|
|
|
6,090,700
|
|
|
(260,800
|
)
|
|
(4.3
|
)%
|
|
(a)
|
Specialty products include dental, vision, and voluntary benefit products. Members included in these products may not be unique to each product since members have the ability to enroll in multiple products.
|
|
|
For the three months ended September 30,
|
|
Change
|
|||||||||||
|
|
2016
|
|
2015
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(in millions)
|
|
|
|||||||||||
|
Premiums and Services Revenue:
|
|
|
|
|
|
|
|
|||||||
|
Premiums:
|
|
|
|
|
|
|
|
|||||||
|
Fully-insured commercial group
|
$
|
1,350
|
|
|
$
|
1,362
|
|
|
$
|
(12
|
)
|
|
(0.9
|
)%
|
|
Group specialty
|
253
|
|
|
260
|
|
|
(7
|
)
|
|
(2.7
|
)%
|
|||
|
Military services
|
2
|
|
|
6
|
|
|
(4
|
)
|
|
(66.7
|
)%
|
|||
|
Total premiums
|
1,605
|
|
|
1,628
|
|
|
(23
|
)
|
|
(1.4
|
)%
|
|||
|
Services
|
158
|
|
|
171
|
|
|
(13
|
)
|
|
(7.6
|
)%
|
|||
|
Total premiums and services revenue
|
$
|
1,763
|
|
|
$
|
1,799
|
|
|
$
|
(36
|
)
|
|
(2.0
|
)%
|
|
Income before income taxes
|
$
|
12
|
|
|
$
|
39
|
|
|
$
|
(27
|
)
|
|
(69.2
|
)%
|
|
Benefit ratio
|
82.7
|
%
|
|
82.4
|
%
|
|
|
|
0.3
|
%
|
||||
|
Operating cost ratio
|
24.1
|
%
|
|
23.4
|
%
|
|
|
|
0.7
|
%
|
||||
|
|
For the nine months ended
September 30, |
|
Change
|
|||||||||||
|
|
2016
|
|
2015
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(in millions)
|
|
|
|||||||||||
|
Premiums and Services Revenue:
|
|
|
|
|
|
|
|
|||||||
|
Premiums:
|
|
|
|
|
|
|
|
|||||||
|
Fully-insured commercial group
|
$
|
4,044
|
|
|
$
|
4,125
|
|
|
$
|
(81
|
)
|
|
(2.0
|
)%
|
|
Group specialty
|
761
|
|
|
795
|
|
|
(34
|
)
|
|
(4.3
|
)%
|
|||
|
Military services
|
12
|
|
|
16
|
|
|
(4
|
)
|
|
(25.0
|
)%
|
|||
|
Total premiums
|
4,817
|
|
|
4,936
|
|
|
(119
|
)
|
|
(2.4
|
)%
|
|||
|
Services
|
537
|
|
|
514
|
|
|
23
|
|
|
4.5
|
%
|
|||
|
Total premiums and services revenue
|
5,354
|
|
|
5,450
|
|
|
$
|
(96
|
)
|
|
(1.8
|
)%
|
||
|
Income before income taxes
|
$
|
271
|
|
|
$
|
236
|
|
|
$
|
35
|
|
|
14.8
|
%
|
|
Benefit ratio
|
78.8
|
%
|
|
79.2
|
%
|
|
|
|
(0.4
|
)%
|
||||
|
Operating cost ratio
|
24.0
|
%
|
|
24.0
|
%
|
|
|
|
—
|
%
|
||||
|
•
|
Group segment pretax income
decreased
$27 million
, or
69.2%
, to
$12 million
for the
2016 quarter
from
$39 million
in the
2015 quarter
primarily due to an increase in both the benefit ratio and operating cost ratio for the
2016 quarter
. For the
2016 period
, Group segment pretax income
increased
$35 million
, or
14.8%
, to
$271 million
from
$236 million
in the
2015 period
primarily reflecting improvement in the benefit ratio as discussed below.
|
|
•
|
Fully-insured commercial group medical membership
decreased
35,900
members, or
3.1%
, from
September 30, 2015
to
September 30, 2016
reflecting lower membership in both large and small group accounts.
|
|
•
|
Group ASO commercial medical membership
decreased
139,500
members, or
19.7%
, from
September 30, 2015
to
September 30, 2016
primarily due to the loss of certain large group accounts as a result of continued discipline in pricing of services for self-funded accounts amid a highly competitive environment.
|
|
•
|
Group specialty membership
decreased
260,800
members, or
4.3%
, from
September 30, 2015
to
September 30, 2016
primarily due to the loss of several large stand-alone dental and vision accounts as well as the loss of certain fully-insured group medical accounts that also had specialty coverage.
|
|
•
|
Group segment premiums
decreased
$23 million
, or
1.4%
from the
2015 quarter
to
$1.6 billion
for the
2016 quarter
and
decreased
$119 million
, or
2.4%
, from the
2015 period
to
$4.8 billion
for the
2016 period
, primarily due to a decline in fully-insured commercial medical membership as described above, partially offset by an increase in fully-insured commercial medical per member premiums.
|
|
•
|
Group segment services revenue
decreased
$13 million
, or
7.6%
, from the
2015 quarter
to
$158 million
for the
2016 quarter
primarily due to a decline in revenue in our group ASO commercial medical business mainly due to membership declines. Group segment services revenue
increased
$23 million
, or
4.5%
, to
$537 million
for the
2016 period
from
$514 million
in the
2015 period
as the decline in revenue in our group ASO commercial medical business was more than offset by higher revenues year-over-year under our TRICARE South Region
|
|
•
|
The Group segment benefit ratio
increased
30
basis points from
82.4%
in the
2015 quarter
to
82.7%
in the
2016 quarter
primarily due to slightly higher utilization in the
2016 quarter
. The Group segment benefit ratio
decreased
40
basis points from
79.2%
in the
2015 period
to
78.8%
in the
2016 period
primarily due to the beneficial effect of favorable prior-period medical claims reserve development in the
2016 period
.
|
|
•
|
The Group segment’s benefits expense included
$3 million
in favorable prior-period medical claims reserve development in each of the
2016 quarter
and the
2015 quarter
. This favorable prior-period medical claims reserve development decreased the Group segment benefit ratio by approximately
20
basis points in each of the
2016 quarter
and the
2015 quarter
. The Group segment’s benefits expense included the beneficial effect of a favorable prior-period medical claims reserve development of
$41 million
in the
2016 period
versus
$2 million
in the
2015 period
. This favorable prior-period medical claims reserve development decreased the Group segment benefit ratio by approximately
90
basis points in the
2016 period
and had a minimal impact on the Group segment benefit ratio in the
2015 period
.
|
|
•
|
The Group segment operating cost ratio of
24.1%
for the
2016 quarter
increased
70
basis points from
23.4%
for the
2015 quarter
primarily due to the unfavorable comparison to unusually low operating expenses in the
2015 quarter
resulting from the temporary suspension of certain administrative costs. For the
2016 period
, the Group segment operating cost ratio of
24.0%
was unchanged from the
2015 period
. The non-deductible health insurance industry fee impacted the operating cost ratio by
150
basis points in each of the
2016 quarter
and the
2016 period
compared to
140
basis points in each of the
2015 quarter
and the
2015 period
.
|
|
|
For the three months ended September 30,
|
|
Change
|
|||||||||||
|
|
2016
|
|
2015
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(in millions)
|
|
|
|||||||||||
|
Revenues:
|
|
|
|
|
|
|
|
|||||||
|
Services:
|
|
|
|
|
|
|
|
|||||||
|
Provider services
|
$
|
19
|
|
|
$
|
27
|
|
|
$
|
(8
|
)
|
|
(29.6
|
)%
|
|
Home based services
|
38
|
|
|
34
|
|
|
4
|
|
|
11.8
|
%
|
|||
|
Pharmacy solutions
|
8
|
|
|
8
|
|
|
—
|
|
|
—
|
%
|
|||
|
Total services revenues
|
65
|
|
|
69
|
|
|
(4
|
)
|
|
(5.8
|
)%
|
|||
|
Intersegment revenues:
|
|
|
|
|
|
|
|
|||||||
|
Pharmacy solutions
|
5,562
|
|
|
5,221
|
|
|
341
|
|
|
6.5
|
%
|
|||
|
Provider services
|
418
|
|
|
326
|
|
|
92
|
|
|
28.2
|
%
|
|||
|
Home based services
|
264
|
|
|
229
|
|
|
35
|
|
|
15.3
|
%
|
|||
|
Clinical programs
|
44
|
|
|
53
|
|
|
(9
|
)
|
|
(17.0
|
)%
|
|||
|
Total intersegment revenues
|
6,288
|
|
|
5,829
|
|
|
459
|
|
|
7.9
|
%
|
|||
|
Total services and intersegment revenues
|
$
|
6,353
|
|
|
$
|
5,898
|
|
|
$
|
455
|
|
|
7.7
|
%
|
|
Income before income taxes
|
$
|
288
|
|
|
$
|
284
|
|
|
$
|
4
|
|
|
1.4
|
%
|
|
Operating cost ratio
|
95.1
|
%
|
|
94.7
|
%
|
|
|
|
0.4
|
%
|
||||
|
|
For the nine months ended
September 30, |
|
Change
|
|||||||||||
|
|
2016
|
|
2015
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(in millions)
|
|
|
|||||||||||
|
Revenues:
|
|
|
|
|
|
|
|
|||||||
|
Services:
|
|
|
|
|
|
|
|
|||||||
|
Provider services
|
$
|
58
|
|
|
$
|
491
|
|
|
$
|
(433
|
)
|
|
(88.2
|
)%
|
|
Home based services
|
118
|
|
|
99
|
|
|
19
|
|
|
19.2
|
%
|
|||
|
Pharmacy solutions
|
22
|
|
|
22
|
|
|
—
|
|
|
—
|
%
|
|||
|
Total services revenues
|
198
|
|
|
612
|
|
|
(414
|
)
|
|
(67.6
|
)%
|
|||
|
Intersegment revenues:
|
|
|
|
|
|
|
|
|
||||||
|
Pharmacy solutions
|
16,404
|
|
|
15,258
|
|
|
1,146
|
|
|
7.5
|
%
|
|||
|
Provider services
|
1,263
|
|
|
964
|
|
|
299
|
|
|
31.0
|
%
|
|||
|
Home based services
|
767
|
|
|
637
|
|
|
130
|
|
|
20.4
|
%
|
|||
|
Clinical programs
|
137
|
|
|
152
|
|
|
(15
|
)
|
|
(9.9
|
)%
|
|||
|
Total intersegment revenues
|
18,571
|
|
|
17,011
|
|
|
1,560
|
|
|
9.2
|
%
|
|||
|
Total services and intersegment revenues
|
$
|
18,769
|
|
|
$
|
17,623
|
|
|
$
|
1,146
|
|
|
6.5
|
%
|
|
Income before income taxes
|
$
|
800
|
|
|
$
|
737
|
|
|
$
|
63
|
|
|
8.5
|
%
|
|
Operating cost ratio
|
95.3
|
%
|
|
95.2
|
%
|
|
|
|
0.1
|
%
|
||||
|
•
|
Healthcare Services segment pretax income of
$288 million
for the
2016 quarter
increased
$4 million
, or
1.4%
, from the
2015 quarter
. For the
2016 period
, the Healthcare Services segment pretax income of
$800 million
increased
$63 million
, or
8.5%
, from
$737 million
for the
2015 period
. These increases primarily were due to
incremental earnings associated with revenue growth from our pharmacy solutions and home based services businesses as they serve our growing individual Medicare membership
. These items were partially offset by ongoing pressures in our provider services business reflecting significantly lower Medicare rates year-over-year associated with CMS' risk coding recalibration for 2016 in geographies where our provider assets are primarily located.
|
|
•
|
Humana Pharmacy Solutions
®
script volumes for Retail and Group segment membership increased to approximately
107 million
in the
2016 quarter
, up
6.3%
, versus scripts of approximately
101 million
in the
2015 quarter
. For the
2016 period
, script volumes for Retail and Group segment membership increased to approximately
316 million
, up
7.2%
, versus scripts of approximately
295 million
in the
2015 period
. These increases primarily reflect growth associated with higher average medical membership for the
2016 quarter
and
2016 period
than in the
2015 quarter
and
2015 period
.
|
|
•
|
Services revenues
decreased
$4 million
, or
5.8%
, from the
2015 quarter
to
$65 million
for the
2016 quarter
and
decreased
$414 million
, or
67.6%
, from the
2015 period
to
$198 million
for the
2016 period
. The decline in the
2016 period
primarily was due to the completion of the sale of Concentra on June 1, 2015.
|
|
•
|
Intersegment revenues
increased
$459 million
, or
7.9%
, from the
2015 quarter
to
$6.3 billion
for the
2016 quarter
and
increased
$1.6 billion
, or
9.2%
, from the
2015 period
to
$18.6 billion
for the
2016 period
primarily due to growth in our individual Medicare Advantage and Medicare stand-alone PDP membership which resulted in increased engagement of members in clinical programs and higher utilization of services across the segment.
|
|
•
|
The Healthcare Services segment operating cost ratio of
95.1%
for the
2016 quarter
increased
40
basis points from
94.7%
for the
2015 quarter
, and was relatively unchanged for the
2016 period
from the
2015 period
increasing
10
basis points year-over-year to
95.3%
. The increases are primarily due to a higher operating cost ratio for our provider services business reflecting significantly lower Medicare rates year-over-year as discussed above, partially offset by operating cost efficiencies associated with our pharmacy operations.
|
|
|
2016
|
|
2015
|
||||
|
|
(in millions)
|
||||||
|
Net cash provided by operating activities
|
$
|
4,709
|
|
|
$
|
531
|
|
|
Net cash (used in) provided by investing activities
|
(534
|
)
|
|
617
|
|
||
|
Net cash provided by (used in) financing activities
|
23
|
|
|
(1,486
|
)
|
||
|
Increase (decrease) in cash and cash equivalents
|
$
|
4,198
|
|
|
$
|
(338
|
)
|
|
|
September 30, 2016
|
|
December 31, 2015
|
|
2016
Period Change |
|
2015
Period Change |
||||||||
|
|
(in millions)
|
||||||||||||||
|
IBNR (1)
|
$
|
3,626
|
|
|
$
|
3,730
|
|
|
$
|
(104
|
)
|
|
$
|
413
|
|
|
Reported claims in process (2)
|
622
|
|
|
600
|
|
|
22
|
|
|
101
|
|
||||
|
Premium deficiency reserve (3)
|
206
|
|
|
176
|
|
|
30
|
|
|
—
|
|
||||
|
Other benefits payable (4)
|
$
|
595
|
|
|
$
|
470
|
|
|
125
|
|
|
(67
|
)
|
||
|
Total benefits payable
|
$
|
5,049
|
|
|
$
|
4,976
|
|
|
$
|
73
|
|
|
$
|
447
|
|
|
(1)
|
IBNR represents an estimate of benefits payable for claims incurred but not reported (IBNR) at the balance sheet date and includes unprocessed claim inventories. The level of IBNR is primarily impacted by membership levels, medical claim trends and the receipt cycle time, which represents the length of time between when a claim is initially incurred and when the claim form is received and processed (i.e. a shorter time span results in a lower IBNR).
|
|
(2)
|
Reported claims in process represents the estimated valuation of processed claims that are in the post claim adjudication process, which consists of administrative functions such as audit and check batching and handling, as well as amounts owed to our pharmacy benefit administrator which fluctuate due to bi-weekly payments and the month-end cutoff.
|
|
(3)
|
Premium deficiency reserve for our individual commercial medical business compliant with the Health Care Reform Law associated with the 2016 coverage year.
|
|
(4)
|
Other benefits payable primarily include amounts owed to providers under capitated and risk sharing arrangements.
|
|
|
September 30, 2016
|
|
December 31, 2015
|
|
2016
Period Change |
|
2015
Period Change |
||||||||
|
|
(in millions)
|
||||||||||||||
|
Medicare
|
$
|
506
|
|
|
$
|
765
|
|
|
$
|
(259
|
)
|
|
$
|
(80
|
)
|
|
Commercial and other
|
320
|
|
|
420
|
|
|
(100
|
)
|
|
49
|
|
||||
|
Military services
|
50
|
|
|
77
|
|
|
(27
|
)
|
|
(30
|
)
|
||||
|
Allowance for doubtful accounts
|
(111
|
)
|
|
(101
|
)
|
|
(10
|
)
|
|
(6
|
)
|
||||
|
Total net receivables
|
$
|
765
|
|
|
$
|
1,161
|
|
|
(396
|
)
|
|
(67
|
)
|
||
|
Reconciliation to cash flow statement:
|
|
|
|
|
|
|
|
||||||||
|
Change in receivables held-for-sale and
disposition of receivables from sale of business |
|
|
|
|
—
|
|
|
11
|
|
||||||
|
Change in receivables per cash flow
statement resulting in cash from operations |
|
|
|
|
$
|
(396
|
)
|
|
$
|
(56
|
)
|
||||
|
Record
Date |
|
Payment
Date |
|
Amount
per Share |
|
Total
Amount |
||||
|
|
|
|
|
|
|
(in millions)
|
||||
|
2015 payments
|
|
|
|
|
|
|
||||
|
12/31/2014
|
|
1/30/2015
|
|
$
|
0.28
|
|
|
$
|
42
|
|
|
3/31/2015
|
|
4/24/2015
|
|
$
|
0.28
|
|
|
$
|
42
|
|
|
6/30/2015
|
|
7/31/2015
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
9/30/2015
|
|
10/30/2015
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
2016 payments
|
|
|
|
|
|
|
||||
|
12/30/2015
|
|
1/29/2016
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
3/31/2016
|
|
4/29/2016
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
6/30/2016
|
|
7/29/2016
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
10/13/2016
|
|
10/28/2016
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
Item 2:
|
Unregistered Sales of Equity Securities and Use of Proceeds
|
|
(a)
|
None.
|
|
(b)
|
N/A
|
|
(c)
|
The following table provides information about our purchases of equity securities that are registered by us pursuant to Section 12 of the Securities Exchange Act of 1934, as amended, during the
three months ended September 30, 2016
:
|
|
Period
|
Total Number
of Shares Purchased (1)(2) |
|
Average
Price Paid per Share |
|
Total Number of
Shares Purchased as Part of Publicly Announced Plans or Programs (1)(2) |
|
Dollar Value of
Shares that May Yet Be Purchased Under the Plans or Programs (1) |
||||||
|
July 2016
|
—
|
|
|
$
|
—
|
|
|
—
|
|
|
$
|
—
|
|
|
August 2016
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||
|
September 2016
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||
|
Total
|
—
|
|
|
$
|
—
|
|
|
—
|
|
|
|
||
|
(1)
|
In September 2014, the Board of Directors replaced a previous share repurchase authorization of up to $1 billion with a current authorization for repurchases of up to $2 billion of our common shares exclusive of shares repurchased in connection with employee stock plans, expiring on December 31, 2016.
Pursuant to the Merger Agreement
, after July 2, 2015, we are prohibited from repurchasing any of our outstanding securities without the prior written consent of Aetna, other than repurchases of shares of our common stock in connection with the exercise of outstanding stock options or the vesting or settlement of outstanding restricted stock awards. Accordingly, as announced on July 3, 2015, we have suspended our share repurchase program.
Our remaining repurchase authorization was
$1.04 billion
as of July 3, 2015.
|
|
(2)
|
Excludes
0.45 million
shares repurchased in connection with employee stock plans.
|
|
Item 3:
|
Defaults Upon Senior Securities
|
|
Item 4:
|
Mine Safety Disclosures
|
|
Item 5:
|
Other Information
|
|
Item 6:
|
Exhibits
|
|
3(i)
|
Restated Certificate of Incorporation of Humana Inc. filed with the Secretary of State of Delaware on November 9, 1989, as restated to incorporate the amendment of January 9, 1992, and the correction of March 23, 1992 (incorporated herein by reference to Exhibit 4(i) to Humana Inc.’s Post-Effective Amendment No. 1 to the Registration Statement on Form S-8 (Reg. No. 33-49305) filed February 2, 1994).
|
|
3(ii)
|
By-Laws of Humana Inc., as amended on January 4, 2007 (incorporated herein by reference to Exhibit 3 to Humana Inc.’s Annual Report on Form 10-K for the year ended December 31, 2006).
|
|
12
|
Computation of ratio of earnings to fixed charges.
|
|
31.1
|
Principal Executive Officer certification pursuant to Section 302 of Sarbanes–Oxley Act of 2002.
|
|
31.2
|
Principal Financial Officer certification pursuant to Section 302 of Sarbanes–Oxley Act of 2002.
|
|
32
|
Principal Executive Officer and Principal Financial Officer certification pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
|
|
101
|
The following materials from Humana Inc.'s Quarterly Report on Form 10-Q formatted in XBRL (Extensible Business Reporting Language): (i) the Condensed Consolidated Balance Sheets at
September 30, 2016
and
December 31, 2015
; (ii) the Condensed Consolidated Statements of Income for the
three and nine
months ended
September 30, 2016
and
2015
; (iii) the Condensed Consolidated Statements of Comprehensive Income for the
three and nine
months ended
September 30, 2016
and
2015
; (iv) the Condensed Consolidated Statements of Cash Flows for the
nine
months ended
September 30, 2016
and
2015
; and (v) Notes to Condensed Consolidated Financial Statements.
|
|
|
|
HUMANA INC.
|
|
|
|
|
(Registrant)
|
|
|
|
|
|
|
|
Date:
|
November 4, 2016
|
By:
|
/s/ CYNTHIA H. ZIPPERLE
|
|
|
|
|
Cynthia H. Zipperle
|
|
|
|
|
Vice President, Chief Accounting Officer and Controller (Principal Accounting Officer)
|
|
|
|
|
|
No information found
* THE VALUE IS THE MARKET VALUE AS OF THE LAST DAY OF THE QUARTER FOR WHICH THE 13F WAS FILED.
| FUND | NUMBER OF SHARES | VALUE ($) | PUT OR CALL |
|---|
| DIRECTORS | AGE | BIO | OTHER DIRECTOR MEMBERSHIPS |
|---|
No information found
No Customers Found
Suppliers
| Supplier name | Ticker |
|---|---|
| Amgen Inc. | AMGN |
| Bristol-Myers Squibb Company | BMY |
| Abbott Laboratories | ABT |
| AbbVie Inc. | ABBV |
| Johnson & Johnson | JNJ |
| Eli Lilly and Company | LLY |
| Merck & Co., Inc. | MRK |
| Pfizer Inc. | PFE |
Price
Yield
| Owner | Position | Direct Shares | Indirect Shares |
|---|