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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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Emerging growth company
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¨
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Class of Common Stock
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Outstanding at
September 30, 2017 |
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$0.16 2/3 par value
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142,860,096 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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Certifications
|
|
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September 30,
2017 |
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December 31,
2016 |
||||
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(in millions, except share amounts)
|
||||||
|
A
SSETS
|
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|
|
||||
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Current assets:
|
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|
||||
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Cash and cash equivalents
|
$
|
9,865
|
|
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$
|
3,877
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Investment securities
|
8,622
|
|
|
7,595
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||
|
Receivables, less allowance for doubtful accounts of $89 in 2017
and $118 in 2016 |
922
|
|
|
1,280
|
|
||
|
Other current assets
|
3,776
|
|
|
3,438
|
|
||
|
Total current assets
|
23,185
|
|
|
16,190
|
|
||
|
Property and equipment, net
|
1,560
|
|
|
1,505
|
|
||
|
Long-term investment securities
|
2,716
|
|
|
2,203
|
|
||
|
Goodwill
|
3,281
|
|
|
3,272
|
|
||
|
Other long-term assets
|
2,214
|
|
|
2,226
|
|
||
|
Total assets
|
$
|
32,956
|
|
|
$
|
25,396
|
|
|
L
IABILITIES
AND
S
TOCKHOLDERS
’ E
QUITY
|
|
|
|
||||
|
Current liabilities:
|
|
|
|
||||
|
Benefits payable
|
$
|
4,959
|
|
|
$
|
4,563
|
|
|
Trade accounts payable and accrued expenses
|
4,888
|
|
|
2,467
|
|
||
|
Book overdraft
|
171
|
|
|
212
|
|
||
|
Unearned revenues
|
3,447
|
|
|
280
|
|
||
|
Short-term debt
|
953
|
|
|
300
|
|
||
|
Total current liabilities
|
14,418
|
|
|
7,822
|
|
||
|
Long-term debt
|
3,977
|
|
|
3,792
|
|
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|
Future policy benefits payable
|
2,893
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|
|
2,834
|
|
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Other long-term liabilities
|
457
|
|
|
263
|
|
||
|
Total liabilities
|
21,745
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|
|
14,711
|
|
||
|
Commitments and contingencies
|
|
|
|
||||
|
Stockholders’ equity:
|
|
|
|
||||
|
Preferred stock, $1 par; 10,000,000 shares authorized; none issued
|
—
|
|
|
—
|
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||
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Common stock, $0.16 2/3 par; 300,000,000 shares authorized;
198,572,158 shares issued at September 30, 2017 and 198,495,007 shares issued at December 31, 2016 |
33
|
|
|
33
|
|
||
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Capital in excess of par value
|
2,641
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|
2,562
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||
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Retained earnings
|
13,542
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|
|
11,454
|
|
||
|
Accumulated other comprehensive income (loss)
|
12
|
|
|
(66
|
)
|
||
|
Treasury stock, at cost, 55,712,062 shares at September 30, 2017 and
49,189,811 shares at December 31, 2016 |
(5,017
|
)
|
|
(3,298
|
)
|
||
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Total stockholders’ equity
|
11,211
|
|
|
10,685
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|
||
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Total liabilities and stockholders’ equity
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$
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32,956
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$
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25,396
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Three months ended
September 30, |
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Nine months ended
September 30, |
||||||||||||
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2017
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2016
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2017
|
|
2016
|
||||||||
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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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12,955
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$
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13,371
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$
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39,556
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$
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40,461
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Services
|
223
|
|
|
227
|
|
|
706
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|
|
749
|
|
||||
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Investment income
|
104
|
|
|
96
|
|
|
316
|
|
|
291
|
|
||||
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Total revenues
|
13,282
|
|
|
13,694
|
|
|
40,578
|
|
|
41,501
|
|
||||
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Operating expenses:
|
|
|
|
|
|
|
|
||||||||
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Benefits
|
10,642
|
|
|
10,900
|
|
|
32,857
|
|
|
33,806
|
|
||||
|
Operating costs
|
1,688
|
|
|
1,739
|
|
|
4,694
|
|
|
5,172
|
|
||||
|
Merger termination fee and related costs, net
|
—
|
|
|
20
|
|
|
(947
|
)
|
|
81
|
|
||||
|
Depreciation and amortization
|
94
|
|
|
86
|
|
|
278
|
|
|
263
|
|
||||
|
Total operating expenses
|
12,424
|
|
|
12,745
|
|
|
36,882
|
|
|
39,322
|
|
||||
|
Income from operations
|
858
|
|
|
949
|
|
|
3,696
|
|
|
2,179
|
|
||||
|
Interest expense
|
59
|
|
|
47
|
|
|
166
|
|
|
141
|
|
||||
|
Income before income taxes
|
799
|
|
|
902
|
|
|
3,530
|
|
|
2,038
|
|
||||
|
Provision for income taxes
|
300
|
|
|
452
|
|
|
1,266
|
|
|
1,023
|
|
||||
|
Net income
|
$
|
499
|
|
|
$
|
450
|
|
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$
|
2,264
|
|
|
$
|
1,015
|
|
|
Basic earnings per common share
|
$
|
3.46
|
|
|
$
|
3.01
|
|
|
$
|
15.56
|
|
|
$
|
6.80
|
|
|
Diluted earnings per common share
|
$
|
3.44
|
|
|
$
|
2.98
|
|
|
$
|
15.44
|
|
|
$
|
6.73
|
|
|
Dividends declared per common share
|
$
|
0.40
|
|
|
$
|
0.29
|
|
|
$
|
1.20
|
|
|
$
|
0.87
|
|
|
|
Three months ended
September 30, |
|
Nine months ended
September 30, |
||||||||||||
|
|
2017
|
|
2016
|
|
2017
|
|
2016
|
||||||||
|
|
(in millions)
|
||||||||||||||
|
Net income
|
$
|
499
|
|
|
$
|
450
|
|
|
$
|
2,264
|
|
|
$
|
1,015
|
|
|
Other comprehensive income:
|
|
|
|
|
|
|
|
||||||||
|
Change in gross unrealized investment
gains/losses |
26
|
|
|
(9
|
)
|
|
152
|
|
|
150
|
|
||||
|
Effect of income taxes
|
(9
|
)
|
|
3
|
|
|
(56
|
)
|
|
(55
|
)
|
||||
|
Total change in unrealized
investment gains/losses, net of tax |
17
|
|
|
(6
|
)
|
|
96
|
|
|
95
|
|
||||
|
Reclassification adjustment for net
realized gains included in investment income |
—
|
|
|
(26
|
)
|
|
(28
|
)
|
|
(65
|
)
|
||||
|
Effect of income taxes
|
—
|
|
|
10
|
|
|
10
|
|
|
24
|
|
||||
|
Total reclassification adjustment, net
of tax |
—
|
|
|
(16
|
)
|
|
(18
|
)
|
|
(41
|
)
|
||||
|
Other comprehensive income (loss), net
of tax |
17
|
|
|
(22
|
)
|
|
78
|
|
|
54
|
|
||||
|
Comprehensive income
|
$
|
516
|
|
|
$
|
428
|
|
|
$
|
2,342
|
|
|
$
|
1,069
|
|
|
|
For the nine months ended
September 30, |
||||||
|
|
2017
|
|
2016
|
||||
|
|
(in millions)
|
||||||
|
Cash flows from operating activities
|
|
|
|
||||
|
Net income
|
$
|
2,264
|
|
|
$
|
1,015
|
|
|
Adjustments to reconcile net income to net cash provided by
operating activities: |
|
|
|
||||
|
Net realized capital gains
|
(28
|
)
|
|
(65
|
)
|
||
|
Stock-based compensation
|
116
|
|
|
76
|
|
||
|
Depreciation
|
303
|
|
|
289
|
|
||
|
Other intangible amortization
|
54
|
|
|
59
|
|
||
|
(Benefit) provision for deferred income taxes
|
(54
|
)
|
|
54
|
|
||
|
Changes in operating assets and liabilities, net of effect of
businesses acquired and dispositions: |
|
|
|
||||
|
Receivables
|
358
|
|
|
396
|
|
||
|
Other assets
|
(369
|
)
|
|
(419
|
)
|
||
|
Benefits payable
|
396
|
|
|
73
|
|
||
|
Other liabilities
|
641
|
|
|
127
|
|
||
|
Unearned revenues
|
3,167
|
|
|
2,987
|
|
||
|
Other, net
|
114
|
|
|
117
|
|
||
|
Net cash provided by operating activities
|
6,962
|
|
|
4,709
|
|
||
|
Cash flows from investing activities
|
|
|
|
||||
|
Acquisitions, net of cash acquired
|
(10
|
)
|
|
(7
|
)
|
||
|
Purchases of property and equipment
|
(376
|
)
|
|
(395
|
)
|
||
|
Purchases of investment securities
|
(4,337
|
)
|
|
(4,533
|
)
|
||
|
Maturities of investment securities
|
919
|
|
|
1,082
|
|
||
|
Proceeds from sales of investment securities
|
2,028
|
|
|
3,319
|
|
||
|
Net cash used in investing activities
|
(1,776
|
)
|
|
(534
|
)
|
||
|
Cash flows from financing activities
|
|
|
|
||||
|
Receipts from contract deposits, net
|
1,931
|
|
|
350
|
|
||
|
Proceeds from issuance of senior notes, net
|
985
|
|
|
—
|
|
||
|
Repayment of commercial paper, net
|
(153
|
)
|
|
(1
|
)
|
||
|
Change in book overdraft
|
(41
|
)
|
|
(118
|
)
|
||
|
Common stock repurchases
|
(1,819
|
)
|
|
(75
|
)
|
||
|
Dividends paid
|
(162
|
)
|
|
(133
|
)
|
||
|
Proceeds from stock option exercises and other
|
61
|
|
|
—
|
|
||
|
Net cash provided by financing activities
|
802
|
|
|
23
|
|
||
|
Increase in cash and cash equivalents
|
5,988
|
|
|
4,198
|
|
||
|
Cash and cash equivalents at beginning of period
|
3,877
|
|
|
2,571
|
|
||
|
Cash and cash equivalents at end of period
|
$
|
9,865
|
|
|
$
|
6,769
|
|
|
Supplemental cash flow disclosures:
|
|
|
|
||||
|
Interest payments
|
$
|
124
|
|
|
$
|
102
|
|
|
Income tax payments, net
|
$
|
1,206
|
|
|
$
|
851
|
|
|
|
Amortized
Cost
|
|
Gross
Unrealized
Gains
|
|
Gross
Unrealized
Losses
|
|
Fair
Value
|
||||||||
|
|
(in millions)
|
||||||||||||||
|
September 30, 2017
|
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and other U.S. government
corporations and agencies: |
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and agency obligations
|
$
|
821
|
|
|
$
|
1
|
|
|
$
|
(8
|
)
|
|
$
|
814
|
|
|
Mortgage-backed securities
|
1,423
|
|
|
5
|
|
|
(19
|
)
|
|
1,409
|
|
||||
|
Tax-exempt municipal securities
|
3,457
|
|
|
28
|
|
|
(16
|
)
|
|
3,469
|
|
||||
|
Mortgage-backed securities:
|
|
|
|
|
|
|
|
||||||||
|
Residential
|
7
|
|
|
—
|
|
|
—
|
|
|
7
|
|
||||
|
Commercial
|
399
|
|
|
3
|
|
|
(2
|
)
|
|
400
|
|
||||
|
Asset-backed securities
|
140
|
|
|
—
|
|
|
—
|
|
|
140
|
|
||||
|
Corporate debt securities
|
4,921
|
|
|
215
|
|
|
(37
|
)
|
|
5,099
|
|
||||
|
Total debt securities
|
$
|
11,168
|
|
|
$
|
252
|
|
|
$
|
(82
|
)
|
|
$
|
11,338
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
December 31, 2016
|
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and other U.S. government
corporations and agencies: |
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and agency obligations
|
$
|
800
|
|
|
$
|
1
|
|
|
$
|
(15
|
)
|
|
$
|
786
|
|
|
Mortgage-backed securities
|
1,662
|
|
|
6
|
|
|
(31
|
)
|
|
1,637
|
|
||||
|
Tax-exempt municipal securities
|
3,358
|
|
|
15
|
|
|
(68
|
)
|
|
3,305
|
|
||||
|
Mortgage-backed securities:
|
|
|
|
|
|
|
|
||||||||
|
Residential
|
9
|
|
|
—
|
|
|
—
|
|
|
9
|
|
||||
|
Commercial
|
307
|
|
|
1
|
|
|
(4
|
)
|
|
304
|
|
||||
|
Asset-backed securities
|
160
|
|
|
—
|
|
|
—
|
|
|
160
|
|
||||
|
Corporate debt securities
|
3,530
|
|
|
145
|
|
|
(78
|
)
|
|
3,597
|
|
||||
|
Total debt securities
|
$
|
9,826
|
|
|
$
|
168
|
|
|
$
|
(196
|
)
|
|
$
|
9,798
|
|
|
|
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, 2017
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
U.S. Treasury and other U.S.
government corporations and agencies: |
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
U.S. Treasury and agency
obligations |
$
|
522
|
|
|
$
|
(5
|
)
|
|
$
|
137
|
|
|
$
|
(3
|
)
|
|
$
|
659
|
|
|
$
|
(8
|
)
|
|
Mortgage-backed
securities |
986
|
|
|
(17
|
)
|
|
82
|
|
|
(2
|
)
|
|
1,068
|
|
|
(19
|
)
|
||||||
|
Tax-exempt municipal
securities |
1,320
|
|
|
(9
|
)
|
|
460
|
|
|
(7
|
)
|
|
1,780
|
|
|
(16
|
)
|
||||||
|
Mortgage-backed securities:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Residential
|
—
|
|
|
—
|
|
|
4
|
|
|
—
|
|
|
4
|
|
|
—
|
|
||||||
|
Commercial
|
115
|
|
|
(2
|
)
|
|
—
|
|
|
—
|
|
|
115
|
|
|
(2
|
)
|
||||||
|
Asset-backed securities
|
64
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
64
|
|
|
—
|
|
||||||
|
Corporate debt securities
|
999
|
|
|
(15
|
)
|
|
469
|
|
|
(22
|
)
|
|
1,468
|
|
|
(37
|
)
|
||||||
|
Total debt securities
|
$
|
4,006
|
|
|
$
|
(48
|
)
|
|
$
|
1,152
|
|
|
$
|
(34
|
)
|
|
$
|
5,158
|
|
|
$
|
(82
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
December 31, 2016
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
U.S. Treasury and other U.S.
government corporations and agencies: |
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
U.S. Treasury and agency
obligations |
$
|
697
|
|
|
$
|
(15
|
)
|
|
$
|
3
|
|
|
$
|
—
|
|
|
$
|
700
|
|
|
$
|
(15
|
)
|
|
Mortgage-backed
securities |
1,528
|
|
|
(31
|
)
|
|
3
|
|
|
—
|
|
|
1,531
|
|
|
(31
|
)
|
||||||
|
Tax-exempt municipal
securities |
2,756
|
|
|
(67
|
)
|
|
43
|
|
|
(1
|
)
|
|
2,799
|
|
|
(68
|
)
|
||||||
|
Mortgage-backed securities:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Residential
|
—
|
|
|
—
|
|
|
4
|
|
|
—
|
|
|
4
|
|
|
—
|
|
||||||
|
Commercial
|
182
|
|
|
(3
|
)
|
|
24
|
|
|
(1
|
)
|
|
206
|
|
|
(4
|
)
|
||||||
|
Asset-backed securities
|
51
|
|
|
—
|
|
|
63
|
|
|
—
|
|
|
114
|
|
|
—
|
|
||||||
|
Corporate debt securities
|
1,544
|
|
|
(71
|
)
|
|
69
|
|
|
(7
|
)
|
|
1,613
|
|
|
(78
|
)
|
||||||
|
Total debt securities
|
$
|
6,758
|
|
|
$
|
(187
|
)
|
|
$
|
209
|
|
|
$
|
(9
|
)
|
|
$
|
6,967
|
|
|
$
|
(196
|
)
|
|
|
Three months ended
September 30, |
|
Nine months ended
September 30, |
||||||||||||
|
|
2017
|
|
2016
|
|
2017
|
|
2016
|
||||||||
|
|
(in millions)
|
||||||||||||||
|
Gross realized gains
|
$
|
3
|
|
|
$
|
37
|
|
|
$
|
34
|
|
|
$
|
88
|
|
|
Gross realized losses
|
(3
|
)
|
|
(11
|
)
|
|
(6
|
)
|
|
(23
|
)
|
||||
|
Net realized capital gains
|
$
|
—
|
|
|
$
|
26
|
|
|
$
|
28
|
|
|
$
|
65
|
|
|
|
Amortized
Cost |
|
Fair
Value |
||||
|
|
(in millions)
|
||||||
|
Due within one year
|
$
|
501
|
|
|
$
|
502
|
|
|
Due after one year through five years
|
2,999
|
|
|
3,014
|
|
||
|
Due after five years through ten years
|
2,555
|
|
|
2,561
|
|
||
|
Due after ten years
|
3,144
|
|
|
3,305
|
|
||
|
Mortgage and asset-backed securities
|
1,969
|
|
|
1,956
|
|
||
|
Total debt securities
|
$
|
11,168
|
|
|
$
|
11,338
|
|
|
|
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, 2017
|
|
|
|
|
|
|
|
||||||||
|
Cash equivalents
|
$
|
9,368
|
|
|
$
|
9,368
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
Debt securities:
|
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and other U.S. government
corporations and agencies: |
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and agency obligations
|
814
|
|
|
—
|
|
|
814
|
|
|
—
|
|
||||
|
Mortgage-backed securities
|
1,409
|
|
|
—
|
|
|
1,409
|
|
|
—
|
|
||||
|
Tax-exempt municipal securities
|
3,469
|
|
|
—
|
|
|
3,469
|
|
|
—
|
|
||||
|
Mortgage-backed securities:
|
|
|
|
|
|
|
|
||||||||
|
Residential
|
7
|
|
|
—
|
|
|
7
|
|
|
—
|
|
||||
|
Commercial
|
400
|
|
|
—
|
|
|
400
|
|
|
—
|
|
||||
|
Asset-backed securities
|
140
|
|
|
—
|
|
|
140
|
|
|
—
|
|
||||
|
Corporate debt securities
|
5,099
|
|
|
—
|
|
|
5,098
|
|
|
1
|
|
||||
|
Total debt securities
|
11,338
|
|
|
—
|
|
|
11,337
|
|
|
1
|
|
||||
|
Total invested assets
|
$
|
20,706
|
|
|
$
|
9,368
|
|
|
$
|
11,337
|
|
|
$
|
1
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
December 31, 2016
|
|
|
|
|
|
|
|
||||||||
|
Cash equivalents
|
$
|
3,654
|
|
|
$
|
3,654
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
Debt securities:
|
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and other U.S. government
corporations and agencies: |
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and agency obligations
|
786
|
|
|
—
|
|
|
786
|
|
|
—
|
|
||||
|
Mortgage-backed securities
|
1,637
|
|
|
—
|
|
|
1,637
|
|
|
—
|
|
||||
|
Tax-exempt municipal securities
|
3,305
|
|
|
—
|
|
|
3,302
|
|
|
3
|
|
||||
|
Mortgage-backed securities:
|
|
|
|
|
|
|
|
||||||||
|
Residential
|
9
|
|
|
—
|
|
|
9
|
|
|
—
|
|
||||
|
Commercial
|
304
|
|
|
—
|
|
|
304
|
|
|
—
|
|
||||
|
Asset-backed securities
|
160
|
|
|
—
|
|
|
160
|
|
|
—
|
|
||||
|
Corporate debt securities
|
3,597
|
|
|
—
|
|
|
3,593
|
|
|
4
|
|
||||
|
Total debt securities
|
9,798
|
|
|
—
|
|
|
9,791
|
|
|
7
|
|
||||
|
Total invested assets
|
$
|
13,452
|
|
|
$
|
3,654
|
|
|
$
|
9,791
|
|
|
$
|
7
|
|
|
|
For the three months ended September 30,
|
||||||||||||||||||||||
|
|
2017
|
|
2016
|
||||||||||||||||||||
|
|
Private
Placements |
|
Auction
Rate Securities |
|
Total
|
|
Private
Placements |
|
Auction
Rate Securities |
|
Total
|
||||||||||||
|
|
(in millions)
|
||||||||||||||||||||||
|
Beginning balance at July 1
|
$
|
4
|
|
|
$
|
—
|
|
|
$
|
4
|
|
|
$
|
6
|
|
|
$
|
3
|
|
|
$
|
9
|
|
|
Sales
|
(3
|
)
|
|
—
|
|
|
(3
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||
|
Balance at September 30
|
$
|
1
|
|
|
$
|
—
|
|
|
$
|
1
|
|
|
$
|
6
|
|
|
$
|
3
|
|
|
$
|
9
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
|
For the nine months ended September 30,
|
||||||||||||||||||||||
|
|
2017
|
|
2016
|
||||||||||||||||||||
|
|
Private
Placements |
|
Auction
Rate Securities |
|
Total
|
|
Private
Placements |
|
Auction
Rate Securities |
|
Total
|
||||||||||||
|
|
(in millions)
|
||||||||||||||||||||||
|
Beginning balance at January 1
|
$
|
4
|
|
|
$
|
3
|
|
|
$
|
7
|
|
|
$
|
6
|
|
|
$
|
5
|
|
|
$
|
11
|
|
|
Sales
|
(3
|
)
|
|
—
|
|
|
(3
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||
|
Settlements
|
—
|
|
|
(3
|
)
|
|
(3
|
)
|
|
—
|
|
|
(2
|
)
|
|
(2
|
)
|
||||||
|
Balance at September 30
|
$
|
1
|
|
|
$
|
—
|
|
|
$
|
1
|
|
|
$
|
6
|
|
|
$
|
3
|
|
|
$
|
9
|
|
|
|
September 30, 2017
|
|
December 31, 2016
|
||||||||||||
|
Risk
Corridor Settlement |
|
CMS
Subsidies/ Discounts |
|
Risk
Corridor Settlement |
|
CMS
Subsidies/ Discounts |
|||||||||
|
|
(in millions)
|
||||||||||||||
|
Other current assets
|
$
|
9
|
|
|
$
|
1,058
|
|
|
$
|
8
|
|
|
$
|
1,001
|
|
|
Trade accounts payable and accrued expenses
|
(118
|
)
|
|
(2,134
|
)
|
|
(158
|
)
|
|
(128
|
)
|
||||
|
Net current (liability) asset
|
(109
|
)
|
|
(1,076
|
)
|
|
(150
|
)
|
|
873
|
|
||||
|
Other long-term assets
|
3
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
Other long-term liabilities
|
(180
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
Net long-term liability
|
(177
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
Total net (liability) asset
|
$
|
(286
|
)
|
|
$
|
(1,076
|
)
|
|
$
|
(150
|
)
|
|
$
|
873
|
|
|
|
September 30, 2017
|
|
December 31, 2016
|
||||||||||||||||
|
|
Risk Adjustment
Settlement |
|
Reinsurance
Recoverables |
|
Risk Adjustment
Settlement |
|
Reinsurance
Recoverables |
||||||||||||
|
|
(in millions)
|
||||||||||||||||||
|
Prior Coverage Years
|
|
|
|
|
|
|
|
||||||||||||
|
Premiums receivable
|
$
|
127
|
|
|
$
|
—
|
|
|
$
|
307
|
|
|
$
|
—
|
|
||||
|
Other current assets
|
—
|
|
|
44
|
|
|
—
|
|
|
260
|
|
||||||||
|
Trade accounts payable and
accrued expenses |
—
|
|
|
—
|
|
|
(117
|
)
|
|
—
|
|
||||||||
|
Net current asset
|
127
|
|
|
44
|
|
|
190
|
|
|
260
|
|
||||||||
|
Other long-term assets
|
—
|
|
|
—
|
|
|
6
|
|
|
—
|
|
||||||||
|
Total prior coverage years' net
asset |
127
|
|
|
44
|
|
|
196
|
|
|
260
|
|
||||||||
|
Current Coverage Year
|
|
|
|
|
|
|
|
||||||||||||
|
Premiums receivable
|
30
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||||
|
Trade accounts payable and
accrued expenses |
(57
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||||
|
Net current liability
|
(27
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||||
|
Other long-term assets
|
29
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||||
|
Other long-term liabilities
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||||
|
Net long-term asset
|
29
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||||
|
Total 2017 coverage year net
asset |
2
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||||
|
Total net asset
|
$
|
129
|
|
|
$
|
44
|
|
|
$
|
196
|
|
|
$
|
260
|
|
||||
|
|
Retail
|
|
Group and Specialty
|
|
Healthcare
Services |
|
Total
|
||||||||
|
|
(in millions)
|
||||||||||||||
|
Balance at January 1, 2017
|
$
|
1,059
|
|
|
$
|
261
|
|
|
$
|
1,952
|
|
|
$
|
3,272
|
|
|
Acquisitions
|
—
|
|
|
—
|
|
|
9
|
|
|
9
|
|
||||
|
Balance at September 30, 2017
|
$
|
1,059
|
|
|
$
|
261
|
|
|
$
|
1,961
|
|
|
$
|
3,281
|
|
|
|
|
|
September 30, 2017
|
|
December 31, 2016
|
||||||||||||||||||||
|
|
Weighted
Average Life |
|
Cost
|
|
Accumulated
Amortization |
|
Net
|
|
Cost
|
|
Accumulated
Amortization |
|
Net
|
||||||||||||
|
|
|
|
($ in millions)
|
||||||||||||||||||||||
|
Other intangible assets:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Customer contracts/
relationships |
9.8 years
|
|
$
|
566
|
|
|
$
|
388
|
|
|
$
|
178
|
|
|
$
|
566
|
|
|
$
|
347
|
|
|
$
|
219
|
|
|
Trade names and
technology |
8.2 years
|
|
104
|
|
|
77
|
|
|
27
|
|
|
104
|
|
|
69
|
|
|
35
|
|
||||||
|
Provider contracts
|
14.1 years
|
|
51
|
|
|
33
|
|
|
18
|
|
|
51
|
|
|
29
|
|
|
22
|
|
||||||
|
Noncompetes and
other |
8.1 years
|
|
33
|
|
|
29
|
|
|
4
|
|
|
32
|
|
|
28
|
|
|
4
|
|
||||||
|
Total other intangible
assets |
9.8 years
|
|
$
|
754
|
|
|
$
|
527
|
|
|
$
|
227
|
|
|
$
|
753
|
|
|
$
|
473
|
|
|
$
|
280
|
|
|
|
(in millions)
|
||
|
For the years ending December 31,
|
|
||
|
2017
|
$
|
71
|
|
|
2018
|
63
|
|
|
|
2019
|
52
|
|
|
|
2020
|
48
|
|
|
|
2021
|
14
|
|
|
|
2022
|
11
|
|
|
|
|
|
For the nine months ended September 30,
|
||||||
|
|
|
2017
|
|
2016
|
||||
|
|
|
(in millions)
|
||||||
|
Balances, beginning of period
|
|
$
|
4,563
|
|
|
$
|
4,976
|
|
|
Less: Premium deficiency reserve
|
|
—
|
|
|
(176
|
)
|
||
|
Less: Reinsurance recoverables
|
|
(76
|
)
|
|
(85
|
)
|
||
|
Balances, beginning of period, net
|
|
4,487
|
|
|
4,715
|
|
||
|
Incurred related to:
|
|
|
|
|
||||
|
Current year
|
|
33,318
|
|
|
34,340
|
|
||
|
Prior years
|
|
(430
|
)
|
|
(525
|
)
|
||
|
Total incurred
|
|
32,888
|
|
|
33,815
|
|
||
|
Paid related to:
|
|
|
|
|
||||
|
Current year
|
|
(28,741
|
)
|
|
(29,768
|
)
|
||
|
Prior years
|
|
(3,745
|
)
|
|
(3,996
|
)
|
||
|
Total paid
|
|
(32,486
|
)
|
|
(33,764
|
)
|
||
|
Premium deficiency reserve
|
|
—
|
|
|
206
|
|
||
|
Reinsurance recoverable
|
|
70
|
|
|
77
|
|
||
|
Balances, end of period
|
|
$
|
4,959
|
|
|
$
|
5,049
|
|
|
|
|
For the nine months ended September 30,
|
||||||
|
|
|
2017
|
|
2016
|
||||
|
|
|
(in millions)
|
||||||
|
Premium deficiency reserve - Individual Commercial
|
|
$
|
—
|
|
|
$
|
30
|
|
|
Military services
|
|
—
|
|
|
7
|
|
||
|
Future policy benefits:
|
|
|
|
|
||||
|
Individual Commercial
|
|
(67
|
)
|
|
(82
|
)
|
||
|
Other Businesses
|
|
36
|
|
|
36
|
|
||
|
Total future policy benefits
|
|
(31
|
)
|
|
(46
|
)
|
||
|
Total
|
|
$
|
(31
|
)
|
|
$
|
(9
|
)
|
|
|
|
For the nine months ended September 30,
|
||||||
|
|
|
2017
|
|
2016
|
||||
|
|
|
(in millions)
|
||||||
|
Balances, beginning of period
|
|
$
|
3,507
|
|
|
$
|
3,600
|
|
|
Less: Reinsurance recoverables
|
|
(76
|
)
|
|
(85
|
)
|
||
|
Balances, beginning of period, net
|
|
3,431
|
|
|
3,515
|
|
||
|
Incurred related to:
|
|
|
|
|
||||
|
Current year
|
|
29,356
|
|
|
28,369
|
|
||
|
Prior years
|
|
(339
|
)
|
|
(378
|
)
|
||
|
Total incurred
|
|
29,017
|
|
|
27,991
|
|
||
|
Paid related to:
|
|
|
|
|
||||
|
Current year
|
|
(25,460
|
)
|
|
(24,822
|
)
|
||
|
Prior years
|
|
(2,822
|
)
|
|
(2,990
|
)
|
||
|
Total paid
|
|
(28,282
|
)
|
|
(27,812
|
)
|
||
|
Reinsurance recoverable
|
|
70
|
|
|
77
|
|
||
|
Balances, end of period
|
|
$
|
4,236
|
|
|
$
|
3,771
|
|
|
|
|
For the nine months ended September 30,
|
||||||
|
|
|
2017
|
|
2016
|
||||
|
|
|
(in millions)
|
||||||
|
Balances, beginning of period
|
|
$
|
578
|
|
|
$
|
616
|
|
|
Incurred related to:
|
|
|
|
|
||||
|
Current year
|
|
3,996
|
|
|
3,918
|
|
||
|
Prior years
|
|
(44
|
)
|
|
(42
|
)
|
||
|
Total incurred
|
|
3,952
|
|
|
3,876
|
|
||
|
Paid related to:
|
|
|
|
|
||||
|
Current year
|
|
(3,452
|
)
|
|
(3,337
|
)
|
||
|
Prior years
|
|
(517
|
)
|
|
(557
|
)
|
||
|
Total paid
|
|
(3,969
|
)
|
|
(3,894
|
)
|
||
|
Balances, end of period
|
|
$
|
561
|
|
|
$
|
598
|
|
|
|
|
For the nine months ended September 30,
|
||||||
|
|
|
2017
|
|
2016
|
||||
|
|
|
(in millions)
|
||||||
|
Balances, beginning of period
|
|
$
|
454
|
|
|
$
|
740
|
|
|
Less: Premium deficiency reserve
|
|
—
|
|
|
(176
|
)
|
||
|
Balances, beginning of period, net
|
|
454
|
|
|
564
|
|
||
|
Incurred related to:
|
|
|
|
|
||||
|
Current year
|
|
502
|
|
|
2,694
|
|
||
|
Prior years
|
|
(46
|
)
|
|
(104
|
)
|
||
|
Total incurred
|
|
456
|
|
|
2,590
|
|
||
|
Paid related to:
|
|
|
|
|
||||
|
Current year
|
|
(393
|
)
|
|
(2,273
|
)
|
||
|
Prior years
|
|
(383
|
)
|
|
(430
|
)
|
||
|
Total paid
|
|
(776
|
)
|
|
(2,703
|
)
|
||
|
Premium deficiency reserve
|
|
—
|
|
|
206
|
|
||
|
Balance, end of period
|
|
$
|
134
|
|
|
$
|
657
|
|
|
Reconciliation of the Disclosure of Incurred and Paid Claims Development to Benefits Payable, net of reinsurance
|
||||
|
|
September 30,
|
|||
|
|
2017
|
|||
|
Net outstanding liabilities
|
|
|||
|
Retail
|
$
|
4,166
|
|
|
|
Group and Specialty
|
561
|
|
||
|
Individual Commercial
|
134
|
|
||
|
Other Businesses
|
28
|
|
||
|
Benefits payable, net of reinsurance
|
4,889
|
|
||
|
|
|
|||
|
Reinsurance recoverable on unpaid claims
|
|
|||
|
Retail
|
70
|
|
||
|
Total reinsurance recoverable on unpaid claims
|
70
|
|
||
|
|
|
|||
|
Total benefits payable, gross
|
$
|
4,959
|
|
|
|
|
Three months ended September 30,
|
|
Nine months ended September 30,
|
||||||||||||
|
|
2017
|
|
2016
|
|
2017
|
|
2016
|
||||||||
|
|
(dollars in millions, except per common share results; number of shares in thousands)
|
||||||||||||||
|
Net income available for common stockholders
|
$
|
499
|
|
|
$
|
450
|
|
|
$
|
2,264
|
|
|
$
|
1,015
|
|
|
Weighted average outstanding shares of common stock
used to compute basic earnings per common share |
144,215
|
|
|
149,417
|
|
|
145,546
|
|
|
149,321
|
|
||||
|
Dilutive effect of:
|
|
|
|
|
|
|
|
||||||||
|
Employee stock options
|
165
|
|
|
210
|
|
|
174
|
|
|
216
|
|
||||
|
Restricted stock
|
980
|
|
|
1,277
|
|
|
902
|
|
|
1,332
|
|
||||
|
Shares used to compute diluted earnings per common share
|
145,360
|
|
|
150,904
|
|
|
146,622
|
|
|
150,869
|
|
||||
|
Basic earnings per common share
|
$
|
3.46
|
|
|
$
|
3.01
|
|
|
$
|
15.56
|
|
|
$
|
6.80
|
|
|
Diluted earnings per common share
|
$
|
3.44
|
|
|
$
|
2.98
|
|
|
$
|
15.44
|
|
|
$
|
6.73
|
|
|
Number of antidilutive stock options and restricted stock
excluded from computation |
399
|
|
|
658
|
|
|
595
|
|
|
873
|
|
||||
|
Record
Date |
|
Payment
Date |
|
Amount
per Share |
|
Total
Amount |
||||
|
|
|
|
|
|
|
(in millions)
|
||||
|
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
|
|
|
2017 payments
|
|
|
|
|
|
|
||||
|
1/12/2017
|
|
1/27/2017
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
3/31/2017
|
|
4/28/2017
|
|
$
|
0.40
|
|
|
$
|
58
|
|
|
6/30/2017
|
|
7/31/2017
|
|
$
|
0.40
|
|
|
$
|
58
|
|
|
9/29/2017
|
|
10/27/2017
|
|
$
|
0.40
|
|
|
$
|
57
|
|
|
|
September 30, 2017
|
|
December 31, 2016
|
||||
|
|
(in millions)
|
||||||
|
Short-term:
|
|
|
|
||||
|
Commercial paper
|
$
|
150
|
|
|
$
|
300
|
|
|
$500 million, 7.20% Senior notes due June 15, 2018
|
501
|
|
|
—
|
|
||
|
$300 million, 6.30% Senior notes due August 1, 2018
|
302
|
|
|
—
|
|
||
|
Total short-term debt
|
953
|
|
|
300
|
|
||
|
|
|
|
|
||||
|
Long-term:
|
|
|
|
||||
|
Senior notes:
|
|
|
|
||||
|
$500 million, 7.20% due June 15, 2018
|
—
|
|
|
501
|
|
||
|
$300 million, 6.30% due August 1, 2018
|
—
|
|
|
304
|
|
||
|
$400 million, 2.625% due October 1, 2019
|
399
|
|
|
398
|
|
||
|
$600 million, 3.15% due December 1, 2022
|
596
|
|
|
595
|
|
||
|
$600 million, 3.85% due October 1, 2024
|
595
|
|
|
595
|
|
||
|
$600 million, 3.95% due March 15, 2027
|
594
|
|
|
—
|
|
||
|
$250 million, 8.15% due June 15, 2038
|
263
|
|
|
264
|
|
||
|
$400 million, 4.625% due December 1, 2042
|
396
|
|
|
396
|
|
||
|
$750 million, 4.95% due October 1, 2044
|
739
|
|
|
739
|
|
||
|
$400 million, 4.80% due March 15, 2047
|
395
|
|
|
—
|
|
||
|
Total long-term debt
|
3,977
|
|
|
3,792
|
|
||
|
|
|
|
|
||||
|
Total debt
|
$
|
4,930
|
|
|
$
|
4,092
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
|
Retail
|
|
Group and Specialty
|
|
Healthcare
Services |
|
Individual Commercial
|
|
Other
Businesses |
|
Eliminations/
Corporate |
|
Consolidated
|
||||||||||||||
|
|
(in millions)
|
||||||||||||||||||||||||||
|
Three months ended September 30, 2017
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||||
|
Revenues - external customers
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
Premiums:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
Individual Medicare Advantage
|
$
|
8,077
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
8,077
|
|
|
Group Medicare Advantage
|
1,272
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
1,272
|
|
|||||||
|
Medicare stand-alone PDP
|
921
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
921
|
|
|||||||
|
Total Medicare
|
10,270
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
10,270
|
|
|||||||
|
Fully-insured
|
121
|
|
|
1,370
|
|
|
—
|
|
|
224
|
|
|
—
|
|
|
—
|
|
|
1,715
|
|
|||||||
|
Specialty
|
—
|
|
|
331
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
331
|
|
|||||||
|
Medicaid and other
|
630
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
9
|
|
|
—
|
|
|
639
|
|
|||||||
|
Total premiums
|
11,021
|
|
|
1,701
|
|
|
—
|
|
|
224
|
|
|
9
|
|
|
—
|
|
|
12,955
|
|
|||||||
|
Services revenue:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
Provider
|
—
|
|
|
—
|
|
|
60
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
60
|
|
|||||||
|
ASO and other
|
2
|
|
|
140
|
|
|
—
|
|
|
—
|
|
|
1
|
|
|
—
|
|
|
143
|
|
|||||||
|
Pharmacy
|
—
|
|
|
—
|
|
|
20
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
20
|
|
|||||||
|
Total services revenue
|
2
|
|
|
140
|
|
|
80
|
|
|
—
|
|
|
1
|
|
|
—
|
|
|
223
|
|
|||||||
|
Total revenues - external customers
|
11,023
|
|
|
1,841
|
|
|
80
|
|
|
224
|
|
|
10
|
|
|
—
|
|
|
13,178
|
|
|||||||
|
Intersegment revenues
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
Services
|
—
|
|
|
5
|
|
|
4,339
|
|
|
—
|
|
|
—
|
|
|
(4,344
|
)
|
|
—
|
|
|||||||
|
Products
|
—
|
|
|
—
|
|
|
1,572
|
|
|
—
|
|
|
—
|
|
|
(1,572
|
)
|
|
—
|
|
|||||||
|
Total intersegment revenues
|
—
|
|
|
5
|
|
|
5,911
|
|
|
—
|
|
|
—
|
|
|
(5,916
|
)
|
|
—
|
|
|||||||
|
Investment income
|
23
|
|
|
7
|
|
|
9
|
|
|
1
|
|
|
22
|
|
|
42
|
|
|
104
|
|
|||||||
|
Total revenues
|
11,046
|
|
|
1,853
|
|
|
6,000
|
|
|
225
|
|
|
32
|
|
|
(5,874
|
)
|
|
13,282
|
|
|||||||
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
Benefits
|
9,294
|
|
|
1,354
|
|
|
—
|
|
|
147
|
|
|
34
|
|
|
(187
|
)
|
|
10,642
|
|
|||||||
|
Operating costs
|
1,081
|
|
|
385
|
|
|
5,726
|
|
|
49
|
|
|
3
|
|
|
(5,556
|
)
|
|
1,688
|
|
|||||||
|
Depreciation and amortization
|
61
|
|
|
21
|
|
|
34
|
|
|
3
|
|
|
—
|
|
|
(25
|
)
|
|
94
|
|
|||||||
|
Total operating expenses
|
10,436
|
|
|
1,760
|
|
|
5,760
|
|
|
199
|
|
|
37
|
|
|
(5,768
|
)
|
|
12,424
|
|
|||||||
|
Income (loss) from operations
|
610
|
|
|
93
|
|
|
240
|
|
|
26
|
|
|
(5
|
)
|
|
(106
|
)
|
|
858
|
|
|||||||
|
Interest expense
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
59
|
|
|
59
|
|
|||||||
|
Income (loss) before income taxes
|
$
|
610
|
|
|
$
|
93
|
|
|
$
|
240
|
|
|
$
|
26
|
|
|
$
|
(5
|
)
|
|
$
|
(165
|
)
|
|
$
|
799
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
|
Retail
|
|
Group and Specialty
|
|
Healthcare
Services |
|
Individual Commercial
|
|
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
|
109
|
|
|
1,350
|
|
|
—
|
|
|
882
|
|
|
—
|
|
|
—
|
|
|
2,341
|
|
|||||||
|
Specialty
|
—
|
|
|
318
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
318
|
|
|||||||
|
Medicaid and other
|
652
|
|
|
2
|
|
|
—
|
|
|
—
|
|
|
10
|
|
|
—
|
|
|
664
|
|
|||||||
|
Total premiums
|
10,809
|
|
|
1,670
|
|
|
—
|
|
|
882
|
|
|
10
|
|
|
—
|
|
|
13,371
|
|
|||||||
|
Services revenue:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
Provider
|
—
|
|
|
—
|
|
|
69
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
69
|
|
|||||||
|
ASO and other
|
2
|
|
|
147
|
|
|
—
|
|
|
—
|
|
|
1
|
|
|
—
|
|
|
150
|
|
|||||||
|
Pharmacy
|
—
|
|
|
—
|
|
|
8
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
8
|
|
|||||||
|
Total services revenue
|
2
|
|
|
147
|
|
|
77
|
|
|
—
|
|
|
1
|
|
|
—
|
|
|
227
|
|
|||||||
|
Total revenues - external customers
|
10,811
|
|
|
1,817
|
|
|
77
|
|
|
882
|
|
|
11
|
|
|
—
|
|
|
13,598
|
|
|||||||
|
Intersegment revenues
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
Services
|
—
|
|
|
5
|
|
|
4,741
|
|
|
—
|
|
|
—
|
|
|
(4,746
|
)
|
|
—
|
|
|||||||
|
Products
|
—
|
|
|
—
|
|
|
1,580
|
|
|
—
|
|
|
—
|
|
|
(1,580
|
)
|
|
—
|
|
|||||||
|
Total intersegment revenues
|
—
|
|
|
5
|
|
|
6,321
|
|
|
—
|
|
|
—
|
|
|
(6,326
|
)
|
|
—
|
|
|||||||
|
Investment income
|
22
|
|
|
7
|
|
|
8
|
|
|
—
|
|
|
17
|
|
|
42
|
|
|
96
|
|
|||||||
|
Total revenues
|
10,833
|
|
|
1,829
|
|
|
6,406
|
|
|
882
|
|
|
28
|
|
|
(6,284
|
)
|
|
13,694
|
|
|||||||
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
Benefits
|
9,031
|
|
|
1,352
|
|
|
—
|
|
|
727
|
|
|
26
|
|
|
(236
|
)
|
|
10,900
|
|
|||||||
|
Operating costs
|
1,143
|
|
|
421
|
|
|
6,073
|
|
|
144
|
|
|
4
|
|
|
(6,046
|
)
|
|
1,739
|
|
|||||||
|
Merger termination fee and related costs, net
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
20
|
|
|
20
|
|
|||||||
|
Depreciation and amortization
|
51
|
|
|
19
|
|
|
36
|
|
|
9
|
|
|
—
|
|
|
(29
|
)
|
|
86
|
|
|||||||
|
Total operating expenses
|
10,225
|
|
|
1,792
|
|
|
6,109
|
|
|
880
|
|
|
30
|
|
|
(6,291
|
)
|
|
12,745
|
|
|||||||
|
Income (loss) from operations
|
608
|
|
|
37
|
|
|
297
|
|
|
2
|
|
|
(2
|
)
|
|
7
|
|
|
949
|
|
|||||||
|
Interest expense
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
47
|
|
|
47
|
|
|||||||
|
Income (loss) before income taxes
|
$
|
608
|
|
|
$
|
37
|
|
|
$
|
297
|
|
|
$
|
2
|
|
|
$
|
(2
|
)
|
|
$
|
(40
|
)
|
|
$
|
902
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
|
Retail
|
|
Group and Specialty
|
|
Healthcare
Services |
|
Individual Commercial
|
|
Other
Businesses |
|
Eliminations/
Corporate |
|
Consolidated
|
||||||||||||||
|
|
(in millions)
|
||||||||||||||||||||||||||
|
Nine months ended September 30, 2017
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||
|
Revenues - external customers
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||
|
Premiums:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
Individual Medicare Advantage
|
$
|
24,735
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
24,735
|
|
|
Group Medicare Advantage
|
3,867
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
3,867
|
|
|||||||
|
Medicare stand-alone PDP
|
2,787
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
2,787
|
|
|||||||
|
Total Medicare
|
31,389
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
31,389
|
|
|||||||
|
Fully-insured
|
357
|
|
|
4,098
|
|
|
—
|
|
|
754
|
|
|
—
|
|
|
—
|
|
|
5,209
|
|
|||||||
|
Specialty
|
—
|
|
|
976
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
976
|
|
|||||||
|
Medicaid and other
|
1,954
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
28
|
|
|
—
|
|
|
1,982
|
|
|||||||
|
Total premiums
|
33,700
|
|
|
5,074
|
|
|
—
|
|
|
754
|
|
|
28
|
|
|
—
|
|
|
39,556
|
|
|||||||
|
Services revenue:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
Provider
|
—
|
|
|
—
|
|
|
193
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
193
|
|
|||||||
|
ASO and other
|
6
|
|
|
444
|
|
|
—
|
|
|
—
|
|
|
5
|
|
|
—
|
|
|
455
|
|
|||||||
|
Pharmacy
|
—
|
|
|
—
|
|
|
58
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
58
|
|
|||||||
|
Total services revenue
|
6
|
|
|
444
|
|
|
251
|
|
|
—
|
|
|
5
|
|
|
—
|
|
|
706
|
|
|||||||
|
Total revenues - external customers
|
33,706
|
|
|
5,518
|
|
|
251
|
|
|
754
|
|
|
33
|
|
|
—
|
|
|
40,262
|
|
|||||||
|
Intersegment revenues
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
Services
|
—
|
|
|
15
|
|
|
12,958
|
|
|
—
|
|
|
—
|
|
|
(12,973
|
)
|
|
—
|
|
|||||||
|
Products
|
—
|
|
|
—
|
|
|
4,706
|
|
|
—
|
|
|
—
|
|
|
(4,706
|
)
|
|
—
|
|
|||||||
|
Total intersegment revenues
|
—
|
|
|
15
|
|
|
17,664
|
|
|
—
|
|
|
—
|
|
|
(17,679
|
)
|
|
—
|
|
|||||||
|
Investment income
|
72
|
|
|
25
|
|
|
25
|
|
|
3
|
|
|
64
|
|
|
127
|
|
|
316
|
|
|||||||
|
Total revenues
|
33,778
|
|
|
5,558
|
|
|
17,940
|
|
|
757
|
|
|
97
|
|
|
(17,552
|
)
|
|
40,578
|
|
|||||||
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
Benefits
|
29,017
|
|
|
3,952
|
|
|
—
|
|
|
389
|
|
|
95
|
|
|
(596
|
)
|
|
32,857
|
|
|||||||
|
Operating costs
|
2,998
|
|
|
1,178
|
|
|
17,083
|
|
|
151
|
|
|
9
|
|
|
(16,725
|
)
|
|
4,694
|
|
|||||||
|
Merger termination fee and related costs, net
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(947
|
)
|
|
(947
|
)
|
|||||||
|
Depreciation and amortization
|
176
|
|
|
63
|
|
|
103
|
|
|
10
|
|
|
—
|
|
|
(74
|
)
|
|
278
|
|
|||||||
|
Total operating expenses
|
32,191
|
|
|
5,193
|
|
|
17,186
|
|
|
550
|
|
|
104
|
|
|
(18,342
|
)
|
|
36,882
|
|
|||||||
|
Income (loss) from operations
|
1,587
|
|
|
365
|
|
|
754
|
|
|
207
|
|
|
(7
|
)
|
|
790
|
|
|
3,696
|
|
|||||||
|
Interest expense
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
166
|
|
|
166
|
|
|||||||
|
Income (loss) before income taxes
|
$
|
1,587
|
|
|
$
|
365
|
|
|
$
|
754
|
|
|
$
|
207
|
|
|
$
|
(7
|
)
|
|
$
|
624
|
|
|
$
|
3,530
|
|
|
|
Retail
|
|
Group and Specialty
|
|
Healthcare
Services |
|
Individual Commercial
|
|
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
|
319
|
|
|
4,044
|
|
|
—
|
|
|
2,799
|
|
|
—
|
|
|
—
|
|
|
7,162
|
|
|||||||
|
Specialty
|
—
|
|
|
957
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
957
|
|
|||||||
|
Medicaid and other
|
1,960
|
|
|
12
|
|
|
—
|
|
|
—
|
|
|
29
|
|
|
—
|
|
|
2,001
|
|
|||||||
|
Total premiums
|
32,620
|
|
|
5,013
|
|
|
—
|
|
|
2,799
|
|
|
29
|
|
|
—
|
|
|
40,461
|
|
|||||||
|
Services revenue:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
Provider
|
—
|
|
|
—
|
|
|
214
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
214
|
|
|||||||
|
ASO and other
|
5
|
|
|
500
|
|
|
1
|
|
|
—
|
|
|
7
|
|
|
—
|
|
|
513
|
|
|||||||
|
Pharmacy
|
—
|
|
|
—
|
|
|
22
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
22
|
|
|||||||
|
Total services revenue
|
5
|
|
|
500
|
|
|
237
|
|
|
—
|
|
|
7
|
|
|
—
|
|
|
749
|
|
|||||||
|
Total revenues - external customers
|
32,625
|
|
|
5,513
|
|
|
237
|
|
|
2,799
|
|
|
36
|
|
|
—
|
|
|
41,210
|
|
|||||||
|
Intersegment revenues
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
Services
|
—
|
|
|
17
|
|
|
14,292
|
|
|
—
|
|
|
—
|
|
|
(14,309
|
)
|
|
—
|
|
|||||||
|
Products
|
—
|
|
|
—
|
|
|
4,373
|
|
|
—
|
|
|
—
|
|
|
(4,373
|
)
|
|
—
|
|
|||||||
|
Total intersegment revenues
|
—
|
|
|
17
|
|
|
18,665
|
|
|
—
|
|
|
—
|
|
|
(18,682
|
)
|
|
—
|
|
|||||||
|
Investment income
|
68
|
|
|
19
|
|
|
22
|
|
|
3
|
|
|
48
|
|
|
131
|
|
|
291
|
|
|||||||
|
Total revenues
|
32,693
|
|
|
5,549
|
|
|
18,924
|
|
|
2,802
|
|
|
84
|
|
|
(18,551
|
)
|
|
41,501
|
|
|||||||
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
Benefits
|
27,991
|
|
|
3,876
|
|
|
—
|
|
|
2,545
|
|
|
82
|
|
|
(688
|
)
|
|
33,806
|
|
|||||||
|
Operating costs
|
3,294
|
|
|
1,278
|
|
|
17,989
|
|
|
465
|
|
|
12
|
|
|
(17,866
|
)
|
|
5,172
|
|
|||||||
|
Merger termination fee and related costs, net
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
81
|
|
|
81
|
|
|||||||
|
Depreciation and amortization
|
145
|
|
|
62
|
|
|
107
|
|
|
27
|
|
|
—
|
|
|
(78
|
)
|
|
263
|
|
|||||||
|
Total operating expenses
|
31,430
|
|
|
5,216
|
|
|
18,096
|
|
|
3,037
|
|
|
94
|
|
|
(18,551
|
)
|
|
39,322
|
|
|||||||
|
Income (loss) from operations
|
1,263
|
|
|
333
|
|
|
828
|
|
|
(235
|
)
|
|
(10
|
)
|
|
—
|
|
|
2,179
|
|
|||||||
|
Interest expense
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
141
|
|
|
141
|
|
|||||||
|
Income (loss) before income taxes
|
$
|
1,263
|
|
|
$
|
333
|
|
|
$
|
828
|
|
|
$
|
(235
|
)
|
|
$
|
(10
|
)
|
|
$
|
(141
|
)
|
|
$
|
2,038
|
|
|
•
|
Our consolidated pretax results for the
three months ended September 30, 2017
as compared to the
three months ended September 30, 2016
, were primarily impacted by the estimated charges associated with voluntary and involuntary workforce reduction programs and lower pretax earnings in the Healthcare Services segment, partially offset by year-over-year improvement in earnings for our Group and Specialty segment as well as Medicare Advantage and Individual Commercial businesses. Our consolidated pretax results for the
nine months ended September 30, 2017
as compared to the
nine months ended September 30, 2016
, primarily reflects the net gain associated with the terminated Merger Agreement, mainly the break-up fee, along with the year-over year improvement in earnings for our Group and Specialty segment as well as Medicare Advantage and Individual Commercial businesses. These were partially offset by lower pretax earnings in the Healthcare Services segment and the recording of estimated charges associated with voluntary and involuntary workforce reduction programs during the
three months ended September 30, 2017
.
|
|
•
|
Year-over-year comparisons of diluted earnings per common share reflect the same factors impacting our consolidated pretax income comparisons year-over-year as well as the beneficial effect of the lower effective tax rate in light of pricing and benefit design assumptions associated with the 2017 temporary suspension of the health insurance industry fee. In addition the year-over-year comparisons were favorably impacted by lower number of shares, primarily reflecting share repurchases.
|
|
•
|
Our
2017
results through
September 30, 2017
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, 2017
, approximately
1,877,800
members, or
65.9%
, of our individual Medicare Advantage members were in value-based relationships under our integrated care delivery model, as compared to
1,816,300
members, or
64.0%
, at
December 31, 2016
and
1,786,100
members, or
63.1%
, at
September 30, 2016
.
|
|
•
|
We recorded
a net gain associated with the terminated Merger Agreement
,
consisting primarily of the break-up
fee, of approximately
$947 million
, or
$4.33
per diluted common share during the
nine months ended September 30, 2017
. We recorded transaction costs in connection with the Merger of approximately
$20 million
, or
$0.12
per diluted common share, and
$81 million
, or
$0.49
per diluted common share, during the
three and nine months ended September 30, 2016
, respectively. Certain costs associated with the Merger were previously not deductible for tax purposes, but became deductible, and were recorded as such in the three months ended March 31, 2017 as a result of the termination of the Merger Agreement.
|
|
•
|
Year-over-year comparisons of results are also impacted by the recognition of a premium deficiency reserve for our Individual Commercial segment related to certain of our 2016 policies as discussed in the Individual Commercial segment highlights that follow. During the
nine months ended September 30, 2016
, we increased the premium deficiency reserve by
$208 million
, or
$0.86
per diluted common share.
|
|
•
|
The annual health insurance industry fee has been suspended for calendar year 2017 but is scheduled to resume in calendar year 2018. Operating cost associated with the health insurer fee attributable to the
three and nine months ended September 30, 2016
was
$231 million
and
$687 million
, respectively. This fee is not deductible for tax purposes, which significantly increased our effective income tax rate. The one-year suspension in 2017 of the health insurer fee has significantly reduced our operating costs and effective tax rate during the
three and nine months ended September 30, 2017
.
|
|
•
|
On February 14, 2017, we announced we are exiting our Individual Commercial medical business commencing January 1, 2018. As discussed previously, we have worked over the past several years to address market and programmatic challenges in order to keep coverage options available wherever we could offer a viable product. This has included pursuing business changes, such as modifying networks, restructuring product offerings, reducing the company’s geographic footprint and increasing premiums. All of these actions were taken with the expectation that our Individual Commercial medical business would stabilize to the point where we could continue to participate in the program. However, based on our analysis of data associated with our healthcare exchange membership following the 2017 open enrollment period, we saw further signs of an unbalanced risk pool. Therefore, we decided that we cannot continue to offer this coverage and will exit this business commencing January 1, 2018.
The
three and nine months ended September 30, 2017
includes pretax income from our Individual Commercial business of
$26 million
, or
$0.11
per diluted common share, and
$207 million
, or
$0.89
per diluted common share, respectively.
|
|
•
|
On March 1, 2017, a court ordered the liquidation of Penn Treaty (an unaffiliated long-term care insurance company), which triggered assessments from state guaranty associations that resulted in our recording a
$54 million
, or
$0.23
per diluted common share, estimate in operating costs in the three months ended March 31, 2017.
|
|
•
|
During the third quarter of 2017
we recorded estimated charges of
$124 million
, or
$0.54
per diluted common share associated with both voluntary and involuntary workforce reduction programs that are expected to impact approximately
2,700
associates, or
5.7%
,
of our workforce. This charge is included with operating costs in the condensed consolidated statement of income for the three and nine month periods ended September 30, 2017.
|
|
•
|
During the
nine months ended September 30, 2017
, cash flow provided by operations was
$7.0 billion
as compared to
$4.7 billion
for the
nine months ended September 30, 2016
. Our operating cash flows for the
nine months ended September 30, 2017
were significantly impacted by the receipt of the
$1 billion
Merger termination fee, net of related expenses and the portion of taxes paid to date. Our operating cash flows were also significantly impacted in both periods by the early receipt of the Medicare premium remittance for October 2017 of $3.1 billion in September 2017 and the receipt of the Medicare premium remittance for October 2016 of $3.0 billion in September 2016 because the payment dates of October 2017 and October 2016 fell on a weekend.
Excluding the Merger termination fee and the timing of the Medicare premium remittances, our operating cash flows were positively impacted by higher earnings and the timing of working capital items.
See further discussion under the section titled "Liquidity" in this report.
|
|
•
|
On April 3, 2017, CMS issued its announcement of 2018 Medicare Advantage Capitation Rates and Medicare Advantage and Part D payment policies and Final Call Letter, which we refer to collectively as the Final Rate Notice. We expect the Final Rate Notice to result in a 0.45% rate increase for Humana versus CMS’ estimate for the sector of 0.85% increase on a comparable basis. The rate increase excludes the impact of Star quality bonus ratings, the impact of encounter data weighting in risk score calculations and estimates of changes in revenue associated with increased accuracy of risk coding. The primary difference between the estimates is the impact of fee-for-service county rebasing/re-pricing by CMS.
|
|
•
|
On March 2, 2017, we received notice that the Defense Health Agency, or DHA, had exercised its option to extend the TRICARE South Region contract
through March 31, 2018.
On July 21, 2016, we were notified by the DHA that we were awarded the contract for the new TRICARE East Region, which is a consolidation of the former North and South Regions, with delivery of health care services expected to commence on October 1, 2017. On March 30, 2017, we received notice that the DHA is moving the date upon which delivery of health care services is expected to commence under the new TRICARE East Region contract from October 1, 2017 to January 1, 2018.
|
|
•
|
At
September 30, 2017
, approximately
51,500
primary care providers were in value-based relationships, an
increase
of
3.8%
from
49,600
at
September 30, 2016
and an
increase
of
2.2%
from
50,400
at
December 31, 2016
. At
September 30, 2017
,
65.9%
of our individual Medicare Advantage members were in value-based relationships compared to
63.1%
at
September 30, 2016
and
64.0%
at
December 31, 2016
.
|
|
•
|
Medicare Advantage and dual demonstration program membership enrolled in a Humana chronic care management program was
825,200
at
September 30, 2017
, a
decrease
of
21.0%
from
1,044,700
at
September 30, 2016
, and
24.9%
from
1,099,200
at
December 31, 2016
. We have undergone an optimization process that ensures the appropriate level of member interaction with clinicians to drive quality outcomes, which has resulted in reduced segment earnings but higher returns on investment.
|
|
|
|
|
|
|
|
|
|
|||||||
|
|
For the three months ended September 30,
|
|
Change
|
|||||||||||
|
|
2017
|
|
2016
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(dollars in millions, except per common share results)
|
|
|
|||||||||||
|
Revenues:
|
|
|
|
|
|
|
|
|||||||
|
Premiums:
|
|
|
|
|
|
|
|
|||||||
|
Retail
|
$
|
11,021
|
|
|
$
|
10,809
|
|
|
$
|
212
|
|
|
2.0
|
%
|
|
Group and Specialty
|
1,701
|
|
|
1,670
|
|
|
31
|
|
|
1.9
|
%
|
|||
|
Individual Commercial
|
224
|
|
|
882
|
|
|
(658
|
)
|
|
(74.6
|
)%
|
|||
|
Other Businesses
|
9
|
|
|
10
|
|
|
(1
|
)
|
|
(10.0
|
)%
|
|||
|
Total premiums
|
12,955
|
|
|
13,371
|
|
|
(416
|
)
|
|
(3.1
|
)%
|
|||
|
Services:
|
|
|
|
|
|
|
|
|||||||
|
Retail
|
2
|
|
|
2
|
|
|
—
|
|
|
—
|
%
|
|||
|
Group and Specialty
|
140
|
|
|
147
|
|
|
(7
|
)
|
|
(4.8
|
)%
|
|||
|
Healthcare Services
|
80
|
|
|
77
|
|
|
3
|
|
|
3.9
|
%
|
|||
|
Other Businesses
|
1
|
|
|
1
|
|
|
—
|
|
|
—
|
%
|
|||
|
Total services
|
223
|
|
|
227
|
|
|
(4
|
)
|
|
(1.8
|
)%
|
|||
|
Investment income
|
104
|
|
|
96
|
|
|
8
|
|
|
8.3
|
%
|
|||
|
Total revenues
|
13,282
|
|
|
13,694
|
|
|
(412
|
)
|
|
(3.0
|
)%
|
|||
|
Operating expenses:
|
|
|
|
|
|
|
|
|||||||
|
Benefits
|
10,642
|
|
|
10,900
|
|
|
(258
|
)
|
|
(2.4
|
)%
|
|||
|
Operating costs
|
1,688
|
|
|
1,739
|
|
|
(51
|
)
|
|
(2.9
|
)%
|
|||
|
Merger termination fee and related costs, net
|
—
|
|
|
20
|
|
|
(20
|
)
|
|
(100.0
|
)%
|
|||
|
Depreciation and amortization
|
94
|
|
|
86
|
|
|
8
|
|
|
9.3
|
%
|
|||
|
Total operating expenses
|
12,424
|
|
|
12,745
|
|
|
(321
|
)
|
|
(2.5
|
)%
|
|||
|
Income from operations
|
858
|
|
|
949
|
|
|
(91
|
)
|
|
(9.6
|
)%
|
|||
|
Interest expense
|
59
|
|
|
47
|
|
|
12
|
|
|
25.5
|
%
|
|||
|
Income before income taxes
|
799
|
|
|
902
|
|
|
(103
|
)
|
|
(11.4
|
)%
|
|||
|
Provision for income taxes
|
300
|
|
|
452
|
|
|
(152
|
)
|
|
(33.6
|
)%
|
|||
|
Net income
|
$
|
499
|
|
|
$
|
450
|
|
|
$
|
49
|
|
|
10.9
|
%
|
|
Diluted earnings per common share
|
$
|
3.44
|
|
|
$
|
2.98
|
|
|
$
|
0.46
|
|
|
15.4
|
%
|
|
Benefit ratio
(a)
|
82.1
|
%
|
|
81.5
|
%
|
|
|
|
0.6
|
%
|
||||
|
Operating cost ratio
(b)
|
12.8
|
%
|
|
12.8
|
%
|
|
|
|
—
|
%
|
||||
|
Effective tax rate
|
37.5
|
%
|
|
50.1
|
%
|
|
|
|
(12.6
|
)%
|
||||
|
|
|
|
|
|
|
|
|
|||||||
|
|
For the nine months ended
September 30, |
|
Change
|
|||||||||||
|
|
2017
|
|
2016
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(dollars in millions, except per common share results)
|
|
|
|||||||||||
|
Revenues:
|
|
|
|
|
|
|
|
|||||||
|
Premiums:
|
|
|
|
|
|
|
|
|||||||
|
Retail
|
$
|
33,700
|
|
|
$
|
32,620
|
|
|
$
|
1,080
|
|
|
3.3
|
%
|
|
Group and Specialty
|
5,074
|
|
|
5,013
|
|
|
61
|
|
|
1.2
|
%
|
|||
|
Individual Commercial
|
754
|
|
|
2,799
|
|
|
(2,045
|
)
|
|
(73.1
|
)%
|
|||
|
Other Businesses
|
28
|
|
|
29
|
|
|
(1
|
)
|
|
(3.4
|
)%
|
|||
|
Total premiums
|
39,556
|
|
|
40,461
|
|
|
(905
|
)
|
|
(2.2
|
)%
|
|||
|
Services:
|
|
|
|
|
|
|
|
|||||||
|
Retail
|
6
|
|
|
5
|
|
|
1
|
|
|
20.0
|
%
|
|||
|
Group and Specialty
|
444
|
|
|
500
|
|
|
(56
|
)
|
|
(11.2
|
)%
|
|||
|
Healthcare Services
|
251
|
|
|
237
|
|
|
14
|
|
|
5.9
|
%
|
|||
|
Other Businesses
|
5
|
|
|
7
|
|
|
(2
|
)
|
|
(28.6
|
)%
|
|||
|
Total services
|
706
|
|
|
749
|
|
|
(43
|
)
|
|
(5.7
|
)%
|
|||
|
Investment income
|
316
|
|
|
291
|
|
|
25
|
|
|
8.6
|
%
|
|||
|
Total revenues
|
40,578
|
|
|
41,501
|
|
|
(923
|
)
|
|
(2.2
|
)%
|
|||
|
Operating expenses:
|
|
|
|
|
|
|
|
|||||||
|
Benefits
|
32,857
|
|
|
33,806
|
|
|
(949
|
)
|
|
(2.8
|
)%
|
|||
|
Operating costs
|
4,694
|
|
|
5,172
|
|
|
(478
|
)
|
|
(9.2
|
)%
|
|||
|
Merger termination fee and related costs, net
|
(947
|
)
|
|
81
|
|
|
(1,028
|
)
|
|
(1,269.1
|
)%
|
|||
|
Depreciation and amortization
|
278
|
|
|
263
|
|
|
15
|
|
|
5.7
|
%
|
|||
|
Total operating expenses
|
36,882
|
|
|
39,322
|
|
|
(2,440
|
)
|
|
(6.2
|
)%
|
|||
|
Income from operations
|
3,696
|
|
|
2,179
|
|
|
1,517
|
|
|
69.6
|
%
|
|||
|
Interest expense
|
166
|
|
|
141
|
|
|
25
|
|
|
17.7
|
%
|
|||
|
Income before income taxes
|
3,530
|
|
|
2,038
|
|
|
1,492
|
|
|
73.2
|
%
|
|||
|
Provision for income taxes
|
1,266
|
|
|
1,023
|
|
|
243
|
|
|
23.8
|
%
|
|||
|
Net income
|
$
|
2,264
|
|
|
$
|
1,015
|
|
|
$
|
1,249
|
|
|
123.1
|
%
|
|
Diluted earnings per common share
|
$
|
15.44
|
|
|
$
|
6.73
|
|
|
$
|
8.71
|
|
|
129.4
|
%
|
|
Benefit ratio
(a)
|
83.1
|
%
|
|
83.6
|
%
|
|
|
|
(0.5
|
)%
|
||||
|
Operating cost ratio
(b)
|
11.7
|
%
|
|
12.6
|
%
|
|
|
|
(0.9
|
)%
|
||||
|
Effective tax rate
|
35.9
|
%
|
|
50.2
|
%
|
|
|
|
(14.3
|
)%
|
||||
|
(a)
|
Represents total benefits expense as a percentage of premiums revenue.
|
|
(b)
|
Represents total operating costs, excluding
Merger termination fee and related costs, net,
and depreciation and amortization, as a percentage of total revenues less investment income.
|
|
|
September 30,
|
|
Change
|
||||||||
|
|
2017
|
|
2016
|
|
Members
|
|
Percentage
|
||||
|
Membership:
|
|
|
|
|
|
|
|
||||
|
Medical membership:
|
|
|
|
|
|
|
|
||||
|
Individual Medicare Advantage
|
2,849,400
|
|
|
2,831,700
|
|
|
17,700
|
|
|
0.6
|
%
|
|
Group Medicare Advantage
|
438,400
|
|
|
353,900
|
|
|
84,500
|
|
|
23.9
|
%
|
|
Medicare stand-alone PDP
|
5,290,900
|
|
|
4,913,400
|
|
|
377,500
|
|
|
7.7
|
%
|
|
Total Retail Medicare
|
8,578,700
|
|
|
8,099,000
|
|
|
479,700
|
|
|
5.9
|
%
|
|
State-based Medicaid
|
363,400
|
|
|
390,100
|
|
|
(26,700
|
)
|
|
(6.8
|
)%
|
|
Medicare Supplement
|
234,900
|
|
|
217,100
|
|
|
17,800
|
|
|
8.2
|
%
|
|
Total Retail medical members
|
9,177,000
|
|
|
8,706,200
|
|
|
470,800
|
|
|
5.4
|
%
|
|
|
|
|
|
|
|
|
|
|||||||
|
|
|
|
|
|
|
|
|
|||||||
|
|
For the three months ended September 30,
|
|
Change
|
|||||||||||
|
|
2017
|
|
2016
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(in millions)
|
|
|
|||||||||||
|
Premiums and Services Revenue:
|
|
|
|
|
|
|
|
|||||||
|
Premiums:
|
|
|
|
|
|
|
|
|||||||
|
Individual Medicare Advantage
|
$
|
8,077
|
|
|
$
|
7,977
|
|
|
$
|
100
|
|
|
1.3
|
%
|
|
Group Medicare Advantage
|
1,272
|
|
|
1,067
|
|
|
205
|
|
|
19.2
|
%
|
|||
|
Medicare stand-alone PDP
|
921
|
|
|
1,004
|
|
|
(83
|
)
|
|
(8.3
|
)%
|
|||
|
Total Retail Medicare
|
10,270
|
|
|
10,048
|
|
|
222
|
|
|
2.2
|
%
|
|||
|
State-based Medicaid
|
630
|
|
|
652
|
|
|
(22
|
)
|
|
(3.4
|
)%
|
|||
|
Medicare Supplement
|
121
|
|
|
109
|
|
|
12
|
|
|
11.0
|
%
|
|||
|
Total premiums
|
11,021
|
|
|
10,809
|
|
|
212
|
|
|
2.0
|
%
|
|||
|
Services
|
2
|
|
|
2
|
|
|
—
|
|
|
—
|
%
|
|||
|
Total premiums and services revenue
|
$
|
11,023
|
|
|
$
|
10,811
|
|
|
$
|
212
|
|
|
2.0
|
%
|
|
Income before income taxes
|
$
|
610
|
|
|
$
|
608
|
|
|
$
|
2
|
|
|
0.3
|
%
|
|
Benefit ratio
|
84.3
|
%
|
|
83.6
|
%
|
|
|
|
0.7
|
%
|
||||
|
Operating cost ratio
|
9.8
|
%
|
|
10.6
|
%
|
|
|
|
(0.8
|
)%
|
||||
|
|
For the nine months ended
September 30, |
|
Change
|
|||||||||||
|
|
2017
|
|
2016
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(in millions)
|
|
|
|||||||||||
|
Premiums and Services Revenue:
|
|
|
|
|
|
|
|
|||||||
|
Premiums:
|
|
|
|
|
|
|
|
|||||||
|
Individual Medicare Advantage
|
$
|
24,735
|
|
|
$
|
24,054
|
|
|
$
|
681
|
|
|
2.8
|
%
|
|
Group Medicare Advantage
|
3,867
|
|
|
3,229
|
|
|
638
|
|
|
19.8
|
%
|
|||
|
Medicare stand-alone PDP
|
2,787
|
|
|
3,058
|
|
|
(271
|
)
|
|
(8.9
|
)%
|
|||
|
Total Retail Medicare
|
31,389
|
|
|
30,341
|
|
|
1,048
|
|
|
3.5
|
%
|
|||
|
State-based Medicaid
|
1,954
|
|
|
1,960
|
|
|
(6
|
)
|
|
(0.3
|
)%
|
|||
|
Medicare Supplement
|
357
|
|
|
319
|
|
|
38
|
|
|
11.9
|
%
|
|||
|
Total premiums
|
33,700
|
|
|
32,620
|
|
|
1,080
|
|
|
3.3
|
%
|
|||
|
Services
|
6
|
|
|
5
|
|
|
1
|
|
|
20.0
|
%
|
|||
|
Total premiums and services revenue
|
$
|
33,706
|
|
|
$
|
32,625
|
|
|
$
|
1,081
|
|
|
3.3
|
%
|
|
Income before income taxes
|
$
|
1,587
|
|
|
$
|
1,263
|
|
|
$
|
324
|
|
|
25.7
|
%
|
|
Benefit ratio
|
86.1
|
%
|
|
85.8
|
%
|
|
|
|
0.3
|
%
|
||||
|
Operating cost ratio
|
8.9
|
%
|
|
10.1
|
%
|
|
|
|
(1.2
|
)%
|
||||
|
•
|
Retail segment pretax income of
$610 million
in the
2017 quarter
was relatively unchanged from
$608 million
in the
2016 quarter
, reflecting the year-over-year improvement in the operating cost ratio being substantially offset by the increase in the benefit ratio. Retail segment pretax income
increased
$324 million
, or
25.7%
, to
$1.6 billion
in the
2017 period
from
$1.3 billion
in the
2016 period
, primarily due to the year-over-year improvement in earnings for our Medicare Advantage business.
|
|
•
|
Individual Medicare Advantage membership
increased
17,700
members, or
0.6%
, from
September 30, 2016
to
September 30, 2017
reflecting net membership additions for Medicare beneficiaries including the effect of market and product exits in 2017. We decided certain markets and/or products were not meeting long term strategic and financial objectives. Additionally, membership growth was muted due to competitive actions including the uncertainty associated with the then-pending Merger transaction during last year's Annual Election Period.
|
|
•
|
Group Medicare Advantage membership
increased
84,500
, or
23.9%
, from
September 30, 2016
to
September 30, 2017
reflecting the addition of a large account in January 2017.
|
|
•
|
Medicare stand-alone PDP membership
increased
377,500
members, or
7.7%
, from
September 30, 2016
to
September 30, 2017
reflecting net membership additions, primarily for our Humana-Walmart plan offering, for the 2017 plan year
.
|
|
•
|
State-based Medicaid membership
decreased
26,700
members, or
6.8%
, from
September 30, 2016
to
September 30, 2017
, primarily driven by lower membership associated with our Florida contracts resulting from network realignments.
|
|
•
|
Retail segment premiums increased
$212 million
, or
2.0%
, from the
2016 quarter
to the
2017 quarter
and increased
$1.1 billion
, or
3.3%
, from the
2016 period
to the
2017 period
. These increases primarily were due to Medicare Advantage membership growth and increased per-member premiums for certain businesses within the segment. Average group and individual Medicare Advantage membership increased
3.2%
for the
2017
|
|
•
|
The Retail segment benefit ratio
increased
70
basis points from
83.6%
in the
2016 quarter
to
84.3%
in the
2017 quarter
, and
increased
30
basis points from
85.8%
in the
2016 period
to
86.1%
in the
2017 period
. These increases primarily were due to the impact of the temporary suspension of the health insurance industry fee for calendar year 2017 which was contemplated in the pricing and benefit design of our products, margin compression associated with the competitive environment in the group Medicare Advantage business and lower favorable prior-period medical claims reserve development. These increases were partially offset by the impact of planned exits from certain Medicare Advantage markets that carried a higher benefit ratio than other markets as well as lower than expected medical costs as compared to the assumptions used in the pricing of our individual Medicare Advantage business.
|
|
•
|
The Retail segment’s benefits expense for the
2017 quarter
included
$52 million
in favorable prior-period medical claims reserve development versus
$80 million
in favorable prior-period medical claims reserve development in the
2016 quarter
. For the
2017 period
, the Retail segment's benefit expense includes the beneficial effect of
$339 million
in favorable prior-period reserve development versus
$379 million
in the
2016 period
. Prior-period medical claims reserve development decreased the Retail segment benefit ratio by approximately
50
basis points in the
2017 quarter
versus approximately
70
basis points in the
2016 quarter
. Favorable prior-period reserve development decreased the benefit ratio by approximately
100
basis points in the
2017 period
versus approximately
120
basis points in the
2016 period
.
|
|
•
|
The Retail segment operating cost ratio of
9.8%
for the
2017 quarter
decreased
80
basis points from
10.6%
for the
2016 quarter
. The Retail segment operating cost ratio of
8.9%
for the
2017 period
decreased
120
basis points from
10.1%
for the
2016 period
. These decreases primarily were due to the temporary suspension of the health insurance industry fee for calendar year 2017, partially offset by the increase in employee compensation costs resulting from the continued strong performance. The non-deductible health insurance industry fee impacted the operating cost ratio by
170
basis points in each of the
2016 quarter
and the
2016 period
.
|
|
|
September 30,
|
|
Change
|
||||||||
|
|
2017
|
|
2016
|
|
Members
|
|
Percentage
|
||||
|
Membership:
|
|
|
|
|
|
|
|
||||
|
Medical membership:
|
|
|
|
|
|
|
|
||||
|
Fully-insured commercial group
|
1,098,800
|
|
|
1,131,500
|
|
|
(32,700
|
)
|
|
(2.9
|
)%
|
|
ASO
|
445,700
|
|
|
570,300
|
|
|
(124,600
|
)
|
|
(21.8
|
)%
|
|
Military services
|
3,099,000
|
|
|
3,080,900
|
|
|
18,100
|
|
|
0.6
|
%
|
|
Total group and specialty medical members
|
4,643,500
|
|
|
4,782,700
|
|
|
(139,200
|
)
|
|
(2.9
|
)%
|
|
Specialty membership (a)
|
6,934,000
|
|
|
6,955,200
|
|
|
(21,200
|
)
|
|
(0.3
|
)%
|
|
(a)
|
Specialty products include dental, vision, voluntary benefit products 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
|
|||||||||||
|
|
2017
|
|
2016
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(in millions)
|
|
|
|||||||||||
|
Premiums and Services Revenue:
|
|
|
|
|
|
|
|
|||||||
|
Premiums:
|
|
|
|
|
|
|
|
|||||||
|
Fully-insured commercial group
|
$
|
1,370
|
|
|
$
|
1,350
|
|
|
$
|
20
|
|
|
1.5
|
%
|
|
Group specialty
|
331
|
|
|
318
|
|
|
13
|
|
|
4.1
|
%
|
|||
|
Military services
|
—
|
|
|
2
|
|
|
(2
|
)
|
|
(100.0
|
)%
|
|||
|
Total premiums
|
1,701
|
|
|
1,670
|
|
|
31
|
|
|
1.9
|
%
|
|||
|
Services
|
140
|
|
|
147
|
|
|
(7
|
)
|
|
(4.8
|
)%
|
|||
|
Total premiums and services revenue
|
$
|
1,841
|
|
|
$
|
1,817
|
|
|
$
|
24
|
|
|
1.3
|
%
|
|
Income before income taxes
|
$
|
93
|
|
|
$
|
37
|
|
|
$
|
56
|
|
|
151.4
|
%
|
|
Benefit ratio
|
79.6
|
%
|
|
81.0
|
%
|
|
|
|
(1.4
|
)%
|
||||
|
Operating cost ratio
|
20.9
|
%
|
|
23.1
|
%
|
|
|
|
(2.2
|
)%
|
||||
|
|
For the nine months ended
September 30, |
|
Change
|
|||||||||||
|
|
2017
|
|
2016
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(in millions)
|
|
|
|||||||||||
|
Premiums and Services Revenue:
|
|
|
|
|
|
|
|
|||||||
|
Premiums:
|
|
|
|
|
|
|
|
|||||||
|
Fully-insured commercial group
|
$
|
4,098
|
|
|
$
|
4,044
|
|
|
$
|
54
|
|
|
1.3
|
%
|
|
Group specialty
|
976
|
|
|
957
|
|
|
19
|
|
|
2.0
|
%
|
|||
|
Military services
|
—
|
|
|
12
|
|
|
(12
|
)
|
|
(100.0
|
)%
|
|||
|
Total premiums
|
5,074
|
|
|
5,013
|
|
|
61
|
|
|
1.2
|
%
|
|||
|
Services
|
444
|
|
|
500
|
|
|
(56
|
)
|
|
(11.2
|
)%
|
|||
|
Total premiums and services revenue
|
$
|
5,518
|
|
|
$
|
5,513
|
|
|
$
|
5
|
|
|
0.1
|
%
|
|
Income before income taxes
|
$
|
365
|
|
|
$
|
333
|
|
|
$
|
32
|
|
|
9.6
|
%
|
|
Benefit ratio
|
77.9
|
%
|
|
77.3
|
%
|
|
|
|
0.6
|
%
|
||||
|
Operating cost ratio
|
21.3
|
%
|
|
23.1
|
%
|
|
|
|
(1.8
|
)%
|
||||
|
•
|
Group and Specialty segment pretax income was
$93 million
in the
2017 quarter
, an increase of
$56 million
, or
151.4%
, from
$37 million
in the
2016 quarter
. This increase primarily reflects the impact of higher pretax earnings associated with our fully-insured commercial medical products. The Group and Specialty segment pretax income was
$365 million
in the
2017 period
, an increase of
$32 million
from
$333 million
in the
2016 period
. The increase primarily reflects the impact of higher pretax earnings associated with our fully-insured commercial medical products, partially offset by the impact of the timing of revenues under our TRICARE contract primarily relating to medical cost trend incentives and amounts for additional services requested under the contract.
|
|
•
|
Fully-insured commercial group medical membership
decreased
32,700
members, or
2.9%
, from
September 30, 2016
to
September 30, 2017
reflecting lower membership in small group accounts due in part to more small group accounts selecting ASO products in 2017.
|
|
•
|
Group ASO commercial medical membership
decreased
124,600
members, or
21.8%
, from
September 30, 2016
to
September 30, 2017
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, partially offset by more small group accounts selecting ASO products in 2017.
|
|
•
|
Specialty membership
decreased
21,200
members, or
0.3%
, from
September 30, 2016
to
September 30, 2017
primarily due to declines in other supplemental benefits membership, as well as a decline in dental ASO membership due to terminations of several large group accounts. Other supplemental benefits include life, disability, and fixed benefit products including cancer and critical illness policies.
|
|
•
|
Group and Specialty segment premiums
increased
$31 million
, or
1.9%
, from the
2016 quarter
to
$1.7 billion
for the
2017 quarter
and
increased
$61 million
, or
1.2%
, from the
2016 period
to
$5.1 billion
for the
2017 period
. These increases primarily were due to an increase in group fully-insured commercial medical per-member premiums, partially offset by a decline in average group fully-insured commercial medical membership.
|
|
•
|
Group and Specialty segment services revenue was relatively unchanged for the
2017 quarter
,
decreasing
$7 million
, or
4.8%
, from the
2016 quarter
. The Group and Specialty segment service revenue
decreased
$56 million
, or
11.2%
, from the
2016 period
to
$444 million
for the
2017 period
, primarily due to a decline in revenue in our group ASO commercial medical business mainly due to membership declines as well as due to the timing of revenue under our TRICARE contract.
|
|
•
|
The Group and Specialty segment benefit ratio
decreased
140
basis points from
81.0%
in the
2016 quarter
to
79.6%
in the
2017 quarter
primarily reflecting favorable utilization in the fully-insured commercial medical business and higher favorable prior-period medical claims reserve development, partially offset by the impact of the temporary suspension of the health insurance industry fee for calendar year 2017 which was contemplated in the pricing of our products. The Group and Specialty segment benefit ratio
increased
60
basis points from
77.3%
in the
2016 period
to
77.9%
in the
2017 period
primarily due to the impact of the temporary suspension of the health insurance industry fee for calendar year 2017 which was contemplated in the pricing of our products, partially offset by lower utilization for the fully-insured commercial medical business in the
2017 period
.
|
|
•
|
The Group and Specialty segment benefits expense included
$13 million
in favorable prior-period medical claims reserve development in the
2017 quarter
versus favorable prior-period medical claims reserve development of
$3 million
in the
2016 quarter
. This favorable prior-period medical claims reserve development decreased the Group and Specialty segment benefit ratio by approximately
80
basis points in the
2017 quarter
and decreased the benefit ratio by
20
basis points in the
2016 quarter
. The Group and Specialty segment’s benefits expense included the beneficial effect of a favorable prior-period medical claims reserve development of
$44 million
in the
2017 period
versus
$41 million
in the
2016 period
. This favorable prior-period medical claims reserve development decreased the Group and Specialty segment benefit ratio by approximately
90
basis points in the
2017 period
and
80
basis points in the
2016 period
.
|
|
•
|
The Group and Specialty segment operating cost ratio of
20.9%
for the
2017 quarter
decreased
220
basis points from
23.1%
for the
2016 quarter
. For the
2017 period
, the Group and Specialty segment operating cost ratio of
21.3%
decreased
180
basis points from
23.1%
for the
2016 period
. These decreases primarily were due to the temporary suspension of the health insurance industry fee for calendar year 2017 as well as operating cost efficiencies, partially offset by an
increase in employee compensation costs resulting from the continued strong performance.
The non-deductible health insurance industry fee impacted the operating cost ratio by
150
basis points in both the
2016 quarter
and period.
|
|
|
|
|
|
|
|
|
|
|||||||
|
|
|
|
|
|
|
|
|
|||||||
|
|
For the three months ended September 30,
|
|
Change
|
|||||||||||
|
|
2017
|
|
2016
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(in millions)
|
|
|
|||||||||||
|
Revenues:
|
|
|
|
|
|
|
|
|||||||
|
Services:
|
|
|
|
|
|
|
|
|||||||
|
Clinical care services
|
$
|
39
|
|
|
$
|
50
|
|
|
$
|
(11
|
)
|
|
(22.0
|
)%
|
|
Pharmacy solutions
|
20
|
|
|
8
|
|
|
12
|
|
|
150.0
|
%
|
|||
|
Provider services
|
21
|
|
|
19
|
|
|
2
|
|
|
10.5
|
%
|
|||
|
Total services revenues
|
80
|
|
|
77
|
|
|
3
|
|
|
3.9
|
%
|
|||
|
Intersegment revenues:
|
|
|
|
|
|
|
|
|||||||
|
Pharmacy solutions
|
5,246
|
|
|
5,562
|
|
|
(316
|
)
|
|
(5.7
|
)%
|
|||
|
Provider services
|
392
|
|
|
418
|
|
|
(26
|
)
|
|
(6.2
|
)%
|
|||
|
Clinical care services
|
273
|
|
|
341
|
|
|
(68
|
)
|
|
(19.9
|
)%
|
|||
|
Total intersegment revenues
|
5,911
|
|
|
6,321
|
|
|
(410
|
)
|
|
(6.5
|
)%
|
|||
|
Total services and intersegment revenues
|
$
|
5,991
|
|
|
$
|
6,398
|
|
|
$
|
(407
|
)
|
|
(6.4
|
)%
|
|
Income before income taxes
|
$
|
240
|
|
|
$
|
297
|
|
|
$
|
(57
|
)
|
|
(19.2
|
)%
|
|
Operating cost ratio
|
95.6
|
%
|
|
94.9
|
%
|
|
|
|
0.7
|
%
|
||||
|
|
For the nine months ended
September 30, |
|
Change
|
|||||||||||
|
|
2017
|
|
2016
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(in millions)
|
|
|
|||||||||||
|
Revenues:
|
|
|
|
|
|
|
|
|||||||
|
Services:
|
|
|
|
|
|
|
|
|||||||
|
Clinical care services
|
$
|
135
|
|
|
$
|
157
|
|
|
$
|
(22
|
)
|
|
(14.0
|
)%
|
|
Pharmacy solutions
|
58
|
|
|
22
|
|
|
36
|
|
|
163.6
|
%
|
|||
|
Provider services
|
58
|
|
|
58
|
|
|
—
|
|
|
—
|
%
|
|||
|
Total services revenues
|
251
|
|
|
237
|
|
|
14
|
|
|
5.9
|
%
|
|||
|
Intersegment revenues:
|
|
|
|
|
|
|
|
|
||||||
|
Pharmacy solutions
|
15,581
|
|
|
16,404
|
|
|
(823
|
)
|
|
(5.0
|
)%
|
|||
|
Provider services
|
1,207
|
|
|
1,263
|
|
|
(56
|
)
|
|
(4.4
|
)%
|
|||
|
Clinical care services
|
876
|
|
|
998
|
|
|
(122
|
)
|
|
(12.2
|
)%
|
|||
|
Total intersegment revenues
|
17,664
|
|
|
18,665
|
|
|
(1,001
|
)
|
|
(5.4
|
)%
|
|||
|
Total services and intersegment revenues
|
$
|
17,915
|
|
|
$
|
18,902
|
|
|
$
|
(987
|
)
|
|
(5.2
|
)%
|
|
Income before income taxes
|
$
|
754
|
|
|
$
|
828
|
|
|
$
|
(74
|
)
|
|
(8.9
|
)%
|
|
Operating cost ratio
|
95.4
|
%
|
|
95.2
|
%
|
|
|
|
0.2
|
%
|
||||
|
•
|
Healthcare Services segment pretax income of
$240 million
for the
2017 quarter
decreased by
$57 million
, or
19.2%
, from
$297 million
in the
2016 quarter
. For the
2017 period
, the Healthcare Services segment pretax income of
$754 million
decreased
$74 million
, or
8.9%
, from
$828 million
in the
2016 period
. These decreases primarily were due to the impact of the optimization process associated with our chronic care management
|
|
•
|
Humana Pharmacy Solutions script volumes on an adjusted 30-day equivalent basis for Retail, Group and Specialty, and Individual Commercial segment membership increased to approximately
108 million
in the
2017 quarter
, up
1.2%
, versus scripts of approximately
107 million
in the
2016 quarter
. For the
2017 period
, script volumes for Retail, Group and Specialty, and Individual Commercial segment membership increased to approximately
323 million
, up
2.1%
, versus scripts of approximately
316 million
in the
2016 period
. These increases primarily reflected growth associated with higher Medicare membership for the
2017 quarter
and
2017 period
compared to the
2016 quarter
and
2016 period
, partially offset by the decline in Individual Commercial membership.
|
|
•
|
Services revenues
increased
$3 million
, or
3.9%
, from the
2016 quarter
to
$80 million
for the
2017 quarter
and
increased
$14 million
, or
5.9%
, from the
2016 period
to
$251 million
for the
2017 period
primarily due to service revenue growth from our pharmacy solutions business.
|
|
•
|
Intersegment revenues
decreased
$410 million
, or
6.5%
, from the
2016 quarter
to
$5.9 billion
for the
2017 quarter
and
decreased
$1.0 billion
, or
5.4%
, from the
2016 period
to
$17.7 billion
for the
2017 period
primarily due to our pharmacy solutions business as well as the result of the optimization process associated with our chronic care management programs discussed previously, as well as ongoing pressures in our provider services business reflecting lower Medicare rates year-over-year in geographies where our provider assets are primarily located. Our pharmacy solutions business revenues were impacted by improvements in net pharmacy costs driven by our pharmacy benefit manager and an increase in the generic dispensing rate. These items were partially offset by higher year-over-year script volume from growth in our Medicare Advantage and stand-alone PDP membership, partially offset by the impact of lower Individual Commercial membership. Our generic dispensing rate improved to
91.2%
and
91.3%
during the
2017 quarter
and
2017 period
, respectively, compared to
90.4%
and
90.3%
during the
2016 quarter
and
2016 period
, respectively. The higher generic dispensing rate reduced revenues (and operating costs) for our pharmacy solutions business as generic drugs are generally priced lower than branded drugs.
|
|
•
|
The Healthcare Services segment operating cost ratio of
95.6%
for the
2017 quarter
increased
70
basis points from
94.9%
for the
2016 quarter
primarily due to the timing of the optimization process associated with our chronic conditions management programs and the
increase in employee compensation costs resulting from the continued strong performance.
As we optimize our chronic care management programs, operating cost reductions may lag the associated reduction in revenue, negatively impacting the operating cost ratio. For the
2017 period
, the Healthcare Services segment operating cost ratio was relatively unchanged from the
2016 period
.
|
|
•
|
As announced on February 14, 2017, we are exiting our Individual Commercial medical business commencing January 1, 2018.
|
|
•
|
Individual Commercial segment pretax income of
$26 million
for the
2017 quarter
increased
$24 million
from the
2016 quarter
, primarily due to the exit of certain markets in 2017, and per-member premium increases. For the
2017 period
, the Individual Commercial segment pretax income of
$207 million
increased
$442 million
from the
2016 period
, primarily due to the same factors impacting the quarter in addition to the $208 million increase in the premium deficiency reserve recorded in the second quarter of 2016 related to certain of our 2016 policies.
|
|
•
|
Individual commercial medical membership
decreased
583,400
members, or
80.3%
, from
September 30, 2016
to
September 30, 2017
reflecting the decline in the number of counties we offered on-exchange coverage and the discontinuance of offering off-exchange products.
|
|
•
|
The benefit ratio for the Individual Commercial segment was
65.6%
and
51.6%
for the
2017 quarter
and
2017 period
, respectively, a significant decrease from
82.4%
and
90.9%
for the
2016 quarter
and
2016 period
, respectively. The year-over-year declines primarily resulted from the impact from planned exits in 2017 in certain markets that carried a higher benefit ratio, and per-member premium increases. The
2017 period
was also impacted by the effect of the $208 million increase in the 2016 premium deficiency reserve recorded in the second quarter of 2016 related to certain of our 2016 policies.
|
|
•
|
The operating cost ratio for the Individual Commercial segment was
21.9%
in the
2017 quarter
, an
increase
of
560
basis points from
16.3%
in the
2016 quarter
. The Individual Commercial segment operating cost ratio of
20.0%
for the
2017 period
increased
340
basis points from
16.6%
in the
2016 period
. These increases are primarily due to the loss of scale efficiency from market exits in 2017 partially offset by the temporary suspension of the health insurance industry fee for calendar year 2017.
|
|
|
Nine Months Ended
|
||||||
|
|
2017
|
|
2016
|
||||
|
|
(in millions)
|
||||||
|
Net cash provided by operating activities
|
$
|
6,962
|
|
|
$
|
4,709
|
|
|
Net cash used in investing activities
|
(1,776
|
)
|
|
(534
|
)
|
||
|
Net cash provided by financing activities
|
802
|
|
|
23
|
|
||
|
Increase in cash and cash equivalents
|
$
|
5,988
|
|
|
$
|
4,198
|
|
|
|
September 30, 2017
|
|
December 31, 2016
|
|
2017
Period Change |
|
2016
Period Change |
||||||||
|
|
(in millions)
|
||||||||||||||
|
IBNR (1)
|
$
|
3,308
|
|
|
$
|
3,422
|
|
|
$
|
(114
|
)
|
|
$
|
(104
|
)
|
|
Reported claims in process (2)
|
698
|
|
|
654
|
|
|
44
|
|
|
22
|
|
||||
|
Premium deficiency reserve (3)
|
—
|
|
|
—
|
|
|
—
|
|
|
30
|
|
||||
|
Other benefits payable (4)
|
953
|
|
|
487
|
|
|
466
|
|
|
125
|
|
||||
|
Total benefits payable
|
$
|
4,959
|
|
|
$
|
4,563
|
|
|
$
|
396
|
|
|
$
|
73
|
|
|
(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, 2017
|
|
December 31, 2016
|
|
2017
Period Change |
|
2016
Period Change |
||||||||
|
|
(in millions)
|
||||||||||||||
|
Medicare
|
$
|
494
|
|
|
$
|
787
|
|
|
$
|
(293
|
)
|
|
$
|
(259
|
)
|
|
Commercial and other
|
441
|
|
|
579
|
|
|
(138
|
)
|
|
(100
|
)
|
||||
|
Military services
|
76
|
|
|
32
|
|
|
44
|
|
|
(27
|
)
|
||||
|
Allowance for doubtful accounts
|
(89
|
)
|
|
(118
|
)
|
|
29
|
|
|
(10
|
)
|
||||
|
Total net receivables
|
$
|
922
|
|
|
$
|
1,280
|
|
|
$
|
(358
|
)
|
|
$
|
(396
|
)
|
|
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, 2017
:
|
|
Period
|
Total Number
of Shares Purchased (1)(2) |
|
Average
Price Paid per Share (3) |
|
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 2017
|
—
|
|
|
$
|
—
|
|
|
—
|
|
|
$
|
1,050,000,093
|
|
|
August 2017
|
953,235
|
|
|
253.02
|
|
|
953,235
|
|
|
721,003,128
|
|
||
|
September 2017
|
844,568
|
|
|
249.56
|
|
|
844,568
|
|
|
510,251,912
|
|
||
|
Total
|
1,797,803
|
|
|
$
|
249.97
|
|
|
1,797,803
|
|
|
|
||
|
(1)
|
On February 14, 2017, we announced that the Board had approved a new authorization for share repurchases of up to
$2.25 billion
of our common stock exclusive of shares repurchased in connection with employee stock plans, expiring on December 31, 2017. Under this new authorization, we entered into a
$1.5 billion
accelerated share repurchase program in the first quarter of 2017. On
August 28, 2017
, we completed the final settlement of our accelerated share repurchase program.
Our remaining repurchase authorization was approximately
$239 million
as of November 3, 2017.
|
|
(2)
|
Includes
0.84 million
shares received in August 2017 upon settlement of an accelerated repurchase program for which no cash was paid during the period and excludes
0.37 million
shares repurchased in connection with employee stock plans.
|
|
(3)
|
Excludes the impact of the
0.84 million
shares received in August 2017 upon settlement of an accelerated repurchase program which were determined by the average daily volume weighted-average share price of our common stock during the term of the ASR Agreement of $224.81.
|
|
Item 3:
|
Defaults Upon Senior Securities
|
|
Item 4:
|
Mine Safety Disclosures
|
|
Item 5:
|
Other Information
|
|
Item 6:
|
Exhibits
|
|
3(i)
|
Restated Certificate of Incorporation of Humana Inc. filed with the Secretary of State of Delaware on November 9, 1989, as restated to incorporate the amendment of January 9, 1992, and the correction of March 23, 1992 (incorporated herein by reference to Exhibit 4(i) to Humana Inc.’s Post-Effective Amendment No. 1 to the Registration Statement on Form S-8 (Reg. No. 33-49305) filed February 2, 1994).
|
|
101
|
The following materials from Humana Inc.'s Quarterly Report on Form 10-Q formatted in XBRL (Extensible Business Reporting Language): (i) the Condensed Consolidated Balance Sheets at
September 30, 2017
and
December 31, 2016
; (ii) the Condensed Consolidated Statements of Income for the
three and nine
months ended
September 30, 2017
and
2016
; (iii) the Condensed Consolidated Statements of Comprehensive Income for the
three and nine
months ended
September 30, 2017
and
2016
; (iv) the Condensed Consolidated Statements of Cash Flows for the
nine
months ended
September 30, 2017
and
2016
; and (v) Notes to Condensed Consolidated Financial Statements.
|
|
|
|
HUMANA INC.
|
|
|
|
|
(Registrant)
|
|
|
|
|
|
|
|
Date:
|
November 8, 2017
|
By:
|
/s/ CYNTHIA H. ZIPPERLE
|
|
|
|
|
Cynthia H. Zipperle
|
|
|
|
|
Vice President, Chief Accounting Officer and Controller (Principal Accounting Officer)
|
|
|
|
|
|
No information found
* THE VALUE IS THE MARKET VALUE AS OF THE LAST DAY OF THE QUARTER FOR WHICH THE 13F WAS FILED.
| FUND | NUMBER OF SHARES | VALUE ($) | 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 |
|---|