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ANTHEM REPORTS SECOND QUARTER 2021 RESULTS, RAISES FULL YEAR OUTLOOK Second quarter GAAP net income was $7.25 per share, including net positive adjustment items of $0.22 per share. Adjusted net income was $

Key Takeaway: ANTHEM REPORTS SECOND QUARTER 2021 RESULTS, RAISES FULL YEAR OUTLOOK Indianapolis, Ind. - July 21, 2021 - Anthem, Inc. (NYSE: ANTM) reported second quarter 2021 results reflecting strong financial performance. We continued to deliver on our commitments to our stakeholders whil

Full Press Release Details

ANTHEM REPORTS SECOND QUARTER 2021 RESULTS,
RAISES FULL YEAR OUTLOOK
Indianapolis, Ind. - July 21, 2021 - Anthem, Inc. (NYSE: ANTM) reported second quarter 2021 results reflecting strong financial performance.
We continued to deliver on our commitments to our stakeholders while making considerable progress against our long-term strategy during the second quarter, all while navigating an uncertain environment due to the pandemic, said Gail Boudreaux, President and CEO. Our continued success is a function of our relentless focus on the needs of our clients and customers and an unwavering commitment to improve the health of humanity, starting with our members, their communities and our own associates.
CONSOLIDATED HIGHLIGHTS
Earnings Per Share: GAAP net income was $7.25 per share in the second quarter, including net positive adjustment items of $0.22 per share. Adjusted net income was $7.03* per share.
Membership: Medical enrollment totaled approximately 44.3 million members at June 30, 2021, an increase of 1.9 million lives, or 4.4 percent from the prior year quarter. Government Business enrollment increased by 2.1 million lives compared to the prior year quarter, driven by Medicaid, reflecting organic growth, aided by the temporary suspension of eligibility recertification efforts in our markets, and growth in Medicare Advantage. In addition, the acquisition of MMM during the second quarter added 315 thousand Medicaid members and 273 thousand Medicare Advantage members. Commercial & Specialty Business enrollment decreased by 174 thousand lives compared to the prior year quarter primarily attributable to in-group attrition in the group fee-based business as a result of the economic environment, partially offset by growth in our risk-based businesses.
During the second quarter of 2021, medical enrollment increased sequentially by 820 thousand lives, primarily driven by the acquisition of MMM, organic growth in the Medicaid business, higher BlueCard activity, and sales in excess of lapses in our Commercial risk-based businesses, partially offset by higher in-group attrition in the group fee-based business.
Operating Revenue: Operating revenue was $33.3 billion in the second quarter of 2021, an increase of $4.1 billion, or 14.1 percent, versus the prior year quarter and 15.8 percent after adjusting for the repeal of the health insurance tax in 2021. The increase was driven by higher premium revenue due to growth in Medicaid and Medicare and, to a lesser extent, rate increases to cover overall cost trend. The increase was further attributable to growth in pharmacy product revenue related to IngenioRx, partially offset by the repeal of the health insurance tax.
Benefit Expense Ratio: The benefit expense ratio was 86.8 percent in the second quarter of 2021, an increase of 890 basis points versus the prior year quarter and an increase of 750 basis points after adjusting for the repeal of the health insurance tax in 2021. The increase was driven by an increase in non-COVID and COVID-related healthcare costs as compared to relatively depressed levels in the same quarter a year ago.
Medical claims reserves established at December 31, 2020 developed better than the Company s expectations during the second quarter of 2021.
Days in Claims Payable: Days in Claims Payable was 48.1 days as of June 30, 2021, an increase of 1.2 days from March 31, 2021 and an increase of 2.1 days as compared to June 30, 2020. The acquisitions of MMM and myNEXUS increased Days in Claims Payable by 1.6 days sequentially.
SG&A Expense Ratio: The SG&A expense ratio was 11.5 percent in the second quarter of 2021, a decrease of 240 basis points from 13.9 percent in the second quarter of 2020, primarily driven by growth in operating revenue and the repeal of the health insurance tax in 2021, partially offset by increased spend to support growth.
Operating Cash Flow: Operating cash flow was $1.7 billion, or 0.9 times net income in the second quarter of 2021, a decrease of $3.8 billion when compared year-over-year. The year-on-year decrease was driven by tax payments made during the second quarter that were deferred out of the same period in the prior year, as was permitted by the IRS, in addition to the negative impact of the repeal of the health insurance tax in 2021 on second quarter revenues.
Share Repurchase Program : During the second quarter of 2021, the Company repurchased 1.3 million shares of its common stock for $480 million, at a weighted average price of $380.59. As of June 30, 2021, the Company had approximately $5.2 billion of Board-approved share repurchase authorization remaining.
Cash Dividend: During the second quarter of 2021, the Company paid a quarterly dividend of $1.13 per share, representing a distribution of cash totaling $278 million.
On July 20, 2021, the Audit Committee declared a third quarter 2021 dividend to shareholders of $1.13 per share. On an annualized basis, this equates to a dividend of $4.52 per share. The third quarter dividend is payable on September 24, 2021 to shareholders of record at the close of business on September 10, 2021.
Investment Portfolio & Capital Position: During the second quarter of 2021, the Company recorded net realized gains of $172 million. During the second quarter of 2020, the Company recorded net realized gains of $29 million. These amounts are excluded from adjusted earnings per share.
As of June 30, 2021, the Company s net unrealized gain position in the investment portfolio was $1.0 billion, consisting primarily of fixed maturity securities. As of June 30, 2021 cash and investments at the parent company totaled approximately $980 million.
REPORTABLE SEGMENTS
Anthem, Inc. has four reportable segments: Commercial & Specialty Business (comprised of Individual, Group risk-based, Group fee-based, and BlueCard businesses); Government Business (comprised of the Medicaid, Medicare, and Federal Health Products & Services businesses); IngenioRx, and Other (comprised of the Diversified Business Group and corporate expenses not allocated to our other reportable segments).
Reportable Segment Highlights
(In millions) Three Months Ended June 30 Six Months Ended June 30
2021 2020 Change 2021 2020 Change
Operating Revenue
Commercial & Specialty Business $ 9,550 $ 8,789 8.7 % $ 19,041 $ 18,150 4.9 %
Government Business 20,066 17,242 16.4 % 39,349 34,708 13.4 %
IngenioRx 6,219 5,269 18.0 % 12,081 10,466 15.4 %
Other 2,517 1,452 73.3 % 4,887 2,479 97.1 %
Eliminations (5,073 ) (3,574 ) 41.9 % (9,981 ) (7,177 ) 39.1 %
Total Operating Revenue 1 $ 33,279 $ 29,178 14.1 % $ 65,377 $ 58,626 11.5 %
Operating Gain (Loss)
Commercial & Specialty Business $ 791 $ 1,372 (42.3 )% $ 2,059 $ 2,792 (26.3 )%
Government Business 868 1,618 (46.4 )% 1,346 2,029 (33.7 )%
IngenioRx 405 304 33.2 % 812 653 24.3 %
Other 17 66 (74.2 )% 25 80 (68.8 )%
Total Operating Gain 1 $ 2,081 $ 3,360 (38.1 )% $ 4,242 $ 5,554 (23.6 )%
Operating Margin
Commercial & Specialty Business 8.3 % 15.6 % (730 ) bp 10.8 % 15.4 % (460 ) bp
Government Business 4.3 % 9.4 % (510 ) bp 3.4 % 5.8 % (240 ) bp
IngenioRx 6.5 % 5.8 % 70 bp 6.7 % 6.2 % 50 bp
Total Operating Margin 1 6.3 % 11.5 % (520 ) bp 6.5 % 9.5 % (300 ) bp
Commercial & Specialty Business: Operating gain in the Commercial & Specialty Business segment totaled $791 million in the second quarter of 2021, a decrease of $581 million from an operating gain of $1,372 million in the second quarter of 2020. The decrease was primarily attributable to an increase in non-COVID related utilization as compared to relatively depressed levels in the prior year quarter, costs associated with COVID-19 including vaccine administration and testing, as well as investments to support growth. The decrease was partially offset by the non-recurring premium credits provided to members enrolled in select employer group and Individual health plans in the second quarter of 2020, as well as growth in our risk-based membership.
Government Business: Operating gain in the Government Business segment was $868 million in the second quarter of 2021, a decrease of $750 million from $1,618 million in the second quarter of 2020. The decrease was primarily attributable to an increase in non-COVID related utilization as compared to relatively depressed levels in the prior year quarter and costs associated with COVID-19. The decrease was partially offset by membership growth in the Medicaid and Medicare businesses.
IngenioRx: Operating gain was $405 million in the second quarter of 2021, an increase of $101 million, or 33.2 percent, from $304 million in the second quarter of 2020. The increase was driven by growth in integrated medical and pharmacy membership.
Other: The Company reported an operating gain of $17 million in the Other segment for the second quarter of 2021, compared with an operating gain of $66 million in the prior year quarter. The decrease was driven by an increase in non-COVID utilization impacting the risk-sharing arrangements within the Diversified Business Group, as utilization was depressed in the second quarter of 2020. This decrease was partially offset by a decline in unallocated corporate expenses.
Full Year 2021:
Basis of Presentation
Conference Call and Webcast
Management will host a conference call and webcast today at 8:30 a.m. Eastern Daylight Time ( EDT ) to discuss the company s second quarter results and outlook. The conference call should be accessed at least 15 minutes prior to the start of the call with the following numbers:
888-947-9963 (Domestic) 800-813-5529 (Domestic Replay)
312-470-0178 (International) 203-369-3826 (International Replay)
The access code for today s conference call is 8339667 . The replay will be available from 11:30 a.m. EDT today, until the end of the day on August 20, 2021. The call will also be available through a live webcast at www.antheminc.com under the Investors link. A webcast replay will be available following the call.
Anthem Contacts:
Investor Relations Media
Stephen Tanal Leslie Porras
Stephen.Tanal@anthem.com Leslie.Porras@anthem.com
About Anthem, Inc.
Anthem is a leading health benefits company dedicated to improving lives and communities, and making healthcare simpler. Through its affiliated companies, Anthem serves more than 117 million people, including more than 44 million within its family of health plans. We aim to be the most innovative, valuable and inclusive partner. For more information, please visit www.antheminc.com or follow @AnthemInc on Twitter.
Membership Summary
(Unaudited and in Thousands)
Change from
Medical Membership June 30, 2021 June 30, 2020 March 31, 2021 June 30, 2020 March 31, 2021
Commercial & Specialty Business
Individual 738 711 731 3.8 % 1.0 %
Group Risk-Based 3,851 3,789 3,837 1.6 % 0.4 %
Commercial Risk-Based 4,589 4,500 4,568 2.0 % 0.5 %
BlueCard 6,235 6,171 6,166 1.0 % 1.1 %
Group Fee-Based 19,372 19,699 19,515 (1.7 )% (0.7 )%
Commercial Fee-Based 25,607 25,870 25,681 (1.0 )% (0.3 )%
Total Commercial & Specialty Business 30,196 30,370 30,249 (0.6 )% (0.2 )%
Government Business
Medicare Advantage 1,824 1,366 1,538 33.5 % 18.6 %
Medicare Supplement 936 921 930 1.6 % 0.6 %
Total Medicare 2,760 2,287 2,468 20.7 % 11.8 %
Medicaid 9,754 8,180 9,172 19.2 % 6.3 %
Federal Employees Health Benefits 1,631 1,616 1,632 0.9 % (0.1 )%
Total Government Business 14,145 12,083 13,272 17.1 % 6.6 %
Total Medical Membership 44,341 42,453 43,521 4.4 % 1.9 %
Other Membership
Life and Disability Members 4,732 5,110 4,766 (7.4 )% (0.7 )%
Dental Members 6,606 6,400 6,599 3.2 % 0.1 %
Dental Administration Members 1,497 1,318 1,488 13.6 % 0.6 %
Vision Members 7,819 7,457 7,798 4.9 % 0.3 %
Medicare Part D Standalone Members 433 392 450 10.5 % (3.8 )%
Consolidated Statements of Income
(In millions, except per share data) Three Months Ended June 30
2021 2020 Change
Revenues
Premiums $ 28,533 $ 25,092 13.7%
Product revenue 3,042 2,543 19.6%
Administrative fees and other revenue 1,704 1,543 10.4%
Total operating revenue 33,279 29,178 14.1%
Net investment income 400 57 601.8%
Net realized gains on financial instruments 172 29 493.1%
Total revenues 33,851 29,264 15.7%
Expenses
Benefit expense 24,763 19,547 26.7%
Cost of products sold 2,614 2,225 17.5%
Selling, general and administrative expense 3,821 4,046 (5.6)%
Interest expense 205 201 2.0%
Amortization of other intangible assets 90 93 (3.2)%
Loss on extinguishment of debt 5 3 66.7%
Total expenses 31,498 26,115 20.6%
Income before income tax expense 2,353 3,149 (25.3)%
Income tax expense 552 873 (36.8)%
Net income 1,801 2,276 (20.9)%
Net income attributable to noncontrolling interests (8) NM
Shareholders net income $ 1,793 $ 2,276 (21.2)%
Shareholders net income per diluted share $ 7.25 $ 8.91 (18.6)%
Diluted shares 247.4 255.4 (3.1)%
Benefit expense as a percentage of premiums 86.8 % 77.9 % 890bp
Selling, general and administrative expense as a percentage of total operating revenue 11.5 % 13.9 % (240)bp
Income before income taxes as a percentage of total revenue 7.0 % 10.8 % (380)bp
Consolidated Statements of Income
(In millions, except per share data) Six Months Ended June 30
2021 2020 Change
Revenues
Premiums $ 56,209 $ 50,609 11.1%
Product revenue 5,779 4,887 18.3%
Administrative fees and other revenue 3,389 3,130 8.3%
Total operating revenue 65,377 58,626 11.5%
Net investment income 691 311 122.2%
Net realized gains (losses) on financial instruments 168 (52) NM
Total revenues 66,236 58,885 12.5%
Expenses
Benefit expense 48,462 41,036 18.1%
Cost of products sold 4,927 4,209 17.1%
Selling, general and administrative expense 7,746 7,827 (1.0)%
Interest expense 397 395 0.5%
Amortization of other intangible assets 170 176 (3.4)%
Loss on extinguishment of debt 5 4 25.0%
Total expenses 61,707 53,647 15.0%
Income before income tax expense 4,529 5,238 (13.5)%
Income tax expense 1,061 1,439 (26.3)%
Net income 3,468 3,799 (8.7)%
Net income attributable to noncontrolling interests (10) NM
Shareholders net income $ 3,458 $ 3,799 (9.0)%
Shareholders net income per diluted share $ 13.95 $ 14.85 (6.1)%
Diluted shares 247.8 255.9 (3.2)%
Benefit expense as a percentage of premiums 86.2 % 81.1 % 510bp
Selling, general and administrative expense as a percentage of total operating revenue 11.8 % 13.4 % (160)bp
Income before income taxes as a percentage of total revenue 6.8 % 8.9 % (210)bp
Consolidated Balance Sheets
(In millions) June 30, 2021 December 31, 2020
Assets (Unaudited)
Current assets:
Cash and cash equivalents $ 5,258 $ 5,741
Fixed maturity securities 25,848 23,433
Equity securities, current 1,746 1,559
Premium receivables 5,834 5,279
Self-funded receivables 3,605 2,849
Other receivables 3,246 2,830
Other current assets 4,701 4,060
Total current assets 50,238 45,751
Long-term investments:
Fixed maturity securities 581 562
Other invested assets 4,917 4,285
Property and equipment, net 3,733 3,483
Goodwill 24,399 21,691
Other intangible assets 10,540 9,405
Other noncurrent assets 1,689 1,438
Total assets $ 96,097 $ 86,615
Liabilities and equity
Liabilities
Current liabilities:
Medical claims payable $ 13,076 $ 11,359
Other policyholder liabilities 5,285 4,590
Unearned income 1,081 1,259
Accounts payable and accrued expenses 5,598 5,493
Short-term borrowings 175
Current portion of long-term debt 849 700
Other current liabilities 7,730 6,052
Total current liabilities 33,794 29,453
Long-term debt, less current portion 22,217 19,335
Reserves for future policy benefits 774 794
Deferred tax liabilities, net 2,397 2,019
Other noncurrent liabilities 1,869 1,815
Total liabilities 61,051 53,416
Shareholders equity
Common stock 2 3
Additional paid-in capital 9,109 9,244
Retained earnings 25,874 23,802
Accumulated other comprehensive (loss) income (17 ) 150
Total shareholders equity 34,968 33,199
Noncontrolling interests 78
Total equity 35,046 33,199
Total liabilities and equity $ 96,097 $ 86,615
Consolidated Statements of Cash Flows
(In millions) Six Months Ended June 30
2021 2020
Operating activities
Net income $ 3,468 $ 3,799
Adjustments to reconcile net income to net cash provided by operating activities:
Net realized (gains) losses on financial instruments (168 ) 52
Depreciation and amortization 591 556
Deferred income taxes (8 ) 60
Share-based compensation 133 134
Changes in operating assets and liabilities:
Receivables, net (1,632 ) (313 )
Other invested assets (44 ) 24
Other assets (247 ) (486 )
Policy liabilities 1,912 1,024
Unearned income (180 ) (110 )
Accounts payable and other liabilities 560 1,868
Income taxes 106 1,313
Other, net (303 ) 104
Net cash provided by operating activities 4,188 8,025
Investing activities
Purchases of investments (11,221 ) (11,135 )
Proceeds from sale of investments 6,345 4,724
Maturities, calls and redemptions from investments 2,246 1,836
Changes in securities lending collateral (642 ) (764 )
Purchases of subsidiaries, net of cash acquired (3,442 ) (1,906 )
Purchases of property and equipment (489 ) (437 )
Other, net (29 ) (36 )
Net cash used in investing activities (7,232 ) (7,718 )
Financing activities
Net proceeds from (repayments of) commercial paper borrowings 300 (400 )
Net proceeds from (repayments of) short-term borrowings 175 (700 )
Net proceeds from long-term borrowings 2,510 2,329
Changes in securities lending payable 642 764
Repurchase and retirement of common stock (927 ) (584 )
Cash dividends (555 ) (482 )
Proceeds from issuance of common stock under employee stock plans 141 92
Taxes paid through withholding of common stock under employee stock plans (93 ) (111 )
Other, net 375 (124 )
Net cash provided by financing activities 2,568 784
Effect of foreign exchange rates on cash and cash equivalents (7 )
Change in cash and cash equivalents (483 ) 1,091
Cash and cash equivalents at beginning of period 5,741 4,937
Cash and cash equivalents at end of period $ 5,258 $ 6,028
Reconciliation of Medical Claims Payable
Six Months Ended June 30 Years Ended December 31
2021 2020 2020 2019 2018
(In millions) (Unaudited) (Unaudited)
Gross medical claims payable, beginning of period $ 11,135 $ 8,647 $ 8,647 $ 7,266 $ 7,814
Ceded medical claims payable, beginning of period (46 ) (33 ) (33 ) (34 ) (105 )
Net medical claims payable, beginning of period 11,089 8,614 8,614 7,232 7,709
Business combinations and purchase adjustments 420 339 339 199
Net incurred medical claims:
Current year 48,343 39,978 85,094 78,695 69,581
Prior years redundancies (1) (1,772 ) (700 ) (637 ) (500 ) (930 )
Total net incurred medical claims 46,571 39,278 84,457 78,195 68,651
Net payments attributable to:
Current year medical claims 37,533 31,625 74,629 70,294 62,748
Prior years medical claims 7,767 7,041 7,692 6,519 6,579
Total net payments 45,300 38,666 82,321 76,813 69,327
Net medical claims payable, end of period 12,780 9,565 11,089 8,614 7,232
Ceded medical claims payable, end of period 41 90 46 33 34
Gross medical claims payable, end of period $ 12,821 $ 9,655 $ 11,135 $ 8,647 $ 7,266
Current year medical claims paid as a percentage of current year net incurred medical claims 77.6 % 79.1 % 87.7 % 89.3 % 90.2 %
Prior year redundancies in the current year as a percentage of prior year net medical claims payable less prior year redundancies in the current year 19.0 % 8.8 % 8.0 % 7.4 % 13.7 %
Prior year redundancies in the current year as a percentage of prior year net incurred medical claims 2.1 % 0.9 % 0.8 % 0.7 % 1.3 %
GAAP Reconciliation
Anthem, Inc. has referenced Adjusted Net Income and Adjusted Net Income Per Share, which are non-GAAP measures, in this document. These non-GAAP measures are not intended to be alternatives to any measure calculated in accordance with GAAP. In addition to these non-GAAP measures, references are made to the measures Operating Revenue and Operating Gain. Each of these measures is provided to further aid investors in understanding and analyzing the company s core operating results and comparing Anthem, Inc. s financial results. A reconciliation of Operating Revenue to Total Revenue is set forth in the Consolidated Statements of Income herein. A reconciliation of the non-GAAP measures to the most directly comparable measures calculated in accordance with GAAP, together with a reconciliation of reportable segments operating gain to income before income tax expense, is reported below. Prior amounts may be grouped differently to conform to current presentation.
Three Months Ended June 30 Six Months Ended June 30
(In millions, except per share data) 2021 2020 Change 2021 2020 Change
Shareholders net income $ 1,793 $ 2,276 (21.2 )% $ 3,458 $ 3,799 (9.0 )%
Add / (Subtract):
Net realized (gains) losses on financial instruments (172 ) (29 ) (168 ) 52
Amortization of other intangible assets 90 93 170 176
Loss on extinguishment of debt 5 3 5 4
Transaction and integration related costs 12 11 21 23
Litigation expenses 6 21 12 29
Tax impact of non-GAAP adjustments 6 (25 ) (19 ) (71 )
Net adjustment items (53 ) 74 21 213
Adjusted shareholders net income $ 1,740 $ 2,350 (26.0 )% $ 3,479 $ 4,012 (13.3 )%
Shareholders net income per diluted share $ 7.25 $ 8.91 (18.6 )% $ 13.95 $ 14.85 (6.1 )%
Add / (Subtract):
Net realized (gains) losses on financial instruments (0.70 ) (0.11 ) (0.68 ) 0.20
Amortization of other intangible assets 0.36 0.36 0.69 0.69
Loss on extinguishment of debt 0.02 0.01 0.02 0.02
Transaction and integration related costs 0.05 0.04 0.08 0.09
Litigation expenses 0.02 0.08 0.05 0.11
Tax impact of non-GAAP adjustments 0.02 (0.10 ) (0.08 ) (0.28 )
Rounding impact 0.01 0.01 0.01
Net adjustment items (0.22 ) 0.29 0.09 0.83
Adjusted shareholders net income per diluted share $ 7.03 $ 9.20 (23.6 )% $ 14.04 $ 15.68 (10.5 )%
Full Year 2021 Outlook
Shareholders net income per diluted share Greater than $24.89
Add / (Subtract):
Net realized gains on financial instruments ($0.68)
Loss on extinguishment of debt $0.02
Transaction and integration related costs $0.08
Litigation expenses $0.05
Amortization of other intangible assets Approximately $1.42
Tax impact of non-GAAP adjustments Approximately $(0.28)
Net adjustment items Approximately $0.61
Adjusted shareholders net income per diluted share Greater than $25.50
Three Months Ended June 30 Six Months Ended June 30
(In millions) 2021 2020 Change 2021 2020 Change
Reportable segments operating gain $ 2,081 $ 3,360 (38.1 )% $ 4,242 $ 5,554 (23.6 )%
Net investment income 400 57 691 311
Net realized gains (losses) on financial instruments 172 29 168 (52 )
Interest expense (205 ) (201 ) (397 ) (395 )
Amortization of other intangible assets (90 ) (93 ) (170 ) (176 )
Loss on extinguishment of debt (5 ) (3 ) (5 ) (4 )
Income before income tax expense $ 2,353 $ 3,149 (25.3 )% $ 4,529 $ 5,238 (13.5 )%
Forward-Looking Statements
This document contains certain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements reflect our views about future events and financial performance and are generally not historical facts. Words such as expect, feel, believe, will, may, should, anticipate, intend, estimate, project, forecast, plan and similar expressions are intended to identify forward-looking statements. These statements include, but are not limited to: financial projections and estimates and their underlying assumptions; statements regarding plans, objectives and expectations with respect to future operations, products and services; and statements regarding future performance. Such statements are subject to certain risks and uncertainties, many of which are difficult to predict and generally beyond our control, that could cause actual results to differ materially from those expressed in, or implied or projected by, the forward-looking statements. You are cautioned not to place undue reliance on these forward- looking statements that speak only as of the date hereof. You are also urged to carefully review and consider the various risks and other disclosures discussed in our reports filed with the U.S. Securities and Exchange Commission from time to time, which attempt to advise interested parties of the factors that affect our business. Except to the extent otherwise required by federal securities laws, we do not undertake any obligation to republish revised forward-looking statements to reflect events or circumstances after the date hereof. These risks and uncertainties include, but are not limited to: the impact of large scale medical emergencies, such as public health epidemics and pandemics, including COVID-19, and catastrophes; trends in healthcare costs and utilization rates; our ability to secure sufficient premium rates, including regulatory approval for and implementation of such rates; the impact of federal and state regulation, including ongoing changes in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended; changes in economic and market conditions, as well as regulations that may negatively affect our liquidity and investment portfolios; our ability to contract with providers on cost-effective and competitive terms; competitive pressures and our ability to adapt to changes in the industry and develop and implement strategic growth opportunities; reduced enrollment; unauthorized disclosure of member or employee sensitive or confidential information, including the impact and outcome of any investigations, inquiries, claims and litigation related thereto; risks and uncertainties regarding Medicare and Medicaid programs, including those related to non-compliance with the complex regulations imposed thereon; our ability to maintain and achieve improvement in Centers for Medicare and Medicaid Services Star ratings and other quality scores and funding risks with respect to revenue received from participation therein; a negative change in our healthcare product mix; costs and other liabilities associated with litigation, government investigations, audits or reviews; risks and uncertainties related to our pharmacy benefit management ( PBM ), business including non-compliance by any party with the PBM services agreement between us and CaremarkPCS Health, L.L.C.; medical malpractice or professional liability claims or other risks related to healthcare and PBM services provided by our subsidiaries; general risks associated with mergers, acquisitions, joint ventures and strategic alliances; changes in U.S. tax laws; possible impairment of the value of our intangible assets if future results do not adequately support goodwill and other intangible assets; possible restrictions in the payment of dividends from our subsidiaries and increases in required minimum levels of capital; our ability to repurchase shares of our common stock and pay dividends on our common stock due to the adequacy of our cash flow and earnings and other considerations; the potential negative effect from our substantial amount of outstanding indebtedness; a downgrade in our financial strength ratings; the effects of any negative publicity related to the health benefits industry in general or us in particular; failure to effectively maintain and modernize our information systems; events that may negatively affect our licenses with the Blue Cross and Blue Shield Association; the impact of international laws and regulations; intense competition to attract and retain employees; and various laws and provisions in our governing documents that may prevent or discourage takeovers and business combinations.
Last updated: Jul 21, 2021