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ANTHEM REPORTS SECOND QUARTER RESULTS REAFFIRMS COMMITMENT TO STAKEHOLDERS DURING COVID-19 PANDEMIC Indianapolis, Ind.

Key Takeaway: ANTHEM REPORTS SECOND QUARTER RESULTS REAFFIRMS COMMITMENT TO STAKEHOLDERS DURING COVID-19 PANDEMIC Indianapolis, Ind. - July 29, 2020 - Against the backdrop of the ongoing pandemic, Anthem, Inc. (NYSE: ANTM) has continued to take bold steps to directly support its health plan

Full Press Release Details

ANTHEM REPORTS SECOND QUARTER RESULTS
REAFFIRMS COMMITMENT TO STAKEHOLDERS
DURING COVID-19 PANDEMIC
Indianapolis, Ind. - July 29, 2020 - Against the backdrop of the ongoing pandemic, Anthem, Inc. (NYSE: ANTM) has continued to take bold steps to directly support its health plan members, customers, care providers, associates, and local communities.
During these uncertain times, our business has continued to adapt and respond to the needs of those we serve in light of COVID-19 and the important discussions around health disparities and racial injustice facing our society. Now more than ever, our members, customers, and local communities are looking to us for support and I am honored by the trust they have placed in us, said President and CEO Gail K. Boudreaux. Together, with our more than 78,000 associates, Anthem is guided by our mission of improving lives and building a better and healthier America.
Anthem has been, and always will be, deeply connected and committed to our local communities. In addition to providing $2.5 billion of financial assistance to ease the burden of the COVID-19 pandemic, Anthem pledged $50 million over the next five years to focus directly on addressing health disparities, racial inequities, and the key drivers of health such as food insecurity, mental health, housing, and economic recovery.
As part of Anthem s efforts to combat the global pandemic, address health inequities, and adapt to the ever-changing healthcare environment, the Company has remained focused on fostering deeper relationships and developing innovative solutions to meet critical needs for its stakeholders. Actions taken to support our members, customers, care providers and local communities include:
Care for our Anthem associates
Care for our consumers, customers, and providers
Care for our communities
Additional actions to support society
CONSOLIDATED HIGHLIGHTS
Earnings Per Share: GAAP net income was $8.91 per share in the quarter, including net negative adjustment items of $0.29 per share. Adjusted net income was $9.20* per share.
*Please refer to the GAAP reconciliation tables on page 17.
Membership: Medical enrollment totaled 42.5 million members at June 30, 2020, an increase of 309 thousand lives, or 0.7 percent, compared to March 31, 2020. The increase was driven by our Government Business, which grew by 599 thousand lives during the quarter, attributable to Medicaid, reflecting organic growth as a result of the temporary suspension of eligibility recertification efforts in our markets, and Medicare Advantage. The increase was partially offset by Commercial & Specialty Business enrollment, which declined by 290 thousand lives driven by higher in-group change as a result of the higher unemployment rate.
Medical enrollment increased by 1.6 million lives, or 3.9 percent compared to the prior year quarter, reflecting growth in the Medicaid, National, and Medicare businesses. Growth in Medicaid was driven by organic growth in our markets as well as our acquisition of the plans in Missouri and Nebraska. The increase in National enrollment reflects growth due to higher BlueCard activity and the acquisition of AmeriBen in the first quarter of 2020.
Operating Revenue: Operating revenue was $29.2 billion in the second quarter of 2020, an increase of $4 billion, or 15.9 percent, versus the prior year quarter, driven by pharmacy product revenue related to the launch of IngenioRx. The increase was further attributable to higher premium revenue due to growth in Medicaid and Medicare and the return of the health insurance tax in 2020, partially offset by a decrease in experience-rated premiums in our Federal Health Products & Services business.
Benefit Expense Ratio: The benefit expense ratio was 77.9 percent in the second quarter of 2020, a decrease of 880 basis points from 86.7 percent in the prior year quarter. The decrease was primarily driven by the deferral of healthcare utilization due to the COVID-19 pandemic, and to a lesser extent, the return of the health insurance tax in 2020. The decrease was partially offset by premium credits provided to members enrolled in select employer group and Individual plans.
Medical claims reserves established at December 31, 2019 developed in line with the Company s expectations during the second quarter of 2020.
Days in Claims Payable: Days in Claims Payable was 46.0 days as of June 30, 2020, an increase of 4.1 days from March 31, 2020.
SG&A Expense Ratio: The SG&A expense ratio was 13.9 percent in the second quarter of 2020, an increase of 90 basis points from 13.0 percent in the second quarter of 2019, primarily driven by the return of the health insurance tax in 2020 and increased spend to support growth, partially offset by growth in operating revenue.
Operating Cash Flow: Operating cash flow was $5.5 billion, or 2.4 times net income in the second quarter of 2020, an increase of $4.1 billion compared to the prior year quarter, primarily driven by growth in net income and the delayed payment of certain federal income and payroll taxes in accordance with the CARES Act. The increase was further attributable to growth in premium revenue due to the return of the health insurance tax in 2020.
Share Repurchase Program : After careful consideration of the Company s financial position in conjunction with the prevailing market conditions, share repurchase activity resumed in late-June.
During the second quarter of 2020, the Company repurchased 213 thousand shares of its common stock for $55 million, or a weighted average price of $258.77. Year to date, the Company has repurchased 2.1 million shares for $584 million, or a weighted average price of $273.72.
As of June 30, 2020, the Company had approximately $3.2 billion of Board-approved share repurchase authorization remaining.
Cash Dividend: During the second quarter of 2020, the Company paid a quarterly dividend of $0.95 per share, representing a distribution of cash totaling $242 million.
On July 28, 2020, the Audit Committee declared a third quarter 2020 dividend to shareholders of $0.95 per share. On an annualized basis, this equates to a dividend of $3.80 per share. The third quarter dividend is payable on September 25, 2020 to shareholders of record at the close of business on September 10, 2020.
Investment Portfolio & Capital Position: During the second quarter of 2020, the Company recorded net realized gains of $18 million and impairment recoveries totaling $11 million. During the second quarter of 2019, the Company recorded net realized gains of $11 million and impairment losses totaling $7 million.
As of June 30, 2020, the Company s net unrealized loss position in the investment portfolio was $713 million, consisting of fixed maturity securities. As of June 30, 2020 cash and investments at the parent company totaled approximately $4.1 billion.
REPORTABLE SEGMENTS
Effective January 1, 2020, Anthem, Inc. has four reportable segments: Commercial & Specialty Business (comprised of the Local Group, National Accounts, Individual and Specialty 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
2020 2019 Change 2020 2019 Change
Operating Revenue
Commercial & Specialty Business $ 8,789 $ 9,417 (6.7 )% $ 18,150 $ 18,809 (3.5 )%
Government Business 17,242 15,538 11.0 % 34,708 30,464 13.9 %
IngenioRx 5,269 248 NM 2 10,466 248 NM 2
Other 1,452 546 165.9 % 2,479 1,094 126.6 %
Eliminations (3,574 ) (572 ) NM 2 (7,177 ) (1,050 ) NM 2
Total Operating Revenue 1 $ 29,178 $ 25,177 15.9 % $ 58,626 $ 49,565 18.3 %
Operating Gain / (Loss)
Commercial & Specialty Business $ 1,372 $ 983 39.6 % $ 2,792 $ 2,581 8.2 %
Government Business 1,618 480 237.1 % 2,029 854 137.6 %
IngenioRx 304 NM 2 653 NM 2
Other 66 (30 ) NM 2 80 (62 ) NM 2
Total Operating Gain 1 $ 3,360 $ 1,433 134.5 % $ 5,554 $ 3,373 64.7 %
Operating Margin
Commercial & Specialty Business 15.6 % 10.4 % 520 bp 15.4 % 13.7 % 170 bp
Government Business 9.4 % 3.1 % 630 bp 5.8 % 2.8 % 300 bp
IngenioRx 5.8 % NM 2 6.2 % % NM 2
Total Operating Margin 1 11.5 % 5.7 % 580 bp 9.5 % 6.8 % 270 bp
Commercial & Specialty Business: Operating gain in the Commercial & Specialty Business segment totaled $1,372 million in the second quarter of 2020, an increase of $389 million, or 39.6 percent, from $983 million in the second quarter of 2019. The increase is primarily attributable to reduced healthcare benefit utilization during the COVID-19 pandemic. The increase was partially offset by premium credits provided to members enrolled in select employer group and Individual health plans, less favorable adjustments to our risk adjustor estimates, as well as the shift of pharmacy earnings to the IngenioRx segment.
Government Business: Operating gain in the Government Business segment was $1,618 million in the second quarter of 2020, an increase of $1,138 million, or 237.1 percent, from $480 million in the second quarter of 2019. The increase is primarily attributable to reduced healthcare benefit utilization during the COVID-19 pandemic, partially offset by experience-rated refunds and retroactive rate adjustments in Medicaid.
IngenioRx: IngenioRx commenced operations in the second quarter of 2019 and the transition of membership was completed on January 1, 2020. Operating gain was $304 million in the second quarter of 2020.
Other: The Company reported an operating gain of $66 million in the Other segment for the second quarter of 2020, compared with an operating loss of $30 million in the prior year quarter. The increase was driven by growth in the Diversified Business Group.
Full Year 2020:
Due to unprecedented uncertainty around the COVID-19 pandemic and its impact, the Company is not providing other financial guidance metrics for 2020 until visibility improves.
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:
800-857-9605 (Domestic) 800-568-6411 (Domestic Replay)
203-827-7032 (International) 203-369-3291 (International Replay)
The access code for today s conference call is 1623092 . The replay will be available from 11:30 a.m. EDT today, until the end of the day on August 29, 2020. 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
Chris Rigg Jill Becher, 414-234-1573
Chris.Rigg@anthem.com Jill.Becher@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 106 million people, including more than 42 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, 2020 June 30, 2019 March 31, 2020 June 30, 2019 March 31, 2020
Customer Type
Local Group 15,616 15,670 15,848 (0.3)% (1.5)%
Individual 711 741 717 (4.0)% (0.8)%
National:
National Accounts 7,872 7,693 7,898 2.3% (0.3)%
BlueCard 6,171 6,009 6,197 2.7% (0.4)%
Total National 14,043 13,702 14,095 2.5% (0.4)%
Medicare:
Medicare Advantage 1,366 1,170 1,341 16.8% 1.9%
Medicare Supplement 921 877 914 5.0% 0.8%
Total Medicare 2,287 2,047 2,255 11.7% 1.4%
Medicaid 8,180 7,099 7,615 15.2% 7.4%
Federal Employees Health Benefits 1,616 1,593 1,614 1.4% 0.1%
Total Medical Membership 42,453 40,852 42,144 3.9% 0.7%
Funding Arrangement
Self-Funded 25,888 25,433 26,120 1.8% (0.9)%
Fully-Insured 16,565 15,419 16,024 7.4% 3.4%
Total Medical Membership 42,453 40,852 42,144 3.9% 0.7%
Reportable Segment
Commercial & Specialty Business 30,370 30,113 30,660 0.9% (0.9)%
Government Business 12,083 10,739 11,484 12.5% 5.2%
Total Medical Membership 42,453 40,852 42,144 3.9% 0.7%
Other Membership
Life and Disability Members 5,110 4,906 5,158 4.2% (0.9)%
Dental Members 6,096 5,931 6,172 2.8% (1.2)%
Dental Administration Members 1,318 5,523 1,311 (76.1)% 0.5%
Vision Members 7,457 7,161 7,510 4.1% (0.7)%
Medicare Part D Standalone Members 392 287 383 36.6% 2.3%
Consolidated Statements of Income
(In millions, except per share data) Three Months Ended June 30
2020 2019 Change
Revenues
Premiums $ 25,092 $ 23,501 6.8%
Product revenue 2,543 144 NM
Administrative fees and other revenue 1,543 1,532 0.7%
Total operating revenue 29,178 25,177 15.9%
Net investment income 57 285 (80.0)%
Net realized gains on financial instruments 18 11 63.6%
Impairment recoveries (losses) on investments:
Total impairment recoveries (losses) on investments 6 (9 ) NM
Portion of impairment losses recognized in other comprehensive income 5 2 150.0%
Impairment recoveries (losses) recognized in income 11 (7 ) NM
Total revenues 29,264 25,466 14.9%
Expenses
Benefit expense 19,547 20,368 (4.0)%
Cost of products sold 2,225 98 NM
Selling, general and administrative expense 4,046 3,278 23.4%
Interest expense 201 184 9.2%
Amortization of other intangible assets 93 85 9.4%
Loss on extinguishment of debt 3 NM
Total expenses 26,115 24,013 8.8%
Income before income tax expense 3,149 1,453 116.7%
Income tax expense 873 314 178.0%
Net income $ 2,276 $ 1,139 99.8%
Net income per diluted share $ 8.91 $ 4.36 104.4%
Diluted shares 255.4 261.0 (2.1)%
Benefit expense as a percentage of premiums 77.9% 86.7% (880)bp
Selling, general and administrative expense as a percentage of total operating revenue 13.9% 13.0% 90bp
Income before income taxes as a percentage of total revenue 10.8% 5.7% 510bp
NM = calculation not meaningful
Consolidated Statements of Income
(In millions, except per share data) Six Months Ended June 30
2020 2019 Change
Revenues
Premiums $ 50,609 $ 46,344 9.2%
Product revenue 4,887 144 NM
Administrative fees and other revenue 3,130 3,077 1.7%
Total operating revenue 58,626 49,565 18.3%
Net investment income 311 495 (37.2)%
Net realized (losses) gains on financial instruments (6 ) 89 NM
Impairment losses on investments:
Total impairment losses on investments (95 ) (22 ) NM
Portion of impairment losses recognized in other comprehensive income 49 5 880.0%
Impairment losses recognized in income (46 ) (17 ) NM
Total revenues 58,885 50,132 17.5%
Expenses
Benefit expense 41,036 39,650 3.5%
Cost of products sold 4,209 98 NM
Selling, general and administrative expense 7,827 6,444 21.5%
Interest expense 395 371 6.5%
Amortization of other intangible assets 176 172 2.3%
Loss (gain) on extinguishment of debt 4 (1 ) NM
Total expenses 53,647 46,734 14.8%
Income before income tax expense 5,238 3,398 54.1%
Income tax expense 1,439 708 103.2%
Net income $ 3,799 $ 2,690 41.2%
Net income per diluted share $ 14.85 $ 10.28 44.5%
Diluted shares 255.9 261.6 (2.2)%
Benefit expense as a percentage of premiums 81.1% 85.6% (450)bp
Selling, general and administrative expense as a percentage of total operating revenue 13.4% 13.0% 40bp
Income before income taxes as a percentage of total revenue 8.9% 6.8% 210bp
NM = calculation not meaningful
Consolidated Balance Sheets
(In millions) June 30, 2020 December 31, 2019
(Unaudited)
Assets
Current assets:
Cash and cash equivalents $ 6,028 $ 4,937
Fixed maturity securities, current 22,018 19,676
Equity securities, current 3,470 1,009
Premium receivables 5,456 5,014
Self-funded receivables 2,460 2,570
Other receivables 3,072 2,807
Other current assets 4,260 3,020
Total current assets 46,764 39,033
Long-term investments:
Fixed maturity securities 520 505
Other invested assets 4,097 4,258
Property and equipment, net 3,427 3,133
Goodwill 21,641 20,500
Other intangible assets 9,577 8,674
Other noncurrent assets 1,950 1,350
Total assets $ 87,976 $ 77,453
Liabilities and shareholders equity
Liabilities
Current liabilities:
Medical claims payable $ 9,878 $ 8,842
Other policyholder liabilities 3,586 3,050
Unearned income 946 1,017
Accounts payable and accrued expenses 5,257 4,198
Short-term borrowings 700
Current portion of long-term debt 1,603 1,598
Other current liabilities 7,252 4,127
Total current liabilities 28,522 23,532
Long-term debt, less current portion 19,873 17,787
Reserves for future policy benefits 776 759
Deferred tax liabilities, net 2,497 2,227
Other noncurrent liabilities 1,853 1,420
Total liabilities 53,521 45,725
Shareholders equity
Common stock 3 3
Additional paid-in capital 9,360 9,448
Retained earnings 25,346 22,573
Accumulated other comprehensive loss (254 ) (296 )
Total shareholders equity 34,455 31,728
Total liabilities and shareholders equity $ 87,976 $ 77,453
Consolidated Statements of Cash Flows
(In millions) Six Months Ended June 30
2020 2019
Operating activities
Net income $ 3,799 $ 2,690
Adjustments to reconcile net income to net cash provided by operating activities:
Net realized losses (gains) on financial instruments 6 (89 )
Depreciation and amortization 556 586
Deferred income taxes 60 79
Share-based compensation 134 140
Changes in operating assets and liabilities:
Receivables, net (313 ) (589 )
Other invested assets 24 (28 )
Other assets (486 ) (258 )
Policy liabilities 1,024 1,251
Unearned income (110 ) (2 )
Accounts payable and other liabilities 1,868 (383 )
Income taxes 1,313 (286 )
Other, net 150 (44 )
Net cash provided by operating activities 8,025 3,067
Investing activities
Purchases of investments (11,135 ) (11,113 )
Proceeds from sale of investments 4,724 8,835
Maturities, calls and redemptions from investments 1,836 894
Purchases of subsidiaries, net of cash acquired (1,906 )
Purchases of property and equipment (437 ) (455 )
Other, net (800 ) 22
Net cash used in investing activities (7,718 ) (1,817 )
Financing activities
Net (repayments of) proceeds from commercial paper borrowings (400 ) 203
Net repayments of short-term borrowings (700 ) (135 )
Net proceeds from (repayments of) long-term borrowings 2,329 (73 )
Repurchase and retirement of common stock (584 ) (752 )
Cash dividends (482 ) (412 )
Proceeds from issuance of common stock under employee stock plans 92 100
Taxes paid through withholding of common stock under employee stock plans (111 ) (80 )
Other, net 640 43
Net cash provided by (used in) financing activities 784 (1,106 )
Change in cash and cash equivalents 1,091 144
Cash and cash equivalents at beginning of year 4,937 3,934
Cash and cash equivalents at end of period $ 6,028 $ 4,078
Reconciliation of Medical Claims Payable
Six Months Ended June 30 Years Ended December 31
2020 2019 2019 2018 2017
(In millions) (Unaudited) (Unaudited)
Gross medical claims payable, beginning of period $ 8,647 $ 7,266 $ 7,266 $ 7,814 $ 7,656
Ceded medical claims payable, beginning of period (33 ) (34 ) (34 ) (105 ) (539 )
Net medical claims payable, beginning of period 8,614 7,232 7,232 7,709 7,117
Business combinations and purchase adjustments 339 199 76
Net incurred medical claims:
Current year 39,978 38,237 78,695 69,581 70,377
Prior years redundancies (1) (700 ) (414 ) (500 ) (930 ) (1,133 )
Total net incurred medical claims 39,278 37,823 78,195 68,651 69,244
Net payments attributable to:
Current year medical claims 31,625 30,367 70,294 62,748 62,923
Prior years medical claims 7,041 6,182 6,519 6,579 5,805
Total net payments 38,666 36,549 76,813 69,327 68,728
Net medical claims payable, end of period 9,565 8,506 8,614 7,232 7,709
Ceded medical claims payable, end of period 90 43 33 34 105
Gross medical claims payable, end of period $ 9,655 $ 8,549 $ 8,647 $ 7,266 $ 7,814
Current year medical claims paid as a percentage of current year net incurred medical claims 79.1% 79.4% 89.3% 90.2% 89.4%
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 8.8% 6.1% 7.4% 13.7% 18.9%
Prior year redundancies in the current year as a percentage of prior year net incurred medical claims 0.9% 0.6% 0.7% 1.3% 1.8%
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.
Three Months Ended June 30 Six Months Ended June 30
(In millions, except per share data) 2020 2019 Change 2020 2019 Change
Net income $ 2,276 $ 1,139 99.8 % $ 3,799 $ 2,690 41.2 %
Add / (Subtract):
Net realized (gains) losses on financial instruments (18 ) (11 ) 6 (89 )
Amortization of other intangible assets 93 85 176 172
Impairment (recoveries) losses recognized in income (11 ) 7 46 17
Loss (gain) on extinguishment of debt 3 4 (1 )
Transaction and integration related costs 11 5 23 5
Litigation expenses 21 9 29 35
Tax impact of non-GAAP adjustments (25 ) (23 ) (71 ) (37 )
Net adjustment items 74 72 213 102
Adjusted net income $ 2,350 $ 1,211 94.1 % $ 4,012 $ 2,792 43.7 %
Net income per diluted share $ 8.91 $ 4.36 104.4 % $ 14.85 $ 10.28 44.5 %
Add / (Subtract):
Net realized (gains) losses on financial instruments (0.07 ) (0.04 ) 0.02 (0.34 )
Amortization of other intangible assets 0.36 0.33 0.69 0.66
Impairment (recoveries) losses recognized in income (0.04 ) 0.03 0.18 0.06
Loss on extinguishment of debt 0.01 0.02
Transaction and integration related costs 0.04 0.02 0.09 0.02
Litigation expenses 0.08 0.03 0.11 0.13
Tax impact of non-GAAP adjustments (0.10 ) (0.09 ) (0.28 ) (0.14 )
Rounding impact 0.01
Net adjustment items 0.29 0.28 0.83 0.39
Adjusted net income per diluted share $ 9.20 $ 4.64 98.3 % $ 15.68 $ 10.67 47.0 %
Full Year 2020 Outlook
Net income per diluted share Greater than $20.91
Add / (Subtract):
Net realized losses on financial instruments 0.02
Impairment losses recognized in income 0.18
Loss on extinguishment of debt 0.02
Transaction and integration related costs 0.09
Litigation expenses 0.11
Amortization of other intangible assets Approximately $1.41
Tax impact of non-GAAP adjustments Approximately ($0.44)
Net adjustment items Approximately $1.39
Adjusted net income per diluted share Greater than $22.30
Three Months Ended June 30 Six Months Ended June 30
(In millions) 2020 2019 Change 2020 2019 Change
Reportable segments operating gain $ 3,360 $ 1,433 134.5 % $ 5,554 $ 3,373 64.7 %
Net investment income 57 285 311 495
Net realized gains (losses) on financial instruments 18 11 (6 ) 89
Impairment recoveries (losses) recognized in income 11 (7 ) (46 ) (17 )
Interest expense (201 ) (184 ) (395 ) (371 )
Amortization of other intangible assets (93 ) (85 ) (176 ) (172 )
(Loss) gain on extinguishment of debt (3 ) (4 ) 1
Income before income tax expense $ 3,149 $ 1,453 116.7 % $ 5,238 $ 3,398 54.1 %
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, or collectively, the ACA, and the ultimate outcome of legal challenges to the ACA; 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, or CMS, 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; the ultimate outcome of litigation between Cigna Corporation and us related to the merger agreement between the parties and the potential for such litigation to cause us to incur substantial additional costs, including potential settlement and judgment costs; risks and uncertainties related to our pharmacy benefit management, or 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; 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; changes in U.S. tax laws; 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 29, 2020