Anthem Reports Second Quarter 2021 Results, Raises Full Year Outlook
Anthem, Inc. (NYSE: ANTM) reported a strong financial performance in Q2 2021, with GAAP net income at $7.25 per share. Medical enrollment rose to 44.3 million members, marking a 4.4% increase. Operating revenue reached $33.3 billion, up 14.1% year-over-year, largely driven by Medicaid and Medicare growth. However, the benefit expense ratio increased to 86.8%, indicating rising healthcare costs. The company also executed a share repurchase of 1.3 million shares for $480 million and declared a quarterly dividend of $1.13 per share.
- GAAP net income of $7.25 per share.
- Medical enrollment rose to 44.3 million members, up 4.4% year-over-year.
- Operating revenue increased by 14.1% to $33.3 billion, driven by Medicaid and Medicare growth.
- Share repurchase of 1.3 million shares for $480 million.
- Declared a quarterly dividend of $1.13 per share.
- Benefit expense ratio increased to 86.8%, reflecting rising healthcare costs.
- Operating gain decreased in both Commercial & Specialty and Government segments by 42.3% and 46.4%, respectively.
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."
*Refer to GAAP reconciliation tables.
CONSOLIDATED HIGHLIGHTS
Earnings Per Share: GAAP net income was
*Please refer to the GAAP reconciliation tables.
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
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
Share Repurchase Program: During the second quarter of 2021, the Company repurchased 1.3 million shares of its common stock for
Cash Dividend: During the second quarter of 2021, the Company paid a quarterly dividend of
On July 20, 2021, the Audit Committee declared a third quarter 2021 dividend to shareholders of
Investment Portfolio & Capital Position: During the second quarter of 2021, the Company recorded net realized gains of
As of June 30, 2021, the Company’s net unrealized gain position in the investment portfolio was
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).
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Anthem, Inc. |
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Reportable Segment Highlights |
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(Unaudited) |
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(In millions) |
Three Months Ended June 30 |
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Six Months Ended June 30 |
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2021 |
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2020 |
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Change |
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2021 |
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2020 |
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Change |
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Operating Revenue |
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Commercial & Specialty Business |
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8.7 |
% |
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4.9 |
% |
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Government Business |
20,066 |
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17,242 |
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16.4 |
% |
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39,349 |
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34,708 |
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13.4 |
% |
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IngenioRx |
6,219 |
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5,269 |
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18.0 |
% |
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12,081 |
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10,466 |
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15.4 |
% |
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Other |
2,517 |
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1,452 |
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73.3 |
% |
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4,887 |
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2,479 |
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97.1 |
% |
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Eliminations |
(5,073) |
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(3,574) |
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41.9 |
% |
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(9,981) |
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(7,177) |
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39.1 |
% |
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Total Operating Revenue1 |
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14.1 |
% |
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11.5 |
% |
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Operating Gain (Loss) |
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Commercial & Specialty Business |
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(42.3) |
% |
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(26.3) |
% |
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Government Business |
868 |
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1,618 |
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(46.4) |
% |
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1,346 |
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2,029 |
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(33.7) |
% |
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IngenioRx |
405 |
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304 |
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33.2 |
% |
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812 |
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653 |
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24.3 |
% |
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Other |
17 |
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66 |
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(74.2) |
% |
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25 |
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80 |
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(68.8) |
% |
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Total Operating Gain1 |
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(38.1) |
% |
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(23.6) |
% |
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Operating Margin |
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8.3 |
% |
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15.6 |
% |
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(730) bp |
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10.8 |
% |
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15.4 |
% |
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(460) bp |
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4.3 |
% |
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9.4 |
% |
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(510) bp |
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3.4 |
% |
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5.8 |
% |
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(240) bp |
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6.5 |
% |
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5.8 |
% |
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70 bp |
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6.7 |
% |
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6.2 |
% |
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50 bp |
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Total Operating Margin1 |
6.3 |
% |
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11.5 |
% |
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(520) bp |
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6.5 |
% |
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9.5 |
% |
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(300) bp |
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(1) |
See “Basis of Presentation.” |
(2) |
"NM" = calculation not meaningful. |
Commercial & Specialty Business: Operating gain in the Commercial & Specialty Business segment totaled
Government Business: Operating gain in the Government Business segment was
IngenioRx: Operating gain was
Other: The Company reported an operating gain of
OUTLOOK
Full Year 2021:
-
GAAP net income is now expected to be greater than
$24.89 per share, including approximately$0.61 per share of net unfavorable items. Excluding these items, adjusted net income is expected to be greater than$25.50 * per share. - Medical membership is now expected to be in the range of 44.8 - 45.3 million. Risk-based membership is now expected to be in the range of 19.3 - 19.6 million. Fee-based membership is expected to be in the range of 25.5 - 25.7 million.
-
Operating revenue is now expected to be approximately
$137.1 billion , including premium revenue of$116.5 billion -$117.5 billion . -
Operating cash flow is now expected to be greater than
$5.8 billion . -
Investment income is now expected to be approximately
$1.1 billion . -
Effective tax rate is now expected to be between 22.0 -
24.0%
* Refer to the GAAP reconciliation tables.
Basis of Presentation
- Operating revenue and operating gain/loss are the key measures used by management to evaluate performance in each of its reporting segments, allocate resources, set incentive compensation targets and to forecast future operating performance. Operating gain/loss is calculated as total operating revenue less benefit expense, cost of products sold and selling, general and administrative expense. It does not include net investment income, net realized gains/losses on financial instruments, interest expense, amortization of other intangible assets, gains/losses on extinguishment of debt or income taxes, as these items are managed in a corporate shared service environment and are not the responsibility of operating segment management. Refer to the GAAP reconciliation tables.
- Operating margin is defined as operating gain divided by operating revenue.
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.
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.
Anthem, Inc. |
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Membership Summary |
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(Unaudited and in Thousands) |
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Change from |
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Medical Membership |
June 30,
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June 30,
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March 31,
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June 30,
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March 31,
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Commercial & Specialty Business |
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Individual |
738 |
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711 |
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731 |
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3.8 |
% |
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1.0 |
% |
Group Risk-Based |
3,851 |
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3,789 |
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3,837 |
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1.6 |
% |
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0.4 |
% |
Commercial Risk-Based |
4,589 |
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4,500 |
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4,568 |
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2.0 |
% |
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0.5 |
% |
BlueCard® |
6,235 |
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6,171 |
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6,166 |
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1.0 |
% |
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1.1 |
% |
Group Fee-Based |
19,372 |
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19,699 |
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19,515 |
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(1.7) |
% |
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(0.7) |
% |
Commercial Fee-Based |
25,607 |
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25,870 |
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25,681 |
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(1.0) |
% |
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(0.3) |
% |
Total Commercial & Specialty Business |
30,196 |
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30,370 |
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30,249 |
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(0.6) |
% |
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(0.2) |
% |
Government Business |
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Medicare Advantage |
1,824 |
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|
1,366 |
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1,538 |
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33.5 |
% |
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18.6 |
% |
Medicare Supplement |
936 |
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|
921 |
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|
930 |
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|
1.6 |
% |
|
0.6 |
% |
Total Medicare |
2,760 |
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|
2,287 |
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|
2,468 |
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20.7 |
% |
|
11.8 |
% |
Medicaid |
9,754 |
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|
8,180 |
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|
9,172 |
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19.2 |
% |
|
6.3 |
% |
Federal Employees Health Benefits |
1,631 |
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|
1,616 |
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|
1,632 |
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0.9 |
% |
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(0.1) |
% |
Total Government Business |
14,145 |
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|
12,083 |
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|
13,272 |
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17.1 |
% |
|
6.6 |
% |
Total Medical Membership |
44,341 |
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42,453 |
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|
43,521 |
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4.4 |
% |
|
1.9 |
% |
Other Membership |
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Life and Disability Members |
4,732 |
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|
5,110 |
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4,766 |
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|
(7.4) |
% |
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(0.7) |
% |
Dental Members |
6,606 |
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|
6,400 |
|
|
6,599 |
|
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3.2 |
% |
|
0.1 |
% |
Dental Administration Members |
1,497 |
|
|
1,318 |
|
|
1,488 |
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13.6 |
% |
|
0.6 |
% |
Vision Members |
7,819 |
|
|
7,457 |
|
|
7,798 |
|
|
4.9 |
% |
|
0.3 |
% |
Medicare Part D Standalone Members |
433 |
|
|
392 |
|
|
450 |
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10.5 |
% |
|
(3.8) |
% |
Anthem, Inc. |
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Consolidated Statements of Income |
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(Unaudited) |
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(In millions, except per share data) |
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Three Months Ended
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2021 |
|
2020 |
|
Change |
|||||
Revenues |
|
|
|
|
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|
|||||
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 |
% |
||
|
|
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|
|||||
Total revenues |
|
33,851 |
|
|
29,264 |
|
|
15.7 |
% |
||
|
|
|
|
|
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|
|||||
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 |
|
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|
|
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|
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|
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Shareholders' net income |
|
$ |
1,793 |
|
|
$ |
2,276 |
|
|
(21.2) |
% |
|
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|
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|
|
|
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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 |
% |
|
890 |
bp |
||
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 |
||
"NM" = calculation not meaningful |
Anthem, Inc. |
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Consolidated Statements of Income |
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(Unaudited) |
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|
|||||
(In millions, except per share data) |
|
Six Months Ended
|
|
|
|||||||
|
|
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 |
% |
|
510 |
bp |
||
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 |
||
"NM" = calculation not meaningful |
Anthem, Inc. |
|||||||
Consolidated Balance Sheets |
|||||||
|
|||||||
(In millions) |
June 30,
|
|
December 31,
|
||||
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 |
|
Anthem, Inc. |
|||||
Consolidated Statements of Cash Flows |
|||||
(Unaudited) |
|||||
|
|
|
|
||
(In millions) |
Six Months Ended June 30 |
||||
|
2021 |
|
2020 |
||
Operating activities |
|
|
|
||
Net income |
|
|
|
|
|
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 |
|
|
|
|
|
Anthem, Inc. |
|||||||||||||||||||
Reconciliation of Medical Claims Payable |
|||||||||||||||||||
|
|||||||||||||||||||
|
Six Months Ended
|
|
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 |
% |
(1) |
Negative amounts reported for net incurred medical claims related to prior years result from claims being settled for amounts less than originally estimated. |
Anthem, Inc. |
GAAP Reconciliation |
(Unaudited) |
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
|
|
|
|
Six Months Ended
|
|
|
||||||||||||||
(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
|
|
|
|
|
|
|
||||||||||||||
Shareholders' net income per diluted share |
Greater than |
|
|
|
|
|
|||||||||||||||
Add / (Subtract): |
|
|
|
|
|
|
|
||||||||||||||
Net realized gains on financial instruments |
( |
|
|
|
|
|
|
|
|||||||||||||
Loss on extinguishment of debt |
|
|
|
|
|
|
|
|
|||||||||||||
Transaction and integration related costs |
|
|
|
|
|
|
|
|
|||||||||||||
Litigation expenses |
|
|
|
|
|
|
|
|
|||||||||||||
Amortization of other intangible assets |
Approximately |
|
|
|
|
|
|||||||||||||||
Tax impact of non-GAAP adjustments |
Approximately |
|
|
|
|
|
|||||||||||||||
Net adjustment items |
Approximately |
|
|
|
|
|
|||||||||||||||
Adjusted shareholders' net income per diluted share |
Greater than |
|
|
|
|
|
|||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Three Months Ended
|
|
|
|
Six Months Ended
|
|
|
||||||||||||||
(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.
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