Table of Contents
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15 (d) OF THE
SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended June 30, 20202021
OR
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15 (d) OF THE
SECURITIES EXCHANGE ACT OF 1934
For the transition period from                     to                     
Commission file number 1-5975
HUMANA INC.
(Exact name of registrant as specified in its charter)
Delaware61-0647538
(State or other jurisdiction of incorporation or organization)(I.R.S. Employer Identification No.)
500 West Main Street
Louisville, Kentucky 40202
(Address of principal executive offices, including zip code)
(502) 580-1000
(Registrant’s telephone number, including area code)

Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading SymbolName of each exchange on which registered
Common stock, $0.16 2/3 par valueHUMNew York Stock Exchange
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes      No  
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes      No  
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer”, “smaller reporting company” and "emerging growth company" in Rule 12b-2 of the Exchange Act.
Large accelerated filerAccelerated filer
Non-accelerated filerSmaller reporting company
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.  
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act).    Yes      No  
Indicate the number of shares outstanding of each of the issuer’s classes of common stock as of the latest practicable date.
Class of Common StockOutstanding at June 30, 20202021
$0.16 2/3 par value132,292,566128,504,664 shares


Table of Contents
Humana Inc.
FORM 10-Q
JUNE 30, 20202021
INDEX
 Page
Part I: Financial Information
Item 1.Financial Statements (Unaudited)
Item 2.
Item 3.
Item 4.
Item 1.
Item 1A.
Item 2.
Item 3.
Item 4.
Item 5.
Item 6.
Certifications




Humana Inc.
CONDENSED CONSOLIDATED BALANCE SHEETS
(Unaudited)
June 30,
2020
December 31, 2019June 30,
2021
December 31, 2020
(in millions, except share amounts)(in millions, except share amounts)
ASSETS
ASSETS
ASSETS
Current assets:Current assets:Current assets:
Cash and cash equivalentsCash and cash equivalents$7,163  $4,054  Cash and cash equivalents$3,378 $4,673 
Investment securitiesInvestment securities12,836  10,972  Investment securities13,471 12,554 
Receivables, less allowance for doubtful accounts of $88 in 2020
and $69 in 2019
2,238  1,056  
Receivables, less allowance for doubtful accounts of $78 in 2021
and $72 in 2020
Receivables, less allowance for doubtful accounts of $78 in 2021
and $72 in 2020
2,438 1,138 
Other current assetsOther current assets5,631  3,806  Other current assets6,503 5,276 
Total current assetsTotal current assets27,868  19,888  Total current assets25,790 23,641 
Property and equipment, netProperty and equipment, net2,118  1,955  Property and equipment, net2,690 2,371 
Long-term investment securitiesLong-term investment securities389  406  Long-term investment securities1,182 1,212 
Equity method investmentsEquity method investments1,122  1,063  Equity method investments1,240 1,170 
GoodwillGoodwill4,443  3,928  Goodwill4,914 4,447 
Other long-term assetsOther long-term assets2,515  1,834  Other long-term assets2,254 2,128 
Total assetsTotal assets$38,455  $29,074  Total assets$38,070 $34,969 
LIABILITIES AND STOCKHOLDERS’ EQUITY
LIABILITIES AND STOCKHOLDERS’ EQUITY
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:Current liabilities:Current liabilities:
Benefits payableBenefits payable$7,980  $6,004  Benefits payable$8,485 $8,143 
Trade accounts payable and accrued expensesTrade accounts payable and accrued expenses6,175  3,754  Trade accounts payable and accrued expenses4,898 4,013 
Book overdraftBook overdraft310  225  Book overdraft236 320 
Unearned revenuesUnearned revenues266  247  Unearned revenues323 318 
Short-term debtShort-term debt1,724  699  Short-term debt1,109 600 
Total current liabilitiesTotal current liabilities16,455  10,929  Total current liabilities15,051 13,394 
Long-term debtLong-term debt6,058  4,967  Long-term debt6,063 6,060 
Future policy benefits payable203  206  
Other long-term liabilitiesOther long-term liabilities1,323  935  Other long-term liabilities2,113 1,787 
Total liabilitiesTotal liabilities24,039  17,037  Total liabilities23,227 21,241 
Stockholders’ equity:Stockholders’ equity:Stockholders’ equity:
Preferred stock, $1 par; 10,000,000 shares authorized; NaN issuedPreferred stock, $1 par; 10,000,000 shares authorized; NaN issued—  —  Preferred stock, $1 par; 10,000,000 shares authorized; NaN issued
Common stock, $0.16 2/3 par; 300,000,000 shares authorized;
198,629,992 shares issued at June 30, 2020 and December 31, 2019
33  33  
Common stock, $0.16 2/3 par; 300,000,000 shares authorized;
198,648,742 shares issued at June 30, 2021 and December 31, 2020
Common stock, $0.16 2/3 par; 300,000,000 shares authorized;
198,648,742 shares issued at June 30, 2021 and December 31, 2020
33 33 
Capital in excess of par valueCapital in excess of par value2,898  2,820  Capital in excess of par value3,018 2,705 
Retained earningsRetained earnings19,616  17,483  Retained earnings21,751 20,517 
Accumulated other comprehensive incomeAccumulated other comprehensive income317  156  Accumulated other comprehensive income216 391 
Treasury stock, at cost, 66,337,426 shares at June 30, 2020 and
66,524,771 shares at December 31, 2019
(8,448) (8,455) 
Treasury stock, at cost, 70,144,078 shares at June 30, 2021 and
69,787,614 shares at December 31, 2020
Treasury stock, at cost, 70,144,078 shares at June 30, 2021 and
69,787,614 shares at December 31, 2020
(10,175)(9,918)
Total stockholders’ equityTotal stockholders’ equity14,416  12,037  Total stockholders’ equity14,843 13,728 
Total liabilities and stockholders’ equityTotal liabilities and stockholders’ equity$38,455  $29,074  Total liabilities and stockholders’ equity$38,070 $34,969 
See accompanying notes to condensed consolidated financial statements.
3


Humana Inc.
CONDENSED CONSOLIDATED STATEMENTS OF INCOME
(Unaudited)
 
Three months ended
June 30,
Six months ended
June 30,
Three months ended
June 30,
Six months ended
June 30,
2020201920202019 2021202020212020
(in millions, except per share results) (in millions, except per share results)
Revenues:Revenues:Revenues:
PremiumsPremiums$18,556  $15,776  $36,918  $31,427  Premiums$19,978 $18,556 $40,102 $36,918 
ServicesServices450  355  874  710  Services491 450 957 874 
Investment incomeInvestment income77  114  226  215  Investment income176 77 254 226 
Total revenuesTotal revenues19,083  16,245  38,018  32,352  Total revenues20,645 19,083 41,313 38,018 
Operating expenses:Operating expenses:Operating expenses:
BenefitsBenefits14,175  13,318  29,804  26,811  Benefits17,149 14,175 34,445 29,804 
Operating costsOperating costs2,354  1,703  4,471  3,363  Operating costs2,116 2,354 4,123 4,471 
Depreciation and amortizationDepreciation and amortization119  109  234  216  Depreciation and amortization144 119 286 234 
Total operating expensesTotal operating expenses16,648  15,130  34,509  30,390  Total operating expenses19,409 16,648 38,854 34,509 
Income from operationsIncome from operations2,435  1,115  3,509  1,962  Income from operations1,236 2,435 2,459 3,509 
Interest expenseInterest expense76  60  136  122  Interest expense79 76 147 136 
Other (income) expense, net(227) (174) 70  (135) 
Other expense (income), netOther expense (income), net419 (227)534 70 
Income before income taxes and equity in net earningsIncome before income taxes and equity in net earnings2,586  1,229  3,303  1,975  Income before income taxes and equity in net earnings738 2,586 1,778 3,303 
Provision for income taxesProvision for income taxes783  301  1,035  484  Provision for income taxes183 783 416 1,035 
Equity in net earningsEquity in net earnings25  12  33  15  Equity in net earnings33 25 54 33 
Net incomeNet income$1,828  $940  $2,301  $1,506  Net income$588 $1,828 $1,416 $2,301 
Basic earnings per common shareBasic earnings per common share$13.83  $6.96  $17.41  $11.14  Basic earnings per common share$4.57 $13.83 $11.00 $17.41 
Diluted earnings per common shareDiluted earnings per common share$13.75  $6.94  $17.31  $11.10  Diluted earnings per common share$4.55 $13.75 $10.94 $17.31 
See accompanying notes to condensed consolidated financial statements.
4


Humana Inc.
CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
(Unaudited)
Three months ended
June 30,
Six months ended
June 30,
 2020201920202019
 (in millions)
Net income$1,828  $940  $2,301  $1,506  
Other comprehensive income:
Change in gross unrealized investment
gains/losses
358  169  266  365  
Effect of income taxes(85) (40) (63) (85) 
Total change in unrealized
investment gains/losses, net of tax
273  129  203  280  
Reclassification adjustment for net
realized gains
(2) (6) (47) (6) 
Effect of income taxes—   10   
Total reclassification adjustment, net
of tax
(2) (4) (37) (4) 
Other comprehensive income, net of tax271  125  166  276  
Comprehensive loss attributable to equity method investments(2) (3) (5) (5) 
Comprehensive income$2,097  $1,062  $2,462  $1,777  
Three months ended
June 30,
Six months ended
June 30,
 2021202020212020
 (in millions)
Net income$588 $1,828 $1,416 $2,301 
Other comprehensive income:
Change in gross unrealized investment gains/losses136 358 (184)266 
Effect of income taxes(31)(85)42 (63)
Total change in unrealized investment gains/losses, net of tax105 273 (142)203 
Reclassification adjustment for net realized gains(9)(2)(64)(47)
Effect of income taxes15 10 
Total reclassification adjustment, net of tax(7)(2)(49)(37)
Other comprehensive gain (loss), net of tax98 271 (191)166 
Comprehensive income (loss) attributable to equity method investments10 (2)16 (5)
Comprehensive income$696 $2,097 $1,241 $2,462 
See accompanying notes to condensed consolidated financial statements.
5



Humana Inc.
CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY
(Unaudited)
Common StockCapital In
Excess of
Par Value
Retained
Earnings
Accumulated
Other
Comprehensive
Income (Loss)
Treasury
Stock
Total
Stockholders’
Equity
Common StockCapital In
Excess of
Par Value
Retained
Earnings
Accumulated
Other
Comprehensive
Income (loss)
Treasury
Stock
Total
Stockholders’
Equity
Issued
Shares
AmountRetained
Earnings
Accumulated
Other
Comprehensive
Income (loss)
Treasury
Stock
Total
Stockholders’
Equity
(dollars in millions, share amounts in thousands)(dollars in millions, share amounts in thousands)
Three months ended June 30, 2020
Balances, March 31, 2020198,630  $33  $2,857  $17,871  $48  $(8,454) $12,355  
Three months ended June 30, 2021Three months ended June 30, 2021
Balances, March 31, 2021Balances, March 31, 2021198,649 $33 $2,712 $21,252 $108 $(9,915)$14,190 
Net incomeNet income1,828  1,828  Net income588 588 
Other comprehensive loss269  269  
Other comprehensive incomeOther comprehensive income108 108 
Common stock repurchasesCommon stock repurchases—  (8) (8) Common stock repurchases263 (265)(2)
Dividends and dividend
equivalents
Dividends and dividend
equivalents
—  (83) (83) Dividends and dividend
equivalents
(89)(89)
Stock-based compensationStock-based compensation46  46  Stock-based compensation45 45 
Restricted stock unit vestingRestricted stock unit vesting—  —  (9)  —  Restricted stock unit vesting(3)
Stock option exercisesStock option exercises—  —     Stock option exercises
Balances, June 30, 2020198,630  $33  $2,898  $19,616  $317  $(8,448) $14,416  
Balances, June 30, 2021Balances, June 30, 2021198,649 $33 $3,018 $21,751 $216 $(10,175)$14,843 
Three months ended June 30, 2019
Balances, March 31, 2019198,595  $33  $2,722  $15,563  $(10) $(7,467) $10,841  
Three months ended June 30, 2020Three months ended June 30, 2020
Balances, March 31, 2020Balances, March 31, 2020198,630 $33 $2,857 $17,871 $48 $(8,454)$12,355 
Net incomeNet income940  940  Net income1,828 1,828 
Other comprehensive incomeOther comprehensive income122  122  Other comprehensive income269 269 
Common stock repurchasesCommon stock repurchases—  —  —  Common stock repurchases(8)(8)
Dividends and dividend
equivalents
Dividends and dividend
equivalents
—  (74) (74) Dividends and dividend
equivalents
(83)(83)
Stock-based compensationStock-based compensation43  43  Stock-based compensation46 46 
Restricted stock unit vestingRestricted stock unit vesting32  —  (3)  (1) Restricted stock unit vesting(9)
Stock option exercisesStock option exercises —    Stock option exercises
Balances, June 30, 2019198,628  $33  $2,763  $16,429  $112  $(7,465) $11,872  
Balances, June 30, 2020Balances, June 30, 2020198,630 $33 $2,898 $19,616 $317 $(8,448)$14,416 
See accompanying notes to condensed consolidated financial statements.


















6


Humana Inc.
CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY — (Continued)
(Unaudited)
 Common StockCapital In
Excess of
Par Value
Retained
Earnings
Accumulated
Other
Comprehensive
Income (Loss)
Treasury
Stock
Total
Stockholders’
Equity
 Issued
Shares
Amount
(dollars in millions, share amounts in thousands)
Six months ended June 30, 2020
Balances, December 31, 2019198,630  $33  $2,820  $17,483  $156  $(8,455) $12,037  
Net income2,301  2,301  
Impact of adopting ASC 326 -
Current expected credit loss
standard (CECL)
(2) (2) 
Other comprehensive income161  161  
Common stock repurchases—  (25) (25) 
Dividends and dividend
equivalents
—  (166) (166) 
Stock-based compensation82  82  
Restricted stock unit vesting—  —  (15) 15  —  
Stock option exercises—  —  11  17  28  
Balances, June 30, 2020198,630  $33  $2,898  $19,616  $317  $(8,448) $14,416  
Six months ended June 30, 2019
Balances, December 31, 2018198,595  $33  $2,535  $15,072  $(159) $(7,320) $10,161  
Net income1,506  1,506  
Other comprehensive loss271  271  
Common stock repurchases150  (160) (10) 
Dividends and dividend
equivalents
—  (149) (149) 
Stock-based compensation76  76  
Restricted stock unit vesting32  —  (3)  —  
Stock option exercises —   12  17  
Balances, June 30, 2019198,628  $33  $2,763  $16,429  $112  $(7,465) $11,872  
 Common StockCapital In
Excess of
Par Value
Retained
Earnings
Accumulated
Other
Comprehensive
Income
Treasury
Stock
Total
Stockholders’
Equity
 Issued
Shares
Amount
(dollars in millions, share amounts in thousands)
Six months ended June 30, 2021
Balances, December 31, 2020198,649 $33 $2,705 $20,517 $391 $(9,918)$13,728 
Net income1,416 1,416 
Other comprehensive loss(175)(175)
Common stock repurchases263 (296)(33)
Dividends and dividend
   equivalents
(182)(182)
Stock-based compensation84 84 
Restricted stock unit vesting(36)36 
Stock option exercises
Balances, June 30, 2021198,649 $33 $3,018 $21,751 $216 $(10,175)$14,843 
Six months ended June 30, 2020
Balances, December 31, 2019198,630 $33 $2,820 $17,483 $156 $(8,455)$12,037 
Net income2,301 2,301 
Impact of adopting ASC 326 -
   Current expected credit loss
   standard (CECL)
(2)(2)
Other comprehensive income161 161 
Common stock repurchases(25)(25)
Dividends and dividend
   equivalents
(166)(166)
Stock-based compensation82 82 
Restricted stock unit vesting(15)15 
Stock option exercises11 17 28 
Balances, June 30, 2020198,630 $33 $2,898 $19,616 $317 $(8,448)$14,416 
See accompanying notes to condensed consolidated financial statements.
7



Humana Inc.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(Unaudited)
For the six months ended
June 30,
For the six months ended
June 30,
20202019 20212020
(in millions) (in millions)
Cash flows from operating activitiesCash flows from operating activitiesCash flows from operating activities
Net incomeNet income$2,301  $1,506  Net income$1,416 $2,301 
Adjustments to reconcile net income to net cash provided by
operating activities:
Adjustments to reconcile net income to net cash (used in) provided by
operating activities:
Adjustments to reconcile net income to net cash (used in) provided by
operating activities:
Net realized capital gains(51) (5) 
Gains on investment securities, netGains on investment securities, net(86)(51)
Equity in net earningsEquity in net earnings(33) (15) Equity in net earnings(54)(33)
Stock-based compensationStock-based compensation82  76  Stock-based compensation84 82 
DepreciationDepreciation252  240  Depreciation308 252 
AmortizationAmortization43  36  Amortization30 43 
Benefit for deferred income taxesBenefit for deferred income taxes(3) (21) Benefit for deferred income taxes(3)
Changes in operating assets and liabilities, net of effect of
businesses acquired and dispositions:
Changes in operating assets and liabilities, net of effect of
businesses acquired and dispositions:
Changes in operating assets and liabilities, net of effect of
businesses acquired and dispositions:
ReceivablesReceivables(1,185) 123  Receivables(1,285)(1,185)
Other assetsOther assets(2,124) (548) Other assets(879)(2,124)
Benefits payableBenefits payable1,976  980  Benefits payable300 1,976 
Other liabilitiesOther liabilities2,267  (116) Other liabilities(301)2,267 
Unearned revenuesUnearned revenues19  29  Unearned revenues19 
OtherOther(3) 45  Other(15)(3)
Net cash provided by operating activities3,541  2,330  
Net cash (used in) provided by operating activitiesNet cash (used in) provided by operating activities(477)3,541 
Cash flows from investing activitiesCash flows from investing activitiesCash flows from investing activities
Acquisitions, net of cash acquiredAcquisitions, net of cash acquired(709) —  Acquisitions, net of cash acquired(325)(709)
Purchases of property and equipmentPurchases of property and equipment(418) (296) Purchases of property and equipment(619)(418)
Purchases of investment securitiesPurchases of investment securities(5,464) (3,135) Purchases of investment securities(5,307)(5,464)
Maturities of investment securitiesMaturities of investment securities1,645  894  Maturities of investment securities1,627 1,645 
Proceeds from sales of investment securitiesProceeds from sales of investment securities2,084  2,626  Proceeds from sales of investment securities2,421 2,084 
Net cash (used in) provided by investing activities(2,862) 89  
Net cash used in investing activitiesNet cash used in investing activities(2,203)(2,862)
Cash flows from financing activitiesCash flows from financing activitiesCash flows from financing activities
Receipts from contract deposits, netReceipts from contract deposits, net389  473  Receipts from contract deposits, net1,183 389 
Proceeds from issuance of senior notes, netProceeds from issuance of senior notes, net1,088  —  Proceeds from issuance of senior notes, net1,088 
Proceeds (repayments) from issuance of commercial paper, net21  (356) 
Proceeds from issuance of commercial paper, netProceeds from issuance of commercial paper, net508 21 
Proceeds from term loanProceeds from term loan1,000  —  Proceeds from term loan1,000 
Debt issue costsDebt issue costs(21)
Change in book overdraftChange in book overdraft85  33  Change in book overdraft(84)85 
Common stock repurchasesCommon stock repurchases(25) (10) Common stock repurchases(33)(25)
Dividends paidDividends paid(156) (142) Dividends paid(173)(156)
Proceeds from stock option exercises and other, netProceeds from stock option exercises and other, net28  18  Proceeds from stock option exercises and other, net28 
Net cash provided by financing activitiesNet cash provided by financing activities2,430  16  Net cash provided by financing activities1,385 2,430 
Increase in cash and cash equivalents3,109  2,435  
(Decrease) increase in cash and cash equivalents(Decrease) increase in cash and cash equivalents(1,295)3,109 
Cash and cash equivalents at beginning of periodCash and cash equivalents at beginning of period4,054  2,343  Cash and cash equivalents at beginning of period4,673 4,054 
Cash and cash equivalents at end of periodCash and cash equivalents at end of period$7,163  $4,778  Cash and cash equivalents at end of period$3,378 $7,163 
Supplemental cash flow disclosures:Supplemental cash flow disclosures:Supplemental cash flow disclosures:
Interest paymentsInterest payments$115  $110  Interest payments$132 $115 
Income tax payments, netIncome tax payments, net$36  $346  Income tax payments, net$386 $36 
See accompanying notes to condensed consolidated financial statements.
8

Table of Contents


Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)

1. BASIS OF PRESENTATION AND SIGNIFICANT EVENTS
The accompanying condensed consolidated financial statements are presented in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the disclosures normally required by accounting principles generally accepted in the United States of America, or GAAP, or those normally made in an Annual Report on Form 10-K. The year-end condensed consolidated balance sheet data was derived from audited financial statements, but does not include all disclosures required by GAAP. For further information, the reader of this Form 10-Q should refer to our Form 10-K for the year ended December 31, 2019,2020, that was filed with the Securities and Exchange Commission, or the SEC, on February 20, 2020.18, 2021. We refer to the Form 10-K as the “2019“2020 Form 10-K” in this document. References throughout this document to “we,” “us,” “our,” “Company,” and “Humana” mean Humana Inc. and its subsidiaries.
The preparation of our condensed consolidated financial statements in accordance with GAAP requires us to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes. The areas involving the most significant use of estimates are the estimation of benefits payable, the impact of risk adjustment provisions related to our Medicare contracts, the valuation and related impairment recognition of investment securities, and the valuation and related impairment recognition of long-lived assets, including goodwill. These estimates are based on knowledge of current events and anticipated future events, and accordingly, actual results may ultimately differ materially from those estimates. Refer to Note 2 to the consolidated financial statements included in our 20192020 Form 10-K for information on accounting policies that we consider in preparing our consolidated financial statements.
The financial information has been prepared in accordance with our customary accounting practices and has not been audited. In our opinion, the information presented reflects all adjustments necessary for a fair statement of interim results. All such adjustments are of a normal and recurring nature.
Kindred at Home Acquisition
On April 27, 2021, we entered into a definitive agreement to acquire the remaining 60% interest in Kindred at Home, or KAH, the nation’s largest home health and hospice provider, from TPG Capital, the private equity platform of global alternative asset firm, or TPG, and Welsh, Carson, Anderson & Stowe, or WCAS, two private equity funds, or the Sponsors, for an enterprise value of $8.1 billion, which includes our existing equity value of $2.4 billion associated with our 40% minority ownership interest. KAH has locations in 40 states, providing extensive geographic coverage with approximately 65% overlap with our individual Medicare Advantage membership. The acquisition, which is expected to close in the third quarter of 2021, is subject to customary state and federal regulatory approvals. We expect to fund the approximate $5.7 billion transaction (net of our existing equity stake) through a combination of parent company cash, debt financing, and the assumption of existing KAH indebtedness.
COVID-19
The temporary deferral of non-essential care resulting from stay-at-homeemergence and physical distancing orders and other restrictions on movement and economic activity implemented throughout the country beginning the second half of March 2020 to reduce the spread of the novel coronavirus, or COVID-19, beginning in the first quarter of 2020 has impacted our business. HospitalDuring periods of increased incidences of COVID-19, non-essential care from a reduction in non-COVID-19 hospital admissions and lower overall healthcare system consumption decreased utilization. Likewise COVID-19 treatment and testing cost increased utilization. The significant disruption in utilization were significantly depressed in April, increased throughout Mayduring 2020 also impacted our ability to implement clinical initiatives to manage health care costs and June,chronic conditions of our members, and remained modestly below normal historical levels atappropriately document their risk profiles, and, as such, affecting our 2021 revenue under the close of the quarter. The impact of the deferral of non-essential care on our second quarter operating results was partially offset by COVID-19 testing and treatment costs, as well as our ongoing pandemic relief efforts.risk adjustment payment model for Medicare Advantage plans.

Revenue Recognition

Our revenues include premium and service revenues. Service revenues include administrative service fees that are recorded based upon established per member per month rates and the number of members for the month and are
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(Unaudited)
recognized as services are provided for the month. Additionally, service revenues include net patient service revenues that are recorded based upon established billing rates, less allowances for contractual adjustments, and are recognized as services are provided. For more information about our revenues, refer to Note 2 to the consolidated financial statements included in our 20192020 Form 10-K for information on accounting policies that we consider in preparing our consolidated financial statements. See Note 14 for disaggregation of revenue by segment and type.
At June 30, 2020,2021, accounts receivable related to services were $147$192 million. For the three and six months ended June 30, 2020,2021, we had no material bad-debt expense and there were no material contract assets, contract liabilities or deferred contract costs recorded on the condensed consolidated balance sheet at June 30, 2020.2021.
For the three and six months ended June 30, 2020,2021, services revenue recognized from performance obligations related to prior periods (for example, due to changes in transaction price), was not material. Further, services revenue expected to be recognized in any future year related to remaining performance obligations was not material.
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(Unaudited)
Health Care Reform
The Patient Protection and Affordable Care Act and The Health Care and Education Reconciliation Act of 2010 (which we collectively refer to as the Health Care Reform Law) enacted significant reforms to various aspects of the U.S. health insurance industry. Certain of these reforms became effective January 1, 2014, including an annual insurance industry premium-based fee. The Continuing Resolution bill, H.R. 195, enacted on January 22, 2018, included a one year suspension in 2019 of the health insurance industry fee, but the fee resumed in calendar year 2020. The Further Consolidated Appropriations Act, 2020, enacted on December 20, 2019, permanently repealed the health insurance industry fee beginning in calendar year 2021.
In September 2020, we expect to pay the federal government $1.2 billion for the annual health insurance industry fee attributed to calendar year 2020. This fee, fixed in amount by law and apportioned to insurance carriers based on market share, is not deductible for tax purposes. Each year on January 1, except when suspended, we record a liability for this fee in trade accounts payable and accrued expenses which we carry until the fee is paid. We record a corresponding deferred cost in other current assets in our condensed consolidated financial statements which is amortized ratably to expense over the calendar year. Amortization of the deferred cost was recorded in operating cost expense of approximately $286 million and $592 million for the three and six months ended June 30, 2020, respectively, resulting from the amortization of the 2020 annual health insurance industry fee.

2. RECENTLY ISSUED ACCOUNTING PRONOUNCEMENTS
In June 2016, the FASB issued guidance introducing a new model for recognizing credit losses on financial instruments based on an estimate of current expected credit losses. The guidance was effective for us beginning January 1, 2020. The new current expected credit losses (CECL) model generally calls for the immediate recognition of all expected credit losses and applies to loans, accounts and trade receivables as well as other financial assets measured at amortized cost, loan commitments and off-balance sheet credit exposures, debt securities and other financial assets measured at fair value through other comprehensive income, and beneficial interests in securitized financial assets. The new guidance replaces the current incurred loss model for measuring expected credit losses, requires expected losses on available for sale debt securities to be recognized through an allowance for credit losses rather than as reductions in the amortized cost of the securities, and provides for additional disclosure requirements. Our investment portfolio consists primarily of available for sale debt securities. We adopted the new standard effective January 1, 2020. Due to the high concentration of our financial assets measured at amortized cost being with the federal government resulting in zero nonpayment risk as well as our available for sale debt securities primarily being in an unrealized gain position, the adoption of the new standard did not have a material impact on our results of operations, financial condition, or cash flows.
In September 2018, the FASB issued new guidance related to accounting for long-duration contracts of insurers which revises key elements of the measurement models and disclosure requirements for long-duration contracts issued by insurers and reinsurers. The new guidance is effective for us beginning with annual and interim periods in 2022,2023, with earlier adoption permitted, and requires retrospective application to previously issued annual and interim financial statements. The FASB has recently proposed delaying the effective date beginning with annual and interim periods in 2023. We are currently evaluating the impact on our results of operations, financial position and cash flows.

There are no other recently issued accounting standards that apply to us or that are expected to have a material impact on our results of operations, financial condition, or cash flows.
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(Unaudited)
3. ACQUISITIONS AND DIVESTITURES
On January 31,During 2021 and 2020, we purchased privately held Enclara Healthcare, or Enclara, one of the nation’s largest hospice pharmacy and benefit management providers for cash consideration of approximately $709 million, net of cash received. This resulted in a preliminary purchase price allocation to goodwill of $515 million, other intangible assets of $240 million, and net tangible liabilities assumed of $11 million. The goodwill was assigned to the Healthcare Services segment. The other intangible assets, which primarily consist of customer contracts, have an estimated weighted average useful life of 11.4 years. The purchase price allocation is preliminary, subject to completion of valuation analysis, including for example, refining assumptions used to calculate the fair value of intangible assets.
On February 1, 2020, our Partners in Primary Care wholly-owned subsidiary entered into a strategic partnership with Welsh, Carson, Anderson & Stowe, or WCAS, to accelerate the expansion of our primary care model. The WCAS partnership is expected to open approximately 50 payor-agnostic, senior-focused primary care centers over 3 years beginning in 2020. Partners in Primary Care committed to the acquisition of a non-controlling interest in the approximately $600 million entity accounted for under the equity method of accounting. In addition, the agreement includes a series of put and call options through which WCAS may require us to purchase their interest in the entity, and through which we may acquire WCAS’s interest, over the next 5 to 10 years.
During 2020 and 2019, we acquired othervarious health and wellness related businesses which, individually or in the aggregate, have not had a material impact on our results of operations, financial condition, or cash flows. The results of operations and financial condition of these businesses acquired in 20202021 and 20192020 have been included in our condensed consolidated statements of income and condensed consolidated balance sheets from the respective acquisition dates. Acquisition-related costs recognized in 20202021 and 20192020 were not material to our results of operations. The pro forma financial information assuming the acquisitions had occurred as of the beginning of the calendar year prior to the year of acquisition, as well as the revenues and earnings generated during the year of acquisition, were not material for disclosure purposes.


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NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)
4. INVESTMENT SECURITIES
Investment securities classified as current and long-term were as follows at June 30, 20202021 and December 31, 2019,2020, respectively:
Amortized
Cost
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Fair
Value
 (in millions)
June 30, 2020
U.S. Treasury and other U.S. government
corporations and agencies:
U.S. Treasury and agency obligations$929  $ $—  $932  
Mortgage-backed securities3,861  183  (1) 4,043  
Tax-exempt municipal securities1,464  35  (3) 1,496  
Commercial mortgage-backed securities961  44  (4) 1,001  
Asset-backed securities1,186   (17) 1,173  
Corporate debt securities4,398  190  (8) 4,580  
Total debt securities$12,799  $459  $(33) $13,225  
December 31, 2019
U.S. Treasury and other U.S. government
corporations and agencies:
U.S. Treasury and agency obligations$353  $ $—  $354  
Mortgage-backed securities3,628  85  (3) 3,710  
Tax-exempt municipal securities1,433  30  —  1,463  
Commercial mortgage-backed securities786  18  —  804  
Asset-backed securities1,093   (3) 1,093  
Corporate debt securities3,867  82  (2) 3,947  
Total debt securities$11,160  $219  $(8) $11,371  
We also held $7 million of equity securities consisting of common stock carried at fair value as of December 31, 2019.
Amortized
Cost
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Fair
Value
 (in millions)
June 30, 2021
U.S. Treasury and other U.S. government
    corporations and agencies:
U.S. Treasury and agency obligations$646 $$(7)$641 
Mortgage-backed securities3,493 79 (42)3,530 
Tax-exempt municipal securities1,052 43 (1)1,094 
Mortgage-backed securities:
Residential257 (1)256 
Commercial1,415 43 (5)1,453 
Asset-backed securities1,450 1,458 
Corporate debt securities5,280 179 (31)5,428 
Total debt securities$13,593 $354 $(87)13,860 
Common stock793 
Total investment securities$14,653 
December 31, 2020
U.S. Treasury and other U.S. government
    corporations and agencies:
U.S. Treasury and agency obligations$616 $$(1)$616 
Mortgage-backed securities3,115 140 (1)3,254 
Tax-exempt municipal securities1,393 54 1,447 
Mortgage-backed securities:
Residential17 17 
Commercial1,260 59 (1)1,318 
Asset-backed securities1,364 10 (2)1,372 
Corporate debt securities4,672 256 (1)4,927 
Total debt securities$12,437 $520 $(6)12,951 
Common stock815 
Total investment securities$13,766 
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(Unaudited)
Gross unrealized losses and fair values aggregated by investment category and length of time of individual debt securities that have been in a continuous unrealized loss position for which no allowances for credit loss has been recorded were as follows at June 30, 20202021 and December 31, 2019,2020, respectively:
 Less than 12 months12 months or moreTotal
 Fair
Value
Gross
Unrealized
Losses
Fair
Value
Gross
Unrealized
Losses
Fair
Value
Gross
Unrealized
Losses
 (in millions)
June 30, 2020
U.S. Treasury and other U.S.
government corporations
and agencies:
U.S. Treasury and agency
obligations
$342  $—  $—  $—  $342  $—  
Mortgage-backed
securities
406  (1) —  —  406  (1) 
Tax-exempt municipal
securities
181  (3) 12  —  193  (3) 
Commercial mortgage-backed securities204  (3) 33  (1) 237  (4) 
Asset-backed securities152  (1) 814  (16) 966  (17) 
Corporate debt securities301  (4) 177  (4) 478  (8) 
Total debt securities$1,586  $(12) $1,036  $(21) $2,622  $(33) 
December 31, 2019
U.S. Treasury and other U.S.
government corporations
and agencies:
U.S. Treasury and agency
obligations
$48  $—  $23  $—  $71  $—  
Mortgage-backed
securities
315  (1) 204  (2) 519  (3) 
Tax-exempt municipal
securities
58  —  75  —  133  —  
Commercial mortgage-backed securities118  —  36  —  154  —  
Asset-backed securities20  —  607  (3) 627  (3) 
Corporate debt securities589  (2) 155  —  744  (2) 
Total debt securities$1,148  $(3) $1,100  $(5) $2,248  $(8) 
 Less than 12 months12 months or moreTotal
 Fair
Value
Gross
Unrealized
Losses
Fair
Value
Gross
Unrealized
Losses
Fair
Value
Gross
Unrealized
Losses
 (in millions)
June 30, 2021
U.S. Treasury and other U.S.
    government corporations
    and agencies:
U.S. Treasury and agency
    obligations
$373 $(7)$17 $$390 $(7)
Mortgage-backed
    securities
2,336 (39)114 (3)2,450 (42)
Tax-exempt municipal
    securities
81 (1)85 (1)
Mortgage-backed securities:
Residential79 (1)79 (1)
Commercial255 (5)74 329 (5)
Asset-backed securities231 149 380 
Corporate debt securities1,388 (31)19 1,407 (31)
Total debt securities$4,743 $(84)$377 $(3)$5,120 $(87)
December 31, 2020
U.S. Treasury and other U.S.
    government corporations
    and agencies:
U.S. Treasury and agency
    obligations
$225 $(1)$$$225 $(1)
Mortgage-backed
    securities
199 (1)199 (1)
Tax-exempt municipal
    securities
16 19 35 
Mortgage-backed securities:
Residential17 17 
Commercial193 (1)43 236 (1)
Asset-backed securities65 498 (2)563 (2)
Corporate debt securities342 (1)16 358 (1)
Total debt securities$1,057 $(4)$576 $(2)$1,633 $(6)

Approximately 96%95% of our debt securities were investment-grade quality, with a weighted average credit rating of AAAA- by Standard & Poor's Rating Service, or S&P, at June 30, 2020.2021. Most of the debt securities that were below investment-grade were rated BB, the higher end of the below investment-grade rating scale. Tax-exempt municipal securities were diversified among general obligation bonds of states and local municipalities in the United States as well as special revenue bonds issued by municipalities to finance specific public works projects such as utilities, water and sewer, transportation, or education. Our general obligation bonds are diversified across the United States
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(Unaudited)
with no individual state exceeding 1% of our total debt securities. Our investment policy limits investments in a single issuer and requires diversification among various asset types.

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NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)
Our unrealized losses from all debt securities were generated from approximately 200405 positions out of a total of approximately 1,5001,700 positions at June 30, 2020.2021. All issuers of debt securities we own that were trading at an unrealized loss at June 30, 20202021 remain current on all contractual payments. After taking into account these and other factors previously described, we believe these unrealized losses primarily were caused by an increase in market interest rates in the current markets since the time thethese debt securities were purchased. At June 30, 2020,2021, we did not intend to sell theany debt securities with an unrealized loss position in accumulated other comprehensive income, and it is not likely that we will be required to sell these debt securities before recovery of their amortized cost basis. Additionally, we did not record any material credit allowances for debt securities that were in an unrealized loss position atfor the three and six months ended June 30, 2021 and 2020.
The detail of realized gains (losses) related to investment securities and included within investment income was as follows for the three and six months ended June 30, 20202021 and 2019:2020:
 Three months ended
June 30,
Six months ended
June 30,
 2020201920202019
 (in millions)
Gross realized gains$13  $ $69  $18  
Gross realized losses(11) (1) (18) (13) 
Net realized capital gains$ $ $51  $ 
 Three months ended
June 30,
Six months ended
June 30,
 2021202020212020
 (in millions)(in millions)
Gross gains on investment securities$14 $13 $109 $69 
Gross losses on investment securities(11)(18)
Net gains (losses) on equity securities62 (23)
Net gains on investment securities$76 $$86 $51 
There were no material other-than-temporary impairmentsPurchases of and proceeds from investment securities for the three and six months ended June 30, 2019.2021 and 2020 relate to debt securities.
The contractual maturities of debt securities available for sale at June 30, 2020,2021, regardless of their balance sheet classification, are shown below. Expected maturities may differ from contractual maturities because borrowers may have the right to call or prepay obligations with or without call or prepayment penalties.
Amortized
Cost
Fair
Value
Amortized
Cost
Fair
Value
(in millions) (in millions)
Due within one yearDue within one year$1,790  $1,795  Due within one year$461 $465 
Due after one year through five yearsDue after one year through five years2,043  2,114  Due after one year through five years2,061 2,134 
Due after five years through ten yearsDue after five years through ten years1,834  1,944  Due after five years through ten years2,958 3,035 
Due after ten yearsDue after ten years1,124  1,155  Due after ten years1,498 1,529 
Mortgage and asset-backed securitiesMortgage and asset-backed securities6,008  6,217  Mortgage and asset-backed securities6,615 6,697 
Total debt securitiesTotal debt securities$12,799  $13,225  Total debt securities$13,593 $13,860 
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(Unaudited)
5. FAIR VALUE
Financial Assets
The following table summarizes our fair value measurements at June 30, 20202021 and December 31, 2019,2020, respectively, for financial assets measured at fair value on a recurring basis:
Fair Value Measurements Using Fair Value Measurements Using
Fair
Value
Quoted Prices
in Active
Markets
(Level 1)
Other
Observable
Inputs
(Level 2)
Unobservable
Inputs
(Level 3)
Fair
Value
Quoted Prices
in Active
Markets
(Level 1)
Other
Observable
Inputs
(Level 2)
Unobservable
Inputs
(Level 3)
(in millions) (in millions)
June 30, 2020
June 30, 2021June 30, 2021
Cash equivalentsCash equivalents$6,771  $6,771  $—  $—  Cash equivalents$3,191 $3,191 $$
Debt securities:Debt securities:Debt securities:
U.S. Treasury and other U.S. government
corporations and agencies:
U.S. Treasury and other U.S. government
corporations and agencies:
U.S. Treasury and other U.S. government
corporations and agencies:
U.S. Treasury and agency obligationsU.S. Treasury and agency obligations932  —  932  —  U.S. Treasury and agency obligations641 641 
Mortgage-backed securitiesMortgage-backed securities4,043  —  4,043  —  Mortgage-backed securities3,530 3,530 
Tax-exempt municipal securitiesTax-exempt municipal securities1,496  —  1,496  —  Tax-exempt municipal securities1,094 1,094 
Commercial mortgage-backed securities1,001  —  1,001  —  
Mortgage-backed securities:Mortgage-backed securities:
ResidentialResidential256 256 
CommercialCommercial1,453 1,453 
Asset-backed securitiesAsset-backed securities1,173  —  1,173  —  Asset-backed securities1,458 1,458 
Corporate debt securitiesCorporate debt securities4,580  —  4,580  —  Corporate debt securities5,428 5,428 
Total debt securitiesTotal debt securities13,225  —  13,225  —  Total debt securities13,860 13,860 
Common stockCommon stock793 793 
Total invested assetsTotal invested assets$19,996  $6,771  $13,225  $—  Total invested assets$17,844 $3,984 $13,860 $
December 31, 2019
December 31, 2020December 31, 2020
Cash equivalentsCash equivalents$3,660  $3,660  $—  $—  Cash equivalents$4,548 $4,548 $$
Debt securities:Debt securities:Debt securities:
U.S. Treasury and other U.S. government
corporations and agencies:
U.S. Treasury and other U.S. government
corporations and agencies:
U.S. Treasury and other U.S. government
corporations and agencies:
U.S. Treasury and agency obligationsU.S. Treasury and agency obligations354  —  354  —  U.S. Treasury and agency obligations616 616 
Mortgage-backed securitiesMortgage-backed securities3,710  —  3,710  —  Mortgage-backed securities3,254 3,254 
Tax-exempt municipal securitiesTax-exempt municipal securities1,463  —  1,463  —  Tax-exempt municipal securities1,447 1,447 
Commercial mortgage-backed securities804  —  804  —  
Mortgage-backed securities:Mortgage-backed securities:
ResidentialResidential17 17 
CommercialCommercial1,318 1,318 
Asset-backed securitiesAsset-backed securities1,093  —  1,093  —  Asset-backed securities1,372 1,372 
Corporate debt securitiesCorporate debt securities3,947  —  3,947  —  Corporate debt securities4,927 4,927 
Total debt securitiesTotal debt securities11,371  —  11,371  —  Total debt securities12,951 12,951 
Common stockCommon stock  —  —  Common stock815 815 
Total invested assetsTotal invested assets$15,038  $3,667  $11,371  $—  Total invested assets$18,314 $5,363 $12,951 $
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NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)
Financial Liabilities
Our debt is recorded at carrying value in our consolidated balance sheets. The carrying value of our senior notes debt outstanding, net of unamortized debt issuance costs, was $6,457 million$6.1 billion at June 30, 20202021 and $5,366 million at December 31, 2019.2020. The fair value of our senior notes debt was $7,609 million$7.1 billion at June 30, 20202021 and $5,916 million$7.4 billion at December 31, 2019.2020. The fair value of our senior notenotes debt is determined based on Level 2 inputs, including
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NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)
quoted market prices for the same or similar debt, or if no quoted market prices are available, on the current prices estimated to be available to us for debt with similar terms and remaining maturities. Due to the short-term nature, carrying value approximates fair value for our term note and commercial paper borrowings. The term loan outstanding and commercial paper borrowings were $1,325 million$1.1 billion and $0.6 billion as of June 30, 2020. The commercial paper borrowings were $300 million as of2021 and December 31, 2019.2020, respectively.
Put and Call Options Measured at Fair Value
As part of our investment in Kindred at Home, we entered into a shareholders agreement with TPG Capital, or TPG, and Welsh, Carson, Anderson & Stowe, or WCAS, the Sponsors, that provides for certain rights and obligations of each party. The shareholders agreementEffective April 27, 2021, with the Sponsors includes a put option under which they havesigning of the rightdefinitive agreement to require us to purchase theiracquire the remaining 60% interest inof KAH, the joint venture beginning on July 2, 2021 and ending on July 1, 2022. Likewise, we have a call option under which we have the right to require the Sponsors to sell their interest in the joint venture to Humana beginning on July 2, 2022 and ending on July 1, 2023. The put and call options which are exercisable at a fixed EBITDA multiplewere terminated. As such, the $63 million put and provide a minimum return on$440 million call fair values as of the Sponsor's investment if exercised, are measured at fair value each period using a Monte Carlo simulation.first quarter of 2021 were reduced to 0, resulting in $377 million in "Other (income) expense, net" in our condensed consolidated statements of income during the three months ended June 30, 2021.
The put and call options were measured at fair value using a Monte Carlo simulation which resulted in fair values were $116of $45 million and $592 million, respectively, at June 30, 2020, and $28 million and $557$503 million, respectively, at December 31, 2019.2020. The put option is included within other long-term liabilities and the call option is included within other long-term assets.assets at December 31, 2020. The change in fair value of the put and call options is reflected as "Other (income) expense, net" in our condensed consolidated statements of income.

The significant unobservable inputs utilized in these Level 3 fair value measurements (and selected values) include the enterprise value of Kindred at Home, annualized volatility and secured credit rate. Enterprise value was derived from a discounted cash flow model, which utilized significant unobservable inputs for long-term net operating profit after tax margin, or NOPAT, to measure underlying cash flows, weighted average cost of capital and long term growth rate. The table below presents the assumptions used for each reporting period.
June 30, 2020December 31, 2019
Annualized volatility34.8 %19.8 %
Secured credit rate1.1 %2.2 %
NOPAT12.0 %12.0 %
Weighted average cost of capital10.0 %10.0 %
Long term growth rate3.0 %3.0 %

The calculation of NOPAT utilized net income plus after tax interest expense. We regularly evaluate each of the assumptions used in establishing these assets and liabilities. Significant changes in assumptions for weighted average cost of capital, long term growth rates, NOPAT, volatility, credit spreads, risk free rate, and underlying cash flow estimates, could result in significantly lower or higher fair value measurements. A change in one of these assumptions is not necessarily accompanied by a change in another assumption.

Other Assets and Liabilities Measured at Fair Value

As disclosed in Note 3, we acquired Enclara during 2020. The values of net tangible assets acquired andOther than the resulting goodwill and other intangible assets were recorded at fair value using Level 3 inputs. The majority of the net tangible liabilities assumed were recorded at their carrying values as of the date of acquisition, as their carrying values approximated their fair values due to their short-term nature. The fair values of goodwill and other intangible assets acquired in this acquisition were internally estimated primarily based on the income approach. The income approach estimates fair value based on the present value of the cash flows that the assets are expected to generate in the future. We developed internal estimates for the expected future cash flows and discount rates used in the present value calculations. Other thanimmaterial assets acquired and liabilities assumed in this acquisition,the acquisitions in Note 3, there were no other material assets or liabilities measured at fair value on a recurring or nonrecurring basis during 2020.2021.
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NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)
6. MEDICARE PART D
We cover prescription drug benefits in accordance with Medicare Part D under multiple contracts with the Centers for Medicare and Medicaid Services, or CMS, as described further in Note 2 to the consolidated financial statements included in our 20192020 Form 10-K. The accompanying condensed consolidated balance sheets include the following amounts associated with Medicare Part D at June 30, 20202021 and December 31, 2019.2020. CMS subsidies/discounts in the table below include the reinsurance and low-income cost subsidies funded by CMS for which we assume no risk as well as brand name prescription drug discounts for Part D plan participants in the coverage gap funded by CMS and pharmaceutical manufacturers.
June 30, 2020December 31, 2019 June 30, 2021December 31, 2020
Risk
Corridor
Settlement
CMS
Subsidies/
Discounts
Risk
Corridor
Settlement
CMS
Subsidies/
Discounts
Risk
Corridor
Settlement
CMS
Subsidies/
Discounts
Risk
Corridor
Settlement
CMS
Subsidies/
Discounts
(in millions) (in millions)
Other current assetsOther current assets$26  $1,010  $ $585  Other current assets$169 $1,635 $216 $1,420 
Trade accounts payable and accrued expensesTrade accounts payable and accrued expenses(100) (1,193) (120) (356) Trade accounts payable and accrued expenses(13)(1,653)(39)(253)
Net current (liability) asset(74) (183) (115) 229  
Net current asset (liability)Net current asset (liability)156 (18)177 1,167 
Other long-term assetsOther long-term assets313  —   —  Other long-term assets317 
Other long-term liabilitiesOther long-term liabilities(149) —  (61) —  Other long-term liabilities(198)(90)
Net long-term asset (liability)Net long-term asset (liability)164  —  (55) —  Net long-term asset (liability)119 (82)
Total net asset (liability)Total net asset (liability)$90  $(183) $(170) $229  Total net asset (liability)$275 $(18)$95 $1,167 

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Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)
7. GOODWILL AND OTHER INTANGIBLE ASSETS
Changes in the carrying amount of goodwill for our reportable segments for the six months ended June 30, 20202021 were as follows:
RetailGroup and SpecialtyHealthcare
Services
Total
 (in millions)
Balance at January 1, 2020$1,535  $261  $2,132  $3,928  
Acquisitions—  —  515  515  
Balance at June 30, 2020$1,535  $261  $2,647  $4,443  
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Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)
RetailGroup and SpecialtyHealthcare
Services
Total
 (in millions)
Balance at January 1, 2021$1,535 $261 $2,651 $4,447 
Acquisitions112 355 467 
Balance at June 30, 2021$1,647 $261 $3,006 $4,914 
    The following table presents details of our other intangible assets included in other long-term assets in the accompanying condensed consolidated balance sheets at June 30, 20202021 and December 31, 2019.2020.
 June 30, 2020December 31, 2019
Weighted
Average
Life
CostAccumulated
Amortization
NetCostAccumulated
Amortization
Net
 ($ in millions)
Other intangible assets:
Customer contracts/
relationships
9.5 years$849  $534  $315  $646  $496  $150  
Trade names and
technology
7.0 years122  86  36  84  84  —  
Provider contracts11.8 years70  47  23  70  44  26  
Noncompetes and
other
7.3 years29  29  —  29  28   
Total other intangible
assets
9.3 years$1,070  $696  $374  $829  $652  $177  
 June 30, 2021December 31, 2020
Weighted
Average
Life
CostAccumulated
Amortization
NetCostAccumulated
Amortization
Net
 ($ in millions)
Other intangible assets:
Customer contracts/
    relationships
9.4 years$875 $596 $279 $849 $572 $277 
Trade names and
    technology
6.7 years136 92 44 122 89 33 
Provider contracts11.8 years69 53 16 69 50 19 
Noncompetes and
    other
7.1 years32 29 29 29 
Total other intangible
    assets
9.1 years$1,112 $770 $342 $1,069 $740 $329 
    For the three months ended June 30, 20202021 and 2019,2020, amortization expense for other intangible assets was approximately $22$15 million and $18$22 million, respectively. For the six months ended June 30, 20202021 and 2019,2020, amortization expense for other intangible assets was approximately $43$30 million and $36$43 million, respectively. The following table presents our estimate of amortization expense remaining for 20202021 and each of the five next succeeding years:
(in millions) (in millions)
For the years ending December 31,For the years ending December 31,For the years ending December 31,
2020$44  
2021202156  2021$33 
2022202253  202262 
2023202340  202348 
2024202433  202440 
2025202533  202539 
2026202627 
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Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)
8. BENEFITS PAYABLE
On a consolidated basis, activity in benefits payable, was as follows for the six months ended June 30, 20202021 and 2019:2020:
For the six months ended June 30,For the six months ended June 30,
2020201920212020
(in millions) (in millions)
Balances, beginning of periodBalances, beginning of period$6,004  $4,862  Balances, beginning of period$8,143 $6,004 
Less: Reinsurance recoverablesLess: Reinsurance recoverables(68) (95) Less: Reinsurance recoverables(68)
Balances, beginning of period, netBalances, beginning of period, net5,936  4,767  Balances, beginning of period, net8,143 5,936 
AcquisitionsAcquisitions42 
Incurred related to:Incurred related to:Incurred related to:
Current yearCurrent year30,039  27,086  Current year35,164 30,039 
Prior yearsPrior years(235) (275) Prior years(719)(235)
Total incurredTotal incurred29,804  26,811  Total incurred34,445 29,804 
Paid related to:Paid related to:Paid related to:
Current yearCurrent year(22,665) (21,700) Current year(27,556)(22,665)
Prior yearsPrior years(5,098) (4,108) Prior years(6,589)(5,098)
Total paidTotal paid(27,763) (25,808) Total paid(34,145)(27,763)
Reinsurance recoverableReinsurance recoverable 72  Reinsurance recoverable
Balances, end of periodBalances, end of period$7,980  $5,842  Balances, end of period$8,485 $7,980 
Amounts incurred related to prior periods vary from previously estimated liabilities as the claims ultimately are settled. Negative amounts reported for incurred related to prior years result from claims being ultimately settled for amounts less than originally estimated (favorable development).
Our reserving practice is to consistently recognize the actuarial best estimate of our ultimate liability for claims. Actuarial standards require the use of assumptions based on moderately adverse experience, which generally results in favorable reserve development, or reserves that are considered redundant.
The higher prior year favorable development for the six months ended June 20, 2021 was primarily attributable to the reversal of actions taken in 2020, including the suspension of certain financial recovery programs for a period of time. The suspension during 2020 was intended to provide financial and administrative relief for providers facing unprecedented strain as a result of the COVID-19 pandemic.

Incurred and Paid Claims Development
The following discussion provides information about incurred and paid claims development for our Retail and Group and Specialty segments as of June 30, 20202021 and 2019,2020, net of reinsurance, and the total estimate of benefits payable for claims incurred but not reported, or IBNR, included within the net incurred claims amounts.








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Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)
Retail Segment
Activity in benefits payable for our Retail segment was as follows for the six months ended June 30, 20202021 and 2019:2020:
For the six months ended June 30,For the six months ended June 30,
2020201920212020
(in millions) (in millions)
Balances, beginning of periodBalances, beginning of period$5,363  $4,338  Balances, beginning of period$7,428 $5,363 
Less: Reinsurance recoverablesLess: Reinsurance recoverables(68) (95) Less: Reinsurance recoverables(68)
Balances, beginning of period, netBalances, beginning of period, net5,295  4,243  Balances, beginning of period, net7,428 5,295 
AcquisitionsAcquisitions42 
Incurred related to:Incurred related to:Incurred related to:
Current yearCurrent year27,921  24,657  Current year32,986 27,921 
Prior yearsPrior years(205) (311) Prior years(619)(205)
Total incurredTotal incurred27,716  24,346  Total incurred32,367 27,716 
Paid related to:Paid related to:Paid related to:
Current yearCurrent year(21,063) (19,826) Current year(25,953)(21,063)
Prior yearsPrior years(4,528) (3,592) Prior years(5,990)(4,528)
Total paidTotal paid(25,591) (23,418) Total paid(31,943)(25,591)
Reinsurance recoverableReinsurance recoverable 72  Reinsurance recoverable
Balances, end of periodBalances, end of period$7,423  $5,243  Balances, end of period$7,894 $7,423 
At June 30, 2020,2021, benefits payable for our Retail segment included IBNR of approximately $4.4$4.9 billion, primarily associated with claims incurred in 2020.2021.
Group and Specialty Segment
Activity in benefits payable for our Group and Specialty segment was as follows for the six months ended June 30, 20202021 and 2019:2020:
For the six months ended June 30,For the six months ended June 30,
2020201920212020
(in millions) (in millions)
Balances, beginning of periodBalances, beginning of period$641  $517  Balances, beginning of period$715 $641 
Incurred related to:Incurred related to:Incurred related to:
Current yearCurrent year2,434  2,693  Current year2,492 2,434 
Prior yearsPrior years(30) 36  Prior years(100)(30)
Total incurredTotal incurred2,404  2,729  Total incurred2,392 2,404 
Paid related to:Paid related to:Paid related to:
Current yearCurrent year(1,918) (2,131) Current year(1,917)(1,918)
Prior yearsPrior years(570) (516) Prior years(599)(570)
Total paidTotal paid(2,488) (2,647) Total paid(2,516)(2,488)
Balances, end of periodBalances, end of period$557  $599  Balances, end of period$591 $557 
At June 30, 2020,2021, benefits payable for our Group and Specialty segment included IBNR of approximately $490$514 million, primarily associated with claims incurred in 2020.2021.
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Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)
Reconciliation to Consolidated

The reconciliation of the net incurred and paid claims development tables to benefits payable in the consolidated statement of financial position is as follows:
Reconciliation of the Disclosure of Incurred and Paid Claims Development to Benefits Payable, net of reinsurance
June 30,
2020
Net outstanding liabilities(in millions)
Retail$7,420 
Group and Specialty557 
    Benefits payable, net of reinsurance7,977 
Reinsurance recoverable on unpaid claims
Retail
     Total benefits payable, gross$7,980 

9. EARNINGS PER COMMON SHARE COMPUTATION
Detail supporting the computation of basic and diluted earnings per common share was as follows for the three and six months ended June 30, 2021 and 2020:
Three months ended June 30,Six months ended June 30,
2021202020212020
(dollars in millions, except per common share results; number of shares in thousands)
Net income available for common stockholders$588 $1,828 $1,416 $2,301 
Weighted average outstanding shares of common stock
    used to compute basic earnings per common share
128,692 132,248 128,811 132,192 
Dilutive effect of:
Employee stock options74 89 63 90 
Restricted stock621 686 595 635 
Shares used to compute diluted earnings per common share129,387 133,023 129,469 132,917 
Basic earnings per common share$4.57 $13.83 $11.00 $17.41 
Diluted earnings per common share$4.55 $13.75 $10.94 $17.31 
Number of antidilutive stock options and restricted stock
    excluded from computation
103 130 317 395 

10. STOCKHOLDERS’ EQUITY
Dividends
The following table provides details of dividend payments, excluding dividend equivalent rights for unvested stock awards, in 2020 and 2019:2021 under our Board approved quarterly cash dividend policy:
Three months ended June 30,Six months ended June 30,
2020201920202019
(dollars in millions, except per common share results; number of shares in thousands)
Net income available for common stockholders$1,828  $940  $2,301  $1,506  
Weighted average outstanding shares of common stock
used to compute basic earnings per common share
132,248  135,063  132,192  135,223  
Dilutive effect of:
Employee stock options89  67  90  98  
Restricted stock686  449  635  449  
Shares used to compute diluted earnings per common share133,023  135,579  132,917  135,770  
Basic earnings per common share$13.83  $6.96  $17.41  $11.14  
Diluted earnings per common share$13.75  $6.94  $17.31  $11.10  
Number of antidilutive stock options and restricted stock
excluded from computation
130  761  395  732  
Record
Date
Payment
Date
Amount
per Share
Total
Amount
(in millions)
2020 payments
12/31/20191/31/2020$0.550 $73 
3/31/20204/24/20200.625 83 
6/30/20207/31/20200.625 83 
9/30/202010/30/20200.625 83 
2021 payments
12/31/20201/29/2021$0.625 $81 
3/31/20204/30/20210.700 90 
In April 2021, the Board declared a cash dividend of $0.70 per share payable on July 30, 2021 to stockholders of record on June 30, 2021.



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Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)
10. STOCKHOLDERS’ EQUITY
Dividends
The following table provides details of dividend payments, excluding dividend equivalent rights for unvested stock awards, in 2019 and 2020 under our Board approved quarterly cash dividend policy:
Record
Date
Payment
Date
Amount
per Share
Total
Amount
(in millions)
2019 payments
12/31/20181/25/2019$0.50  $68  
3/29/20194/26/2019$0.55  $74  
6/28/20197/26/2019$0.55  $74  
9/30/201910/25/2019$0.55  $73  
2020 payments
12/31/20191/31/2020$0.55  $73  
3/31/20204/24/2020$0.625  $83  
6/30/20207/31/2020$0.625  $83  

Stock Repurchases
Our Board of Directors may authorize the purchase of our common stock shares. Under the share repurchase authorization, shares may be purchased from time to time at prevailing prices in the open market, by block purchases, through plans designed to comply with Rule 10b5-1 under the Securities Exchange Act of 1934, as amended, or in privately-negotiated transactions, including pursuant to accelerated share repurchase agreements with investment banks, subject to certain regulatory restrictions on volume, pricing, and timing.
On July 30, 2019, the Board of Directors replaced a previous share repurchase authorization of up to $3 billion (of which approximately $1.03 billion remained unused) with a new authorization for repurchases of up to $3 billion of our common shares exclusive of shares repurchased in connection with employee stock plans, expiring on June 30, 2022.
On July 31, 2019, we entered into an accelerated stock repurchase agreement, the July 2019 ASR, with Citibank, N.A., or Citi, to repurchase $1 billion of our common stock. On August 2, 2019, we made a payment of $1 billion to Citi and received an initial delivery of 2.7 million shares of our common stock. We recorded the payment to Citi as a reduction to stockholders’ equity, consisting of an $800 million increase in treasury stock, which reflects the value of the initial 2.7 million shares received upon initial settlement, and a $200 million decrease in capital in excess of par value, which reflects the value of stock held back by Citi pending final settlement of the July 2019 ASR. Upon final settlement of the July 2019 ASR on December 26, 2019, we received an additional 0.7 million shares as determined by the average daily volume weighted-averages share price of our common stock during the term of the agreement, less a discount, of $296.19, bringing the total shares received under the July 2019 ASR to 3.4 million. In addition, upon settlement we reclassified the $200 million value of stock initially held back by Citi from capital in excess of par value to treasury stock.
On December 22, 2020, we entered into separate accelerated stock repurchase agreements, ("the December 2020 ASR Agreements"), with Citibank, N.A., or Citi, and JPMorgan Chase Bank, or JPM, to repurchase $1.75 billion of our common stock as part of the $3 billion repurchase program authorized by the Board of Directors on July 30, 2019. On December 23, 2020, in accordance with the December 2020 ASR Agreements, we made a payment of $1.75 billion ($875 million to Citi and $875 million to JPM) and received an initial delivery of 3.8 million shares of our common stock (1.9 million shares each from Citi and JPM). We recorded the payments to Citi and JPM as a reduction to stockholders’ equity, consisting of an $1.5 billion increase in treasury stock, which reflects the value of the initial 3.8 million shares received upon initial settlement, and a $262.5 million decrease in capital in excess of par value, which reflects the value of stock held back by Citi and JPM pending final settlement of the December 2020 ASR Agreements. Upon final settlement of the December 2020 ASR agreements with Citi and JPM on May 4, 2021 and May 5, 2021, respectively, we received an additional 0.3 million shares and 0.3 million shares, respectively, as determined by the average daily volume weighted-averages share price of our common stock during the term of the agreement, less a discount, of $400.07 and 401.49, respectively, bringing the total shares received under the December 2020 ASR agreements to 4.4 million. In addition, upon settlement we reclassified the $262.5 million value of stock initially held back by Citi and JPM from capital in excess of par value to treasury stock.
On February 18, 2021, the Board of Directors replaced the previous share repurchase authorization of up to $3 billion (of which approximately $250 million remained unused) with a new authorization for repurchases of up to $3 billion of our common shares exclusive of shares repurchased in connection with employee stock plans, expiring as of February 18, 2024. Our remaining repurchase authorization was approximately $2 billion of the $3 billion share repurchase program as of August 4, 2020.July 27, 2021.
In connection with employee stock plans, we acquired 0.09 million common shares for $33 million and 0.08 million common shares for $25 million and 0.03 million common shares for $10 million during the six months ended June 30, 20202021 and 2019,2020, respectively.

11. INCOME TAXES
The effective income tax rate was 23.7% and 22.7% for the three and six months ended June 30, 2021, respectively, compared to 30.0% and 31.0% for the three and six months ended June 30, 2020, respectively, primarily due to the termination of the non-deductible health insurance industry fee in 2021.

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Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)
11. INCOME TAXES
The effective income tax rate was 30.0% and 31.0% for the three and six months ended June 30, 2020, respectively, compared to 24.2% and 24.3% for the three and six months ended June 30, 2019, respectively, primarily due to the reinstatement of the non-deductible health insurance industry fee in 2020.

12.  DEBT
The carrying value of debt outstanding, net of unamortized debt issuance costs, was as follows at June 30, 20202021 and December 31, 2019:2020:
June 30, 2020December 31, 2019June 30, 2021December 31, 2020
(in millions)(in millions)
Short-term debt:Short-term debt:Short-term debt:
Commercial paperCommercial paper$325  $300  Commercial paper$1,109 $600 
Term note1,000  —  
Senior notes:
$400 million, 2.50% due December 15, 2020399  399  
Total short-term debtTotal short-term debt$1,724  $699  Total short-term debt$1,109 $600 
Long-term debt:Long-term debt:Long-term debt:
Senior notes:Senior notes:Senior notes:
$600 million, 3.15% due December 1, 2022$600 million, 3.15% due December 1, 2022$598  $598  $600 million, 3.15% due December 1, 2022$598 $598 
$400 million, 2.90% due December 15, 2022$400 million, 2.90% due December 15, 2022398  397  $400 million, 2.90% due December 15, 2022398 398 
$600 million, 3.85% due October 1, 2024$600 million, 3.85% due October 1, 2024597  597  $600 million, 3.85% due October 1, 2024598 598 
$600 million, 4.50% due April 1, 2025$600 million, 4.50% due April 1, 2025594  —  $600 million, 4.50% due April 1, 2025595 595 
$600 million, 3.95% due March 15, 2027$600 million, 3.95% due March 15, 2027596  595  $600 million, 3.95% due March 15, 2027596 596 
$500 million, 3.125% due August 15, 2029$500 million, 3.125% due August 15, 2029495  495  $500 million, 3.125% due August 15, 2029496 495 
$500 million, 4.875% due April 1, 2030$500 million, 4.875% due April 1, 2030494  —  $500 million, 4.875% due April 1, 2030495 494 
$250 million, 8.15% due June 15, 2038$250 million, 8.15% due June 15, 2038262  262  $250 million, 8.15% due June 15, 2038262 262 
$400 million, 4.625% due December 1, 2042$400 million, 4.625% due December 1, 2042396  396  $400 million, 4.625% due December 1, 2042396 396 
$750 million, 4.95% due October 1, 2044$750 million, 4.95% due October 1, 2044739  739  $750 million, 4.95% due October 1, 2044740 739 
$400 million, 4.80% due March 15, 2047$400 million, 4.80% due March 15, 2047396  396  $400 million, 4.80% due March 15, 2047396 396 
$500 million, 3.95% due August 15, 2049$500 million, 3.95% due August 15, 2049493  492  $500 million, 3.95% due August 15, 2049493 493 
Total long-term debt Total long-term debt$6,058  $4,967   Total long-term debt$6,063 $6,060 
Senior Notes    
In March 2020, we issued $600 million of 4.500% senior notes due April 1, 2025 and $500 million of 4.875% senior notes due April 1, 2030. Our net proceeds, reduced for the underwriters' discount and commission and offering expenses paid, were approximately $1,088 million as of June 30, 2020. We intend to use the net proceeds for general corporate purposes, which may include the repayment of existing indebtedness.
Our senior notes, which are unsecured, may be redeemed at our option at any time at 100% of the principal amount plus accrued interest and a specified make-whole amount. The 8.15% senior notes are subject to an interest rate adjustment if the debt ratings assigned to the notes are downgraded (or subsequently upgraded). In addition, our senior notes contain a change of control provision that may require us to purchase the notes under certain circumstances.
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NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)
Revolving Credit AgreementAgreements
OurIn June 2021, we entered into two separate revolving credit agreements: (i) a 5-year, $2.0$2.5 billion unsecured revolving credit agreement expires May 2022.and (ii) a 364-day $1.5 billion unsecured revolving credit agreement. Under the revolving credit agreement,agreements, at our option, we can borrow on either a competitive advance basis or a revolving credit basis. The revolving credit portion bears interest at either LIBOR plus a spread or the base rate plus a spread. If drawn upon, the revolving credit would revert to using the alternative base rate once LIBOR is discontinued. The LIBOR spread, currently 110.0 basis points, varies depending on our credit ratings ranging from 91.0 to 150.0 basis points. We also pay an annual facility fee regardless of utilization. This facility fee, currently 15.0 basis points, may fluctuate between 9.0 and 25.0 basis points, depending upon our credit ratings. The competitive advance portion of any borrowings will bear interest at market rates prevailing at the time of borrowing on either a fixed rate or a floating rate based on LIBOR, at our option. The revolving credit agreements provide for the transition from LIBOR and do not require amendment in connection with such transition.

The LIBOR spread, currently 110.0 basis points under the 5-year revolving credit agreements and 115.0 basis points under the 364-day revolving credit agreement, varies depending on our credit ratings ranging from 91.0 to 140.0 basis points under the 5-year revolving credit agreement and from 93.0 to 145.0 basis points under the 364-day revolving credit agreement. We also pay an annual facility fee regardless of utilization. This facility fee, currently 15.0 basis points, under the 5-year revolving credit agreement and 10.0 basis points under the 364-day revolving agreement, various depending on our credit ratings ranging from 9.0 to 22.5 basis points under the 5-year revolving credit agreement and from 7.0 to 17.5 basis points under the 364-day revolving credit agreement.
The terms of the revolving credit agreementagreements include standard provisions related to conditions of borrowing which could limit our ability to borrow additional funds. In addition, the credit agreement containsagreements contain customary restrictive covenants and a financial covenant regarding maximum debt to capitalization of 50%60%, as well as customary events of default. We are in compliance with this financial covenant, with actual debt to capitalization of 35%33% as measured in accordance with the revolving credit agreementagreements as of June 30, 2020.2021. Upon our agreement with one or more financial institutions, we may expand the aggregate commitments under the revolving credit agreementagreements by up to $750 million in the aggregate, to a maximum of $2.5$4.75 billion, through a $500 million incremental loan facility.across the 5-year and 364-day revolving credit agreements.
At June 30, 2020,2021, we had 0 borrowings and 0less than $1 million of letters of credit outstanding under the revolving credit agreement.agreements. Accordingly, as of June 30, 2020,2021, we had $2.0$2.5 billion of remaining borrowing capacity under the 5-year revolving credit agreement and $1.5 billion of remaining borrowing capacity under the 364-day revolving credit agreement (which excludes the uncommitted $500$750 million of incremental loan facility under the credit agreement)facilities), none of which would be restricted by our financial covenant compliance requirement.
We have other customary, arms-length relationships, including financial advisory and banking, with some parties to the revolving credit agreements.
Delayed Draw Term Loan Credit Agreement
In May 2021, we entered into a $500 million unsecured delayed draw term loan credit agreement. Under the term loan credit agreement, loans bear interest at either LIBOR plus a spread or the base rate plus a spread. The loans under the term loan credit agreement mature on the third anniversary of the funding date. The LIBOR spread, currently 125 basis points, varies depending on our credit ratings ranging from 100.0 to 162.5 basis points. The term loan credit agreement provides for the transition from LIBOR and does not require amendment in connection with such transition.

The term loan credit agreement contains customary restrictive covenants and a financial covenant regarding maximum debt to capitalization of 60%, as well as customary events of default. We are in compliance with this financial covenant, with actual debt to capitalization of 33% as measured in accordance with the term loan credit agreement as of June 30, 2021. At June 30, 2021, we had 0 borrowings under the delayed term loan credit agreement. 

We have other customary, arms-length relationships, including financial advisory and banking, with some parties to the term loan agreement.

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NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)
Commercial Paper

Under our commercial paper program we may issue short-term, unsecured commercial paper notes privately placed on a discount basis through certain broker dealers at any time not to exceed $2 billion. Amounts available under the program may be borrowed, repaid and re-borrowed from time to time. The net proceeds of issuances have been and are expected to be used for general corporate purposes. The maximum principal amount outstanding at any one time during the six months ended June 30, 20202021 was $600 million,$1.3 billion, with $325 million$1.1 billion outstanding at June 30, 20202021 compared to $300$600 million outstanding at December 31, 2019.2020. The outstanding commercial paper at June 30, 20202021 had a weighted average annual interest rate of 1%0.32%.
Term NoteOther Short-term Borrowings
We are a member, through one subsidiary, of the Federal Home Loan Bank of Cincinnati, or FHLB. As a member we have the ability to obtain short-term cash advances, subject to certain minimum collateral requirements. At June 30, 2021 we had 0 outstanding short-term FHLB borrowings.

Bridge Loan Financing

In February 2020,April 2021, we entered into a commitment letter with Goldman Sachs Bank USA, or Goldman Sachs, pursuant to which, and subject to the terms and conditions set forth therein, Goldman Sachs committed to lend us up to $3.5 billion under a new $1senior unsecured 364-day bridge loan facility, or Bridge Loan. If we enter into the Bridge Loan, the proceeds of the Bridge Loan will be used to finance a portion of the cash consideration payable for the KAH transaction. The outstanding Bridge Loan commitments under the commitment letter were reduced to $3.0 billion in connection with the effectiveness of the delayed draw term loan commitment with a bank that matures 1 year after the first draw, subject to a 1 year extension. In March 2020, we made a draw on the entire term loan commitment of $1 billion. The facility fee, interest rate and financial covenants are consistent with those of our revolving credit agreement. There is no prepayment penalty.agreement in May 2021.

13. COMMITMENTS, GUARANTEES AND CONTINGENCIES
Government Contracts
Our Medicare products, which accounted for approximately 83% of our total premiums and services revenue for the six months ended June 30, 2020,2021, primarily consisted of products covered under the Medicare Advantage and Medicare Part D Prescription Drug Plan contracts with the federal government. These contracts are renewed generally for a calendar year term unless CMS notifies us of its decision not to renew by May 1 of the calendar year in which the contract would end, or we notify CMS of our decision not to renew by the first Monday in June of the calendar year in which the contract would end. All material contracts between Humana and CMS relating to our
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Medicare products have been renewed for 2021.2022. Our product offerings under those contracts are subject to approval by CMS in the third quarter of 2020.2021.
CMS uses a risk-adjustment model which adjusts premiums paid to Medicare Advantage, or MA, plans according to health status of covered members. The risk-adjustment model, which CMS implemented pursuant to the Balanced Budget Act of 1997 (BBA) and the Benefits Improvement and Protection Act of 2000 (BIPA), generally pays more where a plan's membership has higher expected costs. Under this model, rates paid to MA plans are based on actuarially determined bids, which include a process whereby our prospective payments are based on our estimated cost of providing standard Medicare-covered benefits to an enrollee with a "national average risk profile." That baseline payment amount is adjusted to reflect the health status of our enrolled membership. Under the risk-adjustment methodology, all MA plans must collect from providers and submit the necessary diagnosis code information from hospital inpatient, hospital outpatient, and physician providers to CMS within prescribed deadlines. The CMS risk-adjustment model uses the diagnosis data to calculate the risk-adjusted premium payment to MA plans, which CMS adjusts for coding pattern differences between the health plans and the government fee-for-service program. We generally rely on providers, including certain providers in our network who are our employees, to code their claim submissions with appropriate diagnoses, which we send to CMS as the basis for our payment received from CMS under the actuarial risk-adjustment model. We also rely on these providers to document appropriately all medical data, including the diagnosis data submitted with claims. In addition, we conduct medical record reviews as part of our data and payment accuracy compliance efforts, to more accurately reflect diagnosis conditions under the risk adjustment model. These compliance efforts
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include the internal contract level audits described in more detail below, as well as ordinary course reviews of our internal business processes.
CMS is phasing-in the process of calculating risk scores using diagnoses data from the Risk Adjustment Processing System, or RAPS, to diagnoses data from the Encounter Data System, or EDS. The RAPS process requires MA plans to apply a filter logic based on CMS guidelines and only submit diagnoses that satisfy those guidelines. For submissions through EDS, CMS requires MA plans to submit all the encounter data and CMS will apply the risk adjustment filtering logic to determine the risk scores. For 2019, 25%2020, 50% of the risk score was calculated from claims data submitted through EDS. CMS increased that percentage to 50% in 202075% for 2021 and will increase that percentagecomplete the phased-in transition from RAPS to 75%EDS by using only EDS data to calculate risk scores in 2021.2022. The phase-in from RAPS to EDS could result in different risk scores from each dataset as a result of plan processing issues, CMS processing issues, or filtering logic differences between RAPS and EDS, and could have a material adverse effect on our results of operations, financial position, or cash flows.
CMS and the Office of the Inspector General of Health and Human Services, or HHS-OIG, are continuing to perform audits of various companies’ selected MA contracts related to this risk adjustment diagnosis data. We refer to these audits as Risk-Adjustment Data Validation Audits, or RADV audits. RADV audits review medical records in an attempt to validate provider medical record documentation and coding practices which influence the calculation of premium payments to MA plans.
In 2012, CMS released a “Notice of Final Payment Error Calculation Methodology for Part C Medicare Advantage Risk Adjustment Data Validation (RADV) Contract-Level Audits.” The payment error calculation methodology provided that, in calculating the economic impact of audit results for an MA contract, if any, the results of the RADV audit sample would be extrapolated to the entire MA contract after a comparison of the audit results to a similar audit of the government’s traditional fee-for-service Medicare program, or Medicare FFS. We refer to the process of accounting for errors in FFS claims as the "FFS Adjuster." This comparison of RADV audit results to the FFS error rate is necessary to determine the economic impact, if any, of RADV audit results because the government used the Medicare FFS program data set, including any attendant errors that are present in that data set, to estimate the costs of various health status conditions and to set the resulting adjustments to MA plans’ payment rates in order to establish actuarial equivalence in payment rates as required under the Medicare statute. CMS already makes other adjustments to payment rates based on a comparison of coding pattern differences between MA plans and Medicare FFS data (such as for frequency of coding for certain diagnoses in MA plan data versus the Medicare FFS program dataset).
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The final RADV extrapolation methodology, including the first application of extrapolated audit results to determine audit settlements, is expected to be applied to CMS RADV contract level audits conducted for contract year 2011 and subsequent years. CMS is currently conducting RADV contract level audits for certain of our Medicare Advantage plans.
Estimated audit settlements are recorded as a reduction of premiums revenue in our consolidated statements of income, based upon available information. We perform internal contract level audits based on the RADV audit methodology prescribed by CMS. Included in these internal contract level audits is an audit of our Private Fee-For Service business which we used to represent a proxy of the FFS Adjuster which has not yet been finalized. We based our accrual of estimated audit settlements for each contract year on the results of these internal contract level audits and update our estimates as each audit is completed. Estimates derived from these results were not material to our results of operations, financial position, or cash flows. We report the results of these internal contract level audits to CMS, including identified overpayments, if any.
On October 26, 2018, CMS issued a proposed rule and accompanying materials (which we refer to as the “Proposed Rule”) related to, among other things, the RADV audit methodology described above. If implemented, the Proposed Rule would use extrapolation in RADV audits applicable to payment year 2011 contract-level audits and all subsequent audits, without the application of a FFS Adjuster to audit findings. We believe that the Proposed Rule fails to address adequately the statutory requirement of actuarial equivalence, and have provided substantive
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comments to CMS on the Proposed Rule as part of the notice-and-comment rulemaking process. Whether, and to what extent, CMS finalizes the Proposed Rule, and any related regulatory, industry or company reactions, could have a material adverse effect on our results of operations, financial position, or cash flows.
In addition, as part of our internal compliance efforts, we routinely perform ordinary course reviews of our internal business processes related to, among other things, our risk coding and data submissions in connection with the risk adjustment model. These reviews may also result in the identification of errors and the submission of corrections to CMS, that may, either individually or in the aggregate, be material. As such, the result of these reviews may have a material adverse effect on our results of operations, financial position, or cash flows.

We believe that CMS'CMS's statements and policies regarding the requirement to report and return identified overpayments received by MA plans are inconsistent with CMS'CMS's 2012 RADV audit methodology, and the Medicare statute's requirements. These statements and policies, such as certain statements contained in the preamble to CMS’CMS’s final rule release regarding Medicare Advantage and Part D prescription drug benefit program regulations for Contract Year 2015 (which we refer to as the "Overpayment Rule"), and the Proposed Rule, appear to equate each Medicare Advantage risk adjustment data error with an “overpayment” without addressing the principles underlying the FFS Adjuster referenced above. On September 7, 2018, the Federal District Court for the District of Columbia vacated CMS's Overpayment Rule, concluding that it violated the Medicare statute, including the requirement for actuarial equivalence, and that the Overpayment Rule was also arbitrary and capricious in departing from CMS's RADV methodology without adequate explanation (among other reasons). CMS has appealed the decision to the Circuit Court of Appeals.
We will continue to work with CMS to ensure that MA plans are paid accurately and that payment model principles are in accordance with the requirements of the Social Security Act, which, if not implemented correctly could have a material adverse effect on our results of operations, financial position, or cash flows.
Our state-based Medicaid business, which accounted for approximately 6% of our total premiums and services revenue for the six months ended June 30, 2021 primarily consisted of serving members enrolled in Medicaid, and in certain circumstances members who qualify for both Medicaid and Medicare, under contracts with various states.
At June 30, 2020,2021, our military services business, which accounted for approximately 1% of our total premiums and services revenue for the six months ended June 30, 2020,2021, primarily consisted of the TRICARE T2017 East Region contract. The T2017 East Region contract is a consolidation of the former T3 North and South Regions, comprising NaN32 states and approximately 6 million TRICARE beneficiaries, under which delivery of health care services commenced on January 1, 2018. The T2017 East Region contract is a 5-year contract set to expire on December 31, 2022 and is subject to renewals on January 1 of each year during its term at the government's option.
Our state-based Medicaid business accounted for approximately 5% of our total premiums and services revenue for the six months ended June 30, 2020. In addition to our state-based Temporary Assistance for Needy Families, or
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TANF, Medicaid contracts in Florida and Kentucky, we have contracts in Florida for Long Term Support Services (LTSS), and in Illinois for stand-alone dual eligible demonstration programs serving individuals dually eligible for both the federal Medicare program and the applicable state-based Medicaid program.
The loss of any of the contracts above or significant changes in these programs as a result of legislative or regulatory action, including reductions in premium payments to us, regulatory restrictions on profitability, including reviews by regulatory bodies that may compare our Medicare Advantage profitability to our non-Medicare Advantage business profitability, or compare the profitability of various products within our Medicare Advantage business, and require that they remain within certain ranges of each other, or increases in member benefits or member eligibility criteria without corresponding increases in premium payments to us, may have a material adverse effect on our results of operations, financial position, and cash flows.

Legal Proceedings and Certain Regulatory Matters
As previously disclosed, the Civil Division of the United States Department of Justice provided us with an information request in December 2014, concerning our Medicare Part C risk adjustment practices. The request relates to our oversight and submission of risk adjustment data generated by providers in our Medicare Advantage network, as well as to our business and compliance practices related to risk adjustment data generated by our providers and by us, including medical record reviews conducted as part of our data and payment accuracy compliance efforts, the use of health and well-being assessments, and our fraud detection efforts. We believe that this request for information is in connection with a wider review of Medicare Risk Adjustment generally that
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includes a number of Medicare Advantage plans, providers and vendors. We continue to cooperate with and voluntarily respond to the information requests from the Department of Justice. These matters are expected to result in additional qui tam litigation.
As previously disclosed, on January 19, 2016, an individual filed a qui tam suit captioned United States of America ex rel. Steven Scott v. Humana, Inc., in United States District Court, Central District of California, Western Division. The complaint alleges certain civil violations by us in connection with the actuarial equivalence of the plan benefits under Humana’s Basic PDP plan, a prescription drug plan offered by us under Medicare Part D. The action seeks damages and penalties on behalf of the United States under the False Claims Act. The court ordered the qui tam action unsealed on September 13, 2017, so that the relator could proceed, following notice from the U.S. Government that it was not intervening at that time. On January 29, 2018, the suit was transferred to the United States District Court, Western District of Kentucky, Louisville Division. We take seriously our obligations to comply with applicable CMS requirements and actuarial standards of practice, and continue to vigorously defend against these allegations since the transfer to the Western District of Kentucky. We have substantially completed discovery with the relator who has pursued the matter on behalf of the United States following its unsealing, and expect the Court to consider our motion for summary judgment.
On November 2, 2017, we filed suit against the United States of America in the United States Court of Federal Claims, on behalf of our health plans seeking recovery from the federal government of approximately $611 million in payments under the risk corridor premium stabilization program established under Health Care Reform, for years 2014, 2015 and 2016. Our case had been stayed by the Court, pending resolution of similar cases filed by other insurers. On April 27, 2020, the U.S. Supreme Court ruled that the government is obligated to pay the losses under this risk corridor program, and that Congress did not impliedly repeal the obligation under its appropriations riders. On July 7, 2020, the Court of Federal Claims then issued a judgment for Humana in the amount of $609 million.We are currently pursuing payment of this amount, although the payment timing, processing and receipt remain uncertain. We have not recognized revenue, nor have we recorded a receivable, for any amount due from the federal government for unpaid risk corridor payments as of June 30, 2020. We have fully recognized all liabilities due to the federal government that we have incurred under the risk corridor program, and have paid all amounts due to the federal government as required.



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Other Lawsuits and Regulatory Matters
    Our current and past business practices are subject to review or other investigations by various state insurance and health care regulatory authorities and other state and federal regulatory authorities. These authorities regularly scrutinize the business practices of health insurance, health care delivery and benefits companies. These reviews focus on numerous facets of our business, including claims payment practices, statutory capital requirements, provider contracting, risk adjustment, competitive practices, commission payments, privacy issues, utilization management practices, pharmacy benefits, access to care, and sales practices, among others. Some of these reviews have historically resulted in fines imposed on us and some have required changes to some of our practices. We continue to be subject to these reviews, which could result in additional fines or other sanctions being imposed on us or additional changes in some of our practices.
We also are involved in various other lawsuits that arise, for the most part, in the ordinary course of our business operations, certain of which may be styled as class-action lawsuits. Among other matters, this litigation may include employment matters, claims of medical malpractice, bad faith, nonacceptance or termination of providers, anticompetitive practices, improper rate setting, provider contract rate and payment disputes, including disputes over reimbursement rates required by statute, disputes arising from competitive procurement process, general contractual matters, intellectual property matters, and challenges to subrogation practices. Under state guaranty assessment laws, including those related to state cooperative failures in the industry, we may be assessed (up to prescribed limits) for certain obligations to the policyholders and claimants of insolvent insurance companies that write the same line or lines of business as we do.
As a government contractor, we may also be subject to qui tam litigation brought by individuals who seek to sue on behalf of the government, alleging that the government contractor submitted false claims to the government including, among other allegations, those resulting from coding and review practices under the Medicare risk adjustment model. Qui tam litigation is filed under seal to allow the government an opportunity to investigate and to decide if it wishes to intervene and assume control of the litigation. If the government does not intervene, the individual may continue to prosecute the action on his or her own, on behalf of the government. We also are subject to other allegations of nonperformance of contractual obligations to providers, members, and others, including failure to properly pay claims, improper policy terminations, challenges to our implementation of the Medicare Part D prescription drug program and other litigation.

A limited number of the claims asserted against us are subject to insurance coverage. Personal injury claims, claims for extra contractual damages, care delivery malpractice, and claims arising from medical benefit denials are covered by insurance from our wholly owned captive insurance subsidiary and excess carriers, except to the extent that claimants seek punitive damages, which may not be covered by insurance in certain states in which insurance coverage for punitive damages is not permitted. In addition, insurance coverage for all or certain forms of liability has become increasingly costly and may become unavailable or prohibitively expensive in the future.
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We record accruals for the contingencies discussed in the sections above to the extent that we conclude it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. No estimate of the possible loss or range of loss in excess of amounts accrued, if any, can be made at this time regarding the matters specifically described above because of the inherently unpredictable nature of legal proceedings, which also may be exacerbated by various factors, including: (i) the damages sought in the proceedings are unsubstantiated or indeterminate; (ii) discovery is not complete; (iii) the proceeding is in its early stages; (iv) the matters present legal uncertainties; (v) there are significant facts in dispute; (vi) there are a large number of parties (including where it is uncertain how liability, if any, will be shared among multiple defendants); or (vii) there is a wide range of potential outcomes.
The outcome of any current or future litigation or governmental or internal investigations, including the matters described above, cannot be accurately predicted, nor can we predict any resulting judgments, penalties, fines or other sanctions that may be imposed at the discretion of federal or state regulatory authorities or as a result of actions by third parties. Nevertheless, it is reasonably possible that any such outcome of litigation, judgments, penalties, fines or other sanctions could be substantial, and the outcome of these matters may have a material adverse effect on our results of operations, financial position, and cash flows, and may also affect our reputation.
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14. SEGMENT INFORMATION
We manage our business with 3 reportable segments: Retail, Group and Specialty, and Healthcare Services. The reportable segments are based on a combination of the type of health plan customer and adjacent businesses centered on well-being solutions for our health plans and other customers, as described below. These segment groupings are consistent with information used by our Chief Executive Officer, the Chief Operating Decision Maker, to assess performance and allocate resources.
The Retail segment consists of Medicare benefits, marketed to individuals or directly via group Medicare accounts. In addition, the Retail segment also includes our contract with CMS to administer the Limited Income Newly Eligible Transition, or LI-NET, prescription drug plan program and contracts with various states to provide Medicaid, dual eligible, and Long-Term Support Services benefits, which we refer to collectively as our state-based contracts. The Group and Specialty segment consists of employer group commercial fully-insured medical and specialty health insurance benefits marketed to individuals and employer groups, including dental, vision, and other supplemental health benefits, as well as administrative services only, or ASO products. In addition, our Group and Specialty segment includes our military services business, primarily our TRICARE T2017 East Region contract. The Healthcare Services segment includes our services offered to our health plan members as well as to third parties, including pharmacy solutions, provider services, and clinical care service, such as home health and other services and capabilities to promote wellness and advance population health, including our non-consolidating minority investment in Kindred at Home and the strategic partnership with WCAS to develop and operate senior-focused, payor-agnostic, primary care centers.
Our Healthcare Services intersegment revenues primarily relate to managing prescription drug coverage for members of our other segments through Humana Pharmacy Solutions®, or HPS, and includes the operations of Humana Pharmacy, Inc., our mail order pharmacy business. These revenues consist of the prescription price (ingredient cost plus dispensing fee), including the portion to be settled with the member (co-share) or with the government (subsidies), plus any associated administrative fees. Services revenues related to the distribution of prescriptions by third party retail pharmacies in our networks are recognized when the claim is processed and product revenues from dispensing prescriptions from our mail order pharmacies are recorded when the prescription or product is shipped. Our pharmacy operations, which are responsible for designing pharmacy benefits, including defining member co-share responsibilities, determining formulary listings, contracting with retail pharmacies, confirming member eligibility, reviewing drug utilization, and processing claims, act as a principal in the arrangement on behalf of members in our other segments. As principal, our Healthcare Services segment reports revenues on a gross basis, including co-share amounts from members collected by third party retail pharmacies at the point of service.
In addition, our Healthcare Services intersegment revenues include revenues earned by certain owned providers derived from risk-based and non-risk-based managed care agreements with our health plans. Under risk-based risk based
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agreements, the provider receives a monthly capitated fee that varies depending on the demographics and health status of the member, for each member assigned to these owned providers by our health plans. The owned provider assumes the economic risk of funding the assigned members’ healthcare services. Under non risk-based agreements, our health plans retain the economic risk of funding the assigned members' healthcare services. Our Healthcare Services segment reports provider services revenues associated with risk-based agreements on a gross basis, whereby capitation fee revenue is recognized in the period in which the assigned members are entitled to receive healthcare services. Provider services revenues associated with non-risk-based agreements are presented net of associated healthcare costs.
We present our condensed consolidated results of operations from the perspective of the health plans. As a result, the cost of providing benefits to our members, whether provided via a third party provider or internally through a stand-alone subsidiary, is classified as benefits expense and excludes the portion of the cost for which the health plans do not bear responsibility, including member co-share amounts and government subsidies of $4.0$4.4 billion and $3.6$4.0 billion for the three months ended June 30, 20202021 and 2019,2020, respectively. For the six months ended June 30, 20202021 and 20192020 these amounts were $7.4$8.0 billion and $6.7$7.4 billion, respectively. In addition, depreciation and amortization expense associated with certain businesses in our Healthcare Services segment delivering benefits to our members, primarily associated with our provider services and pharmacy operations, are included with benefits
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expense. The amount of this expense was $26 million and $31 million for both the three months ended June 30, 2021 and 2020, and 2019.respectively. For the six months ended June 30, 20202021 and 2019,2020, the amount of this expense was $61$52 million and $60$61 million, respectively.
Other than those described previously, the accounting policies of each segment are the same and are described in Note 2 to the consolidated financial statements included in our 20192020 Form 10-K. Transactions between reportable segments primarily consist of sales of services rendered by our Healthcare Services segment, primarily pharmacy, provider, and clinical care services, to our Retail and Group and Specialty segment customers. Intersegment sales and expenses are recorded at fair value and eliminated in consolidation. Members served by our segments often use the same provider networks, enabling us in some instances to obtain more favorable contract terms with providers. Our segments also share indirect costs and assets. As a result, the profitability of each segment is interdependent. We allocate most operating expenses to our segments. Assets and certain corporate income and expenses are not allocated to the segments, including the portion of investment income not supporting segment operations, interest expense on corporate debt, and certain other corporate expenses. These items are managed at a corporate level. These corporate amounts are reported separately from our reportable segments and are included with intersegment eliminations in the tables presenting segment results below.




















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Our segment results were as follows for the three and six months ended June 30, 20202021 and 2019:2020:
RetailGroup and SpecialtyHealthcare
Services
Eliminations/
Corporate
ConsolidatedRetailGroup and SpecialtyHealthcare
Services
Eliminations/
Corporate
Consolidated
Three months ended June 30, 2020(in millions)
Three months ended June 30, 2021Three months ended June 30, 2021(in millions)
External revenuesExternal revenuesExternal revenues
Premiums:Premiums:Premiums:
Individual Medicare AdvantageIndividual Medicare Advantage$13,005  $—  $—  $—  $13,005  Individual Medicare Advantage$14,585 $$$$14,585 
Group Medicare AdvantageGroup Medicare Advantage1,976  —  —  —  1,976  Group Medicare Advantage1,775 1,775 
Medicare stand-alone PDPMedicare stand-alone PDP731  —  —  —  731  Medicare stand-alone PDP662 662 
Total MedicareTotal Medicare15,712  —  —  —  15,712  Total Medicare17,022 17,022 
Fully-insuredFully-insured169  1,208  —  —  1,377  Fully-insured182 1,078 1,260 
SpecialtySpecialty—  425  —  —  425  Specialty432 432 
Medicaid and otherMedicaid and other1,042  —  —  —  1,042  Medicaid and other1,264 1,264 
Total premiumsTotal premiums16,923  1,633  —  —  18,556  Total premiums18,468 1,510 19,978 
Services revenue:Services revenue:Services revenue:
ProviderProvider—  —  105  —  105  Provider122 122 
ASO and otherASO and other 192  —  —  198  ASO and other12 194 206 
PharmacyPharmacy—  —  147  —  147  Pharmacy163 163 
Total services revenueTotal services revenue 192  252  —  450  Total services revenue12 194 285 491 
Total external revenuesTotal external revenues16,929  1,825  252  —  19,006  Total external revenues18,480 1,704 285 20,469 
Intersegment revenuesIntersegment revenuesIntersegment revenues
ServicesServices—   4,712  (4,718) —  Services10 4,977 (4,987)
ProductsProducts—  —  1,977  (1,977) —  Products2,261 (2,261)
Total intersegment revenuesTotal intersegment revenues—   6,689  (6,695) —  Total intersegment revenues10 7,238 (7,248)
Investment incomeInvestment income32   —  41  77  Investment income65 106 176 
Total revenuesTotal revenues16,961  1,835  6,941  (6,654) 19,083  Total revenues18,545 1,718 7,524 (7,142)20,645 
Operating expenses:Operating expenses:Operating expenses:
BenefitsBenefits13,251  1,094  —  (170) 14,175  Benefits16,068 1,247 (166)17,149 
Operating costsOperating costs1,638  435  6,603  (6,322) 2,354  Operating costs1,533 409 7,205 (7,031)2,116 
Depreciation and amortizationDepreciation and amortization83  19  46  (29) 119  Depreciation and amortization108 22 41 (27)144 
Total operating expensesTotal operating expenses14,972  1,548  6,649  (6,521) 16,648  Total operating expenses17,709 1,678 7,246 (7,224)19,409 
Income (loss) from operations1,989  287  292  (133) 2,435  
Income from operationsIncome from operations836 40 278 82 1,236 
Interest expenseInterest expense—  —  —  76  76  Interest expense79 79 
Other income, net—  —  —  (227) (227) 
Income before income taxes and equity in net earnings1,989  287  292  18  2,586  
Other expense, netOther expense, net419 419 
Income (loss) before income taxes and equity in net earningsIncome (loss) before income taxes and equity in net earnings836 40 278 (416)738 
Equity in net earningsEquity in net earnings—  —  25  —  25  Equity in net earnings33 33 
Segment earnings$1,989  $287  $317  $18  $2,611  
Segment earnings (loss)Segment earnings (loss)$836 $40 $311 $(416)$771 
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RetailGroup and SpecialtyHealthcare
Services
Eliminations/
Corporate
Consolidated
Three months ended June 30, 2020(in millions)
External revenues
Premiums:
Individual Medicare Advantage$13,005 $$$$13,005 
Group Medicare Advantage1,976 1,976 
Medicare stand-alone PDP731 731 
Total Medicare15,712 15,712 
Fully-insured169 1,208 1,377 
Specialty425 425 
Medicaid and other1,042 1,042 
Total premiums16,923 1,633 18,556 
Services revenue:
Provider105 105 
ASO and other192 198 
Pharmacy147 147 
Total services revenue192 252 450 
Total external revenues16,929 1,825 252 19,006 
Intersegment revenues
Services4,712 (4,718)
Products1,977 (1,977)
Total intersegment revenues6,689 (6,695)
Investment income32 41 77 
Total revenues16,961 1,835 6,941 (6,654)19,083 
Operating expenses:
Benefits13,251 1,094 (170)14,175 
Operating costs1,638 435 6,603 (6,322)2,354 
Depreciation and amortization83 19 46 (29)119 
Total operating expenses14,972 1,548 6,649 (6,521)16,648 
Income (loss) from operations1,989 287 292 (133)2,435 
Interest expense76 76 
Other income, net(227)(227)
Income before income taxes and equity in net earnings1,989 287 292 18 2,586 
Equity in net earnings25 25 
Segment earnings$1,989 $287 $317 $18 $2,611 
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(Unaudited)
RetailGroup and SpecialtyHealthcare
Services
Eliminations/
Corporate
Consolidated
Six months ended June 30, 2021(in millions)
External revenues
Premiums:
Individual Medicare Advantage$29,400 $$$$29,400 
Group Medicare Advantage3,530 3,530 
Medicare stand-alone PDP1,326 1,326 
Total Medicare34,256 34,256 
Fully-insured360 2,177 2,537 
Specialty866 866 
Medicaid and other2,443 2,443 
Total premiums37,059 3,043 40,102 
Services revenue:
Provider237 237 
ASO and other17 384 401 
Pharmacy319 319 
Total services revenue17 384 556 957 
Total external revenues37,076 3,427 556 41,059 
Intersegment revenues
Services20 9,751 (9,771)
Products4,413 (4,413)
Total intersegment revenues20 14,164 (14,184)
Investment income117 127 254 
Total revenues37,193 3,455 14,722 (14,057)41,313 
Operating expenses:
Benefits32,367 2,392 (314)34,445 
Operating costs2,984 806 14,115 (13,782)4,123 
Depreciation and amortization212 43 81 (50)286 
Total operating expenses35,563 3,241 14,196 (14,146)38,854 
Income from operations1,630 214 526 89 2,459 
Interest expense147 147 
Other expense, net534 534 
Income (loss) before income taxes and equity in net earnings1,630 214 526 (592)1,778 
Equity in net earnings54 54 
Segment earnings (loss)$1,630 $214 $580 $(592)$1,832 

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Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)
RetailGroup and SpecialtyHealthcare
Services
Eliminations/
Corporate
Consolidated
Three months ended June 30, 2019(in millions)
External revenues
Premiums:
Individual Medicare Advantage$10,793  $—  $—  $—  $10,793  
Group Medicare Advantage1,626  —  —  —  1,626  
Medicare stand-alone PDP818  —  —  —  818  
Total Medicare13,237  —  —  —  13,237  
Fully-insured144  1,284  —  —  1,428  
Specialty—  387  —  —  387  
Medicaid and other724  —  —  —  724  
Total premiums14,105  1,671  —  —  15,776  
Services revenue:
Provider—  —  111  —  111  
ASO and other 193  —  —  198  
Pharmacy—  —  46  —  46  
Total services revenue 193  157  —  355  
Total external revenues14,110  1,864  157  —  16,131  
Intersegment revenues
Services—   4,496  (4,501) —  
Products—  —  1,733  (1,733) —  
Total intersegment revenues—   6,229  (6,234) —  
Investment income48    60  114  
Total revenues14,158  1,874  6,387  (6,174) 16,245  
Operating expenses:
Benefits12,019  1,442  —  (143) 13,318  
Operating costs1,206  406  6,135  (6,044) 1,703  
Depreciation and amortization77  21  40  (29) 109  
Total operating expenses13,302  1,869  6,175  (6,216) 15,130  
Income from operations856   212  42  1,115  
Interest expense—  —  —  60  60  
Other income, net—  —  —  (174) (174) 
Income before income taxes and equity in net earnings856   212  156  1,229  
Equity in net earnings—  —  12  —  12  
Segment earnings$856  $ $224  $156  $1,241  
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RetailGroup and SpecialtyHealthcare
Services
Eliminations/
Corporate
Consolidated
Six months ended June 30, 2020(in millions)
External Revenues
Premiums:
Individual Medicare Advantage$25,799 $$$$25,799 
Group Medicare Advantage3,987 3,987 
Medicare stand-alone PDP1,486 1,486 
Total Medicare31,272 31,272 
Fully-insured332 2,437 2,769 
Specialty854 854 
Medicaid and other2,023 2,023 
Total premiums33,627 3,291 36,918 
Services revenue:
Provider209 209 
ASO and other10 387 397 
Pharmacy268 268 
Total services revenue10 387 477 874 
Total external revenues33,637 3,678 477 37,792 
Intersegment revenues
Services13 9,662 (9,675)
Products3,887 (3,887)
Total intersegment revenues13 13,549 (13,562)
Investment income86 131 226 
Total revenues33,723 3,700 14,026 (13,431)38,018 
Operating expenses:
Benefits27,715 2,405 (316)29,804 
Operating costs3,170 864 13,403 (12,966)4,471 
Depreciation and amortization164 39 89 (58)234 
Total operating expenses31,049 3,308 13,492 (13,340)34,509 
Income (loss) from operations2,674 392 534 (91)3,509 
Interest expense136 136 
Other expense, net70 70 
Income (loss) before income taxes and equity in net earnings2,674 392 534 (297)3,303 
Equity in net earnings33 33 
Segment earnings (loss)$2,674 $392 $567 $(297)$3,336 


Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)
RetailGroup and SpecialtyHealthcare
Services
Eliminations/
Corporate
Consolidated
Six months ended June 30, 2020(in millions)
External revenues
Premiums:
Individual Medicare Advantage$25,799  $—  $—  $—  $25,799  
Group Medicare Advantage3,987  —  —  —  3,987  
Medicare stand-alone PDP1,486  —  —  —  1,486  
Total Medicare31,272  —  —  —  31,272  
Fully-insured332  2,437  —  —  2,769  
Specialty—  854  —  —  854  
Medicaid and other2,023  —  —  —  2,023  
Total premiums33,627  3,291  —  —  36,918  
Services revenue:
Provider—  —  209  —  209  
ASO and other10  387  —  —  397  
Pharmacy—  —  268  —  268  
Total services revenue10  387  477  —  874  
Total external revenues33,637  3,678  477  —  37,792  
Intersegment revenues
Services—  13  9,662  (9,675) —  
Products—  —  3,887  (3,887) —  
Total intersegment revenues—  13  13,549  (13,562) —  
Investment income86   —  131  226  
Total revenues33,723  3,700  14,026  (13,431) 38,018  
Operating expenses:
Benefits27,715  2,405  —  (316) 29,804  
Operating costs3,170  864  13,403  (12,966) 4,471  
Depreciation and amortization164  39  89  (58) 234  
Total operating expenses31,049  3,308  13,492  (13,340) 34,509  
Income (loss) from operations2,674  392  534  (91) 3,509  
Interest expense—  —  —  136  136  
Other expense, net—  —  —  70  70  
Income before income taxes and equity in net earnings2,674  392  534  (297) 3,303  
Equity in net earnings—  —  33  —  33  
Segment earnings (loss)$2,674  $392  $567  $(297) $3,336  
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Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)
RetailGroup and SpecialtyHealthcare
Services
Eliminations/
Corporate
Consolidated
Six months ended June 30, 2019(in millions)
External Revenues
Premiums:
Individual Medicare Advantage$21,502  $—  $—  $—  $21,502  
Group Medicare Advantage3,258  —  —  —  3,258  
Medicare stand-alone PDP1,627  —  —  —  1,627  
Total Medicare26,387  —  —  —  26,387  
Fully-insured284  2,595  —  —  2,879  
Specialty—  760  —  —  760  
Medicaid and other1,401  —  —  —  1,401  
Total premiums28,072  3,355  —  —  31,427  
Services revenue:
Provider—  —  231  —  231  
ASO and other10  387  —  —  397  
Pharmacy—  —  82  —  82  
Total services revenue10  387  313  —  710  
Total external revenues28,082  3,742  313  —  32,137  
Intersegment revenues
Services—   8,802  (8,811) —  
Products—  —  3,369  (3,369) —  
Total intersegment revenues—   12,171  (12,180) —  
Investment income89  10   115  215  
Total revenues28,171  3,761  12,485  (12,065) 32,352  
Operating expenses:
Benefits24,346  2,729  —  (264) 26,811  
Operating costs2,354  819  12,023  (11,833) 3,363  
Depreciation and amortization150  43  78  (55) 216  
Total operating expenses26,850  3,591  12,101  (12,152) 30,390  
Income from operations1,321  170  384  87  1,962  
Interest expense—  —  —  122  122  
Other income, net—  —  —  (135) (135) 
Income before income taxes and equity in net earnings1,321  170  384  100  1,975  
Equity in net earnings—  —  15  —  15  
Segment earnings$1,321  $170  $399  $100  $1,990  
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Humana Inc.
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS
The condensed consolidated financial statements of Humana Inc. in this document present the Company’s financial position, results of operations and cash flows, and should be read in conjunction with the following discussion and analysis. References to “we,” “us,” “our,” “Company,” and “Humana” mean Humana Inc. and its subsidiaries. This discussion includes forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. When used in filings with the Securities and Exchange Commission, or SEC, in our press releases, investor presentations, and in oral statements made by or with the approval of one of our executive officers, the words or phrases like “believes,” “expects,” “anticipates,” “intends,” “likely will result,” “estimates,” “projects” or variations of such words and similar expressions are intended to identify such forward–looking statements. These forward–looking statements are not guarantees of future performance and are subject to risks, uncertainties and assumptions, including, among other things, information set forth in Item 1A. – Risk Factors in our 20192020 Form 10-K, as modified by any changes to those risk factors included in this document including the potential impacts of risks related to the spread of, and response to, the COVID-19 pandemic as further discussed in Part II of this report and in other reports we filed subsequent to February 20, 2020,18, 2021, in each case incorporated by reference herein. In making these statements, we are not undertaking to address or update such forward-looking statements in future filings or communications regarding our business or results. In light of these risks, uncertainties and assumptions, the forward–looking events discussed in this document might not occur. There may also be other risks that we are unable to predict at this time. Any of these risks and uncertainties may cause actual results to differ materially from the results discussed in the forward–looking statements.
Executive Overview
General
Humana Inc., headquartered in Louisville, Kentucky, is a leading health and well-being company committed to helping our millions of medical and specialty members achieve their best health. Our successful history in care delivery and health plan administration is helping us create a new kind of integrated care with the power to improve health and well being and lower costs. Our efforts are leading to a better quality of life for people with Medicare, families, individuals, military service personnel, and communities at large. To accomplish that, we support physicians and other health care professionals as they work to deliver the right care in the right place for their patients, our members. Our range of clinical capabilities, resources and tools, such as in home care, behavioral health, pharmacy services, data analytics and wellness solutions, combine to produce a simplified experience that makes health care easier to navigate and more effective.
Our industry relies on two key statistics to measure performance. The benefit ratio, which is computed by taking
total benefits expense as a percentage of premiums revenue, represents a statistic used to measure underwriting profitability. The operating cost ratio, which is computed by taking total operating costs, excluding depreciation and amortization, as a percentage of total revenue less investment income, represents a statistic used to measure administrative spending efficiency.
COVID-19Kindred at Home Acquisition
We have continuedOn April 27, 2021, we entered into a definitive agreement to take actions to protect, inform,acquire the remaining 60% interest in Kindred at Home, or KAH, the nation’s largest home health and carehospice provider, from TPG Capital, the private equity platform of global alternative asset firm, or TPG, and Welsh, Carson, Anderson & Stowe, or WCAS, two private equity funds, or the Sponsors, for an enterprise value of $8.1 billion, which includes our members, providers, employees, and other stakeholdersexisting equity value of $2.4 billion associated with our 40% minority ownership interest. KAH has locations in 40 states, providing extensive geographic coverage with approximately 65% overlap with our individual Medicare Advantage membership. The acquisition, which is expected to close in the outbreakthird quarter of 2021, is subject to customary state and federal regulatory approvals. We expect to fund the approximate $5.7 billion transaction (net of our existing equity stake) through a combination of parent company cash, debt financing, and the assumption of existing KAH indebtedness. A mark to market gain on our existing 40% ownership interest, currently expected to approximate $1 billion, will be recorded upon closing of the transaction.
COVID-19
The emergence and spread of the novel coronavirus, or COVID-19. Specifically, we have takenCOVID-19, beginning in the following actions to support our members:

waiving all cost sharing for in-network primary care, outpatient behavioral health, and telehealth visits for the remainderfirst quarter of 2020 forhas impacted our Medicare Advantage members, to reduce financial barriers to members seeking to re-engage with their providers, while continuing to encourage the usebusiness. During periods of telehealth;

making it easier for members to be tested forincreased incidences of COVID-19, by offeringnon-essential care from a pilot at-home testing program, as well as collaborating with other providers to deploy drive-thru testing at hundreds of sites throughout the country;reduction in
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mailing in-home screening kitsnon-COVID-19 hospital admissions and lower overall healthcare system consumption decreased utilization. Likewise COVID-19 treatment and testing cost increased utilization. The significant disruption in utilization during 2020 also impacted our ability to implement clinical initiatives to manage health care costs and chronic conditions of our members, to encourage members to seek preventative care that may have been delayed duringand appropriately document their risk profiles, and, as such, affecting our 2021 revenue under the pandemic;risk adjustment payment model for Medicare Advantage plans.

proactively delivering safety kits, including face masks, to members and employee homes to facilitate access to care and support visits to providers safely;

continuing to extend grace periods for premium payments for our fully-insured commercial group members, to ensure continuity of coverage during times of financial stress; and

providing a concierge line dedicated to COVID-19 related inquiries.
In addition, we took steps to support our provider partners and boost system viability:
expanding modifications to certain utilization management processes, to ease administrative stress and make sure providers are able to most efficiently care for their patients; and
simplifying and expanding claims processing and releasing advanced funding to providers, to get reimbursement payments to providers as quickly as possible and ease financial concerns so that members are able to continue to access the care and information they need.
Finally, we continued to support the communities we serve by donating $200 million ($150 million during the second quarter of 2020) to the Humana Foundation to address social determinants of health in an effort to promote more health days and encourage greater health equity.
The temporary deferral of non-essential care resulting from stay-at-home and physical distancing orders and other restrictions on movement and economic activity implemented throughout the country beginning the second half of March 2020 to reduce the spread of COVID-19 has impacted our business. Hospital admissions and utilization were significantly depressed in April, increased throughout May and June, and remained modestly below normal historical levels at the close of the quarter. The impact of the deferral of non-essential care on our second quarter operating results was partially offset by COVID-19 testing and treatment costs, as well as our ongoing pandemic relief efforts.

We significantly increased our liquidity position during March 2020 with the issuance of $1.1 billion in senior notes and a $1 billion draw under the prior one-year term loan bank commitment. At June 30, 2020, we held $2.5 billion of cash and short-term investments at our parent company and access to an additional $2.0 billion under our credit agreement.
For the remainder of 2020, we expect our second quarter 2020 performance will be offset as demand for previously deferred non-essential care normalizes, combined with the financial impact of our ongoing relief efforts to ease the burden of the pandemic for our constituents. A number of significant variables and uncertainties will impact these trends including, among others, the severity and duration of the pandemic, continued actions taken to mitigate the spread of COVID-19 and in turn, relax those restrictions, the timing and degree in resumption of demand for deferred health care services, the ability of our commercial members to pay their premium, the nature and level of diagnostic testing, the cost and timing of new therapeutic treatments and vaccines, all of which are difficult to predict.As such, our response to this global health crisis and the subsequent recovery will continue to evolve over the coming months to support the needs of our stakeholders.

Recent Transactions
In the first quarter of 2020, we purchased privately held Enclara, one of the nation’s largest hospice pharmacy and benefit management providers, for cash consideration of approximately $709 million, net of cash received.
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We have entered into a strategic partnership with WCAS to accelerate the expansion of our primary care model. The WCAS partnership is expected to open approximately 50 payor-agnostic, senior-focused primary care centers over 3 years beginning in 2020.
These transactions are more fully discussed in Note 3 to the condensed consolidated financial statements.
Business Segments
We manage our business with three reportable segments: Retail, Group and Specialty, and Healthcare Services. The reportable segments are based on a combination of the type of health plan customer and adjacent businesses centered on well-being solutions for our health plans and other customers, as described below. These segment groupings are consistent with information used by our Chief Executive Officer, the Chief Operating Decision Maker, to assess performance and allocate resources.
The Retail segment consists of Medicare benefits, marketed to individuals or directly via group Medicare accounts. In addition, the Retail segment also includes our contract with CMS to administer the Limited Income Newly Eligible Transition, or LI-NET, prescription drug plan program and contracts with various states to provide Medicaid, dual eligible, and Long-Term Support Services benefits, which we refer to collectively as our state-based contracts. The Group and Specialty segment consists of employer group commercial fully-insured medical and specialty health insurance benefits marketed to individuals and employer groups, including dental, vision, and other supplemental health benefits, as well as administrative services only, or ASO products. In addition, our Group and Specialty segment includes our military services business, primarily our TRICARE T2017 East Region contract. The Healthcare Services segment includes our services offered to our health plan members as well as to third parties, including pharmacy solutions, provider services, and clinical care service, such as home health and other services and capabilities to promote wellness and advance population health, including our non-consolidating minority investment in Kindred at Home and the strategic partnership with WCAS to develop and operate senior-focused, payor-agnostic, primary care centers.
The results of each segment are measured by segment earnings, and for our Healthcare Services Segment, also include equity in net earnings from our equity method investees. Transactions between reportable segments primarily consist of sales of services rendered by our Healthcare Services segment, primarily pharmacy, provider, and clinical care services, to our Retail and Group and Specialty segment customers. Intersegment sales and expenses are recorded at fair value and eliminated in consolidation. Members served by our segments often use the same provider networks, enabling us in some instances to obtain more favorable contract terms with providers. Our segments also share indirect costs and assets. As a result, the profitability of each segment is interdependent. We allocate most operating expenses to our segments. Assets and certain corporate income and expenses are not allocated to the segments, including the portion of investment income not supporting segment operations, interest expense on corporate debt, and certain other corporate expenses. These items are managed at a corporate level. These corporate amounts are reported separately from our reportable segments and are included with intersegment eliminations.
Seasonality
COVID-19 disrupted the pattern of our quarterly earnings and operating cash flows largely due to the temporary deferral of non-essential care which resulted in reductions in non-COVID-19 hospital admissions and lower overall healthcare system utilization during higher levels of COVID-19 hospital admissions. Likewise, during periods of increased incidences of COVID-19, COVID-19 treatment and testing costs increase. Similar impacts and seasonal disruptions from either higher or lower utilization are expected to persist as we respond to and recover from the COVID-19 global health crisis.
One of the product offerings of our Retail segment is Medicare stand-alone prescription drug plans, or PDPs, under the Medicare Part D program. Our quarterly Retail segment earnings and operating cash flows are impacted by the Medicare Part D benefit design and changes in the composition of our membership. The Medicare Part D benefit design results in coverage that varies as a member’s cumulative out-of-pocket costs pass through successive
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stages of a member’s plan period, which begins annually on January 1 for renewals. These plan designs generally result in us sharing a greater portion of the responsibility for total prescription drug costs in the early stages and less in the latter stages. As a result, the PDP benefit ratio generally decreases as the year progresses. In addition, the number of low income senior members as well as year-over-year changes in the mix of membership in our stand-alonestandalone PDP products affects the quarterly benefit ratio pattern.
In addition, the Retail segment also experiences seasonality in the operating cost ratio as a result of costs incurred in the second half of the year associated with the Medicare marketing season.
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Our Group and Specialty segment also experiences seasonality in the benefit ratio pattern. However, the effect is opposite of Medicare stand-alone PDP in the Retail segment, with the Group and Specialty segment’s benefit ratio increasing as fully-insured members progress through their annual deductible and maximum out-of-pocket expenses.
20202021 Highlights
Our strategy offers our members affordable health care combined with a positive consumer experience in growing markets. At the core of this strategy is our integrated care delivery model, which unites quality care, high member engagement, and sophisticated data analytics. Our approach to primary, physician-directed care for our members aims to provide quality care that is consistent, integrated, cost-effective, and member-focused, provided by both employed physicians and physicians with network contract arrangements. The model is designed to improve health outcomes and affordability for individuals and for the health system as a whole, while offering our members a simple, seamless healthcare experience. We believe this strategy is positioning us for long-term growth in both membership and earnings. We offer providers a continuum of opportunities to increase the integration of care and offer assistance to providers in transitioning from a fee-for-service to a value-based arrangement. These include performance bonuses, shared savings and shared risk relationships. At June 30, 2020,2021, approximately 2,552,3002,914,300 members, or 66%67%, of our individual Medicare Advantage members were in value-based relationships under our integrated care delivery model, as compared to 2,272,3002,552,300 members, or 65%66%, at June 30, 2019.2020. Medicare Advantage and dual demonstration program membership enrolled in a Humana chronic care management program was 947,400 at June 30, 2021, an increase of 5.1% from 901,000 at June 30, 2020, an increase of 5.6% from 853,600 at June 30, 2019.2020. These members may not be unique to each program since members have the ability to enroll in multiple programs. The increase is primarily driven by our improved process for identifying and enrolling members in the appropriate program at the right time, coupled with growth in Special Needs Plans, or SNP, membership.membership, partially offset by improved predictive modeling leading to a reduction in members being managed by legacy care management programs.
Net income was $588 million, or $4.55 per diluted common share, and $1.8 billion, or $13.75, for the three months ended June 30, 2021, and 2020, respectively. Net income was $1.4 billion, or $10.94 per diluted common share, in the 2020 quarter compared to $940 million, or $6.94 per diluted common share, in the 2019 quarter and was $2.3 billion, or $17.31 per diluted common share infor the six months ended June 30, 2021, and 2020, period compared to $1.5 billion, or $11.10 per diluted common share, in the 2019 period. The comparisons wererespectively. This comparison was significantly impacted by thethe put/call valuation adjustments associated with certain equity method investments, which increased earnings $227 millionthe change in the 2020 quarter compared to $174 million infair value of publicly-traded equity securities, and transaction and integration costs associated with the 2019 quarter.pending Kindred at Home acquisition. The put/call valuation reduced earnings $70 million in the 2020 period, but increased earnings $135 million in the 2019 period. Excludingadjustments included the impact of the termination of the put/call valuationagreement related to Kindred at Home as a result of the transaction announced on April 27, 2021. The impact of these adjustments to our consolidated income before income taxes and equity in net earnings and diluted earnings per common share was as follows for the favorable comparison was driven2021 quarter and period.

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For the three months ended June 30,For the six months ended June 30,
2021202020212020
Consolidated income before income taxes and equity in net earnings:
Change in the fair value of publicly-traded equity securities$63 $— $(22)$— 
Transaction and integration costs associated with pending KAH acquisition(22)— (22)— 
Put/call valuation adjustments(419)227 (534)(70)
Total$(378)$227 $(578)$(70)
For the three months ended June 30,For the six months ended June 30,
2021202020212020
Diluted earnings per common share:
Change in the fair value of publicly-traded equity securities$0.37 $— $(0.13)$— 
Transaction and integration costs associated with pending KAH acquisition(0.13)— (0.13)— 
Put/call valuation adjustments(2.49)1.32 (3.18)(0.40)
Total$(2.25)$1.32 $(3.44)$(0.40)

Excluding these adjustments, comparisons of our results of operations were materially impacted by the significant, temporary deferral of non-essential care amidin 2020 resulting from stay-at-home orders, physical distancing measures, and other restrictions implemented to reduce the spread of COVID-19, pandemic. The temporary reduction in utilization was partially offset byas well as the impact of COVID-19 testing and treatment costs, along withwhich on a net basis significantly and favorably impacted the 2020 quarter and period results when compared to the 2021 quarter and period results.

In addition, our ongoing pandemic relief efforts, including the waiverresults of all cost sharingoperations for in-network primary care, outpatient behavioral health, and telehealth visits for our2021 were favorably impacted by individual Medicare Advantage members. These changes wereand state-based contract membership growth and improved operating performance in the Group and Specialty and Healthcare Services segments. Further, 2021 was also favorably impacted by the lower tax rate resulting from the termination of the non-deductible health insurance industry fee in 2021, as well as a lower number of shares used to compute dilutive earnings per common share, primarily reflecting share repurchases completed during 2019, partially offset by a higher tax rate resulting from the return of the non-deductible health insurance industry fee in 2020.repurchases.

Contributing to our Retail segment revenue growth was our individual Medicare Advantage membership, which increased 392,700 members, or 11.3%, from June 30, 2019 to June 30, 2020.
Our operating cash flows for the 2020 period increased from the 2019 period due to higher income from operations and the timing of working capital items, primarily related to benefits payable, including higher provider surplus accruals from our risk sharing arrangements, and the delayed payment of estimated second quarter of 2020 federal income taxes until the third quarter of 2020 in accordance with the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act. These favorable working capital items were partially offset by the timing of the mid-year Medicare risk adjustment premium revenue collections that were received in July 2020 versus the the second quarter in 2019.
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Health Care Reform
The Health Care Reform Law enacted significant reforms to various aspects of the U.S. health insurance industry. Certain significant provisions of the Health Care Reform Law include, among others, mandated coverage requirements, mandated benefits and guarantee issuance associated with commercial medical insurance, rebates to policyholders based on minimum benefit ratios, adjustments to Medicare Advantage premiums, the establishment of federally facilitated or state-based exchanges coupled with programs designed to spread risk among insurers, and the introduction of plan designs based on set actuarial values. In addition, the Health Care Reform Law established insurance industry assessments, including an annual health insurance industry fee. The annual health insurance industry fee, which was suspended in 2019, but has resumed for calendar year 2020, is not deductible for income tax purposes and significantly increasesincreased our effective tax rate. We expect to pay the federal government $1.2 billionrate, was in Septembereffect for 2020, for this fee. Under current law, the health industry fee will bebut was permanently repealed beginning in calendar year 2021.
It is reasonably possible that the Health Care Reform Law and related regulations, as well as other current or future legislative, judicial or regulatory changes such as the Families First Coronavirus Response Act (the "Families First Act"), the Coronavirus Aid, Relief, and Economic Security Act (the "CARES Act") and other legislative andor regulatory changes associated withaction taken in response to COVID-19 including restrictions on our ability to manage our provider
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network or otherwise operate our business, or restrictions on profitability, including reviews by regulatory bodies that may compare our Medicare Advantage profitability to our non-Medicare Advantage business profitability, or compare the profitability of various products within our Medicare Advantage business, and require that they remain within certain ranges of each other, increases in member benefits or changes to member eligibility criteria without corresponding increases in premium payments to us, or increases in regulation of our prescription drug benefit businesses, in the aggregate may have a material adverse effect on our results of operations (including restricting revenue, enrollment and premium growth in certain products and market segments, restricting our ability to expand into new markets, increasing our medical and operating costs, further lowering our Medicare payment rates and increasing our expenses associated with assessments); our financial position (including our ability to maintain the value of our goodwill); and our cash flows.
We intend for the discussion of our financial condition and results of operations that follows to assist in the understanding of our financial statements and related changes in certain key items in those financial statements from year to year, including the primary factors that accounted for those changes. Transactions between reportable segments primarily consist of sales of services rendered by our Healthcare Services segment, primarily pharmacy, provider, and clinical care services, to our Retail and Group and Specialty segment customers and are described in Note 14 to the condensed consolidated financial statements included in this report.





















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Comparison of Results of Operations for 20202021 and 20192020
The following discussion primarily deals with our results of operations for the three months ended June 30, 2020,2021, or the 20202021 quarter, and the three months ended June 30, 2019,2020, or the 20192020 quarter, the six months ended June 30, 2021, or the 2021 period, and the six months ended June 30, 2020, or the 2020 period, and the six months ended June 30, 2019, or the 2019 period.
Consolidated
For the three months ended June 30,ChangeFor the three months ended June 30,Change
20202019DollarsPercentage20212020DollarsPercentage
(dollars in millions, except per common share results)(dollars in millions, except per common share results)
Revenues:Revenues:Revenues:
Premiums:Premiums:Premiums:
RetailRetail$16,923  $14,105  $2,818  20.0 %Retail$18,468 $16,923 $1,545 9.1 %
Group and SpecialtyGroup and Specialty1,633  1,671  (38) (2.3)%Group and Specialty1,510 1,633 (123)(7.5)%
Total premiumsTotal premiums18,556  15,776  2,780  17.6 %Total premiums19,978 18,556 1,422 7.7 %
Services:Services:Services:
RetailRetail   20.0 %Retail12 100.0 %
Group and SpecialtyGroup and Specialty192  193  (1) (0.5)%Group and Specialty194 192 1.0 %
Healthcare ServicesHealthcare Services252  157  95  60.5 %Healthcare Services285 252 33 13.1 %
Total servicesTotal services450  355  95  26.8 %Total services491 450 41 9.1 %
Investment incomeInvestment income77  114  (37) (32.5)%Investment income176 77 99 128.6 %
Total revenuesTotal revenues19,083  16,245  2,838  17.5 %Total revenues20,645 19,083 1,562 8.2 %
Operating expenses:Operating expenses:Operating expenses:
BenefitsBenefits14,175  13,318  857  6.4 %Benefits17,149 14,175 2,974 21.0 %
Operating costsOperating costs2,354  1,703  651  38.2 %Operating costs2,116 2,354 (238)(10.1)%
Depreciation and amortizationDepreciation and amortization119  109  10  9.2 %Depreciation and amortization144 119 25 21.0 %
Total operating expensesTotal operating expenses16,648  15,130  1,518  10.0 %Total operating expenses19,409 16,648 2,761 16.6 %
Income from operationsIncome from operations2,435  1,115  1,320  118.4 %Income from operations1,236 2,435 (1,199)(49.2)%
Interest expenseInterest expense76  60  16  26.7 %Interest expense79 76 3.9 %
Other income, net(227) (174) (53) 30.5 %
Other expense (income), netOther expense (income), net419 (227)646 284.6 %
Income before income taxes and equity in net earningsIncome before income taxes and equity in net earnings2,586  1,229  1,357  110.4 %Income before income taxes and equity in net earnings738 2,586 (1,848)(71.5)%
Provision for income taxesProvision for income taxes783  301  482  160.1 %Provision for income taxes183 783 (600)(76.6)%
Equity in net earningsEquity in net earnings25  12  13  108.3 %Equity in net earnings33 25 32.0 %
Net incomeNet income$1,828  $940  $888  94.5 %Net income$588 $1,828 $(1,240)(67.8)%
Diluted earnings per common shareDiluted earnings per common share$13.75  $6.94  $6.81  98.1 %Diluted earnings per common share$4.55 $13.75 $(9.20)(66.9)%
Benefit ratio (a)
Benefit ratio (a)
76.4 %84.4 %(8.0)%
Benefit ratio (a)
85.8 %76.4 %9.4 %
Operating cost ratio (b)
Operating cost ratio (b)
12.4 %10.6 %1.8 %
Operating cost ratio (b)
10.3 %12.4 %(2.1)%
Effective tax rateEffective tax rate30.0 %24.2 %5.8 %Effective tax rate23.7 %30.0 %(6.3)%
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For the six months ended
June 30,
ChangeFor the six months ended
June 30,
Change
20202019DollarsPercentage20212020DollarsPercentage
(dollars in millions, except per common share results)(dollars in millions, except per common share results)
Revenues:Revenues:Revenues:
Premiums:Premiums:Premiums:
RetailRetail$33,627  $28,072  $5,555  19.8 %Retail$37,059 $33,627 $3,432 10.2 %
Group and SpecialtyGroup and Specialty3,291  3,355  (64) (1.9)%Group and Specialty3,043 3,291 (248)(7.5)%
Total premiumsTotal premiums36,918  31,427  5,491  17.5 %Total premiums40,102 36,918 3,184 8.6 %
Services:Services:Services:
RetailRetail10  10  —  — %Retail17 10 70.0 %
Group and SpecialtyGroup and Specialty387  387  —  — %Group and Specialty384 387 (3)(0.8)%
Healthcare ServicesHealthcare Services477  313  164  52.4 %Healthcare Services556 477 79 16.6 %
Total servicesTotal services874  710  164  23.1 %Total services957 874 83 9.5 %
Investment incomeInvestment income226  215  11  5.1 %Investment income254 226 28 12.4 %
Total revenuesTotal revenues38,018  32,352  5,666  17.5 %Total revenues41,313 38,018 3,295 8.7 %
Operating expenses:Operating expenses:Operating expenses:
BenefitsBenefits29,804  26,811  2,993  11.2 %Benefits34,445 29,804 4,641 15.6 %
Operating costsOperating costs4,471  3,363  1,108  32.9 %Operating costs4,123 4,471 (348)(7.8)%
Depreciation and amortizationDepreciation and amortization234  216  18  8.3 %Depreciation and amortization286 234 52 22.2 %
Total operating expensesTotal operating expenses34,509  30,390  4,119  13.6 %Total operating expenses38,854 34,509 4,345 12.6 %
Income from operationsIncome from operations3,509  1,962  1,547  78.8 %Income from operations2,459 3,509 (1,050)(29.9)%
Interest expenseInterest expense136  122  14  11.5 %Interest expense147 136 11 8.1 %
Other expense (income), net70  (135) 205  (151.9)%
Other expense, netOther expense, net534 70 464 662.9 %
Income before income taxes and equity in net earningsIncome before income taxes and equity in net earnings3,303  1,975  1,328  67.2 %Income before income taxes and equity in net earnings1,778 3,303 (1,525)(46.2)%
Provision for income taxesProvision for income taxes1,035  484  551  113.8 %Provision for income taxes416 1,035 (619)(59.8)%
Equity in net earningsEquity in net earnings33  15  18  120.0 %Equity in net earnings54 33 21 63.6 %
Net incomeNet income$2,301  $1,506  $795  52.8 %Net income$1,416 $2,301 $(885)(38.5)%
Diluted earnings per common shareDiluted earnings per common share$17.31  $11.10  $6.21  55.9 %Diluted earnings per common share$10.94 $17.31 $(6.37)(36.8)%
Benefit ratio (a)
Benefit ratio (a)
80.7 %85.3 %(4.6)%
Benefit ratio (a)
85.9 %80.7 %5.2 %
Operating cost ratio (b)
Operating cost ratio (b)
11.8 %10.5 %1.3 %
Operating cost ratio (b)
10.0 %11.8 %(1.8)%
Effective tax rateEffective tax rate31.0 %24.3 %6.7 %Effective tax rate22.7 %31.0 %(8.3)%
(a)Represents benefits expense as a percentage of premiums revenue.
(b)Represents operating costs as a percentage of total revenues less investment income.







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Summary
Net income was $1.8 billion, or $13.75 per diluted common share, in the 2020 quarter compared to $940 million, or $6.94 per diluted common share, in the 2019 quarter and was $2.3 billion, or $17.31 per diluted common share, in the 2020 period compared to $1.5 billion, or $11.10 per diluted common share, in the 2019 period. The comparisons were significantly impacted by the put/call valuation adjustments associated with certain equity method investments which increased earnings $227 million in the 2020 quarter compared to $174 million in the 2019 quarter. The put/call valuation adjustment reduced earnings $70 million in the 2020 period, but increased earnings $135 million in the 2019 period. Excluding the impact of the put/call valuation adjustments, the favorable comparison was driven by the result of the previously discussed impact of the temporary deferral of non-essential care amid the COVID-19 pandemic. The temporary reduction in utilization was partially offset by COVID-19 testing and treatment costs along with our ongoing pandemic relief efforts, includingPremiums the waiver of all cost sharing for in-network primary care, outpatient behavioral health, and telehealth visits for our Medicare Advantage members. These changes were also favorably impacted by a lower number of shares used to compute dilutive earnings per common share, primarily reflecting share repurchases completed during 2019, partially offset by a higher tax rate resulting from the return of the non-deductible health insurance industry fee in 2020.  Revenue
Premiums Revenue
Consolidated premiums increased $2.8$1.4 billion, or 17.6%7.7%, from $15.8 billion in the 2019 quarter to $18.6 billion in the 2020 quarter and increased $5.5 billion, or 17.5%, from $31.4to $20.0 billion in the 2019 period to2021 quarter and increased $3.2 billion, or 8.6%, from $36.9 billion in the 2020 period to $40.1 billion in the 2021 period. These increases were primarily due to higher premiums in the Retail segment, mainly resulting fromindividual Medicare Advantage and state-based contracts membership growth, andas well as higher per member individual Medicare Advantage premiums as a result of the improving CMS benchmark rate for 2021, net of Medicare Risk Adjustment, or MRA, headwinds resulting from COVID-19 related utilization disruption in 2020. These increases were partially offset by the impact of declining stand-alone PDP, membership as more fully describedgroup commercial medical, and group Medicare Advantage membership. The 2021 period was further impacted by the Medicare sequestration relief in the detailed segment results discussionfirst quarter of 2021 that follows.
Services Revenuewas not enacted until the second quarter of 2020.
Consolidated services revenue increased $95$41 million, or 26.8%9.1%, from $355 million in the 2019 quarter to $450 million in the 2020 quarter and increased $164 million, or 23.1%, from $710to $491 million in the 2019 period to2021 quarter and increased $83 million, or 9.5%, from $874 million in the 2020 period to $957 million in the 2021 period. These increases were were primarily due to an increase in services revenue in the Healthcare Services segmenthigher revenues associated with higher externalour pharmacy and provider businesses. The 2021 period further reflects additional pharmacy revenues resulting fromassociated with the acquisition of Enclara acquisition inwhich was closed during the first quarter of 2020.
Investment Income
Investment income decreased $37increased $99 million, or 32.5%128.6%, from $114 million in the 2019 quarter to $77 million in the 2020 quarter to $176 million in the 2021 quarter primarily due to lower interest ratesreflecting changes in the fair value of our common stock investments and lowerhigher realized capital gains, partially offset by higherlower average invested balances. Investment income increased $11$28 million, or 5.1%12.4%, from $215 million in the 2019 period to $226 million in the 2020 period primarily due to $254 million in the 2021 period primarily reflecting higher realized capital gains, and higher average invested balances, partially offset by changes in the fair value of our common stock investments and lower interest rates.average invested balances.
BenefitsBenefit Expense
Consolidated benefits expense increased $857 million,$3.0 billion, or 6.4%21.0%, from $13.3 billion in the 2019 quarter to $14.2 billion in the 2020 quarter and increased $3.0 billion, or 11.2%, from $26.8to $17.1 billion in the 2019 period to2021 quarter and increased $4.6 billion, or 15.6%, from $29.8 billion in the 2020 period to $34.4 billion in the 2021 period. The consolidated benefit ratio decreased 800increased 940 basis points from 84.4% for the 2019 quarter to 76.4% for the 2020 quarter to 85.8% for the 2021 quarter and decreased 460increased 520 basis points from 85.3% for the 2019 period to 80.7% for the 2020 period to 85.9% for the 2021 period. These benefit ratio decreases were primarily due toincreases reflect the previously discussedsignificant impact of the temporary deferral of non-essential care, net of COVID-19 treatment and testing costs and our pandemic relief efforts in 2020, amid the COVID-19 pandemic. The temporary reductionpandemic, and the termination in utilization was partially offset by COVID-19 testing and treatment costs along with our ongoing pandemic relief efforts. These relief efforts include the waiver of all cost sharing for in-network primary care, outpatient behavioral health, and telehealth visits for our Medicare Advantage members, delivery of approximately 840,000 meals to senior members in need through the 2020 period, and establishing a clinical outreach team to proactively engage with our most vulnerable members.
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The benefit ratio was further impacted by the reinstatement2021 of the non-deductible health insurance industry fee in 2020 which, along with a portion of the related tax benefit, was contemplated in the pricing and benefit design of our products. The increases were also due to the impact in 2021 associated with the competitive nature of the group Medicare Advantage business, particularly in large group accounts that were recently procured, as well as in the stand-alone PDP business. These factors were partially offset by higher favorable prior-period medical claims reserve development in 2021.
We experienced negative
The higher favorable prior-period medical claims reserve development forwas primarily attributable to the reversal of actions taken in 2020, quarter as a result ofincluding the suspension of certain financial recovery programs for a period of time in the quarter.time. The suspension during 2020 was intended to provide financial and administrative relief for providersprovider facing unprecedented strain duringas a result of the COVID-19 pandemic. We anticipate that we will recover some ofThe favorable prior-period medical claims reserve development decreased the amounts associated with the temporary suspensionconsolidated benefit ratio by approximately 80 basis points in the latter half of 2020 and 2021. The2021 quarter whereas the unfavorable prior-period medical claims reserve development increased the consolidated benefit ratio by approximately 30 basis points in the 2020 quarter, whereas the favorable prior-period medical claims reserve development decreased the consolidated benefit ratio by approximately 10 basis points in the 2019 quarter. The favorable prior-period medical claims reserve development decreased the consolidated benefit ratio by approximately 180 basis points in the 2021 period versus approximately 60 basis points in the 2020 period versus approximately 90 basis points in the 2019 period.

Operating Costs
Our segments incur both direct and shared indirect operating costs. We allocate the indirect costs shared by the segments primarily as a function of revenues. As a result, the profitability of each segment is interdependent.
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Consolidated operating costs increased $651decreased $238 million, or 38.2%10.1%, from $1.7 billion in the 2019 quarter to $2.4 billion in the 2020 quarter and increased $1.1 billion, or 32.9% from $3.4to $2.1 billion in the 2019 period to2021 quarter and decreased $348 million, or 7.8%, from $4.5 billion in the 2020 period.
to $4.1 billion in the 2021 period. The consolidated operating cost ratio increaseddecreased 210 basis points from 12.4% for the 2020 quarter to 10.3% for the 2021 quarter and decreased 180 basis points from 10.6% for the 2019 quarter to 12.4% for the 2020 quarter and increased 130 basis points from 10.5% for the 2019 period to 11.8% for the 2020 period to 10.0% for the 2021 period. These increasesdecreases were primarily due to the reinstatementtermination of the non-deductible health insurance industry fee in 2020, and2021, the impact of a $200$150 million contribution of which $50 million was contributed in the first2020 quarter 2020, to the Humana Foundation to support the communities served by us particularly those with social and health disparities. These increases were also driven bydisparities, as well as the impact of lower COVID-19 related administrative costs including thosein 2021 compared to 2020. Administrative costs in 2020 included costs associated with personal protective equipment, member response efforts, and the build-out of infrastructure necessary to support employees working remotely. These increasesdecreases were partially offsetfurther impacted by scale efficiencies associated with growth in our Medicare Advantage membership and significant operating cost efficiencies in the 2020 quarter driven2021 from previously implemented productivity initiatives. These factors were partially offset by previously disclosed productivity initiatives.continued strategic investments made to position us for long-term success. The non-deductible health insurance industry fee impacted the operating cost ratio by 150 basis points in the 2020 quarter and by 160 basis points in the 2020 period.  period.
Depreciation and Amortization
Depreciation and amortization increased $10$25 million, or 9.2%21.0%, from $109 million in the 2019 quarter to $119 million in the 2020 quarter and increased $18 million, or 8.3%, from $216to $144 million in the 2019 period to2021 quarter and increased $52 million, or 22.2%, from $234 million in the 2020 period.period to $286 million in the 2021 period primarily due to capital expenditures.
Interest Expense
Interest expense increased $16$3 million, or 26.7%3.9%, from $60 million in the 2019 quarter to $76 million in the 2020 quarter and increased $14 million, or 11.5%, from $122to $79 million in the 2019 period to2021 quarter and increased $11 million, or 8.1%, from $136 million in the 2020 period to $147 million in the 2021 period.
Income Taxes
The effective income tax rate was 23.7% and 30.0% for the three months ended June 30, 2021, and 2020, respectively and was 22.7% and 31.0% for the three and six months ended June 30, 2021, and 2020, respectively, compared to 24.2% and 24.3% for the three and six months ended June 30, 2019, respectively. These increasesThe decreases were primarily due to the reinstatementtermination of the non-deductible health insurance industry fee in 2020.2021.

Retail Segment


 June 30,Change
 20212020MembersPercentage
Membership:
Medical membership:
Individual Medicare Advantage4,341,600 3,877,200 464,400 12.0 %
Group Medicare Advantage557,300 608,300 (51,000)(8.4)%
Medicare stand-alone PDP3,653,100 3,888,400 (235,300)(6.1)%
Total Retail Medicare8,552,000 8,373,900 178,100 2.1 %
State-based Medicaid and other877,300 689,200 188,100 27.3 %
Medicare Supplement330,400 324,600 5,800 1.8 %
Total Retail medical members9,759,700 9,387,700 372,000 4.0 %
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Retail Segment
 June 30,Change
 20202019MembersPercentage
Membership:
Medical membership:
Individual Medicare Advantage3,877,200  3,484,500  392,700  11.3 %
Group Medicare Advantage608,300  519,100  89,200  17.2 %
Medicare stand-alone PDP3,888,400  4,400,500  (512,100) (11.6)%
Total Retail Medicare8,373,900  8,404,100  (30,200) (0.4)%
State-based Medicaid689,200  465,200  224,000  48.2 %
Medicare Supplement324,600  276,000  48,600  17.6 %
Total Retail medical members9,387,700  9,145,300  242,400  2.7 %
For the three months ended June 30,ChangeFor the three months ended June 30,Change
20202019DollarsPercentage20212020DollarsPercentage
(in millions)(in millions)
Premiums and Services Revenue:Premiums and Services Revenue:Premiums and Services Revenue:
Premiums:Premiums:Premiums:
Individual Medicare AdvantageIndividual Medicare Advantage$13,005  $10,793  $2,212  20.5 %Individual Medicare Advantage$14,585 $13,005 $1,580 12.1 %
Group Medicare AdvantageGroup Medicare Advantage1,976  1,626  350  21.5 %Group Medicare Advantage1,775 1,976 (201)(10.2)%
Medicare stand-alone PDPMedicare stand-alone PDP731  818  (87) (10.6)%Medicare stand-alone PDP662 731 (69)(9.4)%
Total Retail MedicareTotal Retail Medicare15,712  13,237  2,475  18.7 %Total Retail Medicare17,022 15,712 1,310 8.3 %
State-based Medicaid1,042  724  318  43.9 %
State-based Medicaid and otherState-based Medicaid and other1,264 1,042 222 21.3 %
Medicare SupplementMedicare Supplement169  144  25  17.4 %Medicare Supplement182 169 13 7.7 %
Total premiumsTotal premiums16,923  14,105  2,818  20.0 %Total premiums18,468 16,923 1,545 9.1 %
ServicesServices   20.0 %Services12 100.0 %
Total premiums and services revenueTotal premiums and services revenue$16,929  $14,110  $2,819  20.0 %Total premiums and services revenue18,480 $16,929 $1,551 9.2 %
Segment earningsSegment earnings$1,989  $856  $1,133  132.4 %Segment earnings$836 $1,989 $(1,153)(58.0)%
Benefit ratioBenefit ratio78.3 %85.2 %(6.9)%Benefit ratio87.0 %78.3 %8.7 %
Operating cost ratioOperating cost ratio9.7 %8.5 %1.2 %Operating cost ratio8.3 %9.7 %(1.4)%

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For the six months ended
June 30,
Change
20202019DollarsPercentage
(in millions)
Premiums and Services Revenue:
Premiums:
Individual Medicare Advantage$25,799  $21,502  $4,297  20.0 %
Group Medicare Advantage3,987  3,258  729  22.4 %
Medicare stand-alone PDP1,486  1,627  (141) (8.7)%
Total Retail Medicare31,272  26,387  4,885  18.5 %
State-based Medicaid2,023  1,401  622  44.4 %
Medicare Supplement332  284  48  16.9 %
Total premiums33,627  28,072  5,555  19.8 %
Services10  10  —  — %
Total premiums and services revenue$33,637  $28,082  $5,555  19.8 %
Segment earnings$2,674  $1,321  $1,353  102.4 %
Benefit ratio82.4 %86.7 %(4.3)%
Operating cost ratio9.4 %8.4 %1.0 %

For the six months ended
June 30,
Change
20212020DollarsPercentage
(in millions)
Premiums and Services Revenue:
Premiums:
Individual Medicare Advantage$29,400 $25,799 $3,601 14.0 %
Group Medicare Advantage3,530 3,987 (457)(11.5)%
Medicare stand-alone PDP1,326 1,486 (160)(10.8)%
Total Retail Medicare34,256 31,272 2,984 9.5 %
State-based Medicaid and other2,443 2,023 420 20.8 %
Medicare Supplement360 332 28 8.4 %
Total premiums37,059 33,627 3,432 10.2 %
Services17 10 70.0 %
Total premiums and services revenue$37,076 $33,637 $3,439 10.2 %
Segment earnings$1,630 $2,674 $(1,044)(39.0)%
Benefit ratio87.3 %82.4 %4.9 %
Operating cost ratio8.0 %9.4 %(1.4)%
Segment Earnings
Retail segment earnings increased $1.1decreased $1.2 billion, or 132.4%58.0%, from $856 million in the 2019 quarter to $2.0 billion in the 2020 quarter to $836 million in the 2021 quarter and increased $1.4decreased $1.0 billion, or 102.4%39.0%, from $1.3 billion in the 2019 period to $2.7 billion in the 2020 period to $1.6 billion in the 2021 period. These increases weredecreases primarily dueresulted from the same factors that led to a lowerthe segment's higher benefit ratio, partially offset by a higherthe segment's lower operating cost ratio as more fully described below.
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Enrollment
Individual Medicare Advantage membership increased 392,700464,400 members, or 11.3%12.0%, from June 30, 20192020 to June 30, 2020,2021, primarily due to membership additions associated with the most recent Annual Election Period, or AEP, and Open Election Period, or OEP, for Medicare beneficiaries. The OEP sales period, which ranmembership growth was further impacted by continued enrollment resulting from January 1 to March 31, 2020 added approximately 30,000 members. Since the conclusion of the 2020 OEP, enrollment continued to increase due to special elections, age-ins, and Dual Eligible Special Need Plans, or D-SNP, members. The OEP sales period, which ran from January 1 to March 31, 2021 added approximately 36,000 members compared to the 2020 OEP that added approximately 30,000 members. Individual Medicare Advantage membership includes 365,300532,900 D-SNP members as of June 30, 2020,2021, a net increase of 101,100,167,600, or 38%45.9%, from 264,200365,300 as of June 30, 2019.2020.
Group Medicare Advantage membership increased 89,200,decreased 51,000, or 17.2%8.4%, from June 30, 20192020 to June 30, 2020,2021, primarily due to the additionnet loss of acertain large accountaccounts in January 2020, along with net membership additions associated with the most recent AEP for Medicare beneficiaries.January 2021, partially offset by continued growth in small group accounts.
Medicare stand-alone PDP membership decreased 512,100235,300 members, or 11.6%6.1%, from June 30, 20192020 to June 30, 20202021, primarily reflecting netdue to anticipated declines during the most recent AEP for Medicare beneficiaries. The anticipated decline was primarily theas a result of terminations driven by premium and benefit adjustments experienced by members that were previously enrolled in our 2019 Humana Walmart Rx plan and the 2019 Humana Enhanced plan, which were consolidated into the Premier Rx plan in 2020. The expected PDP losses were partially offset by growth in the new low-price Humana Walmart Value Rx plan driven by both new sales and plan to plan changes.no longer being the low cost leader in 2021.
State-based Medicaid membership increased 224,000188,100 members, or 48.2%27.3%, from June 30, 20192020 to June 30, 2020. This increase2021, primarily reflectsreflecting additional enrollment resulting from the impact of discontinuingeconomic downturn due to the reinsurance agreement with CareSource and the assumption of full financial risk for the existing Kentucky Medicaid contract as of
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January 1, 2020,COVID-19 pandemic, as well as additional enrollment, particularlythe recently completed acquisition in Florida, resulting from the current economic downturn driven by the COVID-19 pandemic.Wisconsin.
Premiums Revenue
Retail segment premiums increased $2.8$1.5 billion, or 20.0%9.1%, from $14.1 billion in the 2019 quarter to $16.9 billion in the 2020 quarter and increased $5.6 billion, or 19.8%, from $28.1to $18.5 billion in the 2019 period to2021 quarter and increased $3.4 billion, or 10.2%, from $33.6 billion in the 2020 period to $37.1 billion in the 2021 period. These increases were primarily reflectdue to higher premiums as a result of individual Medicare Advantage and state-based contracts membership growth and higher per member individual Medicare Advantage premiums.premiums as a result of the improving CMS benchmark rate for 2021, net of MRA headwinds resulting from COVID-19 related utilization disruption in 2020. These favorable items were partially offset by the decline in membership in our stand-alone PDP and group Medicare Advantage offerings. The 2021 period was further impacted by the Medicare sequestration relief in the first quarter of 2021 that was not enacted until the second quarter of 2020.
Benefits Expense
The Retail segment benefit ratio decreased 690increased 870 basis points from 85.2% for the 2019 quarter to 78.3% for the 2020 quarter to 87.0% for the 2021 quarter and decreased 430increased 490 basis points from 86.7% for the 2019 period to 82.4% for the 2020 period to 87.3% for the 2021 period. These decreasesincreases were primarily due to the significant impact of the temporary deferral of non-essential care, net of COVID-19 treatment and testing costs and our pandemic relief efforts in the 2020 quarter, amid the COVID-19 pandemic. The temporary reduction in utilization was partially offset by COVID-19 testing and treatment costs along with our ongoing pandemic relief efforts. These relief efforts include the waiver of all cost sharing for in-network primary care, outpatient behavioral health, and telehealth visits for our Medicare Advantage members, delivery of meals to senior members in need, and establishing a clinical outreach team to proactively engage with our most vulnerable members. These decreasescomparisons were further drivenimpacted by the reinstatementtermination in 2021 of the non-deductible health insurance industry fee in 2020 which, along with a portion of the related tax benefit, was contemplated in the pricing and benefit design of our products.products, as well as the impact in 2021 associated with the competitive nature of the group Medicare Advantage business, particularly in large group accounts that were recently procured, as well as in the stand-alone PDP business. These factors were partially offset by higher favorable prior-period medical claims reserve development.
The Retail segment's benefits expense for the 20202021 quarter included $33includes $156 million in unfavorablefavorable prior-period medical claims reserve development versus $28$33 million in unfavorable prior-period medical claims development in the 2020 quarter. For the 2021 period, the Retail segment’s benefit expense includes the beneficial effect of $619 million in favorable prior-period medical claims reserve development in the 2019 quarter. For the 2020 period, the Retail segment’s benefit expense includes the beneficial effect ofversus $205 million in favorable prior-period reserve development versus $311 million in the 2019 period.2020 period. Prior-period medical claims reserve development decreased the Retail segment's benefit ratio by approximately 80 basis points in the 2021 quarter but increased the Retail segmentsegment's benefit ratio by approximately 20 basis points in the 2020 quarter, but decreased the benefit ratio by approximately 20 basis points in the 2019 quarter. Favorable prior-period medical claims reserve
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development decreased the Retail segment benefit ratio by approximately 170 basis points in the 2021 period versus approximately 60 basis points in the 2020 period versus approximately 110 basis points in the 2019 period.
We experienced negative prior-period medical claims reserve development for the 2020 quarter as a result of the suspension of certain financial recovery programs for a period of time in the quarter. The suspension was intended to provide financial and administrative relief for providers facing unprecedented strain during the COVID-19 pandemic. We anticipate that we will recover some of the amounts associated with the temporary suspension in the latter half of 2020 and in 2021.
Operating Costs
The Retail segment operating cost ratio increased 120decreased 140 basis points from 8.5% for the 2019 quarter to 9.7% for the 2020 quarter to 8.3% for the 2021 quarter and increased 100decreased 140 basis points from 8.4% for the 2019 period to 9.4% for the 2020 period to 8.0% for the 2021 period. These increasesdecreases were primarily due to the reinstatementtermination of the non-deductible health insurance industry fee in 2020 and2021, lower COVID-19 related administrative costs in the 2021 quarter, as previously discussed, partially offset by scale efficiencies associated with growth in our individual Medicare Advantage membership, and significant operating cost efficiencies in the 20202021 quarter driven by previously disclosedimplemented productivity initiatives. These improvements were partially offset by continued strategic investments made to position us for long-term success. The non-deductible health insurance industry fee impacted the operating cost ratio by 160 basis points in the 2020 quarter and period.
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Group and Specialty Segment
June 30,ChangeJune 30,Change
20202019MembersPercentage20212020MembersPercentage
Membership:Membership:Membership:
Medical membership:Medical membership:Medical membership:
Fully-insured commercial groupFully-insured commercial group820,800  942,500  (121,700) (12.9)%Fully-insured commercial group706,100 820,800 (114,700)(14.0)%
ASOASO506,200  496,000  10,200  2.1 %ASO497,800 506,200 (8,400)(1.7)%
Military servicesMilitary services6,033,300  5,971,400  61,900  1.0 %Military services6,038,500 6,033,300 5,200 0.1 %
Total group medical membersTotal group medical members7,360,300  7,409,900  (49,600) (0.7)%Total group medical members7,242,400 7,360,300 (117,900)(1.6)%
Specialty membership (a)Specialty membership (a)5,344,900  5,860,000  (515,100) (8.8)%Specialty membership (a)5,327,500 5,344,900 (17,400)(0.3)%
(a)Specialty products include dental, vision, and other supplemental health. Members included in these products may not be unique to each product since members have the ability to enroll in multiple products.
For the three months ended June 30,Change
20202019DollarsPercentage
(in millions) 
Premiums and Services Revenue:
Premiums:
Fully-insured commercial group$1,208  $1,284  $(76) (5.9)%
Group specialty425  387  38  9.8 %
Total premiums1,633  1,671  (38) (2.3)%
Services192  193  (1) (0.5)%
Total premiums and services revenue$1,825  $1,864  $(39) (2.1)%
Segment earnings$287  $ $282  5640.0 %
Benefit ratio67.0 %86.3 %(19.3)%
Operating cost ratio23.8 %21.7 %2.1 %
For the six months ended
June 30,
ChangeFor the three months ended June 30,Change
20202019DollarsPercentage20212020DollarsPercentage
(in millions) (in millions) 
Premiums and Services Revenue:Premiums and Services Revenue:Premiums and Services Revenue:
Premiums:Premiums:Premiums:
Fully-insured commercial groupFully-insured commercial group$2,437  $2,595  $(158) (6.1)%Fully-insured commercial group$1,078 $1,208 $(130)(10.8)%
Group specialtyGroup specialty854  760  94  12.4 %Group specialty432 425 1.6 %
Total premiumsTotal premiums3,291  3,355  (64) (1.9)%Total premiums1,510 1,633 (123)(7.5)%
ServicesServices387  387  —  — %Services194 192 1.0 %
Total premiums and services revenueTotal premiums and services revenue$3,678  $3,742  $(64) (1.7)%Total premiums and services revenue$1,704 $1,825 $(121)(6.6)%
Segment earningsSegment earnings$392  $170  $222  130.6 %Segment earnings$40 $287 $(247)(86.1)%
Benefit ratioBenefit ratio73.1 %81.3 %(8.2)%Benefit ratio82.6 %67.0 %15.6 %
Operating cost ratioOperating cost ratio23.4 %21.8 %1.6 %Operating cost ratio23.9 %23.8 %0.1 %
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For the six months ended
June 30,
Change
20212020DollarsPercentage
(in millions) 
Premiums and Services Revenue:
Premiums:
Fully-insured commercial group$2,177 $2,437 $(260)(10.7)%
Group specialty866 854 12 1.4 %
Total premiums3,043 3,291 (248)(7.5)%
Services384 387 (3)(0.8)%
Total premiums and services revenue$3,427 $3,678 $(251)(6.8)%
Segment earnings$214 $392 $(178)(45.4)%
Benefit ratio78.6 %73.1 %5.5 %
Operating cost ratio23.4 %23.4 %— %
Segment Earnings
Group and Specialty segment earnings increased $282decreased $247 million, or 86.1%, from $5 million in the 2019 quarter to $287 million in the 2020 quarter and increased $222 million, or 130.6%, from $170to $40 million in the 2019 period to2021 quarter and decreased $178 million, or 45.4%, from $392 million in the 2020 period to $214 million in the 2021 period. These increasesdecreases were primarily due the same factors that led to a lowerthe segment's higher benefit ratio, partially offset by a higher operating cost ratio as more fully described below.ratio.
Enrollment
Fully-insured commercial group medical membership decreased 121,700114,700 members, or 12.9%14.0%, from June 30, 20192020 to June 30, 2020. These anticipated declines primarily reflect2021 reflecting lower membership in small group accounts due in partquoting activity and sales attributable to more small group accounts selecting level-funded ASO products, as well as the loss of certain large group accounts due to disciplined pricing in the competitive environment. Additionally, the declines in membership were modestly impacted by the currentdepressed economic downturn driven byactivity from the COVID-19 pandemic, resultingpartially offset by higher retention of existing customers, particularly in higher unemployment rates and loss of coverage for fully-insured commercial group members.larger groups. The portion of group fully-insured commercial medical membership in small group accounts was approximately 52% at June 30, 2021 and 57% at June 30, 2020 and 61% at June 30, 2019.2020.
Group ASO commercial medical membership increased 10,200membership decreased 8,400 members, or 2.1%1.7%, from June 30, 20192020 to June 30, 2020 reflecting more smal2021. Sl group accounts selecting level-funded ASO products partially offset by the loss of certain large group accounts due to continued discipline in pricing of services for self-funded accounts amid a highly competitive environment and the modest impact from the current economic downturn driven by the COVID_19 pandemic as previously discussed. Smallmall group membership comprised 45% of group ASO medical membership at June 30, 2021 and 45% at June 30, 2020 versus 37% at June 30, 2019.. The membership change reflects intensified competition for small group accounts, partially offset by strong retention among large group accounts.
Military services membership increased 61,9005,200 members, or 1.0%0.1%, from June 30, 20192020 to June 30, 2020.2021. Membership includes military service members, retirees, and their families to whom we are providing healthcare services under the current TRICARE East Region contract.
Specialtypecialty membership decreased 515,10017,400 members, or 8.8%0.3%, from June 30, 20192020 to June 30, 20202021 due primarily dueto the loss of dental and vision groups cross-sold with medical, as reflected in the loss of group fully-insured commercial medical membership described above, as well as the loss of certain group accounts, including one jumbo account, offeringgroups with stand-alone dental and vision products, as well as a modestvision. The decrease also reflects the impact fromof the current economic downturn driven by the COVID-19 pandemic as previously discussed.pandemic.
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Premiums Revenue
Group and Specialty segment premiums decreased $38$123 million, or 2.3%7.5%, from $1.7 billion in the 2019 quarter to $1.6 billion in the 2020 quarter and decreased $64 million, or 1.9%, from $3.4to $1.5 billion in the 2019 period to2021 quarter and decreased $248 million, or 7.5%, from $3.3 billion in the 2020 period. to $3.0 billion in the 2021 period. These decreases were primarily due to the decline in our fully-insured group commercial membership, partially offset by higher stop-loss revenues related to our level-funded ASO accounts resulting from membership growth in this product and higher per member premiums across the fully-insured commercial business.
Services Revenue
Group and Specialty segment services revenue decreased $1increased $2 million, or 0.5%1.0%, from $193 million in the 2019 quarter to $192 million in the 2020 quarter to $194 million in the 2021 quarter and was unchanged atdecreased $3 million, or 0.8%, from $387 million in the 2020 period fromto $384 million in the 20192021 period.
Benefits Expense
The Group and Specialty segment benefit ratio decreased 1,930increased 1,560 basis points from 86.3% in the 2019 quarter to 67.0% in the 2020 quarter to 82.6% in the 2021 quarter and decreased 820increased 550 basis points from 81.3% in the 2019 period to 73.1% in the 2020 period to 78.6% in the 2021 period. These decreasesincreases were primarily due to the result of the previously discussedsignificant impact of the temporary deferral of non-essential care, net of COVID-19 treatment and testing costs and our pandemic relief efforts in the 2020 quarter, amid the COVID-19 pandemic. The temporary reductionpandemic, and the termination in utilization was partially offset by COVID-19 testing and treatment costs along with our ongoing pandemic relief efforts.
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These decreases were further impacted by the reinstatement2021 of the non-deductible health insurance industry fee in 2020 which, along with a portion of the related tax benefit, was contemplated in the pricing and benefit design of our products. These increases were partially offset by higher favorable prior-period medical claims reserve development, as well as deliberate pricing and benefit design efforts to increase profitability and position the commercial business for long-term success.
The Group and Specialty segment's benefits expense included $16$8 million in unfavorablefavorable prior-period medical claims reserve development in the 20202021 quarter versus $20$16 million in the 2019 quarter. This unfavorable prior-period medical claims reserve development in the 2020 quarter. This prior-period medical claims reserve development decreased the Group and Specialty segment benefit ratio by approximately 50 basis points in the 2021 quarter but increased the Group and Specialty segment benefit ratio by approximately 100 basis points in the 2020 quarter and by approximately 120 basis points in the 2019 quarter. The Group and Specialty segment's benefits expense included the effect of a favorable prior-period medical claims reserve development of $100 million in the 2021 period versus $30 million in the 2020 period versus an unfavorable prior-period medical claims reserve development of $36 million in the 2019 period. The favorable prior-periodprior period medical claims reserve development for the 20202021 period decreased the Group and Specialty segment benefit ratio by approximately 330 basis points and 90 basis points and the unfavorable development for the 2019 period increased the Group and Specialty segment benefit ratio 110 basis points.
We experienced negative prior-period medical claims reserve development forin the 2020 quarter as a result of the suspension of certain financial recovery programs for a period of time in the quarter. The suspension was intended to provide financial and administrative relief for providers facing unprecedented strain during the COVID-19 pandemic. We anticipate that we will recover some of the amounts associated with the temporary suspension in the latter half of 2020 and in 2021.period.
Operating Costs
The Group and Specialty segment operating cost ratio increased 21010 basis points from 21.7% for the 2019 quarter to 23.8% for the 2020 quarter and increased 160 basis points from 21.8%to 23.9% for the 2019 period2021 quarter primarily reflecting the continued strategic investments made to 23.4%position us for long-term success. The impact of the 2020 period. These increases were primarily due tostrategic investments was partially offset by the reinstatementtermination of the non-deductible health insurance industry fee in 2020, and2021, lower COVID-19 related administrative costs in 2021, as previously discussed.These increases were partially offset by significantdiscussed, and operating cost efficiencies driven by previously disclosedimplemented productivity initiatives. The Group and Specialty segment operating cost ratio was unchanged from 23.4% for the 2020 period. The non-deductible health insurance industry fee impacted the operating cost ratio by 130 basis points in the 2020 quarter and period.
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Healthcare Services Segment
For the three months ended June 30,ChangeFor the three months ended June 30,Change
20202019DollarsPercentage20212020DollarsPercentage
(in millions)(in millions)
Revenues:Revenues:Revenues:
Services:Services:Services:
Pharmacy solutionsPharmacy solutions$163 $147 $16 10.9 %
Provider servicesProvider services$79  $82  $(3) (3.7)%Provider services97 79 18 22.8 %
Pharmacy solutions147  45  102226.7 %
Clinical care servicesClinical care services26  30  (4) (13.3)%Clinical care services25 26 (1)(3.8)%
Total services revenuesTotal services revenues252  157  95  60.5 %Total services revenues285 252 33 13.1 %
Intersegment revenues:Intersegment revenues:Intersegment revenues:
Pharmacy solutionsPharmacy solutions5,977  5,465  512  9.4 %Pharmacy solutions6,458 5,977 481 8.0 %
Provider servicesProvider services575  602  (27) (4.5)%Provider services642 575 67 11.7 %
Clinical care servicesClinical care services137  162  (25) (15.4)%Clinical care services138 137 0.7 %
Total intersegment revenuesTotal intersegment revenues6,689  6,229  460  7.4 %Total intersegment revenues7,238 6,689 549 8.2 %
Total services and intersegment revenuesTotal services and intersegment revenues$6,941  $6,386  $555  8.7 %Total services and intersegment revenues$7,523 $6,941 $582 8.4 %
Segment earningsSegment earnings$317  $224  $93  41.5 %Segment earnings$311 $317 $(6)(1.9)%
Operating cost ratioOperating cost ratio95.1 %96.1 %(1.0)%Operating cost ratio95.8 %95.1 %0.7 %
For the six months ended
June 30,
Change
20202019DollarsPercentage
(in millions)
Revenues:
Services:
Pharmacy solutions$268  $81  $187  230.9 %
Provider services155  161  (6) (3.7)%
Clinical care services54  71  (17) (23.9)%
Total services revenues477  313  164  52.4 %
Intersegment revenues:
Pharmacy solutions12,117  10,662  1,455  13.6 %
Provider services1,151  1,201  (50) (4.2)%
Clinical care services281  308  (27) (8.8)%
Total intersegment revenues13,549  12,171  1,378  11.3 %
Total services and intersegment revenues$14,026  $12,484  $1,542  12.4 %
Segment earnings$567  $399  $168  42.1 %
Operating cost ratio95.6 %96.3 %(0.7)%




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For the six months ended
June 30,
Change
20212020DollarsPercentage
(in millions)
Revenues:
Services:
Pharmacy solutions$319 $268 $51 19.0 %
Provider services188 155 33 21.3 %
Clinical care services49 54 (5)(9.3)%
Total services revenues556 477 79 16.6 %
Intersegment revenues:
Pharmacy solutions12,675 12,117 558 4.6 %
Provider services1,228 1,151 77 6.7 %
Clinical care services261 281 (20)(7.1)%
Total intersegment revenues14,164 13,549 615 4.5 %
Total services and intersegment revenues$14,720 $14,026 $694 4.9 %
Segment earnings$580 $567 $13 2.3 %
Operating cost ratio95.9 %95.6 %0.3 %
Segment Earnings
Healthcare Services segment earnings increased $93decreased $6 million, or 41.5%1.9%, from $224 million in the 2019 quarter to $317 million in the 2020 quarter and increased $168 million, or 42.1%, from $399 to $311 million in the 2019 period2021 quarter resulting from the same factors that led to the segment's increased operating cost ratio in the 2021 quarter, partially offset by higher earnings from equity method investments. Healthcare Services segment earnings increased $13 million, or 2.3%, from $567 million in the 2020 period. These increases wereperiod
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to $580 million in the 2021 period primarily due to improved operating performance in the provider business, as well as higher earnings from our pharmacy operations, as well as operational improvements and reduced utilization resulting from COVID-19 in our provider services business.equity method investments.
Script Volume
Humana Pharmacy Solutions script volumes on an adjusted 30-day equivalent basis increased to approximately 129 million in the 2021 quarter, up 11.2%, versus scripts of approximately 116 million in the 2020 quarter,quarter. For the 2021 period, script volumes increased to approximately 255 million, up 2.7%7.8%, versus scripts of approximately 113236 million in the 2019 quarter. For the 2020 period, script volumes increased to approximately 236 million, up 5.8%, versus scripts of approximately 223 million in the 2019 period. These increases were primarily due to the growth associated with higher individual Medicare Advantage and state-based contracts membership, along withpartially offset by the decline in stand-alone PDP and group Medicare Advantage membership and the impact of early prescription refills in the second quarter of 2020 as members prepared for extended supply needs in response to COVID-19. These increases were partially offset by the decline in stand-alone PDP membership.COVID-19 restrictions.
Services Revenues
Services revenues increased $95$33 million, or 60.5%13.1%, from $157 million in the 2019 quarter to $252 million in the 2020 quarter and increased $164 million, or 52.4%, from $313to $285 million in the 2019 period to2021 quarter and increased $79 million, or 16.6%, from $477 million in the 2020 period to $556 million in the 2021 period. These increases were primarily due to thehigher revenues associated with our pharmacy and provider businesses. The 2021 period further reflects additional pharmacy revenues associated with the acquisition of Enclara inwhich was closed during the 2020 period.first quarter of 2020.
Intersegment Revenues
Intersegment revenues increased $460$549 million, or 7.4%8.2%, from $6.2 billion in the 2019 quarter to $6.7$6.69 billion in the 2020 quarter and increased $1.4 billion, or 11.3%, from $12.2to $7.24 billion in the 2019 period to2021 quarter and increased $615 million, or 4.5%, from $13.5 billion in the 2020 period to $14.2 billion in the 2021 period. These increases were primarilyprimarily due to strongindividual Medicare Advantage and state-based contracts membership growth, and an increase in pharmacyas well as higher revenues as a result of members being allowed early prescription refills to permit them to prepare for extended supply needs in response to COVID-19, alongassociated with a modest shift by members to 90-day mail supply.our provider business. These increases were partially offset by the loss of intersegment revenues associated with the decline in stand-alone PDP membership.and group Medicare Advantage membership as previously discussed and the impact of increased pharmacy revenues in the 2020 quarter as a result of allowing early prescription refills to permit our members to prepare for extended supply needs due to COVID-19 restrictions.
Operating Costs
The Healthcare Services segment operating cost ratio decreased 100increased 70 basis points from 96.1% for the 2019 quarter to 95.1% for the 2020 quarter to 95.8% for the 2021 quarter and decreased 70increased 30 basis points from 96.3% for the 2019 period to 95.6% for the 2020 period to 95.9% for the 2021 period. These decreases were primarilyincreases reflect increased administrative costs in the pharmacy operations as a result of operational improvementsincremental spend to accelerate growth within the business, additional shipping costs incurred in pharmacy operations to ensure members' timely receipt of prescriptions, and reducedincreased utilization resulting from COVID-19levels in our provider services business as well as significant operating cost efficiencies in 2021 compared to depressed levels in 2020 amid the 2020 quarter driven by previously disclosed productivity initiatives.COVID-19 pandemic. These improvementsincreases were partially offset by the impact on the 2020 ratios associated with COVID-19 administrative related costs, including expenses associated with additional safety measures taken for our pharmacy, provider, and clinical teams who have continued to provide services to members duringthroughout the pandemic.crisis, as well as operational improvement in our provider services business, largely related to Conviva, along with operating cost efficiencies driven by previously implemented productivity initiatives in 2021. The 2021 period was further impacted by pharmacy labor-related overtime costs due to weather disruptions occurring in the first quarter of 2021.

Liquidity
Historically, our primary sources of cash have included receipts of premiums, services revenue, and investment and other income, as well as proceeds from the sale or maturity of our investment securities, and borrowings. Our primary uses of cash historically have included disbursements for claims payments, operating costs, interest on borrowings, taxes, purchases of investment securities, acquisitions, capital expenditures, repayments on borrowings,
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dividends, and share repurchases. Because premiums generally are collected in advance of claim payments by a period of up to several months, our business normally should produce positive cash flows during periods of increasing premiums and enrollment. Conversely, cash flows would be negatively impacted during periods of
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decreasing premiums and enrollment. From period to period, our cash flows may also be affected by the timing of working capital items including premiums receivable, benefits payable, and other receivables and payables. Our cash flows are impacted by the timing of payments to and receipts from CMS associated with Medicare Part D subsidies for which we do not assume risk. The use of cash flows may be limited by regulatory requirements of state departments of insurance (or comparable state regulators) which require, among other items, that our regulated subsidiaries maintain minimum levels of capital and seek approval before paying dividends from the subsidiaries to the parent. Our use of cash flows derived from our non-insurance subsidiaries, such as in our Healthcare Services segment, is generally not restricted by state departments of insurance (or comparable state regulators).
For additional information on our liquidity risk, please refer to the section entitled “Risk Factors” in our 20192020 Form 10-K and Item 1A of Part II of this document.     
Cash and cash equivalents increaseddecreased to approximately $7.2$3.4 billion at June 30, 20202021 from $4.1$4.7 billion at December 31, 2019.2020. The change in cash and cash equivalents for the six months ended June 30, 20202021 and 20192020 is summarized as follows:
Six Months Ended
20202019
 (in millions)
Net cash provided by operating activities$3,541  $2,330  
Net cash (used in) provided by investing activities(2,862) 89  
Net cash provided by financing activities2,430  16  
Increase in cash and cash equivalents$3,109  $2,435  
Six Months Ended
20212020
 (in millions)
Net cash (used in) provided by operating activities$(477)$3,541 
Net cash used in investing activities(2,203)(2,862)
Net cash provided by financing activities1,385 2,430 
(Decrease) increase in cash and cash equivalents$(1,295)$3,109 
Cash Flow from Operating Activities
Our operatingCash flows used in operations of $477 million in the 2021 period decreased $4.0 billion from cash flows forprovided by operations of $3.5 billion in the 2020 period increased from the 2019 periodprimarily due to higher income from operations and the timingnegative impact of working capital items and lower earnings in the 2021 period compared to the 2020 period. Our 2021 period operating cash flows were significantly impacted by changes to working capital levels, primarily related to benefits payable, including higheras a result of prior year disruptions caused by COVID-19. These impacts include paying down claims inventory and capitation for provider surplus accruals from our risk sharing arrangements, andamounts earned in 2020 as well as additional provider support. Further, quarterly tax payment estimates typically paid in the delayed payment of estimated second quarter of 2020 federal income taxes untilperiod were deferred to the third quarter of 2020 in accordance with the CARES Act. These favorable working capital items were partially offset by the timing of the mid-year Medicare risk adjustment premium revenue collections that were received in July 2020 versus the the second quarter in 2019.due to COVID-19.
The most significant drivers of changes in our working capital are typically the timing of payments of benefits expense and receipts for premiums. We illustrate these changes with the following summaries of benefits payable and receivables.







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The detail of benefits payable was as follows at June 30, 20202021 and December 31, 2019:2020:
June 30, 2020December 31, 20192020
Period
Change
2019
Period
Change
June 30, 2021December 31, 20202021
Period
Change
2020
Period
Change
(in millions) (in millions)
IBNR (1)IBNR (1)$4,848  $4,150  $698  $327  IBNR (1)$5,419 $5,290 $129 $698 
Reported claims in process (2)Reported claims in process (2)959  628  331  307  Reported claims in process (2)1,244 816 428 331 
Other benefits payable (3)Other benefits payable (3)2,173  1,226  947  346  Other benefits payable (3)1,822 2,037 (215)947 
Total benefits payableTotal benefits payable$7,980  $6,004  $1,976  $980  Total benefits payable$8,485 $8,143 $342 $1,976 
Payables from acquisitionPayables from acquisition(42)— 
Change in benefits payable per cash flow
statement resulting in cash from operations
Change in benefits payable per cash flow
statement resulting in cash from operations
$300 $1,976 
(1)IBNR represents an estimate of benefits payable for claims incurred but not reported (IBNR) at the balance sheet date and includes unprocessed claim inventories. The level of IBNR is primarily impacted by membership levels, medical claim trends and the receipt cycle time, which represents the length of time between when a claim is initially incurred and when the claim form is received and processed (i.e. a shorter time span results in a lower IBNR). IBNR includes unprocessed claims inventories.
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(2)Reported claims in process represents the estimated valuation of processed claims that are in the post claim adjudication process, which consists of administrative functions such as audit and check batching and handling, as well as amounts owed to our pharmacy benefit administrator which fluctuate due to bi-weekly payments and the month-end cutoff.
(3)Other benefits payable primarily include amounts owed to providers under capitated and risk sharing arrangements.
The increase in benefits payable from December 31, 2019 to June 30, 2020in 2021 was primarily due to an increase in amounts owed to providers under the capitatedreported claims in process and risk sharing arrangements which were affectedhigher IBNR, partially offset by the response to COVID-19 and resulting deferralreduction in capitation accruals. Higher reported claims in process was a function of care impact on medical claims reserves. In addition, the increases in benefits payable from December 31, 2019 to June 30, 2020 and from December 31, 2018 to June 30, 2019 were due to an increase inmonth-end cutoff. IBNR increased primarily as a result of individual Medicare Advantage membership growth and an increasepartially offset by paying down claim inventories. The 2020 period was significantly impacted by higher capitation accruals as significantly lower utilization caused by COVID-19 resulted in the amount of processed but unpaid claims which fluctuate duehigher surplus accruals to month-end cutoff.providers.
The detail of total net receivables was as follows at June 30, 20202021 and December 31, 2019:2020:
June 30, 2020December 31, 20192020
Period
Change
2019
Period
Change
June 30, 2021December 31, 20202021
Period
Change
2020
Period
Change
(in millions) (in millions)
MedicareMedicare$2,014  $835  $1,179  $(139) Medicare$2,153 $928 $1,225 $1,179 
Commercial and otherCommercial and other175  162  13  19  Commercial and other200 122 78 13 
Military servicesMilitary services137  128    Military services163 160 
Allowance for doubtful accountsAllowance for doubtful accounts(88) (69) (19)  Allowance for doubtful accounts(78)(72)(6)(19)
Total net receivablesTotal net receivables$2,238  $1,056  $1,182  $(111) Total net receivables$2,438 $1,138 $1,300 $1,182 
Reconciliation to cash flow statement:Reconciliation to cash flow statement:Reconciliation to cash flow statement:
Receivables from disposition (acquisition) of
business
 (12) 
Receivables from acquisitionReceivables from acquisition(15)
Change in receivables per cash flow
statement resulting in cash from operations
Change in receivables per cash flow
statement resulting in cash from operations
$1,185  $(123) Change in receivables per cash flow
statement resulting in cash from operations
$1,285 $1,185 
The changes in Medicare receivables for the 20
20 period reflects only the final settlement with CMS, whereas the 2019 period reflects both the mid-year and final settlements with CMS. We received the 2020 mid-year settlement in July 2020.
The changes in Medicare receivables for both the 20202021 period and the 20192020 period reflect the typical pattern caused by the timing of accruals and related collections associated with the CMS risk-adjustment model. Significant collections occur with the mid-year and final settlements with CMS in the second and third quarter. We received the 2021 $1.3 billion mid-year settlement in July 2021.
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Cash Flow from Investing Activities
In the first quarterDuring 2021, we acquired various health and wellness related businesses for cash consideration of approximately $325 million, net of cash received.
During 2020, we acquired privately held Enclara Healthcare for cash consideration of approximately $709 million, net of cash received as discussed in Note 3 to the condensed consolidated financial statements.received.

Our ongoing capital expenditures primarily relate to our information technology initiatives, support of services in our provider services operations including medical and administrative facility improvements necessary for activities such as the provision of care to members, claims processing, billing and collections, wellness solutions, care coordination, regulatory compliance and customer service. Total capital expenditures, excluding acquisitions, were $619 million in the 2021 period and $418 million in the 2020 period and $296 million in the 2019 period.

Net purchases of investment securities were $1.3 billion and $1.7 billion in the 2021 and 2020 period, were $1.7 billion as compared to net proceeds from investment securities sales and maturities of $385 million in the 2019 period.

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respectively.
Cash Flow from Financing Activities
Receipts from CMS associated with Medicare Part D claim subsidies for which we do not assume risk were higher than claimsclaim payments by $1.2 billion and $412 million in the 2021 and 2020 period, and $539 million in the 2019 period.respectively.
Under our administrative services only TRICARE contracts, health care costcosts payments for which we do not assume risk exceeded reimbursements from the federal government by $23$2 million and $23 million in the 2021 and 2020 period, and $66respectively.
Net proceeds from the issuance of commercial paper were $508 million in the 20192021 period and $21 million in the 2020 period. The maximum principal amount outstanding at any one time during the 2021 period was $1.3 billion.
In March 2020, we issued $600 million of 4.500% senior notes due April 1, 2025 and $500 million of 4.875% senior notes due April 1, 2030. Our net proceeds, reduced for the underwriters' discount and commission and offering expenses paid as of June 30, 2020 were $1,088 million.
In March 2020, we drew $1 billion on our existing term loan commitment.
We acquired common shares in connection with employee stock plans for an aggregate cost of $33 million in the 2021 period and $25 million in the 2020 period and $10 million in the 2019 period.
Net proceeds from the issuance of commercial paper were $21 million in the 2020 period and net repayments from the issuance of commercial paper were $356 million in the 2019 period. The maximum principal amount outstanding at any one time during the 2020 period was $600 million.
We paid dividends to stockholders of $173 million during the 2021 period and $156 million during the 2020 periodperiod.
In March 2020, we drew $1 billion on our existing term loan commitment, which was repaid in November 2020.

The remainder of the cash used in or provided by financing activities in 2021 and $142 million during2020 primarily resulted from proceeds from stock option exercises and the 2019 period.change in book overdraft.

Future Sources and Uses of Liquidity
Dividends
For a detailed discussion of dividends to stockholders, please refer to Note 10 to the condensed consolidated financial statements.
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Stock Repurchases
For a detailed discussion of stock repurchases, please refer to Note 10 to the condensed consolidated financial statements.
Debt
For a detailed discussion of our debt, including our senior notes, term loan, credit agreement andagreements, commercial paper program, and other short-term borrowings, please refer to Note 12 to the condensed consolidated financial statements.
Acquisitions and DivestituresKindred at Home Acquisition
DuringOn April 27, 2021, we entered into a definitive agreement to acquire the 2020 period, we completed the acquisition of privately held Enclara, one ofremaining 60% interest in KAH, the nation’s largest home health and hospice pharmacyprovider, from TPG and benefit management providersWCAS, two private equity funds, or the Sponsors, for an enterprise value of $8.1 billion, which includes our existing equity value of $2.4 billion associated with our 40% minority ownership interest. KAH has locations in 40 states, providing extensive geographic coverage with approximately 65% overlap with our individual Medicare Advantage membership. The acquisition, which is expected to close in the third quarter of 2021, is subject to customary state and federal regulatory approvals. We expect to fund the approximate $5.7 billion transaction (net of our existing equity stake) through a combination of parent company cash and debt financing.
In April 2021, we entered into a commitment letter with Goldman Sachs Bank USA, or Goldman Sachs, pursuant to which, and subject to the terms and conditions set forth therein, Goldman Sachs committed to lend us up to $3.5 billion under a new senior unsecured 364-day bridge loan facility, or Bridge Loan. If we enter into the Bridge Loan, the proceeds of the Bridge Loan will be used to finance a portion of the cash consideration payable for the KAH transaction. The outstanding Bridge Loan commitments under the commitment letter were reduced to $3.0 billion in connection with the effectiveness of approximately $709the delayed draw term loan credit agreement described below.

In May 2021, we entered into a $500 million netunsecured delayed draw term loan credit agreement. If we draw on the delayed term loan, the proceeds will be used to finance a portion of the cash received. For a detailed discussion of this transaction, please refer to Note 3 toconsideration payable for the condensed consolidated financial statements.KAH transaction.

Liquidity Requirements
We believe our cash balances, investment securities, operating cash flows, and funds available under our credit agreement and our commercial paper program or from other public or private financing sources, taken together, provide adequate resources to fund ongoing operating and regulatory requirements, acquisitions, future expansion opportunities, and capital expenditures for at least the next twelve months, as well as to refinance or repay debt, and repurchase shares.
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Adverse changes in our credit rating may increase the rate of interest we pay and may impact the amount of credit available to us in the future. Our investment-grade credit rating at June 30, 20202021 was BBB+ according to Standard & Poor’s Rating Services, or S&P, and Baa3 according to Moody’s Investors Services, Inc., or Moody’s. A downgrade by S&P to BB+ or by Moody’s to Ba1 triggers an interest rate increase of 25 basis points with respect to $250 million of our senior notes. Successive one notch downgrades increase the interest rate an additional 25 basis points, or annual interest expense by less than $1 million, up to a maximum 100 basis points, or annual interest expense by $3 million.
In addition, we operate as a holding company in a highly regulated industry. Humana Inc., our parent company, is dependent upon dividends and administrative expense reimbursements from our subsidiaries, most of which are subject to regulatory restrictions. We continue to maintain significant levels of aggregate excess statutory capital and surplus in our state-regulated operating subsidiaries. Cash, cash equivalents, and short-term investments at the parent company were $2.5$1.3 billion at June 30, 20202021 compared to $1.4 billion$772 million at December 31, 2019.2020. This increase primarily was due to the net proceedsdividends received from regulated subsidiaries, earnings in non-regulated Healthcare Services subsidiaries, and the issuance of senior notes, proceeds from a term loan, and commercial paper, issuance. The increase was further impacted by regulated subsidiary dividends and non-regulated subsidiary earnings in our Healthcare Services segment. These increases were partially offset by the Enclara acquisition,acquisitions, capital expenditures, cash
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dividends to shareholders, and other working capital changes.contributions to certain subsidiaries. Our use of operating cash derived from our non-insurance subsidiaries, such as our Healthcare Services segment, is generally not restricted by departments of insurance (or comparable state regulators).
Regulatory Requirements
Certain of our subsidiaries operate in states that regulate the payment of dividends, loans, or other cash transfers to Humana Inc., our parent company, and require minimum levels of equity as well as limit investments to approved securities. The amount of dividends that may be paid to Humana Inc. by these subsidiaries, without prior approval by state regulatory authorities, or ordinary dividends, is limited based on the entity’s level of statutory income and statutory capital and surplus. If the dividend, together with other dividends paid within the preceding twelve months, exceeds a specified statutory limit or is paid from sources other than earned surplus, it is generally considered an extraordinary dividend requiring prior regulatory approval. In most states, prior notification is provided before paying a dividend even if approval is not required.
Although minimum required levels of equity are largely based on premium volume, product mix, and the quality of assets held, minimum requirements vary significantly at the state level. Based on the most recently filed statutory financial statements as of March 31, 2020,2021, our state regulated subsidiaries had aggregate statutory capital and surplus of approximately $7.7$10.0 billion, which exceeded aggregate minimum regulatory requirements of $6.3$7.2 billion. The amount of ordinary dividends paid to our parent company was approximately $1.3 billion during the six months ended June 30, 2021 compared to $360 million during the six months ended June 30, 2020 compared to $1.2 billion during the six months ended June 30, 2019. Actual dividends paid may2020. The amount, timing and mix of ordinary and extraordinary dividend payments will vary year over year due to considerationstate regulatory requirements, the level of excess statutory capital and surplus and expected future surplus requirements related to, for example, premium volume and product mix.

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Item 3.    Quantitative and Qualitative Disclosures about Market Risk
Our earnings and financial position are exposed to financial market risk, including those resulting from changes in interest rates.
Interest rate risk also represents a market risk factor affecting our consolidated financial position due to our significant investment portfolio, consisting primarily of fixed maturity securities of investment-grade quality with a weighted average S&P credit rating of AAAA- at June 30, 2020.2021. Our net unrealized position increased $215decreased $247 million from a net unrealized gain position of $211$514 million at December 31, 20192020 to a net unrealized gain position of $426$267 million at June 30, 2020.2021. At June 30, 2020,2021, we had gross unrealized losses of $33$87 million on our investment portfolio primarily due to an increase in market interest rates since the time the securities were purchased. There werewere no material credit allowances duringduring the six months ended June 30, 2020.2021. While we believe that these securities in an unrealized loss will recover in value over time and we currently do not have the intent to sell such securities, given the current market conditions and the significant judgments involved, there is a continuing risk that future declines in fair value may occur and material realized losses from sales or credit allowances may be recorded in future periods.
Duration is the time-weighted average of the present value of the bond portfolio’s cash flow. Duration is indicative of the relationship between changes in fair value and changes in interest rates, providing a general indication of the sensitivity of the fair values of our fixed maturity securities to changes in interest rates. However, actual fair values may differ significantly from estimates based on duration. The average duration of our investment portfolio, including cash and cash equivalents, was approximately 23.6 years as of June 30, 20202021 and approximately 2.53.0 years as of December 31, 2019.2020. The declineincrease in the average duration is reflective of the increaseddecreased holdings of cash and cash equivalents, along with other portfolio management activities. Based on the duration, including cash equivalents, a 1% increase in interest rates would generally decrease the fair value of our securities by approximately $398$619 million at June 30, 2020.2021.

Item 4.    Controls and Procedures
Under the supervision and with the participation of our Chief Executive Officer, or CEO, our Chief Financial Officer, or CFO, and our Principal Accounting Officer, we carried out an evaluation of the effectiveness of the design and operation of our disclosure controls and procedures for the quarter ended June 30, 2020.2021.
Based on our evaluation, our CEO, CFO, and our Principal Accounting Officer concluded that our disclosure controls and procedures are effective to provide reasonable assurance that information the Company is required to disclose in its reports under the Securities Exchange Act of 1934, as amended, is recorded, processed, summarized and reported within the time periods specified in SEC rules and forms, including, without limitation, ensuring that such information is accumulated and communicated to the Company’s management, including its principal executive and principal financial officers, or persons performing similar functions, as appropriate to allow timely decisions regarding required disclosure.
There have been no changes in the Company’s internal control over financial reporting during the quarter ended June 30, 20202021 that have materially affected, or are reasonably likely to materially affect, the Company’s internal control over financial reporting.

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Part II. Other Information

Item 1.     Legal Proceedings
For a description of the legal proceedings pending against us and certain other pending or threatened litigation, investigations, or other matters, see “Legal Proceedings and Certain Regulatory Matters” in Note 13 to the condensed consolidated financial statements beginning on page 2725 of this Form 10-Q.

Item 1A. Risk Factors
In additionThere have been no changes to the other information set forth in this report, you should carefully consider therisk factors discussed in Part I, Item 1A. “Risk factors”included in our Annual Report on2020 Form 10-K for the year ended December 31, 2019, and the risk factor set forth below.

The spread of, and response to, the novel coronavirus, or COVID-19, underscores certain risks we face, including those discussed in our Form 10-K for the fiscal year ended December 31, 2019, and the rapid development and fluidity of this situation precludes any prediction as to the ultimate adverse impact to us of COVID-19.

In December 2019, a novel strain of coronavirus (COVID-19) was reported to have surfaced in Wuhan, China. COVID-19 has since spread to over 200 countries, including every state in the United States. On March 11, 2020 the World Health Organization declared COVID-19 a pandemic, and on March 13, 2020 the United States declared a national emergency with respect to COVID-19. The spread of COVID-19 underscores certain risks we face in our business, including those discussed in our Form 10-K for the fiscal year ended December 31, 2019.

Governmental and non-governmental organizations may not effectively combat the spread and severity of COVID-19, increasing the potential for harm for our members. If the spread of COVID-19 is not contained, the premiums we charge may prove to be insufficient to cover the cost of health care services delivered to our members, which may increase significantly as a result of higher utilization rates of medical facilities and services and other increases in associated hospital and pharmaceutical costs. Over time, we may also experience increased costs or decreased revenues if, as a result of our members being unable to see their providers due to actions taken to mitigate the spread of COVID-19, we are unable to implement clinical initiatives to manage health care costs and chronic conditions of our members, and appropriately document their risk profiles. In addition, we are offering our members expanded benefit coverage, such as providing full coverage for COVID-19 diagnostic testing and treatment, certain additional coverages have been mandated by governmental action and we are taking actions designed to help provide financial and administrative relief for the health care provider community. Such measures and any further steps taken by us, or governmental action, to continue to respond to and to address the ongoing impact of COVID-19, including further expansion or modification of the services delivered to our members, the adoption or modification or regulatory requirements associated with those services and the costs and challenges associated with ensuring timely compliance with such requirements, further relief for the health care provider community, or in connection with the relaxation of stay-at-home and physical distancing orders and other restrictions on movement and economic activity, including the potential for widespread testing as a component of lifting these measures, could adversely impact our profitability.
The spread and impact of COVID-19, or actions taken to mitigate this spread, could have material and adverse effects on our ability to operate effectively, including as a result of the complete or partial closure of facilities or labor shortages. Disruptions in public and private infrastructure, including communications, availability of in-person sales and marketing channels, financial services and supply chains, could materially and adversely disrupt our normal business operations. We have transitioned a significant subset of our employee population to a remote work environment in an effort to mitigate the
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spread of COVID-19, as have a number of our third-party service providers, which may exacerbate certain risks to our business, including an increased demand for information technology resources, increased risk of phishing and other cybersecurity attacks, and increased risk of unauthorized dissemination of sensitive personal information or proprietary or confidential information about us or our members or other third-parties. The outbreak of COVID-19 has severely impacted global economic activity, including the businesses of some of our commercial customers, and caused significant volatility and negative pressure in the financial markets. In addition to disrupting our operations, these developments may adversely affect the timing of commercial customer premium collections and corresponding claim payments, the value of our investment portfolio, or future liquidity needs.

The rapid development and fluidity of this situation precludes any prediction as to the ultimate adverse impact to us of COVID-19. We are continuing to monitor the spread of COVID-19, changes to our benefit coverages, the ongoing costs and business impacts of dealing with COVID-19, including the potential costs and impacts associated with lifting, or reimposing restrictions on movement and economic activity and ultimately a vaccine, and related risks. The magnitude and duration of the pandemic and its ultimate impact on our business, results of operations, financial position, and cash flows is uncertain as this continues to evolve globally, but such impacts could be material to our business, results of operations, financial position and cash flows.10-K.


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Item 2:2.     Unregistered Sales of Equity Securities and Use of Proceeds
(a)None.
(b)N/A
(c)The following table provides information about our purchases of equity securities that are registered by us pursuant to Section 12 of the Securities Exchange Act of 1934, as amended, during the three months ended June 30, 2020:2021:
PeriodTotal Number
of Shares
Purchased (1)(2)
Average
Price Paid
per Share
Total Number of
Shares Purchased
as Part of Publicly
Announced Plans
or Programs (1)(2)
Dollar Value of
Shares that May
Yet Be Purchased
Under the Plans
or Programs (1)
April 20202021— $— — $— 
May 20202021— — — — 
June 20202021— — — — 
Total— $— — 
(1)On December 22, 2020, we entered into separate accelerated stock repurchase agreements, ("the December 2020 ASR Agreements"), with Citibank, N.A., or Citi, and JPMorgan Chase Bank, or JPM, to repurchase $1.75 billion of our common stock as part of the $3 billion repurchase program authorized by the Board of Directors on July 30, 2019,2019. On December 23, 2020, in accordance with the December 2020 ASR Agreements, we made a payment of $1.75 billion ($875 million to Citi and $875 million to JPM) and received an initial delivery of 3.8 million shares of our common stock (1.9 million shares each from Citi and JPM). We recorded the payments to Citi and JPM as a reduction to stockholders’ equity, consisting of an $1.5 billion increase in treasury stock, which reflects the value of the initial 3.8 million shares received upon initial settlement, and a $262.5 million decrease in capital in excess of par value, which reflects the value of stock held back by Citi and JPM pending final settlement of the December 2020 ASR Agreements. Upon final settlement of the December 2020 ASR agreements with Citi and JPM on May 4, 2021 and May 5, 2021, respectively, we received an additional 0.3 million shares and 0.3 million shares, respectively, as determined by the average daily volume weighted-averages share price of our common stock during the term of the agreement, less a discount, of $400.07 and 401.49, respectively, bringing the total shares received under the December 2020 ASR agreements to 4.4 million. In addition, upon settlement we reclassified the $262.5 million value of stock initially held back by Citi and JPM from capital in excess of par value to treasury stock. On February 18, 2021, the Board of Directors replaced athe previous share repurchase authorization of up to $3 billion (of which approximately $250 million remained unused) with a new authorization for repurchases of up to $3 billion of our common shares exclusive of shares repurchased in connection with employee stock plans, expiring on June 30, 2022.as of February 18, 2024. Under our share repurchase authorization, shares may be purchased from time to time at prevailing prices in the open market, by block purchases, through plans designed to comply with Rule 10b5-1 under the Securities Exchange Act of 1934, as amended, or in privately-negotiated transactions (including pursuant to accelerated share repurchase agreements with investment banks), subject to certain regulatory restrictions on volume, pricing, and timing. Our remaining repurchase authorization was approximately $23 billion as of August 4, 2020.July 27, 2021.
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(2)Excludes 80,00090,000 shares repurchased in connection with employee stock plans.

Item 3:3.     Defaults Upon Senior Securities
None.

Item 4:4.     Mine Safety Disclosures
Not applicable.

Item 5:5.     Other Information
None.
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Item 6:     Exhibits
3(i)Restated Certificate of Incorporation of Humana Inc. filed with the Secretary of State of Delaware on November 9, 1989, as restated to incorporate the amendment of January 9, 1992, and the correction of March 23, 1992 (incorporated herein by reference to Exhibit 4(i) to Humana Inc.’s Post-Effective Amendment No. 1 to the Registration Statement on Form S-8 (Reg. No. 33-49305) filed February 2, 1994).
By-Laws of Humana Inc., as amended on December 14, 2017 (incorporated herein by reference to Exhibit 3(b) to Humana Inc.’s Current Report on Form 8-K, filed December 14, 2017).
Five-Year $2.5 Billion Amended and Restated Credit Agreement, dated as of June 4, 2021, among Humana Inc., and JPMorgan Chase Bank, N.A. as Agent and as CAF Loan Agent, Bank of America, N.A. and Goldman Sachs Bank USA as Syndication Agents, Citibank, N.A., PNC Bank, National Association, U.S. Bank National Association and Wells Fargo Securities, LLC, as Documentation Agents, and JPMorgan Chase Bank, N.A., BofA Securities, Inc., Goldman Sachs Bank USA, Citigroup Global Markets, Inc., PNC Capital Markets LLC, U.S. Bank National Association and Wells Fargo Securities, LLC, as Joint-Lead Arrangers and Joint Bookrunners (incorporated herein by reference to Exhibit 10 to Humana Inc.’s Current Report on Form 8-K filed on June 4, 2021).
364-Day $1.5 Billion Revolving Credit Agreement, dated as of June 4, 2021, among Humana Inc., and JPMorgan Chase Bank, N.A. as Agent and as CAF Loan Agent, Bank of America, N.A. and Goldman Sachs Bank USA as Syndication Agents, Citibank, N.A., PNC Bank, National Association, U.S. Bank National Association and Wells Fargo Securities, LLC, as Documentation Agents, and JPMorgan Chase Bank, N.A., BofA Securities, Inc., Goldman Sachs Bank USA, Citigroup Global Markets, Inc., PNC Capital Markets LLC, U.S. Bank National Association and Wells Fargo Securities, LLC, as Joint-Lead Arrangers and Joint Bookrunners (incorporated herein by reference to Exhibit 10 to Humana Inc.’s Current Report on Form 8-K filed on June 4, 2021).
$500 Million Delayed Draw Term Loan Credit Agreement, dated as of May 28, 2021, among Humana Inc., and JPMorgan Chase Bank, N.A. as Agent, Bank of America, N.A. and Goldman Sachs Bank USA as Syndication Agents, Citibank, N.A., PNC Capital Markets LLC, Trust Bank, U.S. Bank, National Association and Wells Fargo Securities, LLC, as Documentation Agents, and Goldman Sachs Bank USA, BofA Securities, Inc., JPMorgan Chase Bank, N.A., Citibank, N.A., PNC Capital Markets LLC, Trust Securities, Inc., U.S. Bank National Association and Wells Fargo Securities, LLC, as Joint-Lead Arrangers and Joint Bookrunners (incorporated herein by reference to Exhibit 10 to Humana Inc.’s Current Report on Form 8-K filed on June 4, 2021).
Principal Executive Officer certification pursuant to Section 302 of Sarbanes–Oxley Act of 2002.
Principal Financial Officer certification pursuant to Section 302 of Sarbanes–Oxley Act of 2002.
Principal Executive Officer and Principal Financial Officer certification pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
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101The following materials from Humana Inc.'s Quarterly Report on Form 10-Q formatted in iXBRL (Inline Extensible Business Reporting Language): (i) the Condensed Consolidated Balance Sheets at June 30, 20202021 and December 31, 2019;2020; (ii) the Condensed Consolidated Statements of Income for the three months and six months ended June 30, 20202021 and 2019;2020; (iii) the Condensed Consolidated Statements of Comprehensive Income for the three and six months ended June 30, 20202021 and 2019;2020; (iv) the Consolidated Statements of Equity for the three and six months ended June 30, 20202021 and 2019;2020; (v) the Condensed Consolidated Statements of Cash Flows for the six months ended June 30, 20202021 and 2019;2020; and (vi) Notes to Condensed Consolidated Financial Statements. The instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document.
104Cover Page Interactive Data File formatted in Inline XBRL and contained in Exhibit 101.
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SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
HUMANA INC.
(Registrant)
Date:August 5, 2020July 28, 2021By:/s/ CYNTHIA H. ZIPPERLE
Cynthia H. Zipperle
Senior Vice President, Chief Accounting Officer and Controller (Principal Accounting Officer)
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