Table of Contents


UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 10‑Q

10-Q

QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934


(Mark One)
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the Quarterly Period Endedquarterly period ended September 30, 2017

2020

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

or


TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from to .

_________ to_________


Commission File Number 001‑01011

Image - Image1.gif

Number: 001-01011


cvs-20200930_g1.jpg
CVS HEALTH CORPORATION

(Exact name of registrant as specified in its charter)

Delaware

05‑0494040

Delaware

05-0494040
(State or other jurisdiction of Incorporation)

incorporation or organization)

(I.R.S. Employer Identification Number)

No.)

One CVS Drive, Woonsocket, Rhode Island 02895

(Address

One CVS Drive,Woonsocket,Rhode Island02895
 (Address of principal executive offices) (Zip Code)
Registrant’s telephone number, including area code:     (401)765-1500
Former name, former address and former fiscal year, if changed since last report:N/A
Securities registered pursuant to Section 12(b) of principal executive offices)

Registrant’s telephone number, including area code: (401) 765‑1500

the Act:

Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, par value $0.01 per shareCVSNew 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 and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S‑TS-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post 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‑212b-2 of the Exchange Act.

Large accelerated filer

Accelerated filer

Non-accelerated filer ☐ (Do not check if a smaller reporting company)

Smaller 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.

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 Exchange Act). Yes ☐ No ☒

Common Stock, $0.01 par value,


As of October 28, 2020, the registrant had 1,308,913,498 shares of common stock issued and outstanding at October 31, 2017:

1,012,992,425 shares


outstanding.

Table of Contents


INDEX




Page

Part I

TABLE OF CONTENTS

Page

Part I

Financial Information
Item 1.

3

Condensed Consolidated Statements of Income (Unaudited) – Three and Nine Months Ended September 30, 2017 and 2016

Item 2.
3

Condensed Consolidated Statements of Comprehensive Income (Unaudited) – Three and Nine Months Ended September 30, 2017 and 2016

4

Condensed Consolidated Balance Sheets (Unaudited) – As of September 30, 2017 and December 31, 2016

5

Condensed Consolidated Statements of Cash Flows (Unaudited) – Nine Months Ended September 30, 2017 and 2016

6

Notes to Condensed Consolidated Financial Statements (Unaudited)

7

Report of Independent Registered Public Accounting Firm

24

Item 2.

Management’s Discussion and Analysis of Financial Condition and Results of Operations

25

Item 3.

42

Item 4.

42

Part II

Other Information
43

Item 1.

43

Item 1A.

Item 2.

43

Item 3

Item 6.

Exhibits

4.
44

Item 5.

Item 6.

45




Form 10-Q Table of Contents

Part I.Financial Information

Item 1.Financial Statements

Index to Condensed Consolidated Financial Statements

Part I

Item 1

Page
Condensed Consolidated Statements of Operations (Unaudited) for the three and nine months ended September 30, 2020 and 2019
Condensed Consolidated Statements of Comprehensive Income (Unaudited) for the three and nine months ended September 30, 2020 and 2019
Condensed Consolidated Balance Sheets (Unaudited) as of September 30, 2020 and December 31, 2019
Condensed Consolidated Statements of Cash Flows (Unaudited) for the nine months ended September 30, 2020 and 2019
Condensed Consolidated Statements of Shareholders’ Equity (Unaudited) for the three months ended September 30, 2020 and 2019, the three months ended June 30, 2020 and 2019 and the three months ended March 31, 2020 and 2019
Notes to Condensed Consolidated Financial Statements (Unaudited)
Report of Independent Registered Public Accounting Firm



1

Index to Condensed Consolidated Financial Statements
CVS Health Corporation

Condensed Consolidated Statements of Income

Operations

(Unaudited)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Nine Months Ended

 

 

September 30, 

 

September 30, 

In millions, except per share amounts

    

2017

    

2016

    

2017

    

2016

 

 

 

 

 

 

 

 

 

 

 

 

 

Net revenues

 

$

46,181

 

$

44,615

 

$

136,380

 

$

131,555

Cost of revenues

 

 

39,055

 

 

37,123

 

 

115,739

 

 

110,304

Gross profit

 

 

7,126

 

 

7,492

 

 

20,641

 

 

21,251

Operating expenses

 

 

4,627

 

 

4,668

 

 

14,232

 

 

13,885

Operating profit

 

 

2,499

 

 

2,824

 

 

6,409

 

 

7,366

Interest expense, net

 

 

245

 

 

253

 

 

744

 

 

816

Loss on early extinguishment of debt

 

 

 —

 

 

101

 

 

 —

 

 

643

Other expense

 

 

192

 

 

 7

 

 

206

 

 

23

Income before income tax provision

 

 

2,062

 

 

2,463

 

 

5,459

 

 

5,884

Income tax provision

 

 

777

 

 

921

 

 

2,115

 

 

2,271

Income from continuing operations

 

 

1,285

 

 

1,542

 

 

3,344

 

 

3,613

Loss from discontinued operations, net of tax

 

 

 —

 

 

(1)

 

 

(8)

 

 

(1)

Net income

 

 

1,285

 

 

1,541

 

 

3,336

 

 

3,612

Net income attributable to noncontrolling interest

 

 

 —

 

 

(1)

 

 

(1)

 

 

(2)

Net income attributable to CVS Health

 

$

1,285

 

$

1,540

 

$

3,335

 

$

3,610

 

 

 

 

 

 

 

 

 

 

 

 

 

Basic earnings per share:

 

 

 

 

 

 

 

 

 

 

 

 

Income from continuing operations attributable to CVS Health

 

$

1.26

 

$

1.44

 

$

3.26

 

$

3.34

Loss from discontinued operations attributable to CVS Health

 

$

 —

 

$

 —

 

$

(0.01)

 

$

 —

Net income attributable to CVS Health

 

$

1.26

 

$

1.44

 

$

3.25

 

$

3.34

Weighted average shares outstanding

 

 

1,016

 

 

1,068

 

 

1,022

 

 

1,076

Diluted earnings per share:

 

 

 

 

 

 

 

 

 

 

 

 

Income from continuing operations attributable to CVS Health

 

$

1.26

 

$

1.43

 

$

3.25

 

$

3.32

Loss from discontinued operations attributable to CVS Health

 

$

 —

 

$

 —

 

$

(0.01)

 

$

 —

Net income attributable to CVS Health

 

$

1.26

 

$

1.43

 

$

3.24

 

$

3.32

Weighted average shares outstanding

 

 

1,020

 

 

1,073

 

 

1,026

 

 

1,082

Dividends declared per share

 

$

0.50

 

$

0.425

 

$

1.50

 

$

1.275

Three Months Ended
September 30,
Nine Months Ended
September 30,
In millions, except per share amounts2020201920202019
Revenues:
Products$47,738 $47,149 $141,096 $136,023 
Premiums17,182 15,539 51,749 47,612 
Services1,932 1,859 5,757 5,447 
Net investment income204 263 550 805 
Total revenues67,056 64,810 199,152 189,887 
Operating costs:
Cost of products sold40,940 40,437 121,529 116,654 
Benefit costs14,396 12,850 40,534 39,396 
Operating expenses8,471 8,595 25,702 24,887 
Total operating costs63,807 61,882 187,765 180,937 
Operating income3,249 2,928 11,387 8,950 
Interest expense731 747 2,229 2,301 
Loss on early extinguishment of debt766 79 766 79 
Other income(54)(31)(153)(93)
Income before income tax provision1,806 2,133 8,545 6,663 
Income tax provision587 604 2,328 1,776 
Net income1,219 1,529 6,217 4,887 
Net (income) loss attributable to noncontrolling interests(11)
Net income attributable to CVS Health$1,224 $1,530 $6,206 $4,887 
Net income per share attributable to CVS Health:
Basic$0.93 $1.17 $4.74 $3.76 
Diluted$0.93 $1.17 $4.72 $3.75 
Weighted average shares outstanding:
Basic1,310 1,302 1,308 1,300 
Diluted1,315 1,305 1,314 1,303 
Dividends declared per share$0.50 $0.50 $1.50 $1.50 


See accompanying notes to condensed consolidated financial statements.

statements (unaudited).

3

2

Table of ContentsIndex to Condensed Consolidated Financial Statements

CVS Health Corporation

Condensed Consolidated Statements of Comprehensive Income

(Unaudited)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended September 30, 

 

Nine Months Ended September 30, 

In millions

    

2017

    

2016

    

2017

    

2016

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income

 

$

1,285

 

$

1,541

 

$

3,336

 

$

3,612

Other comprehensive income:

 

 

 

 

 

 

 

 

 

 

 

 

Foreign currency translation adjustments, net of tax

 

 

 8

 

 

(3)

 

 

 6

 

 

37

Net cash flow hedges, net of tax

 

 

 —

 

 

 1

 

 

 1

 

 

 2

Pension and other postretirement benefits, net of tax

 

 

151

 

 

 —

 

 

151

 

 

 —

Total other comprehensive income (loss)

 

 

159

 

 

(2)

 

 

158

 

 

39

Comprehensive income

 

 

1,444

 

 

1,539

 

 

3,494

 

 

3,651

Comprehensive income attributable to noncontrolling interest

 

 

 —

 

 

(1)

 

 

(1)

 

 

(2)

Comprehensive income attributable to CVS Health

 

$

1,444

 

$

1,538

 

$

3,493

 

$

3,649

Three Months Ended
September 30,
Nine Months Ended
September 30,
In millions2020201920202019
Net income$1,219 $1,529 $6,217 $4,887 
Other comprehensive income, net of tax:
Net unrealized investment gains44 136 257 721 
Foreign currency translation adjustments153 (5)157 
Net cash flow hedges(3)(23)(15)(30)
Pension and other postretirement benefits(1)
Other comprehensive income42 266 236 848 
Comprehensive income1,261 1,795 6,453 5,735 
Comprehensive (income) loss attributable to noncontrolling interests(11)
Comprehensive income attributable to CVS Health$1,266 $1,796 $6,442 $5,735 


See accompanying notes to condensed consolidated financial statements.

statements (unaudited).

4

3

Table of ContentsIndex to Condensed Consolidated Financial Statements

CVS Health Corporation

Condensed Consolidated Balance Sheets

(Unaudited)

 

 

 

 

 

 

 

September 30, 

 

December 31, 

In millions, except per share amounts

    

2017

    

2016

In millions, except per share amountsSeptember 30,
2020
December 31,
2019

 

 

 

 

 

 

Assets:

 

 

 

 

 

 

Assets: 

Cash and cash equivalents

 

$

2,485

 

$

3,371

Cash and cash equivalents$9,256 $5,683 

Short-term investments

 

 

75

 

 

87

InvestmentsInvestments2,831 2,373 

Accounts receivable, net

 

 

12,440

 

 

12,164

Accounts receivable, net23,816 19,617 

Inventories

 

 

14,147

 

 

14,760

Inventories17,478 17,516 

Other current assets

 

 

776

 

 

660

Other current assets5,830 5,113 

Total current assets

 

 

29,923

 

 

31,042

Total current assets59,211 50,302 
Long-term investmentsLong-term investments20,216 17,314 

Property and equipment, net

 

 

9,914

 

 

10,175

Property and equipment, net12,349 12,044 
Operating lease right-of-use assetsOperating lease right-of-use assets20,484 20,860 

Goodwill

 

 

38,169

 

 

38,249

Goodwill79,579 79,749 

Intangible assets, net

 

 

13,303

 

 

13,511

Intangible assets, net31,697 33,121 
Separate accounts assetsSeparate accounts assets4,793 4,459 

Other assets

 

 

1,544

 

 

1,485

Other assets4,569 4,600 

Total assets

 

$

92,853

 

$

94,462

Total assets$232,898 $222,449 

 

 

 

 

 

 

Liabilities:

 

 

 

 

 

 

Liabilities:

Accounts payable

 

$

7,899

 

$

7,946

Accounts payable$11,677 $10,492 

Claims and discounts payable

 

 

9,807

 

 

9,451

Pharmacy claims and discounts payablePharmacy claims and discounts payable15,722 13,601 
Health care costs payableHealth care costs payable7,593 6,879 
Policyholders’ fundsPolicyholders’ funds3,964 2,991 

Accrued expenses

 

 

8,404

 

 

6,937

Accrued expenses14,329 12,133 

Short-term debt

 

 

110

 

 

1,874

Other insurance liabilitiesOther insurance liabilities1,527 1,830 
Current portion of operating lease liabilitiesCurrent portion of operating lease liabilities1,789 1,596 

Current portion of long-term debt

 

 

2,293

 

 

42

Current portion of long-term debt5,443 3,781 

Total current liabilities

 

 

28,513

 

 

26,250

Total current liabilities62,044 53,303 
Long-term operating lease liabilitiesLong-term operating lease liabilities18,489 18,926 

Long-term debt

 

 

23,386

 

 

25,615

Long-term debt61,552 64,699 

Deferred income taxes

 

 

4,442

 

 

4,214

Deferred income taxes7,253 7,294 
Separate accounts liabilitiesSeparate accounts liabilities4,793 4,459 
Other long-term insurance liabilitiesOther long-term insurance liabilities7,135 7,436 

Other long-term liabilities

 

 

1,644

 

 

1,549

Other long-term liabilities2,520 2,162 
Total liabilitiesTotal liabilities163,786 158,279 

 

 

 

 

 

 

Shareholders’ equity:

 

 

 

 

 

 

Shareholders’ equity:

CVS Health shareholders’ equity:

 

 

 

 

 

 

Preferred stock, par value $0.01: 0.1 shares authorized; none issued or outstanding

 

 

 

 

Common stock, par value $0.01: 3,200 shares authorized; 1,712 shares issued and 1,013 shares outstanding at September 30, 2017 and 1,705 shares issued and 1,061 shares outstanding at December 31, 2016

 

 

17

 

 

17

Treasury stock, at cost: 698 shares at September 30, 2017 and 643 shares at December 31, 2016

 

 

(37,764)

 

 

(33,452)

Shares held in trust: 1 share at September 30, 2017 and December 31, 2016

 

 

(31)

 

 

(31)

Capital surplus

 

 

32,009

 

 

31,618

Preferred stock, par value $0.01: 0.1 shares authorized; 0ne issued or outstandingPreferred stock, par value $0.01: 0.1 shares authorized; 0ne issued or outstanding
Common stock, par value $0.01: 3,200 shares authorized; 1,732 shares issued and 1,309 shares outstanding at September 30, 2020 and 1,727 shares issued and 1,302 shares outstanding at December 31, 2019 and capital surplusCommon stock, par value $0.01: 3,200 shares authorized; 1,732 shares issued and 1,309 shares outstanding at September 30, 2020 and 1,727 shares issued and 1,302 shares outstanding at December 31, 2019 and capital surplus46,388 45,972 
Treasury stock, at cost: 423 shares at September 30, 2020 and 425 shares at December 31, 2019Treasury stock, at cost: 423 shares at September 30, 2020 and 425 shares at December 31, 2019(28,164)(28,235)

Retained earnings

 

 

40,779

 

 

38,983

Retained earnings49,328 45,108 

Accumulated other comprehensive income (loss)

 

 

(147)

 

 

(305)

Accumulated other comprehensive incomeAccumulated other comprehensive income1,255 1,019 

Total CVS Health shareholders’ equity

 

 

34,863

 

 

36,830

Total CVS Health shareholders’ equity68,807 63,864 

Noncontrolling interest

 

 

 5

 

 

 4

Noncontrolling interestsNoncontrolling interests305 306 

Total shareholders’ equity

 

 

34,868

 

 

36,834

Total shareholders’ equity69,112 64,170 

Total liabilities and shareholders’ equity

 

$

92,853

 

$

94,462

Total liabilities and shareholders’ equity$232,898 $222,449 


See accompanying notes to condensed consolidated financial statements.

statements (unaudited).

5

4

Table of ContentsIndex to Condensed Consolidated Financial Statements

CVS Health Corporation

Condensed Consolidated Statements of Cash Flows
(Unaudited)
Nine Months Ended
September 30,
In millions20202019
Cash flows from operating activities:
Cash receipts from customers$195,554 $184,519 
Cash paid for inventory and prescriptions dispensed by retail network pharmacies(116,590)(109,958)
Insurance benefits paid(40,221)(38,812)
Cash paid to other suppliers and employees(22,185)(21,411)
Interest and investment income received622 756 
Interest paid(2,517)(2,675)
Income taxes paid(2,365)(2,205)
Net cash provided by operating activities12,298 10,214 
Cash flows from investing activities:
Proceeds from sales and maturities of investments3,790 5,616 
Purchases of investments(6,377)(6,011)
Purchases of property and equipment(1,724)(1,890)
Acquisitions (net of cash acquired)(828)(361)
Proceeds from sale of subsidiary834 
Other16 
Net cash used in investing activities(4,300)(2,630)
Cash flows from financing activities:
Net borrowings of short-term debt350 
Proceeds from issuance of long-term debt7,919 3,458 
Repayments of long-term debt(10,493)(8,350)
Derivative settlements(7)(25)
Dividends paid(1,980)(1,952)
Proceeds from exercise of stock options249 183 
Payments for taxes related to net share settlement of equity awards(75)(85)
Other(33)11 
Net cash used in financing activities(4,420)(6,410)
Net increase in cash, cash equivalents and restricted cash3,578 1,174 
Cash, cash equivalents and restricted cash at the beginning of the period5,954 4,295 
Cash, cash equivalents and restricted cash at the end of the period$9,532 $5,469 

5

Index to Condensed Consolidated Financial Statements

CVS Health Corporation
Condensed Consolidated Statements of Cash Flows
(Unaudited)

 

 

 

 

 

 

 

 

 

Nine Months Ended

 

 

September 30, 

In millions

    

2017

    

2016

Cash flows from operating activities:

 

 

 

 

 

 

Cash receipts from customers

 

$

133,055

 

$

128,545

Cash paid for inventory and prescriptions dispensed by retail network pharmacies

 

 

(110,788)

 

 

(106,371)

Cash paid to other suppliers and employees

 

 

(11,230)

 

 

(11,020)

Interest received

 

 

15

 

 

14

Interest paid

 

 

(869)

 

 

(954)

Income taxes paid

 

 

(2,040)

 

 

(2,194)

Net cash provided by operating activities

 

 

8,143

 

 

8,020

 

 

 

 

 

 

 

Cash flows from investing activities:

 

 

 

 

 

 

Purchases of property and equipment

 

 

(1,412)

 

 

(1,607)

Proceeds from sale-leaseback transactions

 

 

265

 

 

230

Proceeds from sale of property and equipment and other assets

 

 

20

 

 

22

Acquisitions (net of cash acquired) and other investments

 

 

(502)

 

 

(333)

Purchase of available-for-sale investments

 

 

 —

 

 

(40)

Maturities of available-for-sale investments

 

 

21

 

 

76

Net cash used in investing activities

 

 

(1,608)

 

 

(1,652)

 

 

 

 

 

 

 

Cash flows from financing activities:

 

 

 

 

 

 

Increase (decrease) in short-term debt

 

 

(1,764)

 

 

340

Proceeds from issuance of long-term debt

 

 

 —

 

 

3,455

Repayments of long-term debt

 

 

 —

 

 

(5,185)

Purchase of noncontrolling interest in subsidiary

 

 

 —

 

 

(39)

Payment of contingent consideration

 

 

 —

 

 

(26)

Dividends paid

 

 

(1,539)

 

 

(1,384)

Proceeds from exercise of stock options

 

 

314

 

 

277

Payments for taxes related to net share settlement of equity awards

 

 

(70)

 

 

(72)

Repurchase of common stock

 

 

(4,361)

 

 

(4,000)

Other

 

 

(1)

 

 

(6)

Net cash used in financing activities

 

 

(7,421)

 

 

(6,640)

Effect of exchange rate changes on cash and cash equivalents

 

 

 

 

 2

Net decrease in cash and cash equivalents

 

 

(886)

 

 

(270)

Cash and cash equivalents at the beginning of the period

 

 

3,371

 

 

2,459

Cash and cash equivalents at the end of the period

 

$

2,485

 

$

2,189

 

 

 

 

 

 

 

Reconciliation of net income to net cash provided by operating activities:

 

 

 

 

 

 

Net income

 

$

3,336

 

$

3,612

Adjustments required to reconcile net income to net cash provided by operating activities:

 

 

 

 

 

 

Depreciation and amortization

 

 

1,857

 

 

1,847

Goodwill impairment

 

 

135

 

 

 —

Losses on settlements of defined benefit pension plans

 

 

187

 

 

 —

Stock-based compensation

 

 

173

 

 

166

Loss on early extinguishment of debt

 

 

 —

 

 

643

Deferred income taxes and other noncash items

 

 

271

 

 

119

Change in operating assets and liabilities, net of effects from acquisitions:

 

 

 

 

 

 

Accounts receivable, net

 

 

(280)

 

 

(1,714)

Inventories

 

 

620

 

 

(337)

Other current assets

 

 

(212)

 

 

 2

Other assets

 

 

(15)

 

 

(86)

Accounts payable and claims and discounts payable

 

 

330

 

 

1,570

Accrued expenses

 

 

1,670

 

 

2,149

Other long-term liabilities

 

 

71

 

 

49

Net cash provided by operating activities

 

$

8,143

 

$

8,020

Nine Months Ended
September 30,
In millions20202019
Reconciliation of net income to net cash provided by operating activities:
Net income$6,217 $4,887 
Adjustments required to reconcile net income to net cash provided by operating activities:
Depreciation and amortization3,302 3,275 
Stock-based compensation288 355 
(Gain) loss on sale of subsidiary(271)205 
Loss on early extinguishment of debt766 79 
Deferred income taxes and other noncash items(25)(38)
Change in operating assets and liabilities, net of effects from acquisitions:
Accounts receivable, net(3,564)(2,312)
Inventories45 413 
Other assets(211)(374)
Accounts payable and pharmacy claims and discounts payable3,495 2,330 
Health care costs payable and other insurance liabilities(474)535 
Other liabilities2,730 859 
Net cash provided by operating activities$12,298 $10,214 


See accompanying notes to condensed consolidated financial statements.

statements (unaudited).


6


Table of ContentsIndex to Condensed Consolidated Financial Statements

CVS Health Corporation

Condensed Consolidated Statements of Shareholders’ Equity
(Unaudited)
Attributable to CVS Health
Number of shares outstanding
Common
Stock and
Capital
Surplus (2)
Treasury
Stock (1)
Retained
Earnings
Accumulated
Other
Comprehensive
Income
Total
CVS Health
Shareholders’
Equity
Noncontrolling
Interests
Total
Shareholders’
Equity
Common
Shares
Treasury
Shares (1)
In millions
Balance at December 31, 20191,727 (425)$45,972 $(28,235)$45,108 $1,019 $63,864 $306 $64,170 
Adoption of new accounting standard (Note 1)— — — — (3)— (3)— (3)
Net income— — — — 2,007 — 2,007 2,012 
Other comprehensive loss— — — — — (332)(332)— (332)
Stock option activity, stock awards and other— 208 — — — 208 — 208 
ESPP issuances, net of purchase of treasury shares— — 53 — — 53 — 53 
Common stock dividends— — — — (657)— (657)— (657)
Other increases in noncontrolling interests— — — — — — — 23 23 
Balance at March 31, 20201,729 (424)46,180 (28,182)46,455 687 65,140 334 65,474 
Net income— — — — 2,975 — 2,975 11 2,986 
Other comprehensive income— — — — — 526 526 — 526 
Stock option activity, stock awards and other— 96 — — — 96 — 96 
Purchase of treasury shares, net of ESPP issuances— (1)— (53)— — (53)— (53)
Common stock dividends— — — — (662)— (662)— (662)
Other decreases in noncontrolling interests— — — — — — — (12)(12)
Balance at June 30, 20201,732 (425)$46,276 $(28,235)$48,768 $1,213 $68,022 $333 $68,355 
Net income (loss)— — — — 1,224 — 1,224 (5)1,219 
Other comprehensive income (Note 8)— — — — — 42 42 — 42 
Stock option activity, stock awards and other— — 112 — — — 112 — 112 
ESPP issuances, net of purchase of treasury shares— — 71 — — 71 — 71 
Common stock dividends— — — — (664)— (664)— (664)
Other decreases in noncontrolling interests— — — — — — — (23)(23)
Balance at September 30, 20201,732 (423)$46,388 $(28,164)$49,328 $1,255 $68,807 $305 $69,112 

(1)Treasury shares include 1 million shares held in trust and treasury stock includes $29 million related to shares held in trust as of September 30, 2020, June 30, 2020, March 31, 2020 and December 31, 2019.
(2)Common stock and capital surplus includes the par value of common stock of $17 million as of September 30, 2020, June 30, 2020, March 31, 2020 and December 31, 2019.
7

Index to Condensed Consolidated Financial Statements
Attributable to CVS Health
Number of shares outstanding
Common
Stock and
Capital
Surplus (2)
Treasury
Stock (1)
Retained
Earnings
Accumulated
Other
Comprehensive
Income
Total
CVS Health
Shareholders’
Equity
Noncontrolling
Interests
Total
Shareholders’
Equity
Common
Shares
Treasury
Shares (1)
In millions
Balance at December 31, 20181,720 (425)$45,440 $(28,228)$40,911 $102 $58,225 $318 $58,543 
Adoption of new accounting standard (3)
— — — — 178 — 178 — 178 
Net income— — — — 1,421 — 1,421 1,427 
Other comprehensive income— — — — — 331 331 — 331 
Stock option activity, stock awards and other— 175 — — — 175 — 175 
ESPP issuances, net of purchase of treasury shares— — — — — 
Common stock dividends— — — — (651)— (651)— (651)
Other decreases in noncontrolling interests— — — — — — — (4)(4)
Balance at March 31, 20191,722 (424)45,615 (28,221)41,859 433 59,686 320 60,006 
Net income (loss)— — — — 1,936 — 1,936 (5)1,931 
Other comprehensive income— — — — — 251 251 — 251 
Stock option activity, stock awards and other— 104 — — — 104 — 104 
Purchase of treasury shares, net of ESPP issuances— (1)— (36)— — (36)— (36)
Common stock dividends— — — — (659)— (659)— (659)
Other increases in noncontrolling interests— — — — — — — 
Balance at June 30, 20191,724 (425)$45,719 $(28,257)$43,136 $684 $61,282 $317 $61,599 
Net income (loss)— — — — 1,530 — 1,530 (1)1,529 
Other comprehensive income (Note 8)— — — — — 266 266 — 266 
Stock option activity, stock awards and other— 135 — — — 135 — 135 
ESPP issuances, net of purchase of treasury shares— — 50 — — 50 — 50 
Common stock dividends— — — — (649)— (649)— (649)
Other increases in noncontrolling interests— — — — — — — 
Balance at September 30, 20191,725 (424)$45,854 $(28,207)$44,017 $950 $62,614 $319 $62,933 

(1)Treasury shares include 1 million shares held in trust and treasury stock includes $29 million related to shares held in trust as of September 30, 2019, June 30, 2019, March 31, 2019 and December 31, 2018.
(2)Common stock and capital surplus includes the par value of common stock of $17 million as of September 30, 2019, June 30, 2019, March 31, 2019 and December 31, 2018.
(3)Reflects the adoption of Accounting Standards Update (“ASU”) 2016-02, Leases (Topic 842), which resulted in an increase to retained earnings of $178 million during the three months ended March 31, 2019.

See accompanying notes to condensed consolidated financial statements (unaudited).

8

Index to Condensed Consolidated Financial Statements
Notes to Condensed Consolidated Financial Statements

(Unaudited)

Note 1 –


1.Significant Accounting Policies


Description of Business 

CVS Health Corporation (“CVS Health”), together with its subsidiaries (collectively, the “Company”), has more than 9,900 retail locations, approximately 1,100 walk-in medical clinics, a leading pharmacy benefits manager with approximately 103 million plan members, a dedicated senior pharmacy care business serving more than 1000000 patients per year and expanding specialty pharmacy services. The Company also serves an estimated 33 million people through traditional, voluntary and consumer-directed health insurance products and related services, including expanding Medicare Advantage offerings and a leading standalone Medicare Part D prescription drug plan (“PDP”). The Company believes its innovative health care model increases access to quality care, delivers better health outcomes and lowers overall health care costs.

The coronavirus disease 2019 (“COVID-19”) pandemic has severely impacted the economies of the U.S. and other countries around the world. The impact of COVID-19 on the Company’s businesses, operating results, cash flows and financial condition in the three and nine months ended September 30, 2020, as well as information regarding certain expected impacts of COVID-19 on the Company, is discussed throughout this Quarterly Report on Form 10-Q.

The Company has 4 reportable segments: Pharmacy Services, Retail/LTC, Health Care Benefits and Corporate/Other, which are described below.

Pharmacy Services Segment
The Pharmacy Services segment provides a full range of pharmacy benefit management (“PBM”) solutions, including plan design offerings and administration, formulary management, retail pharmacy network management services, mail order pharmacy, specialty pharmacy and infusion services, clinical services, disease management services and medical spend management. The Pharmacy Services segment’s clients are primarily employers, insurance companies, unions, government employee groups, health plans, PDPs, Medicaid managed care plans, plans offered on public health insurance exchanges (“Public Exchanges”) and private health insurance exchanges, other sponsors of health benefit plans and individuals throughout the United States. The Pharmacy Services segment operates retail specialty pharmacy stores, specialty mail order pharmacies, mail order dispensing pharmacies, compounding pharmacies and branches for infusion and enteral nutrition services.

Retail/LTC Segment
The Retail/LTC segment sells prescription drugs and a wide assortment of general merchandise, including over-the-counter drugs, beauty products, cosmetics and personal care products, provides health care services through its MinuteClinic®walk-in medical clinics, provides medical diagnostic testing and conducts long-term care pharmacy (“LTC”) operations, which distribute prescription drugs and provide related pharmacy consulting and other ancillary services to long-term care facilities and other care settings. As of September 30, 2020, the Retail/LTC segment operated more than 9,900 retail locations, approximately 1,100 MinuteCliniclocations as well as online retail pharmacy websites, LTC pharmacies and onsite pharmacies.

Health Care Benefits Segment
The Health Care Benefits segment is one of the nation’s leading diversified health care benefits providers. The Health Care Benefits segment has the information and resources to help members, in consultation with their health care professionals, make more informed decisions about their health care. The Health Care Benefits segment offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, medical management capabilities, Medicare Advantage and Medicare Supplement plans, PDPs, Medicaid health care management services and health information technology products and services. The Health Care Benefits segment also provided workers’ compensation administrative services through its Coventry Health Care Workers’ Compensation business (“Workers’ Compensation business”) prior to the sale of this business on July 31, 2020. The Health Care Benefits segment’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers (“providers”), governmental units, government-sponsored plans, labor groups and expatriates. The Company refers to insurance products (where it assumes all or a majority of the risk for medical and dental care costs) as “Insured” and administrative services contract products (where the plan sponsor assumes all or a majority of the risk for medical and dental care costs) as “ASC.”
9


Corporate/Other Segment
The Company presents the remainder of its financial results in the Corporate/Other segment, which consists of:

Management and administrative expenses to support the Company’s overall operations, which include certain aspects of executive management and the corporate relations, legal, compliance, human resources, information technology and finance departments, expenses associated with the Company’s investments in its transformation and enterprise modernization programs and acquisition-related integration costs; and
Products for which the Company no longer solicits or accepts new customers such as its large case pensions and long-term care insurance products.

Basis of Presentation


The accompanying unaudited condensed consolidated financial statements of CVS Health Corporation and its subsidiaries (collectively, “CVS Health” or the “Company”) have been prepared in accordance with the rules and regulations of the U.S. Securities and Exchange Commission (“SEC”(the “SEC”) regarding interim financial reporting. In accordance with such rules and regulations, certain information and accompanying note disclosures normally included in financial statements prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) have been condensed or omitted, although the Company believes the disclosures included herein are adequate to make the information presented not misleading. These unaudited condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto, which are included in Exhibit 13 to the Company’s Annual Report on Form 10‑K10-K for the year ended December 31, 2016 (“20162019 (the “2019 Form 10‑K”10-K”).

In the opinion of management, the accompanying unaudited condensed consolidated financial statements include all adjustments, consisting only of normal recurring adjustments, necessary for a fair presentation of the results for the interim periods presented. Because of the influence of various factors on the Company’s operations, including business combinations, certain holidays and other seasonal influences, net income for any interim period may not be comparable to the same interim period in previous years or necessarily indicative of income for the full year.


Principles of Consolidation


The unaudited condensed consolidated financial statements include the accounts of the Company and its majority-owned subsidiaries and variable interest entities (“VIEs”) for which the Company is the primary beneficiary. All material intercompany balances and transactions have been eliminated.

The Company continually evaluates its investments to determine if they represent variable interests in a VIE. If the Company determines that it has a variable interest in a VIE, the Company then evaluates if it is the primary beneficiary of the VIE. The evaluation is a qualitative assessment as to whether the Company has the ability to direct the activities of a VIE that most significantly impact the entity’s economic performance. The Company consolidates a VIE if it is considered to be the primary beneficiary.


Assets and liabilities of VIEs for which the Company is the primary beneficiary were not significant to the Company’s unaudited condensed consolidated financial statements. VIE creditors do not have recourse against the general credit of the Company.

Fair Value of Financial Instruments

The Company utilizes


Reclassifications

Certain prior year amounts have been reclassified to conform with the three-level valuation hierarchy forcurrent year presentation.

Restricted Cash

Restricted cash included in other assets on the recognition and disclosure of fair value measurements. The categorization of assets and liabilities within this hierarchy is based upon the lowest level of input that is significant to the measurement of fair value. The three levelsunaudited condensed consolidated balance sheets represents amounts held in a trust in one of the hierarchy consistCompany’s captive insurance companies to satisfy collateral requirements associated with the assignment of the following:

·

Level 1 – Inputs to the valuation methodology are unadjusted quoted prices in active markets for identical assets or liabilities that the Company has the ability to access at the measurement date.

·

Level 2 – Inputs to the valuation methodology are quoted prices for similar assets and liabilities in active markets, quoted prices in markets that are not active or inputs that are observable for the asset or liability, either directly or indirectly, for substantially the full term of the instrument.

·

Level 3 – Inputs to the valuation methodology are unobservable inputs based upon management’s best estimate of inputs market participants could use in pricing the asset or liability at the measurement date, including assumptions about risk.

certain insurance policies. All restricted cash is invested in time deposits, money market funds or commercial paper.


7

10



Table of Contents

As of September 30, 2017, the carrying valueThe following is a reconciliation of cash and cash equivalents short-term investments, accounts receivable, accounts payable, andon the contingent consideration liability included in accrued expenses approximated their fair value due to the nature of these financial instruments. The Company invests in money market funds, commercial paper and time deposits that are classified as cash and cash equivalents within the accompanyingunaudited condensed consolidated balance sheets as these fundsto total cash, cash equivalents and restricted cash on the unaudited condensed consolidated statements of cash flows:

In millionsSeptember 30,
2020
December 31,
2019
Cash and cash equivalents$9,256 $5,683 
Restricted cash (included in other assets)276 271 
Total cash, cash equivalents and restricted cash in the statements of cash flows$9,532 $5,954 

Accounts Receivable

Accounts receivable are highly liquidstated net of allowances for credit losses, customer credit allowances, contractual allowances and readily convertible to known amounts of cash. These investments are classified within Level 1estimated terminations. Accounts receivable, net is composed of the fair value hierarchy because they are valued using quoted market prices. following:
In millionsSeptember 30,
2020
December 31,
2019
Trade receivables$7,265 $6,717 
Vendor and manufacturer receivables10,528 7,856 
Premium receivables2,852 2,663 
Other receivables3,171 2,381 
   Total accounts receivable, net$23,816 $19,617 

The Company’s short-term investments of $75allowance for credit losses was $363 million at September 30, 2017 consist of certificates of deposit with initial maturities of greater than three months when purchased that mature within one year from the balance sheet date. These investments, which are classified within Level 1 of the fair value hierarchy, are carried at fair value, which approximated historical cost at September 30, 2017. The carrying amount and estimated fair value of the Company’s total long-term debt was $25.7 billion and $27.0 billion, respectively, as of September 30, 2017. The fair value2020. When developing an estimate of the Company’s long-term debtexpected credit losses, the Company considers all available relevant information regarding the collectability of cash flows, including historical information, current conditions and reasonable and supportable forecasts of future economic conditions over the contractual life of the receivable. The Company’s accounts receivable are short duration in nature and typically settle in less than 30 days. The Company’s allowance for doubtful accounts was estimated$319 million as of December 31, 2019.
11


Revenue Recognition

Disaggregation of Revenue
The following tables disaggregate the Company’s revenue by major source in each segment for the three and nine months ended September 30, 2020 and 2019:
In millionsPharmacy
Services
Retail/
LTC
Health Care
Benefits
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
Three Months Ended September 30, 2020
Major goods/services lines:
Pharmacy$35,505 $17,608 $$$(10,051)$43,062 
Front Store4,740 4,740 
Premiums17,165 17 17,182 
Net investment income121 83 204 
Other206 377 1,412 16 (143)1,868 
Total$35,711 $22,725 $18,698 $116 $(10,194)$67,056 
Pharmacy Services distribution channel:
Pharmacy network (1)
$21,473 
Mail choice (2)
14,032 
Other206 
Total$35,711 
Three Months Ended September 30, 2019
Major goods/services lines:
Pharmacy (3)
$35,872 $16,687 $$$(9,999)$42,560 
Front Store4,614 4,614 
Premiums15,507 32 15,539 
Net investment income146 117 263 
Other (3)
146 165 1,528 (8)1,834 
Total$36,018 $21,466 $17,181 $152 $(10,007)$64,810 
Pharmacy Services distribution channel:
Pharmacy network (1) (3)
$22,411 
Mail choice (2) (3)
13,461 
Other146 
Total$36,018 
12


In millionsPharmacy
Services
Retail/
LTC
Health Care
Benefits
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
Nine Months Ended September 30, 2020
Major goods/services lines:
Pharmacy$104,924 $51,833 $$$(30,032)$126,725 
Front Store14,601 14,601 
Premiums51,699 50 51,749 
Net investment income341 209 550 
Other659 702 4,324 33 (191)5,527 
Total$105,583 $67,136 $56,364 $292 $(30,223)$199,152 
Pharmacy Services distribution channel:
Pharmacy network (1)
$63,109 
Mail choice (2)
41,815 
Other659 
Total$105,583 
Nine Months Ended September 30, 2019
Major goods/services lines:
Pharmacy (3)
$103,983 $49,197 $$$(31,416)$121,764 
Front Store14,288 14,288 
Premiums47,543 69 47,612 
Net investment income458 347 805 
Other (3)
435 543 4,453 (20)5,418 
Total$104,418 $64,028 $52,454 $423 $(31,436)$189,887 
Pharmacy Services distribution channel:
Pharmacy network (1) (3)
$65,917 
Mail choice (2) (3)
38,066 
Other435 
Total$104,418 

(1)Pharmacy Services pharmacy network is defined as claims filled at retail and specialty retail pharmacies, including the Company’s retail pharmacies and LTC pharmacies, but excluding Maintenance Choice® activity, which is included within the mail choice category. Maintenance Choice permits eligible client plan members to fill their maintenance prescriptions through mail order delivery or at a CVS Pharmacy retail store for the same price as mail order.
(2)Pharmacy Services mail choice is defined as claims filled at a Pharmacy Services mail order facility, which includes specialty mail claims inclusive of Specialty Connect® claims picked up at a retail pharmacy, as well as prescriptions filled at the Company’s retail pharmacies under the Maintenance Choice program.
(3)Certain prior year amounts have been reclassified for consistency with the current period presentation.

Contract Balances
Contract liabilities primarily represent the Company’s obligation to transfer additional goods or services to a customer for which the Company has received consideration, and include ExtraBucks® Rewards and unredeemed Company gift cards. The consideration received remains a contract liability until goods or services have been provided to the customer. In addition, the Company recognizes breakage on Company gift cards based on quoted prices currently offeredhistorical redemption patterns.

The following table provides information about receivables and contract liabilities from contracts with customers:
In millionsSeptember 30,
2020
December 31,
2019
Trade receivables (included in accounts receivable, net)$7,265 $6,717 
Contract liabilities (included in accrued expenses)75 73 
13



During the nine months ended September 30, 2020 and 2019, the contract liabilities balance includes increases related to customers’ earnings in active marketsExtraBucksRewards or issuances of Company gift cards and decreases for revenues recognized during the period as a result of the redemption of ExtraBucks Rewards or Company gift cards and breakage of Company gift cards. Below is a summary of such changes:
Nine Months Ended
September 30,
In millions20202019
Contract liabilities, beginning of the period$73 $67 
Rewards earnings and gift card issuances266 269 
Redemption and breakage(264)(264)
Contract liabilities, end of the period$75 $72 

Health Insurer Fee

Since January 1, 2014, the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively, the “ACA”) has imposed an annual premium-based health insurer fee (the “HIF”). The HIF, which is payable each September, is not deductible for federal income tax purposes. There was no expense related to the HIF in the three and nine months ended September 30, 2019, since there was a one-year suspension of the HIF for 2019. In the three and nine months ended September 30, 2020, operating expenses included $255 million and $774 million, respectively, related to the Company’s debt, which is considered Level 1share of the fair value hierarchy.

2020 HIF. The Company paid approximately $1.0 billion, representing the Company’s portion of the non tax-deductible HIF in 2020. In December 2019, the HIF was repealed for calendar years after 2020.


Related Party Transactions


The Company has an equity method investment in SureScripts, LLC (“SureScripts”), which operates a clinical health information network. The Pharmacy Services and Retail/LTC segments utilizeCompany utilizes this clinical health information network in providing services to its client plan members and retail customers. The Company expensed fees for the use of this network of approximately $5 million and $7$14 million in the three months ended September 30, 20172020 and 2016,2019, respectively, and expensed fees for the use of this network of approximately $29$28 million and $26 million in the nine months ended September 30, 20172020 and 2016.2019, respectively. The Company’s investment in and equity in the earnings of SureScripts for all periods presented is immaterial.


The Company has an equity method investment in Heartland Healthcare Services, LLC (“Heartland”). Heartland operates several long-term careLTC pharmacies in four4 states. Heartland paid the Company approximately $36$15 million and $46$20 million for pharmaceutical inventory purchases during the three months ended September 30, 20172020 and 2016,2019, respectively, and approximately $106$58 million and $116$72 million for pharmaceutical inventory purchases during the nine months ended September 30, 20172020 and 2016.2019, respectively. Additionally, the Company performs certain collection functions for Heartland and then passestransfers those customer cash collections back to Heartland. The Company’s investment in and equity in the earnings of Heartland for all periods presented is immaterial.

Discontinued Operations

In connection with certain business dispositions completed between 1991 and 1997, the Company retained guarantees on store lease obligations for a number of former subsidiaries, including Bob’s Stores and Linens ‘n Things, both of which subsequently filed for bankruptcy. See “Note 12 – Commitments and Contingencies” to the condensed consolidated financial statements. The Company’s discontinued operations include lease-related costs which the Company believes it will likely be required to satisfy pursuant to its lease guarantees.


New Accounting Pronouncements Recently Adopted


Measurement of Credit Losses on Financial Instruments
In July 2015,June 2016, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2015-11, Inventory, which amends Accounting Standard Codification (“ASC”) Topic 330.ASU 2016-13, Financial Instruments - Credit Losses (Topic 326). This ASU simplifies current accounting treatments by requiring entitiesstandard requires the use of a forward-looking expected credit loss impairment model for trade and other receivables, held-to-maturity debt securities, loans and other instruments. This standard also requires impairments and recoveries for available-for-sale debt securities to measure most inventories at “the lower of costbe recorded through an allowance account and net realizable value” rather than using lower of cost or market. This guidance does not apply to inventories measured using the last-in, first-out method or the retail inventory method.revises certain disclosure requirements. The Company adopted this new accounting standard effectiveon January 1, 2017.2020. The Company adopted the credit loss impairment model on a modified retrospective basis and recorded a $3 million cumulative effect adjustment to reduce retained earnings as of the adoption date. The Company adopted the available-for-sale debt security impairment model on a prospective basis. The adoption of this new guidancestandard did not have any impact on the Company’s condensed consolidated results of operations, financial position or cash flows.

In March 2016, the FASB issued ASU No. 2016-09, Improvements to Employee Share-Based Payment Accounting, which amends the accounting for certain aspects of shared-based payments to employees in ASC Topic 718, Compensation - Stock Compensation. The new guidance eliminates the accounting for any excess tax benefits and deficiencies through equity, and requires all excess tax benefits and deficiencies related to employee share-based compensation arrangements to be recorded in the income statement. This aspect of the guidance is required to be applied prospectively. The guidance also requires the presentation of excess tax benefits on the statement of cash flows as an operating activity rather than a financing activity, a change which may be applied prospectively or retrospectively. The

8


Table of Contents

guidance further provides an accounting policy election to account for forfeitures as they occur rather than utilizing the estimated amount of forfeitures at the time of issuance. The Company adopted this guidance effective January 1, 2017. The primary impact of adopting this guidance was the recognition of excess tax benefits in the income statement instead of recognizing them in equity. This income statement guidance was adopted on a prospective basis. As a result, a discrete tax benefit of $18 million and $51 million was recognized in the income tax provision in the three and nine months ended September 30, 2017, respectively.

The Company elected to retrospectively adopt the guidance on the presentation of excess tax benefits in the statement of cash flows. The following is a reconciliation of the effect of the resulting reclassification of the excess tax benefits on the Company’s condensed consolidated statement of cash flows for the nine months ended September 30, 2016:

 

 

 

 

 

 

 

 

 

 

 

    

As Previously

    

 

 

    

 

 

In millions

 

Reported

 

Adjustments

 

As Revised

Cash paid to other suppliers and employees

 

$

(11,092)

 

$

72

 

$

(11,020)

Net cash provided by operating activities

 

 

7,948

 

 

72

 

 

8,020

Excess tax benefits from stock-based compensation

 

 

72

 

 

(72)

 

 

 —

Net cash used in financing activities

 

 

(6,568)

 

 

(72)

 

 

(6,640)

Reconciliation of net income to net cash provided by operating activities:

 

 

 

 

 

 

 

 

 

Accrued expenses

 

 

2,077

 

 

72

 

 

2,149

The Company elected to continue to estimate forfeitures expected to occur to determine the amount of compensation cost to be recognized in each period. None of the other provisions in this guidance had a material impact on the Company’s consolidated operating results, cash flows or financial condition.


14


Refer to “Accounts Receivable” above for a discussion of the Company’s expected credit loss impairment policy for its accounts receivable. The following is a discussion of the Company’s available-for-sale debt security impairment policy and expected credit loss impairment policy for mortgage loans under the new credit loss impairment standard:

Debt Securities
Debt securities consist primarily of United States Treasury and agency securities, mortgage-backed securities, corporate and foreign bonds and other debt securities. Debt securities are classified as either current or long-term investments based on their contractual maturities unless the Company intends to sell an investment within the next 12 months, in which case it is classified as current within the unaudited condensed consolidated financial statements.

balance sheets. Debt securities are classified as available for sale and are carried at fair value.


If a debt security is in an unrealized loss position and the Company has the intent to sell the security, or it is more likely than not that the Company will have to sell the security before recovery of its amortized cost basis, the amortized cost basis of the security is written down to its fair value and the difference is recognized in net income. If a debt security is in an unrealized loss position and the Company does not have the intent to sell and it is more likely than not that the Company will not have to sell such security before recovery of its amortized cost basis, the Company bifurcates the impairment into credit-related and non-credit related components. In March 2017,evaluating whether a credit related loss exists, the Company considers a variety of factors including: the extent to which the fair value is less than the amortized cost basis; adverse conditions specifically related to the issuer of a security, an industry or geographic area; the payment structure of the security; the failure of the issuer of the security to make scheduled interest or principle payments; and any changes to the rating of the security by a rating agency. The amount of the credit-related component is recorded as an allowance for credit losses and recognized in net income, and the amount of the non-credit related component is included in other comprehensive income. Interest is not accrued on debt securities when management believes the collection of interest is unlikely.

The credit-related component is determined by comparing the present value of cash flows expected to be collected from the security, considering all reasonably available information relevant to the collectability of the security, with the amortized cost basis of the security. If the present value of cash flows expected to be collected is less than the amortized cost basis of the security, the Company records an allowance for credit losses, which is limited by the amount that the fair value is less than amortized cost basis.

For mortgage-backed and other asset-backed securities, the Company recognizes income using an effective yield based on anticipated prepayments and the estimated economic life of the securities. When estimates of prepayments change, the effective yield is recalculated to reflect actual payments to date and anticipated future payments. The Company’s investment in the security is adjusted to the amount that would have existed had the new effective yield been applied since the acquisition of the security, with adjustments recognized in net income.

Mortgage Loans
Mortgage loan investments are valued at the unpaid principal balance, net of an allowance for credit losses. Mortgage loans with a maturity date or a committed prepayment date within twelve months are classified as current on the unaudited condensed consolidated balance sheets. The Company assesses whether its loans share similar risk characteristics and, if so, groups such loans in a risk pool when measuring expected credit losses. The Company considers the following characteristics when evaluating whether its loans share similar risk characteristics: loan-to-value ratios, property type (e.g., office, retail, apartment, industrial), geographic location, vacancy rates and property condition.

Credit loss reserves are determined using a loss rate method that multiplies the unpaid principal balance of each loan within a risk pool group by an estimated loss rate percentage. The loss rate percentage considers both the expected loan loss severity and the probability of loan default. For periods where the Company is able to make or obtain reasonable and supportable forecasts of expected economic conditions (e.g., gross domestic product, employment), the Company adjusts its expected loss rates to reflect these forecasted economic conditions. For periods beyond which the Company is able to make or obtain reasonable and supportable forecasts of expected economic conditions, the Company reverts to historical loss rates in determining expected credit losses.

Interest income on a potential problem loan (i.e., high probability of default) or restructured loan is accrued to the extent it is deemed to be collectible and the loan continues to perform under its original or restructured terms. Interest income on problem loans (i.e., more than 60 days delinquent, in bankruptcy or in process of foreclosure) is recognized on a cash basis. Cash payments on loans in the process of foreclosure are treated as a return of principal.

15


Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement that is a Service Contract
In August 2018, the FASB issued ASU 2017-07, Improving the Presentation of Net Periodic Pension Cost and Net Periodic Postretirement Benefit Cost, which amends ASC Topic 715, Compensation – Retirement Benefits. ASU 2017-17 requires entities to disaggregate the current service cost component from the other components of net benefit cost and present it with other current compensation costs for related employees in the income statement and present the other components of net benefit cost elsewhere in the income statement and outside of operating income. Only the service cost component of net benefit cost is eligible for capitalization. The guidance is effective for interim and annual periods beginning after December 15, 2017. Early adoption is permitted as of the beginning of any annual periods for which an entity’s financial statements have not been issued. Entities are required to retrospectively apply the requirement for a separate presentation in the income statement of service costs2018-15, Intangibles - Goodwill and other components of net benefit cost and prospectively adopt- Internal-Use Software (Topic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement that is a Service Contract. This standard requires a customer in a cloud computing arrangement that is a service contract to follow the requirementinternal-use software guidance in Topic 350-40 to limit the capitalization of benefitdetermine which implementation costs to the service component.capitalize as assets. The Company adopted the income statement presentation aspects of this new accounting guidance on a retrospective basis effective January 1, 2017. Nearly all of the Company’s net benefit costs for the Company’s defined benefit pension and postretirement plans do not contain2020 on a service cost component as most of these defined benefit plans have been frozen for an extended period of time.prospective basis. The following is a reconciliation of the effect of the reclassification of the net benefit cost from operating expenses to other expense in the Company’s condensed consolidated statements of income for the three and nine months ended September 30, 2016:

 

 

 

 

 

 

 

 

 

 

 

    

As Previously

    

 

 

    

 

 

In millions

 

Reported

 

Adjustments

 

As Revised

Three Months Ended September 30, 2016

 

 

 

 

 

 

 

 

 

Operating expenses

 

$

4,675

 

$

(7)

 

$

4,668

Operating profit

 

 

2,817

 

 

 7

 

 

2,824

Other expense

 

 

 —

 

 

 7

 

 

 7

Nine Months Ended September 30, 2016

 

 

 

 

 

 

 

 

 

Operating expenses

 

 

13,908

 

 

(23)

 

 

13,885

Operating profit

 

 

7,343

 

 

23

 

 

7,366

Other expense

 

 

 —

 

 

23

 

 

23

In January 2017, the FASB issued ASU 2017-04, Simplifying the Test for Goodwill Impairment, which amends ASC Topic 350, Intangibles – Goodwill and Other. This ASU requires the Company to perform its annual, or applicable interim, goodwill impairment test by comparing the fair value of each reporting unit with its carrying amount. An impairment charge must be recognized at the amount by which the carrying amount exceeds the fair value of the reporting unit; however, the charge recognized should not exceed the total amount of goodwill allocated to that reporting unit. Income tax effects resulting from any tax deductible goodwill should be considered when measuring a goodwill impairment charge, if applicable. The guidance in ASU 2017-04 is effective for annual or interim goodwill impairment

9


Table of Contents

tests in fiscal years beginning after December 15, 2019. The Company elected to early adopt this standard as of January 1, 2017. At the date of adoption of this new guidance, the guidancestandard did not have anya material impact on the Company’s condensed consolidated operating results, of operations,cash flows, financial positioncondition or cash flows.

related disclosures.


New Accounting Pronouncements Not Yet Adopted


Targeted Improvements to the Accounting for Long-Duration Insurance Contracts
In May 2014,August 2018, the FASB issued ASU 2014-09, Revenue from Contracts with Customers (Topic 606). ASU 2014-09 outlines a single comprehensive model for companies to use in accounting for revenue arising from contracts with customers and supersedes most current revenue recognition guidance, including industry-specific guidance. In March 2016, the FASB issued ASU 2016-08, “Principal Versus Agent Considerations (Reporting Revenue Gross Versus Net),” which amends the principal-versus-agent implementation guidance and in April 2016 the FASB issued ASU 2016-10, “Identifying Performance Obligations and Licensing,” which amends the guidance in those areas in the new revenue recognition standard. Both ASUs were issued in response to feedback received from the FASB-International Accounting Standards Board joint revenue recognition transition resource group. The new revenue standard is effective for annual reporting periods (including interim reporting periods within those periods) beginning January 1, 2018. The Company chose not to early adopt the new standard. Companies have the option of using either a full retrospective or a modified retrospective approach to adopt the standard. The Company intends to adopt the new standard on a modified retrospective basis. The Company formed a project team to assess and implement the new revenue standard and is substantially complete in documenting its accounting policies applying the new revenue guidance. The Company does not expect that the implementation of the new standard will have a material effect on the Company's consolidated results of operations, cash flows or financial position. The new standard will however require more extensive revenue-related disclosures. The Company has identified one difference in its Retail/LTC Segment related2018-12, Targeted Improvements to the accountingAccounting for Long-Duration Contracts (Topic 944). This standard requires the Company to review cash flow assumptions for its ExtraBucks Rewards customer loyalty program, which is currently accounted for under a cost deferral method. Underlong-duration insurance contracts at least annually and recognize the neweffect of changes in future cash flow assumptions in net income. This standard this program will be accounted for under a revenue deferral method; however,also requires the difference is not expectedCompany to be material.

In February 2016,update discount rate assumptions quarterly and recognize the FASB issued ASU 2016-02, Leases (Topic 842). Lessees will be requiredeffect of changes in these assumptions in other comprehensive income. The rate used to recognize a right-of-use asset and a leasediscount the Company’s liability for virtually all of their leases (other than leases that meet the definition of a short-term lease). The liability will be equal to the present value of lease payments. The assetfuture policy benefits will be based on an estimate of the liability, subject to adjustment, such asyield for initial direct costs. For income statement purposes,an upper-medium grade fixed-income instrument with a dual model was retained, requiring leases to be classified as either operating or finance leases. Operating leases will resultduration profile matching that of the Company’s liabilities. In addition, this standard changes the amortization method for deferred acquisition costs and requires additional disclosures regarding the long duration insurance contract liabilities in straight-line expense (similar to current operating leases) while finance leases will result in a front-loaded expense pattern (similar to current capital leases). Lessor accounting is similar to the current model, but updated to align with certain changes to the lessee model (e.g., certain definitions, such as initial direct costs, have been updated)Company’s interim and the new revenue recognition standard.annual financial statements. The standard is effective for public companies for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2018. Early adoption is permitted. The Company believes that the new standard will have a material impact on its consolidated balance sheet.2022. The Company is currently evaluating the effect that implementation of this standard will have on the Company’s consolidated operating results, of operations, cash flows, financial positioncondition and related disclosures.


Simplifying the Accounting for Income Taxes
In August 2016,December 2019, the FASB issued ASU No. 2016-15, Classification2019-12, Simplifying the Accounting for Income Taxes (Topic 740). This standard simplifies the accounting for income taxes by eliminating certain exceptions to the guidance in Accounting Standards Codification 740 related to the approach for intraperiod tax allocation, the methodology for calculating income taxes in an interim period and the recognition of Certain Cash Receiptsdeferred tax liabilities for outside basis differences. The standard also simplifies aspects of the accounting for franchise taxes and Cash Payments. ASU 2016-15 is intended to addenacted changes in tax laws or clarify guidance onrates and clarifies the classification of certain cash receipts and paymentsaccounting for transactions that result in a step-up in the statementtax basis of cash flowsgoodwill. The standard is effective for public companies for fiscal years, and to eliminate the diversity in practice related to such classifications. The guidance in ASU 2016-15 is required for annual reportinginterim periods within those fiscal years, beginning after December 15, 2017, with early2020. Early adoption is permitted. The Company is currently evaluating the effect that implementation of this standard will have on the Company’s consolidated operating results, cash flows, financial condition and related disclosures.

2.Divestitures

Divestiture of Workers’ Compensation Business

On July 31, 2020, the Company sold its Workers’ Compensation business for $850 million, subject to a working capital adjustment. The results of this business have historically been reported within the Health Care Benefits segment. The Company recorded a pre-tax gain on the divestiture of $271 million in the three and nine months ended September 30, 2020, which is reflected as a reduction in operating expenses in the Company’s unaudited condensed consolidated statement of cash flowsoperations within the Health Care Benefits segment.

Divestiture of adopting this accounting guidance.

In November 2016,Brazilian Subsidiary

On July 1, 2019, the FASB issued ASU 2016-18, StatementCompany sold its Brazilian subsidiary, Drogaria Onofre Ltda. (“Onofre”) for an immaterial amount. Onofre operates 50 retail pharmacy stores, the results of Cash Flows, which amends ASC Topic 230. This ASU requires entities to showhave historically been reported within the changesRetail/LTC segment. The Company recorded a loss on the divestiture of $205 million in the totalthree months ended September 30, 2019, which primarily relates to the elimination of cash, cash equivalents, restricted cashthe cumulative translation adjustment from accumulated other comprehensive income and restricted cash equivalentsis reflected in operating expenses in the statementCompany’s unaudited condensed consolidated statements of cash flows.operations within the Retail/LTC segment.

16


3.Investments

Total investments at September 30, 2020 and December 31, 2019 were as follows:
 September 30, 2020December 31, 2019
In millionsCurrentLong-termTotalCurrentLong-termTotal
Debt securities available for sale$2,578 $17,820 $20,398 $2,251 $14,671 $16,922 
Mortgage loans253 871 1,124 122 1,091 1,213 
Other investments1,525 1,525 1,552 1,552 
Total investments$2,831 $20,216 $23,047 $2,373 $17,314 $19,687 

Debt Securities

Debt securities available for sale at September 30, 2020 and December 31, 2019 were as follows:
In millionsGross
Amortized
Cost
Allowance
for Credit
Losses (1)
Net
Amortized
Cost
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Fair
Value
September 30, 2020
Debt securities:    
U.S. government securities$2,455 $$2,455 $146 $$2,601 
States, municipalities and political subdivisions2,393 2,393 150 (3)2,540 
U.S. corporate securities7,665 (4)7,661 878 (15)8,524 
Foreign securities2,479 2,479 252 (10)2,721 
Residential mortgage-backed securities680 680 33 713 
Commercial mortgage-backed securities930 930 82 1,012 
Other asset-backed securities2,239 2,239 33 (10)2,262 
Redeemable preferred securities22 22 25 
Total debt securities (2)
$18,863 $(4)$18,859 $1,577 $(38)$20,398 
December 31, 2019
Debt securities:
U.S. government securities$1,791 $$1,791 $62 $(1)$1,852 
States, municipalities and political subdivisions2,202 2,202 108 (1)2,309 
U.S. corporate securities7,167 7,167 573 (3)7,737 
Foreign securities2,149 2,149 200 (1)2,348 
Residential mortgage-backed securities508 508 25 533 
Commercial mortgage-backed securities654 654 46 700 
Other asset-backed securities1,397 1,397 13 (5)1,405 
Redeemable preferred securities30 30 38 
Total debt securities (2)
$15,898 $$15,898 $1,035 $(11)$16,922 

(1)Effective January 1, 2020, the Company adopted the available-for-sale debt security impairment model under ASU 2016-13, Financial Instruments - Credit Losses (Topic 326). The new impairment model requires the write down of amortized cost through an allowance for credit losses, rather than through a reduction of the amortized cost basis of the available-for-sale debt security. As the Company adopted the new available-for-sale debt security impairment model on a result, entities will no longerprospective basis, there was 0 allowance for credit losses recorded on available-for-sale debt securities at December 31, 2019.
(2)Investment risks associated with the Company’s experience-rated products generally do not impact the Company’s consolidated operating results. At September 30, 2020, debt securities with a fair value of $928 million, gross unrealized capital gains of $122 million and gross unrealized capital losses of $1 million and at December 31, 2019, debt securities with a fair value of $965 million, gross unrealized capital gains of $83 million and 0 gross unrealized capital losses were included in total debt securities, but support experience-rated products. Changes in net unrealized capital gains (losses) on these securities are not reflected in accumulated other comprehensive income.
17


The net amortized cost and fair value of debt securities at September 30, 2020 are shown below by contractual maturity. Actual maturities may differ from contractual maturities because securities may be requiredrestructured, called or prepaid, or the Company intends to present transfers between cashsell a security prior to maturity.
In millionsNet
Amortized
Cost
Fair
Value
Due to mature: 
Less than one year$1,588 $1,604 
One year through five years6,009 6,329 
After five years through ten years3,466 3,774 
Greater than ten years3,947 4,704 
Residential mortgage-backed securities680 713 
Commercial mortgage-backed securities930 1,012 
Other asset-backed securities2,239 2,262 
Total$18,859 $20,398 
18


Summarized below are the debt securities the Company held at September 30, 2020 and cash equivalents and restricted cash and restricted cash equivalentsDecember 31, 2019 that were in an unrealized capital loss position, aggregated by the length of time the investments have been in that position:
Less than 12 monthsGreater than 12 monthsTotal
In millions, except number of securitiesNumber of SecuritiesFair
Value
Unrealized
Losses
Number of SecuritiesFair
Value
Unrealized
Losses
Number of SecuritiesFair
Value
Unrealized
Losses
September 30, 2020  
Debt securities:  
U.S. government securities58 $311 $$$58 $311 $
States, municipalities and political subdivisions95 196 95 196 
U.S. corporate securities704 639 15 708 641 15 
Foreign securities198 312 10 198 312 10 
Residential mortgage-backed securities19 70 22 70 
Commercial mortgage-backed securities28 106 28 106 
Other asset-backed securities288 543 90 80 378 623 10 
Total debt securities1,390 $2,177 $35 97 $82 $1,487 $2,259 $38 
December 31, 2019  
Debt securities:  
U.S. government securities52 $168 $$$52 $168 $
States, municipalities and political subdivisions66 115 68 120 
U.S. corporate securities181 305 183 305 
Foreign securities39 75 39 75 
Residential mortgage-backed securities30 16 39 16 
Commercial mortgage-backed securities16 49 16 49 
Other asset-backed securities138 254 187 182 325 436 
Total debt securities522 $982 $200 $187 $722 $1,169 $11 

The Company reviewed the securities in the statement of cash flows. When cash, cash equivalents, restricted cashtable above and restricted cash equivalentsconcluded that they are presented in more than one line item onperforming assets generating investment income to support the balance sheet, the new guidance requires a reconciliationneeds of the totals inCompany’s business. In performing this review, the statement of cash flows toCompany considered factors such as the related captions in the balance sheet. Entities will also have to disclose the nature of their restricted cash and restricted cash equivalent balances. The guidance is effective for fiscal years beginning after December 15, 2017 and interim periods within those years. Early adoption is permitted. Entities are required to apply the guidance retrospectively. The Company is currently evaluating the effect of adopting this accounting guidance.

10


Table of Contents

Note 2 – Goodwill and Intangible Assets

Goodwill is not amortized, but is subject to annual impairment reviews, or more frequent reviews if events or circumstances indicate there may be impairment.

Below is a summaryquality of the changes ininvestment security based on research performed by the Company’s internal credit analysts and external rating agencies and the prospects of realizing the carrying value of goodwillthe security based on the investment’s current prospects for recovery. Unrealized capital losses at September 30, 2020 were generally caused by segmentthe widening of credit spreads on these securities relative to the interest rates on U.S. Treasury securities, driven by the adverse economic conditions in the U.S. and abroad caused by the COVID-19 pandemic. As of September 30, 2020, the Company did not intend to sell these securities, and did not believe it was more likely than not that it would be required to sell these securities prior to the anticipated recovery of their amortized cost basis.








19


The maturity dates for debt securities in an unrealized capital loss position at September 30, 2020 were as follows:
 Supporting
experience-rated products
Supporting
remaining products
Total
In millionsFair
Value
Unrealized
Losses
Fair
Value
Unrealized
Losses
Fair
Value
Unrealized
Losses
Due to mature:      
Less than one year$$$36 $$36 $
One year through five years623 624 
After five years through ten years11 493 12 504 13 
Greater than ten years11 285 296 
Residential mortgage-backed securities70 70 
Commercial mortgage-backed securities104 106 
Other asset-backed securities616 10 623 10 
Total$32 $$2,227 $37 $2,259 $38 

Mortgage Loans

The Company’s mortgage loans are collateralized by commercial real estate. During the three and nine months ended September 30, 2020 and 2019, the Company had the following activity in its mortgage loan portfolio:
Three Months Ended
September 30,
Nine Months Ended
September 30,
In millions2020201920202019
New mortgage loans$31 $12 $55 $90 
Mortgage loans fully repaid37 56 114 127 
Mortgage loans foreclosed

The Company assesses mortgage loans on a regular basis for credit impairments, and assigns a credit quality indicator to each loan. The Company’s credit quality indicator is internally developed and categorizes each loan in its portfolio on a scale from 1 to 7. These indicators are based upon several factors, including current loan-to-value ratios, current and future property cash flow, property condition, market trends, creditworthiness of the borrower and deal structure.

Category 1 - Represents loans of superior quality.
Categories 2 to 4 - Represent loans where credit risk is minimal to acceptable; however, these loans may display some susceptibility to economic changes.
Categories 5 and 6 - Represent loans where credit risk is not substantial, but these loans warrant management’s close attention.
Category 7 - Represents loans where collections are potentially at risk; if necessary, an impairment is recorded.

20


Based on the Company’s assessments at September 30, 2020 and December 31, 2019, the amortized cost basis of the Company's mortgage loans within each credit quality indicator by year of origination was as follows:
Amortized Cost Basis by Year of Origination
In millions, except credit quality indicator20202019201820172016PriorTotal
September 30, 2020
1$$$$23 $$39 $62 
2 to 457 95 90 129 129 516 1,016 
5 and 629 37 
7
Total$57 $95 $94 $165 $129 $584 $1,124 
December 31, 2019
1$$$15 $$43 $58 
2 to 493 93 206 140 611 1,143 
5 and 612 12 
7
Total$93 $93 $221 $140 $666 $1,213 

Net Investment Income

Sources of net investment income for the three and nine months ended September 30, 2020 and 2019 were as follows:
Three Months Ended
September 30,
Nine Months Ended
September 30,
In millions2020201920202019
Debt securities$151 $145 $441 $437 
Mortgage loans15 19 45 54 
Other investments37 60 64 163 
Gross investment income203 224 550 654 
Investment expenses(8)(10)(25)(28)
Net investment income (excluding net realized capital gains or losses)195 214 525 626 
Net realized capital gains (1)
49 25 179 
Net investment income (2)
$204 $263 $550 $805 

(1)Net realized capital gains include credit-related and yield-related impairment losses on debt securities of $1 million and $2 million, respectively, in the three months ended September 30, 2020. Net realized capital gains include credit-related and yield-related impairment losses on debt securities of $4 million and $44 million, respectively, in the nine months ended September 30, 2020. Net realized capital gains are net of other than temporary impairment losses on debt securities of $9 million and $22 million, respectively, in the three and nine months ended September 30, 2019.
(2)Net investment income includes $10 million and $31 million for the three and nine months ended September 30, 2020, respectively, and $10 million and $33 million for the three and nine months ended September 30, 2019, respectively, related to investments supporting experience-rated products.

Excluding amounts related to experience-rated products, proceeds from the sale of available for sale debt securities and the related gross realized capital gains and losses for the three and nine months ended September 30, 2020 and 2019 were as follows:
Three Months Ended
September 30,
Nine Months Ended
September 30,
In millions2020201920202019
Proceeds from sales$905 $1,325 $2,324 $4,087 
Gross realized capital gains17 55 60 127 
Gross realized capital losses59 13 

21


4.Fair Value

The preparation of the Company’s unaudited condensed consolidated financial statements in accordance with GAAP requires certain assets and liabilities to be reflected at their fair value and others to be reflected on another basis, such as an adjusted historical cost basis. The Company’s assets and liabilities carried at fair value have been classified within one of three levels of a hierarchy established by GAAP. The following are the levels of the hierarchy and a brief description of the type of valuation information (“valuation inputs”) that qualifies a financial asset or liability for each level:

Level 1 – Unadjusted quoted prices for identical assets or liabilities in active markets.
Level 2 – Valuation inputs other than Level 1 that are based on observable market data.  These include: quoted prices for similar assets in active markets, quoted prices for identical assets in inactive markets, valuation inputs that are observable that are not prices (such as interest rates and credit risks) and valuation inputs that are derived from or corroborated by observable markets.
Level 3 – Developed from unobservable data, reflecting the Company’s assumptions.

For a description of the methods and assumptions that are used to estimate the fair value and determine the fair value hierarchy classification of each class of financial instrument, see Note 4 “Fair Value” in the 2019 Form 10-K.
22


There were 0 financial liabilities measured at fair value on a recurring basis on the condensed consolidated balance sheets at September 30, 2020 or December 31, 2019. Financial assets measured at fair value on a recurring basis on the condensed consolidated balance sheets at September 30, 2020 and December 31, 2019 were as follows:
In millionsLevel 1Level 2Level 3Total
September 30, 2020    
Cash and cash equivalents$5,670 $3,586 $$9,256 
Debt securities:    
U.S. government securities2,498 103 2,601 
States, municipalities and political subdivisions2,540 2,540 
U.S. corporate securities8,476 48 8,524 
Foreign securities— 2,721 2,721 
Residential mortgage-backed securities713 713 
Commercial mortgage-backed securities1,012 1,012 
Other asset-backed securities2,262 2,262 
Redeemable preferred securities24 25 
Total debt securities2,498 17,851 49 20,398 
Equity securities20 26 46 
Total$8,188 $21,437 $75 $29,700 
December 31, 2019    
Cash and cash equivalents$3,397 $2,286 $$5,683 
Debt securities:    
U.S. government securities1,785 67 1,852 
States, municipalities and political subdivisions2,309 2,309 
U.S. corporate securities7,700 37 7,737 
Foreign securities2,348 2,348 
Residential mortgage-backed securities533 533 
Commercial mortgage-backed securities700 700 
Other asset-backed securities1,405 1,405 
Redeemable preferred securities26 12 38 
Total debt securities1,785 15,088 49 16,922 
Equity securities34 39 73 
Total$5,216 $17,374 $88 $22,678 

During the three and nine months ended September 30, 2020 and 2019, there were no transfers into or out of Level 3.

23


The carrying value and estimated fair value classified by level of fair value hierarchy for financial instruments carried on the condensed consolidated balance sheets at adjusted cost or contract value at September 30, 2020 and December 31, 2019 were as follows:
Carrying
Value
 Estimated Fair Value
In millionsLevel 1Level 2Level 3Total
September 30, 2020
Assets: 
Mortgage loans$1,124 $$$1,148 $1,148 
Equity securities (1)
146 N/AN/AN/AN/A
Liabilities:
Investment contract liabilities:
With a fixed maturity
Without a fixed maturity322 370 370 
Long-term debt66,995 76,642 76,642 
December 31, 2019
Assets: 
Mortgage loans$1,213 $$$1,239 $1,239 
Equity securities (1)
149 N/AN/AN/AN/A
Liabilities:  
Investment contract liabilities:  
With a fixed maturity
Without a fixed maturity372 392 392 
Long-term debt68,480 74,306 74,306 

(1)It was not practical to estimate the fair value of these cost-method investments as it represents shares of unlisted companies.

Separate Accounts assets relate to the Company’s large case pensions products which represent funds maintained to meet specific objectives of contract holders. Since contract holders bear the investment risk of these assets, a corresponding Separate Accounts liability has been established equal to the assets. These assets and liabilities are carried at fair value. Separate Accounts financial assets as of September 30, 2020 and December 31, 2019 were as follows:
 September 30, 2020December 31, 2019
In millionsLevel 1Level 2Level 3TotalLevel 1Level 2Level 3Total
Cash and cash equivalents$$72 $$74 $$143 $$145 
Debt securities1,538 2,576 4,114 1,224 2,589 3,813 
Equity securities
Common/collective trusts603 603 499 499 
Total$1,540 $3,253 $$4,793 $1,226 $3,233 $$4,459 


24


5.Health Care Costs Payable

The following table shows the components of the change in health care costs payable during the nine months ended September 30, 2020 and 2019:
Nine Months Ended
September 30,
In millions20202019
Health care costs payable, beginning of the period$6,879 $6,147 
Less: Reinsurance recoverables
Health care costs payable, beginning of the period, net6,874 6,143 
Acquisition444 
Add: Components of incurred health care costs
  Current year40,777 39,657 
  Prior years(448)(511)
Total incurred health care costs (1)
40,329 39,146 
Less: Claims paid
  Current year34,198 33,032 
  Prior years5,865 5,253 
Total claims paid40,063 38,285 
Add: Premium deficiency reserve
Health care costs payable, end of the period, net7,585 7,010 
Add: Reinsurance recoverables
Health care costs payable, end of the period$7,593 $7,014 

(1)Total incurred health care costs for the nine months ended September 30, 2017:

2020 and 2019 in the table above exclude (i) $1 million and $6 million, respectively, related to a premium deficiency reserve related to the Company’s Medicaid products, (ii) $31 million and $31 million, respectively, of benefit costs recorded in the Health Care Benefits segment that are included in other insurance liabilities on the Company’s unaudited condensed consolidated balance sheets and (iii) $173 million and $213 million, respectively, of benefit costs recorded in the Corporate/Other segment that are included in other insurance liabilities on the Company’s unaudited condensed consolidated balance sheets.

 

 

 

 

 

 

 

 

 

 

 

 

Pharmacy

 

 

 

 

 

 

In millions

    

Services

    

Retail/LTC

    

Total

Balance, December 31, 2016

 

$

21,637

 

$

16,612

 

$

38,249

Acquisitions

 

 

 —

 

 

52

 

 

52

Foreign currency translation adjustments

 

 

 —

 

 

 3

 

 

 3

Impairment

 

 

 —

 

 

(135)

 

 

(135)

Balance, September 30, 2017

 

$

21,637

 

$

16,532

 

$

38,169


During 2017,

The Company’s estimates of prior years’ health care costs payable decreased by $448 million and $511 million, respectively, in the nine months ended September 30, 2020 and 2019, because claims were settled for amounts less than originally estimated (i.e., the amount of claims incurred was lower than originally estimated), primarily due to lower health care cost trends as well as the actual claim submission time being faster than originally assumed (i.e., the Company’s completion factors were higher than originally assumed) in estimating health care costs payable at the end of the prior year.

At September 30, 2020, the Company’s liabilities for the ultimate cost of (i) services rendered to the Company’s Insured members but not yet reported to the Company began pursuing various strategic alternatives for its RxCrossroads (“RxC”) reporting unit. In connection with this ongoing effort,and (ii) claims which have been reported to the Company performed an interim goodwill impairment test in the second quarter of 2017. In conjunction with the impairment test, the fair valuebut not yet paid (collectively, “IBNR”) plus expected development on reported claims totaled approximately $5.8 billion. Substantially all of the RxC reporting unit was estimatedCompany’s liabilities for IBNR plus expected development on reported claims at September 30, 2020 related to be lower than the carrying value, resulting in a $135 million goodwill impairment charge within operating expenses during the second quarter of 2017. The fair value of the RxC reporting unit was determined using a combination of a discounted cash flow method and a market multiple method. During the second quarter of 2017, the Company also performed an impairment test of the intangible assets of the RxC reporting unit and none were impaired. During the third quarter of 2017, the Company performed its required annual impairment tests and concluded there was no impairment of goodwill or trade names.

On November 6, 2017, the Company entered into a definitive agreement to sell RxC to McKesson Corporation for $735 million. The transaction is subject to a working capital adjustment and is expected to close in the first quarter of 2018, subject to customary regulatory approvals.

current year.


25


6.Borrowings
The following table is a summary of the Company’s intangible assets as ofborrowings at September 30, 20172020 and December 31, 2016:

2019:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

September 30, 2017

 

December 31, 2016

 

 

    

Gross

    

 

 

    

Net

    

Gross

    

 

 

    

Net

 

 

 

Carrying

 

Accumulated

 

Carrying

 

Carrying

 

Accumulated

 

Carrying

 

In millions

 

Amount

 

Amortization

 

Amount

 

Amount

 

Amortization

 

Amount

 

Trademark (indefinitely-lived)

 

$

6,398

 

$

 —

 

$

6,398

 

$

6,398

 

$

 

$

6,398

 

Customer contracts and relationships and covenants not to compete

 

 

11,848

 

 

(5,345)

 

 

6,503

 

 

11,485

 

 

(4,802)

 

 

6,683

 

Favorable leases and other

 

 

1,151

 

 

(749)

 

 

402

 

 

1,123

 

 

(693)

 

 

430

 

 

 

$

19,397

 

$

(6,094)

 

$

13,303

 

$

19,006

 

$

(5,495)

 

$

13,511

 

In millionsSeptember 30,
2020
December 31,
2019
Long-term debt
3.125% senior notes due March 2020$$723 
Floating rate notes due March 2020 (2.515% at December 31, 2019)277 
2.8% senior notes due July 20202,750 
3.35% senior notes due March 20212,038 2,038 
Floating rate notes due March 2021 (0.968% at September 30, 2020 and 2.605% at December 31, 2019)1,000 1,000 
4.125% senior notes due May 2021222 222 
2.125% senior notes due June 20211,750 1,750 
4.125% senior notes due June 2021203 203 
5.45% senior notes due June 2021187 187 
3.5% senior notes due July 20221,500 1,500 
2.75% senior notes due November 20221,000 1,000 
2.75% senior notes due December 20221,250 1,250 
4.75% senior notes due December 2022399 399 
3.7% senior notes due March 20233,723 6,000 
2.8% senior notes due June 20231,300 1,300 
4% senior notes due December 2023527 1,250 
3.375% senior notes due August 2024650 650 
2.625% senior notes due August 20241,000 1,000 
3.5% senior notes due November 2024750 750 
5% senior notes due December 2024299 299 
4.1% senior notes due March 20252,000 5,000 
3.875% senior notes due July 20252,828 2,828 
2.875% senior notes due June 20261,750 1,750 
3% senior notes due August 2026750 750 
3.625% senior notes due April 2027750 
6.25% senior notes due June 2027372 372 
1.3% senior notes due August 20271,500 
4.3% senior notes due March 20289,000 9,000 
3.25% senior notes due August 20291,750 1,750 
3.75% senior notes due April 20301,500 
1.75% senior notes due August 20301,250 
4.875% senior notes due July 2035652 652 
6.625% senior notes due June 2036771 771 
6.75% senior notes due December 2037533 533 
4.78% senior notes due March 20385,000 5,000 
6.125% senior notes due September 2039447 447 
4.125% senior notes due April 20401,000 
2.7% senior notes due August 20401,250 
5.75% senior notes due May 2041133 133 
4.5% senior notes due May 2042500 500 
4.125% senior notes due November 2042500 500 
5.3% senior notes due December 2043750 750 
4.75% senior notes due March 2044375 375 
5.125% senior notes due July 20453,500 3,500 
3.875% senior notes due August 20471,000 1,000 
5.05% senior notes due March 20488,000 8,000 
4.25% senior notes due April 2050750 
Finance lease obligations1,036 808 
Other276 279 
Total debt principal67,721 69,246 
Debt premiums245 262 
Debt discounts and deferred financing costs(971)(1,028)
66,995 68,480 
Less:
Current portion of long-term debt(5,443)(3,781)
Long-term debt$61,552 $64,699 

Note 3 – Share Repurchase Programs

During

26


Long-term Borrowings

2020 Notes
On August 21, 2020, the nine months endedCompany issued $1.5 billion aggregate principal amount of 1.3% unsecured senior notes due August 21, 2027, $1.25 billion aggregate principal amount of 1.75% unsecured senior notes due August 21, 2030 and $1.25 billion aggregate principal amount of 2.7% unsecured senior notes due August 21, 2040 (collectively, the “August 2020 Notes”) for total proceeds of approximately $3.97 billion, net of discounts and underwriting fees.

On March 31, 2020, the Company issued $750 million aggregate principal amount of 3.625% unsecured senior notes due April 1, 2027, $1.5 billion aggregate principal amount of 3.75% unsecured senior notes due April 1, 2030, $1.0 billion aggregate principal amount of 4.125% unsecured senior notes due April 1, 2040 and $750 million aggregate principal amount of 4.25% unsecured senior notes due April 1, 2050 (collectively, the “March 2020 Notes”) for total proceeds of approximately $3.95 billion, net of discounts and underwriting fees..

The net proceeds of these offerings will be used for general corporate purposes, which may include working capital, capital expenditures, as well as the repurchase and/or repayment of indebtedness. Net proceeds from these offerings that had not been used for these purposes were held in cash or temporarily invested in cash equivalents and short-term investment-grade securities from the date of issuance through September 30, 2017,2020.

During March 2020, the Company hadentered into several interest rate swap transactions to manage interest rate risk. These agreements were designated as cash flow hedges and were used to hedge the followingexposure to variability in future cash flows resulting from changes in interest rates related to the anticipated issuance of the March 2020 Notes. In connection with the issuance of the March 2020 Notes, the Company terminated all outstanding cash flow hedges. The Company paid a net amount of $7 million to the hedge counterparties upon termination, which was recorded as a loss, net of tax, of $5 million in accumulated other comprehensive income and will be reclassified as interest expense over the life of the March 2020 Notes. See Note 8 ‘‘Other Comprehensive Income’’ for additional information.

Early Extinguishments of Debt
In August 2020, the Company purchased $6.0 billion of its outstanding senior notes through cash tender offers. The senior notes purchased included the following: $723 million of its 4.0% senior notes due 2023, $2.3 billion of its 3.7% senior notes due 2023 and $3.0 billion of its 4.1% senior notes due 2025. In connection with the purchase of such senior notes, the Company paid a premium of $706 million in excess of the aggregate principal amount of the senior notes that were purchased, wrote-off $47 million of unamortized deferred financing costs and incurred $13 million in fees, for a total loss on early extinguishment of debt of $766 million.

In August 2019, the Company purchased $4.0 billion of its outstanding senior notes through cash tender offers. The senior notes purchased included the following: $1.3 billion of its 3.125% senior notes due 2020, $723 million of its floating rate notes due 2020, $328 million of its 4.125% senior notes due 2021, $297 million of 4.125% senior notes due 2021 issued by Aetna, $413 million of 5.45% senior notes due 2021 issued by Coventry Health Care, Inc., a wholly-owned subsidiary of Aetna and $962 million of its 3.35% senior notes due 2021. In connection with the purchase of such senior notes, the Company paid a premium of $76 million in excess of the aggregate principal amount of the senior notes that were purchased, incurred $8 million in fees and recognized a net gain of $5 million on the write-off of net unamortized deferred financing premiums, for a net loss on early extinguishment of debt of $79 million.

7.Shareholders’ Equity

Share Repurchases

On November 2, 2016, CVS Health’s Board of Directors (the “Board”) authorized the 2016 share repurchase programs, bothprogram (“2016 Repurchase Program”) for up to $15.0 billion of which had previously been authorized by the Company’s Board of Directors:

 

 

 

 

 

 

 

In billions

    

 

 

    

 

 

 

 

 

 

 

 

 

Authorization Date

 

Authorized

 

Remaining

November 2, 2016 (“2016 Repurchase Program”)

 

$

15.0

 

$

13.9

December 15, 2014 (“2014 Repurchase Program”)

 

 

10.0

 

 

 —

Each of the 2014 andcommon shares. The 2016 Repurchase Programs, which were effective immediately, permittedProgram permits the Company to effect repurchases from time to time through a combination of open market repurchases, privately negotiated transactions, accelerated share repurchase transactions, and/or other derivative transactions. Each of the repurchase programs couldThe 2016 Repurchase Program can be modified or terminated by the Board of Directors at any time. The 2014 Repurchase Program was completed during the second quarter of 2017.

11


Table of Contents

During the three months ended September 30, 2017, the Company repurchased an aggregate of approximately 5.0 million shares of common stock for approximately $0.4 billion pursuant to the 2016 Repurchase Program. During the nine months ended September 30, 2017,2020 and 2019, the Company repurchased an aggregate of approximately 55.4 million shares of common stock for approximately $4.4 billion pursuant to the 2014 and 2016 Repurchase Programs. This activity includes the accelerated sharedid 0t repurchase agreements (“ASRs”) described below.

Pursuant to the authorization under the 2014 Repurchase Program, effective August 29, 2016, the Company entered into two fixed dollar ASRs with Barclays Bank PLC (“Barclays”) for a total of $3.6 billion. Upon payment of the $3.6 billion purchase price on January 6, 2017, the Company received a number ofany shares of its common stock equalstock. At September 30, 2020, the Company had remaining authorization to 80%repurchase an aggregate of up to approximately $13.9 billion of its common shares under the 2016 Repurchase Program.


27



Dividends

The quarterly cash dividend declared by the Board was $0.50 per share in each of the $3.6 billion notional amount of the ASRs or approximately 36.1 million shares, which were placed into treasury stock in January 2017. The ASRs were accounted for as an initial treasury stock transaction for $2.9 billion and a forward contract for $0.7 billion. In April 2017, the Company received 9.9 million shares of common stock, representing the remaining 20% of the $3.6 billion notional amount of the ASRs, thereby concluding the ASRs. The remaining 9.9 million shares of common stock delivered to the Company by Barclays were placed into treasury stock and the forward contract was reclassified from capital surplus to treasury stock in April 2017.

At the time they were received, the initial and final receipt of shares resulted in an immediate reduction of the outstanding shares used to calculate the weighted average common shares outstanding for basic and diluted earnings per share.

Note 4 – Pension Settlements

As of December 31, 2016, the Company sponsored seven defined benefit pension plans. Two of the plans are tax-qualified plans that are funded based on actuarial calculations and applicable federal laws and regulations. The other five plans are unfunded nonqualified supplemental retirement plans. All seven of these plans are closed to new participants. During the three monthsthree-month periods ended September 30, 2017,2020 and 2019. Cash dividends declared by the Company settledBoard were $1.50 per share in each of the pension obligations of its two tax-qualified plans by irrevocably transferring pension liabilities to an insurance company through the purchase of group annuity contracts and through lump sum distributions. These purchases, funded with pension plan assets, resulted in pre-tax settlement losses of $187 million in the three monthsnine-month periods ended September 30, 2017, related to2020 and 2019. CVS Health has paid cash dividends every quarter since becoming a public company. Future dividend payments will depend on the recognition of accumulated deferred actuarial losses. The settlement losses are included inCompany’s earnings, capital requirements, financial condition and other expense infactors considered relevant by the condensed consolidated statement of income.

Note 5 – Accumulated Board.


28


8.Other Comprehensive Income

Accumulated other comprehensive income consists of foreign currency translation adjustments, unrealized losses on cash flow hedges executed in previous years associated with

Shareholders’ equity included the issuance of long-term debt, and changes in the net actuarial gains and losses associated with pension and other postretirement benefit plans. The following table summarizes the activity within the components of accumulated other comprehensive income.

12


Table of Contents

Changes in accumulated other comprehensive income (loss) by component is shown on the following tables:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended September 30, 2017 (1)

 

  

 

 

  

 

  

Pension and

  

 

 

 

 

 

 

 

Losses on

 

Other

 

 

 

 

 

Foreign

 

Cash Flow

 

Postretirement

 

 

 

In millions

 

Currency

 

Hedges

 

Benefits

 

Total

Balance, June 30, 2017

 

$

(129)

 

$

(4)

 

$

(173)

 

$

(306)

Other comprehensive income before reclassifications

 

 

 8

 

 

 —

 

 

 —

 

 

 8

Amounts reclassified from accumulated other comprehensive income (2)

 

 

 —

 

 

 —

 

 

151

 

 

151

Net other comprehensive income

 

 

 8

 

 

 —

 

 

151

 

 

159

Balance, September 30, 2017

 

$

(121)

 

$

(4)

 

$

(22)

 

$

(147)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended September 30, 2016 (1)

 

  

 

 

  

 

  

Pension and

  

 

 

 

 

 

 

 

Losses on

 

Other

 

 

 

 

 

Foreign

 

Cash Flow

 

Postretirement

 

 

 

 

 

Currency

 

Hedges

 

Benefits

 

Total

Balance, June 30, 2016

 

$

(125)

 

$

(6)

 

$

(186)

 

$

(317)

Other comprehensive income (loss) before reclassifications

 

 

(3)

 

 

 

 

 —

 

 

(3)

Amounts reclassified from accumulated other comprehensive income (2)

 

 

 —

 

 

 1

 

 

 —

 

 

 1

Net other comprehensive income (loss)

 

 

(3)

 

 

 1

 

 

 —

 

 

(2)

Balance, September 30, 2016

 

$

(128)

 

$

(5)

 

$

(186)

 

$

(319)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nine Months Ended September 30, 2017 (1)

 

  

 

 

  

 

  

Pension and

  

 

 

 

 

 

 

 

Losses on

 

Other

 

 

 

 

 

Foreign

 

Cash Flow

 

Postretirement

 

 

 

 

 

Currency

 

Hedges

 

Benefits

 

Total

Balance, December 31, 2016

 

$

(127)

 

$

(5)

 

$

(173)

 

$

(305)

Other comprehensive income before reclassifications

 

 

 6

 

 

 —

 

 

 —

 

 

 6

Amounts reclassified from accumulated other comprehensive income (2)

 

 

 —

 

 

 1

 

 

151

 

 

152

Net other comprehensive income

 

 

 6

 

 

 1

 

 

151

 

 

158

Balance, September 30, 2017

 

$

(121)

 

$

(4)

 

$

(22)

 

$

(147)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nine Months Ended September 30, 2016 (1)

 

  

 

 

  

 

 

  

Pension and

  

 

 

 

 

 

 

 

Losses on

 

Other

 

 

 

 

 

Foreign

 

Cash Flow

 

Postretirement

 

 

 

 

 

Currency

 

Hedges

 

Benefits

 

Total

Balance, December 31, 2015

 

$

(165)

 

$

(7)

 

$

(186)

 

$

(358)

Other comprehensive income before reclassifications

 

 

37

 

 

 

 

 —

 

 

37

Amounts reclassified from accumulated other comprehensive income (2)

 

 

 

 

 2

 

 

 —

 

 

 2

Net other comprehensive income

 

 

37

 

 

 2

 

 

 —

 

 

39

Balance, September 30, 2016

 

$

(128)

 

$

(5)

 

$

(186)

 

$

(319)


(1)

All amounts are net of tax.

(2)

The amounts reclassified from accumulated other comprehensive income for losses on cash flow hedges are recorded within interest expense, net on the condensed consolidated statements of income. The amounts reclassified from accumulated other comprehensive income for pension and other postretirement benefits are included in other expense on the condensed consolidated statements of income.

Note 6 – Stock-Based Compensation

A summary of stock-based compensation for each of the respective periods is as follows:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Nine Months Ended

 

 

September 30, 

 

September 30, 

In millions

    

2017

    

2016

    

2017

    

2016

Stock-based compensation:

    

 

 

    

 

 

    

 

 

    

 

 

Stock options

 

$

15

 

$

20

 

$

49

 

$

60

Restricted stock units

 

 

50

 

 

38

 

 

124

 

 

106

Total stock-based compensation

 

$

65

 

$

58

 

$

173

 

$

166

13


Table of Contents

During the nine months ended September 30, 2017, the Company granted approximately 4 million stock options with a weighted average fair value of $9.43 and a weighted average fair value exercise price of $78.05. The Company had approximately 21 million stock options outstanding as of September 30, 2017 with a weighted average exercise price of $75.09 and a weighted average contractual term of 3.87 years. During the nine months ended September 30, 2017, the Company granted approximately 3 million restricted stock units with a weighted average fair value of $78.35. The Company had approximately 6 million restricted stock units unvested as of September 30, 2017 with a weighted average fair value of $87.20.

Note 7 – Sale-Leaseback Transactions

The Company finances a portion of its store development program through sale-leaseback transactions. The properties are generally sold at net book value, which approximates fair value, and the resulting leases typically qualify and are accounted for as operating leases. The Company does not have any retained or contingent interests in the stores and does not provide any guarantees, other than a guarantee of lease payments, in connection with the sale-leaseback transactions. Proceeds from sale-leaseback transactions totaled $265 million and $230 million for the nine months ended September 30, 2017 and 2016, respectively.

Note 8 – Store Closures

In December 2016, the Company announced an enterprise streamlining initiative designed to reduce costs and enhance operating efficiencies to allow the Company to be more competitive in the current health care environment. In connection with the enterprise streamlining initiative, the Company announced its intention to rationalize the number of retail stores by closing approximately 70 underperforming stores during the year ending December 31, 2017. During the three and nine months ended September 30, 2017,2020 and 2019:

Three Months Ended
September 30,
Nine Months Ended
September 30,
In millions2020201920202019
Net unrealized investment gains:
Beginning of period balance$987 $682 $774 $97 
Other comprehensive income before reclassifications ($83, $214, $278 and $933 pretax)
52 192 218 799 
Amounts reclassified from accumulated other comprehensive income ($(10), $(63), $47 and $(93) pretax) (1)
(8)(56)39 (78)
Other comprehensive income44 136 257 721 
End of period balance1,031 818 1,031 818 
Foreign currency translation adjustments:
Beginning of period balance(2)(154)(158)
Other comprehensive income (loss) before reclassifications(1)(5)
Amounts reclassified from accumulated other comprehensive income (loss) (2)
154 154 
Other comprehensive income (loss)153 (5)157 
End of period balance(1)(1)(1)(1)
Net cash flow hedges:
Beginning of period balance267 305 279 312 
Other comprehensive loss before reclassifications ($0, $(25), $(7) and $(25) pretax)
(18)(5)(18)
Amounts reclassified from accumulated other comprehensive income ($(4), $(7), $(14) and $(16) pretax) (3)
(3)(5)(10)(12)
Other comprehensive loss(3)(23)(15)(30)
End of period balance264 282 264 282 
Pension and other postretirement benefits:
Beginning of period balance(39)(149)(38)(149)
Other comprehensive loss before reclassifications ($0, $0, $(8) and $0 pretax)
(6)
Amounts reclassified from accumulated other comprehensive loss ($0, $0, $7 and $0 pretax) (4)
Other comprehensive loss(1)
End of period balance(39)(149)(39)(149)
Total beginning of period accumulated other comprehensive income1,213 684 1,019 102 
Total other comprehensive income42 266 236 848 
Total end of period accumulated other comprehensive income$1,255 $950 $1,255 $950 

(1)Amounts reclassified from accumulated other comprehensive income for specifically identified debt securities are included in net investment income in the Company closed five and 68 retail stores, respectively, and recorded chargesunaudited condensed consolidated statements of $6 million and $211 million, respectively, withinoperations.
(2)Amounts reclassified from accumulated other comprehensive income (loss) represent the elimination of the cumulative translation adjustment associated with the sale of Onofre, which was sold on July 1, 2019. The loss on the divestiture of Onofre is reflected in operating expenses in the Retail/LTC Segment.unaudited condensed consolidated statements of operations.
(3)Amounts reclassified from accumulated other comprehensive income for specifically identified cash flow hedges are included in interest expense in the unaudited condensed consolidated statements of operations. The charges are primarily comprised of provisions for the present value of noncancelable lease obligations.

The noncancelable lease obligations associated with stores closed during the nine months ended September 30, 2017 extend through the year 2039. In connection with the enterprise streamlining initiative, the Company expects to record additional chargesreclassify approximately $15 million, net of approximately $9 million duringtax, in net gains associated with its cash flow hedges into net income within the fourth quarternext 12 months.

(4)Amounts reclassified from accumulated other comprehensive loss for specifically identified pension and other postretirement benefits are included in other income in the unaudited condensed consolidated statements of 2017 as it continues to rationalize the number of retail stores.

Note 9 – Interest Expense, Net

The following are the components of interest expense, net:

operations.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Nine Months Ended

 

 

September 30, 

 

September 30, 

In millions

    

2017

    

2016

    

2017

    

2016

Interest expense

 

$

250

 

$

258

 

$

759

 

$

830

Interest income

 

 

(5)

 

 

(5)

 

 

(15)

 

 

(14)

Interest expense, net

 

$

245

 

$

253

 

$

744

 

$

816

29

Note 10 –




9.Earnings Per Share


Earnings per share is computed using the two-class method. OptionsStock appreciation rights and options to purchase 10.917 million and 9.916 million sharesshares of common stock were outstanding, but were not included inexcluded from the calculation of diluted earnings per share for the three and nine months ended September 30, 2017,2020, respectively, because thetheir exercise prices of the options were greater than the average market price of the common shares and, therefore, the effect would be antidilutive. For the same reason, stock appreciation rights and options to purchase approximately 7.718 million and 6.419 million shares of common stock were outstanding, but were not included inexcluded from the calculation of diluted earnings per share for the three and nine months ended September 30, 2016,2019, respectively.

14



Table of Contents

The following is a reconciliation of basic and diluted earnings per share from continuing operations for the respective periods:

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Nine Months Ended

 

September 30, 

 

September 30, 

Three Months Ended
September 30,
Nine Months Ended
September 30,

In millions, except per share amounts

    

2017

    

2016

    

2017

    

2016

In millions, except per share amounts2020201920202019

Numerator for earnings per share calculation:

 

 

 

 

 

 

 

 

 

 

 

 

Numerator for earnings per share calculation:

Income from continuing operations

 

$

1,285

 

$

1,542

 

$

3,344

 

$

3,613

Net incomeNet income$1,219 $1,529 $6,217 $4,887 

Income allocated to participating securities

 

 

(3)

 

 

(7)

 

 

(12)

 

 

(18)

Income allocated to participating securities(3)

Net income attributable to noncontrolling interest

 

 

 —

 

 

(1)

 

 

(1)

 

 

(2)

Income from continuing operations attributable to CVS Health

 

$

1,282

 

$

1,534

 

$

3,331

 

$

3,593

Net (income) loss attributable to noncontrolling interestsNet (income) loss attributable to noncontrolling interests(11)
Net income attributable to CVS HealthNet income attributable to CVS Health$1,224 $1,530 $6,206 $4,884 

 

 

 

 

 

 

 

 

 

 

 

 

Denominator for earnings per share calculation:

 

 

 

 

 

 

 

 

 

 

 

 

Denominator for earnings per share calculation:

Weighted average shares, basic

 

 

1,016

 

 

1,068

 

 

1,022

 

 

1,076

Weighted average shares, basic1,310 1,302 1,308 1,300 

Effect of dilutive securities

 

 

 4

 

 

 5

 

 

 4

 

 

 6

Effect of dilutive securities

Weighted average shares, diluted

 

 

1,020

 

 

1,073

 

 

1,026

 

 

1,082

Weighted average shares, diluted1,315 1,305 1,314 1,303 

 

 

 

 

 

 

 

 

 

 

 

 

Earnings per share from continuing operations:

 

 

 

 

 

 

 

 

 

 

 

 

Earnings per share:Earnings per share:

Basic

 

$

1.26

 

$

1.44

 

$

3.26

 

$

3.34

Basic$0.93 $1.17 $4.74 $3.76 

Diluted

 

$

1.26

 

$

1.43

 

$

3.25

 

$

3.32

Diluted$0.93 $1.17 $4.72 $3.75 

Note 11 – Segment Reporting


10.Commitments and Contingencies

COVID-19

The Company has three reportable segments: Pharmacy Services, Retail/LTC and Corporate. The Retail/LTC Segment includes theCOVID-19 pandemic continues to evolve. We believe COVID-19’s impact on our businesses, operating results, cash flows and/or financial condition primarily will be driven by the geographies impacted and the severity and duration of the Company’s Retail Pharmacy and LTC/RxCrossroads operating segments aspandemic; the operations and economic characteristics are similar. The Company’s three reportable segments maintain separate financial information by which operating results are evaluated on a regular basis by the Company’s chief operating decision maker in deciding how to allocate resources and in assessing performance.

The Company evaluates its Pharmacy Services and Retail/LTC segments’ performance based on net revenue, gross profit and operating profit before the effect of nonrecurring charges and gains and certain intersegment activities. The Company evaluates the performance of its Corporate Segment based on operating expenses before the effect of nonrecurring charges and gains and certain intersegment activities. The chief operating decision maker does not use total assets by segment to make decisions regarding resources, therefore the total asset disclosure by segment has not been included.

The Pharmacy Services Segment provides a full range of pharmacy benefit management (“PBM”) solutions including plan design offerings and administration, formulary management, Medicare Part D services, mail order, specialty pharmacy and infusion services, retail pharmacy network management services, prescription management systems, clinical services, disease management services and medical spend management. The Company’s clients are primarily employers, insurance companies, unions, government employee groups, health plans, Medicare Part D, Managed Medicaid plans, plans offeredpandemic’s impact on the publicU.S. and private exchanges,global economies and other sponsors ofconsumer behavior and health benefit plans and individuals throughout the United States. Through the Company’s SilverScript Insurance Company subsidiary, the Pharmacy Services Segment is a national provider of drug benefits to eligible beneficiaries under the federal government’s Medicare Part D program. The Pharmacy Services Segment operates under the CVS Caremark® Pharmacy Services, Caremark®, CVS CaremarkTM, CarePlus CVS PharmacyTM, Accordant®, SilverScript®, Coram®, CVS SpecialtyTM, NovoLogix®, Navarro® Health Services, Advanced Care Scripts and ACS Pharmacy names. As of September 30, 2017, the Pharmacy Services Segment operated 23 retail specialty pharmacy stores, 15 specialty mail order pharmacies, four mail service dispensing pharmacies, and 82 branches for infusion and enteral services, including approximately 73 ambulatory infusion suites and three centers of excellence, located in 41 states, Puerto Ricocare utilization patterns; and the Districttiming, scope and impact of Columbia.

The Retail/LTC Segment sells prescription drugs and a wide assortment of general merchandise, including over-the-counter drugs, beauty products and cosmetics, personal care products, convenience foods, photo finishing services, seasonal merchandise and greeting cards. The Retail/LTC Segment also includes providing the distribution of prescription drugs, related pharmacy consulting and other ancillary services to chronic care facilities and other care settings,stimulus legislation as well as commercialization services thatother federal, state and local governmental responses to the pandemic. Those primary drivers are provided underbeyond our knowledge and control. As a result, the name RxCrossroads®. The Retail/LTC

impact COVID-19 will have on our businesses, operating results, cash flows and/or financial condition is uncertain, but the impact could be adverse and material. COVID-19 also may result in legal and regulatory proceedings, investigations and claims against us.

15



Table of Contents

Segment also provides health care services through its MinuteClinic® health care clinics. MinuteClinics are staffed by nurse practitioners and physician assistants who utilize nationally recognized protocols to diagnose and treat minor health conditions, perform health screenings, monitor chronic conditions and deliver vaccinations. As of September 30, 2017, our Retail/LTC Segment included 9,751 retail locations (of which 8,016 were the Company’s stores that operated a pharmacy and 1,687 were the Company’s pharmacies located within Target stores) located in 49 states, the District of Columbia, Puerto Rico and Brazil operating primarily under the CVS Pharmacy®, CVS®,  CVS Pharmacy y más®,  Longs Drugs®, Navarro Discount Pharmacy® and Drogaria OnofreTM names, 38 onsite pharmacies primarily operating under the CarePlus CVS PharmacyTM, CarePlus® and CVS Pharmacy® names, 1,129 retail health care clinics operating under the MinuteClinic® name (of which 1,122 were located in CVS Pharmacy and Target stores), and our online retail websites, CVS.com®, Navarro.comTM and Onofre.com.brTM. LTC operations are comprised of 143 spoke pharmacies that primarily handle new prescription orders, of which 31 are also hub pharmacies that use proprietary automation to support spoke pharmacies with refill prescriptions. LTC operates primarily under the Omnicare® and NeighborCare® names.

The Corporate Segment provides management and administrative services to support the Company. The Corporate Segment consists of certain aspects of executive management, corporate relations, legal, compliance, human resources, information technology and finance departments.

16


Table of Contents

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pharmacy 

 

 

 

 

 

 

 

 

 

 

 

 

 

    

Services

    

Retail/LTC

    

Corporate

    

Intersegment

    

Consolidated

In millions

 

Segment(1)

 

Segment

 

Segment

 

Eliminations(2)

 

Totals

Three Months Ended

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

September 30, 2017:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 Net revenues

 

$

32,896

 

$

19,593

 

$

 —

 

$

(6,308)

 

$

46,181

 Gross profit (3)

 

 

1,645

 

 

5,685

 

 

 —

 

 

(204)

 

 

7,126

 Operating profit (loss) (4)(5)(6)

 

 

1,353

 

 

1,553

 

 

(220)

 

 

(187)

 

 

2,499

September 30, 2016:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 Net revenues

 

 

30,429

 

 

20,143

 

 

 

 

(5,957)

 

 

44,615

 Gross profit (3)

 

 

1,797

 

 

5,893

 

 

 

 

(198)

 

 

7,492

 Operating profit (loss) (5)(6)(7)

 

 

1,459

 

 

1,778

 

 

(228)

 

 

(185)

 

 

2,824

Nine Months Ended

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

September 30, 2017:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 Net revenues

 

 

96,444

 

 

58,488

 

 

 —

 

 

(18,552)

 

 

136,380

 Gross profit (3)

 

 

4,210

 

 

17,036

 

 

 —

 

 

(605)

 

 

20,641

 Operating profit (loss) (4)(5)(6)

 

 

3,272

 

 

4,375

 

 

(686)

 

 

(552)

 

 

6,409

September 30, 2016:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 Net revenues

 

 

88,704

 

 

60,253

 

 

 

 

(17,402)

 

 

131,555

 Gross profit (3)

 

 

4,266

 

 

17,560

 

 

 

 

(575)

 

 

21,251

 Operating profit (loss) (5)(6)(7)

 

 

3,282

 

 

5,273

 

 

(660)

 

 

(529)

 

 

7,366


(1)

Net revenues of the Pharmacy Services Segment include approximately $2.6 billion and $2.5 billion of retail co‑payments for the three months ended September 30, 2017 and 2016, respectively, as well as $8.4 billion and $8.1 billion of retail co-payments for the nine months ended September 30, 2017 and 2016, respectively.

(2)

Intersegment eliminations relate to intersegment revenue generating activities that occur between the Pharmacy Services Segment and the Retail/LTC Segment. These occur in the following ways: when members of Pharmacy Services Segment clients (“members”) fill prescriptions at the Company’s retail pharmacies to purchase covered products, when members enrolled in programs such as Maintenance Choice® elect to pick up maintenance prescriptions at one of the Company’s retail pharmacies instead of receiving them through the mail, or when members have prescriptions filled at the Company’s long-term care pharmacies. When these occur, both the Pharmacy Services and Retail/LTC segments record the revenues, gross profit and operating profit on a standalone basis.

(3)

The Retail/LTC Segment gross profit for the three months ended September 30, 2017 and 2016 includes $2 million and $5 million, respectively, of acquisition-related integration costs. The Retail/LTC Segment gross profit for the nine months ended September 30, 2017 and 2016 includes $7 million and $15 million, respectively, of acquisition-related integration costs. The integration costs in 2017 are related to the acquisition of Omnicare and the integration costs in 2016 are related to the acquisitions of Omnicare and the pharmacies and clinics of Target.

(4)

The Retail/LTC Segment operating profit for the three and nine months ended September 30, 2017 includes $6 million and $211 million, respectively, of charges associated with store closures (see “Note 8 – Store Closures” to the condensed consolidated financial statements). The Retail/LTC Segment operating profit for the nine months ended September 30, 2017 also includes a $135 million goodwill impairment charge related to the segment’s RxCrossroads reporting unit (see “Note 2 – Goodwill and Intangible Assets” to the condensed consolidated financial statements).

(5)

The Retail/LTC Segment operating profit for the three months ended September 30, 2017 and 2016 includes $9 million and $52 million, respectively, of acquisition-related integration costs. The Retail/LTC Segment operating profit for the nine months ended September 30, 2017 and 2016 includes $34 million and $194 million, respectively, of acquisition-related integration costs. The integration costs in 2017 are related to the acquisition of Omnicare and the integration costs in 2016 are related to the acquisitions of Omnicare and the pharmacies and clinics of Target.

(6)

The Corporate Segment operating loss for the three and nine months ended September 30, 2017 include a $3 million reduction in integration costs for a change in estimate related to the acquisition of Omnicare. The Corporate Segment operating loss for the three and nine months ended September 30, 2016 includes $13 million of integration costs related to the acquisitions of Omnicare and the pharmacies and clinics of Target.

(7)

Amounts revised to reflect the adoption of ASU 2017-07, Improving the Presentation of Net Periodic Pension Cost and Net Periodic Postretirement Benefit Cost, which increased consolidated operating profit by $7 and $23 million for the three and nine months ended September 30, 2016, respectively (see “Note 1 – Accounting Policies” to the condensed consolidated financial statements).

17


Table of Contents

Note 12 – Commitments and Contingencies

Lease Guarantees


Between 19911995 and 1997, the Company sold or spun off a number of subsidiaries, including Bob’s Stores and Linens ‘n Things, Marshalls, Kay-Bee Toys, Wilsons, This End Upeach of which subsequently filed for bankruptcy, and Footstar.Marshalls. In many cases, when a former subsidiary leased a store, the Company provided a guarantee of the store’sformer subsidiary’s lease obligations.obligations for the initial lease term and any extension thereof pursuant to a renewal option provided for in the lease prior to the time of the disposition. When the subsidiaries were disposed of and accounted for as discontinued operations, the Company’s guarantees remained in place, although each initial purchaser has agreed to indemnify the Company for any lease obligations the Company was required to satisfy. If any of the purchasers or any of the former subsidiaries were to become insolvent and failedfail to make the required payments under a store lease, the Company could be required to satisfy thesethose obligations, and any significant adverse impact of COVID-19 on such purchasers and/or former subsidiaries increases the risk that the Company will be required to satisfy those obligations. As of September 30, 2017,2020, the Company guaranteed approximately 8676 such store leases (excluding the lease guarantees related to Linens ‘n Things, which have been recorded as a liability on the unaudited condensed consolidated balance sheet)sheets), with the maximum remaining lease term extending through 2047.

In April 20162030.

30



Guaranty Fund Assessments, Market Stabilization and againOther Non-Voluntary Risk Sharing Pools

Under guaranty fund laws existing in February 2017, Bob’s Storesall states, insurers doing business in those states can be assessed (in most states up to prescribed limits) for certain obligations of insolvent insurance companies to policyholders and its relatedclaimants. The life and successor entities filed for Chapter 11 bankruptcy protection. As described above,health insurance guaranty associations in which the Company throughparticipates that operate under these laws respond to insolvencies of long-term care insurers and life insurers as well as health insurers. The Company’s assessments generally are based on a formula relating to the Company’s health care premiums in the state compared to the premiums of other insurers. Certain states allow assessments to be recovered over time as offsets to premium taxes. Some states have similar laws relating to HMOs and/or other payors such as not-for-profit consumer-governed health plans established under the ACA.

In 2009, the Pennsylvania Insurance Commissioner placed long-term care insurer Penn Treaty Network America Insurance Company and one or more of its affiliates,subsidiaries (collectively, “Penn Treaty”) in rehabilitation, an intermediate action before insolvency, and subsequently petitioned a state court to convert the rehabilitation into a liquidation. Penn Treaty was placed in liquidation in March 2017. The Company has recorded a liability for its estimated share of future assessments by applicable life and health insurance guaranty associations. It is allegedreasonably possible that in the future the Company may record a liability and expense relating to other insolvencies which could have guaranteed certaina material adverse effect on the Company’s operating results, financial condition and cash flows, and this risk is heightened by any significant adverse impact of the Bob’s Stores’ leases (the “Bob’s Leases”). Following these bankruptcy filings, in May 2017COVID-19 pandemic on the solvency of other insurers, including long-term care insurers and life insurers. While historically the Company has ultimately recovered more than half of guaranty fund assessments through statutorily permitted premium tax offsets, significant increases in assessments could lead to legislative and/or regulatory actions that limit future offsets.

HMOs in certain states in which the Company does business are subject to assessments, including market stabilization and SDI Stores, LLC (“SDI Stores”), entered into an agreement regardingother risk-sharing pools, for which the Bob’s Leases, which was amended in August 2017 (the “CVS/SDI Stores Agreement”). PursuantCompany is assessed charges based on incurred claims, demographic membership mix and other factors. The Company establishes liabilities for these assessments based on applicable laws and regulations. In certain states, the ultimate assessments the Company pays are dependent upon the Company’s experience relative to other entities subject to the CVS/SDI Stores Agreement, SDI Stores has acceptedassessment, and the assignmentultimate liability is not known at the financial statement date. While the ultimate amount of the Bob’s Leasesassessment is dependent upon the experience of all pool participants, the Company believes it has adequate reserves to cover such assessments.

Litigation and has agreed to be bound by certain restrictions regarding renewals, extensions and modifications to the Bob’s Leases, in exchange for a series of payments that are immaterial to the Company.

Legal Matters

Regulatory Proceedings


The Company is a party to numerous legal proceedings, investigations, audits and claims arising, for the most part, in the ordinary course of its business,businesses, including the matters described below. The Company records accruals for outstanding legal matters when it believes it is probable that a loss will be incurred and the amount can be reasonably estimated. The Company evaluates, on a quarterly basis, developments in legal matters that could affect the amount of any accrual and developments that would make a loss contingency both probable and reasonably estimable. If a loss contingency is not both probable and reasonably estimable, the Company does not establish an accrued liability. None of the Company’s accruals for outstanding legal matters are material individually or in the aggregate to the Company’s financial position.

condition.


Except as otherwise noted, the Company cannot predict with certainty the timing or outcome of the legal matters described below, and the Company is unable to reasonably estimate a possible loss or range of possible loss in excess of amounts already accrued for these matters.

·

Indiana State District Council of Laborers and HOD Carriers Pension and Welfare Fund v. Omnicare, Inc., et al. (U.S. District Court for the Eastern District of Kentucky). In February 2006, two substantially similar putative class action lawsuits were filed and subsequently consolidated. The consolidated complaint was filed against Omnicare, three of its officers and two of its directors and purported to be brought on behalf of all open-market purchasers of Omnicare common stock from August 3, 2005 through July 27, 2006, as well as all purchasers who bought shares of Omnicare common stock in Omnicare’s public offering in December 2005. The complaint alleged violations of the Securities Exchange Act of 1934 and Section 11 of the Securities Act of 1933 and sought, among other things, compensatory damages and injunctive relief. After dismissals and appeals to the United States Court of Appeals for the Sixth Circuit, the United States Supreme Court remanded the case to the district court. In October 2016, Omnicare filed an answer to plaintiffs’ third amended complaint, and discovery commenced.

·

FTC and Multi-State Investigation. In March 2010, the Company learned that various State Attorneys General offices and certain other government agencies were conducting a multi-state investigation of certain of the Company’s business practices similar to those being investigated at that time by the U.S. Federal Trade Commission (“FTC”). Twenty-eight states, the District of Columbia and the County of Los Angeles are known to be participating in this investigation. The prior FTC investigation, which commenced in August 2009, was officially concluded in May 2012 when the consent order entered into between the FTC and the Company became final. The Company has cooperated with the multi-state investigation.

It is reasonably possible that the outcome of such legal matters could be material to the Company.


18

Usual and Customary Litigation

The Company is named as a defendant in a number of lawsuits, including the cases below, that allege that the Company’s retail stores overcharged for prescription drugs by not submitting the price available to members of the CVS Health Savings Pass program as the pharmacy’s usual and customary price, and related theories. The Company is defending itself against these claims.

Corcoran et al. v. CVS Health Corporation (U.S. District Court for the Northern District of California) and Podgorny et al. v. CVS Health Corporation (U.S. District Court for the Northern District of Illinois). These putative class actions were filed against the Company in July and September 2015. The cases were consolidated in the U.S. District Court for the Northern District of California. Plaintiffs seek damages and injunctive relief under the consumer protection statutes of certain states on behalf of a class of consumers who purchased certain prescription drugs. Several third-party payors filed similar putative class actions on behalf of payors captioned Sheet Metal Workers Local No. 20 Welfare and Benefit Fund v. CVS Health Corp. and Plumbers Welfare Fund, Local 130 v. CVS Health Corporation (both pending in the U.S. District Court for the District of
31



Rhode Island) in February and August 2016. In all of these cases the plaintiffs allege the Company overcharged for certain prescription drugs by not submitting the price available to members of the CVS Health Savings Pass program as the pharmacy’s usual and customary price. In the Corcoran case, the U.S. District Court granted summary judgment to the Company on plaintiffs’ claims in their entirety and certified certain subclasses in September 2017. In June 2019, the U.S. Court of Appeals for the Ninth Circuit reversed the U.S. District Court’s grant of summary judgment and reversed the U.S. District Court’s narrowing of the requested class. The Corcoran case is proceeding to a trial on a six state class basis, and trial is scheduled to occur in 2021. The Sheet Metal Workers plaintiffs have amended their complaint to assert a claim under the federal Racketeer Influenced and Corrupt Organizations Act (“RICO”) premised on an alleged conspiracy between the Company and other PBMs.

State of Mississippi v. CVS Health Corporation, et al. (Circuit Court of DeSoto County, Mississippi, Third Judicial District). In July 2016, the Company was served with a complaint filed on behalf of the State of Mississippi. The complaint alleged that CVS retail pharmacies in Mississippi submitted false claims for reimbursement to the Mississippi Medicaid program by not submitting the price available to members of the CVS Health Savings Pass program as the pharmacy’s usual and customary price. In June 2019, the Company’s motion for judgment on the pleadings was granted in part and denied in part. Also in June 2019, the State of Mississippi’s motion to dismiss the Company’s counterclaim for declaratory relief was granted. In April 2020, the Company’s motion to dismiss the State of Mississippi’s second amended complaint was denied.

Blue Cross and Blue Shield of Alabama, et al. v. CVS Health Corporation, et al. and Horizon Healthcare Services, Inc. (d/b/a Horizon Blue Cross Blue Shield of New Jersey) et al.v. CVS Health Corporation, et al. (U.S. District Court for the District of Rhode Island). In May 2020, 8 Blue Cross Blue Shield entities from 6 states filed a lawsuit against the Company alleging fraud and other state causes of action premised on a theory that the Company’s retail stores overcharged for prescription drugs by not submitting accurate usual and customary prices, including by not submitting the price available to members of the former CVS Health Savings Pass program. In October 2020, 2 Horizon Blue Cross Blue Shield entities from New Jersey filed an almost identical lawsuit premised on the same theories.

PBM Litigation and Investigations

The Company is named as a defendant in a number of lawsuits and is subject to a number of investigations concerning its PBM practices.
Klein, et al. v. Prime Therapeutics, et al. (U.S. District Court for the District of Minnesota). This putative class action was filed against the Company and other PBMs in June 2017 on behalf of ERISA plan members who purchased and paid for EpiPen or EpiPen Jr. Plaintiffs allege that the PBMs are ERISA fiduciaries to plan members and have violated ERISA by allegedly causing higher inflated prices for EpiPens through the process of negotiating increased rebates from EpiPen manufacturer Mylan. This case was consolidated with a similar matter and was proceeding as In re EpiPen ERISA Litigation. In October 2020, the lawsuit was voluntarily dismissed with prejudice following denial of the plaintiffs’ motion for class certification.

County of Harris, Texas v. Eli Lilly and Company, et al. (U.S. District Court for the Southern District of Texas).This lawsuit was filed against Caremark, Aetna, the manufacturers of insulin and other PBMs in November 2019 by Harris County. Harris County alleges that it was overcharged for insulin as a result of a “price fixing conspiracy” between the manufacturers and PBMs to artificially increase the price of insulin and other diabetes medications. The complaint alleges violations of RICO and claims that the manufacturers and PBMs engaged in an “Insulin Pricing Scheme” whereby the manufacturers artificially increased the reported prices of their insulin products while “secretly” paying rebates to the PBMs in exchange for preferred treatment on the PBMs’ drug formularies. The Company is defending itself against these claims.

In re Direct Purchaser EpiPen Litigation (U.S. District Court for the District of Minnesota). This putative class action (originally captioned as Rochester Drug Cooperative, Inc. v. Mylan Inc., et al.) was filed in March 2020 against Caremark, other PBMs and the manufacturer of EpiPen products and their authorized generics on behalf of purported classes of direct purchasers of these products. The complaint alleges violations of RICO and claims that rebate agreements between the drug manufacturer and PBMs caused the direct purchasers to pay inflated prices for these drug products. A nearly identical case was separately filed in the same court (Dakota Drug, Inc. v. Mylan Inc., et al.). The court granted a motion to consolidate the two complaints. The Company is defending itself against these claims.

In re Direct Purchaser Insulin Pricing Litigation (U.S. District Court for the District of New Jersey). This putative class action (originally captioned as Rochester Drug Cooperative, Inc. v. Eli Lilly and Co., et al.) was filed in March 2020 against Caremark, other PBMs and the manufacturers of analog insulin products on behalf of purported classes of direct purchasers of these products. The complaint alleges violations of RICO and claims that rebate agreements between the drug manufacturers and PBMs caused the direct purchasers to pay inflated prices for these drug products. Two nearly identical cases were

Table



separately filed in the same court (FWK Holdings, LLC v. Novo Nordisk, et al. and Value Drug Company v. Eli Lilly & Co., et al.). The court granted a motion to consolidate all three complaints. The Company is defending itself against these claims.

United States ex rel. Behnke v. CVS Caremark Corporation, et al. (U.S. District Court for the Eastern District of Contents

Pennsylvania). In April 2018, the Court unsealed a complaint filed in February 2014. The government has declined to intervene in this case. The relator alleges that the Company submitted, or caused to be submitted, to Part D of the Medicare program Prescription Drug Event data and/or Direct and Indirect Remuneration reports that misrepresented true prices paid by the Company’s PBM to pharmacies for drugs dispensed to Part D beneficiaries with prescription benefits administered by the Company’s PBM. In April 2020, the Company’s motion to dismiss was granted in part and denied in part. The Company is defending itself against these claims.

The Company has received subpoenas, civil investigative demands (“CIDs”) and other requests for documents and information from, and is being investigated by, Attorneys General of several states regarding its PBM practices, including pricing and rebates. In addition, the Company has received inquiries from congressional committees regarding insulin pricing. The Company has been providing documents and information in response to these subpoenas, CIDs and requests for information.

Controlled Substances Litigation, Audits and Subpoenas

In December 2017, the U.S. Judicial Panel on Multidistrict Litigation consolidated numerous cases filed against various defendants by plaintiffs such as counties, cities, hospitals, Indian tribes and third-party payors, alleging claims generally concerning the impacts of widespread prescription opioid abuse. The consolidated multidistrict litigation captioned In re National Prescription Opiate Litigation (MDL No. 2804) is pending in the U.S. District Court for the Northern District of Ohio. This multidistrict litigation presumptively includes hundreds of relevant federal court cases that name the Company as a defendant. A significant number of similar cases that name the Company as a defendant in some capacity are pending in state courts. In addition, the Company has been named as a defendant in similar cases brought by certain state Attorneys General. The Company is defending itself against all such claims. Additionally, the Company has received subpoenas, CIDs and/or other requests for information regarding opioids from state Attorneys General and insurance and other regulators of several states. The Company has been cooperating with the government with respect to these subpoenas, CIDs and other requests for information.

The Company routinely is audited by the U.S. Drug Enforcement Administration (the “DEA”). In some instances, the Company is in discussions with the DEA and U.S. Attorney’s Offices concerning allegations that the Company violated certain requirements of the federal Controlled Substances Act.

In January 2020, the DOJ served the Company with a DEA administrative subpoena. The subpoena seeks documents relating to practices with respect to prescription opioids and other controlled substances at CVS Pharmacy locations in connection with an investigation concerning potential violations of the federal Controlled Substances Act and the federal False Claims Act. The Company has been cooperating with the government with respect to this subpoena.

Prescription Processing Litigation and Investigations

U.S. ex rel. Bassan et al. v. Omnicare, Inc. and CVS Health Corp. and U.S. ex rel. Mohajer et al. v. Omnicare, Inc. and CVS Health Corp. (U.S. District Court for the Southern District of New York). In December 2019, the U.S. Attorney’s Office for the Southern District of New York (the “SDNY”) filed complaints-in-intervention in these two previously sealed qui tam cases. With respect to the Bassan complaint, all states and Washington, D.C. have declined to intervene at this time. The government’s investigation related to these complaints included the previously disclosed CID that the Company received in October 2015 from the SDNY concerning the Company’s Omnicare pharmacies’ cycle fill process for assisted living facilities. The complaints allege that for certain non-skilled nursing facilities, Omnicare improperly filled prescriptions beyond one year where a valid prescription did not exist and that these dispensing events violated the federal False Claims Act. The Mohajer relators have amended their complaint to include claims based on similar theories related to certain skilled nursing facilities. The Company is defending itself against these claims.

In July 2017, the Company also received a subpoena from the California Department of Insurance requesting documents concerning the Company’s Omnicare pharmacies’ cycle fill process for assisted living facilities. The Company has been cooperating with the California Department of Insurance and providing documents and information in response to this subpoena.

33


·

United States ex rel. Jack Chin v. Walgreen Company, et al. (U.S. District Court for the Central District of California). In March 2010, the Company received a subpoena from the U.S. Department of Health and Human Services, Office of the Inspector General (“OIG”) requesting information about programs under which the Company has offered customers remuneration conditioned upon the transfer of prescriptions for drugs or medications to the Company’s pharmacies in the form of gift cards, cash, non-prescription merchandise or discounts or coupons for non-prescription merchandise. In October 2016, the U.S. District Court for the Central District of California unsealed a qui tam complaint, filed in April 2009 against CVS Pharmacy and other retail pharmacies, alleging that the Company violated the federal False Claims Act, and the False Claims Acts of several states, by offering such programs. The complaint was served on the Company in January 2017. The federal government has declined intervention in the case. The Company is defending this lawsuit. 

·

United States ex rel. Anthony R. Spay v. CVS Caremark Corporation, et al. (U.S. District Court for the Eastern District of Pennsylvania). In January 2012, the court unsealed a first amended qui tam complaint filed in August 2011 by an individual relator, Anthony Spay, who is described in the complaint as having once been employed by a firm providing pharmacy prescription benefit audit and recovery services. The complaint seeks monetary damages and alleges that CVS Caremark’s processing of Medicare claims on behalf of one of its clients violated the federal False Claims Act. The United States declined to intervene in the lawsuit. In September 2015, the Court granted CVS Caremark’s motion for summary judgment in its entirety, and entered judgment in favor of CVS Caremark and against Spay. In October 2015, Spay filed a notice of appeal in the United States Court of Appeals for the Third Circuit; that court heard oral arguments on the appeal in November 2016.

·

State of Texas ex rel. Myron Winkelman and Stephani Martinson, et al. v. CVS Health Corporation, (Travis County Texas District Court). In February 2012, the Attorney General of the State of Texas issued Civil Investigative Demands and has issued a series of subsequent requests for documents and information in connection with its investigation concerning the CVS Health Savings Pass program and other pricing practices with respect to claims for reimbursement from the Texas Medicaid program. In January 2017, the court unsealed a first amended petition. The amended petition alleges the Company violated the Texas Medicaid Fraud Prevention Act by submitting false claims for reimbursement to Texas Medicaid by, among other things, failing to use the price available to members of the CVS Health Savings Pass program as the usual and customary price. The amended petition was unsealed following the Company’s filing of CVS Pharmacy, Inc. v. Charles Smith, et al. (Travis County District Court), a declaratory judgment action against the State of Texas in December 2016 seeking a declaration that the prices charged to members of the CVS Health Savings Pass program do not constitute usual and customary prices under the Medicaid regulation. The State of Texas is also pursuing temporary injunctive relief. 

·

Subpoena Concerning PBM Administrative Fees. In March 2014, the Company received a subpoena from the United States Attorney’s Office for theDistrict of Rhode Island, requesting documents and information concerning bona fide service fees and rebates received from pharmaceutical manufacturers in connection with certain drugs utilized under Medicare Part D, as well as the reporting of those fees and rebates to Part D plan sponsors. The Company has been cooperating with the government and providing documents and information in response to the subpoena.

·

Corcoran et al. v. CVS Health Corporation (U.S. District Court for the Northern District of California) and Podgorny et al. v. CVS Health Corporation (U.S. District Court for the Northern District of Illinois). These putative class actions were filed against the Company in July and September 2015. The cases were consolidated in United States District Court in the Northern District of California. Plaintiffs seek damages and injunctive relief on behalf of a class of consumers who purchased certain prescription drugs under the consumer protection statutes and common laws of certain states. Several third-party payors filed similar putative class actions on behalf of payors captioned Sheet Metal Workers Local No. 20 Welfare and Benefit Fund v. CVS Health Corp. and Plumbers Welfare Fund, Local 130 v. CVS Health Corporation (both pending in the U.S. District Court for the District of Rhode Island) in February and August 2016. In all of these cases the plaintiffs allege the Company overcharged for certain prescription drugs by not submitting the price available to members of the CVS Health Savings Pass program as the pharmacy’s usual and customary price. In the consumer case (Corcoran), the Court granted summary judgment to CVS on plaintiffs’ claims in their entirety and certified certain subclasses in September 2017. The plaintiffs have filed a notice of appeal to the Ninth Circuit. The Company continues to defend these actions.

In December 2016, the Company received a CID from the U.S. Attorney’s Office for the Northern District of New York requesting documents and information in connection with a federal False Claims Act investigation concerning whether the Company’s retail pharmacies improperly submitted certain insulin claims to Part D of the Medicare program rather than Part B of the Medicare program. The Company has been cooperating with the government and providing documents and information in response to this CID.


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In May 2017, the Company received a CID from the SDNY requesting documents and information concerning possible false claims submitted to Medicare in connection with reimbursements for prescription drugs under the Medicare Part D program. The Company has been cooperating with the government and providing documents and information in response to this CID.

Provider Proceedings

The Company is named as a defendant in purported class actions and individual lawsuits arising out of its practices related to the payment of claims for services rendered to its members by health care providers with whom the Company has a contract and with whom the Company does not have a contract (“out-of-network providers”). Among other things, these lawsuits allege that the Company paid too little to its health plan members and/or providers for these services and/or otherwise allege that the Company failed to timely or appropriately pay or administer claims and benefits (including the Company’s post payment audit and collection practices and reductions in payments to providers due to sequestration). Other major health insurers are the subject of similar litigation or have settled similar litigation.

The Company also has received subpoenas and/or requests for documents and other information from, and been investigated by, state Attorneys General and other state and/or federal regulators, legislators and agencies relating to, and the Company is involved in other litigation regarding, its out-of-network benefit payment and administration practices. It is reasonably possible that others could initiate additional litigation or additional regulatory action against the Company with respect to its out-of-network benefit payment and/or administration practices.

CMS Actions

The U.S. Centers for Medicare & Medicaid Services (“CMS”) regularly audits the Company’s performance to determine its compliance with CMS’s regulations and its contracts with CMS and to assess the quality of services it provides to Medicare beneficiaries. CMS uses various payment mechanisms to allocate and adjust premium payments to the Company’s and other companies’ Medicare plans by considering the applicable health status of Medicare members as supported by information prepared, maintained and provided by health care providers. The Company collects claim and encounter data from providers and generally relies on providers to appropriately code their submissions to the Company and document their medical records, including the diagnosis data submitted to the Company with claims. CMS pays increased premiums to Medicare Advantage plans and Medicare PDP plans for members who have certain medical conditions identified with specific diagnosis codes. Federal regulators review and audit the providers’ medical records to determine whether those records support the related diagnosis codes that determine the members’ health status and the resulting risk-adjusted premium payments to the Company. In that regard, CMS has instituted risk adjustment data validation (“RADV”) audits of various Medicare Advantage plans, including certain of the Company’s plans, to validate coding practices and supporting medical record documentation maintained by health care providers and the resulting risk adjusted premium payments to the plans. CMS may require the Company to refund premium payments if the Company’s risk adjusted premiums are not properly supported by medical record data. The Office of the Inspector General of Health and Human Services (the “OIG”) also is auditing the Company’s risk adjustment-related data and that of other companies. The Company expects CMS and the OIG to continue these types of audits.

In 2012, CMS revised its audit methodology for RADV audits to determine refunds payable by Medicare Advantage plans for contract year 2011 and forward. Under the revised methodology, among other things, CMS will extrapolate the error rate identified in the audit sample of approximately 200 members to all risk adjusted premium payments made under the contract being audited. For contract years prior to 2011, CMS did not extrapolate sample error rates to the entire contract. As a result, the revised methodology may increase the Company’s exposure to premium refunds to CMS based on incomplete medical records maintained by providers. Since 2013, CMS has selected certain of the Company’s Medicare Advantage contracts for various contract years for RADV audit, and the number of RADV audits continues to increase. The Company is currently unable to predict which of its Medicare Advantage contracts will be selected for future audit, the amounts of any retroactive refunds of, or prospective adjustments to, Medicare Advantage premium payments made to the Company, the effect of any such refunds or adjustments on the actuarial soundness of the Company’s Medicare Advantage bids, or whether any RADV audit findings would require the Company to change its method of estimating future premium revenue in future bid submissions to CMS or compromise premium assumptions made in the Company’s bids for prior contract years, the current contract year or future contract years. Any premium or fee refunds or adjustments resulting from regulatory audits, whether as a result of
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RADV, Public Exchange related or other audits by CMS, the OIG, the U.S. Department of Health and Human Services or otherwise, including audits of the Company’s minimum medical loss ratio (“MLR”) rebates, methodology and/or reports, could be material and could adversely affect the Company’s operating results, cash flows and/or financial condition.

TableMedicare and Medicaid CIDs


The Company has received CIDs from the Civil Division of Contents

the DOJ in connection with a current investigation of the Company’s patient chart review processes in connection with risk adjustment data submissions under Parts C and D of the Medicare program. The Company has been cooperating with the government and providing documents and information in response to these CIDs.

·

Omnicare DEA Subpoena. In September 2015, Omnicare was served with an administrative subpoena by the U.S. Drug Enforcement Administration (“DEA”). The subpoena seeks documents related to controlled substance policies, procedures, and practices at eight pharmacy locations from May 2012 to the present. In September 2017, the DEA expanded the investigation to include an additional pharmacy. The Company has been cooperating and providing documents in response to this administrative subpoena.

·

Omnicare Cycle Fill Civil Investigative Demand. In October 2015, Omnicare received a Civil Investigative Demand from the United States Attorney’s Office for the Southern District of New York requesting information and documents concerning Omnicare’s cycle fill process for assisted living facilities. The Company has been cooperating with the government and providing documents and information in response to the Civil Investigative Demand. In July 2017, Omnicare also received a subpoena from the California Department of Insurance requesting documents on similar subject matter.

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PBM Pricing Civil Investigative Demand. In October 2015, the Company received from the DOJ a Civil Investigative Demand requesting documents and information in connection with a federal False Claims Act investigation concerning allegations that the Company submitted, or caused to be submitted, to the Medicare Part D program prescription drug event data that misrepresented true prices paid by the Company’s PBM to pharmacies for drugs dispensed to Part D beneficiaries with prescription benefits administered by the Company’s PBM. The Company has been cooperating with the government and providing documents and information in response to the Civil Investigative Demand.

·

United States ex rel. Sally Schimelpfenig and John Segura v. Dr. Reddy's Laboratories Limited and Dr. Reddy's Laboratories, Inc. (U.S. District Court for the Eastern District of Pennsylvania). In November 2015, the court unsealed a second amended qui tam complaint filed in September 2015. The DOJ declined to intervene in this action. The relators allege that the Company, Walgreens, Wal-Mart, and Dr. Reddy’s Laboratories violated the federal and various state False Claims Acts by dispensing prescriptions in unit dose packaging supplied by Dr. Reddy’s that was not compliant with the Consumer Product Safety Improvement Act and the Poison Preventive Packaging Act and thereby allegedly rendering the drugs misbranded under the Food, Drug and Cosmetic Act. In March 2017, the Court granted the Company's motion to dismiss with leave to file an amended complaint. In June 2017, the Company moved to dismiss relators’ third amended complaint.

·

Barchock et al. v. CVS Health Corporation, et al. (U.S. District Court for the District of Rhode Island). In February 2016, a class action lawsuit was filed against the Company, the Benefit Plans Committee of the Company, and Galliard Capital Management, Inc., by Mary Barchock, Thomas Wasecko, and Stacy Weller, purportedly on behalf of the 401(k) Plan and the Employee Stock Ownership Plan of the Company (the “Plan”), and participants in the Plan. The complaint alleged that the defendants breached fiduciary duties owed to the plaintiffs and the Plan by investing too much of the Plan’s Stable Value Fund in short-term money market funds and cash management accounts. The court recently granted the Company’s motion to dismiss the plaintiffs’ amended complaint. In May 2017, plaintiffs appealed that ruling in the United States Court of Appeals for the First Circuit.

·

State of California ex rel. Matthew Omlansky v. CVS Caremark Corporation (Superior Court of the State of California, County of Sacramento). In April 2016, the court unsealed a first amended qui tam complaint filed in July 2013. The government has declined intervention in this case. The relator alleges that the Company submitted false claims for payment to California Medicaid in connection with reimbursement for drugs available through the CVS Health Savings Pass program as well as certain other generic drugs. The case has been stayed pending the relator’s appeal of the judgment against him in a similar case against another retailer.

·

Retail DEA Matters. The Company has been also undergoing several audits by the DEA Administrator and is in discussions with the DEA and the U.S. Attorney’s Offices in several locations concerning allegations that the Company has violated certain requirements of the CSA.

·

West Virginia Opioid Litigation. In March 2017, the Company was named as a defendant in four separate lawsuits filed in the U.S. District Court of the Southern District of West Virginia on behalf of counties in the state of West Virginia (Cabell, Fayette, Kanawha and Wayne counties), each of which alleges that CVS Indiana L.L.C., as well as various other distributors of controlled substances, caused a public nuisance related to opioid


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In April 2020, the Company received a CID from the Office of the Washington Attorney General, Medicaid Fraud Control Division, on behalf of the State of Washington and all other states, as well as the District of Columbia, Puerto Rico and the U.S. Virgin Islands. The investigation involves, among other things, possible retention of overpayments and possible submission of false claims for Medicaid reimbursement relating to drugs prescribed by providers who were excluded by the applicable federal and/or state Medicaid programs. The Company is cooperating with the government with respect to this investigation.


Stockholder Matters

Table

The Company and/or its current and/or former directors and/or executive officers are named as defendants in a number of Contents

lawsuits and a request for access to information initiated by holders or putative holders of CVS Health common stock.

abuse by failing to detect and/or report purported suspicious orders of opioids distributed for dispensing in the plaintiff counties. Omnicare Distribution Center, LLC also is named as a defendant in the complaint filed by Kanawha County. The Company is defending these lawsuits.

·

Cherokee Nation Opioid Litigation. In April 2017, the Company was named as a defendant in an action filed on behalf of the Cherokee Nation in the District Court of Cherokee Nation (the “Cherokee Action”). The lawsuit asserts several causes of action arising from allegations that large retail pharmacies and wholesale distributors caused widespread opioid abuse among members of the Cherokee Nation by purportedly failing to comply with the Controlled Substances Act and/or otherwise failing to prevent the diversion of opioids. In June 2017, the Company filed a motion to dismiss the Cherokee Action. The Cherokee Nation has since filed an amended petition in the Cherokee Action. Also in June 2017, the six defendants in the Cherokee Action collectively filed a complaint in the U.S. District Court for the Northern District of Oklahoma, McKesson, et al. v. Hembree, et al., seeking a declaration and preliminary injunction prohibiting the District Court of Cherokee Nation from exercising jurisdiction over the Cherokee Action. 

·

State of Mississippi v. CVS Health Corporation, et al. (Chancery Court of DeSoto County, Mississippi, Third Judicial District). In July 2016, the Company was served with a complaint filed on behalf of the State of Mississippi alleging that CVS retail pharmacies in Mississippi submitted false claims for reimbursement to Mississippi Medicaid by not submitting the price available to members of the CVS Health Savings Pass program as the pharmacy’s usual and customary price. The Company has responded to the complaint, filed a counterclaim, and moved to transfer the case to circuit court. The motion to transfer was granted, which the State has appealed, and the motion to dismiss remains pending.

·

Mayberry v. Walgreens Co., et al.  (U.S. District Court for the Northern District of Illinois). In March 2017, a complaint was filed against the Company (and several other retail pharmacy defendants) alleging that the defendant pharmacies improperly submitted certain insulin claims through Medicare Part D rather than Part B. The Company’s motion to dismiss the complaint was granted. The Company separately received in December 2016 a Civil Investigative Demand from the U.S. Attorney’s Office for the Northern District of New York, requesting documents and information in connection with a False Claims Act investigation concerning whether the Company’s retail pharmacies improperly submitted certain insulin claims to Medicare Part D rather than Part B. The Company has been cooperating with the government and providing documents and information in response to the Civil Investigative Demand.

·

Cold Chain Logistics Civil Investigative Demand. In September 2016, the Company received from the DOJ a Civil Investigative Demand in connection with an investigation as to whether the Company’s handling of certain temperature-sensitive pharmaceuticals violates the federal Food, Drug and Cosmetic Act and the False Claims Act. The Company has been cooperating with the government and providing documents and information in response to the Civil Investigative Demand.

·

Amburgey, et al. v. CaremarkPCS Health, L.L.C. (U.S. District Court for the Central District of California). In March 2017, the Company was served with a complaint challenging the policies and procedures used by CVS Specialty pharmacies to ship temperature-sensitive medications. The case is similar to a matter already pending against the Company in the Superior Court of California (Los Angeles County), Bertram v. Immunex Corp., et al., which was filed in October 2014. The Company is defending these lawsuits.

·

Barnett, et al. v. Novo Nordisk Inc., et al. and Boss, et al. v. CVS Health Corporation, et al. (both pending in the U.S. District Court for the District of New Jersey). These putative class actions were filed against the Company and other PBMs and manufacturers of insulin in March 2017. Plaintiffs in both cases allege that the PBMs and manufacturers have engaged in a conspiracy whereby the PBMs sell access to their formularies by demanding the highest rebates, which in turn causes increased list prices for insulin. The primary claims are antitrust claims, claims under the Racketeer Influenced and Corrupt Organizations Act (“RICO”), violations of state unfair competition and consumer protection laws and in Boss, claims pursuant to the Employee Retirement Income Security Act (“ERISA”). The Barnett plaintiffs seek to represent a nationwide class of all persons who paid any portion of the purchase prices for a prescription for certain insulin products at a price calculated by reference to a benchmark. The Boss plaintiffs purport to represent multiple nationwide classes including a non-ERISA Employee/Exchange Plan class, an ERISA class, a Medicare class and an uninsured class. The Company continues to defend these lawsuits.


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Between February and August 2019, 6 class action complaints were filed by putative plaintiffs against the Company and certain current and former officers and directors: Anarkat v. CVS Health Corp., et al. (U.S. District Court for the District of Rhode Island); Labourers’ Pension Fund of Central and Eastern Canada v. CVS Health Corp., et al. (New York Supreme Court); City of Warren Police and Fire Retirement Sys. v. CVS Health Corp., et. al. (Rhode Island Superior Court); Cambria Co. Employees Retirement Sys. v. CVS Health Corp., et al. (New York Supreme Court); Freundlich v. CVS Health Corp., et al. (Rhode Island Superior Court); and In re CVS Health Corp. Securities Act Litigation (formerly captioned Waterford Twp. Police & Fire Retirement Sys. v. CVS Health Corp., et al.) (U.S. District Court for the District of Rhode Island). The plaintiffs in these cases assert a variety of causes of action under federal securities laws that are premised on allegations that the defendants made certain omissions and misrepresentations relating to the performance of the Company’s LTC business unit, which allegedly injured investors who acquired CVS Health securities between February 9, 2016 and February 20, 2019. The Labourers’ Pension Fund and Cambria County cases have been consolidated into a single action based on the Labourers’ Pension Fund complaint. The Freundlich and City of Warren cases have been consolidated into In re CVS Health Corp. Securities Litigation and stayed in favor of the earlier-filed Anarkat and Labourers’ Pension Fund cases. The Company is defending itself against these claims.


TableIn January 2020, a derivative complaint was filed against the Company’s directors and current and former executive officers in the U.S. District Court for the District of Contents

Rhode Island by a stockholder. Lovoi v. Aguirre, et al. makes allegations similar to those contained the 6 stockholder class action complaints described above, including that the Company made false or misleading statements about its LTC business unit’s financial health. The Lovoi complaint alleges claims for breach of fiduciary duty against the Company’s directors and certain of its current and former executive officers and for violation of the federal securities laws. The Lovoi complaint seeks damages, restitution and equitable relief on behalf of the Company. The Lovoi case has been stayed pending the resolution of the two federal class action complaints described above. The Company’s directors and current and former executive officers are defending themselves against these claims.


·

Insulin Products Investigation. In April 2017, the Company separately received a Civil Investigative Demand from the Attorney General of Washington, seeking documents and information regarding pricing and rebates for insulin products in connection with a pending investigation into unfair and deceptive acts or practice regarding insulin pricing. We have been notified by the Office of the Attorney General of Washington that information provided in response to the Civil Investigative Demand will be shared with the Attorneys General of California, Florida, Minnesota and New Mexico. In July 2017, the Company received a Civil Investigative Demand from the Attorney General of Minnesota, seeking documents and information regarding pricing and rebates for insulin and epinephrine products in connection with a pending investigation into unfair and deceptive acts or practices regarding insulin and epinephrine pricing.

In August and September 2020, two ERISA class actions were filed in the U.S. District Court in the District of Connecticut against CVS Health Corp., Aetna Inc., and several current and former executives, directors and/or members of Aetna’s Compensation and Talent Management Committee: Radcliffe v. Aetna Inc., et al.and Flaim v. Aetna Inc., et al. The plaintiffs in these cases assert a variety of causes of action premised on allegations that the defendants breached fiduciary duties and engaged in prohibited transactions relating to participants in the Aetna 401(k) plan’s investment in company stock between December 3, 2017 and February 20, 2019, claiming losses related to the performance of the Company’s LTC business unit. The Company also received a related document request pursuant to ERISA § 104(b). The Company is evaluating these matters.

·

Bewley, et al. v. CVS Health Corporation, et al. and Prescott, et al. v. CVS Health Corporation, et al. (both pending in the U.S. District Court for the Western District of Washington). These putative class actions were filed in May 2017 against the Company and other pharmacy benefit managers and manufacturers of glucagon kits (Bewley) and diabetes test strips (Prescott).Both cases allege that, by contracting for rebates with the manufacturers of these diabetes products, the Company and other PBMs caused list prices for these products to increase, thereby harming certain consumers. The primary claims are made under federal antitrust laws, RICO, state unfair competition and consumer protection laws, and ERISA. The Company is defending these lawsuits.


·

Klein, et al. v. Prime Therapeutics, et al. (U.S. District Court for the District of Minnesota). In June 2017, a putative class action complaint was filed against the Company and other pharmacy benefit managers on behalf of ERISA plan members who purchased and paid for EpiPen or EpiPen Jr. Plaintiffs allege that the pharmacy benefit managers are ERISA fiduciaries to plan members and have violated ERISA by allegedly causing higher inflated prices for EpiPen through the process of negotiating increased rebates from EpiPen manufacturer, Mylan. The Company is defending this lawsuit.

Other Legal and Regulatory Proceedings

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Medicare Part D Civil Investigative Demand. In May 2017, the United States Attorney’s Office for the Southern District of New York issued a Civil Investigative Demand to the Company concerning possible false claims submitted to Medicare in connection with reimbursements for prescription drugs under the Medicare Part D program. The Company has been cooperating with the government and providing documents and information in response to the Civil Investigative Demand.


·

Shareholder Matters. In August and September 2017, four complaints were filed by putative derivative plaintiffs against certain officers and directors of the Company. Three of those actions, Sherman v. Merlo, et al., Feghali v. Merlo, et al., and Banchalter v. Merlo, et al., were filed in the U.S. District Court for the District of Rhode Island. A fourth, Boron v. Bracken, et al., was filed in Rhode Island Superior Court. These matters assert a variety of causes of action, including breach of fiduciary duty, waste of corporate assets, unjust enrichment, civil conspiracy and violation of Section 14(a) of the Exchange Act, and are premised on the allegation that the defendants approved business plans that exposed the Company to various litigations and investigations. The parties in the three federal matters have filed a joint motion to stay the cases pending resolution of certain of the underlying matters.

·

MSP Recovery Claims Series, LLC, et al. v. CVS Health Corporation, et al. (U.S. District Court for the Western District of Texas). In September 2017, a putative class action complaint was filed against the company, Express Scripts, Inc., and the manufacturers of insulin on behalf of assignees of claims of Medicare Advantage Organizations. Plaintiffs assert that the PBMs and manufacturers have engaged in a conspiracy whereby the PBMs sell access to their formularies by demanding the highest rebates, which in turn causes increased list prices for insulin. The plaintiffs assert claims on behalf of two putative classes: (1) all Medicare C payors and (2) all Medicare D payors. The complaint asserts claims under RICO, and for common law fraud and unjust enrichment.

The Company is also a party to other legal proceedings and is subject to government investigations, inquiries and audits and has received and is cooperating with the government in response to CIDs, subpoenas or similar process from various governmental agencies requesting information, all arising, for the most part, in the normalordinary course of its business, nonebusinesses. These other legal

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proceedings and government actions include claims of which is expectedor relating to bad faith, medical or professional malpractice, claims processing, dispensing of medications, non-compliance with state and federal regulatory regimes, marketing misconduct, failure to timely or appropriately pay or administer claims and benefits, provider network structure (including the use of performance-based networks and termination of provider contracts), rescission of insurance coverage, improper disclosure or use of personal information, anticompetitive practices, general contractual matters, product liability, intellectual property litigation and employment litigation. Some of these other legal proceedings are or are purported to be materialclass actions or derivative claims. The Company is defending itself against the claims brought in these matters.

Awards to the Company. Company and others of certain government contracts, particularly Medicaid contracts and other contracts with government customers in the Company’s Health Care Benefits segment, frequently are subject to protests by unsuccessful bidders. These protests may result in awards to the Company being reversed, delayed or modified. The loss or delay in implementation of any government contract could adversely affect the Company’s operating results. The Company will continue to defend contract awards it receives.

There also continues to be a heightened level of review and/or audit by regulatory authorities and legislators of, and increased litigation regarding, the Company’s and the rest of the health care and related benefits industry’s business and reporting practices, including premium rate increases, utilization management, development and application of medical policies, complaint, grievance and appeal processing, information privacy, provider network structure (including provider network adequacy, the use of performance-based networks and termination of provider contracts), provider directory accuracy, calculation of minimum medical loss ratios and/or payment of related rebates, delegated arrangements, rescission of insurance coverage, limited benefit health products, student health products, pharmacy benefit management practices (including manufacturers’ rebates, pricing, the use of narrow networks and the placement of drugs in formulary tiers), sales practices, customer service practices, vendor oversight and claim payment practices (including payments to out-of-network providers).

As a leading national health care company, the Company regularly is the subject of government actions of the types described above. These government actions may prevent or delay the Company from implementing planned premium rate increases and may result, and have resulted, in restrictions on the Company’s businesses, changes to or clarifications of the Company’s business practices, retroactive adjustments to premiums, refunds or other payments to members, beneficiaries, states or the federal government, withholding of premium payments to the Company by government agencies, assessments of damages, civil or criminal fines or penalties, or other sanctions, including the possible suspension or loss of licensure and/or suspension or exclusion from participation in government programs.

The Company can give no assurance however, that its business,businesses, financial condition, andoperating results of operationsand/or cash flows will not be materially adversely affected, or that the Company will not be required to materially change its business practices, based on: (i) future enactment of new health care or other laws or regulations; (ii) the interpretation or application of existing

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Table of Contents

laws or regulations as they may relate to one or more of the Company’s business,businesses, one or more of the pharmacy services, specialty pharmacy, retail pharmacy, long-term care pharmacy or retail clinic industries in which the Company competes and/or to the health care industry generally; (iii) pending or future federal or state governmentalgovernment investigations of one or more of the Company’s businessbusinesses, one or more of the pharmacy services, specialty pharmacy, retail pharmacy, long-term care pharmacy industries in which the Company competes and/or retail clinic industry or of the health care industry generally; (iv) pending or future government audits, investigations or enforcement actions against the Company; (v) adverse developments in any pending qui tam lawsuit against the Company, whether sealed or unsealed, or in any future qui tam lawsuit that may be filed against the Company; or (vi) adverse developments in pending or future legal proceedings against the Company or affecting one or more of the pharmacy services, specialty pharmacy, retail pharmacy, long-term care pharmacy or retail clinic industry industries in which the Company competes and/or the health care industry generally.


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11.Segment Reporting

The Company has 3 operating segments, Pharmacy Services, Retail/LTC and Health Care Benefits, as well as a Corporate/Other segment. The Company’s segments maintain separate financial information, and the Company’s chief operating decision maker (the “CODM”) evaluates the segments’ operating results on a regular basis in deciding how to allocate resources among the segments and in assessing segment performance. The CODM evaluates the performance of the Company’s segments based on adjusted operating income, which is defined as operating income (GAAP measure) excluding the impact of amortization of intangible assets and other items, if any, that neither relate to the ordinary course of the Company’s business nor reflect the Company’s underlying business performance. See the reconciliations of operating income (GAAP measure) to adjusted operating income below for further context regarding the items excluded from operating income in determining adjusted operating income. The Company uses adjusted operating income as its principal measure of segment performance as it enhances the Company’s ability to compare past financial performance with current performance and analyze underlying business performance and trends. Non-GAAP financial measures the Company discloses, such as consolidated adjusted operating income, should not be considered a substitute for, or superior to, financial measures determined or calculated in accordance with GAAP.

The following is a reconciliation of financial measures of the Company’s segments to the consolidated totals:
In millions
Pharmacy 
Services (1)
Retail/
LTC
Health Care
Benefits
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
Three Months Ended
September 30, 2020
Revenues from external customers$33,492 $14,770 $18,557 $33 $— $66,852 
Intersegment revenues2,219 7,955 20 (10,194)— 
Net investment income121 83 204 
Total revenues35,711 22,725 18,698 116 (10,194)67,056 
Adjusted operating income (loss)1,619 1,412 1,080 (303)(186)3,622 
September 30, 2019
Revenues from external customers$33,680 $13,805 $17,027 $35 $— $64,547 
Intersegment revenues2,338 7,661 (10,007)— 
Net investment income146 117 263 
Total revenues36,018 21,466 17,181 152 (10,007)64,810 
Adjusted operating income (loss)1,439 1,516 1,423 (252)(179)3,947 
Nine Months Ended
September 30, 2020
Revenues from external customers$98,233 $44,314 $55,972 $83 $— $198,602 
Intersegment revenues7,350 22,822 51 (30,223)— 
Net investment income341 209 550 
Total revenues105,583 67,136 56,364 292 (30,223)199,152 
Adjusted operating income (loss)4,127 4,371 6,035 (931)(539)13,063 
September 30, 2019
Revenues from external customers$95,494 $41,536 $51,976 $76 $— $189,082 
Intersegment revenues8,924 22,492 20 (31,436)— 
Net investment income458 347 805 
Total revenues104,418 64,028 52,454 423 (31,436)189,887 
Adjusted operating income (loss)3,682 4,674 4,423 (685)(521)11,573 

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(1)Total revenues of the Pharmacy Services segment include approximately $2.5 billion and $2.7 billion of retail co-payments for the three months ended September 30, 2020 and 2019, respectively, and $8.5 billion and $8.9 billion of retail co-payments for the nine months ended September 30, 2020 and 2019, respectively.
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The following are reconciliations of consolidated operating income to adjusted operating income for the three and nine months ended September 30, 2020 and 2019:
Three Months Ended
September 30,
Nine Months Ended
September 30,
In millions2020201920202019
Operating income (GAAP measure)$3,249 $2,928 $11,387 $8,950 
Amortization of intangible assets (1)
587 607 1,751 1,822 
Acquisition-related integration costs (2)
57 111 196 365 
(Gain) loss on divestiture of subsidiary (3)
(271)205 (271)205 
Store rationalization charges (4)
96 231 
Adjusted operating income$3,622 $3,947 $13,063 $11,573 

(1)The Company’s acquisition activities have resulted in the recognition of intangible assets as required under the acquisition method of accounting which consist primarily of trademarks, customer contracts/relationships, covenants not to compete, technology, provider networks and value of business acquired. Definite-lived intangible assets are amortized over their estimated useful lives and are tested for impairment when events indicate that the carrying value may not be recoverable. The amortization of intangible assets is reflected in the Company’s unaudited GAAP condensed consolidated statements of operations in operating expenses within each segment. Although intangible assets contribute to the Company’s revenue generation, the amortization of intangible assets does not directly relate to the underwriting of the Company’s insurance products, the services performed for the Company’s customers or the sale of the Company’s products or services. Additionally, intangible asset amortization expense typically fluctuates based on the size and timing of the Company’s acquisition activity. Accordingly, the Company believes excluding the amortization of intangible assets enhances the Company’s and investors’ ability to compare the Company’s past financial performance with its current performance and to analyze underlying business performance and trends. Intangible asset amortization excluded from the related non-GAAP financial measure represents the entire amount recorded within the Company’s GAAP financial statements, and the revenue generated by the associated intangible assets has not been excluded from the related non-GAAP financial measure. Intangible asset amortization is excluded from the related non-GAAP financial measure because the amortization, unlike the related revenue, is not affected by operations of any particular period unless an intangible asset becomes impaired or the estimated useful life of an intangible asset is revised.
(2)During the three and nine months ended September 30, 2020 and 2019, acquisition-related integration costs relate to the Aetna Acquisition. The acquisition-related integration costs are reflected in the Company’s unaudited GAAP condensed consolidated statements of operations in operating expenses within the Corporate/Other segment.
(3)During the three and nine months ended September 30, 2020, the gain on divestiture of subsidiary represents the pre-tax gain on the sale of the Workers’ Compensation business, which the Company sold on July 31, 2020 for approximately $850 million. The gain on divestiture is reflected as a reduction in operating expenses in the Company’s unaudited GAAP condensed consolidated statements of operations within the Health Care Benefits segment. During the three and nine months ended September 30, 2019, the loss on divestiture of subsidiary represents the pre-tax loss on the sale of Onofre, which occurred on July 1, 2019. The loss on divestiture primarily relates to the elimination of the cumulative translation adjustment from accumulated other comprehensive income and is reflected in operating expenses in the Company’s unaudited GAAP condensed consolidated statements of operations within the Retail/LTC segment.
(4)During the three and nine months ended September 30, 2019, the store rationalization charges relate to the planned closure of 22 underperforming retail pharmacy stores in the first quarter of 2020. During the nine months ended September 30, 2019, the store rationalization charges also relate to the planned closure of 46 underperforming retail pharmacy stores in the second quarter of 2019. The store rationalization charges primarily relate to operating lease right-of-use asset impairment charges and are reflected in the Company’s unaudited GAAP condensed consolidated statements of operations in operating expenses within the Retail/LTC segment.


12.Subsequent Event

The ACA established a temporary risk corridor program, which expired at the end of 2016, for qualified individual and small group health insurance plans. Under this program, health insurance companies were to make payments to, or receive payments from, the U.S. Department of Health and Human Services (“HHS”) based on their ratio of allowable costs to target costs (as defined by the ACA).

The Company filed a lawsuit in August 2019 to recover the $313 million it was owed under the ACA’s risk corridor program, which had been stayed pending the Supreme Court decision. In April 2020, the U.S. Supreme Court ruled that health insurance companies may sue the federal government for amounts owed as calculated under the ACA’s temporary risk corridor program. At September 30, 2020, the Company did not record any ACA risk corridor receivables because payment was uncertain.

On October 22, 2020, the Company received the $313 million it was owed under the ACA’s risk corridor program. The Company recorded the risk corridor payment as an increase to premium revenue in the fourth quarter of 2020. After considering offsetting items such as the ACA’s minimum MLR rebate requirements and premium taxes, the Company expects to record pre-tax income of approximately $305 million and after-tax income of approximately $220 million during the fourth quarter of 2020.

Table of Contents

38


Index to Condensed Consolidated Financial Statements
Report of Independent Registered Public Accounting Firm

The


To the Shareholders and the Board of Directors and Shareholders

of CVS Health Corporation:

Corporation


Results of Review of Interim Financial Statements

We have reviewed the accompanying condensed consolidated balance sheet of CVS Health Corporation (the Company) as of September 30, 2017,2020, the related condensed consolidated statements of incomeoperations and comprehensive income for the three-month and nine-month periods ended September 30, 20172020 and 2016,2019, the related condensed consolidated statements of shareholders’ equity for the three-month periods ended March 31, 2020 and 2019, June 30, 2020 and 2019 and September 30, 2020 and 2019, the related condensed consolidated statements of cash flows for the nine-month periods ended September 30, 20172020 and 2016. These2019, and the related notes (collectively referred to as the “condensed consolidated interim financial statements”). Based on our reviews, we are not aware of any material modifications that should be made to the condensed consolidated interim financial statements are the responsibility of the Company’s management.

for them to be in conformity with U.S. generally accepted accounting principles.


We conducted our reviewhave previously audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States). (PCAOB), the consolidated balance sheet of the Company as of December 31, 2019, the related consolidated statements of operations, comprehensive income (loss), shareholders’ equity and cash flows for the year then ended, and the related notes (not presented herein); and in our report dated February 18, 2020, we expressed an unqualified audit opinion on those consolidated financial statements. In our opinion, the information set forth in the accompanying condensed consolidated balance sheet as of December 31, 2019, is fairly stated, in all material respects, in relation to the consolidated balance sheet from which it has been derived.

Basis for Review Results

These financial statements are the responsibility of the Company’s management. We are a public accounting firm registered with the PCAOB and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the SEC and the PCAOB. We conducted our review in accordance with the standards of the PCAOB. A review of interim financial informationstatements consists principally of applying analytical procedures and making inquiries of persons responsible for financial and accounting matters. It is substantially less in scope than an audit conducted in accordance with the standards of the Public Company Accounting Oversight Board (United States),PCAOB, the objective of which is the expression of an opinion regarding the financial statements taken as a whole. Accordingly, we do not express such an opinion.

Based on our review, we are not aware of any material modifications that should be made to the condensed consolidated financial statements referred to above for them to be in conformity with U.S. generally accepted accounting principles.

We have previously audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States), the consolidated balance sheet of CVS Health Corporation as of December 31, 2016, and the related consolidated statements of income, comprehensive income, shareholders’ equity and cash flows for the year then ended (not presented herein), and we expressed an unqualified audit opinion on those consolidated financial statements in our report dated February 9, 2017. In our opinion, the accompanying condensed consolidated balance sheet of CVS Health Corporation as of December 31, 2016, is fairly stated, in all material respects, in relation to the consolidated balance sheet from which it has been derived.

/s/ Ernst & Young LLP

November 6, 2017

Boston, Massachusetts


24

/s/ Ernst & Young LLP

Boston, Massachusetts
November 6, 2020
39

Form 10-Q Table of Contents

Part I

Item 2

Item 2.   Management’s Discussion and Analysis of Financial Condition and Results of Operations

(“MD&A”)


Overview of Our Business


CVS Health Corporation (“CVS Health”), together with its subsidiaries (collectively, “CVS Health,” the “Company,” “we,” “our” or “us”), is a pharmacythe nation’s premier health innovation company helping people on their path to better health. At the forefrontWhether in one of a changingits pharmacies or through its health care landscape,services and plans, the Company has an unmatched suite of capabilitiesis pioneering a bold new approach to total health by making quality care more affordable, accessible, simple and the expertise needed to drive innovations that will help shape the future of health care.

We are currently the only integrated pharmacy health care companyseamless. The Company is community-based and locally focused, engaging consumers with the ability to impact consumers, payors,care they need when and providers with innovative, channel-agnostic solutions. We have a deep understanding of their diverse needs through our unique integrated model, and we are bringing them innovative solutions that help increase access to quality care, deliver better health outcomes and lower overall health care costs.

Throughwhere they need it. The Company has more than 9,7009,900 retail locations, more thanapproximately 1,100 walk-in health caremedical clinics, a leading pharmacy benefits manager with nearly 90approximately 103 million plan members, a dedicated senior pharmacy care business serving more than one million patients per year and expanding specialty pharmacy services. The Company also serves an estimated 33 million people through traditional, voluntary and consumer-directed health insurance products and related services, including expanding Medicare Advantage offerings and a leading stand-alonestandalone Medicare Part D prescription drug plan we enable people, businesses, and communities to manage(“PDP”). The Company believes its innovative health in more affordable, effective ways. We are delivering break-through products and services, from advising patients on their medications at our CVS Pharmacy® locations, to introducing unique programs to help control costs for our clients at CVS Caremark®, to innovating how care is delivered to our patients with complex conditions through CVS SpecialtyTM, to improving pharmacy care for the senior community through Omnicare®, or by expandingmodel increases access to high-quality, low-costquality care, at CVS MinuteClinic®.

We have threedelivers better health outcomes and lowers overall health care costs.


The Company has four reportable segments: Pharmacy Services, Retail/LTC, Health Care Benefits and Corporate.

Corporate/Other, which are described below.


Overview of the Pharmacy Services Segment

Our


The Pharmacy Services business generates revenue fromsegment provides a full range of pharmacy benefit management (“PBM”) solutions, including plan design offerings and administration, formulary management, Medicare Part Dretail pharmacy network management services, mail order pharmacy, specialty pharmacy and infusion services, retail pharmacy network management services, prescription management systems, clinical services, disease management services and medical spend management.

Our The Pharmacy Services segment’s clients are primarily employers, insurance companies, unions, government employee groups, health plans, Medicare Part D plans, ManagedPDPs, Medicaid managed care plans, plans offered on the public health insurance exchanges and private health insurance exchanges, other sponsors of health benefit plans and individuals throughout the United States. A portion of covered lives, primarily within the Managed Medicaid, health plan and employer markets have access to our services through public and private exchanges.

As a pharmacy benefits manager, we manage the dispensing of prescription drugs through our mail order pharmacies, specialty pharmacies, long-term care pharmacies and national network of more than 68,000 retail pharmacies, consisting of approximately 41,000 chain pharmacies (which includes our CVS Pharmacy® pharmacies) and 27,000 independent pharmacies, to eligible members in the benefit plans maintained by our clients and utilize our information systems to perform, among other things, safety checks, drug interaction screenings and brand-to-generic substitutions.

Our specialty pharmacies support individuals who require complex and expensive drug therapies. Our specialty pharmacy business includes mail order and retail specialty pharmacies that operate under the CVS Caremark®, CarePlus CVS Pharmacy®, Navarro® Health Services and Advanced Care Scripts or ACS names. The Pharmacy Services Segment also provides health management programs, which include integrated disease management for 18 conditions, through our Accordant® rare disease management offering. In addition, through our SilverScript Insurance Company subsidiary, we are a national provider of drug benefits to eligible beneficiaries under the federal government’s Medicare Part D program. The Pharmacy Services Segmentsegment operates under the CVS Caremark® Pharmacy Services, Caremark®, CVS Caremark®, CarePlus CVS Pharmacy®, Accordant®, SilverScript®, Coram®, CVS SpecialtyTM, NovoLogix®, Navarro® Health Services and Advanced Care Scripts or ACS names. As of September 30, 2017, the Pharmacy Services Segment operated 23 retail specialty pharmacy stores, 15 specialty mail order pharmacies, four mail serviceorder dispensing pharmacies, compounding pharmacies and 82 branches for infusion and enteral services, including approximately 73 ambulatory infusion suites and three centersnutrition services.


Overview of excellence, located in 41 states, Puerto Rico and the District of Columbia.

25


Table of Contents

Retail/LTC Segment

Our


The Retail/LTC Segmentsegment sells prescription drugs and a wide assortment of general merchandise, including over-the-counter drugs, beauty products, cosmetics and cosmetics, personal care products, convenience foods, photo finishing, seasonal merchandiseprovides health care services through its MinuteClinic® walk-in medical clinics, provides medical diagnostic testing and greeting cards through our CVS Pharmacy®, CVS®, Longs Drugs®, Navarro Discount Pharmacy®conducts long-term care pharmacy (“LTC”) operations, which distribute prescription drugs and Drogaria OnofreTM retail locations and online through CVS.com®, Navarro.comTM and Onofre.com.brTM. The Retail/LTC Segment also includes providing the distribution of prescription drugs,provide related pharmacy consulting and other ancillary services to chroniclong-term care facilities and other care settings, as well as commercialization services that are provided under the name RxCrossroads®. Our Retail/LTC Segment derives the majority of its revenues through the sale of prescription drugs, which are dispensed by our more than 31,000 pharmacists. Our Retail/LTC Segment also provides health care services through our MinuteClinic health care clinics. MinuteClinics are staffed by nurse practitioners and physician assistants who utilize nationally recognized protocols to diagnose and treat minor health conditions, perform health screenings, monitor chronic conditions and deliver vaccinations.settings. As of September 30, 2017, our2020, the Retail/LTC Segment included 9,751segment operated more than 9,900 retail locations, (of which 8,016 wereapproximately 1,100 MinuteCliniclocations as well as online retail pharmacy websites, LTC pharmacies and onsite pharmacies.

Overview of the Company’s stores that operated a pharmacy and 1,687 wereHealth Care Benefits Segment

The Health Care Benefits segment is one of the Company’s pharmacies located within a Target store) located in 49 states, the District of Columbia, Puerto Rico and Brazil operating primarily under the CVS Pharmacy®, CVS®,  CVS Pharmacy y más®,  Longs Drugs®, Navarro Discount Pharmacy® and Drogaria OnofreTM names, 38 onsite pharmacies primarily operating under the CarePlus CVS Pharmacy®, CarePlus® and CVS Pharmacy® names, 1,129 retailnation’s leading diversified health care clinics operating underbenefits providers. The Health Care Benefits segment has the MinuteClinic® name (of which 1,122 were locatedinformation and resources to help members, in CVS Pharmacyconsultation with their health care professionals, make more informed decisions about their health care. The Health Care Benefits segment offers a broad range of traditional, voluntary and Target stores)consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, medical management capabilities, Medicare Advantage and Medicare Supplement plans, PDPs, Medicaid health care management services, and health information technology products and services. The Health Care Benefits segment also provided workers’ compensation administrative services through its Coventry Health Care Workers’ Compensation business (“Workers’ Compensation business”) prior to the sale of this business on July 31, 2020. The Health Care Benefits segment’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers (“providers”), governmental units, government-sponsored plans, labor groups and our online retail websites, CVS.com®, Navarro.comTMexpatriates. The Company refers to insurance products (where it assumes all or a majority of the risk for medical and Onofre.com.brTM. LTC operations are comprised of 143 spoke pharmacies that primarily handle new prescription orders, of which 31 are also hub pharmacies that use proprietary automation to support spoke pharmacies with refill prescriptions. LTC operates primarily under the Omnicare® and NeighborCare® names.

Corporate Segment

The Corporate Segment provides managementdental care costs) as “Insured” and administrative services contract products (where the plan sponsor assumes all or a majority of the risk for medical and dental care costs) as “ASC.”


40


Overview of the Corporate/Other Segment

The Company presents the remainder of its financial results in the Corporate/Other segment, which consists of:

Management and administrative expenses to support the Company. The Corporate Segment consists ofCompany’s overall operations, which include certain aspects of our executive management and the corporate relations, legal, compliance, human resources, information technology and finance departments.

Resultsdepartments, expenses associated with the Company’s investments in its transformation and enterprise modernization programs and acquisition-related integration costs; and

Products for which the Company no longer solicits or accepts new customers such as large case pensions and long-term care insurance products.

41


COVID-19 and 2020 Outlook

As coronavirus disease 2019 (“COVID-19”) continues to severely impact the economies of Operations

the U.S. and other countries around the world, the Company continues to execute its preparedness plans to maintain continuity of our operations, while also taking steps to keep our colleagues healthy and safe. In accordance with governmental directions to shelter-in-place, eliminate large gatherings and practice social distancing, the Company has transitioned many office-based colleagues to a remote work environment. The various initiatives we have implemented to slow and/or reduce the impact of COVID-19, such as colleagues working remotely and installing protective equipment in our retail pharmacies, and the COVID-19-related support programs we have put in place for our customers, medical members and colleagues have increased our operating expenses and reduced the efficiency of our operations.

The legislative and regulatory environment governing our businesses is dynamic and changing frequently as described in more detail below under “Government Regulation,” including mandated increases to the medical services we must pay for without a corresponding increase in the premiums we receive in our Insured Health Care Benefits products. Federal, state and local governmental policies and initiatives designed to reduce the transmission of COVID-19 may not effectively combat the severity and/or duration of the COVID-19 pandemic and have resulted in, among other things, a significant reduction in utilization of medical services (“utilization”) that is discretionary, the cancellation of elective medical procedures, reduced customer traffic and front store sales in our retail pharmacies, our customers being ordered to close or severely curtail their operations, the adoption of work-from-home policies and a reduction in diagnostic reporting due to reductions in provider visits and restrictions on our access to providers’ medical records, all of which impact our businesses. Among other impacts of these policies and initiatives, we expect an adverse impact on:

Drug utilization due to the reduction in new therapy prescriptions;
Front store sales as a result of reduced customer traffic in our retail pharmacies due to shelter-in-place orders and COVID-19 related unemployment;
Medical membership in our Health Care Benefits segment and covered lives in our PBM clients due to reductions in workforce at our existing customers (including due to business failures) as well as reduced willingness to change benefits providers by prospective customers;
Benefit costs due to COVID-19 related support programs we have put in place for our medical members and mandated increases to the medical services we must pay for without a corresponding increase in the premiums we receive in our Insured Health Care Benefits products; and
The amount, timing and collectability of payments to the Company from customers, clients, government payers and members as a result of the impact of COVID-19 on them.

In addition to the items described above, we expect the adverse economic conditions in the U.S. and abroad caused by COVID-19 to continue at least throughout 2020 and possibly longer, resulting in increased unemployment, reduced economic activity, continued capital markets volatility, downward pressure on our net investment income and the value of our investment portfolio and lower interest rates. We also expect to see upward pressure on provider unit costs and changes in provider behavior as providers attempt to maintain revenue levels in their efforts to adjust to their own COVID-19 related impacts and other economic challenges. We may continue to experience similar adverse effects on our businesses, operating results and cash flows from a recessionary economic environment that is expected to persist after the COVID-19 pandemic has moderated. As a result, the quarterly cadence of our earnings is likely to continue to vary from historical patterns.

The COVID-19 pandemic continues to evolve. We believe COVID-19’s impact on our businesses, operating results, cash flows and/or financial condition primarily will be driven by the geographies impacted and the severity and duration of the pandemic; the pandemic’s impact on the U.S. and global economies and consumer behavior and health care utilization patterns; and the timing, scope and impact of stimulus legislation as well as other federal, state and local governmental responses to the pandemic. Those primary drivers are beyond our knowledge and control. As a result, the impact COVID-19 will have on our businesses, operating results, cash flows and/or financial condition is uncertain, but the impact could be adverse and material. COVID-19 also may result in legal and regulatory proceedings, investigations and claims against us.

In addition to the COVID-19 related matters described above, the Company expects it will experience the following key trends during the fourth quarter of 2020:

The Pharmacy Services segment is expected to benefit from Specialty pharmacy growth and continued improvements in purchasing economics, partially offset by 2020 selling season net losses and continued price compression.
The Retail/LTC segment is expected to experience continued reimbursement pressure. In addition, the Company expects the impact of COVID-19 will continue to result in incremental operating expenses associated with the Company’s
42


pandemic response efforts, as well as reduced new therapy prescriptions and related front store volume, which will be partially offset by increased diagnostic testing.
The Health Care Benefits segment expects utilization of medical services to continue at more normal levels, with select geographies affected by COVID-19 waves. The Company expects to incur significant planned COVID-19 related investments in the Health Care Benefits segment, including premium credits, minimum medical loss ratio rebates and contractual requirements that benefit customers and members. The Company also expects to incur higher seasonal operating expenses during the fourth quarter to support readiness for the start of the 2021 plan year.
The Company expects changes to its business environment to continue for the next several years as elected and other government officials at the national and state levels continue to propose and enact significant modifications to public policy and existing laws and regulations that govern the Company’s businesses.

The Company’s current expectations described above under “COVID-19 and 2020 Outlook” and below under “Government Regulation” are forward-looking statements. Please see “Cautionary Statement Concerning Forward-Looking Statements” and the Risk Factors sections of this report, and the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2019 (the “2019 Form 10-K”), for information regarding important factors that may cause the Company’s actual results to differ from those currently projected and/or otherwise materially affect the Company.

Government Regulation

The Families First Coronavirus Response Act (the “Families First Act”) and the Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”) were enacted in March 2020. Each of the Families First Act and the CARES Act requires the Company to provide coverage for COVID-19 related medical services, in many cases without member cost sharing, in its Insured Health Care Benefits products.

The CARES Act also provides relief funding to health care providers to reimburse them for health care related expenses incurred in preventing, preparing for and/or responding to COVID-19 (provided no other source is obligated to reimburse those expenses) or lost health care related revenues that are attributable to COVID-19. The Company did not request any funding under the CARES Act. However, in the second quarter of 2020, the Company received $43 million from the CARES Act provider relief fund, all of which has been returned to the U.S. Department of Health and Human Services.

The CARES Act also allows for the deferral of the payment of the employer share of Social Security taxes effective March 27, 2020. The Company has elected to defer its Social Security tax payments in accordance with this provision, and will remit the associated payments in two equal installments on or about December 31, 2021 and December 31, 2022, as required under the CARES Act. The Company deferred approximately $445 million of its Social Security tax payments during the nine months ended September 30, 2020.

In addition to the Families First Act and the CARES Act, the Company is experiencing an unprecedented level of new laws, regulations, directives and orders from federal, state, county and municipal authorities related to the COVID-19 pandemic, most of which have been issued on an emergency basis with immediate, or in some instances retroactive, effect. These governmental actions include, but are not limited to, requirements to waive member cost sharing associated with COVID-19 testing and treatment, provide coverage for additional COVID-19-related services, expand the use of telemedicine, suspend precertification or other utilization management mechanisms (including review of claims for medical necessity), allow earlier or longer renewal of prescriptions, extend grace periods for payments of premiums or limit coverage termination based on non-payment of premiums or fees, modify health benefits coverage eligibility rules to help maintain employee eligibility, and facilitate, accelerate or advance payments to health care providers. Related governmental actions have required the Company to close or significantly limit operations at traditional office worksites and affected the hours of operation of MinuteClinic locations and the Company’s pharmacies. In some instances, the Company has taken permitted proactive actions consistent with more general regulatory directives, such as expanding home delivery of prescription medications, extending hours of operation for member assistance lines and liberalizing certain other terms of coverage. Similar directives have affected the Company’s international operations around the world. The Company anticipates additional mandates and directives from domestic and foreign federal, state, county and city authorities throughout the continuation of the COVID-19 pandemic and for some time thereafter, some of which may result in permanent changes in the Company’s operations or the health care and other benefits cost and other risks assumed by the Company. Further, although the Company has seen regulators relax certain requirements in light of the COVID-19 pandemic, such as temporary suspension of certain audits and extensions of certain filing deadlines, failure to provide regulatory relief or accommodations in other areas may result in increased costs or reduced revenue for the Company.

The impact of this governmental activity on the U.S. economy, consumer, customer and health care provider behavior and health care utilization patterns is beyond our knowledge and control. As a result, the financial and/or operational impact these
43


COVID-19 related governmental actions and inactions will have on our businesses, operating results, cash flows and/or financial condition is uncertain, but the collective impact could be material and adverse.

Separately, in April 2020, the U.S. Supreme Court ruled that health insurance companies may sue the federal government for amounts owed as calculated under the ACA’s temporary risk corridor program. The Company filed a lawsuit in August 2019 to recover the $313 million it was owed under the ACA’s risk corridor program, which had been stayed pending the Supreme Court decision. At September 30, 2020, the Company did not record any ACA risk corridor receivables because payment was uncertain. On October 22, 2020, the Company received the $313 million in funds owed to it under the ACA’s risk corridor program.
44


Operating Results

The following discussion explains the material changes in ourthe Company’s operating results of operations for the three and nine months ended September 30, 20172020 and 2016,2019, and the significant developments affecting ourthe Company’s financial condition since December 31, 2016.2019. We strongly recommend that you read our audited consolidated financial statements and notes thereto and Management’s Discussion and Analysis of Financial Condition and Results of Operations, which are included as Exhibit 13 to our 2016in the 2019 Form 10‑K along with this report.

10-K.

26



Table of Contents

Summary of the Condensed Consolidated Financial Results:

Results

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Nine Months Ended

 

 

September 30, 

 

September 30, 

In millions, except per share amounts

    

2017

    

2016

    

2017

    

2016

Net revenues

 

$

46,181

 

$

44,615

 

$

136,380

 

$

131,555

Cost of revenues

 

 

39,055

 

 

37,123

 

 

115,739

 

 

110,304

Gross profit

 

 

7,126

 

 

7,492

 

 

20,641

 

 

21,251

Operating expenses

 

 

4,627

 

 

4,668

 

 

14,232

 

 

13,885

Operating profit

 

 

2,499

 

 

2,824

 

 

6,409

 

 

7,366

Interest expense, net

 

 

245

 

 

253

 

 

744

 

 

816

Loss on early extinguishment of debt

 

 

 —

 

 

101

 

 

 —

 

 

643

Other expense

 

 

192

 

 

 7

 

 

206

 

 

23

Income before income tax provision

 

 

2,062

 

 

2,463

 

 

5,459

 

 

5,884

Income tax provision

 

 

777

 

 

921

 

 

2,115

 

 

2,271

Income from continuing operations

 

 

1,285

 

 

1,542

 

 

3,344

 

 

3,613

Loss from discontinued operations, net of tax

 

 

 —

 

 

(1)

 

 

(8)

 

 

(1)

Net income

 

 

1,285

 

 

1,541

 

 

3,336

 

 

3,612

Net income attributable to noncontrolling interest

 

 

 —

 

 

(1)

 

 

(1)

 

 

(2)

Net income attributable to CVS Health

 

$

1,285

 

$

1,540

 

$

3,335

 

$

3,610

Change
Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
September 30,
2020 vs 2019
Nine Months Ended
September 30,
2020 vs 2019
In millions2020201920202019$%$%
Revenues:
Products$47,738 $47,149 $141,096 $136,023 $589 1.2 %$5,073 3.7 %
Premiums17,182 15,539 51,749 47,612 1,643 10.6 %4,137 8.7 %
Services1,932 1,859 5,757 5,447 73 3.9 %310 5.7 %
Net investment income204 263 550 805 (59)(22.4)%(255)(31.7)%
Total revenues67,056 64,810 199,152 189,887 2,246 3.5 %9,265 4.9 %
Operating costs:
Cost of products sold40,940 40,437 121,529 116,654 503 1.2 %4,875 4.2 %
Benefit costs14,396 12,850 40,534 39,396 1,546 12.0 %1,138 2.9 %
Operating expenses8,471 8,595 25,702 24,887 (124)(1.4)%815 3.3 %
Total operating costs63,807 61,882 187,765 180,937 1,925 3.1 %6,828 3.8 %
Operating income3,249 2,928 11,387 8,950 321 11.0 %2,437 27.2 %
Interest expense731 747 2,229 2,301 (16)(2.1)%(72)(3.1)%
Loss on early extinguishment of debt766 79 766 79 687 869.6 %687 869.6 %
Other income(54)(31)(153)(93)(23)(74.2)%(60)(64.5)%
Income before income tax provision1,806 2,133 8,545 6,663 (327)(15.3)%1,882 28.2 %
Income tax provision587 604 2,328 1,776 (17)(2.8)%552 31.1 %
Net income1,219 1,529 6,217 4,887 (310)(20.3)%1,330 27.2 %
Net (income) loss attributable to noncontrolling interests(11)— 400.0 %(11)(100.0)%
Net income attributable to CVS Health$1,224 $1,530 $6,206 $4,887 $(306)(20.0)%$1,319 27.0 %

Net


Commentary - Three Months Ended September 30, 2020 vs. 2019

Revenues

Net

Total revenues increased approximately $1.6$2.2 billion, or 3.5%, and $4.8 billion, or 3.7%, in the three and nine months ended September 30, 2017, respectively, as compared to the prior year. The increase is due to increases in the Pharmacy Services Segment partially offset by decreases in the Retail/LTC Segment. The increase in the Pharmacy Services Segment was driven by growth in pharmacy network claim volume attributable to net new business, brand inflation and specialty pharmacy volume, partially offset by increased price compression and generic dispensing. The decrease in the Retail/LTC Segment was primarily due to a decline in same stores sales as a result of the previously-announced marketplace changes, which began to have an impact in the fourth quarter of 2016, that restrict CVS Pharmacy from participating in certain networks. The Retail/LTC Segment decrease was also due to continued reimbursement pressure and an increase in the generic dispensing rate. Generic prescription drugs typically have a lower selling price than brand name prescription drugs.

Please see the section entitled “Segment Analysis” below for additional information regarding net revenues.

Gross Profit

Gross profit dollars decreased $366 million, or 4.9%, and $610 million, or 2.9%, in the three and nine months ended September 30, 2017, respectively, as compared to the prior year. Gross profit dollars for the three months ended September 30, 2017, were negatively affected by continued reimbursement pressure as well as the loss of prescription volume in the Retail/LTC Segment as a result of previously-announced marketplace changes. Gross profit as a percentage of net revenues decreased approximately 135 basis points in the three months ended September 30, 2017 to 15.4%, as compared to the prior year. Gross profit as a percentage of net revenues decreased approximately 100 basis points in the nine months ended September 30, 2017 to 15.1%, as compared to the prior year. The decrease in gross profit as a percentage of net revenues was driven by the increased weighting toward the Pharmacy Services Segment, which has a lower gross profit than the Retail/LTC Segment.

Please see the section entitled “Segment Analysis” below for additional information regarding gross profit.

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Table of Contents

Operating Expenses

Operating expenses decreased $41 million, or 0.9%, in the three months ended September 30, 2017 as2020 compared to the prior year driven by growth in the Health Care Benefits and Retail/LTC segments.

Please see “Segment Analysis” later in this report for additional information about the revenues of the Company’s segments.

Operating expenses
Operating expenses decreased $124 million, or 1.4%, in the three months ended September 30, 2020 compared to the prior year. Operating expenses as a percentage of nettotal revenues decreased approximately 45 basis points to 10.0%were 12.6% in the three months ended September 30, 2017 as2020, a decrease of 70 basis points compared to the prior year. The decrease in operating expenses was primarily due to (i) a $271 million pre-tax gain on the sale of the Workers’ Compensation business, which occurred on July 31, 2020, (ii) the absence
45


of a $205 million pre-tax loss on the sale of the Company’s Brazilian subsidiary, Drogaria Onofre Ltda. (“Onofre”) and a $96 million store rationalization charge, both recorded in the three months ended September 30, 20172019, and (iii) the favorable impact of enterprise-wide cost savings initiatives in the three months ended September 30, 2020. These decreases were partially offset by the reinstatement of the HIF for 2020, incremental operating expenses associated with the Company’s COVID-19 pandemic response efforts and increased operating expenses associated with growth in the business.
Please see “Segment Analysis” later in this report for additional information about the operating expenses of the Company’s segments.

Operating income
Operating income increased $321 million, or 11.0%, in the three months ended September 30, 2020 compared to the prior year. The increase in operating income was primarily due to (i) the following:

·

A decrease in acquisition-related integration costs of $56 million versus the same period in the prior year.

·

The realization of partially reserved receivables within the Pharmacy Services Segment.

$271 million pre-tax gain on the sale of the Workers’ Compensation business, (ii) the absence of the $205 million pre-tax loss on the sale of Onofre and the $96 million store rationalization charge, both recorded in the three months ended September 30, 2019, (iii) improved purchasing economics in the Pharmacy Services segment, and (iv) the favorable impact of enterprise-wide cost savings initiatives in the three months ended September 30, 2020. These itemsincreases were partially offset by:

by declines in the Health Care Benefits segment, largely attributable to the impact of planned COVID-19 related investments benefiting customers and members, and continued reimbursement pressure in the Retail/LTC segment.

·

Hurricane related expenses of $55 million, predominately in the Retail/LTC Segment, as a result of the three major hurricanes that hit the southern United States and Puerto Rico.

Please see “Segment Analysis” later in this report for additional information about the operating income of the Company’s segments.

·

An increase in operating expenses due to incremental store operating costs associated with operating more stores.


Operating expenses increased $347

Interest expense
Interest expense decreased $16 million, or 2.5%2.1%, in the three months ended September 30, 2020 compared to the prior year primarily due to lower average debt in the three months ended September 30, 2020. See “Liquidity and Capital Resources” later in this report for additional information.

Loss on early extinguishment of debt
During the three months ended September 30, 2020, the loss on early extinguishment of debt relates to the Company’s repayment of $6.0 billion of its outstanding senior notes pursuant to its tender offers for such notes in August 2020, which resulted in a loss on early extinguishment of debt of $766 million. During the three months ended September 30, 2019, the loss on early extinguishment of debt relates to the Company’s repayment of $4.0 billion of its outstanding senior notes pursuant to its tender offers for such senior notes in August 2019, which resulted in a loss of early extinguishment of debt of $79 million. See Note 6 ‘‘Borrowings’’ to the unaudited condensed consolidated financial statements for additional information.

Income tax provision
The Company’s effective income tax rate was 32.5% for the three months ended September 30, 2020 compared to 28.3% for the three months ended September 30, 2019. The increase in the effective income tax rate was primarily attributable to basis differences on the sale of the Workers’ Compensation business in the three months ended September 30, 2020 and the reinstatement of the non-deductible HIF for 2020. These increases were partially offset by the absence of the impact of the sale of Onofre in the three months ended September 30, 2019.

Commentary - Nine Months Ended September 30, 2020 vs. 2019

Revenues
Total revenues increased $9.3 billion, or 4.9%, in the nine months ended September 30, 2017 as2020 compared to the prior year driven by growth across all segments.
Please see “Segment Analysis” later in this report for additional information about the revenues of the Company’s segments.

Operating expenses
Operating expenses increased $815 million, or 3.3%, in the nine months ended September 30, 2020 compared to the prior year. Operating expenses as a percentage of nettotal revenues decreased approximately 10 basis points to 10.4%were 12.9% in the nine months ended September 30, 2017 as2020, a decrease of 20 basis points compared to the prior year. The increase in operating expenses was primarily due to the reinstatement of the HIF for 2020, incremental operating expenses associated with the Company’s COVID-19 pandemic response efforts and increased operating expenses associated with growth in the business. The increase in operating expenses was partially offset by (i) the $271 million pre-tax gain on the sale of the Workers’ Compensation business, (ii) the absence of the $231 million of store rationalization charges and the $205 million pre-tax loss on the sale of Onofre,
46


both recorded in the nine months ended September 30, 2017 was due to2019, and (iii) the items mentioned above, which were more than offset by the following:

·

A goodwill impairment charge of $135 millionfavorable impact of enterprise-wide cost savings initiatives in the second quarter of 2017 in the RxCrossroads reporting unit (see “Note 2 – Goodwill and Intangible Assets” to our condensed consolidated financial statements).

·

Charges of $211 million in the nine months ended September 30, 2017 associated with the closure of 68 retail stores in connection with our enterprise streamlining initiative (see “Note 8 – Store Closures” to our condensed consolidated financial statements).

Please see the section entitled “Segment Analysis” below for additional information regarding operating expenses.

Interest Expense, net

Interest expense, net, decreased $8 million and $72 million in the three and nine months ended September 30, 2017, respectively, as compared to the prior year. The decrease in the three and nine months ended was primarily due to the Company’s debt issuance and debt tender offers that occurred in 2016 which resulted in overall more favorable interest rates on the Company’s long-term debt.

For additional information on our financing activities, please see the “Liquidity and Capital Resources” section below.

Loss on Early Extinguishment of Debt

During the three months ended September 30, 2016, the Company exercised its option to redeem outstanding senior notes of approximately $1.1 billion aggregate principal amount. The Company paid a premium of $97 million in excess of the debt principal in connection with the purchase of the senior notes and wrote off $4 million of unamortized deferred financing costs, for a total loss on the early extinguishment of debt of $101 million.

During the nine months ended September 30, 2016,2020.

Please see “Segment Analysis” later in this report for additional information about the Company purchased approximately $4.2 billion aggregate principal amount of certain of its senior notes pursuant to its tender offer for such senior notes and option to redeem the outstanding senior notes. The Company paid a premium of $583 million in excessoperating expenses of the debt principal, wrote off $54 million of unamortized deferred financing costs and incurred $6 millionCompany’s segments.

Operating income
Operating income increased $2.4 billion, or 27.2%, in fees, for a total loss on the early extinguishment of debt of $643 million.

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Table of Contents

Other Expense

Other expense increased $185 million and $183 million in the three and nine months ended September 30, 2017, respectively, as2020 compared to the prior year. The increase in operating income was primarily due to (i) the threeimpact of the COVID-19 pandemic, which resulted in reduced benefit costs due to the deferral of elective procedures and other discretionary utilization in the Health Care Benefits segment in the nine months ended was primarily driven bySeptember 30, 2020, (ii) improved purchasing economics in the lossesPharmacy Services segment, (iii) the $271 million pre-tax gain on the settlementssale of defined benefit pension plansthe Workers’ Compensation business, and (iv) the absence of $187 million.the $231 million of store rationalization charges and the $205 million pre-tax loss on the sale of Onofre, both recorded in the nine months ended September 30, 2019. These increases in operating income were partially offset by continued reimbursement pressure and incremental operating expenses associated with the Company’s COVID-19 pandemic response efforts in the Retail/LTC segment.

Please see “Segment Analysis” later in this report for additional information about the operating income of the Company’s segments.

Interest expense
Interest expense decreased $72 million, or 3.1%, in the nine months ended September 30, 2020 compared to the prior year, primarily due to lower average debt in the nine months ended September 30, 2020. See “Note 4 – Pension Settlements”“Liquidity and Capital Resources” later in this report for additional information.

Loss on early extinguishment of debt
During the nine months ended September 30, 2020, the loss on early extinguishment of debt relates to the Company’s repayment of $6.0 billion of its outstanding senior notes pursuant to its tender offers for such notes in August 2020, which resulted in a loss on early extinguishment of debt of $766 million. During the nine months ended September 30, 2019, the loss on early extinguishment of debt relates to the Company’s repayment of $4.0 billion of its outstanding senior notes pursuant to its tender offers for such senior notes in August 2019, which resulted in a loss of early extinguishment of debt of $79 million. See Note 6 ‘‘Borrowings’’ to the unaudited condensed consolidated financial statements.

statements for additional information.


Income Tax Provision

Ourtax provision

The Company’s effective income tax rate was 37.7%27.2% for the nine months ended September 30, 2020 compared to 26.7% for the nine months ended September 30, 2019. The increase in the effective income tax rate was primarily due to the reinstatement of the non-deductible HIF for 2020 and 37.4%basis differences on the sale of the Workers’ Compensation business in the nine months ended September 30, 2020. These increases were partially offset by the absence of the impact of the sale of Onofre in the nine months ended September 30, 2019 and the favorable resolution of certain income tax matters in the nine months ended September 30, 2020.

47


Segment Analysis

The following discussion of segment operating results is presented based on the Company’s reportable segments in accordance with the accounting guidance for segment reporting and is consistent with the segment disclosure in Note 11 ‘‘Segment Reporting’’ to the unaudited condensed consolidated financial statements.

The Company has three operating segments, Pharmacy Services, Retail/LTC and Health Care Benefits, as well as a Corporate/Other segment. The Company’s segments maintain separate financial information, and the Company’s chief operating decision maker (the “CODM”) evaluates the segments’ operating results on a regular basis in deciding how to allocate resources among the segments and in assessing segment performance. The CODM evaluates the performance of the Company’s segments based on adjusted operating income, which is defined as operating income (GAAP measure) excluding the impact of amortization of intangible assets and other items, if any, that neither relate to the ordinary course of the Company’s business nor reflect the Company’s underlying business performance. See the reconciliations of operating income (GAAP measure) to adjusted operating income below for further context regarding the items excluded from operating income in determining adjusted operating income. The Company uses adjusted operating income as its principal measure of segment performance as it enhances the Company’s ability to compare past financial performance with current performance and analyze underlying business performance and trends. Non-GAAP financial measures the Company discloses, such as consolidated adjusted operating income, should not be considered a substitute for, or superior to, financial measures determined or calculated in accordance with GAAP.

The following is a reconciliation of financial measures of the Company’s segments to the consolidated totals:
In millions
Pharmacy
Services (1)
Retail/
LTC
Health Care
Benefits
Corporate/
Other
Intersegment
Eliminations (2)
Consolidated
Totals
Three Months Ended
September 30, 2020
Total revenues$35,711 $22,725 $18,698 $116 $(10,194)$67,056 
Adjusted operating income (loss)1,619 1,412 1,080 (303)(186)3,622 
September 30, 2019
Total revenues36,018 21,466 17,181 152 (10,007)64,810 
Adjusted operating income (loss)1,439 1,516 1,423 (252)(179)3,947 
Nine Months Ended
September 30, 2020
Total revenues$105,583 $67,136 $56,364 $292 $(30,223)$199,152 
Adjusted operating income (loss)4,127 4,371 6,035 (931)(539)13,063 
September 30, 2019
Total revenues104,418 64,028 52,454 423 (31,436)189,887 
Adjusted operating income (loss)3,682 4,674 4,423 (685)(521)11,573 

(1)Total revenues of the Pharmacy Services segment include approximately $2.5 billion and $2.7 billion of retail co-payments for the three months ended September 30, 20172020 and 2016, respectively. The effective income tax rate in 2017 was higher than in 2016 primarily due to a discrete tax benefit recorded in 2016 related to the successful resolution with the IRS2019, respectively, and $8.5 billion and $8.9 billion of certain tax matters, partially offset by the tax benefit recognized in 2017 for employee share-based compensation. Our effective income tax rate was 38.7% and 38.6%retail co-payments for the nine months ended September 30, 20172020 and 2016,2019, respectively. The effective income tax rate in 2017 was higher than in 2016 primarily due
(2)Intersegment eliminations relate to the impact of the nondeductible goodwill impairment charge recognized in 2017, partially offset by the excess tax benefit recognized for employee share-based compensation.

Loss from Discontinued Operations

The loss from discontinued operations of $8 million for the nine months ended September 30, 2017, was primarily comprised of a $15 million charge (net of tax of $6 million) associated with lease guarantees the Company provided on store lease obligations of Bob’s Stores, a former subsidiary of the Companyintersegment revenue generating activities that filed for bankruptcy subsequent to its disposition. See “Note 12 - Commitments and Contingencies” tooccur between the Company’s condensed consolidated financial statements.

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Table of Contents

Segment Analysis

We evaluate the performance of our Pharmacy Services andsegment, the Retail/LTC segments based on net revenue, gross profit and operating profit beforesegment and/or the effect of nonrecurring charges and gains and certain intersegment activities. We evaluate the performance of our Corporate Segment based on operating expenses before the effect of nonrecurring charges and gains and certain intersegment activities. Health Care Benefits segment.











48


The following is a reconciliationare reconciliations of our segmentsoperating income to the condensed consolidated financial statements:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pharmacy 

 

 

 

 

 

 

 

 

 

 

 

 

 

  

Services

  

Retail/LTC

  

Corporate

  

Intersegment

  

Consolidated

In millions

 

Segment(1)

 

Segment

 

Segment

 

Eliminations(2)

 

Totals

Three Months Ended

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

September 30, 2017:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 Net revenues

 

$

32,896

 

$

19,593

 

$

 —

 

$

(6,308)

 

$

46,181

 Gross profit (3)

 

 

1,645

 

 

5,685

 

 

 —

 

 

(204)

 

 

7,126

 Operating profit (loss) (4)(5)(6)

 

 

1,353

 

 

1,553

 

 

(220)

 

 

(187)

 

 

2,499

September 30, 2016:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 Net revenues

 

 

30,429

 

 

20,143

 

 

 

 

(5,957)

 

 

44,615

 Gross profit (3)

 

 

1,797

 

 

5,893

 

 

 

 

(198)

 

 

7,492

 Operating profit (loss) (5)(6)(7)

 

 

1,459

 

 

1,778

 

 

(228)

 

 

(185)

 

 

2,824

Nine Months Ended

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

September 30, 2017:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 Net revenues

 

 

96,444

 

 

58,488

 

 

 —

 

 

(18,552)

 

 

136,380

 Gross profit (3)

 

 

4,210

 

 

17,036

 

 

 —

 

 

(605)

 

 

20,641

 Operating profit (loss) (4)(5)(6)

 

 

3,272

 

 

4,375

 

 

(686)

 

 

(552)

 

 

6,409

September 30, 2016:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 Net revenues

 

 

88,704

 

 

60,253

 

 

 

 

(17,402)

 

 

131,555

 Gross profit (3)

 

 

4,266

 

 

17,560

 

 

 

 

(575)

 

 

21,251

 Operating profit (loss) (5)(6)(7)

 

 

3,282

 

 

5,273

 

 

(660)

 

 

(529)

 

 

7,366


(1)

Net revenues of the Pharmacy Services Segment include approximately $2.6 billion and $2.5 billion of retail co-payments for the three months ended September 30, 2017 and 2016, respectively, as well as $8.4 billion and $8.1 billion of retail co-payments for the nine months ended September 30, 2017 and 2016, respectively.

(2)

Intersegment eliminations relate to intersegment revenue generating activities that occur between the Pharmacy Services Segment and the Retail/LTC Segment. These occur in the following ways: when members of Pharmacy Services Segment clients ("members") fill prescriptions at the Company's retail pharmacies to purchase covered products, when members enrolled in programs such as Maintenance Choice® elect to pick up maintenance prescriptions at one of the Company's retail pharmacies instead of receiving them through the mail, or when members have prescriptions filled at the Company's long-term care pharmacies. When these occur, both the Pharmacy Services and Retail/LTC segments record the revenues, gross profit and operating profit on a standalone basis.

(3)

The Retail/LTC Segment gross profit for the three months ended September 30, 2017 and 2016 includes $2 million and $5 million, respectively, of acquisition-related integration costs. The Retail/LTC Segment gross profit for the nine months ended September 30, 2017 and 2016 includes $7 million and $15 million, respectively, of acquisition-related integration costs. The integration costs in 2017 are related to the acquisition of Omnicare and the integration costs in 2016 are related to the acquisitions of Omnicare and the pharmacies and clinics of Target.

(4)

The Retail/LTC Segment operating profit for the three and nine months ended September 30, 2017 includes $6 million and $211 million, respectively, of charges associated with store closures (see “Note 8 – Store Closures” to the condensed consolidated financial statements). The Retail/LTC Segment operating profit for the nine months ended September 30, 2017 also includes a $135 million goodwill impairment charge related to the segment’s RxCrossroads reporting unit (see “Note 2 – Goodwill and Intangible Assets” to the condensed consolidated financial statements).

(5)

The Retail/LTC Segment operating profit for the three months ended September 30, 2017 and 2016 includes $9 million and $52 million, respectively, of acquisition-related integration costs. The Retail/LTC Segment operating profit for the nine months ended September 30, 2017 and 2016 includes $34 million and $194 million, respectively, of acquisition-related integration costs. The integration costs in 2017 are related to the acquisition of Omnicare and the integration costs in 2016 are related to the acquisitions of Omnicare and the pharmacies and clinics of Target.

(6)

The Corporate Segment operating loss for the three and nine months ended September 30, 2017 include a $3 million reduction in integration costs for a change in estimate related to the acquisition of Omnicare. The Corporate Segment operating loss for the three and nine months ended September 30, 2016 includes $13 million of integration costs related to the acquisitions of Omnicare and the pharmacies and clinics of Target.

(7)

Amounts revised to reflect the adoption of ASU 2017-07, Improving the Presentation of Net Periodic Pension Cost and Net Periodic Postretirement Benefit Cost, which increased consolidated operating profit by $7 and $23 million for the three and nine months ended September 30, 2016, respectively (see "Note 1 - Accounting Policies" to the condensed consolidated financial statements).

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Table of Contents

Pharmacy Services Segment

The following table summarizes our Pharmacy Services Segment’s performance for the respective periods:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Nine Months Ended

 

 

September 30, 

 

September 30, 

In millions

    

2017

    

2016

    

2017

 

2016

Net revenues

 

$

32,896

 

 

$

30,429

 

 

$

96,444

 

 

$

88,704

 

Gross profit

 

 

1,645

 

 

 

1,797

 

 

 

4,210

 

 

 

4,266

 

Gross profit % of net revenues

 

 

5.0

%

 

 

5.9

%

 

 

4.4

%

 

 

4.8

%

Operating expenses (1)

 

 

292

 

 

 

338

 

 

 

938

 

 

 

984

 

Operating expenses % of net revenues

 

 

0.9

%

 

 

1.1

%

 

 

1.0

%

 

 

1.1

%

Operating profit (1)

 

 

1,353

 

 

 

1,459

 

 

 

3,272

 

 

 

3,282

 

Operating profit % of net revenues

 

 

4.1

%

 

 

4.8

%

 

 

3.4

%

 

 

3.7

%

Net revenues:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mail choice (2)

 

$

11,590

 

 

$

10,872

 

 

$

33,950

 

 

$

31,668

 

Pharmacy network (3)

 

 

21,216

 

 

 

19,469

 

 

 

62,258

 

 

 

56,783

 

Other

 

 

90

 

 

 

88

 

 

 

236

 

 

 

253

 

Pharmacy claims processed (90 Day = 3 prescriptions) (4)(5):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total

 

 

441.1

 

 

 

408.7

 

 

 

1,323.2

 

 

 

1,213.8

 

Mail choice (2)

 

 

66.9

 

 

 

63.0

 

 

 

196.2

 

 

 

186.3

 

Pharmacy network (3)

 

 

374.2

 

 

 

345.7

 

 

 

1,127.0

 

 

 

1,027.5

 

Generic dispensing rate (4)(5):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total

 

 

87.0

%

 

 

86.0

%

 

 

87.1

%

 

 

85.8

%

Mail choice (2)

 

 

83.3

%

 

 

81.7

%

 

 

83.1

%

 

 

81.1

%

Pharmacy network (3)

 

 

87.7

%

 

 

86.8

%

 

 

87.8

%

 

 

86.7

%

Mail choice penetration rate (4)(5)

 

 

15.2

%

 

 

15.4

%

 

 

14.8

%

 

 

15.3

%


(1)

Amounts revised to reflect the adoption of ASU 2017-07, Improving the Presentation of Net Periodic Pension Cost and Net Periodic Postretirement Benefit Cost, which decreased operating expenses and increased operating profit by $1 million for the three months ended September 30, 2016. For the nine months ended September 30, 2016, the adoption of ASU 2017-07 decreased operating expenses and increased operating profit by $4 million.

(2)

Mail choice is defined as claims filled at a Pharmacy Services mail facility, which includes specialty mail claims inclusive of Specialty Connect® claims picked up at retail, as well as prescriptions filled at our retail pharmacies under the Maintenance Choice®  program.

(3)

Pharmacy network net revenues, claims processed and generic dispensing rates do not include Maintenance Choice activity, which is included within the mail choice category. Pharmacy network is defined as claims filled at retail and specialty retail pharmacies, including our retail pharmacies and long-term care pharmacies, but excluding Maintenance Choice activity.

(4)

Includes the adjustment to convert 90-day prescriptions to the equivalent of three 30-day prescriptions. This adjustment reflects the fact that these prescriptions include approximately three times the amount of product days supplied compared to a normal prescription.

(5)

The pharmacy claims processed, the generic dispensing rate and the mail choice penetration rate for the three and nine months ended September 30, 2016 has been revised to reflect 90-day prescriptions to the equivalent of three 30-day prescriptions.

Net Revenues

Net revenues in our Pharmacy Services Segment increased $2.5 billion, or 8.1%, to $32.9 billion in the three months ended September 30, 2017, as compared to the prior year. Net revenues in our Pharmacy Services Segment increased $7.7 billion, or 8.7%, to $96.4 billion in the nine months ended September 30, 2017, as compared to the prior year. The increase is primarily due to growth in pharmacy network claim volume, brand inflation and specialty pharmacy volume, partially offset by increased price compression and generic dispensing. As you review our Pharmacy Services Segment’s performance in this area, we believe you should consider the following important information about the businessadjusted operating income for the three and nine months ended September 30, 2017:

·

In the three months ended September 30, 2017, our mail choice claims processed, on a 30-day equivalent basis, increased 6.1% to 66.9 million claims compared to 63.0 million claims in the prior year. In the nine months ended September 30, 2017, our mail choice claims processed, on a 30-day equivalent basis, increased 5.3% to 196.2 million claims compared to 186.3 million claims in the prior year. The increase in mail choice claims was primarily driven by the continued adoption of our Maintenance Choice offerings and an increase in specialty pharmacy claims.

2020 and 2019:
Three Months Ended September 30, 2020
In millionsPharmacy 
Services
Retail/
LTC
Health Care
Benefits
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
Operating income (loss) (GAAP measure)$1,564 $1,283 $949 $(361)$(186)$3,249 
Non-GAAP adjustments:
Amortization of intangible assets (1)
55 129 402 — 587 
Acquisition-related integration costs (2)
— — — 57 — 57 
Gain on divestiture of subsidiary (3)
— — (271)— — (271)
Adjusted operating income (loss)$1,619 $1,412 $1,080 $(303)$(186)$3,622 

Three Months Ended September 30, 2019
In millionsPharmacy 
Services
Retail/
LTC
Health Care
Benefits
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
Operating income (loss) (GAAP measure)$1,340 $1,095 $1,036 $(364)$(179)$2,928 
Non-GAAP adjustments:
Amortization of intangible assets (1)
99 120 387 — 607 
Acquisition-related integration costs (2)
— — — 111 — 111 
Loss on divestiture of subsidiary (3)
— 205 — — — 205 
Store rationalization charge (4)
— 96 — — — 96 
Adjusted operating income (loss)$1,439 $1,516 $1,423 $(252)$(179)$3,947 
49


Nine Months Ended September 30, 2020
In millionsPharmacy 
Services
Retail/
LTC
Health Care
Benefits
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
Operating income (loss) (GAAP measure)$3,949 $3,996 $5,110 $(1,129)$(539)$11,387 
Non-GAAP adjustments:
Amortization of intangible assets (1)
178 375 1,196 — 1,751 
Acquisition-related integration costs (2)
— — — 196 — 196 
Gain on divestiture of subsidiary (3)
— — (271)— — (271)
Adjusted operating income (loss)$4,127 $4,371 $6,035 $(931)$(539)$13,063 

Nine Months Ended September 30, 2019
In millionsPharmacy 
Services
Retail/
LTC
Health Care
Benefits
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
Operating income (loss) (GAAP measure)$3,387 $3,884 $3,253 $(1,053)$(521)$8,950 
Non-GAAP adjustments:
Amortization of intangible assets (1)
295 354 1,170 — 1,822 
Acquisition-related integration costs (2)
— — — 365 — 365 
Loss on divestiture of subsidiary (3)
— 205 — — — 205 
Store rationalization charges (4)
— 231 — — — 231 
Adjusted operating income (loss)$3,682 $4,674 $4,423 $(685)$(521)$11,573 

(1)The Company’s acquisition activities have resulted in the recognition of intangible assets as required under the acquisition method of accounting which consist primarily of trademarks, customer contracts/relationships, covenants not to compete, technology, provider networks and value of business acquired. Definite-lived intangible assets are amortized over their estimated useful lives and are tested for impairment when events indicate that the carrying value may not be recoverable. The amortization of intangible assets is reflected in the Company’s unaudited GAAP condensed consolidated statements of operations in operating expenses within each segment. Although intangible assets contribute to the Company’s revenue generation, the amortization of intangible assets does not directly relate to the underwriting of the Company’s insurance products, the services performed for the Company’s customers or the sale of the Company’s products or services. Additionally, intangible asset amortization expense typically fluctuates based on the size and timing of the Company’s acquisition activity. Accordingly, the Company believes excluding the amortization of intangible assets enhances the Company’s and investors’ ability to compare the Company’s past financial performance with its current performance and to analyze underlying business performance and trends. Intangible asset amortization excluded from the related non-GAAP financial measure represents the entire amount recorded within the Company’s GAAP financial statements, and the revenue generated by the associated intangible assets has not been excluded from the related non-GAAP financial measure. Intangible asset amortization is excluded from the related non-GAAP financial measure because the amortization, unlike the related revenue, is not affected by operations of any particular period unless an intangible asset becomes impaired or the estimated useful life of an intangible asset is revised.

(2)During the three and nine months ended September 30, 2020 and 2019, acquisition-related integration costs relate to the Company’s acquisition (the “Aetna Acquisition”) of Aetna Inc. (“Aetna”). The acquisition-related integration costs are reflected in the Company’s unaudited GAAP condensed consolidated statements of operations in operating expenses within the Corporate/Other segment.
(3)During the three and nine months ended September 30, 2020, the gain on divestiture of subsidiary represents the pre-tax gain on the sale of the Workers’ Compensation business, which the Company sold on July 31,

2020 for approximately $850 million. The gain on divestiture is reflected as a reduction in operating expenses in the Company’s unaudited GAAP condensed consolidated statements of operations within the Health Care Benefits segment. During the three and nine months ended September 30, 2019, the loss on divestiture of subsidiary represents the pre-tax loss on the sale of Onofre, which occurred on July 1, 2019. The loss on divestiture primarily relates to the elimination of the cumulative translation adjustment from accumulated other comprehensive income and is reflected in operating expenses in the Company’s unaudited GAAP condensed consolidated statements of operations within the Retail/LTC segment.
(4)During the three and nine months ended September 30, 2019, the store rationalization charges relate to the planned closure of 22 underperforming retail pharmacy stores in the first quarter of 2020. During the nine months ended September 30, 2019, the store rationalization charges also relate to the planned closure of 46 underperforming retail pharmacy stores in the second quarter of 2019. The store rationalization charges primarily relate to operating lease right-of-use asset impairment charges and are reflected in the Company’s unaudited GAAP condensed consolidated statements of operations in operating expenses within the Retail/LTC segment.

50

Table of Contents


·

Our average revenue per mail choice claim, on a 30-day equivalent basis, increased 0.4% and 1.8% in the three and nine months ended September 30, 2017, respectively, compared to the prior year. This increase was primarily due to growth in specialty pharmacy.

·

In the three months ended September 30, 2017, our pharmacy network claims processed, on a 30-day equivalent basis, increased 8.3% to 374.2 million claims compared to 345.7 million claims in the prior year. In the nine months ended September 30, 2017, our pharmacy network claims processed, on a 30-day equivalent basis, increased 9.7% to 1,127.0 million claims compared to 1,027.5 million claims in the prior year. The increase in the pharmacy network claim volume was primarily due to net new business.

·

Our average revenue per pharmacy network claim processed, on a 30-day equivalent basis, increased 0.6% and decreased 0.1% in the three and nine months ended September 30, 2017, respectively, compared to the prior year.

·

In the three months ended September 30, 2017, our total generic dispensing rate increased to 87.0%, compared to 86.0% in the prior year. In the nine months ended September 30, 2017, our total generic dispensing rate increased to 87.1%, compared to 85.8% in the prior year. These continued increases in our generic dispensing rate were primarily due to the impact of new generic drug introductions, and our continuous efforts to encourage plan members to use generic drugs when they are available and clinically appropriate. We believe our generic dispensing rate will continue to increase in future periods, albeit at a slower pace. This increase will be affected by, among other things, the number of new brand and generic drug introductions and our success at encouraging plan members to utilize generic drugs when they are available and clinically appropriate.

Gross Profit

Gross profit in our Pharmacy Services Segment includes net revenues less cost


The following table summarizes the Pharmacy Services segment’s performance for the respective periods:
Change
Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
September 30,
2020 vs 2019
Nine Months Ended
September 30,
2020 vs 2019
In millions, except percentages2020201920202019$%$%
Revenues:
Products$35,461 $35,883 $104,802 $104,056 $(422)(1.2)%$746 0.7 %
Services250 135 781 362 115 85.2 %419 115.7 %
Total revenues35,711 36,018 105,583 104,418 (307)(0.9)%1,165 1.1 %
Cost of products sold33,809 34,300 100,583 99,918 (491)(1.4)%665 0.7 %
Operating expenses338 378 1,051 $1,113 (40)(10.6)%(62)(5.6)%
Operating expenses as a % of total revenues0.9 %1.0 %1.0 %1.1 %
Operating income$1,564 $1,340 $3,949 $3,387 $224 16.7 %$562 16.6 %
Operating income as a % of total revenues4.4 %3.7 %3.7 %3.2 %
Adjusted operating income (1)
$1,619 $1,439 $4,127 $3,682 $180 12.5 %$445 12.1 %
Adjusted operating income as a % of total revenues4.5 %4.0 %3.9 %3.5 %
Revenues (by distribution channel):
Pharmacy network (2) (3)
$21,473 $22,411 $63,109 $65,917 $(938)(4.2)%$(2,808)(4.3)%
Mail choice (3) (4)
14,032 13,461 41,815 38,066 571 4.2 %3,749 9.8 %
Other206 146 659 435 60 41.1 %224 51.5 %
Pharmacy claims processed: (5)
Total528.2 509.5 1,575.0 1,480.3 18.7 3.7 %94.7 6.4 %
Pharmacy network (2)
447.7 430.2 1,333.9 1,250.0 17.5 4.1 %83.9 6.7 %
Mail choice (4)
80.5 79.3 241.1 230.3 1.2 1.5 %10.8 4.7 %
Generic dispensing rate: (5)
Total87.9 %88.1 %88.5 %88.3 %
Pharmacy network (2)
88.3 %88.7 %89.0 %88.9 %
Mail choice (4)
85.7 %85.3 %85.7 %85.1 %

(1)See “Segment Analysis” above in this report for a reconciliation of revenues. Cost of revenues includes (i)operating income (GAAP measure) to adjusted operating income for the cost of pharmaceuticals dispensed, either directly through our mail service, specialty mailPharmacy Services segment.
(2)Pharmacy network is defined as claims filled at retail and specialty retail pharmacies, including the Company’s retail pharmacies and LTC pharmacies, but excluding Maintenance Choice activity, which is included within the mail choice category. Maintenance Choice permits eligible client plan members to fill their maintenance prescriptions through mail order delivery or indirectly through ourat a CVS Pharmacy retail store for the same price as mail order.
(3)Certain prior year amounts have been reclassified for consistency with the current period presentation.
(4)Mail choice is defined as claims filled at a Pharmacy Services mail order facility, which includes specialty mail claims inclusive of Specialty Connect® claims picked up at a retail pharmacy, networks, (ii) shipping and handling costs and (iii)as well as prescriptions filled at the operating costsCompany’s retail pharmacies under the Maintenance Choice program.
(5)Includes an adjustment to convert 90-day prescriptions to the equivalent of our mail service dispensing pharmacies, customer service operations and related information technology support.

Gross profitthree 30-day prescriptions. This adjustment reflects the fact that these prescriptions include approximately three times the amount of product days supplied compared to a normal prescription.


Commentary - Three Months Ended September 30, 2020 vs. 2019

Revenues
Total revenues decreased $152$307 million, or 8.4%0.9%, to approximately $1.6$35.7 billion in the three months ended September 30, 2017, as2020 compared to the prior year. Gross profit decreased $56 million, or 1.3%, to approximately $4.2 billion in the nine months ended September 30, 2017, as compared to the prior year. The decrease in gross profit dollars wasyear primarily due todriven by previously disclosed client losses and continued price compression, and a shift in the timing of the Medicare Part D gross profit dollars between the third and fourth quarter in 2017 due to participants moving through benefits slower relative to the prior year, partially offset by network volume increases. Gross profit as a percentage of net revenues decreased to 5.0%growth in the three months ended September 30, 2017, compared to 5.9% in the prior year. Gross profit as a percentage of net revenues decreased to 4.4% in the nine months ended September 30, 2017, compared to 4.8% in the prior year. The decrease in gross profit as a percentage of net revenues was primarily due to continued price compressionspecialty pharmacy and changes in the mix of our business, partially offset by favorable generic dispensing.

As you review our Pharmacy Services Segment’s performance in this area, we believe you should consider the following important information about the business for the three and nine months ended September 30, 2017:

·

Our efforts to (i) retain existing clients, (ii) obtain new business and (iii) maintain or improve the rebates and/or discounts we received from manufacturers, wholesalers and retail pharmacies continue to have an impact on our gross profit dollars and gross profit as a percentage of net revenues. In particular, competitive pressures in the PBM industry have caused us and other PBMs to continue to share with clients a larger portion of rebates and/or discounts received from pharmaceutical manufacturers. In addition, market dynamics and regulatory changes have limited our ability to offer plan sponsors pricing that includes retail network “differential” or “spread,” and we expect these trends to continue. The “differential” or “spread” is any difference between the drug price charged to plan sponsors, including Medicare Part D plan sponsors, by a PBM and the price paid for the drug by the PBM to the dispensing provider.

·

Our gross profit as a percentage of revenues benefited from the increase in our total generic dispensing rate, as noted previously.

brand inflation.


32

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Operating expenses

Table of Contents

Operating Expenses

Operating expenses in ourthe Pharmacy Services Segmentsegment include selling, general and administrative expenses; depreciation and amortization related to selling, general and administrative activities;expense; and expenses related to specialty retail pharmacies, which include store and administrative payroll, employee benefits and occupancy costs.

Operating expenses decreased $46 million to $292$40 million, or 0.9% as a percentage of net revenues,10.6%, in the three months ended September 30, 2017,2020 compared to $338 million, or 1.1% as a percentage of net revenues, in the prior year. Operating expenses decreased $46 million to $938 million, or 1.0% as a percentage of net revenues, in the nine months ended September 30, 2017, compared to $984 million, or 1.1% as a percentage of net revenues, in the prior year. The decrease in operating expenses in the three and nine months ended September 30, 2017 isyear primarily due to the realization of partially reserved receivables.

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Table of Contents

Retail/LTC Segment

The following table summarizes our Retail/LTC Segment’s performance for the respective periods:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Nine Months Ended

 

 

September 30, 

 

September 30, 

In millions

    

2017

    

2016

    

2017

 

2016

Net revenues

 

$

19,593

 

 

$

20,143

 

 

$

58,488

 

 

$

60,253

 

Gross profit (1)(2)

 

 

5,685

 

 

 

5,893

 

 

 

17,036

 

 

 

17,560

 

Gross profit % of net revenues

 

 

29.0

%

 

 

29.3

%

 

 

29.1

%

 

 

29.1

%

Operating expenses (1)(2)(3)(4)

 

 

4,132

 

 

 

4,115

 

 

 

12,661

 

 

 

12,287

 

Operating expenses % of net revenues

 

 

21.1

%

 

 

20.4

%

 

 

21.6

%

 

 

20.4

%

Operating profit (4)

 

 

1,553

 

 

 

1,778

 

 

 

4,375

 

 

 

5,273

 

Operating profit % of net revenues

 

 

7.9

%

 

 

8.8

%

 

 

7.5

%

 

 

8.8

%

Prescriptions filled (90 Day = 3 prescriptions) (5)

 

 

304.0

 

 

 

302.9

 

 

 

908.7

 

 

 

908.9

 

Net revenue increase (decrease):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total

 

 

(2.7)

%

 

 

12.5

%

 

 

(2.9)

%

 

 

15.6

%

Pharmacy

 

 

(2.9)

%

 

 

15.3

%

 

 

(3.1)

%

 

 

19.9

%

Front Store

 

 

(2.1)

%

 

 

0.8

%

 

 

(2.4)

%

 

 

0.9

%

Total prescription volume (90 Day = 3 prescriptions) (5)

 

 

0.4

%

 

 

17.1

%

 

 

0.0

%

 

 

22.1

%

Same store sales increase (decrease) (6):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total

 

 

(3.2)

%

 

 

2.3

%

 

 

(3.5)

%

 

 

2.8

%

Pharmacy

 

 

(3.4)

%

 

 

3.4

%

 

 

(3.6)

%

 

 

4.3

%

Front Store

 

 

(2.8)

%

 

 

(1.0)

%

 

 

(3.3)

%

 

 

(1.0)

%

Prescription volume (90 Day = 3 prescriptions) (5)

 

 

0.3

%

 

 

3.0

%

 

 

(0.4)

%

 

 

4.1

%

Generic dispensing rates

 

 

87.2

%

 

 

85.8

%

 

 

87.4

%

 

 

85.8

%

Pharmacy % of net revenues

 

 

75.9

%

 

 

76.0

%

 

 

75.1

%

 

 

75.2

%


(1)

Gross profit and operating expenses for the three months ended September 30, 2017 include $2 million and $7 million of acquisition-related integration costs. Gross profit and operating expenses for the nine months ended September 30, 2017 include $7 million and $27 million, respectively, of acquisition-related integration costs. The integration costs are related to the acquisition of Omnicare.

(2)

Gross profit and operating expenses for the three months ended September 30, 2016 include $5 million and $47 million, respectively, of acquisition-related integration costs. Gross profit and operating expenses for the nine months ended September 30, 2016 include $15 million and $179 million, respectively, of acquisition-related integration costs. The integration costs are related to the acquisitions of Omnicare and the pharmacies and clinics of Target.

(3)

Operating expenses for the three and nine months ended September 30, 2017 includes $6 million and $211 million, respectively, of charges associated with store closures (see “Note 8 – Store Closures” to our condensed consolidated financial statements). Operating expenses for the nine months ended September 30, 2017 also include a $135 million goodwill impairment charge related to the segment’s RxCrossroads reporting unit (see “Note 2 – Goodwill and Intangible Assets” to our condensed consolidated financial statements).

(4)

Amounts revised to reflect the adoption of ASU 2017-07, Improving the Presentation of Net Periodic Pension Cost and Net Periodic Postretirement Benefit Cost, which decreased operating expenses and increased operating profit by $5 million for the three months ended September 30, 2016. For the nine months ended September 30, 2016, the adoption of ASU 2017-07 decreased operating expenses and increased operating profit by $18 million.

(5)

Includes the adjustment to convert 90-day non-specialty prescriptions to the equivalent of three 30-day prescriptions. This adjustment reflects the fact that these prescriptions include approximately three times the amount of product days supplied compared to a normal prescription.

(6)

Same store sales and prescriptions exclude revenues from MinuteClinic, and revenue and prescriptions from stores in Brazil, LTC operations and from commercialization services.

As of September 30, 2017, we operated 9,751 retail locations (of which 8,016 were our stores that operated a pharmacy and 1,687 were our pharmacies located within Target stores), compared to 9,694 retail locations as of September 30, 2016.

Net Revenues

Net revenues in our Retail/LTC Segment decreased $549 million, or 2.7%, to approximately $19.6 billiondriven by lower amortization expense in the three months ended September 30, 2017,2020.

Operating expenses as a percentage of total revenues remained relatively consistent at 0.9% and 1.0% in the three-month periods ended September 30, 2020 and 2019, respectively.

Operating income and adjusted operating income
Operating income increased $224 million, or 16.7%, and adjusted operating income increased $180 million, or 12.5%, in the three months ended September 30, 2020 compared to the prior year. Net revenuesyear primarily driven by improved purchasing economics and growth in our Retail/LTC Segment decreased $1.8 billion, or 2.9%, to approximately $58.5 billionspecialty pharmacy. The increase was partially offset by continued price compression and previously disclosed client losses. The increase in operating income also was driven by lower amortization expense in the ninethree months ended September 30, 2017, as compared to the prior year. 2020.
As you review our Retail/LTC Segment’sthe Pharmacy Services segment’s performance in this area, we believe you should consider the following important information about the business:
The Company’s efforts to (i) retain existing clients, (ii) obtain new business and (iii) maintain or improve the rebates and/or discounts the Company receives from manufacturers, wholesalers and retail pharmacies continue to have an impact on operating income and adjusted operating income. In particular, competitive pressures in the PBM industry have caused the Company and other PBMs to continue to share with clients a larger portion of rebates and/or discounts received from pharmaceutical manufacturers. In addition, marketplace dynamics and regulatory changes have limited the Company’s ability to offer plan sponsors pricing that includes retail network “differential” or “spread,” and the Company expects these trends to continue. The “differential” or “spread” is any difference between the drug price charged to plan sponsors, including Medicare Part D plan sponsors, by a PBM and the price paid for the drug by the PBM to the dispensing provider.

Pharmacy claims processed
Total pharmacy claims processed represents the number of prescription claims processed through our pharmacy benefits manager and dispensed by either our retail network pharmacies or our own mail and specialty pharmacies. Management uses this metric to understand variances between actual claims processed and expected amounts as well as trends in period-over-period results. This metric provides management and investors with information useful in understanding the impact of pharmacy claim volume on segment total revenues and operating results.
The Company’s pharmacy network claims processed on a 30-day equivalent basis increased 4.1% to 447.7 million claims in the three months ended September 30, 2020 compared to 430.2 million claims in the prior year. The increase in pharmacy network claims processed was primarily driven by net new business, partially offset by reduced new therapy prescriptions in the three months ended September 30, 2020 as a result of COVID-19.
The Company’s mail choice claims processed on a 30-day equivalent basis increased 1.5% to 80.5 million claims in the three months ended September 30, 2020 compared to 79.3 million claims in the prior year. The increase in mail choice claims was primarily driven by net new business and the continued adoption of Maintenance Choice offerings. The increase was partially offset by reduced new therapy prescriptions in the three months ended September 30, 2020 as a result of COVID-19.

Generic dispensing rate
Generic dispensing rate is calculated by dividing the Pharmacy Services segment’s generic drug prescriptions processed or filled by its total prescriptions processed or filled. Management uses this metric to evaluate the effectiveness of the business at encouraging the use of generic drugs when they are available and clinically appropriate, which aids in decreasing costs for client members and retail customers. This metric provides management and investors with information useful in understanding trends in segment total revenues and operating results.
The Pharmacy Services segment’s total generic dispensing rate decreased to 87.9% in the three months ended September 30, 2020 compared to 88.1% in the prior year. The decrease in the segment’s generic dispensing rate was primarily due to an increase in brand prescriptions, reflecting an increase in flu immunizations in the three months ended September 30, 2020 in comparison to the prior year. The Company believes the segment’s generic dispensing rate will likely increase in future periods, affected by, among other things, the number of new brand and generic drug introductions and the Company’s success at encouraging plan members to utilize generic drugs when they are available and clinically appropriate.
52


Commentary - Nine Months Ended September 30, 2020 vs. 2019

Revenues
Total revenues increased $1.2 billion, or 1.1%, to $105.6 billion in the nine months ended September 30, 2017:

2020 compared to the prior year primarily due to growth in specialty pharmacy and brand inflation. The increase was partially offset by previously disclosed client losses and continued price compression.

·

Front store same store sales decreased by 2.8% and 3.3% for the three and nine months ended September 30, 2017, respectively, compared to the prior year as a result of continued softer customer traffic and as promotional


Operating expenses
Operating expenses decreased $62 million, or 5.6%, in the nine months ended September 30, 2020 compared to the prior year primarily driven by lower amortization expense in the nine months ended September 30, 2020, partially offset by incremental operating expenses associated with growth in the business.
Operating expenses as a percentage of total revenues remained relatively consistent at 1.0% and 1.1% in the nine-month periods ended September 30, 2020 and 2019, respectively.

Operating income and adjusted operating income
Operating income increased $562 million, or 16.6%, and adjusted operating income increased $445 million, or 12.1%, in the nine months ended September 30, 2020 compared to the prior year primarily driven by improved purchasing economics and growth in specialty pharmacy, partially offset by previously disclosed client losses and continued price compression. The increase in operating income also was driven by lower amortization expense in the nine months ended September 30, 2020.

Pharmacy claims processed
The Company’s pharmacy network claims processed on a 30-day equivalent basis increased 6.7% to 1.33 billion claims in the nine months ended September 30, 2020 compared to 1.25 billion claims in the prior year. The increase in pharmacy network claims processed was primarily driven by net new business, partially offset by reduced new therapy prescriptions in the nine months ended September 30, 2020 as a result of COVID-19.
The Company’s mail choice claims processed on a 30-day equivalent basis increased 4.7% to 241.1 million claims in the nine months ended September 30, 2020 compared to 230.3 million claims in the prior year. The increase in mail choice claims was primarily driven by net new business and the continued adoption of Maintenance Choice offerings. The increase was partially offset by reduced new therapy prescriptions in the nine months ended September 30, 2020 as a result of COVID-19.

Generic dispensing rate
The Pharmacy Services segment’s total generic dispensing rate increased to 88.5% in the nine months ended September 30, 2020 compared to 88.3% in the prior year. The continued increase in the segment’s generic dispensing rate was primarily due to the impact of new generic drug introductions and the Company’s ongoing efforts to encourage plan members to use generic drugs when they are available and clinically appropriate.
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34



Table of Contents

strategies continue to be rationalized, partially offset by an increase in basket size. For the nine months ended September 30, 2017, front store same store sales were negatively impacted by approximately 35 basis points due to the absence of leap day in the current year.

·

Pharmacy same store sales decreased 3.4% and 3.6% for the three and nine months ended September 30, 2017, respectively, due to the negative impact of approximately 435 and 440 basis points, respectively, of recent generic introductions. Same store prescription volumes increased 0.3% and decreased 0.4%, on a 30-day equivalent basis, in the three and nine months ended September 30, 2017, respectively. The previously-discussed marketplace changes that restrict CVS Pharmacy from participating in certain networks had an approximately 420 and 450 basis point negative impact on same store prescription volumes in the three and nine months ended September 30, 2017, respectively.

·

Due to the previously-discussed marketplace changes that restrict CVS Pharmacy from participating in certain networks, we continue to expect prescription growth to be negatively impacted for the remainder of 2017 although to a lesser extent than the first nine months of the year.

·

Pharmacy revenues continue to be negatively impacted by the conversion of brand name drugs to equivalent generic drugs, which typically have a lower selling price. The generic dispensing rate grew to 87.2% and 87.4% for the three and nine months ended September 30, 2017, respectively, compared to 85.8% in both periods in the prior year. In addition, our pharmacy revenue growth has also been affected by continued reimbursement pressure, the mix of drugs sold and the lack of significant new brand name drug introductions.

·

Pharmacy revenue growth may be impacted by industry changes in the LTC business, such as lower occupancy rates at skilled nursing facilities.

·

Pharmacy revenue continued to benefit from our ability to attract and retain managed care customers, and the increased use of pharmaceuticals by an aging population as the first line of defense for health care.

Gross Profit

Gross profit in our Retail/LTC Segment includes net


The following table summarizes the Retail/LTC segment’s performance for the respective periods:
Change
Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
September 30,
2020 vs 2019
Nine Months Ended
September 30,
2020 vs 2019
In millions, except percentages2020201920202019$%$%
Revenues:
Products$22,424 $21,273 $66,422 $63,403 $1,151 5.4 %$3,019 4.8 %
Services301 193 714 625 108 56.0 %89 14.2 %
Total revenues22,725 21,466 67,136 64,028 1,259 5.9 %3,108 4.9 %
Cost of products sold16,899 15,656 49,697 46,504 1,243 7.9 %3,193 6.9 %
Operating expenses4,543 4,715 13,443 13,640 (172)(3.6)%(197)(1.4)%
Operating expenses as a % of total revenues20.0 %22.0 %20.0 %21.3 %
Operating income$1,283 $1,095 $3,996 $3,884 $188 17.2 %$112 2.9 %
Operating income as a % of total revenues5.6 %5.1 %6.0 %6.1 %
Adjusted operating income (1)
$1,412 $1,516 $4,371 $4,674 $(104)(6.9)%$(303)(6.5)%
Adjusted operating income as a % of total revenues6.2 %7.1 %6.5 %7.3 %
Revenues (by major goods/service lines):
Pharmacy$17,608 $16,687 $51,833 $49,197 $921 5.5 %$2,636 5.4 %
Front Store4,740 4,614 14,601 14,288 126 2.7 %313 2.2 %
Other377 165 702 543 212 128.5 %159 29.3 %
Prescriptions filled (2)
368.4 352.3 1,088.9 1,048.2 16.1 4.6 %40.7 3.9 %
Same store sales increase: (3)
Total5.7 %3.6 %5.7 %3.9 %
Pharmacy6.7 %4.5 %6.8 %4.7 %
Front Store2.2 %0.6 %1.9 %1.3 %
Prescription volume (2)
5.8 %7.8 %5.4 %7.3 %
Generic dispensing rate (2)
87.7 %88.2 %88.7 %88.7 %

(1)See “Segment Analysis” above in this report for a reconciliation of operating income (GAAP measure) to adjusted operating income for the Retail/LTC segment.
(2)Includes an adjustment to convert 90-day prescriptions to the equivalent of three 30-day prescriptions. This adjustment reflects the fact that these prescriptions include approximately three times the amount of product days supplied compared to a normal prescription.
(3)Same store sales and prescription volume represent the change in revenues less the cost of merchandise soldand prescriptions filled in the periodCompany’s retail pharmacy stores that have been operating for greater than one year, expressed as a percentage that indicates the increase or decrease relative to the comparable prior period. Same store metrics exclude revenues from MinuteClinic, revenues and prescriptions from LTC operations and, in 2019, revenues and prescriptions from stores in Brazil. Management uses these metrics to evaluate the related purchasing costs, warehousing costs, delivery costsperformance of existing stores on a comparable basis and actualto inform future decisions regarding existing stores and estimated inventory losses.

Gross profit decreased $209 million,new locations. Same-store metrics provide management and investors with information useful in understanding the portion of current revenues and prescriptions resulting from organic growth in existing locations versus the portion resulting from opening new stores.


Commentary - Three Months Ended September 30, 2020 vs. 2019

Revenues
Total revenues increased $1.3 billion, or 3.5%5.9%, to $5.7$22.7 billion in the three months ended September 30, 2017, as2020 compared to the prior year. Gross profit decreased $524 million, or 3.0%, to $17.0 billion inyear primarily driven by increased prescription volume, higher front store revenues, increased diagnostic testing and brand inflation. These increases were partially offset by continued reimbursement pressure and the nine months ended September 30, 2017, as compared to the prior year. Gross profit as a percentageimpact of net revenues decreased to 29.0%recent generic introductions.
Pharmacy same store sales increased 6.7% in the three months ended September 30, 2017, compared to 29.3% in the prior year. Gross profit as a percentage of net revenues remained flat at 29.1% in the nine months ended September 30, 2017,2020 compared to the prior year.

The decrease in gross profit dollars in both Retail Pharmacy and LTC,increase was primarily driven by the 5.8% increase in pharmacy same store prescription volume on a 30-day equivalent

54


basis, pharmacy drug mix and brand inflation. These increases were partially offset by continued reimbursement pressure as well as lossand the impact of prescriptions in Retail Pharmacy due to previously discussed network restrictions. The decrease in gross profit as a percentage of net revenuesrecent generic introductions.
Front store same store sales increased 2.2% in the three months ended September 30, 20172020 compared to the prior year. The increase was primarily due to continued reimbursement pressure. Gross profitstrength in consumer health sales and an increase in basket size, partially offset by decreased customer traffic in the segment’s retail pharmacies as a percentageresult of netthe COVID-19 pandemic.
Other revenues increased 128.5% in the ninethree months ended September 30, 20172020 compared to the prior year. The increase was flat primarily driven by increased front store margins which offset the continued reimbursement pressure on pharmacy. Front store margins increased due to changesincreased diagnostic testing and the fulfillment of consumer health product boxes to support the Health Care Benefits segment’s Medicare members, both in response to the COVID-19 pandemic in the mix of products sold and efforts to rationalize promotional strategies.

As you review our Retail/LTC Segment’s performance in this area, we believe you should consider the following important information about the business for the three and nine months ended September 30, 2017:

·

Front store revenues as a percentage of total net revenues for the three and nine months ended September 30, 2017 was 22.8% and 23.6% for the three and nine months ended September 30, 2017, respectively, compared to 22.7% and 23.5%, respectively, in the prior year. On average, our gross profit on front store revenues is higher than our gross profit on pharmacy revenues.

·

Our pharmacy gross profit rates have been adversely affected by the efforts of managed care organizations, PBMs and governmental and other third-party payors to reduce their prescription drug costs, including the use

2020.

35



Operating expenses

Table of Contents

of restrictive networks, as well as changes in the mix of our business within the pharmacy portion of the Retail/LTC Segment. In the event the reimbursement pressure accelerates, we may not be able to sustain our current rate of revenue growth and gross profit dollars could be adversely impacted. The increased use of generic drugs has positively impacted our gross profit but has resulted in third-party payors augmenting their efforts to reduce reimbursement payments to retail pharmacies for prescriptions. This trend, which we expect to continue, reduces the benefit we realize from brand to generic product conversions.

Operating Expenses

Operating expenses in ourthe Retail/LTC Segmentsegment include store payroll, andstore employee benefits, store occupancy costs, selling expenses, advertising expenses, depreciation and amortization expense and certain administrative expenses.

Operating expenses increased $16decreased $172 million, to $4.1 billion, or 21.1% as a percentage of net revenues,3.6%, in the three months ended September 30, 2017, as2020 compared to $4.1 billion, or 20.4%the prior year. The decrease was primarily due to the absence of the $205 million pre-tax loss on the sale of Onofre and the $96 million store rationalization charge primarily related to operating lease right-of-use asset impairment charges in connection with planned closure of underperforming retail pharmacy stores, both recorded in the three months ended September 30, 2019. The decrease was partially offset by incremental operating expenses associated with the Company’s COVID-19 pandemic response efforts and the increased volume described above in the three months ended September 30, 2020.
Operating expenses as a percentage of nettotal revenues decreased to 20.0% in the three months ended September 30, 2020 compared to 22.0% in the prior year. OperatingThe decrease in operating expenses increased $373 million to $12.7 billion, or 21.6% as a percentage of nettotal revenues was primarily driven by the increases in total revenues and decreases in operating expenses described above.

Operating income and adjusted operating income
Operating income increased $188 million, or 17.2%, in the three months ended September 30, 2020 compared to the prior year. The increase in operating income was primarily driven by the absence of the $205 million pre-tax loss on the sale of Onofre and the $96 million store rationalization charge, both recorded in the three months ended September 30, 2019. This increase was partially offset by the decrease in adjusted operating income described below.
Adjusted operating income decreased $104 million, or 6.9%, in the three months ended September 30, 2020 compared to the prior year. The decrease in adjusted operating income was primarily due to continued reimbursement pressure, incremental operating expenses associated with the Company’s COVID-19 pandemic response efforts in the three months ended September 30, 2020 and declines in long-term care. These decreases were partially offset by the increased pharmacy and front store volume described above, improved generic drug purchasing and increased diagnostic testing as a result of the COVID-19 pandemic in the three months ended September 30, 2020.
As you review the Retail/LTC segment’s performance in this area, you should consider the following important information about the business:
The segment’s operating income and adjusted operating income have been adversely affected by the efforts of managed care organizations, PBMs and governmental and other third-party payors to reduce their prescription drug costs, including the use of restrictive networks, as well as changes in the mix of business within the pharmacy portion of the Retail/LTC segment. If the reimbursement pressure accelerates, the segment may not be able grow revenues, and its operating income and adjusted operating income could be adversely affected.
The increased use of generic drugs has positively impacted the segment’s operating income and adjusted operating income but has resulted in third-party payors augmenting their efforts to reduce reimbursement payments to retail pharmacies for prescriptions. This trend, which the Company expects to continue, reduces the benefit the segment realizes from brand to generic drug conversions.

Prescriptions filled
Prescriptions filled represents the number of prescriptions dispensed through the Retail/LTC segment’s pharmacies. Management uses this metric to understand variances between actual prescriptions dispensed and expected amounts as well as trends in period-over-period results. This metric provides management and investors with information useful in understanding the impact of prescription volume on segment total revenues and operating results.
Prescriptions filled increased 4.6% on a 30-day equivalent basis in the three months ended September 30, 2020 compared to the prior year primarily driven by the continued adoption of patient care programs. Prescriptions filled in the three months ended September 30, 2020 were adversely impacted by the COVID-19 pandemic, which resulted in reduced new therapy prescriptions, partially offset by greater use of 90-day prescriptions and increased immunizations.




55


Generic dispensing rate
Generic dispensing rate is calculated by dividing the Retail/LTC segment’s generic drug prescriptions filled by its total prescriptions filled. Management uses this metric to evaluate the effectiveness of the business at encouraging the use of generic drugs when they are available and clinically appropriate, which aids in decreasing costs for client members and retail customers. This metric provides management and investors with information useful in understanding trends in segment total revenues and operating results.
The Retail/LTC segment’s generic dispensing rate decreased to 87.7% in the three months ended September 30, 2020 compared to 88.2% in the prior year. The decrease in the segment’s generic dispensing rate was primarily driven by an increase in brand prescriptions, reflecting an increase in flu immunizations in the three months ended September 30, 2020 in comparison to the prior year. The Company believes the segment’s generic dispensing rate will likely increase in future periods, affected by, among other things, the number of new brand and generic drug introductions and the Company’s success at encouraging plan members to utilize generic drugs when they are available and clinically appropriate.

Commentary - Nine Months Ended September 30, 2020 vs. 2019

Revenues
Total revenues increased $3.1 billion, or 4.9%, to $67.1 billion in the nine months ended September 30, 2017, as2020 compared to $12.3 billion,the prior year primarily driven by increased prescription volume, higher front store revenues and brand inflation. These increases were partially offset by continued reimbursement pressure and the impact of recent generic introductions.
Pharmacy same store sales increased 6.8% in the nine months ended September 30, 2020 compared to the prior year. The increase was driven by the 5.4% increase in pharmacy same store prescription volume on a 30-day equivalent basis, pharmacy drug mix and brand inflation. These increases were partially offset by continued reimbursement pressure and the impact of recent generic introductions.
Front store same store sales increased 1.9% in the nine months ended September 30, 2020 compared to the prior year. The increase was primarily due to strength in consumer health and general merchandise sales, which was primarily driven by COVID-19 related sales.
Other revenues increased 29.3% in the nine months ended September 30, 2020 compared to the prior year. The increase was primarily due to increased diagnostic testing and the fulfillment of consumer health product boxes to support the Health Care Benefits segment’s Medicare members, both in response to the COVID-19 pandemic in the nine months ended September 30, 2020.

Operating expenses
Operating expenses decreased $197 million, or 20.4%1.4%, in the nine months ended September 30, 2020 compared to the prior year. The decrease was primarily driven by the absence of the $231 million of store rationalization charges in connection with the planned closure of underperforming retail pharmacy stores and the $205 million pre-tax loss on the sale of Onofre, both recorded in the nine months ended September 30, 2019, and the impact of cost savings initiatives in the nine months ended September 30, 2020. The decrease was partially offset by incremental operating expenses associated with the Company’s COVID-19 pandemic response efforts and the increased volume described above in the nine months ended September 30, 2020.
Operating expenses as a percentage of nettotal revenues decreased to 20.0% in the nine months ended September 30, 2020 compared to 21.3% in the prior year. The decrease in operating expenses as a percentage of total revenues was primarily driven by the increases in total revenues and decreases in operating expenses described above.

Operating income and adjusted operating income
Operating income increased $112 million, or 2.9%, in the nine months ended September 30, 2020 compared to the prior year. The increase in operating income was primarily driven by the absence of the $231 million of store rationalization charges and the $205 million pre-tax loss on the sale of Onofre, both recorded in the nine months ended September 30, 2019. This increase was partially offset by the decrease in adjusted operating income described below.
Adjusted operating income decreased $303 million, or 6.5%, in the nine months ended September 30, 2020 compared to the prior year. The decrease in adjusted operating income was primarily due to continued reimbursement pressure, incremental operating expenses associated with the Company’s COVID-19 pandemic response efforts in the nine months ended September 30, 2020 and declines in long-term care. These decreases were partially offset by the increased prescription and front store volume described above, improved generic drug purchasing and increased diagnostic testing as a result of the COVID-19 pandemic in the nine months ended September 30, 2020.




56


Prescriptions filled
Prescriptions filled increased 3.9% on a 30-day equivalent basis in the nine months ended September 30, 2020 compared to the prior year primarily driven by the continued adoption of patient care programs. Prescriptions filled in the nine months ended September 30, 2020 were adversely impacted by the COVID-19 pandemic, which resulted in reduced new therapy prescriptions, partially offset by greater use of 90-day prescriptions and increased immunizations, as well as decreased long-term care prescription volume.

Generic dispensing rate
The Retail/LTC segment’s generic dispensing rate of 88.7% in the nine months ended September 30, 2020 remained consistent with the prior year.
57


Health Care Benefits Segment

The following table summarizes the Health Care Benefits segment’s performance for the respective periods:
Change
Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
September 30,
2020 vs 2019
Nine Months Ended
September 30,
2020 vs 2019
In millions, except percentages and basis points (“bps”)2020201920202019$%$%
Revenues:
Premiums$17,165 $15,507 $51,699 $47,543 $1,658 10.7 %$4,156 8.7 %
Services1,412 1,528 4,324 4,453 (116)(7.6)%(129)(2.9)%
Net investment income121 146 341 458 (25)(17.1)%(117)(25.5)%
Total revenues18,698 17,181 56,364 52,454 1,517 8.8 %3,910 7.5 %
Benefit costs14,416 12,914 40,816 39,815 1,502 11.6 %1,001 2.5 %
MBR84.0 %83.3 %78.9 %83.7 %70bps(480)bps
Operating expenses$3,333 $3,231 $10,438 $9,386 $102 3.2 %$1,052 11.2 %
Operating expenses as a % of total revenues17.8 %18.8 %18.5 %17.9 %
Operating income$949 $1,036 $5,110 $3,253 $(87)(8.4)%$1,857 57.1 %
Operating income as a % of total revenues5.1 %6.0 %9.1 %6.2 %
Adjusted operating income (1)
$1,080 $1,423 $6,035 $4,423 $(343)(24.1)%$1,612 36.4 %
Adjusted operating income as a % of total revenues5.8 %8.3 %10.7 %8.4 %
Premium revenues (by business):
Government$12,181 $10,247 $36,626 $31,598 $1,934 18.9 %$5,028 15.9 %
Commercial$4,984 $5,260 $15,073 $15,945 (276)(5.2)%(872)(5.5)%

(1)See “Segment Analysis” above in this report for a reconciliation of operating income (GAAP measure) to adjusted operating income for the Health Care Benefits segment.

Commentary - Three Months Ended September 30, 2020 vs. 2019

Revenues
Total revenues increased $1.5 billion, or 8.8%, to $18.7 billion in the three months ended September 30, 2020 compared to the prior year primarily driven by membership growth in the Health Care Benefits segment’s Government products and the favorable impact of the reinstatement of the HIF for 2020. These increases were partially offset by the divestitures of Aetna’s standalone PDPs (which the Company retained the financial results of through 2019) and Workers’ Compensation business, membership declines in the segment’s Commercial products and planned COVID-19 related investments benefiting customers and members in the three months ended September 30, 2020.

Medical Benefit Ratio (“MBR”)
Medical benefit ratio is calculated as benefit costs divided by premium revenues and represents the percentage of premium revenues spent on medical benefits for the Company’s Insured members. Management uses MBR to assess the underlying business performance and underwriting of its insurance products, understand variances between actual results and expected results and identify trends in period-over-period results. MBR provides management and investors with information useful in assessing the operating results of the Company’s Insured Health Care Benefits products.
The Health Care Benefits segment’s MBR increased 70 basis points from 83.3% to 84.0% in the three months ended September 30, 2020 compared to the prior year primarily driven by the planned COVID-19 related investments described above, shifts in business mix and the divestiture of Aetna’s standalone PDPs, partially offset by the reinstatement of the HIF for 2020.

58




Operating expenses
Operating expenses in the Health Care Benefits segment include selling, general and administrative expenses and depreciation and amortization expenses.
Operating expenses increased $102 million, or 3.2%, in the three months ended September 30, 2020 compared to the prior year. The increase in operating expenses was primarily due to the reinstatement of the HIF for 2020 and incremental operating expenses to support the increased membership described above, including operating expenses to support additional Medicaid members onboarded during the first quarter of 2020. The increase was partially offset by the $271 million pre-tax gain on the sale of the Workers’ Compensation business in the three months ended September 30, 2020.
Operating expenses as a percentage of total revenues decreased to 17.8% in the three months ended September 30, 2020 compared to 18.8% in the prior year. The decrease in operating expenses as a percentage of total revenues was primarily due to the $271 million pre-tax gain on the sale of the Workers’ Compensation business in the three months ended September 30, 2020.

Operating income and adjusted operating income
Operating income decreased $87 million, or 8.4%, and adjusted operating income decreased $343 million, or 24.1% in the three months ended September 30, 2020, compared to the prior year. The decrease in both operating income and adjusted operating income was primarily driven by the planned COVID-19 related investments described above and the divestitures of Aetna’s standalone PDPs and Workers’ Compensation business. The decrease in operating income was partially offset by the $271 million pre-tax gain on the sale of the Workers’ Compensation business.

Commentary - Nine Months Ended September 30, 2020 vs. 2019

Revenues
Total revenues increased $3.9 billion, or 7.5%, to $56.4 billion in the nine months ended September 30, 2020 compared to the prior year primarily driven by membership growth in the Health Care Benefits segment’s Government products and the favorable impact of the reinstatement of the HIF for 2020. These increases were partially offset by membership declines in the segment’s Commercial products, the divestitures of Aetna’s standalone PDPs and Workers’ Compensation business and planned COVID-19 related investments benefiting customers and members in the nine months ended September 30, 2020.

MBR
The Health Care Benefits segment’s MBR decreased 480 basis points from 83.7% to 78.9% in the nine months ended September 30, 2020 compared to the prior year primarily due to the deferral of elective procedures and other discretionary utilization in response to the COVID-19 pandemic in the nine months ended September 30, 2020 and the reinstatement of the HIF for 2020.

Operating expenses
Operating expenses increased $1.1 billion, or 11.2%, in the nine months ended September 30, 2020 compared to the prior year. The increase in operating expenses was primarily due to the reinstatement of the HIF for 2020 and incremental operating expenses to support the increased membership described above, including operating expenses to support additional Medicaid members onboarded during the first quarter of 2020. The increase was partially offset by the $271 million pre-tax gain on the sale of the Workers’ Compensation business.
Operating expenses as a percentage of total revenues increased to 18.5% in the nine months ended September 30, 2020 compared to 17.9% in the prior year. The increase in operating expenses in the three and nine months ended September 30, 2017as a percentage of total revenues was primarily due to the following:

reinstatement of the HIF for 2020.

·

Hurricane related expenses of $53 million in the three and nine months ended September 30, 2017 as a result of the three major hurricanes that hit the southern United States and Puerto Rico.


·

Charges of $6 million and $211 million in the three and nine months ended September 30, 2017, respectively, associated with the closure of five and 68 retail stores, respectively, in connection with our enterprise streamlining initiative (see "Note 8 - Store Closures" to our condensed consolidated financial statements).

Operating income and adjusted operating income

·

An increase in operating expenses due to incremental store operating costs associated with operating more stores.

·

These items were partially offset by a decrease in acquisition-related integration costs of $40 million and $152 million in the three and nine months ended September 30, 2017, respectively, versus the same periods in the prior year.

The increaseOperating income increased $1.9 billion, or 57.1%, and adjusted operating income increased $1.6 billion, or 36.4% in the nine months ended September 30, 20172020, compared to the prior year. The increase was primarily driven by reduced benefit costs due to the deferral of elective procedures and other discretionary utilization in response to the COVID-19 pandemic and membership growth in the segment’s Government products, partially offset by membership declines in the segment’s Commercial products. The increase in operating income was also duedriven by the $271 million pre-tax gain on the sale of the Workers’ Compensation business.





59




The following table summarizes the Health Care Benefits segment’s medical membership for the respective periods:
September 30, 2020June 30, 2020December 31, 2019September 30, 2019
In thousandsInsuredASCTotalInsuredASCTotalInsuredASCTotalInsuredASCTotal
Medical membership:
Commercial3,268 13,671 16,939 3,298 14,179 17,477 3,591 14,159 17,750 3,560 14,159 17,719 
Medicare Advantage2,689 — 2,689 2,651 — 2,651 2,321 — 2,321 2,304 — 2,304 
Medicare Supplement1,009 — 1,009 954 — 954 881 — 881 842 — 842 
Medicaid2,028 605 2,633 1,918 586 2,504 1,398 558 1,956 1,382 562 1,944 
Total medical membership8,994 14,276 23,270 8,821 14,765 23,586 8,191 14,717 22,908 8,088 14,721 22,809 
Supplemental membership information:
Medicare Prescription Drug Plan (standalone) (1)
5,540 5,575 5,994 5,998 

(1)Represents the Company’s SilverScript PDP membership only. Excludes 2.5 million members as of both December 31, 2019 and September 30, 2019 related to Aetna’s standalone PDPs that were sold effective December 31, 2018. The Company retained the financial results of the divested plans through 2019 through a goodwill impairment chargereinsurance agreement. Subsequent to 2019, the Company no longer retains the financial results of $135the divested plans.

Medical Membership
Medical membership represents the number of members covered by the Company’s Insured and ASC medical products and related services at a specified point in time. Management uses this metric to understand variances between actual medical membership and expected amounts as well as trends in period-over-period results. This metric provides management and investors with information useful in understanding the impact of medical membership on segment total revenues and operating results.
Medical membership as of September 30, 2020 of 23.3 million decreased 316 thousand members compared with June 30, 2020, primarily reflecting a decline in Commercial products, partially offset by increases in Medicare and Medicaid products. Medical membership as of September 30, 2020 of 23.3 million increased 461 thousand members compared with September 30, 2019, reflecting increases in Medicare and Medicaid products, partially offset by declines in Commercial products.

Medicare Update
On April 6, 2020, the U.S. Centers for Medicare & Medicaid Services issued its final notice detailing final 2021 Medicare Advantage benchmark payment rates (the “Final Notice”). Overall the Company projects the benchmark rates in the Final Notice will increase funding for its Medicare Advantage business, excluding the impact of the HIF, by approximately 1.8% in 2021 compared to 2020.

The ACA ties a portion of each Medicare Advantage plan’s reimbursement to the plan’s “star ratings.” Plans must have a star rating of four or higher (out of five) to qualify for bonus payments. CMS released the Company’s 2021 star ratings in October 2020. The Company’s 2021 star ratings will be used to determine which of the Company’s Medicare Advantage plans have ratings of four stars or higher and qualify for bonus payments in 2022. Based on the Company’s membership at September 1, 2020, 83% of the Company’s Medicare Advantage members were in plans with 2021 star ratings of at least 4.0 stars, consistent with 83% of the Company’s Medicare Advantage members being in plans with 2020 star ratings of at least 4.0 stars based on the Company’s membership at September 1, 2019.
60


Corporate/Other Segment

The following table summarizes the Corporate/Other segment’s performance for the respective periods:
Change
Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
September 30,
2020 vs 2019
Nine Months Ended
September 30,
2020 vs 2019
In millions, except percentages2020201920202019$%$%
Revenues:
Premiums$17 $32 $50 $69 $(15)(46.9)%$(19)(27.5)%
Services16 33 13 433.3 %26 371.4 %
Net investment income83 117 209 347 (34)(29.1)%(138)(39.8)%
Total revenues116 152 292 423 (36)(23.7)%(131)(31.0)%
Benefit costs54 77 173 213 (23)(29.9)%(40)(18.8)%
Operating expenses423 439 1,248 1,263 (16)(3.6)%(15)(1.2)%
Operating loss(361)(364)(1,129)(1,053)0.8 %(76)(7.2)%
Adjusted operating loss (1)
(303)(252)(931)(685)(51)(20.2)%(246)(35.9)%

(1)See “Segment Analysis” above in this report for a reconciliation of operating loss (GAAP measure) to adjusted operating loss for the Corporate/Other segment.

Commentary - Three Months Ended September 30, 2020 vs. 2019

Revenues
Revenues primarily relate to products for which the Company no longer solicits or accepts new customers, such as large case pensions and long-term care insurance products.
Total revenues decreased $36 million in the second quarter of 2017three months ended September 30, 2020 compared to the prior year. The decrease was primarily driven by lower net investment income including a $27 million decrease in net realized capital gains in the RxCrossroads reporting unit (see "Note 2 - Goodwill and Intangible Assets"three months ended September 30, 2020 compared to our condensed consolidated financial statements).

the prior year.

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Operating expenses

Table of Contents

Corporate Segment

Operating Expenses

Operating expenses in our Corporate Segment includewithin the Corporate/Other segment consist of management and administrative expenses fromto support the Company’s overall operations, which include certain aspects of executive management and the corporate relations, legal, compliance, human resources, information technology and finance departments.

departments, expenses associated with the Company’s investments in its transformation and enterprise modernization programs and acquisition-related integration costs. Segment operating expenses also include operating costs to support the Company’s large case pensions and long-term care insurance products.

Operating expenses decreased $8 million, or 3.1%, to $220 million and increased $26 million, or 4.3%, to $686$16 million in the three and nine months ended September 30, 2017, respectively, as2020 compared to the prior year. The change in operating expensesdecrease was partiallyprimarily driven by ongoing investments in strategic initiatives and increased employee benefit costs, offset by a $54 million decrease in acquisition-related integration costs of $16 million forand lower investments in modernization in the three andmonths ended September 30, 2020 compared to the prior year. These decreases were partially offset by an increase in the Company’s investments in transformation in the three months ended September 30, 2020 compared to the prior year.

Commentary - Nine Months Ended September 30, 2020 vs. 2019

Revenues
Total revenues decreased $131 million in the nine months ended September 30, 2017 versus2020 compared to the same periodsprior year. The decrease was primarily driven by lower net investment income due to COVID-19 related capital markets volatility and a $95 million decrease in net realized capital gains in the nine months ended September 30, 2020 compared to the prior year.


Operating expenses
Operating expenses decreased $15 million in the nine months ended September 30, 2020 compared to the prior year. The decrease was primarily driven by a $169 million decrease in acquisition-related integration costs compared to the prior year. The decrease was partially offset by incremental operating expenses associated with the Company’s investments in transformation and COVID-19 pandemic response efforts in the nine months ended September 30, 2020.
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Liquidity and Capital Resources

We maintain


Cash Flows

The Company maintains a level of liquidity sufficient to allow usit to cover ourmeet its cash needs in the short-term. Over the long-term, we manage ourlong term, the Company manages its cash and capital structure to maximize shareholder return, maintain ourits financial positioncondition and maintain flexibility for future strategic initiatives. WeThe Company continuously assess ourassesses its regulatory capital requirements, working capital needs, debt and leverage levels, debt maturity schedule, capital expenditure requirements, dividend payouts, potential share repurchases and future investments or acquisitions. We believe ourThe Company believes its operating cash flows, commercial paper program, credit facilities, sale-leaseback program, as well as any potential future borrowings, will be sufficient to fund these future payments and long-term initiatives.

The change As of September 30, 2020, the Company had approximately $9.3 billion in cash and cash equivalents, isapproximately $3.6 billion of which was held by the parent company or nonrestricted subsidiaries.


The COVID-19 pandemic has severely impacted global economic activity and during the first half of the year caused significant volatility and negative pressure in the capital markets. As a result of the uncertainty generated by COVID-19, on March 31, 2020, the Company issued $4.0 billion aggregate principal amount of unsecured senior notes to enhance its liquidity and strengthen its capital. The net proceeds from this offering will be used for general corporate purposes, which may include working capital, capital expenditures and repayment of indebtedness. As markets stabilized, in August 2020, the Company purchased $6.0 billion of its outstanding senior notes through cash tender offers, while issuing $4.0 billion aggregate principal amount of unsecured senior notes. The Company will continue to monitor the severity and duration of the pandemic and its impact on the U.S. and global economies, consumer behavior and health care utilization patterns and our businesses, results of operations, financial condition, and cash flows.

The net change in cash, cash equivalents and restricted cash during the nine months ended September 30, 2020 and 2019 was as follows:

 

 

 

 

 

 

 

Nine Months Ended September 30, 

Nine Months Ended
September 30,
Change

In millions

    

2017

    

2016

In millions, except percentagesIn millions, except percentages20202019$%

Net cash provided by operating activities

 

$

8,143

 

$

8,020

Net cash provided by operating activities$12,298 $10,214 $2,084 20.4 %

Net cash used in investing activities

 

 

(1,608)

 

 

(1,652)

Net cash used in investing activities(4,300)(2,630)(1,670)63.5 %

Net cash used in financing activities

 

 

(7,421)

 

 

(6,640)

Net cash used in financing activities(4,420)(6,410)1,990 (31.0)%

Effect of exchange rate changes on cash and cash equivalents

 

 

 

 

 2

Net decrease in cash and cash equivalents

 

$

(886)

 

$

(270)

Net increase in cash, cash equivalents and restricted cashNet increase in cash, cash equivalents and restricted cash$3,578 $1,174 $2,404 204.8 %


Commentary

Net cash provided by operating activities was approximately $8.1increased by $2.1 billion in the nine months ended September 30, 2017,2020 compared to $8.0 billionthe prior year due primarily to higher operating income in the nine months ended September 30, 2016.

Health Care Benefits and Pharmacy Services segments and the deferral of approximately $445 million of certain payroll tax payments to future years, as permitted in response to the COVID-19 pandemic.

Net cash used in investing activities was approximately $1.6 billion in the nine months ended September 30, 2017, compared toincreased by $1.7 billion in the nine months ended September 30, 2016. During2020 compared to the nine months ended September 30, 2017prior year primarily due to increased net purchases of investments and an increase in cash used for acquisitions, and other investments increased approximately $0.2 billionpartially offset by $834 million in proceeds from the prior year, which was offset by a decrease in capital expendituressale of approximately $0.2 billion in the current year.

Workers’ Compensation business.

Net cash used in financing activitieswas $7.4$4.4 billion in the nine months ended September 30, 2017,2020 compared to net cash used in financing activities of $6.6$6.4 billion in the prior year. The decrease in cash used in financing activities primarily related to a decrease in net debt repaid during the nine months ended September 30, 2016. The cash used in financing activities increased $0.8 billion primarily due to an increase of $0.4 billion in net debt repayments and an increase of $0.4 billion in share repurchases in the current year.

During the nine months ended September 30, 2017, the Company had the following outstanding share repurchase programs, both of which had previously been authorized by the Company’s Board of Directors:

 

 

 

 

 

 

 

In billions

    

 

 

    

 

 

 

 

 

 

 

 

 

Authorization Date

 

Authorized

 

Remaining

November 2, 2016 (“2016 Repurchase Program”)

 

$

15.0

 

$

13.9

December 15, 2014 (“2014 Repurchase Program”)

 

 

10.0

 

 

 —

Each of the 2014 and 2016 Repurchase Programs, which were effective immediately, permitted the Company to effect repurchases from time to time through a combination of open market repurchases, privately negotiated transactions, accelerated share repurchase transactions, and/or other derivative transactions. Each of the repurchase programs could be

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modified or terminated by the Board of Directors at any time. The 2014 Repurchase Program was completed during the second quarter of 2017.

During the nine months ended September 30, 2017, the Company repurchased an aggregate of approximately 55.4 million shares of common stock for approximately $4.4 billion pursuant2020 compared to the 2014prior year.


Short-term Borrowings

Commercial Paper and 2016 Repurchase Programs. This activity includes the accelerated share repurchase agreements (“ASRs”) described below.

Pursuant to the authorization under the 2014 Repurchase Program, effective August 29, 2016, the Company entered into two fixed dollar ASRs with Barclays Bank PLC (“Barclays”) for a total of $3.6 billion. Upon payment of the $3.6 billion purchase price on January 6, 2017, the Company received a number of shares of its common stock equal to 80% of the $3.6 billion notional amount of the ASRs or approximately 36.1 million shares, which were placed into treasury stock in January 2017. The ASRs were accounted for as an initial treasury stock transaction for $2.9 billion and a forward contract for $0.7 billion. In April 2017, the Company received 9.9 million shares of common stock, representing the remaining 20% of the $3.6 billion notional amount of the ASRs, thereby concluding the ASRs. The remaining 9.9 million shares of common stock delivered to the Company by Barclays were placed into treasury stock and the forward contract was reclassified from capital surplus to treasury stock in April 2017.

At the time they were received, the initial and final receipt of shares resulted in an immediate reduction of the outstanding shares used to calculate the weighted average common shares outstanding for basic and diluted net income per share.

Back-up Credit Facilities

The Company had $110 million ofdid not have any commercial paper outstanding at a weighted average interest rate of 1.26% as of September 30, 2017.2020. In connection with its commercial paper program, the Company maintains a $1.0 billion 364-day unsecured back-up revolving credit facility, which expires on May 12, 2021, a $1.0 billion, five-year unsecured back-up revolving credit facility, which expires on May 18, 2022, a $2.0 billion, five-year unsecured back-up revolving credit facility, which expires on May 17, 2018,2023, and a $1.25$2.0 billion, five-year unsecured back-up credit facility, which expires on July 24, 2019, a $1.25 billion, five-year unsecured back-up credit facility, which expires on July 1, 2020, and a $1.0 billion, five-year unsecured back-uprevolving credit facility, which expires on May 18, 2022.16, 2024. The credit facilities allow for borrowings at various rates that are dependent, in part, on the Company’s public debt ratings and require the Company to pay a weighted average quarterly facility fee of approximately 0.02%, regardless of usage. As of September 30, 2017, there were no borrowings outstanding under the back-up credit facilities.

On January 3, 2017, the Company entered into a $2.5 billion revolving credit facility. The credit facility allowed for borrowings at various rates that are dependent, in part, on the Company’s debt ratings and required the Company to pay a weighted

62


average quarterly facility fee of approximately 0.03%, regardless of usage. As of September 30, 2020, there were no borrowings outstanding under any of the Company’s back-up credit facilities.

Federal Home Loan Bank of Boston
A subsidiary of the Company is a member of the Federal Home Loan Bank of Boston (the “FHLBB”). As a member, the subsidiary has the ability to obtain cash advances, subject to certain minimum collateral requirements. The maximum borrowing capacity available under this credit facility decreased byfrom the FHLBB as of September 30, 2020, was approximately $935 million. As of September 30, 2020, there were no outstanding advances from the FHLBB.

Long-term Borrowings

2020 Notes
On August 21, 2020, the Company issued $1.5 billion aggregate principal amount of 1.3% unsecured senior notes due August 21, 2027, $1.25 billion aggregate principal amount of 1.75% unsecured senior notes due August 21, 2030 and $1.25 billion aggregate principal amount of 2.7% unsecured senior notes due August 21, 2040 (collectively, the “August 2020 Notes”) for total proceeds of approximately $3.97 billion, net of discounts and underwriting fees.

On March 31, 2020, the Company issued $750 million aggregate principal amount of 3.625% unsecured senior notes due April 1, 2027, $1.5 billion aggregate principal amount of 3.75% unsecured senior notes due April 1, 2030, $1.0 billion aggregate principal amount of 4.125% unsecured senior notes due April 1, 2040 and $750 million aggregate principal amount of 4.25% unsecured senior notes due April 1, 2050 (collectively, the “March 2020 Notes”) for total proceeds of approximately $3.95 billion, net of discounts and underwriting fees.

The net proceeds of these offerings will be used for general corporate purposes, which may include working capital, capital expenditures, as well as the repurchase and/or repayment of indebtedness. Net proceeds from these offerings that had not been used for these purposes were held in cash or temporarily invested in cash equivalents and short-term investment-grade securities from the date of issuance through September 30, 2020.

During March 2020, the Company entered into several interest rate swap transactions to $1.75 billion onmanage interest rate risk. These agreements were designated as cash flow hedges and were used to hedge the exposure to variability in future cash flows resulting from changes in interest rates related to the anticipated issuance of the March 31, 2017.2020 Notes. In connection with the issuance of the March 2020 Notes, the Company terminated all outstanding cash flow hedges. The Company terminated this facility effective May 17, 2017.

Our back‑uppaid a net amount of $7 million to the hedge counterparties upon termination, which was recorded as a loss, net of tax, of $5 million in accumulated other comprehensive income and will be reclassified as interest expense over the life of the March 2020 Notes. See Note 8 ‘‘Other Comprehensive Income’’ to the unaudited condensed consolidated financial statements for additional information.


Early Extinguishments of Debt
In August 2020, the Company purchased $6.0 billion of its outstanding senior notes through cash tender offers. The senior notes purchased included the following: $723 million of its 4.0% senior notes due 2023, $2.3 billion of its 3.7% senior notes due 2023 and $3.0 billion of its 4.1% senior notes due 2025. In connection with the purchase of such senior notes, the Company paid a premium of $706 million in excess of the aggregate principal amount of the senior notes that were purchased, wrote-off $47 million of unamortized deferred financing costs and incurred $13 million in fees, for a total loss on early extinguishment of debt of $766 million.

In August 2019, the Company purchased $4.0 billion of its outstanding senior notes through cash tender offers. The senior notes purchased included the following: $1.3 billion of its 3.125% senior notes due 2020, $723 million of its floating rate notes due 2020, $328 million of its 4.125% senior notes due 2021, $297 million of 4.125% senior notes due 2021 issued by Aetna, $413 million of 5.45% senior notes due 2021 issued by Coventry Health Care, Inc., a wholly-owned subsidiary of Aetna and $962 million of its 3.35% senior notes due 2021. In connection with the purchase of such senior notes, the Company paid a premium of $76 million in excess of the aggregate principal amount of the senior notes that were purchased, incurred $8 million in fees and recognized a net gain of $5 million on the write-off of net unamortized deferred financing premiums, for a net loss on early extinguishment of debt of $79 million.

Debt Covenants

The Company’s back-up revolving credit facilities, unsecured senior notes and unsecured seniorfloating rate notes contain customary restrictive financial and operating covenants. These covenants do not include a requirement for thean acceleration of ourthe Company’s debt maturities
63


in the event of a downgrade in ourthe Company’s credit rating. We doratings. The Company does not believe the restrictions contained in these covenants materially affect ourits financial or operating flexibility. As of September 30, 2017,2020, the Company iswas in compliance with all of its debt covenants.


Debt Ratings

As of September 30, 2017, our2020, the Company’s long-term debt was rated “Baa2” by Moody’s as “Baa1” with a stable outlookInvestor Service, Inc. (“Moody’s”) and “BBB” by Standard & Poor’s as “BBB+” with a stable outlook,Financial Services LLC (“S&P”), and ourits commercial paper program was rated “P‑2”“P-2” by Moody’s and “A‑2”“A-2” by Standard & Poor’s.S&P. In assessing ourthe Company’s credit strength, we believethe Company believes that both Moody’s and Standard & Poor’sS&P considered, among other things, ourthe Company’s capital structure and financial policies as well as ourits consolidated balance sheet, ourits historical acquisition activity and other financial information. Although wethe Company currently believe ourbelieves its long-term debt ratings will remain investment grade, weit cannot guarantee the future actions of Moody’s and/or Standard & Poor’s. OurS&P. The Company’s debt ratings have a direct impact on ourits future borrowing costs, access to capital markets and new store operating lease costs.

Off-Balance Sheet Arrangements

In connection with executing operating leases, we provide a guarantee


Share Repurchase Program

During the nine months ended September 30, 2020 and 2019, the Company did not repurchase any shares of common stock. See Note 7 ‘‘Shareholders’ Equity’’ to the lease payments. We also finance a portion of our new store development through sale-leaseback transactions, which involve selling stores to unrelated parties and then leasing the stores back under leases that generally qualify and are accounted for as operating leases. We do not have any retained or contingent interests in the stores, and we do not provide any guarantees, other than a guarantee of the lease payments, in connection with the transactions. In accordance with GAAP, such operating leases are not reflected in

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our condensed consolidated balance sheet. See “Note 12 – Commitments and Contingencies” to ourunaudited condensed consolidated financial statements for a detailed discussion of theseadditional information on the Company’s share repurchase program.


Off-Balance Sheet Arrangements

See Note 10 ‘‘Commitments and Contingencies’’ to the unaudited condensed consolidated financial statements for information on the Company’s lease guarantees.


Critical Accounting Policies

We prepare our


The Company prepares the unaudited condensed consolidated financial statements in conformity with GAAP,generally accepted accounting principles, which requiresrequire management to make certain estimates and apply judgment. We base our estimatesEstimates and judgments are based on historical experience, current trends and other factors that management believes to be important at the time the unaudited condensed consolidated financial statements are prepared. On a regular basis, we review ourthe Company reviews its accounting policies and how they are applied and disclosed in ourthe unaudited condensed consolidated financial statements.

While we believe thatthe Company believes the historical experience, current trends and other factors considered by management support the preparation of ourthe unaudited condensed consolidated financial statements in conformity with GAAP,generally accepted accounting principles, actual results could differ from our estimates, and such differences could be material.

As discussed in “Note 2 – Goodwill


Measurement of Credit Losses on Financial Instruments

Effective January 1, 2020, the Company adopted Accounting Standards Update 2016-13, Financial Instruments - Credit Losses (Topic 326). This standard requires the use of a forward-looking expected credit loss impairment model for trade and Intangible Assets”other receivables, held-to-maturity debt securities, loans and other instruments. This standard also requires impairments and recoveries for available-for-sale debt securities to ourbe recorded through an allowance account and revises certain disclosure requirements. The Company adopted the credit loss impairment model on a modified retrospective basis and recorded a $3 million cumulative effect adjustment to reduce retained earnings as of the adoption date. The Company adopted the available-for-sale debt security impairment model on a prospective basis. The adoption of this standard did not have a material impact on the Company’s consolidated operating results, cash flows or financial condition. See Note 1 ‘‘Significant Accounting Policies’’ to the unaudited condensed consolidated financial statements duringfor a discussion of the adoption of this new accounting standard and associated updates to the Company’s accounting policies from those previously disclosed in the 2019 Form 10-K.

Recoverability of Goodwill

During the three months ended September 30, 2017, we2020, the Company performed ourits required annual impairment teststest of goodwill. The results of thethis impairment teststest indicated that there was no impairment of goodwill.goodwill as of the testing date. The goodwill impairment teststest resulted in the fair values of our Pharmacy Services and Retail Pharmacyall of the Company’s reporting units exceeding their carrying values by significant margins. The fair valuesmargins, with the exception of ourthe Commercial Business and LTC and RxC reporting units, which exceeded their carrying values by approximately 1%6% and 6%12%, respectively. The balance of goodwill for our LTC and RxC reporting units at September 30, 2017 was approximately $6.4 billion and $0.4 billion, respectively.


64


The fair value of ourthe reporting units is estimated using a combination of a discounted cash flow method and a market multiple method. The determination of the fair value of ourthe reporting units requires the Company to make significant assumptions and estimates. These assumptions and estimates primarily include but are not limited to, the selection of appropriate peer group companies; control premiums and valuation multiples appropriate for acquisitions in the industries in which the Company competes; discount rates,rates; terminal growth rates; and forecasts of revenue, operating profit,income, depreciation and amortization, income taxes, capital expenditures and future working capital requirements. When determining these assumptions and preparing these estimates, we considerthe Company considers each reporting unit’s historical results and current operating trends and ourtrends; consolidated revenues, profitability and cash flow results forecastsand forecasts; and industry trends. OurThe Company’s estimates can be affected by a number of factors, including but not limited to, general economic and regulatory conditions, ourconditions; the risk-free interest rate environment; the Company’s market capitalization,capitalization; efforts of customers and payers to reduce costs, including their prescription drug costs, and/or increase member co-payments,co-payments; the continued efforts of competitors to gain market share and consumer spending patterns.


In connection with the Aetna Acquisition in November 2018, the Company added the Health Care Benefits segment which includes the Commercial Business reporting unit. The transaction was accounted for using the acquisition method of accounting which requires, among other things, the assets acquired and liabilities assumed to be recognized at their fair values at the date of acquisition. As previously discussed,a result, at the resultstime of our annual goodwill impairment test resulted inthe acquisition the fair value of ourthe Commercial Business reporting unit was equal to its carrying value. The Company has experienced declines in its Commercial Insured medical membership subsequent to the closing date of the Aetna Acquisition and may continue to do so for a number of reasons, including as a result of the competitive Commercial business environment. In addition, COVID-19 has had and may continue to have an adverse impact on medical membership on the Commercial business due to reductions in workforce at existing customers (including due to business failures) as well as reduced willingness to change benefit providers by prospective customers. The Company’s fair value estimate is sensitive to significant assumptions including changes in medical membership, revenue growth rate, operating income and the discount rate. Although the Company believes the financial projections used to determine the fair value of the Commercial Business reporting unit in the third quarter of 2020 were reasonable and achievable, the challenges described above may affect the Company’s ability to increase medical membership or operating income in the Commercial Business reporting unit at the rate estimated when such goodwill impairment test was performed and may continue to do so.

The LTC reporting unit exceeding its carrying value by approximately 1%. Our multi-year cash flow projections for our LTC reporting unitcontinues to experience industry-wide challenges that have declined fromimpacted management’s ability to grow the prior year due to customer reimbursement pressures, industry trends such asbusiness at the rate that was originally estimated when the Company acquired Omnicare Inc. Those challenges included lower client retention rates, lower occupancy rates in skilled nursing facilities, the deteriorating financial health of numerous skilled nursing facility customers which resulted in a number of customer bankruptcies in 2018, and continued facility reimbursement pressures. COVID-19 has also had an adverse impact on the financial health of the Company’s long-term care facility customers due to declines in occupancy rates and increased operating expenses. A number of these customers have relied on supplemental liquidity sources such as grants and advance Medicare payments under programs expanded or created under the CARES Act to maintain adequate liquidity during the COVID-19 pandemic and may require additional sources of liquidity throughout the duration of the COVID-19 pandemic.

Although the Company believes the financial projections used to determine the fair value of the LTC reporting unit in the third quarter of 2020 were reasonable and achievable, the LTC reporting unit has faced challenges that affect the Company’s ability to grow the LTC reporting unit’s business at the rate estimated when such goodwill impairment test was performed and may continue to do so. These challenges and some of the key assumptions included in the Company’s financial projections to determine the estimated fair value of the LTC reporting unit include client retention rates. Our projected discounted cash flow model assumes future script growth from ourrates; occupancy rates in skilled nursing facilities; the financial health of skilled nursing facility customers; facility reimbursement pressures; the Company’s ability to execute its senior living initiative andinitiative; the impact of acquisitions. Such projections also include expectedCompany’s ability to extract cost savings from labor productivity and other initiatives. Our market multiple method is heavily dependentinitiatives; the geographies impacted and the severity and duration of COVID-19; COVID-19’s impact on earnings multipleshealth care utilization patterns; and the timing, scope and impact of market participants in the pharmacy industry, including certain competitors and suppliers. If we do not achieve our forecasts, given the small excess of fair value over the related carrying value,stimulus legislation as well as current market conditions in the healthcare industry, it is reasonably possible that the operational performanceother federal, state and local governmental responses to COVID-19. The fair value of the LTC reporting unit could be below our current expectationsalso is dependent on market multiples of peer group companies and the risk-free interest rate environment, which impacts the discount rate used in the discounted cash flow valuation method. If the LTC reporting unit does not achieve its forecasts, it is reasonably possible in the near term andthat the goodwill of the LTC reporting unit could be deemed to be impaired by a material amount.

As of September 30, 2020, the goodwill balance in the LTC reporting unit was $431 million.


The COVID-19 pandemic severely impacted global economic activity in the nine months ended September 30, 2020, including the businesses of some of the Company’s customers, and during the first half of the year caused significant volatility and negative pressure in the capital markets. In addition to adversely affecting the Company’s businesses, which may have a material adverse impact on the Company’s profitability and cash flows, these developments may adversely affect the timing and collectability of payments to the Company from customers, clients, government payers and members as a result of the impact of COVID-19 on them. For further information regarding the potential adverse impact of COVID-19 on the Company, please see
65


“Risk Factors” in Part II, Item 1A of this report. The COVID-19 pandemic continues to evolve. We believe COVID-19’s impact on our businesses, operating results, cash flows and/or financial condition primarily will be driven by the geographies impacted and the severity and duration of the pandemic; the pandemic’s impact on the U.S. and global economies and consumer behavior and health care utilization patterns; and the timing, scope and impact of stimulus legislation as well as other federal, state and local governmental responses to the pandemic. Those primary drivers are beyond our knowledge and control. As a result, the impact COVID-19 will have on our businesses, operating results, cash flows and/or financial condition is uncertain, but the impact could be adverse and material. COVID-19 also may result in legal and regulatory proceedings, investigations and claims against us. If the Company’s businesses, results of operations, financial condition and/or cash flows are materially adversely affected, the goodwill of the LTC and Commercial Business reporting units could be deemed to be impaired by a material amount.

For a full description of ourthe Company’s other critical accounting policies, please refer tosee “Critical Accounting Policies” in Item 7 “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our 2016of the 2019 Form 10‑K.

10-K.

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Cautionary Statement Concerning Forward-Looking Statements


The Private Securities Litigation Reform Act of 1995 (the “Reform Act)”Act”) provides a safe harbor“safe harbor” for forward-looking statements, madeso long as (1) those statements are identified as forward-looking and (2) the statements are accompanied by or on behalfmeaningful cautionary statements that identify important factors that could cause actual results to differ materially from those discussed in the statement. We want to take advantage of CVS Health Corporation. The Company and its representatives may, from time to time, make written or verbal forward-looking statements, including statementsthese safe harbor provisions.

Certain information contained in this Quarterly Report on Form 10-Q (this “report”) is forward-looking within the Company’s filings with the U.S. Securities and Exchange Commission (“SEC”) and in its reports to stockholders, press releases, webcasts, conference calls, meetings and other communications. Generally, the inclusionmeaning of the Reform Act or SEC rules. This information includes, but is not limited to: “COVID-19 and 2020 Outlook” and “Government Regulation” of Management’s Discussion and Analysis of Financial Condition and Results of Operations (“MD&A”) included in Part I, Item 2, “Quantitative and Qualitative Disclosures About Market Risk” included in Part I, Item 3, and “Risk Factors” included in Part II, Item 1A of this report. In addition, throughout this report and our other reports and communications, we use the following words “believe,” “expect,” “intend,” “estimate,” “project,” “anticipate,” “will,” “should”or variations or negatives of these words and similar expressions when we intend to identify statements that constitute forward-looking statements. statements:
·Anticipates·Believes·Can·Continue·Could
·Estimates·Evaluate·Expects·Explore·Forecast
·Guidance·Intends·Likely·May·Might
·Outlook·Plans·Potential·Predict·Probable
·Projects·Seeks·Should·View·Will

All statements addressing the future operating performance of CVS Health Corporationor any segment or any subsidiary and/or future events or developments, thatincluding statements relating to the Company expects projected impact of COVID-19 on the Company’s businesses, investment portfolio, operating results, cash flows and/or anticipates will occur in the future, includingfinancial condition; statements relating to corporate strategy; statements relating to future revenue growth; earnings or adjusted revenue, operating income or adjusted operating income, earnings per common share growth; adjusted earnings or adjusted earnings per common share, growth; free cash flow; debt ratings; inventory levels; inventory turn and loss rates; store development; relocations and new market entries; retail pharmacyPharmacy Services segment business, sales results and/or trends and operations; PBMand/or operations, Retail/LTC segment business, sales results and/or trends and operations; specialty pharmacyand/or operations, Health Care Benefits segment business, sales results and/or trends, and operations; LTC pharmacy business, salesmedical cost trends, and operations;medical membership, Medicare Part D membership, medical benefit ratios and/or operations, incremental investment spending, interest expense, effective tax rate, weighted-average share count, cash flow from operations, net capital expenditures, cash available for debt repayment, integration synergies, net synergies, integration costs, enterprise modernization, transformation, leverage ratio, cash available for enhancing shareholder value, inventory reduction, turn rate and/or loss rate, debt ratings, the Company’s ability to attract or retain customers and clients; Medicare Part D competitive bidding, enrollment and operations;clients, store development and/or relocations, new product development;development, and the impact of industry and regulatory developments, as well asdevelopments; and statements expressing optimism or pessimism about future operating results or events, are forward-looking statements within the meaning of the Reform Act.

The forward-looking


Forward-looking statements arerely on a number of estimates, assumptions and will be based upon management’s then-current views and assumptions regardingprojections concerning future events, and operating performance, and are applicable only assubject to a number of the dates of such statements. The Company undertakes no obligation to update or revise any forward-looking statements, whether as a result of new information, future events, or otherwise.

By their nature, all forward-looking statements involvesignificant risks and uncertainties. Actualuncertainties and other factors that could cause actual results mayto differ materially from those contemplated by the forward-looking statements for a numberstatements. Many of reasons asthese risks and uncertainties and other factors are outside our control. Certain of these risks and uncertainties and other factors are described under “Risk Factors” included in Item 1A of our SEC filings, including those set forth in the Risk Factors section within the 2016Annual Report on Form 10-K for the fiscal year ended December 31, 2019 and/or under “Risk Factors” included in Part II, Item 1A of this report; these are not the only risks and including, but not limited to:

·

Risks relating to the health of the economy in general and in the markets we serve, which could impact consumer purchasing power, preferences and/or spending patterns, drug utilization trends, the financial health of our PBM and LTC clients, retail and specialty pharmacy payors or other payors doing business with the Company and our ability to secure necessary financing, suitable store locations and sale-leaseback transactions on acceptable terms.

·

Efforts to reduce reimbursement levels and alter health care financing practices, including pressure to reduce reimbursement levels for generic drugs.

·

The possibility of PBM and LTC client loss and/or the failure to win new PBM and LTC business, including as a result of failure to win renewal of expiring contracts, contract termination rights that may permit clients to terminate a contract prior to expiration and early or periodic renegotiation of pricing by clients prior to expiration of a contract.

·

The possibility of loss of Medicare Part D business and/or failure to obtain new Medicare Part D business, whether as a result of the annual Medicare Part D competitive bidding process or otherwise.

·

Risks related to the frequency and rate of the introduction of generic drugs and brand name prescription products.

·

Risks of declining gross margins attributable to increased competitive pressures, increased client demand for lower prices, enhanced service offerings and/or higher service levels and market dynamics and, with respect to the PBM industry, regulatory changes that impact our ability to offer plan sponsors pricing that includes the use of retail “differential” or “spread” or the use of maximum allowable cost pricing.

·

Regulatory changes, business changes and compliance requirements and restrictions that may be imposed by Centers for Medicare and Medicaid Services (“CMS”), Office of Inspector General or other government agencies relating to the Company’s participation in Medicare, Medicaid and other federal and state government-funded programs, including sanctions and remedial actions that may be imposed by CMS on our Medicare Part D business.

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·

Risks and uncertainties related to the timing and scope of reimbursement from Medicare, Medicaid and other government-funded programs, including the possible impact of sequestration, the impact of other federal budget, debt and deficit negotiations and legislation that could delay or reduce reimbursement from such programs and the impact of any closure, suspension or other changes affecting federal or state government funding or operations.

·

Possible changes in industry pricing benchmarks used to establish pricing in many of our PBM and LTC client contracts, pharmaceutical purchasing arrangements, retail network contracts, specialty payor agreements and other third party payor contracts.

·

Efforts to increase reimbursement rates in PBM pharmacy networks and to inhibit the ability of PBMs to audit network pharmacies for fraud, waste and abuse.

·

Risks related to increasing oversight of PBM activities by state departments of insurance and boards of pharmacy.

·

A highly competitive business environment, including the uncertain impact of increased consolidation in the PBM industry, the possibility of combinations, joint ventures or other collaboration between PBMs and retailers, uncertainty concerning the ability of our retail pharmacy business to secure and maintain contractual relationships with PBMs and other payors on acceptable terms, uncertainty concerning the ability of our PBM business to secure and maintain competitive access, pricing and other contract terms from retail network pharmacies in an environment where some PBM clients are willing to consider adopting narrow or more restricted retail pharmacy networks, and the possibility of our retail stores or specialty pharmacies being excluded from narrow or restricted networks.

·

The Company’s ability to timely identify or effectively respond to changing consumer preferences and spending patterns, an inability to expand the products being purchased by our customers, or the failure or inability to obtain or offer particular categories of products.

·

Risks relating to our ability to secure timely and sufficient access to the products we sell from our domestic and/or international suppliers, including limited distribution drugs.

·

Reform of the U.S. health care system, including ongoing implementation of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act (collectively, “ACA”) and the possible repeal and replacement of all or parts of ACA, continuing legislative efforts, regulatory changes and judicial interpretations impacting our health care system and the possibility of shifting political and legislative priorities related to reform of the health care system in the future.

·

Risks related to changes in legislation, regulation and government policy (including through the use of Executive Orders) that could significantly impact our business and the health care and retail industries, including, but not limited to, the possibility of major developments in tax policy or trade relations, such as the imposition of unilateral tariffs on imported product, changes with respect to the approval process for biosimilars, or changes or developments with respect to the regulation of drug pricing, including federal and state drug pricing programs.

·

Risks relating to any failure to properly maintain our information technology systems, our information security systems and our infrastructure to support our business and to protect the privacy and security of sensitive customer and business information.

·

Risks related to compliance with a broad and complex regulatory framework, including compliance with new and existing federal, state and local laws and regulations relating to health care, network pharmacy reimbursement and auditing, accounting standards, corporate securities, tax, environmental and other laws and regulations affecting our business.

·

Risks related to litigation, government investigations and other legal proceedings as they relate to our business, the pharmacy services, retail pharmacy, LTC pharmacy or retail clinic industries, or to the health care industry generally.

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·

The risk that any condition related to the closing of any proposed acquisition may not be satisfied on a timely basis or at all, including the inability to obtain required regulatory approvals of any proposed acquisition, or on the terms desired or anticipated; the risk that such approvals may result in the imposition of conditions that could adversely affect the resulting combined company or the expected benefits of any proposed transaction; and the risk that the proposed transactions fail to close for any other reason.

·

The possibility that the anticipated synergies and other benefits from any acquisition by us will not be realized, or will not be realized within the expected time periods.

·

The risks and uncertainties related to our ability to integrate the operations, products, services and employees of any entities acquired by us and the effect of the potential disruption of management’s attention from ongoing business operations due to any pending acquisitions.

·

The accessibility or availability of adequate financing on a timely basis and on reasonable terms.

·

Risks related to the outcome of any legal proceedings related to, or involving any entity that is a part of, any proposed acquisition contemplated by us.

·

The possibility of lower than expected valuations at the Company’s reporting units could result in goodwill impairment charges at those reporting units.

·

Other risks and uncertainties detailed from time to time in our filings with the SEC.

The foregoing list is not exhaustive.uncertainties we face. There can be no assurance that the Company has correctly identified and appropriately assessed all factors affecting its business.the risks that affect it. Additional risks and uncertainties not presently known to the Company or that itthe Company currently believes to be

66


immaterial also may adversely impactaffect the Company. ShouldCompany’s businesses. If any of those risks andor uncertainties developdevelops into actual events, these developmentsthose events or circumstances could have a material adverse effect on the Company’s business,businesses, operating results, cash flows, financial condition and results of operations. For these reasons, you are cautionedand/or stock price, among other effects.

You should not to placeput undue reliance on the Company’s forward-looking statements.

Any forward-looking statement speaks only as of the date of this report, and we disclaim any intention or obligation to update or revise forward-looking statements, whether as a result of new information, future events, uncertainties or otherwise.

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Item 3.Quantitative and Qualitative Disclosures About Market Risk

The Company’s earnings and financial condition are exposed to interest rate risk, credit quality risk, market valuation risk, foreign currency risk, commodity risk and operational risk.

Evaluation of Interest Rate and Credit Quality Risk

The Company manages interest rate risk by seeking to maintain a tight match between the durations of assets and liabilities when appropriate. The Company manages credit quality risk by seeking to maintain high average credit quality ratings and diversified sector exposure within its debt securities portfolio. In connection with its investment and risk management objectives, the Company also uses derivative financial instruments whose market value is at least partially determined by, among other things, levels of or changes in interest rates (short-term or long-term), duration, prepayment rates, equity markets or credit ratings/spreads. The Company’s use of these derivatives is generally limited to hedging risk and has principally consisted of using interest rate swaps, treasury rate locks, forward contracts, futures contracts, warrants, put options and credit default swaps. These instruments, viewed separately, subject the Company to varying degrees of interest rate, equity price and credit risk. However, when used for hedging, the Company expects these instruments to reduce overall risk.

Investments

The Company’s investment portfolio supported the following products at September 30, 2020 and December 31, 2019:
In millionsSeptember 30,
2020
December 31,
2019
Experience-rated products$1,046 $1,100 
Remaining products22,001 18,587 
Total investments$23,047 $19,687 

Investment risks associated with experience-rated products generally do not impact the Company’s operating results. The risks associated with investments supporting experience-rated pension and annuity products in the large case pensions business in the Company’s Corporate/Other segment are assumed by the contract holders and not by the Company (subject to, among other things, certain minimum guarantees). Assets supporting experience-rated products may be subject to contract holder or participant withdrawals.

The debt securities in the Company’s investment portfolio had an average credit quality rating of A at both September 30, 2020 and December 31, 2019 with approximately $6.0 billion and $4.4 billion rated AAA at September 30, 2020 and December 31, 2019, respectively. The debt securities that were rated below investment grade (that is, having a credit quality rating below BBB-/Baa3) were $1.7 billion and $1.2 billion at September 30, 2020 and December 31, 2019, respectively (of which 2% and 4% at September 30, 2020 and December 31, 2019, respectively, supported experience-rated products).

At September 30, 2020 and December 31, 2019, the Company held $322 million and $333 million, respectively, of municipal debt securities that were guaranteed by third parties, representing 2% of total investments at both September 30, 2020 and December 31, 2019. These securities had an average credit quality rating of AA at both September 30, 2020 and December 31, 2019 with the guarantee. These securities had an average credit quality rating of A and A+ at September 30, 2020 and December 31, 2019, respectively, without the guarantee. The Company does not have any significant concentration of investments with third party guarantors (either direct or indirect).

The Company generally classifies debt securities as available for sale, and carries them at fair value on the unaudited condensed consolidated balance sheets. At both September 30, 2020 and December 31, 2019, less than 1% of debt securities were valued using inputs that reflect the Company’s assumptions (categorized as Level 3 inputs in accordance with accounting principles generally accepted in the United States of America). See Note 4 ‘‘Fair Value’’ included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2019 for additional information on the methodologies and key assumptions used to determine the fair value of investments. For additional information related to investments, see Note 3 ‘‘Investments’’ to the unaudited condensed consolidated financial statements.

The Company regularly reviews debt securities in its portfolio to determine whether a decline in fair value below the cost basis or carrying value has occurred. If a debt security is in an unrealized loss position and the Company has the intent to sell the security, or it is more likely than not that the Company will have to sell the security before recovery of its amortized cost basis, the amortized cost basis of the security is written down to its fair value and the difference is recognized in net income. If a debt
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As

security is in an unrealized loss position and the Company does not have the intent to sell and it is more likely than not that the Company will not have to sell such security before recovery of its amortized cost basis, the Company bifurcates the impairment into credit-related and non-credit related components. The amount of the credit-related component is recorded as an allowance for credit losses and recognized in net income, and the amount of the non-credit related component is included in other comprehensive income. The accounting for and measurement of credit losses on financial instruments is considered a critical accounting policy. See Note 1 ‘‘Significant Accounting Policies’’ to the unaudited condensed consolidated financial statements for a discussion of the Company’s accounting policy for debt securities.

Evaluation of Market Valuation Risks

The Company regularly evaluates its risk from market-sensitive instruments by examining, among other things, levels of or changes in interest rates (short-term or long-term), duration, prepayment rates, equity markets and/or credit ratings/spreads. The Company also regularly evaluates the appropriateness of investments relative to management-approved investment guidelines (and operates within those guidelines) and the business objectives of its portfolios.

On a quarterly basis, the Company reviews the impact of hypothetical net losses in its investment portfolio on the Company’s consolidated near-term financial condition, operating results and cash flows assuming the occurrence of certain reasonably possible changes in near-term market rates and prices. Interest rate changes (whether resulting from changes in treasury yields or credit spreads or other factors) represent the most material risk exposure category for the Company. The Company has estimated the impact on the fair value of market sensitive instruments based on the net present value of cash flows using a representative set of likely future interest rate scenarios. The assumptions used were as follows: an immediate increase of 100 basis points in interest rates (which the Company believes represents a moderately adverse scenario) and an immediate decrease of 15% in prices for publicly traded domestic equity securities.

Assuming an immediate increase of 100 basis points in interest rates, the theoretical decline in the fair values of market sensitive instruments at September 30, 2020 is as follows:

The fair value of long-term debt would decline by approximately $5.2 billion ($6.5 billion pretax). Changes in the fair value of long-term debt do not impact the Company’s operating results or financial condition.
The theoretical reduction in the fair value of interest rate sensitive investments partially offset by the theoretical reduction in the fair value of interest rate sensitive liabilities would result in a net decline in fair value of approximately $480 million ($605 million pretax) related to continuing non-experience-rated products. Reductions in the fair value of investment securities would be reflected as an unrealized loss in equity, as the Company classifies these debt securities as available for sale. The Company does not record liabilities at fair value.

If the value of the Company’s publicly traded domestic equity securities were to decline by 15%, this would result in a net decline in fair value of $4 million ($5 million pretax).

Based on overall exposure to interest rate risk and equity price risk, the Company believes that these changes in market rates and prices would not materially affect consolidated near-term financial condition, operating results or cash flows as of September 30, 2017,2020.

Evaluation of Foreign Currency and Commodity Risk

At September 30, 2020 and December 31, 2019, the Company did not have any interest rate,material foreign currency exchange rate or commodity derivative instruments in place and believes that as of September 30, 2017 its exposure to interest rate risk (inherent in the Company’s debt portfolio), foreign currency exchange rate risk and commodity price risk is not material.


At September 30, 2020 and December 31, 2019, 5.3% and 6.1%, respectively, of the Company’s investment portfolio was comprised of investments that have exposure to the oil and gas industry, with more than half that amount comprised of investment grade rated debt securities. These exposures are experiencing varied degrees of financial strains in the current depressed oil and gas price environment, and the likelihood of the Company’s portfolio incurring additional realized capital losses on these exposures may increase if such depressed prices persist and/or decline further.

Evaluation of Operational Risks

The Company also faces certain operational risks. Those risks include risks related to the COVID-19 pandemic and risks related to information security, including cybersecurity.

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The spread of COVID-19, or actions taken to mitigate its spread, could have material and adverse effects on our ability to operate our businesses effectively, including as a result of the complete or partial closure of facilities or labor shortages. Disruptions in our supply chains, our distribution chains and/or public and private infrastructure, including communications, financial services and supply chains, could materially and adversely impact our business operations. We have transitioned a significant subset of our colleagues to a remote work environment in an effort to mitigate the spread of COVID-19, as have a significant number of our third-party service providers, which may amplify certain risks to our businesses, including an increased demand for information technology resources, increased risk of phishing and other cyber attacks, increased risk of unauthorized dissemination of sensitive personal information or proprietary or confidential information about us or our medical members or other third-parties and increased risk of business interruptions.

The Company and its vendors have experienced and continue to experience a variety of cyber attacks, and the Company and its vendors expect to continue to experience cyber attacks going forward. Among other things, the Company and its vendors have experienced automated attempts to gain access to public facing networks, brute force, SYN flood and distributed denial of service attacks, attempted malware infections, vulnerability scanning, ransomware attacks, spear-phishing campaigns, mass reconnaissance attempts, injection attempts, phishing, PHP injection and cross-site scripting. The Company also has seen an increase in attacks designed to obtain access to consumers’ accounts using illegally obtained demographic information. The Company is dedicating and will continue to dedicate significant resources and incur significant expenses to maintain and update on an ongoing basis the systems and processes that are designed to mitigate the information security risks it faces and protect the security of its computer systems, software, networks and other technology assets against attempts by unauthorized parties to obtain access to confidential information, destroy data, disrupt or degrade service, sabotage systems or cause other damage. The impact of cyber attacks has not been material to the Company’s operations or operating results through September 30, 2020. The Board of Directors of CVS Health Corporation and its Audit Committee and Nominating and Corporate Governance Committee are regularly informed regarding the Company’s information security policies, practices and status.

Item 4.Controls and Procedures


Evaluation of disclosure controls and procedures: The Company’s Chief Executive Officer and Chief Financial Officer, after evaluating the effectiveness of the design and operation of the Company’s disclosure controls and procedures (as defined in Securities Exchange Act Rules 13a‑15(f) and 15d‑15(f)) as of September 30, 2017,2020, have concluded that as of such date the Company’s disclosure controls and procedures were adequate and effective and designed to provide reasonable assurance that material information relating to the Company and its subsidiaries would be made known to such officers on a timely basis.


Changes in internal control over financial reporting: There havehas been no changeschange in ourthe Company’s internal control over financial reporting identified in connection with the evaluation required by paragraph (d) of Securities Exchange Act Rule 13a‑1513a-15 or Rule 15d‑1515d-15 that occurred in the three months ended September 30, 20172020 that havehas materially affected, or areis reasonably likely to materially affect, ourthe Company’s internal control over financial reporting.

42



Table of Contents

Part II.Other Information

Part II

Item 1.Legal Proceedings

I. Legal Proceedings

We refer you to “Note 12 -


The information contained in Note 10 ‘‘Commitments and Contingencies”Contingencies’’ contained in the “Notes to the Condensed Consolidated Financial Statements”Statements (Unaudited)” in Part I, Item 1 of ourthis Quarterly Report on Form 10‑Q10-Q is incorporated by reference herein.

Item 1A.Risk Factors

The following information supplements the risk factors described in Item 1A of the Company’s Annual Report on Form 10-K for the threefiscal year ended December 31, 2019 (the “2019 10-K”) and nine monthsshould be read in conjunction with the risk factors described in the 2019 10-K. The COVID-19 pandemic underscores and amplifies certain risks we face in our businesses, including those discussed in the 2019 10-K. Due to the unprecedented nature of the pandemic, we cannot identify all of the risks we face from the pandemic.

The spread of, impact of and response to coronavirus disease 2019, or COVID-19, underscores and amplifies certain risks we face, including those discussed in our Form 10-K for the fiscal year ended September 30, 2017December 31, 2019. The impact COVID-19 will have on our businesses, operating results, cash flows and/or financial condition is uncertain, but the impact could be material and adverse.

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Coronavirus disease 2019 (“COVID-19”) has spread to every state in the U.S., has been declared a pandemic by the World Health Organization and has severely impacted, and is expected to continue to severely impact, the economies of the U.S. and other countries around the world.

The legislative and regulatory environment governing our businesses is dynamic and changing frequently, including the Families First Coronavirus Response Act (the “Families First Act”), the Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”) and mandated increases to the medical services we must pay for without a descriptioncorresponding increase in the premiums we receive in our Health Care Benefits insurance products where we assume all or a majority of the risk for medical and dental care costs (our “Insured” products). As a result of COVID-19, including legislative and/or regulatory responses to COVID-19, the premiums we charge in our Insured Health Care Benefits products may prove to be insufficient to cover the cost of medical services delivered to our Insured medical 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. Federal, state and local governmental policies and initiatives to reduce the transmission of COVID-19, including shelter-in-place orders and social distancing directives, may not effectively combat the severity and/or duration of the COVID-19 pandemic and have resulted in, among other things, a reduction in utilization of medical services (“utilization”) that is discretionary, the cancellation of elective medical procedures, reduced customer traffic and front store sales in our retail pharmacies, our customers being ordered to close or severely curtail their operations, the adoption of work-from-home policies and a reduction in diagnostic reporting due to reductions in health care provider visits and restrictions on our access to providers’ medical records, all of which impact our businesses. Among other impacts of these policies and initiatives on our businesses, we expect changes in medical claims submission patterns and an adverse impact on (i) drug utilization due to the reduction in discretionary visits with health care providers; (ii) front store sales as a result of reduced customer traffic in our retail pharmacies due to shelter-in-place orders and COVID-19 related unemployment; (iii) medical membership in our Health Care Benefits segment and covered lives in our PBM clients due to reductions in workforce at our existing customers (including due to business failures) as well as reduced willingness to change benefits providers by prospective customers; (iv) benefit costs due to COVID-19 related support programs we have put in place for our medical members and mandated increases to the medical services we must pay for without a corresponding increase in the premiums we receive in our Insured Health Care Benefits products; and (v) the amount, timing and collectability of payments to the Company from customers, clients, government payers and members as a result of the impact of COVID-19 on them. Over time, these policies and initiatives also may cause us to experience increased benefit costs and/or decreased revenues in our Health Care Benefits segment if, as a result of our medical members not seeing their health care providers as a result of COVID-19, we are unable to implement clinical initiatives to manage benefit costs and chronic conditions of our medical members and appropriately document their risk profiles.

In addition, in response to COVID-19, during the first half of 2020, we began to offer our medical members expanded benefit coverage and became obligated by governmental action to provide other additional coverage. This expanded benefit coverage is being provided without a corresponding increase in the premiums we receive in our Insured Health Care Benefits products. We also are taking actions designed to help provide financial and administrative relief for the health care provider community. Such measures and any further steps we take or are required to take to expand or otherwise modify the services delivered to our Health Care Benefits members, provide relief for the health care provider community, or in connection with the relaxation of shelter-in-place orders and social distancing directives and other restrictions on movement and economic activity intended to reduce the spread of COVID-19, including the potential for widespread testing, and vaccination once available, as a component of lifting those measures, could adversely impact our benefit costs, medical benefit ratio and operating results.

The various initiatives we have implemented to slow and/or reduce the impact of COVID-19, such as colleagues working remotely and installing protective equipment in our retail pharmacies, and the COVID-19-related support programs we have put in place for our customers, medical members and colleagues have increased our operating expenses and reduced the efficiency of our operations. Our operating results will continue to be adversely affected so long as these initiatives continue or if they are expanded. In addition, the adverse economic conditions in the U.S. and abroad caused by COVID-19 have had, and may continue to have, an adverse impact on our net investment income and the value of our investment portfolio.

The spread of COVID-19, or actions taken to mitigate its spread, could have material and adverse effects on our ability to operate our businesses effectively, including as a result of the complete or partial closure of facilities, labor shortages and/or financial difficulties experienced by third-party service providers. Disruptions in our supply chains, our distribution chains and/or public and private infrastructure, including communications, financial services and supply chains, could materially and adversely impact our business operations. We have transitioned a significant subset of our colleagues to a remote work environment in an effort to mitigate the spread of COVID-19, as have a significant number of our third-party service providers, which may amplify certain risks to our businesses, including an increased demand for information technology resources, increased risk of phishing and other cybersecurity attacks, increased risk of unauthorized dissemination of sensitive personal
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information or proprietary or confidential information about us or our medical members or other third-parties and increased risk of business interruptions.

The COVID-19 pandemic continues to evolve. We believe COVID-19’s impact on our businesses, operating results, cash flows and/or financial condition primarily will be driven by the geographies impacted and the severity and duration of the pandemic; the pandemic’s impact on the U.S. and global economies and consumer behavior and health care utilization patterns; and the timing, scope and impact of stimulus legislation as well as other federal, state and local governmental responses to the pandemic. Those primary drivers are beyond our knowledge and control. As a result, the impact COVID-19 will have on our businesses, operating results, cash flows and/or financial condition is uncertain, but the impact could be adverse and material. COVID-19 also may result in legal proceedings.

and regulatory proceedings, investigations and claims against us.


A number of factors, many of which are beyond our control, including COVID-19 and related testing and vaccinations, when available, contribute to rising health care and other benefit costs. We may not be able to accurately forecast health care and other benefit costs, which could adversely affect our Health Care Benefits segment’s operating results. There can be no assurance that future health care and other benefits costs will not exceed our projections.

As a result of COVID-19, the current economic environment is adverse and less predictable than recently experienced, which has caused and may continue to cause unanticipated and significant volatility in our health care and other benefits costs, including COVID-19 related testing and vaccination (when available) and post-acute care skilled nursing facility and behavioral health costs. Premiums for our Insured Health Care Benefits products, which comprised 91% of our Health Care Benefits revenues for 2019, are priced in advance based on our forecasts of health care and other benefit costs during a fixed premium period, which is generally twelve months. These forecasts are typically developed several months before the fixed premium period begins, are influenced by historical data (and recent historical data in particular), are dependent on our ability to anticipate and detect medical cost trends and changes in our members’ behavior and health care utilization patterns and medical claim submission patterns and require a significant degree of judgment. For example, our revenue on Medicare policies is based on bids submitted in June of the year before the contract year. Cost increases in excess of our projections cannot be recovered in the fixed premium period through higher premiums. As a result, our profits are particularly sensitive to the accuracy of our forecasts of the increases in health care and other benefit costs that we expect to occur and our ability to anticipate and detect medical cost trends. For 2020 those forecasts do not include any projections for COVID-19 related costs, including COVID-19 related testing and vaccination costs, post-acute care skilled nursing facility and behavioral health costs and government mandated and voluntary expansions of benefits coverage which may be significant. During periods such as 2020 when health care and other benefit costs, utilization and/or medical costs trends experience significant volatility and medical claim submission patterns are changing rapidly as a result of COVID-19, accurately detecting, forecasting, managing, reserving and pricing for our (and our self-insured customers’) medical cost trends and incurred and future health care and other benefits costs is more challenging. There can be no assurance regarding the accuracy of the health care or other benefit cost projections reflected in our pricing, and our health care and other benefit costs (including COVID-19 related testing and vaccination (when available) and post-acute care skilled nursing facility and behavioral health costs) are affected by COVID-19 and other external events over which we have no control. Even relatively small differences between predicted and actual health care and other benefit costs as a percentage of premium revenues can result in significant adverse changes in our Health Care Benefits segment’s operating results.

A number of factors contribute to rising health care and other benefit costs, including COVID-19, previously uninsured members entering the health care system, changes in members’ behavior and health care utilization patterns, turnover in our membership, additional government mandated benefits or other regulatory changes (including under the Families First Act and the CARES Act), changes in the health status of our members, the aging of the population and other changing demographic characteristics, advances in medical technology, increases in the number and cost of prescription drugs (including specialty pharmacy drugs and ultra-high cost drugs and therapies), direct-to-consumer marketing by drug manufacturers, the increasing influence of social media on our members’ health care utilization and other behaviors, changes in health care practices and general economic conditions (such as inflation and employment levels). In addition, government-imposed limitations on Medicare and Medicaid reimbursements to health plans and providers have caused the private sector to bear a greater share of increasing health care and other benefits costs over time, and future amendments or repeal or replacement of the ACA that increase the uninsured population may amplify this problem. Other factors that affect our health care and other benefit costs include epidemics or other pandemics, changes as a result of the ACA, changes to the ACA and other changes in the regulatory environment, the evolution toward a consumer driven business model, new technologies, influenza related health care costs (which may be substantial and were higher than we projected for the 2019-2020 influenza season), clusters of high-cost cases, health care provider and member fraud, and numerous other factors that are or may be beyond our control.

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Furthermore, if we are not able to accurately and promptly anticipate and detect medical cost trends or accurately estimate the cost of incurred but not yet reported claims or reported claims that have not been paid, our ability to take timely corrective actions to limit future health care costs and reflect our current benefit cost experience in our pricing process may be limited, which would further amplify the extent of any adverse impact on our operating results. These risks are particularly acute during periods such as 2020 when health care and other benefit costs, utilization and/or medical cost trends experience significant volatility and medical claim submission patterns are changing rapidly as a result of COVID-19. Such risks are further magnified by the ACA and other existing and future legislation and regulations that limit our ability to price for our projected and/or experienced increases in utilization and/or medical cost trends.

There can be no assurance that future health care and other benefits costs will not exceed our projections.

Adverse economic conditions in the U.S. and abroad can materially and adversely impact our businesses, operating results, cash flows and financial condition, and we do not expect these conditions to improve in the near future.

The COVID-19 pandemic, the availability and cost of credit and other capital, higher unemployment rates and other factors have contributed to adverse conditions in the global economy and significantly diminished expectations for the global economy, and particularly the U.S. economy, at least through the end of 2020 and possibly longer. Our customers, medical providers and the other companies with which we do business are generally headquartered in the U.S.; however many of our largest customers are global companies with operations around the world. As a result, adverse economic conditions in the U.S. and abroad, including those caused by COVID-19, can materially and adversely impact our businesses, operating results, cash flows and financial condition, including:

In our Pharmacy Services segment, by causing drug utilization to decline, reducing demand for PBM services and adversely affecting the financial health of our PBM clients.
In our Retail/LTC segment, by causing drug utilization to decline, changing consumer purchasing power, preferences and/or spending patterns leading to reduced consumer demand for products sold in our stores and adversely affecting the financial health of our LTC pharmacy customers.
By leading to reductions in workforce by our existing customers (including due to business failures), which would reduce our revenues, the number of covered lives in our PBM clients and/or the number of members our Health Care Benefits segment serves.
By leading our clients and customers and potential clients and customers, particularly those with the most employees or members, and state and local governments, to force us to compete more vigorously on factors such as price and service to retain or obtain their business.
By leading customers and potential customers of our Retail/LTC and Health Care Benefits segments to purchase fewer products and/or products that generate less profit for us than the ones they currently purchase or otherwise would have purchased.
By leading customers and potential customers of our Health Care Benefits segment, particularly smaller employers and individuals, to forego obtaining or renewing their health and other coverage with us.
In our Health Care Benefits segment, by causing unanticipated increases and volatility in utilization of medical and other covered services, including COVID-19 related testing, vaccination (when available) and behavioral health services, by our medical members, changes in medical claim submission patterns and/or increases in medical unit costs and/or provider behavior, each of which would increase our costs and limit our ability to accurately detect, forecast, manage, reserve and price for our (and our self-insured customers’) medical cost trends and incurred and future health care and other benefits costs.
By increasing medical unit costs and causing changes in provider behavior in our Health Care Benefits segment as hospitals and other providers attempt to maintain revenue levels in their efforts to adjust to their own COVID-19-related and other economic challenges.
By weakening the ability or perceived ability of the issuers and/or guarantors of the debt or other securities we hold in our investment portfolio to perform on their obligations to us, which could result in defaults in those securities and has reduced, and may further reduce, the value of those securities and has created, and may continue to create, net realized capital losses for us that reduce our operating results.
By weakening the ability of our customers, including self-insured customers in our Health Care Benefits segment, medical providers and the other companies with which we do business as well as our medical members to perform their obligations to us or causing them not to perform those obligations, either of which could reduce our operating results.
By weakening the ability of our former subsidiaries and/or their purchasers to satisfy their lease obligations that we have guaranteed and causing the Company to be required to satisfy those obligations.
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By weakening the financial condition of other insurers, including long-term care insurers and life insurers, which increases the risk that we will receive significant assessments for obligations of insolvent insurers to policyholders and claimants.
By causing, over time, inflation that could cause interest rates to increase and thereby increase our interest expense and reduce our operating results, as well as decrease the value of the debt securities we hold in our investment portfolio, which would reduce our operating results and/or adversely affect our financial condition.

Furthermore, reductions in workforce by our customers can cause unanticipated increases in the health care and other benefits costs of our Health Care Benefits segment. For example, our business associated with members who have elected to receive benefits under Consolidated Omnibus Budget Reconciliation Act (known as “COBRA”) typically has a medical benefit ratio (“MBR”) that is significantly higher than our overall Commercial MBR.

There can be no assurance that our health care and other benefit costs, businesses, operating results, cash flows and/or financial condition will not be materially and adversely impacted by these economy-related conditions or other factors.

Item 2.Unregistered Sales of Equity Securities and Use of Proceeds


(c) Stock Repurchases


The following table presents the total number of shares purchased in the three months ended September 30, 2017,2020, the average price paid per share and the approximate dollar value of shares that still could have been purchased at the end of the applicable fiscal period, pursuant to the 2016 Repurchase Program.share repurchase program authorized by CVS Health Corporation’s Board of Directors on November 2, 2016. See “Note 3 - Share Repurchase Programs”Note 7 ‘‘Shareholders’ Equity’’ contained in the “Notes to the Condensed Consolidated Financial Statements”Statements (Unaudited)” in Part I, Item 1 of ourthis Quarterly Report on Form 10‑Q10-Q for the three months ended September 30, 2017.

 

 

 

 

 

 

 

 

 

 

 

 

    

 

    

 

 

    

 

    

Approximate Dollar

 

 

 

 

 

 

 

Total Number of Shares

 

Value of Shares that

 

 

Total Number

 

Average

 

Purchased as Part of

 

May Yet Be

 

 

of Shares

 

Price Paid per

 

Publicly Announced

 

Purchased Under the

Fiscal Period

 

Purchased

 

Share

 

Plans or Programs

 

Plans or Programs

July 1, 2017 through July 31, 2017

 

 —

 

$

 —

 

 —

 

$

14,269,392,432

August 1, 2017 through August 31, 2017

 

1,713,436

 

$

76.72

 

1,713,436

 

$

14,137,945,704

September 1, 2017 through September 30, 2017

 

3,364,345

 

$

79.82

 

3,364,345

 

$

13,869,392,446

 

 

5,077,781

 

 

 

 

5,077,781

 

 

 

additional information.

Fiscal PeriodTotal Number
of Shares
Purchased
Average
Price Paid per
Share
Total Number of Shares
Purchased as Part of
Publicly Announced
Plans or Programs
Approximate Dollar
Value of Shares that
May Yet Be
Purchased Under the
Plans or Programs
July 1, 2020 through July 31, 2020— $— — $13,869,392,446 
August 1, 2020 through August 31, 2020— $— — $13,869,392,446 
September 1, 2020 through September 30, 2020— $— — $13,869,392,446 
— — 

43


Item 3.        Defaults Upon Senior Securities

None.

Item 4.        Mine Safety Disclosures

Not Applicable.

Item 5.        Other Information

None.
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Form 10-Q Table of Contents

Item 6. Exhibits

Exhibits:


The exhibits listed in this Item 6 are filed as part of this Quarterly Report on Form 10-Q. Exhibits marked with an asterisk (*) are hereby incorporated by referencemanagement contracts or compensatory plans or arrangements. Exhibits other than those listed are omitted because they are not required to exhibitsbe listed or appendices previously filed byare not applicable. Pursuant to Item 601(b)(4)(iii) of regulation S-K, the Registrant as indicated in brackets followinghereby agrees to furnish to the descriptionSecurities and Exchange Commission a copy of the exhibit.

any omitted instrument that is not required to be listed.

INDEX TO EXHIBITS

3.1*

Amended and Restated Certificate

4Instruments defining the rights of Incorporationsecurity holders, including indentures
4.1

3.1A*

Certificate of Amendment to the Amended and Restated Certificate of Incorporation, effective May 13, 1998 [incorporated by reference to Exhibit 4.1A to the Registrant’s Registration Statement No. 333-52055 on Form S‑3/A dated May 18, 1998 (Commission File No. 001‑01001)].

3.1B*

Certificate of Amendment to the Amended and Restated Certificate of Incorporation [incorporated by reference to Exhibit 3.14.1 to the Registrant’s Current Report on Form 8‑K dated March 22, 2007 (Commission File No. 001‑01011)]8-K filed on August 21, 2020).

3.1C*

4.2

3.1D*

Certificate of Amendment to the Amended and Restated Certificate of Incorporation [incorporated by reference to Exhibit 3.14.2 to the Registrant’s Current Report on Form 8‑K dated May 13, 2010 (Commission File No. 001‑01011)]8-K filed on August 21, 2020).

3.1E*

4.3

3.1F*

Certificate of Amendment to the Amended and Restated Certificate of Incorporation [incorporated by reference to Exhibit 3.1 to the Registrant’s Current Report on Form 8‑K dated May 13, 2013 (Commission File No. 001‑01011)].

3.1G*

10

Certificate of Amendment to the Amended and Restated Certificate of Incorporation [incorporated by reference to Exhibit 3.1 to the Registrant’s Current Report on Form 8‑K dated September 3, 2014 (Commission File No. 001‑01011)].

Material Contracts

3.2*

By‑laws of Registrant, as amended and restated [incorporated by reference to Exhibit 3.2 to the Registrant’s Current Report on Form 8‑K dated January 26, 2016 (Commission File No. 001‑01011)].

15.1

10.1

15Letter re: Unaudited Interim Financial Information.

unaudited interim financial information

31.1

15.1
31Rule 13a-14(a)/15d-14(a) Certifications
31.1

31.2

31.2

32.1

32Section 1350 Certifications
32.1

32.2

32.2

101

101
101The following materials from the CVS Health Corporation Quarterly Report on Form 10‑Q10-Q for the three and nine months ended September 30, 20172020 formatted in Extensible Business Reporting Language (XBRL):Inline XBRL: (i) the Condensed Consolidated Statements of Income,Operations, (ii) the Condensed Consolidated Statements of Comprehensive Income, (iii) the Condensed Consolidated Balance Sheets, (iv) the Condensed Consolidated Statements of Cash Flows, and (v) related Footnotes to the Condensed Consolidated Statements of Shareholders’ Equity and (vi) the related 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.
104
104Cover Page Interactive Data File - The cover page from the Company's Quarterly Report on Form 10-Q for the quarter ended September 30, 2020, formatted in Inline XBRL (included as Exhibit 101).


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75

Form 10-Q Table of Contents

Signatures:

SIGNATURES





Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the Registrantregistrant has duly caused this Quarterly Report on Form 10‑Qreport to be signed on its behalf by the undersigned thereunto duly authorized.



CVS Health Corporation

(Registrant)

CVS HEALTH CORPORATION



Date:

November 6, 2020By:/s/ David M. Denton

Eva C. Boratto

David M. Denton

Eva C. Boratto

Executive Vice President and Chief Financial Officer

November 6, 2017

45