Cover
Cover - shares | 6 Months Ended | |
Jun. 30, 2023 | Jul. 26, 2023 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Jun. 30, 2023 | |
Document Transition Report | false | |
Entity File Number | 001-31826 | |
Entity Registrant Name | CENTENE CORPORATION | |
Entity Incorporation, State or Country Code | DE | |
Entity Tax Identification Number | 42-1406317 | |
Entity Address, Address Line One | 7700 Forsyth Boulevard | |
Entity Address, City or Town | St. Louis, | |
Entity Address, State or Province | MO | |
Entity Address, Postal Zip Code | 63105 | |
City Area Code | 314 | |
Local Phone Number | 725-4477 | |
Title of 12(b) Security | Common Stock $0.001 Par Value | |
Trading Symbol | CNC | |
Security Exchange Name | NYSE | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Large Accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Shell Company | false | |
Entity Common Stock, Shares Outstanding | 541,479,163 | |
Entity Central Index Key | 0001071739 | |
Current Fiscal Year End Date | --12-31 | |
Document Fiscal Year Focus | 2023 | |
Document Fiscal Period Focus | Q2 | |
Amendment Flag | false |
CONSOLIDATED BALANCE SHEETS
CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions | Jun. 30, 2023 | Dec. 31, 2022 |
Current assets: | ||
Cash and cash equivalents | $ 17,170 | $ 12,074 |
Premium and trade receivables | 13,601 | 13,272 |
Short-term investments | 2,212 | 2,321 |
Other current assets | 1,883 | 2,461 |
Total current assets | 34,866 | 30,128 |
Long-term investments | 16,108 | 14,684 |
Restricted deposits | 1,355 | 1,217 |
Property, software and equipment, net | 2,416 | 2,432 |
Goodwill | 18,716 | 18,812 |
Intangible assets, net | 6,520 | 6,911 |
Other long-term assets | 2,872 | 2,686 |
Total assets | 82,853 | 76,870 |
Current liabilities: | ||
Medical claims liability | 16,884 | 16,745 |
Accounts payable and accrued expenses | 9,868 | 9,525 |
Return of premium payable | 2,071 | 1,634 |
Unearned revenue | 2,373 | 478 |
Current portion of long-term debt | 110 | 82 |
Total current liabilities | 31,306 | 28,464 |
Long-term debt | 17,896 | 17,938 |
Deferred tax liability | 495 | 615 |
Other long-term liabilities | 7,369 | 5,616 |
Total liabilities | 57,066 | 52,633 |
Commitments and contingencies | ||
Redeemable noncontrolling interests | 19 | 56 |
Stockholders' equity: | ||
Preferred stock, $0.001 par value; authorized 10,000 shares; no shares issued or outstanding at June 30, 2023 and December 31, 2022 | 0 | 0 |
Common stock, $0.001 par value; authorized 800,000 shares; 614,743 issued and 546,003 outstanding at June 30, 2023, and 607,847 issued and 550,754 outstanding at December 31, 2022 | 1 | 1 |
Additional paid-in capital | 20,183 | 20,060 |
Accumulated other comprehensive (loss) | (998) | (1,132) |
Retained earnings | 11,529 | 9,341 |
Treasury stock, at cost (68,740 and 57,093 shares, respectively) | (5,044) | (4,213) |
Total Centene stockholders' equity | 25,671 | 24,057 |
Nonredeemable noncontrolling interest | 97 | 124 |
Total stockholders' equity | 25,768 | 24,181 |
Total liabilities, redeemable noncontrolling interests and stockholders' equity | $ 82,853 | $ 76,870 |
CONSOLIDATED BALANCE SHEETS (Pa
CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares | Jun. 30, 2023 | Dec. 31, 2022 |
Stockholders' equity | ||
Preferred stock, par value (in dollars per share) | $ 0.001 | $ 0.001 |
Preferred stock, shares authorized (in shares) | 10,000,000 | 10,000,000 |
Preferred stock, shares issued (in shares) | 0 | 0 |
Preferred stock, shares outstanding (in shares) | 0 | 0 |
Common stock, par value (in dollars per share) | $ 0.001 | $ 0.001 |
Common stock, shares authorized (in shares) | 800,000,000 | 800,000,000 |
Common stock, shares issued (in shares) | 614,743,000 | 607,847,000 |
Common stock, shares outstanding (in shares) | 546,003,000 | 550,754,000 |
Treasury stock (in shares) | 68,740,000 | 57,093,000 |
CONSOLIDATED STATEMENTS OF OPER
CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Millions | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2023 | Jun. 30, 2022 | Jun. 30, 2023 | Jun. 30, 2022 | |
Revenues: | ||||
Premium and service revenues | $ 34,838 | $ 33,968 | $ 69,790 | $ 68,200 |
Premium tax | 2,770 | 1,968 | 6,707 | 4,921 |
Total revenues | 37,608 | 35,936 | 76,497 | 73,121 |
Expenses: | ||||
Medical costs | 29,347 | 27,312 | 58,781 | 55,150 |
Cost of services | 877 | 2,099 | 1,747 | 4,087 |
Selling, general and administrative expenses | 3,016 | 2,800 | 6,027 | 5,545 |
Depreciation expense | 146 | 164 | 288 | 320 |
Amortization of acquired intangible assets | 179 | 199 | 362 | 398 |
Premium tax expense | 2,854 | 2,041 | 6,865 | 5,047 |
Impairment | 18 | 1,450 | 38 | 1,450 |
Total operating expenses | 36,437 | 36,065 | 74,108 | 71,997 |
Earnings (loss) from operations | 1,171 | (129) | 2,389 | 1,124 |
Other income (expense): | ||||
Investment and other income | 425 | 42 | 778 | 94 |
Debt extinguishment | 0 | 13 | 0 | 16 |
Interest expense | (181) | (162) | (361) | (322) |
Earnings (loss) before income tax | 1,415 | (236) | 2,806 | 912 |
Income tax expense (benefit) | 360 | (65) | 621 | 231 |
Net earnings (loss) | 1,055 | (171) | 2,185 | 681 |
(Earnings) loss attributable to noncontrolling interests | 3 | (1) | 3 | (4) |
Net earnings (loss) attributable to Centene Corporation | $ 1,058 | $ (172) | $ 2,188 | $ 677 |
Net earnings (loss) per common share attributable to Centene Corporation: | ||||
Basic earnings (loss) per common share (in dollars per share) | $ 1.93 | $ (0.29) | $ 3.98 | $ 1.16 |
Diluted earnings (loss) per common share (in dollars per share) | $ 1.92 | $ (0.29) | $ 3.96 | $ 1.15 |
Weighted average number of common shares outstanding: | ||||
Basic (in shares) | 548,932 | 583,644 | 549,850 | 583,435 |
Diluted (in shares) | 550,308 | 583,644 | 551,996 | 590,226 |
Premium | ||||
Revenues: | ||||
Premium and service revenues | $ 33,713 | $ 31,510 | $ 67,538 | $ 63,399 |
Service | ||||
Revenues: | ||||
Premium and service revenues | $ 1,125 | $ 2,458 | $ 2,252 | $ 4,801 |
CONSOLIDATED STATEMENTS OF COMP
CONSOLIDATED STATEMENTS OF COMPREHENSIVE EARNINGS (LOSS) - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2023 | Jun. 30, 2022 | Jun. 30, 2023 | Jun. 30, 2022 | |
Statement of Comprehensive Income [Abstract] | ||||
Net earnings (loss) | $ 1,055 | $ (171) | $ 2,185 | $ 681 |
Change in unrealized gain (loss) on investments | (142) | (446) | 111 | (1,161) |
Change in unrealized gain (loss) on investments, tax effect | 34 | 106 | (27) | 277 |
Change in unrealized gain (loss) on investments, net of tax | (108) | (340) | 84 | (884) |
Reclassification adjustment, net of tax | 2 | 7 | 4 | 9 |
Foreign currency translation adjustments, net of tax | 23 | (95) | 46 | (115) |
Other comprehensive earnings (loss) | (83) | (428) | 134 | (990) |
Comprehensive earnings (loss) | 972 | (599) | 2,319 | (309) |
Comprehensive (earnings) loss attributable to noncontrolling interests | 3 | (1) | 3 | (4) |
Comprehensive earnings (loss) attributable to Centene Corporation | $ 975 | $ (600) | $ 2,322 | $ (313) |
CONSOLIDATED STATEMENTS OF STOC
CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Millions | Total | Common Stock | Additional Paid-in Capital | Accumulated Other Comprehensive Earnings (Loss) | Retained Earnings | Treasury Stock | Noncontrolling Interest |
Balance (in shares) at Dec. 31, 2021 | 602,704 | ||||||
Treasury stock (in shares) at Dec. 31, 2021 | 20,225 | ||||||
Balance at Dec. 31, 2021 | $ 26,940 | $ 1 | $ 19,672 | $ 77 | $ 8,139 | $ (1,094) | $ 145 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Net earnings (loss) | 848 | 849 | (1) | ||||
Other comprehensive earnings (loss), net of tax | (562) | (562) | |||||
Common stock issued for employee benefit plans (in shares) | 3,221 | ||||||
Common stock issued for employee benefit plans | 28 | 28 | |||||
Fair value of unvested equity awards in connection with acquisition | 60 | 60 | |||||
Common stock repurchases (in shares) | 846 | ||||||
Common stock repurchases | (71) | $ (71) | |||||
Stock compensation expense | 70 | 70 | |||||
Balance (in shares) at Mar. 31, 2022 | 605,925 | ||||||
Treasury stock (in shares) at Mar. 31, 2022 | 21,071 | ||||||
Balance at Mar. 31, 2022 | 27,313 | $ 1 | 19,830 | (485) | 8,988 | $ (1,165) | 144 |
Balance (in shares) at Dec. 31, 2021 | 602,704 | ||||||
Treasury stock (in shares) at Dec. 31, 2021 | 20,225 | ||||||
Balance at Dec. 31, 2021 | 26,940 | $ 1 | 19,672 | 77 | 8,139 | $ (1,094) | 145 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Other comprehensive earnings (loss), net of tax | (990) | ||||||
Balance (in shares) at Jun. 30, 2022 | 606,444 | ||||||
Treasury stock (in shares) at Jun. 30, 2022 | 25,320 | ||||||
Balance at Jun. 30, 2022 | 26,430 | $ 1 | 19,899 | (913) | 8,816 | $ (1,514) | 141 |
Balance (in shares) at Mar. 31, 2022 | 605,925 | ||||||
Treasury stock (in shares) at Mar. 31, 2022 | 21,071 | ||||||
Balance at Mar. 31, 2022 | 27,313 | $ 1 | 19,830 | (485) | 8,988 | $ (1,165) | 144 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Net earnings (loss) | (175) | (172) | (3) | ||||
Other comprehensive earnings (loss), net of tax | (428) | (428) | |||||
Common stock issued for employee benefit plans (in shares) | 519 | ||||||
Common stock issued for employee benefit plans | 10 | 10 | |||||
Common stock repurchases (in shares) | 4,249 | ||||||
Common stock repurchases | (349) | $ (349) | |||||
Stock compensation expense | 59 | 59 | |||||
Balance (in shares) at Jun. 30, 2022 | 606,444 | ||||||
Treasury stock (in shares) at Jun. 30, 2022 | 25,320 | ||||||
Balance at Jun. 30, 2022 | $ 26,430 | $ 1 | 19,899 | (913) | 8,816 | $ (1,514) | 141 |
Balance (in shares) at Dec. 31, 2022 | 550,754 | 607,847 | |||||
Treasury stock (in shares) at Dec. 31, 2022 | 57,093 | 57,093 | |||||
Balance at Dec. 31, 2022 | $ 24,181 | $ 1 | 20,060 | (1,132) | 9,341 | $ (4,213) | 124 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Net earnings (loss) | 1,130 | 1,130 | |||||
Other comprehensive earnings (loss), net of tax | 217 | 217 | |||||
Common stock issued for employee benefit plans (in shares) | 6,508 | ||||||
Common stock issued for employee benefit plans | 12 | 12 | |||||
Common stock repurchases (in shares) | 5,548 | ||||||
Common stock repurchases | (423) | $ (423) | |||||
Stock compensation expense | 61 | 61 | |||||
Purchase of redeemable and non-redeemable noncontrolling interest | (12) | (12) | |||||
Balance (in shares) at Mar. 31, 2023 | 614,355 | ||||||
Treasury stock (in shares) at Mar. 31, 2023 | 62,641 | ||||||
Balance at Mar. 31, 2023 | $ 25,166 | $ 1 | 20,121 | (915) | 10,471 | $ (4,636) | 124 |
Balance (in shares) at Dec. 31, 2022 | 550,754 | 607,847 | |||||
Treasury stock (in shares) at Dec. 31, 2022 | 57,093 | 57,093 | |||||
Balance at Dec. 31, 2022 | $ 24,181 | $ 1 | 20,060 | (1,132) | 9,341 | $ (4,213) | 124 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Other comprehensive earnings (loss), net of tax | $ 134 | ||||||
Balance (in shares) at Jun. 30, 2023 | 546,003 | 614,743 | |||||
Treasury stock (in shares) at Jun. 30, 2023 | 68,740 | 68,740 | |||||
Balance at Jun. 30, 2023 | $ 25,768 | $ 1 | 20,183 | (998) | 11,529 | $ (5,044) | 97 |
Balance (in shares) at Mar. 31, 2023 | 614,355 | ||||||
Treasury stock (in shares) at Mar. 31, 2023 | 62,641 | ||||||
Balance at Mar. 31, 2023 | 25,166 | $ 1 | 20,121 | (915) | 10,471 | $ (4,636) | 124 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Net earnings (loss) | 1,055 | 1,058 | (3) | ||||
Other comprehensive earnings (loss), net of tax | (83) | (83) | |||||
Common stock issued for employee benefit plans (in shares) | 388 | ||||||
Common stock issued for employee benefit plans | 9 | 9 | |||||
Common stock repurchases (in shares) | 6,099 | ||||||
Common stock repurchases | (408) | $ (408) | |||||
Stock compensation expense | 56 | 56 | |||||
Purchase of redeemable and non-redeemable noncontrolling interest | $ (27) | (3) | (24) | ||||
Balance (in shares) at Jun. 30, 2023 | 546,003 | 614,743 | |||||
Treasury stock (in shares) at Jun. 30, 2023 | 68,740 | 68,740 | |||||
Balance at Jun. 30, 2023 | $ 25,768 | $ 1 | $ 20,183 | $ (998) | $ 11,529 | $ (5,044) | $ 97 |
CONSOLIDATED STATEMENTS OF ST_2
CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (Parenthetical) - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended | ||||||
Jun. 30, 2023 | Mar. 31, 2023 | Jun. 30, 2022 | Mar. 31, 2022 | Jun. 30, 2023 | Jun. 30, 2022 | Dec. 31, 2022 | Dec. 31, 2021 | |
Par value (in dollars per share) | $ 0.001 | $ 0.001 | $ 0.001 | |||||
Other comprehensive earning (loss), tax | $ (34) | $ 61 | $ (106) | $ (171) | $ 27 | $ (277) | ||
Common Stock | ||||||||
Par value (in dollars per share) | $ 0.001 | $ 0.001 | $ 0.001 | $ 0.001 | $ 0.001 | $ 0.001 | 0.001 | $ 0.001 |
Treasury Stock | ||||||||
Par value (in dollars per share) | $ 0.001 | $ 0.001 | $ 0.001 | $ 0.001 | $ 0.001 | $ 0.001 | $ 0.001 | $ 0.001 |
CONSOLIDATED STATEMENTS OF CASH
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended | 12 Months Ended | ||
Jun. 30, 2023 | Jun. 30, 2022 | Jun. 30, 2023 | Jun. 30, 2022 | Dec. 31, 2022 | |
Cash flows from operating activities: | |||||
Net earnings | $ 1,055 | $ (171) | $ 2,185 | $ 681 | |
Adjustments to reconcile net earnings to net cash provided by operating activities | |||||
Depreciation and amortization | 650 | 718 | |||
Stock compensation expense | 117 | 129 | |||
Impairment | 18 | 1,450 | 38 | 1,450 | |
(Gain) loss on debt extinguishment | 0 | (16) | |||
(Gain) on acquisition | 0 | (2) | |||
Deferred income taxes | (160) | (417) | |||
(Gain) on divestiture | (172) | 0 | |||
Other adjustments, net | 68 | 162 | |||
Changes in assets and liabilities | |||||
Premium and trade receivables | (319) | (1,288) | |||
Other assets | (325) | (245) | |||
Medical claims liabilities | 139 | 2,089 | |||
Unearned revenue | 1,895 | 75 | |||
Accounts payable and accrued expenses | 618 | 41 | |||
Other long-term liabilities | 2,081 | 1,058 | |||
Other operating activities, net | 0 | 70 | |||
Net cash provided by operating activities | 6,815 | 4,505 | |||
Cash flows from investing activities: | |||||
Capital expenditures | (440) | (524) | |||
Purchases of investments | (3,199) | (3,114) | |||
Sales and maturities of investments | 2,293 | 2,005 | |||
Acquisitions, net of cash acquired | 0 | (1,512) | |||
Divestiture proceeds, net of divested cash | 669 | 0 | |||
Net cash (used in) investing activities | (677) | (3,145) | |||
Cash flows from financing activities: | |||||
Proceeds from long-term debt | 1,281 | 331 | |||
Payments and repurchases of long-term debt | (1,322) | (900) | |||
Common stock repurchases | (828) | (420) | |||
Proceeds from common stock issuances | 21 | 38 | |||
Payments for debt extinguishment | 0 | (27) | |||
Purchase of noncontrolling interest | (85) | 0 | |||
Other financing activities, net | 0 | (6) | |||
Net cash (used in) financing activities | (933) | (984) | |||
Effect of exchange rate changes on cash, cash equivalents, and restricted cash | (7) | (9) | |||
Net increase in cash, cash equivalents, and restricted cash and cash equivalents | 5,198 | 367 | |||
Cash, cash equivalents, and restricted cash and cash equivalents, beginning of period | 12,330 | 13,214 | $ 13,214 | ||
Cash, cash equivalents, and restricted cash and cash equivalents, end of period | 17,528 | 13,581 | 17,528 | 13,581 | 12,330 |
Supplemental disclosures of cash flow information: | |||||
Interest paid | 348 | 327 | |||
Income taxes paid | 592 | 411 | |||
The following table provides a reconciliation of cash, cash equivalents, and restricted cash and cash equivalents reported within the Consolidated Balance Sheets to the totals above: | |||||
Cash and cash equivalents | 17,170 | 13,435 | 17,170 | 13,435 | 12,074 |
Restricted cash and cash equivalents, included in restricted deposits | 358 | 146 | 358 | 146 | |
Total cash, cash equivalents, and restricted cash and cash equivalents | $ 17,528 | $ 13,581 | $ 17,528 | $ 13,581 | $ 12,330 |
Organization and Operations
Organization and Operations | 6 Months Ended |
Jun. 30, 2023 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Organization and Operations | Organization and Operations Basis of Presentation The accompanying interim financial statements have been prepared under the presumption that users of the interim financial information have either read or have access to the audited financial statements included in the Form 10-K for the fiscal year ended December 31, 2022. The unaudited interim financial statements herein have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission. Accordingly, footnote disclosures that would substantially duplicate the disclosures contained in the December 31, 2022 audited financial statements have been omitted from these interim financial statements, where appropriate. In the opinion of management, these financial statements reflect all adjustments, consisting only of normal recurring adjustments, which are necessary for a fair presentation of the results of the interim periods presented. Certain 2022 amounts in the consolidated financial statements and notes to the consolidated financial statements have been reclassified to conform to the 2023 presentation, including reclassifications related to the Company's new segment reporting structure as outlined below. These reclassifications have no effect on net earnings or stockholders' equity as previously reported. Segment Reporting In the first quarter of 2023, and in conjunction with the Company's updated strategic plan, executive leadership realignment, and corresponding 2023 divestitures, the Company revised the way it manages the business, evaluates performance, and allocates resources, resulting in an updated segment structure comprised of (1) a Medicaid segment, (2) a Medicare segment, (3) a Commercial segment, and (4) an Other segment. The Medicaid, Medicare, and Commercial segments represent the government-sponsored or subsidized programs under which the Company offers managed healthcare services. Specifically, the Medicaid segment includes the Temporary Assistance for Needy Families (TANF) program, Medicaid Expansion programs, the Aged, Blind, or Disabled (ABD) program, the Children's Health Insurance Program (CHIP), Long-Term Services and Supports (LTSS), Foster Care, Medicare-Medicaid Plans (MMP), which cover beneficiaries who are dually eligible for Medicaid and Medicare, and other state-based programs. The Medicare segment includes Medicare Advantage, Medicare Supplement, Dual Eligible Special Needs Plans (D-SNPs), and Medicare Prescription Drug Plans (PDPs), also known as Medicare Part D. The Commercial segment includes the Health Insurance Marketplace along with individual, small group, and large group commercial healthcare products. The Other segment includes the Company's pharmacy operations, vision and dental services, clinical healthcare, behavioral health, international operations, and corporate management companies, among others. Accounting Guidance Not Yet Adopted The Company has determined that there are no recently issued accounting pronouncements that will have a material impact on its consolidated financial position, results of operations, or cash flows. |
Acquisitions and Divestitures
Acquisitions and Divestitures | 6 Months Ended |
Jun. 30, 2023 | |
Business Combination and Asset Acquisition [Abstract] | |
Acquisitions and Divestitures | Acquisitions and Divestitures On January 5, 2023, the Company completed the divestiture of HealthSmart, its third-party health plan administration business. On January 10, 2023, the Company signed and closed on a definitive agreement to divest Centurion, its prison healthcare business. During 2022, the Company recorded impairment charges related to goodwill and other current assets associated with the pending divestiture. During the second quarter of 2023, the Company recognized a $15 million gain on the divestiture of the Centurion business reflecting additional proceeds for contingent consideration, partially offset by net working capital adjustments. The gain is included in investment and other income on the Consolidated Statements of Operations. On January 20, 2023, the Company completed the divestiture of Magellan Specialty Health for approximately $646 million in cash and stock, including an estimated working capital adjustment and recognized a pre-tax gain of $79 million. The stock consideration was subsequently sold in April 2023 for cash proceeds of $245 million. The Company could also receive up to an additional $150 million in cash and stock in 2024 based on certain 2023 performance metrics. The Company will recognize the appropriate amount of contingent consideration related to the additional $150 million when realized or realizable. On June 13, 2023, the Company completed the divestiture of its majority stake in Apixio. The Company recognized a pre-tax gain of $91 million, or $63 million after-tax, which is included in investment and other income on the Consolidated Statements of Operations. During the second quarter of 2023, the Company recognized an additional $13 million expense related to the divestiture of its Spanish and Central European businesses, in addition to the previously recorded impairment charge of $163 million, or $140 million after-tax. The expense is included in investment and other income on the Consolidated Statements of Operations. |
Short-term and Long-term Invest
Short-term and Long-term Investments, Restricted Deposits | 6 Months Ended |
Jun. 30, 2023 | |
Investments, Debt and Equity Securities [Abstract] | |
Short-term and Long-term Investments, Restricted Deposits | Short-term and Long-term Investments, Restricted Deposits Short-term and long-term investments and restricted deposits by investment type consist of the following ($ in millions): June 30, 2023 December 31, 2022 Amortized Cost Gross Gross Fair Value Amortized Cost Gross Gross Fair Value Debt securities: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 465 $ — $ (15) $ 450 $ 695 $ — $ (16) $ 679 Corporate securities 10,578 13 (724) 9,867 10,127 12 (778) 9,361 Restricted certificates of deposit 4 — — 4 4 — — 4 Restricted cash equivalents 358 — — 358 256 — — 256 Short-term time deposits 419 — — 419 204 — — 204 Municipal securities 4,156 9 (234) 3,931 4,055 6 (280) 3,781 Asset-backed securities 1,507 1 (60) 1,448 1,396 — (70) 1,326 Residential mortgage-backed securities 1,346 1 (120) 1,227 1,165 2 (121) 1,046 Commercial mortgage-backed securities 1,081 — (100) 981 961 — (99) 862 Equity securities 2 — — 2 5 — — 5 Private equity investments 805 — — 805 529 — — 529 Life insurance contracts 183 — — 183 169 — — 169 Total $ 20,904 $ 24 $ (1,253) $ 19,675 $ 19,566 $ 20 $ (1,364) $ 18,222 The Company's investments are debt securities classified as available-for-sale with the exception of equity securities, certain private equity investments, and life insurance contracts. The Company's investment policies are designed to provide liquidity, preserve capital, and maximize total return on invested assets with a focus on high credit quality securities. The Company limits the size of investment in any single issuer other than U.S. treasury securities and obligations of U.S. government corporations and agencies. As of June 30, 2023, 99% of the Company's investments in rated securities carry an investment grade rating by nationally recognized statistical rating organizations. At June 30, 2023, the Company held certificates of deposit, equity securities, private equity investments, and life insurance contracts, which did not carry a credit rating. Accrued interest income on available-for-sale debt securities was $149 million and $132 million at June 30, 2023 and December 31, 2022, respectively, and is included in other current assets on the Consolidated Balance Sheets. The Company's residential mortgage-backed securities are primarily issued by the Federal National Mortgage Association, Government National Mortgage Association, or Federal Home Loan Mortgage Corporation, which carry implicit or explicit guarantees of the U.S. government. The Company's commercial mortgage-backed securities are primarily senior tranches with a weighted average rating of AAA and a weighted average duration of 4 years at June 30, 2023. The fair value of available-for-sale debt securities with gross unrealized losses by investment type and length of time that individual securities have been in a continuous unrealized loss position were as follows ($ in millions): June 30, 2023 December 31, 2022 Less Than 12 Months 12 Months or More Less Than 12 Months 12 Months or More Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value U.S. Treasury securities and obligations of U.S. government corporations and agencies $ (3) $ 207 $ (12) $ 191 $ (5) $ 342 $ (11) $ 184 Corporate securities (73) 2,942 (651) 6,049 (340) 5,368 (438) 3,400 Municipal securities (26) 1,413 (208) 1,990 (142) 2,437 (138) 995 Asset-backed securities (8) 431 (52) 949 (29) 786 (41) 486 Residential mortgage-backed securities (16) 494 (104) 644 (55) 629 (66) 352 Commercial mortgage-backed securities (8) 224 (92) 736 (49) 513 (50) 330 Total $ (134) $ 5,711 $ (1,119) $ 10,559 $ (620) $ 10,075 $ (744) $ 5,747 As of June 30, 2023, the gross unrealized losses were generated from 6,392 positions out of a total of 6,910 positions. The change in fair value of available-for-sale debt securities is primarily a result of movement in interest rates subsequent to the purchase of the security. For each security in an unrealized loss position, the Company assesses whether it intends to sell the security or if it is more likely than not the Company will be required to sell the security before recovery of the amortized cost basis for reasons such as liquidity, contractual, or regulatory purposes. If the security meets this criterion, the decline in fair value is recorded in earnings. The Company does not intend to sell these securities prior to maturity and it is not likely that the Company will be required to sell these securities prior to maturity; therefore, the Company did not record an impairment for these securities. In addition, the Company monitors available-for-sale debt securities for credit losses. Certain investments have experienced a decline in fair value due to changes in credit quality, market interest rates, and/or general economic conditions. The Company recognizes an allowance when evidence demonstrates that the decline in fair value is credit related. Evidence of a credit related loss may include rating agency actions, adverse conditions specifically related to the security, or failure of the issuer of the security to make scheduled payments. The contractual maturities of short-term and long-term debt securities and restricted deposits are as follows ($ in millions): June 30, 2023 December 31, 2022 Investments Restricted Deposits Investments Restricted Deposits Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value One year or less $ 2,095 $ 2,064 $ 627 $ 625 $ 2,207 $ 2,179 $ 534 $ 532 One year through five years 8,144 7,630 509 477 7,651 7,147 524 490 Five years through ten years 4,169 3,826 254 232 4,066 3,613 224 195 Greater than ten years 160 154 22 21 135 129 — — Asset-backed securities 3,934 3,656 — — 3,522 3,234 — — Total $ 18,502 $ 17,330 $ 1,412 $ 1,355 $ 17,581 $ 16,302 $ 1,282 $ 1,217 Actual maturities may differ from contractual maturities due to call or prepayment options. Equity securities, private equity investments, and life insurance contracts are excluded from the table above because they do not have a contractual maturity. The Company has an option to redeem at amortized cost substantially all of the securities included in the greater than ten years category listed above. |
Fair Value Measurements
Fair Value Measurements | 6 Months Ended |
Jun. 30, 2023 | |
Fair Value Disclosures [Abstract] | |
Fair Value Measurements | Fair Value Measurements Assets and liabilities recorded at fair value in the Consolidated Balance Sheets are categorized based upon observable or unobservable inputs used to estimate fair value. Level inputs are as follows: Level Input: Input Definition: Level I Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date. Level II Inputs other than quoted prices included in Level I that are observable for the asset or liability through corroboration with market data at the measurement date. Level III Unobservable inputs that reflect management's best estimate of what market participants would use in pricing the asset or liability at the measurement date. The following table summarizes fair value measurements by level at June 30, 2023, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 17,170 $ — $ — $ 17,170 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 112 $ — $ — $ 112 Corporate securities — 9,833 — 9,833 Municipal securities — 3,310 — 3,310 Short-term time deposits — 419 — 419 Asset-backed securities — 1,448 — 1,448 Residential mortgage-backed securities — 1,227 — 1,227 Commercial mortgage-backed securities — 981 — 981 Equity securities — 2 — 2 Total investments $ 112 $ 17,220 $ — $ 17,332 Restricted deposits: Cash and cash equivalents $ 358 $ — $ — $ 358 U.S. Treasury securities and obligations of U.S. government corporations and agencies 338 — — 338 Corporate securities — 34 — 34 Certificates of deposit — 4 — 4 Municipal securities — 621 — 621 Total restricted deposits $ 696 $ 659 $ — $ 1,355 Total assets at fair value $ 17,978 $ 17,879 $ — $ 35,857 The following table summarizes fair value measurements by level at December 31, 2022, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 12,074 $ — $ — $ 12,074 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 366 $ 5 $ — $ 371 Corporate securities — 9,328 — 9,328 Municipal securities — 3,165 — 3,165 Short-term time deposits — 204 — 204 Asset backed securities — 1,326 — 1,326 Residential mortgage-backed securities — 1,046 — 1,046 Commercial mortgage-backed securities — 862 — 862 Equity securities 3 2 — 5 Total investments $ 369 $ 15,938 $ — $ 16,307 Restricted deposits: Cash and cash equivalents $ 256 $ — $ — $ 256 U.S. Treasury securities and obligations of U.S. government corporations and agencies 308 — — 308 Corporate securities — 33 — 33 Certificates of deposit — 4 — 4 Municipal securities — 616 — 616 Total restricted deposits $ 564 $ 653 $ — $ 1,217 Total assets at fair value $ 13,007 $ 16,591 $ — $ 29,598 The Company utilizes matrix-pricing services to estimate fair value for securities which are not actively traded on the measurement date. The Company designates these securities as Level II fair value measurements. In addition, the aggregate carrying amount of the Company's private equity investments and life insurance contracts, which approximates fair value, was $988 million and $698 million as of June 30, 2023 and December 31, 2022, respectively. |
Goodwill and Intangible Assets
Goodwill and Intangible Assets | 6 Months Ended |
Jun. 30, 2023 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
Goodwill and Intangible Assets | Goodwill and Intangible Assets As discussed in Note 1. Organization and Operations, in the first quarter of 2023 the Company updated its segment structure. Prior year information has been adjusted to reflect the change in segment reporting. The following table summarizes the changes in goodwill by operating segment ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, December 31, 2021 $ 10,194 $ 1,592 $ 5,424 $ 2,561 $ 19,771 Acquisition and purchase accounting adjustments — — — 1,077 1,077 Divestitures — — — (1,533) (1,533) Reallocation 4 — — (4) — Impairments — — — (370) (370) Translation impact — — — (133) (133) Balance, December 31, 2022 $ 10,198 $ 1,592 $ 5,424 $ 1,598 $ 18,812 Divestitures — — — (152) (152) Translation impact — — — 56 56 Balance, June 30, 2023 $ 10,198 $ 1,592 $ 5,424 $ 1,502 $ 18,716 |
Medical Claims Liability
Medical Claims Liability | 6 Months Ended |
Jun. 30, 2023 | |
Insurance [Abstract] | |
Medical Claims Liability | Medical Claims Liability As discussed in Note 1. Organization and Operations, in the first quarter of 2023 the Company updated its segment structure. Prior year information has been adjusted to reflect the change in segment reporting. The following table summarizes the change in medical claims liability for the six months ended June 30, 2023 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2023 $ 11,253 $ 3,431 $ 1,921 $ 140 $ 16,745 Less: Reinsurance recoverable 7 — 19 — 26 Balance, January 1, 2023, net 11,246 3,431 1,902 140 16,719 Incurred related to: Current year 40,622 10,083 8,857 773 60,335 Prior years (1,153) (191) (208) (2) (1,554) Total incurred 39,469 9,892 8,649 771 58,781 Paid related to: Current year 31,837 7,726 6,751 656 46,970 Prior years 7,890 2,357 1,282 137 11,666 Total paid 39,727 10,083 8,033 793 58,636 Balance, June 30, 2023, net 10,988 3,240 2,518 118 16,864 Plus: Reinsurance recoverable 5 — 15 — 20 Balance, June 30, 2023 $ 10,993 $ 3,240 $ 2,533 $ 118 $ 16,884 The following table summarizes the change in medical claims liability for the six months ended June 30, 2022 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2022 $ 9,845 $ 2,286 $ 2,014 $ 98 $ 14,243 Less: Reinsurance recoverable 23 — — — 23 Balance, January 1, 2022, net 9,822 2,286 2,014 98 14,220 Acquisitions and divestitures — — — 249 249 Incurred related to: Current year 37,803 9,918 7,001 1,457 56,179 Prior years (770) (46) (198) (15) (1,029) Total incurred 37,033 9,872 6,803 1,442 55,150 Paid related to: Current year 29,007 6,977 5,475 1,427 42,886 Prior years 6,808 1,784 1,489 80 10,161 Total paid 35,815 8,761 6,964 1,507 53,047 Balance, June 30, 2022, net 11,040 3,397 1,853 282 16,572 Plus: Reinsurance recoverable 9 — — — 9 Balance, June 30, 2022 $ 11,049 $ 3,397 $ 1,853 $ 282 $ 16,581 Reinsurance recoverables related to medical claims are included in premium and trade receivables. Changes in estimates of incurred claims for prior years are primarily attributable to reserving under moderately adverse conditions. Additionally, as a result of minimum health benefits ratio (HBR) and other return of premium programs, the Company recorded $319 million and $48 million as a reduction to premium revenue in the six months ended June 30, 2023 and 2022, respectively. |
Affordable Care Act
Affordable Care Act | 6 Months Ended |
Jun. 30, 2023 | |
Affordable Care Act [Abstract] | |
Affordable Care Act | Affordable Care Act The Affordable Care Act established risk spreading premium stabilization programs as well as a minimum annual medical loss ratio (MLR) and cost sharing reductions. The Company's net receivables (payables) for each of the programs are as follows ($ in millions): June 30, 2023 December 31, 2022 Risk adjustment receivable $ 1,088 $ 838 Risk adjustment payable (2,303) (780) Minimum medical loss ratio (233) (103) Cost sharing reduction receivable 2 — Cost sharing reduction payable (87) (99) In June 2023, the Centers for Medicare and Medicaid Services (CMS) announced the final risk adjustment transfers for the 2022 benefit year. As a result of the announcement, the Company increased its risk adjustment net receivables by $240 million from December 31, 2022. After consideration of minimum MLR and other related impacts, the net pre-tax benefit recognized was approximately $196 million in the six months ended June 30, 2023. |
Debt
Debt | 6 Months Ended |
Jun. 30, 2023 | |
Debt Disclosure [Abstract] | |
Debt | Debt Debt consists of the following ($ in millions): June 30, 2023 December 31, 2022 $2,500 million 4.25% Senior Notes due December 15, 2027 $ 2,394 $ 2,393 $2,300 million 2.45% Senior Notes due July 15, 2028 2,303 2,303 $3,500 million 4.625% Senior Notes due December 15, 2029 3,277 3,277 $2,000 million 3.375% Senior Notes due February 15, 2030 2,000 2,000 $2,200 million 3.00% Senior Notes due October 15, 2030 2,200 2,200 $2,200 million 2.50% Senior Notes due March 1, 2031 2,200 2,200 $1,300 million 2.625% Senior Notes due August 1, 2031 1,300 1,300 Total senior notes 15,674 15,673 Term loan facility 2,156 2,183 Revolving credit agreement 61 58 Finance leases and other 250 253 Debt issuance costs (135) (147) Total debt 18,006 18,020 Less: current portion (110) (82) Long-term debt $ 17,896 $ 17,938 |
Leases
Leases | 6 Months Ended |
Jun. 30, 2023 | |
Leases [Abstract] | |
Leases | Leases The following table sets forth the right-of-use (ROU) assets and lease liabilities ($ in millions): June 30, 2023 December 31, 2022 Assets ROU assets (recorded within other long-term assets) $ 2,613 $ 2,554 Liabilities Short-term (recorded within accounts payable and accrued expenses) $ 176 $ 180 Long-term (recorded within other long-term liabilities) 3,171 3,133 Total lease liabilities $ 3,347 $ 3,313 As of June 30, 2023, the weighted average remaining lease term for the Company was 21.0 years. The average remaining lease term of the Circle Health portfolio is 27.3 years. Excluding Circle Health, the Company's portfolio average remaining lease term is 8.4 years. The lease liabilities as of June 30, 2023 reflect a weighted average discount rate of 5.9%. |
Stockholders' Equity
Stockholders' Equity | 6 Months Ended |
Jun. 30, 2023 | |
Equity [Abstract] | |
Stockholders' Equity | Stockholders' Equity The Company's Board of Directors has authorized a stock repurchase program of the Company's common stock from time to time on the open market or through privately negotiated transactions. In 2022, the Company's Board of Directors authorized increases under the program including $3,000 million in June 2022 and an additional $2,000 million in December 2022. With these increases, the Company is authorized to repurchase up to $6,000 million, inclusive of past authorizations. As of June 30, 2023, the Company had a remaining amount of $2,029 million available under the stock repurchase program. In July 2023, the Company repurchased an additional 4.5 million shares for $300 million. The following represents the Company's share repurchase activity ($ in millions, shares in thousands): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Shares Cost Shares Cost Shares Cost Shares Cost Share buybacks 6,028 $ 400 4,188 $ 344 10,880 $ 777 4,188 $ 344 Income tax withholding 71 5 61 5 767 51 907 76 Total share repurchases (1) 6,099 $ 405 4,249 $ 349 11,647 $ 828 5,095 $ 420 (1) Excludes share repurchase excise tax of $3 million accrued as of June 30, 2023. Shares repurchased for income tax withholding are shares withheld in connection with employee stock plans to meet applicable tax withholding requirements. These shares are typically included in the Company's treasury stock. |
Earnings Per Share
Earnings Per Share | 6 Months Ended |
Jun. 30, 2023 | |
Earnings Per Share [Abstract] | |
Earnings Per Share | Earnings Per Share The following table sets forth the calculation of basic and diluted net earnings (loss) per common share ($ in millions, except per share data in dollars and shares in thousands): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Earnings (loss) attributable to Centene Corporation $ 1,058 $ (172) $ 2,188 $ 677 Shares used in computing per share amounts: Weighted average number of common shares outstanding 548,932 583,644 549,850 583,435 Common stock equivalents (as determined by applying the treasury stock method) (1) 1,376 — 2,146 6,791 Weighted average number of common shares and potential dilutive common shares outstanding 550,308 583,644 551,996 590,226 Net earnings (loss) per common share attributable to Centene Corporation: Basic earnings (loss) per common share $ 1.93 $ (0.29) $ 3.98 $ 1.16 Diluted earnings (loss) per common share $ 1.92 $ (0.29) $ 3.96 $ 1.15 (1) The reduction in common stock equivalents is primarily driven by the distribution of long-term stock awards to the estate of the Company's former CEO during the first quarter of 2023, which were fully dilutive prior to their distribution. The calculation of diluted earnings per common share for the three months ended June 30, 2023 excludes 2 million shares related to anti-dilutive stock options, restricted stock, and restricted stock units. The calculation of diluted (loss) per common share for the three months ended June 30, 2022 excludes 6 million shares related to anti-dilutive stock equivalents due to the net loss for the quarter. The calculation of diluted earnings per common share for the six months ended June 30, 2023 and 2022 excludes 2 million shares and 226 thousand shares, respectively, related to anti-dilutive stock options, restricted stock, and restricted stock units. |
Segment Information
Segment Information | 6 Months Ended |
Jun. 30, 2023 | |
Segment Reporting [Abstract] | |
Segment Information | Segment Information In the first quarter of 2023, and in conjunction with the Company's updated strategic plan, executive leadership realignment, and corresponding 2023 divestitures, the Company revised the way it manages the business, evaluates performance, and allocates resources, resulting in an updated segment structure comprised of (1) a Medicaid segment, (2) a Medicare segment, (3) a Commercial segment and (4) an Other segment. Prior year information has been adjusted to reflect the change in segment reporting. The Medicaid, Medicare, and Commercial segments represent the government-sponsored or subsidized programs under which the Company offers managed healthcare services. The Other segment includes the Company's pharmacy operations, vision and dental services, clinical healthcare, behavioral health, international operations, and corporate management companies, among others. Factors used in determining the reportable business segments include the nature of operating activities, the existence of separate senior management teams, and the type of information presented to the Company's chief operating decision-maker to evaluate all results of operations. The Company does not report total assets by segment since this is not a metric used to allocate resources or evaluate segment performance. Segment information for the three months ended June 30, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 21,895 $ 5,665 $ 5,734 $ 419 $ 33,713 Service — — — 1,125 1,125 Premium and service revenues 21,895 5,665 5,734 1,544 34,838 Premium tax 2,770 — — — 2,770 Total external revenues 24,665 5,665 5,734 1,544 37,608 Internal revenues — — — 3,789 3,789 Eliminations — — — (3,789) (3,789) Total revenues $ 24,665 $ 5,665 $ 5,734 $ 1,544 $ 37,608 Medical costs $ 19,459 $ 4,884 $ 4,644 $ 360 $ 29,347 Cost of services $ 2 $ — $ — $ 875 $ 877 Gross margin (1) $ 2,434 $ 781 $ 1,090 $ 309 $ 4,614 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the three months ended June 30, 2022, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 20,488 $ 5,639 $ 4,554 $ 829 $ 31,510 Service (1) — 1 2,458 2,458 Premium and service revenues 20,487 5,639 4,555 3,287 33,968 Premium tax 1,968 — — — 1,968 Total external revenues 22,455 5,639 4,555 3,287 35,936 Internal revenues — — — 5,986 5,986 Eliminations — — — (5,986) (5,986) Total revenues $ 22,455 $ 5,639 $ 4,555 $ 3,287 $ 35,936 Medical costs $ 18,258 $ 4,826 $ 3,529 $ 699 $ 27,312 Cost of services $ — $ — $ — $ 2,099 $ 2,099 Gross margin (1) $ 2,229 $ 813 $ 1,026 $ 489 $ 4,557 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the six months ended June 30, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 44,122 $ 11,541 $ 10,986 $ 889 $ 67,538 Service — — — 2,252 2,252 Premium and service revenues 44,122 11,541 10,986 3,141 69,790 Premium tax 6,707 — — — 6,707 Total external revenues 50,829 11,541 10,986 3,141 76,497 Internal revenues — — — 7,656 7,656 Eliminations — — — (7,656) (7,656) Total revenues $ 50,829 $ 11,541 $ 10,986 $ 3,141 $ 76,497 Medical costs $ 39,469 $ 9,892 $ 8,649 $ 771 $ 58,781 Cost of services $ 2 $ — $ — $ 1,745 $ 1,747 Gross margin (1) $ 4,651 $ 1,649 $ 2,337 $ 625 $ 9,262 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the six months ended June 30, 2022, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 41,609 $ 11,396 $ 8,686 $ 1,708 $ 63,399 Service (1) — 1 4,801 4,801 Premium and service revenues 41,608 11,396 8,687 6,509 68,200 Premium tax 4,921 — — — 4,921 Total external revenues 46,529 11,396 8,687 6,509 73,121 Internal revenues — — — 12,436 12,436 Eliminations — — — (12,436) (12,436) Total revenues $ 46,529 $ 11,396 $ 8,687 $ 6,509 $ 73,121 Medical costs $ 37,033 $ 9,872 $ 6,803 $ 1,442 $ 55,150 Cost of services $ — $ — $ — $ 4,087 $ 4,087 Gross margin (1) $ 4,575 $ 1,524 $ 1,884 $ 980 $ 8,963 (1) Gross margin represents premium and service revenues less medical costs and cost of services. |
Contingencies
Contingencies | 6 Months Ended |
Jun. 30, 2023 | |
Commitments and Contingencies Disclosure [Abstract] | |
Contingencies | Contingencies Overview The Company is routinely subjected to legal and regulatory proceedings in the normal course of business. These matters can include, without limitation: • periodic compliance and other reviews and investigations by various federal and state regulatory agencies with respect to requirements applicable to the Company's business, including, without limitation, those related to payment of out-of-network claims, submissions to CMS related to risk adjustment payments, or the False Claims Act, the calculation of minimum MLR and rebates related thereto, submissions to state agencies related to payments or state false claims acts, pre-authorization penalties, timely review of grievances and appeals, timely and accurate payment of claims, cybersecurity issues, including those related to the Company's or the Company's third party vendors' information systems, and the Health Insurance Portability and Accountability Act of 1996 and other federal and state fraud, waste and abuse laws; • litigation arising out of general business activities, such as tax matters, disputes related to healthcare benefits coverage or reimbursement, putative securities class actions, and medical malpractice, privacy, real estate, intellectual property and employment-related claims; and • disputes regarding reinsurance arrangements, claims arising out of the acquisition or divestiture of various assets, class actions, and claims relating to the performance of contractual and non-contractual obligations to providers, members, employer groups and others, including, but not limited to, the alleged failure to properly pay claims and challenges to the manner in which the Company processes claims, claims related to network adequacy and claims alleging that the Company has engaged in unfair business practices. Among other things, these matters may result in awards of damages, fines or penalties, which could be substantial, and/or could require changes to the Company's business. The Company intends to vigorously defend itself against legal and regulatory proceedings to which it is currently a party; however, these proceedings are subject to many uncertainties. In some of the cases pending against the Company, substantial non-economic or punitive damages are being sought. The Company records reserves and accrues costs for certain legal proceedings and regulatory matters to the extent that it determines an unfavorable outcome is probable and the amount of the loss can be reasonably estimated. While such reserves and accrued costs reflect the Company's best estimate of the probable loss for such matters, the recorded amounts may differ materially from the actual amount of any such losses. In some cases, no estimate of the possible loss or range of loss in excess of amounts accrued, if any, can be made because of the inherently unpredictable nature of legal and regulatory proceedings, which may be exacerbated by various factors, including but not limited to, they may involve indeterminate claims for monetary damages or may involve fines, penalties or punitive damages; present novel legal theories or legal uncertainties; involve disputed facts; represent a shift in regulatory policy; involve a large number of parties, claimants or regulatory bodies; are in the early stages of the proceedings; involve a number of separate proceedings and/or a wide range of potential outcomes; or result in a change of business practices. As of the date of this report, amounts accrued for legal proceedings and regulatory matters were not material, except for the reserve estimate as described below with respect to claims or potential claims involving services provided by Envolve Pharmacy Solutions, Inc. (Envolve), as the Company's pharmacy benefits management (PBM) subsidiary. It is possible that in a particular quarter or annual period the Company's financial condition, results of operations, cash flow and/or liquidity could be materially adversely affected by an ultimate unfavorable resolution of or development in legal and/or regulatory proceedings, including as described below. Except for the discussion below, the Company believes that the ultimate outcome of any of the regulatory and legal proceedings that are currently pending against it should not have a material adverse effect on financial condition, results of operations, cash flow, or liquidity. California On October 20, 2015, the Company's California subsidiary, Health Net of California, Inc. (Health Net California), was named as a defendant in a California taxpayer action filed in Los Angeles County Superior Court, captioned as Michael D. Myers v. State Board of Equalization, Dave Jones, Insurance Commissioner of the State of California, Betty T. Yee, Controller of the State of California, et al., Los Angeles Superior Court Case No. BS158655. This action is brought under a California statute that permits an individual taxpayer to sue a governmental agency when the taxpayer believes the agency has failed to enforce governing law. Plaintiff contends that Health Net California, a California licensed Health Care Service Plan (HCSP), is an "insurer" for purposes of taxation despite acknowledging it is not an "insurer" under regulatory law. Under California law, "insurers" must pay a gross premiums tax (GPT), calculated as 2.35% on gross premiums. As a licensed HCSP, Health Net California has paid the California Corporate Franchise Tax (CFT), the tax generally paid by California businesses. Plaintiff contends that Health Net California must pay the GPT rather than the CFT. Plaintiff seeks a writ of mandate directing the California taxing agencies to collect the GPT, and seeks an order requiring Health Net California to pay GPT, interest and penalties for a period dating to eight years prior to the October 2015 filing of the complaint. This lawsuit is being coordinated with similar lawsuits filed against other entities (collectively, Related Actions). In March 2018, the Court overruled the Company's demurrer seeking to dismiss the complaint and denied the Company's motion to strike allegations seeking retroactive relief. In August 2018, the trial court stayed all the Related Actions pending determination of a writ of mandate by the California Court of Appeals in two of the Related Actions. In March 2019, the California Court of Appeals denied the writ of mandate. The defendants in those Related Actions sought review by the California Supreme Court, which declined to review the matter. Upon the return of the matter to the Los Angeles County Superior Court, motions for summary judgment were scheduled. Health Net California's motion for summary judgment was heard by the Court in March 2020. In March 2020, the Court granted Health Net California's motion for summary judgment. In April 2023, the California Court of Appeals affirmed the grant of summary judgment in Health Net California's favor. In June 2023, plaintiff filed a petition for review with the California Supreme Court, which was denied in July 2023. Beginning in April 2021, several lawsuits have been filed against the Company and its subsidiaries, alleging that the defendants failed to prevent Health Net members' personal and health data from being exposed in connection with a data breach involving Accellion's File Transfer Appliance. The Company denies any wrongdoing, and at a mediation in September 2021, the Company reached a settlement with plaintiffs in three of the pending class actions which, if approved by court, should resolve most or all of the pending litigation related to this matter. In addition, claims related to these lawsuits are anticipated to be covered in part by the Company's insurance carrier. As a result, while these matters are subject to many uncertainties, the Company does not believe that an adverse outcome in these matters is likely to have a materially adverse impact on the Company's financial condition, results of operations and cash flows. Pharmacy Benefits Management Matters On March 11, 2021, the State of Ohio filed a civil action against the Company and the Company's subsidiaries, Buckeye Health Plan Community Solutions, Inc. and Envolve, in Franklin County Court of Common Pleas, captioned as Ohio Department of Medicaid, et al. v. Centene Corporation, et al. The complaint alleged breaches of contract with the Ohio Department of Medicaid relating to the provision of PBM services and violations of Ohio law relating to such contracts, including among other things, by (i) seeking payment for services already reimbursed, (ii) not accurately disclosing to the Ohio Department of Medicaid the true cost of the PBM services and (iii) inflating dispensing fees for prescription drugs. The plaintiffs sought an undisclosed sum of money in damages, penalties, and possible termination of the contract with Buckeye Health Plan. The Company has reached a no-fault settlement with the Ohio Attorney General regarding this matter and the complaint was dismissed. The Company has reached no-fault settlement agreements with the Attorneys General in other states to resolve claims and/or allegations made by those states related to services previously provided by Envolve. Additionally, the Company is in discussions to bring final resolution to similar concerns in other affected states. Consistent with those discussions, the Company recorded a reserve estimate of $1,250 million in the second quarter of 2021 related to this issue, inclusive of the above settlements and rebates that the Company determined in the course of the matter are payable across products. Additional claims, reviews or investigations relating to the Company's historical PBM business across products may be brought by other states, the federal government, or shareholder litigants, and there is no guarantee the Company will have the ability to settle such claims with other states within the reserve estimate the Company has recorded and on other acceptable terms, or at all. This matter is subject to many uncertainties, and an adverse outcome in this matter could have an adverse impact on the Company's financial condition, results of operations and cash flows. |
Organization and Operations (Po
Organization and Operations (Policies) | 6 Months Ended |
Jun. 30, 2023 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Basis of Presentation | Basis of Presentation The accompanying interim financial statements have been prepared under the presumption that users of the interim financial information have either read or have access to the audited financial statements included in the Form 10-K for the fiscal year ended December 31, 2022. The unaudited interim financial statements herein have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission. Accordingly, footnote disclosures that would substantially duplicate the disclosures contained in the December 31, 2022 audited financial statements have been omitted from these interim financial statements, where appropriate. In the opinion of management, these financial statements reflect all adjustments, consisting only of normal recurring adjustments, which are necessary for a fair presentation of the results of the interim periods presented. Certain 2022 amounts in the consolidated financial statements and notes to the consolidated financial statements have been reclassified to conform to the 2023 presentation, including reclassifications related to the Company's new segment reporting structure as outlined below. These reclassifications have no effect on net earnings or stockholders' equity as previously reported. |
Segment Reporting | Segment Reporting In the first quarter of 2023, and in conjunction with the Company's updated strategic plan, executive leadership realignment, and corresponding 2023 divestitures, the Company revised the way it manages the business, evaluates performance, and allocates resources, resulting in an updated segment structure comprised of (1) a Medicaid segment, (2) a Medicare segment, (3) a Commercial segment, and (4) an Other segment. The Medicaid, Medicare, and Commercial segments represent the government-sponsored or subsidized programs under which the Company offers managed healthcare services. Specifically, the Medicaid segment includes the Temporary Assistance for Needy Families (TANF) program, Medicaid Expansion programs, the Aged, Blind, or Disabled (ABD) program, the Children's Health Insurance Program (CHIP), Long-Term Services and Supports (LTSS), Foster Care, Medicare-Medicaid Plans (MMP), which cover beneficiaries who are dually eligible for Medicaid and Medicare, and other state-based programs. The Medicare segment includes Medicare Advantage, Medicare Supplement, Dual Eligible Special Needs Plans (D-SNPs), and Medicare Prescription Drug Plans (PDPs), also known as Medicare Part D. The Commercial segment includes the Health Insurance Marketplace along with individual, small group, and large group commercial healthcare products. The Other segment includes the Company's pharmacy operations, vision and dental services, clinical healthcare, behavioral health, international operations, and corporate management companies, among others. |
Accounting Guidance Not Yet Adopted | Accounting Guidance Not Yet Adopted The Company has determined that there are no recently issued accounting pronouncements that will have a material impact on its consolidated financial position, results of operations, or cash flows. |
Short-term and Long-term Inve_2
Short-term and Long-term Investments, Restricted Deposits (Tables) | 6 Months Ended |
Jun. 30, 2023 | |
Investments, Debt and Equity Securities [Abstract] | |
Short-term and long-term investments and restricted deposits by investment type | Short-term and long-term investments and restricted deposits by investment type consist of the following ($ in millions): June 30, 2023 December 31, 2022 Amortized Cost Gross Gross Fair Value Amortized Cost Gross Gross Fair Value Debt securities: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 465 $ — $ (15) $ 450 $ 695 $ — $ (16) $ 679 Corporate securities 10,578 13 (724) 9,867 10,127 12 (778) 9,361 Restricted certificates of deposit 4 — — 4 4 — — 4 Restricted cash equivalents 358 — — 358 256 — — 256 Short-term time deposits 419 — — 419 204 — — 204 Municipal securities 4,156 9 (234) 3,931 4,055 6 (280) 3,781 Asset-backed securities 1,507 1 (60) 1,448 1,396 — (70) 1,326 Residential mortgage-backed securities 1,346 1 (120) 1,227 1,165 2 (121) 1,046 Commercial mortgage-backed securities 1,081 — (100) 981 961 — (99) 862 Equity securities 2 — — 2 5 — — 5 Private equity investments 805 — — 805 529 — — 529 Life insurance contracts 183 — — 183 169 — — 169 Total $ 20,904 $ 24 $ (1,253) $ 19,675 $ 19,566 $ 20 $ (1,364) $ 18,222 |
Fair value of available-for-sale investments with gross unrealized losses by investment type and length of time | The fair value of available-for-sale debt securities with gross unrealized losses by investment type and length of time that individual securities have been in a continuous unrealized loss position were as follows ($ in millions): June 30, 2023 December 31, 2022 Less Than 12 Months 12 Months or More Less Than 12 Months 12 Months or More Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value U.S. Treasury securities and obligations of U.S. government corporations and agencies $ (3) $ 207 $ (12) $ 191 $ (5) $ 342 $ (11) $ 184 Corporate securities (73) 2,942 (651) 6,049 (340) 5,368 (438) 3,400 Municipal securities (26) 1,413 (208) 1,990 (142) 2,437 (138) 995 Asset-backed securities (8) 431 (52) 949 (29) 786 (41) 486 Residential mortgage-backed securities (16) 494 (104) 644 (55) 629 (66) 352 Commercial mortgage-backed securities (8) 224 (92) 736 (49) 513 (50) 330 Total $ (134) $ 5,711 $ (1,119) $ 10,559 $ (620) $ 10,075 $ (744) $ 5,747 |
Contractual maturities of short-term and long-term investments and restricted deposits | The contractual maturities of short-term and long-term debt securities and restricted deposits are as follows ($ in millions): June 30, 2023 December 31, 2022 Investments Restricted Deposits Investments Restricted Deposits Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value One year or less $ 2,095 $ 2,064 $ 627 $ 625 $ 2,207 $ 2,179 $ 534 $ 532 One year through five years 8,144 7,630 509 477 7,651 7,147 524 490 Five years through ten years 4,169 3,826 254 232 4,066 3,613 224 195 Greater than ten years 160 154 22 21 135 129 — — Asset-backed securities 3,934 3,656 — — 3,522 3,234 — — Total $ 18,502 $ 17,330 $ 1,412 $ 1,355 $ 17,581 $ 16,302 $ 1,282 $ 1,217 |
Fair Value Measurements (Tables
Fair Value Measurements (Tables) | 6 Months Ended |
Jun. 30, 2023 | |
Fair Value Disclosures [Abstract] | |
Assets and Liabilities, Based Upon Observable or Unobservable Inputs, Level Input Definitions | Assets and liabilities recorded at fair value in the Consolidated Balance Sheets are categorized based upon observable or unobservable inputs used to estimate fair value. Level inputs are as follows: Level Input: Input Definition: Level I Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date. Level II Inputs other than quoted prices included in Level I that are observable for the asset or liability through corroboration with market data at the measurement date. Level III Unobservable inputs that reflect management's best estimate of what market participants would use in pricing the asset or liability at the measurement date. |
Fair Value Measurements by Level for Assets and Liabilities Measured at Fair Value on a Recurring Basis | The following table summarizes fair value measurements by level at June 30, 2023, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 17,170 $ — $ — $ 17,170 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 112 $ — $ — $ 112 Corporate securities — 9,833 — 9,833 Municipal securities — 3,310 — 3,310 Short-term time deposits — 419 — 419 Asset-backed securities — 1,448 — 1,448 Residential mortgage-backed securities — 1,227 — 1,227 Commercial mortgage-backed securities — 981 — 981 Equity securities — 2 — 2 Total investments $ 112 $ 17,220 $ — $ 17,332 Restricted deposits: Cash and cash equivalents $ 358 $ — $ — $ 358 U.S. Treasury securities and obligations of U.S. government corporations and agencies 338 — — 338 Corporate securities — 34 — 34 Certificates of deposit — 4 — 4 Municipal securities — 621 — 621 Total restricted deposits $ 696 $ 659 $ — $ 1,355 Total assets at fair value $ 17,978 $ 17,879 $ — $ 35,857 The following table summarizes fair value measurements by level at December 31, 2022, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 12,074 $ — $ — $ 12,074 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 366 $ 5 $ — $ 371 Corporate securities — 9,328 — 9,328 Municipal securities — 3,165 — 3,165 Short-term time deposits — 204 — 204 Asset backed securities — 1,326 — 1,326 Residential mortgage-backed securities — 1,046 — 1,046 Commercial mortgage-backed securities — 862 — 862 Equity securities 3 2 — 5 Total investments $ 369 $ 15,938 $ — $ 16,307 Restricted deposits: Cash and cash equivalents $ 256 $ — $ — $ 256 U.S. Treasury securities and obligations of U.S. government corporations and agencies 308 — — 308 Corporate securities — 33 — 33 Certificates of deposit — 4 — 4 Municipal securities — 616 — 616 Total restricted deposits $ 564 $ 653 $ — $ 1,217 Total assets at fair value $ 13,007 $ 16,591 $ — $ 29,598 |
Goodwill and Intangible Assets
Goodwill and Intangible Assets (Tables) | 6 Months Ended |
Jun. 30, 2023 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
Schedule of Goodwill | The following table summarizes the changes in goodwill by operating segment ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, December 31, 2021 $ 10,194 $ 1,592 $ 5,424 $ 2,561 $ 19,771 Acquisition and purchase accounting adjustments — — — 1,077 1,077 Divestitures — — — (1,533) (1,533) Reallocation 4 — — (4) — Impairments — — — (370) (370) Translation impact — — — (133) (133) Balance, December 31, 2022 $ 10,198 $ 1,592 $ 5,424 $ 1,598 $ 18,812 Divestitures — — — (152) (152) Translation impact — — — 56 56 Balance, June 30, 2023 $ 10,198 $ 1,592 $ 5,424 $ 1,502 $ 18,716 |
Medical Claims Liability (Table
Medical Claims Liability (Tables) | 6 Months Ended |
Jun. 30, 2023 | |
Insurance [Abstract] | |
Schedule of change in medical claims liability | The following table summarizes the change in medical claims liability for the six months ended June 30, 2023 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2023 $ 11,253 $ 3,431 $ 1,921 $ 140 $ 16,745 Less: Reinsurance recoverable 7 — 19 — 26 Balance, January 1, 2023, net 11,246 3,431 1,902 140 16,719 Incurred related to: Current year 40,622 10,083 8,857 773 60,335 Prior years (1,153) (191) (208) (2) (1,554) Total incurred 39,469 9,892 8,649 771 58,781 Paid related to: Current year 31,837 7,726 6,751 656 46,970 Prior years 7,890 2,357 1,282 137 11,666 Total paid 39,727 10,083 8,033 793 58,636 Balance, June 30, 2023, net 10,988 3,240 2,518 118 16,864 Plus: Reinsurance recoverable 5 — 15 — 20 Balance, June 30, 2023 $ 10,993 $ 3,240 $ 2,533 $ 118 $ 16,884 The following table summarizes the change in medical claims liability for the six months ended June 30, 2022 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2022 $ 9,845 $ 2,286 $ 2,014 $ 98 $ 14,243 Less: Reinsurance recoverable 23 — — — 23 Balance, January 1, 2022, net 9,822 2,286 2,014 98 14,220 Acquisitions and divestitures — — — 249 249 Incurred related to: Current year 37,803 9,918 7,001 1,457 56,179 Prior years (770) (46) (198) (15) (1,029) Total incurred 37,033 9,872 6,803 1,442 55,150 Paid related to: Current year 29,007 6,977 5,475 1,427 42,886 Prior years 6,808 1,784 1,489 80 10,161 Total paid 35,815 8,761 6,964 1,507 53,047 Balance, June 30, 2022, net 11,040 3,397 1,853 282 16,572 Plus: Reinsurance recoverable 9 — — — 9 Balance, June 30, 2022 $ 11,049 $ 3,397 $ 1,853 $ 282 $ 16,581 |
Affordable Care Act (Tables)
Affordable Care Act (Tables) | 6 Months Ended |
Jun. 30, 2023 | |
Affordable Care Act [Abstract] | |
Schedule of net receivables (payables) related to the Affordable Care Act Programs | The Company's net receivables (payables) for each of the programs are as follows ($ in millions): June 30, 2023 December 31, 2022 Risk adjustment receivable $ 1,088 $ 838 Risk adjustment payable (2,303) (780) Minimum medical loss ratio (233) (103) Cost sharing reduction receivable 2 — Cost sharing reduction payable (87) (99) |
Debt (Tables)
Debt (Tables) | 6 Months Ended |
Jun. 30, 2023 | |
Debt Disclosure [Abstract] | |
Schedule of Debt | Debt consists of the following ($ in millions): June 30, 2023 December 31, 2022 $2,500 million 4.25% Senior Notes due December 15, 2027 $ 2,394 $ 2,393 $2,300 million 2.45% Senior Notes due July 15, 2028 2,303 2,303 $3,500 million 4.625% Senior Notes due December 15, 2029 3,277 3,277 $2,000 million 3.375% Senior Notes due February 15, 2030 2,000 2,000 $2,200 million 3.00% Senior Notes due October 15, 2030 2,200 2,200 $2,200 million 2.50% Senior Notes due March 1, 2031 2,200 2,200 $1,300 million 2.625% Senior Notes due August 1, 2031 1,300 1,300 Total senior notes 15,674 15,673 Term loan facility 2,156 2,183 Revolving credit agreement 61 58 Finance leases and other 250 253 Debt issuance costs (135) (147) Total debt 18,006 18,020 Less: current portion (110) (82) Long-term debt $ 17,896 $ 17,938 |
Leases (Tables)
Leases (Tables) | 6 Months Ended |
Jun. 30, 2023 | |
Leases [Abstract] | |
ROU Assets and Liabilities | The following table sets forth the right-of-use (ROU) assets and lease liabilities ($ in millions): June 30, 2023 December 31, 2022 Assets ROU assets (recorded within other long-term assets) $ 2,613 $ 2,554 Liabilities Short-term (recorded within accounts payable and accrued expenses) $ 176 $ 180 Long-term (recorded within other long-term liabilities) 3,171 3,133 Total lease liabilities $ 3,347 $ 3,313 |
Stockholders' Equity (Tables)
Stockholders' Equity (Tables) | 6 Months Ended |
Jun. 30, 2023 | |
Equity [Abstract] | |
Class of Treasury Stock | The following represents the Company's share repurchase activity ($ in millions, shares in thousands): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Shares Cost Shares Cost Shares Cost Shares Cost Share buybacks 6,028 $ 400 4,188 $ 344 10,880 $ 777 4,188 $ 344 Income tax withholding 71 5 61 5 767 51 907 76 Total share repurchases (1) 6,099 $ 405 4,249 $ 349 11,647 $ 828 5,095 $ 420 (1) Excludes share repurchase excise tax of $3 million accrued as of June 30, 2023. |
Earnings Per Share (Tables)
Earnings Per Share (Tables) | 6 Months Ended |
Jun. 30, 2023 | |
Earnings Per Share [Abstract] | |
Calculation of Basic and Diluted Net Earnings Per Common Share | The following table sets forth the calculation of basic and diluted net earnings (loss) per common share ($ in millions, except per share data in dollars and shares in thousands): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Earnings (loss) attributable to Centene Corporation $ 1,058 $ (172) $ 2,188 $ 677 Shares used in computing per share amounts: Weighted average number of common shares outstanding 548,932 583,644 549,850 583,435 Common stock equivalents (as determined by applying the treasury stock method) (1) 1,376 — 2,146 6,791 Weighted average number of common shares and potential dilutive common shares outstanding 550,308 583,644 551,996 590,226 Net earnings (loss) per common share attributable to Centene Corporation: Basic earnings (loss) per common share $ 1.93 $ (0.29) $ 3.98 $ 1.16 Diluted earnings (loss) per common share $ 1.92 $ (0.29) $ 3.96 $ 1.15 (1) The reduction in common stock equivalents is primarily driven by the distribution of long-term stock awards to the estate of the Company's former CEO during the first quarter of 2023, which were fully dilutive prior to their distribution. |
Segment Information (Tables)
Segment Information (Tables) | 6 Months Ended |
Jun. 30, 2023 | |
Segment Reporting [Abstract] | |
Segment Information | Segment information for the three months ended June 30, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 21,895 $ 5,665 $ 5,734 $ 419 $ 33,713 Service — — — 1,125 1,125 Premium and service revenues 21,895 5,665 5,734 1,544 34,838 Premium tax 2,770 — — — 2,770 Total external revenues 24,665 5,665 5,734 1,544 37,608 Internal revenues — — — 3,789 3,789 Eliminations — — — (3,789) (3,789) Total revenues $ 24,665 $ 5,665 $ 5,734 $ 1,544 $ 37,608 Medical costs $ 19,459 $ 4,884 $ 4,644 $ 360 $ 29,347 Cost of services $ 2 $ — $ — $ 875 $ 877 Gross margin (1) $ 2,434 $ 781 $ 1,090 $ 309 $ 4,614 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the three months ended June 30, 2022, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 20,488 $ 5,639 $ 4,554 $ 829 $ 31,510 Service (1) — 1 2,458 2,458 Premium and service revenues 20,487 5,639 4,555 3,287 33,968 Premium tax 1,968 — — — 1,968 Total external revenues 22,455 5,639 4,555 3,287 35,936 Internal revenues — — — 5,986 5,986 Eliminations — — — (5,986) (5,986) Total revenues $ 22,455 $ 5,639 $ 4,555 $ 3,287 $ 35,936 Medical costs $ 18,258 $ 4,826 $ 3,529 $ 699 $ 27,312 Cost of services $ — $ — $ — $ 2,099 $ 2,099 Gross margin (1) $ 2,229 $ 813 $ 1,026 $ 489 $ 4,557 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the six months ended June 30, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 44,122 $ 11,541 $ 10,986 $ 889 $ 67,538 Service — — — 2,252 2,252 Premium and service revenues 44,122 11,541 10,986 3,141 69,790 Premium tax 6,707 — — — 6,707 Total external revenues 50,829 11,541 10,986 3,141 76,497 Internal revenues — — — 7,656 7,656 Eliminations — — — (7,656) (7,656) Total revenues $ 50,829 $ 11,541 $ 10,986 $ 3,141 $ 76,497 Medical costs $ 39,469 $ 9,892 $ 8,649 $ 771 $ 58,781 Cost of services $ 2 $ — $ — $ 1,745 $ 1,747 Gross margin (1) $ 4,651 $ 1,649 $ 2,337 $ 625 $ 9,262 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the six months ended June 30, 2022, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 41,609 $ 11,396 $ 8,686 $ 1,708 $ 63,399 Service (1) — 1 4,801 4,801 Premium and service revenues 41,608 11,396 8,687 6,509 68,200 Premium tax 4,921 — — — 4,921 Total external revenues 46,529 11,396 8,687 6,509 73,121 Internal revenues — — — 12,436 12,436 Eliminations — — — (12,436) (12,436) Total revenues $ 46,529 $ 11,396 $ 8,687 $ 6,509 $ 73,121 Medical costs $ 37,033 $ 9,872 $ 6,803 $ 1,442 $ 55,150 Cost of services $ — $ — $ — $ 4,087 $ 4,087 Gross margin (1) $ 4,575 $ 1,524 $ 1,884 $ 980 $ 8,963 (1) Gross margin represents premium and service revenues less medical costs and cost of services. |
Acquisitions and Divestitures -
Acquisitions and Divestitures -Divestiture (Details) - USD ($) $ in Millions | 1 Months Ended | 3 Months Ended | 6 Months Ended | 12 Months Ended | ||||
Jun. 13, 2023 | Jan. 20, 2023 | Apr. 30, 2023 | Jun. 30, 2023 | Jun. 30, 2022 | Jun. 30, 2023 | Jun. 30, 2022 | Dec. 31, 2022 | |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||||||
Gain on divestiture | $ 172 | $ 0 | ||||||
Impairment charge | $ 18 | $ 1,450 | $ 38 | $ 1,450 | ||||
Centurion | Disposal Group, Disposed of by Sale, Not Discontinued Operations | ||||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||||||
Gain on divestiture | 15 | |||||||
Magellan Specialty Health | Disposal Group, Disposed of by Sale, Not Discontinued Operations | ||||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||||||
Gain on divestiture | $ 79 | |||||||
Consideration received on divestiture | 646 | |||||||
Proceeds from sale of business | $ 245 | |||||||
Contingent consideration on disposal (up to) | $ 150 | |||||||
Spanish and Central European Businesses | Disposal Group, Disposed of by Sale, Not Discontinued Operations | ||||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||||||
Gain on divestiture | $ 13 | |||||||
Impairment charge | $ (163) | |||||||
Impairment charge, net of tax | $ (140) | |||||||
Apixio | Disposal Group, Disposed of by Sale, Not Discontinued Operations | ||||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||||||
Gain on disposal | $ 91 | |||||||
Gain on disposal, net of tax | $ 63 |
Short-term and Long-term Inve_3
Short-term and Long-term Investments, Restricted Deposits - By Investment Type (Details) - USD ($) $ in Millions | Jun. 30, 2023 | Dec. 31, 2022 |
Debt Securities | ||
Gross Unrealized Gains | $ 24 | $ 20 |
Gross Unrealized Losses | (1,253) | (1,364) |
Equity securities | 2 | 5 |
Private equity investments | 805 | 529 |
Life insurance contracts | 183 | 169 |
Total, Amortized Cost | 20,904 | 19,566 |
Total, Fair Value | 19,675 | 18,222 |
U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Debt Securities | ||
Amortized Cost | 465 | 695 |
Gross Unrealized Gains | 0 | 0 |
Gross Unrealized Losses | (15) | (16) |
Fair Value | 450 | 679 |
Corporate securities | ||
Debt Securities | ||
Amortized Cost | 10,578 | 10,127 |
Gross Unrealized Gains | 13 | 12 |
Gross Unrealized Losses | (724) | (778) |
Fair Value | 9,867 | 9,361 |
Restricted certificates of deposit | ||
Debt Securities | ||
Amortized Cost | 4 | 4 |
Gross Unrealized Gains | 0 | 0 |
Gross Unrealized Losses | 0 | 0 |
Fair Value | 4 | 4 |
Restricted cash equivalents | ||
Debt Securities | ||
Amortized Cost | 358 | 256 |
Gross Unrealized Gains | 0 | 0 |
Gross Unrealized Losses | 0 | 0 |
Fair Value | 358 | 256 |
Short-term time deposits | ||
Debt Securities | ||
Amortized Cost | 419 | 204 |
Gross Unrealized Gains | 0 | 0 |
Gross Unrealized Losses | 0 | 0 |
Fair Value | 419 | 204 |
Municipal securities | ||
Debt Securities | ||
Amortized Cost | 4,156 | 4,055 |
Gross Unrealized Gains | 9 | 6 |
Gross Unrealized Losses | (234) | (280) |
Fair Value | 3,931 | 3,781 |
Asset-backed securities | ||
Debt Securities | ||
Amortized Cost | 1,507 | 1,396 |
Gross Unrealized Gains | 1 | 0 |
Gross Unrealized Losses | (60) | (70) |
Fair Value | 1,448 | 1,326 |
Residential mortgage-backed securities | ||
Debt Securities | ||
Amortized Cost | 1,346 | 1,165 |
Gross Unrealized Gains | 1 | 2 |
Gross Unrealized Losses | (120) | (121) |
Fair Value | 1,227 | 1,046 |
Commercial mortgage-backed securities | ||
Debt Securities | ||
Amortized Cost | 1,081 | 961 |
Gross Unrealized Gains | 0 | 0 |
Gross Unrealized Losses | (100) | (99) |
Fair Value | $ 981 | $ 862 |
Short-term and Long-term Inve_4
Short-term and Long-term Investments, Restricted Deposits - Narrative (Details) $ in Millions | 6 Months Ended | |
Jun. 30, 2023 USD ($) position | Dec. 31, 2022 USD ($) | |
Schedule Of Investments And Restricted Deposits By Type [Line Items] | ||
Accrued interest income | $ | $ 149 | $ 132 |
Positions from which gross unrealized losses were generated | 6,392 | |
Total investment positions | 6,910 | |
Commercial mortgage-backed securities | ||
Schedule Of Investments And Restricted Deposits By Type [Line Items] | ||
Investments recorded at fair value that carry rating of AAA Plus, weighted average (in years) | 4 years | |
Rated Securities | External Credit Rating, Investment Grade | Investment Securities | ||
Schedule Of Investments And Restricted Deposits By Type [Line Items] | ||
Percentage of investments in rated securities carry an investment grade rating by nationally recognized statistical rating organizations | 99% |
Short-term and Long-term Inve_5
Short-term and Long-term Investments, Restricted Deposits - Fair Value of Available-For-Sale Investments with Gross Unrealized Losses by Investment Type and Length of Time (Details) - USD ($) $ in Millions | Jun. 30, 2023 | Dec. 31, 2022 |
Unrealized Losses | ||
Less Than 12 Months | $ (134) | $ (620) |
12 Months or More | (1,119) | (744) |
Fair Value | ||
Fair Value, Less Than 12 Months | 5,711 | 10,075 |
Fair Value, 12 Months or More | 10,559 | 5,747 |
U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Unrealized Losses | ||
Less Than 12 Months | (3) | (5) |
12 Months or More | (12) | (11) |
Fair Value | ||
Fair Value, Less Than 12 Months | 207 | 342 |
Fair Value, 12 Months or More | 191 | 184 |
Corporate securities | ||
Unrealized Losses | ||
Less Than 12 Months | (73) | (340) |
12 Months or More | (651) | (438) |
Fair Value | ||
Fair Value, Less Than 12 Months | 2,942 | 5,368 |
Fair Value, 12 Months or More | 6,049 | 3,400 |
Municipal securities | ||
Unrealized Losses | ||
Less Than 12 Months | (26) | (142) |
12 Months or More | (208) | (138) |
Fair Value | ||
Fair Value, Less Than 12 Months | 1,413 | 2,437 |
Fair Value, 12 Months or More | 1,990 | 995 |
Asset-backed securities | ||
Unrealized Losses | ||
Less Than 12 Months | (8) | (29) |
12 Months or More | (52) | (41) |
Fair Value | ||
Fair Value, Less Than 12 Months | 431 | 786 |
Fair Value, 12 Months or More | 949 | 486 |
Residential mortgage-backed securities | ||
Unrealized Losses | ||
Less Than 12 Months | (16) | (55) |
12 Months or More | (104) | (66) |
Fair Value | ||
Fair Value, Less Than 12 Months | 494 | 629 |
Fair Value, 12 Months or More | 644 | 352 |
Commercial mortgage-backed securities | ||
Unrealized Losses | ||
Less Than 12 Months | (8) | (49) |
12 Months or More | (92) | (50) |
Fair Value | ||
Fair Value, Less Than 12 Months | 224 | 513 |
Fair Value, 12 Months or More | $ 736 | $ 330 |
Short-term and Long-term Inve_6
Short-term and Long-term Investments, Restricted Deposits - Contractual Maturities of Short-Term and Long-Term Investments and Restricted Deposits (Details) - USD ($) $ in Millions | Jun. 30, 2023 | Dec. 31, 2022 |
Investments | ||
Amortized Cost | ||
One year or less | $ 2,095 | $ 2,207 |
One year through five years | 8,144 | 7,651 |
Five years through ten years | 4,169 | 4,066 |
Greater than ten years | 160 | 135 |
Asset-backed securities | 3,934 | 3,522 |
Amortized Cost | 18,502 | 17,581 |
Fair Value | ||
One year or less | 2,064 | 2,179 |
One year through five years | 7,630 | 7,147 |
Five years through ten years | 3,826 | 3,613 |
Greater than ten years | 154 | 129 |
Asset-backed securities | 3,656 | 3,234 |
Fair Value | 17,330 | 16,302 |
Restricted Deposits | ||
Amortized Cost | ||
One year or less | 627 | 534 |
One year through five years | 509 | 524 |
Five years through ten years | 254 | 224 |
Greater than ten years | 22 | 0 |
Asset-backed securities | 0 | 0 |
Amortized Cost | 1,412 | 1,282 |
Fair Value | ||
One year or less | 625 | 532 |
One year through five years | 477 | 490 |
Five years through ten years | 232 | 195 |
Greater than ten years | 21 | 0 |
Asset-backed securities | 0 | 0 |
Fair Value | $ 1,355 | $ 1,217 |
Fair Value Measurements - Fair
Fair Value Measurements - Fair Value Measurements by Level for Assets and Liabilities Measured at Fair Value on a Recurring Basis (Details) - USD ($) $ in Millions | Jun. 30, 2023 | Dec. 31, 2022 |
Assets | ||
Cash and cash equivalents | $ 17,170 | $ 12,074 |
Investments: | ||
Equity securities | 2 | 5 |
Total assets at fair value | 35,857 | 29,598 |
U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair Value | 450 | 679 |
Corporate securities | ||
Investments: | ||
Fair Value | 9,867 | 9,361 |
Municipal securities | ||
Investments: | ||
Fair Value | 3,931 | 3,781 |
Short-term time deposits | ||
Investments: | ||
Fair Value | 419 | 204 |
Asset-backed securities | ||
Investments: | ||
Fair Value | 1,448 | 1,326 |
Residential mortgage-backed securities | ||
Investments: | ||
Fair Value | 1,227 | 1,046 |
Commercial mortgage-backed securities | ||
Investments: | ||
Fair Value | 981 | 862 |
Investments | ||
Investments: | ||
Fair Value | 17,330 | 16,302 |
Total investments | 17,332 | 16,307 |
Investments | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair Value | 112 | 371 |
Investments | Corporate securities | ||
Investments: | ||
Fair Value | 9,833 | 9,328 |
Investments | Municipal securities | ||
Investments: | ||
Fair Value | 3,310 | 3,165 |
Investments | Short-term time deposits | ||
Investments: | ||
Fair Value | 419 | 204 |
Investments | Asset-backed securities | ||
Investments: | ||
Fair Value | 1,448 | 1,326 |
Investments | Residential mortgage-backed securities | ||
Investments: | ||
Fair Value | 1,227 | 1,046 |
Investments | Commercial mortgage-backed securities | ||
Investments: | ||
Fair Value | 981 | 862 |
Investments | Equity securities | ||
Investments: | ||
Equity securities | 2 | 5 |
Restricted deposits | ||
Investments: | ||
Fair Value | 1,355 | 1,217 |
Restricted deposits | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair Value | 338 | 308 |
Restricted deposits | Corporate securities | ||
Investments: | ||
Fair Value | 34 | 33 |
Restricted deposits | Municipal securities | ||
Investments: | ||
Fair Value | 621 | 616 |
Restricted deposits | Cash and cash equivalents | ||
Investments: | ||
Fair Value | 358 | 256 |
Restricted deposits | Certificates of deposit | ||
Investments: | ||
Fair Value | 4 | 4 |
Level I | ||
Assets | ||
Cash and cash equivalents | 17,170 | 12,074 |
Investments: | ||
Total assets at fair value | 17,978 | 13,007 |
Level I | Investments | ||
Investments: | ||
Total investments | 112 | 369 |
Level I | Investments | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair Value | 112 | 366 |
Level I | Investments | Corporate securities | ||
Investments: | ||
Fair Value | 0 | 0 |
Level I | Investments | Municipal securities | ||
Investments: | ||
Fair Value | 0 | 0 |
Level I | Investments | Short-term time deposits | ||
Investments: | ||
Fair Value | 0 | 0 |
Level I | Investments | Asset-backed securities | ||
Investments: | ||
Fair Value | 0 | 0 |
Level I | Investments | Residential mortgage-backed securities | ||
Investments: | ||
Fair Value | 0 | 0 |
Level I | Investments | Commercial mortgage-backed securities | ||
Investments: | ||
Fair Value | 0 | 0 |
Level I | Investments | Equity securities | ||
Investments: | ||
Equity securities | 0 | 3 |
Level I | Restricted deposits | ||
Investments: | ||
Fair Value | 696 | 564 |
Level I | Restricted deposits | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair Value | 338 | 308 |
Level I | Restricted deposits | Corporate securities | ||
Investments: | ||
Fair Value | 0 | 0 |
Level I | Restricted deposits | Municipal securities | ||
Investments: | ||
Fair Value | 0 | 0 |
Level I | Restricted deposits | Cash and cash equivalents | ||
Investments: | ||
Fair Value | 358 | 256 |
Level I | Restricted deposits | Certificates of deposit | ||
Investments: | ||
Fair Value | 0 | 0 |
Level II | ||
Assets | ||
Cash and cash equivalents | 0 | 0 |
Investments: | ||
Total assets at fair value | 17,879 | 16,591 |
Level II | Investments | ||
Investments: | ||
Total investments | 17,220 | 15,938 |
Level II | Investments | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair Value | 0 | 5 |
Level II | Investments | Corporate securities | ||
Investments: | ||
Fair Value | 9,833 | 9,328 |
Level II | Investments | Municipal securities | ||
Investments: | ||
Fair Value | 3,310 | 3,165 |
Level II | Investments | Short-term time deposits | ||
Investments: | ||
Fair Value | 419 | 204 |
Level II | Investments | Asset-backed securities | ||
Investments: | ||
Fair Value | 1,448 | 1,326 |
Level II | Investments | Residential mortgage-backed securities | ||
Investments: | ||
Fair Value | 1,227 | 1,046 |
Level II | Investments | Commercial mortgage-backed securities | ||
Investments: | ||
Fair Value | 981 | 862 |
Level II | Investments | Equity securities | ||
Investments: | ||
Equity securities | 2 | 2 |
Level II | Restricted deposits | ||
Investments: | ||
Fair Value | 659 | 653 |
Level II | Restricted deposits | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair Value | 0 | 0 |
Level II | Restricted deposits | Corporate securities | ||
Investments: | ||
Fair Value | 34 | 33 |
Level II | Restricted deposits | Municipal securities | ||
Investments: | ||
Fair Value | 621 | 616 |
Level II | Restricted deposits | Cash and cash equivalents | ||
Investments: | ||
Fair Value | 0 | 0 |
Level II | Restricted deposits | Certificates of deposit | ||
Investments: | ||
Fair Value | 4 | 4 |
Level III | ||
Assets | ||
Cash and cash equivalents | 0 | 0 |
Investments: | ||
Total assets at fair value | 0 | 0 |
Level III | Investments | ||
Investments: | ||
Total investments | 0 | 0 |
Level III | Investments | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair Value | 0 | 0 |
Level III | Investments | Corporate securities | ||
Investments: | ||
Fair Value | 0 | 0 |
Level III | Investments | Municipal securities | ||
Investments: | ||
Fair Value | 0 | 0 |
Level III | Investments | Short-term time deposits | ||
Investments: | ||
Fair Value | 0 | 0 |
Level III | Investments | Asset-backed securities | ||
Investments: | ||
Fair Value | 0 | 0 |
Level III | Investments | Residential mortgage-backed securities | ||
Investments: | ||
Fair Value | 0 | 0 |
Level III | Investments | Commercial mortgage-backed securities | ||
Investments: | ||
Fair Value | 0 | 0 |
Level III | Investments | Equity securities | ||
Investments: | ||
Equity securities | 0 | 0 |
Level III | Restricted deposits | ||
Investments: | ||
Fair Value | 0 | 0 |
Level III | Restricted deposits | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair Value | 0 | 0 |
Level III | Restricted deposits | Corporate securities | ||
Investments: | ||
Fair Value | 0 | 0 |
Level III | Restricted deposits | Municipal securities | ||
Investments: | ||
Fair Value | 0 | 0 |
Level III | Restricted deposits | Cash and cash equivalents | ||
Investments: | ||
Fair Value | 0 | 0 |
Level III | Restricted deposits | Certificates of deposit | ||
Investments: | ||
Fair Value | $ 0 | $ 0 |
Fair Value Measurements - Narra
Fair Value Measurements - Narrative (Details) - USD ($) $ in Millions | Jun. 30, 2023 | Dec. 31, 2022 |
Fair Value Disclosures [Abstract] | ||
Aggregate carrying amount of life insurance contracts and equity investments, fair value | $ 988 | $ 698 |
Goodwill and Intangible Asset_2
Goodwill and Intangible Assets (Details) - USD ($) $ in Millions | 6 Months Ended | 12 Months Ended |
Jun. 30, 2023 | Dec. 31, 2022 | |
Goodwill and Intangible Assets Disclosure [Abstract] | ||
Goodwill, Balance beginning | $ 18,812 | $ 19,771 |
Acquisition and purchase accounting adjustments | 1,077 | |
Divestitures | (152) | (1,533) |
Reallocation | 0 | |
Impairments | (370) | |
Translation impact | 56 | (133) |
Goodwill, Balance ending | 18,716 | 18,812 |
Medicaid | ||
Goodwill and Intangible Assets Disclosure [Abstract] | ||
Goodwill, Balance beginning | 10,198 | 10,194 |
Acquisition and purchase accounting adjustments | 0 | |
Divestitures | 0 | 0 |
Reallocation | 4 | |
Impairments | 0 | |
Translation impact | 0 | 0 |
Goodwill, Balance ending | 10,198 | 10,198 |
Medicare | ||
Goodwill and Intangible Assets Disclosure [Abstract] | ||
Goodwill, Balance beginning | 1,592 | 1,592 |
Acquisition and purchase accounting adjustments | 0 | |
Divestitures | 0 | 0 |
Reallocation | 0 | |
Impairments | 0 | |
Translation impact | 0 | 0 |
Goodwill, Balance ending | 1,592 | 1,592 |
Commercial | ||
Goodwill and Intangible Assets Disclosure [Abstract] | ||
Goodwill, Balance beginning | 5,424 | 5,424 |
Acquisition and purchase accounting adjustments | 0 | |
Divestitures | 0 | 0 |
Reallocation | 0 | |
Impairments | 0 | |
Translation impact | 0 | 0 |
Goodwill, Balance ending | 5,424 | 5,424 |
Other | ||
Goodwill and Intangible Assets Disclosure [Abstract] | ||
Goodwill, Balance beginning | 1,598 | 2,561 |
Acquisition and purchase accounting adjustments | 1,077 | |
Divestitures | (152) | (1,533) |
Reallocation | (4) | |
Impairments | (370) | |
Translation impact | 56 | (133) |
Goodwill, Balance ending | $ 1,502 | $ 1,598 |
Medical Claims Liability - Sche
Medical Claims Liability - Schedule of Change in Medical Claims Liability (Details) - USD ($) $ in Millions | 6 Months Ended | |
Jun. 30, 2023 | Jun. 30, 2022 | |
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward] | ||
Balance, January 1 | $ 16,745 | $ 14,243 |
Less: Reinsurance recoverable | 26 | 23 |
Balance, January 1, net | 16,719 | 14,220 |
Acquisitions and divestitures | 249 | |
Incurred related to: | ||
Current year | 60,335 | 56,179 |
Prior years | (1,554) | (1,029) |
Total incurred | 58,781 | 55,150 |
Paid related to: | ||
Current year | 46,970 | 42,886 |
Prior years | 11,666 | 10,161 |
Total paid | 58,636 | 53,047 |
Balance, June 30, net | 16,864 | 16,572 |
Plus: Reinsurance recoverable | 20 | 9 |
Balance, June 30 | 16,884 | 16,581 |
Medicaid | ||
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward] | ||
Balance, January 1 | 11,253 | 9,845 |
Less: Reinsurance recoverable | 7 | 23 |
Balance, January 1, net | 11,246 | 9,822 |
Acquisitions and divestitures | 0 | |
Incurred related to: | ||
Current year | 40,622 | 37,803 |
Prior years | (1,153) | (770) |
Total incurred | 39,469 | 37,033 |
Paid related to: | ||
Current year | 31,837 | 29,007 |
Prior years | 7,890 | 6,808 |
Total paid | 39,727 | 35,815 |
Balance, June 30, net | 10,988 | 11,040 |
Plus: Reinsurance recoverable | 5 | 9 |
Balance, June 30 | 10,993 | 11,049 |
Medicare | ||
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward] | ||
Balance, January 1 | 3,431 | 2,286 |
Less: Reinsurance recoverable | 0 | 0 |
Balance, January 1, net | 3,431 | 2,286 |
Acquisitions and divestitures | 0 | |
Incurred related to: | ||
Current year | 10,083 | 9,918 |
Prior years | (191) | (46) |
Total incurred | 9,892 | 9,872 |
Paid related to: | ||
Current year | 7,726 | 6,977 |
Prior years | 2,357 | 1,784 |
Total paid | 10,083 | 8,761 |
Balance, June 30, net | 3,240 | 3,397 |
Plus: Reinsurance recoverable | 0 | 0 |
Balance, June 30 | 3,240 | 3,397 |
Commercial | ||
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward] | ||
Balance, January 1 | 1,921 | 2,014 |
Less: Reinsurance recoverable | 19 | 0 |
Balance, January 1, net | 1,902 | 2,014 |
Acquisitions and divestitures | 0 | |
Incurred related to: | ||
Current year | 8,857 | 7,001 |
Prior years | (208) | (198) |
Total incurred | 8,649 | 6,803 |
Paid related to: | ||
Current year | 6,751 | 5,475 |
Prior years | 1,282 | 1,489 |
Total paid | 8,033 | 6,964 |
Balance, June 30, net | 2,518 | 1,853 |
Plus: Reinsurance recoverable | 15 | 0 |
Balance, June 30 | 2,533 | 1,853 |
Other | ||
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward] | ||
Balance, January 1 | 140 | 98 |
Less: Reinsurance recoverable | 0 | 0 |
Balance, January 1, net | 140 | 98 |
Acquisitions and divestitures | 249 | |
Incurred related to: | ||
Current year | 773 | 1,457 |
Prior years | (2) | (15) |
Total incurred | 771 | 1,442 |
Paid related to: | ||
Current year | 656 | 1,427 |
Prior years | 137 | 80 |
Total paid | 793 | 1,507 |
Balance, June 30, net | 118 | 282 |
Plus: Reinsurance recoverable | 0 | 0 |
Balance, June 30 | $ 118 | $ 282 |
Medical Claims Liability - Narr
Medical Claims Liability - Narrative (Details) - USD ($) $ in Millions | 6 Months Ended | |
Jun. 30, 2023 | Jun. 30, 2022 | |
Insurance [Abstract] | ||
Amounts recorded as an adjustment to premium revenues related to minimum HBR and return of premium programs | $ 319 | $ 48 |
Short-duration insurance contracts, Incurred but not reported and expected development on reported claims | $ 11,360 |
Affordable Care Act - Net Recei
Affordable Care Act - Net Receivables (Payables) for Each of the Ongoing Programs (Details) - USD ($) $ in Millions | Jun. 30, 2023 | Dec. 31, 2022 |
Affordable Care Act [Abstract] | ||
Risk adjustment receivable | $ 1,088 | $ 838 |
Risk adjustment payable | (2,303) | (780) |
Minimum medical loss ratio | (233) | (103) |
Cost sharing reduction receivable | 2 | 0 |
Cost sharing reduction payable | $ (87) | $ (99) |
Affordable Care Act - Additiona
Affordable Care Act - Additional information (Details) $ in Millions | 6 Months Ended |
Jun. 30, 2023 USD ($) | |
Affordable Care Act [Abstract] | |
Risk adjustment, increase to net receivables | $ 240 |
Risk adjustment and reinsurance pre-tax benefit | $ (196) |
Debt - Schedule of Debt (Detail
Debt - Schedule of Debt (Details) - USD ($) | Jun. 30, 2023 | Dec. 31, 2022 |
Debt Instrument [Line Items] | ||
Total senior notes | $ 15,674,000,000 | $ 15,673,000,000 |
Finance leases and other | 250,000,000 | 253,000,000 |
Debt issuance costs | (135,000,000) | (147,000,000) |
Total debt | 18,006,000,000 | 18,020,000,000 |
Less: current portion | (110,000,000) | (82,000,000) |
Long-term debt | 17,896,000,000 | 17,938,000,000 |
Revolving credit agreement | ||
Debt Instrument [Line Items] | ||
Credit facility | 61,000,000 | 58,000,000 |
Term loan facility | ||
Debt Instrument [Line Items] | ||
Credit facility | 2,156,000,000 | 2,183,000,000 |
$2,500 million 4.25% Senior Notes due December 15, 2027 | Senior Notes | ||
Debt Instrument [Line Items] | ||
Debt, face amount | $ 2,500,000,000 | |
Interest rate | 4.25% | |
Senior notes | $ 2,394,000,000 | 2,393,000,000 |
$2,300 million 2.45% Senior Notes due July 15, 2028 | Senior Notes | ||
Debt Instrument [Line Items] | ||
Debt, face amount | $ 2,300,000,000 | |
Interest rate | 2.45% | |
Senior notes | $ 2,303,000,000 | 2,303,000,000 |
$3,500 million 4.625% Senior Notes due December 15, 2029 | Senior Notes | ||
Debt Instrument [Line Items] | ||
Debt, face amount | $ 3,500,000,000 | |
Interest rate | 4.625% | |
Senior notes | $ 3,277,000,000 | 3,277,000,000 |
$2,000 million 3.375% Senior Notes due February 15, 2030 | Senior Notes | ||
Debt Instrument [Line Items] | ||
Debt, face amount | $ 2,000,000,000 | |
Interest rate | 3.375% | |
Senior notes | $ 2,000,000,000 | 2,000,000,000 |
$2,200 million 3.00% Senior Notes due October 15, 2030 | Senior Notes | ||
Debt Instrument [Line Items] | ||
Debt, face amount | $ 2,200,000,000 | |
Interest rate | 3% | |
Senior notes | $ 2,200,000,000 | 2,200,000,000 |
$2,200 million 2.50% Senior Notes due March 1, 2031 | Senior Notes | ||
Debt Instrument [Line Items] | ||
Debt, face amount | $ 2,200,000,000 | |
Interest rate | 2.50% | |
Senior notes | $ 2,200,000,000 | 2,200,000,000 |
$1,300 million 2.625% Senior Notes due August 1, 2031 | Senior Notes | ||
Debt Instrument [Line Items] | ||
Debt, face amount | $ 1,300,000,000 | |
Interest rate | 2.625% | |
Senior notes | $ 1,300,000,000 | $ 1,300,000,000 |
Leases - Right-of-use (ROU) Ass
Leases - Right-of-use (ROU) Assets and Lease Liabilities (Details) - USD ($) $ in Millions | Jun. 30, 2023 | Dec. 31, 2022 |
Assets | ||
ROU assets (recorded within other long-term assets) | $ 2,613 | $ 2,554 |
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List] | Other long-term assets | Other long-term assets |
Liabilities | ||
Short-term (recorded within accounts payable and accrued expenses) | $ 176 | $ 180 |
Long-term (recorded within other long-term liabilities) | 3,171 | 3,133 |
Total lease liabilities | $ 3,347 | $ 3,313 |
Operating Lease, Liability, Current, Statement of Financial Position [Extensible List] | Accounts payable and accrued expenses | Accounts payable and accrued expenses |
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible List] | Other long-term liabilities | Other long-term liabilities |
Leases - Narrative (Details)
Leases - Narrative (Details) | Jun. 30, 2023 |
Lessee, Lease, Description [Line Items] | |
Weighted average remaining lease term | 21 years |
Weighted-average discount rate for operating leases | 5.90% |
Circle Health | |
Lessee, Lease, Description [Line Items] | |
Weighted average remaining lease term | 27 years 3 months 18 days |
Excluding Circle Health | |
Lessee, Lease, Description [Line Items] | |
Weighted average remaining lease term | 8 years 4 months 24 days |
Stockholders' Equity - Narrativ
Stockholders' Equity - Narrative (Details) - USD ($) shares in Millions, $ in Millions | 1 Months Ended | 3 Months Ended | |||||
Jul. 28, 2023 | Dec. 31, 2022 | Jun. 30, 2022 | Jun. 30, 2023 | Mar. 31, 2023 | Jun. 30, 2022 | Mar. 31, 2022 | |
Equity, Class of Treasury Stock [Line Items] | |||||||
Stock repurchase program, increase to authorized amount | $ 2,000 | $ 3,000 | |||||
Stock repurchase program, authorized amount | $ 6,000 | ||||||
Stock repurchase program, remaining available | 2,029 | ||||||
Common stock repurchases | $ 408 | $ 423 | $ 349 | $ 71 | |||
Subsequent Event | |||||||
Equity, Class of Treasury Stock [Line Items] | |||||||
Common stock repurchases (in shares) | 4.5 | ||||||
Common stock repurchases | $ 300 |
Stockholders' Equity - Share Re
Stockholders' Equity - Share Repurchase Activity (Details) - USD ($) shares in Thousands, $ in Millions | 3 Months Ended | 6 Months Ended | ||||
Jun. 30, 2023 | Mar. 31, 2023 | Jun. 30, 2022 | Mar. 31, 2022 | Jun. 30, 2023 | Jun. 30, 2022 | |
Subsidiary, Sale of Stock [Line Items] | ||||||
Common stock repurchases | $ 408 | $ 423 | $ 349 | $ 71 | ||
Stock repurchases, excise tax accrual | $ 3 | $ 3 | ||||
Employee Stock Compensation Plan | ||||||
Subsidiary, Sale of Stock [Line Items] | ||||||
Income tax withholding (in shares) | 71 | 61 | 767 | 907 | ||
Income tax withholding | $ 5 | $ 5 | $ 51 | $ 76 | ||
Common Stock | ||||||
Subsidiary, Sale of Stock [Line Items] | ||||||
Share buybacks (in shares) | 6,028 | 4,188 | 10,880 | 4,188 | ||
Common stock repurchases (in shares) | 6,099 | 4,249 | 11,647 | 5,095 | ||
Share buybacks | $ 400 | $ 344 | $ 777 | $ 344 | ||
Common stock repurchases | $ 405 | $ 349 | $ 828 | $ 420 |
Earnings Per Share (Details)
Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2023 | Jun. 30, 2022 | Jun. 30, 2023 | Jun. 30, 2022 | |
Net Income (Loss) Attributable to Parent [Abstract] | ||||
Earnings (loss) attributable to Centene Corporation | $ 1,058 | $ (172) | $ 2,188 | $ 677 |
Shares used in computing per share amounts: | ||||
Weighted average number of common shares outstanding (in shares) | 548,932 | 583,644 | 549,850 | 583,435 |
Common stock equivalents (as determined by applying the treasury stock method) (in shares) | 1,376 | 0 | 2,146 | 6,791 |
Weighted average number of common shares and potential dilutive common shares outstanding (in shares) | 550,308 | 583,644 | 551,996 | 590,226 |
Net earnings (loss) per common share attributable to Centene Corporation: | ||||
Basic earnings (loss) per common share (in dollars per share) | $ 1.93 | $ (0.29) | $ 3.98 | $ 1.16 |
Diluted earnings (loss) per common share (in dollars per share) | $ 1.92 | $ (0.29) | $ 3.96 | $ 1.15 |
Anti-dilutive restricted stock and restricted stock units excluded from the calculation of diluted earnings (loss) per common share (in shares) | 2,000 | 6,000 | 2,000 | 226 |
Segment Information (Details)
Segment Information (Details) - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2023 | Jun. 30, 2022 | Jun. 30, 2023 | Jun. 30, 2022 | |
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | $ 34,838 | $ 33,968 | $ 69,790 | $ 68,200 |
Premium tax | 2,770 | 1,968 | 6,707 | 4,921 |
Total external revenues | 37,608 | 35,936 | 76,497 | 73,121 |
Revenues | 37,608 | 35,936 | 76,497 | 73,121 |
Medical costs | 29,347 | 27,312 | 58,781 | 55,150 |
Cost of services | 877 | 2,099 | 1,747 | 4,087 |
Gross margin | 4,614 | 4,557 | 9,262 | 8,963 |
Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | 3,789 | 5,986 | 7,656 | 12,436 |
Eliminations | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | (3,789) | (5,986) | (7,656) | (12,436) |
Premium | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 33,713 | 31,510 | 67,538 | 63,399 |
Service | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 1,125 | 2,458 | 2,252 | 4,801 |
Premium and service revenues | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 34,838 | 33,968 | 69,790 | 68,200 |
Medicaid | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | 24,665 | 22,455 | 50,829 | 46,529 |
Medical costs | 19,459 | 18,258 | 39,469 | 37,033 |
Cost of services | 2 | 0 | 2 | 0 |
Gross margin | 2,434 | 2,229 | 4,651 | 4,575 |
Medicaid | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium tax | 2,770 | 1,968 | 6,707 | 4,921 |
Total external revenues | 24,665 | 22,455 | 50,829 | 46,529 |
Revenues | 0 | 0 | 0 | 0 |
Medicaid | Eliminations | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | 0 | 0 | 0 | 0 |
Medicaid | Premium | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 21,895 | 20,488 | 44,122 | 41,609 |
Medicaid | Service | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 0 | (1) | 0 | (1) |
Medicaid | Premium and service revenues | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 21,895 | 20,487 | 44,122 | 41,608 |
Medicare | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | 5,665 | 5,639 | 11,541 | 11,396 |
Medical costs | 4,884 | 4,826 | 9,892 | 9,872 |
Cost of services | 0 | 0 | 0 | 0 |
Gross margin | 781 | 813 | 1,649 | 1,524 |
Medicare | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium tax | 0 | 0 | 0 | 0 |
Total external revenues | 5,665 | 5,639 | 11,541 | 11,396 |
Revenues | 0 | 0 | 0 | 0 |
Medicare | Eliminations | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | 0 | 0 | 0 | 0 |
Medicare | Premium | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 5,665 | 5,639 | 11,541 | 11,396 |
Medicare | Service | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 0 | 0 | 0 | 0 |
Medicare | Premium and service revenues | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 5,665 | 5,639 | 11,541 | 11,396 |
Commercial | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | 5,734 | 4,555 | 10,986 | 8,687 |
Medical costs | 4,644 | 3,529 | 8,649 | 6,803 |
Cost of services | 0 | 0 | 0 | 0 |
Gross margin | 1,090 | 1,026 | 2,337 | 1,884 |
Commercial | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium tax | 0 | 0 | 0 | 0 |
Total external revenues | 5,734 | 4,555 | 10,986 | 8,687 |
Revenues | 0 | 0 | 0 | 0 |
Commercial | Eliminations | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | 0 | 0 | 0 | 0 |
Commercial | Premium | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 5,734 | 4,554 | 10,986 | 8,686 |
Commercial | Service | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 0 | 1 | 0 | 1 |
Commercial | Premium and service revenues | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 5,734 | 4,555 | 10,986 | 8,687 |
Other/Eliminations | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | 1,544 | 3,287 | 3,141 | 6,509 |
Medical costs | 360 | 699 | 771 | 1,442 |
Cost of services | 875 | 2,099 | 1,745 | 4,087 |
Gross margin | 309 | 489 | 625 | 980 |
Other/Eliminations | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium tax | 0 | 0 | 0 | 0 |
Total external revenues | 1,544 | 3,287 | 3,141 | 6,509 |
Revenues | 3,789 | 5,986 | 7,656 | 12,436 |
Other/Eliminations | Eliminations | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | (3,789) | (5,986) | (7,656) | (12,436) |
Other/Eliminations | Premium | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 419 | 829 | 889 | 1,708 |
Other/Eliminations | Service | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 1,125 | 2,458 | 2,252 | 4,801 |
Other/Eliminations | Premium and service revenues | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | $ 1,544 | $ 3,287 | $ 3,141 | $ 6,509 |
Contingencies (Details)
Contingencies (Details) - Pending Litigation $ in Millions | Sep. 30, 2021 claim | Jun. 30, 2021 USD ($) |
Loss Contingencies [Line Items] | ||
Pending claims | claim | 3 | |
Reserve estimate | $ | $ 1,250 |