Cover
Cover - shares shares in Thousands | 9 Months Ended | |
Sep. 30, 2023 | Oct. 20, 2023 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Sep. 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 $0.001 Par Value | |
Trading Symbol | CNC | |
Security Exchange Name | NYSE | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Large Accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Shell Company | false | |
Entity Common Stock, Shares Outstanding | 534,201 | |
Entity Central Index Key | 0001071739 | |
Current Fiscal Year End Date | --12-31 | |
Document Fiscal Year Focus | 2023 | |
Document Fiscal Period Focus | Q3 | |
Amendment Flag | false |
CONSOLIDATED BALANCE SHEETS
CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions | Sep. 30, 2023 | Dec. 31, 2022 |
Assets, Current [Abstract] | ||
Cash and cash equivalents | $ 18,190 | $ 12,074 |
Premium and trade receivables | 15,503 | 13,272 |
Short-term investments | 2,241 | 2,321 |
Other current assets | 5,471 | 2,461 |
Total current assets | 41,405 | 30,128 |
Long-term investments | 15,234 | 14,684 |
Restricted deposits | 1,343 | 1,217 |
Property, software and equipment, net | 2,004 | 2,432 |
Goodwill | 17,558 | 18,812 |
Intangible assets, net | 6,277 | 6,911 |
Other long-term assets | 560 | 2,686 |
Total assets | 84,381 | 76,870 |
Liabilities, Current [Abstract] | ||
Medical claims liability | 17,141 | 16,745 |
Accounts payable and accrued expenses | 15,081 | 9,525 |
Return of premium payable | 2,160 | 1,634 |
Unearned revenue | 2,356 | 478 |
Current portion of long-term debt | 113 | 82 |
Total current liabilities | 36,851 | 28,464 |
Long-term debt | 17,888 | 17,938 |
Deferred tax liability | 577 | 615 |
Other long-term liabilities | 3,649 | 5,616 |
Total liabilities | 58,965 | 52,633 |
Commitments and contingencies | ||
Redeemable noncontrolling interests | 21 | 56 |
Stockholders' equity: | ||
Preferred stock, $0.001 par value; authorized 10,000 shares; no shares issued or outstanding at September 30, 2023 and December 31, 2022 | 0 | 0 |
Common stock, $0.001 par value; authorized 800,000 shares; 614,956 issued and 534,596 outstanding at September 30, 2023, and 607,847 issued and 550,754 outstanding at December 31, 2022 | 1 | 1 |
Additional paid-in capital | 20,243 | 20,060 |
Accumulated other comprehensive (loss) | (1,122) | (1,132) |
Retained earnings | 11,998 | 9,341 |
Treasury stock, at cost (80,360 and 57,093 shares, respectively) | (5,825) | (4,213) |
Total Centene stockholders' equity | 25,295 | 24,057 |
Nonredeemable noncontrolling interest | 100 | 124 |
Total stockholders' equity | 25,395 | 24,181 |
Total liabilities, redeemable noncontrolling interests and stockholders' equity | $ 84,381 | $ 76,870 |
CONSOLIDATED BALANCE SHEETS (Pa
CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares | Sep. 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) | 614,956,000 | 607,847,000 |
Common stock, shares outstanding (in shares) | 534,596,000 | 550,754,000 |
Treasury stock (in shares) | 80,360,000 | 57,093,000 |
CONSOLIDATED STATEMENTS OF OPER
CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Millions | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Revenues: | ||||
Premium and service revenues | $ 34,967 | $ 33,726 | $ 104,757 | $ 101,926 |
Premium tax | 3,075 | 2,139 | 9,782 | 7,060 |
Total revenues | 38,042 | 35,865 | 114,539 | 108,986 |
Expenses: | ||||
Medical costs | 29,479 | 28,111 | 88,260 | 83,261 |
Cost of services | 856 | 1,571 | 2,603 | 5,658 |
Selling, general and administrative expenses | 3,048 | 2,846 | 9,075 | 8,391 |
Depreciation expense | 148 | 150 | 436 | 470 |
Amortization of acquired intangible assets | 180 | 211 | 542 | 609 |
Premium tax expense | 3,156 | 2,211 | 10,021 | 7,258 |
Impairment | 440 | 289 | 478 | 1,739 |
Total operating expenses | 37,307 | 35,389 | 111,415 | 107,386 |
Earnings from operations | 735 | 476 | 3,124 | 1,600 |
Other income (expense): | ||||
Investment and other income | 214 | 692 | 992 | 786 |
Debt extinguishment | 0 | 10 | 0 | 26 |
Interest expense | (181) | (169) | (542) | (491) |
Earnings before income tax | 768 | 1,009 | 3,574 | 1,921 |
Income tax expense | 293 | 269 | 914 | 500 |
Net earnings | 475 | 740 | 2,660 | 1,421 |
(Earnings) attributable to noncontrolling interests | (6) | (2) | (3) | (6) |
Net earnings attributable to Centene Corporation | $ 469 | $ 738 | $ 2,657 | $ 1,415 |
Net earnings per common share attributable to Centene Corporation: | ||||
Basic earnings per common share (in dollars per share) | $ 0.87 | $ 1.29 | $ 4.86 | $ 2.44 |
Diluted earnings per common share (in dollars per share) | $ 0.87 | $ 1.27 | $ 4.85 | $ 2.41 |
Weighted average number of common shares outstanding: | ||||
Basic (in shares) | 539,535 | 573,961 | 546,374 | 580,277 |
Diluted (in shares) | 541,270 | 580,607 | 548,412 | 587,084 |
Premium | ||||
Revenues: | ||||
Premium and service revenues | $ 33,866 | $ 31,848 | $ 101,404 | $ 95,247 |
Service | ||||
Revenues: | ||||
Premium and service revenues | $ 1,101 | $ 1,878 | $ 3,353 | $ 6,679 |
CONSOLIDATED STATEMENTS OF COMP
CONSOLIDATED STATEMENTS OF COMPREHENSIVE EARNINGS (LOSS) - USD ($) $ in Millions | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Statement of Comprehensive Income [Abstract] | ||||
Net earnings | $ 475 | $ 740 | $ 2,660 | $ 1,421 |
Change in unrealized gain (loss) on investments | (235) | (503) | (124) | (1,664) |
Change in unrealized gain (loss) on investments, tax effect | 56 | 120 | 29 | 397 |
Change in unrealized gain (loss) on investments, net of tax | (179) | (383) | (95) | (1,267) |
Reclassification adjustment, net of tax | 57 | 3 | 61 | 12 |
Foreign currency translation adjustments, net of tax | (22) | (101) | 24 | (216) |
Net unrealized gain on cash flow hedge, net of tax | 20 | 0 | 20 | 0 |
Other comprehensive earnings (loss) | (124) | (481) | 10 | (1,471) |
Comprehensive earnings (loss) | 351 | 259 | 2,670 | (50) |
Comprehensive (earnings) attributable to noncontrolling interests | (6) | (2) | (3) | (6) |
Comprehensive earnings (loss) attributable to Centene Corporation | $ 345 | $ 257 | $ 2,667 | $ (56) |
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 | (1,471) | ||||||
Balance (in shares) at Sep. 30, 2022 | 606,931 | ||||||
Treasury stock (in shares) at Sep. 30, 2022 | 36,840 | ||||||
Balance at Sep. 30, 2022 | 25,534 | $ 1 | 19,774 | (1,394) | 9,554 | $ (2,557) | 156 |
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 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Net earnings (loss) | 736 | 738 | (2) | ||||
Other comprehensive earnings (loss), net of tax | (481) | (481) | |||||
Common stock issued for employee benefit plans (in shares) | 487 | ||||||
Common stock issued for employee benefit plans | 24 | 24 | |||||
Common stock repurchases (in shares) | 11,520 | ||||||
Common stock repurchases | (1,243) | (200) | $ (1,043) | ||||
Stock compensation expense | 51 | 51 | |||||
Reclassification to redeemable | 17 | 17 | |||||
Balance (in shares) at Sep. 30, 2022 | 606,931 | ||||||
Treasury stock (in shares) at Sep. 30, 2022 | 36,840 | ||||||
Balance at Sep. 30, 2022 | $ 25,534 | $ 1 | 19,774 | (1,394) | 9,554 | $ (2,557) | 156 |
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 | $ 10 | ||||||
Balance (in shares) at Sep. 30, 2023 | 534,596 | 614,956 | |||||
Treasury stock (in shares) at Sep. 30, 2023 | 80,360 | 80,360 | |||||
Balance at Sep. 30, 2023 | $ 25,395 | $ 1 | 20,243 | (1,122) | 11,998 | $ (5,825) | 100 |
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 | 614,743 | ||||||
Treasury stock (in shares) at Jun. 30, 2023 | 68,740 | ||||||
Balance at Jun. 30, 2023 | 25,768 | $ 1 | 20,183 | (998) | 11,529 | $ (5,044) | 97 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Net earnings (loss) | 472 | 469 | 3 | ||||
Other comprehensive earnings (loss), net of tax | (124) | (124) | |||||
Common stock issued for employee benefit plans (in shares) | 213 | ||||||
Common stock issued for employee benefit plans | 11 | 11 | |||||
Common stock repurchases (in shares) | 11,620 | ||||||
Common stock repurchases | (781) | $ (781) | |||||
Stock compensation expense | 50 | 50 | |||||
Purchase of redeemable and non-redeemable noncontrolling interest | $ (1) | (1) | |||||
Balance (in shares) at Sep. 30, 2023 | 534,596 | 614,956 | |||||
Treasury stock (in shares) at Sep. 30, 2023 | 80,360 | 80,360 | |||||
Balance at Sep. 30, 2023 | $ 25,395 | $ 1 | $ 20,243 | $ (1,122) | $ 11,998 | $ (5,825) | $ 100 |
CONSOLIDATED STATEMENTS OF ST_2
CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (Parenthetical) - USD ($) $ in Millions | 3 Months Ended | |||||||
Sep. 30, 2023 | Jun. 30, 2023 | Mar. 31, 2023 | Sep. 30, 2022 | Jun. 30, 2022 | Mar. 31, 2022 | Dec. 31, 2022 | Dec. 31, 2021 | |
Par value (in dollars per share) | $ 0.001 | $ 0.001 | ||||||
Other comprehensive earning (loss), tax | $ (34) | $ (34) | $ 61 | $ (120) | $ (106) | $ (171) | ||
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 | 9 Months Ended | 12 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | Dec. 31, 2022 | |
Cash flows from operating activities: | |||||
Net earnings | $ 475 | $ 740 | $ 2,660 | $ 1,421 | |
Adjustments to reconcile net earnings to net cash provided by operating activities | |||||
Depreciation and amortization | 978 | 1,079 | |||
Stock compensation expense | 167 | 180 | |||
Impairment | 440 | 289 | 478 | 1,739 | |
(Gain) loss on debt extinguishment | 0 | (26) | |||
Deferred income taxes | 14 | (682) | |||
(Gain) loss on divestitures | (172) | (503) | |||
Other adjustments, net | 158 | 164 | |||
Changes in assets and liabilities | |||||
Premium and trade receivables | (2,329) | (1,274) | |||
Other assets | (103) | 152 | |||
Medical claims liabilities | 401 | 1,976 | |||
Unearned revenue | 1,878 | 1,964 | |||
Accounts payable and accrued expenses | 3,127 | 686 | |||
Other long-term liabilities | 583 | 863 | |||
Other operating activities, net | (4) | 98 | |||
Net cash provided by operating activities | 7,836 | 7,837 | |||
Cash flows from investing activities: | |||||
Capital expenditures | (576) | (771) | |||
Purchases of investments | (4,729) | (5,118) | |||
Sales and maturities of investments | 4,373 | 2,842 | |||
Acquisitions, net of cash acquired | 0 | (1,457) | |||
Divestiture proceeds, net of divested cash | 690 | 1,362 | |||
Net cash (used in) investing activities | (242) | (3,142) | |||
Cash flows from financing activities: | |||||
Proceeds from long-term debt | 2,170 | 357 | |||
Payments and repurchases of long-term debt | (1,970) | (1,202) | |||
Common stock repurchases | (1,602) | (1,663) | |||
Proceeds from common stock issuances | 32 | 62 | |||
Payments for debt extinguishment | 0 | (14) | |||
Purchase of noncontrolling interest | (87) | 0 | |||
Other financing activities, net | 0 | (5) | |||
Net cash (used in) financing activities | (1,457) | (2,465) | |||
Effect of exchange rate changes on cash, cash equivalents, and restricted cash | 19 | (37) | |||
Net increase in cash, cash equivalents, and restricted cash and cash equivalents | 6,156 | 2,193 | |||
Cash and cash equivalents reclassified from (to) held for sale | (36) | (192) | (36) | (192) | |
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 | 18,450 | 15,215 | 18,450 | 15,215 | 12,330 |
Supplemental disclosures of cash flow information: | |||||
Interest paid | 496 | 462 | |||
Income taxes paid | 759 | 448 | |||
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 | 18,190 | 14,987 | 18,190 | 14,987 | 12,074 |
Restricted cash and cash equivalents, included in restricted deposits | 260 | 228 | 260 | 228 | |
Total cash, cash equivalents, and restricted cash and cash equivalents | $ 18,450 | $ 15,215 | $ 18,450 | $ 15,215 | $ 12,330 |
Organization and Operations
Organization and Operations | 9 Months Ended |
Sep. 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 product along with individual, small group, and large group commercial health insurance 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 | 9 Months Ended |
Sep. 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 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 in 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 in 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 in the Consolidated Statements of Operations. Circle Health Group Divestiture On August 28, 2023, the Company signed a definitive agreement to sell Circle Health Group (Circle Health), one of the U.K.'s largest independent hospital operators, which is included in the Other segment. As of September 30, 2023, the assets and liabilities of Circle Health were considered held for sale resulting in $3,744 million of assets held for sale in other current assets and $2,947 million of liabilities held for sale in accounts payable and accrued expenses in the Consolidated Balance Sheet. The majority of the held for sale assets were previously reported as other long-term assets, goodwill and property, software and equipment. The majority of the liabilities were previously reported as debt and other long-term liabilities. During the third quarter of 2023, the Company recorded an impairment charge related to goodwill associated with the pending divestiture of $251 million, or $269 million after-tax. In order to manage the foreign exchange risk on the sale price associated with the pending divestiture of Circle Health, in August 2023 the Company entered into a foreign currency swap agreement for a notional amount of $931 million, to sell £740 million. The swap agreement was formally designated and qualified as a cash flow hedge. The swap expires on March 28, 2024. The gain or loss due to changes in the fair value of the foreign currency swap is recorded in other comprehensive income until the Circle Health divestiture closes, at which time the gain or loss will be recorded in earnings to the same line in the Consolidated Statement of Operations as the gain or loss on sale. The fair value of the swap agreement as of September 30, 2023 was $27 million, which was recorded in other current assets in the Consolidated Balance Sheet. |
Short-term and Long-term Invest
Short-term and Long-term Investments, Restricted Deposits | 9 Months Ended |
Sep. 30, 2023 | |
Investments, Debt and Equity Securities [Abstract] | |
Short-term and Long-term Investments, Restricted Deposits | Short-term and Long-term Investments, Restricted Deposits Short-term and long-term investments and restricted deposits by investment type consist of the following ($ in millions): September 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 $ 421 $ — $ (13) $ 408 $ 695 $ — $ (16) $ 679 Corporate securities 9,922 2 (750) 9,174 10,127 12 (778) 9,361 Restricted certificates of deposit 4 — — 4 4 — — 4 Restricted cash equivalents 260 — — 260 256 — — 256 Short-term time deposits 470 — — 470 204 — — 204 Municipal securities 3,931 1 (294) 3,638 4,055 6 (280) 3,781 Asset-backed securities 1,633 2 (52) 1,583 1,396 — (70) 1,326 Residential mortgage-backed securities 1,475 — (172) 1,303 1,165 2 (121) 1,046 Commercial mortgage-backed securities 1,100 — (112) 988 961 — (99) 862 Equity securities 2 — — 2 5 — — 5 Private equity investments 810 — — 810 529 — — 529 Life insurance contracts 178 — — 178 169 — — 169 Total $ 20,206 $ 5 $ (1,393) $ 18,818 $ 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. Private equity investments include direct investments in private equity securities as well as private equity funds. 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 September 30, 2023, 99% of the Company's investments in rated securities carry an investment grade rating by nationally recognized statistical rating organizations. At September 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 $144 million and $132 million at September 30, 2023 and December 31, 2022, respectively, and is included in other current assets in the Consolidated Balance Sheets. The Company's residential mortgage-backed securities are primarily issued by the Federal National Mortgage Association, Government National Mortgage Association, or Federal Home Loan Mortgage Corporation, which carry implicit or explicit guarantees of the U.S. government. The Company's commercial mortgage-backed securities are primarily senior tranches with a weighted average rating of AA+ and a weighted average duration of 4 years at September 30, 2023. The fair value of available-for-sale debt securities with gross unrealized losses by investment type and length of time that individual securities have been in a continuous unrealized loss position were as follows ($ in millions): September 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 $ (1) $ 161 $ (12) $ 247 $ (5) $ 342 $ (11) $ 184 Corporate securities (76) 2,470 (674) 6,393 (340) 5,368 (438) 3,400 Municipal securities (44) 1,308 (250) 2,211 (142) 2,437 (138) 995 Asset-backed securities (7) 486 (45) 946 (29) 786 (41) 486 Residential mortgage-backed securities (23) 517 (149) 786 (55) 629 (66) 352 Commercial mortgage-backed securities (11) 228 (101) 748 (49) 513 (50) 330 Total $ (162) $ 5,170 $ (1,231) $ 11,331 $ (620) $ 10,075 $ (744) $ 5,747 As of September 30, 2023, the gross unrealized losses were generated from 6,355 positions out of a total of 6,604 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): September 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 $ 2,121 $ 2,091 $ 537 $ 534 $ 2,207 $ 2,179 $ 534 $ 532 One year through five years 7,421 6,906 531 496 7,651 7,147 524 490 Five years through ten years 3,931 3,501 312 282 4,066 3,613 224 195 Greater than ten years 123 113 32 31 135 129 — — Asset-backed securities 4,208 3,874 — — 3,522 3,234 — — Total $ 17,804 $ 16,485 $ 1,412 $ 1,343 $ 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 substantially all of the securities included in the greater than ten years category listed above at amortized cost. |
Fair Value Measurements
Fair Value Measurements | 9 Months Ended |
Sep. 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 September 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 $ 18,190 $ — $ — $ 18,190 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 81 $ — $ — $ 81 Corporate securities — 9,142 — 9,142 Municipal securities — 2,918 — 2,918 Short-term time deposits — 470 — 470 Asset-backed securities — 1,583 — 1,583 Residential mortgage-backed securities — 1,303 — 1,303 Commercial mortgage-backed securities — 988 — 988 Equity securities — 2 — 2 Total investments $ 81 $ 16,406 $ — $ 16,487 Restricted deposits: Cash and cash equivalents $ 260 $ — $ — $ 260 U.S. Treasury securities and obligations of U.S. government corporations and agencies 327 — — 327 Corporate securities — 32 — 32 Certificates of deposit — 4 — 4 Municipal securities — 720 — 720 Total restricted deposits $ 587 $ 756 $ — $ 1,343 Other current assets: Foreign currency swap agreement $ — $ 27 $ — $ 27 Total assets at fair value $ 18,858 $ 17,189 $ — $ 36,047 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 $698 million as of September 30, 2023 and December 31, 2022, respectively. |
Goodwill and Intangible Assets
Goodwill and Intangible Assets | 9 Months Ended |
Sep. 30, 2023 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
Goodwill and Intangible Assets | Goodwill and Intangible Assets As discussed in Note 1. Organization and Operations, in the first quarter of 2023, the Company updated its segment structure. Prior year information has been adjusted to reflect the change in segment reporting. The following table summarizes the changes in goodwill by operating segment ($ 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 — — — (933) (933) Impairments — — — (348) (348) Translation impact — — — 27 27 Balance, September 30, 2023 $ 10,198 $ 1,592 $ 5,424 $ 344 $ 17,558 The decrease in the Other segment goodwill in 2023 was primarily driven by the pending divestiture of Circle Health, which resulted in held for sale accounting and an impairment of $251 million as discussed in Note 2. Acquisitions and Divestitures, and an impairment of the Company's Operose Health business based on market indicators of fair value. |
Medical Claims Liability
Medical Claims Liability | 9 Months Ended |
Sep. 30, 2023 | |
Insurance [Abstract] | |
Medical Claims Liability | Medical Claims Liability As discussed in Note 1. Organization and Operations, in the first quarter of 2023, the Company updated its segment structure. Prior year information has been adjusted to reflect the change in segment reporting. The following table summarizes the change in medical claims liability for the nine months ended September 30, 2023 ($ 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 60,379 14,680 13,994 1,095 90,148 Prior years (1,303) (326) (256) (3) (1,888) Total incurred 59,076 14,354 13,738 1,092 88,260 Paid related to: Current year 50,774 12,069 11,575 984 75,402 Prior years 8,517 2,452 1,376 136 12,481 Total paid 59,291 14,521 12,951 1,120 87,883 Balance, September 30, 2023, net 11,031 3,264 2,689 112 17,096 Plus: Reinsurance recoverable 4 — 41 — 45 Balance, September 30, 2023 $ 11,035 $ 3,264 $ 2,730 $ 112 $ 17,141 The following table summarizes the change in medical claims liability for the nine months ended September 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 57,074 14,624 10,609 2,150 84,457 Prior years (966) (22) (193) (15) (1,196) Total incurred 56,108 14,602 10,416 2,135 83,261 Paid related to: Current year 47,481 11,603 9,046 2,175 70,305 Prior years 7,343 1,963 1,580 82 10,968 Total paid 54,824 13,566 10,626 2,257 81,273 Balance, September 30, 2022, net 11,106 3,322 1,804 225 16,457 Plus: Reinsurance recoverable 8 — — — 8 Balance, September 30, 2022 $ 11,114 $ 3,322 $ 1,804 $ 225 $ 16,465 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 development within "Incurred related to: Prior years," the Company recorded $341 million and $121 million as a reduction to premium revenue in the nine months ended September 30, 2023 and 2022, respectively, for minimum health benefits ratio (HBR) and other return of premium programs. Incurred but not reported (IBNR) plus expected development on reported claims as of September 30, 2023 was $11,661 million. Total IBNR plus expected development on reported claims represents estimates for claims incurred but not reported, development on reported claims, and estimates for the costs necessary to process unpaid claims at the end of each period. The Company estimates its liability using actuarial methods that are commonly used by health insurance actuaries and meet Actuarial Standards of Practice. These actuarial methods consider factors such as historical data for payment patterns, cost trends, product mix, seasonality, utilization of healthcare services, and other relevant factors. |
Affordable Care Act
Affordable Care Act | 9 Months Ended |
Sep. 30, 2023 | |
Affordable Care Act [Abstract] | |
Affordable Care Act | Affordable Care Act The Affordable Care Act established risk spreading premium stabilization programs as well as a minimum annual medical loss ratio (MLR) and cost sharing reductions. The Company's net receivables (payables) for each of the programs are as follows ($ in millions): September 30, 2023 December 31, 2022 Risk adjustment receivable $ 1,130 $ 838 Risk adjustment payable (2,312) (780) Minimum medical loss ratio (90) (103) Cost sharing reduction payable (104) (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 and subsequent to the announcement, the Company increased its risk adjustment net receivables by $244 million from December 31, 2022. After consideration of minimum MLR and other related impacts, the net pre-tax benefit recognized was approximately $198 million in the nine months ended September 30, 2023. |
Debt
Debt | 9 Months Ended |
Sep. 30, 2023 | |
Debt Disclosure [Abstract] | |
Debt | Debt Debt consists of the following ($ in millions): September 30, 2023 December 31, 2022 $2,500 million 4.25% Senior Notes due December 15, 2027 $ 2,395 $ 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 15,675 15,673 Term Loan Facility 2,142 2,183 Revolving Credit Agreement 309 58 Finance leases and other 3 253 Debt issuance costs (128) (147) Total debt 18,001 18,020 Less: current portion (113) (82) Long-term debt $ 17,888 $ 17,938 In May 2023, the Company entered into a first amendment to the Company's Fourth Amended and Restated Credit Agreement. The amendment removed and replaced the interest rate benchmark based on the London Interbank Offered Rate (LIBOR) and related LIBOR-based mechanics applicable to U.S. dollar borrowings under the Amended and Restated Credit Agreement with an interest rate benchmark based on the Secured Overnight Financing Rate (SOFR) (including a customary credit spread adjustment) and related SOFR-based mechanics. Additionally, the amendment removed certain provisions which required the Company to make certain mandatory prepayments of the Term Loan Facility. |
Leases
Leases | 9 Months Ended |
Sep. 30, 2023 | |
Leases [Abstract] | |
Leases | Leases The following table sets forth the right-of-use (ROU) assets and lease liabilities ($ in millions): September 30, 2023 December 31, 2022 Assets ROU assets (recorded within other long-term assets) $ 430 $ 2,554 Liabilities Short-term (recorded within accounts payable and accrued expenses) $ 170 $ 180 Long-term (recorded within other long-term liabilities) 936 3,133 Total lease liabilities $ 1,106 $ 3,313 The decrease in ROU assets and lease liabilities in 2023 was primarily driven by divestiture related activity as discussed in Note 2. Acquisitions and Divestitures . Specifically, as of September 30, 2023, Circle Health was considered held for sale and accordingly the associated ROU assets and lease liabilities were reclassified to other current assets and accounts payable and accrued expenses, respectively, in the Consolidated Balance Sheet. Additionally, in conjunction with ongoing real estate optimization initiatives, the Company recognized $35 million and $37 million of ROU asset impairments for the three and nine months ended September 30, 2023, respectively. The remainder of the $85 million real estate optimization impairment charge for the nine months ended September 30, 2023 was related to property, software and equipment. As of September 30, 2023, the weighted average remaining lease term for the Company was 20.3 years. The average remaining lease term of the Circle Health portfolio is 26.5 years. Excluding Circle Health, the Company's portfolio average remaining lease term is 8.3 years. The lease liabilities as of September 30, 2023, reflect a weighted average discount rate of 5.8%, or 3.2% excluding Circle Health. Excluding Circle Health, the Company had $51 million remaining in lease payments for 2023 as of September 30, 2023. Lease payments over the next five years and thereafter are as follows ($ in millions): Lease Payments 2024 $ 201 2025 176 2026 151 2027 133 2028 113 Thereafter 441 Total lease payments 1,215 Less: imputed interest (160) Total lease liabilities $ 1,055 |
Stockholders' Equity
Stockholders' Equity | 9 Months Ended |
Sep. 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 September 30, 2023, the Company had a remaining amount of $1,256 million available under the stock repurchase program. In October 2023, the Company repurchased an additional 397 thousand shares for $27 million. The following represents the Company's share repurchase activity ($ in millions, shares in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 (2) 2023 2022 (2) Shares Cost Shares Cost Shares Cost Shares Cost Share buybacks 11,609 $ 773 11,486 $ 1,040 22,489 $ 1,550 15,674 $ 1,384 Income tax withholding 11 1 34 3 778 52 941 79 Total share repurchases (1) 11,620 $ 774 11,520 $ 1,043 23,267 $ 1,602 16,615 $ 1,463 (1) Excludes share repurchase excise tax of $10 million accrued as of September 30, 2023. (2) Includes 8.6 million shares delivered as part of an accelerated share repurchase (ASR) agreement, representing 80% of the $1,000 million notional amount. Remaining shares were delivered in the fourth quarter of 2022 upon the settlement of the ASR. Shares repurchased for income tax withholding are shares withheld in connection with employee stock plans to meet applicable tax withholding requirements. These shares are typically included in the Company's treasury stock. |
Earnings Per Share
Earnings Per Share | 9 Months Ended |
Sep. 30, 2023 | |
Earnings Per Share [Abstract] | |
Earnings Per Share | Earnings Per Share The following table sets forth the calculation of basic and diluted net earnings per common share ($ in millions, except per share data in dollars and shares in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Earnings attributable to Centene Corporation $ 469 $ 738 $ 2,657 $ 1,415 Shares used in computing per share amounts: Weighted average number of common shares outstanding 539,535 573,961 546,374 580,277 Common stock equivalents (as determined by applying the treasury stock method) (1) 1,735 6,646 2,038 6,807 Weighted average number of common shares and potential dilutive common shares outstanding 541,270 580,607 548,412 587,084 Net earnings per common share attributable to Centene Corporation: Basic earnings per common share $ 0.87 $ 1.29 $ 4.86 $ 2.44 Diluted earnings per common share $ 0.87 $ 1.27 $ 4.85 $ 2.41 (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 September 30, 2023 and 2022 excludes 1,313 thousand shares and 152 thousand shares, respectively, related to anti-dilutive stock options, restricted stock, and restricted stock units. The calculation of diluted earnings per common share for the nine months ended September 30, 2023 and 2022 excludes 1,383 thousand shares and 193 thousand shares, respectively, related to anti-dilutive stock options, restricted stock, and restricted stock units. |
Segment Information
Segment Information | 9 Months Ended |
Sep. 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 September 30, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 21,619 $ 5,430 $ 6,451 $ 366 $ 33,866 Service — — 2 1,099 1,101 Premium and service revenues 21,619 5,430 6,453 1,465 34,967 Premium tax 3,075 — — — 3,075 Total external revenues 24,694 5,430 6,453 1,465 38,042 Internal revenues — — — 3,978 3,978 Eliminations — — — (3,978) (3,978) Total revenues $ 24,694 $ 5,430 $ 6,453 $ 1,465 $ 38,042 Medical costs $ 19,607 $ 4,462 $ 5,089 $ 321 $ 29,479 Cost of services $ — $ — $ — $ 856 $ 856 Gross margin (1) $ 2,012 $ 968 $ 1,364 $ 288 $ 4,632 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the three months ended September 30, 2022, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 21,154 $ 5,639 $ 4,291 $ 764 $ 31,848 Service — — 1 1,877 1,878 Premium and service revenues 21,154 5,639 4,292 2,641 33,726 Premium tax 2,139 — — — 2,139 Total external revenues 23,293 5,639 4,292 2,641 35,865 Internal revenues — — — 6,420 6,420 Eliminations — — — (6,420) (6,420) Total revenues $ 23,293 $ 5,639 $ 4,292 $ 2,641 $ 35,865 Medical costs $ 19,075 $ 4,730 $ 3,613 $ 693 $ 28,111 Cost of services $ — $ — $ — $ 1,571 $ 1,571 Gross margin (1) $ 2,079 $ 909 $ 679 $ 377 $ 4,044 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the nine months ended September 30, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 65,741 $ 16,971 $ 17,437 $ 1,255 $ 101,404 Service — — 2 3,351 3,353 Premium and service revenues 65,741 16,971 17,439 4,606 104,757 Premium tax 9,782 — — — 9,782 Total external revenues 75,523 16,971 17,439 4,606 114,539 Internal revenues — — — 11,634 11,634 Eliminations — — — (11,634) (11,634) Total revenues $ 75,523 $ 16,971 $ 17,439 $ 4,606 $ 114,539 Medical costs $ 59,076 $ 14,354 $ 13,738 $ 1,092 $ 88,260 Cost of services $ 2 $ — $ — $ 2,601 $ 2,603 Gross margin (1) $ 6,663 $ 2,617 $ 3,701 $ 913 $ 13,894 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the nine months ended September 30, 2022, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 62,763 $ 17,035 $ 12,977 $ 2,472 $ 95,247 Service (1) — 2 6,678 6,679 Premium and service revenues 62,762 17,035 12,979 9,150 101,926 Premium tax 7,060 — — — 7,060 Total external revenues 69,822 17,035 12,979 9,150 108,986 Internal revenues — — — 18,856 18,856 Eliminations — — — (18,856) (18,856) Total revenues $ 69,822 $ 17,035 $ 12,979 $ 9,150 $ 108,986 Medical costs $ 56,108 $ 14,602 $ 10,416 $ 2,135 $ 83,261 Cost of services $ — $ — $ — $ 5,658 $ 5,658 Gross margin (1) $ 6,654 $ 2,433 $ 2,563 $ 1,357 $ 13,007 (1) Gross margin represents premium and service revenues less medical costs and cost of services. |
Contingencies
Contingencies | 9 Months Ended |
Sep. 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. Accellion 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. |
Organization and Operations (Po
Organization and Operations (Policies) | 9 Months Ended |
Sep. 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 product along with individual, small group, and large group commercial health insurance 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) | 9 Months Ended |
Sep. 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): September 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 $ 421 $ — $ (13) $ 408 $ 695 $ — $ (16) $ 679 Corporate securities 9,922 2 (750) 9,174 10,127 12 (778) 9,361 Restricted certificates of deposit 4 — — 4 4 — — 4 Restricted cash equivalents 260 — — 260 256 — — 256 Short-term time deposits 470 — — 470 204 — — 204 Municipal securities 3,931 1 (294) 3,638 4,055 6 (280) 3,781 Asset-backed securities 1,633 2 (52) 1,583 1,396 — (70) 1,326 Residential mortgage-backed securities 1,475 — (172) 1,303 1,165 2 (121) 1,046 Commercial mortgage-backed securities 1,100 — (112) 988 961 — (99) 862 Equity securities 2 — — 2 5 — — 5 Private equity investments 810 — — 810 529 — — 529 Life insurance contracts 178 — — 178 169 — — 169 Total $ 20,206 $ 5 $ (1,393) $ 18,818 $ 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): September 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 $ (1) $ 161 $ (12) $ 247 $ (5) $ 342 $ (11) $ 184 Corporate securities (76) 2,470 (674) 6,393 (340) 5,368 (438) 3,400 Municipal securities (44) 1,308 (250) 2,211 (142) 2,437 (138) 995 Asset-backed securities (7) 486 (45) 946 (29) 786 (41) 486 Residential mortgage-backed securities (23) 517 (149) 786 (55) 629 (66) 352 Commercial mortgage-backed securities (11) 228 (101) 748 (49) 513 (50) 330 Total $ (162) $ 5,170 $ (1,231) $ 11,331 $ (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): September 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 $ 2,121 $ 2,091 $ 537 $ 534 $ 2,207 $ 2,179 $ 534 $ 532 One year through five years 7,421 6,906 531 496 7,651 7,147 524 490 Five years through ten years 3,931 3,501 312 282 4,066 3,613 224 195 Greater than ten years 123 113 32 31 135 129 — — Asset-backed securities 4,208 3,874 — — 3,522 3,234 — — Total $ 17,804 $ 16,485 $ 1,412 $ 1,343 $ 17,581 $ 16,302 $ 1,282 $ 1,217 |
Fair Value Measurements (Tables
Fair Value Measurements (Tables) | 9 Months Ended |
Sep. 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 September 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 $ 18,190 $ — $ — $ 18,190 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 81 $ — $ — $ 81 Corporate securities — 9,142 — 9,142 Municipal securities — 2,918 — 2,918 Short-term time deposits — 470 — 470 Asset-backed securities — 1,583 — 1,583 Residential mortgage-backed securities — 1,303 — 1,303 Commercial mortgage-backed securities — 988 — 988 Equity securities — 2 — 2 Total investments $ 81 $ 16,406 $ — $ 16,487 Restricted deposits: Cash and cash equivalents $ 260 $ — $ — $ 260 U.S. Treasury securities and obligations of U.S. government corporations and agencies 327 — — 327 Corporate securities — 32 — 32 Certificates of deposit — 4 — 4 Municipal securities — 720 — 720 Total restricted deposits $ 587 $ 756 $ — $ 1,343 Other current assets: Foreign currency swap agreement $ — $ 27 $ — $ 27 Total assets at fair value $ 18,858 $ 17,189 $ — $ 36,047 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) | 9 Months Ended |
Sep. 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 — — — (933) (933) Impairments — — — (348) (348) Translation impact — — — 27 27 Balance, September 30, 2023 $ 10,198 $ 1,592 $ 5,424 $ 344 $ 17,558 |
Medical Claims Liability (Table
Medical Claims Liability (Tables) | 9 Months Ended |
Sep. 30, 2023 | |
Insurance [Abstract] | |
Schedule of change in medical claims liability | The following table summarizes the change in medical claims liability for the nine months ended September 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 60,379 14,680 13,994 1,095 90,148 Prior years (1,303) (326) (256) (3) (1,888) Total incurred 59,076 14,354 13,738 1,092 88,260 Paid related to: Current year 50,774 12,069 11,575 984 75,402 Prior years 8,517 2,452 1,376 136 12,481 Total paid 59,291 14,521 12,951 1,120 87,883 Balance, September 30, 2023, net 11,031 3,264 2,689 112 17,096 Plus: Reinsurance recoverable 4 — 41 — 45 Balance, September 30, 2023 $ 11,035 $ 3,264 $ 2,730 $ 112 $ 17,141 The following table summarizes the change in medical claims liability for the nine months ended September 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 57,074 14,624 10,609 2,150 84,457 Prior years (966) (22) (193) (15) (1,196) Total incurred 56,108 14,602 10,416 2,135 83,261 Paid related to: Current year 47,481 11,603 9,046 2,175 70,305 Prior years 7,343 1,963 1,580 82 10,968 Total paid 54,824 13,566 10,626 2,257 81,273 Balance, September 30, 2022, net 11,106 3,322 1,804 225 16,457 Plus: Reinsurance recoverable 8 — — — 8 Balance, September 30, 2022 $ 11,114 $ 3,322 $ 1,804 $ 225 $ 16,465 |
Affordable Care Act (Tables)
Affordable Care Act (Tables) | 9 Months Ended |
Sep. 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): September 30, 2023 December 31, 2022 Risk adjustment receivable $ 1,130 $ 838 Risk adjustment payable (2,312) (780) Minimum medical loss ratio (90) (103) Cost sharing reduction payable (104) (99) |
Debt (Tables)
Debt (Tables) | 9 Months Ended |
Sep. 30, 2023 | |
Debt Disclosure [Abstract] | |
Schedule of Debt | Debt consists of the following ($ in millions): September 30, 2023 December 31, 2022 $2,500 million 4.25% Senior Notes due December 15, 2027 $ 2,395 $ 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 15,675 15,673 Term Loan Facility 2,142 2,183 Revolving Credit Agreement 309 58 Finance leases and other 3 253 Debt issuance costs (128) (147) Total debt 18,001 18,020 Less: current portion (113) (82) Long-term debt $ 17,888 $ 17,938 |
Leases (Tables)
Leases (Tables) | 9 Months Ended |
Sep. 30, 2023 | |
Leases [Abstract] | |
ROU Assets and Liabilities | The following table sets forth the right-of-use (ROU) assets and lease liabilities ($ in millions): September 30, 2023 December 31, 2022 Assets ROU assets (recorded within other long-term assets) $ 430 $ 2,554 Liabilities Short-term (recorded within accounts payable and accrued expenses) $ 170 $ 180 Long-term (recorded within other long-term liabilities) 936 3,133 Total lease liabilities $ 1,106 $ 3,313 |
Maturity of Operating Lease Liabilities | Lease payments over the next five years and thereafter are as follows ($ in millions): Lease Payments 2024 $ 201 2025 176 2026 151 2027 133 2028 113 Thereafter 441 Total lease payments 1,215 Less: imputed interest (160) Total lease liabilities $ 1,055 |
Stockholders' Equity (Tables)
Stockholders' Equity (Tables) | 9 Months Ended |
Sep. 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 September 30, Nine Months Ended September 30, 2023 2022 (2) 2023 2022 (2) Shares Cost Shares Cost Shares Cost Shares Cost Share buybacks 11,609 $ 773 11,486 $ 1,040 22,489 $ 1,550 15,674 $ 1,384 Income tax withholding 11 1 34 3 778 52 941 79 Total share repurchases (1) 11,620 $ 774 11,520 $ 1,043 23,267 $ 1,602 16,615 $ 1,463 (1) Excludes share repurchase excise tax of $10 million accrued as of September 30, 2023. (2) Includes 8.6 million shares delivered as part of an accelerated share repurchase (ASR) agreement, representing 80% of the $1,000 million notional amount. Remaining shares were delivered in the fourth quarter of 2022 upon the settlement of the ASR. |
Earnings Per Share (Tables)
Earnings Per Share (Tables) | 9 Months Ended |
Sep. 30, 2023 | |
Earnings Per Share [Abstract] | |
Calculation of Basic and Diluted Net Earnings Per Common Share | The following table sets forth the calculation of basic and diluted net earnings per common share ($ in millions, except per share data in dollars and shares in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Earnings attributable to Centene Corporation $ 469 $ 738 $ 2,657 $ 1,415 Shares used in computing per share amounts: Weighted average number of common shares outstanding 539,535 573,961 546,374 580,277 Common stock equivalents (as determined by applying the treasury stock method) (1) 1,735 6,646 2,038 6,807 Weighted average number of common shares and potential dilutive common shares outstanding 541,270 580,607 548,412 587,084 Net earnings per common share attributable to Centene Corporation: Basic earnings per common share $ 0.87 $ 1.29 $ 4.86 $ 2.44 Diluted earnings per common share $ 0.87 $ 1.27 $ 4.85 $ 2.41 (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) | 9 Months Ended |
Sep. 30, 2023 | |
Segment Reporting [Abstract] | |
Segment Information | Segment information for the three months ended September 30, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 21,619 $ 5,430 $ 6,451 $ 366 $ 33,866 Service — — 2 1,099 1,101 Premium and service revenues 21,619 5,430 6,453 1,465 34,967 Premium tax 3,075 — — — 3,075 Total external revenues 24,694 5,430 6,453 1,465 38,042 Internal revenues — — — 3,978 3,978 Eliminations — — — (3,978) (3,978) Total revenues $ 24,694 $ 5,430 $ 6,453 $ 1,465 $ 38,042 Medical costs $ 19,607 $ 4,462 $ 5,089 $ 321 $ 29,479 Cost of services $ — $ — $ — $ 856 $ 856 Gross margin (1) $ 2,012 $ 968 $ 1,364 $ 288 $ 4,632 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the three months ended September 30, 2022, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 21,154 $ 5,639 $ 4,291 $ 764 $ 31,848 Service — — 1 1,877 1,878 Premium and service revenues 21,154 5,639 4,292 2,641 33,726 Premium tax 2,139 — — — 2,139 Total external revenues 23,293 5,639 4,292 2,641 35,865 Internal revenues — — — 6,420 6,420 Eliminations — — — (6,420) (6,420) Total revenues $ 23,293 $ 5,639 $ 4,292 $ 2,641 $ 35,865 Medical costs $ 19,075 $ 4,730 $ 3,613 $ 693 $ 28,111 Cost of services $ — $ — $ — $ 1,571 $ 1,571 Gross margin (1) $ 2,079 $ 909 $ 679 $ 377 $ 4,044 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the nine months ended September 30, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 65,741 $ 16,971 $ 17,437 $ 1,255 $ 101,404 Service — — 2 3,351 3,353 Premium and service revenues 65,741 16,971 17,439 4,606 104,757 Premium tax 9,782 — — — 9,782 Total external revenues 75,523 16,971 17,439 4,606 114,539 Internal revenues — — — 11,634 11,634 Eliminations — — — (11,634) (11,634) Total revenues $ 75,523 $ 16,971 $ 17,439 $ 4,606 $ 114,539 Medical costs $ 59,076 $ 14,354 $ 13,738 $ 1,092 $ 88,260 Cost of services $ 2 $ — $ — $ 2,601 $ 2,603 Gross margin (1) $ 6,663 $ 2,617 $ 3,701 $ 913 $ 13,894 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the nine months ended September 30, 2022, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 62,763 $ 17,035 $ 12,977 $ 2,472 $ 95,247 Service (1) — 2 6,678 6,679 Premium and service revenues 62,762 17,035 12,979 9,150 101,926 Premium tax 7,060 — — — 7,060 Total external revenues 69,822 17,035 12,979 9,150 108,986 Internal revenues — — — 18,856 18,856 Eliminations — — — (18,856) (18,856) Total revenues $ 69,822 $ 17,035 $ 12,979 $ 9,150 $ 108,986 Medical costs $ 56,108 $ 14,602 $ 10,416 $ 2,135 $ 83,261 Cost of services $ — $ — $ — $ 5,658 $ 5,658 Gross margin (1) $ 6,654 $ 2,433 $ 2,563 $ 1,357 $ 13,007 (1) Gross margin represents premium and service revenues less medical costs and cost of services. |
Acquisitions and Divestitures -
Acquisitions and Divestitures - Divestiture (Details) £ in Millions, $ in Millions | 1 Months Ended | 3 Months Ended | 9 Months Ended | 12 Months Ended | |||||||
Jun. 13, 2023 USD ($) | Jan. 20, 2023 USD ($) | Apr. 30, 2023 USD ($) | Sep. 30, 2023 USD ($) | Jun. 30, 2023 USD ($) | Sep. 30, 2022 USD ($) | Sep. 30, 2023 USD ($) | Sep. 30, 2022 USD ($) | Dec. 31, 2022 USD ($) | Aug. 31, 2023 USD ($) | Aug. 31, 2023 GBP (£) | |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | |||||||||||
Gain on divestiture | $ 172 | $ 503 | |||||||||
Impairment charge | $ (440) | $ (289) | (478) | $ (1,739) | |||||||
Goodwill impairment | 348 | $ 370 | |||||||||
Currency Swap | |||||||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | |||||||||||
Notional amount | $ 931 | £ 740 | |||||||||
Fair value, swap agreement | 27 | 27 | |||||||||
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 | ||||||||||
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 | ||||||||||
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) | ||||||||||
Circle Health | Disposal Group, Held-for-sale, Not Discontinued Operations | |||||||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | |||||||||||
Assets held for sale | 3,744 | 3,744 | |||||||||
Liabilities held for sale | 2,947 | $ 2,947 | |||||||||
Goodwill impairment | 251 | ||||||||||
Goodwill, impairment, net of tax | $ 269 |
Short-term and Long-term Inve_3
Short-term and Long-term Investments, Restricted Deposits - By Investment Type (Details) - USD ($) $ in Millions | Sep. 30, 2023 | Dec. 31, 2022 |
Debt Securities | ||
Gross Unrealized Gains | $ 5 | $ 20 |
Gross Unrealized Losses | (1,393) | (1,364) |
Equity securities | 2 | 5 |
Private equity investments | 810 | 529 |
Life insurance contracts | 178 | 169 |
Total, Amortized Cost | 20,206 | 19,566 |
Total, Fair Value | 18,818 | 18,222 |
U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Debt Securities | ||
Amortized Cost | 421 | 695 |
Gross Unrealized Gains | 0 | 0 |
Gross Unrealized Losses | (13) | (16) |
Fair Value | 408 | 679 |
Corporate securities | ||
Debt Securities | ||
Amortized Cost | 9,922 | 10,127 |
Gross Unrealized Gains | 2 | 12 |
Gross Unrealized Losses | (750) | (778) |
Fair Value | 9,174 | 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 | 260 | 256 |
Gross Unrealized Gains | 0 | 0 |
Gross Unrealized Losses | 0 | 0 |
Fair Value | 260 | 256 |
Short-term time deposits | ||
Debt Securities | ||
Amortized Cost | 470 | 204 |
Gross Unrealized Gains | 0 | 0 |
Gross Unrealized Losses | 0 | 0 |
Fair Value | 470 | 204 |
Municipal securities | ||
Debt Securities | ||
Amortized Cost | 3,931 | 4,055 |
Gross Unrealized Gains | 1 | 6 |
Gross Unrealized Losses | (294) | (280) |
Fair Value | 3,638 | 3,781 |
Asset-backed securities | ||
Debt Securities | ||
Amortized Cost | 1,633 | 1,396 |
Gross Unrealized Gains | 2 | 0 |
Gross Unrealized Losses | (52) | (70) |
Fair Value | 1,583 | 1,326 |
Residential mortgage-backed securities | ||
Debt Securities | ||
Amortized Cost | 1,475 | 1,165 |
Gross Unrealized Gains | 0 | 2 |
Gross Unrealized Losses | (172) | (121) |
Fair Value | 1,303 | 1,046 |
Commercial mortgage-backed securities | ||
Debt Securities | ||
Amortized Cost | 1,100 | 961 |
Gross Unrealized Gains | 0 | 0 |
Gross Unrealized Losses | (112) | (99) |
Fair Value | $ 988 | $ 862 |
Short-term and Long-term Inve_4
Short-term and Long-term Investments, Restricted Deposits - Narrative (Details) $ in Millions | 9 Months Ended | |
Sep. 30, 2023 USD ($) position | Dec. 31, 2022 USD ($) | |
Schedule Of Investments And Restricted Deposits By Type [Line Items] | ||
Accrued interest income | $ | $ 144 | $ 132 |
Positions from which gross unrealized losses were generated | 6,355 | |
Total investment positions | 6,604 | |
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 | Sep. 30, 2023 | Dec. 31, 2022 |
Unrealized Losses | ||
Less Than 12 Months | $ (162) | $ (620) |
12 Months or More | (1,231) | (744) |
Fair Value | ||
Fair Value, Less Than 12 Months | 5,170 | 10,075 |
Fair Value, 12 Months or More | 11,331 | 5,747 |
U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Unrealized Losses | ||
Less Than 12 Months | (1) | (5) |
12 Months or More | (12) | (11) |
Fair Value | ||
Fair Value, Less Than 12 Months | 161 | 342 |
Fair Value, 12 Months or More | 247 | 184 |
Corporate securities | ||
Unrealized Losses | ||
Less Than 12 Months | (76) | (340) |
12 Months or More | (674) | (438) |
Fair Value | ||
Fair Value, Less Than 12 Months | 2,470 | 5,368 |
Fair Value, 12 Months or More | 6,393 | 3,400 |
Municipal securities | ||
Unrealized Losses | ||
Less Than 12 Months | (44) | (142) |
12 Months or More | (250) | (138) |
Fair Value | ||
Fair Value, Less Than 12 Months | 1,308 | 2,437 |
Fair Value, 12 Months or More | 2,211 | 995 |
Asset-backed securities | ||
Unrealized Losses | ||
Less Than 12 Months | (7) | (29) |
12 Months or More | (45) | (41) |
Fair Value | ||
Fair Value, Less Than 12 Months | 486 | 786 |
Fair Value, 12 Months or More | 946 | 486 |
Residential mortgage-backed securities | ||
Unrealized Losses | ||
Less Than 12 Months | (23) | (55) |
12 Months or More | (149) | (66) |
Fair Value | ||
Fair Value, Less Than 12 Months | 517 | 629 |
Fair Value, 12 Months or More | 786 | 352 |
Commercial mortgage-backed securities | ||
Unrealized Losses | ||
Less Than 12 Months | (11) | (49) |
12 Months or More | (101) | (50) |
Fair Value | ||
Fair Value, Less Than 12 Months | 228 | 513 |
Fair Value, 12 Months or More | $ 748 | $ 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 | Sep. 30, 2023 | Dec. 31, 2022 |
Investments | ||
Amortized Cost | ||
One year or less | $ 2,121 | $ 2,207 |
One year through five years | 7,421 | 7,651 |
Five years through ten years | 3,931 | 4,066 |
Greater than ten years | 123 | 135 |
Asset-backed securities | 4,208 | 3,522 |
Amortized Cost | 17,804 | 17,581 |
Fair Value | ||
One year or less | 2,091 | 2,179 |
One year through five years | 6,906 | 7,147 |
Five years through ten years | 3,501 | 3,613 |
Greater than ten years | 113 | 129 |
Asset-backed securities | 3,874 | 3,234 |
Fair Value | 16,485 | 16,302 |
Restricted Deposits | ||
Amortized Cost | ||
One year or less | 537 | 534 |
One year through five years | 531 | 524 |
Five years through ten years | 312 | 224 |
Greater than ten years | 32 | 0 |
Asset-backed securities | 0 | 0 |
Amortized Cost | 1,412 | 1,282 |
Fair Value | ||
One year or less | 534 | 532 |
One year through five years | 496 | 490 |
Five years through ten years | 282 | 195 |
Greater than ten years | 31 | 0 |
Asset-backed securities | 0 | 0 |
Fair Value | $ 1,343 | $ 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 | Sep. 30, 2023 | Dec. 31, 2022 |
Assets | ||
Cash and cash equivalents | $ 18,190 | $ 12,074 |
Investments: | ||
Equity securities | 2 | 5 |
Total assets at fair value | 36,047 | 29,598 |
U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair Value | 408 | 679 |
Corporate securities | ||
Investments: | ||
Fair Value | 9,174 | 9,361 |
Municipal securities | ||
Investments: | ||
Fair Value | 3,638 | 3,781 |
Short-term time deposits | ||
Investments: | ||
Fair Value | 470 | 204 |
Asset-backed securities | ||
Investments: | ||
Fair Value | 1,583 | 1,326 |
Residential mortgage-backed securities | ||
Investments: | ||
Fair Value | 1,303 | 1,046 |
Commercial mortgage-backed securities | ||
Investments: | ||
Fair Value | 988 | 862 |
Investments | ||
Investments: | ||
Fair Value | 16,485 | 16,302 |
Total investments | 16,487 | 16,307 |
Investments | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair Value | 81 | 371 |
Investments | Corporate securities | ||
Investments: | ||
Fair Value | 9,142 | 9,328 |
Investments | Municipal securities | ||
Investments: | ||
Fair Value | 2,918 | 3,165 |
Investments | Short-term time deposits | ||
Investments: | ||
Fair Value | 470 | 204 |
Investments | Asset-backed securities | ||
Investments: | ||
Fair Value | 1,583 | 1,326 |
Investments | Residential mortgage-backed securities | ||
Investments: | ||
Fair Value | 1,303 | 1,046 |
Investments | Commercial mortgage-backed securities | ||
Investments: | ||
Fair Value | 988 | 862 |
Investments | Equity securities | ||
Investments: | ||
Equity securities | 2 | 5 |
Restricted deposits | ||
Investments: | ||
Fair Value | 1,343 | 1,217 |
Restricted deposits | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair Value | 327 | 308 |
Restricted deposits | Corporate securities | ||
Investments: | ||
Fair Value | 32 | 33 |
Restricted deposits | Municipal securities | ||
Investments: | ||
Fair Value | 720 | 616 |
Restricted deposits | Cash and cash equivalents | ||
Investments: | ||
Fair Value | 260 | 256 |
Restricted deposits | Certificates of deposit | ||
Investments: | ||
Fair Value | 4 | 4 |
Other current assets | Currency Swap | ||
Investments: | ||
Foreign currency swap agreement | 27 | |
Level I | ||
Assets | ||
Cash and cash equivalents | 18,190 | 12,074 |
Investments: | ||
Total assets at fair value | 18,858 | 13,007 |
Level I | Investments | ||
Investments: | ||
Total investments | 81 | 369 |
Level I | Investments | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair Value | 81 | 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 | 587 | 564 |
Level I | Restricted deposits | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair Value | 327 | 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 | 260 | 256 |
Level I | Restricted deposits | Certificates of deposit | ||
Investments: | ||
Fair Value | 0 | 0 |
Level I | Other current assets | Currency Swap | ||
Investments: | ||
Foreign currency swap agreement | 0 | |
Level II | ||
Assets | ||
Cash and cash equivalents | 0 | 0 |
Investments: | ||
Total assets at fair value | 17,189 | 16,591 |
Level II | Investments | ||
Investments: | ||
Total investments | 16,406 | 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 | 9,142 | 9,328 |
Level II | Investments | Municipal securities | ||
Investments: | ||
Fair Value | 2,918 | 3,165 |
Level II | Investments | Short-term time deposits | ||
Investments: | ||
Fair Value | 470 | 204 |
Level II | Investments | Asset-backed securities | ||
Investments: | ||
Fair Value | 1,583 | 1,326 |
Level II | Investments | Residential mortgage-backed securities | ||
Investments: | ||
Fair Value | 1,303 | 1,046 |
Level II | Investments | Commercial mortgage-backed securities | ||
Investments: | ||
Fair Value | 988 | 862 |
Level II | Investments | Equity securities | ||
Investments: | ||
Equity securities | 2 | 2 |
Level II | Restricted deposits | ||
Investments: | ||
Fair Value | 756 | 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 | 32 | 33 |
Level II | Restricted deposits | Municipal securities | ||
Investments: | ||
Fair Value | 720 | 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 II | Other current assets | Currency Swap | ||
Investments: | ||
Foreign currency swap agreement | 27 | |
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 |
Level III | Other current assets | Currency Swap | ||
Investments: | ||
Foreign currency swap agreement | $ 0 |
Fair Value Measurements - Narra
Fair Value Measurements - Narrative (Details) - USD ($) $ in Millions | Sep. 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 - Summary of Changes in Goodwill (Details) - USD ($) $ in Millions | 9 Months Ended | 12 Months Ended |
Sep. 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 | (933) | (1,533) |
Reallocation | 0 | |
Impairments | (348) | (370) |
Translation impact | 27 | (133) |
Goodwill, Balance ending | 17,558 | 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 | 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 | 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 | 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 | (933) | (1,533) |
Reallocation | (4) | |
Impairments | (348) | (370) |
Translation impact | 27 | (133) |
Goodwill, Balance ending | $ 344 | $ 1,598 |
Goodwill and Intangible Asset_3
Goodwill and Intangible Assets - Narrative (Details) - USD ($) $ in Millions | 3 Months Ended | 9 Months Ended | 12 Months Ended |
Sep. 30, 2023 | Sep. 30, 2023 | Dec. 31, 2022 | |
Goodwill [Line Items] | |||
Impairments | $ 348 | $ 370 | |
Circle Health | Disposal Group, Held-for-sale, Not Discontinued Operations | |||
Goodwill [Line Items] | |||
Impairments | $ 251 |
Medical Claims Liability - Sche
Medical Claims Liability - Schedule of Change in Medical Claims Liability (Details) - USD ($) $ in Millions | 9 Months Ended | |
Sep. 30, 2023 | Sep. 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 | 90,148 | 84,457 |
Prior years | (1,888) | (1,196) |
Total incurred | 88,260 | 83,261 |
Paid related to: | ||
Current year | 75,402 | 70,305 |
Prior years | 12,481 | 10,968 |
Total paid | 87,883 | 81,273 |
Balance, June 30, net | 17,096 | 16,457 |
Plus: Reinsurance recoverable | 45 | 8 |
Balance, June 30 | 17,141 | 16,465 |
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 | 60,379 | 57,074 |
Prior years | (1,303) | (966) |
Total incurred | 59,076 | 56,108 |
Paid related to: | ||
Current year | 50,774 | 47,481 |
Prior years | 8,517 | 7,343 |
Total paid | 59,291 | 54,824 |
Balance, June 30, net | 11,031 | 11,106 |
Plus: Reinsurance recoverable | 4 | 8 |
Balance, June 30 | 11,035 | 11,114 |
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 | 14,680 | 14,624 |
Prior years | (326) | (22) |
Total incurred | 14,354 | 14,602 |
Paid related to: | ||
Current year | 12,069 | 11,603 |
Prior years | 2,452 | 1,963 |
Total paid | 14,521 | 13,566 |
Balance, June 30, net | 3,264 | 3,322 |
Plus: Reinsurance recoverable | 0 | 0 |
Balance, June 30 | 3,264 | 3,322 |
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 | 13,994 | 10,609 |
Prior years | (256) | (193) |
Total incurred | 13,738 | 10,416 |
Paid related to: | ||
Current year | 11,575 | 9,046 |
Prior years | 1,376 | 1,580 |
Total paid | 12,951 | 10,626 |
Balance, June 30, net | 2,689 | 1,804 |
Plus: Reinsurance recoverable | 41 | 0 |
Balance, June 30 | 2,730 | 1,804 |
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 | 1,095 | 2,150 |
Prior years | (3) | (15) |
Total incurred | 1,092 | 2,135 |
Paid related to: | ||
Current year | 984 | 2,175 |
Prior years | 136 | 82 |
Total paid | 1,120 | 2,257 |
Balance, June 30, net | 112 | 225 |
Plus: Reinsurance recoverable | 0 | 0 |
Balance, June 30 | $ 112 | $ 225 |
Medical Claims Liability - Narr
Medical Claims Liability - Narrative (Details) - USD ($) $ in Millions | 9 Months Ended | |
Sep. 30, 2023 | Sep. 30, 2022 | |
Insurance [Abstract] | ||
Amounts recorded as an adjustment to premium revenues related to minimum HBR and return of premium programs | $ 341 | $ 121 |
Short-duration insurance contracts, Incurred but not reported and expected development on reported claims | $ 11,661 |
Affordable Care Act - Net Recei
Affordable Care Act - Net Receivables (Payables) for Each of the Ongoing Programs (Details) - USD ($) $ in Millions | Sep. 30, 2023 | Dec. 31, 2022 |
Affordable Care Act [Abstract] | ||
Risk adjustment receivable | $ 1,130 | $ 838 |
Risk adjustment payable | (2,312) | (780) |
Minimum medical loss ratio | (90) | (103) |
Cost sharing reduction payable | $ (104) | $ (99) |
Affordable Care Act - Additiona
Affordable Care Act - Additional information (Details) $ in Millions | 9 Months Ended |
Sep. 30, 2023 USD ($) | |
Affordable Care Act [Abstract] | |
Risk adjustment, increase to net receivables | $ 244 |
Risk adjustment and reinsurance pre-tax benefit | $ 198 |
Debt - Schedule of Debt (Detail
Debt - Schedule of Debt (Details) - USD ($) | Sep. 30, 2023 | Dec. 31, 2022 |
Debt Instrument [Line Items] | ||
Total senior notes | $ 15,675,000,000 | $ 15,673,000,000 |
Finance leases and other | 3,000,000 | 253,000,000 |
Debt issuance costs | (128,000,000) | (147,000,000) |
Total debt | 18,001,000,000 | 18,020,000,000 |
Less: current portion | (113,000,000) | (82,000,000) |
Long-term debt | 17,888,000,000 | 17,938,000,000 |
Revolving Credit Agreement | ||
Debt Instrument [Line Items] | ||
Credit facility | 309,000,000 | 58,000,000 |
Term Loan Facility | ||
Debt Instrument [Line Items] | ||
Credit facility | 2,142,000,000 | 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 | $ 2,395,000,000 | 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 | Sep. 30, 2023 | Dec. 31, 2022 |
Assets | ||
ROU assets (recorded within other long-term assets) | $ 430 | $ 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) | $ 170 | $ 180 |
Long-term (recorded within other long-term liabilities) | 936 | 3,133 |
Total lease liabilities | $ 1,106 | $ 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) $ in Millions | 3 Months Ended | 9 Months Ended |
Sep. 30, 2023 USD ($) | Sep. 30, 2023 USD ($) | |
Lessee, Lease, Description [Line Items] | ||
ROU impairment | $ 35 | $ 37 |
Remaining asset impairment charges | $ 85 | |
Weighted average remaining lease term | 20 years 3 months 18 days | 20 years 3 months 18 days |
Weighted-average discount rate for operating leases | 5.80% | 5.80% |
Weighted-average discount rate for operating leases excluding disposal group | 3.20% | 3.20% |
Remaining lease payments in 2023 excluding disposal group | $ 51 | $ 51 |
Circle Health | ||
Lessee, Lease, Description [Line Items] | ||
Weighted average remaining lease term | 26 years 6 months | 26 years 6 months |
Excluding Circle Health | ||
Lessee, Lease, Description [Line Items] | ||
Weighted average remaining lease term | 8 years 3 months 18 days | 8 years 3 months 18 days |
Leases - Operating Lease Paymen
Leases - Operating Lease Payments Over Next Five Years Excluding Circle Health (Details) $ in Millions | Sep. 30, 2023 USD ($) |
Leases [Abstract] | |
2024 | $ 201 |
2025 | 176 |
2026 | 151 |
2027 | 133 |
2028 | 113 |
Thereafter | 441 |
Total lease payments | 1,215 |
Less: imputed interest | (160) |
Total lease liabilities | $ 1,055 |
Stockholders' Equity - Narrativ
Stockholders' Equity - Narrative (Details) - USD ($) shares in Thousands, $ in Millions | 1 Months Ended | 3 Months Ended | |||||||
Oct. 24, 2023 | Dec. 31, 2022 | Jun. 30, 2022 | Sep. 30, 2023 | Jun. 30, 2023 | Mar. 31, 2023 | Sep. 30, 2022 | 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 | 1,256 | ||||||||
Common stock repurchases | $ 781 | $ 408 | $ 423 | $ 1,243 | $ 349 | $ 71 | |||
Subsequent Event | |||||||||
Equity, Class of Treasury Stock [Line Items] | |||||||||
Common stock repurchases (in shares) | 397 | ||||||||
Common stock repurchases | $ 27 |
Stockholders' Equity - Share Re
Stockholders' Equity - Share Repurchase Activity (Details) - USD ($) shares in Thousands, $ in Millions | 3 Months Ended | 9 Months Ended | ||||||
Sep. 30, 2023 | Jun. 30, 2023 | Mar. 31, 2023 | Sep. 30, 2022 | Jun. 30, 2022 | Mar. 31, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Subsidiary, Sale of Stock [Line Items] | ||||||||
Common stock repurchases | $ 781 | $ 408 | $ 423 | $ 1,243 | $ 349 | $ 71 | ||
Stock repurchases, excise tax accrual | $ 10 | $ 10 | ||||||
Employee Stock Compensation Plan | ||||||||
Subsidiary, Sale of Stock [Line Items] | ||||||||
Income tax withholding (in shares) | 11 | 34 | 778 | 941 | ||||
Income tax withholding | $ 1 | $ 3 | $ 52 | $ 79 | ||||
Common Stock | ||||||||
Subsidiary, Sale of Stock [Line Items] | ||||||||
Share buybacks (in shares) | 11,609 | 11,486 | 22,489 | 15,674 | ||||
Common stock repurchases (in shares) | 11,620 | 11,520 | 23,267 | 16,615 | ||||
Share buybacks | $ 773 | $ 1,040 | $ 1,550 | $ 1,384 | ||||
Common stock repurchases | $ 774 | $ 1,043 | $ 1,602 | $ 1,463 | ||||
Common Stock | Accelerated Share Repurchase Agreement | ||||||||
Subsidiary, Sale of Stock [Line Items] | ||||||||
Common stock repurchases (in shares) | 8,600 | 8,600 | ||||||
Percentage of notional amount under ASR | 80% | 80% | ||||||
Accelerated share repurchases agreement, amount (up to) | $ 1,000 | $ 1,000 |
Earnings Per Share (Details)
Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Net Income (Loss) Attributable to Parent [Abstract] | ||||
Earnings attributable to Centene Corporation | $ 469 | $ 738 | $ 2,657 | $ 1,415 |
Shares used in computing per share amounts: | ||||
Weighted average number of common shares outstanding (in shares) | 539,535 | 573,961 | 546,374 | 580,277 |
Common stock equivalents (as determined by applying the treasury stock method) (in shares) | 1,735 | 6,646 | 2,038 | 6,807 |
Weighted average number of common shares and potential dilutive common shares outstanding (in shares) | 541,270 | 580,607 | 548,412 | 587,084 |
Net earnings per common share attributable to Centene Corporation: | ||||
Basic earnings per common share (in dollars per share) | $ 0.87 | $ 1.29 | $ 4.86 | $ 2.44 |
Diluted earnings per common share (in dollars per share) | $ 0.87 | $ 1.27 | $ 4.85 | $ 2.41 |
Anti-dilutive restricted stock and restricted stock units excluded from the calculation of diluted earnings (loss) per common share (in shares) | 1,313 | 152 | 1,383 | 193 |
Segment Information (Details)
Segment Information (Details) - USD ($) $ in Millions | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2023 | Sep. 30, 2022 | Sep. 30, 2023 | Sep. 30, 2022 | |
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | $ 34,967 | $ 33,726 | $ 104,757 | $ 101,926 |
Premium tax | 3,075 | 2,139 | 9,782 | 7,060 |
Total external revenues | 38,042 | 35,865 | 114,539 | 108,986 |
Revenues | 38,042 | 35,865 | 114,539 | 108,986 |
Medical costs | 29,479 | 28,111 | 88,260 | 83,261 |
Cost of services | 856 | 1,571 | 2,603 | 5,658 |
Gross margin | 4,632 | 4,044 | 13,894 | 13,007 |
Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | 3,978 | 6,420 | 11,634 | 18,856 |
Eliminations | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | (3,978) | (6,420) | (11,634) | (18,856) |
Premium | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 33,866 | 31,848 | 101,404 | 95,247 |
Service | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 1,101 | 1,878 | 3,353 | 6,679 |
Premium and service revenues | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 34,967 | 33,726 | 104,757 | 101,926 |
Medicaid | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | 24,694 | 23,293 | 75,523 | 69,822 |
Medical costs | 19,607 | 19,075 | 59,076 | 56,108 |
Cost of services | 0 | 0 | 2 | 0 |
Gross margin | 2,012 | 2,079 | 6,663 | 6,654 |
Medicaid | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium tax | 3,075 | 2,139 | 9,782 | 7,060 |
Total external revenues | 24,694 | 23,293 | 75,523 | 69,822 |
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 | 21,619 | 21,154 | 65,741 | 62,763 |
Medicaid | Service | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 0 | 0 | 0 | (1) |
Medicaid | Premium and service revenues | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 21,619 | 21,154 | 65,741 | 62,762 |
Medicare | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | 5,430 | 5,639 | 16,971 | 17,035 |
Medical costs | 4,462 | 4,730 | 14,354 | 14,602 |
Cost of services | 0 | 0 | 0 | 0 |
Gross margin | 968 | 909 | 2,617 | 2,433 |
Medicare | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium tax | 0 | 0 | 0 | 0 |
Total external revenues | 5,430 | 5,639 | 16,971 | 17,035 |
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 | 5,430 | 5,639 | 16,971 | 17,035 |
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 | 5,430 | 5,639 | 16,971 | 17,035 |
Commercial | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | 6,453 | 4,292 | 17,439 | 12,979 |
Medical costs | 5,089 | 3,613 | 13,738 | 10,416 |
Cost of services | 0 | 0 | 0 | 0 |
Gross margin | 1,364 | 679 | 3,701 | 2,563 |
Commercial | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium tax | 0 | 0 | 0 | 0 |
Total external revenues | 6,453 | 4,292 | 17,439 | 12,979 |
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 | 6,451 | 4,291 | 17,437 | 12,977 |
Commercial | Service | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 2 | 1 | 2 | 2 |
Commercial | Premium and service revenues | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 6,453 | 4,292 | 17,439 | 12,979 |
Other/Eliminations | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | 1,465 | 2,641 | 4,606 | 9,150 |
Medical costs | 321 | 693 | 1,092 | 2,135 |
Cost of services | 856 | 1,571 | 2,601 | 5,658 |
Gross margin | 288 | 377 | 913 | 1,357 |
Other/Eliminations | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium tax | 0 | 0 | 0 | 0 |
Total external revenues | 1,465 | 2,641 | 4,606 | 9,150 |
Revenues | 3,978 | 6,420 | 11,634 | 18,856 |
Other/Eliminations | Eliminations | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | (3,978) | (6,420) | (11,634) | (18,856) |
Other/Eliminations | Premium | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 366 | 764 | 1,255 | 2,472 |
Other/Eliminations | Service | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | 1,099 | 1,877 | 3,351 | 6,678 |
Other/Eliminations | Premium and service revenues | Operating Segments | ||||
Segment Reporting Information [Line Items] | ||||
Premium and service revenues | $ 1,465 | $ 2,641 | $ 4,606 | $ 9,150 |
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 |