CONSOLIDATED HIGHLIGHTS
Membership:Medical enrollment totaled 41.0 million members at December 31, 2019, an increase of 1.1 million, or 2.7 percent, from December 31, 2018. Total risk enrollment grew by 931 thousand lives, or 6.4 percent, andfee-based enrollment grew by 131 thousand lives, or 0.5 percent. Government Business enrollment increased by 854 thousand lives as the Company experienced growth in Medicaid and Medicare. Commercial & Specialty Business enrollment increased by 208 thousand lives driven by growth in the National and Individual businesses.
During the fourth quarter of 2019, medical enrollment increased sequentially by 16 thousand lives, reflecting growth in the Local Group, National, and Medicare businesses.
Operating Revenue:Operating revenue was $27.1 billion in the fourth quarter of 2019, an increase of $3.8 billion, or 16.4 percent, versus the prior year quarter. The increase in operating revenue reflected higher premium revenue from membership growth across our businesses and rate increases to cover overall cost trends. The increase in operating revenue was further driven by growth in our value-added services, including our pharmacy and integrated health offerings, partially offset by the one year waiver of the health insurance tax in 2019.
Benefit Expense Ratio:The benefit expense ratio was 89.0 percent in the fourth quarter of 2019, an increase of 220 basis points from 86.8 percent in the prior year quarter. The increase, as expected, was primarily driven by the one year waiver of the health insurance tax in 2019.
Medical claims reserves established at December 31, 2018 developed in line with the Company’s expectations during 2019.
Medical Cost Trend:For the full year 2019, Local Group medical cost trend was approximately 6.0%. The Company anticipates Local Group medical cost trend will be in the range of 4.0% +/- 50 basis points in 2020, including the benefit of improved pharmacy cost from the launch of IngenioRx and other medical cost management initiatives.
Days in Claims Payable:Days in Claims Payable was 38.0 days as of December 31, 2019, a decrease of 1.8 days from September 30, 2019, but an increase of 1.8 days as compared to December 31, 2018.
SG&A Expense Ratio:The SG&A expense ratio was 12.9 percent in the fourth quarter of 2019, a decrease of 260 basis points from 15.5 percent in the fourth quarter of 2018. The decrease, as expected, was primarily driven by growth in operating revenue and the one year waiver of the health insurance tax in 2019.
Operating Cash Flow:Operating cash flow in the fourth quarter of 2019 was $1.3 billion, or 1.4 times net income, which represents an increase of $864 million compared to the fourth quarter of 2018. Operating cash flow was $6.1 billion, or 1.3 times net income for the year ending December 31, 2019.
Share Repurchase Program: During the fourth quarter of 2019, the Company repurchased 1.2 million shares of its common stock for $306 million, or a weighted average price of $260.87. For the full year, the Company repurchased 6.3 million shares of its stock for $1.7 billion, or a weighted average price of $268.65. As of December 31, 2019, the Company had approximately $3.8 billion of Board-approved share repurchase authorization remaining.
Cash Dividend:During the fourth quarter of 2019, the Company paid a quarterly dividend of $0.80 per share, representing a distribution of cash totaling $202 million.
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