Cover Page
Cover Page - shares shares in Millions | 3 Months Ended | |
Mar. 31, 2022 | Apr. 22, 2022 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Mar. 31, 2022 | |
Document Transition Report | false | |
Entity File Number | 001-31719 | |
Entity Registrant Name | MOLINA HEALTHCARE, INC. | |
Entity Incorporation, State or Country Code | DE | |
Entity Tax Identification Number | 13-4204626 | |
Entity Address, Address Line One | 200 Oceangate | |
Entity Address, Address Line Two | Suite 100 | |
Entity Address, City or Town | Long Beach, | |
Entity Address, State or Province | CA | |
Entity Address, Postal Zip Code | 90802 | |
City Area Code | 562 | |
Local Phone Number | 435-3666 | |
Title of 12(b) Security | Common Stock, $0.001 Par Value | |
Trading Symbol | MOH | |
Security Exchange Name | NYSE | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Large Accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Shell Company | false | |
Entity Common Stock, Shares Outstanding | 58.7 | |
Entity Central Index Key | 0001179929 | |
Current Fiscal Year End Date | --12-31 | |
Document Fiscal Year Focus | 2022 | |
Document Fiscal Period Focus | Q1 | |
Amendment Flag | false |
CONSOLIDATED STATEMENTS OF INCO
CONSOLIDATED STATEMENTS OF INCOME - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2022 | Mar. 31, 2021 | |
Revenue: | ||
Premium revenue | $ 7,531 | $ 6,306 |
Premium tax revenue | 208 | 187 |
Investment income | 11 | 9 |
Other revenue | 20 | 20 |
Total revenue | 7,770 | 6,522 |
Operating expenses: | ||
Medical care costs | 6,563 | 5,474 |
General and administrative expenses | 571 | 473 |
Premium tax expenses | 208 | 187 |
Depreciation and amortization | 40 | 33 |
Other | 16 | 20 |
Total operating expenses | 7,398 | 6,187 |
Operating income | 372 | 335 |
Other expenses, net: | ||
Interest expense | 28 | 30 |
Total other expenses, net | 28 | 30 |
Income before income tax expense | 344 | 305 |
Income tax expense | 86 | 77 |
Net income | $ 258 | $ 228 |
Net income per share: | ||
Net income per share - Basic (in dollars per share) | $ 4.45 | $ 3.95 |
Net income per share - Diluted (in dollars per share) | $ 4.39 | $ 3.89 |
CONSOLIDATED STATEMENTS OF COMP
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2022 | Mar. 31, 2021 | |
Statement of Comprehensive Income [Abstract] | ||
Net income | $ 258 | $ 228 |
Other comprehensive loss: | ||
Unrealized investment loss | (100) | (15) |
Less: effect of income taxes | (24) | (4) |
Other comprehensive loss, net of tax | (76) | (11) |
Comprehensive income | $ 182 | $ 217 |
CONSOLIDATED BALANCE SHEETS
CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions | Mar. 31, 2022 | Dec. 31, 2021 |
Current assets: | ||
Cash and cash equivalents | $ 4,804 | $ 4,438 |
Investments | 2,988 | 3,202 |
Receivables | 2,156 | 2,177 |
Prepaid expenses and other current assets | 198 | 247 |
Total current assets | 10,146 | 10,064 |
Property, equipment, and capitalized software, net | 393 | 396 |
Goodwill, and intangible assets, net | 1,305 | 1,252 |
Restricted investments | 221 | 212 |
Deferred income taxes | 114 | 106 |
Other assets | 181 | 179 |
Total assets | 12,360 | 12,209 |
Current liabilities: | ||
Medical claims and benefits payable | 3,601 | 3,363 |
Amounts due government agencies | 2,613 | 2,472 |
Accounts payable, accrued liabilities and other | 809 | 842 |
Deferred revenue | 18 | 370 |
Total current liabilities | 7,041 | 7,047 |
Long-term debt | 2,174 | 2,173 |
Finance lease liabilities | 217 | 219 |
Other long-term liabilities | 134 | 140 |
Total liabilities | 9,566 | 9,579 |
Stockholders’ equity: | ||
Common stock, $0.001 par value, 150 million shares authorized; outstanding: 59 million shares at March 31, 2022, and 58 million shares at December 31, 2021 | 0 | 0 |
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding | 0 | 0 |
Additional paid-in capital | 218 | 236 |
Accumulated other comprehensive loss | (81) | (5) |
Retained earnings | 2,657 | 2,399 |
Total stockholders’ equity | 2,794 | 2,630 |
Total liabilities and stockholders’ equity | $ 12,360 | $ 12,209 |
CONSOLIDATED BALANCE SHEETS (Pa
CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares | Mar. 31, 2022 | Dec. 31, 2021 |
Statement of Financial Position [Abstract] | ||
Common stock, par value (in dollars per share) | $ 0.001 | $ 0.001 |
Common stock, shares authorized (in shares) | 150,000,000 | 150,000,000 |
Common stock, shares outstanding (in shares) | 59,000,000 | 58,000,000 |
Preferred stock, par value (in dollars per share) | $ 0.001 | $ 0.001 |
Preferred stock, shares authorized (in shares) | 20,000,000 | 20,000,000 |
Preferred stock, shares issued (in shares) | 0 | 0 |
Preferred stock, shares outstanding (in shares) | 0 | 0 |
CONSOLIDATED STATEMENTS OF STOC
CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Millions, $ in Millions | Total | Common Stock | Additional Paid-in Capital | Accumulated Other Comprehensive Loss | Retained Earnings |
Beginning balance (in shares) at Dec. 31, 2020 | 59 | ||||
Beginning balance at Dec. 31, 2020 | $ 2,096 | $ 0 | $ 199 | $ 37 | $ 1,860 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||
Net income | 228 | 228 | |||
Other comprehensive loss, net | (11) | (11) | |||
Common stock purchases (in shares) | (1) | ||||
Common stock purchases | (122) | (2) | (120) | ||
Share-based compensation | (27) | (27) | |||
Ending balance (in shares) at Mar. 31, 2021 | 58 | ||||
Ending balance at Mar. 31, 2021 | 2,164 | $ 0 | 170 | 26 | 1,968 |
Beginning balance (in shares) at Dec. 31, 2021 | 58 | ||||
Beginning balance at Dec. 31, 2021 | 2,630 | $ 0 | 236 | (5) | 2,399 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||
Net income | 258 | 258 | |||
Other comprehensive loss, net | (76) | (76) | |||
Share-based compensation (in shares) | 1 | ||||
Share-based compensation | (18) | (18) | |||
Ending balance (in shares) at Mar. 31, 2022 | 59 | ||||
Ending balance at Mar. 31, 2022 | $ 2,794 | $ 0 | $ 218 | $ (81) | $ 2,657 |
CONSOLIDATED STATEMENTS OF CASH
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2022 | Mar. 31, 2021 | |
Operating activities: | ||
Net income | $ 258 | $ 228 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation and amortization | 40 | 33 |
Deferred income taxes | 16 | 6 |
Share-based compensation | 34 | 24 |
Other, net | (8) | 12 |
Changes in operating assets and liabilities: | ||
Receivables | 21 | (98) |
Prepaid expenses and other current assets | (32) | (15) |
Medical claims and benefits payable | 263 | 168 |
Amounts due government agencies | 137 | 432 |
Accounts payable, accrued liabilities and other | (81) | 16 |
Deferred revenue | (352) | (304) |
Income taxes | 67 | 66 |
Net cash provided by operating activities | 363 | 568 |
Investing activities: | ||
Purchases of investments | (403) | (388) |
Proceeds from sales and maturities of investments | 513 | 308 |
Purchases of property, equipment and capitalized software | (23) | (16) |
Other, net | (13) | 9 |
Net cash provided by (used in) investing activities | 74 | (87) |
Financing activities: | ||
Common stock withheld to settle employee tax obligations | (52) | (51) |
Contingent consideration liabilities settled | (20) | (20) |
Common stock purchases | 0 | (128) |
Other, net | (5) | (8) |
Net cash used in financing activities | (77) | (207) |
Net increase in cash, cash equivalents, and restricted cash and cash equivalents | 360 | 274 |
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period | 4,506 | 4,223 |
Cash, cash equivalents, and restricted cash and cash equivalents at end of period | $ 4,866 | $ 4,497 |
Organization and Basis of Prese
Organization and Basis of Presentation | 3 Months Ended |
Mar. 31, 2022 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Organization and Basis of Presentation | Organization and Basis of Presentation Organization and Operations Molina Healthcare, Inc. provides managed healthcare services under the Medicaid and Medicare programs, and through the state insurance marketplaces (the “Marketplace”). We currently have four reportable segments consisting of: 1) Medicaid; 2) Medicare; 3) Marketplace; and 4) Other. Our reportable segments are consistent with how we currently manage the business and view the markets we serve. As of March 31, 2022, we served approximately 5.1 million members eligible for government-sponsored healthcare programs, located across 19 states. Our state Medicaid contracts typically have terms of three In addition to contract renewal, our state Medicaid contracts may be periodically amended to include or exclude certain health benefits (such as pharmacy services, behavioral health services, or long-term care services); populations such as the aged, blind or disabled (“ABD”); and regions or service areas. Recent Developments California Procurement—Medicaid. In April 2022, we submitted our RFP response. We expect the award to be announced in early August 2022, with an effective date of January 2024. Texas Procurement—Medicaid. In March 2022, the Texas Health and Human Services Commission posted the ABD program (known in Texas as STAR+PLUS) RFP, with awards estimated to be announced in the fourth quarter of 2022, and start of operations in September 2023. Texas Acquisition—Medicaid and Medicare. On January 1, 2022, we closed on our acquisition of Cigna Corporation’s Texas Medicaid and Medicare-Medicaid Plan (“MMP”) contracts, along with certain operating assets. See Note 4, “Business Combinations,” for further information. Nevada Procurement—Medicaid. Our new contract in Clark and Washoe Counties commenced on January 1, 2022, and offers health coverage to TANF, CHIP and Medicaid Expansion beneficiaries. The four year contract with a possible two-year extension was ratified in September 2021. Consolidation and Interim Financial Information The consolidated financial statements include the accounts of Molina Healthcare, Inc., and its subsidiaries. In the opinion of management, all adjustments considered necessary for a fair presentation of the results as of the date and for the interim periods presented have been included; such adjustments consist of normal recurring adjustments. All significant intercompany balances and transactions have been eliminated. The consolidated results of operations for the three months ended March 31, 2022 are not necessarily indicative of the results for the entire year ending December 31, 2022. The unaudited consolidated interim financial statements have been prepared under the assumption that users of the interim financial data have either read or have access to our audited consolidated financial statements for the fiscal year ended December 31, 2021. Accordingly, certain disclosures that would substantially duplicate the disclosures contained in our December 31, 2021, audited consolidated financial statements have been omitted. These unaudited consolidated interim financial statements should be read in conjunction with our audited consolidated financial statements for the fiscal year ended December 31, 2021. Use of Estimates |
Significant Accounting Policies
Significant Accounting Policies | 3 Months Ended |
Mar. 31, 2022 | |
Accounting Policies [Abstract] | |
Significant Accounting Policies | Significant Accounting Policies Cash and Cash Equivalents Cash and cash equivalents consist of cash and short-term, highly liquid investments that are both readily convertible into known amounts of cash and have a maturity of three months or less on the date of purchase. The following table provides a reconciliation of cash, cash equivalents, and restricted cash and cash equivalents reported within the accompanying consolidated balance sheets that sum to the total of the same such amounts presented in the accompanying consolidated statements of cash flows. The restricted cash and cash equivalents presented below are included in “Restricted investments” in the accompanying consolidated balance sheets. March 31, 2022 2021 (In millions) Cash and cash equivalents $ 4,804 $ 4,431 Restricted cash and cash equivalents 62 66 Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows $ 4,866 $ 4,497 Receivables Receivables consist primarily of premium amounts due from government agencies, which are subject to potential retroactive adjustments. Because substantially all of our receivable amounts are readily determinable and substantially all of our creditors are governmental authorities, our allowance for credit losses is insignificant. Any amounts determined to be uncollectible are charged to expense when such determination is made. March 31, December 31, (In millions) Government receivables $ 1,589 $ 1,566 Pharmacy rebate receivables 306 276 Other 261 335 Total $ 2,156 $ 2,177 Premium Revenue Recognition and Amounts Due Government Agencies Premium revenue is generated from our contracts with state and federal agencies, in connection with our participation in the Medicaid, Medicare, and Marketplace programs. Premium revenue is generally received based on per member per month (“PMPM”) rates established in advance of the periods covered. These premium revenues are recognized in the month that members are entitled to receive healthcare services, and premiums collected in advance are deferred. State Medicaid programs and the federal Medicare program periodically adjust premium rates. Certain components of premium revenue are subject to accounting estimates and are described in further detail below, and in our 2021 Annual Report on Form 10-K, Note 2, “Significant Accounting Policies,” under “Contractual Provisions That May Adjust or Limit Revenue or Profit,” and “Quality Incentives.” Contractual Provisions That May Adjust or Limit Revenue or Profit Many of our contracts contain provisions that may adjust or limit revenue or profit, as described below. Consequently, we recognize premium revenue as it is earned under such provisions. Liabilities accrued for premiums to be returned under such provisions are reported in the aggregate as “Amounts due government agencies,” in the accompanying consolidated balance sheets. The following table sets forth amounts due government agencies, categorized by program: March 31, December 31, (In millions) Medicaid program: Minimum MLR and profit sharing $ 1,033 $ 1,016 Other 270 263 Medicare program: Risk adjustment and Part D risk sharing 105 89 Minimum MLR and profit sharing 103 101 Other 31 35 Marketplace program: Risk adjustment 949 902 Minimum MLR 20 18 Other 102 48 Total amounts due government agencies $ 2,613 $ 2,472 Medicaid Program Minimum MLR and Retroactive Premium Adjustments. State Medicaid programs periodically adjust premium rates on a retroactive basis. In these cases, we adjust our premium revenue in the period in which we determine that the adjustment is probable and reasonably estimable, based on our best estimate of the ultimate premium we expect to realize for the period being adjusted. Beginning in 2020, various states enacted temporary risk corridors in response to the reduced demand for medical services stemming from COVID-1 9 , which have resulted in a reduction of our medical margin. In some cases, these risk corridors were retroactive to earlier periods in 2020, or as early as the beginning of the states’ fiscal years in 2019. Beginning in the second quarter of 2020, we have recognized risk corridors that we believe to be probable, and where the ultimate premium amount is reasonably estimable. For the three months ended March 31, 2022, we recognized approximately $28 million related to such risk corridors, primarily in the Medicaid segment, compared to $110 million recognized in the three months ended March 31, 2021. The decrease is due to the elimination of several of the COVID-19 risk corridors. It is possible that certain states could change the structure of existing risk corridors, implement new risk corridors in the future or discontinue existing risk corridors. Due to these uncertainties, the ultimate outcomes could differ materially from our estimates as a result of changes in facts or further developments, which could have an adverse effect on our consolidated financial position, results of operations, or cash flows. Marketplace Program Risk Adjustment. Under this program, our health plans’ composite risk scores are compared with the overall average risk score for the relevant state and market pool. Generally, our health plans will make a risk adjustment payment into the pool if their composite risk scores are below the average risk score (risk adjustment payable), and will receive a risk adjustment payment from the pool if their composite risk scores are above the average risk score (risk adjustment receivable). We estimate our ultimate premium based on insurance policy year-to-date experience, and recognize estimated premiums relating to the risk adjustment program as an adjustment to premium revenue in our consolidated statements of income. As of March 31, 2022, Marketplace risk adjustment payables amounted to $949 million and related receivables amounted to $33 million, for a net payable of $916 million. As of December 31, 2021, Marketplace risk adjustment payables amounted to $902 million and related receivables amounted to $7 million, for a net payable of $895 million. Concentrations of Credit Risk Financial instruments that potentially subject us to concentrations of credit risk consist primarily of cash and cash equivalents, investments, receivables, and restricted investments. Our investments and a portion of our cash equivalents are managed by professional portfolio managers operating under documented investment guidelines. Our portfolio managers must obtain our prior approval before selling investments where the loss position of those investments exceeds certain levels. Our investments consist primarily of investment-grade debt securities with final maturities of less than 15 years, or less than 15 years average life for structured securities. Restricted investments are invested principally in cash, cash equivalents, and U.S. Treasury securities. Concentration of credit risk with respect to accounts receivable is limited because our payors consist principally of the federal government, and governments of each state in which our health plan subsidiaries operate. Income Taxes The provision for income taxes is determined using an estimated annual effective tax rate, which generally differs from the U.S. federal statutory rate primarily because of foreign and state taxes, and nondeductible expenses such as certain compensation and other general and administrative expenses. The effective tax rate may be subject to fluctuations during the year as new information is obtained. Such information may affect the assumptions used to estimate the annual effective tax rate, including projected pretax earnings, the mix of pretax earnings in the various tax jurisdictions in which we operate, valuation allowances against deferred tax assets, the recognition or the reversal of the recognition of tax benefits related to uncertain tax positions, and changes in or the interpretation of tax laws in jurisdictions where we conduct business. We recognize deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of our assets and liabilities, along with net operating loss and tax credit carryovers. Recent Accounting Pronouncements Recent accounting pronouncements issued by the FASB (including its Emerging Issues Task Force), the American Institute of Certified Public Accountants, and the Securities and Exchange Commission (“SEC”) did not have, nor does management expect such pronouncements to have, a significant impact on our present or future consolidated financial statements. |
Net Income Per Share
Net Income Per Share | 3 Months Ended |
Mar. 31, 2022 | |
Earnings Per Share [Abstract] | |
Net Income Per Share | Net Income Per Share The following table sets forth the calculation of basic and diluted net income per share: Three Months Ended March 31, 2022 2021 (In millions, except net income per share) Numerator: Net income $ 258 $ 228 Denominator: Shares outstanding at the beginning of the period 57.9 58.0 Weighted-average number of shares issued: Stock-based compensation 0.1 0.1 Stock purchases — (0.4) Denominator for basic net income per share 58.0 57.7 Effect of dilutive securities: (1) Stock-based compensation 0.7 0.9 Denominator for diluted net income per share 58.7 58.6 Net income per share - Basic (2) $ 4.45 $ 3.95 Net income per share - Diluted (2) $ 4.39 $ 3.89 ______________________________ (1) The dilutive effect of all potentially dilutive common shares is calculated using the treasury stock method. |
Business Combinations
Business Combinations | 3 Months Ended |
Mar. 31, 2022 | |
Business Combination and Asset Acquisition [Abstract] | |
Business Combinations | Business Combinations Cigna. On January 1, 2022, we closed on our acquisition of Cigna Corporation’s Texas Medicaid and Medicare-Medicaid Plan contracts, along with certain operating assets, for purchase consideration of approximately $60 million. We acquired membership and a provider network with a preliminary fair value of approximately $36 million. We allocated the remaining $24 million of purchase consideration to goodwill, primarily in the Medicaid segment, which relates to future economic benefits arising from expected synergies from the use of our existing infrastructure to support the added membership, and from the assembled workforce. The goodwill is deductible for income tax purposes. |
Fair Value Measurements
Fair Value Measurements | 3 Months Ended |
Mar. 31, 2022 | |
Fair Value Disclosures [Abstract] | |
Fair Value Measurements | Fair Value Measurements We consider the carrying amounts of current assets and current liabilities to approximate their fair values because of the relatively short period of time between the origination of these instruments and their expected realization or payment. For our financial instruments measured at fair value on a recurring basis, we prioritize the inputs used in measuring fair value according to the three-tier fair value hierarchy. For a description of the methods and assumptions used to: a) estimate the fair value; and b) determine the classification according to the fair value hierarchy for each financial instrument, refer to our 2021 Annual Report on Form 10-K, Note 5, “Fair Value Measurements.” The net changes in fair value of Level 3 financial instruments are reported in “Other” operating expenses in our consolidated statements of income. In the three months ended March 31, 2022 and 2021, we recognized a loss of $4 million and $8 million, respectively, for the increase in the fair value of the contingent consideration liabilities described below. Our financial instruments measured at fair value on a recurring basis at March 31, 2022, were as follows: Observable Inputs Directly or Indirectly Observable Inputs Unobservable Inputs Total (Level 1) (Level 2) (Level 3) (In millions) Corporate debt securities $ 1,808 $ — $ 1,808 $ — Mortgage-backed securities 598 — 598 — Asset-backed securities 252 — 252 — U.S. Treasury notes 174 — 174 — Municipal securities 117 — 117 — Other 39 — 39 — Total assets $ 2,988 $ — $ 2,988 $ — Contingent consideration liabilities $ 8 $ — $ — $ 8 Total liabilities $ 8 $ — $ — $ 8 Our financial instruments measured at fair value on a recurring basis at December 31, 2021, were as follows: Observable Inputs Directly or Indirectly Observable Inputs Unobservable Inputs Total (Level 1) (Level 2) (Level 3) (In millions) Corporate debt securities $ 1,833 $ — $ 1,833 $ — Mortgage-backed securities 614 — 614 — Asset-backed securities 247 — 247 — U.S. Treasury notes 353 — 353 — Municipal securities 123 — 123 — Other 32 — 32 — Total assets $ 3,202 $ — $ 3,202 $ — Contingent consideration liabilities $ 47 $ — $ — $ 47 Total liabilities $ 47 $ — $ — $ 47 Contingent Consideration Liabilities Our Level 3 financial instruments at March 31, 2022 are comprised solely of contingent consideration liabilities of $8 million, in connection with our 2020 acquisition of certain assets of Passport Health Plan, Inc., a Medicaid health plan in Kentucky. Such liabilities are recorded at fair value on a recurring basis. In the three months ended March 31, 2022, the estimated fair value of contingent purchase consideration increased by approximately $4 million, relating to an operating income guarantee. In the three months ended March 31, 2022 we paid the seller $43 million, of which $23 million was for the remaining half of the consideration due for minimum member enrollment targets and $20 million was for the first payment of the consideration due for the operating income guarantee. For the amounts paid in the three months ended March 31, 2022, $20 million has been presented in “Financing activities” in the accompanying consolidated statements of cash flows, with the balance reflected in “Operating activities.” The remaining balance of the liabilities is reported in “Accounts payable, accrued liabilities and other” in the accompanying consolidated balance sheets. Fair Value Measurements – Disclosure Only The carrying amounts and estimated fair values of our notes payable are classified as Level 2 financial instruments. Fair value for these securities is determined using a market approach based on quoted market prices for similar securities in active markets or quoted prices for identical securities in inactive markets. March 31, 2022 December 31, 2021 Carrying Fair Value Carrying Fair Value (In millions) 4.375% Notes due 2028 $ 791 $ 789 $ 791 $ 829 3.875% Notes due 2030 642 624 642 675 3.875% Notes due 2032 741 713 740 760 Total $ 2,174 $ 2,126 $ 2,173 $ 2,264 |
Investments
Investments | 3 Months Ended |
Mar. 31, 2022 | |
Investments, Debt and Equity Securities [Abstract] | |
Investments | Investments Available-for-Sale We consider all of our investments classified as current assets to be available-for-sale. The following tables summarize our current investments as of the dates indicated: March 31, 2022 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 1,874 $ 1 $ 67 $ 1,808 Mortgage-backed securities 622 — 24 598 Asset-backed securities 261 — 9 252 U.S. Treasury notes 174 — — 174 Municipal securities 123 — 6 117 Other 40 — 1 39 Total $ 3,094 $ 1 $ 107 $ 2,988 December 31, 2021 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 1,836 $ 9 $ 12 $ 1,833 Mortgage-backed securities 616 2 4 614 Asset-backed securities 248 — 1 247 U.S. Treasury notes 353 — — 353 Municipal securities 123 1 1 123 Other 32 — — 32 Total $ 3,208 $ 12 $ 18 $ 3,202 The contractual maturities of our current investments as of March 31, 2022 are summarized below: Amortized Cost Estimated (In millions) Due in one year or less $ 466 $ 466 Due after one year through five years 1,733 1,668 Due after five years through ten years 318 306 Due after ten years 577 548 Total $ 3,094 $ 2,988 Gross realized gains and losses from sales of available-for-sale securities are calculated under the specific identification method and are included in investment income. Gross realized investment gains and losses were insignificant for the three months ended March 31, 2022, and 2021. We have determined that unrealized losses at March 31, 2022, and December 31, 2021, primarily resulted from fluctuating interest rates, rather than a deterioration of the creditworthiness of the issuers. Therefore, we determined that an allowance for credit losses was not necessary. So long as we maintain the intent and ability to hold these securities to maturity, we are unlikely to experience losses. In the event that we dispose of these securities before maturity, we expect that realized losses, if any, will be insignificant. The following table summarizes those available-for-sale investments that have been in a continuous loss position for less than 12 months. No investments have been in a continuous loss position for 12 months or more as of March 31, 2022, and December 31, 2021. March 31, 2022 December 31, 2021 Estimated Unrealized Total Estimated Unrealized Total (Dollars in millions) Corporate debt securities $ 1,516 $ 67 624 $ 1,063 $ 12 395 Mortgage-backed securities 582 24 238 408 4 146 Asset-backed securities 208 9 99 166 1 75 Municipal securities 97 6 120 69 1 61 Other 25 1 10 — — — Total $ 2,428 $ 107 1,091 $ 1,706 $ 18 677 Restricted Investments Held-to-Maturity Pursuant to the regulations governing our state health plan subsidiaries, we maintain statutory deposits and deposits required by government authorities primarily in cash, cash equivalents, and U.S. Treasury securities. We also maintain restricted investments as protection against the insolvency of certain capitated providers. The use of these funds is limited as required by regulations in the various states in which we operate, or as needed in the event of insolvency of capitated providers. Therefore, such investments are reported as “Restricted investments” in the accompanying consolidated balance sheets. We have the ability to hold these restricted investments until maturity, and as a result, we would not expect the value of these investments to decline significantly due to a sudden change in market interest rates. Our held-to-maturity restricted investments are carried at amortized cost, which approximates fair value. Such investments amounted to $221 million at March 31, 2022, of which $190 million will mature in one year or less, and $31 million will mature in one through five years. |
Medical Claims and Benefits Pay
Medical Claims and Benefits Payable | 3 Months Ended |
Mar. 31, 2022 | |
Other Liabilities Disclosure [Abstract] | |
Medical Claims and Benefits Payable | Medical Claims and Benefits Payable The following table provides the details of our medical claims and benefits payable as of the dates indicated: March 31, December 31, (In millions) Claims incurred but not paid (“IBNP”) $ 2,521 $ 2,486 Pharmacy payable 240 219 Capitation payable 95 82 Other 745 576 Total $ 3,601 $ 3,363 “Other” medical claims and benefits payable include amounts payable to certain providers for which we act as an intermediary on behalf of various government agencies without assuming financial risk. Such receipts and payments do not impact our consolidated statements of income. Non-risk provider payables amounted to $322 million and $226 million as of March 31, 2022, and December 31, 2021, respectively. The following tables present the components of the change in our medical claims and benefits payable for the periods indicated. The amounts presented for “Components of medical care costs related to: Prior years” represent the amount by which our original estimate of medical claims and benefits payable at the beginning of the year varied from the actual liabilities, based on information (principally the payment of claims) developed since those liabilities were first reported. Three Months Ended March 31, 2022 Medicaid Medicare Marketplace Consolidated (In millions) Medical claims and benefits payable, beginning balance $ 2,580 $ 404 $ 379 $ 3,363 Components of medical care costs related to: Current year 5,424 840 505 6,769 Prior years (154) (25) (27) (206) Total medical care costs 5,270 815 478 6,563 Payments for medical care costs related to: Current year 3,402 465 330 4,197 Prior years 1,633 306 260 2,199 Total paid 5,035 771 590 6,396 Acquired balances, net of post-acquisition adjustments (25) — — (25) Change in non-risk and other provider payables 93 3 — 96 Medical claims and benefits payable, ending balance $ 2,883 $ 451 $ 267 $ 3,601 Three Months Ended March 31, 2021 Medicaid Medicare Marketplace Consolidated (In millions) Medical claims and benefits payable, beginning balance $ 2,129 $ 392 $ 175 $ 2,696 Components of medical care costs related to: Current year 4,394 738 536 5,668 Prior years (158) (16) (20) (194) Total medical care costs 4,236 722 516 5,474 Payments for medical care costs related to: Current year 2,790 410 313 3,513 Prior years 1,364 304 113 1,781 Total paid 4,154 714 426 5,294 Acquired balances, net of post-acquisition adjustments 8 (33) — (25) Change in non-risk and other provider payables (11) (1) — (12) Medical claims and benefits payable, ending balance $ 2,208 $ 366 $ 265 $ 2,839 Our estimates of medical claims and benefits payable recorded at December 31, 2021, and 2020 developed favorably by approximately $206 million and $194 million as of March 31, 2022, and 2021, respectively. The favorable prior year development recognized in the three months ended March 31, 2022 was primarily due to lower than expected utilization of medical services by our members and improved operating performance. Consequently, the ultimate costs recognized in 2022, as claims payments were processed, were lower than our estimates in 2021. |
Debt
Debt | 3 Months Ended |
Mar. 31, 2022 | |
Debt Disclosure [Abstract] | |
Debt | Debt All our debt is held at the parent, which is reported in the Other segment. The following table summarizes our outstanding debt obligations, all of which are non-current as of the dates reported below: March 31, December 31, (In millions) Non-current long-term debt: 4.375% Notes due 2028 $ 800 $ 800 3.875% Notes due 2030 650 650 3.875% Notes due 2032 750 750 Deferred debt issuance costs (26) (27) Total $ 2,174 $ 2,173 Credit Agreement We are party to a credit agreement (the “Credit Agreement”) which includes a revolving credit facility (“Credit Facility”) of $1.0 billion, among other provisions. The Credit Agreement has a term of five years, and all amounts outstanding will be due and payable on June 8, 2025. Borrowings under the Credit Agreement bear interest based, at our election, on a base rate or other defined rate, plus in each case, the applicable margin. In addition to interest payable on the principal amount of indebtedness outstanding from time to time under the Credit Agreement, we are required to pay a quarterly commitment fee. The Credit Agreement contains customary non-financial and financial covenants. As of March 31, 2022, we were in compliance with all financial and non-financial covenants under the Credit Agreement and other long-term debt. As of March 31, 2022, no amounts were outstanding under the Credit Facility. Senior Notes Our senior notes are described below. Each of these notes are senior unsecured obligations of Molina and rank equally in right of payment with all existing and future senior debt, and senior to all existing and future subordinated debt of Molina. In addition, each of the notes contain customary non-financial covenants and change of control provisions. The indentures governing the senior notes contain cross-default provisions that are triggered upon default by us or any of our subsidiaries on any indebtedness in excess of the amount specified in the applicable indenture. 4.375% Notes due 2028. We had $800 million aggregate principal amount of senior notes (the “4.375% Notes”) outstanding as of March 31, 2022, which are due June 15, 2028, unless earlier redeemed. Interest, at a rate of 4.375% per annum, is payable semiannually in arrears on June 15 and December 15. 3.875% Notes due 2030. We had $650 million aggregate principal amount of senior notes (the “3.875% Notes due 2030”) outstanding as of March 31, 2022, which are due November 15, 2030, unless earlier redeemed. Interest, at a rate of 3.875% per annum, is payable semiannually in arrears on May 15 and November 15. |
Stockholders' Equity
Stockholders' Equity | 3 Months Ended |
Mar. 31, 2022 | |
Equity [Abstract] | |
Stockholders' Equity | Stockholders' Equity In September 2021, our board of directors authorized the purchase of up to $500 million, in the aggregate, of our common stock. This new program, which superseded the stock purchase program approved by our board of directors in September 2020, is funded with cash on hand and extends through December 31, 2022. The exact timing and amount of any repurchase is determined by management based on market conditions and share price, in addition to other factors, and subject to the restrictions relating to volume, price, and timing under applicable law. As of April 27, 2022, we have purchased 85,000 shares under the stock purchase program approved in 2021. |
Segments
Segments | 3 Months Ended |
Mar. 31, 2022 | |
Segment Reporting [Abstract] | |
Segments | Segments We currently have four reportable segments consisting of: 1) Medicaid; 2) Medicare; 3) Marketplace; and 4) Other. Our reportable segments are consistent with how we currently manage the business and view the markets we serve. The Medicaid, Medicare, and Marketplace segments represent the government-funded or sponsored programs under which we offer managed healthcare services. The Other segment, which is insignificant to our consolidated results of operations, includes certain corporate amounts not associated with or allocated to the Medicaid, Medicare, or Marketplace segments. Additionally, the Other segment includes service revenues and service costs associated with the long-term services and supports consultative services we provide in Wisconsin. The key metrics used to assess the performance of our Medicaid, Medicare, and Marketplace segments are premium revenue, medical margin and medical care ratio (“MCR”). MCR represents the amount of medical care costs as a percentage of premium revenue. Therefore, the underlying medical margin, or the amount earned by the Medicaid, Medicare, and Marketplace segments after medical costs are deducted from premium revenue, represents the most important measure of earnings reviewed by management, and is used by our chief executive officer to review results, assess performance, and allocate resources. The key metric used to assess the performance of our Other segment is service margin. The service margin is equal to service revenue minus cost of service revenue. We do not report total assets by segment because this is not a metric used to assess segment performance or allocate resources. The following table presents total revenue by segment. Inter-segment revenue was insignificant for all periods presented. Three Months Ended March 31, 2022 2021 (In millions) Total revenue: Medicaid $ 6,187 $ 5,020 Medicare 949 805 Marketplace 616 680 Other 18 17 Total $ 7,770 $ 6,522 The following table reconciles margin by segment to consolidated income before income taxes. Three Months Ended March 31, 2022 2021 (In millions) Margin: Medicaid $ 710 $ 604 Medicare 128 77 Marketplace 130 151 Other 3 4 Total margin 971 836 Add: other operating revenues (1) 221 199 Less: other operating expenses (2) (820) (700) Operating income 372 335 Other expenses, net 28 30 Income before income tax expense $ 344 $ 305 ______________________ (1) Other operating revenues include premium tax revenue, investment income, and other revenue. (2) Other operating expenses include general and administrative expenses, premium tax expenses, depreciation and amortization, and other operating expenses. |
Commitments and Contingencies
Commitments and Contingencies | 3 Months Ended |
Mar. 31, 2022 | |
Commitments and Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | Commitments and Contingencies COVID-19 Pandemic We continue to monitor and assess the estimated operating and financial impact of the COVID-19 pandemic, and as it evolves, we continue to process, assemble, and assess member utilization information. We believe that our cash resources, borrowing capacity available under the Credit Agreement, and cash flow generated from operations will be sufficient to withstand the financial impact of the pandemic, and will enable us to continue to support our operations, regulatory requirements, debt repayment obligations, and capital expenditures for the foreseeable future. Legal Proceedings The healthcare industry is subject to numerous laws and regulations of federal, state, and local governments. Compliance with these laws and regulations can be subject to government review and interpretation, as well as regulatory actions unknown and unasserted at this time. Penalties associated with violations of these laws and regulations include significant fines and penalties, exclusion from participating in publicly funded programs, the repayment of previously billed and collected revenues and reputational damage. We are involved in legal actions in the ordinary course of business including, but not limited to, various employment claims, vendor disputes and provider claims. Some of these legal actions seek monetary damages, including claims for punitive damages, which may not be covered by insurance. We review legal matters and update our estimates of reasonably possible losses and related disclosures, as necessary. We have accrued liabilities for legal matters for which we deem the loss to be both probable and reasonably estimable. These liability estimates could change as a result of further developments of the matters. The outcome of legal actions is inherently uncertain. An adverse determination in one or more of these pending matters could have an adverse effect on our consolidated financial position, results of operations, or cash flows. Kentucky RFP . On September 4, 2020, Anthem Kentucky Managed Care Plan, Inc. brought an action in Franklin County Circuit Court against the Kentucky Finance and Administration Cabinet, the Kentucky Cabinet for Health and Family Services, and all of the five winning bidder health plans, including our Kentucky health plan. The appellate briefing has concluded and no assurances can be given regarding the ultimate outcome. Under the Court’s June 16, 2021 final Order, our Kentucky health plan will continue to operate for the foreseeable future under its current Medicaid contract and provide care to Kentucky Medicaid members. Puerto Rico. On August 13, 2021, Molina Healthcare of Puerto Rico, Inc. (“MHPR”) filed a complaint asserting, among other claims, breach of contract against the Puerto Rico Health Insurance Administration (“ASES”). On September 13, 2021, in addition to filing its answer to MHPR’s complaint, ASES filed a counterclaim and a third-party complaint against MHPR and the Company. The counterclaim alleges that MHPR and the Company breached contractual obligations by failing to pay providers, and seeks damages and various equitable remedies. On October 8, 2021, MHPR filed its reply to the counterclaim, denying all the allegations, and on November 1, 2021, the Company filed its answer to the third-party complaint. On December 3, 2021, MHPR filed a request for disbursement of illegally withheld funds, and ASES filed its opposition. At a status hearing on January 19, 2022, the Court heard MHPR’s request for disbursement. The Court has not ruled on the request. On March 23, 2022, the Court informed the parties that it will appoint a Special Commissioner to review the merits of the entire case, with the assigned judge retaining final authority over any resolution. The parties are negotiating the engagement of the Special Commissioner. This matter is in its early stages and remains subject to significant additional proceedings, and no prediction can be made as to the outcome. No gain or loss is probable and reasonably estimable with regard to either MHPR’s complaint or the counterclaim of ASES. |
Significant Accounting Polici_2
Significant Accounting Policies (Policies) | 3 Months Ended |
Mar. 31, 2022 | |
Accounting Policies [Abstract] | |
Consolidation and Interim Financial Information | Consolidation and Interim Financial Information The consolidated financial statements include the accounts of Molina Healthcare, Inc., and its subsidiaries. In the opinion of management, all adjustments considered necessary for a fair presentation of the results as of the date and for the interim periods presented have been included; such adjustments consist of normal recurring adjustments. All significant intercompany balances and transactions have been eliminated. The consolidated results of operations for the three months ended March 31, 2022 are not necessarily indicative of the results for the entire year ending December 31, 2022. |
Use of Estimates | Use of EstimatesThe preparation of consolidated financial statements in conformity with U.S. generally accepted accounting principles (“GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities. Estimates also affect the reported amounts of revenues and expenses during the reporting period. Actual results could differ from these estimates. |
Cash and Cash Equivalents | Cash and Cash EquivalentsCash and cash equivalents consist of cash and short-term, highly liquid investments that are both readily convertible into known amounts of cash and have a maturity of three months or less on the date of purchase. |
Receivables | Receivables Receivables consist primarily of premium amounts due from government agencies, which are subject to potential retroactive adjustments. Because substantially all of our receivable amounts are readily determinable and substantially all of our creditors are governmental authorities, our allowance for credit losses is insignificant. Any amounts determined to be uncollectible are charged to expense when such determination is made. |
Premium Revenue Recognition and Amounts Due Government Agencies and Contractual Provisions That May Adjust or Limit Revenue or Profit | Premium Revenue Recognition and Amounts Due Government Agencies Premium revenue is generated from our contracts with state and federal agencies, in connection with our participation in the Medicaid, Medicare, and Marketplace programs. Premium revenue is generally received based on per member per month (“PMPM”) rates established in advance of the periods covered. These premium revenues are recognized in the month that members are entitled to receive healthcare services, and premiums collected in advance are deferred. State Medicaid programs and the federal Medicare program periodically adjust premium rates. Certain components of premium revenue are subject to accounting estimates and are described in further detail below, and in our 2021 Annual Report on Form 10-K, Note 2, “Significant Accounting Policies,” under “Contractual Provisions That May Adjust or Limit Revenue or Profit,” and “Quality Incentives.” Medicaid Program Minimum MLR and Retroactive Premium Adjustments. State Medicaid programs periodically adjust premium rates on a retroactive basis. In these cases, we adjust our premium revenue in the period in which we determine that the adjustment is probable and reasonably estimable, based on our best estimate of the ultimate premium we expect to realize for the period being adjusted. Beginning in 2020, various states enacted temporary risk corridors in response to the reduced demand for medical services stemming from COVID-1 9 , which have resulted in a reduction of our medical margin. In some cases, these risk corridors were retroactive to earlier periods in 2020, or as early as the beginning of the states’ fiscal years in 2019. Beginning in the second quarter of 2020, we have recognized risk corridors that we believe to be probable, and where the ultimate premium amount is reasonably estimable. For the three months ended March 31, 2022, we recognized approximately $28 million related to such risk corridors, primarily in the Medicaid segment, compared to $110 million recognized in the three months ended March 31, 2021. The decrease is due to the elimination of several of the COVID-19 risk corridors. It is possible that certain states could change the structure of existing risk corridors, implement new risk corridors in the future or discontinue existing risk corridors. Due to these uncertainties, the ultimate outcomes could differ materially from our estimates as a result of changes in facts or further developments, which could have an adverse effect on our consolidated financial position, results of operations, or cash flows. Marketplace Program |
Concentrations of Credit Risk | Concentrations of Credit Risk Financial instruments that potentially subject us to concentrations of credit risk consist primarily of cash and cash equivalents, investments, receivables, and restricted investments. Our investments and a portion of our cash equivalents are managed by professional portfolio managers operating under documented investment guidelines. Our portfolio managers must obtain our prior approval before selling investments where the loss position of those investments exceeds certain levels. Our investments consist primarily of investment-grade debt securities with final maturities of less than 15 years, or less than 15 years average life for structured securities. Restricted investments are invested principally in cash, cash equivalents, and U.S. Treasury securities. Concentration of credit risk with respect to accounts receivable is limited because our payors consist principally of the federal government, and governments of each state in which our health plan subsidiaries operate. |
Income Taxes | Income Taxes The provision for income taxes is determined using an estimated annual effective tax rate, which generally differs from the U.S. federal statutory rate primarily because of foreign and state taxes, and nondeductible expenses such as certain compensation and other general and administrative expenses. The effective tax rate may be subject to fluctuations during the year as new information is obtained. Such information may affect the assumptions used to estimate the annual effective tax rate, including projected pretax earnings, the mix of pretax earnings in the various tax jurisdictions in which we operate, valuation allowances against deferred tax assets, the recognition or the reversal of the recognition of tax benefits related to uncertain tax positions, and changes in or the interpretation of tax laws in jurisdictions where we conduct business. We recognize deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of our assets and liabilities, along with net operating loss and tax credit carryovers. |
Recent Accounting Pronouncements | Recent Accounting Pronouncements Recent accounting pronouncements issued by the FASB (including its Emerging Issues Task Force), the American Institute of Certified Public Accountants, and the Securities and Exchange Commission (“SEC”) did not have, nor does management expect such pronouncements to have, a significant impact on our present or future consolidated financial statements. |
Significant Accounting Polici_3
Significant Accounting Policies (Tables) | 3 Months Ended |
Mar. 31, 2022 | |
Accounting Policies [Abstract] | |
Schedule of Cash and cash equivalents | The following table provides a reconciliation of cash, cash equivalents, and restricted cash and cash equivalents reported within the accompanying consolidated balance sheets that sum to the total of the same such amounts presented in the accompanying consolidated statements of cash flows. The restricted cash and cash equivalents presented below are included in “Restricted investments” in the accompanying consolidated balance sheets. March 31, 2022 2021 (In millions) Cash and cash equivalents $ 4,804 $ 4,431 Restricted cash and cash equivalents 62 66 Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows $ 4,866 $ 4,497 |
Schedule of Restricted Cash and Cash Equivalents | The following table provides a reconciliation of cash, cash equivalents, and restricted cash and cash equivalents reported within the accompanying consolidated balance sheets that sum to the total of the same such amounts presented in the accompanying consolidated statements of cash flows. The restricted cash and cash equivalents presented below are included in “Restricted investments” in the accompanying consolidated balance sheets. March 31, 2022 2021 (In millions) Cash and cash equivalents $ 4,804 $ 4,431 Restricted cash and cash equivalents 62 66 Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows $ 4,866 $ 4,497 |
Schedule of Receivables | March 31, December 31, (In millions) Government receivables $ 1,589 $ 1,566 Pharmacy rebate receivables 306 276 Other 261 335 Total $ 2,156 $ 2,177 |
Schedule of Amounts Due to Government Agencies | Liabilities accrued for premiums to be returned under such provisions are reported in the aggregate as “Amounts due government agencies,” in the accompanying consolidated balance sheets. The following table sets forth amounts due government agencies, categorized by program: March 31, December 31, (In millions) Medicaid program: Minimum MLR and profit sharing $ 1,033 $ 1,016 Other 270 263 Medicare program: Risk adjustment and Part D risk sharing 105 89 Minimum MLR and profit sharing 103 101 Other 31 35 Marketplace program: Risk adjustment 949 902 Minimum MLR 20 18 Other 102 48 Total amounts due government agencies $ 2,613 $ 2,472 |
Net Income Per Share (Tables)
Net Income Per Share (Tables) | 3 Months Ended |
Mar. 31, 2022 | |
Earnings Per Share [Abstract] | |
Summary of Denominators for The Computation of Basic and Diluted Earnings Per Share | The following table sets forth the calculation of basic and diluted net income per share: Three Months Ended March 31, 2022 2021 (In millions, except net income per share) Numerator: Net income $ 258 $ 228 Denominator: Shares outstanding at the beginning of the period 57.9 58.0 Weighted-average number of shares issued: Stock-based compensation 0.1 0.1 Stock purchases — (0.4) Denominator for basic net income per share 58.0 57.7 Effect of dilutive securities: (1) Stock-based compensation 0.7 0.9 Denominator for diluted net income per share 58.7 58.6 Net income per share - Basic (2) $ 4.45 $ 3.95 Net income per share - Diluted (2) $ 4.39 $ 3.89 ______________________________ (1) The dilutive effect of all potentially dilutive common shares is calculated using the treasury stock method. |
Fair Value Measurements (Tables
Fair Value Measurements (Tables) | 3 Months Ended |
Mar. 31, 2022 | |
Fair Value Disclosures [Abstract] | |
Schedule of Fair Value of Assets Measured on Recurring Basis | Our financial instruments measured at fair value on a recurring basis at March 31, 2022, were as follows: Observable Inputs Directly or Indirectly Observable Inputs Unobservable Inputs Total (Level 1) (Level 2) (Level 3) (In millions) Corporate debt securities $ 1,808 $ — $ 1,808 $ — Mortgage-backed securities 598 — 598 — Asset-backed securities 252 — 252 — U.S. Treasury notes 174 — 174 — Municipal securities 117 — 117 — Other 39 — 39 — Total assets $ 2,988 $ — $ 2,988 $ — Contingent consideration liabilities $ 8 $ — $ — $ 8 Total liabilities $ 8 $ — $ — $ 8 Our financial instruments measured at fair value on a recurring basis at December 31, 2021, were as follows: Observable Inputs Directly or Indirectly Observable Inputs Unobservable Inputs Total (Level 1) (Level 2) (Level 3) (In millions) Corporate debt securities $ 1,833 $ — $ 1,833 $ — Mortgage-backed securities 614 — 614 — Asset-backed securities 247 — 247 — U.S. Treasury notes 353 — 353 — Municipal securities 123 — 123 — Other 32 — 32 — Total assets $ 3,202 $ — $ 3,202 $ — Contingent consideration liabilities $ 47 $ — $ — $ 47 Total liabilities $ 47 $ — $ — $ 47 |
Schedule of Fair Value Measurements of Senior Notes | March 31, 2022 December 31, 2021 Carrying Fair Value Carrying Fair Value (In millions) 4.375% Notes due 2028 $ 791 $ 789 $ 791 $ 829 3.875% Notes due 2030 642 624 642 675 3.875% Notes due 2032 741 713 740 760 Total $ 2,174 $ 2,126 $ 2,173 $ 2,264 |
Investments (Tables)
Investments (Tables) | 3 Months Ended |
Mar. 31, 2022 | |
Investments, Debt and Equity Securities [Abstract] | |
Schedule of Investments | The following tables summarize our current investments as of the dates indicated: March 31, 2022 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 1,874 $ 1 $ 67 $ 1,808 Mortgage-backed securities 622 — 24 598 Asset-backed securities 261 — 9 252 U.S. Treasury notes 174 — — 174 Municipal securities 123 — 6 117 Other 40 — 1 39 Total $ 3,094 $ 1 $ 107 $ 2,988 December 31, 2021 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 1,836 $ 9 $ 12 $ 1,833 Mortgage-backed securities 616 2 4 614 Asset-backed securities 248 — 1 247 U.S. Treasury notes 353 — — 353 Municipal securities 123 1 1 123 Other 32 — — 32 Total $ 3,208 $ 12 $ 18 $ 3,202 |
Schedule of Contractual Maturities of Investments | The contractual maturities of our current investments as of March 31, 2022 are summarized below: Amortized Cost Estimated (In millions) Due in one year or less $ 466 $ 466 Due after one year through five years 1,733 1,668 Due after five years through ten years 318 306 Due after ten years 577 548 Total $ 3,094 $ 2,988 |
Schedule of Available-for-Sale Investments | The following table summarizes those available-for-sale investments that have been in a continuous loss position for less than 12 months. No investments have been in a continuous loss position for 12 months or more as of March 31, 2022, and December 31, 2021. March 31, 2022 December 31, 2021 Estimated Unrealized Total Estimated Unrealized Total (Dollars in millions) Corporate debt securities $ 1,516 $ 67 624 $ 1,063 $ 12 395 Mortgage-backed securities 582 24 238 408 4 146 Asset-backed securities 208 9 99 166 1 75 Municipal securities 97 6 120 69 1 61 Other 25 1 10 — — — Total $ 2,428 $ 107 1,091 $ 1,706 $ 18 677 |
Medical Claims and Benefits P_2
Medical Claims and Benefits Payable (Tables) | 3 Months Ended |
Mar. 31, 2022 | |
Other Liabilities Disclosure [Abstract] | |
Schedule of Liability for Unpaid Claims and Claims Adjustment Expense | The following table provides the details of our medical claims and benefits payable as of the dates indicated: March 31, December 31, (In millions) Claims incurred but not paid (“IBNP”) $ 2,521 $ 2,486 Pharmacy payable 240 219 Capitation payable 95 82 Other 745 576 Total $ 3,601 $ 3,363 |
Schedule of Components of The Change in Medical Claims and Benefits Payable | The following tables present the components of the change in our medical claims and benefits payable for the periods indicated. The amounts presented for “Components of medical care costs related to: Prior years” represent the amount by which our original estimate of medical claims and benefits payable at the beginning of the year varied from the actual liabilities, based on information (principally the payment of claims) developed since those liabilities were first reported. Three Months Ended March 31, 2022 Medicaid Medicare Marketplace Consolidated (In millions) Medical claims and benefits payable, beginning balance $ 2,580 $ 404 $ 379 $ 3,363 Components of medical care costs related to: Current year 5,424 840 505 6,769 Prior years (154) (25) (27) (206) Total medical care costs 5,270 815 478 6,563 Payments for medical care costs related to: Current year 3,402 465 330 4,197 Prior years 1,633 306 260 2,199 Total paid 5,035 771 590 6,396 Acquired balances, net of post-acquisition adjustments (25) — — (25) Change in non-risk and other provider payables 93 3 — 96 Medical claims and benefits payable, ending balance $ 2,883 $ 451 $ 267 $ 3,601 Three Months Ended March 31, 2021 Medicaid Medicare Marketplace Consolidated (In millions) Medical claims and benefits payable, beginning balance $ 2,129 $ 392 $ 175 $ 2,696 Components of medical care costs related to: Current year 4,394 738 536 5,668 Prior years (158) (16) (20) (194) Total medical care costs 4,236 722 516 5,474 Payments for medical care costs related to: Current year 2,790 410 313 3,513 Prior years 1,364 304 113 1,781 Total paid 4,154 714 426 5,294 Acquired balances, net of post-acquisition adjustments 8 (33) — (25) Change in non-risk and other provider payables (11) (1) — (12) Medical claims and benefits payable, ending balance $ 2,208 $ 366 $ 265 $ 2,839 |
Debt (Tables)
Debt (Tables) | 3 Months Ended |
Mar. 31, 2022 | |
Debt Disclosure [Abstract] | |
Schedule of Long Term Debt | The following table summarizes our outstanding debt obligations, all of which are non-current as of the dates reported below: March 31, December 31, (In millions) Non-current long-term debt: 4.375% Notes due 2028 $ 800 $ 800 3.875% Notes due 2030 650 650 3.875% Notes due 2032 750 750 Deferred debt issuance costs (26) (27) Total $ 2,174 $ 2,173 |
Segments (Tables)
Segments (Tables) | 3 Months Ended |
Mar. 31, 2022 | |
Segment Reporting [Abstract] | |
Schedule of Operating Segment Information | The following table presents total revenue by segment. Inter-segment revenue was insignificant for all periods presented. Three Months Ended March 31, 2022 2021 (In millions) Total revenue: Medicaid $ 6,187 $ 5,020 Medicare 949 805 Marketplace 616 680 Other 18 17 Total $ 7,770 $ 6,522 The following table reconciles margin by segment to consolidated income before income taxes. Three Months Ended March 31, 2022 2021 (In millions) Margin: Medicaid $ 710 $ 604 Medicare 128 77 Marketplace 130 151 Other 3 4 Total margin 971 836 Add: other operating revenues (1) 221 199 Less: other operating expenses (2) (820) (700) Operating income 372 335 Other expenses, net 28 30 Income before income tax expense $ 344 $ 305 ______________________ (1) Other operating revenues include premium tax revenue, investment income, and other revenue. (2) Other operating expenses include general and administrative expenses, premium tax expenses, depreciation and amortization, and other operating expenses. |
Organization and Basis of Pre_2
Organization and Basis of Presentation (Details) member in Millions | 1 Months Ended | 3 Months Ended |
Sep. 30, 2021 | Mar. 31, 2022positionmembersegment | |
Segment Reporting Information [Line Items] | ||
Reportable segment | segment | 4 | |
Contract term | 4 years | |
Extension option | 2 years | |
Health Plans | ||
Segment Reporting Information [Line Items] | ||
Number of members eligible for the health care programs, approximately | member | 5.1 | |
Number of states with programs | position | 19 | |
Health Plans | Minimum | ||
Segment Reporting Information [Line Items] | ||
Contract term | 3 years | |
Health Plans | Maximum | ||
Segment Reporting Information [Line Items] | ||
Contract term | 5 years |
Significant Accounting Polici_4
Significant Accounting Policies - Cash, Cash Equivalents, and Restricted Cash (Details) - USD ($) $ in Millions | Mar. 31, 2022 | Dec. 31, 2021 | Mar. 31, 2021 | Dec. 31, 2020 |
Accounting Policies [Abstract] | ||||
Cash and cash equivalents | $ 4,804 | $ 4,438 | $ 4,431 | |
Restricted cash and cash equivalents | 62 | 66 | ||
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows | $ 4,866 | $ 4,506 | $ 4,497 | $ 4,223 |
Significant Accounting Polici_5
Significant Accounting Policies - Receivables (Details) - USD ($) $ in Millions | Mar. 31, 2022 | Dec. 31, 2021 |
Accounts, Notes, Loans and Financing Receivable [Line Items] | ||
Total receivables | $ 2,156 | $ 2,177 |
Government receivables | ||
Accounts, Notes, Loans and Financing Receivable [Line Items] | ||
Total receivables | 1,589 | 1,566 |
Pharmacy rebate receivables | ||
Accounts, Notes, Loans and Financing Receivable [Line Items] | ||
Total receivables | 306 | 276 |
Other | ||
Accounts, Notes, Loans and Financing Receivable [Line Items] | ||
Total receivables | $ 261 | $ 335 |
Significant Accounting Polici_6
Significant Accounting Policies - Amounts Due To Government Agencies (Details) - USD ($) $ in Millions | Mar. 31, 2022 | Dec. 31, 2021 |
Medicaid program: | ||
Minimum MLR and profit sharing | $ 1,033 | $ 1,016 |
Other | 270 | 263 |
Medicare program: | ||
Risk adjustment and Part D risk sharing | 105 | 89 |
Minimum MLR and profit sharing | 103 | 101 |
Other | 31 | 35 |
Marketplace program: | ||
Risk adjustment | 949 | 902 |
Minimum MLR | 20 | 18 |
Other | 102 | 48 |
Total amounts due government agencies | $ 2,613 | $ 2,472 |
Significant Accounting Polici_7
Significant Accounting Policies - Narrative (Details) - USD ($) $ in Millions | 3 Months Ended | ||
Mar. 31, 2022 | Mar. 31, 2021 | Dec. 31, 2021 | |
Schedule of Premium Revenue by Health Plan Type [Line Items] | |||
Risk adjustment payable | $ (949) | $ 902 | |
Risk adjustment receivable | 33 | 7 | |
Risk adjustment, net payable | $ 916 | $ 895 | |
Maturity period (less than) | 15 years | ||
Structured Securities | |||
Schedule of Premium Revenue by Health Plan Type [Line Items] | |||
Average maturity period (less than) | 15 years | ||
COVID-19 | |||
Schedule of Premium Revenue by Health Plan Type [Line Items] | |||
Reduction in premiums | $ 28 | $ 110 |
Net Income Per Share (Details)
Net Income Per Share (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions | 3 Months Ended | |||
Mar. 31, 2022 | Mar. 31, 2021 | Dec. 31, 2021 | Dec. 31, 2020 | |
Numerator: | ||||
Net income | $ 258 | $ 228 | ||
Denominator: | ||||
Shares outstanding at the beginning of the period ( in shares) | 57.9 | 58 | ||
Weighted-average number of shares issued: | ||||
Stock-based compensation (in shares) | 0.1 | 0.1 | ||
Stock purchases (in shares) | 0 | (0.4) | ||
Denominator for basic net income per share (in shares) | 58 | 57.7 | ||
Effect of dilutive securities: | ||||
Stock-based compensation (in shares) | 0.7 | 0.9 | ||
Denominator for diluted net income per share (in shares) | 58.7 | 58.6 | ||
Net income per share: | ||||
Net income per share - Basic (in dollars per share) | $ 4.45 | $ 3.95 | ||
Net income per share - Diluted (in dollars per share) | $ 4.39 | $ 3.89 |
Business Combinations (Details)
Business Combinations (Details) - USD ($) $ in Millions | Jan. 01, 2022 | Oct. 25, 2021 | Mar. 31, 2022 |
Magellan Complete Care | |||
Business Acquisition, Contingent Consideration [Line Items] | |||
Total purchase price | $ 60 | ||
Goodwill | 24 | ||
Magellan Complete Care | Member list | |||
Business Acquisition, Contingent Consideration [Line Items] | |||
Acquired membership with a preliminary fair value | $ 36,000 | ||
Affinity Health Plan, Inc | |||
Business Acquisition, Contingent Consideration [Line Items] | |||
Total purchase price | $ 176 | ||
Goodwill | $ 11 | ||
Medical claims and benefits payable | 25 | ||
Amounts due government agencies | $ 4 |
Fair Value Measurements - Finan
Fair Value Measurements - Financial Instruments on a Recurring Basis (Details) - USD ($) $ in Millions | Mar. 31, 2022 | Dec. 31, 2021 |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | $ 2,988 | $ 3,202 |
Total assets | 2,988 | 3,202 |
Contingent consideration liabilities | 8 | 47 |
Total liabilities | 8 | 47 |
Corporate debt securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 1,808 | 1,833 |
Mortgage-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 598 | 614 |
Asset-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 252 | 247 |
U.S. Treasury notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 174 | 353 |
Municipal securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 117 | 123 |
Other | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 39 | 32 |
(Level 1) | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Total assets | 0 | 0 |
Contingent consideration liabilities | 0 | 0 |
Total liabilities | 0 | 0 |
(Level 1) | Corporate debt securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 1) | Mortgage-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 1) | Asset-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 1) | U.S. Treasury notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 1) | Municipal securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 1) | Other | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 2) | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Total assets | 2,988 | 3,202 |
Contingent consideration liabilities | 0 | 0 |
Total liabilities | 0 | 0 |
(Level 2) | Corporate debt securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 1,808 | 1,833 |
(Level 2) | Mortgage-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 598 | 614 |
(Level 2) | Asset-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 252 | 247 |
(Level 2) | U.S. Treasury notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 174 | 353 |
(Level 2) | Municipal securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 117 | 123 |
(Level 2) | Other | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 39 | 32 |
(Level 3) | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Total assets | 0 | 0 |
Contingent consideration liabilities | 47 | |
Total liabilities | 8 | 47 |
(Level 3) | Corporate debt securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 3) | Mortgage-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 3) | Asset-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 3) | U.S. Treasury notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 3) | Municipal securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 3) | Other | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | $ 0 | $ 0 |
Fair Value Measurements - Narra
Fair Value Measurements - Narrative (Details) - USD ($) $ in Millions | 3 Months Ended | ||
Mar. 31, 2022 | Mar. 31, 2021 | Dec. 31, 2021 | |
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | |||
Recognized gain (loss) | $ 4 | $ 8 | |
Contingent consideration liabilities | 8 | $ 47 | |
Contingent consideration liabilities settled | 20 | $ 20 | |
(Level 3) | |||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | |||
Contingent consideration liabilities | $ 47 | ||
Passport Health Plan, Inc. | |||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | |||
Contingent consideration liabilities | 43 | ||
Paid to seller | 23 | ||
Consideration due for minimum member | 20 | ||
Passport Health Plan, Inc. | (Level 3) | |||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | |||
Contingent consideration liabilities | $ 8 |
Fair Value Measurements - Long-
Fair Value Measurements - Long-Term Debt (Details) - USD ($) $ in Millions | Mar. 31, 2022 | Dec. 31, 2021 |
Carrying Amount | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 2,174 | $ 2,173 |
Fair Value | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 2,126 | 2,264 |
Senior Notes | 4.375% Notes due 2028 | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Debt instrument, interest rate, stated percentage | 4.375% | |
Senior Notes | 4.375% Notes due 2028 | Carrying Amount | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 791 | 791 |
Senior Notes | 4.375% Notes due 2028 | Fair Value | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 789 | 829 |
Senior Notes | 3.875% Notes due 2030 | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Debt instrument, interest rate, stated percentage | 3.875% | |
Senior Notes | 3.875% Notes due 2030 | Carrying Amount | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 642 | 642 |
Senior Notes | 3.875% Notes due 2030 | Fair Value | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 624 | 675 |
Senior Notes | 3.875% Notes due 2032 | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Debt instrument, interest rate, stated percentage | 3.875% | |
Senior Notes | 3.875% Notes due 2032 | Carrying Amount | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 741 | 740 |
Senior Notes | 3.875% Notes due 2032 | Fair Value | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 713 | $ 760 |
Investments - Summary of Invest
Investments - Summary of Investments (Details) - USD ($) $ in Millions | Mar. 31, 2022 | Dec. 31, 2021 |
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | $ 3,094 | $ 3,208 |
Gross unrealized gains | 1 | 12 |
Gross unrealized losses | 107 | 18 |
Estimated Fair Value | 2,988 | 3,202 |
Corporate debt securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 1,874 | 1,836 |
Gross unrealized gains | 1 | 9 |
Gross unrealized losses | 67 | 12 |
Estimated Fair Value | 1,808 | 1,833 |
Mortgage-backed securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 622 | 616 |
Gross unrealized gains | 0 | 2 |
Gross unrealized losses | 24 | 4 |
Estimated Fair Value | 598 | 614 |
Asset-backed securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 261 | 248 |
Gross unrealized gains | 0 | 0 |
Gross unrealized losses | 9 | 1 |
Estimated Fair Value | 252 | 247 |
U.S. Treasury notes | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 174 | 353 |
Gross unrealized gains | 0 | 0 |
Gross unrealized losses | 0 | 0 |
Estimated Fair Value | 174 | 353 |
Municipal securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 123 | 123 |
Gross unrealized gains | 0 | 1 |
Gross unrealized losses | 6 | 1 |
Estimated Fair Value | 117 | 123 |
Other | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 40 | 32 |
Gross unrealized gains | 0 | 0 |
Gross unrealized losses | 1 | 0 |
Estimated Fair Value | $ 39 | $ 32 |
Investments - Contractual Matur
Investments - Contractual Maturities of Available-for-Sale Investments (Details) - USD ($) $ in Millions | Mar. 31, 2022 | Dec. 31, 2021 |
Amortized Cost | ||
Due in one year or less | $ 466 | |
Due after one year through five years | 1,733 | |
Due after five years through ten years | 318 | |
Due after ten years | 577 | |
Amortized Cost | 3,094 | $ 3,208 |
Estimated Fair Value | ||
Due in one year or less | 466 | |
Due after one year through five years | 1,668 | |
Due after five years through ten years | 306 | |
Due after ten years | 548 | |
Total | $ 2,988 |
Investments - Narrative (Detail
Investments - Narrative (Details) $ in Millions | Mar. 31, 2022USD ($) |
Investments, Debt and Equity Securities [Abstract] | |
Debt securities held to maturity | $ 221 |
Amortized cost, due in one year or less | 190 |
Amortized cost, due one year through five years | $ 31 |
Investments - Available-for-Sal
Investments - Available-for-Sale Investments (Details) $ in Millions | Mar. 31, 2022USD ($)positionsecurity | Dec. 31, 2021USD ($)securityposition |
Debt Securities, Available-for-sale [Line Items] | ||
Estimated Fair Value | $ 2,428 | $ 1,706 |
Unrealized Losses | $ 107 | $ 18 |
Total Number of Positions | position | 1,091 | 677 |
Corporate debt securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Estimated Fair Value | $ 1,516 | $ 1,063 |
Unrealized Losses | $ 67 | $ 12 |
Total Number of Positions | position | 624 | 395 |
Mortgage-backed securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Estimated Fair Value | $ 582 | $ 408 |
Unrealized Losses | $ 24 | $ 4 |
Total Number of Positions | position | 238 | 146 |
Asset-backed securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Estimated Fair Value | $ 208 | $ 166 |
Unrealized Losses | $ 9 | $ 1 |
Total Number of Positions | security | 99 | 75 |
Municipal securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Estimated Fair Value | $ 97 | $ 69 |
Unrealized Losses | $ 6 | $ 1 |
Total Number of Positions | security | 120 | 61 |
Other | ||
Debt Securities, Available-for-sale [Line Items] | ||
Estimated Fair Value | $ 25 | $ 0 |
Unrealized Losses | $ 1 | $ 0 |
Total Number of Positions | security | 10 | 0 |
Medical Claims and Benefits P_3
Medical Claims and Benefits Payable - Medical Claims and Benefits Payable (Details) - USD ($) $ in Millions | Mar. 31, 2022 | Dec. 31, 2021 | Mar. 31, 2021 | Dec. 31, 2020 |
Other Liabilities Disclosure [Abstract] | ||||
Claims incurred but not paid (“IBNP”) | $ 2,521 | $ 2,486 | ||
Pharmacy payable | 240 | 219 | ||
Capitation payable | 95 | 82 | ||
Other | 745 | 576 | ||
Total | $ 3,601 | $ 3,363 | $ 2,839 | $ 2,696 |
Medical Claims and Benefits P_4
Medical Claims and Benefits Payable - Narrative (Details) - USD ($) $ in Millions | 3 Months Ended | ||
Mar. 31, 2022 | Mar. 31, 2021 | Dec. 31, 2021 | |
Other Liabilities Disclosure [Abstract] | |||
Non-risk provider payables | $ 322 | $ 226 | |
Prior period claims, favorable development | $ (206) | $ (194) |
Medical Claims and Benefits P_5
Medical Claims and Benefits Payable - Components of Change in Medical Claims and Benefits Payable (Details) - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2022 | Mar. 31, 2021 | |
Insurance Claims | ||
Medical claims and benefits payable, beginning balance | $ 3,363 | $ 2,696 |
Components of medical care costs related to: | ||
Current year | 6,769 | 5,668 |
Prior years | (206) | (194) |
Total medical care costs | 6,563 | 5,474 |
Payments for medical care costs related to: | ||
Current year | 4,197 | 3,513 |
Prior years | 2,199 | 1,781 |
Total paid | 6,396 | 5,294 |
Acquired balances, net of post-acquisition adjustments | (25) | (25) |
Change in non-risk and other provider payables | 96 | (12) |
Medical claims and benefits payable, ending balance | 3,601 | 2,839 |
Medicaid | ||
Insurance Claims | ||
Medical claims and benefits payable, beginning balance | 2,580 | 2,129 |
Components of medical care costs related to: | ||
Current year | 5,424 | 4,394 |
Prior years | (154) | (158) |
Total medical care costs | 5,270 | 4,236 |
Payments for medical care costs related to: | ||
Current year | 3,402 | 2,790 |
Prior years | 1,633 | 1,364 |
Total paid | 5,035 | 4,154 |
Acquired balances, net of post-acquisition adjustments | (25) | 8 |
Change in non-risk and other provider payables | 93 | (11) |
Medical claims and benefits payable, ending balance | 2,883 | 2,208 |
Medicare | ||
Insurance Claims | ||
Medical claims and benefits payable, beginning balance | 404 | 392 |
Components of medical care costs related to: | ||
Current year | 840 | 738 |
Prior years | (25) | (16) |
Total medical care costs | 815 | 722 |
Payments for medical care costs related to: | ||
Current year | 465 | 410 |
Prior years | 306 | 304 |
Total paid | 771 | 714 |
Acquired balances, net of post-acquisition adjustments | 0 | (33) |
Change in non-risk and other provider payables | 3 | (1) |
Medical claims and benefits payable, ending balance | 451 | 366 |
Marketplace | ||
Insurance Claims | ||
Medical claims and benefits payable, beginning balance | 379 | 175 |
Components of medical care costs related to: | ||
Current year | 505 | 536 |
Prior years | (27) | (20) |
Total medical care costs | 478 | 516 |
Payments for medical care costs related to: | ||
Current year | 330 | 313 |
Prior years | 260 | 113 |
Total paid | 590 | 426 |
Acquired balances, net of post-acquisition adjustments | 0 | 0 |
Change in non-risk and other provider payables | 0 | 0 |
Medical claims and benefits payable, ending balance | $ 267 | $ 265 |
Debt - Schedule of Long-Term De
Debt - Schedule of Long-Term Debt (Details) - USD ($) $ in Millions | Mar. 31, 2022 | Dec. 31, 2021 |
Debt Instrument [Line Items] | ||
Deferred debt issuance costs | $ (26) | $ (27) |
Total | $ 2,174 | 2,173 |
Senior Notes | 4.375% Notes due 2028 | ||
Debt Instrument [Line Items] | ||
Percentage of contractual interest rate on notes | 4.375% | |
Non-current portion of long-term debt | $ 800 | 800 |
Senior Notes | 3.875% Notes due 2030 | ||
Debt Instrument [Line Items] | ||
Percentage of contractual interest rate on notes | 3.875% | |
Non-current portion of long-term debt | $ 650 | 650 |
Senior Notes | 3.875% Notes due 2032 | ||
Debt Instrument [Line Items] | ||
Percentage of contractual interest rate on notes | 3.875% | |
Non-current portion of long-term debt | $ 750 | $ 750 |
Debt - Narrative (Details)
Debt - Narrative (Details) | 3 Months Ended |
Mar. 31, 2022USD ($) | |
Line of Credit | |
Debt Instrument [Line Items] | |
Debt term | 5 years |
Line of Credit | Credit Facility | |
Debt Instrument [Line Items] | |
Maximum borrowing capacity | $ 1,000,000,000 |
Amount outstanding under letter of credit | $ 0 |
Senior Notes | 4.375% Notes due 2028 | |
Debt Instrument [Line Items] | |
Percentage of contractual interest rate on notes | 4.375% |
Face amount | $ 800,000,000 |
Senior Notes | 3.875% Notes due 2030 | |
Debt Instrument [Line Items] | |
Percentage of contractual interest rate on notes | 3.875% |
Face amount | $ 650,000,000 |
Senior Notes | 3.875% Notes due 2032 | |
Debt Instrument [Line Items] | |
Percentage of contractual interest rate on notes | 3.875% |
Face amount | $ 750,000,000 |
Stockholders' Equity (Details)
Stockholders' Equity (Details) - USD ($) | Apr. 27, 2022 | Mar. 31, 2021 | Sep. 30, 2021 |
Subsequent event | |||
Class of Stock [Line Items] | |||
Repurchased of common stock (in shares) | 85,000 | ||
Common Stock | |||
Class of Stock [Line Items] | |||
Common stock authorized | $ 500,000,000 | ||
Repurchased of common stock (in shares) | 1,000,000 |
Segments - Narrative (Details)
Segments - Narrative (Details) | Mar. 31, 2022segment |
Segment Reporting [Abstract] | |
Reportable segment | 4 |
Segments - Schedule of Operatin
Segments - Schedule of Operating Segment Information (Details) - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2022 | Mar. 31, 2021 | |
Segment Reporting Information [Line Items] | ||
Revenues | $ 7,770 | $ 6,522 |
Medicaid | ||
Segment Reporting Information [Line Items] | ||
Revenues | 6,187 | 5,020 |
Medicare | ||
Segment Reporting Information [Line Items] | ||
Revenues | 949 | 805 |
Marketplace | ||
Segment Reporting Information [Line Items] | ||
Revenues | 616 | 680 |
Other | ||
Segment Reporting Information [Line Items] | ||
Revenues | $ 18 | $ 17 |
Segments - Reconciliation of Gr
Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2022 | Mar. 31, 2021 | |
Segment Reporting Information [Line Items] | ||
Add: other operating revenues | $ 7,770 | $ 6,522 |
Less: other operating expenses | (7,398) | (6,187) |
Operating income | 372 | 335 |
Other expenses, net | 28 | 30 |
Income before income tax expense | 344 | 305 |
Medicaid | ||
Segment Reporting Information [Line Items] | ||
Add: other operating revenues | 6,187 | 5,020 |
Medicare | ||
Segment Reporting Information [Line Items] | ||
Add: other operating revenues | 949 | 805 |
Marketplace | ||
Segment Reporting Information [Line Items] | ||
Add: other operating revenues | 616 | 680 |
Other | ||
Segment Reporting Information [Line Items] | ||
Add: other operating revenues | 18 | 17 |
Operating segments | ||
Segment Reporting Information [Line Items] | ||
Total margin | 971 | 836 |
Operating segments | Medicaid | ||
Segment Reporting Information [Line Items] | ||
Total margin | 710 | 604 |
Operating segments | Medicare | ||
Segment Reporting Information [Line Items] | ||
Total margin | 128 | 77 |
Operating segments | Marketplace | ||
Segment Reporting Information [Line Items] | ||
Total margin | 130 | 151 |
Operating segments | Other | ||
Segment Reporting Information [Line Items] | ||
Total margin | 3 | 4 |
Other operating | ||
Segment Reporting Information [Line Items] | ||
Add: other operating revenues | 221 | 199 |
Less: other operating expenses | $ (820) | $ (700) |