Cover Page
Cover Page - shares shares in Thousands | 6 Months Ended | |
Jun. 30, 2022 | Jul. 22, 2022 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Jun. 30, 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, $0.001 Par Value | |
Trading Symbol | MOH | |
Security Exchange Name | NYSE | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Large Accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Shell Company | false | |
Entity Common Stock, Shares Outstanding | 58,100 | |
Entity Central Index Key | 0001179929 | |
Current Fiscal Year End Date | --12-31 | |
Document Fiscal Year Focus | 2022 | |
Document Fiscal Period Focus | Q2 | |
Amendment Flag | false |
CONSOLIDATED STATEMENTS OF INCO
CONSOLIDATED STATEMENTS OF INCOME - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Revenue: | ||||
Premium revenue | $ 7,799 | $ 6,583 | $ 15,330 | $ 12,889 |
Premium tax revenue | 215 | 185 | 423 | 372 |
Investment income | 22 | 10 | 33 | 19 |
Other revenue | 18 | 22 | 38 | 42 |
Total revenue | 8,054 | 6,800 | 15,824 | 13,322 |
Operating expenses: | ||||
Medical care costs | 6,872 | 5,819 | 13,435 | 11,293 |
General and administrative expenses | 551 | 484 | 1,122 | 957 |
Premium tax expenses | 215 | 185 | 423 | 372 |
Depreciation and amortization | 44 | 31 | 84 | 64 |
Other | 11 | 8 | 27 | 28 |
Total operating expenses | 7,693 | 6,527 | 15,091 | 12,714 |
Operating income | 361 | 273 | 733 | 608 |
Other expenses, net: | ||||
Interest expense | 27 | 30 | 55 | 60 |
Total other expenses, net | 27 | 30 | 55 | 60 |
Income before income tax expense | 334 | 243 | 678 | 548 |
Income tax expense | 86 | 58 | 172 | 135 |
Net income | $ 248 | $ 185 | $ 506 | $ 413 |
Net income per share: | ||||
Net income per share - Basic (in dollars per share) | $ 4.29 | $ 3.20 | $ 8.74 | $ 7.14 |
Net income per share - Diluted (in dollars per share) | $ 4.25 | $ 3.16 | $ 8.63 | $ 7.05 |
CONSOLIDATED STATEMENTS OF COMP
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Statement of Comprehensive Income [Abstract] | ||||
Net income | $ 248 | $ 185 | $ 506 | $ 413 |
Other comprehensive loss: | ||||
Unrealized investment (loss) gain | (62) | 1 | (162) | (14) |
Less: effect of income taxes | (15) | 1 | (39) | (3) |
Other comprehensive loss, net of tax | (47) | 0 | (123) | (11) |
Comprehensive income | $ 201 | $ 185 | $ 383 | $ 402 |
CONSOLIDATED BALANCE SHEETS
CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions | Jun. 30, 2022 | Dec. 31, 2021 |
Current assets: | ||
Cash and cash equivalents | $ 4,312 | $ 4,438 |
Investments | 3,567 | 3,202 |
Receivables | 2,240 | 2,177 |
Prepaid expenses and other current assets | 213 | 247 |
Total current assets | 10,332 | 10,064 |
Property, equipment, and capitalized software, net | 401 | 396 |
Goodwill, and intangible assets, net | 1,286 | 1,252 |
Restricted investments | 219 | 212 |
Deferred income taxes | 141 | 106 |
Other assets | 193 | 179 |
Total assets | 12,572 | 12,209 |
Current liabilities: | ||
Medical claims and benefits payable | 3,775 | 3,363 |
Amounts due government agencies | 2,722 | 2,472 |
Accounts payable, accrued liabilities and other | 715 | 842 |
Deferred revenue | 13 | 370 |
Total current liabilities | 7,225 | 7,047 |
Long-term debt | 2,175 | 2,173 |
Finance lease liabilities | 216 | 219 |
Other long-term liabilities | 126 | 140 |
Total liabilities | 9,742 | 9,579 |
Stockholders’ equity: | ||
Common stock, $0.001 par value, 150 million shares authorized; outstanding: 58 million shares at June 30, 2022 and 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 | 251 | 236 |
Accumulated other comprehensive loss | (128) | (5) |
Retained earnings | 2,707 | 2,399 |
Total stockholders’ equity | 2,830 | 2,630 |
Total liabilities and stockholders’ equity | $ 12,572 | $ 12,209 |
CONSOLIDATED BALANCE SHEETS (Pa
CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares | Jun. 30, 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) | 58,000,000 | 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 Thousands, $ in Millions | Total | Common Stock | Additional Paid-in Capital | Accumulated Other Comprehensive Loss | Retained Earnings |
Beginning balance (in shares) at Dec. 31, 2020 | 59,000 | ||||
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) | (1,000) | ||||
Common stock purchases | (122) | (2) | (120) | ||
Share-based compensation | (27) | (27) | |||
Ending balance (in shares) at Mar. 31, 2021 | 58,000 | ||||
Ending balance at Mar. 31, 2021 | 2,164 | $ 0 | 170 | 26 | 1,968 |
Beginning balance (in shares) at Dec. 31, 2020 | 59,000 | ||||
Beginning balance at Dec. 31, 2020 | 2,096 | $ 0 | 199 | 37 | 1,860 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||
Net income | 413 | ||||
Other comprehensive loss, net | (11) | ||||
Ending balance (in shares) at Jun. 30, 2021 | 58,000 | ||||
Ending balance at Jun. 30, 2021 | 2,370 | $ 0 | 191 | 26 | 2,153 |
Beginning balance (in shares) at Mar. 31, 2021 | 58,000 | ||||
Beginning balance at Mar. 31, 2021 | 2,164 | $ 0 | 170 | 26 | 1,968 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||
Net income | 185 | 185 | |||
Other comprehensive loss, net | 0 | ||||
Share-based compensation | 21 | 21 | |||
Ending balance (in shares) at Jun. 30, 2021 | 58,000 | ||||
Ending balance at Jun. 30, 2021 | 2,370 | $ 0 | 191 | 26 | 2,153 |
Beginning balance (in shares) at Dec. 31, 2021 | 58,000 | ||||
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) | 1,000 | ||||
Share-based compensation | (18) | (18) | |||
Ending balance (in shares) at Mar. 31, 2022 | 59,000 | ||||
Ending balance at Mar. 31, 2022 | 2,794 | $ 0 | 218 | (81) | 2,657 |
Beginning balance (in shares) at Dec. 31, 2021 | 58,000 | ||||
Beginning balance at Dec. 31, 2021 | 2,630 | $ 0 | 236 | (5) | 2,399 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||
Net income | 506 | ||||
Other comprehensive loss, net | (123) | ||||
Ending balance (in shares) at Jun. 30, 2022 | 58,000 | ||||
Ending balance at Jun. 30, 2022 | 2,830 | $ 0 | 251 | (128) | 2,707 |
Beginning balance (in shares) at Mar. 31, 2022 | 59,000 | ||||
Beginning balance at Mar. 31, 2022 | 2,794 | $ 0 | 218 | (81) | 2,657 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||
Net income | 248 | 248 | |||
Other comprehensive loss, net | (47) | (47) | |||
Common stock purchases (in shares) | (658) | ||||
Common stock purchases | (200) | (2) | (198) | ||
Share-based compensation | 35 | 35 | |||
Ending balance (in shares) at Jun. 30, 2022 | 58,000 | ||||
Ending balance at Jun. 30, 2022 | $ 2,830 | $ 0 | $ 251 | $ (128) | $ 2,707 |
CONSOLIDATED STATEMENTS OF CASH
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions | 6 Months Ended | |
Jun. 30, 2022 | Jun. 30, 2021 | |
Operating activities: | ||
Net income | $ 506 | $ 413 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation and amortization | 84 | 64 |
Deferred income taxes | 3 | 7 |
Share-based compensation | 57 | 35 |
Other, net | (6) | 10 |
Changes in operating assets and liabilities: | ||
Receivables | (43) | (192) |
Prepaid expenses and other current assets | (64) | (6) |
Medical claims and benefits payable | 405 | 272 |
Amounts due government agencies | 247 | 792 |
Accounts payable, accrued liabilities and other | (147) | (15) |
Deferred revenue | (357) | (333) |
Income taxes | 46 | 14 |
Net cash provided by operating activities | 731 | 1,061 |
Investing activities: | ||
Purchases of investments | (1,413) | (1,006) |
Proceeds from sales and maturities of investments | 879 | 622 |
Purchases of property, equipment and capitalized software | (50) | (29) |
Other, net | (7) | 5 |
Net cash used in investing activities | (591) | (408) |
Financing activities: | ||
Common stock purchases | (200) | (128) |
Common stock withheld to settle employee tax obligations | (53) | (52) |
Contingent consideration liabilities settled | (20) | (20) |
Other, net | 5 | 0 |
Net cash used in financing activities | (268) | (200) |
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents | (128) | 453 |
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 | $ 4,378 | $ 4,676 |
Organization and Basis of Prese
Organization and Basis of Presentation | 6 Months Ended |
Jun. 30, 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 June 30, 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 Wisconsin Acquisition — Medicaid and Medicare. On July 13, 2022, we announced a definitive agreement to acquire substantially all the assets of My Choice Wisconsin (“MCW”). As of May 2022, MCW served over 44,000 managed long-term services and supports and core Medicaid members throughout Wisconsin, delivering approximately $1 billion in premium revenue for the 12 months ended March 31, 2022. The purchase price for the transaction is approximately $150 million, net of expected tax benefits and required regulatory capital, which we intend to fund with cash on hand. The transaction is subject to receipt of applicable federal and state regulatory approvals, and the satisfaction of other customary closing conditions. We currently expect the transaction to close in 2022. 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. New York Acquisition—Medicaid. On October 7, 2021, we announced a definitive agreement to acquire the Medicaid Managed Long Term Care business of AgeWell New York. The purchase price for the transaction is approximately $106 million, net of certain tax benefits and target allocation of required regulatory capital, which we intend to fund with cash on hand. The transaction is subject to applicable federal and state regulatory approvals and the satisfaction of other customary closing conditions. We currently expect the transaction to close in the fourth quarter of 2022. 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 first quarter of 2023, and start of operations in February 2024. 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, these financial statements reflect all normal recurring adjustments, which are considered necessary for a fair presentation of the results as of the dates and for the interim periods presented have been included. All significant intercompany balances and transactions have been eliminated. The consolidated results of operations for the six months ended June 30, 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 | 6 Months Ended |
Jun. 30, 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 and 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. June 30, 2022 2021 (In millions) Cash and cash equivalents $ 4,312 $ 4,608 Restricted cash and cash equivalents 66 68 Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows $ 4,378 $ 4,676 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. June 30, December 31, (In millions) Government receivables $ 1,628 $ 1,566 Pharmacy rebate receivables 272 276 Other 340 335 Total $ 2,240 $ 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: June 30, December 31, (In millions) Medicaid program: Minimum MLR and profit sharing $ 1,018 $ 1,016 Other 402 263 Medicare program: Risk adjustment and Part D risk sharing 68 89 Minimum MLR and profit sharing 115 101 Other 22 35 Marketplace program: Risk adjustment 1,037 902 Minimum MLR 7 18 Other 53 48 Total amounts due government agencies $ 2,722 $ 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. Since 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 and six months ended June 30, 2022, we recognized approximately $94 million and $122 million, respectively, related to such risk corridors, primarily in the Medicaid segment, compared to $56 million and $166 million, respectively, recognized in the three and six months ended June 30, 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 June 30, 2022, Marketplace risk adjustment payables amounted to $1,037 million and related receivables amounted to $61 million, for a net payable of $976 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 | 6 Months Ended |
Jun. 30, 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 June 30, Six Months Ended June 30, 2022 2021 2022 2021 (In millions, except net income per share) Numerator: Net income $ 248 $ 185 $ 506 $ 413 Denominator: Shares outstanding at the beginning of the period 58.1 57.7 57.9 58.0 Weighted-average number of shares issued: Stock-based compensation — — 0.2 0.2 Stock purchases (0.3) — (0.2) (0.5) Denominator for basic net income per share 57.8 57.7 57.9 57.7 Effect of dilutive securities: (1) Stock-based compensation 0.6 0.7 0.7 0.8 Denominator for diluted net income per share 58.4 58.4 58.6 58.5 Net income per share - Basic (2) $ 4.29 $ 3.20 $ 8.74 $ 7.14 Net income per share - Diluted (2) $ 4.25 $ 3.16 $ 8.63 $ 7.05 ______________________________ (1) The dilutive effect of all potentially dilutive common shares is calculated using the treasury stock method. (2) Source data for calculations in thousands. |
Business Combinations
Business Combinations | 6 Months Ended |
Jun. 30, 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 | 6 Months Ended |
Jun. 30, 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 six months ended June 30, 2022 and 2021, we recognized a loss of $4 million and $3 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 June 30, 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 $ 2,268 $ — $ 2,268 $ — Mortgage-backed securities 717 — 717 — Asset-backed securities 293 — 293 — Municipal securities 146 — 146 — U.S. Treasury notes 96 — 96 — Other 47 — 47 — Total assets $ 3,567 $ — $ 3,567 $ — 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 — Municipal securities 123 — 123 — U.S. Treasury notes 353 — 353 — 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 June 30, 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 six months ended June 30, 2022, the estimated fair value of contingent purchase consideration increased by approximately $4 million, relating to an operating income guarantee. In the six months ended June 30, 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 six months ended June 30, 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. June 30, 2022 December 31, 2021 Carrying Fair Value Carrying Fair Value (In millions) 4.375% Notes due 2028 $ 792 $ 724 $ 791 $ 829 3.875% Notes due 2030 642 550 642 675 3.875% Notes due 2032 741 630 740 760 Total $ 2,175 $ 1,904 $ 2,173 $ 2,264 |
Investments
Investments | 6 Months Ended |
Jun. 30, 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: June 30, 2022 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 2,372 $ 2 $ 106 $ 2,268 Mortgage-backed securities 759 — 42 717 Asset-backed securities 306 — 13 293 Municipal securities 153 — 7 146 U.S. Treasury notes 96 — — 96 Other 49 — 2 47 Total $ 3,735 $ 2 $ 170 $ 3,567 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 Municipal securities 123 1 1 123 U.S. Treasury notes 353 — — 353 Other 32 — — 32 Total $ 3,208 $ 12 $ 18 $ 3,202 The contractual maturities of our current investments as of June 30, 2022 are summarized below: Amortized Cost Estimated (In millions) Due in one year or less $ 340 $ 338 Due after one year through five years 2,276 2,175 Due after five years through ten years 377 358 Due after ten years 742 696 Total $ 3,735 $ 3,567 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 six months ended June 30, 2022, and 2021. We have determined that unrealized losses at June 30, 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 segregates those available-for-sale investments that have been in a continuous loss position for less than 12 months, and those that have been in a continuous loss position for 12 months or more as of June 30, 2022: In a Continuous Loss Position In a Continuous Loss Position Estimated Unrealized Total Number of Positions Estimated Unrealized Total Number of Positions (Dollars in millions) Corporate debt securities $ 1,971 $ 104 921 $ 36 $ 2 19 Mortgage-backed securities 647 40 273 50 2 26 Asset-backed securities 264 13 134 — — — Municipal securities 100 7 124 — — — Other 27 2 14 — — — Total $ 3,009 $ 166 1,466 $ 86 $ 4 45 The following table segregates those available-for-sale investments that have been in a continuous loss position for less than 12 months, and those that have been in a continuous loss position for 12 months or more as of December 31, 2021: In a Continuous Loss Position In a Continuous Loss Position Estimated Unrealized Total Number of Positions Estimated Unrealized Total Number of Positions (Dollars in millions) Corporate debt securities $ 1,063 $ 12 395 $ — $ — — Mortgage-backed securities 408 4 146 — — — Asset-backed securities 166 1 75 — — — Municipal securities 69 1 61 — — — Total $ 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 $219 million at June 30, 2022, of which $191 million will mature in one year or less, and $28 million will mature in one through five years. |
Medical Claims and Benefits Pay
Medical Claims and Benefits Payable | 6 Months Ended |
Jun. 30, 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: June 30, December 31, (In millions) Claims incurred but not paid (“IBNP”) $ 2,719 $ 2,486 Pharmacy payable 229 219 Capitation payable 94 82 Other 733 576 Total $ 3,775 $ 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 $229 million and $226 million as of June 30, 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. Six Months Ended June 30, 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 11,059 1,681 1,006 13,746 Prior years (243) (33) (35) (311) Total medical care costs 10,816 1,648 971 13,435 Payments for medical care costs related to: Current year 8,532 1,270 820 10,622 Prior years 1,801 330 280 2,411 Total paid 10,333 1,600 1,100 13,033 Acquired balances, net of post-acquisition adjustments 7 — — 7 Change in non-risk and other provider payables 3 — — 3 Medical claims and benefits payable, ending balance $ 3,073 $ 452 $ 250 $ 3,775 Six Months Ended June 30, 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 8,869 1,459 1,158 11,486 Prior years (150) (24) (19) (193) Total medical care costs 8,719 1,435 1,139 11,293 Payments for medical care costs related to: Current year 7,043 1,111 869 9,023 Prior years 1,491 330 128 1,949 Total paid 8,534 1,441 997 10,972 Acquired balances, net of post-acquisition adjustments (19) (7) — (26) Change in non-risk and other provider payables (48) (1) — (49) Medical claims and benefits payable, ending balance $ 2,247 $ 378 $ 317 $ 2,942 Our estimates of medical claims and benefits payable recorded at December 31, 2021, and 2020 developed favorably by approximately $311 million and $193 million as of June 30, 2022, and 2021, respectively. The favorable prior year development recognized in the six months ended June 30, 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 | 6 Months Ended |
Jun. 30, 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: June 30, 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 (25) (27) Total $ 2,175 $ 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 June 30, 2022, we were in compliance with all financial and non-financial covenants under the Credit Agreement. As of June 30, 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 indentures governing the senior notes contain customary non-financial covenants and change of control provisions. As of June 30, 2022, we were in compliance with all non-financial covenants in the indentures governing the senior notes. 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 June 30, 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 June 30, 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 | 6 Months Ended |
Jun. 30, 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. Under this program, pursuant to a Rule 10b5-1 trading plan, we purchased approximately 658,000 shares for $200 million in the second quarter of 2022 (average cost of $304.13 per share). |
Segments
Segments | 6 Months Ended |
Jun. 30, 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 June 30, Six Months Ended June 30, 2022 2021 2022 2021 (In millions) Total revenue: Medicaid $ 6,524 $ 5,209 $ 12,711 $ 10,229 Medicare 963 822 1,912 1,627 Marketplace 549 751 1,165 1,431 Other 18 18 36 35 Total $ 8,054 $ 6,800 $ 15,824 $ 13,322 The following table reconciles margin by segment to consolidated income before income taxes. Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 (In millions) Margin: Medicaid $ 755 $ 551 $ 1,465 $ 1,155 Medicare 124 101 252 178 Marketplace 48 112 178 263 Other 3 3 6 7 Total margin 930 767 1,901 1,603 Add: other operating revenues (1) 237 199 458 398 Less: other operating expenses (2) (806) (693) (1,626) (1,393) Operating income 361 273 733 608 Other expenses, net 27 30 55 60 Income before income tax expense $ 334 $ 243 $ 678 $ 548 ______________________ (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 | 6 Months Ended |
Jun. 30, 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 on our business 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 against the Puerto Rico Health Insurance Administration (“ASES”), asserting, among other claims, breach of contract. On September 13, 2021, ASES filed a counterclaim and a third-party complaint against MHPR and the Company. The parties are currently awaiting the Court’s appointment of a 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. |
Significant Accounting Polici_2
Significant Accounting Policies (Policies) | 6 Months Ended |
Jun. 30, 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, these financial statements reflect all normal recurring adjustments, which are considered necessary for a fair presentation of the results as of the dates and for the interim periods presented have been included. All significant intercompany balances and transactions have been eliminated. The consolidated results of |
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. Since 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 and six months ended June 30, 2022, we recognized approximately $94 million and $122 million, respectively, related to such risk corridors, primarily in the Medicaid segment, compared to $56 million and $166 million, respectively, recognized in the three and six months ended June 30, 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) | 6 Months Ended |
Jun. 30, 2022 | |
Accounting Policies [Abstract] | |
Schedule of Cash and Cash Equivalents | The following table provides a reconciliation of cash and 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. June 30, 2022 2021 (In millions) Cash and cash equivalents $ 4,312 $ 4,608 Restricted cash and cash equivalents 66 68 Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows $ 4,378 $ 4,676 |
Schedule of Restricted Cash and Cash Equivalents | The following table provides a reconciliation of cash and 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. June 30, 2022 2021 (In millions) Cash and cash equivalents $ 4,312 $ 4,608 Restricted cash and cash equivalents 66 68 Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows $ 4,378 $ 4,676 |
Schedule of Receivables | June 30, December 31, (In millions) Government receivables $ 1,628 $ 1,566 Pharmacy rebate receivables 272 276 Other 340 335 Total $ 2,240 $ 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: June 30, December 31, (In millions) Medicaid program: Minimum MLR and profit sharing $ 1,018 $ 1,016 Other 402 263 Medicare program: Risk adjustment and Part D risk sharing 68 89 Minimum MLR and profit sharing 115 101 Other 22 35 Marketplace program: Risk adjustment 1,037 902 Minimum MLR 7 18 Other 53 48 Total amounts due government agencies $ 2,722 $ 2,472 |
Net Income Per Share (Tables)
Net Income Per Share (Tables) | 6 Months Ended |
Jun. 30, 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 June 30, Six Months Ended June 30, 2022 2021 2022 2021 (In millions, except net income per share) Numerator: Net income $ 248 $ 185 $ 506 $ 413 Denominator: Shares outstanding at the beginning of the period 58.1 57.7 57.9 58.0 Weighted-average number of shares issued: Stock-based compensation — — 0.2 0.2 Stock purchases (0.3) — (0.2) (0.5) Denominator for basic net income per share 57.8 57.7 57.9 57.7 Effect of dilutive securities: (1) Stock-based compensation 0.6 0.7 0.7 0.8 Denominator for diluted net income per share 58.4 58.4 58.6 58.5 Net income per share - Basic (2) $ 4.29 $ 3.20 $ 8.74 $ 7.14 Net income per share - Diluted (2) $ 4.25 $ 3.16 $ 8.63 $ 7.05 ______________________________ (1) The dilutive effect of all potentially dilutive common shares is calculated using the treasury stock method. (2) Source data for calculations in thousands. |
Fair Value Measurements (Tables
Fair Value Measurements (Tables) | 6 Months Ended |
Jun. 30, 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 June 30, 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 $ 2,268 $ — $ 2,268 $ — Mortgage-backed securities 717 — 717 — Asset-backed securities 293 — 293 — Municipal securities 146 — 146 — U.S. Treasury notes 96 — 96 — Other 47 — 47 — Total assets $ 3,567 $ — $ 3,567 $ — 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 — Municipal securities 123 — 123 — U.S. Treasury notes 353 — 353 — 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 | June 30, 2022 December 31, 2021 Carrying Fair Value Carrying Fair Value (In millions) 4.375% Notes due 2028 $ 792 $ 724 $ 791 $ 829 3.875% Notes due 2030 642 550 642 675 3.875% Notes due 2032 741 630 740 760 Total $ 2,175 $ 1,904 $ 2,173 $ 2,264 |
Investments (Tables)
Investments (Tables) | 6 Months Ended |
Jun. 30, 2022 | |
Investments, Debt and Equity Securities [Abstract] | |
Schedule of Investments | The following tables summarize our current investments as of the dates indicated: June 30, 2022 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 2,372 $ 2 $ 106 $ 2,268 Mortgage-backed securities 759 — 42 717 Asset-backed securities 306 — 13 293 Municipal securities 153 — 7 146 U.S. Treasury notes 96 — — 96 Other 49 — 2 47 Total $ 3,735 $ 2 $ 170 $ 3,567 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 Municipal securities 123 1 1 123 U.S. Treasury notes 353 — — 353 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 June 30, 2022 are summarized below: Amortized Cost Estimated (In millions) Due in one year or less $ 340 $ 338 Due after one year through five years 2,276 2,175 Due after five years through ten years 377 358 Due after ten years 742 696 Total $ 3,735 $ 3,567 |
Schedule of Available-for-Sale Investments | The following table segregates those available-for-sale investments that have been in a continuous loss position for less than 12 months, and those that have been in a continuous loss position for 12 months or more as of June 30, 2022: In a Continuous Loss Position In a Continuous Loss Position Estimated Unrealized Total Number of Positions Estimated Unrealized Total Number of Positions (Dollars in millions) Corporate debt securities $ 1,971 $ 104 921 $ 36 $ 2 19 Mortgage-backed securities 647 40 273 50 2 26 Asset-backed securities 264 13 134 — — — Municipal securities 100 7 124 — — — Other 27 2 14 — — — Total $ 3,009 $ 166 1,466 $ 86 $ 4 45 The following table segregates those available-for-sale investments that have been in a continuous loss position for less than 12 months, and those that have been in a continuous loss position for 12 months or more as of December 31, 2021: In a Continuous Loss Position In a Continuous Loss Position Estimated Unrealized Total Number of Positions Estimated Unrealized Total Number of Positions (Dollars in millions) Corporate debt securities $ 1,063 $ 12 395 $ — $ — — Mortgage-backed securities 408 4 146 — — — Asset-backed securities 166 1 75 — — — Municipal securities 69 1 61 — — — Total $ 1,706 $ 18 677 $ — $ — — |
Medical Claims and Benefits P_2
Medical Claims and Benefits Payable (Tables) | 6 Months Ended |
Jun. 30, 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: June 30, December 31, (In millions) Claims incurred but not paid (“IBNP”) $ 2,719 $ 2,486 Pharmacy payable 229 219 Capitation payable 94 82 Other 733 576 Total $ 3,775 $ 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. Six Months Ended June 30, 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 11,059 1,681 1,006 13,746 Prior years (243) (33) (35) (311) Total medical care costs 10,816 1,648 971 13,435 Payments for medical care costs related to: Current year 8,532 1,270 820 10,622 Prior years 1,801 330 280 2,411 Total paid 10,333 1,600 1,100 13,033 Acquired balances, net of post-acquisition adjustments 7 — — 7 Change in non-risk and other provider payables 3 — — 3 Medical claims and benefits payable, ending balance $ 3,073 $ 452 $ 250 $ 3,775 Six Months Ended June 30, 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 8,869 1,459 1,158 11,486 Prior years (150) (24) (19) (193) Total medical care costs 8,719 1,435 1,139 11,293 Payments for medical care costs related to: Current year 7,043 1,111 869 9,023 Prior years 1,491 330 128 1,949 Total paid 8,534 1,441 997 10,972 Acquired balances, net of post-acquisition adjustments (19) (7) — (26) Change in non-risk and other provider payables (48) (1) — (49) Medical claims and benefits payable, ending balance $ 2,247 $ 378 $ 317 $ 2,942 |
Debt (Tables)
Debt (Tables) | 6 Months Ended |
Jun. 30, 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: June 30, 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 (25) (27) Total $ 2,175 $ 2,173 |
Segments (Tables)
Segments (Tables) | 6 Months Ended |
Jun. 30, 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 June 30, Six Months Ended June 30, 2022 2021 2022 2021 (In millions) Total revenue: Medicaid $ 6,524 $ 5,209 $ 12,711 $ 10,229 Medicare 963 822 1,912 1,627 Marketplace 549 751 1,165 1,431 Other 18 18 36 35 Total $ 8,054 $ 6,800 $ 15,824 $ 13,322 The following table reconciles margin by segment to consolidated income before income taxes. Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 (In millions) Margin: Medicaid $ 755 $ 551 $ 1,465 $ 1,155 Medicare 124 101 252 178 Marketplace 48 112 178 263 Other 3 3 6 7 Total margin 930 767 1,901 1,603 Add: other operating revenues (1) 237 199 458 398 Less: other operating expenses (2) (806) (693) (1,626) (1,393) Operating income 361 273 733 608 Other expenses, net 27 30 55 60 Income before income tax expense $ 334 $ 243 $ 678 $ 548 ______________________ (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 Thousands, $ in Millions | 1 Months Ended | 3 Months Ended | 6 Months Ended | 12 Months Ended | |||||
Jul. 13, 2022 USD ($) | Oct. 07, 2021 USD ($) | Sep. 30, 2021 | Jun. 30, 2022 USD ($) position member | Jun. 30, 2021 USD ($) | Jun. 30, 2022 USD ($) position segment member | Jun. 30, 2021 USD ($) | Mar. 31, 2022 USD ($) | May 31, 2022 member | |
Segment Reporting Information [Line Items] | |||||||||
Reportable segments | segment | 4 | ||||||||
Contract term | 4 years | ||||||||
Premium revenue | $ 7,799 | $ 6,583 | $ 15,330 | $ 12,889 | |||||
Extension option | 2 years | ||||||||
MCW | Subsequent event | |||||||||
Segment Reporting Information [Line Items] | |||||||||
Purchase price | $ 150 | ||||||||
New York Acquisition Medicaid | |||||||||
Segment Reporting Information [Line Items] | |||||||||
Purchase price | $ 106 | ||||||||
WISCONSIN | MCW | |||||||||
Segment Reporting Information [Line Items] | |||||||||
Number of members covered | member | 44 | ||||||||
Premium revenue | $ 1,000 | ||||||||
Health Plans | |||||||||
Segment Reporting Information [Line Items] | |||||||||
Number of members eligible for the health care programs, approximately | member | 5,100 | 5,100 | |||||||
Number of states with programs | position | 19 | 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 | Jun. 30, 2022 | Dec. 31, 2021 | Jun. 30, 2021 | Dec. 31, 2020 |
Accounting Policies [Abstract] | ||||
Cash and cash equivalents | $ 4,312 | $ 4,438 | $ 4,608 | |
Restricted cash and cash equivalents | 66 | 68 | ||
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows | $ 4,378 | $ 4,506 | $ 4,676 | $ 4,223 |
Significant Accounting Polici_5
Significant Accounting Policies - Receivables (Details) - USD ($) $ in Millions | Jun. 30, 2022 | Dec. 31, 2021 |
Accounts, Notes, Loans and Financing Receivable [Line Items] | ||
Total receivables | $ 2,240 | $ 2,177 |
Government receivables | ||
Accounts, Notes, Loans and Financing Receivable [Line Items] | ||
Total receivables | 1,628 | 1,566 |
Pharmacy rebate receivables | ||
Accounts, Notes, Loans and Financing Receivable [Line Items] | ||
Total receivables | 272 | 276 |
Other | ||
Accounts, Notes, Loans and Financing Receivable [Line Items] | ||
Total receivables | $ 340 | $ 335 |
Significant Accounting Polici_6
Significant Accounting Policies - Amounts Due To Government Agencies (Details) - USD ($) $ in Millions | Jun. 30, 2022 | Dec. 31, 2021 |
Medicaid program: | ||
Minimum MLR and profit sharing | $ 1,018 | $ 1,016 |
Other | 402 | 263 |
Medicare program: | ||
Risk adjustment and Part D risk sharing | 68 | 89 |
Minimum MLR and profit sharing | 115 | 101 |
Other | 22 | 35 |
Marketplace program: | ||
Risk adjustment | 1,037 | 902 |
Minimum MLR | 7 | 18 |
Other | 53 | 48 |
Total amounts due government agencies | $ 2,722 | $ 2,472 |
Significant Accounting Polici_7
Significant Accounting Policies - Narrative (Details) - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended | |||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | Dec. 31, 2021 | |
Schedule of Premium Revenue by Health Plan Type [Line Items] | |||||
Risk adjustment payable | $ 1,037 | $ 1,037 | $ 902 | ||
Risk adjustment receivable | 61 | 61 | 7 | ||
Risk adjustment, net payable | (976) | $ (976) | $ 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 | $ 94 | $ 56 | $ 122 | $ 166 |
Net Income Per Share (Details)
Net Income Per Share (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions | 3 Months Ended | 6 Months Ended | ||||||
Jun. 30, 2022 | Mar. 31, 2022 | Jun. 30, 2021 | Mar. 31, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | Dec. 31, 2021 | Dec. 31, 2020 | |
Numerator: | ||||||||
Net income | $ 248 | $ 258 | $ 185 | $ 228 | $ 506 | $ 413 | ||
Denominator: | ||||||||
Shares outstanding at the beginning of the period ( in shares) | 58.1 | 57.7 | 57.9 | 58 | ||||
Weighted-average number of shares issued: | ||||||||
Stock-based compensation (in shares) | 0 | 0 | 0.2 | 0.2 | ||||
Stock purchases (in shares) | (0.3) | 0 | (0.2) | (0.5) | ||||
Denominator for basic net income per share (in shares) | 57.8 | 57.7 | 57.9 | 57.7 | ||||
Effect of dilutive securities: | ||||||||
Stock-based compensation (in shares) | 0.6 | 0.7 | 0.7 | 0.8 | ||||
Denominator for diluted net income per share (in shares) | 58.4 | 58.4 | 58.6 | 58.5 | ||||
Net income per share: | ||||||||
Net income per share - Basic (in dollars per share) | $ 4.29 | $ 3.20 | $ 8.74 | $ 7.14 | ||||
Net income per share - Diluted (in dollars per share) | $ 4.25 | $ 3.16 | $ 8.63 | $ 7.05 |
Business Combinations (Details)
Business Combinations (Details) - USD ($) $ in Millions | 6 Months Ended | ||
Jan. 01, 2022 | Oct. 25, 2021 | Jun. 30, 2022 | |
Cigna Corporation's Texas Medicaid and Medicare-Medicaid Plan | |||
Business Acquisition, Contingent Consideration [Line Items] | |||
Total purchase price | $ 60 | ||
Goodwill | 24 | ||
Cigna Corporation's Texas Medicaid and Medicare-Medicaid Plan | 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 | 7 | ||
Increase to receivables, net of amounts due government agencies | $ 17 |
Fair Value Measurements - Finan
Fair Value Measurements - Financial Instruments on a Recurring Basis (Details) - USD ($) $ in Millions | Jun. 30, 2022 | Dec. 31, 2021 |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | $ 3,567 | $ 3,202 |
Total assets | 3,567 | 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 | 2,268 | 1,833 |
Mortgage-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 717 | 614 |
Asset-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 293 | 247 |
Municipal securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 146 | 123 |
U.S. Treasury notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 96 | 353 |
Other | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 47 | 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) | Municipal 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) | 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 | 3,567 | 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 | 2,268 | 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 | 717 | 614 |
(Level 2) | Asset-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 293 | 247 |
(Level 2) | Municipal securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 146 | 123 |
(Level 2) | U.S. Treasury notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 96 | 353 |
(Level 2) | Other | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 47 | 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) | Municipal 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) | 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 | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Dec. 31, 2021 | |
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | |||
Recognized gain (loss) | $ 4 | $ 3 | |
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 | Jun. 30, 2022 | Dec. 31, 2021 |
Carrying Amount | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 2,175 | $ 2,173 |
Fair Value | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 1,904 | 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 | $ 792 | 791 |
Senior Notes | 4.375% Notes due 2028 | Fair Value | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 724 | 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 | $ 550 | 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 | $ 630 | $ 760 |
Investments - Summary of Invest
Investments - Summary of Investments (Details) - USD ($) $ in Millions | Jun. 30, 2022 | Dec. 31, 2021 |
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | $ 3,735 | $ 3,208 |
Gross unrealized gains | 2 | 12 |
Gross unrealized losses | 170 | 18 |
Estimated Fair Value | 3,567 | 3,202 |
Corporate debt securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 2,372 | 1,836 |
Gross unrealized gains | 2 | 9 |
Gross unrealized losses | 106 | 12 |
Estimated Fair Value | 2,268 | 1,833 |
Mortgage-backed securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 759 | 616 |
Gross unrealized gains | 0 | 2 |
Gross unrealized losses | 42 | 4 |
Estimated Fair Value | 717 | 614 |
Asset-backed securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 306 | 248 |
Gross unrealized gains | 0 | 0 |
Gross unrealized losses | 13 | 1 |
Estimated Fair Value | 293 | 247 |
Municipal securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 153 | 123 |
Gross unrealized gains | 0 | 1 |
Gross unrealized losses | 7 | 1 |
Estimated Fair Value | 146 | 123 |
U.S. Treasury notes | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 96 | 353 |
Gross unrealized gains | 0 | 0 |
Gross unrealized losses | 0 | 0 |
Estimated Fair Value | 96 | 353 |
Other | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 49 | 32 |
Gross unrealized gains | 0 | 0 |
Gross unrealized losses | 2 | 0 |
Estimated Fair Value | $ 47 | $ 32 |
Investments - Contractual Matur
Investments - Contractual Maturities of Available-for-Sale Investments (Details) - USD ($) $ in Millions | Jun. 30, 2022 | Dec. 31, 2021 |
Amortized Cost | ||
Due in one year or less | $ 340 | |
Due after one year through five years | 2,276 | |
Due after five years through ten years | 377 | |
Due after ten years | 742 | |
Amortized Cost | 3,735 | $ 3,208 |
Estimated Fair Value | ||
Due in one year or less | 338 | |
Due after one year through five years | 2,175 | |
Due after five years through ten years | 358 | |
Due after ten years | 696 | |
Total | $ 3,567 |
Investments - Available-for-Sal
Investments - Available-for-Sale Investments (Details) $ in Millions | Jun. 30, 2022 USD ($) position security | Dec. 31, 2021 USD ($) position security |
Debt Securities, Available-for-sale [Line Items] | ||
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value | $ 3,009 | $ 1,706 |
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses | $ 166 | $ 18 |
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position | 1,466 | 677 |
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value | $ 86 | |
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses | $ 4 | |
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | position | 45 | |
Corporate debt securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value | $ 1,971 | $ 1,063 |
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses | $ 104 | $ 12 |
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position | 921 | 395 |
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value | $ 36 | $ 0 |
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses | $ 2 | $ 0 |
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | position | 19 | 0 |
Mortgage-backed securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value | $ 647 | $ 408 |
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses | $ 40 | $ 4 |
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position | 273 | 146 |
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value | $ 50 | $ 0 |
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses | $ 2 | $ 0 |
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | position | 26 | 0 |
Asset-backed securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value | $ 264 | $ 166 |
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses | $ 13 | $ 1 |
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | security | 134 | 75 |
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value | $ 0 | $ 0 |
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses | $ 0 | $ 0 |
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | security | 0 | 0 |
Municipal securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value | $ 100 | $ 69 |
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses | $ 7 | $ 1 |
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | security | 124 | 61 |
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value | $ 0 | $ 0 |
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses | $ 0 | $ 0 |
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | security | 0 | 0 |
Other | ||
Debt Securities, Available-for-sale [Line Items] | ||
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value | $ 27 | |
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses | $ 2 | |
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | security | 14 | |
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value | $ 0 | $ 0 |
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses | $ 0 | $ 0 |
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | security | 0 | 0 |
Investments - Narrative (Detail
Investments - Narrative (Details) $ in Millions | Jun. 30, 2022 USD ($) |
Investments, Debt and Equity Securities [Abstract] | |
Debt securities held to maturity | $ 219 |
Amortized cost, due in one year or less | 191 |
Amortized cost, due one year through five years | $ 28 |
Medical Claims and Benefits P_3
Medical Claims and Benefits Payable - Medical Claims and Benefits Payable (Details) - USD ($) $ in Millions | Jun. 30, 2022 | Dec. 31, 2021 | Jun. 30, 2021 | Dec. 31, 2020 |
Other Liabilities Disclosure [Abstract] | ||||
Claims incurred but not paid (“IBNP”) | $ 2,719 | $ 2,486 | ||
Pharmacy payable | 229 | 219 | ||
Capitation payable | 94 | 82 | ||
Other | 733 | 576 | ||
Total | $ 3,775 | $ 3,363 | $ 2,942 | $ 2,696 |
Medical Claims and Benefits P_4
Medical Claims and Benefits Payable - Narrative (Details) - USD ($) $ in Millions | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Dec. 31, 2021 | |
Other Liabilities Disclosure [Abstract] | |||
Non-risk provider payables | $ 229 | $ 226 | |
Prior period claims, favorable development | $ (311) | $ (193) |
Medical Claims and Benefits P_5
Medical Claims and Benefits Payable - Components of Change in Medical Claims and Benefits Payable (Details) - USD ($) $ in Millions | 6 Months Ended | |
Jun. 30, 2022 | Jun. 30, 2021 | |
Insurance Claims | ||
Medical claims and benefits payable, beginning balance | $ 3,363 | $ 2,696 |
Components of medical care costs related to: | ||
Current year | 13,746 | 11,486 |
Prior years | (311) | (193) |
Total medical care costs | 13,435 | 11,293 |
Payments for medical care costs related to: | ||
Current year | 10,622 | 9,023 |
Prior years | 2,411 | 1,949 |
Total paid | 13,033 | 10,972 |
Acquired balances, net of post-acquisition adjustments | 7 | (26) |
Change in non-risk and other provider payables | 3 | (49) |
Medical claims and benefits payable, ending balance | 3,775 | 2,942 |
Medicaid | ||
Insurance Claims | ||
Medical claims and benefits payable, beginning balance | 2,580 | 2,129 |
Components of medical care costs related to: | ||
Current year | 11,059 | 8,869 |
Prior years | (243) | (150) |
Total medical care costs | 10,816 | 8,719 |
Payments for medical care costs related to: | ||
Current year | 8,532 | 7,043 |
Prior years | 1,801 | 1,491 |
Total paid | 10,333 | 8,534 |
Acquired balances, net of post-acquisition adjustments | 7 | (19) |
Change in non-risk and other provider payables | 3 | (48) |
Medical claims and benefits payable, ending balance | 3,073 | 2,247 |
Medicare | ||
Insurance Claims | ||
Medical claims and benefits payable, beginning balance | 404 | 392 |
Components of medical care costs related to: | ||
Current year | 1,681 | 1,459 |
Prior years | (33) | (24) |
Total medical care costs | 1,648 | 1,435 |
Payments for medical care costs related to: | ||
Current year | 1,270 | 1,111 |
Prior years | 330 | 330 |
Total paid | 1,600 | 1,441 |
Acquired balances, net of post-acquisition adjustments | 0 | (7) |
Change in non-risk and other provider payables | 0 | (1) |
Medical claims and benefits payable, ending balance | 452 | 378 |
Marketplace | ||
Insurance Claims | ||
Medical claims and benefits payable, beginning balance | 379 | 175 |
Components of medical care costs related to: | ||
Current year | 1,006 | 1,158 |
Prior years | (35) | (19) |
Total medical care costs | 971 | 1,139 |
Payments for medical care costs related to: | ||
Current year | 820 | 869 |
Prior years | 280 | 128 |
Total paid | 1,100 | 997 |
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 | $ 250 | $ 317 |
Debt - Schedule of Long-Term De
Debt - Schedule of Long-Term Debt (Details) - USD ($) $ in Millions | Jun. 30, 2022 | Dec. 31, 2021 |
Debt Instrument [Line Items] | ||
Deferred debt issuance costs | $ (25) | $ (27) |
Total | $ 2,175 | 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) | 6 Months Ended |
Jun. 30, 2022 USD ($) | |
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 ($) $ / shares in Units, shares in Thousands | 3 Months Ended | 6 Months Ended | |||
Jun. 30, 2022 | Mar. 31, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | Sep. 30, 2021 | |
Class of Stock [Line Items] | |||||
Common stock purchases | $ 200,000,000 | $ 128,000,000 | |||
Common Stock | |||||
Class of Stock [Line Items] | |||||
Common stock authorized | $ 500,000,000 | ||||
Repurchased of common stock (in shares) | 658 | 1,000 | |||
Common stock purchases | $ 200,000,000 | ||||
Average cost (USD per share) | $ 304.13 |
Segments - Narrative (Details)
Segments - Narrative (Details) | 6 Months Ended |
Jun. 30, 2022 segment | |
Segment Reporting [Abstract] | |
Reportable segments | 4 |
Segments - Schedule of Operatin
Segments - Schedule of Operating Segment Information (Details) - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Segment Reporting Information [Line Items] | ||||
Revenues | $ 8,054 | $ 6,800 | $ 15,824 | $ 13,322 |
Medicaid | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | 6,524 | 5,209 | 12,711 | 10,229 |
Medicare | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | 963 | 822 | 1,912 | 1,627 |
Marketplace | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | 549 | 751 | 1,165 | 1,431 |
Other | ||||
Segment Reporting Information [Line Items] | ||||
Revenues | $ 18 | $ 18 | $ 36 | $ 35 |
Segments - Reconciliation of Gr
Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Segment Reporting Information [Line Items] | ||||
Add: other operating revenues | $ 8,054 | $ 6,800 | $ 15,824 | $ 13,322 |
Less: other operating expenses | (7,693) | (6,527) | (15,091) | (12,714) |
Operating income | 361 | 273 | 733 | 608 |
Other expenses, net | 27 | 30 | 55 | 60 |
Income before income tax expense | 334 | 243 | 678 | 548 |
Medicaid | ||||
Segment Reporting Information [Line Items] | ||||
Add: other operating revenues | 6,524 | 5,209 | 12,711 | 10,229 |
Medicare | ||||
Segment Reporting Information [Line Items] | ||||
Add: other operating revenues | 963 | 822 | 1,912 | 1,627 |
Marketplace | ||||
Segment Reporting Information [Line Items] | ||||
Add: other operating revenues | 549 | 751 | 1,165 | 1,431 |
Other | ||||
Segment Reporting Information [Line Items] | ||||
Add: other operating revenues | 18 | 18 | 36 | 35 |
Operating segments | ||||
Segment Reporting Information [Line Items] | ||||
Total margin | 930 | 767 | 1,901 | 1,603 |
Operating segments | Medicaid | ||||
Segment Reporting Information [Line Items] | ||||
Total margin | 755 | 551 | 1,465 | 1,155 |
Operating segments | Medicare | ||||
Segment Reporting Information [Line Items] | ||||
Total margin | 124 | 101 | 252 | 178 |
Operating segments | Marketplace | ||||
Segment Reporting Information [Line Items] | ||||
Total margin | 48 | 112 | 178 | 263 |
Operating segments | Other | ||||
Segment Reporting Information [Line Items] | ||||
Total margin | 3 | 3 | 6 | 7 |
Other operating | ||||
Segment Reporting Information [Line Items] | ||||
Add: other operating revenues | 237 | 199 | 458 | 398 |
Less: other operating expenses | $ (806) | $ (693) | $ (1,626) | $ (1,393) |