- 4Q 2025 operating revenue of $49.3 billion; FY 2025 of $197.6 billion
- 4Q 2025 diluted EPS1 of $2.47; adjusted diluted EPS2 of $3.33
- FY 2025 diluted EPS1 of $25.21; adjusted diluted EPS2 of $30.29
- Projected FY 2026 GAAP diluted EPS1 to be at least $22.30
- Projected FY 2026 adjusted diluted EPS2 to be at least $25.50
- Returned $4.1 billion of capital to shareholders in 2025
- Reaffirming long-term earnings algorithm; recalibrating segment margin targets
INDIANAPOLIS–(BUSINESS WIRE)–Elevance Health, Inc. (NYSE: ELV) reported fourth quarter and full year 2025 results.
“Elevance Health delivered fourth quarter results in line with our outlook, reflecting disciplined execution in a dynamic environment. As we enter 2026, our focus is on advancing affordability and making healthcare easier to access and navigate for the members we serve. Through pricing discipline and targeted investments, we are strengthening the earnings power of our diversified platform and remain confident in our ability to return to at least 12% adjusted EPS growth in 2027.”
Gail K. Boudreaux
President and Chief Executive Officer
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Earnings per diluted share (“EPS”). |
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Refer to GAAP reconciliation tables herein for reconciliation of GAAP to adjusted measures. |
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Elevance Health |
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Consolidated Enterprise Highlights |
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(In billions) |
Three Months Ended |
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Twelve Months Ended |
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December 31, |
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December 31, |
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December 31, |
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December 31, |
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Operating Revenue1 |
$49.3 |
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$45.0 |
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$197.6 |
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$175.2 |
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Operating Gain1,2 |
$0.3 |
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$0.7 |
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$7.2 |
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$7.9 |
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Adjusted Operating Gain1,3 |
$0.4 |
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$0.8 |
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$7.5 |
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$9.3 |
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Operating Margin1 |
0.6% |
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1.5% |
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3.6% |
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4.5% |
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Adjusted Operating Margin1,3 |
0.8% |
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1.9% |
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3.8% |
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5.3% |
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| 1. |
See “Basis of Presentation.” |
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| 2. |
Operating Gain for the three and twelve months ended December 31, 2025, and December 31, 2024, includes items that are excluded from adjusted shareholders’ net income. See “GAAP Reconciliation.” |
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| 3. |
Adjusted Operating Gain for the three and twelve months ended December 31, 2025, and December 31, 2024, excludes items that are excluded from adjusted shareholders’ net income. See “GAAP Reconciliation.” |
Operating revenue was $49.3 billion in the fourth quarter of 2025, an increase of $4.3 billion, or 10 percent compared to the prior year quarter. Operating revenue was $197.6 billion in 2025, an increase of $22.4 billion, or 13 percent. The increase in revenue for the quarter and year was driven by higher premium yields in our Health Benefits segment, contributions from acquisitions, and growth in Medicare Advantage membership, partially offset by membership attrition in our Medicaid business.
The benefit expense ratio was 93.5 percent in the fourth quarter, an increase of 110 basis points compared to the prior year period, reflecting higher medical cost trend primarily in our Affordable Care Act health plans and heightened Medicare Part D seasonality driven by Inflation Reduction Act changes. For the year, our benefit expense ratio was 90.0 percent, an increase of 150 basis points year over year, driven by elevated medical cost trends.
Days in Claims Payable was 41.3 days as of December 31, 2025, a decrease of 0.1 days from September 30, 2025, and a decrease of 1.9 days compared to December 31, 2024.
The operating expense ratio was 11.0 percent in the fourth quarter and 10.6 percent for the full year. On an adjusted basis, the corresponding operating expense ratios were 10.8 percent and 10.5 percent. We maintained expense discipline while investing to support and strengthen our workforce, scale Carelon’s capabilities, and accelerate technology adoption across the enterprise.
Cash Flow & Balance Sheet
Operating cash flow was $4.3 billion in 2025, approximately 0.8 times GAAP net income. As of December 31, 2025, cash and investments at the parent company totaled approximately $2.6 billion.
During the fourth quarter of 2025, the Company repurchased 1.4 million shares of its common stock for $471 million, at a weighted average price of $335.64, and paid a quarterly dividend of $1.71 per share, representing a distribution of cash totaling $377 million. As of December 31, 2025, the Company had approximately $6.7 billion of Board approved share repurchase authorization remaining.
Health Benefits is comprised of Individual, Employer Group risk-based, Employer Group fee-based, BlueCard®, Medicare, Medicaid, and Federal Employee Program businesses.
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Health Benefits |
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(In billions) |
Three Months Ended |
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December 31, |
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December 31, |
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December 31, |
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December 31, |
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Operating Revenue1 |
$41.8 |
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$37.6 |
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$167.1 |
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$150.3 |
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Operating Gain1,2 |
($0.2) |
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$0.2 |
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$4.2 |
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$6.2 |
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Adjusted Operating Gain1,3 |
($0.2) |
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$0.2 |
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$4.2 |
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$6.3 |
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Operating Margin1 |
(0.5%) |
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0.6% |
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2.5% |
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4.2% |
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Adjusted Operating Margin1 |
(0.5%) |
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0.6% |
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2.5% |
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4.2% |
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| 1. |
See “Basis of Presentation.” |
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| 2. |
Operating Gain for the three and twelve months ended December 31, 2024 includes items that are excluded from adjusted shareholders’ net income. See “GAAP Reconciliation.” |
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| 3. |
Adjusted Operating Gain for three and twelve months ended December 31, 2024 excludes $16 and $66 million, respectively, of 2024 business dispositions and related items adjusted out of adjusted shareholders’ net income for the Health Benefits segment. |
Health Benefits segment operating revenue was $41.8 billion in the fourth quarter of 2025, an increase of $4.3 billion, or 11 percent compared to the fourth quarter of 2024. Operating revenue was $167.1 billion in 2025, an increase of $16.8 billion, or 11 percent. The increases for the quarter and year were driven primarily by higher premium yields, contributions from acquisitions, and growth in our Medicare Advantage membership, partially offset by membership attrition in our Medicaid business.
The Company reported an adjusted operating loss of $0.2 billion in the fourth quarter of 2025 and an adjusted operating gain of $4.2 billion for the full year. Adjusted operating results in both periods were impacted primarily by higher medical cost trend.
Medical membership totaled approximately 45.2 million as of December 31, 2025, a decrease of 0.5 million, or 1 percent, year over year, driven by attrition in our Medicaid business.
Carelon is comprised of CarelonRx and Carelon Services.
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Carelon |
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(In billions) |
Three Months Ended |
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Twelve Months Ended |
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December 31, |
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December 31, |
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December 31, |
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December 31, |
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Operating Revenue1,2 |
$18.7 |
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$14.7 |
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$71.7 |
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$53.9 |
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Operating Gain1,3 |
$0.6 |
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$0.6 |
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$3.4 |
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$2.9 |
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Adjusted Operating Gain1,4,5 |
$0.6 |
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$0.6 |
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$3.4 |
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$3.1 |
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Operating Margin1 |
3.1% |
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3.9% |
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4.7% |
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5.4% |
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Adjusted Operating Margin1 |
3.3% |
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4.4% |
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4.8% |
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5.8% |
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| 1. |
See “Basis of Presentation.” |
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| 2. |
Operating revenue for the three and twelve months ended December 31, 2024 includes $0.2 and $0.8 billion, respectively, of revenue related to 2024 business dispositions and related items that have been excluded from adjusted operating gain. |
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| 3. |
Operating Gain for the three and twelve months ended December 31, 2025, and December 31, 2024, includes items that are excluded from adjusted shareholders’ net income. See “GAAP Reconciliation.” |
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| 4. |
Adjusted Operating Gain for three and twelve months ended December 31, 2025 excludes $38 million of 2025 business dispositions and related items adjusted out of adjusted shareholders’ net income for the Carelon segment. |
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| 5. |
Adjusted Operating Gain for the three and twelve months ended December 31, 2024 excludes $74 and $215 million, respectively, of 2024 business dispositions and related items adjusted out of adjusted shareholders’ net income for the Carelon segment. |
Operating revenue for Carelon was $18.7 billion in the fourth quarter of 2025, an increase of $3.9 billion, or 27 percent compared to the prior year period, driven by growth in CarelonRx product revenue, the expansion of Carelon Services risk-based solutions, and the acquisition of CareBridge. Operating revenue was $71.7 billion in 2025, an increase of $17.8 billion, or 33 percent.
Adjusted operating gain for Carelon totaled $0.6 billion in the fourth quarter, approximately flat year over year. On a full year basis, adjusted operating gain was $3.4 billion in 2025, an increase of $0.3 billion, or 10 percent, driven by improved CarelonRx performance and growth in Carelon Services risk-based solutions.
Quarterly Dividend
On January 27, 2026, the Audit Committee of the Company’s Board of Directors declared a first quarter 2026 dividend to shareholders of $1.72 per share. The first quarter dividend is payable on March 25, 2026 to shareholders of record at the close of business on March 10, 2026.
About Elevance Health
Elevance Health is a lifetime, trusted health partner whose purpose is to improve the health of humanity. The company supports consumers, families, and communities across the entire healthcare journey – connecting them to the care, support, and resources they need to lead better lives. Elevance Health’s companies serve approximately 104 million consumers through a diverse portfolio of industry-leading medical, pharmacy, behavioral, clinical, home health, and complex care solutions. For more information, please visit www.elevancehealth.com or follow us @ElevanceHealth on X and Elevance Health on LinkedIn.
Conference Call and Webcast
Management will host a conference call and webcast today at 8:30 a.m. Eastern Standard Time (“EST”) to discuss the company’s fourth quarter and full year 2025 results and 2026 outlook. The conference call should be accessed at least 15 minutes prior to the start of the call with the following numbers:
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888-947-9963 (Domestic) |
888-566-0046 (Domestic Replay) |
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312-470-0178 (International) |
203-369-3677 (International Replay) |
The access code for today’s conference call is 3972058. There is no access code for the replay. The replay will be available from 11:30 a.m. EST today, until the end of the day on February 27, 2026. The call will also be available through a live webcast at www.elevancehealth.com under the “Investors” link. A webcast replay will be available following the call.
Basis of Presentation
- Operating revenue and operating gain/loss are the key measures used by management to evaluate performance in each of its reporting segments, allocate resources, set incentive compensation targets and to forecast future operating performance. Operating gain/loss is calculated as total operating revenue less benefit expense, cost of products sold and operating expense. It does not include net investment income, net gains/losses on financial instruments, interest expense, amortization of other intangible assets, gains/losses on extinguishment of debt or income taxes, as these items are managed in a corporate shared service environment and are not the responsibility of operating segment management. Refer to the GAAP reconciliation tables.
- Operating margin is defined as operating gain divided by operating revenue.
Elevance Health
Earnings Release Financial Schedules and Supplementary Information
Quarter & Year Ended December 31, 2025
- Membership and Other Metrics
- Quarterly & Full Year Consolidated Statements of Income
- Condensed Consolidated Balance Sheet
- Condensed Consolidated Statement of Cash Flows
- Supplemental Financial Information – Reportable Segments
- Supplemental Financial Information – Reconciliation of Medical Claims Payable
- Reconciliation of Non-GAAP Financial Measures
- Financial Guidance Summary
- Membership Guidance Summary
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Elevance Health |
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Membership and Other Metrics |
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(Unaudited) |
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Change from |
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Medical Membership (in thousands) |
December 31, |
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December 31, |
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September 30, |
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December 31, |
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September 30, |
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Individual |
1,307 |
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1,287 |
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1,354 |
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1.6% |
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(3.5%) |
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Employer Group Risk-Based |
3,617 |
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3,713 |
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3,616 |
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(2.6%) |
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—% |
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Commercial Risk-Based |
4,924 |
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5,000 |
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4,970 |
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(1.5%) |
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(0.9%) |
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BlueCard® |
6,509 |
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6,630 |
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6,394 |
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(1.8%) |
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1.8% |
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Employer Group Fee-Based |
20,583 |
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20,569 |
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20,608 |
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0.1% |
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(0.1%) |
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Commercial Fee-Based |
27,092 |
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27,199 |
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27,002 |
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(0.4%) |
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0.3% |
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Medicare Advantage |
2,230 |
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2,066 |
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2,245 |
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7.9% |
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(0.7%) |
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Medicare Supplement |
882 |
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891 |
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877 |
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(1.0%) |
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0.6% |
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Total Medicare |
3,112 |
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2,957 |
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3,122 |
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5.2% |
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(0.3%) |
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Medicaid |
8,500 |
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8,917 |
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8,645 |
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(4.7%) |
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(1.7%) |
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Federal Employee Program |
1,604 |
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1,661 |
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1,630 |
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(3.4%) |
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(1.6%) |
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Total Medical Membership |
45,232 |
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45,734 |
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45,369 |
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(1.1%) |
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(0.3%) |
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Other Metrics (in millions) |
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CarelonRx Quarterly Adjusted Scripts |
88.5 |
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82.9 |
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85.0 |
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6.8% |
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4.1% |
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Carelon Services Consumers Served |
91.8 |
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101.1 |
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97.6 |
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(9.2%) |
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(5.9%) |
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Elevance Health |
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Consolidated Statements of Income |
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(Unaudited) |
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(In millions, except per share data) |
Three Months Ended December 31 |
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Twelve Months Ended December 31 |
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2025 |
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2024 |
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Change |
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2025 |
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2024 |
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Change |
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Revenues |
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Premiums |
$ |
40,690 |
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$ |
36,245 |
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12.3% |
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$ |
164,639 |
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$ |
144,166 |
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14.2% |
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Product revenue |
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6,460 |
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6,714 |
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(3.8%) |
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24,470 |
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22,630 |
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8.1% |
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Service fees |
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2,161 |
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2,030 |
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6.5% |
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8,475 |
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8,408 |
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0.8% |
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Total operating revenue |
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49,311 |
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44,989 |
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9.6% |
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197,584 |
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175,204 |
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12.8% |
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Net investment income |
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493 |
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527 |
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(6.5%) |
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2,194 |
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2,051 |
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7.0% |
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Net losses on financial instruments |
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(57) |
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(74) |
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NM |
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(653) |
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(445) |
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NM |
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Gain on sale of business |
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— |
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— |
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NM |
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— |
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201 |
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NM |
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Total revenues |
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49,747 |
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45,442 |
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9.5% |
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199,125 |
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177,011 |
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12.5% |
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Expenses |
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Benefit expense |
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38,065 |
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33,500 |
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13.6% |
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148,223 |
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127,567 |
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16.2% |
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Cost of products sold |
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5,522 |
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6,012 |
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(8.2%) |
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21,178 |
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19,750 |
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7.2% |
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Operating expense |
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5,415 |
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4,804 |
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12.7% |
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20,984 |
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20,025 |
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4.8% |
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Interest expense |
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366 |
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340 |
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7.6% |
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1,402 |
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|
1,185 |
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18.3% |
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Amortization of other intangible assets |
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164 |
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180 |
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(8.9%) |
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|
628 |
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|
580 |
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8.3% |
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Total expenses |
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49,532 |
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44,836 |
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10.5% |
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192,415 |
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169,107 |
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13.8% |
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Income before income tax expense |
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215 |
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606 |
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(64.5%) |
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6,710 |
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7,904 |
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(15.1%) |
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Income tax expense (benefit) |
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(331) |
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193 |
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NM |
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1,049 |
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1,933 |
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(45.7%) |
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Net income |
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546 |
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|
413 |
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32.2% |
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|
5,661 |
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|
5,971 |
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(5.2%) |
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Net loss attributable to noncontrolling interests |
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1 |
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5 |
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NM |
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1 |
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|
9 |
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NM |
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Shareholders’ net income |
$ |
547 |
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$ |
418 |
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30.9% |
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$ |
5,662 |
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$ |
5,980 |
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(5.3%) |
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Shareholders’ earnings per diluted share |
$ |
2.47 |
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$ |
1.81 |
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36.5% |
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$ |
25.21 |
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$ |
25.68 |
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(1.8%) |
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Diluted shares |
|
221.8 |
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|
231.1 |
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(4.0%) |
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|
224.6 |
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|
232.9 |
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(3.6%) |
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Benefit expense as a percentage of premiums |
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93.5% |
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92.4% |
|
110 bp |
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90.0% |
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|
88.5% |
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150 bp |
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Operating expense as a percentage of total operating revenue |
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11.0% |
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10.7% |
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30 bp |
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10.6% |
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11.4% |
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(80) bp |
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Income before income tax expense as a percentage of total revenue |
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0.4% |
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|
1.3% |
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(90) bp |
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3.4% |
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|
4.5% |
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(110) bp |
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“NM” = calculation not meaningful |
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Elevance Health |
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Condensed Consolidated Balance Sheet |
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(In millions) |
December 31, |
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December 31, |
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Assets |
(Unaudited) |
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|
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Current assets: |
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|
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Cash and cash equivalents |
$9,491 |
|
$8,288 |
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Fixed maturity and equity securities |
26,624 |
|
26,393 |
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Premium and other receivables |
21,542 |
|
19,071 |
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Other current assets |
5,344 |
|
4,700 |
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Assets held for sale |
— |
|
490 |
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Total current assets |
63,001 |
|
58,942 |
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Long-term investments |
11,960 |
|
10,784 |
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Property and equipment, net |
4,679 |
|
4,652 |
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Goodwill and other intangible assets |
39,544 |
|
40,371 |
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Other noncurrent assets |
2,310 |
|
2,140 |
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Total assets |
$121,494 |
|
$116,889 |
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Liabilities and equity |
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Liabilities |
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Current liabilities: |
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Medical claims payable |
$17,084 |
|
$15,746 |
|
Short-term borrowings |
150 |
|
365 |
|
Current portion of long-term debt |
1,099 |
|
1,649 |
|
Other current liabilities |
22,702 |
|
22,668 |
|
Liabilities held for sale |
— |
|
153 |
|
Total current liabilities |
41,035 |
|
40,581 |
|
|
|
|
|
|
Long-term debt, less current portion |
30,797 |
|
29,218 |
|
Other noncurrent liabilities |
5,636 |
|
5,664 |
|
Total liabilities |
77,468 |
|
75,463 |
|
|
|
|
|
|
Total shareholders’ equity |
43,882 |
|
41,315 |
|
Noncontrolling interests |
144 |
|
111 |
|
Total equity |
44,026 |
|
41,426 |
|
Total liabilities and equity |
$121,494 |
|
$116,889 |
|
Elevance Health |
|||||||
|
Condensed Consolidated Statement of Cash Flows |
|||||||
|
(Unaudited) |
|||||||
|
|
|
|
|
||||
|
(In millions) |
Twelve Months Ended |
||||||
|
|
|
2025 |
|
|
|
2024 |
|
|
|
|
|
|
||||
|
Operating activities |
|
|
|
||||
|
Net income |
$ |
5,661 |
|
|
$ |
5,971 |
|
|
Depreciation and amortization |
|
1,546 |
|
|
|
1,393 |
|
|
Share-based compensation |
|
276 |
|
|
|
191 |
|
|
Changes in operating assets and liabilities |
|
(3,680 |
) |
|
|
(1,719 |
) |
|
Other non-cash items |
|
487 |
|
|
|
(28 |
) |
|
Net cash provided by operating activities |
|
4,290 |
|
|
|
5,808 |
|
|
|
|
|
|
||||
|
Investing activities |
|
|
|
||||
|
Proceeds from sale of investments, net of maturities |
|
69 |
|
|
|
586 |
|
|
Net purchases of subsidiaries, net of cash acquired/sold |
|
88 |
|
|
|
(4,446 |
) |
|
Purchases of property and equipment |
|
(1,116 |
) |
|
|
(1,256 |
) |
|
Other, net |
|
(385 |
) |
|
|
(51 |
) |
|
Net cash used in investing activities |
|
(1,344 |
) |
|
|
(5,167 |
) |
|
|
|
|
|
||||
|
Financing activities |
|
|
|
||||
|
Net change in short-term and long-term borrowings |
|
629 |
|
|
|
6,200 |
|
|
Repurchase and retirement of common stock |
|
(2,605 |
) |
|
|
(2,900 |
) |
|
Cash dividends |
|
(1,529 |
) |
|
|
(1,508 |
) |
|
Other, net |
|
1,767 |
|
|
|
(599 |
) |
|
Net cash provided by (used in) financing activities |
|
(1,738 |
) |
|
|
1,193 |
|
|
|
|
|
|
||||
|
Effect of foreign exchange rates on cash and cash equivalents |
|
(5 |
) |
|
|
(6 |
) |
|
|
|
|
|
||||
|
Change in cash and cash equivalents |
|
1,203 |
|
|
|
1,828 |
|
|
Cash and cash equivalents at beginning of period |
|
8,288 |
|
|
|
6,526 |
|
|
Cash and equivalents included in assets held for sale at end of period |
|
— |
|
|
|
(66 |
) |
|
|
|
|
|
||||
|
Cash and cash equivalents at end of period |
$ |
9,491 |
|
|
$ |
8,288 |
|
REPORTABLE SEGMENTS
Elevance Health has four reportable segments: Health Benefits (comprised of Individual, Employer Group risk-based, Employer Group fee-based, BlueCard®, Medicare, Medicaid, and Federal Employee Program businesses); CarelonRx; Carelon Services; and Corporate & Other (comprised of businesses that do not individually meet the quantitative thresholds for an operating division as well as corporate expenses not allocated to our other reportable segments).
|
|
Elevance Health |
|
|||||||||||
|
|
Reportable Segment Details |
|
|||||||||||
|
|
(Unaudited) |
|
|||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(In millions) |
Three Months Ended December 31 |
|
Twelve Months Ended December 31 |
|
||||||||
|
|
|
2025 |
|
2024 |
|
Change |
|
2025 |
|
2024 |
|
Change |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Operating Revenue |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Health Benefits |
$41,835 |
|
$37,580 |
|
11.3% |
|
$167,094 |
|
$150,275 |
|
11.2% |
|
|
|
CarelonRx |
11,644 |
|
9,977 |
|
16.7% |
|
43,400 |
|
35,961 |
|
20.7% |
|
|
|
Carelon Services |
7,015 |
|
4,769 |
|
47.1% |
|
28,316 |
|
17,961 |
|
57.7% |
|
|
|
Corporate & Other |
(83) |
|
(14) |
|
NM6 |
|
463 |
|
309 |
|
49.8% |
|
|
|
Eliminations |
(11,100) |
|
(7,323) |
|
NM6 |
|
(41,689) |
|
(29,302) |
|
NM6 |
|
|
|
Total Operating Revenue1 |
$49,311 |
|
$44,989 |
|
9.6% |
|
$197,584 |
|
$175,204 |
|
12.8 % |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Operating Gain (Loss) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Health Benefits2 |
($220) |
|
$207 |
|
NM6 |
|
$4,158 |
|
$6,243 |
|
(33.4%) |
|
|
|
CarelonRx3 |
724 |
|
533 |
|
35.8% |
|
2,418 |
|
2,172 |
|
11.3% |
|
|
|
Carelon Services2,3 |
(150) |
|
35 |
|
NM6 |
|
960 |
|
717 |
|
33.9% |
|
|
|
Corporate & Other2,3 |
(45) |
|
(102) |
|
NM6 |
|
(337) |
|
(1,270) |
|
NM6 |
|
|
|
Total Operating Gain1,4 |
$309 |
|
$673 |
|
(54.1%) |
|
$7,199 |
|
$7,862 |
|
(8.4%) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Operating Margin |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Health Benefits |
(0.5%) |
|
0.6% |
|
(110) bp |
|
2.5% |
|
4.2% |
|
(170) bp |
|
|
|
CarelonRx |
6.2% |
|
5.3% |
|
90 bp |
|
5.6% |
|
6.0% |
|
(40) bp |
|
|
|
Carelon Services |
(2.1%) |
|
0.7% |
|
(280) bp |
|
3.4% |
|
4.0% |
|
(60) bp |
|
|
|
Total Operating Margin1 |
0.6% |
|
1.5% |
|
(90) bp |
|
3.6% |
|
4.5% |
|
(90) bp |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Health Benefits Revenue Details |
|
|||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(In millions) |
Three Months Ended December 31 |
|
Twelve Months Ended December 31 |
|
||||||||
|
|
|
2025 |
|
2024 |
|
Change |
|
2025 |
|
2024 |
|
Change |
|
|
|
Health Benefits Operating Revenue |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Commercial |
$12,747 |
|
$11,851 |
|
7.6% |
|
$50,401 |
|
$46,816 |
|
7.7% |
|
|
|
Individual5 |
2,248 |
|
2,117 |
|
6.2% |
|
9,295 |
|
8,295 |
|
12.1% |
|
|
|
Medicare |
10,762 |
|
9,054 |
|
18.9% |
|
44,752 |
|
36,795 |
|
21.6% |
|
|
|
Medicaid |
14,500 |
|
12,755 |
|
13.7% |
|
56,620 |
|
51,937 |
|
9.0% |
|
|
|
Federal Employee Program |
3,826 |
|
3,920 |
|
(2.4%) |
|
15,321 |
|
14,727 |
|
4.0% |
|
|
|
Total Health Benefits Operating Revenue1 |
$41,835 |
|
$37,580 |
|
11.3% |
|
$167,094 |
|
$150,275 |
|
11.2% |
|
| 1. |
See “Basis of Presentation.” |
|
| 2. |
Operating Gain for the three and twelve months ended December 31, 2024 included $90 and $281 million, respectively, of 2024 business dispositions and related items; including $74 and $215 million, respectively, for the Carelon Services segment; and $16 and $66 million, respectively, for the Health Benefits segment. Operating Gain for the three and twelve months ended December 31, 2024 included $66 and $224 million, respectively, of transaction and integration related costs, $12 and $692 million, respectively, of litigation and settlement expenses, and $0 and $268 million, respectively, of business optimization charges, all of which reside in the Corporate & Other reportable segment. |
|
| 3. |
Operating Gain for the three and twelve months ended December 31, 2025 included $41 million of 2025 business dispositions and related items; including $45 million for the CarelonRx segment; ($7) million for the Carelon Services segment; and $3 million for the Corporate & Other segment. Operating Gain for the three and twelve months ended December 31, 2025 included $54 and $236 million, respectively, of transaction and integration related costs, $5 and $24 million, respectively, of litigation and settlement expenses, and ($34) and ($38) million, respectively, of business optimization charges, all of which reside in the Corporate & Other reportable segment. |
|
| 4. |
Operating Gain for the three and twelve months ended December 31, 2025, and December 31, 2024, included items excluded from adjusted shareholders’ net income. See “GAAP Reconciliation.” |
|
| 5. |
The Individual business, including ACA products, is reported as part of Commercial Operating Revenue. |
|
| 6. |
“NM” = calculation not meaningful. |
|
Elevance Health |
||||||||||||
|
Reconciliation of Medical Claims Payable |
||||||||||||
|
|
||||||||||||
|
|
Years Ended December 31 |
|||||||||||
|
|
|
2025 |
|
|
|
2024 |
|
|
|
2023 |
|
|
|
(In millions) |
(Unaudited) |
|
|
|
|
|||||||
|
|
|
|
|
|
|
|||||||
|
Gross medical claims payable, beginning of year |
$ |
15,580 |
|
|
$ |
15,865 |
|
|
$ |
15,348 |
|
|
|
Ceded medical claims payable, beginning of year |
|
(13 |
) |
|
|
(7 |
) |
|
|
(6 |
) |
|
|
Net medical claims payable, beginning of year |
|
15,567 |
|
|
|
15,858 |
|
|
|
15,342 |
|
|
|
|
|
|
|
|
|
|||||||
|
Business combinations and purchase adjustments |
|
344 |
|
|
|
143 |
|
|
|
— |
|
|
|
|
|
|
|
|
|
|||||||
|
Net incurred medical claims: |
|
|
|
|
|
|||||||
|
Current year |
|
145,566 |
|
|
|
125,370 |
|
|
|
121,798 |
|
|
|
Prior years redundancies1 |
|
(1,290 |
) |
|
|
(1,731 |
) |
|
|
(1,571 |
) |
|
|
Total net incurred medical claims |
|
144,276 |
|
|
|
123,639 |
|
|
|
120,227 |
|
|
|
|
|
|
|
|
|
|||||||
|
Net payments attributable to: |
|
|
|
|
|
|||||||
|
Current year medical claims |
|
130,265 |
|
|
|
110,930 |
|
|
|
107,146 |
|
|
|
Prior years medical claims |
|
13,141 |
|
|
|
13,143 |
|
|
|
12,565 |
|
|
|
Total net payments |
|
143,406 |
|
|
|
124,073 |
|
|
|
119,711 |
|
|
|
|
|
|
|
|
|
|||||||
|
Net medical claims payable, end of year |
|
16,781 |
|
|
|
15,567 |
|
|
|
15,858 |
|
|
|
Ceded medical claims payable, end of year |
|
48 |
|
|
|
13 |
|
|
|
7 |
|
|
|
Gross medical claims payable, end of year2 |
$ |
16,829 |
|
|
$ |
15,580 |
|
|
$ |
15,865 |
|
|
|
|
|
|
|
|
|
|||||||
|
Current year medical claims paid as a percentage of current year net incurred medical claims |
|
89.5 |
% |
|
|
88.5 |
% |
|
|
88.0 |
% |
|
|
|
|
|
|
|
|
|||||||
|
Prior year redundancies in the current year as a percentage of prior year net medical claims payable less prior year redundancies in the current year |
|
9.0 |
% |
|
|
12.3 |
% |
|
|
11.4 |
% |
|
|
|
|
|
|
|
|
|||||||
|
Prior year redundancies in the current year as a percentage of prior year net incurred medical claims |
|
1.0 |
% |
|
|
1.4 |
% |
|
|
1.4 |
% |
|
|
|
|
|
|
|
|
|||||||
|
||||||||||||
Elevance Health
GAAP Reconciliation
(Unaudited)
This document references non-GAAP measures, including “Adjusted Shareholders’ Net Income,” “Adjusted Shareholders’ Net Income Per Share,” “Adjusted EPS,” “Adjusted Operating Gain,” “Adjusted Operating Expense” and “Adjusted Operating Expense Ratio,” which are non-GAAP measures.
Contacts
Elevance Health Contacts:
Investor Relations
Nathan Rich
[email protected]
Media
Leslie Porras
[email protected]
