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Segment Information
6 Months Ended
Jun. 30, 2020
Segment Reporting [Abstract]  
Segment Information
Segment Information
The results of our operations are now described through four reportable segments: Commercial & Specialty Business, Government Business, IngenioRx and Other.
Our Commercial & Specialty Business segment includes our Local Group, National Accounts, Individual and Specialty businesses. Business units in the Commercial & Specialty Business segment offer fully-insured health products; provide a broad array of managed care services to self-funded customers including claims processing, underwriting, stop loss insurance, actuarial services, provider network access, medical cost management, disease management, wellness programs and other administrative services; and provide an array of specialty and other insurance products and services such as dental, vision, life and disability insurance benefits.
Our Government Business segment includes our Medicare and Medicaid businesses, National Government Services, or NGS, and services provided to the federal government in connection with the FEHB program. Our Medicare business includes services such as Medicare Supplement plans; Medicare Advantage, including Special Needs Plans; Medicare Part D; and dual-eligible programs through Medicare-Medicaid Plans. Our Medicaid business includes our managed care alternatives through publicly funded healthcare programs, including Medicaid, Medicaid expansion programs related to the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended, Temporary Assistance for Needy Families, programs for seniors and people with disabilities, Children’s Health Insurance Programs, and specialty programs such as those focused on long-term services and support, HIV/AIDS, foster care, behavioral health and/or substance abuse disorders, and intellectual disabilities or developmental disabilities. NGS acts as a Medicare contractor for the federal government in several regions across the nation.
Our IngenioRx segment includes our PBM business, which began its operations during the second quarter of 2019. IngenioRx markets and offers PBM services to fully-insured and self-funded Anthem health plan customers, as well as to external customers outside of the health plans we own. IngenioRx has a comprehensive PBM services portfolio, which includes services such as formulary management, pharmacy networks, prescription drug database, member services and mail order capabilities. In 2019, IngenioRx was included in our Other reportable segment. Beginning in 2020, IngenioRx meets
the quantitative thresholds for a reportable segment based on the FASB guidance. Amounts for the three and six months ended June 30, 2019 have been reclassified to conform to the current year presentation for comparability.
Our Other segment includes our Diversified Business Group, or DBG, which is our integrated health services business, and certain eliminations and corporate expenses not allocated to our other reportable segments. We reclassified DBG from our Government Business segment to the Other segment during the second quarter of 2019 to reflect changes in how our segments are being managed. Also, beginning on February 28, 2020, DBG includes Beacon.
For our 2019 segment reporting, operating gains (losses) generated from IngenioRx and DBG affiliated activity were included in our Commercial & Specialty Business and Government Business segments based upon their utilization of services from IngenioRx and DBG, which aligns with the method by which we assessed the 2019 operating performance of our reportable segments. Beginning January 1, 2020, we are managing the operating performance of each of our segments on a standalone basis.
Affiliated revenues represent revenues or cost for services provided by IngenioRx and DBG to our subsidiaries, are recorded at cost or management’s estimate of fair market value, and are eliminated in consolidation.
Financial data by reportable segment for the three and six months ended June 30, 2020 and 2019 is as follows:
 
Commercial
& Specialty
Business
 
Government
Business
 
IngenioRx
 
Other
 
Eliminations
 
Total
Three Months Ended June 30, 2020
 
 
 
 
 
 
 
 
 
 
 
Operating revenue - unaffiliated
$
8,789

 
$
17,242

 
$
2,544

 
$
603

 
$

 
$
29,178

Operating revenue - affiliated

 

 
2,725

 
849

 
(3,574
)
 

Operating gain
1,372

 
1,618

 
304

 
66

 

 
3,360

Three Months Ended June 30, 2019
 
 
 
 
 
 
 
 
 
 
 
Operating revenue - unaffiliated
$
9,417

 
$
15,538

 
$
145

 
$
77

 
$

 
$
25,177

Operating revenue - affiliated

 

 
103

 
469

 
(572
)
 

Operating gain (loss)
983

 
480

 

 
(30
)
 

 
1,433

Six Months Ended June 30, 2020
 
 
 
 
 
 
 
 
 
 
 
Operating revenue - unaffiliated
$
18,150

 
$
34,708

 
$
4,887

 
$
881

 
$

 
$
58,626

Operating revenue - affiliated

 

 
5,579

 
1,598

 
(7,177
)
 

Operating gain
2,792

 
2,029

 
653

 
80

 

 
5,554

Six Months Ended June 30, 2019
 
 
 
 
 
 
 
 
 
 
 
Operating revenue - unaffiliated
$
18,809

 
$
30,464

 
$
145

 
$
147

 
$

 
$
49,565

Operating revenue - affiliated

 

 
103

 
947

 
(1,050
)
 

Operating gain (loss)
2,581

 
854

 

 
(62
)
 

 
3,373


The major product revenues for each of the reportable segments for the three and six months ended June 30, 2020 and 2019 are as follows:
 
Three Months Ended 
 June 30
 
Six Months Ended 
 June 30
 
2020
 
2019
 
2020
 
2019
Commercial & Specialty Business
 
 
 
 
 
 
 
Managed care products
$
7,132

 
$
7,646

 
$
14,700

 
$
15,264

Managed care services
1,263

 
1,353

 
2,645

 
2,719

Dental/Vision products and services
284

 
327

 
599

 
650

Other
110

 
91

 
206

 
176

Total Commercial & Specialty Business
8,789

 
9,417

 
18,150

 
18,809

Government Business
 
 
 
 
 
 
 
Managed care products
17,149

 
15,444

 
34,524

 
30,264

Managed care services
93

 
94

 
184

 
200

Total Government Business
17,242

 
15,538

 
34,708

 
30,464

IngenioRx
 
 
 
 
 
 
 
Pharmacy products and services
5,269

 
248

 
10,466

 
248

Total IngenioRx
5,269

 
248

 
10,466

 
248

Other
 
 
 
 
 
 
 
Other
1,452

 
546

 
2,479

 
1,094

Eliminations
 
 
 
 
 
 
 
Eliminations
(3,574
)
 
(572
)
 
(7,177
)
 
(1,050
)
Total product revenues
$
29,178

 
$
25,177

 
$
58,626

 
$
49,565


The classification between managed care products and managed care services in the above table primarily distinguishes between the levels of risk assumed. Managed care products represent insurance products where we bear the insurance risk, whereas managed care services represent product offerings where we provide claims adjudication and other administrative services to the customer, but the customer principally bears the insurance risk. 
A reconciliation of reportable segments’ operating revenue to the amounts of total revenues included in our consolidated statements of income for the three and six months ended June 30, 2020 and 2019 is as follows:
 
Three Months Ended 
 June 30
 
Six Months Ended 
 June 30
 
2020
 
2019
 
2020
 
2019
Reportable segments’ operating revenue
$
29,178

 
$
25,177

 
$
58,626

 
$
49,565

Net investment income
57

 
285

 
311

 
495

Net realized gains (losses) on financial instruments
18

 
11

 
(6
)
 
89

Impairment recoveries (losses) recognized in income
11

 
(7
)
 
(46
)
 
(17
)
Total revenues
$
29,264

 
$
25,466

 
$
58,885

 
$
50,132


A reconciliation of reportable segments’ operating gain to income before income tax expense included in our consolidated statements of income for the three and six months ended June 30, 2020 and 2019 is as follows:
 
Three Months Ended 
 June 30
 
Six Months Ended 
 June 30
 
2020
 
2019
 
2020
 
2019
Reportable segments’ operating gain
$
3,360

 
$
1,433

 
$
5,554

 
$
3,373

Net investment income
57

 
285

 
311

 
495

Net realized gains (losses) on financial instruments
18

 
11

 
(6
)
 
89

Impairment recoveries (losses) recognized in income
11

 
(7
)
 
(46
)
 
(17
)
Interest expense
(201
)
 
(184
)
 
(395
)
 
(371
)
Amortization of other intangible assets
(93
)
 
(85
)
 
(176
)
 
(172
)
(Loss) gain on extinguishment of debt
(3
)
 

 
(4
)
 
1

Income before income tax expense
$
3,149

 
$
1,453

 
$
5,238

 
$
3,398