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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
(Mark One)
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the Quarterly Period Ended June 30, 2023
OR
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from                     to                     
Commission file number: 001-16751
eh_logo.jpg
ELEVANCE HEALTH, INC.
(Exact name of registrant as specified in its charter)
Indiana 35-2145715
(State or other jurisdiction of
incorporation or organization)
 (I.R.S. Employer
Identification Number)
220 Virginia Avenue
Indianapolis, Indiana 46204
(Address of principal executive offices) (Zip Code)
Registrant’s telephone number, including area code: (833401-1577
Not Applicable
(Former name, former address and former fiscal year, if changed since last report)
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading symbol(s)Name of each exchange on which registered
Common Stock, $0.01 par valueELVNew York Stock Exchange
Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes ☒ No  ☐
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes  ☒    No  ☐
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer”, “accelerated filer”, “smaller reporting company”, and “emerging growth company” in Rule 12b-2 of the Exchange Act:
Large accelerated filer  Accelerated filer
Non-accelerated filer  Smaller reporting company
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes      No  ☒
As of July 13, 2023, 235,647,808 shares of the Registrant’s Common Stock were outstanding.



Elevance Health, Inc.
Quarterly Report on Form 10-Q
For the Period Ended June 30, 2023
Table of Contents
 
  Page
PART I. FINANCIAL INFORMATION
ITEM 1.
ITEM 2.
ITEM 3.
ITEM 4.
PART II. OTHER INFORMATION
ITEM 1.
ITEM 1A.
ITEM 2.
ITEM 3.
ITEM 4.
ITEM 5.
ITEM 6.
-1-


PART I. FINANCIAL INFORMATION
ITEM 1.    FINANCIAL STATEMENTS
Elevance Health, Inc.
Consolidated Balance Sheets
June 30,
2023
December 31,
2022
(In millions, except share and per share data)(Unaudited)(Restated)
Assets
Current assets:
Cash and cash equivalents$9,991 $7,387 
Fixed maturity securities (amortized cost of $29,915 and $28,226; allowance for credit losses of $7 and $9)
28,021 25,952 
Equity securities272 953 
Premium receivables7,431 7,083 
Self-funded receivables3,896 4,663 
Other receivables5,196 4,298 
Other current assets4,936 5,281 
Total current assets59,743 55,617 
Long-term investments:
Fixed maturity securities (amortized cost of $809 and $789; allowance for credit losses of $0 and $0)
775 752 
Other invested assets5,993 5,685 
Property and equipment, net4,547 4,316 
Goodwill25,274 24,383 
Other intangible assets10,703 10,315 
Other noncurrent assets2,133 1,687 
Total assets$109,168 $102,755 
Liabilities and equity
Liabilities
Current liabilities:
Medical claims payable$16,165 $15,596 
Other policyholder liabilities5,954 5,933 
Unearned income4,458 1,112 
Accounts payable and accrued expenses5,033 5,607 
Short-term borrowings265 265 
Current portion of long-term debt 1,500 
Other current liabilities9,696 9,683 
Total current liabilities41,571 39,696 
Long-term debt, less current portion24,859 22,349 
Reserves for future policy benefits797 803 
Deferred tax liabilities, net1,852 2,015 
Other noncurrent liabilities1,777 1,562 
Total liabilities70,856 66,425 
Commitments and contingencies – Note 10
Shareholders’ equity
Preferred stock, without par value, shares authorized – 100,000,000; shares issued and outstanding – none
  
Common stock, par value $0.01, shares authorized – 900,000,000; shares issued and outstanding –
235,861,650 and 237,958,067
2 2 
Additional paid-in capital8,761 9,084 
Retained earnings31,608 29,647 
Accumulated other comprehensive loss(2,166)(2,490)
Total shareholders’ equity38,205 36,243 
Noncontrolling interests107 87 
Total equity38,312 36,330 
Total liabilities and equity$109,168 $102,755 


See accompanying notes.
-2-


Elevance Health, Inc.
Consolidated Statements of Income
(Unaudited) 
 Three Months Ended 
 June 30
Six Months Ended 
 June 30
2023202220232022
(In millions, except per share data)(Restated)(Restated)
Revenues
Premiums$36,589 $33,076 $72,457 $65,861 
Product revenue4,859 3,568 8,881 6,869 
Service fees1,929 1,838 3,937 3,638 
Total operating revenue43,377 38,482 85,275 76,368 
Net investment income416 381 803 741 
Net losses on financial instruments(121)(231)(234)(382)
Total revenues43,672 38,632 85,844 76,727 
Expenses
Benefit expense31,604 28,795 62,390 57,026 
Cost of products sold4,327 3,069 7,808 5,952 
Operating expense4,818 4,272 9,618 8,617 
Interest expense261 208 512 409 
Amortization of other intangible assets221 166 456 295 
Total expenses41,231 36,510 80,784 72,299 
Income before income tax expense
2,441 2,122 5,060 4,428 
Income tax expense585 488 1,200 1,015 
Net income1,856 1,634 3,860 3,413 
Net (income) loss attributable to noncontrolling interests(3)3 (18)13 
Shareholders’ net income$1,853 $1,637 $3,842 $3,426 
Shareholders’ net income per share
Basic $7.83 $6.80 $16.21 $14.22 
Diluted $7.79 $6.73 $16.10 $14.05 
Dividends per share$1.48 $1.28 $2.96 $2.56 















See accompanying notes.
-3-


Elevance Health, Inc.
Consolidated Statements of Comprehensive Income
(Unaudited) 
 Three Months Ended 
 June 30
Six Months Ended 
 June 30
(In millions)2023202220232022
(Restated)(Restated)
Net income$1,856 $1,634 $3,860 $3,413 
Other comprehensive (loss) income, net of tax:
Change in net unrealized losses/gains on investments(119)(922)308 (1,991)
Change in non-credit component of impairment losses on investments
(1)(1)(3)(2)
Change in net unrealized gains/losses on cash flow hedges4 3 15 6 
Change in net periodic pension and postretirement costs3 9 5 16 
Change in future policy benefits (3)8 (1)17 
Foreign currency translation adjustments (5)2 (8)
Other comprehensive (loss) income(116)(908)326 (1,962)
Net (income) loss attributable to noncontrolling interests(3)3 (18)13 
Other comprehensive loss (income) attributable to noncontrolling interests 3 (2)8 
Total shareholders’ comprehensive income$1,737 $732 $4,166 $1,472 




















See accompanying notes.
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Elevance Health, Inc.
Consolidated Statements of Cash Flows
(Unaudited)
Six Months Ended 
 June 30
20232022
(In millions)(Restated)
Operating activities
Net income$3,860 $3,413 
Adjustments to reconcile net income to net cash provided by operating activities:
Net losses on financial instruments234 382 
Equity in net earnings of other invested assets73 (258)
Depreciation and amortization895 751 
Deferred income taxes(393)(181)
Share-based compensation139 122 
Changes in operating assets and liabilities:
Receivables, net(299)(662)
Other invested assets(42)32 
Other assets(529)(412)
Policy liabilities583 1,548 
Unearned income3,346 (182)
Accounts payable and other liabilities160 632 
Income taxes391 (159)
Other, net1 (33)
Net cash provided by operating activities8,419 4,993 
Investing activities
Purchases of investments(17,648)(13,253)
Proceeds from sale of investments5,339 7,140 
Maturities, calls and redemptions from investments10,656 4,347 
Changes in securities lending collateral145 (620)
Purchases of subsidiaries, net of cash acquired(1,651)(609)
Purchases of property and equipment(651)(549)
Other, net(46)(58)
Net cash used in investing activities(3,856)(3,602)
Financing activities
Net proceeds from commercial paper borrowings90 250 
Proceeds from long-term borrowings2,574 1,300 
Repayments of long-term borrowings(1,908)(943)
Proceeds from short-term borrowings 1,275 
Repayments of short-term borrowings(90)(1,375)
Changes in securities lending payable(145)620 
Changes in bank overdrafts(500)817 
Repurchase and retirement of common stock(1,268)(1,169)
Cash dividends(701)(618)
Proceeds from issuance of common stock under employee stock plans81 116 
Taxes paid through withholding of common stock under employee stock plans(99)(88)
Other, net5 10 
Net cash (used in) provided by financing activities(1,961)195 
Effect of foreign exchange rates on cash and cash equivalents2 (10)
Change in cash and cash equivalents2,604 1,576 
Cash and cash equivalents at beginning of period7,387 4,880 
Cash and cash equivalents at end of period$9,991 $6,456 
See accompanying notes.
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Elevance Health, Inc.
Consolidated Statements of Changes in Equity
(Unaudited)
Total Shareholders’ Equity
 Common StockAdditional
Paid-in
Capital
Retained
Earnings
Accumulated
Other
Comprehensive
Loss
Noncontrolling
Interests
Total
Equity
(In millions)Number of
Shares
Par
Value
December 31, 2022 (restated)238.0 $2 $9,084 $29,647 $(2,490)$87 $36,330 
Net income— — — 1,989 — 15 2,004 
Other comprehensive income— — — — 440 2 442 
Repurchase and retirement of common stock, including excise tax(1.3)— (51)(575)— — (626)
Dividends and dividend equivalents— — — (354)— — (354)
Issuance of common stock under employee stock plans, net of related tax benefits0.4 — 6  — — 6 
Convertible debenture repurchases, conversions and tax adjustments— — (342)— — — (342)
March 31, 2023237.1 2 8,697 30,707 (2,050)104 37,460 
Net income — — — 1,853 — 3 1,856 
Other comprehensive income— — — — (116) (116)
Repurchase and retirement of common stock, including excise tax(1.4)— (52)(600)— — (652)
Dividends and dividend equivalents— — — (352)— — (352)
Issuance of common stock under employee stock plans, net of related tax benefits0.2 — 116 — — — 116 
June 30, 2023235.9 $2 $8,761 $31,608 $(2,166)$107 $38,312 



















See accompanying notes.
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Elevance Health, Inc.
Consolidated Statements of Changes in Equity (continued)
(Unaudited)
Total Shareholders’ Equity
 Common StockAdditional
Paid-in
Capital
Retained
Earnings
Accumulated
Other
Comprehensive
Loss
Noncontrolling
Interests
Total
Equity
(In millions)Number of
Shares
Par
Value
December 31, 2021 (restated)241.8 $2 $9,148 $27,142 $(197)$68 $36,163 
Adoption of Accounting Standards Update 2020-06— — — (23)— — (23)
January 1, 2022 (restated)241.8 2 9,148 27,119 (197)68 36,140 
Net income (loss) (restated)— — — 1,789 — (10)1,779 
Other comprehensive loss (restated)— — — — (1,049)(5)(1,054)
Noncontrolling interests adjustment— — — — — 3 3 
Repurchase and retirement of common stock(1.2) (45)(500)— — (545)
Dividends and dividend equivalents— —  (312)— — (312)
Issuance of common stock under employee stock plans, net of related tax benefits
0.5 — 39 — — — 39 
Convertible debenture repurchases and conversions
— — 9 — — — 9 
March 31, 2022 (restated)241.1 2 9,151 28,096 (1,246)56 36,059 
Net income (loss) restated— — — 1,637 — (3)1,634 
Other comprehensive loss (restated)— — — — (905)(3)(908)
Noncontrolling interests adjustment— — — — — 5 5 
Repurchase and retirement of common stock
(1.3) (48)(576)— — (624)
Dividends and dividend equivalents— — — (310)— — (310)
Issuance of common stock under employee stock plans, net of related tax benefits
0.2 — 111 — — — 111 
Convertible debenture repurchases and conversions
— — (80)— — — (80)
June 30, 2022 (restated)240.0 $2 $9,134 $28,847 $(2,151)$55 $35,887 













See accompanying notes.
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Elevance Health, Inc.
Notes to Consolidated Financial Statements
(Unaudited)
June 30, 2023
(In Millions, Except Per Share Data or As Otherwise Stated Herein)
 
1.     Organization
References to the terms “we,” “our,” “us” or “Elevance Health” used throughout these Notes to Consolidated Financial Statements refer to Elevance Health, Inc., an Indiana corporation, and unless the context otherwise requires, its direct and indirect subsidiaries. References to the “states” include the District of Columbia and Puerto Rico unless the context otherwise requires.
Elevance Health is a health company with the purpose of improving the health of humanity. We are one of the largest health insurers in the United States in terms of medical membership, serving approximately 48 million medical members through our affiliated health plans as of June 30, 2023. We offer a broad spectrum of network-based managed care risk-based plans to Individual, Employer Group, Medicaid and Medicare markets. In addition, we provide a broad array of managed care services to fee-based customers, including claims processing, stop loss insurance, provider network access, medical management, care management, wellness programs, actuarial services and other administrative services. We provide services to the federal government in connection with our Federal Health Products & Services business, which administers the Federal Employees Health Benefits (“FEHB”) Program. We provide an array of specialty services both to customers of our subsidiary health plans and also unaffiliated health plans, including pharmacy services and dental, vision, life, disability and supplemental health insurance benefits, as well as integrated health services.
We are an independent licensee of the Blue Cross and Blue Shield Association (“BCBSA”), an association of independent health benefit plans. We serve our members as the Blue Cross licensee for California and as the Blue Cross and Blue Shield (“BCBS”) licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (with the exception of 30 counties in the Kansas City area), Nevada, New Hampshire, New York (in the New York City metropolitan area and upstate New York), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.) and Wisconsin. In a majority of these service areas, we do business as Anthem Blue Cross, Anthem Blue Cross and Blue Shield, and Empire Blue Cross Blue Shield or Empire Blue Cross. We also serve members in numerous states as Amerigroup, Freedom Health, HealthLink, HealthSun, MMM, Optimum HealthCare, Simply Healthcare, UniCare and/or Wellpoint. We also conduct business through arrangements with other BCBS licensees as well as other strategic partners. We are licensed to conduct insurance operations in all 50 states, the District of Columbia and Puerto Rico through our subsidiaries. Through various subsidiaries, we also offer pharmacy services as CarelonRx and other healthcare-related services as Carelon Services, Aspire Health, Carelon Behavioral Health and CareMore.
As we announced in 2022, over the next several years we are organizing our brand portfolio into the following core go-to-market brands:
Anthem Blue Cross/Anthem Blue Cross and Blue Shield — represents our existing Anthem-branded and affiliated Blue Cross and/or Blue Shield licensed plans; and
Wellpoint — we are uniting select non-BCBSA licensed Medicare, Medicaid and commercial plans under the Wellpoint name; and
Carelon — this brand brings together our healthcare-related brands and capabilities, including our CarelonRx and Carelon Services businesses, under a single brand name.
Our branding strategy reflects the evolution of our business from a traditional health insurance company to a lifetime, trusted health partner. Given this evolution, we reviewed and modified how we manage our business, monitor our performance and allocate our resources, and made changes to our reportable segments beginning in the first quarter of 2023. The results of our operations are now reported in the following four reportable segments: Health Benefits (aggregates our previously reported Commercial & Specialty Business and Government Business segments), CarelonRx, Carelon Services (previously included in our Other segment) and Corporate & Other (our businesses that do not individually meet the quantitative thresholds for an operating segment, as well as corporate expenses not allocated to our other reportable
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segments). In 2022, we managed and presented our operations through the following four reportable segments: Commercial & Specialty Business, Government Business, CarelonRx and Other. Previously reported information in this Form 10-Q has been reclassified to conform to the new presentation. For additional discussion regarding our segments, including the changes made, see Note 14 “Segment Information.”
2.     Basis of Presentation and Significant Accounting Policies
Basis of Presentation: The accompanying unaudited consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) for interim financial reporting. Accordingly, they do not include all of the information and footnotes required by GAAP for annual financial statements. We have omitted certain footnote disclosures that would substantially duplicate the disclosures in our Annual Report on Form 10-K for the year ended December 31, 2022 (the “2022 Annual Report on Form 10-K”) , unless the information contained in those disclosures materially changed or is required by GAAP. In the opinion of management, all adjustments, including normal recurring adjustments, necessary for a fair statement of the consolidated financial statements as of and for the three and six months ended June 30, 2023 and 2022 have been recorded. The results of operations for the three and six months ended June 30, 2023 are not necessarily indicative of the results that may be expected for the full year ending December 31, 2023, or any other period. The seasonal nature of portions of our health care and related benefits business, as well as competitive and other market conditions, may cause full-year results to differ from estimates based upon our interim results of operations. These unaudited consolidated financial statements should be read in conjunction with our audited consolidated financial statements as of and for the year ended December 31, 2022 included in our 2022 Annual Report on Form 10-K.
Certain of our subsidiaries operate outside of the United States and have functional currencies other than the U.S. dollar (“USD”). We translate the assets and liabilities of those subsidiaries to USD using the exchange rate in effect at the end of the period. We translate the revenues and expenses of those subsidiaries to USD using the average exchange rates in effect during the period. The net effect of these translation adjustments is included in “Foreign currency translation adjustments” in our consolidated statements of comprehensive income.
Cash and Cash Equivalents: We control a number of bank accounts that are used exclusively to hold customer funds for the administration of customer benefits, and we have cash and cash equivalents on deposit to meet certain regulatory requirements. These amounts totaled $391 and $258 at June 30, 2023 and December 31, 2022, respectively, and are included in the cash and cash equivalents line on our consolidated balance sheets.
Investments: We classify fixed maturity securities in our investment portfolio as “available-for-sale” and report those securities at fair value. Certain fixed maturity securities are available to support current operations and, accordingly, we classify such investments as current assets without regard to their contractual maturity. Investments used to satisfy contractual, regulatory or other requirements are classified as long-term, without regard to contractual maturity.
If a fixed maturity security is in an unrealized loss position and we have the intent to sell the fixed maturity security, or it is more likely than not that we will have to sell the fixed maturity security before recovery of its amortized cost basis, we write down the fixed maturity security’s cost basis to fair value and record an impairment loss in our consolidated statements of income. For impaired fixed maturity securities that we do not intend to sell or if it is more likely than not that we will not have to sell such securities, but we expect that we will not fully recover the amortized cost basis, we recognize the credit component of the impairment as an allowance for credit loss in our consolidated balance sheets and record an impairment loss in our consolidated statements of income. The non-credit component of the impairment is recognized in accumulated other comprehensive loss. Furthermore, unrealized losses entirely caused by non-credit-related factors related to fixed maturity securities for which we expect to fully recover the amortized cost basis continue to be recognized in accumulated other comprehensive loss.
The credit component of an impairment is determined primarily by comparing the net present value of projected future cash flows with the amortized cost basis of the fixed maturity security. The net present value is calculated by discounting our best estimate of projected future cash flows at the effective interest rate implicit in the fixed maturity security at the date of purchase. For mortgage-backed and asset-backed securities, cash flow estimates are based on assumptions regarding the underlying collateral, including prepayment speeds, vintage, type of underlying asset, geographic concentrations, default rates, recoveries and changes in value. For all other securities, cash flow estimates are driven by assumptions regarding
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probability of default, including changes in credit ratings and estimates regarding timing and amount of recoveries associated with a default.
For asset-backed securities included in fixed maturity securities, we recognize income using an effective yield based on anticipated prepayments and the estimated economic life of the securities. When estimates of prepayments change, the effective yield is recalculated to reflect actual payments to date and anticipated future payments. The net investment in the securities is adjusted to the amount that would have existed had the new effective yield been applied since the purchase date of the securities. Such adjustments are reported within net investment income.
The changes in fair value of our marketable equity securities are recognized in our results of operations within net gains and losses on financial instruments. Certain marketable equity securities are held to satisfy contractual obligations and are reported under the caption “Other invested assets” in our consolidated balance sheets.
We have corporate-owned life insurance policies on certain participants in our deferred compensation plans and other members of management. The cash surrender value of the corporate-owned life insurance policies is reported under the caption “Other invested assets” in our consolidated balance sheets.
We use the equity method of accounting for investments in companies in which our ownership interest may enable us to influence the operating or financial decisions of the investee company. Our proportionate share of equity in net income of these unconsolidated affiliates is reported within net investment income. The equity method investments are reported under the caption “Other invested assets” in our consolidated balance sheets.
Investment income is recorded when earned. All securities sold resulting in investment gains and losses are recorded on the trade date. Realized gains and losses are determined on the basis of the cost or amortized cost of the specific securities sold.
We participate in securities lending programs whereby marketable securities in our investment portfolio are transferred to independent brokers or dealers in exchange for cash and securities collateral. We recognize the collateral as an asset, which is reported under the caption “Other current assets” on our consolidated balance sheets, and we record a corresponding liability for the obligation to return the collateral to the borrower, which is reported under the caption “Other current liabilities.” The securities on loan are reported in the applicable investment category on our consolidated balance sheets. Unrealized gains or losses on securities lending collateral are included in accumulated other comprehensive loss as a separate component of shareholders’ equity. The market value of loaned securities and that of the collateral pledged can fluctuate in non-synchronized fashions. To the extent the loaned securities’ value appreciates faster or depreciates slower than the value of the collateral pledged, we are exposed to the risk of the shortfall. As a primary mitigating mechanism, the loaned securities and collateral pledged are marked to market on a daily basis and the shortfall, if any, is collected accordingly. Secondarily, the collateral level is set at 102% of the value of the loaned securities, which provides a cushion before any shortfall arises. The investment of the cash collateral is subject to market risk, which is managed by limiting the investments to higher quality and shorter duration instruments.
Receivables: Receivables are reported net of amounts for expected credit losses. The allowance for doubtful accounts is based on historical collection trends, future forecasts and our judgment regarding the ability to collect specific accounts.
Premium receivables include the uncollected amounts from employer risk-based groups, individuals and government programs for insurance services. Premium receivables are reported net of an allowance for doubtful accounts of $184 and $152 at June 30, 2023 and December 31, 2022, respectively.
Self-funded receivables include administrative fees, claims and other amounts due from fee-based customers for administrative services. Self-funded receivables are reported net of an allowance for doubtful accounts of $86 and $68 at June 30, 2023 and December 31, 2022, respectively.
Other receivables include pharmacy rebates, provider advances, claims recoveries, reinsurance receivables, proceeds due from brokers on investment trades, accrued investment income and other miscellaneous amounts due to us. These receivables are reported net of an allowance for doubtful accounts of $816 and $744 at June 30, 2023 and December 31, 2022, respectively.
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Revenue Recognition: For our non-risk-based contracts, we had no material contract assets, contract liabilities or deferred contract costs recorded on our consolidated balance sheet at June 30, 2023. For the three and six months ended June 30, 2023 and 2022, revenue recognized from performance obligations related to prior periods, such as changes in transaction price, were not material. For contracts that have an original, expected duration of greater than one year, revenue expected to be recognized in future periods related to unfulfilled contractual performance obligations and contracts with variable consideration related to undelivered performance obligations is not material.
Recently Adopted Accounting Guidance: In November 2020, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update No. 2020-11, Financial Services—Insurance (Topic 944): Effective Date and Early Application (“ASU 2020-11”). The amendments in ASU 2020-11 change the effective date and early application of Accounting Standards Update No. 2018-12, Financial Services—Insurance (Topic 944): Targeted Improvements to the Accounting for Long-Duration Contracts (“ASU 2018-12”), which was issued in November 2018. The amendments in ASU 2020-11 extended the original effective date by one year, and now the amendments are required for our interim and annual reporting periods beginning after December 15, 2022. This standard requires us to review cash flow assumptions for our long-duration insurance contracts at least annually and recognize the effect of changes in future cash flow assumptions in net income. This standard also requires us to update discount rate assumptions quarterly and recognize the effect of changes in these assumptions in other comprehensive income. The rate used to discount our reserves for future policy benefits will be based on an estimate of the yield for an upper-medium grade fixed-income instrument with a duration profile matching that of our liabilities. In addition, this standard changes the amortization method for deferred acquisition costs. We adopted these amendments on January 1, 2023, using the modified retrospective transition method for changes to the liability for future policy benefits and deferred acquisition costs as of the transition date, January 1, 2021. While the adoption did not have an overall material impact, our prior period financial statements presented in this Form 10-Q have been restated to reflect the impacts of our adoption as required by the new standard.
There were no other new accounting pronouncements that were issued or became effective since the issuance of our 2022 Annual Report on Form 10-K that had, or are expected to have, a material impact on our consolidated financial position, results of operations or cash flows.
3.    Business Acquisitions and Divestitures
Pending Divestiture
On March 28, 2023, we announced our entrance into an agreement to sell our life and disability businesses to StanCorp Financial Group, Inc. (“The Standard”), a provider of financial protection products and services for employers and individuals. Upon closing, we and The Standard will enter into a product distribution partnership. The divestiture is expected to close by the end of the first quarter of 2024 and is subject to standard closing conditions and customary approvals. The related net assets held for sale and results of operations for the employee benefits businesses to be divested as of and for the three and six months ending June 30, 2023 were not material.
Pending Acquisition
On January 23, 2023, we announced our entrance into an agreement to acquire Louisiana Health Service & Indemnity Company, d/b/a Blue Cross and Blue Shield of Louisiana (“BCBSLA”), an independent licensee of the BCBSA that provides healthcare plans to the Individual, Employer Group, Medicaid and Medicare markets, primarily in the State of Louisiana. This acquisition aligns with our mission to become a lifetime, trusted health partner as we bring our innovative whole-health solutions to BCBSLA’s members. The acquisition is expected to close by the end of the fourth quarter of 2023 and is subject to standard closing conditions and customary approvals.
Completed Acquisitions
On February 15, 2023, we completed our acquisition of BioPlus Parent, LLC and subsidiaries (“BioPlus”) from CarepathRx Aggregator, LLC. Prior to the acquisition, BioPlus was one of the largest independent specialty pharmacy organizations in the United States. BioPlus, which operates as part of CarelonRx, seeks to connect payors and providers of specialty pharmaceuticals to meet the medication therapy needs of patients with complex medical conditions. This acquisition aligns with our vision to be an innovative, valuable and inclusive healthcare partner by providing care management programs that improve the lives of the people we serve. As of June 30, 2023, the purchase price was allocated to the tangible and
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intangible net assets acquired based on management’s initial estimates of their fair values, of which $820 has been allocated to finite-lived intangible assets and $877 to goodwill, including an increase to goodwill for measurement period adjustments of $149 during the quarter ended June 30, 2023. The majority of goodwill is not deductible for income tax purposes. As of June 30, 2023, the initial accounting for the acquisition had not been finalized. The proforma effects of this acquisition for prior periods were not material to our consolidated results of operations.
On May 5, 2022, we completed our acquisition of Integra Managed Care (“Integra”). Integra is a managed long-term care plan that serves New York state Medicaid members, enabling adults with long-term care needs and disabilities to live safely and independently in their own homes. The initial accounting for this acquisition was finalized as of June 30, 2023. The purchase price was allocated to tangible and intangible net assets acquired based on management’s estimates of their fair values, of which $89 has been allocated to finite-lived intangible assets, $250 to indefinite-lived intangible assets, and $139 to goodwill. Contractual purchase price adjustments during the quarter ended June 30, 2023 were $13 and resulted in an increase to goodwill. The majority of goodwill is deductible for income tax purposes. The proforma effects of this acquisition for prior periods were not material to our consolidated results of operations.
4.     Investments
Fixed Maturity Securities
We evaluate our available-for-sale fixed maturity securities for declines based on qualitative and quantitative factors. We have established an allowance for credit loss and recorded credit loss expense as a reflection of our expected impairment losses. We continue to review our investment portfolios under our impairment review policy. Given the inherent uncertainty of changes in market conditions and the significant judgments involved, there is a continuing risk that declines in fair value may occur and additional material impairment losses for credit losses on investments may be recorded in future periods.
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A summary of current and long-term fixed maturity securities, available-for-sale, at June 30, 2023 and December 31, 2022 is as follows:
Cost or
Amortized
Cost
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Allowance
For Credit
Losses
Estimated
Fair Value
 
June 30, 2023
Fixed maturity securities:
United States Government securities$1,957 $1 $(75)$ $1,883 
Government sponsored securities94 1 (4) 91 
Foreign government securities337 2 (41)(1)297 
States, municipalities and political subdivisions, tax-exempt3,957 22 (207) 3,772 
Corporate securities14,276 50 (997)(4)13,325 
Residential mortgage-backed securities3,617 11 (313) 3,315 
Commercial mortgage-backed securities2,262 2 (180)(2)2,082 
Other asset-backed securities4,224 15 (208) 4,031 
Total fixed maturity securities$30,724 $104 $(2,025)$(7)$28,796 
December 31, 2022
Fixed maturity securities:
United States Government securities$1,502 $2 $(103)$ $1,401 
Government sponsored securities82 1 (5) 78 
Foreign government securities321 1 (46)(2)274 
States, municipalities and political subdivisions, tax-exempt4,389 19 (265) 4,143 
Corporate securities13,721 31 (1,218)(5)12,529 
Residential mortgage-backed securities2,978 9 (324) 2,663 
Commercial mortgage-backed securities2,055 1 (176)(2)1,878 
Other asset-backed securities3,967 12 (241) 3,738 
Total fixed maturity securities$29,015 $76 $(2,378)$(9)$26,704 
Other asset-backed securities primarily consists of collateralized loan obligations and other debt securities.
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For fixed maturity securities in an unrealized loss position at June 30, 2023 and December 31, 2022, the following table summarizes the aggregate fair values and gross unrealized losses by length of time those securities have continuously been in an unrealized loss position: 
 Less than 12 Months12 Months or Greater
(Securities are whole amounts)Number of
Securities
Estimated
Fair Value
Gross
Unrealized
Loss
Number of
Securities
Estimated
Fair Value
Gross
Unrealized
Loss
June 30, 2023
Fixed maturity securities:
United States Government securities58$1,019 $(29)48$278 $(46)
Government sponsored securities1863 (2)2918 (2)
Foreign government securities
9756 (2)224186 (39)
States, municipalities and political subdivisions, tax-exempt7021,278 (20)9251,598 (187)
Corporate securities2,0514,323 (129)3,2166,910 (868)
Residential mortgage-backed securities6421,251 (38)1,2861,714 (275)
Commercial mortgage-backed securities246701 (28)5531,316 (152)
Other asset-backed securities3481,258 (62)8272,265 (146)
Total fixed maturity securities4,162$9,949 $(310)7,108$14,285 $(1,715)
December 31, 2022
Fixed maturity securities:
United States Government securities61$701 $(40)38$442 $(63)
Government sponsored securities3973 (4)65 (1)
Foreign government securities
150100 (10)198142 (36)
States, municipalities and political subdivisions, tax-exempt1,3982,615 (147)396652 (118)
Corporate securities3,5517,826 (549)2,2043,521 (669)
Residential mortgage-backed securities
1,3411,435 (121)496982 (203)
Commercial mortgage-backed securities
4571,082 (76)324719 (100)
Other asset-backed securities7842,203 (124)3981,074 (117)
Total fixed maturity securities7,781$16,035 $(1,071)4,060$7,537 $(1,307)
Unrealized losses on our securities shown in the table above have not been recognized into income because, as of June 30, 2023, we do not intend to sell these investments and it is likely that we will not be required to sell these investments prior to their maturity or anticipated recovery. The declines in fair values are largely due to increasing interest rates driven by the higher rate of inflation and other market conditions.
Allowances for credit losses have been recorded in the amounts of $7 and $9 at June 30, 2023 and December 31, 2022, respectively, for declines in fair value due to unfavorable changes in the credit quality characteristics that impact our assessment of collectability of principal and interest.


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The amortized cost and fair value of fixed maturity securities at June 30, 2023, by contractual maturity, are shown below. Expected maturities may differ from contractual maturities because the issuers of the securities may have the right to prepay obligations.
Amortized
Cost
Estimated
Fair Value
Due in one year or less$1,127 $1,118 
Due after one year through five years8,193 7,810 
Due after five years through ten years9,466 8,883 
Due after ten years6,059 5,588 
Mortgage-backed securities5,879 5,397 
Total fixed maturity securities$30,724 $28,796 
During the three and six months ended June 30, 2023, we received total proceeds from sales, maturities, calls or redemptions of fixed maturity securities of $9,675 and $15,085, respectively. During the three and six months ended June 30, 2022, we received total proceeds from sales, maturities, calls or redemptions of fixed maturity securities of $7,026 and $10,672, respectively.
In the ordinary course of business, we may sell securities at a loss for a number of reasons, including, but not limited to: (i) changes in the investment environment; (ii) expectation that the fair value could deteriorate further; (iii) desire to reduce exposure to an issuer or an industry; (iv) changes in credit quality; or (v) changes in expected cash flow.
All securities sold resulting in investment gains and losses are recorded on the trade date. Realized gains and losses are determined on the basis of the cost or amortized cost of the specific securities sold.
Equity Securities
A summary of marketable equity securities at June 30, 2023 and December 31, 2022 is as follows:
 June 30, 2023December 31, 2022
Equity securities:
Exchange traded funds$166 $822 
Common equity securities31 43 
Private equity securities75 88 
Total$272 $953 
Other Invested Assets
Other invested assets include primarily our investments in limited partnerships, joint ventures and other non-controlled corporations, mortgage loans and the cash surrender value of corporate-owned life insurance policies. Investments in limited partnerships, joint ventures and other non-controlled corporations are carried at our share in the entities’ undistributed earnings, which approximates fair value. Financial information for certain of these investments is reported on a one or three month lag due to the timing of when we receive financial information from the companies.
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Investment Gains and Losses
Net investment (losses) gains for the three and six months ended June 30, 2023 and 2022 are as follows:
Three Months Ended June 30Six Months Ended June 30
2023202220232022
Net (losses) gains:
Fixed maturity securities:
Gross realized gains from sales$11 $16 $21 $36 
Gross realized losses from sales(99)(176)(214)(254)
Impairment losses recognized in income(3)(1)(10)(21)
Net realized losses from sales of fixed maturity securities(91)(161)(203)(239)
Equity securities:
Unrealized gains (losses) recognized on equity securities still held at the end of the period2 (83)(2)(154)
Net realized gains (losses) recognized on equity securities sold during the period1 (5)4 (19)
Net gains (losses) on equity securities3 (88)2 (173)
Other investments:
Gross gains2 10 20 33 
Gross losses(16)(15)(9)(44)
Impairment losses recognized in income(26)(1)(29)(5)
Net losses on other investments(40)(6)(18)(16)
Net losses on investments$(128)$(255)$(219)$(428)
Accrued Investment Income
At June 30, 2023 and December 31, 2022, accrued investment income totaled $266 and $245, respectively. We recognize accrued investment income under the caption “Other receivables” on our consolidated balance sheets.
Securities Lending Programs
We participate in securities lending programs whereby marketable securities in our investment portfolio are transferred to independent brokers or dealers in exchange for cash and securities collateral. The fair value of the collateral received at the time of the transactions amounted to $2,311 and $2,457 at June 30, 2023 and December 31, 2022, respectively. The value of the collateral represented 102% of the market value of the securities on loan at each of June 30, 2023 and December 31, 2022. We recognize the collateral as an asset under the caption “Other current assets” in our consolidated balance sheets, and we recognize a corresponding liability for the obligation to return the collateral to the borrower under the caption “Other current liabilities.” The securities on loan are reported in the applicable investment category on our consolidated balance sheets.
At June 30, 2023 and December 31, 2022, the remaining contractual maturity of our securities lending agreements included overnight and continuous transactions of cash for $2,237 and $2,221, respectively, of United States Government securities for $73 and $224, respectively, and of Residential Mortgage-Backed securities for $1 and $12, respectively.
5.    Derivative Financial Instruments
We primarily invest in the following types of derivative financial instruments: interest rate swaps, futures, forward contracts, put and call options, swaptions, embedded derivatives and warrants. We also enter into master netting agreements, which reduce credit risk by permitting net settlement of transactions.
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We have entered into various interest rate swap contracts to convert a portion of our interest rate exposure on our long-term debt from fixed rates to floating rates. The floating rates payable on all of our fair value hedges are benchmarked to the Secured Overnight Financing Rate (“SOFR”). Any amounts recognized for changes in fair value of these derivatives are included in the captions “Other current assets,” “Other noncurrent assets,” “Other current liabilities” or “Other noncurrent liabilities” in our consolidated balance sheets.
The unrecognized loss for all expired and terminated cash flow hedges included in accumulated other comprehensive loss, net of tax, was $214 and $229 at June 30, 2023 and December 31, 2022, respectively.
During the three and six months ended months ended June 30, 2023, we recognized net gains of $7 and net losses of $15, respectively, on non-hedging derivatives. During the three and six months ended months ended June 30, 2022, we recognized net gains on non-hedging derivatives of $24 and $46, respectively.
For additional information relating to the fair value of our derivative assets and liabilities, see Note 6, “Fair Value,” of this Form 10-Q.
6.    Fair Value
Assets and liabilities recorded at fair value in our consolidated balance sheets are categorized based upon the level of judgment associated with the inputs used to measure their fair value. Level inputs, as defined by FASB guidance for fair value measurements and disclosures, are as follows:
Level InputInput Definition
Level IInputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date.
Level IIInputs other than quoted prices included in Level I that are observable for the asset or liability through corroboration with market data at the measurement date.
Level IIIUnobservable inputs that reflect management’s best estimate of what market participants would use in pricing the asset or liability at the measurement date.
The following methods, assumptions and inputs were used to determine the fair value of each class of the following assets and liabilities recorded at fair value in our consolidated balance sheets:
Cash equivalents: Cash equivalents primarily consist of highly rated money market funds with maturities of three months or less and are purchased daily at par value with specified yield rates. Due to the high ratings and short-term nature of the funds, we designate all cash equivalents as Level I.
Fixed maturity securities, available-for-sale: Fair values of available-for-sale fixed maturity securities are based on quoted market prices, where available. These fair values are obtained primarily from third-party pricing services, which generally use Level I or Level II inputs for the determination of fair value to facilitate fair value measurements and disclosures. Level II securities primarily include corporate securities, securities from states, municipalities and political subdivisions, mortgage-backed securities, United States government securities, foreign government securities, and certain other asset-backed securities. For securities not actively traded, the pricing services may use quoted market prices of comparable instruments or discounted cash flow analyses, incorporating inputs that are currently observable in the markets for similar securities. We have controls in place to review the pricing services’ qualifications and procedures used to determine fair values. In addition, we periodically review the pricing services’ pricing methodologies, data sources and pricing inputs to ensure the fair values obtained are reasonable. Inputs that are often used in the valuation methodologies include, but are not limited to, broker quotes, benchmark yields, credit spreads, default rates and prepayment speeds. We also have certain fixed maturity securities, primarily collateralized loan obligation securities and corporate debt securities, that are designated Level III securities. For these securities, the valuation methodologies may incorporate broker quotes or discounted cash flow analyses using assumptions for inputs such as expected cash flows, benchmark yields, credit spreads, default rates and prepayment speeds that are not observable in the markets.
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Equity securities: Fair values of equity securities are generally designated as Level I and are based on quoted market prices. For certain equity securities, quoted market prices for the identical security are not always available, and the fair value is estimated by reference to similar securities for which quoted prices are available. These securities are designated Level II. We also have certain equity securities, including private equity securities, for which the fair value is estimated based on each security’s current condition and future cash flow projections. Such securities are designated Level III. The fair values of these private equity securities are generally based on either broker quotes or discounted cash flow projections using assumptions for inputs such as the weighted-average cost of capital, long-term revenue growth rates and earnings before interest, taxes, depreciation and amortization, and/or revenue multiples that are not observable in the markets.
Securities lending collateral: Fair values of securities lending collateral are based on quoted market prices, where available. These fair values are obtained primarily from third-party pricing services, which generally use Level I or Level II inputs for the determination of fair value, to facilitate fair value measurements and disclosures.
Derivatives: Fair values are based on the quoted market prices by the financial institution that is the counterparty to the derivative transaction. We independently verify prices provided by the counterparties using valuation models that incorporate observable market inputs for similar derivative transactions. Derivatives are designated as Level II securities. Derivatives presented within the fair value hierarchy table below are presented on a gross basis and not on a master netting basis by counterparty.
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A summary of fair value measurements by level for assets and liabilities measured at fair value on a recurring basis at June 30, 2023 and December 31, 2022 is as follows:
Level ILevel IILevel IIITotal
June 30, 2023
Assets:
Cash equivalents$6,100 $ $ $6,100 
Fixed maturity securities, available-for-sale:
United States Government securities 1,883  1,883 
Government sponsored securities 91  91 
Foreign government securities 297  297 
States, municipalities and political subdivisions, tax-exempt 3,772  3,772 
Corporate securities 13,222 103 13,325 
Residential mortgage-backed securities 3,315  3,315 
Commercial mortgage-backed securities 2,082  2,082 
Other asset-backed securities 3,665 366 4,031 
Total fixed maturity securities, available-for-sale 28,327 469 28,796 
Equity securities:
Exchange traded funds166   166 
Common equity securities12 19  31 
Private equity securities  75 75 
Total equity securities178 19 75 272 
Other invested assets - common equity securities121   121 
Securities lending collateral 2,312  2,312 
Derivatives - other assets 3  3 
Total assets$6,399 $30,661