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Segment Information
 12 Months Ended
Dec. 31, 2025
Segment Reporting [Abstract]  
Segment Information Segment Information
We report our results of operations in the following four reportable segments: Health Benefits, CarelonRx, Carelon Services and Corporate & Other. An immaterial amount of our total consolidated revenues is derived from activities outside of the U.S. and Puerto Rico.
Our Health Benefits segment offers a comprehensive suite of health plans and services to our Individual, Employer Group risk-based, Employer Group fee-based, BlueCard®, Medicare, Medicaid and FEP® members. The Health Benefits segment offers health products on a full-risk basis; provides a broad array of administrative managed care services to our fee-based customers; and provides a variety of specialty and other insurance products and services such as stop loss, dental, vision and supplemental health insurance benefits.
Our CarelonRx segment includes our pharmacy services business. CarelonRx markets and offers pharmacy services to our affiliated health plan customers, as well as to external customers outside of the health plans we own. CarelonRx offers a comprehensive pharmacy services portfolio, which includes all core pharmacy services, such as home delivery and specialty pharmacies, claims adjudication, formulary management, pharmacy networks, rebate administration, a prescription drug database and member services, as well as infusion services and injectable therapies.
Our Carelon Services segment integrates physical, behavioral, pharmacy, and social services with the aim of delivering whole health affordably by offering a broad array of healthcare related services and capabilities to internal and external customers through our Carelon Health and Carelon Insights businesses. Carelon promotes affordability by managing complex areas of the healthcare system, leveraging data and insights to ensure members receive safe, appropriate, high-quality care and providers are reimbursed accurately and timely. Our approach to cost management relies on capabilities including provider enablement, value-based networks, member engagement, and utilization management. Our care delivery services primarily target serving chronic and complex populations by providing personalized care in the home and virtually. As a part of Carelon Health, we completed our acquisition of CareBridge at the end of 2024, which provides virtual care to complex Medicaid and Medicare patients and supports plans in managing home and community-based services.
Our Corporate & Other segment includes our businesses that do not individually meet the quantitative threshold for an operating segment, as well as corporate expenses not allocated to our other reportable segments.
We define operating revenues to include premiums, product revenue and service fees. Operating revenues are derived from premiums and fees received, primarily from the sale and administration of health benefits and pharmacy products and services. Operating gain is calculated as total operating revenue less benefit expense, cost of products sold and operating expense.
Affiliated operating revenues represent revenues or costs for services provided to our subsidiaries by CarelonRx and Carelon Services, in addition to certain administrative and other services provided by our international businesses, which are recorded at cost or management’s estimate of fair market value. These affiliated operating revenues are eliminated in our consolidated financial statements. For segment reporting, we present all capitation risk arrangements on a gross basis; therefore, eliminations also include adjustments for capitated risk arrangements that are recognized on a net basis under GAAP.
Through our participation in various federal government programs, we generated approximately 32%, 31% and 29% of our total consolidated revenues from agencies of the U.S. government for the year ended December 31, 2025, 2024 and 2023, respectively. The majority of these revenues are contained in our Health Benefits segment.
The accounting policies of the segments are consistent with those described in the summary of significant accounting policies in Note 2, “Basis of Presentation and Significant Accounting Policies,” except that all capitation risk arrangements are reported on a gross basis with an adjustment included in eliminations for capitated risk arrangements that are presented on a net basis under GAAP.
Our chief operating decision maker (the “CODM”) is our Chief Executive Officer. The CODM assesses the performance of our reportable segments based on operating gain or loss as defined above. The CODM evaluates net investment income, net gains (losses) on financial instruments, interest expense, depreciation and amortization expense, income taxes and assets, liabilities and equity on a consolidated basis, as these items are managed in a corporate shared service environment and are not the responsibility of segment operating management.
The CODM uses operating gain or loss, developed during the annual budget process, and updated during the periodic forecasting process, as a basis to assess performance and allocate operating and capital resources to each segment.
Financial data by reportable segment for the years ended December 31, 2025, 2024 and 2023 is as follows:
Carelon
Health
Benefits		CarelonRxCarelon
Services		TotalCorporate
& Other		EliminationsTotal
Year Ended December 31, 2025
Premiums$159,458 $— $6,315 $6,315 $— $(1,134)$164,639 
Product revenue— 24,470 — 24,470 — — 24,470 
Service fees7,636 13 826 839 — — 8,475 
Operating revenue - unaffiliated167,094 24,483 7,141 31,624 — (1,134)197,584 
Operating revenue - affiliated— 18,917 21,175 40,092 463 (40,555)— 
Operating revenue - total$167,094 $43,400 $28,316 $71,716 $463 $(41,689)$197,584 
Benefit expense
$143,889 $— $24,283 $24,283 $25 $(19,974)$148,223 
Cost of products sold
— 40,077 — 40,077 — (18,899)21,178 
Operating expense
19,047 905 3,073 3,978 775 (2,816)20,984 
Operating gain (loss)$4,158 $2,418 $960 $3,378 $(337)$— $7,199 
Year Ended December 31, 2024
Premiums$142,668 $— $2,630 $2,630 $— $(1,132)$144,166 
Product revenue— 22,630 — 22,630 — — 22,630 
Service fees7,607 5 790 795 6 — 8,408 
Operating revenue - unaffiliated150,275 22,635 3,420 26,055 6 (1,132)175,204 
Operating revenue - affiliated— 13,326 14,541 27,867 303 (28,170)— 
Operating revenue - total$150,275 $35,961 $17,961 $53,922 $309 $(29,302)$175,204 
Benefit expense
$126,703 $— $14,388 $14,388 $19 $(13,543)$127,567 
Cost of products sold
— 32,978 — 32,978 — (13,228)19,750 
Operating expense
17,329 811 2,856 3,667 1,560 (2,531)20,025 
Operating gain (loss)$6,243 $2,172 $717 $2,889 $(1,270)$— $7,862 
Year Ended December 31, 2023
Premiums$141,515 $— $1,679 $1,679 $— $(340)$142,854 
Product revenue— 19,452 — 19,452 — — 19,452 
Service fees7,056 6 813 819 28 — 7,903 
Operating revenue - unaffiliated148,571 19,458 2,492 21,950 28 (340)170,209 
Operating revenue - affiliated— 14,377 11,655 26,032 451 (26,483)— 
Operating revenue - total$148,571 $33,835 $14,147 $47,982 $479 $(26,823)$170,209 
Benefit expense
$123,705 $— $10,610 $10,610 $35 $(10,020)$124,330 
Cost of products sold
— 31,588 — 31,588 — (14,295)17,293 
Operating expense
17,9782722,8573,1291,488(2,508)20,087
Operating gain (loss)$6,888 $1,975 $680 $2,655 $(1,044)$— $8,499 
 
A reconciliation of reportable segments’ operating revenue to the amounts of total revenues included in our consolidated statements of income for the years ended December 31, 2025, 2024 and 2023 is as follows:
202520242023
Reportable segments’ operating revenues$197,584 $175,204 $170,209 
Net investment income2,194 2,051 1,825 
Net losses on financial instruments
(653)(445)(694)
Gain on sale of business
— 201 — 
Total revenues$199,125 $177,011 $171,340 
A reconciliation of reportable segments’ operating gain to income before income tax expense included in our consolidated statements of income for the years ended December 31, 2025, 2024 and 2023 is as follows:
202520242023
Income before income tax expense$6,710 $7,904 $7,715 
Net investment income(2,194)(2,051)(1,825)
Net losses on financial instruments
653 445 694 
Gain on sale of business
— (201)— 
Interest expense1,402 1,185 1,030 
Amortization of other intangible assets628 580 885 
Reportable segments’ operating gain$7,199 $7,862 $8,499