EX-99.1 2 d655691dex991.htm EX-99.1 EX-99.1

Exhibit 99.1

 

LOGO

ANTHEM REPORTS FOURTH QUARTER AND FULL YEAR 2018 RESULTS

REFLECTING STRONG CORE PERFORMANCE

 

   

Fourth quarter net income was $1.61 per share, including net negative adjustment items of $0.83 per share. Adjusted net income was $2.44 per share.

 

   

Full year net income was $14.19 per share, including net negative adjustment items of $1.70 per share. Adjusted net income was $15.89 per share.

 

   

Medical enrollment increased by 37 thousand members sequentially to 39.9 million members.

 

   

Operating gain grew by 30% year-over-year to $5.4 billion in 2018.

 

   

IngenioRx now scheduled to launch in 2Q 2019.

 

   

Full year 2019 net income is expected to be greater than $18.00 per share, an increase of 27% versus 2018 net income per share. Adjusted net income is expected to be greater than $19.00* per share, an increase of 20% versus 2018 adjusted net income per share.

 

   

Quarterly dividend increased by 6.7% to $0.80 per share.

Indianapolis, Ind. — January 30, 2019 — Anthem, Inc. (NYSE: ANTM) reported fourth quarter and full year 2018 financial results that reflected enhanced performance across the core businesses and increasing operating momentum.

“In 2018, we achieved our objectives of improving execution and strengthening our value proposition with innovative and affordable solutions designed to more effectively meet the unique needs of our customers,” said Gail K. Boudreaux, President and CEO. “Our fourth quarter and full year performance provides a strong foundation for 2019. In addition, I am pleased to announce that we are accelerating the launch of IngenioRx and now expect to begin transitioning members in the second quarter of this year. Since announcing our intent to create IngenioRx, we have been carefully planning the transition, including the possibility of an early launch, and are confident in our ability to execute the transition under the accelerated schedule. This will allow us to go to market with better economics earlier, and also accelerate our whole person health strategy, which is proven to reduce total cost of care.”

 

1


Anthem continues to expect gross annual savings through IngenioRx of greater than $4 billion, with more than 20% of that amount being returned to our shareholders. The Company, pursuant to the terms of its pharmacy benefits management services agreement with Express Scripts, Inc. (the “PBM Agreement”), has provided notice to Express Scripts that it will exercise its contractual rights to terminate the PBM Agreement earlier than the original expiration date of December 31, 2019 due to the recent acquisition of Express Scripts by Cigna Corporation. As a result of exercising our early termination rights, the PBM Agreement will now terminate on March 1, 2019 and the twelve month transition period to migrate the business will begin on March 2, 2019.

Anthem expects its full year 2019 adjusted net income to be greater than $19.00* per share, which reflects the benefit from the accelerated launch of IngenioRx, including expected expenses related to the revised transition schedule.

 

 

*

Refer to the GAAP reconciliation tables on page 15.

 

2


CONSOLIDATED HIGHLIGHTS

Membership: Medical enrollment totaled approximately 39.9 million members at December 31, 2018, an increase of 37 thousand members from September 30, 2018. Commercial & Specialty Business enrollment increased by 30 thousand members, as the Company experienced growth in the fully insured and fee-based Local Group businesses and growth in the National business. The increase was partially offset by a decline in Individual enrollment. Government Business enrollment increased by 7 thousand members, driven by growth in Medicare that was partially offset by a decrease in Medicaid membership.

Medical enrollment declined by 361 thousand members from 40.3 million members at December 31, 2017. The decrease reflected declines due to a reduced footprint in the Individual ACA-compliant marketplace and declines in Local Group enrollment. These declines were partially offset by growth in the Medicare, National, and Medicaid businesses.

Operating Revenue: Operating revenue was $23.3 billion in the fourth quarter of 2018, an increase of $857 million, or 3.8 percent, versus $22.4 billion in the prior year quarter. The growth in operating revenue reflected premium rate increases to cover overall cost trends and the return of the health insurance tax in 2018 as well as growth in Medicare. The increase was partially offset by a reduced footprint in the Individual ACA-compliant marketplace.

Benefit Expense Ratio: The benefit expense ratio was 86.8 percent in the fourth quarter of 2018, a decrease of 180 basis points from 88.6 percent in the prior year quarter. The decrease, as expected, was largely driven by the return of the health insurance tax in 2018 and improved medical cost performance in our Commercial & Specialty Business.

Medical claims reserves established at December 31, 2017 developed moderately better than the Company’s expectation during 2018.

Medical Cost Trend: For the full year 2018, Local Group medical cost trend was approximately 5.9%. The Company anticipates medical cost trend will be in the range of 6.0% +/- 50 bps in 2019.

Days in Claims Payable: Days in Claims Payable (“DCP”) was 36.2 days as of December 31, 2018, a decrease of 2.5 days from 38.7 days as of September 30, 2018.

SG&A Expense Ratio: The SG&A expense ratio was 15.5 percent in the fourth quarter of 2018, an increase of 40 basis points from 15.1 percent in the fourth quarter of 2017. The increase, as expected, was primarily driven by the return of the health insurance tax in 2018, partially offset by expense efficiency initiatives.

Operating Cash Flow: Operating cash flow was $463 million, or 1.1 times net income in the fourth quarter of 2018, bringing full year 2018 operating cash flow to $3.8 billion, or 1.0 times net income.

Share Repurchase Program: During the fourth quarter of 2018, the Company repurchased 1.8 million shares of its common stock for $493 million, or a weighted average price of $270.66. For the full year, the Company repurchased 6.8 million shares of its common stock for $1.7 billion, or a weighted average price of $248.34. As of December 31, 2018, the Company had approximately $5.5 billion of Board-approved share repurchase authorization remaining.

Cash Dividend: During the fourth quarter of 2018, the Company paid a quarterly dividend of $0.75 per share, representing a distribution of cash totaling $193 million.

 

3


On January 29, 2019, the Audit Committee declared a first quarter 2019 dividend to shareholders of $0.80 per share. On an annualized basis, this equates to a dividend of $3.20 per share. The first quarter dividend is payable on March 29, 2019 to shareholders of record at the close of business on March 18, 2019.

Investment Portfolio & Capital Position: During the fourth quarter of 2018, the Company recorded net realized losses on financial instruments totaling $185 million and other-than-temporary impairment losses totaling $8 million. During the fourth quarter of 2017, the Company recorded net realized gains of $7 million and other-than-temporary impairment losses totaling $12 million.

As of December 31, 2018, the Company’s net unrealized loss position in the investment portfolio was $201 million, consisting of fixed maturity securities. The adoption of a change in accounting standards has resulted in the Company accounting for unrealized changes in the value of equity securities in realized gains or losses. As of December 31, 2018 cash and investments at the parent company totaled approximately $1.9 billion.

 

4


REPORTABLE SEGMENTS

Anthem, Inc. has three reportable segments: Commercial & Specialty Business (comprised of the Local Group, National Accounts, Individual and Specialty businesses); Government Business (comprised of the Medicaid and Medicare businesses, National Government Services, and the Federal Employee Program); and Other (comprised of certain eliminations and corporate expenses not allocated to either of our other reportable segments).

Anthem, Inc.

Reportable Segment Highlights

(Unaudited)

 

(In millions)    Three Months Ended December 31     Twelve Months Ended December 31  
     2018     2017     Change     2018     2017     Change  

Operating Revenue

            

Commercial & Specialty Business

   $ 8,843     $ 10,006       (11.6 )%    $ 35,782     $ 40,363       (11.3 )% 

Government Business

     14,462       12,444       16.2     55,567       48,702       14.1

Other

     (1     (3     NM 2       (8     (4     NM 2  
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total Operating Revenue1

   $ 23,304     $ 22,447       3.8   $ 91,341     $ 89,061       2.6

Operating Gain / (Loss)

            

Commercial & Specialty Business

   $ 322     $ 67       380.6   $ 3,629     $ 2,847       27.5

Government Business

     444       360       23.3     1,895       1,445       31.1

Other

     (16     (46     NM 2       (98     (117     NM 2  
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total Operating Gain1

   $ 750     $ 381       96.9   $ 5,426     $ 4,175       30.0

Operating Margin

            

Commercial & Specialty Business

     3.6     0.7     290 bp       10.1     7.1     300 bp  

Government Business

     3.1     2.9     20 bp       3.4     3.0     40 bp  

Total Operating Margin1

     3.2     1.7     150 bp       5.9     4.7     120 bp  

 

(1)

See “Basis of Presentation” on page 7 herein.

(2)

“NM” = calculation not meaningful.

Commercial & Specialty Business: Operating gain in the Commercial & Specialty Business segment totaled $322 million in the fourth quarter of 2018, an increase of $255 million, or 380.6 percent, from $67 million in the fourth quarter of 2017. The increase reflected improved medical cost performance and a decrease in certain general and administrative expenses compared to the prior year quarter.

Government Business: Operating gain in the Government Business segment was $444 million in the fourth quarter of 2018, an increase of $84 million, or 23.3 percent, from $360 million in the fourth quarter of 2017. The increase is a result of the acquisitions of HealthSun and America’s 1st Choice and the return of the health insurer fee in 2018. The increase was partially offset by higher medical costs in the Medicaid business.

Other: The Company reported an operating loss of $16 million in the Other segment for the fourth quarter of 2018, compared with an operating loss of $46 million in the prior year quarter.

 

5


OUTLOOK

Full Year 2019:

 

   

GAAP net income is expected to be greater than $18.00 per share, including approximately $1.00 per share of net unfavorable items. Excluding these items, adjusted net income is expected to be greater than $19.00* per share.

 

   

Medical membership is expected to be in the range of 40,900,000 - 41,300,000. Fully-insured membership is expected to be in the range of 15,500,000 - 15,700,000 and self-funded membership is expected to be in the range of 25,400,000 - 25,600,000.

 

   

Operating revenue is expected to be approximately $100.0 billion, including premium revenue of $90.5 billion - $92.5 billion.

 

   

Benefit expense ratio is expected to be in the range of 86.2% plus or minus 30 basis points.

 

   

Cost of products sold of $1.6 billion - $1.8 billion.

 

   

SG&A ratio is expected to be in the range of 13.5% plus or minus 30 basis points.

 

   

Operating cash flow is expected to be greater than $5.2 billion.

 

   

Share count is expected to be between 261 - 263 million.

 

   

Effective tax rate is expected to be between 19.5% - 21.5%.

 

   

Investment income is expected to be $1.0 billion.

 

 

* 

Refer to the GAAP reconciliation tables on page 15.

 

6


Basis of Presentation

 

1.

Operating revenue and operating gain 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 is calculated as total operating revenue less benefit expense and selling, general and administrative expense. It does not include net investment income, net realized gains/losses on financial instruments, other-than-temporary impairment losses recognized in income, 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 page 15 for the GAAP reconciliation tables.

 

2.

Operating margin is defined as operating gain divided by operating revenue.

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 results and outlook. The conference call should be accessed at least 15 minutes prior to the start of the call with the following numbers:

 

800-230-1059 (Domestic)

  

800-475-6701 (Domestic Replay)

612-234-9960 (International)

  

320-365-3844 (International Replay)

An access code is not required for today’s conference call. The access code for the replay is 432041. The replay will be available from 11:00 a.m. EST today, until the end of the day on February 13, 2019. The call will also be available through a live webcast at www.antheminc.com under the “Investors” link. A webcast replay will be available following the call.

Anthem Contacts:

 

Investor Relations    Media   
Chris Rigg    Jill Becher, 414-234-1573   
Chris.rigg@anthem.com    Jill.becher@anthem.com   

 

7


About Anthem, Inc.

Anthem is a leading health benefits company dedicated to improving lives and communities, and making healthcare simpler. Through its affiliated companies, Anthem serves more than 74 million people, including nearly 40 million within its family of health plans. We aim to be the most innovative, valuable and inclusive partner. For more information, please visit www.antheminc.com or follow @AnthemInc on Twitter.

 

8


Anthem, Inc.

Membership Summary

(Unaudited and in Thousands)

 

                          Change from  

Medical Membership

   December 31,
2018
     December 31,
2017
     September 30,
2018
     December 31,
2017
    September 30,
2018
 

Customer Type

             

Local Group

     15,733        15,888        15,688        (1.0 )%      0.3

Individual

     655        1,588        692        (58.8 )%      (5.3 )% 

National:

             

National Accounts

     7,588        7,463        7,610        1.7     (0.3 )% 

BlueCard®

     5,838        5,733        5,794        1.8     0.8
  

 

 

    

 

 

    

 

 

      

Total National

     13,426        13,196        13,404        1.7     0.2

Medicare:

             

Medicare Advantage

     1,006        746        992        34.9     1.4

Medicare Supplement

     846        823        837        2.8     1.1
  

 

 

    

 

 

    

 

 

      

Total Medicare

     1,852        1,569        1,829        18.0     1.3

Medicaid

     6,716        6,496        6,731        3.4     (0.2 )% 

FEP®

     1,556        1,562        1,557        (0.4 )%      (0.1 )% 
  

 

 

    

 

 

    

 

 

      

Total Medical Membership

     39,938        40,299        39,901        (0.9 )%      0.1
  

 

 

    

 

 

    

 

 

      

Funding Arrangement

             

Self-Funded

     25,287        24,862        25,253        1.7     0.1

Fully-Insured

     14,651        15,437        14,648        (5.1 )%      —  
  

 

 

    

 

 

    

 

 

      

Total Medical Membership

     39,938        40,299        39,901        (0.9 )%      0.1
  

 

 

    

 

 

    

 

 

      

Reportable Segment

             

Commercial & Specialty Business

     29,814        30,672        29,784        (2.8 )%      0.1

Government Business

     10,124        9,627        10,117        5.2     0.1
  

 

 

    

 

 

    

 

 

      

Total Medical Membership

     39,938        40,299        39,901        (0.9 )%      0.1
  

 

 

    

 

 

    

 

 

      

Other Membership

             

Life and Disability Members

     4,795        4,700        4,701        2.0     2.0

Dental Members

     5,807        5,864        5,804        (1.0 )%      0.1

Dental Administration Members

     5,327        5,342        5,367        (0.3 )%      (0.7 )% 

Vision Members

     6,946        6,867        6,906        1.2     0.6

Medicare Part D Standalone Members

     309        318        312        (2.8 )%      (1.0 )% 

 

9


Anthem, Inc.

Consolidated Statements of Income

(Unaudited)

 

(In millions, except per share data)    Three Months Ended
December 31
       
     2018     2017     Change  

Revenues

      

Premiums

   $ 21,819     $ 21,087       3.5

Administrative fees and other revenue

     1,485       1,360       9.2
  

 

 

   

 

 

   

Total operating revenue

     23,304       22,447       3.8

Net investment income

     262       240       9.2

Net realized (losses)/gains on financial instruments

     (185     7       NM  

Other-than-temporary impairment losses on investments:

      

Total other-than-temporary impairment losses on investments

     (9     (12     (25.0 )% 

Portion of other-than-temporary impairment losses recognized in other comprehensive income

     1       —         NM  
  

 

 

   

 

 

   

Other-than-temporary impairment losses recognized in income

     (8     (12     (33.3 )% 
  

 

 

   

 

 

   

Total revenues

     23,373       22,682       3.0

Expenses

      

Benefit expense

     18,936       18,672       1.4

Selling, general and administrative expense

     3,618       3,394       6.6

Interest expense

     189       164       15.2

Amortization of other intangible assets

     94       44       113.6

(Gain) loss on extinguishment of debt

     (6     282       NM  
  

 

 

   

 

 

   

Total expenses

     22,831       22,556       1.2

Income before income tax expense

     542       126       330.2

Income tax expense

     118       (1,106     NM  
  

 

 

   

 

 

   

Net income

   $ 424     $ 1,232       (65.6 )% 
  

 

 

   

 

 

   

Net income per diluted share

   $ 1.61     $ 4.67       (65.5 )% 
  

 

 

   

 

 

   

Diluted shares

     264.2       263.3       0.3

Benefit expense as a percentage of premiums

     86.8     88.6     (180)bp  

Selling, general and administrative expense as a percentage of total operating revenue

     15.5     15.1     40bp  

Income before income taxes as a percentage of total revenue

     2.3     0.6     170bp  

 

(1)

“NM” = calculation not meaningful

 

10


Anthem, Inc.

Consolidated Statements of Income

(Unaudited)

 

(In millions, except per share data)    Twelve Months Ended
December 31
       
     2018     2017     Change  

Revenues

      

Premiums

   $ 85,421     $ 83,648       2.1

Administrative fees and other revenue

     5,920       5,413       9.4
  

 

 

   

 

 

   

Total operating revenue

     91,341       89,061       2.6

Net investment income

     970       867       11.9

Net realized (losses)/gains on financial instruments

     (180     145       (224.1 )% 

Other-than-temporary impairment losses on investments:

      

Total other-than-temporary impairment losses on investments

     (29     (35     (17.1 )% 

Portion of other-than-temporary impairment losses recognized in other comprehensive income

     3       2       50.0
  

 

 

   

 

 

   

Other-than-temporary impairment losses recognized in income

     (26     (33     (21.2 )% 
  

 

 

   

 

 

   

Total revenues

     92,105       90,040       2.3

Expenses

      

Benefit expense

     71,895       72,236       (0.5 )% 

Selling, general and administrative expense

     14,020       12,650       10.8

Interest expense

     753       739       1.9

Amortization of other intangible assets

     358       169       111.8

Loss on extinguishment of debt

     11       282       (96.1 )% 
  

 

 

   

 

 

   

Total expenses

     87,037       86,076       1.1
  

 

 

   

 

 

   

Income before income tax expense

     5,068       3,964       27.9

Income tax expense

     1,318       121       989.3
  

 

 

   

 

 

   

Net income

   $ 3,750     $ 3,843       (2.4 )% 
  

 

 

   

 

 

   

Net income per diluted share

   $ 14.19     $ 14.35       (1.1 )% 
  

 

 

   

 

 

   

Diluted shares

     264.2       267.8       (1.3 )% 

Benefit expense as a percentage of premiums

     84.2     86.4     (220)bp  

Selling, general and administrative expense as a percentage of total operating revenue

     15.3     14.2     110bp  

Income before income taxes as a percentage of total revenue

     5.5     4.4     110bp  

 

(1)

“NM” = calculation not meaningful

 

11


Anthem, Inc.

Consolidated Balance Sheets

 

(In millions)    December 31,
2018
    December 31,
2017
 
     (Unaudited)        

Assets

    

Current assets:

    

Cash and cash equivalents

   $ 3,934     $ 3,609  

Fixed maturity securities

     16,692       17,377  

Equity securities

     1,493       3,599  

Other invested assets, current

     21       17  

Accrued investment income

     162       163  

Premium receivables

     4,465       3,605  

Self-funded receivables

     2,278       2,580  

Other receivables

     2,558       2,267  

Income taxes receivable

     10       342  

Securities lending collateral

     604       455  

Other current assets

     2,104       2,249  
  

 

 

   

 

 

 

Total current assets

     34,321       36,263  

Long-term investments:

    

Fixed maturity securities

     487       561  

Equity securities

     33       33  

Other invested assets

     3,726       3,344  

Property and equipment, net

     2,735       2,175  

Goodwill

     20,504       19,231  

Other intangible assets

     9,007       8,368  

Other noncurrent assets

     758       565  
  

 

 

   

 

 

 

Total assets

   $ 71,571     $ 70,540  
  

 

 

   

 

 

 

Liabilities and shareholders’ equity

    

Liabilities

    

Current liabilities:

    

Policy liabilities:

    

Medical claims payable

   $ 7,454     $ 7,992  

Reserves for future policy benefits

     75       70  

Other policyholder liabilities

     2,590       2,950  
  

 

 

   

 

 

 

Total policy liabilities

     10,119       11,012  

Unearned income

     902       860  

Accounts payable and accrued expenses

     4,959       5,024  

Security trades pending payable

     197       113  

Securities lending payable

     604       454  

Short-term borrowings

     1,145       1,275  

Current portion of long-term debt

     849       1,275  

Other current liabilities

     3,190       3,343  
  

 

 

   

 

 

 

Total current liabilities

     21,965       23,356  

Long-term debt, less current portion

     17,217       17,382  

Reserves for future policy benefits, noncurrent

     706       647  

Deferred tax liabilities, net

     1,960       1,727  

Other noncurrent liabilities

     1,182       925  
  

 

 

   

 

 

 

Total liabilities

     43,030       44,037  
  

 

 

   

 

 

 

Shareholders’ equity

    

Common stock

     3       3  

Additional paid-in capital

     9,536       8,547  

Retained earnings

     19,988       18,054  

Accumulated other comprehensive loss

     (986     (101
  

 

 

   

 

 

 

Total shareholders’ equity

     28,541       26,503  
  

 

 

   

 

 

 

Total liabilities and shareholders’ equity

   $ 71,571     $ 70,540  
  

 

 

   

 

 

 

 

12


Anthem, Inc.

Consolidated Statements of Cash Flows

(Unaudited)

 

(In millions)    Twelve Months
Ended December 31
 
     2018     2017  

Operating activities

    

Net income

   $ 3,750     $ 3,843  

Adjustments to reconcile net income to net cash provided by operating activities:

    

Net realized losses/(gains) on financial instruments

     180       (145

Other-than-temporary impairment losses recognized in income

     26       33  

Loss on extinguishment of debt

     11       282  

Loss on disposal of assets

     13       13  

Deferred income taxes

     91       (1,272

Amortization, net of accretion

     1,008       780  

Depreciation expense

     119       111  

Impairment of property and equipment

     5       2  

Share-based compensation

     226       170  

Changes in operating assets and liabilities:

    

Receivables, net

     (707     (22

Other invested assets

     (1     (36

Other assets

     (26     (629

Policy liabilities

     (1,059     732  

Unearned income

     (36     (120

Accounts payable and accrued expenses

     134       922  

Other liabilities

     (25     (120

Income taxes

     323       (194

Other, net

     (205     (165
  

 

 

   

 

 

 

Net cash provided by operating activities

     3,827       4,185  

Investing activities

    

Purchases of fixed maturity securities

     (8,244     (9,795

Proceeds from sales and maturities of fixed maturity securities

     8,380       9,780  

Purchases of equity securities

     (896     (5,416

Proceeds from sales of equity securities

     2,809       3,463  

Purchases of other invested assets

     (531     (1,164

Proceeds from sales of other invested assets

     411       219  

Change in collateral and settlements of non-hedging derivatives

     —         65  

Changes in securities lending collateral

     (150     625  

Purchases of subsidiaries, net of cash acquired

     (1,760     (2,080

Net purchases of property and equipment

     (1,208     (791

Other, net

     (70     12  
  

 

 

   

 

 

 

Net cash used in investing activities

     (1,259     (5,082

Financing activities

    

Net (repayments of)/proceeds from commercial paper borrowings

     (106     175  

Net (repayments of)/proceeds from short-term borrowings

     (130     835  

Net (repayments of)/proceeds from long-term borrowings

     (849     2,643  

Changes in securities lending payable

     150       (625

Changes in bank overdrafts

     (210     71  

Proceeds from sale of put options

     —         1  

Premiums paid on equity call options

     (1     —    

Proceeds from issuance of common stock under Equity Units stock purchase contracts

     1,250       —    

Repurchase and retirement of common stock

     (1,685     (1,998

Change in collateral and settlements of debt-related derivatives

     24       (149

Cash dividends

     (776     (705

Proceeds from issuance of common stock under employee stock plans

     173       225  

Taxes paid through withholding of common stock under employee stock plans

     (81     (46
  

 

 

   

 

 

 

Net cash (used in)/provided by financing activities

     (2,241     427  

Effect of foreign exchange rates on cash and cash equivalents

     (2     4  
  

 

 

   

 

 

 

Change in cash and cash equivalents

     325       (466

Cash and cash equivalents at beginning of year

     3,609       4,075  
  

 

 

   

 

 

 

Cash and cash equivalents at end of period

   $ 3,934     $ 3,609  
  

 

 

   

 

 

 

 

13


Anthem, Inc.

Reconciliation of Medical Claims Payable

 

     Years Ended December 31  
     2018     2017     2016  
(In millions)    (Unaudited)              

Gross medical claims payable, beginning of year

   $ 7,814     $ 7,656     $ 7,360  

Ceded medical claims payable, beginning of year

     (105     (539     (646
  

 

 

   

 

 

   

 

 

 

Net medical claims payable, beginning of year

     7,709       7,117       6,714  
  

 

 

   

 

 

   

 

 

 

Business combinations and purchase adjustments

     199       76       —    

Net incurred medical claims:

      

Current year

     69,581       70,377       64,868  

Prior years redundancies(1)

     (930     (1,133     (835
  

 

 

   

 

 

   

 

 

 

Total net incurred medical claims

     68,651       69,244       64,033  
  

 

 

   

 

 

   

 

 

 

Net payments attributable to:

      

Current year medical claims

     62,748       62,923       57,879  

Prior years medical claims

     6,579       5,805       5,751  
  

 

 

   

 

 

   

 

 

 

Total net payments

     69,327       68,728       63,630  
  

 

 

   

 

 

   

 

 

 

Net medical claims payable, end of year

     7,232       7,709       7,117  

Ceded medical claims payable, end of year

     34       105       539  
  

 

 

   

 

 

   

 

 

 

Gross medical claims payable, end of year*

   $ 7,266     $ 7,814     $ 7,656  
  

 

 

   

 

 

   

 

 

 

Current year medical claims paid as a percentage of current year net incurred medical claims

     90.2     89.4     89.2

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

     13.7     18.9     14.2

Prior year redundancies in the current year as a percentage of prior year net incurred medical claims

     1.3     1.8     1.4

 

(1) 

Negative amounts reported for net incurred medical claims related to prior years result from claims being settled for amounts less than originally estimated.

*

Excludes insurance lines other than short duration.

 

14


Anthem, Inc.

GAAP Reconciliation

(Unaudited)

Anthem, Inc. has referenced “Adjusted Net Income” and “Adjusted Net Income Per Share,” which are non-GAAP measures, in this document. These non-GAAP measures are not intended to be alternatives to any measure calculated in accordance with GAAP. In addition to these non-GAAP measures, references are made to the measures “Operating Revenue” and “Operating Gain.” Each of these measures is provided to further aid investors in understanding and analyzing the company’s core operating results and comparing Anthem, Inc.’s financial results. A reconciliation of Operating Revenue to Total Revenue is set forth in the Consolidated Statements of Income herein. A reconciliation of the non-GAAP measures to the most directly comparable measures calculated in accordance with GAAP, together with a reconciliation of reportable segments operating gain to income before income tax expense, is reported below. Prior amounts may be rounded differently to conform to current presentation.

 

     Three Months Ended
December 31
          Twelve Months Ended
December 31
       
(In millions, except per share data)    2018     2017     Change     2018     2017     Change  

Net income

   $ 424     $ 1,232       (65.6 )%    $ 3,750     $ 3,843       (2.4 )% 

Add / (Subtract):

            

Net realized losses/(gains) on financial instruments

     185       (7       180       (145  

Amortization of other intangible assets

     94       44         358       169    

Other-than-temporary impairment losses recognized in income

     8       12         26       33    

(Gain)/Loss on extinguishment of debt

     (6     282         11       282    

Transaction related costs

     —         9         9       166    

2015 cyber attack litigation

     —         —           —         115    

Penn Treaty assessment costs

     —         —           —         254    

Income tax true-up of prior transaction costs

     —         —           —         (69  

Deferred tax benefit from corporate tax reform

     —         (1,108       —         (1,108  

Tax impact of non-GAAP adjustments

     (61     (125       (135     (316  
  

 

 

   

 

 

     

 

 

   

 

 

   

Net adjustment items

     220       (893       449       (619  
  

 

 

   

 

 

     

 

 

   

 

 

   

Adjusted net income

   $ 644     $ 339       90.0   $ 4,199     $ 3,224       30.2
  

 

 

   

 

 

     

 

 

   

 

 

   

Net income per diluted share

   $ 1.61     $ 4.67       (65.5 )%    $ 14.19     $ 14.35       (1.1 )% 

Add / (Subtract):

            

Net realized losses/(gains) on financial instruments

     0.70       (0.03       0.68       (0.54  

Amortization of other intangible assets

     0.36       0.17         1.36       0.63    

Other-than-temporary impairment losses recognized in income

     0.03       0.05         0.10       0.12    

(Gain)/Loss on extinguishment of debt

     (0.02     1.07         0.04       1.05    

Transaction related costs

     —         0.03         0.03       0.62    

2015 cyber attack litigation

     —         —           —         0.43    

Penn Treaty assessment costs

     —         —           —         0.95    

Income tax true-up of prior transaction costs

     —         —           —         (0.26  

Deferred tax benefit from corporate tax reform

     —         (4.21       —         (4.14  

Tax impact of non-GAAP adjustments

     (0.23     (0.47       (0.51     (1.18  

Rounding Impact

     (0.01     0.01         —         0.01    
  

 

 

   

 

 

     

 

 

   

 

 

   

Net adjustment items

     0.83       (3.38       1.70       (2.31  
  

 

 

   

 

 

     

 

 

   

 

 

   

Adjusted net income per diluted share

   $ 2.44     $ 1.29       89.1   $ 15.89     $ 12.04       32.0
  

 

 

   

 

 

     

 

 

   

 

 

   
     Full Year 2019
Outlook
                         

Net income per diluted share

     Greater than $18.00          

Add / (Subtract):

            

Amortization of other intangible assets

     Approximately $1.30          

Tax impact of non-GAAP adjustments

     Approximately ($0.30)          
  

 

 

         

Net adjustment items

     Approximately $1.00          
  

 

 

         

Adjusted net income per diluted share

     Greater than $19.00          
     Three Months Ended
December 31
          Twelve Months Ended
December 31
       
(In millions)    2018     2017     Change     2018     2017     Change  

Reportable segments operating gain

   $ 750     $ 381       96.9   $ 5,426     $ 4,175       30.0

Net investment income

     262       240         970       867    

Net realized gains/(losses) on financial instruments

     (185     7         (180     145    

Other-than-temporary impairment losses recognized in income

     (8     (12       (26     (33  

Interest expense

     (189     (164       (753     (739  

Amortization of other intangible assets

     (94     (44       (358     (169  

(Gain)/Loss on extinguishment of debt

     6       (282       (11     (282  
  

 

 

   

 

 

     

 

 

   

 

 

   

Income before income tax expense

   $ 542     $ 126       330.2   $ 5,068     $ 3,964       27.9
  

 

 

   

 

 

     

 

 

   

 

 

   

 

15


Anthem, Inc.

Reclassified Membership Summary

(Unaudited and in Thousands)

 

     Three Months Ended  
Medical Membership    March 31,
2017
     June 30,
2017
     September 30,
2017
     December 31,
2017
 

Customer Type

           

Local Group

     15,714        15,720        15,875        15,888  

Individual

     1,886        1,779        1,696        1,588  

National:

           

National Accounts

     7,570        7,538        7,497        7,463  

BlueCard®

     5,868        5,775        5,704        5,733  
  

 

 

    

 

 

    

 

 

    

 

 

 

Total National

     13,438        13,313        13,201        13,196  

Medicare:

           

Medicare Advantage

     672        683        697        746  

Medicare Supplement

     826        824        825        823  
  

 

 

    

 

 

    

 

 

    

 

 

 

Total Medicare

     1,498        1,507        1,522        1,569  

Medicaid

     6,577        6,550        6,454        6,496  

FEP®

     1,573        1,569        1,564        1,562  
  

 

 

    

 

 

    

 

 

    

 

 

 

Total Medical Membership

     40,686        40,438        40,312        40,299  
  

 

 

    

 

 

    

 

 

    

 

 

 

Funding Arrangement

           

Self-Funded

     25,068        24,833        24,844        24,862  

Fully-Insured

     15,618        15,605        15,468        15,437  
  

 

 

    

 

 

    

 

 

    

 

 

 

Total Medical Membership

     40,686        40,438        40,312        40,299  
  

 

 

    

 

 

    

 

 

    

 

 

 

Reportable Segment

           

Commercial & Specialty Business

     31,038        30,812        30,772        30,672  

Government Business

     9,648        9,626        9,540        9,627  
  

 

 

    

 

 

    

 

 

    

 

 

 

Total Medical Membership

     40,686        40,438        40,312        40,299  
  

 

 

    

 

 

    

 

 

    

 

 

 

Other Membership

           

Life and Disability Members

     4,715        4,705        4,717        4,700  

Dental Members

     5,859        5,818        5,803        5,864  

Dental Administration Members

     5,395        5,335        5,351        5,342  

Vision Members

     6,793        6,791        6,905        6,867  

Medicare Part D Standalone Members

     324        322        320        318  

 

16


Anthem, Inc.

Reclassified Membership Summary

(Unaudited and in Thousands)

 

     Three Months Ended  
Medical Membership    March 31,
2018
     June 30,
2018
     September 30,
2018
     December 31,
2018
 

Customer Type

           

Local Group

     15,670        15,634        15,688        15,733  

Individual

     755        712        692        655  

National:

           

National Accounts

     7,684        7,658        7,610        7,588  

BlueCard®

     5,820        5,819        5,794        5,838  
  

 

 

    

 

 

    

 

 

    

 

 

 

Total National

     13,504        13,477        13,404        13,426  

Medicare:

           

Medicare Advantage

     916        937        992        1,006  

Medicare Supplement

     823        827        837        846  
  

 

 

    

 

 

    

 

 

    

 

 

 

Total Medicare

     1,739        1,764        1,829        1,852  

Medicaid

     6,457        6,414        6,731        6,716  

FEP®

     1,562        1,560        1,557        1,556  
  

 

 

    

 

 

    

 

 

    

 

 

 

Total Medical Membership

     39,687        39,561        39,901        39,938  
  

 

 

    

 

 

    

 

 

    

 

 

 

Funding Arrangement

           

Self-Funded

     25,282        25,245        25,253        25,287  

Fully-Insured

     14,405        14,316        14,648        14,651  
  

 

 

    

 

 

    

 

 

    

 

 

 

Total Medical Membership

     39,687        39,561        39,901        39,938  
  

 

 

    

 

 

    

 

 

    

 

 

 

Reportable Segment

           

Commercial & Specialty Business

     29,929        29,823        29,784        29,814  

Government Business

     9,758        9,738        10,117        10,124  
  

 

 

    

 

 

    

 

 

    

 

 

 

Total Medical Membership

     39,687        39,561        39,901        39,938  
  

 

 

    

 

 

    

 

 

    

 

 

 

Other Membership

           

Life and Disability Members

     4,641        4,673        4,701        4,795  

Dental Members

     5,786        5,788        5,804        5,807  

Dental Administration Members

     5,357        5,384        5,367        5,327  

Vision Members

     6,781        6,760        6,906        6,946  

Medicare Part D Standalone Members

     316        312        312        309  

 

17


Anthem, Inc.

Reclassified Reportable Segment Highlights

(unaudited)

 

(In millions)    Three Months Ended  
     March 31,
2017
    June 30,
2017
    September 30,
2017
    December 31,
2017
 

Operating Revenue

        

Commercial & Specialty Business

   $ 10,192     $ 10,211     $ 9,954     $ 10,006  

Government Business

     12,128       11,987       12,143       12,444  

Other

     (1     —         —         (3
  

 

 

   

 

 

   

 

 

   

 

 

 

Total Operating Revenue1

   $ 22,319     $ 22,198     $ 22,097     $ 22,447  

Operating Gain / (Loss)

        

Commercial & Specialty Business

   $ 1,294     $ 963     $ 523     $ 67  

Government Business

     324       296       465       360  

Other

     (33     (32     (6     (46
  

 

 

   

 

 

   

 

 

   

 

 

 

Total Operating Gain1

   $ 1,585     $ 1,227     $ 982     $ 381  
(In millions)    Three Months Ended  
     March 31,
2018
    June 30,
2018
    September 30,
2018
    December 31,
2018
 

Operating Revenue

        

Commercial & Specialty Business

   $ 8,951     $ 9,055     $ 8,933     $ 8,843  

Government Business

     13,390       13,665       14,050       14,462  

Other

     1       (5     (3     (1
  

 

 

   

 

 

   

 

 

   

 

 

 

Total Operating Revenue1

   $ 22,342     $ 22,715     $ 22,980     $ 23,304  

Operating Gain / (Loss)

        

Commercial & Specialty Business

   $ 1,409     $ 1,056     $ 842     $ 322  

Government Business

     481       524       446       444  

Other

     (22     (21     (39     (16
  

 

 

   

 

 

   

 

 

   

 

 

 

Total Operating Gain1

   $ 1,868     $ 1,559     $ 1,249     $ 750  

 

(1)

See “Basis of Presentation” on page 7 herein.

 

18


Anthem, Inc.

Financial Guidance Summary

(Unaudited)

 

    

Full Year 2018 Actual

  

Full Year 2019 Outlook

  

Approximate Change

Year-End Medical Enrollment

        

Self-funded

   25,287    25,400 - 25,600    113k - 313k

Fully-Insured

   14,651    15,500 - 15,700    849k - 1,049k
  

 

  

 

  

 

Total

   39,938    40,900 - 41,300    962k - 1,362k

Operating Revenue

   $91.3 billion    Approximately $100.0 billion   

Approximately $8.7 billion

or 9.5%

Premium Revenue

   $85.4 billion    $90.5 billion - $92.5 billion    $5.1 billion - $7.1 billion or 6.0% - 8.3%

Benefit Expense Ratio

   84.2%    86.2% +/- 30 basis points    (200 bps) +/- 30 bps

Cost of Products Sold

   $—      $1.6 billion - $1.8 billion    $1.6 billion - $1.8 billion

SG&A Expense Ratio

   15.3%    13.5% +/- 30 basis points    180 bps +/- 30 bps

Operating Gain

   $5.4 billion    Greater than $6.0 billion    Greater than $600 million or 11.1%

Other Pre-Tax Items:

        

Net Investment income

   $970 million    $1.0 billion    $30 million

Interest Expense

   ($753) million    ($800) million    ($47) million

Amortization of Intangible Assets

   ($358) million    ($340 million)    $18 million
  

 

  

 

  

 

Net Pre-Tax Expense

   ($141) million    ($140) million    $1 million

Effective Tax Rate

   26.0%    19.5% - 21.5%    4.5% - 6.5%

GAAP EPS

   $14.19    Greater than $18.00    26.8% or better

Adjusted EPS

   $15.89    Greater than $19.00    19.6% or better

Diluted Shares

   264.2 million    261 - 263 million    0.5% - 1.2%

Operating Cash Flow

   $3.8 billion    Greater than $5.2 billion    Greater than $1.4 billion

 

19


Forward-Looking Statements

This document contains “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements reflect our views about future events and financial performance and are generally not historical facts. Words such as “expect,” “feel,” “believe,” “will,” “may,” “should,” “anticipate,” “intend,” “estimate,” “project,” “forecast,” “plan” and similar expressions are intended to identify forward-looking statements. These statements include, but are not limited to: financial projections and estimates and their underlying assumptions; statements regarding plans, objectives and expectations with respect to future operations, products and services; and statements regarding future performance. Such statements are subject to certain risks and uncertainties, many of which are difficult to predict and generally beyond our control, that could cause actual results to differ materially from those expressed in, or implied or projected by, the forward-looking statements. You are cautioned not to place undue reliance on these forward-looking statements that speak only as of the date hereof. You are also urged to carefully review and consider the various risks and other disclosures discussed in our reports filed with the U.S. Securities and Exchange Commission from time to time, which attempt to advise interested parties of the factors that affect our business. Except to the extent otherwise required by federal securities laws, we do not undertake any obligation to republish revised forward-looking statements to reflect events or circumstances after the date hereof. These risks and uncertainties include, but are not limited to: the impact of federal and state regulation, including ongoing changes in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended, or collectively, the ACA and the ultimate outcome of legal challenges to the ACA; trends in healthcare costs and utilization rates; our ability to contract with providers on cost-effective and competitive terms; our ability to secure sufficient premium rates including regulatory approval for and implementation of such rates; competitive pressures and our ability to adapt to changes in the industry and develop and implement strategic growth opportunities; reduced enrollment; unauthorized disclosure of member or employee sensitive or confidential information, including the impact and outcome of any investigations, inquires, claims and litigation related thereto; risks and uncertainties regarding Medicare and Medicaid programs, including those related to non-compliance with the complex regulations imposed thereon, our ability to maintain and achieve improvement in Centers for Medicare and Medicaid Services, or CMS, Star ratings and other quality scores and funding risks with respect to revenue received from participation therein; a negative change in our health care product mix; costs and other liabilities associated with litigation, government investigations, audits or reviews; the ultimate outcome of litigation between Cigna Corporation, or Cigna, and us related to the merger agreement between the parties, including our claim for damages against Cigna, Cigna’s claim for payment of a termination fee and other damages against us, and the potential for such litigation to cause us to incur substantial costs, materially distract management and negatively impact our reputation and financial condition; non-compliance by any party with the pharmacy benefit management services agreement between Express Scripts, Inc., or Express Scripts and us, as well as any agreements governing the transition of pharmacy benefit management services provided to us from Express Scripts to CaremarkPCS Health, L.L.C., a subsidiary of CVS Health Corporation, which could result in financial penalties, our inability to meet customer demands, and sanctions imposed by governmental entities, including CMS; medical malpractice or professional liability claims or other risks related to health care services and pharmacy benefit management services provided by our subsidiaries; possible restrictions in the payment of dividends from our subsidiaries and increases in required minimum levels of capital; the potential negative effect from our substantial amount of outstanding indebtedness; a downgrade in our financial strength ratings; the effects of any negative publicity related to the health benefits industry in general or us in particular; failure to effectively maintain and modernize our information systems; events that may negatively affect our licenses with the Blue Cross and Blue Shield Association; large scale medical emergencies, such as future public health epidemics and catastrophes; general risks associated with mergers, acquisitions, joint ventures and strategic alliances; possible impairment of the value of our intangible assets if future results do not adequately support goodwill and other intangible assets; changes in economic and market conditions, as well as regulations that may negatively affect our liquidity and investment portfolios; changes in U.S. tax laws; intense competition to attract and retain employees; and, various laws and provisions in our governing documents that may prevent or discourage takeovers and business combinations.

 

20