0001193125-19-272013.txt : 20191023 0001193125-19-272013.hdr.sgml : 20191023 20191023060809 ACCESSION NUMBER: 0001193125-19-272013 CONFORMED SUBMISSION TYPE: 8-K PUBLIC DOCUMENT COUNT: 14 CONFORMED PERIOD OF REPORT: 20191023 ITEM INFORMATION: Results of Operations and Financial Condition ITEM INFORMATION: Financial Statements and Exhibits FILED AS OF DATE: 20191023 DATE AS OF CHANGE: 20191023 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Anthem, Inc. CENTRAL INDEX KEY: 0001156039 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 352145715 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 8-K SEC ACT: 1934 Act SEC FILE NUMBER: 001-16751 FILM NUMBER: 191162583 BUSINESS ADDRESS: STREET 1: 220 VIRGINIA AVENUE CITY: INDIANAPOLIS STATE: IN ZIP: 46204 BUSINESS PHONE: 3174886000 MAIL ADDRESS: STREET 1: 220 VIRGINIA AVENUE CITY: INDIANAPOLIS STATE: IN ZIP: 46204 FORMER COMPANY: FORMER CONFORMED NAME: WELLPOINT, INC DATE OF NAME CHANGE: 20100105 FORMER COMPANY: FORMER CONFORMED NAME: WELLPOINT INC DATE OF NAME CHANGE: 20041130 FORMER COMPANY: FORMER CONFORMED NAME: ANTHEM INC DATE OF NAME CHANGE: 20010730 8-K 1 d820068d8k.htm 8-K 8-K
false 0001156039 0001156039 2019-10-23 2019-10-23

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549 

 

FORM 8-K 

 

CURRENT REPORT

Pursuant to Section 13 or 15(d)

of the Securities Exchange Act of 1934

Date of Report (Date of earliest event reported): October 23, 2019

 

ANTHEM, INC.

(Exact name of registrant as specified in its charter) 

 

Indiana

  

001-16751

 

35-2145715

(State or other jurisdiction

of incorporation)

  

(Commission

File Number)

  

(IRS Employer

Identification No.)

220 Virginia Ave

Indianapolis, IN 46204

(Address of principal executive offices) (Zip Code)

Registrant’s telephone number, including area code: (800) 331-1476

N/A

(Former name or former address, if changed since last report)

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions (see General Instruction A.2. below):

☐ Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

☐ Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

☐ Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

☐ Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

Securities registered pursuant to Section 12(b) of the Act:

Title of each class

  

Trading

Symbol(s)

  

Name of each exchange

on which registered

Common Stock

  

ANTM

  

New York Stock Exchange

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).

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.  ☐

 

 

Item 2.02 Results of Operations and Financial Condition.

On October 23, 2019, Anthem, Inc. issued a press release reporting its financial results for its third quarter ended September 30, 2019. A copy of the press release is furnished as Exhibit 99.1 to this report and incorporated herein by reference.

None of the information furnished in Item 2.02 or Exhibit 99.1 hereto shall be deemed to be “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended. Unless expressly set forth by specific reference in such filings, none of the information furnished in this report shall be incorporated by reference in any filing under the Securities Act of 1933, as amended, whether made before or after the date hereof and regardless of any general incorporation language in such filings.

Item 9.01 Financial Statements and Exhibits.

  (d) Exhibits.

Exhibit
    No.    

    

Exhibit

         
 

99.1

   

Press Release, dated October 23, 2019, reporting Anthem, Inc. financial results for its third quarter ended September 30, 2019.

         
 

104

   

Cover Page Interactive Data File (embedded within the Inline XBRL document)

FORWARD-LOOKING STATEMENTS

This document contains certain 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, inquiries, 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 healthcare 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 agreements between us and each of Express Scripts, Inc., or Express Scripts, and CaremarkPCS Health, L.L.C., or CVS Health, as well as any agreements governing the transition of pharmacy benefit management services provided to us from Express Scripts to CVS Health, 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 healthcare 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; our ability to repurchase shares of our common stock and pay dividends on our common stock due to the adequacy of our cash flow and earnings and other considerations; 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.

SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

Dated: October 23, 2019

ANTHEM, INC.

     

By:

 

/s/ Kathleen S. Kiefer

Name:

 

Kathleen S. Kiefer

Title:

 

Corporate Secretary

EX-99.1 2 d820068dex991.htm EX-99.1 EX-99.1

Exhibit 99.1

PRESS RELEASE

 

LOGO

ANTHEM REPORTS THIRD QUARTER 2019 RESULTS

 

  •  

Third quarter net income was $4.55 per share, including net negative adjustment items of $0.32 per share. Adjusted net income was $4.87* per share.

 

  •  

Operating revenue increased $3.5 billion, or 15.1 percent, over the prior year quarter to $26.4 billion.

 

  •  

Medical enrollment was 41.0 million members, an increase of 1.1 million members over the prior year quarter, driven by growth in the fully insured businesses.

 

  •  

The Company now expects full year net income to be greater than $18.45 per share. Full year adjusted net income is now expected to be greater than $19.40* per share.

 

  •  

Fourth quarter 2019 dividend of $0.80 per share declared to shareholders.

Indianapolis, Ind. – October 23, 2019 – Anthem, Inc. (NYSE: ANTM) today announced third quarter financial results driven by strong revenue growth and improved operational execution.

“Anthem’s third quarter results showed continued membership growth – together with strong operating revenue growth – giving us great momentum as we head into 2020,” said Gail K. Boudreaux, President and CEO.

“I am pleased with our success to date as we remain committed to delivering a simpler, more affordable and more personalized healthcare experience for those we serve.”

 

*

Refer to the GAAP reconciliation tables on page 14.

 

1

CONSOLIDATED HIGHLIGHTS

Membership: Medical enrollment totaled approximately 41.0 million members at September 30, 2019, an increase of 1.1 million, or 2.7 percent, from September 30, 2018. Total fully insured enrollment grew by 968 thousand lives, or 6.6 percent, and self-funded enrollment grew by 115 thousand lives, or 0.5 percent. Government Business enrollment increased by 864 thousand lives as the Company experienced growth in Medicaid and Medicare. Commercial & Specialty Business enrollment increased by 219 thousand lives driven by growth in the National and Individual businesses, partially offset by a decline in Local Group enrollment.

Medical enrollment increased sequentially by 132 thousand lives during the third quarter of 2019, reflecting growth in Medicaid and Medicare, partially offset by declines in Commercial & Specialty Business enrollment.

Operating Revenue: Operating revenue was $26.4 billion in the third quarter of 2019, an increase of $3.5 billion, or 15.1 percent, versus the prior year quarter. The increase in operating revenue reflected membership growth across our businesses, premium rate increases to cover overall cost trends, and growth in our value-added services, including our pharmacy and integrated health offerings. The increase was partially offset by the one year waiver of the health insurance tax in 2019.

Benefit Expense Ratio: The benefit expense ratio was 87.2 percent in the third quarter of 2019, an increase of 240 basis points from 84.8 percent in the prior year quarter. The increase, as expected, was primarily driven by the one year waiver of the health insurance tax in 2019.

Medical claims reserves established at December 31, 2018 developed in line with the Company’s expectation during the first nine months of 2019.

Medical Cost Trend: For the full year 2019, the Company continues to expect underlying Local Group medical cost trend will be in the range of 6.0% +/- 50 basis points.

Days in Claims Payable: Days in Claims Payable was 39.8 days as of September 30, 2019, an increase of 0.7 days from 39.1 days as of June 30, 2019.

SG&A Expense Ratio: The SG&A expense ratio was 12.9 percent in the third quarter of 2019, a decrease of 250 basis points from 15.4 percent in the third quarter of 2018. The decrease, as expected, was primarily driven by growth in operating revenue and the one year waiver of the health insurance tax in 2019.

Operating Cash Flow: Operating cash flow in the third quarter of 2019 was $1.7 billion, or 1.4 times net income, and an increase of $1.1 billion compared to the third quarter of 2018. Operating cash flow was $4.7 billion, or 1.2 times net income for the nine months ending September 30, 2019.

Share Repurchase Program: During the third quarter of 2019, the Company repurchased 2.4 million shares of its common stock for $644 million, or a weighted average price of $266.52. As of September 30, 2019, the Company had approximately $4.1 billion of Board-approved share repurchase authorization remaining.

 

2

Cash Dividend: During the third quarter of 2019, the Company paid a quarterly dividend of $0.80 per share, representing a distribution of cash totaling $204 million.

On October 22, 2019, the Audit Committee declared a fourth 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 fourth quarter dividend is payable on December 20, 2019 to shareholders of record at the close of business on December 5, 2019.

Investment Portfolio & Capital Position: During the third quarter of 2019, the Company recorded net realized gains of $1 million and other-than-temporary impairment losses totaling $13 million. During the third quarter of 2018, the Company recorded net realized gains of $27 million and other-than-temporary impairment losses totaling $6 million.

As of September 30, 2019, the Company’s net unrealized gain position in the investment portfolio was $711 million, consisting of fixed maturity securities. As of September 30, 2019 cash and investments at the parent company totaled approximately $3.0 billion.

 

3

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, Medicare, and Federal Health Products & Services businesses); and Other (comprised of IngenioRx, the Diversified Business Group, and corporate expenses not allocated to our other reportable segments).

Anthem, Inc.

Reportable Segment Highlights

(Unaudited)

 

(In millions)    Three Months Ended September 30     Nine Months Ended September 30  
     2019     2018     Change     2019     2018     Change  

Operating Revenue

             

Commercial & Specialty Business

    $ 9,284     $ 8,933       3.9 %    $ 28,093     $ 26,939       4.3 % 

Government Business

      15,955       13,979       14.1 %      46,419       40,951       13.4 % 

Other

      2,508       398       530.2 %      3,850       1,108       247.5 % 

Eliminations

      (1,303 )      (330 )      NM 2      (2,353 )      (961 )      NM 2 
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

  

Total Operating Revenue1

    $ 26,444     $ 22,980       15.1 %    $ 76,009     $ 68,037       11.7 % 

Operating Gain / (Loss)

             

Commercial & Specialty Business

    $ 930     $ 834       11.5 %    $ 3,511     $ 3,284       6.9 % 

Government Business

      616       456       35.1 %      1,471       1,477       (0.4 )% 

Other

      (18 )      (41 )      NM 2      (81 )      (85 )      NM 2 
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

    

 

 

  

Total Operating Gain1

    $ 1,528     $ 1,249       22.3 %    $ 4,901     $ 4,676       4.8 % 

Operating Margin

             

Commercial & Specialty Business

      10.0 %      9.3 %      70  bp      12.5 %      12.2 %      30  bp 

Government Business

      3.9 %      3.3 %      60  bp      3.2 %      3.6 %      (40 ) bp 

Total Operating Margin1

      5.8 %      5.4 %      40  bp      6.4 %      6.9 %      (50 ) bp 

 

(1)

See “Basis of Presentation” on page 6 herein.

(2)

“NM” = calculation not meaningful.

Commercial & Specialty Business: Operating gain in the Commercial & Specialty Business segment totaled $930 million in the third quarter of 2019, an increase of $96 million, or 11.5 percent, from $834 million in the third quarter of 2018. The increase is primarily driven by greater penetration of value-added services, including our pharmacy and integrated health offerings, partially offset by unfavorable reserve development.

Government Business: Operating gain in the Government Business segment was $616 million in the third quarter of 2019, an increase of $160 million, or 35.1 percent, from $456 million in the third quarter of 2018. The increase is driven by improved medical cost performance in Medicaid partially offset by the one year waiver of the health insurance tax.

Other: The Company reported an operating loss of $18 million in the Other segment for the third quarter of 2019, compared with an operating loss of $41 million in the prior year quarter.

 

4

OUTLOOK

Full Year 2019:

 

  •  

GAAP net income is now expected to be greater than $18.45 per share, including approximately $0.95 per share of net unfavorable items. Excluding these items, adjusted net income is now expected to be greater than $19.40*.

 

  •  

Medical membership is now expected to be approximately 41.0 million. Fully-insured membership is now expected to be approximately 15.6 million and self-funded membership now is expected to be approximately 25.4 million.

 

  •  

Operating revenue is now expected to be approximately $103.0 billion, including premium revenue of $94.0 billion - $95.0 billion.

 

  •  

Benefit expense ratio is now expected to be in the range of 86.5% - 86.8%.

 

  •  

SG&A ratio is now expected to be in the range of 13.0% - 13.3%.

 

  •  

Operating cash flow is now expected to be greater than $5.5 billion.

 

  •  

Share count is now expected to be approximately 260 - 261 million.

 

*

Refer to the GAAP reconciliation tables on page 14.

 

5

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, cost of products sold 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 14 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 Daylight Time (“EDT”) to discuss the company’s third 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:

 

877-260-8898 (Domestic)

    800-475-6701 (Domestic Replay)

612-332-0530 (International)

    320-365-3844 (International Replay)

An access code is not required for today’s conference call. The access code for the replay is 432048. The replay will be available from 11:00 a.m. EDT today, until the end of the day on November 6, 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

   

 

6

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 77 million people, including over 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.

 

7

Anthem, Inc.

Membership Summary

(Unaudited and in Thousands)

 

                          Change from  

Medical Membership

    September 30,
2019		      September 30,
2018		      December 31,
2018		      September 30,
2018		     December 31,
2018		  

Customer Type

              

Local Group

      15,659        15,688        15,733        (0.2 )%      (0.5 )% 

Individual

      711        692        655        2.7 %      8.5 % 

National:

              

National Accounts

      7,666        7,610        7,588        0.7 %      1.0 % 

BlueCard®

      5,967        5,794        5,838        3.0 %      2.2 % 
  

 

 

     

 

 

     

 

 

       

Total National

      13,633        13,404        13,426        1.7 %      1.5 % 

Medicare:

              

Medicare Advantage

      1,203        992        1,006        21.3 %      19.6 % 

Medicare Supplement

      893        837        846        6.7 %      5.6 % 
  

 

 

     

 

 

     

 

 

       

Total Medicare

      2,096        1,829        1,852        14.6 %      13.2 % 

Medicaid

      7,293        6,731        6,716        8.3 %      8.6 % 

Federal Health Products & Services

      1,592        1,557        1,556        2.2 %      2.3 % 
  

 

 

     

 

 

     

 

 

       

Total Medical Membership

      40,984        39,901        39,938        2.7 %      2.6 % 
  

 

 

     

 

 

     

 

 

       

Funding Arrangement

              

Self-Funded

      25,368        25,253        25,287        0.5 %      0.3 % 

Fully-Insured

      15,616        14,648        14,651        6.6 %      6.6 % 
  

 

 

     

 

 

     

 

 

       

Total Medical Membership

      40,984        39,901        39,938        2.7 %      2.6 % 
  

 

 

     

 

 

     

 

 

       

Reportable Segment

              

Commercial & Specialty Business

      30,003        29,784        29,814        0.7 %      0.6 % 

Government Business

      10,981        10,117        10,124        8.5 %      8.5 % 
  

 

 

     

 

 

     

 

 

       

Total Medical Membership

      40,984        39,901        39,938        2.7 %      2.6 % 
  

 

 

     

 

 

     

 

 

       

Other Membership

              

Life and Disability Members

      4,970        4,701        4,795        5.7 %      3.6 % 

Dental Members

      5,942        5,804        5,807        2.4 %      2.3 % 

Dental Administration Members

      5,526        5,367        5,327        3.0 %      3.7 % 

Vision Members

      7,232        6,906        6,946        4.7 %      4.1 % 

Medicare Part D Standalone Members

      285        312        309        (8.7 )%      (7.8 )% 

 

8

Anthem, Inc.

Consolidated Statements of Income

(Unaudited)

 

(In millions, except per share data)    Three Months Ended
September 30		        
     2019     2018     Change  

Revenues

       

Premiums

    $ 23,793     $ 21,451       10.9 % 

Administrative fees and other revenue

      2,651       1,529       73.4 % 
  

 

 

    

 

 

    

Total operating revenue

      26,444       22,980       15.1 % 

Net investment income

      242       250       (3.2 )% 

Net realized gains on financial instruments

      1       27       (96.3 )% 

Other-than-temporary impairment losses on investments:

       

Total other-than-temporary impairment losses on investments

      (14 )      (8 )      NM  

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

      1       2       (50.0 )% 
  

 

 

    

 

 

    

Other-than-temporary impairment losses recognized in income

      (13 )      (6 )      NM  
  

 

 

    

 

 

    

Total revenues

      26,674       23,251       14.7 % 

Expenses

       

Benefit expense

      20,753       18,185       14.1 % 

Cost of products sold

      745       —         NM  

Selling, general and administrative expense

      3,418       3,546       (3.6 )% 

Interest expense

      185       188       (1.6 )% 

Amortization of other intangible assets

      84       91       (7.7 )% 

Gain on extinguishment of debt

      —         (1 )      NM  
  

 

 

    

 

 

    

Total expenses

      25,185       22,009       14.4 % 
  

 

 

    

 

 

    

Income before income tax expense

      1,489       1,242       19.9 % 

Income tax expense

      306       282       8.5 % 
  

 

 

    

 

 

    

Net income

    $ 1,183     $ 960       23.2 % 
  

 

 

    

 

 

    

Net income per diluted share

    $ 4.55     $ 3.62       25.7 % 
  

 

 

    

 

 

    

Diluted shares

      260.0       265.4       (2.0 )% 

Benefit expense as a percentage of premiums

      87.2 %      84.8 %      240  bp 

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

      12.9 %      15.4 %      (250 )bp 

Income before income taxes as a percentage of total revenue

      5.6 %      5.3 %      30  bp 

“NM” = calculation not meaningful

 

9

Anthem, Inc.

Consolidated Statements of Income

(Unaudited)

 

(In millions, except per share data)    Nine Months Ended
September 30		        
     2019     2018     Change  

Revenues

       

Premiums

    $ 70,137     $ 63,602       10.3 % 

Administrative fees and other revenue

      5,872       4,435       32.4 % 
  

 

 

    

 

 

    

Total operating revenue

      76,009       68,037       11.7 % 

Net investment income

      737       708       4.1 % 

Net realized gains on financial instruments

      90       5       NM  

Other-than-temporary impairment losses on investments:

       

Total other-than-temporary impairment losses on investments

      (36 )      (20 )      NM  

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

      6       2       NM  
  

 

 

    

 

 

    

Other-than-temporary impairment losses recognized in income

      (30 )      (18 )      NM  
  

 

 

    

 

 

    

Total revenues

      76,806       68,732       11.7 % 

Expenses

       

Benefit expense

      60,403       52,959       14.1 % 

Cost of products sold

      843       —         NM  

Selling, general and administrative expense

      9,862       10,402       (5.2 )% 

Interest expense

      556       564       (1.4 )% 

Amortization of other intangible assets

      256       265       (3.4 )% 

(Gain) loss on extinguishment of debt

      (1 )      17       NM  
  

 

 

    

 

 

    

Total expenses

      71,919       64,207       12.0 % 
  

 

 

    

 

 

    

Income before income tax expense

      4,887       4,525       8.0 % 

Income tax expense

      1,014       1,200       (15.5 )% 
  

 

 

    

 

 

    

Net income

    $ 3,873     $ 3,325       16.5 % 
  

 

 

    

 

 

    

Net income per diluted share

    $ 14.83     $ 12.58       17.9 % 
  

 

 

    

 

 

    

Diluted shares

      261.1       264.3       (1.2 )% 

Benefit expense as a percentage of premiums

      86.1 %      83.3 %      280  bp 

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

      13.0 %      15.3 %      (230 )bp 

Income before income taxes as a percentage of total revenue

      6.4 %      6.6 %      (20 )bp 

“NM” = calculation not meaningful

 

10

Anthem, Inc.

Consolidated Balance Sheets

 

     September 30,     December 31,  
(In millions)    2019     2018  
     (Unaudited)        

Assets

     

Current assets:

     

Cash and cash equivalents

    $ 4,190     $ 3,934  

Fixed maturity securities, current

      19,960       16,692  

Equity securities, current

      2,300       1,493  

Other invested assets, current

      10       21  

Accrued investment income

      168       162  

Premium receivables

      4,782       4,465  

Self-funded receivables

      2,555       2,278  

Other receivables

      2,870       2,558  

Income taxes receivable

      91       10  

Securities lending collateral

      465       604  

Other current assets

      2,113       2,104  
  

 

 

    

 

 

  

Total current assets

      39,504       34,321  

Long-term investments:

     

Fixed maturity securities

      518       487  

Equity securities

      29       33  

Other invested assets

      3,914       3,726  

Property and equipment, net

      2,921       2,735  

Goodwill

      20,500       20,504  

Other intangible assets

      8,756       9,007  

Other noncurrent assets

      1,667       758  
  

 

 

    

 

 

  

Total assets

    $ 77,809     $ 71,571  
  

 

 

    

 

 

  

Liabilities and shareholders’ equity

     

Liabilities

     

Current liabilities:

     

Policy liabilities:

     

Medical claims payable

    $ 8,977     $ 7,454  

Reserves for future policy benefits

      77       75  

Other policyholder liabilities

      2,503       2,590  
  

 

 

    

 

 

  

Total policy liabilities

      11,557       10,119  

Unearned income

      948       902  

Accounts payable and accrued expenses

      4,445       4,959  

Security trades pending payable

      542       197  

Securities lending payable

      465       604  

Short-term borrowings

      710       1,145  

Current portion of long-term debt

      700       849  

Other current liabilities

      3,867       3,190  
  

 

 

    

 

 

  

Total current liabilities

      23,234       21,965  

Long-term debt, less current portion

      18,820       17,217  

Reserves for future policy benefits, noncurrent

      661       706  

Deferred tax liabilities, net

      2,140       1,960  

Other noncurrent liabilities

      1,622       1,182  
  

 

 

    

 

 

  

Total liabilities

      46,477       43,030  
  

 

 

    

 

 

  

Shareholders’ equity

     

Common stock

      3       3  

Additional paid-in capital

      9,524       9,536  

Retained earnings

      22,104       19,988  

Accumulated other comprehensive loss

      (299 )      (986 ) 
  

 

 

    

 

 

  

Total shareholders’ equity

      31,332       28,541  
  

 

 

    

 

 

  

Total liabilities and shareholders’ equity

    $ 77,809     $ 71,571  
  

 

 

    

 

 

  

 

11

Anthem, Inc.

Consolidated Statements of Cash Flows

(Unaudited)

 

(In millions)    Nine Months Ended September 30  
     2019     2018  

Operating activities

     

Net income

    $ 3,873     $ 3,325  

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

     

Net realized gains on financial instruments

      (90 )      (5 ) 

Other-than-temporary impairment losses recognized in income

      30       18  

(Gain) loss on extinguishment of debt

      (1 )      17  

Loss on disposal of assets

      1       2  

Deferred income taxes

      (29 )      141  

Amortization, net of accretion

      778       752  

Depreciation expense

      109       92  

Share-based compensation

      226       135  

Changes in operating assets and liabilities:

     

Receivables, net

      (880 )      (823 ) 

Other invested assets

      (30 )      (17 ) 

Other assets

      (280 )      (734 ) 

Policy liabilities

      1,394       (556 ) 

Unearned income

      46       (42 ) 

Accounts payable and accrued expenses

      (931 )      756  

Other liabilities

      675       190  

Income taxes

      (81 )      273  

Other, net

      (76 )      (160 ) 
  

 

 

    

 

 

  

Net cash provided by operating activities

      4,734       3,364  

Investing activities

     

Purchases of fixed maturity securities

      (7,616 )      (6,790 ) 

Proceeds from sales and maturities of fixed maturity securities

      5,502       6,413  

Purchases of equity securities

      (9,408 )      (812 ) 

Proceeds from sales of equity securities

      8,671       2,119  

Purchases of other invested assets

      (286 )      (324 ) 

Proceeds from sales of other invested assets

      242       251  

Changes in securities lending collateral

      139       (286 ) 

Purchases of subsidiaries, net of cash acquired

      —         (1,732 ) 

Net purchases of property and equipment

      (726 )      (888 ) 

Other, net

      (33 )      17  
  

 

 

    

 

 

  

Net cash used in investing activities

      (3,515 )      (2,032 ) 

Financing activities

     

Net repayments of commercial paper borrowings

      (197 )      (54 ) 

Net repayments of short-term borrowings

      (435 )      (5 ) 

Net proceeds from (repayments of) long-term borrowings

      1,550       (558 ) 

Changes in securities lending payable

      (139 )      287  

Changes in bank overdrafts

      250       97  

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

      —         1,250  

Repurchase and retirement of common stock

      (1,396 )      (1,192 ) 

Change in collateral and settlements of debt-related derivatives

      (34 )      22  

Cash dividends

      (616 )      (583 ) 

Proceeds from issuance of common stock under employee stock plans

      137       133  

Taxes paid through withholding of common stock under employee stock plans

      (82 )      (77 ) 
  

 

 

    

 

 

  

Net cash used in financing activities

      (962 )      (680 ) 

Effect of foreign exchange rates on cash and cash equivalents

      (1 )      (1 ) 
  

 

 

    

 

 

  

Change in cash and cash equivalents

      256       651  

Cash and cash equivalents at beginning of year

      3,934       3,609  
  

 

 

    

 

 

  

Cash and cash equivalents at end of period

    $ 4,190     $ 4,260  
  

 

 

    

 

 

  

 

12

Anthem, Inc.

Reconciliation of Medical Claims Payable

 

     Nine Months Ended                    
     September 30     Years Ended December 31  
     2019     2018     2018     2017     2016  
(In millions)    (Unaudited)     (Unaudited)                    

Gross medical claims payable, beginning of period

    $ 7,266     $ 7,814     $ 7,814     $ 7,656     $ 7,360  

Ceded medical claims payable, beginning of period

      (34 )      (105 )      (105 )      (539 )      (646 ) 
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

  

Net medical claims payable, beginning of period

      7,232       7,709       7,709       7,117       6,714  
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

  

Business combinations and purchase adjustments

      —         199       199       76       —    

Net incurred medical claims:

           

Current year

      58,157       51,396       69,581       70,377       64,868  

Prior years redundancies(1)

      (437 )      (858 )      (930 )      (1,133 )      (835 ) 
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

  

Total net incurred medical claims

      57,720       50,538       68,651       69,244       64,033  
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

  

Net payments attributable to:

           

Current year medical claims

      49,751       44,511       62,748       62,923       57,879  

Prior years medical claims

      6,466       6,504       6,579       5,805       5,751  
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

  

Total net payments

      56,217       51,015       69,327       68,728       63,630  
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

  

Net medical claims payable, end of period

      8,735       7,431       7,232       7,709       7,117  

Ceded medical claims payable, end of period

      35       37       34       105       539  
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

  

Gross medical claims payable, end of period

    $ 8,770     $ 7,468     $ 7,266     $ 7,814     $ 7,656  
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

  

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

      85.5 %      86.6 %      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

      6.4 %      12.5 %      13.7 %      18.9 %      14.2 % 

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

      0.6 %      1.2 %      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.

 

13

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           Nine Months Ended        
     September 30           September 30        
(In millions, except per share data)    2019     2018     Change     2019     2018     Change  

Net income

    $ 1,183     $ 960       23.2 %    $ 3,873     $ 3,325       16.5 % 

Add / (Subtract):

             

Net realized (gains) losses on financial instruments

      (1 )      (27 )        (90 )      (5 )   

Amortization of other intangible assets

      84       91         256       265    

Other-than-temporary impairment losses recognized in income

      13       6         30       18    

(Gain) loss on extinguishment of debt

      —         (1 )        (1 )      17    

Transaction and integration related costs

      3       —           8       9    

Litigation expenses

      9       —           44       —      

Tax impact of non-GAAP adjustments

      (24 )      (18 )        (61 )      (73 )   
  

 

 

    

 

 

      

 

 

    

 

 

    

Net adjustment items

      84       51         186       231    
  

 

 

    

 

 

      

 

 

    

 

 

    

Adjusted net income

    $ 1,267     $ 1,011       25.3 %    $ 4,059     $ 3,556       14.1 % 
  

 

 

    

 

 

      

 

 

    

 

 

    

Net income per diluted share

    $ 4.55     $ 3.62       25.7 %    $ 14.83     $ 12.58       17.9 % 

Add / (Subtract):

             

Net realized (gains) losses on financial instruments

      —         (0.10 )        (0.34 )      (0.02 )   

Amortization of other intangible assets

      0.32       0.34         0.98       1.00    

Other-than-temporary impairment losses recognized in income

      0.05       0.02         0.11       0.07    

(Gain) loss on extinguishment of debt

      —         —           —         0.06    

Transaction and integration related costs

      0.01       —           0.03       0.03    

Litigation expenses

      0.03       —           0.17       —      

Tax impact of non-GAAP adjustments

      (0.09 )      (0.07 )        (0.23 )      (0.28 )   

Rounding Impact

      —         —           —         0.01    
  

 

 

    

 

 

      

 

 

    

 

 

    

Net adjustment items

      0.32       0.19         0.72       0.87    
  

 

 

    

 

 

      

 

 

    

 

 

    

Adjusted net income per diluted share

    $ 4.87     $ 3.81       27.8 %    $ 15.55     $ 13.45       15.6 % 
  

 

 

    

 

 

      

 

 

    

 

 

    

 

     Full Year 2019 Outlook  

Net income per diluted share

      Greater than $18.45  

Add / (Subtract):

   

Net realized gains on financial instruments

      (0.34 ) 

Other-than-temporary impairment losses recognized in income

      0.11  

Transaction and integration related costs

      0.03  

Litigation expenses

      0.17  

Amortization of other intangible assets

      Approximately $1.30  

Tax impact of non-GAAP adjustments

      Approximately ($0.32 ) 
  

 

 

  

Net adjustment items

      Approximately $0.95  
  

 

 

  

Adjusted net income per diluted share

      Greater than $19.40  
  

 

 

  

 

     Three Months Ended           Nine Months Ended        
     September 30           September 30        
(In millions)    2019     2018     Change     2019     2018     Change  

Reportable segments operating gain

    $ 1,528     $ 1,249       22.3 %    $ 4,901     $ 4,676       4.8 % 

Net investment income

      242       250         737       708    

Net realized gains (losses) on financial instruments

      1       27         90       5    

Other-than-temporary impairment losses recognized in income

      (13 )      (6 )        (30 )      (18 )   

Interest expense

      (185 )      (188 )        (556 )      (564 )   

Amortization of other intangible assets

      (84 )      (91 )        (256 )      (265 )   

Gain (loss) on extinguishment of debt

      —         1         1       (17 )   
  

 

 

    

 

 

      

 

 

    

 

 

    

Income before income tax expense

    $ 1,489     $ 1,242       19.9 %    $ 4,887     $ 4,525       8.0 % 
  

 

 

    

 

 

      

 

 

    

 

 

    

 

14

Forward-Looking Statements

This document contains certain 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, inquiries, 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 healthcare 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 agreements between us and each of Express Scripts, Inc., or Express Scripts, and CaremarkPCS Health, L.L.C., or CVS Health, as well as any agreements governing the transition of pharmacy benefit management services provided to us from Express Scripts to CVS Health, 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 healthcare 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; our ability to repurchase shares of our common stock and pay dividends on our common stock due to the adequacy of our cash flow and earnings and other considerations; 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

 

15

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.

 

16

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Document and Entity Information
Oct. 23, 2019
Cover [Abstract]  
Amendment Flag false
Entity Central Index Key 0001156039
Document Type 8-K
Document Period End Date Oct. 23, 2019
Entity Registrant Name ANTHEM, INC.
Entity Incorporation State Country Code IN
Entity File Number 001-16751
Entity Tax Identification Number 35-2145715
Entity Address, Address Line One 220 Virginia Ave
Entity Address, City or Town Indianapolis
Entity Address, State or Province IN
Entity Address, Postal Zip Code 46204
City Area Code (800)
Local Phone Number 331-1476
Written Communications false
Soliciting Material false
Pre Commencement Tender Offer false
Pre Commencement Issuer Tender Offer false
Security 12b Title Common Stock
Trading Symbol ANTM
Security Exchange Name NYSE
Entity Emerging Growth Company false
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