Segment Information

3 Months Ended

Mar. 31, 2020

– Segment Information

See Note 1 for a description of our segments. A description of our basis for reporting segment operating results is outlined below. Intersegment transactions primarily reflect pharmacy sales to insured customers of the Integrated Medical segment. These and other transactions are eliminated in consolidation.

The Company uses “pre-tax adjusted income from operations” and “adjusted revenues” as its principal financial measures of segment operating performance because management believes they best reflect the underlying results of business operations and permit analysis of trends in underlying revenue, expenses and profitability. Pre-tax adjusted income from operations is defined as income before taxes excluding realized investment results, amortization of acquired intangible assets, special items and, for periods prior to 2020, earnings contribution from transitioning clients Anthem and Coventry Health Care, Inc. (the “transitioning clients”). As of December 31, 2019, the transition of these clients was substantially complete; therefore, beginning in 2020, we no longer exclude results of transitioning clients from our adjusted revenues and adjusted income from operations. Income or expense amounts that are excluded from adjusted income from operations because they are not indicative of underlying performance or the responsibility of operating segment management include:

•Realized investment gains (losses) including changes in market values of certain financial instruments between balance sheet dates, as well as gains and losses associated with invested asset sales.

•Amortization of acquired intangible assets because these relate to costs incurred for acquisitions.

•Results of transitioning clients, for periods prior to 2020, because those results are not indicative of ongoing results.

•Special items, if any, that management believes are not representative of the underlying results of operations due to the nature or size of these matters.

The Company does not report total assets by segment because this is not a metric used to allocate resources or evaluate segment performance.

Adjusted revenues is defined as revenues excluding: 1) revenue contribution from transitioning clients for periods prior to 2020; 2) the Company’s share of certain realized investment results of its joint ventures reported in the International Markets segment using the equity method of accounting; and 3) special items, if any.

The following tables present the special items recorded by the Company for the three months ended March 31, 2020 and 2019.










	Three Months Ended
(In millions)	March 31, 2020						March 31, 2019
Description of Special Item Charges (Benefits) and Financial Statement Line Item(s)	After-tax		Before-tax		After-tax		Before-tax
Debt extinguishment costs (Debt extinguishment costs)	$	140	$	185	$	—	$	—
Integration and transaction-related costs (Selling, general and administrative expenses)	74		97		108		136
Charge for organizational efficiency plan (Selling, general and administrative expenses)	24		31		—		—
Charges associated with litigation matters (Selling, general and administrative expenses)	19		25		—		—
Contractual adjustment for a former client (Pharmacy revenues)	(66)		(87)		—		—

Total impact from special items	$	191	$	251	$	108	$	136

Summarized segment financial information for the three months ended March 31 was as follows:


(In millions)	Health Services		Integrated Medical		International Markets		Group Disability and Other		Corporate and Eliminations		Total
Three months ended March 31, 2020
Revenues from external customers⁽¹⁾	$	26,256	$	9,268	$	1,420	$	1,172	$	—	$	38,116
Inter-segment revenues	974		466		—		5		(1,445)
Net investment income	25		126		40		162		—		353
Total revenues	27,255		9,860		1,460		1,339		(1,445)		38,469
Net realized investment results from certain equity method investments⁽²⁾	—		—		10		—		—		10
Special items	(87)		—		—		—		—		(87)
Adjusted revenues	$	27,168	$	9,860	$	1,470	$	1,339	$	(1,445)	$	38,392
Income (loss) before taxes	$	694	$	1,140	$	234	$	72	$	(743)	$	1,397
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(4)		—		(5)		—		—		(9)
Net realized investment losses ⁽²⁾	—		48		46		4		—		98
Amortization of acquired intangible assets	479		11		7		1		—		498
Special items
Debt extinguishment costs	—		—		—		—		185		185
Integration and transaction-related costs	—		—		—		—		97		97
Charge for organizational efficiency plan	—		—		—		—		31		31
Charges associated with litigation matters	—		—		—		—		25		25
Contractual adjustment for a former client	(87)		—		—		—		—		(87)
Pre-tax adjusted income (loss) from operations	$	1,082	$	1,199	$	282	$	77	$	(405)	$	2,235

(In millions)	Health Services		Integrated Medical		International Markets		Group Disability and Other		Corporate and Eliminations		Total
Three months ended March 31, 2019
Revenues from external customers⁽¹⁾	$	26,197	$	8,910	$	1,384	$	1,109	$	—	$	37,600
Inter-segment revenues	737		162		—		7		(906)
Net investment income (loss)	15		123		38		180		(10)		346
Total revenues	26,949		9,195		1,422		1,296		(916)		37,946
Revenue contribution from transitioning clients	(4,489)		—		—		—		—		(4,489)
Net realized investment results from certain equity method investments⁽²⁾	—		—		(28)		—		—		(28)
Adjusted revenues	$	22,460	$	9,195	$	1,394	$	1,296	$	(916)	$	33,429
Income (loss) before taxes	$	942	$	1,157	$	222	$	93	$	(626)	$	1,788
Pre-tax adjustments to reconcile to adjusted income from operations
Adjustment for transitioning clients	(660)		—		—		—		—		(660)
(Income) attributable to noncontrolling interests	(1)		—		(4)		—		—		(5)
Net realized investment (gains) ⁽²⁾	—		(5)		(23)		(10)		—		(38)
Amortization of acquired intangible assets	713		18		11		1		—		743
Special items
Integration and transaction-related costs	—		—		—		—		136		136
Pre-tax adjusted income (loss) from operations	$	994	$	1,170	$	206	$	84	$	(490)	$	1,964

(1)Includes the Company’s share of the earnings of its joint ventures reported in the International Markets segment using the equity method of accounting.

(2)Includes the Company’s share of certain realized investment (gains) losses of its joint ventures reported in the International Markets segment using the equity method of accounting.

Revenue from external customers includes pharmacy revenues, premiums and fees and other revenues. The following table presents these revenues by product, premium and service type for the three months ended March 31:


	Three Months Ended March 31,
(In millions)	2020		2019
Products (Pharmacy revenues) (ASC 606)
Network revenues	$	12,142	$	12,273
Home delivery and specialty revenues	11,714		11,784
Other	1,242		1,122
Total pharmacy revenues	25,098		25,179
Insurance premiums (ASC 944)
Integrated Medical premiums
Commercial
Health Insurance	3,461		3,039
Stop loss	1,161		1,069
Other	289		278
Government
Medicare Advantage	1,881		1,607
Medicare Part D	462		525
Other	1,066		1,065
Total Integrated Medical premiums	8,320		7,583
International Markets premiums	1,375		1,304
Domestic disability, life and accident premiums	1,116		1,047
Other premiums	29		37
Total premiums	10,840		9,971
Services (ASC 606)
Fees	2,154		2,390
Other external revenues	24		60
Total services	2,178		2,450
Total revenues from external customers	$	38,116	$	37,600

The Health Services segment may provide certain financial and performance guarantees, including a minimum level of discounts a client may receive, generic utilization rates and various service levels. Clients may be entitled to receive compensation if we fail to meet these guarantees. Actual performance is compared to the contractual guarantee for each measure throughout the period and the Company defers revenue for any estimated payouts within Accrued expenses and other liabilities (current). These estimates are adjusted at the end of the guarantee period. Historically, adjustments to original estimates have not been material. The performance guarantee liability was $1.2 billion as of March 31, 2020 and $1.0 billion as of December 31, 2019.