SEGMENT INFORMATION

During the three months ended March 31, 2017, we realigned certain of our businesses among our reportable segments to correspond with internal management reporting changes and our previously announced planned exit from the individual commercial medical business on January 1, 2018. Additionally, we renamed our Group segment to the Group and Specialty segment, and began presenting the individual commercial business results as a separate segment rather than as part of the Retail segment. Specialty health insurance benefits, including dental, vision, other supplement health, and financial protection products, marketed to individuals are now included in the Group and Specialty segment. Specialty health insurance benefits marketed to employer groups continue to be included in the Group and Specialty segment. As a result of this realignment, our reportable segments now include Retail, Group and Specialty, Healthcare Services, and Individual Commercial. Prior period segment financial information has been recast to conform to the 2017 presentation.

We manage our business with four reportable segments: Retail, Group and Specialty, Healthcare Services and Individual Commercial. In addition, the Other Businesses category includes businesses that are not individually reportable because they do not meet the quantitative thresholds required by generally accepted accounting principles. These segments are based on a combination of the type of health plan customer and adjacent businesses centered on well-being solutions for our health plans and other customers, as described below. These segment groupings are consistent with information used by our Chief Executive Officer to assess performance and allocate resources.

The Retail segment consists of Medicare benefits, marketed to individuals or directly via group accounts. In addition, the Retail segment also includes our contract with CMS to administer the Limited Income Newly Eligible Transition, or LI-NET, prescription drug plan program and contracts with various states to provide Medicaid, dual eligible, and Long-Term Support Services benefits, collectively our state-based contracts. The Group and Specialty segment consists of employer group commercial fully-insured medical and specialty health insurance benefits marketed to individuals and employer groups, including dental, vision, and other supplemental health and voluntary insurance benefits and financial protection products, as well as administrative services only, or ASO products. In addition, our Group and Specialty segment includes military services business, primarily our TRICARE South Region contract. The Healthcare Services segment includes services offered to our health plan members as well as to third parties, including pharmacy solutions, provider services, and clinical care service, as well as services and capabilities to promote wellness and advance population health. The Individual Commercial segment consists of our individual commercial fully-insured medical health insurance benefits. We report under the category of Other Businesses those businesses which do not align with the reportable segments described above, primarily our closed-block long-term care insurance policies.

Our Healthcare Services intersegment revenues primarily relate to managing prescription drug coverage for members of our other segments through Humana Pharmacy Solutions^®, or HPS, and includes the operations of Humana Pharmacy, Inc., our mail order pharmacy business. These revenues consist of the prescription price (ingredient cost plus dispensing fee), including the portion to be settled with the member (co-share) or with the government (subsidies), plus any associated administrative fees. Services revenues related to the distribution of prescriptions by third party retail pharmacies in our networks are recognized when the claim is processed and product revenues from dispensing prescriptions from our mail order pharmacies are recorded when the prescription or product is shipped. Our pharmacy operations, which are responsible for designing pharmacy benefits, including defining member co-share responsibilities, determining formulary listings, contracting with retail pharmacies, confirming member eligibility, reviewing drug utilization, and processing claims, act as a principal in the arrangement on behalf of members in our other segments. As principal, our Healthcare Services segment reports revenues on a gross basis, including co-share amounts from members collected by third party retail pharmacies at the point of service.

In addition, our Healthcare Services intersegment revenues include revenues earned by certain owned providers derived from risk-based and non risk-based managed care agreements with our health plans. Under risk based agreements, the provider receives a monthly capitated fee that varies depending on the demographics and health status of the member, for each member assigned to these owned providers by our health plans. The owned provider assumes the economic risk of funding the assigned members’ healthcare services. Under non risk-based agreements, our health plans retain the economic risk of funding the assigned members' healthcare services. Our Healthcare Services segment reports provider services revenues associated with risk-based agreements on a gross basis, whereby capitation fee revenue is recognized in the period in which the assigned members are entitled to receive healthcare services. Provider services revenues associated with non risk-based agreements are presented net of associated healthcare costs.

We present our consolidated results of operations from the perspective of the health plans. As a result, the cost of providing benefits to our members, whether provided via a third party provider or internally through a stand-alone subsidiary, is classified as benefits expense and excludes the portion of the cost for which the health plans do not bear responsibility, including member co-share amounts and government subsidies of $3.0 billion and $2.9 billion for the three months ended March 31, 2017 and 2016, respectively. In addition, depreciation and amortization expense associated with certain businesses in our Healthcare Services segment delivering benefits to our members, primarily associated with our provider services and pharmacy operations, are included with benefits expense. The amount of this expense was $26 million and $27 million for the three months ended March 31, 2017 and 2016, respectively.

Other than those described previously, the accounting policies of each segment are the same and are described in Note 2 to the consolidated financial statements included in our 2016 Form 10-K. Transactions between reportable segments primarily consist of sales of services rendered by our Healthcare Services segment, primarily pharmacy, provider, and clinical care services, to our Retail, Group and Specialty, and Individual Commercial segment customers. Intersegment sales and expenses are recorded at fair value and eliminated in consolidation. Members served by our segments often use the same provider networks, enabling us in some instances to obtain more favorable contract terms with providers. Our segments also share indirect costs and assets. As a result, the profitability of each segment is interdependent. We allocate most operating expenses to our segments. Assets and certain corporate income and expenses are not allocated to the segments, including the portion of investment income not supporting segment operations, interest expense on corporate debt, and certain other corporate expenses. These items are managed at a corporate level. These corporate amounts are reported separately from our reportable segments and are included with intersegment eliminations in the tables presenting segment results below.

Our segment results were as follows for the three and three months ended March 31, 2017 and 2016:




	Retail		Group and Specialty		Healthcare Services		Individual Commercial		Other Businesses			Eliminations/ Corporate			Consolidated
	(in millions)
Three months ended March 31, 2017
Revenues - external customers
Premiums:
Individual Medicare Advantage	$	8,376	$	—	$	—	$	—	$	—		$	—		$	8,376
Group Medicare Advantage	1,318		—		—		—		—			—			1,318
Medicare stand-alone PDP	941		—		—		—		—			—			941
Total Medicare	10,635		—		—		—		—			—			10,635
Fully-insured	118		1,378		—		283		—			—			1,779
Specialty	—		322		—		—		—			—			322
Medicaid and other	653		—		—		—		9			—			662
Total premiums	11,406		1,700		—		283		9			—			13,398
Services revenue:
Provider	—		—		70		—		—			—			70
ASO and other	2		161		—		—		2			—			165
Pharmacy	—		—		18		—		—			—			18
Total services revenue	2		161		88		—		2			—			253
Total revenues - external customers	11,408		1,861		88		283		11			—			13,651
Intersegment revenues
Services	—		5		4,310		—		—			(4,315		)	—
Products	—		—		1,552		—		—			(1,552		)	—
Total intersegment revenues	—		5		5,862		—		—			(5,867		)	—
Investment income	25		11		8		1		21			45			111
Total revenues	11,433		1,877		5,958		284		32			(5,822		)	13,762
Operating expenses:
Benefits	10,051		1,286		—		156		29			(196		)	11,326
Operating costs	954		399		5,680		62		4			(5,546		)	1,553
Merger termination fee and related costs, net	—		—		—		—		—			(947		)	(947		)
Depreciation and amortization	58		21		34		3		—			(24		)	92
Total operating expenses	11,063		1,706		5,714		221		33			(6,713		)	12,024
Income (loss) from operations	370		171		244		63		(1		)	891			1,738
Interest expense	—		—		—		—		—			49			49
Income (loss) before income taxes	$	370	$	171	$	244	$	63	$	(1	)	$	842		$	1,689



	Retail		Group and Specialty		Healthcare Services		Individual Commercial			Other Businesses			Eliminations/ Corporate			Consolidated
	(in millions)
Three months ended March 31, 2016
Revenues - external customers
Premiums:
Individual Medicare Advantage	$	8,027	$	—	$	—	$	—		$	—		$	—		$	8,027
Group Medicare Advantage	1,077		—		—		—			—			—			1,077
Medicare stand-alone PDP	1,039		—		—		—			—			—			1,039
Total Medicare	10,143		—		—		—			—			—			10,143
Fully-insured	104		1,337		—		893			—			—			2,334
Specialty	—		318		—		—			—			—			318
Medicaid and other	630		5		—		—			10			—			645
Total premiums	10,877		1,660		—		893			10			—			13,440
Services revenue:
Provider	—		—		71		—			—			—			71
ASO and other	1		177		1		—			3			—			182
Pharmacy	—		—		7		—			—			—			7
Total services revenue	1		177		79		—			3			—			260
Total revenues - external customers	10,878		1,837		79		893			13			—			13,700
Intersegment revenues
Services	—		6		4,784		—			—			(4,790		)	—
Products	—		—		1,360		—			—			(1,360		)	—
Total intersegment revenues	—		6		6,144		—			—			(6,150		)	—
Investment income	24		6		7		2			15			46			100
Total revenues	10,902		1,849		6,230		895			28			(6,104		)	13,800
Operating expenses:
Benefits	9,633		1,222		—		729			25			(212		)	11,397
Operating costs	1,082		434		5,942		169			4			(5,897		)	1,734
Merger termination fee and related costs, net	—		—		—		—			—			34			34
Depreciation and amortization	46		21		36		9			—			(24		)	88
Total operating expenses	10,761		1,677		5,978		907			29			(6,099		)	13,253
Income (loss) from operations	141		172		252		(12		)	(1		)	(5		)	547
Interest expense	—		—		—		—			—			47			47
Income (loss) before income taxes	$	141	$	172	$	252	$	(12	)	$	(1	)	$	(52	)	$	500