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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
(Mark One)
☑ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended March 31, 2023
or
☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from _________ to_________
Commission File Number: 001-01011
CVS HEALTH CORPORATION
(Exact name of registrant as specified in its charter)
| | | | | | | | |
Delaware | | 05-0494040 |
(State or other jurisdiction of incorporation or organization) | | (I.R.S. Employer Identification No.) |
| | | | | | | | | | | | | | | | | | | | |
| One CVS Drive, | Woonsocket, | Rhode Island | | 02895 |
(Address of principal executive offices) | | (Zip Code) |
| | | | |
Registrant’s telephone number, including area code: | | (401) | 765-1500 |
Former name, former address and former fiscal year, if changed since last report: | N/A |
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, par value $0.01 per share | CVS | New York Stock Exchange |
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. ☑ Yes ☐ No
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). ☑ Yes ☐ No
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
| | | | | | | | | | | |
Large accelerated filer | ☑ | Accelerated filer | ☐ |
Non-accelerated filer | ☐ | Smaller reporting company | ☐ |
| | 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. | ☐ |
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). ☐ Yes ☑ No
As of April 26, 2023, the registrant had 1,282,025,283 shares of common stock issued and outstanding.
| | | | | | | | |
TABLE OF CONTENTS | |
| | Page |
Part I | Financial Information | |
| | |
Item 1. | | |
Item 2. | | |
Item 3. | | |
Item 4. | | |
| | |
Part II | Other Information | |
| | |
Item 1. | | |
Item 1A. | | |
Item 2. | | |
Item 3 | | |
Item 4. | | |
Item 5. | | |
Item 6. | | |
| | |
| |
Part I.Financial Information
Item 1.Financial Statements
Index to Condensed Consolidated Financial Statements
| | | | | |
| Page |
Condensed Consolidated Statements of Operations (Unaudited) for the three months ended March 31, 2023 and 2022 | |
| |
Condensed Consolidated Statements of Comprehensive Income (Unaudited) for the three months ended March 31, 2023 and 2022 | |
| |
Condensed Consolidated Balance Sheets (Unaudited) as of March 31, 2023 and December 31, 2022 | |
| |
Condensed Consolidated Statements of Cash Flows (Unaudited) for the three months ended March 31, 2023 and 2022 | |
| |
Condensed Consolidated Statements of Shareholders’ Equity (Unaudited) for the three months ended March 31, 2023 and 2022 | |
| |
Notes to Condensed Consolidated Financial Statements (Unaudited) | |
| |
Report of Independent Registered Public Accounting Firm | |
CVS Health Corporation
Condensed Consolidated Statements of Operations
(Unaudited)
| | | | | | | | | | | | | | | |
| Three Months Ended March 31, | | |
In millions, except per share amounts | 2023 | | 2022 | | | | |
Revenues: | | | | | | | |
Products | $ | 58,147 | | | $ | 52,522 | | | | | |
Premiums | 24,352 | | | 21,631 | | | | | |
Services | 2,445 | | | 2,505 | | | | | |
Net investment income | 334 | | | 168 | | | | | |
Total revenues | 85,278 | | | 76,826 | | | | | |
Operating costs: | | | | | | | |
Cost of products sold | 51,455 | | | 45,509 | | | | | |
Benefit costs | 20,448 | | | 17,923 | | | | | |
Opioid litigation charge | — | | | 484 | | | | | |
Loss on assets held for sale | 349 | | | 41 | | | | | |
| | | | | | | |
Operating expenses | 9,580 | | | 9,324 | | | | | |
Total operating costs | 81,832 | | | 73,281 | | | | | |
Operating income | 3,446 | | | 3,545 | | | | | |
Interest expense | 589 | | | 586 | | | | | |
| | | | | | | |
Other income | (22) | | | (42) | | | | | |
Income before income tax provision | 2,879 | | | 3,001 | | | | | |
Income tax provision | 737 | | | 646 | | | | | |
| | | | | | | |
| | | | | | | |
Net income | 2,142 | | | 2,355 | | | | | |
Net income attributable to noncontrolling interests | (6) | | | (1) | | | | | |
Net income attributable to CVS Health | $ | 2,136 | | | $ | 2,354 | | | | | |
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Net income per share attributable to CVS Health: | | | | | | | |
Basic | $ | 1.66 | | | $ | 1.79 | | | | | |
Diluted | $ | 1.65 | | | $ | 1.77 | | | | | |
Weighted average shares outstanding: | | | | | | | |
Basic | 1,283 | | | 1,312 | | | | | |
Diluted | 1,291 | | | 1,328 | | | | | |
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Dividends declared per share | $ | 0.605 | | | $ | 0.55 | | | | | |
See accompanying notes to condensed consolidated financial statements (unaudited).
CVS Health Corporation
Condensed Consolidated Statements of Comprehensive Income
(Unaudited)
| | | | | | | | | | | | | | | |
| Three Months Ended March 31, | | |
In millions | 2023 | | 2022 | | | | |
Net income | $ | 2,142 | | | $ | 2,355 | | | | | |
Other comprehensive income (loss), net of tax: | | | | | | | |
Net unrealized investment gains (losses) | 470 | | | (1,132) | | | | | |
Change in discount rate on long-duration insurance reserves | (74) | | | 369 | | | | | |
Foreign currency translation adjustments | (1) | | | 3 | | | | | |
Net cash flow hedges | (6) | | | (3) | | | | | |
| | | | | | | |
Other comprehensive income (loss) | 389 | | | (763) | | | | | |
Comprehensive income | 2,531 | | | 1,592 | | | | | |
Comprehensive income attributable to noncontrolling interests | (6) | | | (1) | | | | | |
Comprehensive income attributable to CVS Health | $ | 2,525 | | | $ | 1,591 | | | | | |
See accompanying notes to condensed consolidated financial statements (unaudited).
CVS Health Corporation
Condensed Consolidated Balance Sheets
(Unaudited)
| | | | | | | | | | | |
In millions, except per share amounts | March 31, 2023 | | December 31, 2022 |
Assets: | | | |
Cash and cash equivalents | $ | 14,618 | | | $ | 12,945 | |
Investments | 3,102 | | | 2,778 | |
Accounts receivable, net | 28,331 | | | 27,276 | |
Inventories | 18,263 | | | 19,090 | |
Assets held for sale | 625 | | | 908 | |
Other current assets | 3,767 | | | 2,636 | |
Total current assets | 68,706 | | | 65,633 | |
Long-term investments | 21,612 | | | 21,096 | |
Property and equipment, net | 12,872 | | | 12,873 | |
Operating lease right-of-use assets | 17,660 | | | 17,872 | |
Goodwill | 84,057 | | | 78,150 | |
Intangible assets, net | 26,368 | | | 24,803 | |
Separate accounts assets | 3,231 | | | 3,228 | |
Other assets | 4,824 | | | 4,620 | |
Total assets | $ | 239,330 | | | $ | 228,275 | |
| | | |
Liabilities: | | | |
Accounts payable | $ | 12,527 | | | $ | 14,838 | |
Pharmacy claims and discounts payable | 20,047 | | | 19,423 | |
Health care costs payable | 10,895 | | | 10,142 | |
Policyholders’ funds | 1,426 | | | 1,500 | |
Accrued expenses | 21,515 | | | 18,745 | |
Other insurance liabilities | 4,974 | | | 1,089 | |
Current portion of operating lease liabilities | 1,679 | | | 1,678 | |
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Current portion of long-term debt | 1,778 | | | 1,778 | |
Liabilities held for sale | 213 | | | 228 | |
Total current liabilities | 75,054 | | | 69,421 | |
Long-term operating lease liabilities | 16,571 | | | 16,800 | |
Long-term debt | 56,450 | | | 50,476 | |
Deferred income taxes | 4,095 | | | 4,016 | |
Separate accounts liabilities | 3,231 | | | 3,228 | |
Other long-term insurance liabilities | 5,678 | | | 5,835 | |
Other long-term liabilities | 6,671 | | | 6,730 | |
Total liabilities | 167,750 | | | 156,506 | |
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Shareholders’ equity: | | | |
Preferred stock, par value $0.01: 0.1 shares authorized; none issued or outstanding | — | | | — | |
Common stock, par value $0.01: 3,200 shares authorized; 1,759 shares issued and 1,279 shares outstanding at March 31, 2023 and 1,758 shares issued and 1,300 shares outstanding at December 31, 2022 and capital surplus | 48,306 | | | 48,193 | |
Treasury stock, at cost: 480 shares at March 31, 2023 and 458 shares at December 31, 2022 | (33,802) | | | (31,858) | |
Retained earnings | 57,753 | | | 56,398 | |
Accumulated other comprehensive loss | (875) | | | (1,264) | |
Total CVS Health shareholders’ equity | 71,382 | | | 71,469 | |
Noncontrolling interests | 198 | | | 300 | |
Total shareholders’ equity | 71,580 | | | 71,769 | |
Total liabilities and shareholders’ equity | $ | 239,330 | | | $ | 228,275 | |
See accompanying notes to condensed consolidated financial statements (unaudited).
CVS Health Corporation
Condensed Consolidated Statements of Cash Flows
(Unaudited)
| | | | | | | | | | | |
| Three Months Ended March 31, |
In millions | 2023 | | 2022 |
Cash flows from operating activities: | | | |
Cash receipts from customers | $ | 87,798 | | | $ | 74,192 | |
Cash paid for prescriptions dispensed and health services rendered | (50,223) | | | (44,365) | |
Insurance benefits paid | (19,757) | | | (16,616) | |
Cash paid to other suppliers and employees | (9,958) | | | (8,969) | |
Interest and investment income received | 426 | | | 199 | |
Interest paid | (773) | | | (782) | |
Income taxes paid | (75) | | | (96) | |
Net cash provided by operating activities | 7,438 | | | 3,563 | |
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Cash flows from investing activities: | | | |
Proceeds from sales and maturities of investments | 1,891 | | | 2,570 | |
Purchases of investments | (2,358) | | | (3,474) | |
Purchases of property and equipment | (984) | | | (1,051) | |
Acquisitions (net of cash acquired) | (7,094) | | | (7) | |
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Other | 31 | | | (31) | |
Net cash used in investing activities | (8,514) | | | (1,993) | |
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Cash flows from financing activities: | | | |
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Proceeds from issuance of long-term debt | 5,951 | | | — | |
Repayments of long-term debt | (362) | | | (14) | |
Repurchase of common stock | (2,018) | | | (2,000) | |
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Dividends paid | (779) | | | (722) | |
Proceeds from exercise of stock options | 96 | | | 297 | |
Payments for taxes related to net share settlement of equity awards | (34) | | | (62) | |
Other | (128) | | | (149) | |
Net cash provided by (used in) financing activities | 2,726 | | | (2,650) | |
Net increase (decrease) in cash, cash equivalents and restricted cash | 1,650 | | | (1,080) | |
Cash, cash equivalents and restricted cash at the beginning of the period | 13,305 | | | 12,691 | |
Cash, cash equivalents and restricted cash at the end of the period | $ | 14,955 | | | $ | 11,611 | |
CVS Health Corporation
Condensed Consolidated Statements of Cash Flows
(Unaudited)
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| Three Months Ended March 31, |
In millions | 2023 | | 2022 |
Reconciliation of net income to net cash provided by operating activities: | | | |
Net income | $ | 2,142 | | | $ | 2,355 | |
Adjustments required to reconcile net income to net cash provided by operating activities: | | | |
Depreciation and amortization | 1,001 | | | 1,049 | |
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Stock-based compensation | 103 | | | 89 | |
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Deferred income taxes and other noncash items | 155 | | | (175) | |
Change in operating assets and liabilities, net of effects from acquisitions: | | | |
Accounts receivable, net | (751) | | | (1,967) | |
Inventories | 828 | | | (400) | |
Other assets | (1,255) | | | (348) | |
Accounts payable and pharmacy claims and discounts payable | (1,203) | | | 1,974 | |
Health care costs payable and other insurance liabilities | 4,382 | | | 1,430 | |
Other liabilities | 2,036 | | | (444) | |
Net cash provided by operating activities | $ | 7,438 | | | $ | 3,563 | |
See accompanying notes to condensed consolidated financial statements (unaudited).
CVS Health Corporation
Condensed Consolidated Statements of Shareholders’ Equity
(Unaudited)
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| | | Attributable to CVS Health | | |
| Number of shares outstanding | | Common Stock and Capital Surplus (2) | Treasury Stock (1) | Retained Earnings | Accumulated Other Comprehensive Income (Loss) | Total CVS Health Shareholders’ Equity | Noncontrolling Interests | Total Shareholders’ Equity |
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| Common Shares | Treasury Shares (1) | |
In millions | |
Balance at December 31, 2022 | 1,758 | | (458) | | | $ | 48,193 | | $ | (31,858) | | $ | 56,398 | | $ | (1,264) | | $ | 71,469 | | $ | 300 | | $ | 71,769 | |
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Net income | — | | — | | | — | | — | | 2,136 | | — | | 2,136 | | 6 | | 2,142 | |
Other comprehensive income (Note 9) | — | | — | | | — | | — | | — | | 389 | | 389 | | — | | 389 | |
Stock option activity, stock awards and other | 1 | | — | | | 122 | | — | | — | | — | | 122 | | — | | 122 | |
Purchase of treasury shares, net of ESPP issuances | — | | (22) | | | (18) | | (1,944) | | — | | — | | (1,962) | | — | | (1,962) | |
Common stock dividends | — | | — | | | — | | — | | (781) | | — | | (781) | | — | | (781) | |
Other decreases in noncontrolling interests | — | | — | | | 9 | | — | | — | | — | | 9 | | (108) | | (99) | |
Balance at March 31, 2023 | 1,759 | | (480) | | | $ | 48,306 | | $ | (33,802) | | $ | 57,753 | | $ | (875) | | $ | 71,382 | | $ | 198 | | $ | 71,580 | |
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Balance at December 31, 2021 | 1,744 | | (422) | | | $ | 47,377 | | $ | (28,173) | | $ | 54,906 | | $ | 965 | | $ | 75,075 | | $ | 306 | | $ | 75,381 | |
Adoption of new accounting standard (Note 1) (3) | — | | — | | | — | | — | | 91 | | (631) | | (540) | | — | | (540) | |
Net income | — | | — | | | — | | — | | 2,354 | | — | | 2,354 | | 1 | | 2,355 | |
Other comprehensive loss (Note 9) | — | | — | | | — | | — | | — | | (763) | | (763) | | — | | (763) | |
Stock option activity, stock awards and other | 3 | | — | | | 300 | | — | | — | | — | | 300 | | — | | 300 | |
Purchase of treasury shares, net of ESPP issuances | — | | (19) | | | — | | (1,972) | | — | | — | | (1,972) | | — | | (1,972) | |
Common stock dividends | — | | — | | | — | | — | | (730) | | — | | (730) | | — | | (730) | |
Other increases in noncontrolling interests | — | | — | | | — | | — | | — | | — | | — | | 3 | | 3 | |
Balance at March 31, 2022 | 1,747 | | (441) | | | $ | 47,677 | | $ | (30,145) | | $ | 56,621 | | $ | (429) | | $ | 73,724 | | $ | 310 | | $ | 74,034 | |
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_____________________________________________
(1)Treasury shares include 1 million shares held in trust and treasury stock includes $29 million related to shares held in trust as of March 31, 2023 and 2022 and December 31, 2022 and 2021.
(2)Common stock and capital surplus includes the par value of common stock of $18 million as of March 31, 2023 and December 31, 2022 and $17 million as of March 31, 2022 and December 31, 2021.
(3)Reflects the adoption of Accounting Standards Update (“ASU”) 2018-12, Targeted Improvements to the Accounting for Long-Duration Contracts (Topic 944) during the three months ended March 31, 2023. See Note 1 ‘‘Significant Accounting Policies’’ for additional information.
See accompanying notes to condensed consolidated financial statements (unaudited).
Notes to Condensed Consolidated Financial Statements (Unaudited)
1.Significant Accounting Policies
Description of Business
CVS Health Corporation, together with its subsidiaries (collectively, “CVS Health” or the “Company”), has more than 9,000 retail locations, more than 1,100 walk-in medical clinics, a leading pharmacy benefits manager with over 110 million plan members and expanding specialty pharmacy solutions, and a dedicated senior pharmacy care business serving more than one million patients per year. The Company also serves an estimated 37 million people through traditional, voluntary and consumer-directed health insurance products and related services, including expanding Medicare Advantage offerings and a leading standalone Medicare Part D prescription drug plan (“PDP”). The Company is a leader in key segments of health care through its foundational businesses and is creating new sources of value by expanding into next generation care delivery and health services, with a goal of improving satisfaction levels for both providers and consumers. The Company believes its integrated health care model increases access to quality care, delivers better health outcomes and lowers overall health care costs.
In connection with its new operating model adopted in the first quarter of 2023, the Company realigned the composition of its segments to reflect how its Chief Operating Decision Maker (the “CODM”) reviews information and manages the business. As a result of this realignment, the Company formed a new Health Services segment, which in addition to providing a full range of pharmacy benefit management (“PBM”) solutions, also delivers health care services in the Company’s medical clinics, virtually, and in the home, as well as provider enablement solutions. In addition, the Company created a new Pharmacy & Consumer Wellness segment, which includes its retail and long-term care pharmacy operations and related pharmacy services, as well as its retail front store operations. This segment will also provide pharmacy fulfillment services to support the Health Services segment’s specialty and mail order pharmacy offerings. Prior period segment financial information has been recast to conform with the current period presentation.
Following the segment realignment described above, the Company’s four reportable segments are as follows: Health Care Benefits, Health Services, Pharmacy & Consumer Wellness and Corporate/Other, which are described below.
Health Care Benefits Segment
The Health Care Benefits segment operates as one of the nation’s leading diversified health care benefits providers. The Health Care Benefits segment has the information and resources to help members, in consultation with their health care professionals, make more informed decisions about their health care. The Health Care Benefits segment offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, medical management capabilities, Medicare Advantage and Medicare Supplement plans, PDPs and Medicaid health care management services. The Health Care Benefits segment’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers (“providers”), governmental units, government-sponsored plans, labor groups and expatriates. The Company refers to insurance products (where it assumes all or a majority of the risk for medical and dental care costs) as “Insured” and administrative services contract products (where the plan sponsor assumes all or a majority of the risk for medical and dental care costs) as “ASC.” In addition, effective January 2022, the Company entered the individual public health insurance exchanges (“Public Exchanges”) in eight states through which it sells Insured plans directly to individual consumers. The Company entered Public Exchanges in four additional states effective January 2023.
Health Services Segment
The Health Services segment provides a full range of PBM solutions, delivers health care services in its medical clinics, virtually, and in the home, and offers provider enablement solutions. PBM solutions include plan design offerings and administration, formulary management, retail pharmacy network management services, and specialty and mail order pharmacy services. In addition, the Company provides clinical services, disease management services, medical spend management and pharmacy and/or other administrative services for providers and federal 340B drug pricing program covered entities (“Covered Entities”). The Company operates a group purchasing organization that negotiates pricing for the purchase of pharmaceuticals and rebates with pharmaceutical manufacturers on behalf of its participants and provides various administrative, management and reporting services to pharmaceutical manufacturers. The Health Services segment’s clients are primarily employers, insurance companies, unions, government employee groups, health plans, PDPs, Medicaid managed care plans, plans offered on Public Exchanges and private health insurance exchanges, other sponsors of health benefit plans throughout the United States and Covered Entities.
Pharmacy & Consumer Wellness Segment
The Pharmacy & Consumer Wellness segment dispenses prescriptions in its retail pharmacies and through its infusion operations, provides ancillary pharmacy services including pharmacy patient care programs, diagnostic testing and vaccination administration, and sells a wide assortment of health and wellness products and general merchandise. The segment also conducts long-term care pharmacy (“LTC”) operations, which distribute prescription drugs and provide related pharmacy consulting and ancillary services to long-term care facilities and other care settings, and provides pharmacy fulfillment services to support the Health Services segment’s specialty and mail order pharmacy offerings. As of March 31, 2023, the Pharmacy & Consumer Wellness segment operated more than 9,000 retail locations, as well as online retail pharmacy websites, LTC pharmacies and on-site pharmacies, retail specialty pharmacy stores, compounding pharmacies and branches for infusion and enteral nutrition services.
Corporate/Other Segment
The Company presents the remainder of its financial results in the Corporate/Other segment, which primarily consists of:
•Management and administrative expenses to support the Company’s overall operations, which include certain aspects of executive management and the corporate relations, legal, compliance, human resources, information technology and finance departments, expenses associated with the Company’s investments in its transformation and enterprise modernization programs and acquisition-related transaction and integration costs; and
•Products for which the Company no longer solicits or accepts new customers such as its large case pensions and long-term care insurance products.
Basis of Presentation
The accompanying unaudited condensed consolidated financial statements of CVS Health and its subsidiaries have been prepared in accordance with the rules and regulations of the U.S. Securities and Exchange Commission (the “SEC”) regarding interim financial reporting. In accordance with such rules and regulations, certain information and accompanying note disclosures normally included in financial statements prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) have been omitted, although the Company believes the disclosures included herein are adequate to make the information presented not misleading. These unaudited condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto, which are included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2022 (the “2022 Form 10-K”).
In the opinion of management, the accompanying unaudited condensed consolidated financial statements include all adjustments, consisting only of normal recurring adjustments, necessary for a fair presentation of the results for the interim periods presented. Because of the influence of various factors on the Company’s operations, including business combinations, certain holidays and other seasonal influences, net income for any interim period may not be comparable to the same interim period in previous years or necessarily indicative of income for the full year.
Principles of Consolidation
The unaudited condensed consolidated financial statements include the accounts of the Company and its majority-owned subsidiaries and variable interest entities (“VIEs”) for which the Company is the primary beneficiary. All material intercompany balances and transactions have been eliminated.
The Company continually evaluates its investments to determine if they represent variable interests in a VIE. If the Company determines that it has a variable interest in a VIE, the Company then evaluates if it is the primary beneficiary of the VIE. The evaluation is a qualitative assessment as to whether the Company has the ability to direct the activities of a VIE that most significantly impact the entity’s economic performance. The Company consolidates a VIE if it is considered to be the primary beneficiary.
Assets and liabilities of VIEs for which the Company is the primary beneficiary were not significant to the Company’s unaudited condensed consolidated financial statements. VIE creditors do not have recourse against the general credit of the Company.
Reclassifications
Certain prior year amounts have been reclassified to conform with the current year presentation.
Restricted Cash
Restricted cash included in other current assets on the unaudited condensed consolidated balance sheets primarily represents funds held on behalf of members and funds held in escrow in connection with agreements with accountable care organizations.
Restricted cash included in other assets on the unaudited condensed consolidated balance sheets represents amounts held in a trust in one of the Company’s captive insurance companies to satisfy collateral requirements associated with the assignment of certain insurance policies.
All restricted cash is invested in demand deposits, time deposits and money market funds.
The following is a reconciliation of cash and cash equivalents on the unaudited condensed consolidated balance sheets to total cash, cash equivalents and restricted cash on the unaudited condensed consolidated statements of cash flows:
| | | | | | | | | | | |
In millions | March 31, 2023 | | December 31, 2022 |
Cash and cash equivalents | $ | 14,618 | | | $ | 12,945 | |
Restricted cash (included in other current assets) | 107 | | | 144 | |
Restricted cash (included in other assets) | 230 | | | 216 | |
Total cash, cash equivalents and restricted cash in the statements of cash flows | $ | 14,955 | | | $ | 13,305 | |
Accounts Receivable
Accounts receivable are stated net of allowances for credit losses, customer credit allowances, contractual allowances and estimated terminations. Accounts receivable, net at March 31, 2023 and December 31, 2022 was composed of the following:
| | | | | | | | | | | |
In millions | March 31, 2023 | | December 31, 2022 |
Trade receivables | $ | 9,229 | | | $ | 8,983 | |
Vendor and manufacturer receivables | 13,357 | | | 12,395 | |
Premium receivables | 3,636 | | | 2,676 | |
Other receivables | 2,320 | | | 3,449 | |
Total accounts receivable, net (1) | $ | 28,542 | | | $ | 27,503 | |
_____________________________________________
(1)Includes accounts receivable of $211 million and $227 million which have been accounted for as assets held for sale and are included in assets held for sale on the unaudited condensed consolidated balance sheets at March 31, 2023 and December 31, 2022, respectively. See Note 2 ‘‘Acquisitions and Assets Held for Sale’’ for additional information.
The Company’s allowance for credit losses was $324 million and $333 million as of March 31, 2023 and December 31, 2022, respectively. When developing an estimate of the Company’s expected credit losses, the Company considers all available relevant information regarding the collectability of cash flows, including historical information, current conditions and reasonable and supportable forecasts of future economic conditions over the contractual life of the receivable. The Company’s accounts receivable are short duration in nature and typically settle in less than 30 days.
Health Care Contract Acquisition Costs
Insurance products included in the Health Care Benefits segment are cancellable by either the customer or the member monthly upon written notice. Acquisition costs related to prepaid health care and health indemnity contracts are generally expensed as incurred. For certain long-duration insurance contracts, acquisition costs directly related to the successful acquisition of a new or renewal insurance contract, including commissions, are deferred and are recorded as other current assets or other assets on the unaudited condensed consolidated balance sheets. Contracts are grouped by product and issue year into cohorts consistent with the grouping used in estimating the associated liability and are amortized on a constant level basis based on the remaining in-force policies over the estimated term of the contracts to approximate straight-line amortization. Changes to the Company’s assumptions, including assumptions related to persistency, are reflected at the cohort level at the time of change and are recognized prospectively over the estimated terms of the contract. The amortization of deferred acquisition costs is recorded in operating expenses in the unaudited condensed consolidated statements of operations.
The following is a roll forward of deferred acquisition costs for the three months ended March 31, 2023 and 2022:
| | | | | | | | | | | |
| Three Months Ended March 31, |
In millions | 2023 | | 2022 |
Deferred acquisition costs, beginning of the period | $ | 1,219 | | $ | 879 |
Capitalizations | 135 | | 139 |
Amortization expense | (64) | | (47) |
| | | |
Deferred acquisition costs, end of the period | $ | 1,290 | | $ | 971 |
Goodwill
The Company accounts for business combinations using the acquisition method of accounting, which requires the excess cost of an acquisition over the fair value of net assets acquired and identifiable intangible assets to be recorded as goodwill. Goodwill is not amortized, but is subject to impairment reviews annually, or more frequently, if necessary.
Intangible Assets
The Company’s identifiable intangible assets consist primarily of trademarks, trade names, customer contracts/relationships, covenants not to compete, technology, provider networks and value of business acquired (“VOBA”). These intangible assets arise primarily from the determination of their respective fair market values at the date of acquisition. Amounts assigned to identifiable intangible assets, and their related useful lives, are derived from established valuation techniques and management estimates.
The Company’s definite-lived intangible assets are amortized over their estimated useful lives based upon the pattern of future cash flows attributable to the asset. Definite-lived intangible assets are amortized using the straight-line method. VOBA is subject to loss recognition testing annually, or more frequently, if necessary.
Indefinite lived intangible assets are not amortized but are tested for impairment annually, or more frequently, if necessary.
Separate Accounts
Separate Accounts assets and liabilities related to large case pensions products represent funds maintained to meet specific objectives of contract holders who bear the investment risk. These assets and liabilities are carried at fair value. Net investment income (including net realized capital gains and losses) accrue directly to such contract holders. The assets of each account are legally segregated and are not subject to claims arising from the Company’s other businesses. Deposits, withdrawals and net investment income (including net realized and net unrealized capital gains and losses) on Separate Accounts assets are not reflected in the unaudited condensed consolidated statements of operations or cash flows. Management fees charged to contract holders are included in services revenue and recognized over the period earned.
See Note 4 ‘‘Fair Value’’ and Note 6 ‘‘Other Insurance Liabilities and Separate Accounts’’ for additional information about separate accounts.
Future Policy Benefits
Future policy benefits consist primarily of reserves for products for which the Company no longer solicits or accepts new customers, including limited payment pension and annuity contracts and long-term care insurance contracts and are recorded in other insurance liabilities and other long-term liabilities on the unaudited condensed consolidated balance sheets. Contracts are grouped into cohorts by contract type and issue year. The liability for future policy benefits is adjusted for differences between actual and expected experience.
Reserves for limited payment pension and annuity contracts represent the Company’s estimate of the present value of future benefits to be paid to or on behalf of policyholders and are computed using actuarial principles that consider, among other things, assumptions reflecting anticipated mortality and retirement experience. On an annual basis, or more frequently if necessary, the Company reviews mortality assumptions against both industry standards and its experience.
Reserves for long-term care insurance contracts represent the Company’s estimate of the present value of future benefits and settlement costs to be paid to or on behalf of policyholders less the present value of future net premiums. The Company’s
estimate of the present value of future benefits under such contracts is based upon mortality, morbidity, lapse and interest rate assumptions. On an annual basis, or more frequently if necessary, the Company reviews its mortality, morbidity and lapse assumptions against its experience. Annually, or each time the assumptions are changed, the net premium ratio used to calculate the future policy benefit liability is updated to reflect actual experience, as well as the impact of any change in assumptions on the Company’s future cash flows.
The Company discounts its future policy benefit liability using a curve of spot rates derived from an upper-medium grade fixed-income investment. At each reporting date, the Company will measure its liability for future policy benefits using both the current spot rate curve and the locked-in discount rate at each cohort’s inception. Any difference between the measured liabilities is recorded in other comprehensive income (loss). In subsequent periods, the current period amount recorded in other comprehensive income (loss) will be adjusted for amounts previously recorded in accumulated other comprehensive loss.
As of March 31, 2023, future policy benefits balances of $529 million and $4.6 billion were recorded in other insurance liabilities and other long-term insurance liabilities, respectively. As of December 31, 2022, future policy benefits balances of $334 million and $4.7 billion were recorded in other insurance liabilities and other long-term insurance liabilities, respectively.
See Note 6 ‘‘Other Insurance Liabilities and Separate Accounts’’ for additional information about future policy benefits.
Revenue Recognition
Disaggregation of Revenue
The following table disaggregates the Company’s revenue by major source in each segment for the three months ended March 31, 2023 and 2022:
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
In millions | Health Care Benefits | | Health Services | | Pharmacy & Consumer Wellness | | Corporate/ Other | | Intersegment Eliminations | | Consolidated Totals |
Three Months Ended March 31, 2023 | | | | | | | | |
Major goods/services lines: | | | | | | | | | | | |
Pharmacy | $ | — | | | $ | 43,737 | | | $ | 21,495 | | | $ | — | | | $ | (12,732) | | | $ | 52,500 | |
Front Store | — | | | — | | | 5,597 | | | — | | | — | | | 5,597 | |
Premiums | 24,339 | | | — | | | — | | | 13 | | | — | | | 24,352 | |
Net investment income (loss) | 164 | | | — | | | (3) | | | 173 | | | — | | | 334 | |
Other | 1,374 | | | 854 | | | 833 | | | 2 | | | (568) | | | 2,495 | |
Total | $ | 25,877 | | | $ | 44,591 | | | $ | 27,922 | | | $ | 188 | | | $ | (13,300) | | | $ | 85,278 | |
| | | | | | | | | | | |
Health Services distribution channel: | | | | | | | | |
Pharmacy network (1) | | | $ | 27,592 | | | | | | | | | |
Mail & specialty (2) | | | 16,145 | | | | | | | | | |
Other | | | 854 | | | | | | | | | |
Total | | | $ | 44,591 | | | | | | | | | |
| | | | | | | | | | | |
Three Months Ended March 31, 2022 | | | | | | | | |
Major goods/services lines: | | | | | | | | | | | |
Pharmacy | $ | — | | | $ | 38,796 | | | $ | 19,532 | | | $ | — | | | $ | (11,276) | | | $ | 47,052 | |
Front Store | — | | | — | | | 5,313 | | | — | | | — | | | 5,313 | |
Premiums | 21,614 | | | — | | | — | | | 17 | | | — | | | 21,631 | |
Net investment income (loss) | 89 | | | — | | | (16) | | | 95 | | | — | | | 168 | |
Other | 1,391 | | | 819 | | | 1,069 | | | 14 | | | (631) | | | 2,662 | |
Total | $ | 23,094 | | | $ | 39,615 | | | $ | 25,898 | | | $ | |