8-K
false 0001156039 0001156039 2020-07-29 2020-07-29

 

 

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): July 29, 2020

 

 

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   NYSE

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 July 29, 2020, Anthem, Inc. issued a press release reporting its financial results for the quarter ended June 30, 2020. 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 July 29, 2020, reporting Anthem, Inc. financial results for the quarter ended June 30, 2020.
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 large scale medical emergencies, such as public health epidemics and pandemics, including COVID-19, and catastrophes; trends in healthcare costs and utilization rates; our ability to secure sufficient premium rates, including regulatory approval for and implementation of such rates; 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; changes in economic and market conditions, as well as regulations that may negatively affect our liquidity and investment portfolios; our ability to contract with providers on cost-effective and competitive terms; 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 and us related to the merger agreement between the parties and the potential for such litigation to cause us to incur substantial additional costs, including potential settlement and judgment costs; risks and uncertainties related to our pharmacy benefit management, or PBM, business including non-compliance by any party with the PBM services agreement between us and CaremarkPCS Health, L.L.C.; medical malpractice or professional liability claims or other risks related to healthcare and PBM services provided by our subsidiaries; 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; 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; the impact of international laws and regulations; 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: July 29, 2020

 

ANTHEM, INC.
By:  

/s/ Kathleen S. Kiefer

Name:   Kathleen S. Kiefer
Title:   Corporate Secretary
EX-99.1

Exhibit 99.1

 

LOGO

ANTHEM REPORTS SECOND QUARTER RESULTS

REAFFIRMS COMMITMENT TO STAKEHOLDERS

DURING COVID-19 PANDEMIC

Indianapolis, Ind. - July 29, 2020 - Against the backdrop of the ongoing pandemic, Anthem, Inc. (NYSE: ANTM) has continued to take bold steps to directly support its health plan members, customers, care providers, associates, and local communities.

“During these uncertain times, our business has continued to adapt and respond to the needs of those we serve in light of COVID-19 and the important discussions around health disparities and racial injustice facing our society. Now more than ever, our members, customers, and local communities are looking to us for support and I am honored by the trust they have placed in us,” said President and CEO Gail K. Boudreaux. “Together, with our more than 78,000 associates, Anthem is guided by our mission of improving lives and building a better and healthier America.”

Anthem has been, and always will be, deeply connected and committed to our local communities. In addition to providing $2.5 billion of financial assistance to ease the burden of the COVID-19 pandemic, Anthem pledged $50 million over the next five years to focus directly on addressing health disparities, racial inequities, and the key drivers of health such as food insecurity, mental health, housing, and economic recovery.

As part of Anthem’s efforts to combat the global pandemic, address health inequities, and adapt to the ever-changing healthcare environment, the Company has remained focused on fostering deeper relationships and developing innovative solutions to meet critical needs for its stakeholders. Actions taken to support our members, customers, care providers and local communities include:

 

1


Care for our Anthem associates

 

  Deployed business continuity plans and transitioned nearly all of our associates to work from home while maintaining service operations.

 

  Waived one month of premium costs for associates enrolled in an Anthem health plan.

 

  Expanded associate benefits to provide additional support, including providing up to 80 hours of additional paid leave, reimbursement of installation and monthly internet service fees for hourly associates, and offering virtual wellbeing resources.

 

  Ensuring our frontline medical staff are following CDC guidelines and are provided with the proper equipment and supplies to minimize risk to themselves and patients.

Care for our consumers, customers, and providers

 

  Waived all cost-sharing for COVID-19 diagnostic tests and treatment through December 31, 2020.

 

  Increased access to virtual care and waived cost-sharing for telehealth and phone visits, including those for mental health, through September 30, 2020.

 

  Relaxed early prescription refill policies for maintenance and specialty medications.

 

  Provided a one-month premium credit to members enrolled in select individual plans and fully insured employer group customers ranging from 10 to 15 percent of monthly premium.

 

  Provided a one-month 50 percent premium credit to individuals in standalone and group dental plans.

 

  Offering enhanced flexibility with regard to premium payments to eligible employer groups.

 

  Working with providers to accelerate claims processing, resolving claims, and accelerating payments to support state-specific Medicaid programs.

 

  Providing financial assistance to care provider partners facing undue financial pressure and to support ramping up telehealth capabilities and the cost of PPE.

 

  Offering in-network dental providers a $10 PPE credit per patient, per visit through the end of August 2020.
  Suspended select prior authorization requirements.

 

  Deployed C19 Explorer, a digital tool that aggregates real-time COVID-19 data to present trends and predictions for communities across the nation to assess readiness to reopen, plan next steps, and respond to potential changes.

 

  Deployed C19 Navigator, a dashboard solution designed for Anthem employer customers to help inform workplace decisions and resource planning with employee-level data.

 

  Launched Passport, powered by doc.ai, an app that empowers employers to minimize risk and support safer entry into the workplace by verifying their employees’ health status. The app evaluates possible COVID-19 symptoms through daily attestations.

 

  Opened hundreds of digital solutions kiosks in health centers across California to provide real-time video interpretation services and access to telehealth.

 

  Introduced the Anthem Skill to members of our commercial medical and dental health plans. Through an Alexa-enabled device, members can use the Anthem Skill to take actions such as order prescriptions and quickly access some of their health and dental plan benefit information.

 

  Deployed a Coronavirus Assessment tool within our Sydney Care app to help people quickly and safely evaluate symptoms, assess their risk of having COVID-19, and connect directly to a board-certified doctor via text or video.

 

  Deployed Serenity, a free chatbot companion offered by doc.ai, providing expert and confidential mental health counseling through AI.

 

  Facilitating connections with Medicaid beneficiaries and state and social services, helping newly eligible and at risk members enroll in the Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

 

  Outreach to Medicare Advantage and Medicaid consumers to make sure they have necessary medications on hand, their nutritional needs are being met, and critical health needs are addressed.

 

  Recruiting and expediting the onboarding of care providers interested in providing telehealth services to members.

 

  Providing resources to support the whole health needs of members, including resources to manage social isolation, job loss, food insecurity and stress.
 

 

2


Care for our communities

 

  Committed $50 million from the Anthem Foundation for COVID-19 response and recovery efforts to help areas of greatest need, including care provider safety, food insecurity, and mental and behavioral health resources.

 

  In collaboration with Gleaners Food Bank, we are working to provide more than 10 million meals in our home city of Indianapolis by providing a $1 million matching grant to fight food insecurity and expand access to nutritious food.

 

  Partnered with NYC-based Coalition of Asian-American IPA, an independent practice association with over 1,000 private practice providers, to provide free mobile testing across NYC while increasing access to testing in many other markets across the U.S.

 

  Partnered with ConvenientMD to provide drive-up testing services in Maine and New Hampshire.

 

  Providing virtual volunteer opportunities, such as remote teaching or mailing cards to seniors facing loneliness, to help associates safely give back to communities.

 

  Provided funding to support COVID-19 testing infrastructure for community health centers in Ohio.

 

  Contributed $1 million to the newly created Rapid Response Loan Fund established by the Indianapolis Chamber of Commerce to provide critical funding for nearly 43 thousand small businesses in Central Indiana.
  Anthem and the Anthem Foundation are founding anchor partners of XPRIZE Rapid COVID Testing, a collaboration with XPRIZE, OpenCovidScreen, and other Blue Cross and Blue Shield plans and innovative organizations to launch a $5 million competition to accelerate the development of high-quality COVID-19 testing that is low cost, easy to use, and quick-reporting, paving the way for more frequent testing.

Additional actions to support society

 

  Pledged $50 million over the next 5 years focused on directly impacting racial injustice, strengthening our communities, and addressing health inequities.

 

  Contributed to the Central Indiana Racial Equity Fund in support of organizations focused on having difficult conversations about Indiana’s and the Nation’s complicated past; building additional capacity within the nonprofit sector to address issues of inequality, in particular relating to the criminal justice system; and advancing effective, data-driven solutions at the local level.

 

  Joined the UN Global Compact (UNGC), the world’s largest corporate sustainability initiative and a call to companies to align with universal principles on human rights, labor, environment, and anti-corruption, and take actions that advance societal roles.
 

 

3


CONSOLIDATED HIGHLIGHTS

Earnings Per Share: GAAP net income was $8.91 per share in the quarter, including net negative adjustment items of $0.29 per share. Adjusted net income was $9.20* per share.

*Please refer to the GAAP reconciliation tables on page 17.

Membership: Medical enrollment totaled 42.5 million members at June 30, 2020, an increase of 309 thousand lives, or 0.7 percent, compared to March 31, 2020. The increase was driven by our Government Business, which grew by 599 thousand lives during the quarter, attributable to Medicaid, reflecting organic growth as a result of the temporary suspension of eligibility recertification efforts in our markets, and Medicare Advantage. The increase was partially offset by Commercial & Specialty Business enrollment, which declined by 290 thousand lives driven by higher in-group change as a result of the higher unemployment rate.

Medical enrollment increased by 1.6 million lives, or 3.9 percent compared to the prior year quarter, reflecting growth in the Medicaid, National, and Medicare businesses. Growth in Medicaid was driven by organic growth in our markets as well as our acquisition of the plans in Missouri and Nebraska. The increase in National enrollment reflects growth due to higher BlueCard activity and the acquisition of AmeriBen in the first quarter of 2020.

Operating Revenue: Operating revenue was $29.2 billion in the second quarter of 2020, an increase of $4 billion, or 15.9 percent, versus the prior year quarter, driven by pharmacy product revenue related to the launch of IngenioRx. The increase was further attributable to higher premium revenue due to growth in Medicaid and Medicare and the return of the health insurance tax in 2020, partially offset by a decrease in experience-rated premiums in our Federal Health Products & Services business.

Benefit Expense Ratio: The benefit expense ratio was 77.9 percent in the second quarter of 2020, a decrease of 880 basis points from 86.7 percent in the prior year quarter. The decrease was primarily driven by the deferral of healthcare utilization due to the COVID-19 pandemic, and to a lesser extent, the return of the health insurance tax in 2020. The decrease was partially offset by premium credits provided to members enrolled in select employer group and Individual plans.

Medical claims reserves established at December 31, 2019 developed in line with the Company’s expectations during the second quarter of 2020.

Days in Claims Payable: Days in Claims Payable was 46.0 days as of June 30, 2020, an increase of 4.1 days from March 31, 2020.

SG&A Expense Ratio: The SG&A expense ratio was 13.9 percent in the second quarter of 2020, an increase of 90 basis points from 13.0 percent in the second quarter of 2019, primarily driven by the return of the health insurance tax in 2020 and increased spend to support growth, partially offset by growth in operating revenue.

Operating Cash Flow: Operating cash flow was $5.5 billion, or 2.4 times net income in the second quarter of 2020, an increase of $4.1 billion compared to the prior year quarter, primarily driven by growth in net income and the delayed payment of certain federal income and payroll taxes in accordance with the CARES Act. The increase was further attributable to growth in premium revenue due to the return of the health insurance tax in 2020.

Share Repurchase Program: After careful consideration of the Company’s financial position in conjunction with the prevailing market conditions, share repurchase activity resumed in late-June.

 

4


During the second quarter of 2020, the Company repurchased 213 thousand shares of its common stock for $55 million, or a weighted average price of $258.77. Year to date, the Company has repurchased 2.1 million shares for $584 million, or a weighted average price of $273.72.

As of June 30, 2020, the Company had approximately $3.2 billion of Board-approved share repurchase authorization remaining.

Cash Dividend: During the second quarter of 2020, the Company paid a quarterly dividend of $0.95 per share, representing a distribution of cash totaling $242 million.

On July 28, 2020, the Audit Committee declared a third quarter 2020 dividend to shareholders of $0.95 per share. On an annualized basis, this equates to a dividend of $3.80 per share. The third quarter dividend is payable on September 25, 2020 to shareholders of record at the close of business on September 10, 2020.

Investment Portfolio & Capital Position: During the second quarter of 2020, the Company recorded net realized gains of $18 million and impairment recoveries totaling $11 million. During the second quarter of 2019, the Company recorded net realized gains of $11 million and impairment losses totaling $7 million.

As of June 30, 2020, the Company’s net unrealized loss position in the investment portfolio was $713 million, consisting of fixed maturity securities. As of June 30, 2020 cash and investments at the parent company totaled approximately $4.1 billion.

 

5


REPORTABLE SEGMENTS

Effective January 1, 2020, Anthem, Inc. has four 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); IngenioRx, and Other (comprised of 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 June 30     Six Months Ended June 30  
     2020     2019     Change     2020     2019     Change  

Operating Revenue

            

Commercial & Specialty Business

   $ 8,789     $ 9,417       (6.7 )%    $ 18,150     $ 18,809       (3.5 )% 

Government Business

     17,242       15,538       11.0     34,708       30,464       13.9

IngenioRx

     5,269       248       NM 2      10,466       248       NM 2 

Other

     1,452       546       165.9     2,479       1,094       126.6

Eliminations

     (3,574     (572     NM 2      (7,177     (1,050     NM 2 
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total Operating Revenue1

   $ 29,178     $ 25,177       15.9   $ 58,626     $ 49,565       18.3

Operating Gain / (Loss)

            

Commercial & Specialty Business

   $ 1,372     $ 983       39.6   $ 2,792     $ 2,581       8.2

Government Business

     1,618       480       237.1     2,029       854       137.6

IngenioRx

     304       —         NM 2      653       —         NM 2 

Other

     66       (30     NM 2      80       (62     NM 2 
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total Operating Gain1

   $ 3,360     $ 1,433       134.5   $ 5,554     $ 3,373       64.7

Operating Margin

            

Commercial & Specialty Business

     15.6     10.4     520 bp       15.4     13.7     170 bp  

Government Business

     9.4     3.1     630 bp       5.8     2.8     300 bp  

IngenioRx

     5.8     —         NM 2      6.2     —       NM 2 

Total Operating Margin1

     11.5     5.7     580 bp       9.5     6.8     270 bp  

 

(1)

See “Basis of Presentation” on page 9 herein.

(2)

“NM” = calculation not meaningful.

Commercial & Specialty Business: Operating gain in the Commercial & Specialty Business segment totaled $1,372 million in the second quarter of 2020, an increase of $389 million, or 39.6 percent, from $983 million in the second quarter of 2019. The increase is primarily attributable to reduced healthcare benefit utilization during the COVID-19 pandemic. The increase was partially offset by premium credits provided to members enrolled in select employer group and Individual health plans, less favorable adjustments to our risk adjustor estimates, as well as the shift of pharmacy earnings to the IngenioRx segment.

Government Business: Operating gain in the Government Business segment was $1,618 million in the second quarter of 2020, an increase of $1,138 million, or 237.1 percent, from $480 million in the second quarter of 2019. The increase is primarily attributable to reduced healthcare benefit utilization during the COVID-19 pandemic, partially offset by experience-rated refunds and retroactive rate adjustments in Medicaid.

 

6


IngenioRx: IngenioRx commenced operations in the second quarter of 2019 and the transition of membership was completed on January 1, 2020. Operating gain was $304 million in the second quarter of 2020.

Other: The Company reported an operating gain of $66 million in the Other segment for the second quarter of 2020, compared with an operating loss of $30 million in the prior year quarter. The increase was driven by growth in the Diversified Business Group.

 

7


OUTLOOK

Full Year 2020:

 

   

GAAP net income is expected to be greater than $20.91 per share, including approximately $1.39 per share of net unfavorable items. Excluding these items, adjusted net income is expected to be greater than $22.30* per share.

Due to unprecedented uncertainty around the COVID-19 pandemic and its impact, the Company is not providing other financial guidance metrics for 2020 until visibility improves.

 

*

Refer to the GAAP reconciliation tables on page 17.

 

8


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

 

800-857-9605 (Domestic)    800-568-6411 (Domestic Replay)
203-827-7032 (International)    203-369-3291 (International Replay)

The access code for today’s conference call is 1623092. The replay will be available from 11:30 a.m. EDT today, until the end of the day on August 29, 2020. 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

 

9


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 106 million people, including more than 42 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.

 

10


Anthem, Inc.

Membership Summary

(Unaudited and in Thousands)

 

                          Change from  

Medical Membership

   June 30,
2020
     June 30,
2019
     March 31,
2020
     June 30,
2019
     March 31,
2020
 

Customer Type

              

Local Group

     15,616        15,670        15,848        (0.3)%        (1.5)%  

Individual

     711        741        717        (4.0)%        (0.8)%  

National:

              

National Accounts

     7,872        7,693        7,898        2.3%        (0.3)%  

BlueCard®

     6,171        6,009        6,197        2.7%        (0.4)%  
  

 

 

    

 

 

    

 

 

       

Total National

     14,043        13,702        14,095        2.5%        (0.4)%  

Medicare:

              

Medicare Advantage

     1,366        1,170        1,341        16.8%        1.9%  

Medicare Supplement

     921        877        914        5.0%        0.8%  
  

 

 

    

 

 

    

 

 

       

Total Medicare

     2,287        2,047        2,255        11.7%        1.4%  

Medicaid

     8,180        7,099        7,615        15.2%        7.4%  

Federal Employees Health Benefits

     1,616        1,593        1,614        1.4%        0.1%  
  

 

 

    

 

 

    

 

 

       

Total Medical Membership

     42,453        40,852        42,144        3.9%        0.7%  
  

 

 

    

 

 

    

 

 

       

Funding Arrangement

              

Self-Funded

     25,888        25,433        26,120        1.8%        (0.9)%  

Fully-Insured

     16,565        15,419        16,024        7.4%        3.4%  
  

 

 

    

 

 

    

 

 

       

Total Medical Membership

     42,453        40,852        42,144        3.9%        0.7%  
  

 

 

    

 

 

    

 

 

       

Reportable Segment

              

Commercial & Specialty Business

     30,370        30,113        30,660        0.9%        (0.9)%  

Government Business

     12,083        10,739        11,484        12.5%        5.2%  
  

 

 

    

 

 

    

 

 

       

Total Medical Membership

     42,453        40,852        42,144        3.9%        0.7%  
  

 

 

    

 

 

    

 

 

       

Other Membership

              

Life and Disability Members

     5,110        4,906        5,158        4.2%        (0.9)%  

Dental Members

     6,096        5,931        6,172        2.8%        (1.2)%  

Dental Administration Members

     1,318        5,523        1,311        (76.1)%        0.5%  

Vision Members

     7,457        7,161        7,510        4.1%        (0.7)%  

Medicare Part D Standalone Members

     392        287        383        36.6%        2.3%  

 

11


Anthem, Inc.

Consolidated Statements of Income

(Unaudited)

 

(In millions, except per share data)    Three Months Ended
June 30
       
     2020      2019     Change  

Revenues

       

Premiums

   $ 25,092      $ 23,501       6.8%  

Product revenue

     2,543        144       NM  

Administrative fees and other revenue

     1,543        1,532       0.7%  
  

 

 

    

 

 

   

Total operating revenue

     29,178        25,177       15.9%  

Net investment income

     57        285       (80.0)%  

Net realized gains on financial instruments

     18        11       63.6%  

Impairment recoveries (losses) on investments:

       

Total impairment recoveries (losses) on investments

     6        (9     NM  

Portion of impairment losses recognized in other comprehensive income

     5        2       150.0%  
  

 

 

    

 

 

   

Impairment recoveries (losses) recognized in income

     11        (7     NM  
  

 

 

    

 

 

   

Total revenues

     29,264        25,466       14.9%  

Expenses

       

Benefit expense

     19,547        20,368       (4.0)%  

Cost of products sold

     2,225        98       NM  

Selling, general and administrative expense

     4,046        3,278       23.4%  

Interest expense

     201        184       9.2%  

Amortization of other intangible assets

     93        85       9.4%  

Loss on extinguishment of debt

     3        —         NM  
  

 

 

    

 

 

   

Total expenses

     26,115        24,013       8.8%  
  

 

 

    

 

 

   

Income before income tax expense

     3,149        1,453       116.7%  

Income tax expense

     873        314       178.0%  
  

 

 

    

 

 

   

Net income

   $ 2,276      $ 1,139       99.8%  
  

 

 

    

 

 

   

Net income per diluted share

   $ 8.91      $ 4.36       104.4%  
  

 

 

    

 

 

   

Diluted shares

     255.4        261.0       (2.1)%  

Benefit expense as a percentage of premiums

     77.9%        86.7%       (880)bp  

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

     13.9%        13.0%       90bp  

Income before income taxes as a percentage of total revenue

     10.8%        5.7%       510bp  

“NM” = calculation not meaningful

 

12


Anthem, Inc.

Consolidated Statements of Income

 

(Unaudited)

 

(In millions, except per share data)    Six Months Ended
June 30
       
     2020     2019     Change  

Revenues

      

Premiums

   $ 50,609     $ 46,344       9.2%  

Product revenue

     4,887       144       NM  

Administrative fees and other revenue

     3,130       3,077       1.7%  
  

 

 

   

 

 

   

Total operating revenue

     58,626       49,565       18.3%  

Net investment income

     311       495       (37.2)%  

Net realized (losses) gains on financial instruments

     (6     89       NM  

Impairment losses on investments:

      

Total impairment losses on investments

     (95     (22     NM  

Portion of impairment losses recognized in other comprehensive income

     49       5       880.0%  
  

 

 

   

 

 

   

Impairment losses recognized in income

     (46     (17     NM  
  

 

 

   

 

 

   

Total revenues

     58,885       50,132       17.5%  

Expenses

      

Benefit expense

     41,036       39,650       3.5%  

Cost of products sold

     4,209       98       NM  

Selling, general and administrative expense

     7,827       6,444       21.5%  

Interest expense

     395       371       6.5%  

Amortization of other intangible assets

     176       172       2.3%  

Loss (gain) on extinguishment of debt

     4       (1     NM  
  

 

 

   

 

 

   

Total expenses

     53,647       46,734       14.8%  
  

 

 

   

 

 

   

Income before income tax expense

     5,238       3,398       54.1%  

Income tax expense

     1,439       708       103.2%  
  

 

 

   

 

 

   

Net income

   $ 3,799     $ 2,690       41.2%  
  

 

 

   

 

 

   

Net income per diluted share

   $ 14.85     $ 10.28       44.5%  
  

 

 

   

 

 

   

Diluted shares

     255.9       261.6       (2.2)%  

Benefit expense as a percentage of premiums

     81.1%       85.6%       (450)bp  

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

     13.4%       13.0%       40bp  

Income before income taxes as a percentage of total revenue

     8.9%       6.8%       210bp  

“NM” = calculation not meaningful

 

13


Anthem, Inc.

Consolidated Balance Sheets

 

(In millions)    June 30,
2020
    December 31,
2019
 
     (Unaudited)        

Assets

    

Current assets:

    

Cash and cash equivalents

   $ 6,028     $ 4,937  

Fixed maturity securities, current

     22,018       19,676  

Equity securities, current

     3,470       1,009  

Premium receivables

     5,456       5,014  

Self-funded receivables

     2,460       2,570  

Other receivables

     3,072       2,807  

Other current assets

     4,260       3,020  
  

 

 

   

 

 

 

Total current assets

     46,764       39,033  

Long-term investments:

    

Fixed maturity securities

     520       505  

Other invested assets

     4,097       4,258  

Property and equipment, net

     3,427       3,133  

Goodwill

     21,641       20,500  

Other intangible assets

     9,577       8,674  

Other noncurrent assets

     1,950       1,350  
  

 

 

   

 

 

 

Total assets

   $ 87,976     $ 77,453  
  

 

 

   

 

 

 

Liabilities and shareholders’ equity

    

Liabilities

    

Current liabilities:

    

Medical claims payable

   $ 9,878     $ 8,842  

Other policyholder liabilities

     3,586       3,050  

Unearned income

     946       1,017  

Accounts payable and accrued expenses

     5,257       4,198  

Short-term borrowings

     —         700  

Current portion of long-term debt

     1,603       1,598  

Other current liabilities

     7,252       4,127  
  

 

 

   

 

 

 

Total current liabilities

     28,522       23,532  

Long-term debt, less current portion

     19,873       17,787  

Reserves for future policy benefits

     776       759  

Deferred tax liabilities, net

     2,497       2,227  

Other noncurrent liabilities

     1,853       1,420  
  

 

 

   

 

 

 

Total liabilities

     53,521       45,725  
  

 

 

   

 

 

 

Shareholders’ equity

    

Common stock

     3       3  

Additional paid-in capital

     9,360       9,448  

Retained earnings

     25,346       22,573  

Accumulated other comprehensive loss

     (254     (296
  

 

 

   

 

 

 

Total shareholders’ equity

     34,455       31,728  
  

 

 

   

 

 

 

Total liabilities and shareholders’ equity

   $ 87,976     $ 77,453  
  

 

 

   

 

 

 

 

14


Anthem, Inc.

Consolidated Statements of Cash Flows

(Unaudited)

 

(In millions)    Six Months Ended June 30  
     2020     2019  

Operating activities

    

Net income

   $ 3,799     $ 2,690  

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

    

Net realized losses (gains) on financial instruments

     6       (89

Depreciation and amortization

     556       586  

Deferred income taxes

     60       79  

Share-based compensation

     134       140  

Changes in operating assets and liabilities:

    

Receivables, net

     (313     (589

Other invested assets

     24       (28

Other assets

     (486     (258

Policy liabilities

     1,024       1,251  

Unearned income

     (110     (2

Accounts payable and other liabilities

     1,868       (383

Income taxes

     1,313       (286

Other, net

     150       (44
  

 

 

   

 

 

 

Net cash provided by operating activities

     8,025       3,067  

Investing activities

    

Purchases of investments

     (11,135     (11,113

Proceeds from sale of investments

     4,724       8,835  

Maturities, calls and redemptions from investments

     1,836       894  

Purchases of subsidiaries, net of cash acquired

     (1,906     —    

Purchases of property and equipment

     (437     (455

Other, net

     (800     22  
  

 

 

   

 

 

 

Net cash used in investing activities

     (7,718     (1,817

Financing activities

    

Net (repayments of) proceeds from commercial paper borrowings

     (400     203  

Net repayments of short-term borrowings

     (700     (135

Net proceeds from (repayments of) long-term borrowings

     2,329       (73

Repurchase and retirement of common stock

     (584     (752

Cash dividends

     (482     (412

Proceeds from issuance of common stock under employee stock plans

     92       100  

Taxes paid through withholding of common stock under employee stock plans

     (111     (80

Other, net

     640       43  
  

 

 

   

 

 

 

Net cash provided by (used in) financing activities

     784       (1,106

Change in cash and cash equivalents

     1,091       144  

Cash and cash equivalents at beginning of year

     4,937       3,934  

Cash and cash equivalents at end of period

   $ 6,028     $ 4,078  
  

 

 

   

 

 

 

 

15


Anthem, Inc.

Reconciliation of Medical Claims Payable

 

     Six Months Ended
June 30
    Years Ended December 31  
     2020     2019     2019     2018     2017  
(In millions)    (Unaudited)     (Unaudited)                    

Gross medical claims payable, beginning of period

   $ 8,647     $ 7,266     $ 7,266     $ 7,814     $ 7,656  

Ceded medical claims payable, beginning of period

     (33     (34     (34     (105     (539
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net medical claims payable, beginning of period

     8,614       7,232       7,232       7,709       7,117  
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Business combinations and purchase adjustments

     339       —         —         199       76  

Net incurred medical claims:

          

Current year

     39,978       38,237       78,695       69,581       70,377  

Prior years redundancies(1)

     (700     (414     (500     (930     (1,133
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total net incurred medical claims

     39,278       37,823       78,195       68,651       69,244  
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net payments attributable to:

          

Current year medical claims

     31,625       30,367       70,294       62,748       62,923  

Prior years medical claims

     7,041       6,182       6,519       6,579       5,805  
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total net payments

     38,666       36,549       76,813       69,327       68,728  
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net medical claims payable, end of period

     9,565       8,506       8,614       7,232       7,709  

Ceded medical claims payable, end of period

     90       43       33       34       105  
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Gross medical claims payable, end of period

   $ 9,655     $ 8,549     $ 8,647     $ 7,266     $ 7,814  
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

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

     79.1%       79.4%       89.3%       90.2%       89.4%  

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

     8.8%       6.1%       7.4%       13.7%       18.9%  

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

     0.9%       0.6%       0.7%       1.3%       1.8%  

 

(1) 

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

 

16


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.

 

     Three Months Ended
June 30
   

 

    Six Months Ended
June 30
       
(In millions, except per share data)    2020     2019     Change     2020     2019     Change  

Net income

   $ 2,276     $ 1,139       99.8   $ 3,799     $ 2,690       41.2

Add / (Subtract):

            

Net realized (gains) losses on financial instruments

     (18     (11       6       (89  

Amortization of other intangible assets

     93       85         176       172    

Impairment (recoveries) losses recognized in income

     (11     7         46       17    

Loss (gain) on extinguishment of debt

     3       —           4       (1  

Transaction and integration related costs

     11       5         23       5    

Litigation expenses

     21       9         29       35    

Tax impact of non-GAAP adjustments

     (25     (23       (71     (37  
  

 

 

   

 

 

     

 

 

   

 

 

   

Net adjustment items

     74       72         213       102    
  

 

 

   

 

 

     

 

 

   

 

 

   

Adjusted net income

   $ 2,350     $ 1,211       94.1   $ 4,012     $ 2,792       43.7
  

 

 

   

 

 

     

 

 

   

 

 

   

Net income per diluted share

   $ 8.91     $ 4.36       104.4   $ 14.85     $ 10.28       44.5

Add / (Subtract):

            

Net realized (gains) losses on financial instruments

     (0.07     (0.04       0.02       (0.34  

Amortization of other intangible assets

     0.36       0.33         0.69       0.66    

Impairment (recoveries) losses recognized in income

     (0.04     0.03         0.18       0.06    

Loss on extinguishment of debt

     0.01       —           0.02       —      

Transaction and integration related costs

     0.04       0.02         0.09       0.02    

Litigation expenses

     0.08       0.03         0.11       0.13    

Tax impact of non-GAAP adjustments

     (0.10     (0.09       (0.28     (0.14  

Rounding impact

     0.01       —           —         —      
  

 

 

   

 

 

     

 

 

   

 

 

   

Net adjustment items

     0.29       0.28         0.83       0.39    
  

 

 

   

 

 

     

 

 

   

 

 

   

Adjusted net income per diluted share

   $ 9.20     $ 4.64       98.3   $ 15.68     $ 10.67       47.0
  

 

 

   

 

 

     

 

 

   

 

 

   
     Full Year 2020 Outlook  

Net income per diluted share

     Greater than $20.91  

Add / (Subtract):

  

Net realized losses on financial instruments

     0.02  

Impairment losses recognized in income

     0.18  

Loss on extinguishment of debt

     0.02  

Transaction and integration related costs

     0.09  

Litigation expenses

     0.11  

Amortization of other intangible assets

     Approximately $1.41  

Tax impact of non-GAAP adjustments

     Approximately ($0.44)  
  

 

 

 

Net adjustment items

     Approximately $1.39  
  

 

 

 

Adjusted net income per diluted share

     Greater than $22.30  
  

 

 

 
     Three Months Ended
June 30
   

 

    Six Months Ended
June 30
       
(In millions)    2020     2019     Change     2020     2019     Change  

Reportable segments operating gain

   $ 3,360     $ 1,433       134.5   $ 5,554     $ 3,373       64.7

Net investment income

     57       285         311       495    

Net realized gains (losses) on financial instruments

     18       11         (6     89    

Impairment recoveries (losses) recognized in income

     11       (7       (46     (17  

Interest expense

     (201     (184       (395     (371  

Amortization of other intangible assets

     (93     (85       (176     (172  

(Loss) gain on extinguishment of debt

     (3     —           (4     1    
  

 

 

   

 

 

     

 

 

   

 

 

   

Income before income tax expense

   $ 3,149     $ 1,453       116.7   $ 5,238     $ 3,398       54.1
  

 

 

   

 

 

     

 

 

   

 

 

   

 

17


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 large scale medical emergencies, such as public health epidemics and pandemics, including COVID-19, and catastrophes; trends in healthcare costs and utilization rates; our ability to secure sufficient premium rates, including regulatory approval for and implementation of such rates; 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; changes in economic and market conditions, as well as regulations that may negatively affect our liquidity and investment portfolios; our ability to contract with providers on cost-effective and competitive terms; 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 and us related to the merger agreement between the parties and the potential for such litigation to cause us to incur substantial additional costs, including potential settlement and judgment costs; risks and uncertainties related to our pharmacy benefit management, or PBM, business including non-compliance by any party with the PBM services agreement between us and CaremarkPCS Health, L.L.C.; medical malpractice or professional liability claims or other risks related to healthcare and PBM services provided by our subsidiaries; 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; 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; the impact of international laws and regulations; 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.

 

18

v3.20.2
Document and Entity Information
Jul. 29, 2020
Cover [Abstract]  
Amendment Flag false
Entity Central Index Key 0001156039
Document Type 8-K
Document Period End Date Jul. 29, 2020
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