Open the filing on EDGARE A R N I N G S R E L E A S E
ELEVANCE HEALTH REPORTS FOURTH QUARTER AND
FULL YEAR 2025 RESULTS; SETS FULL YEAR 2026 OUTLOOK
- 4Q 2025 operating revenue of $49.3 billion; FY 2025 of $197.6 billion
- 4Q 2025 diluted EPS of $2.47; adjusted diluted EPS of $3.33
- FY 2025 diluted EPS of $25.21; adjusted diluted EPS of $30.29
- Projected FY 2026 GAAP diluted EPS to be at least $22.30
- Projected FY 2026 adjusted diluted EPS to be at least $25.50
- Returned $4.1 billion of capital to shareholders in 2025
- Reaffirming long-term earnings algorithm; recalibrating segment margin targets
Indianapolis, IN - January 28, 2026 - Elevance Health, Inc. (NYSE: ELV) reported fourth quarter and full year 2025 results.
"Elevance Health delivered fourth quarter results in line with our outlook, reflecting disciplined execution in a dynamic environment. As we enter 2026, our focus is on advancing affordability and making healthcare easier to access and navigate for the members we serve. Through pricing discipline and targeted investments, we are strengthening the earnings power of our diversified platform and remain confident in our ability to return to at least 12% adjusted EPS growth in 2027."
Gail K. Boudreaux
President and Chief Executive Officer
1.Earnings per diluted share ("EPS").
2.Refer to GAAP reconciliation tables on pages 13 and 14 herein for reconciliation of GAAP to adjusted measures.
| Elevance Health |
|---|
| Consolidated Enterprise Highlights |
|---|
| (Unaudited) |
|---|
| (In billions) | Three Months Ended | Twelve Months Ended |
|---|
| December 31, 2025 | December 31, 2024 | December 31, 2025 | December 31, 2024 |
|---|
| Operating Revenue | $49.3 | $45.0 | $197.6 | $175.2 |
|---|
| Operating Gain | $0.3 | $0.7 | $7.2 | $7.9 |
|---|
| Adjusted Operating Gain | $0.4 | $0.8 | $7.5 | $9.3 |
|---|
| Operating Margin | 0.6% | | 1.5% | | 3.6% | | 4.5% | |
|---|
| Adjusted Operating Margin | 0.8% | | 1.9% | | 3.8% | | 5.3% | |
|---|
2.Operating Gain for the three and twelve months ended December 31, 2025, and December 31, 2024, includes items that are excluded from adjusted shareholders' net income. See "GAAP Reconciliation" on pages 13 and 14 herein.
3.Adjusted Operating Gain for the three and twelve months ended December 31, 2025, and December 31, 2024, excludes items that are excluded from adjusted shareholders' net income. See "GAAP Reconciliation" on pages 13 and 14 herein.
Operating revenue was $49.3 billion in the fourth quarter of 2025, an increase of $4.3 billion, or 10 percent compared to the prior year quarter. Operating revenue was $197.6 billion in 2025, an increase of $22.4 billion, or 13 percent. The increase in revenue for the quarter and year was driven by higher premium yields in our Health Benefits segment, contributions from acquisitions, and growth in Medicare Advantage membership, partially offset by membership attrition in our Medicaid business.
The benefit expense ratio was 93.5 percent in the fourth quarter, an increase of 110 basis points compared to the prior year period, reflecting higher medical cost trend primarily in our Affordable Care Act health plans and heightened Medicare Part D seasonality driven by Inflation Reduction Act changes. For the year, our benefit expense ratio was 90.0 percent, an increase of 150 basis points year over year, driven by elevated medical cost trends.
Days in Claims Payable was 41.3 days as of December 31, 2025, a decrease of 0.1 days from September 30, 2025, and a decrease of 1.9 days compared to December 31, 2024.
The operating expense ratio was 11.0 percent in the fourth quarter and 10.6 percent for the full year. On an adjusted basis, the corresponding operating expense ratios were 10.8 percent and 10.5 percent. We maintained expense discipline while investing to support and strengthen our workforce, scale Carelon's capabilities, and accelerate technology adoption across the enterprise.
Cash Flow & Balance Sheet
Operating cash flow was $4.3 billion in 2025, approximately 0.8 times GAAP net income. As of December 31, 2025, cash and investments at the parent company totaled approximately $2.6 billion.
During the fourth quarter of 2025, the Company repurchased 1.4 million shares of its common stock for $471 million, at a weighted average price of $335.64, and paid a quarterly dividend of $1.71 per share, representing a distribution of cash totaling $377 million. As of December 31, 2025, the Company had approximately $6.7 billion of Board approved share repurchase authorization remaining.
Health Benefits is comprised of Individual, Employer Group risk-based, Employer Group fee-based, BlueCard®, Medicare, Medicaid, and Federal Employee Program businesses.
| Health Benefits |
|---|
| Reportable Segment Highlights |
|---|
| (Unaudited) |
|---|
| (In billions) | Three Months Ended | Twelve Months Ended |
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| December 31, 2025 | December 31, 2024 | December 31, 2025 | December 31, 2024 |
|---|
| Operating Revenue | $41.8 | $37.6 | $167.1 | $150.3 |
|---|
| Operating Gain | ($0.2) | $0.2 | $4.2 | $6.2 |
|---|
| Adjusted Operating Gain | ($0.2) | $0.2 | $4.2 | $6.3 |
|---|
| Operating Margin | (0.5%) | | 0.6% | | 2.5% | | 4.2% | |
|---|
| Adjusted Operating Margin | (0.5%) | | 0.6% | | 2.5% | | 4.2% | |
|---|
2.Operating Gain for the three and twelve months ended December 31, 2024 includes items that are excluded from adjusted shareholders' net income. See "GAAP Reconciliation" on pages 13 and 14 herein.
3.Adjusted Operating Gain for three and twelve months ended December 31, 2024 excludes $16 and $66 million, respectively, of 2024 business dispositions and related items adjusted out of adjusted shareholders' net income for the Health Benefits segment.
Health Benefits segment operating revenue was $41.8 billion in the fourth quarter of 2025, an increase of $4.3 billion, or 11 percent compared to the fourth quarter of 2024. Operating revenue was $167.1 billion in 2025, an increase of $16.8 billion, or 11 percent. The increases for the quarter and year were driven primarily by higher premium yields, contributions from acquisitions, and growth in our Medicare Advantage membership, partially offset by membership attrition in our Medicaid business.
The Company reported an adjusted operating loss of $0.2 billion in the fourth quarter of 2025 and an adjusted operating gain of $4.2 billion for the full year. Adjusted operating results in both periods were impacted primarily by higher medical cost trend.
Medical membership totaled approximately 45.2 million as of December 31, 2025, a decrease of 0.5 million, or 1 percent, year over year, driven by attrition in our Medicaid business.
Carelon is comprised of CarelonRx and Carelon Services.
| Carelon |
|---|
| Reportable Segment Highlights |
|---|
| (Unaudited) |
|---|
| (In billions) | Three Months Ended | Twelve Months Ended |
|---|
| December 31, 2025 | December 31, 2024 | December 31, 2025 | December 31, 2024 |
|---|
| Operating Revenue | $18.7 | $14.7 | $71.7 | $53.9 |
|---|
| Operating Gain | $0.6 | $0.6 | $3.4 | $2.9 |
|---|
| Adjusted Operating Gain1,4,5 | $0.6 | $0.6 | $3.4 | $3.1 |
|---|
| Operating Margin | 3.1% | | 3.9% | | 4.7% | | 5.4% | |
|---|
| Adjusted Operating Margin | 3.3% | | 4.4% | | 4.8% | | 5.8% | |
|---|
2.Operating revenue for the three and twelve months ended December 31, 2024 includes $0.2 and $0.8 billion, respectively, of revenue related to 2024 business dispositions and related items that have been excluded from adjusted operating gain.
3.Operating Gain for the three and twelve months ended December 31, 2025, and December 31, 2024, includes items that are excluded from adjusted shareholders' net income. See "GAAP Reconciliation" on pages 13 and 14 herein.
4.Adjusted Operating Gain for three and twelve months ended December 31, 2025 excludes $38 million of 2025 business dispositions and related items adjusted out of adjusted shareholders' net income for the Carelon segment.
5.Adjusted Operating Gain for the three and twelve months ended December 31, 2024 excludes $74 and $215 million, respectively, of 2024 business dispositions and related items adjusted out of adjusted shareholders' net income for the Carelon segment.
Operating revenue for Carelon was $18.7 billion in the fourth quarter of 2025, an increase of $3.9 billion, or 27 percent compared to the prior year period, driven by growth in CarelonRx product revenue, the expansion of Carelon Services risk-based solutions, and the acquisition of CareBridge. Operating revenue was $71.7 billion in 2025, an increase of $17.8 billion, or 33 percent.
Adjusted operating gain for Carelon totaled $0.6 billion in the fourth quarter, approximately flat year over year. On a full year basis, adjusted operating gain was $3.4 billion in 2025, an increase of $0.3 billion, or 10 percent, driven by improved CarelonRx performance and growth in Carelon Services risk-based solutions.
Quarterly Dividend
On January 27, 2026, the Audit Committee of the Company's Board of Directors declared a first quarter 2026 dividend to shareholders of $1.72 per share. The first quarter dividend is payable on March 25, 2026 to shareholders of record at the close of business on March 10, 2026.
About Elevance Health
Elevance Health is a lifetime, trusted health partner whose purpose is to improve the health of humanity. The company supports consumers, families, and communities across the entire healthcare journey - connecting them to the care, support, and resources they need to lead better lives. Elevance Health’s companies serve approximately 104 million consumers through a diverse portfolio of industry-leading medical, pharmacy, behavioral, clinical, home health, and complex care solutions. For more information, please visit www.elevancehealth.com or follow us @ElevanceHealth on X and Elevance Health on LinkedIn.
Conference Call and Webcast
Management will host a conference call and webcast today at 8:30 a.m. Eastern Standard Time (“EST”) to discuss the company’s fourth quarter and full year 2025 results and 2026 outlook. The conference call should be accessed at least 15 minutes prior to the start of the call with the following numbers:
The access code for today's conference call is 3972058. There is no access code for the replay. The replay will be available from 11:30 a.m. EST today, until the end of the day on February 27, 2026. The call will also be available through a live webcast at www.elevancehealth.com under the “Investors” link. A webcast replay will be available following the call.
Basis of Presentation
1.Operating revenue and operating gain/loss 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/loss is calculated as total operating revenue less benefit expense, cost of products sold and operating expense. It does not include net investment income, net gains/losses on financial instruments, 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 pages 13 and 14 for the GAAP reconciliation tables.
2.Operating margin is defined as operating gain divided by operating revenue.
Elevance Health
Earnings Release Financial Schedules and Supplementary Information
Quarter & Year Ended December 31, 2025
- Membership and Other Metrics
- Quarterly & Full Year Consolidated Statements of Income
- Condensed Consolidated Balance Sheet
- Condensed Consolidated Statement of Cash Flows
- Supplemental Financial Information - Reportable Segments
- Supplemental Financial Information - Reconciliation of Medical Claims Payable
- Reconciliation of Non-GAAP Financial Measures
- Financial Guidance Summary
- Membership Guidance Summary
| | | | Change from |
|---|
| Elevance Health |
| Membership and Other Metrics |
| (Unaudited) |
| Medical Membership (in thousands) | December 31, 2025 | December 31, 2024 | September 30, 2025 | December 31, 2024 | September 30, 2025 |
| Individual | 1,307 | 1,287 | 1,354 | | 1.6% | (3.5%) |
| Employer Group Risk-Based | 3,617 | 3,713 | 3,616 | | (2.6%) | - % |
| Commercial Risk-Based | 4,924 | 5,000 | 4,970 | | (1.5%) | (0.9%) |
| BlueCard® | 6,509 | 6,630 | 6,394 | | (1.8%) | 1.8% |
| Employer Group Fee-Based | 20,583 | 20,569 | 20,608 | | 0.1% | (0.1%) |
| Commercial Fee-Based | 27,092 | 27,199 | 27,002 | | (0.4%) | 0.3% |
| Medicare Advantage | 2,230 | 2,066 | 2,245 | | 7.9% | (0.7%) |
| Medicare Supplement | 882 | 891 | 877 | | (1.0%) | 0.6% |
| Total Medicare | 3,112 | 2,957 | 3,122 | | 5.2% | (0.3%) |
| Medicaid | 8,500 | 8,917 | 8,645 | | (4.7%) | (1.7%) |
| Federal Employee Program | 1,604 | 1,661 | 1,630 | | (3.4%) | (1.6%) |
| Total Medical Membership | 45,232 | 45,734 | 45,369 | | (1.1%) | (0.3%) |
| Other Metrics (in millions) | | | | | |
| CarelonRx Quarterly Adjusted Scripts | 88.5 | 82.9 | 85.0 | | 6.8% | 4.1% |
| Carelon Services Consumers Served | 91.8 | 101.1 | | 97.6 | (9.2%) | (5.9%) |
| Elevance Health |
| Consolidated Statements of Income |
| (Unaudited) |
| (In millions, except per share data) | Three Months Ended December 31 | Twelve Months Ended December 31 |
| | 2025 | | 2024 | Change | | 2025 | | 2024 | Change |
| Revenues | | | | | | |
| Premiums | | $40,690 | | $36,245 | | 12.3% | | $164,639 | | $144,166 | | 14.2% |
| Product revenue | | 6,460 | | 6,714 | | (3.8%) | | 24,470 | | 22,630 | | 8.1% |
| Service fees | | 2,161 | | 2,030 | | 6.5% | | 8,475 | | 8,408 | | 0.8% |
| Total operating revenue | | 49,311 | | 44,989 | | 9.6% | | 197,584 | | 175,204 | | 12.8% |
| Net investment income | | 493 | | 527 | | (6.5%) | | 2,194 | | 2,051 | | 7.0% |
| Net losses on financial instruments | | (57) | | (74) | | NM | | (653) | | (445) | | NM |
| Gain on sale of business | | - | | - | | NM | | - | | 201 | | NM |
| Total revenues | | 49,747 | | 45,442 | | 9.5% | | 199,125 | | 177,011 | | 12.5% |
| Expenses | | | | | | |
| Benefit expense | | 38,065 | | 33,500 | | 13.6% | | 148,223 | | 127,567 | | 16.2% |
| Cost of products sold | | 5,522 | | 6,012 | | (8.2%) | | 21,178 | | 19,750 | | 7.2% |
| Operating expense | | 5,415 | | 4,804 | | 12.7% | | 20,984 | | 20,025 | | 4.8% |
| Interest expense | | 366 | | 340 | | 7.6% | | 1,402 | | 1,185 | | 18.3% |
| Amortization of other intangible assets | | 164 | | 180 | | (8.9%) | | 628 | | 580 | | 8.3% |
| Total expenses | | 49,532 | | 44,836 | | 10.5% | | 192,415 | | 169,107 | | 13.8% |
| Income before income tax expense | | 215 | | 606 | | (64.5%) | | 6,710 | | 7,904 | | (15.1%) |
| Income tax expense (benefit) | | (331) | | 193 | | NM | | 1,049 | | 1,933 | | (45.7%) |
| Net income | | 546 | | 413 | | 32.2% | | 5,661 | | 5,971 | | (5.2%) |
| Net loss attributable to noncontrolling interests | | 1 | | 5 | | NM | | 1 | | 9 | | NM |
| Shareholders' net income | | $547 | | $418 | | 30.9% | | $5,662 | | $5,980 | | (5.3%) |
| Shareholders' earnings per diluted share | | $2.47 | | $1.81 | | 36.5% | | $25.21 | | $25.68 | | (1.8%) |
| Diluted shares | | 221.8 | | 231.1 | | (4.0%) | | 224.6 | | 232.9 | | (3.6%) |
| Benefit expense as a percentage of premiums | 93.5% | | 92.4% | | 110bp | | 90.0% | | 88.5% | | 150bp | |
| Operating expense as a percentage of total operating revenue | 11.0% | | 10.7% | | 30bp | | 10.6% | | 11.4% | | (80)bp | |
| Income before income tax expense as a percentage of total revenue | 0.4% | | 1.3% | | (90)bp | | 3.4% | | 4.5% | | (110)bp | |
"NM" = calculation not meaningful
| Elevance Health |
| Condensed Consolidated Balance Sheet |
| (In millions) | December 31, 2025 | December 31, 2024 |
| Assets | (Unaudited) | |
| Current assets: | | |
| Cash and cash equivalents | | $9,491 | | $8,288 |
| Fixed maturity and equity securities | 26,624 | | 26,393 | |
| Premium and other receivables | 21,542 | | 19,071 | |
| Other current assets | 5,344 | | 4,700 | |
| Assets held for sale | - | | 490 | |
| Total current assets | 63,001 | | 58,942 | |
| Long-term investments | 11,960 | | 10,784 | |
| Property and equipment, net | 4,679 | | 4,652 | |
| Goodwill and other intangible assets | 39,544 | | 40,371 | |
| Other noncurrent assets | 2,310 | | 2,140 | |
| Total assets | | $121,494 | | $116,889 |
| Liabilities and equity | | |
| Liabilities | | |
| Current liabilities: | | |
| Medical claims payable | | $17,084 | | $15,746 |
| Short-term borrowings | 150 | | 365 | |
| Current portion of long-term debt | 1,099 | | 1,649 | |
| Other current liabilities | 22,702 | | 22,668 | |
| Liabilities held for sale | - | | 153 | |
| Total current liabilities | 41,035 | | 40,581 | |
| Long-term debt, less current portion | 30,797 | | 29,218 | |
| Other noncurrent liabilities | 5,636 | | 5,664 | |
| Total liabilities | 77,468 | | 75,463 | |
| Total shareholders’ equity | 43,882 | | 41,315 | |
| Noncontrolling interests | 144 | | 111 | |
| Total equity | 44,026 | | 41,426 | |
| Total liabilities and equity | | $121,494 | | $116,889 |
| Elevance Health |
| Condensed Consolidated Statement of Cash Flows |
| (Unaudited) |
| (In millions) | Twelve Months Ended December 31 |
| | 2025 | | 2024 |
| Operating activities | | |
| Net income | $5,661 | | $5,971 | |
| Depreciation and amortization | 1,546 | | 1,393 | |
| Share-based compensation | 276 | | 191 | |
| Changes in operating assets and liabilities | (3,680) | | (1,719) | |
| Other non-cash items | 487 | | (28) | |
| Net cash provided by operating activities | 4,290 | | 5,808 | |
| Investing activities | | |
| Proceeds from sale of investments, net of maturities | 69 | | 586 | |
| Net purchases of subsidiaries, net of cash acquired/sold | 88 | | (4,446) | |
| Purchases of property and equipment | (1,116) | | (1,256) | |
| Other, net | (385) | | (51) | |
| Net cash used in investing activities | (1,344) | | (5,167) | |
| Financing activities | | |
| Net change in short-term and long-term borrowings | 629 | | 6,200 | |
| Repurchase and retirement of common stock | (2,605) | | (2,900) | |
| Cash dividends | (1,529) | | (1,508) | |
| Other, net | 1,767 | | (599) | |
| Net cash provided by (used in) financing activities | (1,738) | | 1,193 | |
| Effect of foreign exchange rates on cash and cash equivalents | (5) | | (6) | |
| Change in cash and cash equivalents | 1,203 | | 1,828 | |
| Cash and cash equivalents at beginning of period | 8,288 | | 6,526 | |
| Cash and equivalents included in assets held for sale at end of period | - | | (66) | |
| Cash and cash equivalents at end of period | | $9,491 | | $8,288 |
REPORTABLE SEGMENTS
Elevance Health has four reportable segments: Health Benefits (comprised of Individual, Employer Group risk-based, Employer Group fee-based, BlueCard®, Medicare, Medicaid, and Federal Employee Program businesses); CarelonRx; Carelon Services; and Corporate & Other (comprised of businesses that do not individually meet the quantitative thresholds for an operating division as well as corporate expenses not allocated to our other reportable segments).
| Elevance Health |
|---|
| Reportable Segment Details |
|---|
| (Unaudited) |
|---|
| (In millions) | Three Months Ended December 31 | Twelve Months Ended December 31 |
|---|
| 2025 | 2024 | Change | 2025 | 2024 | Change |
|---|
| Operating Revenue | | | | | | |
|---|
| Health Benefits | $41,835 | $37,580 | 11.3% | | $167,094 | $150,275 | 11.2% | |
|---|
| CarelonRx | 11,644 | 9,977 | 16.7% | | 43,400 | 35,961 | 20.7% | |
|---|
| Carelon Services | 7,015 | 4,769 | 47.1% | | 28,316 | 17,961 | 57.7% | |
|---|
| Corporate & Other | (83) | (14) | NM | 463 | 309 | 49.8% | |
|---|
| Eliminations | (11,100) | (7,323) | NM | (41,689) | (29,302) | NM |
|---|
| Total Operating Revenue | $49,311 | $44,989 | 9.6% | | $197,584 | $175,204 | 12.8% | |
|---|
| Operating Gain (Loss) | | | | | | |
|---|
| Health Benefits | ($220) | $207 | NM | $4,158 | $6,243 | (33.4%) | |
|---|
| CarelonRx | 724 | 533 | 35.8% | | 2,418 | 2,172 | 11.3% | |
|---|
| Carelon Services | (150) | 35 | NM | 960 | 717 | 33.9% | |
|---|
| Corporate & Other | (45) | (102) | NM | (337) | (1,270) | NM |
|---|
| Total Operating Gain | $309 | $673 | (54.1%) | | $7,199 | $7,862 | (8.4%) | |
|---|
| Operating Margin | | | | | | |
|---|
| Health Benefits | (0.5%) | | 0.6% | | (110) bp | 2.5% | | 4.2% | | (170) bp |
|---|
| CarelonRx | 6.2% | | 5.3% | | 90 bp | 5.6% | | 6.0% | | (40) bp |
|---|
| Carelon Services | (2.1%) | | 0.7% | | (280) bp | 3.4% | | 4.0% | | (60) bp |
|---|
| Total Operating Margin | 0.6% | | 1.5% | | (90) bp | 3.6% | | 4.5% | | (90) bp |
|---|
| Health Benefits Revenue Details |
|---|
| (In millions) | Three Months Ended December 31 | Twelve Months Ended December 31 |
|---|
| 2025 | 2024 | Change | 2025 | 2024 | Change |
|---|
| Health Benefits Operating Revenue | | | | | | |
|---|
| Commercial | $12,747 | $11,851 | 7.6% | | $50,401 | $46,816 | 7.7% | |
|---|
| Individual | 2,248 | 2,117 | 6.2% | | 9,295 | 8,295 | 12.1% | |
|---|
| Medicare | 10,762 | 9,054 | 18.9% | | 44,752 | 36,795 | 21.6% | |
|---|
| Medicaid | 14,500 | 12,755 | 13.7% | | 56,620 | 51,937 | 9.0% | |
|---|
| Federal Employee Program | 3,826 | 3,920 | (2.4%) | | 15,321 | 14,727 | 4.0% | |
|---|
| Total Health Benefits Operating Revenue | $41,835 | $37,580 | 11.3% | | $167,094 | $150,275 | 11.2% | |
|---|
2.Operating Gain for the three and twelve months ended December 31, 2024 included $90 and $281 million, respectively, of 2024 business dispositions and related items; including $74 and $215 million, respectively, for the Carelon Services segment; and $16 and $66 million, respectively, for the Health Benefits segment. Operating Gain for the three and twelve months ended December 31, 2024 included $66 and $224 million, respectively, of transaction and integration related costs, $12 and $692 million, respectively, of litigation and settlement expenses, and $0 and $268 million, respectively, of business optimization charges, all of which reside in the Corporate & Other reportable segment.
3.Operating Gain for the three and twelve months ended December 31, 2025 included $41 million of 2025 business dispositions and related items; including $45 million for the CarelonRx segment; ($7) million for the Carelon Services segment; and $3 million for the Corporate & Other segment. Operating Gain for the three and twelve months ended December 31, 2025 included $54 and $236 million, respectively, of transaction and integration related costs, $5 and $24 million, respectively, of litigation and settlement expenses, and ($34) and ($38) million, respectively, of business optimization charges, all of which reside in the Corporate & Other reportable segment.
4.Operating Gain for the three and twelve months ended December 31, 2025, and December 31, 2024, included items excluded from adjusted shareholders' net income. See "GAAP Reconciliation" on pages 13 and 14 herein.
5.The Individual business, including ACA products, is reported as part of Commercial Operating Revenue.
6."NM" = calculation not meaningful.
| Elevance Health |
|---|
| Reconciliation of Medical Claims Payable |
|---|
| Years Ended December 31 |
|---|
| 2025 | 2024 | 2023 |
|---|
| (In millions) | (Unaudited) | | |
|---|
| Gross medical claims payable, beginning of year | $15,580 | | $15,865 | | $15,348 | |
|---|
| Ceded medical claims payable, beginning of year | (13) | | (7) | | (6) | |
|---|
| Net medical claims payable, beginning of year | 15,567 | | 15,858 | | 15,342 | |
|---|
| Business combinations and purchase adjustments | 344 | | 143 | | - | |
|---|
| Net incurred medical claims: | | | |
|---|
| Current year | 145,566 | | 125,370 | | 121,798 | |
|---|
| Prior years redundancies | (1,290) | | (1,731) | | (1,571) | |
|---|
| Total net incurred medical claims | 144,276 | | 123,639 | | 120,227 | |
|---|
| Net payments attributable to: | | | |
|---|
| Current year medical claims | 130,265 | | 110,930 | | 107,146 | |
|---|
| Prior years medical claims | 13,141 | | 13,143 | | 12,565 | |
|---|
| Total net payments | 143,406 | | 124,073 | | 119,711 | |
|---|
| Net medical claims payable, end of year | 16,781 | | 15,567 | | 15,858 | |
|---|
| Ceded medical claims payable, end of year | 48 | | 13 | | 7 | |
|---|
| Gross medical claims payable, end of year | $16,829 | | $15,580 | | $15,865 | |
|---|
| Current year medical claims paid as a percentage of current year net incurred medical claims | 89.5% | | 88.5% | | 88.0% | |
|---|
| 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 | 9.0% | | 12.3% | | 11.4% | |
|---|
| Prior year redundancies in the current year as a percentage of prior year net incurred medical claims | 1.0% | | 1.4% | | 1.4% | |
|---|
| 1.Negative amounts reported for net incurred medical claims related to prior years result from claims being settled for amounts less than originally estimated.2.Excludes insurance lines other than short duration. |
|---|
Elevance Health
GAAP Reconciliation
(Unaudited)
This document references non-GAAP measures, including “Adjusted Shareholders’ Net Income,” “Adjusted Shareholders’ Net Income Per Share,” “Adjusted EPS,” “Adjusted Operating Gain,” “Adjusted Operating Expense” and “Adjusted Operating Expense Ratio,” which are non-GAAP measures. These non-GAAP measures are intended to aid investors when comparing Elevance Health’s financial results among periods and are not intended to be alternatives to any measure calculated in accordance with GAAP. Reconciliations of these non-GAAP measures to the most directly comparable measures calculated in accordance with GAAP are available below. In addition to these non-GAAP measures, references are made to the measures “Operating Revenue” and “Operating Gain/Loss,” “Operating Margin” and “Adjusted EPS”. Operating revenue and operating gain/loss are the key measures used by management to evaluate performance in each of its reportable segments, allocate resources, set incentive compensation targets and to forecast future operating performance. Operating gain/loss is calculated as total operating revenue less benefit expense, cost of products sold and operating expense. It does not include net investment income, net gains/losses on financial instruments, interest expense, amortization of other intangible assets and 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. Each of these measures is provided to further aid investors in understanding and analyzing Elevance Health’s operating and 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 provided below. Prior amounts may be grouped differently to conform to the current presentation. Net adjustment items per share may not sum due to rounding. A reconciliation of Operating Revenue to Total Revenue is set forth in the Consolidated Statements of Income herein.
| Three Months Ended December 31 | | Twelve Months Ended December 31 | |
|---|
| (In millions, except per share data) | | 2025 | | 2024 | Change | | 2025 | | 2024 | Change |
| Shareholders' net income | $547 | | $418 | | 30.9% | $5,662 | | $5,980 | | (5.3%) |
| Add / (Subtract): | | | | | | |
| Amortization of other intangible assets | 164 | | 180 | | | 628 | | 580 | | |
| Net losses on financial instruments | 57 | | 74 | | | 653 | | 445 | | |
| Transaction and integration related costs | 54 | | 66 | | | 236 | | 224 | | |
| Business dispositions and related items | 41 | | 90 | | | 41 | | 281 | | |
| Litigation and settlement expenses | 5 | | 12 | | | 24 | | 692 | | |
| Gain on sale of business | - | | - | | | - | | (201) | | |
| Business optimization charges | (34) | | - | | | (38) | | 268 | | |
| Tax impact of non-GAAP adjustments | (95) | | (93) | | | (402) | | (575) | | |
| Net adjustment items | 192 | | 329 | | | 1,142 | | 1,714 | | |
| Adjusted shareholders' net income | $739 | | $747 | | (1.1%) | $6,804 | | $7,694 | | (11.6%) |
| Shareholders' earnings per diluted share | $2.47 | | $1.81 | | 36.5% | $25.21 | | $25.68 | | (1.8%) |
| Add / (Subtract): | | | | | | |
| Amortization of other intangible assets | 0.74 | | 0.78 | | | 2.80 | | 2.49 | | |
| Net losses on financial instruments | 0.26 | | 0.32 | | | 2.91 | | 1.91 | | |
| Transaction and integration related costs | 0.24 | | 0.29 | | | 1.05 | | 0.96 | | |
| Business dispositions and related items | 0.18 | | 0.39 | | | 0.18 | | 1.21 | | |
| Litigation and settlement expenses | 0.02 | | 0.05 | | | 0.11 | | 2.97 | | |
| Gain on sale of business | - | | - | | | - | | (0.86) | | |
| Business optimization charges | (0.15) | | - | | | (0.17) | | 1.15 | | |
| Tax impact of non-GAAP adjustments | (0.43) | | (0.40) | | | (1.79) | | (2.47) | | |
| Net adjustment items | 0.86 | | 1.42 | | | 5.08 | | 7.36 | | |
| Adjusted shareholders' earnings per diluted share | $3.33 | | $3.23 | | 3.1% | $30.29 | | $33.04 | | (8.3%) |
| Three Months Ended December 31 | | Twelve Months Ended December 31 | |
| (In millions) | | 2025 | | 2024 | Change | | 2025 | | 2024 | Change |
| Income before income tax expense | $215 | | $606 | | (64.5%) | $6,710 | | $7,904 | | (15.1%) |
| Net investment income | (493) | | (527) | | | (2,194) | | (2,051) | | |
| Gain on sale of business | - | | - | | | - | | (201) | | |
| Net losses on financial instruments | 57 | | 74 | | | 653 | | 445 | | |
| Interest expense | 366 | | 340 | | | 1,402 | | 1,185 | | |
| Amortization of other intangible assets | 164 | | 180 | | | 628 | | 580 | | |
| Reportable segments operating gain | $309 | | $673 | | (54.1%) | $7,199 | | $7,862 | | (8.4%) |
1.Adjustment item resides in the Corporate & Other reportable segment.
2.Adjustment item resides in the Health Benefits, CarelonRx, Carelon Services, and Corporate & Other reportable segments.
Elevance Health
GAAP Reconciliation
(Unaudited)
| Three Months Ended December 31 | | Twelve Months Ended December 31 | |
|---|
| (In millions) | | 2025 | | 2024 | Change | | 2025 | | 2024 | Change |
| Reportable segments operating gain | $309 | | $673 | | (54.1%) | | $7,199 | | $7,862 | | (8.4%) | |
| Add / (Subtract): | | | | | | |
| Transaction and integration related costs | 54 | | 66 | | | 236 | | 224 | | |
| Business dispositions and related items | 41 | | 90 | | | 41 | | 281 | | |
| Litigation and settlement expenses | 5 | | 12 | | | 24 | | 692 | | |
| Business optimization charges | (34) | | - | | | (38) | | 268 | | |
| Net adjustment items | 66 | | 168 | | | 263 | | 1,465 | | |
| Reportable segments adjusted operating gain | $375 | | $841 | | (55.4%) | | $7,462 | | $9,327 | | (20.0%) | |
| Three Months Ended December 31 | | Twelve Months Ended December 31 | |
| (In millions) | | 2025 | | 2024 | Change | | 2025 | | 2024 | Change |
| Operating expense | $5,415 | | $4,804 | | 12.7% | | $20,984 | | $20,025 | | 4.8% | |
| Add / (Subtract): | | | | | | |
| Transaction and integration related costs | (54) | | (66) | | | (236) | | (224) | | |
| Business dispositions and related items | (41) | | (90) | | | (41) | | (281) | | |
| Litigation and settlement expenses | (5) | | (12) | | | (24) | | (692) | | |
| Business optimization charges | 34 | | - | | | 38 | | (268) | | |
| Net adjustment items | (66) | | (168) | | | (263) | | (1,465) | | |
| Adjusted operating expense | $5,349 | | $4,636 | | 15.4% | | $20,721 | | $18,560 | | 11.6% | |
| Operating revenue | | $49,311 | | $44,989 | 9.6% | | | $197,584 | | $175,204 | 12.8% | |
| Operating expense ratio | 11.0% | | 10.7% | | | 30 bp | 10.6% | | 11.4% | | | (80) bp |
| Adjusted operating expense ratio | 10.8% | | 10.3% | | | 50 bp | 10.5% | | 10.6% | | | (10) bp |
| Full Year 2026 Outlook | | | | |
| Shareholders' earnings per diluted share | At least $22.30 | | | | |
| Add / (Subtract): | | | | | |
| Amortization of other intangibles | | | $2.00 | | | | | |
| Net losses on financial instruments | | | $1.15 | | | | | |
| Transaction and integration related costs | | | $0.90 | | | | | |
| Litigation and settlement expenses | | | $0.10 | | | | | |
| Tax impact of non-GAAP adjustments | Approximately ($0.95) | | | | |
| Net adjustment items | | | $3.20 | | | | | |
| Adjusted shareholders' earnings per diluted share | At least $25.50 | | | | |
1.Adjustment item resides in the Corporate & Other reportable segment.
2.Adjustment item resides in the Health Benefits, CarelonRx, Carelon Services, and Corporate & Other reportable segments.
3.Adjustment item represents the midpoint of a projected range and serves as the estimated full year adjustment amount.
| Full Year 2025 Actual | Full Year 2026 Outlook |
|---|
| Elevance Health |
| Financial Guidance Summary |
| (Unaudited) |
| Premium Revenue | $164.6 billion | Mid single digit decline |
| Product Revenue | $24.5 billion | Mid single digit growth |
| Service Fees | $8.5 billion | Mid single digit growth |
| Total Operating Revenue | $197.6 billion | Low single digit decline |
| Benefit Expense Ratio | 90.0% | 90.2% +/- 50 bps |
| Adjusted Operating Expense Ratio | 10.5% | 10.6% +/- 50 bps |
| Adjusted Operating Gain | $7.5 billion | At least $6.8 billion |
| Other Pre-Tax Items: | | |
| Net Investment income | $2,194 million | $1,875 million |
| Interest Expense | ($1,402) million | ($1,530) million |
| Amortization of Intangible Assets | ($628) million | ($440) million |
| Adjusted Effective Tax Rate | 17.6% | 22.0% - 24.0% |
| GAAP Diluted EPS | $25.21 | At least $22.30 |
| Adjusted Diluted EPS | $30.29 | At least $25.50 |
| Diluted Shares | 224.6 million | 219-220 million |
| Operating Cash Flow | $4.3 billion | At least $5.5 billion |
| Segment Level Guidance Metrics | | |
| Operating Revenue Growth Rate | | |
| Health Benefits | $167.1 billion | Low single digit decline |
| CarelonRx | $43.4 billion | Low single digit growth |
| Carelon Services | $28.3 billion | Low single digit growth |
| GAAP Operating Margin vs. 2025 | | |
| Health Benefits | 2.5% | (50) - (25) bps |
| CarelonRx | 5.6% | (25) - 0 bps |
| Carelon Services | 3.4% | 0 - 25 bps |
| Full Year 2025 Actual | Full Year 2026 Outlook |
|---|
| Elevance Health |
| Membership Guidance Summary |
| (Unaudited) |
| Year-End Medical Enrollment (in 000s) | | |
| Commercial Fee-Based | 27,092 | 27,200 - 27,500 |
| Commercial Risk-Based | 4,924 | 4,150 - 4,250 |
| Medicaid | 8,500 | 7,650 - 7,850 |
| Medicare Advantage | 2,230 | 1,775 - 1,875 |
| Medicare Supplement | 882 | Approximately 850 |
| Federal Employee Program | 1,604 | Approximately 1,550 |
| Fee-Based | 27,092 | 27,200 - 27,500 |
| Risk-Based | 18,140 | 15,975 - 16,375 |
| Total | 45,232 | 43,175 - 43,875 |
Forward-Looking Statements
Forward-looking statements notice
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,” “potential,” “predict” 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 required by law, we do not update or revise any forward-looking statements to reflect events or circumstances occurring after the date hereof. These risks and uncertainties include, but are not limited to: trends in healthcare costs and utilization rates; reduced enrollment; our ability to secure and implement sufficient premium rates; the impact of large scale medical emergencies, such as public health epidemics and pandemics, and other catastrophes; the impact of new or changes in existing federal, state and international laws or regulations, including laws and regulations impacting healthcare, insurance, pharmacy services and other diversified products and services, or their enforcement or application; the impact of cyber-attacks or other privacy or data security incidents or our failure to comply with any privacy, data or security laws or regulations, including any investigations, claims or litigation related thereto; failure to effectively maintain and modernize our information systems; failure of our information systems or technology, including artificial intelligence, to operate as intended; failure to effectively maintain the availability and integrity of our data; changes in economic and market conditions, as well as regulations that may negatively affect our liquidity and investment portfolios; competitive pressures and our ability to adapt to changes in the industry and develop and implement strategic growth opportunities; 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 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; our ability to contract with providers on cost-effective and competitive terms; risks associated with providing healthcare, pharmacy and other diversified products and services, including medical malpractice or professional liability claims and non-compliance by any party with the pharmacy services agreement between us and CaremarkPCS Health, L.L.C.; the effects of any negative publicity or sentiment related to the health benefits industry in general or us in particular; 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 and the risk that increased interest rates or market volatility could impact our access to or further increase the cost of financing; a downgrade in our financial strength ratings; events that may negatively affect our licenses with the Blue Cross and Blue Shield Association; intense competition to attract and retain employees; risks associated with our international operations; and various laws and provisions in our governing documents that may prevent or discourage takeovers and business combinations.
Contacts
888-947-9963 (Domestic) · 312-470-0178 (International)
888-566-0046 (Domestic Replay) · 203-369-3677 (International Replay)
Elevance Health Contacts: Investor Relations · Nathan Rich · Investor.Relations@elevancehealth.com
Media · Leslie Porras · Leslie.Porras@elevancehealth.com