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Deloitte & Touche LLP
Certified Public Accountants
Suite 3600
201 N Franklin Street
Tampa, FL 33602-5818
USA
Tel: +1 813 273 8300
www.deloitte.com
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Page
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Independent Auditors’ Report
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F-2
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Consolidated Statements of Comprehensive Income for the years ended December 31, 2019, 2018 and 2017
|
F-3
|
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Consolidated Balance Sheets as of December 31, 2019 and 2018
|
F-4
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Consolidated Statements of Changes in Stockholders’ Equity for the years ended December 31, 2019, 2018 and 2017
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F-5
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Consolidated Statements of Cash Flows for the years ended December 31, 2019, 2018 and 2017
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F-6
|
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Notes to Consolidated Financial Statements
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F-7
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For the Years Ended December 31,
|
||||||||||||
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2019
|
2018
|
2017
|
||||||||||
|
Revenues:
|
||||||||||||
|
Premium
|
$
|
27,230.2
|
$
|
20,146.3
|
$
|
16,960.3
|
||||||
|
Products and services
|
509.8
|
154.1
|
—
|
|||||||||
|
Investment and other income
|
161.0
|
113.7
|
46.9
|
|||||||||
|
Total revenues
|
27,901.0
|
20,414.1
|
17,007.2
|
|||||||||
|
Expenses and other:
|
||||||||||||
|
Medical benefits
|
23,936.6
|
17,128.1
|
14,744.8
|
|||||||||
|
Costs of products and services
|
495.7
|
148.6
|
—
|
|||||||||
|
Selling, general and administrative
|
2,225.7
|
1,701.0
|
1,484.7
|
|||||||||
|
ACA industry fee
|
—
|
344.1
|
—
|
|||||||||
|
Medicaid premium taxes
|
132.9
|
126.8
|
119.8
|
|||||||||
|
Depreciation and amortization
|
266.3
|
179.7
|
120.4
|
|||||||||
|
Interest
|
118.6
|
87.5
|
68.5
|
|||||||||
|
Total expenses, net
|
27,175.8
|
19,715.8
|
16,538.2
|
|||||||||
|
Income from operations
|
725.2
|
698.3
|
469.0
|
|||||||||
|
Loss on extinguishment of debt
|
—
|
—
|
26.1
|
|||||||||
|
Income before income taxes and equity in earnings of unconsolidated subsidiaries
|
725.2
|
698.3
|
442.9
|
|||||||||
|
Equity in earnings (losses) of unconsolidated subsidiaries
|
17.0
|
(5.5
|
)
|
18.7
|
||||||||
|
Income before income taxes
|
742.2
|
692.8
|
461.6
|
|||||||||
|
Income tax expense
|
159.3
|
253.0
|
87.9
|
|||||||||
|
Net income
|
$
|
582.9
|
$
|
439.8
|
$
|
373.7
|
||||||
|
Other comprehensive income, before tax:
|
||||||||||||
|
Change in net unrealized gains and losses on available-for-sale securities
|
23.9
|
(9.1
|
)
|
(2.2
|
)
|
|||||||
|
Income tax expense (benefit) related to other comprehensive income (loss)
|
6.0
|
(2.9
|
)
|
(0.5
|
)
|
|||||||
|
Other comprehensive income (loss), net of tax
|
17.9
|
(6.2
|
)
|
(1.7
|
)
|
|||||||
|
Comprehensive income
|
$
|
600.8
|
$
|
433.6
|
$
|
372.0
|
||||||
|
Earnings per common share (see Note 5):
|
||||||||||||
|
Basic
|
$
|
11.60
|
$
|
9.40
|
$
|
8.40
|
||||||
|
Diluted
|
$
|
11.46
|
$
|
9.29
|
$
|
8.31
|
||||||
|
Weighted average common shares outstanding:
|
||||||||||||
|
Basic
|
50,262,636
|
46,767,626
|
44,474,016
|
|||||||||
|
Diluted
|
50,869,514
|
47,354,536
|
44,967,061
|
|||||||||
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December 31,
|
||||||||
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Assets
|
2019
|
2018
|
||||||
|
Current Assets:
|
||||||||
|
Cash and cash equivalents
|
$
|
1,794.6
|
$
|
3,653.9
|
||||
|
Short-term investments
|
513.4
|
830.1
|
||||||
|
Premiums receivable, net
|
1,774.9
|
1,223.4
|
||||||
|
Pharmacy rebates receivable, net
|
456.6
|
460.6
|
||||||
|
Funds receivable for the benefit of members
|
205.9
|
187.3
|
||||||
|
Prepaid expenses and other current assets, net
|
1,204.9
|
477.1
|
||||||
|
Total current assets
|
5,950.3
|
6,832.4
|
||||||
|
Property, equipment and capitalized software, net
|
470.4
|
428.2
|
||||||
|
Goodwill
|
2,265.2
|
2,227.7
|
||||||
|
Other intangible assets, net
|
824.7
|
996.2
|
||||||
|
Long-term investments
|
2,719.2
|
813.2
|
||||||
|
Restricted cash, cash equivalents and investments
|
322.1
|
234.7
|
||||||
|
Other assets
|
269.3
|
18.7
|
||||||
|
Assets of discontinued operations
|
225.1
|
213.6
|
||||||
|
Total Assets
|
$
|
13,046.3
|
$
|
11,764.7
|
||||
|
Liabilities and Stockholders’ Equity
|
||||||||
|
Current Liabilities:
|
||||||||
|
Medical benefits payable
|
$
|
3,353.5
|
$
|
2,897.4
|
||||
|
Unearned premiums
|
110.2
|
1.4
|
||||||
|
Accounts payable and accrued expenses
|
1,606.2
|
964.6
|
||||||
|
Funds payable for the benefit of members
|
298.4
|
693.3
|
||||||
|
Other payables to government partners
|
233.7
|
458.9
|
||||||
|
Total current liabilities
|
5,602.0
|
5,015.6
|
||||||
|
Deferred income tax liability
|
148.4
|
134.2
|
||||||
|
Long-term debt, net
|
1,930.0
|
2,126.4
|
||||||
|
Other liabilities
|
245.5
|
34.9
|
||||||
|
Liabilities of discontinued operations
|
225.1
|
213.6
|
||||||
|
Total Liabilities
|
8,151.0
|
7,524.7
|
||||||
|
Commitments and contingencies (see Note 14)
|
—
|
—
|
||||||
|
Stockholders’ Equity:
|
||||||||
|
Preferred stock, $0.01 par value (20,000,000 authorized, no shares issued or outstanding)
|
—
|
—
|
||||||
|
Common stock, $0.01 par value (100,000,000 authorized, 50,387,921 and 49,993,219 shares issued and outstanding at December 31, 2019 and 2018, respectively)
|
0.5
|
0.5
|
||||||
|
Paid-in capital
|
2,035.6
|
1,981.1
|
||||||
|
Retained earnings
|
2,850.2
|
2,267.3
|
||||||
|
Accumulated other comprehensive loss
|
9.0
|
(8.9
|
)
|
|||||
|
Total Stockholders’ Equity
|
4,895.3
|
4,240.0
|
||||||
|
Total Liabilities and Stockholders’ Equity
|
$
|
13,046.3
|
$
|
11,764.7
|
||||
|
Common Stock
|
Paid in | Retained |
Accumulated
Other
Comprehensive
|
Total
Stockholders’
|
||||||||||||||||||||
|
Shares
|
Amount
|
Capital
|
Earnings
|
Loss
|
Equity
|
|||||||||||||||||||
|
Balance at January 1, 2017
|
44,293,881
|
$
|
0.4
|
$
|
546.9
|
$
|
1,453.8
|
$
|
(1.0
|
)
|
$
|
2,000.1
|
||||||||||||
|
Common stock issued for vested stock-based compensation awards
|
332,508
|
—
|
—
|
—
|
—
|
—
|
||||||||||||||||||
|
Repurchase and retirement of shares to satisfy tax withholding requirements
|
(103,401
|
)
|
—
|
(15.2
|
)
|
—
|
—
|
(15.2
|
)
|
|||||||||||||||
|
Stock-based compensation expense, net of forfeitures
|
—
|
—
|
59.8
|
—
|
—
|
59.8
|
||||||||||||||||||
|
Comprehensive income
|
—
|
—
|
—
|
373.7
|
(1.7
|
)
|
372.0
|
|||||||||||||||||
|
Balance at December 31, 2017
|
44,522,988
|
0.4
|
591.5
|
1,827.5
|
(2.7
|
)
|
2,416.7
|
|||||||||||||||||
|
Issuance of common stock, net of issuance costs
|
5,207,547
|
0.1
|
1,342.2
|
—
|
—
|
1,342.3
|
||||||||||||||||||
|
Common stock issued for vested stock-based compensation awards
|
377,688
|
—
|
—
|
—
|
—
|
—
|
||||||||||||||||||
|
Repurchase and retirement of shares to satisfy tax withholding requirements
|
(115,004
|
)
|
—
|
(23.4
|
)
|
—
|
—
|
(23.4
|
)
|
|||||||||||||||
|
Stock-based compensation expense, net of forfeitures
|
—
|
—
|
70.8
|
—
|
—
|
70.8
|
||||||||||||||||||
|
Comprehensive income (loss)
|
—
|
—
|
—
|
439.8
|
(6.2
|
)
|
433.6
|
|||||||||||||||||
|
Balance at December 31, 2018
|
49,993,219
|
0.5
|
1,981.1
|
2,267.3
|
(8.9
|
)
|
4,240.0
|
|||||||||||||||||
|
Common stock issued for vested equity-compensation awards
|
585,747
|
—
|
—
|
—
|
—
|
—
|
||||||||||||||||||
|
Repurchase and retirement of shares to satisfy tax withholding requirements
|
(191,045
|
)
|
—
|
(52.3
|
)
|
—
|
—
|
(52.3
|
)
|
|||||||||||||||
|
Stock-based compensation expense, net of forfeitures
|
—
|
—
|
106.8
|
—
|
—
|
106.8
|
||||||||||||||||||
|
Comprehensive income
|
—
|
—
|
—
|
582.9
|
17.9
|
600.8
|
||||||||||||||||||
|
Balance at December 31, 2019
|
50,387,921
|
$
|
0.5
|
$
|
2,035.6
|
$
|
2,850.2
|
$
|
9.0
|
$
|
4,895.3
|
|||||||||||||
|
For the Years Ended December 31,
|
||||||||||||
|
2019
|
2018
|
2017
|
||||||||||
|
Cash flows from operating activities:
|
||||||||||||
|
Net income
|
$
|
582.9
|
$
|
439.8
|
$
|
373.7
|
||||||
|
Adjustments to reconcile net income to cash flows from operating activities:
|
||||||||||||
|
Depreciation and amortization
|
266.3
|
179.7
|
120.4
|
|||||||||
|
Loss on extinguishment of debt
|
—
|
—
|
26.1
|
|||||||||
|
Stock-based compensation expense
|
106.8
|
70.8
|
59.8
|
|||||||||
|
Deferred taxes, net
|
18.9
|
1.1
|
(47.1
|
)
|
||||||||
|
Other, net
|
21.6
|
23.0
|
18.2
|
|||||||||
|
Changes in operating accounts, net of effects from acquisitions:
|
||||||||||||
|
Premiums receivable, net
|
(563.5
|
)
|
(399.9
|
)
|
136.4
|
|||||||
|
Pharmacy rebates receivable, net
|
4.0
|
(104.7
|
)
|
(44.1
|
)
|
|||||||
|
Medical benefits payable
|
456.1
|
216.8
|
328.3
|
|||||||||
|
Unearned premiums
|
108.8
|
(94.1
|
)
|
63.9
|
||||||||
|
Other receivables/payables to government partners
|
(350.0
|
)
|
129.1
|
8.0
|
||||||||
|
Prepaid and other current assets
|
(142.3
|
)
|
(148.1
|
)
|
(26.6
|
)
|
||||||
|
Accrued liabilities and other, net
|
75.4
|
(34.5
|
)
|
33.0
|
||||||||
|
Net cash provided by operating activities
|
$
|
585.0
|
$
|
279.0
|
$
|
1,050.0
|
||||||
|
Cash flows from investing activities:
|
||||||||||||
|
Acquisitions and acquisition-related settlements
|
$
|
(8.6
|
)
|
$
|
(2,142.9
|
)
|
$
|
(728.3
|
)
|
|||
|
Purchases of investments
|
(7,594.0
|
)
|
(1,832.7
|
)
|
(1,395.5
|
)
|
||||||
|
Proceeds from sales and maturities of investments
|
5,999.3
|
1,561.1
|
515.7
|
|||||||||
|
Additions to property, equipment and capitalized software, net
|
(190.4
|
)
|
(153.5
|
)
|
(128.4
|
)
|
||||||
|
Net cash used in investing activities
|
$
|
(1,793.7
|
)
|
$
|
(2,568.0
|
)
|
$
|
(1,736.5
|
)
|
|||
|
Cash flows from financing activities:
|
||||||||||||
|
Proceeds from debt, net of financing costs paid
|
$
|
—
|
$
|
739.0
|
$
|
1,182.2
|
||||||
|
Borrowings on Revolving Credit Facility, net of financing costs paid
|
140.0
|
221.3
|
—
|
|||||||||
|
Payments on debt
|
(340.0
|
)
|
(25.0
|
)
|
(1,026.1
|
)
|
||||||
|
Proceeds from issuance of common stock, net of issuance fees paid
|
—
|
1,342.3
|
—
|
|||||||||
|
Repurchase and retirement of shares to satisfy tax withholding requirements
|
(39.7
|
)
|
(23.4
|
)
|
(15.2
|
)
|
||||||
|
Funds (paid) received for the benefit of members, net
|
(361.1
|
)
|
(520.6
|
)
|
671.6
|
|||||||
|
Other, net
|
13.7
|
9.0
|
15.7
|
|||||||||
|
Net cash (used in) provided by financing activities
|
$
|
(587.1
|
)
|
$
|
1,742.6
|
$
|
828.2
|
|||||
|
(Decrease) increase in cash, cash equivalents and restricted cash and cash equivalents
|
(1,795.8
|
)
|
(546.4
|
)
|
141.7
|
|||||||
|
Balance at beginning of period
|
3,716.6
|
4,263.0
|
4,121.3
|
|||||||||
|
Balance at end of period
|
$
|
1,920.8
|
$
|
3,716.6
|
$
|
4,263.0
|
||||||
|
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION:
|
||||||||||||
|
Cash paid for taxes, net of refunds
|
$
|
148.9
|
$
|
221.3
|
$
|
167.2
|
||||||
|
Cash paid for interest
|
$
|
114.1
|
$
|
68.2
|
$
|
57.0
|
||||||
|
SUPPLEMENTAL DISCLOSURES OF NON-CASH TRANSACTIONS:
|
||||||||||||
|
Non-cash additions to property, equipment, and capitalized software
|
$
|
14.4
|
$
|
13.8
|
$
|
3.5
|
||||||
|
As of December 31,
|
||||||||
|
2019
|
2018
|
|||||||
|
Liability to states under Medicaid risk sharing provisions
|
$
|
(152.3
|
)
|
$
|
(178.5
|
)
|
||
|
Receivable from / (liability to) CMS under risk corridor and other provisions
|
94.9
|
(232.0
|
)
|
|||||
|
Liability to CMS under MA/PDP minimum MLR provisions of the ACA
|
(23.0
|
)
|
(19.9
|
)
|
||||
|
Net payables to government partners(1)
|
$
|
(80.4
|
)
|
$
|
(430.4
|
)
|
||
|
As of December 31,
|
||||||||
|
2019
|
2018
|
|||||||
|
Low-income cost sharing subsidy
|
$
|
87.8
|
$
|
97.7
|
||||
|
Catastrophic reinsurance subsidy
|
(150.5
|
)
|
(583.2
|
)
|
||||
|
Coverage gap discount subsidy
|
(29.8
|
)
|
(20.5
|
)
|
||||
|
Funds payable for the benefit of members, net(1)
|
$
|
(92.5
|
)
|
$
|
(506.0
|
)
|
||
| • |
our entry into new geographical markets;
|
| • |
our provision of services to new populations such as the aged, blind and disabled;
|
| • |
variations in utilization of benefits and increasing medical costs, including higher drug costs;
|
| • |
changes in provider reimbursement arrangements;
|
| • |
variations in claims processing speed and patterns, claims payment and the severity of claims; and
|
| • |
health epidemics or outbreaks of disease such as the flu or enterovirus.
|
| • |
Financial and Quality Performance Goals: Certain of our PSUs are subject to variable accounting as they do not have a grant date fair value for accounting purposes due to the subjective nature of the terms of the PSUs, which
precludes a mutual understanding of the key terms and conditions. We recognize expense for PSUs ultimately expected to vest over the requisite service period based on our estimates of progress made towards the achievement of the
predetermined performance measures and changes in the market price of our common stock. In March 2016, we issued certain PSUs whereby a mutual understanding of key terms and conditions exist; therefore, for these awards we estimate
compensation cost based on the grant date fair value, as well as our estimate of the performance outcome, and recognize the expense ratably over the vesting period of the award with cumulative changes in expense recognized in periods in
which performance conditions change or are ultimately met.
|
| • |
Market Based Goals: Beginning in 2016, we issued certain PSUs, which are subject to a market condition (total shareholder return relative to industry peer companies or prescribed stock price growth) and we estimate compensation cost
based on the grant date fair value and recognize the expense ratably over the vesting period of the award. For these PSUs, the grant date fair value is measured using a Monte Carlo simulation approach, which estimates the fair value of
awards based on randomly generated simulated stock-price paths through a lattice-type structure. PSUs expected to vest are recognized as expense either on a straight-line or accelerated basis, depending on the award structure, over the
vesting period.
|
| • |
the length of time and the extent to which the market value has been below cost;
|
| • |
the potential for impairments of securities when the issuer is experiencing significant financial difficulties;
|
| • |
the potential for impairments in an entire industry sector or sub-sector;
|
| • |
the potential for impairments in certain economically depressed geographic locations;
|
| • |
the potential for impairments of securities where the issuer, series of issuers or industry has suffered a catastrophic type of loss or has exhausted natural resources;
|
| • |
unfavorable changes in forecasted cash flows on asset-backed securities; and
|
| • |
other subjective factors, including concentrations and information obtained from regulators and rating agencies.
|
|
Assets
|
(in millions)
|
|||
|
Cash, cash equivalents and restricted cash
|
$
|
484.4
|
||
|
Investments, including restricted investments
|
180.4
|
|||
|
Premiums receivable, net
|
379.6
|
|||
|
Other current assets
|
139.2
|
|||
|
Property, equipment and capitalized software, net
|
49.3
|
|||
|
Goodwill
|
1,598.2
|
|||
|
Other intangible assets, net
|
543.5
|
|||
|
Fair value of total assets acquired
|
$
|
3,374.6
|
||
|
Liabilities
|
||||
|
Medical benefits payable
|
$
|
534.3
|
||
|
ACA Fee liability
|
66.5
|
|||
|
Other liabilities
|
253.7
|
|||
|
Fair value of liabilities assumed
|
854.5
|
|||
|
Fair value of net assets acquired
|
$
|
2,520.1
|
||
|
Gross Fair Value
(in millions)
|
Weighted Average
Useful Life (in years)
|
|||||||
|
Membership
|
$
|
326.8
|
8.2
|
|||||
|
Tradenames
|
113.8
|
4.9
|
||||||
|
Provider network
|
8.3
|
15.0
|
||||||
|
Technology and other
|
94.6
|
5.8
|
||||||
|
Total
|
$
|
543.5
|
7.2
|
|||||
|
For the years ended December 31,
|
||||||||
|
(in millions, except per share data)
|
2018
|
2017
|
||||||
|
Total revenues
|
$
|
23,408.6
|
$
|
20,598.2
|
||||
|
Net income
|
$
|
420.8
|
$
|
376.1
|
||||
|
Earnings per common share:
|
||||||||
|
Basic
|
$
|
8.47
|
$
|
7.57
|
||||
|
Diluted
|
$
|
8.16
|
$
|
7.50
|
||||
| • |
Elimination of historical intangible asset amortization expense and addition of amortization expense based on the current preliminary values of identified intangible assets;
|
| • |
Elimination of interest expense associated with retired obligations and addition of interest expense based on debt incurred to finance the Meridian transaction;
|
| • |
Elimination of results for Meridian operations not acquired;
|
| • |
Elimination of transaction and integration-related costs;
|
| • |
Elimination of Universal American discontinued operations;
|
| • |
Include 5,207,547 shares of our common stock issued to finance the Meridian transaction;
|
| • |
Adjustments to align the acquisitions to our accounting policies; and
|
| • |
Tax effects of the adjustments noted above.
|
|
For the Years Ended December 31,
|
||||||||||||
|
2019
|
2018
|
2017
|
||||||||||
|
Florida
|
19
|
%
|
12
|
%
|
15
|
%
|
||||||
|
Illinois
|
13
|
%
|
*
|
*
|
||||||||
|
Kentucky
|
10
|
%
|
14
|
%
|
15
|
%
|
||||||
|
Medicaid
Health Plan
|
Medicare
Health Plan
|
Medicare
PDP
|
Corporate &
Other
|
Consolidated
|
||||||||||||||||
|
For the Year Ended December 31, 2019
|
(in millions)
|
|||||||||||||||||||
|
Premium
|
$
|
18,826.2
|
$
|
7,331.6
|
$
|
1,053.8
|
$
|
18.6
|
$
|
27,230.2
|
||||||||||
|
Products and services
|
—
|
—
|
—
|
509.8
|
509.8
|
|||||||||||||||
|
Total premium and products and services revenues
|
18,826.2
|
7,331.6
|
1,053.8
|
528.4
|
27,740.0
|
|||||||||||||||
|
Medical benefits
|
16,907.0
|
6,175.2
|
843.4
|
11.0
|
23,936.6
|
|||||||||||||||
|
Costs of products and services
|
—
|
—
|
—
|
495.7
|
495.7
|
|||||||||||||||
|
ACA industry fee
|
—
|
—
|
—
|
—
|
—
|
|||||||||||||||
|
Medicaid premium taxes
|
132.9
|
—
|
—
|
—
|
132.9
|
|||||||||||||||
|
Total gross margin expenses
|
17,039.9
|
6,175.2
|
843.4
|
506.7
|
24,565.2
|
|||||||||||||||
|
Gross margin
|
1,786.3
|
1,156.4
|
210.4
|
21.7
|
3,174.8
|
|||||||||||||||
|
Investment and other income
|
—
|
—
|
—
|
—
|
161.0
|
|||||||||||||||
|
Other expenses
|
—
|
—
|
—
|
—
|
(2,610.6
|
)
|
||||||||||||||
|
Income from operations
|
$
|
1,786.3
|
$
|
1,156.4
|
$
|
210.4
|
$
|
21.7
|
$
|
725.2
|
||||||||||
|
For the Year Ended December 31, 2018
|
||||||||||||||||||||
|
Premium
|
$
|
12,992.8
|
$
|
6,313.8
|
$
|
835.0
|
$
|
4.7
|
$
|
20,146.3
|
||||||||||
|
Products and services
|
—
|
—
|
—
|
154.1
|
154.1
|
|||||||||||||||
|
Total premium and products and services revenues
|
12,992.8
|
6,313.8
|
835.0
|
158.8
|
20,300.4
|
|||||||||||||||
|
Medical benefits
|
11,171.3
|
5,347.8
|
604.8
|
4.2
|
17,128.1
|
|||||||||||||||
|
Costs of products and services
|
—
|
—
|
—
|
148.6
|
148.6
|
|||||||||||||||
|
ACA industry fee
|
216.3
|
109.4
|
18.3
|
0.1
|
344.1
|
|||||||||||||||
|
Medicaid premium taxes
|
126.8
|
—
|
—
|
—
|
126.8
|
|||||||||||||||
|
Total gross margin expenses
|
11,514.4
|
5,457.2
|
623.1
|
152.9
|
17,747.6
|
|||||||||||||||
|
Gross margin
|
1,478.4
|
856.6
|
211.9
|
5.9
|
2,552.8
|
|||||||||||||||
|
Investment and other income
|
—
|
—
|
—
|
113.7
|
113.7
|
|||||||||||||||
|
Other expenses
|
—
|
—
|
—
|
(1,968.2
|
)
|
(1,968.2
|
)
|
|||||||||||||
|
Income from operations
|
$
|
1,478.4
|
$
|
856.6
|
$
|
211.9
|
$
|
(1,848.6
|
)
|
$
|
698.3
|
|||||||||
|
Medicaid
Health Plan
|
Medicare
Health Plan
|
Medicare
PDP
|
Corporate &
Other
|
Consolidated
|
||||||||||||||||
|
For the Year Ended December 31, 2017
|
(in millions)
|
|||||||||||||||||||
|
Premium
|
$
|
10,726.3
|
$
|
5,320.2
|
$
|
913.8
|
$
|
—
|
$
|
16,960.3
|
||||||||||
|
Products and services
|
—
|
—
|
—
|
—
|
—
|
|||||||||||||||
|
Total premium and products and services revenues
|
10,726.3
|
5,320.2
|
913.8
|
—
|
16,960.3
|
|||||||||||||||
|
Medical benefits
|
9,414.1
|
4,577.3
|
753.4
|
—
|
14,744.8
|
|||||||||||||||
|
Costs of products and services
|
—
|
—
|
—
|
—
|
—
|
|||||||||||||||
|
ACA industry fee
|
—
|
—
|
—
|
—
|
—
|
|||||||||||||||
|
Medicaid premium taxes
|
119.8
|
—
|
—
|
—
|
119.8
|
|||||||||||||||
|
Total gross margin expenses
|
9,533.9
|
4,577.3
|
753.4
|
—
|
14,864.6
|
|||||||||||||||
|
Gross margin
|
1,192.4
|
742.9
|
160.4
|
—
|
2,095.7
|
|||||||||||||||
|
Investment and other income
|
—
|
—
|
—
|
46.9
|
46.9
|
|||||||||||||||
|
Other expenses
|
—
|
—
|
—
|
(1,673.6
|
)
|
(1,673.6
|
)
|
|||||||||||||
|
Income from operations
|
$
|
1,192.4
|
$
|
742.9
|
$
|
160.4
|
$
|
(1,626.7
|
)
|
$
|
469.0
|
|||||||||
|
For the Years Ended December 31,
|
||||||||||||
|
2019
|
2018
|
2017
|
||||||||||
|
Weighted-average common shares outstanding — basic
|
50,262,636
|
46,767,626
|
44,474,016
|
|||||||||
|
Dilutive effect of outstanding stock-based compensation awards
|
606,878
|
586,910
|
493,045
|
|||||||||
|
Weighted-average common shares outstanding — diluted
|
50,869,514
|
47,354,536
|
44,967,061
|
|||||||||
|
Anti-dilutive stock-based compensation awards excluded from computation
|
108,339
|
211,978
|
76,446
|
|||||||||
|
Amortized
Cost
|
Gross
Unrealized
Gains
|
Gross
Unrealized
Losses
|
Estimated
Fair Value
|
|||||||||||||
|
December 31, 2019
|
||||||||||||||||
|
Debt securities:
|
||||||||||||||||
|
Asset-backed securities
|
$
|
315.5
|
$
|
0.6
|
$
|
(0.6
|
)
|
$
|
315.5
|
|||||||
|
Corporate debt securities
|
1,360.0
|
10.8
|
(1.2
|
)
|
1,369.6
|
|||||||||||
|
Municipal securities
|
161.9
|
1.9
|
(0.6
|
)
|
163.2
|
|||||||||||
|
Residential mortgage-backed securities
|
514.5
|
1.4
|
(0.9
|
)
|
515.0
|
|||||||||||
|
Short-term time deposits
|
82.6
|
—
|
—
|
82.6
|
||||||||||||
|
Government and agency obligations
|
38.1
|
—
|
(0.1
|
)
|
38.0
|
|||||||||||
|
Other securities
|
231.6
|
0.2
|
(1.1
|
)
|
230.7
|
|||||||||||
|
Total debt securities
|
$
|
2,704.2
|
$
|
14.9
|
$
|
(4.5
|
)
|
$
|
2,714.6
|
|||||||
|
Equity securities(1)
|
518.0
|
—
|
$
|
—
|
518.0
|
|||||||||||
|
Total
|
$
|
3,222.2
|
$
|
14.9
|
$
|
(4.5
|
)
|
$
|
3,232.6
|
|||||||
|
December 31, 2018
|
||||||||||||||||
|
Asset-backed securities
|
$
|
144.7
|
$
|
—
|
$
|
(0.5
|
)
|
$
|
144.2
|
|||||||
|
Corporate debt securities
|
943.0
|
0.5
|
(10.1
|
)
|
933.4
|
|||||||||||
|
Municipal securities
|
199.6
|
0.6
|
(0.9
|
)
|
199.3
|
|||||||||||
|
Residential mortgage-backed securities
|
7.2
|
—
|
(0.2
|
)
|
7.0
|
|||||||||||
|
Short-term time deposits
|
242.2
|
—
|
—
|
242.2
|
||||||||||||
|
Government and agency obligations
|
44.9
|
—
|
(0.1
|
)
|
44.8
|
|||||||||||
|
Other securities
|
72.5
|
—
|
(0.1
|
)
|
72.4
|
|||||||||||
|
Total(1)
|
$
|
1,654.1
|
$
|
1.1
|
$
|
(11.9
|
)
|
$
|
1,643.3
|
|||||||
|
Amortized Costs
|
Fair Value
|
|||||||
|
Due in one year or less
|
$
|
455.7
|
$
|
456.0
|
||||
|
Due after one year through five years
|
932.7
|
939.3
|
||||||
|
Due after five years through ten years
|
286.9
|
290.9
|
||||||
|
Due after ten years
|
15.4
|
15.3
|
||||||
|
Asset-backed and mortgage-backed securities
|
1,013.5
|
1,013.1
|
||||||
|
Total
|
$
|
2,704.2
|
$
|
2,714.6
|
||||
|
Amortized
Cost
|
Gross
Unrealized
Gains
|
Gross
Unrealized
Losses
|
Estimated
Fair Value
|
|||||||||||||
|
December 31, 2019
|
||||||||||||||||
|
Cash
|
$
|
5.2
|
$
|
—
|
$
|
—
|
$
|
5.2
|
||||||||
|
Money market funds
|
121.0
|
—
|
—
|
121.0
|
||||||||||||
|
U.S. government securities and other
|
195.8
|
0.1
|
—
|
195.9
|
||||||||||||
|
Total
|
$
|
322.0
|
$
|
0.1
|
$
|
—
|
$
|
322.1
|
||||||||
|
December 31, 2018
|
||||||||||||||||
|
Cash
|
$
|
11.3
|
$
|
—
|
$
|
—
|
$
|
11.3
|
||||||||
|
Money market funds
|
51.4
|
—
|
—
|
51.4
|
||||||||||||
|
U.S. government securities and other
|
172.5
|
—
|
(0.5
|
)
|
172.0
|
|||||||||||
|
Total
|
$
|
235.2
|
$
|
—
|
$
|
(0.5
|
)
|
$
|
234.7
|
|||||||
|
December 31,
|
||||||||
|
2019
|
2018
|
|||||||
|
Capitalized software
|
$
|
800.4
|
$
|
671.7
|
||||
|
Computer equipment
|
208.6
|
173.2
|
||||||
|
Leasehold improvements
|
86.1
|
75.5
|
||||||
|
Furniture and equipment
|
73.2
|
69.3
|
||||||
|
1,168.3
|
989.7
|
|||||||
|
Less accumulated depreciation
|
(697.9
|
)
|
(561.5
|
)
|
||||
|
Total property, equipment and capitalized software, net
|
$
|
470.4
|
$
|
428.2
|
||||
|
Medicaid
Health
Plans
|
Medicare
Health
Plans
|
Corporate
and Other
|
Not
Assigned
|
Total
|
||||||||||||||||
|
Balance as of December 31, 2017 (1)(2)
|
$
|
274.7
|
$
|
386.0
|
$
|
—
|
$
|
—
|
$
|
660.7
|
||||||||||
|
Acquired goodwill
|
—
|
—
|
—
|
1,560.7
|
1,560.7
|
|||||||||||||||
|
Measurement period adjustments
|
—
|
6.3
|
—
|
—
|
6.3
|
|||||||||||||||
|
Balance as of December 31, 2018 (1)
|
274.7
|
392.3
|
—
|
1,560.7
|
2,227.7
|
|||||||||||||||
|
Acquired goodwill
|
—
|
—
|
—
|
—
|
—
|
|||||||||||||||
|
Measurement period adjustments (2)
|
1,416.3
|
119.0
|
62.9
|
(1,560.7
|
)
|
37.5
|
||||||||||||||
|
Balance as of December 31, 2019 (1)
|
$
|
1,691.0
|
$
|
511.3
|
$
|
62.9
|
$
|
—
|
$
|
2,265.2
|
||||||||||
|
As of December 31,
|
||||||||||||||||||||||||||||
|
2019
|
2018
|
|||||||||||||||||||||||||||
|
Weighted
Average
Amortization
Period
(In Years)
|
Gross
Carrying
Amount
|
Accumulated
Amortization
|
Other
Intangibles,
Net
|
Gross
Carrying
Amount
|
Accumulated
Amortization
|
Other
Intangibles,
Net
|
||||||||||||||||||||||
|
Membership and state contracts
|
9.1
|
$
|
787.0
|
$
|
(173.7
|
)
|
$
|
613.3
|
$
|
830.1
|
$
|
(100.7
|
)
|
$
|
729.4
|
|||||||||||||
|
Trademarks and tradenames
|
15.0
|
163.1
|
(55.8
|
)
|
107.3
|
159.8
|
(22.6
|
)
|
137.2
|
|||||||||||||||||||
|
Provider networks
|
5.7
|
35.6
|
(9.2
|
)
|
26.4
|
35.6
|
(7.0
|
)
|
28.6
|
|||||||||||||||||||
|
Licenses and permits
|
13.7
|
7.9
|
$
|
(5.1
|
)
|
2.8
|
7.9
|
(4.5
|
)
|
3.4
|
||||||||||||||||||
|
Technology and other
|
7.5
|
108.7
|
(33.8
|
)
|
74.9
|
110.8
|
(13.2
|
)
|
97.6
|
|||||||||||||||||||
|
Total other intangible assets
|
8.8
|
$
|
1,102.3
|
$
|
(277.6
|
)
|
$
|
824.7
|
$
|
1,144.2
|
$
|
(148.0
|
)
|
$
|
996.2
|
|||||||||||||
|
Expected
Amortization
Expense
|
||||
|
2020
|
$
|
135.1
|
||
|
2021
|
134.9
|
|||
|
2022
|
132.3
|
|||
|
2023
|
119.8
|
|||
|
2024
|
88.5
|
|||
|
2025 and thereafter
|
214.1
|
|||
|
Total
|
$
|
824.7
|
||
|
December 31, 2019
|
December 31, 2018
|
|||||||
|
Long-term debt, net:
|
||||||||
|
5.25% Senior Notes, due April 1, 2025
|
$
|
1,200.0
|
$
|
1,200.0
|
||||
|
5.375% Senior Notes, due August 15, 2026
|
750.0
|
750.0
|
||||||
|
Revolving Credit Facility
|
—
|
200.0
|
||||||
|
Debt issuance costs
|
(20.0
|
)
|
(23.6
|
)
|
||||
|
Total long-term debt, net
|
$
|
1,930.0
|
$
|
2,126.4
|
||||
| • |
incur additional indebtedness and issue preferred stock;
|
| • |
pay dividends or make other distributions;
|
| • |
make other restricted payments and investments;
|
| • |
sell assets, including capital stock of restricted subsidiaries;
|
| • |
create certain liens;
|
| • |
incur restrictions on the ability of restricted subsidiaries to pay dividends or make other payments, and in the case of our subsidiaries, guarantee indebtedness;
|
| • |
engage in transactions with affiliates; and
|
| • |
create unrestricted subsidiaries.
|
| (1) |
at least 50% of the aggregate principal amount of the 2026 Notes issued under the Indenture (including any additional 2026 Notes, but excluding 2026 Notes held by the Company or its subsidiaries) remains outstanding immediately after
the occurrence of such redemption, unless all such 2026 Notes are redeemed substantially concurrently with the redemption of 2026 Notes; and
|
| (2) |
the redemption occurs within 180 days of the date of the closing of such equity offering.
|
|
Period
|
Redemption Price
|
|||
|
2021
|
104.031
|
%
|
||
|
2022
|
102.688
|
%
|
||
|
2023
|
101.344
|
%
|
||
|
2024 and thereafter
|
100.000
|
%
|
||
| • |
incur additional indebtedness and issue preferred stock;
|
| • |
pay dividends or make distributions;
|
| • |
make other restricted payments and investments;
|
| • |
sell assets, including capital stock of restricted subsidiaries;
|
| • |
create certain liens;
|
| • |
incur restrictions on the ability of restricted subsidiaries to pay dividends or make other payments, and in the case of our subsidiaries, guarantee indebtedness;
|
| • |
engage in transactions with affiliates; and
|
| • |
create unrestricted subsidiaries.
|
|
Period
|
Redemption Price
|
|||
|
2020
|
103.938
|
%
|
||
|
2021
|
102.625
|
%
|
||
|
2022
|
101.313
|
%
|
||
|
2023 and thereafter
|
100.000
|
%
|
||
|
Fair Value Measurements Using
|
||||||||||||||||
|
Carrying Value
|
Quoted Prices in
Active Markets
for Identical
Assets
(Level 1)
|
Significant Other
Observable
Inputs
(Level 2)
|
Significant
Unobservable
Inputs
(Level 3)
|
|||||||||||||
|
Investments:
|
||||||||||||||||
|
Debt securities:
|
||||||||||||||||
|
Asset-backed securities
|
$
|
315.5
|
$
|
—
|
$
|
315.5
|
$
|
—
|
||||||||
|
Corporate debt securities
|
1,369.6
|
—
|
1,369.6
|
—
|
||||||||||||
|
Municipal securities
|
163.2
|
—
|
163.2
|
—
|
||||||||||||
|
Residential mortgage-backed securities
|
515.0
|
—
|
515.0
|
—
|
||||||||||||
|
Short-term time deposits
|
82.6
|
—
|
82.6
|
—
|
||||||||||||
|
Government and agency obligations
|
38.0
|
38.0
|
—
|
—
|
||||||||||||
|
Other securities
|
230.7
|
48.1
|
182.6
|
—
|
||||||||||||
|
Total debt securities
|
2,714.6
|
86.1
|
2,628.5
|
—
|
||||||||||||
|
Equity securities(1)
|
518.0
|
516.0
|
2.0
|
—
|
||||||||||||
|
Total investments
|
$
|
3,232.6
|
$
|
602.1
|
$
|
2,630.5
|
$
|
—
|
||||||||
|
Restricted cash, cash equivalents and investments:
|
||||||||||||||||
|
Cash
|
$
|
5.2
|
$
|
5.2
|
$
|
—
|
$
|
—
|
||||||||
|
Money market funds
|
121.0
|
121.0
|
—
|
—
|
||||||||||||
|
U.S. government securities and other
|
195.9
|
195.7
|
0.2
|
—
|
||||||||||||
|
Total restricted cash, cash equivalents and investments
|
$
|
322.1
|
$
|
321.9
|
$
|
0.2
|
$
|
—
|
||||||||
|
Fair Value Measurements Using
|
||||||||||||||||
|
Carrying Value
|
Quoted Prices in
Active Markets
for Identical
Assets
(Level 1)
|
Significant
Other
Observable
Inputs
(Level 2)
|
Significant
Unobservable
Inputs
(Level 3)
|
|||||||||||||
|
Investments:
|
||||||||||||||||
|
Asset-backed securities
|
$
|
144.2
|
$
|
—
|
$
|
144.2
|
$
|
—
|
||||||||
|
Corporate debt securities
|
933.4
|
—
|
933.4
|
—
|
||||||||||||
|
Municipal securities
|
199.3
|
—
|
199.3
|
—
|
||||||||||||
|
Residential mortgage-backed securities
|
7.0
|
—
|
7.0
|
—
|
||||||||||||
|
Short-term time deposits
|
242.2
|
—
|
242.2
|
—
|
||||||||||||
|
Government and agency obligations
|
44.8
|
44.8
|
—
|
—
|
||||||||||||
|
Other securities
|
72.4
|
49.8
|
22.6
|
—
|
||||||||||||
|
Total investments(1)
|
$
|
1,643.3
|
$
|
94.6
|
$
|
1,548.7
|
$
|
—
|
||||||||
|
Restricted cash, cash equivalents and investments:
|
||||||||||||||||
|
Cash
|
11.3
|
11.3
|
—
|
—
|
||||||||||||
|
Money market funds
|
$
|
51.4
|
$
|
51.4
|
$
|
—
|
$
|
—
|
||||||||
|
U.S. government securities and other
|
172.0
|
171.8
|
0.2
|
—
|
||||||||||||
|
Total restricted cash, cash equivalents and investments
|
$
|
234.7
|
$
|
234.5
|
$
|
0.2
|
$
|
—
|
||||||||
|
Fair Value Measurements Using Significant
Unobservable Inputs (Level 3)
|
||||||||||||
|
December 31,
|
||||||||||||
|
2019
|
2018
|
2017
|
||||||||||
|
Balance as of January 1
|
$
|
—
|
$
|
12.3
|
$
|
12.4
|
||||||
|
Realized gains (losses) in earnings
|
—
|
(1.2
|
)
|
—
|
||||||||
|
Changes in net unrealized gains and losses in other comprehensive income
|
—
|
1.4
|
—
|
|||||||||
|
Purchases, sales and redemptions
|
—
|
(12.5
|
)
|
(0.1
|
)
|
|||||||
|
Net transfers in or (out) of Level 3
|
—
|
—
|
—
|
|||||||||
|
Balance as of December 31
|
$
|
—
|
$
|
—
|
$
|
12.3
|
||||||
|
Fair Value Measurements Using
|
||||||||||||||||
|
Carrying
Value
|
Quoted Prices
in Active
Markets for
Identical Assets
(Level 1)
|
Significant
Other
Observable
Inputs
(Level 2)
|
Significant
Unobservable
Inputs
(Level 3)
|
|||||||||||||
|
Long-term debt - December 31, 2019
|
$
|
1,930.0
|
$
|
2,057.7
|
$
|
—
|
$
|
—
|
||||||||
|
Long-term debt - December 31, 2018
|
2,126.4
|
1,885.2
|
200.0
|
—
|
||||||||||||
|
(in millions)
|
As of
December 31,
2019
|
% of
Total
|
As of
December 31,
2018
|
% of
Total
|
||||||||||||
|
IBNR
|
$
|
2,345.7
|
70
|
%
|
$
|
2,029.8
|
70
|
%
|
||||||||
|
Other medical benefits payable
|
1,007.8
|
30
|
%
|
867.6
|
30
|
%
|
||||||||||
|
Total medical benefits payable
|
$
|
3,353.5
|
100
|
%
|
$
|
2,897.4
|
100
|
%
|
||||||||
|
For the years ended December 31,
|
||||||||||||
|
2019
|
2018
|
2017
|
||||||||||
|
(in millions)
|
||||||||||||
|
Beginning balance
|
$
|
2,897.4
|
$
|
2,146.3
|
$
|
1,690.5
|
||||||
|
Acquisitions
|
—
|
534.3
|
128.1
|
|||||||||
|
Medical benefits incurred related to:
|
||||||||||||
|
Current year (1)
|
24,412.8
|
17,603.3
|
15,112.4
|
|||||||||
|
Prior years
|
(476.2
|
)
|
(475.2
|
)
|
(367.6
|
)
|
||||||
|
Total
|
23,936.6
|
17,128.1
|
14,744.8
|
|||||||||
|
Medical benefits paid related to:
|
||||||||||||
|
Current year
|
(21,407.5
|
)
|
(15,486.2
|
)
|
(13,355.9
|
)
|
||||||
|
Prior years
|
(2,073.0
|
)
|
(1,425.1
|
)
|
(1,061.2
|
)
|
||||||
|
Total
|
(23,480.5
|
)
|
(16,911.3
|
)
|
(14,417.1
|
)
|
||||||
|
Ending balance
|
$
|
3,353.5
|
$
|
2,897.4
|
$
|
2,146.3
|
||||||
|
For the years ended December 31,
|
||||||||||||
|
2019
|
2018
|
2017
|
||||||||||
|
(in millions)
|
||||||||||||
|
Beginning balance
|
$
|
2,012.8
|
$
|
1,373.2
|
$
|
1,135.8
|
||||||
|
Acquisitions
|
—
|
484.0
|
—
|
|||||||||
|
Medical benefits incurred related to:
|
||||||||||||
|
Current year (1)
|
17,207.7
|
11,454.4
|
9,612.2
|
|||||||||
|
Prior years
|
(300.7
|
)
|
(283.1
|
)
|
(198.1
|
)
|
||||||
|
Total
|
16,907.0
|
11,171.3
|
9,414.1
|
|||||||||
|
Medical benefits paid related to:
|
||||||||||||
|
Current year
|
(15,190.4
|
)
|
(10,081.7
|
)
|
(8,417.4
|
)
|
||||||
|
Prior years
|
(1,434.1
|
)
|
(934.0
|
)
|
(759.3
|
)
|
||||||
|
Total
|
(16,624.5
|
)
|
(11,015.7
|
)
|
(9,176.7
|
)
|
||||||
|
Ending balance
|
$
|
2,295.3
|
$
|
2,012.8
|
$
|
1,373.2
|
||||||
|
Incurred Claims and Allocated Claim Adjustment Expenses, Net of
Reinsurance
|
As of December 31, 2019
|
|||||||||||||||
|
Incurred amount
|
Total of IBNR Liabilities
Plus Expected Development
on Reported Claims |
Cumulative
Number of
Reported Claims
|
||||||||||||||
|
Incurred Year
|
2018
|
2019
|
||||||||||||||
|
2018(1)
|
$
|
13,163.3
|
$
|
12,945.9
|
$
|
203.2
|
104.9
|
|||||||||
|
2019
|
17,195.1
|
2,004.6
|
112.6
|
|||||||||||||
|
Total
|
$
|
30,141.0
|
||||||||||||||
|
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
|
||||||||
|
Incurred Year
|
2018
|
2019
|
||||||
|
2018
|
$
|
(11,326.4
|
)
|
$
|
(12,742.7
|
)
|
||
|
2019
|
(15,190.5
|
)
|
||||||
|
Total
|
$
|
(27,933.2
|
)
|
|||||
|
All outstanding liabilities before 2018, net of reinsurance
|
69.5
|
|||||||
|
Liabilities for claims and claim adjustment expenses, net of reinsurance
|
$
|
2,277.3
|
||||||
|
For the years ended December 31,
|
||||||||||||
|
2019
|
2018
|
2017
|
||||||||||
|
(in millions)
|
||||||||||||
|
Beginning balance
|
$
|
823.5
|
$
|
722.5
|
$
|
510.0
|
||||||
|
Acquisitions
|
—
|
47.7
|
128.1
|
|||||||||
|
Medical benefits incurred related to:
|
||||||||||||
|
Current year
|
6,302.7
|
5,478.2
|
4,676.8
|
|||||||||
|
Prior years
|
(126.7
|
)
|
(130.4
|
)
|
(99.5
|
)
|
||||||
|
Total
|
6,176.0
|
5,347.8
|
4,577.3
|
|||||||||
|
Medical benefits paid related to:
|
||||||||||||
|
Current year
|
(5,384.4
|
)
|
(4,780.9
|
)
|
(4,164.6
|
)
|
||||||
|
Prior years
|
(633.6
|
)
|
(513.6
|
)
|
(328.3
|
)
|
||||||
|
Total
|
(6,018.0
|
)
|
(5,294.5
|
)
|
(4,492.9
|
)
|
||||||
|
Ending balance
|
$
|
981.5
|
$
|
823.5
|
$
|
722.5
|
||||||
|
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
|
As of December 31, 2019
|
|||||||||||||||
|
Incurred amount
|
Total of IBNR Liabilities
Plus Expected Development
on Reported Claims
|
Cumulative
Number of
Reported Claims
|
||||||||||||||
|
Incurred Year
|
2018
|
2019
|
||||||||||||||
|
2018
|
$
|
5,603.5
|
$
|
5,504.2
|
$
|
35
|
34.5
|
|||||||||
|
2019
|
6,302.7
|
918.3
|
31.8
|
|||||||||||||
|
Total
|
$
|
11,806.9
|
||||||||||||||
|
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
|
||||||||
|
Incurred Year
|
2018
|
2019
|
||||||
|
2018
|
$
|
(4,861.2
|
)
|
$
|
(5,469.2
|
)
|
||
|
2019
|
(5,384.4
|
)
|
||||||
|
Total
|
$
|
(10,853.6
|
)
|
|||||
|
All outstanding liabilities before 2018, net of reinsurance
|
28.2
|
|||||||
|
Liabilities for claims and claim adjustment expenses, net of reinsurance
|
$
|
981.5
|
||||||
|
For the years ended December 31,
|
||||||||||||
|
2019
|
2018
|
2017
|
||||||||||
|
(in millions)
|
||||||||||||
|
Beginning balance
|
$
|
59.1
|
$
|
50.6
|
$
|
44.7
|
||||||
|
Acquisitions
|
—
|
—
|
—
|
|||||||||
|
Medical benefits incurred related to:
|
||||||||||||
|
Current year
|
891.3
|
666.6
|
823.4
|
|||||||||
|
Prior years
|
(47.9
|
)
|
(61.9
|
)
|
(70.0
|
)
|
||||||
|
Total
|
843.4
|
604.7
|
753.4
|
|||||||||
|
Medical benefits paid related to:
|
||||||||||||
|
Current year
|
(823.3
|
)
|
(618.7
|
)
|
(773.9
|
)
|
||||||
|
Prior years
|
(4.4
|
)
|
22.5
|
26.4
|
||||||||
|
Total
|
(827.7
|
)
|
(596.2
|
)
|
(747.5
|
)
|
||||||
|
Ending balance
|
$
|
74.8
|
$
|
59.1
|
$
|
50.6
|
||||||
|
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
|
As of December 31, 2019
|
|||||||||||||||
|
Incurred amount
|
Total of IBNR Liabilities
Plus Expected Development
on Reported Claims
|
Cumulative
Number of
Reported Claims
|
||||||||||||||
|
Incurred Year
|
2018
|
2019
|
||||||||||||||
|
2018
|
$
|
666.6
|
$
|
622.9
|
$
|
—
|
47.8
|
|||||||||
|
2019
|
891.3
|
68
|
58.2
|
|||||||||||||
|
Total
|
$
|
1,514.2
|
||||||||||||||
|
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
|
||||||||
|
Incurred Year
|
2018
|
2019
|
||||||
|
2018
|
$
|
(618.8
|
)
|
$
|
(622.9
|
)
|
||
|
2019
|
(823.3
|
)
|
||||||
|
Total
|
$
|
(1,446.2
|
)
|
|||||
|
All outstanding liabilities before 2018, net of reinsurance
|
6.8
|
|||||||
|
Liabilities for claims and claim adjustment expenses, net of reinsurance
|
$
|
74.8
|
||||||
|
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
|
As of December 31, 2019
|
|||||||||||||||
|
Incurred amount
|
Total of IBNR Liabilities
Plus Expected Development
on Reported Claims
|
Cumulative
Number of
Reported Claims
|
||||||||||||||
|
Incurred Year
|
2018
|
2019
|
||||||||||||||
|
2018(1)
|
$
|
19,440.6
|
$
|
19,079.1
|
$
|
238.2
|
187.2
|
|||||||||
|
2019
|
24,400.3
|
2,992.9
|
202.7
|
|||||||||||||
|
Total
|
$
|
43,479.4
|
||||||||||||||
|
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
|
||||||||
|
Incurred Year
|
2018
|
2019
|
||||||
|
2018
|
$
|
(16,811.6
|
)
|
$
|
(18,840.9
|
)
|
||
|
2019
|
(21,407.4
|
)
|
||||||
|
Total
|
$
|
(40,248.3
|
)
|
|||||
|
All outstanding liabilities before 2018, net of reinsurance
|
104.4
|
|||||||
|
Liabilities for claims and claim adjustment expenses, net of reinsurance
|
$
|
3,335.5
|
||||||
|
Reconciliation of the Disclosure of Incurred and Paid Claims Development to the Liability
for Unpaid Claims and Claim Adjustment Expenses
|
||||
|
December 31, 2019
|
||||
|
Net Outstanding Liabilities
|
||||
|
Medicaid Health Plans
|
$
|
2,277.3
|
||
|
Medicare Health Plans
|
981.5
|
|||
|
Medicare PDPs
|
74.8
|
|||
|
Corporate and other (1)
|
$
|
1.9
|
||
|
Liabilities for unpaid claims and claim adjustment expenses, net of reinsurance
|
$
|
3,335.5
|
||
|
Reinsurance Recoverable
|
18.0
|
|||
|
Total gross liability for unpaid claims and claim adjustment expense
|
$
|
3,353.5
|
||
|
Classification
|
December 31, 2019
|
||||
|
Assets:
|
|||||
|
Right of use assets
|
Other assets
|
$
|
248.3
|
||
|
Liabilities:
|
|||||
|
Current
|
Accounts payable and accrued expenses
|
41.6
|
|||
|
Noncurrent
|
Other liabilities
|
228.3
|
|||
|
Total liabilities
|
$
|
269.9
|
|||
|
Year Ended December 31, 2019
|
||||
|
Cash paid for operating leases
|
$
|
48.7
|
||
|
Leased assets obtained in exchange for new operating lease liabilities
|
$
|
33.8
|
||
|
December 31, 2019
|
||||
|
2020
|
$
|
53.1
|
||
|
2021
|
52.9
|
|||
|
2022
|
44.0
|
|||
|
2023
|
39.0
|
|||
|
2024
|
36.6
|
|||
|
Thereafter
|
116.4
|
|||
|
Total lease payments
|
$
|
342.0
|
||
|
Less: imputed interest
|
72.1
|
|||
|
Present value of lease liabilities
|
$
|
269.9
|
||
|
December 31, 2018
|
||||
|
2019
|
$
|
42.4
|
||
|
2020
|
44.4
|
|||
|
2021
|
45.5
|
|||
|
2022
|
41.9
|
|||
|
2023
|
38.7
|
|||
|
2024 and Thereafter
|
151.4
|
|||
|
Total
|
$
|
364.3
|
||
|
For the Years Ended December 31,
|
||||||||||||
|
2019
|
2018
|
2017
|
||||||||||
|
Current:
|
||||||||||||
|
Federal
|
$
|
118.9
|
$
|
203.8
|
$
|
120.8
|
||||||
|
State
|
21.5
|
48.1
|
14.2
|
|||||||||
|
140.4
|
251.9
|
135.0
|
||||||||||
|
Deferred:
|
||||||||||||
|
Federal
|
9.2
|
(0.3
|
)
|
(48.3
|
)
|
|||||||
|
State
|
9.7
|
1.4
|
1.2
|
|||||||||
|
18.9
|
1.1
|
(47.1
|
)
|
|||||||||
|
Total income tax expense
|
$
|
159.3
|
$
|
253.0
|
$
|
87.9
|
||||||
|
For the Years Ended December 31,
|
||||||||||||
|
2019
|
2018
|
2017
|
||||||||||
|
Income tax expense at statutory federal rate
|
$
|
155.9
|
$
|
145.5
|
$
|
161.6
|
||||||
|
Adjustments resulting from:
|
||||||||||||
|
State income tax, net of federal benefit
|
24.8
|
36.6
|
11.7
|
|||||||||
|
Tax rate change
|
(7.3
|
)
|
3.1
|
(56.1
|
)
|
|||||||
|
Release of valuation allowance
|
(7.8
|
)
|
(0.6
|
)
|
—
|
|||||||
|
Equity compensation
|
(3.9
|
)
|
(0.6
|
)
|
1.3
|
|||||||
|
Unrecognized tax benefits
|
(0.1
|
)
|
2.5
|
(23.5
|
)
|
|||||||
|
Tax credits
|
(2.2
|
)
|
(2.3
|
)
|
(1.4
|
)
|
||||||
|
Non-deductible ACA industry fees
|
—
|
72.3
|
—
|
|||||||||
|
Other, net
|
(0.1
|
)
|
(3.5
|
)
|
(5.7
|
)
|
||||||
|
Total income tax expense
|
$
|
159.3
|
$
|
253.0
|
$
|
87.9
|
||||||
|
As of December 31,
|
||||||||
|
Deferred tax assets:
|
2019
|
2018
|
||||||
|
Net operating losses
|
$
|
19.9
|
$
|
31.6
|
||||
|
Foreign tax credits
|
14.4
|
17.1
|
||||||
|
Medical and other benefits discounting
|
26.1
|
17.9
|
||||||
|
Allowance for doubtful accounts
|
36.2
|
30.4
|
||||||
|
Stock-based compensation
|
21.0
|
17.2
|
||||||
|
Unearned premium discounting
|
5.4
|
0.1
|
||||||
|
Capital losses
|
4.9
|
7.1
|
||||||
|
Premium deficiency reserve
|
—
|
3.9
|
||||||
|
Acquisition costs
|
7.5
|
4.8
|
||||||
|
Accrued expenses and other
|
6.6
|
14.6
|
||||||
|
Total deferred tax assets
|
142.0
|
144.7
|
||||||
|
Valuation allowance
|
(31.8
|
)
|
(39.7
|
)
|
||||
|
Net deferred tax assets
|
110.2
|
105.0
|
||||||
|
Deferred tax liabilities:
|
||||||||
|
Goodwill and other intangible assets
|
(149.8
|
)
|
(150.5
|
)
|
||||
|
Software development costs and property and equipment
|
(98.5
|
)
|
(77.2
|
)
|
||||
|
Prepaid assets
|
(10.3
|
)
|
(11.5
|
)
|
||||
|
Total deferred tax liabilities
|
(258.6
|
)
|
(239.2
|
)
|
||||
|
Net deferred tax liability
|
$
|
(148.4
|
)
|
$
|
(134.2
|
)
|
||
|
Years Ended December 31,
|
||||||||
|
2019
|
2018
|
|||||||
|
Unrecognized tax benefits, beginning of period
|
$
|
7.8
|
$
|
3.5
|
||||
|
Increases:
|
||||||||
|
Prior year tax positions
|
—
|
2.6
|
||||||
|
Current year tax positions
|
1.0
|
1.7
|
||||||
|
Decreases:
|
||||||||
|
Prior year tax positions
|
(1.1
|
)
|
—
|
|||||
|
Unrecognized tax benefits, end of period
|
$
|
7.7
|
$
|
7.8
|
||||
|
RSUs
|
Weighted
Average
Grant-Date
Fair Value
|
|||||||
|
Outstanding as of January 1, 2019
|
253,235
|
$
|
164.88
|
|||||
|
Granted
|
116,507
|
250.47
|
||||||
|
Vested
|
(140,238
|
)
|
153.22
|
|||||
|
Forfeited
|
(17,903
|
)
|
193.73
|
|||||
|
Outstanding as of December 31, 2019
|
211,601
|
$
|
217.29
|
|||||
|
PSUs
|
Weighted
Average
Award-Issuance
Fair Value
|
|||||||
|
Outstanding as of January 1, 2019
|
606,708
|
$
|
149.16
|
|||||
|
Granted
|
392,060
|
267.99
|
||||||
|
Vested
|
(445,283
|
)
|
112.58
|
|||||
|
Forfeited and expired
|
(41,131
|
)
|
183.57
|
|||||
|
Outstanding as of December 31, 2019
|
512,354
|
$
|
201.60
|
|||||
|
December 31,
2019
|
December 31,
2018
|
|||||||
|
(in millions)
|
||||||||
|
Assets
|
||||||||
|
Cash and cash equivalents
|
$
|
0.8
|
$
|
0.1
|
||||
|
Investments
|
49.8
|
42.8
|
||||||
|
Reinsurance recoverables
|
174.0
|
170.2
|
||||||
|
Other assets
|
0.5
|
0.5
|
||||||
|
Total Assets
|
$
|
225.1
|
$
|
213.6
|
||||
|
Liabilities
|
||||||||
|
Reserves and other policy liabilities
|
$
|
171.5
|
$
|
166.9
|
||||
|
Other liabilities
|
53.6
|
46.7
|
||||||
|
Total liabilities
|
$
|
225.1
|
$
|
213.6
|
||||
|
For the Three Month Periods Ended
|
||||||||||||||||
|
March 31,
2019
|
June 30,
2019
|
September 30,
2019
|
December 31,
2019
|
|||||||||||||
|
Total revenues
|
$
|
6,762.2
|
$
|
7,010.1
|
$
|
7,140.2
|
$
|
6,988.5
|
||||||||
|
Gross margin
|
750.0
|
786.9
|
907.5
|
730.4
|
||||||||||||
|
Income from operations
|
184.1
|
242.1
|
293.3
|
5.7
|
||||||||||||
|
Income (loss) before income taxes
|
184.9
|
243.8
|
313.7
|
(0.2
|
)
|
|||||||||||
|
Net income
|
151.4
|
182.8
|
241.0
|
7.7
|
||||||||||||
|
Net income per share - basic (1)
|
$
|
3.02
|
$
|
3.63
|
$
|
4.79
|
$
|
0.15
|
||||||||
|
Net income per share - diluted (1)
|
2.98
|
3.60
|
4.74
|
0.15
|
||||||||||||
|
Period end membership
|
6,316,000
|
6,314,000
|
6,350,000
|
6,344,000
|
||||||||||||
|
For the Three Month Periods Ended
|
||||||||||||||||
|
March 31,
2018
|
June 30,
2018
|
September 30,
2018
|
December 31,
2018
|
|||||||||||||
|
Total revenues
|
$
|
4,646.2
|
$
|
4,639.0
|
$
|
5,058.1
|
$
|
6,070.8
|
||||||||
|
Gross margin
|
550.7
|
637.0
|
676.9
|
688.2
|
||||||||||||
|
Income from operations
|
161.2
|
233.9
|
208.6
|
94.6
|
||||||||||||
|
Income before income taxes
|
158.5
|
229.9
|
215.2
|
89.2
|
||||||||||||
|
Net income
|
101.7
|
151.6
|
130.6
|
55.9
|
||||||||||||
|
Net income per share - basic (1)
|
$
|
2.28
|
$
|
3.39
|
$
|
2.74
|
$
|
1.12
|
||||||||
|
Net income per share - diluted (1)
|
2.25
|
3.35
|
2.70
|
1.11
|
||||||||||||
|
Period end membership
|
4,284,000
|
4,384,000
|
5,508,000
|
5,538,000
|
||||||||||||
|
Series of Senior Notes
|
Aggregate
Principal Amount
Tendered and
Accepted
|
Aggregate
Principal Amount
Outstanding
Following
Settlement
|
||||||
|
5.25% Senior Notes due 2025
|
$
|
1,145,791,000
|
$
|
54,209,000
|
||||
|
5.375% Senior Notes due 2026
|
$
|
747,218,000
|
$
|
2,782,000
|
||||