UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15 (d) OF THE
    SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended June 30, 2019March 31, 2020
OR
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15 (d) OF THE
    SECURITIES EXCHANGE ACT OF 1934
For the transition period from                     to                     
Commission file number 1-5975
 
HUMANA INC.
(Exact name of registrant as specified in its charter)
 
Delaware 61-0647538
(State or other jurisdiction of incorporation or organization) (I.R.S. Employer Identification No.)
500 West Main Street
Louisville, Kentucky 40202
(Address of principal executive offices, including zip code)
(502) 580-1000
(Registrant’s telephone number, including area code)

Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading SymbolName of each exchange on which registered
Common stock, $0.16 2/3 par valueHUMNew York Stock Exchange

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes      No  
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes      No  
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer”, “smaller reporting company” and "emerging growth company" in Rule 12b-2 of the Exchange Act.
Large accelerated filer Accelerated filer
     
Non-accelerated filer Smaller reporting company
     
Emerging growth company   
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.  
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act).    Yes      No  
Indicate the number of shares outstanding of each of the issuer’s classes of common stock as of the latest practicable date.
Class of Common StockOutstanding at June 30, 2019March 31, 2020
$0.16 2/3 par value135,089,290132,206,069 shares



Humana Inc.
FORM 10-Q
JUNE 30, 2019MARCH 31, 2020
INDEX
  Page
Part I: Financial Information 
Item 1.Financial Statements (Unaudited) 
   
 
   
 
   
 
   
 
   
 
   
 
   
Item 2.
   
Item 3.
   
Item 4.
   
 
   
Item 1.
   
Item 1A.
   
Item 2.
   
Item 3.
   
Item 4.
   
Item 5.
   
Item 6.
   
 
   
 Certifications 





Humana Inc.
CONDENSED CONSOLIDATED BALANCE SHEETS
(Unaudited)
June 30,
2019
 December 31,
2018
March 31,
2020
 December 31,
2019
(in millions, except share amounts)(in millions, except share amounts)
ASSETS
      
Current assets:      
Cash and cash equivalents$4,778
 $2,343
$6,054
 $4,054
Investment securities9,991
 10,026
11,104
 10,972
Receivables, less allowance for doubtful accounts of $73 in 2019
and $79 in 2018
904
 1,015
Receivables, less allowance for doubtful accounts of $73 in 2020
and $69 in 2019
2,009
 1,056
Other current assets4,487
 3,564
5,384
 3,806
Total current assets20,160
 16,948
24,551
 19,888
Property and equipment, net1,796
 1,735
2,023
 1,955
Long-term investment securities411
 411
393
 406
Equity method investment in Kindred at Home1,056
 1,047
Equity method investments1,093
 1,063
Goodwill3,922
 3,897
4,443
 3,928
Other long-term assets1,568
 1,375
2,130
 1,834
Total assets$28,913
 $25,413
$34,633
 $29,074
LIABILITIES AND STOCKHOLDERS’ EQUITY
      
Current liabilities:      
Benefits payable$5,842
 $4,862
$7,090
 $6,004
Trade accounts payable and accrued expenses3,832
 3,067
5,399
 3,754
Book overdraft204
 171
169
 225
Unearned revenues312
 283
274
 247
Short-term debt1,349
 1,694
1,898
 699
Total current liabilities11,539
 10,077
14,830
 10,929
Long-term debt4,377
 4,375
6,057
 4,967
Future policy benefits payable214
 219
205
 206
Other long-term liabilities911
 581
1,186
 935
Total liabilities17,041
 15,252
22,278
 17,037
Commitments and contingencies (Note 14)

 

Commitments and contingencies (Note 13)

 

Stockholders’ equity:      
Preferred stock, $1 par; 10,000,000 shares authorized; none issued
 

 
Common stock, $0.16 2/3 par; 300,000,000 shares authorized;
198,627,992 shares issued at June 30, 2019 and 198,594,841 shares
issued at December 31, 2018
33
 33
Common stock, $0.16 2/3 par; 300,000,000 shares authorized;
198,629,992 shares issued at March 31, 2020 and December 31, 2019
33
 33
Capital in excess of par value2,763
 2,535
2,857
 2,820
Retained earnings16,429
 15,072
17,871
 17,483
Accumulated other comprehensive income (loss)112
 (159)
Treasury stock, at cost, 63,538,702 shares at June 30, 2019 and
63,028,169 shares at December 31, 2018
(7,465) (7,320)
Accumulated other comprehensive income48
 156
Treasury stock, at cost, 66,423,923 shares at March 31, 2020 and
66,524,771 shares at December 31, 2019
(8,454) (8,455)
Total stockholders’ equity11,872
 10,161
12,355
 12,037
Total liabilities and stockholders’ equity$28,913
 $25,413
$34,633
 $29,074
See accompanying notes to condensed consolidated financial statements.

Humana Inc.
CONDENSED CONSOLIDATED STATEMENTS OF INCOME
(Unaudited)
 
Three months ended
June 30,
 Six months ended
June 30,
Three months ended
March 31,
2019 2018 2019 20182020 2019
(in millions, except per share results)(in millions, except per share results)
Revenues:          
Premiums$15,776
 $13,713
 $31,427
 $27,524
$18,362
 $15,651
Services355
 382
 710
 709
424
 355
Investment income114
 164
 215
 305
149
 101
Total revenues16,245
 14,259
 32,352
 28,538
18,935
 16,107
Operating expenses:          
Benefits13,318
 11,536
 26,811
 23,206
15,629
 13,493
Operating costs1,703
 1,761
 3,363
 3,510
2,117
 1,660
Depreciation and amortization109
 100
 216
 200
115
 107
Total operating expenses15,130
 13,397
 30,390
 26,916
17,861
 15,260
Income from operations1,115
 862
 1,962
 1,622
1,074
 847
Loss on sale of business
 790
 
 790
Interest expense60
 53
 122
 106
60
 62
Other income, net(174) 
 (135) 
Other expense, net297
 39
Income before income taxes and equity in net earnings1,229
 19
 1,975
 726
717
 746
Provision (benefit) for income taxes301
 (174) 484
 42
Equity in net earnings of Kindred at Home12
 
 15
 
Provision for income taxes252
 183
Equity in net earnings8
 3
Net income$940
 $193
 $1,506
 $684
$473
 $566
Basic earnings per common share$6.96
 $1.40
 $11.14
 $4.96
$3.58
 $4.18
Diluted earnings per common share$6.94
 $1.39
 $11.10
 $4.93
$3.56
 $4.16
See accompanying notes to condensed consolidated financial statements.

Humana Inc.
CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
(Unaudited)
Three months ended
June 30,
 Six months ended
June 30,
Three months ended
March 31,
2019 2018 2019 20182020 2019
(in millions)(in millions)
Net income$940
 $193
 $1,506
 $684
$473
 $566
Other comprehensive income:          
Change in gross unrealized investment
gains/losses
169
 (9) 365
 (212)(92) 196
Effect of income taxes(40) 2
 (85) 54
22
 (45)
Total change in unrealized
investment gains/losses, net of tax
129
 (7) 280
 (158)(70) 151
Reclassification adjustment for net
realized gains
(6) (23) (6) (52)(45) 
Effect of income taxes2
 8
 2
 15
10
 
Total reclassification adjustment, net
of tax
(4) (15) (4) (37)(35) 
Other comprehensive income (loss), net
of tax
125
 (22) 276
 (195)
Comprehensive loss attributable to equity method investment in Kindred at Home(3) 
 (5) 
Other comprehensive (loss) income, net of tax(105) 151
Comprehensive loss attributable to equity method investments(3) (2)
Comprehensive income$1,062
 $171
 $1,777
 $489
$365
 $715


See accompanying notes to condensed consolidated financial statements.


Humana Inc.
CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY
(Unaudited)
Common Stock
Capital In
Excess of
Par Value

Retained
Earnings

Accumulated
Other
Comprehensive
Income (Loss)

Treasury
Stock

Total
Stockholders’
Equity
Common Stock
Capital In
Excess of
Par Value

Retained
Earnings

Accumulated
Other
Comprehensive
Income (Loss)

Treasury
Stock

Total
Stockholders’
Equity
Issued
Shares

Amount
Issued
Shares

Amount

(dollars in millions, share amounts in thousands)(dollars in millions, share amounts in thousands)
Three months ended June 30, 2019
Balances, March 31, 2019198,595

$33

$2,722

$15,563

$(10)
$(7,467)
$10,841
Three months ended March 31, 2020Three months ended March 31, 2020
Balances, December 31, 2019198,630
 $33
 $2,820
 $17,483
 $156
 $(8,455) $12,037
Net income
 
 
 473
 
 
 473
Impact of adopting ASC 326 -
Current expected credit loss
standard (CECL)
      (2)     (2)
Other comprehensive loss

 

 

 

 (108) 

 (108)
Common stock repurchases
 
 
 

 
 (17) (17)
Dividends and dividend
equivalents

 
 
 (83) 

 
 (83)
Stock-based compensation
 
 36
 
 
 

 36
Restricted stock unit vesting
 
 (6) 

 
 6
 
Stock option exercises
 
 7
 
 
 12
 19
Balances, March 31, 2020198,630
 $33
 $2,857
 $17,871
 $48
 $(8,454) $12,355
             
Three months ended March 31, 2019Three months ended March 31, 2019
Balances, December 31, 2018198,595
 $33
 $2,535
 $15,072
 $(159) $(7,320) $10,161
Net income





940





940

 
 
 566
 
 
 566
Other comprehensive income











122




122


 

 

 

 149
 

 149
Common stock repurchases














 
 150
 

 
 (160) (10)
Dividends and dividend
equivalents






(74)





(74)
 
 
 (75) 

 
 (75)
Stock-based compensation



43








43

 
 33
 
 
 

 33
Restricted stock unit vesting32



(3)





2

(1)
 
 (13) 

 
 13
 
Stock option exercises1



1







1

 
 17
 
 
 
 17
Balances, June 30, 2019198,628

$33

$2,763

$16,429

$112

$(7,465)
$11,872
             
Three months ended June 30, 2018
Balances, March 31, 2018198,585

$33

$2,626

$14,086

$(154)
$(6,510)
$10,081
Net income





193





193
Other comprehensive loss











(22)



(22)
Common stock repurchases










(42)
(42)
Dividends and dividend
equivalents






(68)





(68)
Stock-based compensation



34








34
Restricted stock unit vesting



(1)





23

22
Stock option exercises6



13







13
Balances, June 30, 2018198,591

$33

$2,672

$14,211

$(176)
$(6,529)
$10,211
Balances, March 31, 2019198,595
 $33
 $2,722
 $15,563
 $(10) $(7,467) $10,841
See accompanying notes to condensed consolidated financial statements.



















Humana Inc.
CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY
(Unaudited)

 Common Stock Capital In
Excess of
Par Value
 Retained
Earnings
 Accumulated
Other
Comprehensive
Income (Loss)
 Treasury
Stock
 Total
Stockholders’
Equity
 Issued
Shares
 Amount 
 (dollars in millions, share amounts in thousands)
Six months ended June 30, 2019
Balances, December 31, 2018198,595
 $33
 $2,535
 $15,072
 $(159) $(7,320) $10,161
Net income
 
 
 1,506
 
 
 1,506
Other comprehensive income

 

 

 

 271
 

 271
Common stock repurchases
 
 150
 

 
 (160) (10)
Dividends and dividend
equivalents

 
 
 (149) 

 
 (149)
Stock-based compensation
 
 76
 
 
 

 76
Restricted stock unit vesting32
 
 (3) 

 
 3
 
Stock option exercises1
 
 5
 
 
 12
 17
Balances, June 30, 2019198,628
 $33
 $2,763
 $16,429
 $112
 $(7,465) $11,872
Six months ended June 30, 2018
Balances, December 31, 2017198,572
 $33
 $2,445
 $13,670
 $19
 $(6,325) $9,842
Net income
 
 
 684
 
 
 684
Other comprehensive loss

 

 

 (4) (195) 

 (199)
Common stock repurchases
 
 200
 

 
 (293) (93)
Dividends and dividend
equivalents

 
 
 (139) 

 
 (139)
Stock-based compensation
 
 69
 
 
 

 69
Restricted stock unit vesting
 
 (60) 

 
 60
 
Stock option exercises19
 
 18
 
 
 29
 47
Balances, June 30, 2018198,591
 $33
 $2,672
 $14,211
 $(176) $(6,529) $10,211
See accompanying notes to condensed consolidated financial statements.



Humana Inc.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(Unaudited)
For the six months ended
June 30,
For the three months ended
March 31,
2019 20182020 2019
(in millions)(in millions)
Cash flows from operating activities      
Net income$1,506
 $684
$473
 $566
Adjustments to reconcile net income to net cash provided by
operating activities:
      
Loss on sale of business
 790
Net realized capital gains(5) (82)
Equity in net earnings of Kindred at Home(15) 
Net realized capital (gains) losses(49) 2
Equity in net earnings(8) (3)
Stock-based compensation76
 69
36
 33
Depreciation240
 218
124
 118
Amortization36
 51
21
 18
Benefit for deferred income taxes(21) (304)(3) (21)
Changes in operating assets and liabilities, net of effect of
businesses acquired and dispositions:
      
Receivables123
 (619)(953) (940)
Other assets(548) (1,658)(1,470) (102)
Benefits payable980
 410
1,086
 1,162
Other liabilities(116) 680
1,203
 16
Unearned revenues29
 3,252
27
 29
Other45
 70
(13) 18
Net cash provided by operating activities2,330
 3,561
474
 896
Cash flows from investing activities      
Acquisitions, net of cash acquired
 (354)(709) 
Purchases of property and equipment(296) (272)(192) (139)
Purchases of investment securities(3,135) (2,624)(2,459) (2,175)
Maturities of investment securities894
 555
735
 397
Proceeds from sales of investment securities2,626
 2,408
1,415
 2,062
Net cash provided by (used in) investing activities89
 (287)
Net cash (used in) provided by investing activities(1,210) 145
Cash flows from financing activities      
Receipts from contract deposits, net473
 1,515
574
 554
(Repayments) proceeds from issuance of commercial paper, net(356) 243
Proceeds from issuance of senior notes, net1,090
 
Proceeds from issuance of commercial paper, net198
 17
Proceeds from term loan1,000
 
Change in book overdraft33
 (67)(55) (17)
Common stock repurchases(10) (93)(17) (10)
Dividends paid(142) (126)(73) (68)
Proceeds from stock option exercises and other, net18
 43
19
 17
Net cash provided by financing activities16
 1,515
2,736
 493
Increase in cash and cash equivalents2,435
 4,789
2,000
 1,534
Cash and cash equivalents at beginning of period2,343
 4,042
4,054
 2,343
Cash and cash equivalents at end of period$4,778
 $8,831
$6,054
 $3,877
Supplemental cash flow disclosures:      
Interest payments$110
 $98
$40
 $29
Income tax payments, net$346
 $405
Income tax refunds, net$(6) $(22)

See accompanying notes to condensed consolidated financial statements.


Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)


1. BASIS OF PRESENTATION AND SIGNIFICANT EVENTS
The accompanying condensed consolidated financial statements are presented in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the disclosures normally required by accounting principles generally accepted in the United States of America, or GAAP, or those normally made in an Annual Report on Form 10-K. The year-end condensed consolidated balance sheet data was derived from audited financial statements, but does not include all disclosures required by GAAP. For further information, the reader of this Form 10-Q should refer to our Form 10-K for the year ended December 31, 2018,2019, that was filed with the Securities and Exchange Commission, or the SEC, on February 21, 2019.20, 2020. We refer to the Form 10-K as the “2018“2019 Form 10-K” in this document. References throughout this document to “we,” “us,” “our,” “Company,” and “Humana” mean Humana Inc. and its subsidiaries.
The preparation of our condensed consolidated financial statements in accordance with GAAP requires us to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes. The areas involving the most significant use of estimates are the estimation of benefits payable, the impact of risk adjustment provisions related to our Medicare contracts, the valuation and related impairment recognition of investment securities, and the valuation and related impairment recognition of long-lived assets, including goodwill. These estimates are based on knowledge of current events and anticipated future events, and accordingly, actual results may ultimately differ materially from those estimates. Refer to Note 2 to the consolidated financial statements included in our 20182019 Form 10-K for information on accounting policies that we consider in preparing our consolidated financial statements.
The financial information has been prepared in accordance with our customary accounting practices and has not been audited. In our opinion, the information presented reflects all adjustments necessary for a fair statement of interim results. All such adjustments are of a normal and recurring nature.
COVID-19
The emergence of stay-at-home and physical distancing orders and other restrictions on movement and economic activity intended to reduce the spread of the novel coronavirus, or COVID-19, during the second half of March 2020 has impacted our business. During this short period of time, we experienced lower hospital admissions and utilization as members and providers began to defer non-essential procedures. We also saw an increase in pharmacy costs as a result of us allowing early prescription refills to permit members to prepare for extended supply needs as well as COVID-19 specific administrative costs, including a $50 million contribution to the Humana Foundation to promote its COVID-19 relief efforts in the communities served by Humana. Taken together, the net impact of COVID-19 was not material to the results of our operations during the first quarter of 2020.
Revenue Recognition
Our revenues include premium and service revenues. Service revenues include administrative service fees that are recorded based upon established per member per month rates and the number of members for the month and are recognized as services are provided for the month. Additionally, service revenues include net patient service revenues that are recorded based upon established billing rates, less allowances for contractual adjustments, and are recognized as services are provided. For more information about our revenues, refer to Note 2 to the consolidated financial statements included in our 20182019 Form 10-K for information on accounting policies that we consider in preparing our consolidated financial statements. See Note 1514 for disaggregation of revenue by segment and type.
At June 30, 2019,March 31, 2020, accounts receivable related to services were $135$141 million. For the three and six months ended June 30, 2019,March 31, 2020, we had no material bad-debt expense and there were no material contract assets, contract liabilities or deferred contract costs recorded on the condensed consolidated balance sheet at June 30, 2019.March 31, 2020.
For the three and six months ended June 30, 2019,March 31, 2020, services revenue recognized from performance obligations related to prior periods (for example, due to changes in transaction price), was not material. Further, services revenue expected to be recognized in any future year related to remaining performance obligations was not material.
Equity Method Investment

Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

Health Care Reform
The Patient Protection and Affordable Care Act and The Health Care and Education Reconciliation Act of 2010 (which we collectively refer to as the Health Care Reform Law) enacted significant reforms to various aspects of the U.S. health insurance industry. Certain of these reforms became effective January 1, 2014, including an annual insurance industry premium-based fee. The Continuing Resolution bill, H.R. 195, enacted on January 22, 2018, included a one year suspension in Kindred at Home2019 of the health insurance industry fee, but the fee resumed in calendar year 2020. The Further Consolidated Appropriations Act, 2020, enacted on December 20, 2019, permanently repealed the health insurance industry fee beginning in calendar year 2021.
In September 2020, we expect to pay the federal government $1.2 billion for the annual health insurance industry fee attributed to calendar year 2020. This fee, fixed in amount by law and apportioned to insurance carriers based on market share, is not deductible for tax purposes. Each year on January 1, except when suspended, we record a liability for this fee in trade accounts payable and accrued expenses which we carry until the fee is paid. We record a corresponding deferred cost in other current assets in our condensed consolidated financial statements which is amortized ratably to expense over the calendar year. Amortization of the deferred cost was recorded in operating cost expense of approximately $306 million for the three months ended March 31, 2020 resulting from the amortization of the 2020 annual health insurance industry fee.
2. RECENTLY ISSUED ACCOUNTING PRONOUNCEMENTS
In June 2016, the third quarterFASB issued guidance introducing a new model for recognizing credit losses on financial instruments based on an estimate of current expected credit losses. The guidance was effective for us beginning January 1, 2020. The new current expected credit losses (CECL) model generally calls for the immediate recognition of all expected credit losses and applies to loans, accounts and trade receivables as well as other financial assets measured at amortized cost, loan commitments and off-balance sheet credit exposures, debt securities and other financial assets measured at fair value through other comprehensive income, and beneficial interests in securitized financial assets. The new guidance replaces the current incurred loss model for measuring expected credit losses, requires expected losses on available for sale debt securities to be recognized through an allowance for credit losses rather than as reductions in the amortized cost of the securities, and provides for additional disclosure requirements. Our investment portfolio consists primarily of available for sale debt securities. We adopted the new standard effective January 1, 2020. Due to the high concentration of our financial assets measured at amortized cost being with the federal government resulting in zero nonpayment risk as well as our available for sale debt securities primarily being in an unrealized gain position, the adoption of the new standard did not have a material impact on our results of operations, financial condition, or cash flows.
In September 2018, the FASB issued new guidance related to accounting for long-duration contracts of insurers which revises key elements of the measurement models and disclosure requirements for long-duration contracts issued by insurers and reinsurers. The new guidance is effective for us beginning with annual and interim periods in 2022, with earlier adoption permitted, and requires retrospective application to previously issued annual and interim financial statements. We are currently evaluating the impact on our results of operations, financial position and cash flows.

There are no other recently issued accounting standards that apply to us or that are expected to have a material impact on our results of operations, financial condition, or cash flows.


Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

3. ACQUISITIONS AND DIVESTITURES
On January 31, 2020, we alongpurchased privately held Enclara Healthcare, or Enclara, one of the nation’s largest hospice pharmacy and benefit management providers for cash consideration of approximately $709 million, net of cash received. This resulted in a preliminary purchase price allocation to goodwill of $515 million, other intangible assets of $240 million, and net tangible liabilities assumed of $11 million. The goodwill was assigned to the Healthcare Services segment. The other intangible assets, which primarily consist of customer contracts, have an estimated weighted average useful life of 11.4 years. The purchase price allocation is preliminary, subject to completion of valuation analysis, including for example, refining assumptions used to calculate the fair value of intangible assets.
On February 1, 2020, our Partners in Primary Care wholly-owned subsidiary entered into a strategic partnership with TPG Capital, or TPG, and Welsh, Carson, Anderson & Stowe, or WCAS, completedto accelerate the expansion of our primary care model. The WCAS partnership is expected to open approximately 50 payor-agnostic, senior-focused primary care centers over 3 years beginning in 2020. Partners in Primary Care committed to the acquisition of a non-controlling interest in the approximately $600 million entity accounted for under the equity method of accounting. In addition, the agreement includes a series of put and call options through which WCAS may require us to purchase their interest in the entity, and through which we may acquire WCAS’s interest, over the next 5 to 10 years.
During 2019, we acquired other health and wellness related businesses which, individually or in the aggregate, have not had a material impact on our results of operations, financial condition, or cash flows. The results of operations and financial condition of these businesses acquired in 2020 and 2019 have been included in our condensed consolidated statements of income and condensed consolidated balance sheets from the respective acquisition dates. Acquisition-related costs recognized in 2020 and 2019 were not material to our results of operations. The pro forma financial information assuming the acquisitions of Kindred Healthcare, Inc., or Kindred, and privately-held Curo Health Services, or Curo, respectively, merging Curo with the hospice businesshad occurred as of the Kindredbeginning of the calendar year prior to the year of acquisition, as well as the revenues and earnings generated during the year of acquisition, were not material for disclosure purposes.


Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

4. INVESTMENT SECURITIES
Investment securities classified as current and long-term were as follows at Home Division,March 31, 2020 and December 31, 2019, respectively:
 
Amortized
Cost
 
Gross
Unrealized
Gains
 
Gross
Unrealized
Losses
 
Fair
Value
 (in millions)
March 31, 2020       
U.S. Treasury and other U.S. government
corporations and agencies:
       
U.S. Treasury and agency obligations$394
 $4
 $
 $398
Mortgage-backed securities3,438
 160
 (1) 3,597
Tax-exempt municipal securities1,549
 16
 (12) 1,553
Mortgage-backed securities:       
Commercial834
 16
 (28) 822
Asset-backed securities1,126
 1
 (46) 1,081
Corporate debt securities4,082
 48
 (84) 4,046
Total debt securities$11,423
 $245
 $(171) $11,497
        
December 31, 2019       
U.S. Treasury and other U.S. government
corporations and agencies:
       
U.S. Treasury and agency obligations$353
 $1
 $
 $354
Mortgage-backed securities3,628
 85
 (3) 3,710
Tax-exempt municipal securities1,433
 30
 
 1,463
Mortgage-backed securities:       
Commercial786
 18
 
 804
Asset-backed securities1,093
 3
 (3) 1,093
Corporate debt securities3,867
 82
 (2) 3,947
Total debt securities$11,160
 $219
 $(8) $11,371

We also held $7 million of equity securities consisting of common stock carried at fair value as of December 31, 2019.


Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

Gross unrealized losses and fair values aggregated by investment category and length of time that individual securities have been in a continuous unrealized loss position were as follows at March 31, 2020 and December 31, 2019, respectively:
 Less than 12 months 12 months or more Total
 Fair
Value
 Gross
Unrealized
Losses
 Fair
Value
 Gross
Unrealized
Losses
 Fair
Value
 Gross
Unrealized
Losses
 (in millions)
March 31, 2020           
U.S. Treasury and other U.S.
government corporations
and agencies:
           
U.S. Treasury and agency
obligations
$2
 $
 $
 $
 $2
 $
Mortgage-backed
securities
67
 (1) 1
 
 68
 (1)
Tax-exempt municipal
securities
309
 (10) 176
 (2) 485
 (12)
Mortgage-backed securities:           
Commercial198
 (15) 131
 (13) 329
 (28)
Asset-backed securities144
 (5) 891
 (41) 1,035
 (46)
Corporate debt securities1,453
 (55) 710
 (29) 2,163
 (84)
Total debt securities$2,173
 $(86) $1,909
 $(85) $4,082
 $(171)
            
December 31, 2019           
U.S. Treasury and other U.S.
government corporations
and agencies:
           
U.S. Treasury and agency
obligations
$48
 $
 $23
 $
 $71
 $
Mortgage-backed
securities
315
 (1) 204
 (2) 519
 (3)
Tax-exempt municipal
securities
58
 
 75
 
 133
 
Mortgage-backed securities:           
Commercial118
 
 36
 
 154
 
Asset-backed securities20
 
 607
 (3) 627
 (3)
Corporate debt securities589
 (2) 155
 
 744
 (2)
Total debt securities$1,148
 $(3) $1,100
 $(5) $2,248
 $(8)

Approximately 96% of our debt securities were investment-grade quality, with a weighted average credit rating of AA by Standard & Poor's Rating Service, or KindredS&P, at Home. As partMarch 31, 2020. Most of these transactions, we acquiredthe debt securities that were below investment-grade were rated BB, the higher end of the below investment-grade rating scale. Tax-exempt municipal securities were diversified among general obligation bonds of states and local municipalities in the United States as well as special revenue bonds issued by municipalities to finance specific public works projects such as utilities, water and sewer, transportation, or education. Our general obligation bonds are diversified across the United States with no individual state exceeding 1% of our total debt securities. Our investment policy limits investments in a 40% minority interest in Kindred at Home,single issuer and requires diversification among various asset types.


Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

Our unrealized losses from all securities were generated from approximately 450 positions out of a leading home health and hospice company, for total cash consideration of approximately $1.1 billion.1,500 positions at March 31, 2020. All issuers of securities we own that were trading at an unrealized loss at March 31, 2020 remain current on all contractual payments. After taking into account these and other factors previously described, we believe these unrealized losses primarily were caused by an increase in market interest rates in the current markets since the time the securities were purchased. At March 31, 2020, we did not intend to sell the securities with an unrealized loss position in accumulated other comprehensive income, and it is not likely that we will be required to sell these securities before recovery of their amortized cost basis. Additionally, we did not record any material credit allowances for securities that were in an unrealized loss position at March 31, 2020.
The detail of realized gains (losses) related to investment securities and included within investment income was as follows for the three months ended March 31, 2020 and 2019:
 Three months ended
March 31,
 2020 2019
 (in millions)
Gross realized gains$56
 $10
Gross realized losses(7) (12)
Net realized capital gains (losses)$49
 $(2)

There were no material other-than-temporary impairments for the three months ended March 31, 2019.
The contractual maturities of debt securities available for sale at March 31, 2020, regardless of their balance sheet classification, are shown below. Expected maturities may differ from contractual maturities because borrowers may have the right to call or prepay obligations with or without call or prepayment penalties.
 Amortized
Cost
 Fair
Value
 (in millions)
Due within one year$1,337
 $1,339
Due after one year through five years1,918
 1,905
Due after five years through ten years1,750
 1,736
Due after ten years1,020
 1,017
Mortgage and asset-backed securities5,398
 5,500
Total debt securities$11,423
 $11,497



Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

5. FAIR VALUE
Financial Assets
The following table summarizes our fair value measurements at March 31, 2020 and December 31, 2019, respectively, for financial assets measured at fair value on a recurring basis:
 Fair Value Measurements Using
 Fair
Value
 Quoted Prices
in Active
Markets
(Level 1)
 Other
Observable
Inputs
(Level 2)
 Unobservable
Inputs
(Level 3)
 (in millions)
March 31, 2020       
Cash equivalents$5,857
 $5,857
 $
 $
Debt securities:       
U.S. Treasury and other U.S. government
corporations and agencies:
       
U.S. Treasury and agency obligations398
 
 398
 
Mortgage-backed securities3,597
 
 3,597
 
Tax-exempt municipal securities1,553
 
 1,553
 
Mortgage-backed securities:       
Commercial822
 
 822
 
Asset-backed securities1,081
 
 1,081
 
Corporate debt securities4,046
 
 4,046
 
Total debt securities11,497
 
 11,497
 
Total invested assets$17,354
 $5,857
 $11,497
 $
        
December 31, 2019       
Cash equivalents$3,660
 $3,660
 $
 $
Debt securities:       
U.S. Treasury and other U.S. government
corporations and agencies:
       
U.S. Treasury and agency obligations354
 
 354
 
Mortgage-backed securities3,710
 
 3,710
 
Tax-exempt municipal securities1,463
 
 1,463
 
Mortgage-backed securities:       
Commercial804
 
 804
 
Asset-backed securities1,093
 
 1,093
 
Corporate debt securities3,947
 
 3,947
 
Total debt securities11,371
 
 11,371
 
Common stock7
 7
 
 
Total invested assets$15,038
 $3,667
 $11,371
 $





Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

We accountFinancial Liabilities
Our debt is recorded at carrying value in our consolidated balance sheets. The carrying value of our senior notes debt outstanding, net of unamortized debt issuance costs, was $6,455 million at March 31, 2020 and $5,366 million at December 31, 2019. The fair value of our senior notes debt was $6,841 million at March 31, 2020 and $5,916 million at December 31, 2019. The fair value of our senior note debt is determined based on Level 2 inputs, including quoted market prices for the same or similar debt, or if no quoted market prices are available, on the current prices estimated to be available to us for debt with similar terms and remaining maturities. Due to the short-term nature, carrying value approximates fair value for our 40%term note and commercial paper borrowings. The term loan outstanding and commercial paper borrowings were $1,500 million as of March 31, 2020. The commercial paper borrowings were $300 million as of December 31, 2019.
Put and Call Options Measured at Fair Value
As part of our investment in Kindred at Home, using the equity method of accounting. This investment is reflected as "Equity method investment in Kindred at Home" in our condensed consolidated balance sheets, with our share of income or loss reported as "Equity in net earnings of Kindred at Home" in our condensed consolidated statements of income.

Wewe entered into a shareholders agreement with TPG Capital, or TPG, and Welsh, Carson, Anderson & Stowe, or WCAS, the Sponsors, that provides for certain rights and obligations of each party. The shareholders agreement with the Sponsors includes a put option under which they have the right to require us to purchase their interest in the joint venture beginning on July 2, 2021 and ending on July 1, 2022. Likewise, we have a call option under which we have the right to require the Sponsors to sell their interest in the joint venture to Humana beginning on July 2, 2022 and ending on July 1, 2023. The put and call options, which are exercisable at a fixed EBITDA multiple and provide a minimum return on the Sponsor's investment if exercised, are measured at fair value each period using a Monte Carlo simulation.
The simulation relies on assumptions around Kindred at Home's equity value, risk free interest rates, volatility, and the details specific to the put and call options. The final purchase price allocation resulted in approximately $1 billion being allocated to the investment and $236 million and $291 million allocated to the put and call options respectively. The fair values of the put option and call option were $128$137 million and $285$368 million, respectively, at June 30,March 31, 2020, and $28 million and $557 million, respectively, at December 31, 2019. The put option is included within other long-term liabilities and the call option is included within other long-term assets. The change in fair value of the put and call options is reflected as "Other income,(income) expense, net" in our condensed consolidated statements of income.
Health Care Reform
The Patient Protectionsignificant unobservable inputs utilized in these Level 3 fair value measurements (and selected values) include the enterprise value of Kindred at Home, annualized volatility and Affordable Care Act and The Health Care and Education Reconciliation Act of 2010 (which we collectively refersecured credit rate. Enterprise value was derived from a discounted cash flow model, which utilized significant unobservable inputs for long-term net operating profit after tax margin, or NOPAT, to as the Health Care Reform Law) enacted significant reforms to various aspects of the U.S. health insurance industry. Certain of these reforms became effective January 1, 2014, including an annual insurance industry premium-based fee. The Continuing Resolution bill, H.R. 195, enacted on January 22, 2018, included a one year suspension in 2019 of the health insurance industry fee, but under current law, the fee is scheduled to resume in calendar year 2020. In October 2018, we paid the federal government $1.04 billion for the annual health insurance industry fee attributed to calendar year 2018. This fee, fixed in amount by law and apportioned to insurance carriers based on market share, was not deductible for tax purposes. Each year on January 1, except when suspended, we record a liability for this fee in trade accounts payable and accrued expenses which we carry until the fee is paid. We record a corresponding deferred cost in other current assets in our condensed consolidated financial statements which is amortized ratably to expense over the calendar year. Amortization of the deferred cost was recorded in operating cost expense of approximately $257 million and $520 million for the three and six months ended June 30, 2018, respectively, resulting from the amortization of the 2018 annual health insurance industry fee.
2. RECENTLY ISSUED ACCOUNTING PRONOUNCEMENTS
In February 2016, the FASB issued new guidance related to accounting for leases which requires lessees to record assets and liabilities reflecting the leased assets and lease obligations, respectively, while following the dual model for recognition in statements of income requiring leases to be classified as either operating or finance. Operating leases will result in straight-line expense (similar to current operating leases) while finance leases will result in a front-loaded expense pattern (similar to current capital leases). We adopted the new standard effective January 1, 2019, as allowed, using the modified retrospective approach. We elected the practical expedients of not reassessing whether any expired or existing contracts are or contain leases, not reassessing the lease classification for any expired or existing leases and not reassessing any initial direct costs for existing leases. In addition, we elected the practical expedient to not separate lease and nonlease components for all of our asset classes. We made a permitted accounting policy election to not apply the new guidance to leases with an initial term of 12 months or less. We recognize those lease payments in the condensed consolidated statement of income on a straight-line basis over the lease term. As of January 1, 2019, the adoption of the standard resulted in recognition of right-of-use, or ROU, liabilities of approximately $470 million and ROU assets of $436 million, which equals the ROU liabilities net of accrued rent and lease incentives. The standard does not materially affect our results of operations,measure underlying cash flows, weighted average cost of capital and liquidity. See Note 8long term growth rate. The table below presents the assumptions used for further information.each reporting period.

In June 2016, the FASB issued guidance introducing a new model for recognizing credit losses on financial instruments based on an estimate of current expected credit losses. The guidance is effective for us beginning January


Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

1, 2020. The new current expected credit losses (CECL) model generally calls for the immediate recognition of all expected credit losses and applies to loans, accounts and trade receivables as well as other financial assets measured at amortized cost, loan commitments and off-balance sheet credit exposures, debt securities and other financial assets measured at fair value through other comprehensive income, and beneficial interests in securitized financial assets. The new guidance replaces the current incurred loss model for measuring expected credit losses, requires expected losses on available for sale debt securities to be recognized through an allowance for credit losses rather than as reductions in the amortized cost of the securities, and provides for additional disclosure requirements. Our investment portfolio consists of available for sale debt securities. We are in the process of identifying and analyzing financial assets measured at amortized cost balances that are in scope of the new CECL model. We are currently evaluating the impact on our results of operations, financial condition, and cash flows.

In March 2017, the FASB issued new guidance that amends the accounting for premium amortization on purchased callable debt securities by shortening the amortization period. This amended guidance requires the premium to be amortized to the earliest call date instead of maturity date. The new guidance is effective for us beginning with annual and interim periods in 2019. This guidance did not have a material impact on our results of operations, financial condition or cash flows.

In September 2018, the FASB issued new guidance related to accounting for long-duration contracts of insurers which revises key elements of the measurement models and disclosure requirements for long-duration contracts issued by insurers and reinsurers. The new guidance is effective for us beginning with annual and interim periods in 2021, with earlier adoption permitted, and requires retrospective application to previously issued annual and interim financial statements. We are currently evaluating the impact on our results of operations, financial position and cash flows.

There are no other recently issued accounting standards that apply to us or that are expected to have a material impact on our results of operations, financial condition, or cash flows.
3. ACQUISITIONS AND DIVESTITURES
Sale of Closed Block of Commercial Long-Term Care Insurance Business

In the third quarter of 2018, we completed the sale of our wholly-owned subsidiary, KMG America Corporation, or KMG, to Continental General Insurance Company, or CGIC, a Texas-based insurance company wholly owned by HC2 Holdings, Inc., a diversified holding company. KMG's subsidiary, Kanawha Insurance Company, or KIC, included our closed block of non-strategic commercial long-term care policies. Upon closing, we funded the transaction with approximately $190 million of parent company cash contributed into KMG, subject to customary adjustments, in addition to the transfer of approximately $160 million of statutory capital with the sale.
In connection with the sale of KMG, we recognized a pretax loss, including transaction costs, of $786 million and a corresponding $452 million income tax benefit.  
Also, in the third quarter of 2018, we entered into reinsurance contracts to transfer the risk associated with certain voluntary benefit and financial protection products previously issued primarily by KIC to a third party. We transferred approximately $245 million of cash to the third party and recorded a commensurate reinsurance recoverable as a result of these transactions. The reinsurance recoverable was included as part of the net assets disposed. There was no material impact to operating results from these reinsurance transactions.
KMG revenues for the three and six months ended June 30, 2018 were $93 million and $172 million, respectively. KMG pretax income for the three and six months ended June 30, 2018 were $35 million and $53 million, respectively.






Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)


Other Acquisitions and Divestitures
In the first quarter of 2018, we acquired the remaining equity interest in MCCI Holdings, LLC, or MCCI, a privately held management service organization headquartered in Miami, Florida, that primarily coordinates medical care for Medicare Advantage beneficiaries in Florida and Texas. The purchase price consisted primarily of $169 million cash, as well as our existing investment in MCCI and a note receivable and a revolving note with an aggregate balance of $383 million. This resulted in a purchase price allocation to goodwill of $483 million, other intangible assets of $80 million, and net tangible assets of $24 million. The goodwill was assigned to the Retail and Healthcare Services segments. The other intangible assets, which primarily consist of customer contracts, have an estimated weighted average useful life of 8 years. Goodwill and other intangible assets are amortizable as deductible expenses for tax purposes.
In the second quarter of 2018, we acquired Family Physicians Group, or FPG, for cash consideration of approximately $185 million, net of cash received. FPG serves Medicare Advantage and Managed Medicaid HMO patients in Greater Orlando, Florida with a footprint that includes clinics located in Lake, Orange, Osceola and Seminole counties. This resulted in a purchase price allocation to goodwill of $133 million, other intangible assets of $38 million and net tangible assets of $14 million. The goodwill was assigned to the Retail and Healthcare Services segments. The other intangible assets, which primarily consist of customer contracts, have an estimated weighted average useful life of 4.9 years. The purchase price allocations for MCCI and FPG are final.
During 2019 and 2018, we acquired other health and wellness related businesses which, individually or in the aggregate, have not had a material impact on our results of operations, financial condition, or cash flows. The results of operations and financial condition of these businesses have been included in our condensed consolidated statements of income and condensed consolidated balance sheets from the respective acquisition dates. Acquisition-related costs recognized in 2019 and 2018 were not material to our results of operations. The pro forma financial information assuming the acquisitions had occurred as of the beginning of the calendar year prior to the year of acquisition, as well as the revenues and earnings generated during the year of acquisition, were not material for disclosure purposes.


Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

4. INVESTMENT SECURITIES
Investment securities classified as current and long-term were as follows at June 30, 2019 and December 31, 2018, respectively:
 
Amortized
Cost
 
Gross
Unrealized
Gains
 
Gross
Unrealized
Losses
 
Fair
Value
 (in millions)
June 30, 2019       
U.S. Treasury and other U.S. government
corporations and agencies:
       
U.S. Treasury and agency obligations$370
 $2
 $
 $372
Mortgage-backed securities3,459
 69
 (8) 3,520
Tax-exempt municipal securities1,632
 28
 (1) 1,659
Mortgage-backed securities:       
Residential1
 
 
 1
Commercial621
 17
 
 638
Asset-backed securities1,037
 2
 (3) 1,036
Corporate debt securities3,125
 56
 (5) 3,176
Total debt securities$10,245
 $174
 $(17) $10,402
        
December 31, 2018       
U.S. Treasury and other U.S. government
corporations and agencies:
       
U.S. Treasury and agency obligations$419
 $1
 $(3) $417
Mortgage-backed securities2,595
 3
 (54) 2,544
Tax-exempt municipal securities2,805
 3
 (37) 2,771
Mortgage-backed securities:       
Residential55
 
 
 55
Commercial537
 
 (14) 523
Asset-backed securities991
 1
 (7) 985
Corporate debt securities3,239
 1
 (98) 3,142
Total debt securities$10,641
 $9
 $(213) $10,437
 March 31, 2020December 31, 2019
Annualized volatility28.0%19.8%
Secured credit rate4.1%2.2%
NOPAT12.0%12.0%
Weighted average cost of capital10.5%10.0%
Long term growth rate3.0%3.0%



Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

Gross unrealized lossesThe calculation of NOPAT utilized net income plus after tax interest expense. We regularly evaluate each of the assumptions used in establishing these assets and fair values aggregated by investment category and length of time that individual securities have beenliabilities. Significant changes in a continuous unrealized loss position were as follows at June 30, 2019 and December 31, 2018, respectively:
 Less than 12 months 12 months or more Total
 Fair
Value
 Gross
Unrealized
Losses
 Fair
Value
 Gross
Unrealized
Losses
 Fair
Value
 Gross
Unrealized
Losses
 (in millions)
June 30, 2019           
U.S. Treasury and other U.S.
government corporations
and agencies:
           
U.S. Treasury and agency
obligations
$34
 $
 $71
 $
 $105
 $
Mortgage-backed
securities
38
 
 546
 (8) 584
 (8)
Tax-exempt municipal
securities

 
 294
 (1) 294
 (1)
Mortgage-backed securities:           
Residential
 
 1
 
 1
 
Commercial
 
 70
 
 70
 
Asset-backed securities308
 (1) 452
 (2) 760
 (3)
Corporate debt securities9
 (1) 552
 (4) 561
 (5)
Total debt securities$389
 $(2) $1,986
 $(15) $2,375
 $(17)
            
December 31, 2018           
U.S. Treasury and other U.S.
government corporations
and agencies:
           
U.S. Treasury and agency
obligations
$179
 $(1) $153
 $(2) $332
 $(3)
Mortgage-backed
securities
956
 (16) 1,019
 (38) 1,975
 (54)
Tax-exempt municipal
securities
809
 (9) 1,648
 (28) 2,457
 (37)
Mortgage-backed securities:           
Residential
 
 15
 
 15
 
Commercial372
 (8) 133
 (6) 505
 (14)
Asset-backed securities824
 (7) 40
 
 864
 (7)
Corporate debt securities1,434
 (35) 1,439
 (63) 2,873
 (98)
Total debt securities$4,574
 $(76) $4,447
 $(137) $9,021
 $(213)

Approximately 96% of our debt securities were investment-grade quality, with aassumptions for weighted average cost of capital, long term growth rates, NOPAT, volatility, credit ratingspreads, risk free rate, and underlying cash flow estimates, could result in significantly lower or higher fair value measurements. A change in one of AA by Standard & Poor's Rating Service, or S&P, at June 30, 2019. Most of the debt securities that were below investment-grade were rated BB, the higher end of the below investment-grade rating scale. Tax-exempt municipal securities were diversified among general obligation bonds of states and local municipalities in the United States as well as special revenue bonds issued by municipalities to finance specific public works projects such as utilities, water and sewer, transportation, or education. Our general obligation bonds are diversified across the United States with no


Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

individual state exceeding 16%. Our investment policy limits investments in a single issuer and requires diversification among various asset types.
Our unrealized losses from all securities were generated from approximately 330 positions out of a total of approximately 1,460 positions at June 30, 2019. All issuers of securities we own that were trading at an unrealized loss at June 30, 2019 remain current on all contractual payments. After taking into account these and other factors previously described, we believe these unrealized losses primarily were caused by an increase in market interest rates in the current markets since the time the securities were purchased. At June 30, 2019, we did not intend to sell the securities with an unrealized loss position in accumulated other comprehensive income, and itassumptions is not likely that we will be required to sell these securities before recovery of their amortized cost basis. Asnecessarily accompanied by a result, we believe that the securities with an unrealized loss were not other-than-temporarily impaired at June 30, 2019.
The detail of realized gains (losses) related to investment securities and included within investment income was as follows for the three and six months ended June 30, 2019 and 2018:
 Three months ended
June 30,
Six months ended
June 30,
 2019 20182019 2018
 (in millions)
Gross realized gains$8
 $63
$18
 $94
Gross realized losses(1) (10)(13) (12)
Net realized capital (losses) gains$7
 $53
$5

$82

There were no material other-than-temporary impairments for the three and six months ended June 30, 2019 or 2018.
The contractual maturities of debt securities available for sale at June 30, 2019, regardless of their balance sheet classification, are shown below. Expected maturities may differ from contractual maturities because borrowers may have the right to call or prepay obligations with or without call or prepayment penalties.
 Amortized
Cost
 Fair
Value
 (in millions)
Due within one year$628
 $628
Due after one year through five years2,332
 2,357
Due after five years through ten years1,694
 1,734
Due after ten years473
 488
Mortgage and asset-backed securities5,118
 5,195
Total debt securities$10,245
 $10,402

change in another assumption.


Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

5. FAIR VALUE
Financial Assets
The following table summarizes our fair value measurements at June 30, 2019 and December 31, 2018, respectively, for financial assets measured at fair value on a recurring basis:
 Fair Value Measurements Using
 Fair
Value
 Quoted Prices
in Active
Markets
(Level 1)
 Other
Observable
Inputs
(Level 2)
 Unobservable
Inputs
(Level 3)
 (in millions)
June 30, 2019       
Cash equivalents$4,553
 $4,553
 $
 $
Debt securities:       
U.S. Treasury and other U.S. government
corporations and agencies:
       
U.S. Treasury and agency obligations372
 
 372
 
Mortgage-backed securities3,520
 
 3,520
 
Tax-exempt municipal securities1,659
 
 1,659
 
Mortgage-backed securities:       
Residential1
 
 1
 
Commercial638
 
 638
 
Asset-backed securities1,036
 
 1,036
 
Corporate debt securities3,176
 
 3,176
 
Total debt securities10,402
 
 10,402
 
Total invested assets$14,955
 $4,553
 $10,402
 $
        
December 31, 2018       
Cash equivalents$2,024
 $2,024
 $
 $
Debt securities:       
U.S. Treasury and other U.S. government
corporations and agencies:
       
U.S. Treasury and agency obligations417
 
 417
 
Mortgage-backed securities2,544
 
 2,544
 
Tax-exempt municipal securities2,771
 
 2,771
 
Mortgage-backed securities:       
Residential55
 
 55
 
Commercial523
 
 523
 
Asset-backed securities985
 
 985
 
Corporate debt securities3,142
 
 3,142
 
Total debt securities10,437
 
 10,437
 
Total invested assets$12,461
 $2,024
 $10,437
 $




Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

Financial Liabilities
Our debt is recorded at carrying value in our consolidated balance sheets. The carrying value of our senior notes debt outstanding, net of unamortized debt issuance costs, was $4,776 million at June 30, 2019 and $4,774 million at December 31, 2018. The fair value of our senior notes debt was $5,115 million at June 30, 2019 and $5,191 million at December 31, 2018. The fair value of our long-term debt is determined based on Level 2 inputs, including quoted market prices for the same or similar debt, or if no quoted market prices are available, on the current prices estimated to be available to us for debt with similar terms and remaining maturities. Due to the short-term nature, carrying value approximates fair value for our term note and commercial paper borrowings. The term loan outstanding and commercial paper borrowings were $950 million as of June 30, 2019 and $1,295 million as of December 31, 2018.
Other Assets and Liabilities Measured at Fair Value

As disclosed in Note 3, we acquired MCCI and FPGEnclara during 2018.2020. The values of net tangible assets acquired and the resulting goodwill and other intangible assets were recorded at fair value using Level 3 inputs. The majority of the net tangible assets acquired and liabilities assumed were recorded at their carrying values as of the respective datesdate of acquisition, as their carrying values


Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

approximated their fair values due to their short-term nature. The fair values of goodwill and other intangible assets acquired in these acquisitionsthis acquisition were internally estimated primarily based on the income approach. The income approach estimates fair value based on the present value of the cash flows that the assets are expected to generate in the future. We developed internal estimates for the expected future cash flows and discount rates used in the present value calculations. Other than assets acquired and liabilities assumed in these acquisitions, and the put option liability and call option asset associated with our investment in Kindred at Home as detailed in Note 1,this acquisition, there were no other material assets or liabilities measured at fair value on a recurring or nonrecurring basis during 2019 or 2018.2020.
6. MEDICARE PART D
We cover prescription drug benefits in accordance with Medicare Part D under multiple contracts with the Centers for Medicare and Medicaid Services, or CMS, as described further in Note 2 to the consolidated financial statements included in our 20182019 Form 10-K. The accompanying condensed consolidated balance sheets include the following amounts associated with Medicare Part D at June 30, 2019March 31, 2020 and December 31, 2018.2019. CMS subsidies/discounts in the table below include the reinsurance and low-income cost subsidies funded by CMS for which we assume no risk as well as brand name prescription drug discounts for Part D plan participants in the coverage gap funded by CMS and pharmaceutical manufacturers.
June 30, 2019 December 31, 2018March 31, 2020 December 31, 2019
Risk
Corridor
Settlement
 CMS
Subsidies/
Discounts
 Risk
Corridor
Settlement
 CMS
Subsidies/
Discounts
Risk
Corridor
Settlement
 CMS
Subsidies/
Discounts
 Risk
Corridor
Settlement
 CMS
Subsidies/
Discounts
(in millions)(in millions)
Other current assets$11
 $388
 $15
 $172
$59
 $894
 $5
 $585
Trade accounts payable and accrued expenses(48) (1,259) (103) (503)(148) (1,241) (120) (356)
Net current liability(37) (871) (88) (331)
Net current (liability) asset(89) (347) (115) 229
Other long-term assets26
 
 7
 
183
 
 6
 
Other long-term liabilities(137) 
 (89) 
(130) 
 (61) 
Net long-term liability(111) 
 (82) 
Total net liability$(148) $(871) $(170) $(331)
Net long-term asset (liability)53
 
 (55) 
Total net (liability) asset$(36) $(347) $(170) $229

7. GOODWILL AND OTHER INTANGIBLE ASSETS
Changes in the carrying amount of goodwill for our reportable segments for the three months ended March 31, 2020 were as follows:
 Retail Group and Specialty Healthcare
Services
 Total
 (in millions)
Balance at January 1, 2020$1,535
 $261
 $2,132
 $3,928
Acquisitions
 
 515
 515
Balance at March 31, 2020$1,535
 $261
 $2,647
 $4,443



Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

7. GOODWILL AND OTHER INTANGIBLE ASSETS
Changes in the carrying amount of goodwill for our reportable segments for the six months ended June 30, 2019 were as follows:
 Retail Group and Specialty Healthcare
Services
 Total
 (in millions)
Balance at January 1, 2019$1,535
 $261
 $2,101
 $3,897
Acquisitions
 
 25
 25
Balance at June 30, 2019$1,535
 $261
 $2,126
 $3,922

The following table presents details of our other intangible assets included in other long-term assets in the accompanying condensed consolidated balance sheets at June 30, 2019March 31, 2020 and December 31, 2018.2019.
 June 30, 2019 December 31, 2018 March 31, 2020 December 31, 2019
Weighted
Average
Life
 Cost Accumulated
Amortization
 Net Cost Accumulated
Amortization
 NetWeighted
Average
Life
 Cost Accumulated
Amortization
 Net Cost Accumulated
Amortization
 Net
 ($ in millions) ($ in millions)
Other intangible assets:                        
Customer contracts/
relationships
8.7 years $647
 $465
 $182
 $646
 $434
 $212
9.5 years $849
 $514
 $335
 $646
 $496
 $150
Trade names and
technology
6.4 years 84
 84
 
 84
 83
 1
7.0 years 121
 85
 36
 84
 84
 
Provider contracts11.8 years 69
 41
 28
 68
 37
 31
11.8 years 70
 46
 24
 70
 44
 26
Noncompetes and
other
7.3 years 29
 28
 1
 29
 28
 1
7.3 years 29
 28
 1
 29
 28
 1
Total other intangible
assets
8.7 years $829
 $618
 $211
 $827
 $582
 $245
9.3 years $1,069
 $673
 $396
 $829
 $652
 $177

Amortization expense for other intangible assets was approximately $21 million for the three months ended March 31, 2020 and $18 million for the three months ended June 30, 2019 and $21 million for the three months ended June 30, 2018. For the six months ended June 30, 2019 and 2018, amortization expense for other intangible assets was approximately $36 million and $51 million, respectively. Amortization expense for the six months ended June 30, 2018 included $12 million associated with the write-off of a trade name value reflecting the re-branding of certain provider assets.March 31, 2019. The following table presents our estimate of amortization expense remaining for 20192020 and each of the five next succeeding years:
(in millions)(in millions)
For the years ending December 31,  
2019$34
202067
$67
202134
56
202231
53
202318
40
202411
33
202533



Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

8. LEASES
2019
We determine if a contract contains a lease by evaluating the nature and substance of the agreement. We lease facilities, computer hardware, and other furniture and equipment. Leases with an initial term of 12 months or less are not recorded on the balance sheet; we recognize lease expense for these leases on a straight-line basis over the lease term. For new lease agreements, we combine lease and nonlease components for all of our asset classes. See Note 2 for further information.

When portions of the lease payments are not fixed or depend on an index or rate, we consider those payments to be variable in nature. These include, but are not limited to, common area maintenance, taxes and insurance. Variable lease payments are recorded in the period in which the obligation for the payment is incurred.

Most leases include options to renew, with renewal terms that can extend the lease term. The exercise of lease renewal options is at our sole discretion. Certain leases also include options to purchase the leased property. The depreciable life of assets and leasehold improvements are limited by the expected lease term, unless there is a transfer of title or purchase option reasonably certain of exercise. Our lease agreements do not contain any material residual value guarantees or material restrictive covenants.

At June 30, 2019, $406 million of operating ROU assets are included within other long-term assets in our condensed consolidated balance sheet. Additionally, at June 30, 2019, $121 million and $324 million of operating ROU lease liabilities are included within trade accounts payable and accrued expenses and other long-term liabilities, respectively, in our condensed consolidated balance sheet based on the remaining lease term.

For the three and six months ended June 30, 2019, total fixed operating lease costs, excluding short-term lease costs, were $39 million and $78 million, respectively, and are included within operating costs in our condensed consolidated statement of income. Short-term lease costs were not material. In addition, for the three and six months ended June 30, 2019, total variable operating lease costs were $19 million and $35 million, respectively and are included within operating costs in our condensed consolidated statement of income. We sublease facilities or partial facilities to third party tenants for space not used in our operations. For the three and six months ended June 30, 2019, sublease rental income was $10 million and $19 million, respectively, and is included within operating costs in our condensed consolidated statement of income.

The weighted average remaining lease term is 4.8 years with a weighted average discount rate of 4.3% at June 30, 2019. For the six months ended June 30, 2019, cash paid for amounts included in the measurement of lease liabilities included within our operating cash flows was $75 million.

Maturity of Lease Liabilities June 30, 2019
  (in millions)
2019 (excluding the six months ended June 30, 2019) $72
2020 122
2021 103
2022 84
2023 39
After 2023 74
Total lease payments 494
Less: Interest 49
Present value of ROU lease liabilities $445




Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

As most of our leases do not provide an implicit rate, we use our incremental borrowing rate, as adjusted for collateralized borrowings, based on the information available at date of adoption or commencement date in determining the present value of lease payments.
For the year ended 2018, under prior lease disclosure requirements
We lease facilities, computer hardware, and other furniture and equipment under long-term operating leases that are non-cancelable and expire on various dates through 2046. We sublease facilities or partial facilities to third party tenants for space not used in our operations. Rent with scheduled escalation terms are accounted for on a straight-line basis over the lease term. Rent expense and sublease rental income, which are recorded net as an operating cost, for all operating leases were as follows for the years ended December 31, 2018, 2017 and 2016:

 2018 2017 2016
 (in millions)
Rent expense$167
 $204
 $179
Sublease rental income(32) (33) (26)
Net rent expense$135
 $171
 $153



Future annual minimum payments due subsequent to December 31, 2018 under all of our noncancelable operating leases with initial terms in excess of one year are as follows:
 Minimum
Lease
Payments
 Sublease
Rental
Receipts
 Net  Lease
Commitments
 (in millions)
For the years ending December 31,:     
2019$147
 $(13) $134
2020113
 (12) 101
202196
 (10) 86
202279
 (9) 70
202334
 (9) 25
Thereafter50
 (23) 27
Total$519
 $(76) $443




Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

9. BENEFITS PAYABLE
On a consolidated basis, activity in benefits payable, was as follows for the sixthree months ended June 30, 2019March 31, 2020 and 2018:2019:
 For the six months ended June 30, For the three months ended March 31,
 2019 2018 2020 2019
 (in millions) (in millions)
Balances, beginning of period $4,862
 $4,668
 $6,004
 $4,862
Less: Reinsurance recoverables (95) (70) (68) (95)
Balances, beginning of period, net 4,767
 4,598
 5,936
 4,767
Incurred related to:        
Current year 27,086
 23,543
 15,913
 13,760
Prior years (275) (338) (284) (267)
Total incurred 26,811
 23,205
 15,629
 13,493
Paid related to:        
Current year (21,700) (18,914) (10,205) (8,725)
Prior years (4,108) (3,897) (4,280) (3,595)
Total paid (25,808) (22,811) (14,485) (12,320)
Reinsurance recoverable 72
 86
 10
 84
Less: Held-for-sale 
 (58)
Balances, end of period $5,842
 $5,020
 $7,090
 $6,024

Amounts incurred related to prior periods vary from previously estimated liabilities as the claims ultimately are settled. Negative amounts reported for incurred related to prior years result from claims being ultimately settled for amounts less than originally estimated (favorable development).
Our reserving practice is to consistently recognize the actuarial best estimate of our ultimate liability for claims. Actuarial standards require the use of assumptions based on moderately adverse experience, which generally results in favorable reserve development, or reserves that are considered redundant.
Benefits expense excluded from the previous table related to our long duration policies was as follows for the six months ended June 30, 2019 and 2018. The Other Businesses category was related to our closed-block of commercial long-term care insurance policies, which were sold in 2018. We also exited our Individual Commercial business beginning January 1, 2018.
  For the six months ended June 30,
  2019 2018
  (in millions)
Future policy benefits:    
Individual Commercial $
 $(14)
Other Businesses 
 15
Total future policy benefits $
 $1




Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

Incurred and Paid Claims Development
The following discussion provides information about incurred and paid claims development for our Retail and Group and Specialty segments as of June 30,March 31, 2020 and 2019, and 2018, net of reinsurance, and the total estimate of benefits payable for claims incurred but not reported, or IBNR, included within the net incurred claims amounts. Our Individual Commercial segment incurred claims development was favorable by $55 million for the six months ended June 30, 2018.
Retail Segment
Activity in benefits payable for our Retail segment was as follows for the six months ended June 30, 2019 and 2018:
  For the six months ended June 30,
  2019 2018
  (in millions)
Balances, beginning of period $4,338
 $3,963
Less: Reinsurance recoverables (95) (70)
Balances, beginning of period, net 4,243
 3,893
Incurred related to:    
Current year 24,657
 21,069
Prior years (311) (247)
Total incurred 24,346
 20,822
Paid related to:    
Current year (19,826) (17,061)
Prior years (3,592) (3,327)
Total paid (23,418) (20,388)
Reinsurance recoverable 72
 86
Balances, end of period $5,243
 $4,413

At June 30, 2019, benefits payable for our Retail segment included IBNR of approximately $3.2 billion, primarily associated with claims incurred in 2019.












Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

Retail Segment
Activity in benefits payable for our Retail segment was as follows for the three months ended March 31, 2020 and 2019:
  For the three months ended March 31,
  2020 2019
  (in millions)
Balances, beginning of period $5,363
 $4,338
Less: Reinsurance recoverables (68) (95)
Balances, beginning of period, net 5,295
 4,243
Incurred related to:    
Current year 14,698
 12,606
Prior years (238) (283)
Total incurred 14,460
 12,323
Paid related to:    
Current year (9,490) (8,032)
Prior years (3,778) (3,133)
Total paid (13,268) (11,165)
Reinsurance recoverable 10
 84
Balances, end of period $6,497
 $5,485

At March 31, 2020, benefits payable for our Retail segment included IBNR of approximately $4.4 billion, primarily associated with claims incurred in 2019.
Group and Specialty Segment
Activity in benefits payable for our Group and Specialty segment, was as follows for the sixthree months ended June 30, 2019March 31, 2020 and 2018:2019:
 For the six months ended June 30, For the three months ended March 31,
 2019 2018 2020 2019
 (in millions) (in millions)
Balances, beginning of period $517
 $568
 $641
 $517
Incurred related to:        
Current year 2,693
 2,665
 1,357
 1,271
Prior years 36
 (34) (46) 16
Total incurred 2,729
 2,631
 1,311
 1,287
Paid related to:        
Current year (2,131) (2,094) (857) (803)
Prior years (516) (496) (502) (462)
Total paid (2,647) (2,590) (1,359) (1,265)
Balances, end of period $599
 $609
 $593
 $539

At June 30, 2019,March 31, 2020, benefits payable for our Group and Specialty segment included IBNR of approximately $505$528 million, primarily associated with claims incurred in 2019.


Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

Reconciliation to Consolidated

The reconciliation of the net incurred and paid claims development tables to benefits payable in the consolidated
statement of financial position is as follows:
 Reconciliation of the Disclosure of Incurred and Paid Claims Development to Benefits Payable, net of reinsurance
 
  June 30,
  2019
 Net outstanding liabilities(in millions)
 Retail$5,171
 Group and Specialty599
     Benefits payable, net of reinsurance5,770
   
 Reinsurance recoverable on unpaid claims 
 Retail72
      Total benefits payable, gross$5,842
 Reconciliation of the Disclosure of Incurred and Paid Claims Development to Benefits Payable, net of reinsurance
 
  March 31,
  2020
 Net outstanding liabilities(in millions)
 Retail$6,487
 Group and Specialty593
     Benefits payable, net of reinsurance7,080
   
 Reinsurance recoverable on unpaid claims 
 Retail10
      Total benefits payable, gross$7,090



Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

10.9. EARNINGS PER COMMON SHARE COMPUTATION
Detail supporting the computation of basic and diluted earnings per common share was as follows for the three and six months ended June 30, 2019March 31, 2020 and 2018:2019:
Three months ended June 30, Six months ended June 30,Three months ended March 31,
2019 2018 2019 20182020 2019
(dollars in millions, except per common share results; number of shares in thousands)(dollars in millions, except per common share results; number of shares in thousands)
Net income available for common stockholders$940
 $193
 $1,506
 $684
$473
 $566
Weighted average outstanding shares of common stock
used to compute basic earnings per common share
135,063
 137,763
 135,223
 137,833
132,135
 135,383
Dilutive effect of:          
Employee stock options67
 197
 98
 205
92
 130
Restricted stock449
 616
 449
 665
584
 449
Shares used to compute diluted earnings per common share135,579
 138,576
 135,770
 138,703
132,811
 135,962
Basic earnings per common share$6.96
 $1.40
 $11.14
 $4.96
$3.58
 $4.18
Diluted earnings per common share$6.94
 $1.39
 $11.10
 $4.93
$3.56
 $4.16
Number of antidilutive stock options and restricted stock
excluded from computation
761
 171
 732
 408
660
 703


11.
Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

10. STOCKHOLDERS’ EQUITY
Dividends
The following table provides details of dividend payments, excluding dividend equivalent rights for unvested stock awards, in 20182019 and 20192020 under our Board approved quarterly cash dividend policy:
Record
Date
 Payment
Date
 Amount
per Share
 Total
Amount
 Payment
Date
 Amount
per Share
 Total
Amount
   (in millions)   (in millions)
2018 payments    
12/29/2017 1/26/2018 $0.40
 $55
3/30/2018 4/27/2018 $0.50
 $69
6/29/2018 7/27/2018 $0.50
 $69
9/28/2018 10/26/2018 $0.50
 $69
2019 payments        
12/31/2018 1/25/2019 $0.50
 $68
 1/25/2019 $0.50
 $68
3/29/2019 4/26/2019 $0.55
 $74
 4/26/2019 $0.55
 $74
6/28/2019 7/26/2019 $0.55
 $74
 7/26/2019 $0.55
 $74
9/30/2019 10/25/2019 $0.55
 $73
2020 payments    
12/31/2019 1/31/2020 $0.55
 $73
3/31/2020 4/24/2020 $0.625
 $83


In April 2020, the Board declared a cash dividend of $0.625 per share payable on July 31, 2020, to stockholders of record on June 30, 2020.
Stock Repurchases
Our Board of Directors may authorize the purchase of our common stock shares. Under the share repurchase authorization, shares may be purchased from time to time at prevailing prices in the open market, by block purchases, through plans designed to comply with Rule 10b5-1 under the Securities Exchange Act of 1934, as amended, or in


Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

privately-negotiated transactions, including pursuant to accelerated share repurchase agreements with investment banks, subject to certain regulatory restrictions on volume, pricing, and timing.
On December 14, 2017, our Board of Directors authorized the repurchase of up to $3.0 billion of our common shares expiring on December 31, 2020, exclusive of shares repurchased in connection with employee stock plans.
On November 28, 2018, we entered into an accelerated stock repurchase agreement, the November 2018 ASR, with Goldman Sachs to repurchase $750 million of our common stock as part of the $3.0 billion share repurchase program authorized by the Board of Directors on December 14, 2017. On November 29, 2018, we made a payment of $750 million to Goldman Sachs from available cash on hand and received an initial delivery of 1.94 million shares of our common stock from Goldman Sachs. The payment to Goldman Sachs was recorded as a reduction to stockholders’ equity, consisting of a $600 million increase in treasury stock, which reflects the value of the initial 1.94 million shares received upon initial settlement, and a $150 million decrease in capital in excess of par value, which reflected the value of stock held back by Goldman Sachs pending final settlement of the November 2018 ASR. Upon final settlement of the November 2018 ASR on February 28, 2019, we received an additional 0.6 million shares as determined by the average daily volume weighted-averages share price of our common stock during the term of the agreement of $295.15, bringing the total shares received under this program to 2.54 million. In addition, upon settlement we reclassified the $150 million value of stock initially held back by Goldman Sachs from capital in excess of par value to treasury stock.
On July 30, 2019, the Board of Directors replaced a previous share repurchase authorization of up to $3$3 billion (of which approximately $1.03 billion remained unused) with a new authorization for repurchases of up to $3 billion of our common shares exclusive of shares repurchased in connection with employee stock plans, expiring on June 30, 2022.
On July 31, 2019, we entered into an accelerated stock repurchase agreement, the July 2019 ASR, with Citibank, N.A., or Citi, to repurchase $1 billion of our common stock. On August 2, 2019, we made a payment of $1 billion to Citi and received an initial delivery of 2.7 million shares of our common stock. We recorded the payment to Citi as a reduction to stockholders’ equity, consisting of an $800 million increase in treasury stock, which reflects the value of the initial 2.7 million shares received upon initial settlement, and a $200 million decrease in capital in excess of par value, which reflects the value of stock held back by Citi pending final settlement of the July 2019 ASR. Upon final settlement of the July 2019 ASR on December 26, 2019, we received an additional 0.7 million shares as determined by the average daily volume weighted-averages share price of our common stock during the term of the agreement, less a discount, of $296.19, bringing the total shares received under the July 2019 ASR to 3.4 million. In addition, upon settlement we reclassified the $200 million value of stock initially held back by Citi from capital in excess of par value to treasury stock.
Our remaining repurchase authorization was approximately $2 billion of the $3 billion share repurchase program as of April 28, 2020.
In connection with employee stock plans, we acquired 34 thousand0.04 million common shares for $17 million and 0.03 million common shares for $10 million and 0.3 million common shares for $69 million during the six months ended June 30, 2019 and 2018, respectively.
Treasury Stock Reissuance
We reissued 0.13 million shares of treasury stock during the six months ended June 30, 2019 at a cost of $15 million associated with restricted stock unit vestings and option exercises.
Accumulated Other Comprehensive Income
Accumulated other comprehensive income included net unrealized gains, net of tax, on our investment securities of $112 million at June 30, 2019 and net unrealized losses, net of tax, on our investment securities of $159 million at December 31, 2018.
12. INCOME TAXES
The effective income tax rate was 24.3% for the six months ended June 30, 2019 compared to 5.8% for the six months ended June 30, 2018, primarily due to the impact of the suspension of the non-deductible health insurance industry fee in 2019 as well as the deferred tax benefit recognized in 2018 from the loss on sale of KMG. The effective income tax rate was 24.2% for the three months ended June 30, 2019. The effective income tax rate for the three months ended June 30, 2018 reflects a $430 million deferred tax benefit recorded during the three months ended June 30, 2018, resulting from the loss on the sale of KMG attributable to its original tax basisMarch 31, 2020 and subsequent capital contributions to fund accumulated losses.2019, respectively.



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13.11. INCOME TAXES
The effective income tax rate was 34.8% for the three months ended March 31, 2020, compared to 24.4% for the three months ended March 31, 2019, primarily due to the reinstatement of the non-deductible health insurance industry fee in 2020.
12.  DEBT
The carrying value of debt outstanding, net of unamortized debt issuance costs, was as follows at June 30, 2019March 31, 2020 and December 31, 20182019:
June 30, 2019 December 31, 2018March 31, 2020 December 31, 2019
(in millions)(in millions)
Short-term debt:      
Commercial paper$300
 $645
$500
 $300
Term note650
 650
1,000
 
Senior note:
  
$400 million, 2.625% due October 1, 2019399
 399
Senior notes:
  
$400 million, 2.50% due December 15, 2020398
 399
Total short-term debt$1,349
 $1,694
$1,898
 $699
      
Long-term debt:      
Senior notes:      
$400 million, 2.50% due December 15, 2020$399
 $398
$600 million, 3.15% due December 1, 2022$598
 $598
$400 million, 2.90% due December 15, 2022397
 396
398
 397
$600 million, 3.15% due December 1, 2022597
 596
$600 million, 3.85% due October 1, 2024597
 597
597
 597
$600 million, 4.50% due April 1, 2025594
 
$600 million, 3.95% due March 15, 2027595
 594
596
 595
$500 million, 3.125% due August 15, 2029495
 495
$500 million, 4.875% due April 1, 2030494
 
$250 million, 8.15% due June 15, 2038262
 263
262
 262
$400 million, 4.625% due December 1, 2042396
 396
396
 396
$750 million, 4.95% due October 1, 2044739
 739
739
 739
$400 million, 4.80% due March 15, 2047395
 396
396
 396
$500 million, 3.95% due August 15, 2049492
 492
Total long-term debt$4,377
 $4,375
$6,057
 $4,967

Senior Notes    
In March 2020, we issued $600 million of 4.500% senior notes due April 1, 2025 and $500 million of 4.875% senior notes due April 1, 2030. Our net proceeds, reduced for the underwriters' discount and commission and offering expenses paid, were approximately $1,090 million. We intend to use the net proceeds for general corporate purposes, which may include the repayment of existing indebtedness.
Our senior notes, which are unsecured, may be redeemed at our option at any time at 100% of the principal amount plus accrued interest and a specified make-whole amount. The 8.15% senior notes are subject to an interest rate adjustment if the debt ratings assigned to the notes are downgraded (or subsequently upgraded). In addition, our senior notes contain a change of control provision that may require us to purchase the notes under certain circumstances.


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Credit Agreement
Our 5-year, $2.0 billion unsecured revolving credit agreement expires May 2022. Under the credit agreement, at our option, we can borrow on either a competitive advance basis or a revolving credit basis. The revolving credit portion bears interest at either LIBOR plus a spread or the base rate plus a spread. If drawn upon, the revolving credit would revert to using the alternative base rate once LIBOR is discontinued. The LIBOR spread, currently 110.0 basis points, varies depending on our credit ratings ranging from 91.0 to 150.0 basis points. We also pay an annual facility fee regardless of utilization. This facility fee, currently 15.0 basis points, may fluctuate between 9.0 and 25.0 basis points, depending upon our credit ratings. The competitive advance portion of any borrowings will bear interest at market rates prevailing at the time of borrowing on either a fixed rate or a floating rate based on LIBOR, at our option.
The terms of the credit agreement include standard provisions related to conditions of borrowing which could limit our ability to borrow additional funds. In addition, the credit agreement contains customary restrictive covenants and a financial covenant regarding maximum debt to capitalization of 50%, as well as customary events of default. We are in compliance with this financial covenant, with actual debt to capitalization of 32.5%39% as measured in accordance with the credit agreement as of June 30, 2019.March 31, 2020. Upon our agreement with one or more financial institutions, we may expand


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the aggregate commitments under the credit agreement to a maximum of $2.5 billion, through a $500 million incremental loan facility.
At June 30, 2019March 31, 2020, we had no0 borrowings and no0 letters of credit outstanding under the credit agreement. Accordingly, as of June 30, 2019March 31, 2020, we had $2.0$2.0 billion of remaining borrowing capacity (which excludes the uncommitted $500 million incremental loan facility under the credit agreement), none of which would be restricted by our financial covenant compliance requirement. We have other customary, arms-length relationships, including financial advisory and banking, with some parties to the credit agreement.
Commercial Paper
Under our commercial paper program we may issue short-term, unsecured commercial paper notes privately placed on a discount basis through certain broker dealers at any time not to exceed $2 billion. Amounts available under the program may be borrowed, repaid and re-borrowed from time to time. The net proceeds of issuances have been and are expected to be used for general corporate purposes. The maximum principal amount outstanding at any one time during the sixthree months ended June 30, 2019March 31, 2020 was $670$600 million, with $300$500 million outstanding at June 30, 2019March 31, 2020 compared to $645$300 million outstanding at December 31, 2018.2019. The outstanding commercial paper at June 30, 2019March 31, 2020 had a weighted average annual interest rate of 2.85%2%.
Term Note
In November 2018,February 2020, we entered into a $1.0new $1 billion term note agreementloan commitment with a bank atthat matures 1 year after the first draw, subject to a variable rate1 year extension. In March 2020, we made a draw on the entire term loan commitment of interest due within one year. We may elect to incur interest at either the bank's base rate or LIBOR plus 115 basis points.$1 billion. The base rate is defined as the higher of the daily federal funds rate plus 50 basis points; or the bank's prime rate; or LIBOR plus 100 basis points. Thefacility fee, interest rate in effect at June 30, 2019 was 3.55%. The note is prepayable without penalty. We repaid $350 million prior to December 31, 2018. The term note shares the customary terms and provisions as well as financial covenants are consistent with those of our Credit Agreement, as discussed above.revolving credit agreement. There is no prepayment penalty.
14.13. COMMITMENTS, GUARANTEES AND CONTINGENCIES
Government Contracts
Our Medicare products, which accounted for approximately 82%83% of our total premiums and services revenue for the sixthree months ended June 30, 2019,March 31, 2020, primarily consisted of products covered under the Medicare Advantage and Medicare Part D Prescription Drug Plan contracts with the federal government. These contracts are renewed generally for a calendar year term unless CMS notifies us of its decision not to renew by May 1 of the calendar year in which the contract would end, or we notify CMS of our decision not to renew by the first Monday in June of the calendar year in which the contract would end. All material contracts between Humana and CMS relating to our Medicare products have been renewed for 2020. Our2020, and all of our product offerings under those contracts are subject to approval by CMS in the third quarter of 2019.for 2020 have been approved.


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CMS uses a risk-adjustment model which adjusts premiums paid to Medicare Advantage, or MA, plans according to health status of covered members. The risk-adjustment model, which CMS implemented pursuant to the Balanced Budget Act of 1997 (BBA) and the Benefits Improvement and Protection Act of 2000 (BIPA), generally pays more where a plan's membership has higher expected costs. Under this model, rates paid to MA plans are based on actuarially determined bids, which include a process whereby our prospective payments are based on our estimated cost of providing standard Medicare-covered benefits to an enrollee with a "national average risk profile." That baseline payment amount is adjusted to reflect the health status of our enrolled membership. Under the risk-adjustment methodology, all MA plans must collect and submit the necessary diagnosis code information from hospital inpatient, hospital outpatient, and physician providers to CMS within prescribed deadlines. The CMS risk-adjustment model uses the diagnosis data to calculate the risk-adjusted premium payment to MA plans, which CMS adjusts for coding pattern differences between the health plans and the government fee-for-service program. We generally rely on providers, including certain providers in our network who are our employees, to code their claim submissions with appropriate diagnoses, which we send to CMS as the basis for our payment received from CMS under the actuarial risk-adjustment model. We also rely on these


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providers to document appropriately all medical data, including the diagnosis data submitted with claims. In addition, we conduct medical record reviews as part of our data and payment accuracy compliance efforts, to more accurately reflect diagnosis conditions under the risk adjustment model. These compliance efforts include the internal contract level audits described in more detail below, as well as ordinary course reviews of our internal business processes.
CMS is phasing-in the process of calculating risk scores using diagnoses data from the Risk Adjustment Processing System, or RAPS, to diagnoses data from the Encounter Data System, or EDS. The RAPS process requires MA plans to apply a filter logic based on CMS guidelines and only submit diagnoses that satisfy those guidelines. For submissions through EDS, CMS requires MA plans to submit all the encounter data and CMS will apply the risk adjustment filtering logic to determine the risk scores. For 2018, 15%2019, 25% of the risk score was calculated from claims data submitted through EDS. In 2019CMS increased that percentage to 50% in 2020 and 2020 CMS will increase that percentage to 25% and 50%, respectively.75% in 2021. The phase-in from RAPS to EDS could result in different risk scores from each dataset as a result of plan processing issues, CMS processing issues, or filtering logic differences between RAPS and EDS, and could have a material adverse effect on our results of operations, financial position, or cash flows.
CMS and the Office of the Inspector General of Health and Human Services, or HHS-OIG, are continuing to perform audits of various companies’ selected MA contracts related to this risk adjustment diagnosis data. We refer to these audits as Risk-Adjustment Data Validation Audits, or RADV audits. RADV audits review medical records in an attempt to validate provider medical record documentation and coding practices which influence the calculation of premium payments to MA plans.
In 2012, CMS released a “Notice of Final Payment Error Calculation Methodology for Part C Medicare Advantage Risk Adjustment Data Validation (RADV) Contract-Level Audits.” The payment error calculation methodology provided that, in calculating the economic impact of audit results for an MA contract, if any, the results of the RADV audit sample would be extrapolated to the entire MA contract after a comparison of the audit results to a similar audit of the government’s traditional fee-for-service Medicare program, or Medicare FFS. We refer to the process of accounting for errors in FFS claims as the "FFS Adjuster." This comparison of RADV audit results to the FFS error rate is necessary to determine the economic impact, if any, of RADV audit results because the government used the Medicare FFS program data set, including any attendant errors that are present in that data set, to estimate the costs of various health status conditions and to set the resulting adjustments to MA plans’ payment rates in order to establish actuarial equivalence in payment rates as required under the Medicare statute. CMS already makes other adjustments to payment rates based on a comparison of coding pattern differences between MA plans and Medicare FFS data (such as for frequency of coding for certain diagnoses in MA plan data versus the Medicare FFS program dataset).
The final RADV extrapolation methodology, including the first application of extrapolated audit results to determine audit settlements, is expected to be applied to CMS RADV contract level audits conducted for contract year 2011 and subsequent years. CMS is currently conducting RADV contract level audits for certain of our Medicare Advantage plans.
Estimated audit settlements are recorded as a reduction of premiums revenue in our consolidated statements of income, based upon available information. We perform internal contract level audits based on the RADV audit


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methodology prescribed by CMS. Included in these internal contract level audits is an audit of our Private Fee-For Service business which we used to represent a proxy of the FFS Adjuster which has not yet been finalized. We based our accrual of estimated audit settlements for each contract year on the results of these internal contract level audits and update our estimates as each audit is completed. Estimates derived from these results were not material to our results of operations, financial position, or cash flows. We report the results of these internal contract level audits to CMS, including identified overpayments, if any.
On October 26, 2018, CMS issued a proposed rule and accompanying materials (which we refer to as the “Proposed Rule”) related to, among other things, the RADV audit methodology described above. If implemented, the Proposed Rule would use extrapolation in RADV audits applicable to payment year 2011 contract-level audits and all subsequent audits, without the application of a FFS Adjuster to audit findings. We are studying the Proposed Rule and CMS’ underlying analysis contained therein. We believe however, that the Proposed Rule fails to address adequately the statutory requirement of actuarial equivalence, and we expect to providehave provided substantive comments to CMS on the Proposed


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Rule as part of the notice-and-comment rulemaking process. We are also evaluating the potential impact ofWhether, and to what extent, CMS finalizes the Proposed Rule, and any related regulatory, industry or company reactions, all or any of which could have a material adverse effect on our results of operations, financial position, or cash flows.
In addition, as part of our internal compliance efforts, we routinely perform ordinary course reviews of our internal business processes related to, among other things, our risk coding and data submissions in connection with the risk-risk adjustment model. These reviews may also result in the identification of errors and the submission of corrections to CMS, that may, either individually or in the aggregate, be material. As such, the result of these reviews may have a
material adverse effect on our results of operations, financial position, or cash flows.

We believe that CMS' statements and policies regarding the requirement to report and return identified overpayments received by MA plans are inconsistent with CMS' 2012 RADV audit methodology, and the Medicare statute's requirements. These statements and policies, such as certain statements contained in the preamble to CMS’ final rule release regarding Medicare Advantage and Part D prescription drug benefit program regulations for Contract Year 2015 (which we refer to as the "Overpayment Rule"), and the Proposed Rule, appear to equate each Medicare Advantage risk adjustment data error with an “overpayment” without addressing the principles underlying the FFS Adjuster referenced above. On September 7, 2018, the Federal District Court for the District of Columbia vacated CMS's Overpayment Rule, concluding that it violated the Medicare statute, including the requirement for actuarial equivalence, and that the Overpayment Rule was also arbitrary and capricious in departing from CMS's RADV methodology without adequate explanation (among other reasons). CMS has filed a motion for reconsideration related to certain aspects of the Federal District Court's opinion and has simultaneously filed a notice to appealappealed the decision to the Circuit Court of Appeals.
We will continue to work with CMS to ensure that MA plans are paid accurately and that payment model principles are in accordance with the requirements of the Social Security Act, which, if not implemented correctly could have a material adverse effect on our results of operations, financial position, or cash flows.
At June 30, 2019,March 31, 2020, our military services business, which accounted for approximately 1% of our total premiums and services revenue for the sixthree months ended June 30, 2019,March 31, 2020, primarily consisted of the TRICARE T2017 East Region contract. The T2017 East Region contract is a consolidation of the former T3 North and South Regions, comprising thirty-two states and approximately 6 million TRICARE beneficiaries, under which delivery of health care services commenced on January 1, 2018. The T2017 East Region contract is a 5-year contract set to expire on December 31, 2022 and is subject to renewals on January 1 of each year during its term at the government's option.
Our state-based Medicaid business accounted for approximately 4%5% of our total premiums and services revenue for the sixthree months ended June 30, 2019.March 31, 2020. In addition to our state-based Temporary Assistance for Needy Families, or TANF, Medicaid contracts in Florida and Kentucky, we have contracts in Florida for Long Term Support Services (LTSS), and in Illinois for stand-alone dual eligible demonstration programs serving individuals dually eligible for both the federal Medicare program and the applicable state-based Medicaid program.
The loss of any of the contracts above or significant changes in these programs as a result of legislative or regulatory action, including reductions in premium payments to us, regulatory restrictions on profitability, including reviews by regulatory bodies that may compare our Medicare Advantage profitability to our non-Medicare Advantage business profitability, or compare the profitability of various products within our Medicare Advantage business, and require that


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they remain within certain ranges of each other, or increases in member benefits or member eligibility criteria without corresponding increases in premium payments to us, may have a material adverse effect on our results of operations, financial position, and cash flows.


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Legal Proceedings and Certain Regulatory Matters
As previously disclosed, the Civil Division of the United States Department of Justice provided us with an information request in December 2014, concerning our Medicare Part C risk adjustment practices. The request relates to our oversight and submission of risk adjustment data generated by providers in our Medicare Advantage network, as well as to our business and compliance practices related to risk adjustment data generated by our providers and by us, including medical record reviews conducted as part of our data and payment accuracy compliance efforts, the use of health and well-being assessments, and our fraud detection efforts. We believe that this request for information is in connection with a wider review of Medicare Risk Adjustment generally that includes a number of Medicare Advantage plans, providers and vendors. We continue to cooperate with and voluntarily respond to the information requests from the Department of Justice. These matters are expected to result in additional qui tam litigation.
As previously disclosed, on January 19, 2016, an individual filed a qui tam suit captioned United States of America ex rel. Steven Scott v. Humana, Inc.,in United States District Court, Central District of California, Western Division. The complaint alleges certain civil violations by us in connection with the actuarial equivalence of the plan benefits under Humana’s Basic PDP plan, a prescription drug plan offered by us under Medicare Part D. The action seeks damages and penalties on behalf of the United States under the False Claims Act. The court ordered the qui tam action unsealed on September 13, 2017, so that the relator could proceed, following notice from the U.S. Government that it was not intervening at that time. On January 29, 2018, the suit was transferred to the United States District Court, Western District of Kentucky, Louisville Division. We take seriously our obligations to comply with applicable CMS requirements and actuarial standards of practice, and continue to vigorously defend against these allegations since the transfer to the Western District of Kentucky. We have engaged in active discovery with the relator who has pursued the matter on behalf of the United States following its unsealing, and expect that discovery process to conclude in the near future and for the Court to consider our motion for summary judgment.
On November 2, 2017, we filed suit against the United States of America in the United States Court of Federal Claims, on behalf of our health plans seeking recovery from the federal government of approximately $611 million in payments under the risk corridor premium stabilization program established under Health Care Reform, for years 2014, 2015 and 2016. Our case has been stayed by the Court, pending resolution of similar cases filed by other insurers. On April 27, 2020, the U.S. Supreme Court ruled that the government is obligated to pay the losses under this risk corridor program, and that Congress did not impliedly repeal the obligation under its appropriations riders.  As such, we will continue to seek payments owed to us. We have not recognized revenue, nor have we recorded a receivable, for any amount due from the federal government for unpaid risk corridor payments as of June 30, 2019.March 31, 2020. We have fully recognized all liabilities due to the federal government that we have incurred under the risk corridor program, and have paid all amounts due to the federal government as required. There is no assurance that we will prevail in the lawsuit.
Other Lawsuits and Regulatory Matters
Our current and past business practices are subject to review or other investigations by various state insurance and health care regulatory authorities and other state and federal regulatory authorities. These authorities regularly scrutinize the business practices of health insurance, health care delivery and benefits companies. These reviews focus on numerous facets of our business, including claims payment practices, statutory capital requirements, provider contracting, risk adjustment, competitive practices, commission payments, privacy issues, utilization management practices, pharmacy benefits, access to care, and sales practices, among others. Some of these reviews have historically resulted in fines imposed on us and some have required changes to some of our practices. We continue to be subject to these reviews, which could result in additional fines or other sanctions being imposed on us or additional changes in some of our practices.
We also are involved in various other lawsuits that arise, for the most part, in the ordinary course of our business
operations, certain of which may be styled as class-action lawsuits. Among other matters, this litigation may include employment matters, claims of medical malpractice, bad faith, nonacceptance or termination of providers,


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anticompetitive practices, improper rate setting, provider contract rate and payment disputes, including disputes over reimbursement rates required by statute, general contractual matters, intellectual property matters, and challenges to subrogation practices. Under state guaranty assessment laws, including those related to state cooperative failures in the industry, we may be assessed (up to prescribed limits) for certain obligations to the policyholders and claimants of insolvent insurance companies that write the same line or lines of business as we do.


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As a government contractor, we may also be subject to qui tam litigation brought by individuals who seek to sue on behalf of the government, alleging that the government contractor submitted false claims to the government including, among other allegations, those resulting from coding and review practices under the Medicare risk adjustment model. Qui tam litigation is filed under seal to allow the government an opportunity to investigate and to decide if it wishes to intervene and assume control of the litigation. If the government does not intervene, the individual may continue to prosecute the action on his or her own, on behalf of the government. We also are subject to other allegations of non-performancenonperformance of contractual obligations to providers, members, and others, including failure to properly pay claims, improper policy terminations, challenges to our implementation of the Medicare Part D prescription drug program and other litigation.

A limited number of the claims asserted against us are subject to insurance coverage. Personal injury claims, claims for extra contractual damages, care delivery malpractice, and claims arising from medical benefit denials are covered by insurance from our wholly owned captive insurance subsidiary and excess carriers, except to the extent that claimants seek punitive damages, which may not be covered by insurance in certain states in which insurance coverage for punitive damages is not permitted. In addition, insurance coverage for all or certain forms of liability has become increasingly costly and may become unavailable or prohibitively expensive in the future.
We record accruals for the contingencies discussed in the sections above to the extent that we conclude it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. No estimate of the possible loss or range of loss in excess of amounts accrued, if any, can be made at this time regarding the matters specifically described above because of the inherently unpredictable nature of legal proceedings, which also may be exacerbated by various factors, including: (i) the damages sought in the proceedings are unsubstantiated or indeterminate; (ii) discovery is not complete; (iii) the proceeding is in its early stages; (iv) the matters present legal uncertainties; (v) there are significant facts in dispute; (vi) there are a large number of parties (including where it is uncertain how liability, if any, will be shared among multiple defendants); or (vii) there is a wide range of potential outcomes.
The outcome of any current or future litigation or governmental or internal investigations, including the matters described above, cannot be accurately predicted, nor can we predict any resulting judgments, penalties, fines or other sanctions that may be imposed at the discretion of federal or state regulatory authorities or as a result of actions by third parties. Nevertheless, it is reasonably possible that any such outcome of litigation, judgments, penalties, fines or other sanctions could be substantial, and the outcome of these matters may have a material adverse effect on our results of operations, financial position, and cash flows, and may also affect our reputation.
15.14. SEGMENT INFORMATION
We manage our business with three3 reportable segments: Retail, Group and Specialty, and Healthcare Services. Beginning January 1, 2018, we exited the individual commercial fully-insured medical health insurance business, as well as certain other business, and therefore no longer report separately the Individual Commercial segment and the Other Business category in the current year. Previously, the Other Business category included businesses that were not individuallyThe reportable because they did not meet the quantitative thresholds required by generally accepted accounting principles, primarily our closed-block of commercial long-term care insurance policies which were sold in 2018. These segments are based on a combination of the type of health plan customer and adjacent businesses centered on well-being solutions for our health plans and other customers, as described below. These segment groupings are consistent with information used by our Chief Executive Officer, the Chief Operating Decision Maker, to assess performance and allocate resources.
The Retail segment consists of Medicare benefits, marketed to individuals or directly via group Medicare accounts. In addition, the Retail segment also includes our contract with CMS to administer the Limited Income Newly Eligible Transition, or LI-NET, prescription drug plan program and contracts with various states to provide Medicaid, dual eligible, and Long-Term Support Services benefits, which we refer to collectively as our state-based contracts. The Group and Specialty segment consists of employer group commercial fully-insured medical and specialty health insurance benefits marketed to individuals and employer groups, including dental, vision, and other supplemental health benefits, as well as administrative services only, or ASO products. In addition, our Group and Specialty segment includes our military services business, primarily our TRICARE T2017 East Region contract. The Healthcare Services segment includes our services


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includes our services offered to our health plan members as well as to third parties, including pharmacy solutions, provider services, and clinical care service, such as home health and other services and capabilities to promote wellness and advance population health, including our minority investment in Kindred at Home. We reported underHome and the category of Other Businesses those businesses that did not alignstrategic partnership with the reportable segments described above, primarily our closed-block long-termWCAS to develop and operate senior-focused, payor-agnostic, primary care insurance policies, which were sold in 2018.centers.
Our Healthcare Services intersegment revenues primarily relate to managing prescription drug coverage for members of our other segments through Humana Pharmacy Solutions®, or HPS, and includes the operations of Humana Pharmacy, Inc., our mail order pharmacy business. These revenues consist of the prescription price (ingredient cost plus dispensing fee), including the portion to be settled with the member (co-share) or with the government (subsidies), plus any associated administrative fees. Services revenues related to the distribution of prescriptions by third party retail pharmacies in our networks are recognized when the claim is processed and product revenues from dispensing prescriptions from our mail order pharmacies are recorded when the prescription or product is shipped. Our pharmacy operations, which are responsible for designing pharmacy benefits, including defining member co-share responsibilities, determining formulary listings, contracting with retail pharmacies, confirming member eligibility, reviewing drug utilization, and processing claims, act as a principal in the arrangement on behalf of members in our other segments. As principal, our Healthcare Services segment reports revenues on a gross basis, including co-share amounts from members collected by third party retail pharmacies at the point of service.
In addition, our Healthcare Services intersegment revenues include revenues earned by certain owned providers derived from risk-based and non-risk-based managed care agreements with our health plans. Under risk-based agreements, the provider receives a monthly capitated fee that varies depending on the demographics and health status of the member, for each member assigned to these owned providers by our health plans. The owned provider assumes the economic risk of funding the assigned members’ healthcare services. Under non risk-based agreements, our health plans retain the economic risk of funding the assigned members' healthcare services. Our Healthcare Services segment reports provider services revenues associated with risk-based agreements on a gross basis, whereby capitation fee revenue is recognized in the period in which the assigned members are entitled to receive healthcare services. Provider services revenues associated with non-risk-based agreements are presented net of associated healthcare costs.
We present our condensed consolidated results of operations from the perspective of the health plans. As a result, the cost of providing benefits to our members, whether provided via a third party provider or internally through a stand-alone subsidiary, is classified as benefits expense and excludes the portion of the cost for which the health plans do not bear responsibility, including member co-share amounts and government subsidies of $3.6$3.5 billion and $3.3$3.1 billion for the three months ended June 30,March 31, 2020 and 2019, and 2018, respectively. For the six months ended June 30, 2019 and 2018 these amounts were $6.7 billion and $6.2 billion, respectively. In addition, depreciation and amortization expense associated with certain businesses in our Healthcare Services segment delivering benefits to our members, primarily associated with our provider services and pharmacy operations, are included with benefits expense. The amount of this expense was $31$30 million and $30$29 million for the three months ended June 30,March 31, 2020 and 2019, and 2018, respectively. For the six months ended June 30, 2019 and 2018, the amount of this expense was $60 million and $69 million, respectively.
Other than those described previously, the accounting policies of each segment are the same and are described in Note 2 to the consolidated financial statements included in our 20182019 Form 10-K. Transactions between reportable segments primarily consist of sales of services rendered by our Healthcare Services segment, primarily pharmacy, provider, and clinical care services, to our Retail and Group and Specialty segment customers. Intersegment sales and expenses are recorded at fair value and eliminated in consolidation. Members served by our segments often use the same provider networks, enabling us in some instances to obtain more favorable contract terms with providers. Our segments also share indirect costs and assets. As a result, the profitability of each segment is interdependent. We allocate most operating expenses to our segments. Assets and certain corporate income and expenses are not allocated to the segments, including the portion of investment income not supporting segment operations, interest expense on corporate debt, and certain other corporate expenses. These items are managed at a corporate level. These corporate amounts are reported separately from our reportable segments and are included with intersegment eliminations in the tables presenting segment results below.





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Our segment results were as follows for the three and six months ended June 30, 2019March 31, 2020 and 2018:2019:
Retail Group and Specialty Healthcare
Services
 Eliminations/
Corporate
 ConsolidatedRetail Group and Specialty Healthcare
Services
 Eliminations/
Corporate
 Consolidated
(in millions)
Three months ended June 30, 2019      
Three months ended March 31, 2020(in millions)
External revenuesExternal revenues        External revenues        
Premiums:                  
Individual Medicare Advantage$10,793
 $
 $
 $
 $10,793
$12,794
 $
 $
 $
 $12,794
Group Medicare Advantage1,626
 
 
 
 1,626
2,011
 
 
 
 2,011
Medicare stand-alone PDP818
 
 
 
 818
755
 
 
 
 755
Total Medicare13,237
 
 
 
 13,237
15,560
 
 
 
 15,560
Fully-insured144
 1,284
 
 
 1,428
163
 1,229
 
 
 1,392
Specialty
 387
 
 
 387

 429
 
 
 429
Medicaid and other724
 
 
 
 724
981
 
 
 
 981
Total premiums14,105
 1,671
 
 
 15,776
16,704
 1,658
 
 
 18,362
Services revenue:                  
Provider
 
 111
 
 111

 
 104
 
 104
ASO and other5
 193
 
 
 198
4
 195
 
 
 199
Pharmacy
 
 46
 
 46

 
 121
 
 121
Total services revenue5
 193
 157
 
 355
4
 195
 225
 
 424
Total external revenues14,110
 1,864
 157
 
 16,131
16,708
 1,853
 225
 
 18,786
Intersegment revenues                  
Services
 5
 4,496
 (4,501) 

 7
 4,950
 (4,957) 
Products
 
 1,733
 (1,733) 

 
 1,910
 (1,910) 
Total intersegment revenues
 5
 6,229
 (6,234) 

 7
 6,860
 (6,867) 
Investment income48
 5
 1
 60
 114
54
 5
 
 90
 149
Total revenues14,158
 1,874
 6,387
 (6,174) 16,245
16,762
 1,865
 7,085
 (6,777) 18,935
Operating expenses:                  
Benefits12,019
 1,442
 
 (143) 13,318
14,464
 1,311
 
 (146) 15,629
Operating costs1,206
 406
 6,135
 (6,044) 1,703
1,532
 429
 6,800
 (6,644) 2,117
Depreciation and amortization77
 21
 40
 (29) 109
81
 20
 43
 (29) 115
Total operating expenses13,302
 1,869
 6,175
 (6,216) 15,130
16,077
 1,760
 6,843
 (6,819) 17,861
Income from operations856
 5
 212
 42
 1,115
685
 105
 242
 42
 1,074
Interest expense
 
 
 60
 60

 
 
 60
 60
Other income, net
 
 
 (174) (174)
Income before income taxes and equity in net earnings856
 5
 212
 156
 1,229
Equity in net earnings of Kindred at Home
 
 12
 
 12
Segment earnings$856
 $5
 $224
 $156
 $1,241
Other expense, net
 
 
 297
 297
Income (loss) before income taxes and equity in net earnings685
 105
 242
 (315) 717
Equity in net earnings
 
 8
 
 8
Segment earnings (loss)$685
 $105
 $250
 $(315) $725


Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

                      
Retail Group and Specialty Healthcare
Services
 Individual Commercial Other
Businesses
 Eliminations/
Corporate
 ConsolidatedRetail Group and Specialty Healthcare
Services
 Eliminations/
Corporate
 Consolidated
(in millions)(in millions)
Three months ended June 30, 2018          
Three months ended March 31, 2019Three months ended March 31, 2019      
External revenuesExternal revenues            External revenues        
Premiums:                      
Individual Medicare Advantage$8,908
 $
 $
 $
 $
 $
 $8,908
$10,709
 $
 $
 $
 $10,709
Group Medicare Advantage1,509
 
 
 
 
 
 1,509
1,632
 
 
 
 1,632
Medicare stand-alone PDP914
 
 
 
 
 
 914
809
 
 
 
 809
Total Medicare11,331
 
 
 
 
 
 11,331
13,150
 
 
 
 13,150
Fully-insured125
 1,346
 
 10
 
 
 1,481
140
 1,311
 
 
 1,451
Specialty
 342
 
 
 
 
 342

 373
 
 
 373
Medicaid and other550
 
 
 
 9
 
 559
677
 
 
 
 677
Total premiums12,006
 1,688
 
 10
 9
 
 13,713
13,967
 1,684
 
 
 15,651
Services revenue:                      
Provider
 
 112
 
 
 
 112

 
 120
 
 120
ASO and other3
 208
 
 
 2
 
 213
5
 194
 
 
 199
Pharmacy
 
 57
 
 
 
 57

 
 36
 
 36
Total services revenue3
 208
 169
 
 2
 
 382
5
 194
 156
 
 355
Total external revenues12,009
 1,896
 169
 10
 11
 
 14,095
13,972
 1,878
 156
 
 16,006
Intersegment revenues                      
Services
 4
 4,194
 
 
 (4,198) 

 4
 4,306
 (4,310) 
Products
 
 1,611
 
 
 (1,611) 

 
 1,636
 (1,636) 
Total intersegment revenues
 4
 5,805
 
 
 (5,809) 

 4
 5,942
 (5,946) 
Investment income30
 6
 17
 
 65
 46
 164
41
 5
 
 55
 101
Total revenues12,039
 1,906
 5,991
 10
 76
 (5,763) 14,259
14,013
 1,887
 6,098
 (5,891) 16,107
Operating expenses:                      
Benefits10,270
 1,357
 
 (9) 39
 (121) 11,536
12,327
 1,287
 
 (121) 13,493
Operating costs1,210
 447
 5,749
 1
 2
 (5,648) 1,761
1,148
 413
 5,888
 (5,789) 1,660
Depreciation and amortization66
 22
 36
 
 
 (24) 100
73
 22
 38
 (26) 107
Total operating expenses11,546
 1,826
 5,785
 (8) 41
 (5,793) 13,397
13,548
 1,722
 5,926
 (5,936) 15,260
Income from operations493
 80
 206
 18
 35
 30
 862
465
 165
 172
 45
 847
Loss on sale of business
 
 
 
 
 790
 790
Interest expense
 
 
 
 
 53
 53

 
 
 62
 62
Other expense, net
 
 
 39
 39
Income (loss) before income taxes and equity in net earnings493
 80
 206
 18
 35
 (813) 19
465
 165
 172
 (56) 746
Equity in net earnings of Kindred at Home
 
 
 
 
 
 
Equity in net earnings
 
 3
 
 3
Segment earnings (loss)$493
 $80
 $206
 $18
 $35
 $(813) $19
$465
 $165
 $175
 $(56) $749


Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

          
 Retail Group and Specialty Healthcare
Services
 Eliminations/
Corporate
 Consolidated
 (in millions)
Six months ended June 30, 2019        
External revenues        
Premiums:         
Individual Medicare Advantage$21,502
 $
 $
 $
 $21,502
Group Medicare Advantage3,258
 
 
 
 3,258
Medicare stand-alone PDP1,627
 
 
 
 1,627
Total Medicare26,387
 
 
 
 26,387
Fully-insured284
 2,595
 
 
 2,879
Specialty
 760
 
 
 760
Medicaid and other1,401
 
 
 
 1,401
Total premiums28,072
 3,355
 
 
 31,427
Services revenue:         
Provider
 
 231
 
 231
ASO and other10
 387
 
 
 397
Pharmacy
 
 82
 
 82
Total services revenue10
 387
 313
 
 710
Total external revenues28,082
 3,742
 313
 
 32,137
Intersegment revenues         
Services
 9
 8,802
 (8,811) 
Products
 
 3,369
 (3,369) 
Total intersegment revenues
 9
 12,171
 (12,180) 
Investment income89
 10
 1
 115
 215
Total revenues28,171
 3,761
 12,485
 (12,065) 32,352
Operating expenses:         
Benefits24,346
 2,729
 
 (264) 26,811
Operating costs2,354
 819
 12,023
 (11,833) 3,363
Depreciation and amortization150
 43
 78
 (55) 216
Total operating expenses26,850
 3,591
 12,101
 (12,152) 30,390
Income from operations1,321
 170
 384
 87
 1,962
Interest expense
 
 
 122
 122
Other income, net
 
 
 (135) (135)
Income before income taxes and equity in net earnings1,321
 170
 384
 100
 1,975
Equity in net earnings of Kindred at Home
 
 15
 
 15
Segment earnings$1,321
 $170
 $399
 $100
 $1,990






Humana Inc.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(Unaudited)

              
 Retail Group and Specialty Healthcare
Services
 Individual Commercial Other
Businesses
 Eliminations/
Corporate
 Consolidated
 (in millions)
Six months ended June 30, 2018          
External Revenues            
Premiums:             
Individual Medicare Advantage$17,878
 $
 $
 $
 $
 $
 $17,878
Group Medicare Advantage3,033
 
 
 
 
 
 3,033
Medicare stand-alone PDP1,810
 
 
 
 
 
 1,810
Total Medicare22,721
 
 
 
 
 
 22,721
Fully-insured250
 2,738
 
 5
 
 
 2,993
Specialty
 689
 
 
 
 
 689
Medicaid and other1,103
 
 
 
 18
 
 1,121
Total premiums24,074
 3,427
 
 5
 18
 
 27,524
Services revenue:             
Provider
 
 177
 
 
 
 177
ASO and other5
 427
 
 
 4
 
 436
Pharmacy
 
 96
 
 
 
 96
Total services revenue5
 427
 273
 
 4
 
 709
Total external revenues24,079
 3,854
 273
 5
 22
 
 28,233
Intersegment revenues             
Services
 9
 8,212
 
 
 (8,221) 
Products
 
 3,146
 
 
 (3,146) 
Total intersegment revenues
 9
 11,358
 
 
 (11,367) 
Investment income67
 13
 23
 
 100
 102
 305
Total revenues24,146
 3,876
 11,654
 5
 122
 (11,265) 28,538
Operating expenses:             
Benefits20,822
 2,630
 
 (69) 65
 (242) 23,206
Operating costs2,432
 910
 11,190
 3
 4
 (11,029) 3,510
Depreciation and amortization132
 45
 85
 
 
 (62) 200
Total operating expenses23,386
 3,585
 11,275
 (66) 69
 (11,333) 26,916
Income from operations760
 291
 379
 71
 53
 68
 1,622
Loss on sale of business
 
 
 
 
 790
 790
Interest expense
 
 
 
 
 106
 106
Income (loss) before income taxes and equity in net earnings760
 291
 379
 71
 53
 (828) 726
Equity in net earnings of Kindred at Home
 
 
 
 
 
 
Segment earnings (loss)$760
 $291
 $379
 $71
 $53
 $(828) $726



Humana Inc.
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS

The condensed consolidated financial statements of Humana Inc. in this document present the Company’s financial position, results of operations and cash flows, and should be read in conjunction with the following discussion and analysis. References to “we,” “us,” “our,” “Company,” and “Humana” mean Humana Inc. and its subsidiaries. This discussion includes forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. When used in filings with the Securities and Exchange Commission, or SEC, in our press releases, investor presentations, and in oral statements made by or with the approval of one of our executive officers, the words or phrases like “believes,” “expects,” “anticipates,” “intends,” “likely will result,” “estimates,” “projects” or variations of such words and similar expressions are intended to identify such forward–looking statements. These forward–looking statements are not guarantees of future performance and are subject to risks, uncertainties and assumptions, including, among other things, information set forth in Item 1A. – Risk Factors in our 20182019 Form 10-K, as modified by any changes to those risk factors included in this document including the potential impacts of risks related to the spread of, and response to, the COVID-19 pandemic as further discussed in Part II of this report and in other reports we filed subsequent to February 21, 2019,20, 2020, in each case incorporated by reference herein. In making these statements, we are not undertaking to address or update such forward-looking statements in future filings or communications regarding our business or results. In light of these risks, uncertainties and assumptions, the forward–looking events discussed in this document might not occur. There may also be other risks that we are unable to predict at this time. Any of these risks and uncertainties may cause actual results to differ materially from the results discussed in the forward–looking statements.
Executive Overview
General
Humana Inc., headquartered in Louisville, Kentucky, is a leading health and well-being company committed to
helping our millions of medical and specialty members achieve their best health. Our successful history in care delivery and health plan administration is helping us create a new kind of integrated care with the power to improve health and well being and lower costs. Our efforts are leading to a better quality of life for people with Medicare, families, individuals, military service personnel, and communities at large. To accomplish that, we support physicians and other health care professionals as they work to deliver the right care in the right place for their patients, our members. Our range of clinical capabilities, resources and tools, such as in home care, behavioral health, pharmacy services, data analytics and wellness solutions, combine to produce a simplified experience that makes health care easier to navigate and more effective.
Our industry relies on two key statistics to measure performance. The benefit ratio, which is computed by taking
total benefits expense as a percentage of premiums revenue, represents a statistic used to measure underwriting profitability. The operating cost ratio, which is computed by taking total operating costs, excluding depreciation and amortization, as a percentage of total revenue less investment income, represents a statistic used to measure administrative spending efficiency.
Acquisitions and DivestituresCOVID-19
InWe moved quickly during the thirdfirst quarter of 2018, we completed2020 to ease some of the saleburden associated with the outbreak of the novel coronavirus, or COVID-19. We have taken several proactive steps to be a part of the solution for our members, providers, and employees, including:
waiving costs associated with the diagnostic testing, medical costs related to the treatment of COVID-19 as well as FDA-approved medications or vaccines when they become available;
lifting administrative requirements including modifying prior authorization and referral requirements;
expanding access to telehealth services to help reduce the risk of infection and spread, waiving member cost share for all telehealth services delivered by participating/in-network providers and accepting audio-only telephone visits for reimbursement;
allowing early refills on prescription medicines to provide for member’s extended supply needs given stay-at-home and other restrictions on movement;

simplifying and expediting claims processing for providers to promote the speed of reimbursement payments and help ease their financial concerns beginning in April 2020;
transitioning a significant subset of our wholly-owned subsidiary KMGemployee population to CGIC. KMG's subsidiary, KIC, includedwork-at-home and providing additional support and benefits.
The emergence of stay-at-home and physical distancing orders and other restrictions on movement and economic activity intended to reduce the spread of COVID-19, during the second half of March 2020 has impacted our closed blockbusiness. During this short period of non-strategic commercial long-term care policies. Upon closing,time, we fundedexperienced lower hospital admissions and utilization as members and providers began to defer non-essential procedures. We also saw an increase in pharmacy costs as a result of us allowing early prescription refills to permit members to prepare for extended supply needs as well as COVID-19 specific administrative costs, including a $50 million contribution to the transactionHumana Foundation to promote its COVID-19 relief efforts in the communities served by Humana. Taken together, the net impact of COVID-19 was not material to the results of our operations during the first quarter of 2020.
We significantly increased our liquidity position during March 2020 with approximately $190 millionthe issuance of $1.1 billion in senior notes and a $1 billion draw under the prior one-year term loan bank commitment. At March 31, 2020, we held $2.4 billion of cash and short-term investments at our parent company cash contributedand access to an additional $2.0 billion under our credit agreement.
For the remainder of 2020, we have seen the trend of lower utilization persist while stay-at-home and other restrictions remain in place into KMG, subject to customary adjustments, in addition to the transfer of approximately $160 million of statutory capital with the sale.
Also in the third quarter of 2018, we, along with TPG and WCAS, completed the acquisitions of Kindred and Curo, respectively, merging Curo with the hospice business of Kindred at Home. As part of these transactions, we acquired a 40% minority interest in Kindred at Home, a leading home health and hospice company, for total cash consideration of approximately $1.1 billion.
In the second quarter, and expect a period of 2018, we acquired FPG for cash considerationrecovery in utilization rates in the coming weeks and months as previously deferred non-essential procedures resume with a back log of approximately $185 million, netdemand and COVID-19 testing increases. A number of cash received. FPG is onesignificant variables and uncertainties will impact these trends including, among others, the severity and duration of the largest at-risk providers serving Medicare Advantagepandemic, continued actions taken to mitigate the spread of COVID-19 and Managed Medicaid HMO patients in Greater Orlando, Florida with a footprint that includes clinics locatedturn, relax those restrictions, the timing and degree in Lake, Orange, Osceolaresumption of demand for deferred health care services, the ability of our commercial members to pay their premium, the nature and Seminole counties. The acquisitionlevel of FPG advancesdiagnostic testing, the cost and timing of new therapeutic treatments and vaccines all of which are difficult to predict. As such, our strategyresponse to this global health crisis and the subsequent recovery will continue to evolve over the coming months to support the needs of helping physicians and clinicians evolve from treating health episodically to managing health holistically.our stakeholders.

Recent Transactions
In the first quarter of 2018,2020, we acquired the remaining equity interest in MCCI, apurchased privately held Enclara, one of the nation’s largest hospice pharmacy and benefit management service organization headquarteredproviders, for cash consideration of approximately $709 million, net of cash received.
We have entered into a strategic partnership with WCAS to accelerate the expansion of our primary care model. The WCAS partnership is expected to open approximately 50 payor-agnostic, senior-focused primary care centers over 3 years beginning in Miami, Florida, that primarily coordinates medical care for Medicare Advantage beneficiaries in Florida and Texas. The purchase price consisted primarily of $169 million cash, as well as our existing investment in MCCI and a note receivable and a revolving note with an aggregate balance of $383 million.2020.
These transactions are more fully discussed in Note 1 and Note 3 to the condensed consolidated financial statements.
Business Segments
We manage our business with three reportable segments: Retail, Group and Specialty, and Healthcare Services. Beginning January 1, 2018, we exited the individual commercial fully-insured medical health insurance business, as well as certain other business, and therefore no longer report separately the Individual Commercial segment and the Other Business category in the current year. Previously, the Other Business category included businesses that were not individuallyThe reportable because they did not meet the quantitative thresholds required by generally accepted accounting principles, primarily our closed-block of commercial long-term care insurance policies which were sold in 2018. These segments are based on a combination of the type of health plan customer and adjacent businesses centered on well-being solutions for our health plans and other customers, as described below. These segment groupings are consistent with information used by our Chief Executive Officer, the Chief Operating Decision Maker, to assess performance and allocate resources.
The Retail segment consists of Medicare benefits, marketed to individuals or directly via group Medicare accounts. In addition, the Retail segment also includes our contract with CMS to administer the Limited Income Newly Eligible Transition, or LI-NET, prescription drug plan program and contracts with various states to provide Medicaid, dual eligible, and Long-Term Support Services benefits, which we refer to collectively as our state-based contracts. The Group and Specialty segment consists of employer group commercial fully-insured medical and specialty health insurance benefits marketed to individuals and employer groups, including dental, vision, and other supplemental health

benefits, as well as administrative services only, or ASO products. In addition, our Group and Specialty segment includes our military services business, primarily our TRICARE T2017 East Region contract. The Healthcare Services segment includes our services offered to our health plan members as well as to third parties, including pharmacy solutions, provider services, and clinical care service, such as home health and other services and capabilities to promote wellness and advance population health, including our minority investment in Kindred at Home. We reported underHome and the category of Other Businesses those businesses that did not alignstrategic partnership with the reportable segments described above, primarily our closed-block long-termWCAS to develop and operate senior-focused, payor-agnostic, primary care insurance policies, which were sold in 2018.centers.
The results of each segment are measured by segment earnings, and for our Healthcare Services Segment, also include the equity in net earnings of Kindred at Home.from our equity method investees. Transactions between reportable segments primarily consist of sales of services rendered by our Healthcare Services segment, primarily pharmacy, provider, and clinical care services, to our Retail and Group and Specialty segment customers. Intersegment sales and expenses are recorded at fair value and eliminated in consolidation. Members served by our segments often use the same provider networks, enabling us in some instances to obtain more favorable contract terms with providers. Our segments also share indirect costs and assets. As a result, the profitability of each segment is interdependent. We allocate most operating expenses to our segments. Assets and certain corporate income and expenses are not allocated to the segments, including the portion of investment income not supporting segment operations, interest expense on corporate debt, and certain other corporate expenses. These items are managed at a corporate level. These corporate amounts are reported separately from our reportable segments and are included with intersegment eliminations.
Seasonality
One of the product offerings of our Retail segment is Medicare stand-alone prescription drug plans, or PDPs, under the Medicare Part D program. Our quarterly Retail segment earnings and operating cash flows are impacted by the Medicare Part D benefit design and changes in the composition of our membership. The Medicare Part D benefit design results in coverage that varies as a member’s cumulative out-of-pocket costs pass through successive stages of a member’s plan period, which begins annually on January 1 for renewals. These plan designs generally result in us sharing a greater portion of the responsibility for total prescription drug costs in the early stages and less in the latter stages. As a result, the PDP benefit ratio generally decreases as the year progresses. In addition, the number of low-

low income senior members as well as year-over-year changes in the mix of membership in our stand-alone PDP products affects the quarterly benefit ratio pattern.
In addition, the Retail segment also experiences seasonality in the operating cost ratio as a result of costs incurred in the second half of the year associated with the Medicare marketing season.
Our Group and Specialty segment also experiences seasonality in the benefit ratio pattern. However, the effect is opposite of Medicare stand-alone PDP in the Retail segment, with the Group and Specialty segment’s benefit ratio increasing as fully-insured members progress through their annual deductible and maximum out-of-pocket expenses.
20192020 Highlights
Our strategy offers our members affordable health care combined with a positive consumer experience in growing markets. At the core of this strategy is our integrated care delivery model, which unites quality care, high member engagement, and sophisticated data analytics. Our approach to primary, physician-directed care for our members aims to provide quality care that is consistent, integrated, cost-effective, and member-focused, provided by both employed physicians and physicians with network contract arrangements. The model is designed to improve health outcomes and affordability for individuals and for the health system as a whole, while offering our members a simple, seamless healthcare experience. We believe this strategy is positioning us for long-term growth in both membership and earnings. We offer providers a continuum of opportunities to increase the integration of care and offer assistance to providers in transitioning from a fee-for-service to a value-based arrangement. These include performance bonuses, shared savings and shared risk relationships. At June 30, 2019,March 31, 2020, approximately 2,272,3002,514,000 members, or 65%66%, of our individual Medicare Advantage members were in value-based relationships under our integrated care delivery model, as compared to 1,978,2002,223,300 members, or 65%, at June 30, 2018.March 31, 2019. Medicare Advantage and dual demonstration program membership enrolled in a Humana chronic care management program was 853,600899,700 at June 30, 2019,March 31, 2020, an increase of 13.4%7.8% from 752,700834,700 at June 30, 2018.March 31, 2019. These members may not be unique to each program since members have

the ability to enroll in multiple programs. The increase is driven by our improved process for identifying and enrolling members in the appropriate program at the right time, coupled with growth in Special Needs Plans, or SNP, membership and the insuring of certain SNP membership to Humana At Home's care management program.membership.
Net income increased $747was $473 million, from $193 million in 2018 to $940 million in 2019 and earnings per diluted common share increased $5.55 from $1.39 earningsor $3.56 per diluted common share, in 2018the 2020 quarter compared to $6.94 earnings$566 million, or $4.16 per diluted common share, in 2019. This comparison was primarilythe 2019 quarter. The quarter over quarter comparisons were significantly impacted by the loss onput/call valuation adjustments associated with certain equity method investments which reduced earnings $297 million in the sale of KMG recognized during2020 quarter compared to $39 million in the three months ended June 30, 2018 as well as2019 quarter. Excluding the beneficial impact of the suspension ofput/call valuation adjustments, the health industry insurance fee in 2019. The year-over-year comparisons were further impactedfavorable comparison was driven by the improvement instrong performance of our RetailMedicare Advantage business and Healthcare Services segment results,in the 2020 quarter partially offset by the expected lower contribution from our Group and Specialty segment results as detailed in the discussion that follows, as well as the impact of previously implemented productivity initiatives which have led to significant operating cost efficiencies in our segments. In addition, year-over-year comparisons aresegment. These changes were further favorably impacted by a lower number of shares used to compute dilutive earnings per common share, primarily reflecting share repurchases.repurchases completed during 2019, partially offset by a higher tax rate resulting from the return of the non-deductible health insurance industry fee in 2020.
Contributing to our Retail segment revenue growth was our individual Medicare Advantage membership, which increased 457,300404,800 members, or 15.1%11.8%, from June 30, 2018March 31, 2019 to June 30, 2019.March 31, 2020.
On April 6, 2020, CMS published its Announcement of Calendar Year 2021 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies (the Final Rate Notice). We expect the Final Rate Notice to result in a 1.20% rate increase for our non end stage renal disease (ESRD) Medicare Advantage business, excluding the impact of Employer Group Waiver Plan (EGWP) funding changes. Our 1.20% rate increase compares to CMS’ estimate for the sector of 1.66% on a comparable basis, with the variance primarily driven by county rebasing and our geographic footprint. CMS also establishes separate rates of payment for ESRD beneficiaries enrolled in Medicare Advantage plans. We expect the Final Rate Notice to result in a 3.7% rate increase in 2021 for ESRD beneficiaries. Our estimate of 3.7% is slightly higher than CMS’ 3.6% which is also impacted by our geographic footprint.
Our operating cash flow of $2.3 billionflows for the 2020 quarter decreased from the 2019 improved primarily fromquarter due to the timing of the mid-year Medicare risk adjustment premium revenue collections which were received during the second quarter of 2019 as compared to the third quarter of 2018, higher earnings,working capital items, including the impact of approximately $230 million payment relatedearly prescription refills permitting members to reinsuring certain voluntary benefit and financial protection productsprepare for extended supply needs in response to a third party in connection with the sale of KMG in 2018, as well as the timing of other working capital changes.
On July 31, 2019, we announced that we intend to enter into an agreement with a third party financial institution to effect a $1 billion accelerated stock repurchase program. We will repurchase shares through the program as part of the $3 billion authorized on July 30, 2019. The actual number of shares repurchased under the

agreement will be determined based on a volume-weighted average price of our common stock during the purchase period.

COVID-19, partially offset by higher income from operations.
Health Care Reform
The Health Care Reform Law enacted significant reforms to various aspects of the U.S. health insurance industry. Certain significant provisions of the Health Care Reform Law include, among others, mandated coverage requirements, mandated benefits and guarantee issuance associated with commercial medical insurance, rebates to policyholders based on minimum benefit ratios, adjustments to Medicare Advantage premiums, the establishment of federally facilitated or state-based exchanges coupled with programs designed to spread risk among insurers, and the introduction of plan designs based on set actuarial values. In addition, the Health Care Reform Law established insurance industry assessments, including an annual health insurance industry fee. The annual health insurance industry fee, levied on the insurance industrywhich was $14.3 billionsuspended in 2018 and was2019, but has resumed for calendar year 2020, is not deductible for income tax purposes whichand significantly increased our effective income tax rate. A one year suspension of the health insurance industry fee, as we experienced in 2017 and are experiencing in 2019, significantly impacts our trend in key operating metrics including our operating cost and medical expense ratios, as well asincreases our effective tax rate. The annualWe expect to pay the federal government $1.2 billion in September 2020 for this fee. Under current law, the health insurance industry fee is scheduled to resume forwill be permanently repealed beginning in calendar year 2020 under current law.2021.

It is reasonably possible that the Health Care Reform Law and related regulations, as well as other current or future legislative, judicial or regulatory changes, such as legislative and regulatory changes associated with COVID-19, including restrictions on our ability to manage our provider network or otherwise operate our business, or restrictions on profitability, including reviews by regulatory bodies that may compare our Medicare Advantage profitability to our non-Medicare Advantage business profitability, or compare the profitability of various products within our Medicare Advantage business, and require that they remain within certain ranges of each other, increases in member benefits or changes to member eligibility criteria without corresponding increases in premium payments to us, or increases in regulation of our prescription drug benefit businesses, in the aggregate may have a material adverse effect on our results of operations (including restricting revenue, enrollment and premium growth in certain products and market segments, restricting our ability to expand into new markets, increasing our medical and operating costs, further lowering our Medicare payment rates and increasing our expenses associated with the non-deductible health insurance industry fee and other assessments); our financial position (including our ability to maintain the value of our goodwill); and our cash flows.
We intend for the discussion of our financial condition and results of operations that follows to assist in the understanding of our financial statements and related changes in certain key items in those financial statements from year to year, including the primary factors that accounted for those changes. Transactions between reportable segments primarily consist of sales of services rendered by our Healthcare Services segment, primarily pharmacy, provider, and clinical care services, to our Retail and Group and Specialty segment customers and are described in Note 1514 to the condensed consolidated financial statements included in this report.


Comparison of Results of Operations for 20192020 and 20182019
The following discussion primarily deals with our results of operations for the three months ended June 30,March 31, 2020, or the 2020 quarter, and the three months ended March 31, 2019, or the 2019 quarter, the three months ended June 30, 2018, or the 2018 quarter, the six months ended June 30, 2019, or the 2019 period, and the six months ended June 30, 2018, or the 2018 period.quarter.
Consolidated
 For the three months ended June 30, Change
 2019 2018 Dollars Percentage
 (dollars in millions, except per common share results)
Revenues:       
Premiums:       
Retail$14,105
 $12,006
 $2,099
 17.5 %
Group and Specialty1,671
 1,688
 (17) (1.0)%
Individual Commercial
 10
 (10) (100.0)%
Other Businesses
 9
 (9) (100.0)%
Total premiums15,776
 13,713
 2,063
 15.0 %
Services:       
Retail5
 3
 2
 66.7 %
Group and Specialty193
 208
 (15) (7.2)%
Healthcare Services157
 169
 (12) (7.1)%
Other Businesses
 2
 (2) (100.0)%
Total services355
 382
 (27) (7.1)%
Investment income114
 164
 (50) (30.5)%
Total revenues16,245
 14,259
 1,986
 13.9 %
Operating expenses:       
Benefits13,318
 11,536
 1,782
 15.4 %
Operating costs1,703
 1,761
 (58) (3.3)%
Depreciation and amortization109
 100
 9
 9.0 %
Total operating expenses15,130
 13,397
 1,733
 12.9 %
Income from operations1,115
 862
 253
 29.4 %
Loss on sale of business
 790
 (790) (100.0)%
Interest expense60
 53
 7
 13.2 %
Other income, net(174) 
 (174) 100.0 %
Income before income taxes and equity in net earnings1,229
 19
 1,210
 6,368.4 %
Provision for income taxes301
 (174) 475
 (273.0)%
Equity in net earnings of Kindred at Home12
 
 12
 100.0 %
Net income$940
 $193
 $747
 387.0 %
Diluted earnings per common share$6.94
 $1.39
 $5.55
 399.3 %
Benefit ratio (a)
84.4% 84.1%   0.3 %
Operating cost ratio (b)
10.6% 12.5%   (1.9)%
Effective tax rate24.2% n/m
   n/m
n/m - not meaningful
(a)Represents benefits expense as a percentage of premiums revenue.
(b)Represents operating costs as a percentage of total revenues less investment income.

       
For the six months ended
June 30,
 ChangeFor the three months ended
March 31,
 Change
2019 2018 Dollars Percentage2020 2019 Dollars Percentage
(dollars in millions, except per common share results)(dollars in millions, except per common share results)
Revenues:              
Premiums:              
Retail$28,072
 $24,074
 $3,998
 16.6 %$16,704
 $13,967
 $2,737
 19.6 %
Group and Specialty3,355
 3,427
 (72) (2.1)%1,658
 1,684
 (26) (1.5)%
Individual Commercial
 5
 (5) (100.0)%
Other Businesses
 18
 (18) (100.0)%
Total premiums31,427
 27,524
 3,903
 14.2 %18,362
 15,651
 2,711
 17.3 %
Services:              
Retail10
 5
 5
 100.0 %4
 5
 (1) (20.0)%
Group and Specialty387
 427
 (40) (9.4)%195
 194
 1
 0.5 %
Healthcare Services313
 273
 40
 14.7 %225
 156
 69
 44.2 %
Other Businesses
 4
 (4) (100.0)%
Total services710
 709
 1
 0.1 %424
 355
 69
 19.4 %
Investment income215
 305
 (90) (29.5)%149
 101
 48
 47.5 %
Total revenues32,352
 28,538
 3,814
 13.4 %18,935
 16,107
 2,828
 17.6 %
Operating expenses:              
Benefits26,811
 23,206
 3,605
 15.5 %15,629
 13,493
 2,136
 15.8 %
Operating costs3,363
 3,510
 (147) (4.2)%2,117
 1,660
 457
 27.5 %
Depreciation and amortization216
 200
 16
 8.0 %115
 107
 8
 7.5 %
Total operating expenses30,390
 26,916
 3,474
 12.9 %17,861
 15,260
 2,601
 17.0 %
Income from operations1,962
 1,622
 340
 21.0 %1,074
 847
 227
 26.8 %
Loss on sale of business
 790
 (790) (100.0)%
Interest expense122
 106
 16
 15.1 %60
 62
 (2) (3.2)%
Other income, net(135) 
 (135) 100.0 %
Other expense, net297
 39
 258
 661.5 %
Income before income taxes and equity in net earnings1,975
 726
 1,249
 172.0 %717
 746
 (29) (3.9)%
Provision for income taxes484
 42
 442
 1,052.4 %252
 183
 69
 37.7 %
Equity in net earnings of Kindred at Home15
 
 15
 100.0 %
Equity in net earnings8
 3
 5
 166.7 %
Net income$1,506
 $684
 $822
 120.2 %$473
 $566
 $(93) (16.4)%
Diluted earnings per common share$11.10
 $4.93
 $6.17
 125.2 %$3.56
 $4.16
 $(0.60) (14.4)%
Benefit ratio (a)
85.3% 84.3%   1.0 %85.1% 86.2%   (1.1)%
Operating cost ratio (b)
10.5% 12.4%   (1.9)%11.3% 10.4%   0.9 %
Effective tax rate24.3% 5.8%   18.5 %34.8% 24.4%   10.4 %
(a)Represents benefits expense as a percentage of premiums revenue.
(b)Represents operating costs as a percentage of total revenues less investment income.


Summary
Net income was $940$473 million, or $6.94$3.56 per diluted common share, in the 2020 quarter compared to $566 million, or $4.16 per diluted common share, in the 2019 quarter. The quarter over quarter comparisons were significantly impacted by the put/call valuation adjustments associated with certain equity method investments which reduced earnings $297 million in the 2020 quarter compared to $193$39 million or $1.39 per diluted common share, in the 2018 quarter. Net income was $1.5 billion, or $11.10 per diluted common share, in the 2019 period compared to $684 million, or $4.93 per diluted common share, inquarter. Excluding the 2018 period. These increases were primarily impacted by the loss on the sale of KMG recognized during the three months ended June 30, 2018 as well as the beneficial impact of the suspension ofput/call valuation adjustments, the health industry insurance fee in 2019. The year-over-year comparisons were further impactedfavorable comparison was driven by the improvement instrong performance of our Retail and Healthcare Services segment results,segments partially offset by the expected lower contribution from our Group and Specialty segment results as detailedmore fully described in the detailed segment results discussion that follows, as well as the impact of previously implemented productivity initiatives which have led to significant operating cost efficiencies in our segments. In addition, year-over-year comparisons arefollows. These changes were further favorably impacted by a lower number of shares used to compute dilutive earnings per common share, primarily reflecting share repurchases.repurchases completed during 2019, partially offset by a higher tax rate resulting from the return of the non-deductible health insurance industry fee in 2020.
Premiums Revenue
Consolidated premiums increased $2.1$2.7 billion, or 15.0%17.3%, from the 2018 quarter to $15.8$15.7 billion for the 2019 quarter and increased $3.9 billion, or 14.2%, from the 2018 period to $31.4$18.4 billion for the 2019 period2020 quarter primarily due to higher premiums in the Retail segment, driven by membershipmainly resulting from growth and higher per member premiums in our Medicare Advantage business. These increases wereand state-based contract businesses, partially offset by the impact of declining stand-alone PDP membership year-over-year, as well as lower premiums in the Group and Specialty segment as discussedmore fully described in the detailed segment results discussion that follows.
Services Revenue
Consolidated services revenue decreased $27increased $69 million, or 7.1%19.4%, from the 20182019 quarter to $355$424 million for the 2020 quarter primarily due to an increase in services revenue in the Healthcare Services segment associated with higher external pharmacy revenues resulting from the Enclara acquisition in the 2020 quarter.
Investment Income
Investment income totaled $149 million for the 2020 quarter, increasing $48 million, or 47.5%, from $101 million for the 2019 quarter primarily due to a decline in services revenue in the Group and Specialty and Healthcare Services segments as detailed in the segment results discussion that follows. Consolidated services revenue was relatively unchanged at $710 million for the 2019 period increasing $1 million, or 0.1%, from the 2018 period.
Investment Income
Investment income totaled $114 million for the 2019 quarter, decreasing $50 million, or 30.5%, from $164 million for the 2018 quarter. For the 2019 period, investment income totaled $215 million, decreasing $90 million, or 29.5%, from $305 million in the 2018 period. These decreases primarily reflect lowerreflecting higher realized capital gains and lower average invested balances, partially offset by higher interest rates.gains.
Benefits Expense
Consolidated benefits expense was $13.3$15.6 billion for the 20192020 quarter, an increase of $1.8$2.1 billion from the 2018 quarter. For the 2019 period, benefits expense was $26.8 billion,quarter, corresponding with an increase of $3.6 billion from the 2018 period.in Retail segment premium growth. The consolidated benefit ratio for the 20192020 quarter of 84.4% increased 3085.1% decreased 110 basis points from 84.1%86.2% in the 2018 quarter. The consolidated benefit ratio for the 2019 period increased 100 basis points to 85.3% from 84.3% in the 2018 period. These increases werequarter primarily due to the suspensionlower benefit ratio in the Retail segment partially offset by a higher benefit ratio in the Group and Specialty segment as more fully described in the detailed segment results that follows. Both segments’ benefit ratios were impacted favorably by the reinstatement of the non-deductible health insurance industry fee in 2019,2020 which was contemplated in the pricing and benefit design of our products lower favorable prior-period claims medical reserve development,and unfavorably by the impact of weekday seasonality including the impact of the exit of the Individual Commercial business, and an increasea leap year in the Group and Specialty benefit ratio as discussed in the detailed segment results discussion that follows. These increases were partially offset by engaging our Medicare Advantage members in clinical programs, as well as ensuring they are appropriately documented under the CMS risk-adjustment model, and lower than expected medical costs as compared to the assumptions used in the pricing of our individual Medicare Advantage business for 2019.2020 quarter.
The favorable prior-period medical claims reserve development decreased the consolidated benefit ratio by approximately 10150 basis points in the 2020 quarter versus approximately 170 basis points in the 2019 quarter versus approximately 50 basis points in the 2018 quarter. The favorable prior-period medical claims reserve development decreased the consolidated benefit ratio by approximately 90 basis points to 84.4% for the 2019 period compared to approximately 120 basis points to 84.1% for the 2018 period.


Operating Costs
Our segments incur both direct and shared indirect operating costs. We allocate the indirect costs shared by the segments primarily as a function of revenues. As a result, the profitability of each segment is interdependent.
Consolidated operating costs decreased $58increased $457 million, or 3.3%27.5%, during the 20192020 quarter compared to the 2018 quarter and decreased $147 million, or 4.2%, during the 2019 period compared to the 2018 period. These decreases were primarily due to a decrease in operating costs in the Retail and the Group and Specialty segments.
quarter. The consolidated operating cost ratio for the 20192020 quarter of 10.6% decreased 19011.3% increased 90 basis points from 12.5%10.4% in the 20182019 quarter and for the 2019 period decreased 190 basis points to 10.5% from 12.4% in the 2018 period. These decreases were primarily due to the suspensionreinstatement of the non-deductible health insurance industry fee in 20192020, and COVID-19 related costs, including a $50 million contribution to the Humana Foundation to promote its coronavirus relief efforts in the communities served by Humana. These increases were partially offset by scale efficiencies associated with growth in our Medicare Advantage membership and significant operating cost efficiencies in 2019 the 2020 quarter

driven by previously implementeddisclosed productivity initiatives. These improvements were partially offset by strategic investments in our integrated care delivery model and the impact of higher compensation expense accruals for the annual incentive program, or AIP, offered to employees across all levels. The higher accruals resulted from the continued strong performance, including improved customer satisfaction as measured by our net promoter score, along with higher than anticipated individual Medicare Advantage membership. The non-deductible health insurance industry fee impacted the operating cost ratio by 180160 basis points in both the 2018 quarter and period.2020 quarter.
Depreciation and Amortization
Depreciation and amortization for the 20192020 quarter totaled $109$115 million compared to $100$107 million for the 20182019 quarter. For the 2019 period, depreciation and amortization totaled $216 million compared to $200 million for the 2018 period.
Interest Expense
Interest expense for the 20192020 quarter of $60 million increased $7decreased $2 million, compared to $53$62 million for the 20182019 quarter. Interest expense for the 2019 period of $122 million increased $16 million, compared to $106 million for the 2018 period. These increases were primarily due to the higher average borrowings outstanding including the impact of the borrowings under the November 2018 term loan agreement.
Income Taxes
The effective income tax rate was 24.3%34.8% for the sixthree months ended June 30, 2019March 31, 2020, compared to 5.8%24.4% for the sixthree months ended June 30, 2018,March 31, 2019, primarily due to the impact of the suspensionreinstatement of the non-deductible health insurance industry fee in 2019 as well as the deferred tax benefit recognized in 2018 from the loss on sale of KMG. The effective income tax rate was 24.2% for the three months ended June 30, 2019. The effective income tax rate for the three months ended June 30, 2018 reflects a $430 million deferred tax benefit recorded during the three months ended June 30, 2018, resulting from the loss on the sale of KMG attributable to its original tax basis and subsequent capital contributions to fund accumulated losses.










2020.
Retail Segment
June 30, ChangeMarch 31, Change
2019 2018 Members Percentage2020 2019 Members Percentage
Membership:              
Medical membership:              
Individual Medicare Advantage3,484,500
 3,027,200
 457,300
 15.1 %3,838,100
 3,433,300
 404,800
 11.8 %
Group Medicare Advantage519,100
 493,100
 26,000
 5.3 %607,400
 517,900
 89,500
 17.3 %
Medicare stand-alone PDP4,400,500
 5,008,200
 (607,700) (12.1)%3,895,100
 4,448,400
 (553,300) (12.4)%
Total Retail Medicare8,404,100
 8,528,500
 (124,400) (1.5)%8,340,600
 8,399,600
 (59,000) (0.7)%
State-based Medicaid465,200
 325,200
 140,000
 43.1 %617,300
 461,300
 156,000
 33.8 %
Medicare Supplement276,000
 241,500
 34,500
 14.3 %314,000
 267,300
 46,700
 17.5 %
Total Retail medical members9,145,300
 9,095,200
 50,100
 0.6 %9,271,900
 9,128,200
 143,700
 1.6 %
        
 For the three months ended June 30, Change
 2019 2018 Dollars Percentage
 (in millions)  
Premiums and Services Revenue:       
Premiums:       
Individual Medicare Advantage$10,793
 $8,908
 $1,885
 21.2 %
Group Medicare Advantage1,626
 1,509
 117
 7.8 %
Medicare stand-alone PDP818
 914
 (96) (10.5)%
Total Retail Medicare13,237
 11,331
 1,906
 16.8 %
State-based Medicaid724
 550
 174
 31.6 %
Medicare Supplement144
 125
 19
 15.2 %
Total premiums14,105
 12,006
 2,099
 17.5 %
Services5
 3
 2
 66.7 %
Total premiums and services revenue$14,110
 $12,009
 $2,101
 17.5 %
Segment earnings$856
 $493
 $363
 73.6 %
Benefit ratio85.2% 85.5%   (0.3)%
Operating cost ratio8.5% 10.1%   (1.6)%

       
For the six months ended
June 30,
 ChangeFor the three months ended
March 31,
 Change
2019 2018 Dollars Percentage2020 2019 Dollars Percentage
(in millions)  (in millions)  
Premiums and Services Revenue:              
Premiums:              
Individual Medicare Advantage$21,502
 $17,878
 $3,624
 20.3 %$12,794
 $10,709
 $2,085
 19.5 %
Group Medicare Advantage3,258
 3,033
 225
 7.4 %2,011
 1,632
 379
 23.2 %
Medicare stand-alone PDP1,627
 1,810
 (183) (10.1)%755
 809
 (54) (6.7)%
Total Retail Medicare26,387
 22,721
 3,666
 16.1 %15,560
 13,150
 2,410
 18.3 %
State-based Medicaid1,401
 1,103
 298
 27.0 %981
 677
 304
 44.9 %
Medicare Supplement284
 250
 34
 13.6 %163
 140
 23
 16.4 %
Total premiums28,072
 24,074
 3,998
 16.6 %16,704
 13,967
 2,737
 19.6 %
Services10
 5
 5
 100.0 %4
 5
 (1) (20.0)%
Total premiums and services revenue$28,082
 $24,079
 $4,003
 16.6 %$16,708
 13,972
 $2,736
 19.6 %
Segment earnings$1,321
 $760
 $561
 73.8 %$685
 $465
 $220
 47.3 %
Benefit ratio86.7% 86.5%   0.2 %86.6% 88.3%   (1.7)%
Operating cost ratio8.4% 10.1%   (1.7)%9.2% 8.2%   1.0 %
Segment Earnings
Retail segment earnings increased $363$220 million, or 73.6%47.3%, from $493 million in the 2018 quarter to $856$465 million in the 2019 quarter to $685 million in the 2020 quarter primarily due the segment'sto a lower benefit andratio, partially offset by a higher operating cost ratios, as well as increased premiums, primarily associated with significant growth in our individual Medicare Advantage membershipratio as more fully described below. Retail segment earnings increased $561 million, or 73.8%, from $760 million in the 2018 period to $1.3 billion in the 2019 period primarily reflecting the lower operating cost ratio along with increased premiums associated with the significant growth in ourOur higher-than-anticipated individual Medicare Advantage membership partially offset bygrowth in 2019, which had a muted impact on the segment's higher benefit ratioearnings last year, is now more profitable as a result of more fully described below.members being engaged in our clinical programs and appropriately documented under the CMS risk-adjustment model.
Enrollment
Individual Medicare Advantage membership increased 457,300404,800 members, or 15.1%11.8%, from June 30, 2018March 31, 2019 to June 30, 2019,March 31, 2020, primarily due to membership additions associated with the most recent Annual Election Period, or AEP, and Open Election Period, (OEP)or OEP, for Medicare beneficiaries. The membership growth was further impacted by strong sales to age-ins and Dual Eligible Special Need Plans, or D-SNP. Individual Medicare Advantage membership includes 342,500 D-SNP members as of March 31, 2020, a net increase of 94,000, or 38%, from 248,500 as of March 31, 2019. The OEP sales period, which ran from January 1 to March 31, 2020 added approximately 20,700 members through March 31, 2020. An additional 10,300 members became effective April 1, 2020, for a total 2020 OEP impact of 31,000 members. In comparison, the 2019 OEP added approximately 28,700 members through March 31, 2019 and an additional 15,000 members with an April 1, 2019 effective date for a total 2019 OEP impact of 43,700 members . The increase in Individual Medicare Advantage membership includes the addition of approximately 55,200 Dual Eligible Special Need Plan (D-SNP) members from June 30, 2018 to June 30, 2019.members.
Group Medicare Advantage membership increased 26,000,89,500, or 5.3%17.3%, from June 30, 2018March 31, 2019 to June 30, 2019,March 31, 2020, primarily due to the addition of a large account in January 2020, along with net membership additions associated with the most recent AEP for Medicare beneficiaries.
Medicare stand-alone PDP membership decreased 607,700553,300 members, or 12.1%12.4%, from June 30, 2018March 31, 2019 to June 30, 2019March 31, 2020 primarily reflecting net declines during the most recent AEP for Medicare beneficiaries. TheseThe anticipated declinesdecline was primarily the result of terminations driven by premium and benefit adjustments experienced by members that were primarily due to the competitive nature of the industrypreviously enrolled in our 2019 Humana Walmart Rx plan and the pricing discipline we have employed,2019 Humana Enhanced plan, which has resulted in us no longer beingwere consolidated into the low costPremier Rx plan in any market for 2019.2020. The expected PDP losses were partially offset by growth in the new low-price Humana Walmart Value Rx plan, driven by both new sales and plan to plan changes.

State-based Medicaid membership increased 140,000156,000 members, or 43.1%33.8%, from June 30, 2018March 31, 2019 to June 30, 2019,March 31, 2020. This increase primarily driven byreflects the statewide awardimpact of a comprehensivediscontinuing the reinsurance agreement with CareSource and the assumption of full financial risk for the existing Kentucky Medicaid contract under the Managed Medical Assistance (MMA) program in Florida.



as of January 1, 2020.
Premiums Revenue
Retail segment premiums increased $2.1$2.7 billion, or 17.5%19.6%, from the 20182019 quarter to the 20192020 quarter and increased $4.0 billion, or 16.6%, from the 2018 period to the 2019 period primarily due to individual and group Medicare Advantagereflecting higher premiums as a result of membership growth and higher per member premiums as well as increasedin our Medicare Advantage and state-based contracts membership.contract businesses. These favorable items were partially offset by the decline in membership in our stand-alone PDP offerings.
Benefits Expense
The Retail segment benefit ratio decreased 30170 basis points from 85.5% in the 2018 quarter to 85.2%88.3% in the 2019 quarter to 86.6% in the 2020 quarter primarily as a result of engaging our Medicare Advantage members in clinical programs, as well as ensuring that they are appropriately documented under the CMS risk-adjustment model. In addition the decreases were impacted by the lower than expected medical costs as compareddue to the pricing assumptions used in our individual Medicare Advantage business for 2019. This improvement was partially offset by the suspensionreinstatement of the non-deductible health insurance industry fee in 20192020 which was contemplated in the pricing and benefit design of our products, and engaging our Medicare Advantage members, including the robust growth of members in 2019, in clinical programs, as well as ensuring they are appropriately documented under the CMS risk-adjustment model. The benefit ratio was further favorably impacted by the continued shift in Medicare membership mix due to the decline of stand-alone PDP members and significant growth in Medicare Advantage members; the benefit ratio for stand-alone PDP members generally is higher earlier in the year and then decreases as the year progresses. Lastly, the decrease in the benefit ratio was impacted by the benefit design of Humana’s 2020 Premier Rx plan, which includes a member deductible. These decreases were partially offset by the unfavorable impact of weekday seasonality including the impact of a leap year day in the 2020 quarter and lower favorable prior-period medical reserve development in the 20192020 quarter. The Retail segment benefit ratio increased 20 basis points from 86.5% in the 2018 period to 86.7% in the 2019 period, primarily reflecting the net-negative impact of the same factors that affected the 2019 quarter described above. These increases were partially offset by higher favorable prior-period reserve development and the impact of a less severe flu season in the 2019 period.
The Retail segment's benefits expense for the 20192020 quarter included $28$238 million in favorable prior-period medical claims reserve development versus $60$283 million in the 20182019 quarter. For the 2019 period, the Retail segment’s benefit expense includes the beneficial effect of $311 million in favorable prior-period reserve development versus $247 million in the 2018 period. Prior-period medical claims reserve development decreased the Retail segment benefit ratio by approximately 20140 basis points in the 2020 quarter versus approximately 200 basis points in the 2019 quarter.
Operating Costs
The Retail segment operating cost ratio of 9.2% for the 2020 quarter versus approximately 50increased 100 basis points from 8.2% for the 2019 quarter primarily due to the reinstatement of the non-deductible health insurance industry fee in 2020, partially offset by scale efficiencies associated with growth in our Medicare Advantage membership and significant operating cost efficiencies in the 2020 quarter driven by previously disclosed productivity initiatives. The non-deductible health insurance industry fee impacted the operating cost ratio by 170 basis points in the 20182020 quarter. Favorable prior-period reserve development decreased the Retail segment benefit ratio by approximately 110 basis points in the 2019 period versus approximately 100 basis points in the 2018 period.
Operating Costs
The Retail segment operating cost ratio of 8.5% for the 2019 quarter decreased 160 basis points from 10.1% for the 2018 quarter. The Retail segment operating cost ratio of 8.4% for the 2019 period decreased 170 basis points from 10.1% for the 2018 period. The year-over-year comparison was primarily due to the suspension of the health insurance industry fee in 2019, as well as operating costs efficiencies from previously implemented productivity initiatives. These decreases were partially offset by the strategic investments in our integrated care delivery model and the impact of higher compensation expense accruals in 2019 for the AIP as a result of our continued strong performance. The non-deductible health insurance industry fee impacted the operating cost ratio by 190 basis points in the 2018 quarter and period.

Group and Specialty Segment
June 30, ChangeMarch 31, Change
2019 2018 Members Percentage2020 2019 Members Percentage
Membership:              
Medical membership:              
Fully-insured commercial group942,500
 1,050,900
 (108,400) (10.3)%861,600
 958,200
 (96,600) (10.1)%
ASO496,000
 458,800
 37,200
 8.1 %506,100
 478,600
 27,500
 5.7 %
Military services5,971,400
 5,931,500

39,900

0.7 %5,999,200
 5,942,500

56,700

1.0 %
Total group and specialty medical members7,409,900
 7,441,200
 (31,300) (0.4)%
Total group medical members7,366,900
 7,379,300
 (12,400) (0.2)%
Specialty membership (a)5,860,000
 6,227,700
 (367,700) (5.9)%5,470,700
 5,835,200
 (364,500) (6.2)%
(a)Specialty products include dental, vision, voluntary benefit products and other supplemental health. Members included in these products may not be unique to each product since members have the ability to enroll in multiple products.
        
 For the three months ended June 30, Change
 2019 2018 Dollars Percentage
 (in millions)  
Premiums and Services Revenue:       
Premiums:       
Fully-insured commercial group$1,284
 $1,346
 $(62) (4.6)%
Group specialty387
 342
 45
 13.2 %
Total premiums1,671
 1,688
 (17) (1.0)%
Services193
 208
 (15) (7.2)%
Total premiums and services revenue$1,864
 $1,896
 $(32) (1.7)%
Segment earnings$5
 $80
 $(75) (93.8)%
Benefit ratio86.3% 80.4%   5.9 %
Operating cost ratio21.7% 23.5%   (1.8)%

              
For the six months ended
June 30,
 ChangeFor the three months ended
March 31,
 Change
2019 2018 Dollars Percentage2020 2019 Dollars Percentage
(in millions)  (in millions)  
Premiums and Services Revenue:              
Premiums:              
Fully-insured commercial group$2,595
 $2,738
 $(143) (5.2)%$1,229
 $1,311
 $(82) (6.3)%
Group specialty760
 689
 71
 10.3 %429
 373
 56
 15.0 %
Total premiums3,355
 3,427
 (72) (2.1)%1,658
 1,684
 (26) (1.5)%
Services387
 427
 (40) (9.4)%195
 194
 1
 0.5 %
Total premiums and services revenue$3,742
 $3,854
 $(112) (2.9)%$1,853
 $1,878
 $(25) (1.3)%
Segment earnings$170
 $291
 $(121) (41.6)%$105
 $165
 $(60) (36.4)%
Benefit ratio81.3% 76.7%   4.6 %79.1% 76.4%   2.7 %
Operating cost ratio21.8% 23.6%   (1.8)%23.1% 21.9%   1.2 %
Segment Earnings
Group and Specialty segment earnings decreased $75$60 million, or 93.8%36.4%, from $80 million in the 2018 quarter to $5$165 million in the 2019 quarter. Group and Specialty segment earnings decreased $121 million, or 41.6%, from $291quarter to $105 million in the 2018 period2020 quarter primarily reflecting our deliberate pricing and benefit design changes in our commercial business in response to $170 million in the 2019 period. These decreases were primarily due to a higher benefit ratio, along with lower military services business earnings. Earnings comparisons related to the military services business were unfavorably impacted by the receipt of certain contractual incentives and adjustments in 2018 related to the previous TRICARE contract which did not recur in 2019. These decreases were partially offset by improvement in the operating cost ratio as more fully described below.performance.
Enrollment
Fully-insured commercial group medical membership decreased 108,40096,600 members, or 10.3%10.1%, from June 30, 2018March 31, 2019 to June 30, 2019March 31, 2020. These anticipated declines primarily reflectingreflect lower membership in small group accounts due in part to more small group accounts selecting level-funded ASO products, in 2019, as well as the loss of certain large group accounts due to disciplined pricing in the competitive pricing environment. The portion of group fully-insured commercial medical membership in small group accounts was approximately 57% at March 31, 2020 and 61% at June 30, 2019 and 62% at June 30, 2018.March 31, 2019.
Group ASO commercial medical membership increased 37,20027,500 members, or 8.1%5.7%, from June 30, 2018March 31, 2019 to June 30, 2019March 31, 2020 reflecting more small group accounts selecting level-funded ASO products in 2019, partially offset bycombined with the loss of certain large group accounts as a result ofdue to continued discipline in pricing of services for self-funded

accounts amid a highly competitive environment. Small group membership comprised 45% of group ASO medical membership at March 31, 2020 versus 34% at March 31, 2019.
Military services membership increased 39,90056,700 members, or 0.7%1.0%, from June 30, 2018March 31, 2019 to June 30, 2019.March 31, 2020. Membership includes military service members, retirees, and their families to whom the company provideswe are providing healthcare services under the current T2017 TRICARE East Region contract. The current contract, which covers 32 states, became effective on January 1, 2018.
Specialty membership decreased 367,700364,500 members, or 5.9%6.2%, from June 30, 2018March 31, 2019 to June 30, 2019March 31, 2020 primarily due to the exit of our voluntary benefits and financial protection products in connection with the sale of KMG in 2018, as well as the loss of somecertain group accounts, including one jumbo account, offering stand-alone dental and vision products.



Premiums Revenue
Group and Specialty segment premiums decreased $17 million, or 1.0%, from the 2018 quarter to $1.67 billion for the 2019 quarter and decreased $72 million, or 2.1%, from the 2018 period to $3.36 billion for the 2019 period. These decreases were primarily due to a decline in our fully-insured group commercial and specialty membership and the exit of our voluntary benefit and financial protection products in connection with the sale of KMG in 2018. These decreases were partially offset by higher stop-loss revenues related to our level-funded ASO accounts resulting from membership growth in this product. Additionally, the impact of the lower unfavorable commercial risk adjustment, or CRA, payable estimates in 2019 as compared to 2018 resulted in higher small group fully-insured commercial revenues.
Group and Specialty segment premiums decreased $26 million, or 1.5%, from $1.68 billion in the 2019 quarter to $1.66 billion for the 2020 quarter, primarily due to the decline in our fully-insured group commercial membership. The decrease was partially offset by higher stop-loss revenues related to our level-funded ASO accounts resulting from membership growth in this product and higher per member premiums across the fully-insured commercial business.
Services Revenue
Group and Specialty segment services revenue decreased $15increased $1 million, or 7.2%0.5%, from the 20182019 quarter to $193$195 million for the 2019 quarter and decreased $40 million, or 9.4%, from the 2018 period to $387 million for the 2019 period primarily due to the impact of certain contractual incentives and adjustments related to the previous TRICARE contract received in 2018, which did not recur in 2019.2020 quarter.
Benefits Expense
The Group and Specialty segment benefit ratio increased 590270 basis points from 80.4% in the 2018 quarter to 86.3%76.4% in the 2019 quarter. The Group and Specialty segment benefit ratio increased 460 basis points from 76.7%quarter to 79.1% in the 2018 period2020 quarter primarily due to 81.3%deliberate pricing and benefit design changes in the commercial business in response to the 2019 period.performance and the unfavorable impact of weekday seasonality including the impact of a leap year in the 2020 quarter. These increases were primarily due topartially offset by the impactreinstatement of unfavorable prior-period reserve development in 2019, the suspension of thenon-deductible health insurance industry fee in 20192020 which was contemplated in the pricing and benefit design of our products as well as membership mix, including the continued migration of groups to level-funded ASO products in 2019. These items were partially offset by the smaller unfavorable premium adjustment in 2019 as compared to 2018 related to our CRA accrual associated with the ACA-compliant business as a result of the release of CMS's final 2018 CRA data.higher favorable prior-period medical reserve development.
The Group and Specialty segment's benefits expense included $20$46 million in unfavorablefavorable prior-period medical claims reserve development in the 20192020 quarter versus noneunfavorable prior-period medical reserve development of $16 million in the 20182019 quarter. This unfavorablefavorable prior-period medical claims reserve development increaseddecreased the Group and Specialty segment benefit ratio by approximately 120280 basis points in the 2020 quarter while the unfavorable prior-period medical reserve development increased the benefit ratio by approximately 100 basis points in the 2019 quarter and had no impact in the 2018 quarter. The Group and Specialty segment's benefits expense included the effect of an unfavorable prior-period medical claims reserve development of $36 million in the 2019 period versus favorable prior-period medical claims reserve development of $34 million in the 2018 period. The unfavorable prior-period medical claims reserve development for the 2019 period increased the Group and Specialty segment benefit ratio by approximately 110 basis points and the favorable development for the 2018 period decreased the Group and Specialty segment benefit ratio 100 basis points.
Operating Costs
The Group and Specialty segment operating cost ratio of 21.7%23.1% for the 2020 quarter increased 120 basis points from 21.9% for the 2019 quarter decreased 180 basis points from 23.5% forprimarily reflecting the 2018 quarter. Forreinstatement of the 2019 period, the Group and Specialty segment operating cost ratio of 21.8% decreased 180 basis points from 23.6% for the 2018 period. These improvements primarily were due to the suspension of thenon-deductible health insurance industry fee in 2019, as well as2020, partially offset by significant operating cost efficiencies in the 20192020 quarter driven by previously implementeddisclosed productivity initiatives. The improvement was further impacted by the exit of the voluntary benefits and financial protection products in connection with the previously disclosed sale of KMG recognized during the second quarter of 2018, which carried a higher operating cost ratio. These improvements were offset by the higher compensation expense accruals in 2019 for the AIP as a result of our continued strong performance.
The non-deductible health insurance industry fee impacted the operating cost ratio by 160140 basis points in the 2018 quarter and period.2020 quarter.

Healthcare Services Segment
        
 For the three months ended June 30, Change
 2019 2018 Dollars Percentage
 (in millions)  
Revenues:       
Services:       
Provider services$82
 $67
 $15
 22.4 %
Pharmacy solutions45
 57
 (12) (21.1)%
Clinical care services30
 45
 (15) (33.3)%
Total services revenues157
 169
 (12) (7.1)%
Intersegment revenues:       
Pharmacy solutions5,465
 5,094
 371
 7.3 %
Provider services602
 541
 61
 11.3 %
Clinical care services162

170

(8)
(4.7)%
Total intersegment revenues6,229
 5,805
 424
 7.3 %
Total services and intersegment revenues$6,386
 $5,974
 $412
 6.9 %
Segment earnings$224
 $206
 $18
 8.7 %
Operating cost ratio96.1% 96.2%   (0.1)%
              
For the six months ended
June 30,
 ChangeFor the three months ended
March 31,
 Change
2019 2018 Dollars Percentage2020 2019 Dollars Percentage
(in millions)  (in millions)  
Revenues:              
Services:              
Pharmacy solutions$121
 $36
 $85
 236.1 %
Provider services$161
 $88
 $73
 83.0 %76
 79
 (3) (3.8)%
Pharmacy solutions81
 96
 (15) (15.6)%
Clinical care services71
 89
 (18) (20.2)%28
 41
 (13) (31.7)%
Total services revenues313
 273
 40
 14.7 %225
 156
 69
 44.2 %
Intersegment revenues:  

      

    
Pharmacy solutions10,662
 10,089
 573
 5.7 %6,140
 5,197
 943
 18.1 %
Provider services1,201
 919
 282
 30.7 %576
 599
 (23) (3.8)%
Clinical care services308
 350
 (42) (12.0)%144
 146
 (2) (1.4)%
Total intersegment revenues12,171
 11,358
 813
 7.2 %6,860
 5,942
 918
 15.4 %
Total services and intersegment revenues$12,484
 $11,631
 $853
 7.3 %$7,085
 $6,098
 $987
 16.2 %
Segment earnings$399
 $379
 $20
 5.3 %$250
 $175
 $75
 42.9 %
Operating cost ratio96.3% 96.2%   0.1 %96.0% 96.6%   (0.6)%
Segment Earnings
Healthcare Services segment earnings of $224$250 million for the 20192020 quarter increased $18$75 million, or 8.7%42.9%, from $206$175 million in the 2018 quarter. For the 2019 period, the Healthcare Services segment earnings of $399 million increased $20 million, or 5.3%, from $379 million in the 2018 period. These increases werequarter primarily due to the impact of Kindred at Home operations, higher earnings from our pharmacy operations, and the

operational improvement in core operating results from the provider services business. These factors were partially offset by additional investments in new clinical assets associated with our provider services business.business, and higher earnings from our investment in Kindred at Home.
Script Volume
Humana Pharmacy Solutions script volumes on an adjusted 30-day equivalent basis increased to approximately 113 million in the 2019 quarter, up 2.6%, versus scripts of approximately 110 million in the 2018 quarter. For the 2019 period, script volumes increased to approximately 223 million, up 2.2%, versus scripts of approximately 218 million in the 2018 period. These increases primarily reflect
Humana Pharmacy Solutions script volumes on an adjusted 30-day equivalent basis increased to approximately 120 million in the 2020 quarter, up 9.1%, versus scripts of approximately 110 million in the 2019 quarter, primarily reflecting growth associated with higher individual Medicare Advantage membership along with the impact of early prescription refills as members prepared for extended supply needs in response to COVID-19. These increases were partially offset by the decline in stand-alone PDP membership.
Services Revenues
Services revenues was relatively unchanged forincreased $69 million, or 44.2%, from the 2019 quarter at $157 million, a decrease of $12 million, or 7.1%, from the 2018 quarter. Services revenues increased $40 million, or 14.7%, from the 2018 period to $313$225 million for the 2019 period2020 quarter primarily due to revenue growth from our provider services.the additional pharmacy revenues associated with the acquisition of Enclara in the 2020 quarter.
Intersegment Revenues
Intersegment revenues increased $424$918 million, or 7.3%15.4%, from the 20182019 quarter to $6.2$6.9 billion for the 20192020 quarter and increased $813 million, or 7.2%, from the 2018 period to $12.2 billion for the 2019 period primarily was due to strong Medicare Advantage membership growth and higheran increase in pharmacy revenues associated with our provider services business reflecting the acquisitionas a result of MCCI and FPG.members being allowed early prescription refills to permit them to prepare for extended supply needs in response to COVID-19. These increases were partially offset by the loss of intersegment revenues associated with the reduction ofdecline in stand-alone PDP membership.

Operating Costs
The Healthcare Services segment operating cost ratio of 96.1% and 96.3%96.0% for the 2020 quarter decreased 60 basis points from 96.6% in the 2019 quarter and period, respectively, were relatively unchanged from 96.2%primarily as a result of operational improvements in bothour provider services business, largely related to Conviva, along with significant operating cost efficiencies in the 20182020 quarter and period.driven by previously disclosed productivity initiatives.
Liquidity
Historically, our primary sources of cash have included receipts of premiums, services revenue, and investment and other income, as well as proceeds from the sale or maturity of our investment securities, borrowings, and proceeds from sales of businesses.borrowings. Our primary uses of cash historically have included disbursements for claims payments, operating costs, interest on borrowings, taxes, purchases of investment securities, acquisitions, capital expenditures, repayments on borrowings, dividends, and share repurchases. Because premiums generally are collected in advance of claim payments by a period of up to several months, our business normally should produce positive cash flows during periods of increasing premiums and enrollment. Conversely, cash flows would be negatively impacted during periods of decreasing premiums and enrollment. From period to period, our cash flows may also be affected by the timing of working capital items including premiums receivable, benefits payable, and other receivables and payables. Our cash flows are impacted by the timing of payments to and receipts from CMS associated with Medicare Part D subsidies for which we do not assume risk. The use of cash flows may be limited by regulatory requirements of state departments of insurance (or comparable state regulators) which require, among other items, that our regulated subsidiaries maintain minimum levels of capital and seek approval before paying dividends from the subsidiaries to the parent. Our use of cash flows derived from our non-insurance subsidiaries, such as in our Healthcare Services segment, is generally not restricted by state departments of insurance (or comparable state regulators).
For additional information on our liquidity risk, please refer to the section entitled “Risk Factors” in our 20182019 Form 10-K.

Cash and cash equivalents increased to approximately $4.8$6.1 billion at June 30, 2019March 31, 2020 from $2.3$4.1 billion at December 31, 2018.2019. The change in cash and cash equivalents for the sixthree months ended June 30,March 31, 2020 and 2019 and 2018 is summarized as follows:
Six Months EndedThree Months Ended
2019 20182020 2019
(in millions)(in millions)
Net cash provided by operating activities$2,330
 $3,561
$474
 $896
Net cash provided by (used in) investing activities89
 (287)
Net cash (used in) provided by investing activities(1,210) 145
Net cash provided by financing activities16
 1,515
2,736
 493
Increase in cash and cash equivalents$2,435
 $4,789
$2,000
 $1,534
Cash Flow from Operating Activities
Our operating cash flows for the 2018 period were significantly impacted by the early receipt of the Medicare premium remittances of $3.3 billion in June 2018 because the payment date of July 1, 2018 fell on a weekend. Generally, when the first day of a month falls on a weekend or holiday, with the exception of January 1 (New Year's Day), we receive this payment at the end of the previous month. Excluding the 2018 impact2020 quarter decreased from the early receipt of the Medicare premium remittance, our operating cash flow for the 2019 period improved from the 2018 period primarily fromquarter due to the timing of the mid-year Medicare risk adjustment premium revenue collections which were received during the second quarter of 2019 as compared to the third quarter of 2018, higher earnings,working capital items, including the impact of approximately $230 million payment relatedearly prescription refills permitting members to reinsuring certain voluntary benefit and financial protection productsprepare for extended supply needs in response to a third party in connection with the sale of KMG in 2018, as well as the timing of other working capital changes. COVID-19, partially offset by higher income from operations.
The most significant drivers of changes in our working capital are typically the timing of payments of benefits expense and receipts for premiums. We illustrate these changes with the following summaries of benefits payable and receivables.



The detail of benefits payable was as follows at June 30, 2019March 31, 2020 and December 31, 2018:2019:
June 30, 2019 December 31, 2018 2019
Period
Change
 2018
Period
Change
March 31, 2020 December 31, 2019 2020
Quarter
Change
 2019
Quarter
Change
(in millions)(in millions)
IBNR (1)$3,688
 $3,361
 $327
 $276
$4,887
 $4,150
 $737
 $561
Reported claims in process (2)924
 617
 307
 118
856
 628
 228
 402
Other benefits payable (3)1,230
 884
 346
 16
1,347
 1,226
 121
 199
Total benefits payable$5,842
 $4,862
 $980
 $410
$7,090
 $6,004
 $1,086
 $1,162
(1)IBNR represents an estimate of benefits payable for claims incurred but not reported (IBNR) at the balance sheet date and includes unprocessed claim inventories. The level of IBNR is primarily impacted by membership levels, medical claim trends and the receipt cycle time, which represents the length of time between when a claim is initially incurred and when the claim form is received and processed (i.e. a shorter time span results in a lower IBNR). IBNR includes unprocessed claims inventories.
(2)Reported claims in process represents the estimated valuation of processed claims that are in the post claim adjudication process, which consists of administrative functions such as audit and check batching and handling, as well as amounts owed to our pharmacy benefit administrator which fluctuate due to bi-weekly payments and the month-end cutoff.
(3)Other benefits payable primarily include amounts owed to providers under capitated and risk sharing arrangements.
The increase in benefits payable from December 31, 20182019 to June 30, 2019March 31, 2020 and from December 31, 20172018 to June 30, 2018March 31, 2019 primarily was due to an increase in IBNR primarily as a result of Medicare Advantage membership growth, as

well as an increase in the amount of processed but unpaid claims which fluctuate due to month-end cutoff. The increase in benefits payable from December 31, 2018 to June 30, 2019 was also impacted bycutoff and an increase in the amounts owed to providers under the capitated and risk sharing arrangements.
The detail of total net receivables was as follows at June 30, 2019March 31, 2020 and December 31, 2018:2019:
June 30, 2019 December 31, 2018 2019
Period
Change
 2018
Period
Change
March 31, 2020 December 31, 2019 2020
Quarter
Change
 2019
Quarter
Change
(in millions)(in millions)
Medicare$697
 $836
 $(139) $670
$1,767
 $835
 $932
 $935
Commercial and other154
 135
 19
 (35)182
 162
 20
 1
Military services126
 123
 3
 (34)133
 128
 5
 3
Allowance for doubtful accounts(73) (79) 6
 16
(73) (69) (4) 1
Total net receivables$904
 $1,015
 $(111) $617
$2,009
 $1,056
 $953
 $940
Reconciliation to cash flow statement:       
Receivables from acquisition of business    (12) 2
Change in receivables per cash flow
statement resulting in cash from operations
    $(123) $619
The changes in Medicare receivables for both the 2020 quarter and the 2019 period reflects bothquarter reflect the typical pattern caused by the timing of accruals and related collections associated with the CMS risk-adjustment model. Significant collections occur with the mid-year and final settlements with CMS whereasin the 2018 period reflects just the final settlement with CMS. The 2018 mid-year settlement of approximately $1 billion was collected one quarter later duringsecond and third quarter of 2018.quarter.
Cash Flow from Investing Activities
Net proceeds from investment securities sales and maturities inIn the 2019 period and 2018 period were $385 million and $339 million, respectively.
During the 2018 period,first quarter of 2020, we acquired the remaining equity interest in MCCI and acquired FPGprivately held Enclara for cash consideration of $169approximately $709 million, and $185 million, respectively,net of cash received as discussed in Note 3 to the condensed consolidated financial statements.

Our ongoing capital expenditures primarily relate to our information technology initiatives, support of services in our provider services operations including medical and administrative facility improvements necessary for activities such as the provision of care to members, claims processing, billing and collections, wellness solutions, care coordination, regulatory compliance and customer service. Total capital expenditures, excluding acquisitions, were $296$192 million in the 2020 quarter and $139 million in the 2019 periodquarter.


Net purchases of investment securities in the 2020 quarter were $309 million as compared to net proceeds from sales and $272maturities of $284 million in the 2018 period.

2019 quarter.
Cash Flow from Financing Activities
Receipts from CMS associated with Medicare Part D claim subsidies for which we do not assume risk were higher than claims payments by $539$575 million in the 2020 quarter and $620 million in the 2019 period and $1.6 billion in the 2018 period.quarter.
Under our administrative services only TRICARE contracts, health care cost payments for which we do not assume risk exceeded reimbursements from the federal government by $1 million in the 2020 quarter and by $66 million in the 2019 periodquarter.
In March 2020, we issued $600 million of 4.500% senior notes due April 1, 2025 and $33$500 million inof 4.875% senior notes due April 1, 2030. Our net proceeds, reduced for the 2018 period.
Claim payments to the Departmentunderwriters' discount and commission and offering expenses paid as of Health and Human Services, or HHS, associated with cost sharing provisions of the Health Care Reform Law for which we do not assume riskMarch 31, 2020 were $13 million higher than reimbursements from HHS during the 2018 period.
On March 26, 2018 we completed the final settlement of our accelerated stock repurchase along with 0.08 million additional share repurchases under the current stock repurchase authorization during the 2018 period for $24$1,090 million.

In March 2020, we drew $1 billion on our existing term loan commitment.
We also acquired common shares in connection with employee stock plans for an aggregate cost of $17 million in the 2020 quarter and $10 million in the 2019 period and $69 million in the 2018 period.quarter.
Net repayments of commercial paper were $356 million in the 2019 period and net proceeds from the issuance of commercial paper were $243$198 million in the 2018 period.2020 quarter and $17 million in the 2019 quarter. The maximum principal amount outstanding at any one time during the 20192020 quarter was $670$600 million.
We paid dividends to stockholders of $142$73 million during the 2020 quarter and $68 million during the 2019 period and $126 million during the 2018 period.quarter.
Future Sources and Uses of Liquidity
Dividends
For a detailed discussion of dividends to stockholders, please refer to Note 1110 to the condensed consolidated financial statements.
Stock Repurchases
On July 31, 2019, we announced that we intend to enter into an agreement with a third party financial institution to effect a $1 billion accelerated stock repurchase program. We will repurchase shares through the program as part of the $3 billion authorized on July 30, 2019. The actual number of shares repurchased under the agreement will be determined based on a volume-weighted average price of our common stock during the purchase period.
For a detailed discussion of stock repurchases, please refer to Note 1110 to the condensed consolidated financial statements.
Debt
For a detailed discussion of our debt, including our senior notes, term loan, credit agreement and commercial paper program, please refer to Note 1312 to the condensed consolidated financial statements.
Acquisitions and Divestitures
During the 2018 period,2020 quarter, we completed the acquisition of MCCIprivately held Enclara, one of the nation’s largest hospice pharmacy and FPGbenefit management providers for total cash consideration of $354 million.

approximately $709 million, net of cash received. For a detailed discussion of these transactions,this transaction, please refer to Note 3 to the condensed consolidated financial statements.

Liquidity Requirements
We believe our cash balances, investment securities, operating cash flows, and funds available under our credit agreement and our commercial paper program or from other public or private financing sources, taken together, provide adequate resources to fund ongoing operating and regulatory requirements, acquisitions, future expansion opportunities, and capital expenditures for at least the next twelve months, as well as to refinance or repay debt, and repurchase shares.

Adverse changes in our credit rating may increase the rate of interest we pay and may impact the amount of credit available to us in the future. Our investment-grade credit rating at June 30, 2019March 31, 2020 was BBB+ according to Standard & Poor’s Rating Services, or S&P, and Baa3 according to Moody’s Investors Services, Inc., or Moody’s. A downgrade by S&P to BB+ or by Moody’s to Ba1 triggers an interest rate increase of 25 basis points with respect to $250 million of our senior notes. Successive one notch downgrades increase the interest rate an additional 25 basis points, or annual interest expense by less than $1 million, up to a maximum 100 basis points, or annual interest expense by $3 million.
In addition, we operate as a holding company in a highly regulated industry. Humana Inc., our parent company, is dependent upon dividends and administrative expense reimbursements from our subsidiaries, most of which are subject to regulatory restrictions. We continue to maintain significant levels of aggregate excess statutory capital and surplus in our state-regulated operating subsidiaries. Cash, cash equivalents, and short-term investments at the parent company

were $1.9$2.4 billion at June 30, 2019March 31, 2020 compared to $578 million$1.4 billion at December 31, 2018.2019. This increase primarily was due to insurance subsidiary dividends in excessthe net proceeds from the issuance of capital contributions from our parent companysenior notes, as well as operating cash derivedproceeds from our non-insurancea term loan and commercial paper issuance. The increase was further impacted by non-regulated subsidiary earnings and other working capital changes.in our Healthcare Services segment. These increases were partially offset by the net repayment of commercial paper borrowings,Enclara acquisition, capital expenditures, subsidiaries capital contributions, and cash dividends to shareholders.shareholders, and other working capital changes. Our use of operating cash derived from our non-insurance subsidiaries, such as our Healthcare Services segment, is generally not restricted by departments of insurance (or comparable state regulator)regulators).
Regulatory Requirements
Certain of our subsidiaries operate in states that regulate the payment of dividends, loans, or other cash transfers to Humana Inc., our parent company, and require minimum levels of equity as well as limit investments to approved securities. The amount of dividends that may be paid to Humana Inc. by these subsidiaries, without prior approval by state regulatory authorities, or ordinary dividends, is limited based on the entity’s level of statutory income and statutory capital and surplus. If the dividend, together with other dividends paid within the preceding twelve months, exceeds a specified statutory limit or is paid from sources other than earned surplus, it is generally considered an extraordinary dividend requiring prior regulatory approval. In most states, prior notification is provided before paying a dividend even if approval is not required.
Although minimum required levels of equity are largely based on premium volume, product mix, and the quality of assets held, minimum requirements vary significantly at the state level. Based on the most recently filed statutory financial statements as of MarchDecember 31, 2019, our state regulated subsidiaries had aggregate statutory capital and surplus of approximately $8.1$8.0 billion, which exceeded aggregate minimum regulatory requirements of $5.5$5.9 billion. The amount of ordinary dividends that may be paid to our parent company wasin 2020 is approximately $1.2$1.0 billion duringin the six months ended June 30, 2019 compared to $1.9 billion during the six months ended June 30, 2018. Actual dividends paid mayaggregate. The amount, timing and mix of ordinary and extraordinary dividend payments will vary year over year due to considerationstate regulatory requirements, the level of excess statutory capital and surplus and expected future surplus requirements related to, for example, premium volume and product mix. Actual dividends that were paid to our parent company were approximately $1.8 billion in 2019.



Item 3.    Quantitative and Qualitative Disclosures about Market Risk
Our earnings and financial position are exposed to financial market risk, including those resulting from changes in interest rates.
Interest rate risk also represents a market risk factor affecting our consolidated financial position due to our significant investment portfolio, consisting primarily of fixed maturity securities of investment-grade quality with a weighted average S&P credit rating of AA at June 30, 2019.March 31, 2020. Our net unrealized position increased $361decreased $137 million from a net unrealized lossgain position of $204$211 million at December 31, 20182019 to a net unrealized gain position of $157$74 million at June 30, 2019.March 31, 2020. At June 30, 2019,March 31, 2020, we had gross unrealized losses of $17$171 million on our investment portfolio primarily due to an increase in market interest rates since the time the securities were purchased. There were no material other-than-temporary impairmentscredit allowances during the sixthree months ended June 30, 2019.March 31, 2020. While we believe that these impairments are temporarysecurities in an unrealized loss will recover in value over time and we currently do not have the intent to sell such securities, given the current market conditions and the significant judgments involved, there is a continuing risk that future declines in fair value may occur and material realized losses from sales or other-than-temporary impairmentscredit allowances may be recorded in future periods.
Duration is the time-weighted average of the present value of the bond portfolio’s cash flow. Duration is indicative of the relationship between changes in fair value and changes in interest rates, providing a general indication of the sensitivity of the fair values of our fixed maturity securities to changes in interest rates. However, actual fair values may differ significantly from estimates based on duration. The average duration of our investment portfolio, including cash and cash equivalents, was approximately 2.11.9 years as of June 30, 2019March 31, 2020 and approximately 2.92.5 years as of December 31, 2018.2019. The decline in the average duration is reflective of the longer duration securities associatedincreased holdings of cash and cash equivalents, along with the sale of KMG.other portfolio management activities. Based on the duration, including cash equivalents, a 1% increase in interest rates would generally decrease the fair value of our securities by approximately $316$335 million at June 30, 2019.March 31, 2020.
Item 4.    Controls and Procedures
Under the supervision and with the participation of our Chief Executive Officer, or CEO, our Chief Financial Officer, or CFO, and our Principal Accounting Officer, we carried out an evaluation of the effectiveness of the design and operation of our disclosure controls and procedures for the quarter ended June 30, 2019.March 31, 2020.
Based on our evaluation, our CEO, CFO, and our Principal Accounting Officer concluded that our disclosure controls and procedures are effective to provide reasonable assurance that information the Company is required to disclose in its reports under the Securities Exchange Act of 1934, as amended, is recorded, processed, summarized and reported within the time periods specified in SEC rules and forms, including, without limitation, ensuring that such information is accumulated and communicated to the Company’s management, including its principal executive and principal financial officers, or persons performing similar functions, as appropriate to allow timely decisions regarding required disclosure.
There have been no changes in the Company’s internal control over financial reporting during the quarter ended June 30, 2019March 31, 2020 that have materially affected, or are reasonably likely to materially affect, the Company’s internal control over financial reporting.


Part II. Other Information
Item 1.     Legal Proceedings
For a description of the legal proceedings pending against us and certain other pending or threatened litigation, investigations, or other matters, see “Legal Proceedings and Certain Regulatory Matters” in Note 1413 to the condensed consolidated financial statements beginning on page 3026 of this Form 10-Q.
Item 1A.    Risk Factors
ThereIn addition to the other information set forth in this report, you should carefully consider the factors discussed in Part I, Item 1A. “Risk factors” in our Annual Report on Form 10-K for the year ended December 31, 2019, and the risk factor set forth below.

The spread of, and response to, the novel coronavirus, or COVID-19, underscores certain risks we face, including those discussed in our Form 10-K for the fiscal year ended December 31, 2019, and the rapid development and fluidity of this situation precludes any prediction as to the ultimate adverse impact to us of COVID-19.

In December 2019, a novel strain of coronavirus (COVID-19) was reported to have surfaced in Wuhan, China. COVID-19 has since spread to over 200 countries, including every state in the United States. On March 11, 2020 the World Health Organization declared COVID-19 a pandemic, and on March 13, 2020 the United States declared a national emergency with respect to COVID-19. The spread of COVID-19 underscores certain risks we face in our business, including those discussed in our Form 10-K for the fiscal year ended December 31, 2019.

Governmental and non-governmental organizations may not effectively combat the spread and severity of COVID-19, increasing the potential for harm for our members. If the spread of COVID-19 is not contained, the premiums we charge may prove to be insufficient to cover the cost of health care services delivered to our members, which may increase significantly as a result of higher utilization rates of medical facilities and services and other increases in associated hospital and pharmaceutical costs. Over time, we may also experience increased costs or decreased revenues if, as a result of our members being unable to see their providers due to actions taken to mitigate the spread of COVID-19, we are unable to implement clinical initiatives to manage health care costs and chronic conditions of our members, and appropriately document their risk profiles. In addition, we are offering our members expanded benefit coverage, such as providing full coverage for COVID-19 diagnostic testing and treatment, certain additional coverages have been nomandated by governmental action and we are taking actions designed to help provide financial and administrative relief for the health care provider community. Such measures and any further steps taken by us, or governmental action, to expand or otherwise modify the services delivered to our members, provide relief for the health care provider community, or in connection with the relaxation of stay-at-home and physical distancing orders and other restrictions on movement and economic activity intended to reduce the spread of COVID-19, including the potential for widespread testing as a component of lifting these measures, could adversely impact our profitability.
The spread of COVID-19, or actions taken to mitigate this spread, could have material and adverse effects on our ability to operate effectively, including as a result of the complete or partial closure of facilities or labor shortages. Disruptions in public and private infrastructure, including communications, financial services and supply chains, could materially and adversely disrupt our normal business operations. We have transitioned a significant subset of our employee population to a remote work environment in an effort to mitigate the spread of COVID-19, as have a number of our third-party service providers, which may exacerbate certain risks to our business, including an increased demand for information technology resources, increased risk of phishing and other cybersecurity attacks, and increased risk of unauthorized dissemination of sensitive personal information or proprietary or confidential information about us or our members or other third-parties. The outbreak of COVID-19 has severely impacted global economic

activity, including the businesses of some of our commercial customers, and caused significant volatility and negative pressure in the financial markets. In addition to disrupting our operations, these developments may adversely affect the timing of commercial customer premium collections and corresponding claim payments as well as the value of our investment portfolio.

The rapid development and fluidity of this situation precludes any prediction as to the ultimate adverse impact to us of COVID-19. We are continuing to monitor the spread of COVID-19, changes to our benefit coverages, the risk factors included inongoing costs and business impacts of dealing with COVID-19, including the potential costs associated with lifting restrictions on movement and economic activity and ultimately a vaccine, and related risks. The magnitude and duration of the pandemic and its ultimate impact on our 2018 Form 10-K.business, results of operations, financial position, and cash flows is uncertain as this continues to evolve globally, but such impacts could be material to our business, results of operations, financial position and cash flows.
Item 2:Unregistered Sales of Equity Securities and Use of Proceeds
(a)None.
(b)N/A
(c)The following table provides information about our purchases of equity securities that are registered by us pursuant to Section 12 of the Securities Exchange Act of 1934, as amended, during the three months ended June 30, 2019:March 31, 2020:
PeriodTotal Number
of Shares
Purchased (1)(2)
 Average
Price Paid
per Share
 Total Number of
Shares Purchased
as Part of Publicly
Announced Plans
or Programs (1)(2)
 Dollar Value of
Shares that May
Yet Be Purchased
Under the Plans
or Programs (1)
April 2019
 $
 
 $1,026,354,011
May 2019
 
 
 1,026,354,011
June 2019
 
 
 1,026,354,011
Total
 $
 
  
PeriodTotal Number
of Shares
Purchased (1)(2)
Average
Price Paid
per Share
Total Number of
Shares Purchased
as Part of Publicly
Announced Plans
or Programs (1)(2)
Dollar Value of
Shares that May
Yet Be Purchased
Under the Plans
or Programs (1)
January 2020
$

$
February 2020



March 2020



Total
$

(1)
On July 30, 2019, the Board of Directors replaced a previous share repurchase authorization of up to $3$3 billion (of which approximately $1.03 billion remained unused) with a new authorization for repurchases of up to $3 billion of our common shares exclusive of shares repurchased in connection with employee stock plans, expiring on June 30, 2022.Under our share repurchase authorization, shares may be purchased from time to time at prevailing prices in the open market, by block purchases, through plans designed to comply with Rule 10b5-1 under the Securities Exchange Act of 1934, as amended, or in privately-negotiated transactions (including pursuant to accelerated share repurchase agreements with investment banks), subject to certain regulatory restrictions on volume, pricing, and timing. Our remaining repurchase authorization was approximately $2 billion as of April 28, 2020.
(2)Excludes 34 thousand40,000 shares repurchased in connection with employee stock plans.
Item 3:Defaults Upon Senior Securities
None.
Item 4:Mine Safety Disclosures
Not applicable.
Item 5:Other Information
None.

Item 6:     Exhibits
3(i)Restated Certificate of Incorporation of Humana Inc. filed with the Secretary of State of Delaware on November 9, 1989, as restated to incorporate the amendment of January 9, 1992, and the correction of March 23, 1992 (incorporated herein by reference to Exhibit 4(i) to Humana Inc.’s Post-Effective Amendment No. 1 to the Registration Statement on Form S-8 (Reg. No. 33-49305) filed February 2, 1994).
By-Laws of Humana Inc., as amended on December 14, 2017 (incorporated herein by reference to Exhibit 3(b) to Humana Inc.’s Current Report on Form 8-K, filed December 14, 2017).
Sixteenth Supplemental Indenture, dated March 26, 2020, between the Company and The Bank of New York Mellon Trust Company, N.A., as trustee (incorporated herein by reference to Exhibit 4.2 to Humana Inc.’s Current Report on Form 8-K, filed March 27, 2020).
Seventeenth Supplemental Indenture, dated March 26, 2020, between the Company and The Bank of New York Mellon Trust Company, N.A., as trustee (incorporated herein by reference to Exhibit 4.3 to Humana Inc.’s Current Report on Form 8-K, filed March 27, 2020).
Principal Executive Officer certification pursuant to Section 302 of Sarbanes–Oxley Act of 2002.
Principal Financial Officer certification pursuant to Section 302 of Sarbanes–Oxley Act of 2002.
Principal Executive Officer and Principal Financial Officer certification pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
101The following materials from Humana Inc.'s Quarterly Report on Form 10-Q formatted in iXBRL (Inline Extensible Business Reporting Language): (i) the Condensed Consolidated Balance Sheets at June 30, 2019March 31, 2020 and December 31, 2018;2019; (ii) the Condensed Consolidated Statements of Income for the three and six months ended June 30, 2019March 31, 2020 and 2018;2019; (iii) the Condensed Consolidated Statements of Comprehensive Income for the three and six months ended June 30, 2019March 31, 2020 and 2018;2019; (iv) the Consolidated Statements of Equity for the three and six months ended June 30, 2019March 31, 2020 and 2019; (v) the Condensed Consolidated Statements of Cash Flows for the sixthree months ended June 30, 2019March 31, 2020 and 2018;2019; and (vi) Notes to Condensed Consolidated Financial Statements. The instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document.
104Cover Page Interactive Data File formatted in Inline XBRL and contained in Exhibit 101.

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 thereunto duly authorized.
  HUMANA INC.
  (Registrant)
    
Date:July 31, 2019April 29, 2020By:/s/ CYNTHIA H. ZIPPERLE
   Cynthia H. Zipperle
   Senior Vice President, Chief Accounting Officer and Controller (Principal Accounting Officer)
    

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