UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
    
FORM 10-Q

(Mark One)
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended June 30, 20212022
or

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from _________ to_________

Commission File Number: 001-01011

cvs-20220630_g1.jpg
CVS HEALTH CORPORATION
(Exact name of registrant as specified in its charter)
Delaware05-0494040
(State or other jurisdiction of incorporation or organization)(I.R.S. Employer Identification No.)
One CVS Drive,Woonsocket,Rhode Island02895
 (Address of principal executive offices) (Zip Code)
Registrant’s telephone number, including area code:     (401)765-1500
Former name, former address and former fiscal year, if changed since last report:N/A
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, par value $0.01 per shareCVSNew York Stock Exchange

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes No

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).      Yes No

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,��� and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filerAccelerated filer
Non-accelerated filerSmaller reporting company
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes No

As of July 28, 2021,27, 2022, the registrant had 1,319,574,7441,312,828,807 shares of common stock issued and outstanding.




TABLE OF CONTENTS
Page
Part IFinancial Information
 
Item 1.
Item 2.
Item 3.
Item 4.
   
Part IIOther Information 
   
Item 1.
Item 1A.
Item 2.
Item 3
Item 4.
Item 5.
Item 6.
   



Form 10-Q Table of Contents
Part I.Financial Information

Item 1.Financial Statements

Index to Condensed Consolidated Financial Statements
Page
Condensed Consolidated Statements of Operations (Unaudited) for the three and six months ended June 30, 20212022 and 20202021
Condensed Consolidated Statements of Comprehensive Income (Unaudited) for the three and six months ended June 30, 20212022 and 20202021
Condensed Consolidated Balance Sheets (Unaudited) as of June 30, 20212022 and December 31, 20202021
Condensed Consolidated Statements of Cash Flows (Unaudited) for the six months ended June 30, 20212022 and 20202021
Condensed Consolidated Statements of Shareholders’ Equity (Unaudited) for the three months ended June 30, 20212022 and 20202021 and the three months ended March 31, 20212022 and 20202021
Notes to Condensed Consolidated Financial Statements (Unaudited)
Report of Independent Registered Public Accounting Firm


1

Index to Condensed Consolidated Financial Statements
CVS Health Corporation
Condensed Consolidated Statements of Operations
(Unaudited)
Three Months Ended
June 30,
Six Months Ended
June 30,
Three Months Ended
June 30,
Six Months Ended
June 30,
In millions, except per share amountsIn millions, except per share amounts2021202020212020In millions, except per share amounts2022202120222021
Revenues:Revenues:Revenues:
ProductsProducts$50,525 $46,355 $97,912 $93,358 Products$56,794 $50,525 $109,316 $97,912 
PremiumsPremiums18,983 16,927 37,943 34,567 Premiums21,260 18,983 42,891 37,943 
ServicesServices2,819 1,875 5,272 3,825 Services2,436 2,819 4,941 5,272 
Net investment incomeNet investment income289 184 586 346 Net investment income146 289 314 586 
Total revenuesTotal revenues72,616 65,341 141,713 132,096 Total revenues80,636 72,616 157,462 141,713 
Operating costs:Operating costs:Operating costs:
Cost of products soldCost of products sold43,520 40,242 84,414 80,589 Cost of products sold49,290 43,520 94,799 84,414 
Benefit costsBenefit costs15,901 11,751 31,605 26,138 Benefit costs17,606 15,901 35,557 31,605 
Operating expensesOperating expenses8,869 8,668 17,791 17,231 Operating expenses9,171 8,869 19,047 17,791 
Total operating costsTotal operating costs68,290 60,661 133,810 123,958 Total operating costs76,067 68,290 149,403 133,810 
Operating incomeOperating income4,326 4,680 7,903 8,138 Operating income4,569 4,326 8,059 7,903 
Interest expenseInterest expense636 765 1,293 1,498 Interest expense583 636 1,169 1,293 
Other incomeOther income(45)(45)(95)(99)Other income(43)(45)(85)(95)
Income before income tax provisionIncome before income tax provision3,735 3,960 6,705 6,739 Income before income tax provision4,029 3,735 6,975 6,705 
Income tax provisionIncome tax provision944 974 1,690 1,741 Income tax provision1,068 944 1,701 1,690 
Net incomeNet income2,791 2,986 5,015 4,998 Net income2,961 2,791 5,274 5,015 
Net income attributable to noncontrolling interestsNet income attributable to noncontrolling interests(8)(11)(9)(16)Net income attributable to noncontrolling interests(10)(8)(11)(9)
Net income attributable to CVS HealthNet income attributable to CVS Health$2,783 $2,975 $5,006 $4,982 Net income attributable to CVS Health$2,951 $2,783 $5,263 $5,006 
Net income per share attributable to CVS Health:Net income per share attributable to CVS Health:Net income per share attributable to CVS Health:
BasicBasic$2.11 $2.27 $3.80 $3.81 Basic$2.25 $2.11 $4.01 $3.80 
DilutedDiluted$2.10 $2.26 $3.78 $3.79 Diluted$2.23 $2.10 $3.97 $3.78 
Weighted average shares outstanding:Weighted average shares outstanding:Weighted average shares outstanding:
BasicBasic1,319 1,309 1,316 1,307 Basic1,313 1,319 1,312 1,316 
DilutedDiluted1,327 1,314 1,325 1,313 Diluted1,321 1,327 1,325 1,325 
Dividends declared per shareDividends declared per share$0.50 $0.50 $1.00 $1.00 Dividends declared per share$0.55 $0.50 $1.10 $1.00 

See accompanying notes to condensed consolidated financial statements (unaudited).
2

Index to Condensed Consolidated Financial Statements
CVS Health Corporation
Condensed Consolidated Statements of Comprehensive Income
(Unaudited)
Three Months Ended
June 30,
Six Months Ended
June 30,
Three Months Ended
June 30,
Six Months Ended
June 30,
In millionsIn millions2021202020212020In millions2022202120222021
Net incomeNet income$2,791 $2,986 $5,015 $4,998 Net income$2,961 $2,791 $5,274 $5,015 
Other comprehensive income (loss), net of tax:Other comprehensive income (loss), net of tax:Other comprehensive income (loss), net of tax:
Net unrealized investment gains (losses)Net unrealized investment gains (losses)149 524 (237)213 Net unrealized investment gains (losses)(813)149 (1,968)(237)
Foreign currency translation adjustmentsForeign currency translation adjustments(1)(6)Foreign currency translation adjustments(1)(1)
Net cash flow hedgesNet cash flow hedges(3)(3)(7)(12)Net cash flow hedges15 (3)12 (7)
Pension and other postretirement benefitsPension and other postretirement benefits(1)(1)Pension and other postretirement benefits
Other comprehensive income (loss)Other comprehensive income (loss)148 526 (244)194 Other comprehensive income (loss)(798)148 (1,953)(244)
Comprehensive incomeComprehensive income2,939 3,512 4,771 5,192 Comprehensive income2,163 2,939 3,321 4,771 
Comprehensive income attributable to noncontrolling interestsComprehensive income attributable to noncontrolling interests(8)(11)(9)(16)Comprehensive income attributable to noncontrolling interests(10)(8)(11)(9)
Comprehensive income attributable to CVS HealthComprehensive income attributable to CVS Health$2,931 $3,501 $4,762 $5,176 Comprehensive income attributable to CVS Health$2,153 $2,931 $3,310 $4,762 

See accompanying notes to condensed consolidated financial statements (unaudited).
3

Index to Condensed Consolidated Financial Statements
CVS Health Corporation
Condensed Consolidated Balance Sheets
(Unaudited)
In millions, except per share amountsIn millions, except per share amountsJune 30,
2021
December 31,
2020
In millions, except per share amountsJune 30,
2022
December 31,
2021
Assets:Assets: Assets: 
Cash and cash equivalentsCash and cash equivalents$7,119 $7,854 Cash and cash equivalents$12,116 $9,408 
InvestmentsInvestments3,006 3,000 Investments2,877 3,117 
Accounts receivable, netAccounts receivable, net24,164 21,742 Accounts receivable, net27,233 24,431 
InventoriesInventories16,979 18,496 Inventories17,375 17,760 
Other current assetsOther current assets5,291 5,277 Other current assets2,541 5,292 
Total current assetsTotal current assets56,559 56,369 Total current assets62,142 60,008 
Long-term investmentsLong-term investments22,136 20,812 Long-term investments21,124 23,025 
Property and equipment, netProperty and equipment, net12,664 12,606 Property and equipment, net12,764 12,896 
Operating lease right-of-use assetsOperating lease right-of-use assets20,476 20,729 Operating lease right-of-use assets18,562 19,122 
GoodwillGoodwill79,552 79,552 Goodwill78,560 79,121 
Intangible assets, netIntangible assets, net30,080 31,142 Intangible assets, net28,135 29,026 
Separate accounts assetsSeparate accounts assets4,880 4,881 Separate accounts assets4,140 5,087 
Other assetsOther assets4,817 4,624 Other assets4,852 4,714 
Total assetsTotal assets$231,164 $230,715 Total assets$230,279 $232,999 
Liabilities:Liabilities:Liabilities:
Accounts payableAccounts payable$11,052 $11,138 Accounts payable$13,238 $12,544 
Pharmacy claims and discounts payablePharmacy claims and discounts payable17,225 15,795 Pharmacy claims and discounts payable18,393 17,330 
Health care costs payableHealth care costs payable8,414 7,936 Health care costs payable10,400 8,808 
Policyholders’ fundsPolicyholders’ funds4,567 4,270 Policyholders’ funds1,628 4,301 
Accrued expensesAccrued expenses14,827 14,243 Accrued expenses17,728 17,670 
Other insurance liabilitiesOther insurance liabilities1,375 1,557 Other insurance liabilities1,197 1,303 
Current portion of operating lease liabilitiesCurrent portion of operating lease liabilities1,791 1,638 Current portion of operating lease liabilities1,854 1,646 
Current portion of long-term debtCurrent portion of long-term debt60 5,440 Current portion of long-term debt4,019 4,205 
Total current liabilitiesTotal current liabilities59,311 62,017 Total current liabilities68,457 67,807 
Long-term operating lease liabilitiesLong-term operating lease liabilities18,509 18,757 Long-term operating lease liabilities17,502 18,177 
Long-term debtLong-term debt59,294 59,207 Long-term debt50,797 51,971 
Deferred income taxesDeferred income taxes6,557 6,794 Deferred income taxes5,450 6,270 
Separate accounts liabilitiesSeparate accounts liabilities4,880 4,881 Separate accounts liabilities4,140 5,087 
Other long-term insurance liabilitiesOther long-term insurance liabilities6,734 7,007 Other long-term insurance liabilities6,287 6,402 
Other long-term liabilitiesOther long-term liabilities2,314 2,351 Other long-term liabilities2,140 1,904 
Total liabilitiesTotal liabilities157,599 161,014 Total liabilities154,773 157,618 
Shareholders’ equity:Shareholders’ equity:Shareholders’ equity:
Preferred stock, par value $0.01: 0.1 shares authorized; 0ne issued or outstandingPreferred stock, par value $0.01: 0.1 shares authorized; 0ne issued or outstandingPreferred stock, par value $0.01: 0.1 shares authorized; 0ne issued or outstanding— — 
Common stock, par value $0.01: 3,200 shares authorized; 1,742 shares issued and 1,318 shares outstanding at June 30, 2021 and 1,733 shares issued and 1,310 shares outstanding at December 31, 2020 and capital surplus46,995 46,513 
Treasury stock, at cost: 424 shares at June 30, 2021 and 423 shares at December 31, 2020(28,252)(28,178)
Common stock, par value $0.01: 3,200 shares authorized; 1,755 shares issued and 1,312 shares outstanding at June 30, 2022 and 1,744 shares issued and 1,322 shares outstanding at December 31, 2021 and capital surplusCommon stock, par value $0.01: 3,200 shares authorized; 1,755 shares issued and 1,312 shares outstanding at June 30, 2022 and 1,744 shares issued and 1,322 shares outstanding at December 31, 2021 and capital surplus47,874 47,377 
Treasury stock, at cost: 443 shares at June 30, 2022 and 422 shares at December 31, 2021Treasury stock, at cost: 443 shares at June 30, 2022 and 422 shares at December 31, 2021(30,412)(28,173)
Retained earningsRetained earnings53,331 49,640 Retained earnings58,710 54,906 
Accumulated other comprehensive income1,170 1,414 
Accumulated other comprehensive income (loss)Accumulated other comprehensive income (loss)(988)965 
Total CVS Health shareholders’ equityTotal CVS Health shareholders’ equity73,244 69,389 Total CVS Health shareholders’ equity75,184 75,075 
Noncontrolling interestsNoncontrolling interests321 312 Noncontrolling interests322 306 
Total shareholders’ equityTotal shareholders’ equity73,565 69,701 Total shareholders’ equity75,506 75,381 
Total liabilities and shareholders’ equityTotal liabilities and shareholders’ equity$231,164 $230,715 Total liabilities and shareholders’ equity$230,279 $232,999 

See accompanying notes to condensed consolidated financial statements (unaudited).
4

Index to Condensed Consolidated Financial Statements
CVS Health Corporation
Condensed Consolidated Statements of Cash Flows
(Unaudited)
Six Months Ended
June 30,
Six Months Ended
June 30,
In millionsIn millions20212020In millions20222021
Cash flows from operating activities:Cash flows from operating activities:Cash flows from operating activities:
Cash receipts from customersCash receipts from customers$136,621 $129,218 Cash receipts from customers$151,769 $136,621 
Cash paid for inventory and prescriptions dispensed by retail network pharmaciesCash paid for inventory and prescriptions dispensed by retail network pharmacies(79,316)(76,381)Cash paid for inventory and prescriptions dispensed by retail network pharmacies(90,887)(79,316)
Insurance benefits paidInsurance benefits paid(31,245)(26,483)Insurance benefits paid(33,920)(31,245)
Cash paid to other suppliers and employeesCash paid to other suppliers and employees(14,900)(14,688)Cash paid to other suppliers and employees(15,119)(14,900)
Interest and investment income receivedInterest and investment income received394 395 Interest and investment income received200 394 
Interest paidInterest paid(1,263)(1,407)Interest paid(1,150)(1,263)
Income taxes paidIncome taxes paid(1,552)(230)Income taxes paid(1,887)(1,552)
Net cash provided by operating activitiesNet cash provided by operating activities8,739 10,424 Net cash provided by operating activities9,006 8,739 
Cash flows from investing activities:Cash flows from investing activities:Cash flows from investing activities:
Proceeds from sales and maturities of investmentsProceeds from sales and maturities of investments3,947 2,710 Proceeds from sales and maturities of investments4,360 3,947 
Purchases of investmentsPurchases of investments(5,570)(3,688)Purchases of investments(5,010)(5,570)
Purchases of property and equipmentPurchases of property and equipment(1,315)(1,190)Purchases of property and equipment(1,459)(1,315)
Acquisitions (net of cash acquired)Acquisitions (net of cash acquired)(108)(768)Acquisitions (net of cash acquired)(125)(108)
Proceeds from sale of subsidiaries (net of cash and restricted cash sold of $2,807)Proceeds from sale of subsidiaries (net of cash and restricted cash sold of $2,807)(1,943)— 
OtherOther72 Other54 72 
Net cash used in investing activitiesNet cash used in investing activities(2,974)(2,930)Net cash used in investing activities(4,123)(2,974)
Cash flows from financing activities:Cash flows from financing activities:Cash flows from financing activities:
Proceeds from issuance of long-term debt3,946 
Repayments of long-term debtRepayments of long-term debt(5,423)(1,016)Repayments of long-term debt(1,529)(5,423)
Repurchase of common stockRepurchase of common stock(2,000)— 
Dividends paidDividends paid(1,306)(1,315)Dividends paid(1,462)(1,306)
Proceeds from exercise of stock optionsProceeds from exercise of stock options330 166 Proceeds from exercise of stock options348 330 
Payments for taxes related to net share settlement of equity awardsPayments for taxes related to net share settlement of equity awards(159)(68)Payments for taxes related to net share settlement of equity awards(329)(159)
OtherOther(16)Other(139)46 
Net cash provided by (used in) financing activities(6,558)1,697 
Net increase (decrease) in cash, cash equivalents and restricted cash(793)9,191 
Net cash used in financing activitiesNet cash used in financing activities(5,111)(6,512)
Net decrease in cash, cash equivalents and restricted cashNet decrease in cash, cash equivalents and restricted cash(228)(747)
Cash, cash equivalents and restricted cash at the beginning of the periodCash, cash equivalents and restricted cash at the beginning of the period8,130 5,954 Cash, cash equivalents and restricted cash at the beginning of the period12,691 11,043 
Cash, cash equivalents and restricted cash at the end of the periodCash, cash equivalents and restricted cash at the end of the period$7,337 $15,145 Cash, cash equivalents and restricted cash at the end of the period$12,463 $10,296 

5

Index to Condensed Consolidated Financial Statements
CVS Health Corporation
Condensed Consolidated Statements of Cash Flows
(Unaudited)
Six Months Ended
June 30,
Six Months Ended
June 30,
In millionsIn millions20212020In millions20222021
Reconciliation of net income to net cash provided by operating activities:Reconciliation of net income to net cash provided by operating activities:Reconciliation of net income to net cash provided by operating activities:
Net incomeNet income$5,015 $4,998 Net income$5,274 $5,015 
Adjustments required to reconcile net income to net cash provided by operating activities:Adjustments required to reconcile net income to net cash provided by operating activities:Adjustments required to reconcile net income to net cash provided by operating activities:
Depreciation and amortizationDepreciation and amortization2,263 2,188 Depreciation and amortization2,142 2,263 
Stock-based compensationStock-based compensation232 179 Stock-based compensation236 232 
Gain on sale of subsidiaryGain on sale of subsidiary(225)— 
Deferred income taxes and other noncash itemsDeferred income taxes and other noncash items(370)(101)Deferred income taxes and other noncash items(281)(370)
Change in operating assets and liabilities, net of effects from acquisitions:Change in operating assets and liabilities, net of effects from acquisitions:Change in operating assets and liabilities, net of effects from acquisitions:
Accounts receivable, netAccounts receivable, net(2,384)(2,233)Accounts receivable, net(2,687)(2,384)
InventoriesInventories1,517 1,003 Inventories469 1,517 
Other assetsOther assets(145)(560)Other assets(325)(219)
Accounts payable and pharmacy claims and discounts payableAccounts payable and pharmacy claims and discounts payable1,702 1,671 Accounts payable and pharmacy claims and discounts payable2,033 1,702 
Health care costs payable and other insurance liabilitiesHealth care costs payable and other insurance liabilities104 (415)Health care costs payable and other insurance liabilities1,467 104 
Other liabilitiesOther liabilities805 3,694 Other liabilities903 879 
Net cash provided by operating activitiesNet cash provided by operating activities$8,739 $10,424 Net cash provided by operating activities$9,006 $8,739 

See accompanying notes to condensed consolidated financial statements (unaudited).

6

Index to Condensed Consolidated Financial Statements
CVS Health Corporation
Condensed Consolidated Statements of Shareholders’ Equity
(Unaudited)
Attributable to CVS HealthAttributable to CVS Health
Number of shares
outstanding
Common
Stock and
Capital
Surplus (2)
Treasury
Stock (1)
Retained
Earnings
Accumulated
Other
Comprehensive
Income
Total
CVS Health
Shareholders’
 Equity
Noncontrolling
Interests
Total
Shareholders’
Equity
Number of shares
outstanding
Common
Stock and
Capital
Surplus (2)
Treasury
Stock (1)
Retained
Earnings
Accumulated
Other
Comprehensive
Income (Loss)
Total
CVS Health
Shareholders’
 Equity
Noncontrolling
Interests
Total
Shareholders’
Equity
Common
Shares
Treasury
Shares (1)
Common
Shares
Treasury
Shares (1)
In millionsIn millionsIn millions
Balance at December 31, 20201,733 (423)$46,513 $(28,178)$49,640 $1,414 $69,389 $312 $69,701 
Balance at December 31, 2021Balance at December 31, 20211,744 (422)$47,377 $(28,173)$54,906 $965 $75,075 $306 $75,381 
Net incomeNet income— — — — 2,223 — 2,223 2,224 Net income— — — — 2,312 — 2,312 2,313 
Other comprehensive lossOther comprehensive loss— — — — — (392)(392)— (392)Other comprehensive loss— — — — — (1,155)(1,155)— (1,155)
Stock option activity, stock awards and otherStock option activity, stock awards and other— 214 — — — 214 — 214 Stock option activity, stock awards and other— 300 — — — 300 — 300 
ESPP issuances, net of purchase of treasury shares— — 76 — — 76 — 76 
Purchase of treasury shares, net of ESPP issuancesPurchase of treasury shares, net of ESPP issuances— (19)— (1,972)— — (1,972)— (1,972)
Common stock dividendsCommon stock dividends— — — — (660)— (660)— (660)Common stock dividends— — — — (730)— (730)— (730)
Other increases in noncontrolling interestsOther increases in noncontrolling interests— — — — — — — Other increases in noncontrolling interests— — — — — — — 
Balance at March 31, 20211,735 (422)46,727 (28,102)51,203 1,022 70,850 314 71,164 
Balance at March 31, 2022Balance at March 31, 20221,747 (441)47,677 (30,145)56,488 (190)73,830 310 74,140 
Net incomeNet income— — — — 2,783 — 2,783 2,791 Net income— — — — 2,951 — 2,951 10 2,961 
Other comprehensive income (Note 6)— — — — — 148 148 — 148 
Other comprehensive loss (Note 8)Other comprehensive loss (Note 8)— — — — — (798)(798)— (798)
Stock option activity, stock awards and otherStock option activity, stock awards and other— 268 — — — 268 — 268 Stock option activity, stock awards and other— 197 — — — 197 — 197 
Purchase of treasury shares, net of ESPP issuancesPurchase of treasury shares, net of ESPP issuances— (2)— (150)— — (150)— (150)Purchase of treasury shares, net of ESPP issuances— (2)— (267)— — (267)— (267)
Common stock dividendsCommon stock dividends— — — — (655)— (655)— (655)Common stock dividends— — — — (729)— (729)— (729)
Other decreases in noncontrolling interests— — — — — — — (1)(1)
Balance at June 30, 20211,742 (424)$46,995 $(28,252)$53,331 $1,170 $73,244 $321 $73,565 
Other increases in noncontrolling interestsOther increases in noncontrolling interests— — — — — — — 
Balance at June 30, 2022Balance at June 30, 20221,755 (443)$47,874 $(30,412)$58,710 $(988)$75,184 $322 $75,506 

(1)Treasury shares include 1 million shares held in trust and treasury stock includes $29 million related to shares held in trust as of June 30, 2022, March 31, 2022 and December 31, 2021.
(2)Common stock and capital surplus includes the par value of common stock of $18 million as of June 30, 2022 and $17 million as of March 31, 2022 and December 31, 2021.
7

Index to Condensed Consolidated Financial Statements
Attributable to CVS Health
Number of shares
outstanding
Common
Stock and
Capital
Surplus (2)
Treasury
Stock (1)
Retained
Earnings
Accumulated
Other
Comprehensive
Income
Total
CVS Health
Shareholders’
 Equity
Noncontrolling
Interests
Total
Shareholders’
Equity
Common
Shares
Treasury
Shares (1)
In millions
Balance at December 31, 20201,733 (423)$46,513 $(28,178)$49,640 $1,414 $69,389 $312 $69,701 
Net income— — — — 2,223 — 2,223 2,224 
Other comprehensive loss— — — — — (392)(392)— (392)
Stock option activity, stock awards and other— 214 — — — 214 — 214 
ESPP issuances, net of purchase of treasury shares— — 76 — — 76 — 76 
Common stock dividends— — — — (660)— (660)— (660)
Other increases in noncontrolling interests— — — — — — — 
Balance at March 31, 20211,735 (422)46,727 (28,102)51,203 1,022 70,850 314 71,164 
Net income— — — — 2,783 — 2,783 2,791 
Other comprehensive income (Note 8)— — — — — 148 148 — 148 
Stock option activity, stock awards and other— 268 — — — 268 — 268 
Purchase of treasury shares, net of ESPP issuances— (2)— (150)— — (150)— (150)
Common stock dividends— — — — (655)— (655)— (655)
Other decreases in noncontrolling interests— — — — — — — (1)(1)
Balance at June 30, 20211,742 (424)$46,995 $(28,252)$53,331 $1,170 $73,244 $321 $73,565 

(1)Treasury shares include 1 million shares held in trust and treasury stock includes $29 million related to shares held in trust as of June 30, 2021, March 31, 2021 and December 31, 2020.
(2)Common stock and capital surplus includes the par value of common stock of $17 million as of June 30, 2021, March 31, 2021 and December 31, 2020.




7

Index to Condensed Consolidated Financial Statements
Attributable to CVS Health
Number of shares
outstanding
Common
Stock and
Capital
Surplus (2)
Treasury
Stock (1)
Retained
Earnings
Accumulated
Other
Comprehensive
Income
Total
CVS Health
Shareholders’
 Equity
Noncontrolling
Interests
Total
Shareholders’
Equity
Common
Shares
Treasury
Shares (1)
In millions
Balance at December 31, 20191,727 (425)$45,972 $(28,235)$45,108 $1,019 $63,864 $306 $64,170 
Adoption of new accounting standard (3)
— — — — (3)— (3)— (3)
Net income— — — — 2,007 — 2,007 2,012 
Other comprehensive loss— — — — — (332)(332)— (332)
Stock option activity, stock awards and other— 208 — — — 208 — 208 
ESPP issuances, net of purchase of treasury shares— — 53 — — 53 — 53 
Common stock dividends— — — — (657)— (657)— (657)
Other increases in noncontrolling interests— — — — — — — 23 23 
Balance at March 31, 20201,729 (424)46,180 (28,182)46,455 687 65,140 334 65,474 
Net income— — — — 2,975 — 2,975 11 2,986 
Other comprehensive income (Note 6)— — — — — 526 526 — 526 
Stock option activity, stock awards and other— 96 — — — 96 — 96 
Purchase of treasury shares, net of ESPP issuances— (1)— (53)— — (53)— (53)
Common stock dividends— — — — (662)— (662)— (662)
Other decreases in noncontrolling interests— — — — — — — (12)(12)
Balance at June 30, 20201,732 (425)$46,276 $(28,235)$48,768 $1,213 $68,022 $333 $68,355 

(1)Treasury shares include 1 million shares held in trust and treasury stock includes $29 million related to shares held in trust as of June 30, 2020, March 31, 2020 and December 31, 2019.
(2)Common stock and capital surplus includes the par value of common stock of $17 million as of June 30, 2020, March 31, 2020 and December 31, 2019.
(3)Reflects the adoption of Accounting Standards Update (“ASU”) 2016-13, Financial Instruments - Credit Losses (Topic 326), which resulted in a decrease to retained earnings of $3 million during the three months ended March 31, 2020.

See accompanying notes to condensed consolidated financial statements (unaudited).

8

Index to Condensed Consolidated Financial Statements
Notes to Condensed Consolidated Financial Statements (Unaudited)

1.Significant Accounting Policies

Description of Business 

CVS Health Corporation, (“CVS Health”), together with its subsidiaries (collectively, “CVS Health” or the “Company”), has more than 9,9009,000 retail locations, approximatelymore than 1,100 walk-in medical clinics, a leading pharmacy benefits manager with approximately 108over 110 million plan members with expanding specialty pharmacy solutions and a dedicated senior pharmacy care business serving more than 1000000 patients per year and expanding specialty pharmacy services.year. The Company also serves an estimated 3435 million people through traditional, voluntary and consumer-directed health insurance products and related services, including expanding Medicare Advantage offerings and a leading standalone Medicare Part D prescription drug plan (“PDP”). The Company believes its innovative health care model increases access to quality care, delivers better health outcomes and lowers overall health care costs.

The coronavirus disease 2019 (“COVID-19”) continuesand its emerging new variants continue to impact the economies of the U.S. and other countries around the world. The impact of COVID-19 on the Company’s businesses, operating results, cash flows and financial condition, as well as information regarding certain expected impacts of COVID-19 on the Company, is discussed throughout this Quarterly Report on Form 10-Q.

The Company has 4 reportable segments: Health Care Benefits, Pharmacy Services, Retail/LTC and Corporate/Other, which are described below.

Health Care Benefits Segment
The Health Care Benefits segment isoperates as one of the nation’s leading diversified health care benefits providers. The Health Care Benefits segment has the information and resources to help members, in consultation with their health care professionals, make more informed decisions about their health care. The Health Care Benefits segment offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, medical management capabilities, Medicare Advantage and Medicare Supplement plans, PDPs, Medicaid health care management services and health information technology products and services. The Health Care Benefits segment also provided workers’ compensation administrative services through its Coventry Health Care Workers’ Compensation business (“Workers’ Compensation business”) prior to the sale of this business on July 31, 2020. The Health Care Benefits segment’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers (“providers”), governmental units, government-sponsored plans, labor groups and expatriates. The Company refers to insurance products (where it assumes all or a majority of the risk for medical and dental care costs) as “Insured” and administrative services contract products (where the plan sponsor assumes all or a majority of the risk for medical and dental care costs) as “ASC.” In addition, effective January 2022, the Company entered the individual public health insurance exchanges (“Public Exchanges”) in 8 states through which it sells Insured plans directly to individual consumers. The Company has submitted regulatory filings to remain on the Public Exchanges in 2023 in each of those 8 states, and has submitted regulatory filings to enter the Public Exchanges in 4 additional states effective January 2023.

Pharmacy Services Segment
The Pharmacy Services segment provides a full range of pharmacy benefit management (“PBM”) solutions, including plan design offerings and administration, formulary management, retail pharmacy network management services and mail order pharmacy,pharmacy. In addition, through the Pharmacy Services segment, the Company provides specialty pharmacy and infusion services, clinical services, disease management services, medical spend management and pharmacy and/or other administrative services for providers and federal 340B drug pricing program covered entities (“Covered Entities”). The Company operates a group purchasing organization that negotiates pricing for the purchase of pharmaceuticals and rebates with pharmaceutical manufacturers on behalf of its participants. The Company also provides various administrative, management and reporting services to pharmaceutical manufacturers. The Pharmacy Services segment’s clients are primarily employers, insurance companies, unions, government employee groups, health plans, PDPs, Medicaid managed care plans, plans offered on public health insurance exchanges (“Public Exchanges”)Exchanges and private health insurance exchanges, other sponsors of health benefit plans throughout the United States and Covered Entities. The Pharmacy Services segment operates retail specialty pharmacy stores, specialty mail order pharmacies, mail order dispensing pharmacies, compounding pharmacies and branches for infusion and enteral nutrition services.

Retail/LTC Segment
The Retail/LTC segment sells prescription drugs and a wide assortment of health and wellness products and general merchandise, provides health care services through its MinuteClinic® walk-in medical clinics, provides medical diagnostic testing, administers vaccinations for illnesses such as influenza, COVID-19 and shingles and conducts long-term care pharmacy (“LTC”) operations, which distribute prescription drugs and provide related pharmacy consulting and other ancillary services to long-term care facilities and other care settings. As of June 30, 2021,2022, the Retail/LTC segment operated more than 9,9009,000 retail
9


locations, approximatelymore than 1,100 MinuteClinic locations as well as online retail pharmacy websites, LTC pharmacies and on-site pharmacies.


9



Corporate/Other Segment
The Company presents the remainder of its financial results in the Corporate/Other segment, which primarily consists of:

Management and administrative expenses to support the Company’s overall operations, which include certain aspects of executive management and the corporate relations, legal, compliance, human resources, information technology and finance departments, expenses associated with the Company’s investments in its transformation and enterprise modernization programs and acquisition-related integration costs; and
Products for which the Company no longer solicits or accepts new customers such as its large case pensions and long-term care insurance products.

Basis of Presentation

The accompanying unaudited condensed consolidated financial statements of CVS Health and its subsidiaries have been prepared in accordance with the rules and regulations of the U.S. Securities and Exchange Commission (the “SEC”) regarding interim financial reporting. In accordance with such rules and regulations, certain information and accompanying note disclosures normally included in financial statements prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) have been omitted, although the Company believes the disclosures included herein are adequate to make the information presented not misleading. These unaudited condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto, which are included in the Company’s Annual Report on Form 10-K for the year ended December 31, 20202021 (the “2020“2021 Form 10-K”).
 
In the opinion of management, the accompanying unaudited condensed consolidated financial statements include all adjustments, consisting only of normal recurring adjustments, necessary for a fair presentation of the results for the interim periods presented. Because of the influence of various factors on the Company’s operations, including business combinations, certain holidays and other seasonal influences, net income for any interim period may not be comparable to the same interim period in previous years or necessarily indicative of income for the full year.

Principles of Consolidation

The unaudited condensed consolidated financial statements include the accounts of the Company and its majority-owned subsidiaries and variable interest entities (“VIEs”) for which the Company is the primary beneficiary. All material intercompany balances and transactions have been eliminated.
 
The Company continually evaluates its investments to determine if they represent variable interests in a VIE. If the Company determines that it has a variable interest in a VIE, the Company then evaluates if it is the primary beneficiary of the VIE. The evaluation is a qualitative assessment as to whether the Company has the ability to direct the activities of a VIE that most significantly impact the entity’s economic performance. The Company consolidates a VIE if it is considered to be the primary beneficiary.

Assets and liabilities of VIEs for which the Company is the primary beneficiary were not significant to the Company’s unaudited condensed consolidated financial statements. VIE creditors do not have recourse against the general credit of the Company.

Reclassifications

Certain prior year amounts have been reclassified to conform with the current year presentation.


10


Restricted Cash

Restricted cash included in other current assets on the unaudited condensed consolidated balance sheets represents funds held on behalf of members, including health savings account funds associated with high deductible health plans. Restricted cash included in other assets on the unaudited condensed consolidated balance sheets represents amounts held in a trust in one of the Company’s captive insurance companies to satisfy collateral requirements associated with the assignment of certain insurance policies. All restricted cash is invested in time deposits and money market funds or commercial paper.funds.

The following is a reconciliation of cash and cash equivalents on the unaudited condensed consolidated balance sheets to total cash, cash equivalents and restricted cash on the unaudited condensed consolidated statements of cash flows:
In millionsIn millionsJune 30,
2021
December 31,
2020
In millionsJune 30,
2022
December 31,
2021
June 30,
2021
Cash and cash equivalentsCash and cash equivalents$7,119 $7,854 Cash and cash equivalents$12,116 $9,408 $7,119 
Restricted cash (included in other current assets)Restricted cash (included in other current assets)131 3,065 2,959 
Restricted cash (included in other assets)Restricted cash (included in other assets)218 276 Restricted cash (included in other assets)216 218 218 
Total cash, cash equivalents and restricted cash in the statements of cash flowsTotal cash, cash equivalents and restricted cash in the statements of cash flows$7,337 $8,130 Total cash, cash equivalents and restricted cash in the statements of cash flows$12,463 $12,691 $10,296 

The decrease in restricted cash included in other current assets as of June 30, 2022 compared to December 31, 2021 was primarily due to a decrease in health savings account funds held on behalf of customers as a result of the sale of PayFlex Holdings, Inc. (“PayFlex”). See Note 2 ‘‘Divestitures and Asset Sales’’ for additional information on the Company’s sale of PayFlex.

Accounts Receivable

Accounts receivable are stated net of allowances for credit losses, customer credit allowances, contractual allowances and estimated terminations. Accounts receivable, net is composed of the following:
In millionsIn millionsJune 30,
2021
December 31,
2020
In millionsJune 30,
2022
December 31,
2021
Trade receivablesTrade receivables$8,021 $7,101 Trade receivables$9,084 $7,932 
Vendor and manufacturer receivablesVendor and manufacturer receivables10,955 9,815 Vendor and manufacturer receivables12,242 10,573 
Premium receivablesPremium receivables2,942 2,628 Premium receivables3,399 2,537 
Other receivablesOther receivables2,246 2,198 Other receivables2,508 3,389 
Total accounts receivable, net Total accounts receivable, net$24,164 $21,742  Total accounts receivable, net$27,233 $24,431 

The Company’s allowance for credit losses was $367$340 million and $358$339 million as of June 30, 20212022 and December 31,
2020,
2021, respectively. When developing an estimate of the Company’s expected credit losses, the Company considers all available relevant information regarding the collectability of cash flows, including historical information, current conditions and reasonable and supportable forecasts of future economic conditions over the contractual life of the receivable. The Company’s accounts receivable are short duration in nature and typically settle in less than 30 days.
11


Revenue Recognition

Disaggregation of Revenue
The following tables disaggregate the Company’s revenue by major source in each segment for the three and six months ended June 30, 20212022 and 2020:2021:
In millionsIn millionsHealth Care
Benefits
Pharmacy
Services
Retail/
LTC
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
In millionsHealth Care
Benefits
Pharmacy
Services
Retail/
LTC
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
Three Months Ended June 30, 2022Three Months Ended June 30, 2022
Major goods/services lines:Major goods/services lines:
PharmacyPharmacy$— $42,567 $20,017 $— $(11,258)$51,326 
Front StoreFront Store— — 5,736 — — 5,736 
PremiumsPremiums21,245 — — 15 — 21,260 
Net investment income (loss)Net investment income (loss)88 — (18)76 — 146 
OtherOther1,423 245 551 19 (70)2,168 
TotalTotal$22,756 $42,812 $26,286 $110 $(11,328)$80,636 
Pharmacy Services distribution channel:Pharmacy Services distribution channel:
Pharmacy network (1)
Pharmacy network (1)
$24,537 
Mail choice (2)
Mail choice (2)
18,030 
OtherOther245 
TotalTotal$42,812 
Three Months Ended June 30, 2021Three Months Ended June 30, 2021Three Months Ended June 30, 2021
Major goods/services lines:Major goods/services lines:Major goods/services lines:
PharmacyPharmacy$$38,153 $18,873 $$(11,094)$45,932 Pharmacy$— $38,153 $18,873 $— $(11,094)$45,932 
Front StoreFront Store5,254 5,254 Front Store— — 5,254 — — 5,254 
PremiumsPremiums18,968 15 18,983 Premiums18,968 — — 15 — 18,983 
Net investment incomeNet investment income137 152 289 Net investment income137 — — 152 — 289 
OtherOther1,420 161 601 15 (39)2,158 Other1,420 161 601 15 (39)2,158 
TotalTotal$20,525 $38,314 $24,728 $182 $(11,133)$72,616 Total$20,525 $38,314 $24,728 $182 $(11,133)$72,616 
Pharmacy Services distribution channel:Pharmacy Services distribution channel:Pharmacy Services distribution channel:
Pharmacy network (1)
Pharmacy network (1)
$22,918 
Pharmacy network (1)
$22,918 
Mail choice (2)
Mail choice (2)
15,235 
Mail choice (2)
15,235 
OtherOther161 Other161 
TotalTotal$38,314 Total$38,314 
Three Months Ended June 30, 2020
Major goods/services lines:
Pharmacy$$34,645 $16,870 $$(9,741)$41,774 
Front Store4,653 4,653 
Premiums16,913 14 16,927 
Net investment income127 57 184 
Other1,428 244 139 15 (23)1,803 
Total$18,468 $34,889 $21,662 $86 $(9,764)$65,341 
Pharmacy Services distribution channel:
Pharmacy network (1)
$20,536 
Mail choice (2)
14,109 
Other244 
Total$34,889 










12


In millionsIn millionsHealth Care
Benefits
Pharmacy
Services
Retail/
LTC
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
In millionsHealth Care
Benefits
Pharmacy
Services
Retail/
LTC
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
Six Months Ended June 30, 2022Six Months Ended June 30, 2022
Major goods/services lines:Major goods/services lines:
PharmacyPharmacy$— $81,765 $39,549 $— $(22,498)$98,816 
Front StoreFront Store— — 11,049 — — 11,049 
PremiumsPremiums42,859 — — 32 — 42,891 
Net investment income (loss)Net investment income (loss)177 — (34)171 — 314 
OtherOther2,829 508 1,140 33 (118)4,392 
TotalTotal$45,865 $82,273 $51,704 $236 $(22,616)$157,462 
Pharmacy Services distribution channel:Pharmacy Services distribution channel:
Pharmacy network (1)
Pharmacy network (1)
$47,361 
Mail choice (2)
Mail choice (2)
34,404 
OtherOther508 
TotalTotal$82,273 
Six Months Ended June 30, 2021Six Months Ended June 30, 2021Six Months Ended June 30, 2021
Major goods/services lines:Major goods/services lines:Major goods/services lines:
PharmacyPharmacy$$74,294 $36,758 $$(22,168)$88,884 Pharmacy$— $74,294 $36,758 $— $(22,168)$88,884 
Front StoreFront Store9,896 9,896 Front Store— — 9,896 — — 9,896 
PremiumsPremiums37,910 33 37,943 Premiums37,910 — — 33 — 37,943 
Net investment incomeNet investment income285 46 255 586 Net investment income285 — 46 255 — 586 
OtherOther2,813 341 1,302 29 (81)4,404 Other2,813 341 1,302 29 (81)4,404 
TotalTotal$41,008 $74,635 $48,002 $317 $(22,249)$141,713 Total$41,008 $74,635 $48,002 $317 $(22,249)$141,713 
Pharmacy Services distribution channel:Pharmacy Services distribution channel:Pharmacy Services distribution channel:
Pharmacy network (1)
Pharmacy network (1)
$44,811 
Pharmacy network (1)
$44,811 
Mail choice (2)
Mail choice (2)
29,483 
Mail choice (2)
29,483 
OtherOther341 Other341 
TotalTotal$74,635 Total$74,635 
Six Months Ended June 30, 2020
Major goods/services lines:
Pharmacy$$69,419 $34,225 $$(19,998)$83,646 
Front Store9,861 9,861 
Premiums34,534 33 34,567 
Net investment income220 126 346 
Other2,912 453 325 17 (31)3,676 
Total$37,666 $69,872 $44,411 $176 $(20,029)$132,096 
Pharmacy Services distribution channel:
Pharmacy network (1)
$41,636 
Mail choice (2)
27,783 
Other453 
Total$69,872 

(1)Pharmacy Services pharmacy network is defined as claims filled at retail and specialty retail pharmacies, including the Company’s retail pharmacies and LTC pharmacies, but excluding Maintenance Choice® activity, which is included within the mail choice category. Maintenance Choice permits eligible client plan members to fill their maintenance prescriptions through mail order delivery or at a CVS Pharmacypharmacy retail store for the same price as mail order.
(2)Pharmacy Services mail choice is defined as claims filled at a Pharmacy Services mail order facility, which includes specialty mail claims inclusive of Specialty Connect® claims picked up at a retail pharmacy, as well as prescriptions filled at the Company’s retail pharmacies under the Maintenance Choice program.

Contract Balances
Contract liabilities primarily represent the Company’s obligation to transfer additional goods or services to a customer for which the Company has received consideration, and include ExtraBucks® Rewards and unredeemed Company gift cards. The consideration received remains a contract liability until goods or services have been provided to the customer. In addition, the Company recognizes breakage on Company gift cards based on historical redemption patterns.

The following table provides information about receivables and contract liabilities from contracts with customers:
In millionsIn millionsJune 30,
2021
December 31,
2020
In millionsJune 30,
2022
December 31,
2021
Trade receivables (included in accounts receivable, net)Trade receivables (included in accounts receivable, net)$8,021 $7,101 Trade receivables (included in accounts receivable, net)$9,084 $7,932 
Contract liabilities (included in accrued expenses)Contract liabilities (included in accrued expenses)79 71 Contract liabilities (included in accrued expenses)80 87 

13


During the six months ended June 30, 20212022 and 2020,2021, the contract liabilities balance includes increases related to customers’ earnings in ExtraBucks Rewards or issuances of Company gift cards and decreases for revenues recognized during the period as a result of the redemption of ExtraBucks Rewards or Company gift cards and breakage of Company gift cards. Below is a summary of such changes:
Six Months Ended
June 30,
In millions20212020
Contract liabilities, beginning of the period$71 $73 
Rewards earnings and gift card issuances183 179 
Redemption and breakage(175)(174)
Contract liabilities, end of the period$79 $78 

Health Insurer Fee

Since January 1, 2014, the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively, the “ACA”) has imposed an annual premium-based health insurer fee (the “HIF”). The HIF, which is payable each September, is not deductible for federal income tax purposes. In December 2019, the HIF was repealed for calendar years after 2020, therefore there was 0 expense related to the HIF in the three and six months ended June 30, 2021. In the three and six months ended June 30, 2020, operating expenses included $248 million and $519 million, respectively, related to the Company’s estimated share of the 2020 HIF.
Six Months Ended
June 30,
In millions20222021
Contract liabilities, beginning of the period$87 $71 
Rewards earnings and gift card issuances175 183 
Redemption and breakage(182)(175)
Contract liabilities, end of the period$80 $79 

Related Party Transactions

The Company has an equity method investment in SureScripts, LLC (“SureScripts”), which operates a clinical health information network. The Company utilizes this clinical health information network in providing services to its client plan members and retail customers. The Company expensed fees for the use of this network of $10$16 million and $3$10 million in the three months ended June 30, 20212022 and 2020,2021, respectively, and expensed fees for the use of this network of approximately $19$31 million and $23$19 million in the six months ended June 30, 20212022 and 2020,2021, respectively. The Company’s investment in and equity in the earnings of SureScripts for all periods presented is immaterial.

The Company has an equity method investment in Heartland Healthcare Services, LLC (“Heartland”). Heartland operates several LTC pharmacies in 4 states. Heartland paid the Company $19$23 million and $22$19 million for pharmaceutical inventory purchases during the three months ended June 30, 20212022 and 2020,2021, respectively, and $37$44 million and $43$37 million for pharmaceutical inventory purchases during the six months ended June 30, 20212022 and 2020,2021, respectively. Additionally, the Company performs certain collection functions for Heartland and then transfers those customer cash collections to Heartland. The Company’s investment in and equity in the earnings of Heartland for all periods presented is immaterial.

New Accounting Pronouncements Recently Adopted

Simplifying the Accounting for Income Taxes
In December 2019, the Financial Accounting Standards Board (“FASB”) issued ASU 2019-12, Simplifying the Accounting for Income Taxes (Topic 740). This standard simplifies the accounting for income taxes by eliminating certain exceptions to the guidance in Accounting Standards Codification (“ASC”) 740 related to the approach for intraperiod tax allocation, the methodology for calculating income taxes in an interim period and the recognition of deferred tax liabilities for outside basis differences. The standard also simplifies aspects of the accounting for franchise taxes and enacted changes in tax laws or rates and clarifies the accounting for transactions that result in a step-up in the tax basis of goodwill. The Company adopted this new accounting standard on January 1, 2021. The adoption of this standard did not have a material impact on the Company’s consolidated operating results, cash flows, financial condition or related disclosures.

New Accounting Pronouncements Not Yet Adopted

Targeted Improvements to the Accounting for Long-Duration Insurance Contracts
In August 2018, the FASBFinancial Accounting Standards Board issued ASUAccounting Standards Update 2018-12, Targeted Improvements to the Accounting for Long-Duration Contracts (Topic 944). This standard requires the Company to review cash flow assumptions for its long-duration insurance contracts at least annually and recognize the effect of changes in future cash flow assumptions in net income. This standard also requires the Company to update discount rate assumptions quarterly and recognize the effect of changes in these assumptions in other
14


comprehensive income. The rate used to discount the Company’s liability for future policy benefits will be based on an estimate of the yield for an upper-medium grade fixed-income instrument with a duration profile matching that of the Company’s liabilities. In addition, this standard changes the amortization method for deferred acquisition costs and requires additional disclosures regarding the long duration insurance contract liabilities in the Company’s interim and annual financial statements. The standard is effective for public companies for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2022. The Company will adopt the new standard on January 1, 2023, using the modified retrospective transition method as of the earliest period presented for changes to the liability for future policy benefits and deferred acquisition costs. While the Company is still evaluating the impact of the new standard on its financial statements, the Company anticipates an increase to its liability for future policy benefits with a corresponding change in accumulated other comprehensive income as a result of updating the rate used to discount the liabilities to reflect the yield for an upper-medium grade fixed-income instrument compared to the Company’s expected investment yield under the existing guidance.

1514


2.Divestitures and Asset Sales

Divestiture of PayFlex
2.
On June 1, 2022, the Company sold PayFlex for approximately $775 million. PayFlex provides services to employers, their employees, and their former employees in the areas of tax-advantaged account reimbursement administration (flexible spending, health reimbursement, health savings, transit and parking), Consolidated Omnibus Budget Reconciliation Act (“COBRA”) administration and special-member billing administration. The results of this business have historically been reported within the Health Care Benefits segment. The Company recorded a pre-tax gain on the divestiture of $225 million in the three and six months ended June 30, 2022, which is reflected as a reduction in operating expenses in the Company’s unaudited condensed consolidated statements of operations within the Health Care Benefits segment.

Divestiture of Thailand Health Care Business

In March 2022, the Company reached an agreement to sell its international health care business domiciled in Thailand (“Thailand business”), comprised of approximately 266,000 medical members, which was included in the Commercial Business reporting unit within the Health Care Benefits segment. At that time, a portion of the Commercial Business goodwill was specifically allocated to the Thailand business. The net assets of the Thailand business were accounted for as assets held for sale at March 31, 2022. The carrying value of the Thailand business was determined to be greater than its fair value and, accordingly, the Company recorded a $41 million loss on assets held for sale within the Health Care Benefits segment during the first quarter of 2022. The sale closed in the second quarter of 2022, and the consideration received and ultimate loss on the sale were not material.

International Health Care Benefits Renewal Rights Asset Sale

In May 2022, the Company sold the renewal rights of approximately 200,000 international medical members outside of the Americas, Thailand and India in connection with an Asset Purchase Agreement. As part of this agreement, the Company will introduce and help migrate these existing international medical members to the purchaser upon renewal. The Company expects the migration process to occur over a 16-month period between July 2022 and October 2023. The Company expects to cease writing any new or renewal business for international medical members outside of the Americas after October 31, 2022. The consideration received related to this agreement was not material.
15


3.Investments

Total investments at June 30, 20212022 and December 31, 20202021 were as follows:
June 30, 2021December 31, 2020 June 30, 2022December 31, 2021
In millionsIn millionsCurrentLong-termTotalCurrentLong-termTotalIn millionsCurrentLong-termTotalCurrentLong-termTotal
Debt securities available for saleDebt securities available for sale$2,878 $19,468 $22,346 $2,774 $18,414 $21,188 Debt securities available for sale$2,775 $17,976 $20,751 $3,009 $20,231 $23,240 
Mortgage loansMortgage loans128 848 976 226 821 1,047 Mortgage loans88 905 993 58 844 902 
Other investmentsOther investments1,820 1,820 1,577 1,577 Other investments14 2,243 2,257 50 1,950 2,000 
Total investmentsTotal investments$3,006 $22,136 $25,142 $3,000 $20,812 $23,812 Total investments$2,877 $21,124 $24,001 $3,117 $23,025 $26,142 

Debt Securities

Debt securities available for sale at June 30, 20212022 and December 31, 20202021 were as follows:
In millionsIn millions
Amortized
 Cost (1)
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Fair
Value
In millionsGross
Amortized
Cost
Allowance
for Credit
Losses
Net
Amortized
 Cost
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Fair
Value
June 30, 2021
June 30, 2022June 30, 2022
Debt securities:Debt securities:  Debt securities:    
U.S. government securitiesU.S. government securities$2,320 $91 $(1)$2,410 U.S. government securities$2,194 $— $2,194 $$(118)$2,078 
States, municipalities and political subdivisionsStates, municipalities and political subdivisions2,978 168 (2)3,144 States, municipalities and political subdivisions2,472 — 2,472 11 (110)2,373 
U.S. corporate securitiesU.S. corporate securities8,754 822 (14)9,562 U.S. corporate securities9,910 — 9,910 29 (740)9,199 
Foreign securitiesForeign securities2,652 247 (6)2,893 Foreign securities2,857 (8)2,849 18 (236)2,631 
Residential mortgage-backed securitiesResidential mortgage-backed securities812 20 (3)829 Residential mortgage-backed securities808 — 808 — (61)747 
Commercial mortgage-backed securitiesCommercial mortgage-backed securities1,023 63 (5)1,081 Commercial mortgage-backed securities1,222 — 1,222 — (114)1,108 
Other asset-backed securitiesOther asset-backed securities2,372 26 (1)2,397 Other asset-backed securities2,721 — 2,721 (135)2,591 
Redeemable preferred securitiesRedeemable preferred securities27 30 Redeemable preferred securities25 — 25 — (1)24 
Total debt securities (2)
$20,938 $1,440 $(32)$22,346 
Total debt securities (1)
Total debt securities (1)
$22,209 $(8)$22,201 $65 $(1,515)$20,751 
December 31, 2020
December 31, 2021December 31, 2021
Debt securities:Debt securities:Debt securities:
U.S. government securitiesU.S. government securities$2,341 $128 $$2,469 U.S. government securities$2,349 $— $2,349 $70 $(3)$2,416 
States, municipalities and political subdivisionsStates, municipalities and political subdivisions2,556 172 2,728 States, municipalities and political subdivisions2,947 — 2,947 148 (4)3,091 
U.S. corporate securitiesU.S. corporate securities7,879 1,023 (8)8,894 U.S. corporate securities9,093 — 9,093 682 (40)9,735 
Foreign securitiesForeign securities2,595 324 (1)2,918 Foreign securities2,821 — 2,821 196 (24)2,993 
Residential mortgage-backed securitiesResidential mortgage-backed securities673 32 705 Residential mortgage-backed securities870 — 870 15 (10)875 
Commercial mortgage-backed securitiesCommercial mortgage-backed securities962 84 1,046 Commercial mortgage-backed securities1,278 — 1,278 44 (12)1,310 
Other asset-backed securitiesOther asset-backed securities2,369 36 (2)2,403 Other asset-backed securities2,791 — 2,791 14 (13)2,792 
Redeemable preferred securitiesRedeemable preferred securities21 25 Redeemable preferred securities25 — 25 — 28 
Total debt securities (2)
$19,396 $1,803 $(11)$21,188 
Total debt securities (1)
Total debt securities (1)
$22,174 $— $22,174 $1,172 $(106)$23,240 

(1)There was 0 allowance for expected credit losses recorded on available-for-sale debt securities at June 30, 2021 or December 31, 2020.
(2)Investment risks associated with the Company’s experience-rated products generally do not impact the Company’s consolidated operating results. At June 30, 2022, debt securities with a fair value of $658 million, gross unrealized capital gains of $5 million and gross unrealized capital losses of $39 million and at December 31, 2021, debt securities with a fair value of $886$864 million, gross unrealized capital gains of $110$94 million and gross unrealized capital losses of $1$2 million and at December 31, 2020, debt securities with a fair value of $919 million, gross unrealized capital gains of $135 million and 0 gross unrealized capital losses were included in total debt securities, but support experience-rated products. Changes in net unrealized capital gains (losses) on these securities are not reflected in accumulated other comprehensive income.income (loss).
16



The net amortized cost and fair value of debt securities at June 30, 20212022 are shown below by contractual maturity. Actual maturities may differ from contractual maturities because securities may be restructured, called or prepaid, or the Company intends to sell a security prior to maturity.
In millionsIn millionsAmortized
Cost
Fair
Value
In millionsNet
Amortized
Cost
Fair
Value
Due to mature:Due to mature: Due to mature: 
Less than one yearLess than one year$1,168 $1,183 Less than one year$1,221 $1,221 
One year through five yearsOne year through five years7,095 7,397 One year through five years6,807 6,503 
After five years through ten yearsAfter five years through ten years4,418 4,682 After five years through ten years5,031 4,559 
Greater than ten yearsGreater than ten years4,050 4,777 Greater than ten years4,391 4,022 
Residential mortgage-backed securitiesResidential mortgage-backed securities812 829 Residential mortgage-backed securities808 747 
Commercial mortgage-backed securitiesCommercial mortgage-backed securities1,023 1,081 Commercial mortgage-backed securities1,222 1,108 
Other asset-backed securitiesOther asset-backed securities2,372 2,397 Other asset-backed securities2,721 2,591 
TotalTotal$20,938 $22,346 Total$22,201 $20,751 
17


Summarized below are the debt securities the Company held at June 30, 20212022 and December 31, 20202021 that were in an unrealized capital loss position, aggregated by the length of time the investments have been in that position:
Less than 12 monthsGreater than 12 monthsTotalLess than 12 monthsGreater than 12 monthsTotal
In millions, except number of securitiesIn millions, except number of securitiesNumber
of
Securities
Fair
Value
Unrealized
Losses
Number
of
Securities
Fair
Value
Unrealized
Losses
Number
of
Securities
Fair
Value
Unrealized
Losses
In millions, except number of securitiesNumber
of
Securities
Fair
Value
Unrealized
Losses
Number
of
Securities
Fair
Value
Unrealized
Losses
Number
of
Securities
Fair
Value
Unrealized
Losses
June 30, 2021  
June 30, 2022June 30, 2022  
Debt securities:Debt securities:  Debt securities:  
U.S. government securitiesU.S. government securities15 $76 $$$15 $76 $U.S. government securities464 $1,616 $115 12 $58 $476 $1,674 $118 
States, municipalities and political subdivisionsStates, municipalities and political subdivisions146 302 147 306 States, municipalities and political subdivisions875 1,372 104 27 55 902 1,427 110 
U.S. corporate securitiesU.S. corporate securities807 1,125 13 815 1,134 14 U.S. corporate securities5,583 6,989 674 364 508 66 5,947 7,497 740 
Foreign securitiesForeign securities237 374 239 376 Foreign securities1,304 1,872 206 119 172 30 1,423 2,044 236 
Residential mortgage-backed securitiesResidential mortgage-backed securities100 398 105 398 Residential mortgage-backed securities388 644 50 23 65 11 411 709 61 
Commercial mortgage-backed securitiesCommercial mortgage-backed securities85 241 85 241 Commercial mortgage-backed securities436 955 91 53 118 23 489 1,073 114 
Other asset-backed securitiesOther asset-backed securities272 505 24 28 296 533 Other asset-backed securities1,324 2,358 126 91 114 1,415 2,472 135 
Redeemable preferred securitiesRedeemable preferred securitiesRedeemable preferred securities10 19 — 11 22 
Total debt securitiesTotal debt securities1,663 $3,024 $31 40 $43 $1,703 $3,067 $32 Total debt securities10,384 $15,825 $1,367 690 $1,093 $148 11,074 $16,918 $1,515 
December 31, 2020  
December 31, 2021December 31, 2021  
Debt securities:Debt securities:  Debt securities:  
U.S. government securitiesU.S. government securities32 $205 $$$32 $205 $U.S. government securities43 $242 $10 $40 $53 $282 $
States, municipalities and political subdivisionsStates, municipalities and political subdivisions49 83 49 83 States, municipalities and political subdivisions233 428 13 33 246 461 
U.S. corporate securitiesU.S. corporate securities145 155 147 155 U.S. corporate securities1,610 2,296 31 165 238 1,775 2,534 40 
Foreign securitiesForeign securities41 69 46 74 Foreign securities449 747 20 57 91 506 838 24 
Residential mortgage-backed securitiesResidential mortgage-backed securities23 26 26 26 Residential mortgage-backed securities165 593 10 36 175 629 10 
Commercial mortgage-backed securitiesCommercial mortgage-backed securities22 75 22 75 Commercial mortgage-backed securities188 462 35 112 223 574 12 
Other asset-backed securitiesOther asset-backed securities156 256 49 41 205 297 Other asset-backed securities1,011 2,030 12 26 31 1,037 2,061 13 
Redeemable preferred securitiesRedeemable preferred securities— — — 
Total debt securitiesTotal debt securities468 $869 $10 59 $46 $527 $915 $11 Total debt securities3,700 $6,800 $84 317 $584 $22 4,017 $7,384 $106 

The Company reviewed the securities in the table above and concluded that they are performing assets generating investment income to support the needs of the Company’s business. In performing this review, the Company considered factors such as the quality of the investment security based on research performed by the Company’s internal credit analysts and external rating agencies and the prospects of realizing the carrying value of the security based on the investment’s current prospects for recovery. Unrealized capital losses at June 30, 20212022 were generally caused by interest rate increases and not by unfavorable changes in the credit quality associated with these securities. As of June 30, 2021,2022, the Company did not intend to sell these securities, and did not believe it was more likely than not that it would be required to sell these securities prior to the anticipated recovery of their amortized cost basis.







18


The maturity dates for debt securities in an unrealized capital loss position at June 30, 20212022 were as follows:
Supporting
experience-rated products
Supporting
remaining products
Total Supporting
experience-rated products
Supporting
remaining products
Total
In millionsIn millionsFair
Value
Unrealized
Losses
Fair
Value
Unrealized
Losses
Fair
Value
Unrealized
Losses
In millionsFair
Value
Unrealized
Losses
Fair
Value
Unrealized
Losses
Fair
Value
Unrealized
Losses
Due to mature:Due to mature:      Due to mature:      
Less than one yearLess than one year$$$23 $$23 $Less than one year$$— $438 $$445 $
One year through five yearsOne year through five years1,005 1,006 One year through five years54 5,062 320 5,116 322 
After five years through ten yearsAfter five years through ten years15 613 11 628 11 After five years through ten years151 15 3,713 471 3,864 486 
Greater than ten yearsGreater than ten years236 238 Greater than ten years196 18 3,043 374 3,239 392 
Residential mortgage-backed securitiesResidential mortgage-backed securities398 398 Residential mortgage-backed securities11 698 60 709 61 
Commercial mortgage-backed securitiesCommercial mortgage-backed securities235 241 Commercial mortgage-backed securities33 1,040 112 1,073 114 
Other asset-backed securitiesOther asset-backed securities532 533 Other asset-backed securities16 2,456 134 2,472 135 
TotalTotal$25 $$3,042 $31 $3,067 $32 Total$468 $39 $16,450 $1,476 $16,918 $1,515 

Mortgage Loans

The Company’s mortgage loans are collateralized by commercial real estate. During the three and six months ended June 30, 20212022 and 2020,2021, the Company had the following activity in its mortgage loan portfolio:
Three Months Ended
June 30,
Six Months Ended
June 30,
Three Months Ended
June 30,
Six Months Ended
June 30,
In millionsIn millions2021202020212020In millions2022202120222021
New mortgage loansNew mortgage loans$73 $16 $120 $24 New mortgage loans$121 $73 $180 $120 
Mortgage loans fully repaidMortgage loans fully repaid82 33 172 77 Mortgage loans fully repaid39 82 74 172 
Mortgage loans foreclosedMortgage loans foreclosedMortgage loans foreclosed— — — — 

The Company assesses mortgage loans on a regular basis for credit impairments, and assigns a credit quality indicator to each loan. The Company’s credit quality indicator is internally developed and categorizes each loan in its portfolio on a scale from 1 to 7. These indicators are based upon several factors, including current loan-to-value ratios, current and future property cash flow, property condition, market trends, creditworthiness of the borrower and deal structure.

Category 1 - Represents loans of superior quality.
Categories 2 to 4 - Represent loans where credit risk is minimal to acceptable; however, these loans may display some susceptibility to economic changes.
Categories 5 and 6 - Represent loans where credit risk is not substantial, but these loans warrant management’s close attention.
Category 7 - Represents loans where collections are potentially at risk; if necessary, an impairment is recorded.

19


Based on the Company’s assessments at June 30, 20212022 and December 31, 2020,2021, the amortized cost basis of the Company's mortgage loans within each credit quality indicator by year of origination was as follows:
Amortized Cost Basis by Year of OriginationAmortized Cost Basis by Year of Origination
In millions, except credit quality indicatorIn millions, except credit quality indicator20212020201920182017PriorTotalIn millions, except credit quality indicator20222021202020192018PriorTotal
June 30, 2021
June 30, 2022June 30, 2022
11$$$$$23 $30 $53 1$— $— $— $— $— $17 $17 
2 to 42 to 4118 57 88 73 71 490 897 2 to 4162 250 48 20 65 418 963 
5 and 65 and 611 18 5 and 6— — — — 10 13 
777— — — — — — — 
TotalTotal$118 $57 $88 $76 $98 $539 $976 Total$162 $250 $48 $20 $68 $445 $993 
December 31, 2020
December 31, 2021December 31, 2021
11$$$$22 $37 $59 1$— $— $— $— $28 $28 
2 to 42 to 446 96 91 124 595 952 2 to 4255 48 40 72 446 861 
5 and 65 and 629 36 5 and 6— — — 10 13 
777— — — — — — 
TotalTotal$46 $96 $94 $150 $661 $1,047 Total$255 $48 $40 $75 $484 $902 

Net Investment Income

Sources of net investment income for the three and six months ended June 30, 20212022 and 20202021 were as follows:
Three Months Ended
June 30,
Six Months Ended
June 30,
Three Months Ended
June 30,
Six Months Ended
June 30,
In millionsIn millions2021202020212020In millions2022202120222021
Debt securitiesDebt securities$160 $146 $317 $290 Debt securities$172 $160 $336 $317 
Mortgage loansMortgage loans13 15 28 30 Mortgage loans13 13 24 28 
Other investmentsOther investments112 (20)198 27 Other investments68 112 145 198 
Gross investment incomeGross investment income285 141 543 347 Gross investment income253 285 505 543 
Investment expensesInvestment expenses(9)(9)(17)(17)Investment expenses(9)(9)(18)(17)
Net investment income (excluding net realized capital gains or losses)Net investment income (excluding net realized capital gains or losses)276 132 526 330 Net investment income (excluding net realized capital gains or losses)244 276 487 526 
Net realized capital gains (1)
13 52 60 16 
Net realized capital gains (losses) (1)
Net realized capital gains (losses) (1)
(98)13 (173)60 
Net investment income (2)
Net investment income (2)
$289 $184 $586 $346 
Net investment income (2)
$146 $289 $314 $586 

(1)Net realized capital losses include yield-related impairment losses on debt securities of $30 million and are shown net of the reversal of previously recorded credit-related impairment losses on debt securities of $22 million in the three months ended June 30, 2022. Net realized capital losses include credit-related and yield-related impairment losses on debt securities of $16 million and $48 million, respectively, in the six months ended June 30, 2022. Net realized capital gains are net of yield-related impairment losses on debt securities of $2 million and $32 million, respectively, in the three and six months ended June 30, 2021. There were 0no credit-related losses on debt securities in the three and six months ended June 30, 2021. Net realized capital gains include the reversal of previously recorded credit-related impairment losses on debt securities of $42 million and yield-related impairment losses on debt securities of $1 million in the three months ended June 30, 2020. Net realized capital gains are net of credit-related and yield-related impairment losses on debt securities of $3 million and $42 million, respectively, in the six months ended June 30, 2020.
(2)Net investment income includes $9 million and $18 million for the three and six months ended June 30, 2022, respectively, and $10 million and $19 million for the three and six months ended June 30, 2021, respectively, and $10 million and $21 million for the three and six months ended June 30, 2020, respectively, related to investments supporting experience-rated products.

Excluding amounts related to experience-rated products, proceeds from the sale of available-for-sale debt securities and the related gross realized capital gains and losses for the three and six months ended June 30, 20212022 and 20202021 were as follows:
Three Months Ended
June 30,
Six Months Ended
June 30,
Three Months Ended
June 30,
Six Months Ended
June 30,
In millionsIn millions2021202020212020In millions2022202120222021
Proceeds from salesProceeds from sales$919 $1,419 $2,267 $2,142 Proceeds from sales$1,052 $919 $2,963 $2,267 
Gross realized capital gainsGross realized capital gains20 23 42 43 Gross realized capital gains20 17 42 
Gross realized capital lossesGross realized capital losses21 10 56 Gross realized capital losses72 107 10 

20


3.4.Fair Value

The preparation of the Company’s unaudited condensed consolidated financial statements in accordance with GAAP requires certain assets and liabilities to be reflected at their fair value and others to be reflected on another basis, such as an adjusted historical cost basis. The Company’s assets and liabilities carried at fair value have been classified within one of three levels of a hierarchy established by GAAP. The following are the levels of the hierarchy and a brief description of the type of valuation information (“valuation inputs”) that qualifies a financial asset or liability for each level:

Level 1 – Unadjusted quoted prices for identical assets or liabilities in active markets.
Level 2 – Valuation inputs other than Level 1 that are based on observable market data.  These include: quoted prices for similar assets in active markets, quoted prices for identical assets in inactive markets, valuation inputs that are observable that are not prices (such as interest rates and credit risks) and valuation inputs that are derived from or corroborated by observable markets.
Level 3 – Developed from unobservable data, reflecting the Company’s assumptions.

For a description of the methods and assumptions that are used to estimate the fair value and determine the fair value hierarchy classification of each class of financial instrument, see Note 4 “Fair Value” in the 20202021 Form 10-K.
21


There were 0no financial liabilities measured at fair value on a recurring basis on the unaudited condensed consolidated balance sheets at June 30, 20212022 or December 31, 2020.2021. Financial assets measured at fair value on a recurring basis on the unaudited condensed consolidated balance sheets at June 30, 20212022 and December 31, 20202021 were as follows:
In millionsIn millionsLevel 1Level 2Level 3TotalIn millionsLevel 1Level 2Level 3Total
June 30, 2021    
June 30, 2022June 30, 2022    
Cash and cash equivalentsCash and cash equivalents$3,538 $3,581 $$7,119 Cash and cash equivalents$7,335 $4,781 $— $12,116 
Debt securities:Debt securities:    Debt securities:    
U.S. government securitiesU.S. government securities2,365 45 2,410 U.S. government securities2,045 33 — 2,078 
States, municipalities and political subdivisionsStates, municipalities and political subdivisions3,144 3,144 States, municipalities and political subdivisions— 2,373 — 2,373 
U.S. corporate securitiesU.S. corporate securities9,521 41 9,562 U.S. corporate securities— 9,169 30 9,199 
Foreign securitiesForeign securities2,893 2,893 Foreign securities— 2,623 2,631 
Residential mortgage-backed securitiesResidential mortgage-backed securities829 829 Residential mortgage-backed securities— 747 — 747 
Commercial mortgage-backed securitiesCommercial mortgage-backed securities1,081 1,081 Commercial mortgage-backed securities— 1,108 — 1,108 
Other asset-backed securitiesOther asset-backed securities2,397 2,397 Other asset-backed securities— 2,591 — 2,591 
Redeemable preferred securitiesRedeemable preferred securities29 30 Redeemable preferred securities— 24 — 24 
Total debt securitiesTotal debt securities2,365 19,939 42 22,346 Total debt securities2,045 18,668 38 20,751 
Equity securitiesEquity securities30 30 60 Equity securities121 — 68 189 
TotalTotal$5,933 $23,520 $72 $29,525 Total$9,501 $23,449 $106 $33,056 
December 31, 2020    
December 31, 2021December 31, 2021    
Cash and cash equivalentsCash and cash equivalents$3,985 $3,869 $$7,854 Cash and cash equivalents$4,954 $4,454 $— $9,408 
Debt securities:Debt securities:    Debt securities:    
U.S. government securitiesU.S. government securities2,370 99 2,469 U.S. government securities2,372 44 — 2,416 
States, municipalities and political subdivisionsStates, municipalities and political subdivisions2,727 2,728 States, municipalities and political subdivisions— 3,086 3,091 
U.S. corporate securitiesU.S. corporate securities8,842 52 8,894 U.S. corporate securities— 9,697 38 9,735 
Foreign securitiesForeign securities2,918 2,918 Foreign securities— 2,983 10 2,993 
Residential mortgage-backed securitiesResidential mortgage-backed securities705 705 Residential mortgage-backed securities— 875 — 875 
Commercial mortgage-backed securitiesCommercial mortgage-backed securities1,046 1,046 Commercial mortgage-backed securities— 1,310 — 1,310 
Other asset-backed securitiesOther asset-backed securities2,403 2,403 Other asset-backed securities— 2,789 2,792 
Redeemable preferred securitiesRedeemable preferred securities24 25 Redeemable preferred securities— 28 — 28 
Total debt securitiesTotal debt securities2,370 18,764 54 21,188 Total debt securities2,372 20,812 56 23,240 
Equity securitiesEquity securities17 30 47 Equity securities114 — 55 169 
TotalTotal$6,372 $22,633 $84 $29,089 Total$7,440 $25,266 $111 $32,817 

During the three and six months ended June 30, 20212022 there were $26 million and 2020,$29 million of transfers out of Level 3. During the three and six months ended June 30, 2021, there were no transfers into or out of Level 3.

22


The carrying value and estimated fair value classified by level of fair value hierarchy for financial instruments carried on the unaudited condensed consolidated balance sheets at adjusted cost or contract value at June 30, 20212022 and December 31, 20202021 were as follows:
Carrying
Value
 Estimated Fair ValueCarrying
Value
 Estimated Fair Value
In millionsIn millionsLevel 1Level 2Level 3TotalIn millionsLevel 1Level 2Level 3Total
June 30, 2021
June 30, 2022June 30, 2022
Assets:Assets: Assets: 
Mortgage loansMortgage loans$976 $$$992 $992 Mortgage loans$993 $— $— $940 $940 
Equity securities (1)
Equity securities (1)
129 N/AN/AN/AN/A
Equity securities (1)
183 N/AN/AN/AN/A
Liabilities:Liabilities:Liabilities:
Investment contract liabilities:Investment contract liabilities:Investment contract liabilities:
With a fixed maturityWith a fixed maturityWith a fixed maturity— — 
Without a fixed maturityWithout a fixed maturity324 363 363 Without a fixed maturity333 — — 317 317 
Long-term debtLong-term debt59,354 68,364 68,364 Long-term debt54,816 51,825 — — 51,825 
December 31, 2020
December 31, 2021December 31, 2021
Assets:Assets: Assets: 
Mortgage loansMortgage loans$1,047 $$$1,070 $1,070 Mortgage loans$902 $— $— $907 $907 
Equity securities (1)
Equity securities (1)
145 N/AN/AN/AN/A
Equity securities (1)
126 N/AN/AN/AN/A
Liabilities:Liabilities:  Liabilities:  
Investment contract liabilities:Investment contract liabilities:  Investment contract liabilities:  
With a fixed maturityWith a fixed maturityWith a fixed maturity— — 
Without a fixed maturityWithout a fixed maturity322 371 371 Without a fixed maturity336 — — 373 373 
Long-term debtLong-term debt64,647 75,940 75,940 Long-term debt56,176 64,157 — — 64,157 

(1)It was not practical to estimate the fair value of these cost-method investments as it represents shares of unlisted companies.

Separate Accounts assets relate to the Company’s large case pensions products which represent funds maintained to meet specific objectives of contract holders. Since contract holders bear the investment risk of these assets, a corresponding Separate Accounts liability has been established equal to the assets. These assets and liabilities are carried at fair value. Separate Accounts financial assets as of June 30, 20212022 and December 31, 20202021 were as follows:
June 30, 2021December 31, 2020 June 30, 2022December 31, 2021
In millionsIn millionsLevel 1Level 2Level 3TotalLevel 1Level 2Level 3TotalIn millionsLevel 1Level 2Level 3TotalLevel 1Level 2Level 3Total
Cash and cash equivalentsCash and cash equivalents$$227 $$229 $$186 $$188 Cash and cash equivalents$$178 $— $182 $$186 $— $188 
Debt securitiesDebt securities1,075 2,961 4,036 1,465 2,634 4,099 Debt securities913 2,535 — 3,448 1,233 3,048 — 4,281 
Equity securitiesEquity securitiesEquity securities— — — — 
Common/collective trustsCommon/collective trusts513 513 563 563 Common/collective trusts— 421 — 421 — 547 — 547 
Total (1)
Total (1)
$1,077 $3,703 $$4,780 $1,467 $3,385 $$4,852 
Total (1)
$917 $3,135 $— $4,052 $1,235 $3,782 $— $5,017 

(1)Excludes $100$88 million and $29$70 million of other receivables at June 30, 20212022 and December 31, 2020,2021, respectively.

23


4.5.Health Care Costs Payable

The following table shows the components of the change in health care costs payable during the six months ended June 30, 20212022 and 2020:2021:
Six Months Ended
June 30,
Six Months Ended
June 30,
In millionsIn millions20212020In millions20222021
Health care costs payable, beginning of the periodHealth care costs payable, beginning of the period$7,936 $6,879 Health care costs payable, beginning of the period$8,808 $7,936 
Less: Reinsurance recoverablesLess: Reinsurance recoverables10 Less: Reinsurance recoverables10 
Health care costs payable, beginning of the period, netHealth care costs payable, beginning of the period, net7,926 6,874 Health care costs payable, beginning of the period, net8,800 7,926 
Acquisition412 
Add: Components of incurred health care costsAdd: Components of incurred health care costsAdd: Components of incurred health care costs
Current year Current year32,183 26,390  Current year35,960 32,183 
Prior years Prior years(709)(420) Prior years(666)(709)
Total incurred health care costs (1)
Total incurred health care costs (1)
31,474 25,970 
Total incurred health care costs (1)
35,294 31,474 
Less: Claims paidLess: Claims paidLess: Claims paid
Current year Current year24,600 20,223  Current year26,971 24,600 
Prior years Prior years6,409 5,704  Prior years6,732 6,409 
Total claims paidTotal claims paid31,009 25,927 Total claims paid33,703 31,009 
Add: Premium deficiency reserveAdd: Premium deficiency reserve29 Add: Premium deficiency reserve
Health care costs payable, end of the period, netHealth care costs payable, end of the period, net8,396 7,358 Health care costs payable, end of the period, net10,396 8,396 
Add: Reinsurance recoverablesAdd: Reinsurance recoverables18 Add: Reinsurance recoverables18 
Health care costs payable, end of the periodHealth care costs payable, end of the period$8,414 $7,362 Health care costs payable, end of the period$10,400 $8,414 

(1)Total incurred health care costs for the six months ended June 30, 20212022 and 20202021 in the table above exclude (i) $5 million and $29$5 million, respectively, related to afor premium deficiency reservereserves related to the Company’s Medicaid products, (ii) $27$37 million and $20$27 million, respectively, of benefit costs recorded in the Health Care Benefits segment that are included in other insurance liabilities on the Company’s unaudited condensed consolidated balance sheets and (iii) $99$221 million and $119$99 million, respectively, of benefit costs recorded in the Corporate/Other segment that are included in other insurance liabilities on the Company’s unaudited condensed consolidated balance sheets.

The Company’s estimates of prior years’ health care costs payable decreased by $709$666 million and $420$709 million, respectively, in the six months ended June 30, 20212022 and 2020,2021, because claims were settled for amounts less than originally estimated (i.e., the amount of claims incurred was lower than originally estimated), primarily due to lower health care cost trends as well as the actual claim submission time being faster than originally assumed (i.e., the Company’s completion factors were higher than originally assumed) in estimating health care costs payable at the end of the prior year.

At June 30, 2021,2022, the Company’s liabilities for the ultimate cost of (i) services rendered to the Company’s Insured members but not yet reported to the Company and (ii) claims which have been reported to the Company but not yet paid (collectively, “IBNR”) plus expected development on reported claims totaled approximately $6.4$8.0 billion. Substantially all of the Company’s liabilities for IBNR plus expected development on reported claims at June 30, 20212022 related to the current year.
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6.Borrowings

The following table is a summary of the Company’s borrowings at June 30, 2022 and December 31, 2021:
In millionsJune 30,
2022
December 31,
2021
Long-term debt
3.5% senior notes due July 2022$— $1,500 
2.75% senior notes due November 20221,000 1,000 
2.75% senior notes due December 20221,250 1,250 
4.75% senior notes due December 2022399 399 
2.8% senior notes due June 20231,300 1,300 
4% senior notes due December 2023414 414 
3.375% senior notes due August 2024650 650 
2.625% senior notes due August 20241,000 1,000 
3.5% senior notes due November 2024750 750 
5% senior notes due December 2024299 299 
4.1% senior notes due March 2025950 950 
3.875% senior notes due July 20252,828 2,828 
2.875% senior notes due June 20261,750 1,750 
3% senior notes due August 2026750 750 
3.625% senior notes due April 2027750 750 
6.25% senior notes due June 2027372 372 
1.3% senior notes due August 20272,250 2,250 
4.3% senior notes due March 20285,000 5,000 
3.25% senior notes due August 20291,750 1,750 
3.75% senior notes due April 20301,500 1,500 
1.75% senior notes due August 20301,250 1,250 
1.875% senior notes due February 20311,250 1,250 
2.125% senior notes due September 20311,000 1,000 
4.875% senior notes due July 2035652 652 
6.625% senior notes due June 2036771 771 
6.75% senior notes due December 2037533 533 
4.78% senior notes due March 20385,000 5,000 
6.125% senior notes due September 2039447 447 
4.125% senior notes due April 20401,000 1,000 
2.7% senior notes due August 20401,250 1,250 
5.75% senior notes due May 2041133 133 
4.5% senior notes due May 2042500 500 
4.125% senior notes due November 2042500 500 
5.3% senior notes due December 2043750 750 
4.75% senior notes due March 2044375 375 
5.125% senior notes due July 20453,500 3,500 
3.875% senior notes due August 20471,000 1,000 
5.05% senior notes due March 20488,000 8,000 
4.25% senior notes due April 2050750 750 
Finance lease liabilities1,407 1,300 
Other316 320 
Total debt principal55,346 56,743 
Debt premiums210 219 
Debt discounts and deferred financing costs(740)(786)
54,816 56,176 
Less:
Current portion of long-term debt(4,019)(4,205)
Long-term debt$50,797 $51,971 
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Long-term Borrowings

In May 2022, the Company exercised the par call option on its outstanding 3.5% senior notes due July 2022 and redeemed for cash on hand the entire $1.5 billion aggregate principal amount.

On July 15, 2022, the Company announced that it will exercise the par call option on its outstanding 2.75% senior notes due November 2022 (issued by Aetna Inc.) and will redeem for cash on hand the entire $1.0 billion aggregate principal amount. The redemption is expected to occur on or about August 15, 2022.

On August 2, 2022, the Company announced that it will exercise the par call options on its outstanding 2.75% senior notes due December 2022 and 4.75% senior notes due December 2022 (including the unexchanged notes issued by Omnicare, Inc.) and will redeem for cash on hand the entire $1.25 billion and $399 million aggregate principal amounts, respectively. The redemptions are expected to occur on or about September 1, 2022.

5.7.Shareholders’ Equity

Share Repurchases

On November 2, 2016,The following share repurchase program has been authorized by CVS Health’sHealth Corporation’s Board of Directors (the “Board”) authorized the 2016 share repurchase program (“2016 Repurchase Program”) for up to $15.0 billion of the Company’s common shares. :
In billions
Authorization Date
AuthorizedRemaining as of
June 30, 2022
December 9, 2021 (“2021 Repurchase Program”)$10.0 $8.0 

The 20162021 Repurchase Program permits the Company to effect repurchases from time to time through a combination of open market repurchases, privately negotiated transactions, accelerated share repurchase (“ASR”) transactions, and/or other derivative transactions. The 20162021 Repurchase Program can be modified or terminated by the Board at any time.
 
During the six months ended June 30, 2022, the Company repurchased approximately 19.1 million shares of common stock for approximately $2.0 billion pursuant to the 2021 and 2020,Repurchase Program, including share repurchases under the ASR transaction described below. During the six months ended June 30, 2021, the Company did 0tnot repurchase any shares of its common stock. At June 30,

Pursuant to the authorization under the 2021 Repurchase Program, the Company hadentered into a $1.5 billion fixed dollar ASR with Barclays Bank PLC (“Barclays”). Upon payment of the $1.5 billion purchase price on January 4, 2022, the Company received a number of shares of CVS Health Corporation’s common stock equal to 80% of the $1.5 billion notional amount of the ASR or approximately 11.6 million shares at a price of $103.34 per share, which were placed into treasury stock in January 2022. The ASR was accounted for as an initial treasury stock transaction for $1.2 billion and a forward contract for $0.3 billion. The forward contract was classified as an equity instrument and was recorded within capital surplus. In February 2022, the Company received approximately 2.7 million shares of CVS Health Corporation’s common stock, representing the remaining authorization20% of the $1.5 billion notional amount of the ASR, thereby concluding the ASR. These shares were placed into treasury stock and the forward contract was reclassified from capital surplus to repurchasetreasury stock in February 2022.

At the time they were received, the initial and final receipt of shares resulted in an aggregateimmediate reduction of upthe outstanding shares used to approximately $13.9 billion of itscalculate the weighted average common shares under the 2016 Repurchase Program.outstanding for basic and diluted earnings per share.

Dividends

The quarterly cash dividend declared by the Board was $0.55 and $0.50 per share in each of the three-month periodsthree months ended June 30, 2022 and 2021, and 2020.respectively. Cash dividends declared by the Board were $1.10 and $1.00 per share in each of the six-month periodssix months ended June 30, 2022 and 2021, and 2020.respectively. CVS Health Corporation has paid cash dividends every quarter since becoming a public company. Future dividend payments will depend on the Company’s earnings, capital requirements, financial condition and other factors considered relevant by the Board.
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6.8.Other Comprehensive Income
Shareholders’ equity included the following activity in accumulated other comprehensive income (loss) for the three and six months ended June 30, 20212022 and 2020:2021:
Three Months Ended
June 30,
Six Months Ended
June 30,
Three Months Ended
June 30,
Six Months Ended
June 30,
In millionsIn millions2021202020212020In millions2022202120222021
Net unrealized investment gains (losses):Net unrealized investment gains (losses):Net unrealized investment gains (losses):
Beginning of period balanceBeginning of period balance$828 $463 $1,214 $774 Beginning of period balance$(377)$828 $778 $1,214 
Other comprehensive income (loss) before reclassifications ($214, $681, $(273), $195 pretax)
164 560 (236)166 
Amounts reclassified from accumulated other comprehensive income ($(18), $(44), $(1), $57 pretax) (1)
(15)(36)(1)47 
Other comprehensive income (loss) before reclassifications ($(1,105), $214, $(2,510), $(273) pretax)
Other comprehensive income (loss) before reclassifications ($(1,105), $214, $(2,510), $(273) pretax)
(868)164 (2,098)(236)
Amounts reclassified from accumulated other comprehensive income (loss) ($77, $(18), $154, $(1) pretax) (1)
Amounts reclassified from accumulated other comprehensive income (loss) ($77, $(18), $154, $(1) pretax) (1)
55 (15)130 (1)
Other comprehensive income (loss)Other comprehensive income (loss)149 524 (237)213 Other comprehensive income (loss)(813)149 (1,968)(237)
End of period balanceEnd of period balance977 987 977 987 End of period balance(1,190)977 (1,190)977 
Foreign currency translation adjustments:Foreign currency translation adjustments:Foreign currency translation adjustments:
Beginning of period balanceBeginning of period balance(8)Beginning of period balance— 
Other comprehensive income (loss) before reclassificationsOther comprehensive income (loss) before reclassifications(1)(6)Other comprehensive income (loss) before reclassifications(1)(1)
Other comprehensive income (loss)Other comprehensive income (loss)(1)(6)Other comprehensive income (loss)(1)(1)
End of period balanceEnd of period balance(2)(2)End of period balance
Net cash flow hedges:Net cash flow hedges:Net cash flow hedges:
Beginning of period balanceBeginning of period balance244 270 248 279 Beginning of period balance219 244 222 248 
Other comprehensive loss before reclassifications ($0, $0, $0, $(7) pretax)
(5)
Amounts reclassified from accumulated other comprehensive income ($(4), $(4), $(9), $(10) pretax) (2)
(3)(3)(7)(7)
Other comprehensive loss(3)(3)(7)(12)
Other comprehensive income before reclassifications ($24, $0, $24, $0 pretax)
Other comprehensive income before reclassifications ($24, $0, $24, $0 pretax)
18 — 18 — 
Amounts reclassified from accumulated other comprehensive income ($(4), $(4), $(8), $(9) pretax) (2)
Amounts reclassified from accumulated other comprehensive income ($(4), $(4), $(8), $(9) pretax) (2)
(3)(3)(6)(7)
Other comprehensive income (loss)Other comprehensive income (loss)15 (3)12 (7)
End of period balanceEnd of period balance241 267 241 267 End of period balance234 241 234 241 
Pension and other postretirement benefits:Pension and other postretirement benefits:Pension and other postretirement benefits:
Beginning of period balanceBeginning of period balance(55)(38)(55)(38)Beginning of period balance(35)(55)(35)(55)
Other comprehensive loss before reclassifications ($0, $(8), $0, and $(8) pretax)
(6)(6)
Amounts reclassified from accumulated other comprehensive loss ($1, $7, $1 and $7 pretax) (3)
Other comprehensive income (loss)(1)(1)
Amounts reclassified from accumulated other comprehensive loss ($1, $1, $1, $1 pretax) (3)
Amounts reclassified from accumulated other comprehensive loss ($1, $1, $1, $1 pretax) (3)
Other comprehensive incomeOther comprehensive income
End of period balanceEnd of period balance(54)(39)(54)(39)End of period balance(34)(54)(34)(54)
Total beginning of period accumulated other comprehensive income1,022 687 1,414 1,019 
Total beginning of period accumulated other comprehensive income (loss)Total beginning of period accumulated other comprehensive income (loss)(190)1,022 965 1,414 
Total other comprehensive income (loss)Total other comprehensive income (loss)148 526 (244)194 Total other comprehensive income (loss)(798)148 (1,953)(244)
Total end of period accumulated other comprehensive income$1,170 $1,213 $1,170 $1,213 
Total end of period accumulated other comprehensive income (loss)Total end of period accumulated other comprehensive income (loss)$(988)$1,170 $(988)$1,170 

(1)Amounts reclassified from accumulated other comprehensive income (loss) for specifically identified debt securities are included in net investment income in the unaudited condensed consolidated statements of operations.
(2)Amounts reclassified from accumulated other comprehensive income for specifically identified cash flow hedges are included in interest expense in the unaudited condensed consolidated statements of operations. The Company expects to reclassify approximately $13$11 million, net of tax, in net gains associated with its cash flow hedges into net income within the next 12 months.
(3)Amounts reclassified from accumulated other comprehensive loss for specifically identified pension and other postretirement benefits are included in other income in the unaudited condensed consolidated statements of operations.




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7.9.Earnings Per Share

Earnings per share is computed using the two-classtreasury stock method. Stock options and stock appreciation rights to purchase 4 million and 3 million shares of common stock were outstanding, but were excluded from the calculation of diluted earnings per share for the three and six months ended June 30, 2022, respectively, because their exercise prices were greater than the average market price of the common shares and, therefore, the effect would be antidilutive. For the same reason, stock options and stock appreciation rights to purchase 8 million and 9 million shares of common stock were outstanding, but were excluded from the calculation of diluted earnings per share for the three and six months ended June 30, 2021, respectively, because their exercise prices were greater than the average market price of the common shares and, therefore, the effect would be antidilutive. For the same reason, stock appreciation rights and options to purchase 17 million and 15 million shares of common stock were outstanding, but were excluded from the calculation of diluted earnings per share for the three and six months ended June 30, 2020, respectively.

The following is a reconciliation of basic and diluted earnings per share for the respective periods:
Three Months Ended
June 30,
Six Months Ended
June 30,
Three Months Ended
June 30,
Six Months Ended
June 30,
In millions, except per share amountsIn millions, except per share amounts2021202020212020In millions, except per share amounts2022202120222021
Numerator for earnings per share calculation:Numerator for earnings per share calculation:Numerator for earnings per share calculation:
Net income attributable to CVS HealthNet income attributable to CVS Health$2,783 $2,975 $5,006 $4,982 Net income attributable to CVS Health$2,951 $2,783 $5,263 $5,006 
Denominator for earnings per share calculation:Denominator for earnings per share calculation:Denominator for earnings per share calculation:
Weighted average shares, basicWeighted average shares, basic1,319 1,309 1,316 1,307 Weighted average shares, basic1,313 1,319 1,312 1,316 
Effect of dilutive securities
Restricted stock units and performance stock unitsRestricted stock units and performance stock units
Stock options and stock appreciation rightsStock options and stock appreciation rights
Weighted average shares, dilutedWeighted average shares, diluted1,327 1,314 1,325 1,313 Weighted average shares, diluted1,321 1,327 1,325 1,325 
Earnings per share:Earnings per share:Earnings per share:
BasicBasic$2.11 $2.27 $3.80 $3.81 Basic$2.25 $2.11 $4.01 $3.80 
DilutedDiluted$2.10 $2.26 $3.78 $3.79 Diluted$2.23 $2.10 $3.97 $3.78 

8.10.Commitments and Contingencies

COVID-19

The COVID-19 pandemic continues to evolve. We believeThe Company believes COVID-19’s impact on ourits businesses, operating results, cash flows and/or financial condition primarily will be driven by the geographies impacted and the severity and duration of the pandemic; the pandemic’s impact on the U.S. and global economies and consumer behavior and health care utilization patterns; and the timing, scope and impact of stimulus legislation as well as other federal, state and local governmental responses to the pandemic. Those primary drivers are beyond ourthe Company’s knowledge and control. As a result, the impact COVID-19 will have on ourthe Company’s businesses, operating results, cash flows and/or financial condition is uncertain, but the impact could be adverse and material. COVID-19 also may result in legal and regulatory proceedings, investigations and claims against us.the Company.

Lease Guarantees

Between 1995 and 1997, the Company sold or spun off a number of subsidiaries, including Bob’s Stores and Linens ‘n Things, each of which subsequently filed for bankruptcy, and Marshalls. In many cases, when a former subsidiary leased a store, the Company provided a guarantee of the former subsidiary’s lease obligations for the initial lease term and any extension thereof pursuant to a renewal option provided for in the lease prior to the time of the disposition. When the subsidiaries were disposed of and accounted for as discontinued operations, the Company’s guarantees remained in place, although each initial purchaser agreed to indemnify the Company for any lease obligations the Company was required to satisfy. If any of the purchasers or any of the former subsidiaries fail to make the required payments under a store lease, the Company could be required to satisfy those obligations, and any significant adverse impact of COVID-19 on such purchasers and/or former subsidiaries increases the risk that the Company will be required to satisfy those obligations. As of June 30, 2021,2022, the Company guaranteed 7368 such store leases (excluding the lease guarantees related to Linens ‘n Things, which have been recorded as a liability on the unaudited condensed consolidated balance sheets), with the maximum remaining lease term extending through 2030.
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Guaranty Fund Assessments, Market Stabilization and Other Non-Voluntary Risk Sharing Pools

Under guaranty fund laws existing in all states, insurers doing business in those states can be assessed (in most states up to prescribed limits) for certain obligations of insolvent insurance companies to policyholders and claimants. The life and health
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insurance guaranty associations in which the Company participates that operate under these laws respond to insolvencies of long-term care insurers and life insurers as well as health insurers. The Company’s assessments generally are based on a formula relating to the Company’s health care premiums in the state compared to the premiums of other insurers. Certain states allow assessments to be recovered over time as offsets to premium taxes. Some states have similar laws relating to HMOs and/or other payors such as not-for-profit consumer-governed health plans established under the ACA.Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010.

In 2009, the Pennsylvania Insurance Commissioner placed long-term care insurer Penn Treaty Network America Insurance Company and one of its subsidiaries (collectively, “Penn Treaty”) in rehabilitation, an intermediate action before insolvency, and subsequently petitioned a state court to convert the rehabilitation into a liquidation. Penn Treaty was placed in liquidation in March 2017. The Company has recorded a liability for its estimated share of future assessments by applicable life and health insurance guaranty associations. It is reasonably possible that in the future the Company may record a liability and expense relating to other insolvencies which could have a material adverse effect on the Company’s operating results, financial condition and cash flows, and the risk is heightened by any significant adverse impact of the COVID-19 pandemic on the solvency of other insurers, including long-term care and life insurers. While historically the Company has ultimately recovered more than half of guaranty fund assessments through statutorily permitted premium tax offsets, significant increases in assessments could lead to legislative and/or regulatory actions that limit future offsets.

HMOs in certain states in which the Company does business are subject to assessments, including market stabilization and other risk-sharing pools, for which the Company is assessed charges based on incurred claims, demographic membership mix and other factors. The Company establishes liabilities for these assessments based on applicable laws and regulations. In certain states, the ultimate assessments the Company pays are dependent upon the Company’s experience relative to other entities subject to the assessment, and the ultimate liability is not known at the financial statement date. While the ultimate amount of the assessment is dependent upon the experience of all pool participants, the Company believes it has adequate reserves to cover such assessments.

Litigation and Regulatory Proceedings

The Company has been involved or is currently involved in numerous legal proceedings, including litigation, arbitration, government investigations, audits, reviews and claims. These include routine, regular and special investigations, audits and reviews by the U.S. Centers for Medicare & Medicaid Services (“CMS”), state insurance and health and welfare departments, the U.S. Department of Justice (the “DOJ”), state attorneys general, the U.S. Drug Enforcement Administration (the “DEA”), the Federal Trade Commission (the “FTC”) and other governmental authorities.

Legal proceedings, in general, and securities, class action and multi-district litigation, in particular, and governmental special investigations, audits and reviews can be expensive and disruptive. Some of the litigation matters may purport or be determined to be class actions and/or involve parties seeking large and/or indeterminate amounts, including punitive or exemplary damages, and may remain unresolved for several years. The Company also may be named from time to time in qui tam actions initiated by private third parties that could also be separately pursued by a governmental body. The results of legal proceedings, including government investigations, are often uncertain and difficult to predict, and the costs incurred in these matters can be substantial, regardless of the outcome.

The Company records accruals for outstanding legal matters when it believes it is probable that a loss will be incurred and the amount can be reasonably estimated. The Company evaluates, on a quarterly basis, developments in legal matters that could affect the amount of any accrual and developments that would make a loss contingency both probable and reasonably estimable. If a loss contingency is not both probable and reasonably estimable, the Company does not establish an accrued liability. None of the Company’s accruals for outstanding legal matters are material individually or in the aggregate to the Company’s financial condition.

Except as otherwise noted, the Company cannot predict with certainty the timing or outcome of the legal matters described below, and the Company is unable to reasonably estimate a possible loss or range of possible loss in excess of amounts already accrued for these matters. The Company believes that its defenses and assertions in pending legal proceedings have merit and does not believe that any of these pending matters, after consideration of applicable reserves and rights to indemnification, will
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have a material adverse effect on the Company’s financial position. Substantial unanticipated verdicts, fines and rulings, however, do sometimes occur, which could result in judgments against the Company, entry into settlements or a revision to its expectations regarding the outcome of certain matters, and such developments could have a material adverse effect on its results of operations. In addition, as a result of governmental investigations or proceedings, the Company may be subject to damages, civil or criminal fines or penalties, or other sanctions including possible suspension or loss of licensure and/or exclusion from participating in government programs. The outcome of such governmental investigations of proceedings could be material to the Company.
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Usual and Customary Pricing Litigation

The Company and certain current and former directors and officers are named as a defendant in a number of lawsuits that allege that the Company’s retail pharmacies overcharged for prescription drugs by not submitting the correct usual and customary price during the claims adjudication process. These actions are brought by a number of different types of plaintiffs, including plan members, private payors, government payors, and shareholders based on different legal theories. Some of these cases are brought as putative class actions, and in some instances, classes have been certified. The Company is defending itself against these claims.

PBM Litigation and Investigations

The Company is named as a defendant in a number of lawsuits and is subject to a number of investigations concerning its PBM practices.

The Company is facing multiple lawsuits, including by a State Attorney General, governmental subdivisions and several putative class actions, regarding drug pricing and its rebate arrangements with drug manufacturers. These complaints, brought by a number of different types of plaintiffs under a variety of legal theories, generally allege that rebate agreements between the drug manufacturers and PBMs caused inflated prices for certain drug products. The Company is defending itself against these claims. The Company has also received subpoenas, civil investigative demands (“CIDs”) and other requests for documents and information from, and is being investigated by, the FTC and Attorneys General of several states and the District of Columbia regarding its PBM practices, including pricing and rebates. The Company has been providing documents and information in response to these subpoenas, CIDs and requests for information.

United States ex rel. Behnke v. CVS Caremark Corporation, et al. (U.S. District Court for the Eastern District of Pennsylvania). In April 2018, the Court unsealed a complaint filed in February 2014. The government has declined to intervene in this case. The relator alleges that the Company submitted, or caused to be submitted, to Part D of the Medicare program Prescription Drug Event data and/or Direct and Indirect Remuneration reports that misrepresented true prices paid by the Company’s PBM to pharmacies for drugs dispensed to Part D beneficiaries with prescription benefits administered by the Company’s PBM. The Company is defending itself against these claims.

Controlled Substances Litigation, Audits and Subpoenas

In December 2017, the U.S. Judicial Panel on Multidistrict Litigation consolidated numerous cases filed against various defendants by plaintiffs such as counties, cities, hospitals, Indian tribes and third-party payors, alleging claims generally concerning the impacts of widespread prescription opioid abuse. The consolidated multidistrict litigation captioned In re National Prescription Opiate Litigation (MDL No. 2804) is pending in the U.S. District Court for the Northern District of Ohio. This multidistrict litigation presumptively includes hundreds of relevant federal court cases that name the Company as a defendant. A significant number of similar cases that name the Company as a defendant in some capacity are pending in state courts.

In addition, the Company has been named as a defendant in similar cases brought by certain state Attorneys General. The Company is defending itself against all such claims. Additionally, the Company has received subpoenas, CIDs and/or other requests for information regarding opioids from state Attorneys General and insurance and other regulators of several U.S. jurisdictions. The Company has been cooperating with the government with respect to these subpoenas, CIDs and other requests for information.In JuneNovember 2021, priorthe Company was among the chain pharmacies found liable by a jury in a trial in federal court in Ohio; the remedy pursuant to that verdict has not been determined and the startCompany plans to appeal.

In March 2022, CVS Health Corporation and CVS Pharmacy, Inc. entered into a settlement agreement with the State of Florida to resolve claims related to opioid medications dating back more than a decade. Under the terms of the New Yorksettlement agreement, CVS Health Corporation settled all opioid claims against it and its subsidiaries by the State Court bellwether trial,of Florida for $484 million, which is
30


to be paid over a period of 18 years. During the three months ended March 31, 2022, the Company reachedrecorded a settlement$484 million liability associated with Nassau and Suffolk Counties for an immaterial amount.this legal settlement.

In January 2020, the U.S. Department of Justice (the “DOJ”)DOJ served the Company with a DEA administrative subpoena. The subpoena seeks documents relating to practices with respect to prescription opioids and other controlled substances at CVS Pharmacypharmacy locations in connection with an investigation concerning potential violations of the federal Controlled Substances Act and the federal False Claims Act. In January 2022, the DOJ served the Company with a CID regarding similar subjects. The Company has beenis providing documents and information in response to this subpoena.these matters.

Prescription Processing Litigation and Investigations

The Company is named as a defendant in a number of lawsuits and is subject to a number of investigations concerning its prescription processing practices, including the following:

U.S. ex rel. Bassan et al. v. Omnicare, Inc. and CVS Health Corp. (U.S. District Court for the Southern District of New York). In December 2019, the U.S. Attorney’s Office for the Southern District of New York (the “SDNY”) filed a complaint-in-
29


interventioncomplaint-in-intervention in this previously sealed qui tam case. The complaint alleges that for certain non-skilled nursing facilities, Omnicare improperly filled prescriptions beyond one year where a valid prescription did not exist and that these dispensing events violated the federal False Claims Act. The Company is defending itself against these claims.

U.S. ex rel. Gill et al. v. CVS Health Corp. et al. (U.S. District Court for the Northern District of Illinois). In July 2022, the Delaware Attorney General’s Office moved for partial intervention as to allegations under the Delaware false claims act related to not escheating alleged overpayments in this previously sealed qui tam case. The federal government and the remaining states declined to intervene on other additional theories in the relator’s complaint. The Company is defending itself against all of the claims.

In July 2017, the Company also received a subpoena from the California Department of Insurance requesting documents concerning the Company’s Omnicare pharmacies’ cycle fill process for assisted living facilities. The Company has been cooperating with the California Department of Insurance and providing documents and information in response to this subpoena.

In December 2016, the Company received a CID from the U.S. Attorney’s Office for the Northern District of New York requesting documents and information in connection with a federal False Claims Act investigation concerning whether the Company’s retail pharmacies improperly submitted certain insulin claims to Part D of the Medicare program rather than Part B of the Medicare program. The Company has been cooperating with the government and providing documents and information in response to this CID.

Provider Proceedings

The Company is named as a defendant in purported class actions and individual lawsuits arising out of its practices related to the payment of claims for services rendered to its members by providers with whom the Company has a contract and with whom the Company does not have a contract (“out-of-network providers”). Among other things, these lawsuits allege that the Company paid too little to its health plan members and/or providers for out-of-network services (including COVID-19 testing) and/or otherwise allege that the Company failed to timely or appropriately pay or administer out-of-network claims and benefits (including the Company’s post payment audit and collection practices and reductions in payments to providers due to sequestration). Other major health insurers are the subject of similar litigation or have settled similar litigation.

The Company also has received subpoenas and/or requests for documents and other information from, and been investigated by, state Attorneys General and other state and/or federal regulators, legislators and agencies relating to, and the Company is involved in other litigation regarding, its out-of-network benefit payment and administration practices. It is reasonably possible that others could initiate additional litigation or additional regulatory action against the Company with respect to its out-of-network benefit payment and/or administration practices.

CMS Actions

CMS regularly audits the Company’s performance to determine its compliance with CMS’s regulations and its contracts with CMS and to assess the quality of services it provides to Medicare beneficiaries. CMS uses various payment mechanisms to allocate and adjust premium payments to the Company’s and other companies’ Medicare plans by considering the applicable
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health status of Medicare members as supported by information prepared, maintained and provided by providers. The Company collects claim and encounter data from providers and generally relies on providers to appropriately code their submissions to the Company and document their medical records, including the diagnosis data submitted to the Company with claims. CMS pays increased premiums to Medicare Advantage plans and Medicare PDP plans for members who have certain medical conditions identified with specific diagnosis codes. Federal regulators review and audit the providers’ medical records to determine whether those records support the related diagnosis codes that determine the members’ health status and the resulting risk-adjusted premium payments to the Company. In that regard, CMS has instituted risk adjustment data validation (“RADV”) audits of various Medicare Advantage plans, including certain of the Company’s plans, to validate coding practices and supporting medical record documentation maintained by providers and the resulting risk adjustedrisk-adjusted premium payments to the plans. CMS may require the Company to refund premium payments if the Company’s risk adjustedrisk-adjusted premiums are not properly supported by medical record data. The Office of the Inspector General of the U.S. Department of Health and Human Services (“HHS-OIG”OIG”) also is auditing the Company’s risk adjustment-related data and that of other companies. The Company expects CMS and the OIG to continue these types of audits.

In 2012, CMS revised its audit methodology for RADV audits to determine refunds payable by Medicare Advantage plans for contract year 2011 and forward. Under the revised methodology, among other things, CMS will extrapolate the error rate identified in the audit sample of approximately 200 members to all risk adjustedrisk-adjusted premium payments made under the contract being audited. For contract years prior to 2011, CMS did not extrapolate sample error rates to the entire contract. As a result, the revised methodology may increase the Company’s exposure to premium refunds to CMS based on incomplete medical records maintained by providers. Since 2013, CMS has selected certain of the Company’s Medicare Advantage contracts for various contract years for RADV audit, and the number of RADV audits continues to increase. The Company is currently unable to predict which of its Medicare Advantage contracts will be selected for future audit, the amounts of any retroactive
30


refunds of, or prospective adjustments to, Medicare Advantage premium payments made to the Company, the effect of any such refunds or adjustments on the actuarial soundness of the Company’s Medicare Advantage bids, or whether any RADV audit findings would require the Company to change its method of estimating future premium revenue in future bid submissions to CMS or compromise premium assumptions made in the Company’s bids for prior contract years, the current contract year or future contract years. Any premium or fee refunds or adjustments resulting from regulatory audits, whether as a result of RADV, Public Exchange related or other audits by CMS, HHS-OIGthe OIG or otherwise, including audits of the Company’s minimum medical loss ratio (“MLR”) rebates, methodology and/or reports, could be material and could adversely affect the Company’s operating results, cash flows and/or financial condition.

Medicare and Medicaid CIDs

The Company has received CIDs from the Civil Division of the DOJ in connection with a current investigation of the Company’s patient chart review processes in connection with risk adjustment data submissions under Parts C and D of the Medicare program. The Company has been cooperating with the government and providing documents and information in response to these CIDs.

In May 2017, the Company received a CID from the SDNY requesting documents and information concerning possible false claims submitted to Medicare in connection with reimbursements for prescription drugs under the Medicare Part D program. The Company has been cooperating with the government and providing documents and information in response to this CID.

In April 2020, the Company received a CID from the Office of the Washington Attorney General, Medicaid Fraud Control Division, on behalf of the State of Washington and all other states, as well as the District of Columbia, Puerto Rico and the U.S. Virgin Islands. The investigation involved, among other things, possible retention of overpayments and possible submission of false claims for Medicaid reimbursement relating to drugs prescribed by providers who were excluded by the applicable federal and/or state Medicaid programs. In June 2021, the government withdrew this CID and indicated that no further action is required from the Company with respect to the April 2020 CID.

Stockholder Matters

Beginning in February 2019, multiple class action complaints, as well as a derivative complaint, were filed by putative plaintiffs against the Company and certain current and former officers and directors. The plaintiffs in these cases assert a variety of causes of action under federal securities laws that are premised on allegations that the defendants made certain omissions and misrepresentations relating to the performance of the Company’s LTC business unit. The Company and its current and former officers and directors are defending themselves against these claims. Since filing, several of the cases have been consolidated, and the first-filed federal case, City of Miami Fire Fighters’ and Police Officers’ Retirement Trust, et al. (formerly known as Anarkat), was dismissed with prejudice in February 2021. Plaintiffs filed a notice of appeal withhave appealed that decision to the First Circuit after their motion for reconsideration was denied. The Company has moved to dismiss the other federal case, In re CVS Health Corp. Securities Act Litigation (formerly known as Waterford). and In March 2021, the New York Supreme Court, Appellate Division (First Department) dismissed the consolidated Labourers’ Pension Fund of Central & Eastern Canadare CVS Health Corp. Securities Litigation case; plaintiffs’ motion for reargument was denied(formerly known as City of Warren and this matter is now concluded.Freundlich) have been stayed pending the outcome of the First Circuit appeal.

In August and September 2020, 2 ERISA class actions under the Employee Retirement Income Security Act of 1974 (“ERISA”)were filed in the U.S. District Court for the District of Connecticut against CVS Health, Aetna Inc. (“Aetna”), and several current and former executives, directors and/or members of Aetna’s Compensation and Talent Management Committee:
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Radcliffe v. Aetna Inc., et al. and Flaim v. Aetna Inc., et al. The plaintiffs in these cases assert a variety of causes of action premised on allegations that the defendants breached fiduciary duties and engaged in prohibited transactions relating to participants in the Aetna 401(k) Plan’s investment in company stock between December 3, 2017 and February 20, 2019, claiming losses related to the performance of the Company’s LTC business unit. The district court consolidated the actions, and in October 2021, dismissed the consolidated action without prejudice. Plaintiffs filed an amended consolidated complaint, which the Company is defending itself against these claims.has moved to dismiss. The Company also received a related document request pursuant to ERISA § 104(b), to which the Company has responded. The Company and its current and former officers and directors are defending themselves against these claims.

In December 2021, the Company received a demand for inspection of books and records pursuant to Delaware Corporation Law Section 220 (the “Demand”). The Demand purports to be related to potential breaches of fiduciary duties by the Board in relation to certain matters concerning opioids.

Other Legal and Regulatory Proceedings

The Company is also a party to other legal proceedings and is subject to government investigations, inquiries and audits and has received and is cooperating with the government in response to CIDs, subpoenas or similar process from various governmental agencies requesting information. These other legal proceedings and government actions include claims of or relating to bad faith, medical or professional malpractice, breach of fiduciary duty, claims processing, dispensing of medications, non-compliance with state and federal regulatory regimes, marketing misconduct, denial of or failure to timely or appropriately pay or administer claims and benefits, provider network structure (including the use of performance-based networks and termination of provider contracts), rescission of insurance coverage, improper disclosure or use of personal information, anticompetitive practices, general contractual matters,
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product liability, intellectual property litigation and employment litigation. Some of these other legal proceedings are or are purported to be class actions or derivative claims. The Company is defending itself against the claims brought in these matters.

Awards to the Company and others of certain government contracts, particularly Medicaid contracts and other contracts with government customers in the Company’s Health Care Benefits segment, frequently are subject to protests by unsuccessful bidders. These protests may result in awards to the Company being reversed, delayed or modified. The loss or delay in implementation of any government contract could adversely affect the Company’s operating results. The Company will continue to defend contract awards it receives.

There also continues to be a heightened level of review and/or audit by regulatory authorities and legislators of, and increased litigation regarding, the Company’s and the rest of the health care and related benefits industry’s business and reporting practices, including premium rate increases, utilization management, development and application of medical policies, complaint, grievance and appeal processing, information privacy, provider network structure (including provider network adequacy, the use of performance-based networks and termination of provider contracts), provider directory accuracy, calculation of minimum medical loss ratios and/or payment of related rebates, delegated arrangements, rescission of insurance coverage, limited benefit health products, student health products, pharmacy benefit management practices (including manufacturers’ rebates, pricing, the use of narrow networks and the placement of drugs in formulary tiers), sales practices, customer service practices, vendor oversight and claim payment practices (including payments to out-of-network providers).

As a leading national health caresolutions company, the Company regularly is the subject of government actions of the types described above. These government actions may prevent or delay the Company from implementing planned premium rate increases and may result, and have resulted, in restrictions on the Company’s businesses, changes to or clarifications of the Company’s business practices, retroactive adjustments to premiums, refunds or other payments to members, beneficiaries, states or the federal government, withholding of premium payments to the Company by government agencies, assessments of damages, civil or criminal fines or penalties, or other sanctions, including the possible suspension or loss of licensure and/or suspension or exclusion from participation in government programs.

The Company can give no assurance that its businesses, financial condition, operating results and/or cash flows will not be materially adversely affected, or that the Company will not be required to materially change its business practices, based on: (i) future enactment of new health care or other laws or regulations; (ii) the interpretation or application of existing laws or regulations as they may relate to one or more of the Company’s businesses, one or more of the industries in which the Company competes and/or the health care industry generally; (iii) pending or future federal or state government investigations of one or more of the Company’s businesses, one or more of the industries in which the Company competes and/or the health care industry generally; (iv) pending or future government audits, investigations or enforcement actions against the Company; (v) adverse developments in any pending qui tam lawsuit against the Company, whether sealed or unsealed, or in any future qui
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tam lawsuit that may be filed against the Company; or (vi) adverse developments in pending or future legal proceedings against the Company or affecting one or more of the industries in which the Company competes and/or the health care industry generally.

9.11.Segment Reporting

The Company has 3 operating segments, Health Care Benefits, Pharmacy Services and Retail/LTC, as well as a Corporate/Other segment. The Company’s segments maintain separate financial information, and the Company’s chief operating decision maker (the “CODM”) evaluates the segments’ operating results on a regular basis in deciding how to allocate resources among the segments and in assessing segment performance. The CODM evaluates the performance of the Company’s segments based on adjusted operating income, which is defined as operating income (GAAP measure) excluding the impact of amortization of intangible assets and other items, if any, that neither relate to the ordinary course of the Company’s business nor reflect the Company’s underlying business performance. See the reconciliations of consolidated operating income (GAAP measure) to consolidated adjusted operating income below for further context regarding the items excluded from operating income in determining adjusted operating income. The Company uses adjusted operating income as its principal measure of segment performance as it enhances the Company’s ability to compare past financial performance with current performance and analyze underlying business performance and trends. Non-GAAP financial measures the Company discloses, such as consolidated adjusted operating income, should not be considered a substitute for, or superior to, financial measures determined or calculated in accordance with GAAP.


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The following is a reconciliation of financial measures of the Company’s segments to the consolidated totals:
In millionsIn millionsHealth Care
Benefits
Pharmacy 
Services (1)
Retail/
LTC
Corporate/
Other
Intersegment
Eliminations (2)
Consolidated
Totals
In millionsHealth Care
Benefits
Pharmacy 
Services (1)
Retail/
LTC
Corporate/
Other
Intersegment
Eliminations (2)
Consolidated
Totals
Three Months EndedThree Months EndedThree Months Ended
June 30, 2022June 30, 2022
Revenues from external customersRevenues from external customers$22,645 $39,859 $17,952 $34 $— $80,490 
Intersegment revenuesIntersegment revenues23 2,953 8,352 — (11,328)— 
Net investment income (loss)Net investment income (loss)88 — (18)76 — 146 
Total revenuesTotal revenues22,756 42,812 26,286 110 (11,328)80,636 
Adjusted operating income (loss)Adjusted operating income (loss)1,831 1,855 1,862 (555)(183)4,810 
June 30, 2021June 30, 2021June 30, 2021
Revenues from external customersRevenues from external customers$20,367 $35,745 $16,185 $30 $— $72,327 Revenues from external customers$20,367 $35,745 $16,185 $30 $— $72,327 
Intersegment revenuesIntersegment revenues21 2,569 8,543 — (11,133)— Intersegment revenues21 2,569 8,543 — (11,133)— 
Net investment incomeNet investment income137 152 289 Net investment income137 — — 152 — 289 
Total revenuesTotal revenues20,525 38,314 24,728 182 (11,133)72,616 Total revenues20,525 38,314 24,728 182 (11,133)72,616 
Adjusted operating income (loss)Adjusted operating income (loss)1,614 1,755 2,049 (369)(162)4,887 Adjusted operating income (loss)1,614 1,755 2,049 (369)(162)4,887 
June 30, 2020
Six Months EndedSix Months Ended
June 30, 2022June 30, 2022
Revenues from external customersRevenues from external customers$18,318 $32,623 $14,187 $29 $— $65,157 Revenues from external customers$45,642 $76,055 $35,386 $65 $— $157,148 
Intersegment revenuesIntersegment revenues23 2,266 7,475 — (9,764)— Intersegment revenues46 6,218 16,352 — (22,616)— 
Net investment income127 57 184 
Net investment income (loss)Net investment income (loss)177 — (34)171 — 314 
Total revenuesTotal revenues18,468 34,889 21,662 86 (9,764)65,341 Total revenues45,865 82,273 51,704 236 (22,616)157,462 
Adjusted operating income (loss)Adjusted operating income (loss)3,464 1,327 1,057 (343)(177)5,328 Adjusted operating income (loss)3,582 3,491 3,467 (860)(387)9,293 
Six Months Ended
June 30, 2021June 30, 2021June 30, 2021
Revenues from external customersRevenues from external customers$40,682 $69,058 $31,325 $62 $— $141,127 Revenues from external customers$40,682 $69,058 $31,325 $62 $— $141,127 
Intersegment revenuesIntersegment revenues41 5,577 16,631 — (22,249)— Intersegment revenues41 5,577 16,631 — (22,249)— 
Net investment incomeNet investment income285 46 255 586 Net investment income285 — 46 255 — 586 
Total revenuesTotal revenues41,008 74,635 48,002 317 (22,249)141,713 Total revenues41,008 74,635 48,002 317 (22,249)141,713 
Adjusted operating income (loss)Adjusted operating income (loss)3,396 3,262 3,443 (672)(337)9,092 Adjusted operating income (loss)3,396 3,262 3,443 (672)(337)9,092 
June 30, 2020
Revenues from external customers$37,415 $64,741 $29,544 $50 $— $131,750 
Intersegment revenues31 5,131 14,867 — (20,029)— 
Net investment income220 126 346 
Total revenues37,666 69,872 44,411 176 (20,029)132,096 
Adjusted operating income (loss)4,955 2,508 2,959 (628)(353)9,441 

(1)Total revenues of the Pharmacy Services segment include approximately $2.8$3.1 billion and $2.6$2.8 billion of retail co-payments for the three months ended June 30, 20212022 and 2020,2021, respectively, and $6.2$6.9 billion and $6.0$6.2 billion of retail co-payments for the six months ended June 30, 20212022 and 2020,2021, respectively.
(2)Intersegment revenue eliminations relate to intersegment revenue generating activities that occur between the Health Care Benefits segment, the Pharmacy Services segment, and/or the Retail/LTC segment. Intersegment adjusted operating income eliminations occur when members of Pharmacy Services Segment clients (“PSS members”) enrolled in Maintenance Choice® elect to pick up maintenance prescriptions at one of the Company’s retail pharmacies instead of receiving them through the mail. When this occurs, both the Pharmacy Services and Retail/LTC segments record the adjusted operating income on a stand-alone basis.


33
35


The following are reconciliations of consolidated operating income to adjusted operating income for the three and six months ended June 30, 20212022 and 2020:2021:
Three Months Ended
June 30,
Six Months Ended
June 30,
Three Months Ended
June 30,
Six Months Ended
June 30,
In millionsIn millions2021202020212020In millions2022202120222021
Operating income (GAAP measure)Operating income (GAAP measure)$4,326 $4,680 $7,903 $8,138 Operating income (GAAP measure)$4,569 $4,326 $8,059 $7,903 
Amortization of intangible assets (1)
Amortization of intangible assets (1)
582 578 1,169 1,164 
Amortization of intangible assets (1)
466 582 934 1,169 
Acquisition-related integration costs (2)
40 70 81 139 
Acquisition purchase price adjustment outside of measurement period (3)
(61)(61)
Gain on divestiture of subsidiary (2)
Gain on divestiture of subsidiary (2)
(225)— (225)— 
Legal settlement (3)
Legal settlement (3)
— — 484 — 
Loss on assets held for sale (4)
Loss on assets held for sale (4)
— — 41 — 
Acquisition-related integration costs (5)
Acquisition-related integration costs (5)
— 40 — 81 
Acquisition purchase price adjustment outside of measurement period (6)
Acquisition purchase price adjustment outside of measurement period (6)
— (61)— (61)
Adjusted operating incomeAdjusted operating income$4,887 $5,328 $9,092 $9,441 Adjusted operating income$4,810 $4,887 $9,293 $9,092 

(1)The Company’s acquisition activities have resulted in the recognition of intangible assets as required under the acquisition method of accounting which consist primarily of trademarks, customer contracts/relationships, covenants not to compete, technology, provider networks and value of business acquired. Definite-lived intangible assets are amortized over their estimated useful lives and are tested for impairment when events indicate that the carrying value may not be recoverable. The amortization of intangible assets is reflected in the Company’s unaudited GAAP condensed consolidated statements of operations in operating expenses within each segment. Although intangible assets contribute to the Company’s revenue generation, the amortization of intangible assets does not directly relate to the underwriting of the Company’s insurance products, the services performed for the Company’s customers or the sale of the Company’s products or services. Additionally, intangible asset amortization expense typically fluctuates based on the size and timing of the Company’s acquisition activity. Accordingly, the Company believes excluding the amortization of intangible assets enhances the Company’s and investors’ ability to compare the Company’s past financial performance with its current performance and to analyze underlying business performance and trends. Intangible asset amortization excluded from the related non-GAAP financial measure represents the entire amount recorded within the Company’s GAAP financial statements, and the revenue generated by the associated intangible assets has not been excluded from the related non-GAAP financial measure. Intangible asset amortization is excluded from the related non-GAAP financial measure because the amortization, unlike the related revenue, is not affected by operations of any particular period unless an intangible asset becomes impaired or the estimated useful life of an intangible asset is revised.
(2)During the three and six months ended June 30, 20212022, the gain on divestiture of subsidiary represents the pre-tax gain on the sale of PayFlex, which the Company sold on June 1, 2022, for approximately $775 million. The gain on divestiture is reflected as a reduction in operating expenses in the Company’s unaudited condensed consolidated statements of operations within the Health Care Benefits segment.
(3)During the six months ended June 30, 2022, the legal settlement relates to the agreement with the State of Florida, entered into in March 2022, to resolve claims dating back more than a decade related to opioid medications. Under this agreement, CVS Health Corporation settled all opioid claims against it and 2020,its subsidiaries by the State of Florida for $484 million, inclusive of certain legal fees, to be paid over a period of 18 years. The legal settlement is reflected in the unaudited condensed consolidated statement of operations in operating expenses within the Corporate/Other segment.
(4)During the six months ended June 30, 2022, the loss on assets held for sale relates to the Commercial Business reporting unit within the Health Care Benefits segment. In March 2022, the Company reached an agreement to sell its Thailand business, which was included in the Commercial Business reporting unit. At that time, a portion of the Commercial Business goodwill was specifically allocated to the Thailand business. The net assets of the Thailand business were accounted for as assets held for sale at March 31, 2022. The carrying value of the Thailand business was determined to be greater than its fair value and a loss on assets held for sale was recorded during the first quarter of 2022. The sale closed in the second quarter of 2022, and the ultimate loss on the sale was not material. The loss on assets held for sale is reflected in the unaudited condensed consolidated statement of operations in operating expenses within the Health Care Benefits segment.
(5)During the three and six months ended June 30, 2021, acquisition-related integration costs relate to the acquisition of Aetna. The acquisition-related integration costs are reflected in the Company’s unaudited GAAP condensed consolidated statements of operations in operating expenses within the Corporate/Other segment.
(3)(6)In June 2021, the Company received $61 million related to a purchase price working capital adjustment for an acquisition completed during the first quarter of 2020. The resolution of this matter occurred subsequent to the acquisition accounting measurement period and is reflected in the Company’s unaudited GAAP condensed consolidated statements of operations for the three and six months ended June 30, 2021 as a reduction of operating expenses within the Health Care Benefits segment.


3436

Index to Condensed Consolidated Financial Statements
Report of Independent Registered Public Accounting Firm

To the Shareholders and the Board of Directors of CVS Health Corporation

Results of Review of Interim Financial Statements

We have reviewed the accompanying condensed consolidated balance sheet of CVS Health Corporation (the Company) as of June 30, 2021,2022, the related condensed consolidated statements of operations and comprehensive income for the three-month and six-month periods ended June 30, 20212022 and 2020,2021, the related condensed consolidated statements of shareholders’ equity for the three-month periods ended March 31, 20212022 and 20202021 and June 30, 20212022 and 2020,2021, the related condensed consolidated statements of cash flows for the six-month periods ended June 30, 20212022 and 2020,2021, and the related notes (collectively referred to as the “condensed consolidated interim financial statements”). Based on our reviews, we are not aware of any material modifications that should be made to the condensed consolidated interim financial statements for them to be in conformity with U.S. generally accepted accounting principles.

We have previously audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) (PCAOB), the consolidated balance sheet of the Company as of December 31, 2020,2021, the related consolidated statements of operations, comprehensive income, (loss), shareholders’ equity and cash flows for the year then ended, and the related notes (not presented herein); and in our report dated February 16, 2021,9, 2022, we expressed an unqualified audit opinion on those consolidated financial statements. In our opinion, the information set forth in the accompanying condensed consolidated balance sheet as of December 31, 2020,2021, is fairly stated, in all material respects, in relation to the consolidated balance sheet from which it has been derived.

Basis for Review Results

These financial statements are the responsibility of the Company’s management. We are a public accounting firm registered with the PCAOB and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the SEC and the PCAOB. We conducted our review in accordance with the standards of the PCAOB. A review of interim financial statements consists principally of applying analytical procedures and making inquiries of persons responsible for financial and accounting matters. It is substantially less in scope than an audit conducted in accordance with the standards of the PCAOB, the objective of which is the expression of an opinion regarding the financial statements taken as a whole. Accordingly, we do not express such an opinion.

/s/ Ernst & Young LLP

Boston, Massachusetts
August 4, 20213, 2022
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Form 10-Q Table of Contents
Item 2.   Management’s Discussion and Analysis of Financial Condition and Results of Operations (“MD&A”)

Overview of Business

CVS Health Corporation, (“CVS Health”), together with its subsidiaries (collectively, “CVS Health,” the “Company,” “we,” “our” or “us”), is a diversified health servicessolutions company united around a common purpose of helping people on their path to better health. In an increasingly connected and digital world, we are meeting people wherever they are and changing health care to meet their needs. The Company has more than 9,9009,000 retail locations, approximatelymore than 1,100 walk-in medical clinics, a leading pharmacy benefits manager with approximately 108over 110 million plan members with expanding specialty pharmacy solutions and a dedicated senior pharmacy care business serving more than one million patients per year and expanding specialty pharmacy services.year. The Company also serves an estimated 3435 million people through traditional, voluntary and consumer-directed health insurance products and related services, including expanding Medicare Advantage offerings and a leading standalone Medicare Part D prescription drug plan (“PDP”). The Company believes its innovative health care model increases access to quality care, delivers better health outcomes and lowers overall health care costs.

The Company has four reportable segments: Health Care Benefits, Pharmacy Services, Retail/LTC and Corporate/Other, which are described below.

Overview of the Health Care Benefits Segment

The Health Care Benefits segment isoperates as one of the nation’s leading diversified health care benefits providers. The Health Care Benefits segment has the information and resources to help members, in consultation with their health care professionals, make more informed decisions about their health care. The Health Care Benefits segment offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, medical management capabilities, Medicare Advantage and Medicare Supplement plans, PDPs, Medicaid health care management services, and health information technology products and services. The Health Care Benefits segment also provided workers’ compensation administrative services through its Coventry Health Care Workers’ Compensation business (“Workers’ Compensation business”) prior to the sale of this business on July 31, 2020. The Health Care Benefits segment’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers (“providers”), governmental units, government-sponsored plans, labor groups and expatriates. The Company refers to insurance products (where it assumes all or a majority of the risk for medical and dental care costs) as “Insured” and administrative services contract products (where the plan sponsor assumes all or a majority of the risk for medical and dental care costs) as “ASC.” In addition, effective January 2022, the Company entered the individual public health insurance exchanges (“Public Exchanges”) in eight states through which it sells Insured plans directly to individual consumers. The Company has submitted regulatory filings to remain on the Public Exchanges in 2023 in each of those eight states, and has submitted regulatory filings to enter the Public Exchanges in four additional states effective January 2023.

Overview of the Pharmacy Services Segment

The Pharmacy Services segment provides a full range of pharmacy benefit management (“PBM”) solutions, including plan design offerings and administration, formulary management, retail pharmacy network management services and mail order pharmacy,pharmacy. In addition, through the Pharmacy Services segment, the Company provides specialty pharmacy and infusion services, clinical services, disease management services, medical spend management and pharmacy and/or other administrative services for providers and federal 340B drug pricing program covered entities (“Covered Entities.Entities”). The Company operates a group purchasing organization that negotiates pricing for the purchase of pharmaceuticals and rebates with pharmaceutical manufacturers on behalf of its participants. The Company also provides various administrative, management and reporting services to pharmaceutical manufacturers. The Pharmacy Services segment’s clients are primarily employers, insurance companies, unions, government employee groups, health plans, PDPs, Medicaid managed care plans, plans offered on public health insurance exchangesPublic Exchanges and private health insurance exchanges, other sponsors of health benefit plans throughout the United States and Covered Entities. The Pharmacy Services segment operates retail specialty pharmacy stores, specialty mail order pharmacies, mail order dispensing pharmacies, compounding pharmacies and branches for infusion and enteral nutrition services.

Overview of the Retail/LTC Segment

The Retail/LTC segment sells prescription drugs and a wide assortment of health and wellness products and general merchandise, provides health care services through its MinuteClinic® walk-in medical clinics, provides medical diagnostic testing, administers vaccinations for illnesses such as influenza, coronavirus disease 2019 (“COVID-19”) and shingles and conducts long-term care pharmacy (“LTC”) operations, which distribute prescription drugs and provide related pharmacy consulting and other ancillary services to long-term care facilities and other care settings. As of June 30, 2021,2022, the Retail/LTC
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segment operated more than 9,9009,000 retail locations, approximatelymore than 1,100 MinuteClinic locations as well as online retail pharmacy websites, LTC pharmacies and onsiteon-site pharmacies.



36


Overview of the Corporate/Other Segment

The Company presents the remainder of its financial results in the Corporate/Other segment, which primarily consists of:

Management and administrative expenses to support the Company’s overall operations, which include certain aspects of executive management and the corporate relations, legal, compliance, human resources, information technology and finance departments, expenses associated with the Company’s investments in its transformation and enterprise modernization programs and acquisition-related integration costs; and
Products for which the Company no longer solicits or accepts new customers such as its large case pensions and long-term care insurance products.

Overview of Current Trends

We also face trends and uncertainties specific to our reportable segments, certain of which are summarized below and also discussed in the review of our segment results. For the remainder of the year, the Company believes you should consider the following important information:

The Health Care Benefits segment is expected to continue to benefit from Medicare and Commercial membership growth, partially offset by the impact of the International Health Care Benefits Renewal Rights Asset sale as described in Note 2 ‘‘Divestitures and Asset Sales’’ to the unaudited condensed consolidated financial statements. We now expect the public health emergency to extend through the end of fiscal year 2022. The projected MBR is expected to decrease compared to 2021, reflecting pricing and a reduction in COVID-19 related medical costs. While the Company still expects a net negative impact from COVID-19 in 2022 within the Health Care Benefits segment, including the impact of the assumption that a fourth COVID-19 booster will be administered to adults aged 50 and older and to certain immunocompromised individuals as per the guidelines set forth by the CDC, the expectation is the impact will be less adverse than what was experienced in 2021.
The Pharmacy Services segment is expected to continue to benefit from the Company’s ability to drive further improvements in purchasing economics and strong pharmacy network volume. These increases are expected to be partially offset by continued client price improvements, decreased contributions from pharmacy and/or other administrative services for Covered Entities and regulation of pharmacy pricing.
The Retail/LTC segment is expected to continue to benefit from increased prescription volume and improved generic drug purchasing, partially offset by continued pharmacy reimbursement pressure and incremental operating expenses associated with the Company’s minimum wage investment. As noted above, the Company now expects the public health emergency to extend through the end of fiscal year 2022. The Company expects that COVID-19 vaccinations, including the impact of the assumption of a fourth COVID-19 booster as described above, and diagnostic testing will continue in 2022, albeit at lower levels than those experienced during 2021. The Company expects to see continued strength in front store sales, including sales of over-the-counter (“OTC”) test kits, in 2022. The extent of COVID-19 vaccinations, diagnostic testing and OTC test kit sales will be dependent upon various factors including vaccine hesitancy, the emergence of new variants, government testing initiatives and the availability and administration of pediatric and booster vaccinations.
The Company is expected to benefit from the continuation of its enterprise-wide cost savings initiatives, which aim to reduce the Company’s operating cost structure in a way that improves the consumer experience and is sustainable. Key drivers include:
Investments in digital, technology and analytics capabilities that will streamline processes and improve outcomes,
Implementing workforce and workplace strategies, and
Deploying vendor and procurement strategies.
The Company expects changes to its business environment to continue as elected and other government officials at the national and state levels continue to propose and enact significant modifications to public policy and existing laws and regulations that govern or impact the Company’s businesses.
The COVID-19 pandemic continues to impact the economies of the U.S. and other countries around the world. We believeThe Company believes COVID-19’s impact on ourits businesses, operating results, cash flows and/or financial condition primarily will be driven by the geographies impacted and the severity and duration of the pandemic, as well as the pandemic’s impact on the U.S. and global economies, global supply chain, consumer behavior, and health care utilization patterns. In addition, as described in the “Government Regulation” section of the 2020Company’s Annual Report on Form 10-K for the year ended
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December 31, 2021 (the “2021 Form 10-K”), federal, state and local governmental policies and initiatives designed to reduce the transmission of COVID-19 and emerging new variants may not effectively combat the severity and/or duration of the COVID-19 pandemic, and have resulted in a myriad of impacts on ourthe Company’s businesses. Those primary drivers are beyond ourthe Company’s knowledge and control. As a result, the impact COVID-19 will have on ourthe Company’s businesses, operating results, cash flows and/or financial condition is uncertain, but the impact could be adverse and material. Specific COVID-19 related impacts on

The Company’s current expectations described above are forward-looking statements. Please see the Company during“Cautionary Statement Concerning Forward-Looking Statements” in this Form 10-Q for information regarding important factors that may cause the three and six months ended June 30, 2021 and 2020 are further described below.Company’s actual results to differ from those currently projected and/or otherwise materially affect the Company.


The Health Care Benefits segment is expected to experience lower Medicare risk adjustment revenue and modestly elevated medical costs for the remainder of the year, with non-COVID-19 related utilization returning towards baseline levels and continued COVID-19 related costs, largely related to treatment, testing and the administration of the vaccine. The Company also expects to incur higher operating expenses during the fourth quarter related to investments to support future growth and readiness for the start of the 2022 plan year.
The Pharmacy Services segment is expected to continue to benefit from our ability to drive improvements in purchasing economics and growth in specialty pharmacy, albeit at a slower pace than experienced in the first half of the year, partially offset by continued price compression. We expect year-over-year growth to moderate in the remainder of the year due to operating results in the second half of 2020 reflecting the benefit of the launch of our group purchasing organization entity and specialty generic launches. The Company also expects to incur higher operating expenses during the fourth quarter related to investments to enhance operations, digital and clinical trials capabilities and readiness for the start of the 2022 plan year.
The Retail/LTC segment is expected to continue to benefit from increased prescription volume and improved generic drug purchasing, partially offset by continued pharmacy reimbursement pressure. While COVID-19 diagnostic testing and vaccinations are expected to continue for the remainder of 2021, we expect vaccinations to slow in the second half of the year. The extent of COVID-19 vaccinations and diagnostic testing will be dependent upon various factors including vaccine hesitancy, the emergence of new variants and the availability and administration of pediatric and booster vaccinations.
The Company is expected to continue to benefit from its cost savings initiatives, including ongoing digitalization and technology improvements, a reduction in non-retail real estate associated with workforce management changes and initiatives to increase productivity and operational efficiency. The Company also expects incremental investments in wages, including an increase in the minimum wage for store, warehouse and call center colleagues in support of its initiatives to retain and attract talent for its community health destinations.
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Operating Results

The following discussion explains the material changes in the Company’s operating results for the three and six months ended June 30, 20212022 and 2020,2021, and the significant developments affecting the Company’s financial condition since December 31, 2020.2021. We strongly recommend that you read our audited consolidated financial statements and notes thereto and Management’s Discussion and Analysis of Financial Condition and Results of Operations, which are included in the 20202021 Form 10-K.

Summary of Consolidated Financial Results
ChangeChange
Three Months Ended
June 30,
Six Months Ended
June 30,
Three Months Ended
June 30,
2021 vs 2020
Six Months Ended
June 30,
2021 vs 2020
Three Months Ended
June 30,
Six Months Ended
June 30,
Three Months Ended
June 30,
2022 vs 2021
Six Months Ended
June 30,
2022 vs 2021
In millionsIn millions2021202020212020$%$%In millions2022202120222021$%$%
Revenues:Revenues:Revenues:
ProductsProducts$50,525 $46,355 $97,912 $93,358 $4,170 9.0 %$4,554 4.9 %Products$56,794 $50,525 $109,316 $97,912 $6,269 12.4 %$11,404 11.6 %
PremiumsPremiums18,983 16,927 37,943 34,567 2,056 12.1 %3,376 9.8 %Premiums21,260 18,983 42,891 37,943 2,277 12.0 %4,948 13.0 %
ServicesServices2,819 1,875 5,272 3,825 944 50.3 %1,447 37.8 %Services2,436 2,819 4,941 5,272 (383)(13.6)%(331)(6.3)%
Net investment incomeNet investment income289 184 586 346 105 57.1 %240 69.4 %Net investment income146 289 314 586 (143)(49.5)%(272)(46.4)%
Total revenuesTotal revenues72,616 65,341 141,713 132,096 7,275 11.1 %9,617 7.3 %Total revenues80,636 72,616 157,462 141,713 8,020 11.0 %15,749 11.1 %
Operating costs:Operating costs:Operating costs:
Cost of products soldCost of products sold43,520 40,242 84,414 80,589 3,278 8.1 %3,825 4.7 %Cost of products sold49,290 43,520 94,799 84,414 5,770 13.3 %10,385 12.3 %
Benefit costsBenefit costs15,901 11,751 31,605 26,138 4,150 35.3 %5,467 20.9 %Benefit costs17,606 15,901 35,557 31,605 1,705 10.7 %3,952 12.5 %
Operating expensesOperating expenses8,869 8,668 17,791 17,231 201 2.3 %560 3.2 %Operating expenses9,171 8,869 19,047 17,791 302 3.4 %1,256 7.1 %
Total operating costsTotal operating costs68,290 60,661 133,810 123,958 7,629 12.6 %9,852 7.9 %Total operating costs76,067 68,290 149,403 133,810 7,777 11.4 %15,593 11.7 %
Operating incomeOperating income4,326 4,680 7,903 8,138 (354)(7.6)%(235)(2.9)%Operating income4,569 4,326 8,059 7,903 243 5.6 %156 2.0 %
Interest expenseInterest expense636 765 1,293 1,498 (129)(16.9)%(205)(13.7)%Interest expense583 636 1,169 1,293 (53)(8.3)%(124)(9.6)%
Other incomeOther income(45)(45)(95)(99)— — %4.0 %Other income(43)(45)(85)(95)4.4 %10 10.5 %
Income before income tax provisionIncome before income tax provision3,735 3,960 6,705 6,739 (225)(5.7)%(34)(0.5)%Income before income tax provision4,029 3,735 6,975 6,705 294 7.9 %270 4.0 %
Income tax provisionIncome tax provision944 974 1,690 1,741 (30)(3.1)%(51)(2.9)%Income tax provision1,068 944 1,701 1,690 124 13.1 %11 0.7 %
Net incomeNet income2,791 2,986 5,015 4,998 (195)(6.5)%17 0.3 %Net income2,961 2,791 5,274 5,015 170 6.1 %259 5.2 %
Net income attributable to noncontrolling interestsNet income attributable to noncontrolling interests(8)(11)(9)(16)27.3 %43.8 %Net income attributable to noncontrolling interests(10)(8)(11)(9)(2)(25.0)%(2)(22.2)%
Net income attributable to CVS HealthNet income attributable to CVS Health$2,783 $2,975 $5,006 $4,982 $(192)(6.5)%$24 0.5 %Net income attributable to CVS Health$2,951 $2,783 $5,263 $5,006 $168 6.0 %$257 5.1 %

Commentary - Three Months Ended June 30, 20212022 vs. 20202021

Revenues
Total revenues increased $7.3$8.0 billion, or 11.1%11.0%, in the three months ended June 30, 20212022 compared to the prior year driven by growth across all segments.
Please see “Segment Analysis” later in this report for additional information about the revenues of the Company’s segments.

Operating expenses
Operating expenses increased $201$302 million, or 2.3%3.4%, in the three months ended June 30, 20212022 compared to the prior year. The increase in operating expenses was primarily due to incremental costs associated with growth in the business including costs associated with COVID-19 vaccinations and diagnostic testing in the Retail/LTC segment. The increase was partially offset by the repealabsence of the HIF for 2021, the favorable impact of company-wide cost savings initiatives in 2021 and a $137 million gain from an anti-trust legal settlement, of which $125 million was included in the Retail/LTC segment and $12 million was included in the Pharmacy Services segment, recorded in the three months ended June 30, 2021. These increases were partially offset by a $225 million pre-tax gain on the sale of PayFlex Holdings, Inc. (“PayFlex”), which was consummated on June 1, 2022.
Operating expenses as a percentage of total revenues were 12.2%11.4% in the three months ended June 30, 2021,2022, a decrease of 11080 basis points compared to the prior year. The decrease in operating expenses as a percentage of total revenues was primarily due to the increases in total revenues described above.
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Please see “Segment Analysis” later in this report for additional information about the operating expenses of the Company’s segments.

Operating income
Operating income decreased $354increased $243 million, or 7.6%5.6%, in the three months ended June 30, 20212022 compared to the prior year primarily due to the return of more normalized utilization levelsincreases in the Health Care Benefits segment, followingincluding the $225 million pre-tax gain on the sale of PayFlex and a significant decrease in utilization during the three months ended June 30, 2020 dueamortization of intangible assets compared to the COVID-19 pandemic. The decrease in operating income in the three months ended June 30, 2021 was partially offset by increased prescription and front store volume, COVID-19 vaccinations and diagnostic testing in the Retail/LTC segmentprior year, as well as improved purchasing economics and increased pharmacy claims volume in the Pharmacy Services segment, duringpartially offset by declines in the three months ended June 30, 2021.Retail/LTC and Corporate/Other segments.
Please see “Segment Analysis” later in this report for additional information about the operating results of the Company’s segments.

Interest expense
Interest expense decreased $129$53 million, or 16.9%8.3%, in the three months ended June 30, 20212022 compared to the prior year due to lower debt in the three months ended June 30, 2021.2022. See “Liquidity and Capital Resources” later in this report for additional information.

Income tax provision
The Company’s effective income tax rate was 26.5% for the three months ended June 30, 2022 compared to 25.3% for the three months ended June 30, 2021 compared to 24.6% for the three months ended June 30, 2020.2021. The increase in the effective income tax rate was primarily due to basis differences on the sale of PayFlex in the three months ended June 30, 2021 was primarily due to the absence of the favorable impact associated with the resolution of several state and local income tax matters in the three months ended June 30, 2020, partially offset by the repeal of the non-deductible HIF for 2021.2022.

Commentary - Six Months EndedJune 30, 20212022 vs. 20202021

Revenues
Total revenues increased $9.6$15.7 billion, or 7.3%11.1%, in the six months ended June 30, 20212022 compared to the prior year driven by growth across all segments.
Please see “Segment Analysis” later in this report for additional information about the revenues of the Company’s segments.

Operating expenses
Operating expenses increased $560 million,$1.3 billion, or 3.2%7.1%, in the six months ended June 30, 20212022 compared to the prior year. The increase in operating expenses was primarily due to a $484 million pretax ($370 million after-tax) legal settlement related to the agreement with the State of Florida to settle all opioid claims against the Company and incremental costs associated with growth in the business, including costs associated with COVID-19 vaccinations and diagnostic testing in the Retail/LTC segment. The increase was partially offset by the repeal$225 million pre-tax gain on the sale of the HIF for 2021 and the favorable impact of company-wide cost savings initiatives in 2021.PayFlex.
Operating expenses as a percentage of total revenues were 12.6%12.1% in the six months ended June 30, 2021,2022, a decrease of 4050 basis points compared to the prior year. The decrease in operating expenses as a percentage of total revenues was primarily due to the increases in total revenues described above.
Please see “Segment Analysis” later in this report for additional information about the operating expenses of the Company’s segments.

Operating income
Operating income decreased $235increased $156 million, or 2.9%2.0%, in the six months ended June 30, 20212022 compared to the prior year. The decrease in operating income wasyear primarily driven by the deferral of elective procedures and other discretionary utilization in response to the COVID-19 pandemic during the six months ended June 30, 2020increases in the Health Care Benefits segment. Thesegment, including the $225 million pre-tax gain on the sale of PayFlex and a decrease was partially offset by improved purchasing economics in amortization of intangible assets compared to the prior year, as well as the Pharmacy Services segment, and COVID-19 vaccinations and diagnostic testingpartially offset by a decline in the Retail/LTCCorporate/Other segment, inincluding the six months ended June 30, 2021.legal settlement related to the Company’s agreement with the State of Florida described above.
Please see “Segment Analysis” later in this report for additional information about the operating results of the Company’s segments.

Interest expense
Interest expense decreased $205$124 million, or 13.7%9.6%, in the six months ended June 30, 20212022 compared to the prior year due to lower debt in the six months ended June 30, 2021.2022. See “Liquidity and Capital Resources” later in this report for additional information.
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Income tax provision
The Company’s effective income tax rate was 24.4% for the six months ended June 30, 2022 compared to 25.2% for the six months ended June 30, 2021 compared to 25.8% for the six months ended June 30, 2020.2021. The decrease in the effective income tax rate was primarily due to the impact of certain discrete tax
42


items concluded in the first quarter of 2022, partially offset by basis differences on the sale of PayFlex in the six months ended June 30, 2021 was primarily due to the repeal of the non-deductible HIF for 2021, partially offset by the absence of the favorable impact associated with the resolution of several state and local income tax matters in the six months ended June 30, 2020.2022.
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Segment Analysis

The following discussion of segment operating results is presented based on the Company’s reportable segments in accordance with the accounting guidance for segment reporting and is consistent with the segment disclosure in Note 911 ‘‘Segment Reporting’’ to the unaudited condensed consolidated financial statements.

The Company has three operating segments, Health Care Benefits, Pharmacy Services and Retail/LTC, as well as a Corporate/Other segment. The Company’s segments maintain separate financial information, and the Company’s chief operating decision maker (the “CODM”) evaluates the segments’ operating results on a regular basis in deciding how to allocate resources among the segments and in assessing segment performance. The CODM evaluates the performance of the Company’s segments based on adjusted operating income, which is defined as operating income (GAAP measure) excluding the impact of amortization of intangible assets and other items, if any, that neither relate to the ordinary course of the Company’s business nor reflect the Company’s underlying business performance. See the reconciliations of operating income (GAAP measure) to adjusted operating income below for further context regarding the items excluded from operating income in determining adjusted operating income. The Company uses adjusted operating income as its principal measure of segment performance as it enhances the Company’s ability to compare past financial performance with current performance and analyze underlying business performance and trends. Non-GAAP financial measures the Company discloses, such as consolidated adjusted operating income, should not be considered a substitute for, or superior to, financial measures determined or calculated in accordance with GAAP.

The following is a reconciliation of financial measures of the Company’s segments to the consolidated totals:
In millionsIn millionsHealth Care
Benefits
Pharmacy
Services (1)
Retail/
LTC
Corporate/
Other
Intersegment
Eliminations (2)
Consolidated
Totals
In millionsHealth Care
Benefits
Pharmacy
Services (1)
Retail/
LTC
Corporate/
Other
Intersegment
Eliminations (2)
Consolidated
Totals
Three Months EndedThree Months EndedThree Months Ended
June 30, 2021
June 30, 2022June 30, 2022
Total revenuesTotal revenues$20,525 $38,314 $24,728 $182 $(11,133)$72,616 Total revenues$22,756 $42,812 $26,286 $110 $(11,328)$80,636 
Adjusted operating income (loss)Adjusted operating income (loss)1,614 1,755 2,049 (369)(162)4,887 Adjusted operating income (loss)1,831 1,855 1,862 (555)(183)4,810 
June 30, 2020
June 30, 2021June 30, 2021
Total revenuesTotal revenues18,468 34,889 21,662 86 (9,764)65,341 Total revenues20,525 38,314 24,728 182 (11,133)72,616 
Adjusted operating income (loss)Adjusted operating income (loss)3,464 1,327 1,057 (343)(177)5,328 Adjusted operating income (loss)1,614 1,755 2,049 (369)(162)4,887 
Six Months EndedSix Months EndedSix Months Ended
June 30, 2022June 30, 2022
Total revenuesTotal revenues$45,865 $82,273 $51,704 $236 $(22,616)$157,462 
Adjusted operating income (loss)Adjusted operating income (loss)3,582 3,491 3,467 (860)(387)9,293 
June 30, 2021June 30, 2021June 30, 2021
Total revenuesTotal revenues$41,008 $74,635 $48,002 $317 $(22,249)$141,713 Total revenues41,008 74,635 48,002 317 (22,249)141,713 
Adjusted operating income (loss)Adjusted operating income (loss)3,396 3,262 3,443 (672)(337)9,092 Adjusted operating income (loss)3,396 3,262 3,443 (672)(337)9,092 
June 30, 2020
Total revenues37,666 69,872 44,411 176 (20,029)132,096 
Adjusted operating income (loss)4,955 2,508 2,959 (628)(353)9,441 

(1)Total revenues of the Pharmacy Services segment include approximately $2.8$3.1 billion and $2.6$2.8 billion of retail co-payments for the three months ended June 30, 20212022 and 2020,2021, respectively, and $6.2$6.9 billion and $6.0$6.2 billion of retail co-payments for the six months ended June 30, 20212022 and 2020,2021, respectively.
(2)Intersegment revenue eliminations relate to intersegment revenue generating activities that occur between the Health Care Benefits segment, the Pharmacy Services segment, and/or the Retail/LTC segment. Intersegment adjusted operating income eliminations occur when members of Pharmacy Services Segment clients (“PSS members”) enrolled in Maintenance Choice® elect to pick up maintenance prescriptions at one of the Company’s retail pharmacies instead of receiving them through the mail. When this occurs, both the Pharmacy Services and Retail/LTC segments record the adjusted operating income on a stand-alone basis.









41
44


The following are reconciliations of consolidated operating income (GAAP measure) to consolidated adjusted operating income, as well as reconciliations of segment GAAP operating income to segment adjusted operating income:
Three Months Ended June 30, 2021Three Months Ended June 30, 2022
In millionsIn millionsHealth Care
Benefits
Pharmacy
Services
Retail/
LTC
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
In millionsHealth Care
Benefits
Pharmacy
Services
Retail/
LTC
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
Operating income (loss) (GAAP measure)Operating income (loss) (GAAP measure)$1,273 $1,705 $1,919 $(409)$(162)$4,326 Operating income (loss) (GAAP measure)$1,754 $1,814 $1,740 $(556)$(183)$4,569 
Amortization of intangible assets (1)
Amortization of intangible assets (1)
402 50 130 — — 582 
Amortization of intangible assets (1)
302 41 122 — 466 
Acquisition-related integration costs (2)
— — — 40 — 40 
Acquisition purchase price adjustment outside of measurement period (3)
(61)— — — — (61)
Gain on divestiture of subsidiary (2)
Gain on divestiture of subsidiary (2)
(225)— — — — (225)
Adjusted operating income (loss)Adjusted operating income (loss)$1,614 $1,755 $2,049 $(369)$(162)$4,887 Adjusted operating income (loss)$1,831 $1,855 $1,862 $(555)$(183)$4,810 

Three Months Ended June 30, 2020Three Months Ended June 30, 2021
In millionsIn millionsHealth Care
Benefits
Pharmacy
Services
Retail/
LTC
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
In millionsHealth Care
Benefits
Pharmacy
Services
Retail/
LTC
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
Operating income (loss) (GAAP measure)Operating income (loss) (GAAP measure)$3,066 $1,271 $933 $(413)$(177)$4,680 Operating income (loss) (GAAP measure)$1,273 $1,705 $1,919 $(409)$(162)$4,326 
Amortization of intangible assets (1)
Amortization of intangible assets (1)
398 56 124 — — 578 
Amortization of intangible assets (1)
402 50 130 — — 582 
Acquisition-related integration costs (2)(3)
Acquisition-related integration costs (2)(3)
— — — 70 — 70 
Acquisition-related integration costs (2)(3)
— — — 40 — 40 
Acquisition purchase price adjustment outside of measurement period (4)
Acquisition purchase price adjustment outside of measurement period (4)
(61)— — — — (61)
Adjusted operating income (loss)Adjusted operating income (loss)$3,464 $1,327 $1,057 $(343)$(177)$5,328 Adjusted operating income (loss)$1,614 $1,755 $2,049 $(369)$(162)$4,887 

Six Months Ended June 30, 2021Six Months Ended June 30, 2022
In millionsIn millionsHealth Care
Benefits
Pharmacy
Services
Retail/
LTC
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
In millionsHealth Care
Benefits
Pharmacy
Services
Retail/
LTC
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
Operating income (loss) (GAAP measure)Operating income (loss) (GAAP measure)$2,653 $3,157 $3,184 $(754)$(337)$7,903 Operating income (loss) (GAAP measure)$3,163 $3,406 $3,223 $(1,346)$(387)$8,059 
Amortization of intangible assets (1)
Amortization of intangible assets (1)
804 105 259 — 1,169 
Amortization of intangible assets (1)
603 85 244 — 934 
Acquisition-related integration costs (2)
— — — 81 — 81 
Acquisition purchase price adjustment outside of measurement period (3)
(61)— — — — (61)
Gain on divestiture of subsidiary (2)
Gain on divestiture of subsidiary (2)
(225)— — — — (225)
Legal settlement (5)
Legal settlement (5)
— — — 484 — 484 
Loss on assets held for sale (6)
Loss on assets held for sale (6)
41 — — — — 41 
Adjusted operating income (loss)Adjusted operating income (loss)$3,396 $3,262 $3,443 $(672)$(337)$9,092 Adjusted operating income (loss)$3,582 $3,491 $3,467 $(860)$(387)$9,293 

Six Months Ended June 30, 2020Six Months Ended June 30, 2021
In millionsIn millionsHealth Care
Benefits
Pharmacy
Services
Retail/
LTC
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
In millionsHealth Care
Benefits
Pharmacy
Services
Retail/
LTC
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
Operating income (loss) (GAAP measure)Operating income (loss) (GAAP measure)$4,161 $2,385 $2,713 $(768)$(353)$8,138 Operating income (loss) (GAAP measure)$2,653 $3,157 $3,184 $(754)$(337)$7,903 
Amortization of intangible assets (1)
Amortization of intangible assets (1)
794 123 246 — 1,164 
Amortization of intangible assets (1)
804 105 259 — 1,169 
Acquisition-related integration costs (2)(3)
Acquisition-related integration costs (2)(3)
— — — 139 — 139 
Acquisition-related integration costs (2)(3)
— — — 81 — 81 
Acquisition purchase price adjustment outside of measurement period (4)
Acquisition purchase price adjustment outside of measurement period (4)
(61)— — — — (61)
Adjusted operating income (loss)Adjusted operating income (loss)$4,955 $2,508 $2,959 $(628)$(353)$9,441 Adjusted operating income (loss)$3,396 $3,262 $3,443 $(672)$(337)$9,092 

(1)The Company’s acquisition activities have resulted in the recognition of intangible assets as required under the acquisition method of accounting which consist primarily of trademarks, customer contracts/relationships, covenants not to compete, technology, provider networks and value of business acquired. Definite-lived intangible assets are amortized over their estimated useful lives and are tested for impairment when events indicate that the carrying value may not be recoverable. The amortization of intangible assets is reflected in the Company’s unaudited GAAP condensed consolidated statements of operations in operating expenses within each segment. Although intangible assets contribute to the Company’s revenue generation, the amortization of intangible assets does not directly relate to the underwriting of the Company’s insurance products, the services performed for the Company’s customers or the sale of the Company’s products or services. Additionally, intangible asset amortization expense typically fluctuates based on the size and timing of the Company’s acquisition activity. Accordingly, the Company believes excluding the amortization of intangible assets enhances the Company’s and investors’ ability to compare the Company’s past financial performance with its current performance and to analyze underlying business performance and trends. Intangible asset amortization excluded from the related non-GAAP financial measure represents the entire amount recorded within the Company’s GAAP financial statements, and the revenue generated by the associated intangible assets has not been excluded from the related non-GAAP financial
45


measure. Intangible asset amortization is excluded from the related non-GAAP financial measure because the amortization, unlike the related revenue, is not affected by operations of any particular period unless an intangible asset becomes impaired or the estimated useful life of an intangible asset is revised.
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(2)During the three and six months ended June 30, 20212022, the gain on divestiture of subsidiary represents the pre-tax gain on the sale of PayFlex, which the Company sold on June 1, 2022, for approximately $775 million. The gain on divestiture is reflected as a reduction in operating expenses in the Company’s unaudited condensed consolidated statements of operations within the Health Care Benefits segment.
(3)During the three and 2020,six months ended June 30, 2021, acquisition-related integration costs relate to the Company’s acquisition (the “Aetna Acquisition”) of Aetna Inc. (“Aetna”). The acquisition-related integration costs are reflected in the Company’s unaudited GAAP condensed consolidated statements of operations in operating expenses within the Corporate/Other segment.
(3)(4)In June 2021, the Company received $61 million related to a purchase price working capital adjustment for an acquisition completed during the first quarter of 2020. The resolution of this matter occurred subsequent to the acquisition accounting measurement period and is reflected in the Company’s unaudited GAAP condensed consolidated statements of operations for the three and six months ended June 30, 2021 as a reduction of operating expenses within the Health Care Benefits segment.
(5)During the six months ended June 30, 2022, the legal settlement relates to the agreement with the State of Florida, entered into in March 2022, to resolve claims dating back more than a decade related to opioid medications. Under this agreement, CVS Health Corporation settled all opioid claims against it and its subsidiaries by the State of Florida for $484 million, inclusive of certain legal fees, to be paid over a period of 18 years. The legal settlement is reflected in the unaudited condensed consolidated statement of operations in operating expenses within the Corporate/Other segment.
(6)During the six months ended June 30, 2022, the loss on assets held for sale relates to the Commercial Business reporting unit within the Health Care Benefits segment. In March 2022, the Company reached an agreement to sell its international health care business domiciled in Thailand (“Thailand business”), which was included in the Commercial Business reporting unit. At that time, a portion of the Commercial Business goodwill was specifically allocated to the Thailand business. The net assets of the Thailand business were accounted for as assets held for sale at March 31, 2022. The carrying value of the Thailand business was determined to be greater than its fair value and a loss on assets held for sale was recorded during the first quarter of 2022. The sale closed in the second quarter of 2022, and the ultimate loss on the sale was not material. The loss on assets held for sale is reflected in the unaudited condensed consolidated statement of operations in operating expenses within the Health Care Benefits segment.



4346


Health Care Benefits Segment

The following table summarizes the Health Care Benefits segment’s performance for the respective periods:
ChangeChange
Three Months Ended
June 30,
Six Months Ended
June 30,
Three Months Ended
June 30,
2021 vs 2020
Six Months Ended
June 30,
2021 vs 2020
Three Months Ended
June 30,
Six Months Ended
June 30,
Three Months Ended
June 30,
2022 vs 2021
Six Months Ended
June 30,
2022 vs 2021
In millions, except percentages and basis points (“bps”)In millions, except percentages and basis points (“bps”)2021202020212020$%$%In millions, except percentages and basis points (“bps”)2022202120222021$%$%
Revenues:Revenues:Revenues:
PremiumsPremiums$18,968$16,913$37,910$34,534$2,055 12.2 %$3,376 9.8 %Premiums$21,245$18,968$42,859$37,910$2,277 12.0 %$4,949 13.1 %
ServicesServices1,4201,4282,8132,912(8)(0.6)%(99)(3.4)%Services1,4231,4202,8292,8130.2 %16 0.6 %
Net investment incomeNet investment income13712728522010 7.9 %65 29.5 %Net investment income88137177285(49)(35.8)%(108)(37.9)%
Total revenuesTotal revenues20,52518,46841,00837,6662,057 11.1 %3,342 8.9 %Total revenues22,75620,52545,86541,0082,231 10.9 %4,857 11.8 %
Benefit costsBenefit costs15,95411,88431,71126,4004,070 34.2 %5,311 20.1 %Benefit costs17,61115,95435,66031,7111,657 10.4 %3,949 12.5 %
MBRMBR84.1 %70.3 %83.6 %76.4 %1,380bps720bpsMBR82.9 %84.1 %83.2 %83.6 %(120)bps(40)bps
Operating expensesOperating expenses$3,298$3,518$6,644$7,105$(220)(6.3)%$(461)(6.5)%Operating expenses$3,391$3,298$7,042$6,644$93 2.8 %$398 6.0 %
Operating expenses as a % of total revenuesOperating expenses as a % of total revenues16.1 %19.0 %16.2 %18.9 %Operating expenses as a % of total revenues14.9 %16.1 %15.4 %16.2 %
Operating incomeOperating income$1,273$3,066$2,653$4,161$(1,793)(58.5)%$(1,508)(36.2)%Operating income$1,754$1,273$3,163$2,653$481 37.8 %$510 19.2 %
Operating income as a % of total revenuesOperating income as a % of total revenues6.2 %16.6 %6.5 %11.0 %Operating income as a % of total revenues7.7 %6.2 %6.9 %6.5 %
Adjusted operating income (1)
Adjusted operating income (1)
$1,614$3,464$3,396$4,955$(1,850)(53.4)%$(1,559)(31.5)%
Adjusted operating income (1)
$1,831$1,614$3,582$3,396$217 13.4 %$186 5.5 %
Adjusted operating income as a % of total revenuesAdjusted operating income as a % of total revenues7.9 %18.8 %8.3 %13.2 %Adjusted operating income as a % of total revenues8.0 %7.9 %7.8 %8.3 %
Premium revenues (by business):Premium revenues (by business):Premium revenues (by business):
GovernmentGovernment$13,897$11,976$27,814$24,445$1,921 16.0 %$3,369 13.8 %Government$15,751$13,897$31,946$27,814$1,854 13.3 %$4,132 14.9 %
CommercialCommercial5,0714,93710,09610,089134 2.7 %0.1 %Commercial5,4945,07110,91310,096423 8.3 %817 8.1 %

(1)See “Segment Analysis” above in this report for a reconciliation of Health Care Benefits segment operating income (GAAP measure) to adjusted operating income, which represents the Company’s principal measure of segment performance.

Commentary - Three Months Ended June 30, 20212022 vs. 20202021

Revenues
Total revenues increased $2.1$2.2 billion, or 11.1%10.9%, to $20.5$22.8 billion in the three months ended June 30, 20212022 compared to the prior year primarily driven by growth in the Government Services business, partially offset by the unfavorable impact of the repeal of the HIF for 2021.across all product lines.

Medical Benefit Ratio (“MBR”)
Medical benefit ratio is calculated as benefit costs divided by premium revenues and represents the percentage of premium revenues spent on medical benefits for the Company’s Insured members. Management uses MBR to assess the underlying business performance and underwriting of its insurance products, understand variances between actual results and expected results and identify trends in period-over-period results. MBR provides management and investors with information useful in assessing the operating results of the Company’s Insured Health Care Benefits products.
The MBR increased from 70.3%decreased to 84.1%82.9% in the three months ended June 30, 20212022 compared to 84.1% in the prior year primarily driven by the deferralreflective of elective procedures and other discretionary utilizationstrong underlying performance, including higher favorable development of prior-periods’ health care cost estimates in response to the COVID-19 pandemic during the three months ended June 30, 2020 and2022 compared to the repeal of the HIF for 2021.prior year.

Operating expenses
Operating expenses in the Health Care Benefits segment include selling, general and administrative expenses and depreciation and amortization expenses.
Operating expenses decreased $220increased $93 million, or 6.3%2.8%, in the three months ended June 30, 20212022 compared to the prior year. The decrease in operating expenses wasyear primarily due to the repeal of the HIF for 2021, the impact of cost savings initiatives in the three months ended June 30, 2021 and the receipt of a $61 million purchase price working capital adjustment subsequent to the acquisition accounting measurement period related to an acquisition completed during the
44


first quarter of 2020, which was recorded as a reduction in operating expenses in the three months ended June 30, 2021. These decreases were partially offsetdriven by incrementalincreased operating expenses to support the growth across all product lines described above, as well as incremental investments in the Government Services business, described above.partially offset by the $225 million pre-tax gain on the sale of PayFlex.
47


Operating expenses as a percentage of total revenues decreased to 16.1%14.9% in the three months ended June 30, 20212022 compared to 19.0%16.1% in the prior year. The decrease in operating expenses as a percentage of total revenues was primarily due todriven by the repeal of the HIF for 2021.increases in total revenues described above.

Adjusted operating income
Adjusted operating income decreased $1.9 billion,increased $217 million, or 53.4%13.4%, in the three months ended June 30, 20212022 compared to the prior year. The decrease in adjusted operating income wasyear primarily driven by the deferralstrong underlying performance, including higher favorable development of elective procedures and other discretionary utilizationprior-periods’ health care cost estimates in response to the COVID-19 pandemic during the three months ended June 30, 2020.2022 compared to the prior year, and membership growth across all product lines. These increases were partially offset by incremental investments to support growth in the business and net realized capital losses.

Commentary - Six Months EndedJune 30, 20212022 vs. 20202021

Revenues
Total revenues increased $3.3$4.9 billion, or 8.9%11.8%, to $41.0$45.9 billion in the six months ended June 30, 20212022 compared to the prior year primarily driven by growth in the Government Services business, partially offset by the unfavorable impact of the repeal of the HIF for 2021.across all product lines.

Medical Benefit Ratio (“MBR”)
The MBR increased from 76.4%decreased slightly to 83.6%83.2% in the six months ended June 30, 20212022 compared to 83.6% in the prior year primarily driven by the deferralreflective of elective procedures and other discretionary utilization in response to the COVID-19 pandemic during the six months ended June 30, 2020 and the repeal of the HIF for 2021. These increases were partially offset by higher favorable development of prior-years’ health care cost estimates in the six months ended June 30, 2021 compared to the prior year.strong underlying performance.

Operating expenses
Operating expenses decreased $461increased $398 million, or 6.5%6.0%, in the six months ended June 30, 20212022 compared to the prior year. The decrease in operating expenses wasyear primarily due to the repeal of the HIF for 2021 and the impact of cost savings initiatives in the six months ended June 30, 2021, partially offsetdriven by incrementalincreased operating expenses to support the growth across all product lines described above, as well as incremental investments in the Government Services business, described above.partially offset by the $225 million pre-tax gain on the sale of PayFlex.
Operating expenses as a percentage of total revenues decreased to 16.2%15.4% in the six months ended June 30, 20212022 compared to 18.9%16.2% in the prior year. The decrease in operating expenses as a percentage of total revenues was primarily due todriven by the repeal of the HIF for 2021.increases in total revenues described above.

Adjusted operating income
Adjusted operating income decreased $1.6 billion,increased $186 million, or 31.5%5.5%, in the six months ended June 30, 20212022 compared to the prior year. The decrease in adjusted operating income wasyear primarily driven by the deferralnet favorable impact of elective procedures and other discretionary utilization in responseCOVID-19 compared to the COVID-19 pandemic during the six months ended June 30, 2020,prior year, membership growth across all product lines and strong underlying performance. These increases were partially offset by improved performanceincremental investments to support growth in the Government Services business.business and net realized capital losses.

The following table summarizes the Health Care Benefits segment’s medical membership for the respective periods:
June 30, 2021March 31, 2021December 31, 2020June 30, 2020June 30, 2022March 31, 2022December 31, 2021June 30, 2021
In thousandsIn thousandsInsuredASCTotalInsuredASCTotalInsuredASCTotalInsuredASCTotalIn thousandsInsuredASCTotalInsuredASCTotalInsuredASCTotalInsuredASCTotal
Medical membership:Medical membership:Medical membership:
CommercialCommercial3,183 13,541 16,724 3,201 13,584 16,785 3,258 13,644 16,902 3,298 14,179 17,477 Commercial3,158 13,835 16,993 3,285 13,924 17,209 3,258 13,530 16,788 3,183 13,541 16,724 
Medicare AdvantageMedicare Advantage2,911 — 2,911 2,874 — 2,874 2,705 — 2,705 2,651 — 2,651 Medicare Advantage3,216 — 3,216 3,169 — 3,169 2,971 — 2,971 2,911 — 2,911 
Medicare SupplementMedicare Supplement1,193 — 1,193 1,146 — 1,146 1,082 — 1,082 954 — 954 Medicare Supplement1,314 — 1,314 1,292 — 1,292 1,285 — 1,285 1,193 — 1,193 
MedicaidMedicaid2,231 451 2,682 2,184 637 2,821 2,100 623 2,723 1,918 586 2,504 Medicaid2,425 484 2,909 2,375 477 2,852 2,333 471 2,804 2,231 451 2,682 
Total medical membershipTotal medical membership9,518 13,992 23,510 9,405 14,221 23,626 9,145 14,267 23,412 8,821 14,765 23,586 Total medical membership10,113 14,319 24,432 10,121 14,401 24,522 9,847 14,001 23,848 9,518 13,992 23,510 
Supplemental membership information:Supplemental membership information:Supplemental membership information:
Medicare Prescription Drug Plan (standalone)Medicare Prescription Drug Plan (standalone)5,704 5,694 5,490 5,575 Medicare Prescription Drug Plan (standalone)6,051 6,022 5,777 5,704 

Medical Membership
Medical membership represents the number of members covered by the Company’s Insured and ASC medical products and related services at a specified point in time. Management uses this metric to understand variances between actual medical
45


membership and expected amounts as well as trends in period-over-period results. This metric provides management and investors with information useful in understanding the impact of medical membership on segment total revenues and operating results.
48


Medical membership as of June 30, 20212022 of 23.524.4 million decreased 116,00090,000 members compared with March 31, 2021,2022, primarily reflecting declinesdue to the decrease of approximately 266,000 members in Medicaid and Commercial products, partially offset by an increase in Medicare products. The decline in Medicaid membership reflectsconnection with the lossdivestiture of a large ASC customerthe Company’s Thailand business during the three months ended June 30, 2021.second quarter of 2022. Excluding the impact of this divestiture, membership increased across all product lines compared with March 31, 2022.
Medical membership as of June 30, 20212022 of 23.524.4 million decreased 76,000increased 922,000 members compared with June 30, 2020 primarily2021, reflecting a decline in Commercial products, partially offset by increases in Medicare and Medicaid products.across all product lines.

Medicare Update
On January 15, 2021,April 4, 2022, the U.S. Centers for Medicare & Medicaid Services issued its final notice detailing final 20222023 Medicare Advantage benchmark payment rates (the “Final Notice”).rates. Final 20222023 Medicare Advantage rates resulted in an increase in industry benchmark rates of approximately 4.1%5.0%.


4649


Pharmacy Services Segment

The following table summarizes the Pharmacy Services segment’s performance for the respective periods:
ChangeChange
Three Months Ended
June 30,
Six Months Ended
June 30,
Three Months Ended
June 30,
2021 vs 2020
Six Months Ended
June 30,
2021 vs 2020
Three Months Ended
June 30,
Six Months Ended
June 30,
Three Months Ended
June 30,
2022 vs 2021
Six Months Ended
June 30,
2022 vs 2021
In millions, except percentagesIn millions, except percentages2021202020212020$%$%In millions, except percentages2022202120222021$%$%
Revenues:Revenues:Revenues:
ProductsProducts$38,010$34,595$74,077$69,341$3,415 9.9 %$4,736 6.8 %Products$42,554$38,010$81,718$74,077$4,544 12.0 %$7,641 10.3 %
ServicesServices30429455853110 3.4 %27 5.1 %Services258304555558(46)(15.1)%(3)(0.5)%
Total revenuesTotal revenues38,31434,88974,63569,8723,425 9.8 %4,763 6.8 %Total revenues42,81238,31482,27374,6354,498 11.7 %7,638 10.2 %
Cost of products soldCost of products sold36,26633,27170,78966,7742,995 9.0 %4,015 6.0 %Cost of products sold40,54036,26678,03070,7894,274 11.8 %7,241 10.2 %
Operating expensesOperating expenses343347689713(4)(1.2)%(24)(3.4)%Operating expenses458343837689115 33.5 %148 21.5 %
Operating expenses as a % of total revenuesOperating expenses as a % of total revenues0.9 %1.0 %0.9 %1.0 %Operating expenses as a % of total revenues1.1 %0.9 %1.0 %0.9 %
Operating incomeOperating income$1,705$1,271$3,157$2,385$434 34.1 %$772 32.4 %Operating income$1,814$1,705$3,406$3,157$109 6.4 %$249 7.9 %
Operating income as a % of total revenuesOperating income as a % of total revenues4.5 %3.6 %4.2 %3.4 %Operating income as a % of total revenues4.2 %4.5 %4.1 %4.2 %
Adjusted operating income (1)
Adjusted operating income (1)
$1,755$1,327$3,262$2,508$428 32.3 %$754 30.1 %
Adjusted operating income (1)
$1,855$1,755$3,491$3,262$100 5.7 %$229 7.0 %
Adjusted operating income as a % of total revenuesAdjusted operating income as a % of total revenues4.6 %3.8 %4.4 %3.6 %Adjusted operating income as a % of total revenues4.3 %4.6 %4.2 %4.4 %
Revenues (by distribution channel):Revenues (by distribution channel):Revenues (by distribution channel):
Pharmacy network (2)
Pharmacy network (2)
$22,918$20,536$44,811$41,636$2,382 11.6 %$3,175 7.6 %
Pharmacy network (2)
$24,537$22,918$47,361$44,811$1,619 7.1 %$2,550 5.7 %
Mail choice (3)
Mail choice (3)
15,23514,10929,48327,7831,126 8.0 %1,700 6.1 %
Mail choice (3)
18,03015,23534,40429,4832,795 18.3 %4,921 16.7 %
OtherOther161244341453(83)(34.0)%(112)(24.7)%Other24516150834184 52.2 %167 49.0 %
Pharmacy claims processed: (4)
Pharmacy claims processed: (4)
Pharmacy claims processed: (4)
TotalTotal562.2505.41,098.11,046.856.8 11.2 %51.3 4.9 %Total584.3562.21,151.31,098.122.1 3.9 %53.2 4.8 %
Pharmacy network (2)
Pharmacy network (2)
479.3425.1934.7886.254.2 12.7 %48.5 5.5 %
Pharmacy network (2)
499.1479.3983.4934.719.8 4.1 %48.7 5.2 %
Mail choice (3)
Mail choice (3)
82.980.3163.4160.62.6 3.2 %2.8 1.7 %
Mail choice (3)
85.282.9167.9163.42.3 2.8 %4.5 2.8 %
Generic dispensing rate: (4)
Generic dispensing rate: (4)
Generic dispensing rate: (4)
TotalTotal86.7 %88.7 %87.4 %88.8 %Total88.0 %86.7 %87.9 %87.4 %
Pharmacy network (2)
Pharmacy network (2)
86.9 %89.3 %87.7 %89.4 %
Pharmacy network (2)
88.4 %86.9 %88.3 %87.7 %
Mail choice (3)
Mail choice (3)
85.5 %85.7 %85.6 %85.7 %
Mail choice (3)
85.7 %85.5 %85.6 %85.6 %

(1)See “Segment Analysis” above in this report for a reconciliation of Pharmacy Services segment operating income (GAAP measure) to adjusted operating income, which represents the Company’s principal measure of segment performance.
(2)Pharmacy network is defined as claims filled at retail and specialty retail pharmacies, including the Company’s retail pharmacies and LTC pharmacies, but excluding Maintenance Choice activity, which is included within the mail choice category. Maintenance Choice permits eligible client plan members to fill their maintenance prescriptions through mail order delivery or at a CVS Pharmacypharmacy retail store for the same price as mail order.
(3)Mail choice is defined as claims filled at a Pharmacy Services mail order facility, which includes specialty mail claims inclusive of Specialty Connect® claims picked up at a retail pharmacy, as well as prescriptions filled at the Company’s retail pharmacies under the Maintenance Choice program.
(4)Includes an adjustment to convert 90-day prescriptions to the equivalent of three 30-day prescriptions. This adjustment reflects the fact that these prescriptions include approximately three times the amount of product days supplied compared to a normal prescription.

Commentary - Three Months Ended June 30, 20212022 vs. 20202021

Revenues
Total revenues increased $3.4$4.5 billion, or 9.8%11.7%, to $38.3$42.8 billion in the three months ended June 30, 20212022 compared to the prior year primarily driven by increased pharmacy claims volume, growth in specialty pharmacy and brand inflation, partially offset by continued client price compression.


improvements.


4750


Operating expenses
Operating expenses in the Pharmacy Services segment include selling, general and administrative expenses; depreciation and amortization expense; and expenses related to specialty retail pharmacies, which include store and administrative payroll, employee benefits and occupancy costs.
Operating expenses increased $115 million, or 33.5%, in the three months ended June 30, 2022 compared to the prior year primarily driven by increased restructuring and business integration costs in the three months ended June 30, 2022 compared to the prior year.
Operating expenses as a percentage of total revenues remained relatively consistent at 1.1% and 0.9% and 1.0% in each of the three-month periods ended June 30, 20212022 and 2020,2021, respectively.

Adjusted operating income
Adjusted operating income increased $428$100 million, or 32.3%5.7%, in the three months ended June 30, 20212022 compared to the prior year. The increase in adjusted operating income was primarily driven by improved purchasing economics, that reflectedincluding increased contributions from the products and services of ourthe Company’s group purchasing organization that was launched in the second quarter of 2020 and specialty pharmacy (including pharmacy and/or administrative services for providers and Covered Entities), as well as increased pharmacy claims volume.organization. These increases were partially offset by continued client price compression.improvements, decreased contributions from pharmacy and/or other administrative services for Covered Entities and increased restructuring and business integration costs in the three months ended June 30, 2022 compared to the prior year.
As you review the Pharmacy Services segment’s performance in this area, you should consider the following important information about the business:
The Company’s efforts to (i) retain existing clients, (ii) obtain new business and (iii) maintain or improve the rebates, fees and/or discounts the Company receives from manufacturers, wholesalers and retail pharmacies continue to have an impact on adjusted operating income. In particular, competitive pressures in the PBM industry have caused the Company and other PBMs to continue to share with clients a larger portion of rebates, fees and/or discounts received from pharmaceutical manufacturers. In addition, marketplace dynamics and regulatory changes have limited the Company’s ability to offer plan sponsors pricing that includes retail network “differential” or “spread,” and the Company expects these trends to continue. The “differential” or “spread” is any difference between the drug price charged to plan sponsors, including Medicare Part D plan sponsors, by a PBM and the price paid for the drug by the PBM to the dispensing provider.

Pharmacy claims processed
Total pharmacy claims processed represents the number of prescription claims processed through our pharmacy benefits manager and dispensed by either our retail network pharmacies or our own mail and specialty pharmacies. Management uses this metric to understand variances between actual claims processed and expected amounts as well as trends in period-over-period results. This metric provides management and investors with information useful in understanding the impact of pharmacy claim volume on segment total revenues and operating results.
The Company’s pharmacy network claims processed on a 30-day equivalent basis increased 12.7% to 479.3 million claims4.1% in the three months ended June 30, 20212022 compared to 425.1 million claims in the prior year primarily driven by net new business, increased utilization and the impact of an extended cough, cold and flu season compared to the prior year, partially offset by decreased COVID-19 vaccinations and increased new therapy prescriptions, which were adversely impacted by the COVID-19 pandemic during the three months ended June 30, 2020.vaccinations.
The Company’s mail choice claims processed on a 30-day equivalent basis increased 3.2% to 82.9 million claims2.8% in the three months ended June 30, 20212022 compared to 80.3 million claims in the prior year primarily driven by net new business and the continued adoptionincreased utilization of Maintenance Choice offerings.prescriptions.
Excluding the impact of COVID-19 vaccinations, total pharmacy claims processed increased 8.4%5.7% on a 30-day equivalent basis for the three months ended June 30, 20212022 compared to the prior year.

Generic dispensing rate
Generic dispensing rate is calculated by dividing the Pharmacy Services segment’s generic drug prescriptions processed or filled by its total prescriptions processed or filled. Management uses this metric to evaluate the effectiveness of the business at encouraging the use of generic drugs when they are available and clinically appropriate, which aids in decreasing costs for client members and retail customers. This metric provides management and investors with information useful in understanding trends in segment total revenues and operating results.
The Pharmacy Services segment’s total generic dispensing rate decreasedincreased to 86.7%88.0% in the three months ended June 30, 20212022 compared to 88.7%86.7% in the prior year. The decreaseincrease in the segment’s generic dispensing rate was primarily driven by an increasea decrease in brand prescriptions, largely attributable to decreased COVID-19 vaccinations in the three months ended June 30, 2021.2022 compared to the prior year. Excluding the impact of COVID-19 vaccinations, the segment’s total generic dispensing rate increased towas 88.8% and 89.0% in the three months ended June 30, 2021.

2022 and 2021, respectively.

4851


Commentary - Six Months Ended June 30, 20212022 vs. 20202021

Revenues
Total revenues increased $4.8$7.6 billion, or 6.8%10.2%, to $74.6$82.3 billion in the six months ended June 30, 20212022 compared to the prior year primarily driven by increased pharmacy claims volume, growth in specialty pharmacy and brand inflation, partially offset by continued client price compression.improvements.

Operating expenses
Operating expenses increased $148 million, or 21.5%, in the six months ended June 30, 2022 compared to the prior year primarily driven by increased restructuring and business integration costs in the six months ended June 30, 2022 compared to the prior year.
Operating expenses as a percentage of total revenues remained relatively consistent at 0.9%1.0% and 1.0%0.9% in the six-month periods ended June 30, 20212022 and 2020,2021, respectively.

Adjusted operating income
Adjusted operating income increased $754$229 million, or 30.1%7.0%, in the six months ended June 30, 20212022 compared to the prior year. The increase in adjusted operating income was primarily driven by improved purchasing economics, that reflectedincluding increased contributions from the products and services of ourthe Company’s group purchasing organization that was launched in the second quarter of 2020 and specialty pharmacy (including pharmacy and/or administrative services for providers and Covered Entities),organization. These increases were partially offset by continued client price compression.improvements, decreased contributions from pharmacy and/or other administrative services for Covered Entities and increased restructuring and business integration costs in the six months ended June 30, 2022 compared to the prior year.

Pharmacy claims processed
The Company’s pharmacy network claims processed on a 30-day equivalent basis increased 5.5% to 934.7 million claims5.2% in the six months ended June 30, 20212022 compared to 886.2 million claims in the prior year primarily driven by net new business, increased utilization and the impact of a weaker cough, cold and flu season experienced in the prior year, partially offset by decreased COVID-19 vaccinations.
The Company’s mail choice claims processed on a 30-day equivalent basis increased 1.7% to 163.4 million claims2.8% in the six months ended June 30, 20212022 compared to 160.6 million claims in the prior year primarily driven by net new business and the continued adoptionincreased utilization of Maintenance Choice offerings.prescriptions.
Excluding the impact of COVID-19 vaccinations, total pharmacy claims processed increased 3.0%5.6% on a 30-day equivalent basis for the six months ended June 30, 20212022 compared to the prior year.

Generic dispensing rate
The Pharmacy Services segment’s total generic dispensing rate decreasedincreased to 87.4%87.9% in the six months ended June 30, 20212022 compared to 88.8%87.4% in the prior year. The decreaseincrease in the segment’s generic dispensing rate was primarily driven by an increasea decrease in brand prescriptions, largely attributable to decreased COVID-19 vaccinations in the six months ended June 30, 2021.2022 compared to the prior year. Excluding the impact of COVID-19 vaccinations, the segment’s total generic dispensing rate increased towas 88.8% and 89.0% in the six months ended June 30, 2021.2022 and 2021, respectively.



4952


Retail/LTC Segment

The following table summarizes the Retail/LTC segment’s performance for the respective periods:
ChangeChange
Three Months Ended
June 30,
Six Months Ended
June 30,
Three Months Ended
June 30,
2021 vs 2020
Six Months Ended
June 30,
2021 vs 2020
Three Months Ended
June 30,
Six Months Ended
June 30,
Three Months Ended
June 30,
2022 vs 2021
Six Months Ended
June 30,
2022 vs 2021
In millions, except percentagesIn millions, except percentages2021202020212020$%$%In millions, except percentages2022202120222021$%$%
Revenues:Revenues:Revenues:
ProductsProducts$23,609$21,476$46,003$43,998$2,133 9.9 %$2,005 4.6 %Products$25,528$23,609$50,133$46,003$1,919 8.1 %$4,130 9.0 %
ServicesServices1,1191861,953413933 501.6 %1,540 372.9 %Services7761,1191,6051,953(343)(30.7)%(348)(17.8)%
Net investment income46— — %46 100.0 %
Net investment income (loss)Net investment income (loss)(18)(34)46(18)(100.0)%(80)(173.9)%
Total revenuesTotal revenues24,72821,66248,00244,4113,066 14.2 %3,591 8.1 %Total revenues26,28624,72851,70448,0021,558 6.3 %3,702 7.7 %
Cost of products soldCost of products sold17,95216,22034,99432,7981,732 10.7 %2,196 6.7 %Cost of products sold19,55417,95238,31934,9941,602 8.9 %3,325 9.5 %
Operating expensesOperating expenses4,8574,5099,8248,900348 7.7 %924 10.4 %Operating expenses4,9924,85710,1629,824135 2.8 %338 3.4 %
Operating expenses as a % of total revenuesOperating expenses as a % of total revenues19.6 %20.8 %20.5 %20.0 %Operating expenses as a % of total revenues19.0 %19.6 %19.7 %20.5 %
Operating incomeOperating income$1,919$933$3,184$2,713$986 105.7 %$471 17.4 %Operating income$1,740$1,919$3,223$3,184$(179)(9.3)%$39 1.2 %
Operating income as a % of total revenuesOperating income as a % of total revenues7.8 %4.3 %6.6 %6.1 %Operating income as a % of total revenues6.6 %7.8 %6.2 %6.6 %
Adjusted operating income (1)
Adjusted operating income (1)
$2,049$1,057$3,443$2,959$992 93.9 %$484 16.4 %
Adjusted operating income (1)
$1,862$2,049$3,467$3,443$(187)(9.1)%$24 0.7 %
Adjusted operating income as a % of total revenuesAdjusted operating income as a % of total revenues8.3 %4.9 %7.2 %6.7 %Adjusted operating income as a % of total revenues7.1 %8.3 %6.7 %7.2 %
Revenues (by major goods/service lines):Revenues (by major goods/service lines):Revenues (by major goods/service lines):
PharmacyPharmacy$18,873$16,870$36,758$34,225$2,003 11.9 %$2,533 7.4 %Pharmacy$20,017$18,873$39,549$36,758$1,144 6.1 %$2,791 7.6 %
Front StoreFront Store5,2544,6539,8969,861601 12.9 %35 0.4 %Front Store5,7365,25411,0499,896482 9.2 %1,153 11.7 %
OtherOther6011391,302325462 332.4 %977 300.6 %Other5516011,1401,302(50)(8.3)%(162)(12.4)%
Net investment income46— — %46 100.0 %
Net investment income (loss)Net investment income (loss)(18)(34)46(18)(100.0)%(80)(173.9)%
Prescriptions filled (2)
Prescriptions filled (2)
394.4345.4769.8720.549.0 14.2 %49.3 6.8 %
Prescriptions filled (2)
400.8394.4795.4769.86.4 1.6 %25.6 3.3 %
Same store sales increase (decrease): (3)
Same store sales increase (decrease): (3)
Same store sales increase (decrease): (3)
TotalTotal12.3 %2.4 %6.2 %5.7 %Total8.0 %12.3 %9.3 %6.2 %
PharmacyPharmacy12.4 %4.6 %8.2 %6.9 %Pharmacy7.6 %12.4 %8.8 %8.2 %
Front StoreFront Store12.0 %(4.5)%(0.4)%1.7 %Front Store9.4 %12.0 %11.2 %(0.4)%
Prescription volume (2)
Prescription volume (2)
14.8 %0.6 %7.6 %5.2 %
Prescription volume (2)
3.1 %14.8 %4.5 %7.6 %
Generic dispensing rate (2)
Generic dispensing rate (2)
85.7 %89.1 %86.5 %89.2 %
Generic dispensing rate (2)
88.5 %85.7 %88.0 %86.5 %

(1)See “Segment Analysis” above in this report for a reconciliation of Retail/LTC segment operating income (GAAP measure) to adjusted operating income, which represents the Company’s principal measure of segment performance.
(2)Includes an adjustment to convert 90-day prescriptions to the equivalent of three 30-day prescriptions. This adjustment reflects the fact that these prescriptions include approximately three times the amount of product days supplied compared to a normal prescription.
(3)Same store sales and prescription volume represent the change in revenues and prescriptions filled in the Company’s retail pharmacy stores that have been operating for greater than one year, expressed as a percentage that indicates the increase or decrease relative to the comparable prior period. Same store metrics exclude revenues from MinuteClinic, revenues and prescriptions from LTC operations. Management uses these metrics to evaluate the performance of existing stores on a comparable basis and to inform future decisions regarding existing stores and new locations. Same-store metrics provide management and investors with information useful in understanding the portion of current revenues and prescriptions resulting from organic growth in existing locations versus the portion resulting from opening new stores.

Commentary - Three Months Ended June 30, 20212022 vs. 20202021

Revenues
Total revenues increased $3.1$1.6 billion, or 14.2%6.3%, to $24.7$26.3 billion in the three months ended June 30, 20212022 compared to the prior year primarily driven by increased prescription volume, COVID-19 vaccinations and diagnostic testing and higher front store revenues.volume, including the sale of COVID-19 OTC test kits and the impact of an extended cough, cold and flu season compared to the prior year, as well as pharmacy brand inflation. These increases were partially offset by continued pharmacy reimbursement pressure.decreased COVID-19 vaccinations and diagnostic testing, contributed nearly a thirdthe impact of the increase in the segment’s revenues for the three monthsrecent generic introductions and continued pharmacy reimbursement pressure.
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ended June 30, 2021 compared to the prior year, as the prior year included an immaterial impact from diagnostic testing and no COVID-19 vaccinations.
Pharmacy same store sales increased 12.4%7.6% in the three months ended June 30, 20212022 compared to the prior year. The increase was primarily driven by the 14.8%3.1% increase in pharmacy same store prescription volume on a 30-day equivalent basis, including the impact of an extended cough, cold and flu season compared to the prior year, and pharmacy brand inflation. These increases were partially offset by continued pharmacy reimbursement pressure and the impact of recent generic introductions.introductions and continued pharmacy reimbursement pressure.
Front store same store sales increased 12.0%9.4% in the three months ended June 30, 20212022 compared to the prior year. The increase was primarily due to reduced customer trafficstrength in consumer health, including the segment’s retail pharmacies due to shelter-in-place orders in responsesale of COVID-19 OTC test kits and the impact of an extended cough, cold and flu season compared to the COVID-19 pandemicprior year, in the three months ended June 30, 2020 as well as strength across all product categories in the three months ended June 30, 2021.2022.
Other revenues increased $462decreased $50 million in the three months ended June 30, 20212022 compared to the prior year. The increasedecrease was primarily due to increaseddecreased COVID-19 diagnostic testing in the three months ended June 30, 2021.2022 compared to the prior year.

Operating expenses
Operating expenses in the Retail/LTC segment include store payroll, store employee benefits, store occupancy costs, selling expenses, advertising expenses, depreciation and amortization expense and certain administrative expenses.
Operating expenses increased $348$135 million, or 7.7%2.8%, in the three months ended June 30, 20212022 compared to the prior year. The increase was primarily due to incremental costs associated with increased volume, including COVID-19 vaccinationsincreased investments in the segment’s operations and diagnostic testing, partially offset by acapabilities and the absence of the $125 million gain from an anti-trust legal settlement recorded in the three months ended June 30, 2021 and the absence of incremental2021. These increases were partially offset by lower expenses associated with COVID-19 vaccination administration compared to the Company’s initial COVID-19 pandemic mitigation efforts incurred in the three months ended June 30, 2020.prior year.
Operating expenses as a percentage of total revenues decreased to 19.6%19.0% in the three months ended June 30, 20212022 compared to 20.8%19.6% in the prior year. The decrease in operating expenses as a percentage of total revenues was primarily driven by the increases in total revenues described above.

Adjusted operating income
Adjusted operating income increased $992decreased $187 million, or 93.9%9.1% in the three months ended June 30, 20212022 compared to the prior year. The increasedecrease in adjusted operating income was primarily driven by the increased prescription and front store volume described above,continued pharmacy reimbursement pressure, decreased COVID-19 vaccinations, increased investments in the segment’s operations and diagnostic testingcapabilities and athe absence of the $125 million gain from an anti-trust legal settlement recorded in the three months ended June 30, 2021. These increasesdecreases were partially offset by continued pharmacy reimbursement pressure.the increased prescription and front store volume described above, improved generic drug purchasing and the favorable impact of business initiatives in the three months ended June 30, 2022.
As you review the Retail/LTC segment’s performance in this area, you should consider the following important information about the business:
The segment’s adjusted operating income has been adversely affected by the efforts of managed care organizations, PBMs and governmental and other third-party payors to reduce their prescription drug costs, including the use of restrictive networks, as well as changes in the mix of business within the pharmacy portion of the Retail/LTC segment. If the pharmacy reimbursement pressure accelerates, the segment may not be able grow revenues, and its adjusted operating income could be adversely affected.
The increased use of generic drugs has positively impacted the segment’s adjusted operating income but has resulted in third-party payors augmenting their efforts to reduce reimbursement payments to retail pharmacies for prescriptions. This trend, which the Company expects to continue, reduces the benefit the segment realizes from brand to generic drug conversions.
The segment’s adjusted operating income benefited from the administration of COVID-19 vaccinations and diagnostic testing, which contributed approximately half of the increase in adjusted operating income for the three months ended June 30, 2021 compared to the prior year.

Prescriptions filled
Prescriptions filled represents the number of prescriptions dispensed through the Retail/LTC segment’s pharmacies. Management uses this metric to understand variances between actual prescriptions dispensed and expected amounts as well as trends in period-over-period results. This metric provides management and investors with information useful in understanding the impact of prescription volume on segment total revenues and operating results.
Prescriptions filled increased 14.2%1.6% on a 30-day equivalent basis in the three months ended June 30, 20212022 compared to the prior year primarily driven by increased utilization and the impact of an extended cough, cold and flu season compared to the prior year, partially offset by decreased COVID-19 vaccinations, as well as the continued adoption of patient care programs and increased new therapy prescriptions, both of which were adversely impacted by the COVID-19 pandemic during the three months ended June 30, 2020.vaccinations. Excluding the impact of COVID-19 vaccinations, prescriptions filled increased 9.3%4.6% on a 30-day equivalent basis for the three months ended June 30, 20212022 compared to the prior year.



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Generic dispensing rate
Generic dispensing rate is calculated by dividing the Retail/LTC segment’s generic drug prescriptions filled by its total prescriptions filled. Management uses this metric to evaluate the effectiveness of the business at encouraging the use of generic drugs when they are available and clinically appropriate, which aids in decreasing costs for client members and
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retail customers. This metric provides management and investors with information useful in understanding trends in segment total revenues and operating results.
The Retail/LTC segment’s generic dispensing rate decreasedincreased to 85.7%88.5% in the three months ended June 30, 20212022 compared to 89.1%85.7% in the prior year. The decreaseincrease in the segment’s generic dispensing rate was primarily driven by an increasea decrease in brand prescriptions, largely attributable to decreased COVID-19 vaccinations in the three months ended June 30, 2021.2022 compared to the prior year. Excluding the impact of COVID-19 vaccinations, the segment’s total generic dispensing rate increased towas 89.9% and 89.5% in the three months ended June 30, 2021.2022 and 2021, respectively.

Commentary - Six Months Ended June 30, 20212022 vs. 20202021

Revenues
Total revenues increased $3.6$3.7 billion, or 8.1%7.7%, to $48.0$51.7 billion in the six months ended June 30, 20212022 compared to the prior year primarily driven by COVID-19 vaccinations and diagnostic testing, increased prescription and front store volume, including the sale of COVID-19 OTC test kits and the impact of a weaker cough, cold and flu season experienced in the prior year, as well as pharmacy brand inflation. These increases were partially offset by continued pharmacy reimbursement pressuredecreased COVID-19 vaccinations and diagnostic testing, the impact of recent generic introductions. COVID-19 vaccinationsintroductions and diagnostic testing contributed nearly half of the increase in the segment’s revenues for the six months ended June 30, 2021, as the prior year included an immaterial impact from diagnostic testing and no COVID-19 vaccinations.continued pharmacy reimbursement pressure.
Pharmacy same store sales increased 8.2%8.8% in the six months ended June 30, 20212022 compared to the prior year. The increase was primarily driven by the 7.6%4.5% increase in pharmacy same store prescription volume on a 30-day equivalent basis, including the impact of a weaker cough, cold and flu season experienced in the prior year, and pharmacy brand inflation. These increases were partially offset by continued pharmacy reimbursement pressure and the impact of recent generic introductions.introductions and continued pharmacy reimbursement pressure.
Front store same store sales decreased 0.4%increased 11.2% in the six months ended June 30, 20212022 compared to the prior year. The increase was primarily due to strength in consumer health, including the sale of COVID-19 OTC test kits and the impact of a weaker cough, cold and flu season experienced in the prior year, in the six months ended June 30, 2022.
Other revenues decreased $162 million in the six months ended June 30, 2022 compared to the prior year. The decrease was primarily due to a weak cough, cold and flu season in the first quarter of 2021, partially offset by increased consumer health and beauty care sales in the six months ended June 30, 2021.
Other revenues increased $977 million in the six months ended June 30, 2021 compared to the prior year. The increase was primarily due to increaseddecreased COVID-19 diagnostic testing in the six months ended June 30, 2021.2022 compared to the prior year.

Operating expenses
Operating expenses increased $924$338 million, or 10.4%3.4%, in the six months ended June 30, 20212022 compared to the prior year. The increase was primarily due to incremental costs associated with increased volume, including COVID-19 vaccinationsas well as increased investments in the segment’s operations and diagnostic testing,capabilities, partially offset by the absence of incrementallower expenses associated with COVID-19 vaccination administration compared to the Company’s initial COVID-19 pandemic mitigation efforts incurred in the six months ended June 30, 2020.prior year.
Operating expenses as a percentage of total revenues increaseddecreased to 20.5%19.7% in the six months ended June 30, 20212022 compared to 20.0%20.5% in the prior year. The increasedecrease in operating expenses as a percentage of total revenues was primarily driven by the increases in operating expensestotal revenues described above.

Adjusted operating income
Adjusted operating income increased $484$24 million, or 16.4%0.7% in the six months ended June 30, 20212022 compared to the prior year. The increase in adjusted operating income was primarily driven by COVID-19 vaccinations and diagnostic testing,the increased prescription and front store volume anddescribed above, improved generic drug purchasing.purchasing and the favorable impact of business initiatives in the six months ended June 30, 2022. These increases were partially offset by continued pharmacy reimbursement pressure.pressure, decreased COVID-19 vaccinations and diagnostic testing contributed approximately 20% ofand increased investments in the segment’s adjusted operating income for the six months ended June 30, 2021.operations and capabilities.

Prescriptions filled
Prescriptions filled increased 6.8%3.3% on a 30-day equivalent basis in the six months ended June 30, 20212022 compared to the prior year primarily driven by COVID-19 vaccinationsincreased utilization and the continued adoptionimpact of patient care programs.a weaker cough, cold and flu season experienced in the prior year, partially offset by decreased COVID-19 vaccinations. Excluding the impact of COVID-19 vaccinations, prescriptions filled increased 3.2%5.1% on a 30-day equivalent basis for the six months ended June 30, 20212022 compared to the prior year.

Generic dispensing rate
The Retail/LTC segment’s generic dispensing rate decreasedincreased to 86.5%88.0% in the six months ended June 30, 20212022 compared to 89.2%86.5% in the prior year. The decreaseincrease in the segment’s generic dispensing rate was primarily driven by an increasea decrease in brand prescriptions, largely attributable to decreased COVID-19 vaccinations in the six months ended June 30, 2021.2022 compared to the prior year. Excluding the impact of COVID-19 vaccinations, the segment’s total generic dispensing rate increased towas 89.9% and 89.6% in the six months ended June 30, 2021.2022 and 2021, respectively.

5255


Corporate/Other Segment

The following table summarizes the Corporate/Other segment’s performance for the respective periods:
ChangeChange
Three Months Ended
June 30,
Six Months Ended
June 30,
Three Months Ended
June 30,
2021 vs 2020
Six Months Ended
June 30,
2021 vs 2020
Three Months Ended
June 30,
Six Months Ended
June 30,
Three Months Ended
June 30,
2022 vs 2021
Six Months Ended
June 30,
2022 vs 2021
In millions, except percentagesIn millions, except percentages2021202020212020$%$%In millions, except percentages2022202120222021$%$%
Revenues:Revenues:Revenues:
PremiumsPremiums$15 $14 $33 $33 $7.1 %$— — %Premiums$15 $15 $32 $33 $— — %$(1)(3.0)%
ServicesServices15 15 29 17 — — %12 70.6 %Services19 15 33 29 26.7 %13.8 %
Net investment incomeNet investment income152 57 255 126 95 166.7 %129 102.4 %Net investment income76 152 171 255 (76)(50.0)%(84)(32.9)%
Total revenuesTotal revenues182 86 317 176 96 111.6 %141 80.1 %Total revenues110 182 236 317 (72)(39.6)%(81)(25.6)%
Cost of products soldCost of products sold— 16 — 100.0 %16 100.0 %Cost of products sold10 20 16 25.0 %25.0 %
Benefit costsBenefit costs54 51 99 119 5.9 %(20)(16.8)%Benefit costs162 54 221 99 108 200.0 %122 123.2 %
Operating expensesOperating expenses529 448 956 825 81 18.1 %131 15.9 %Operating expenses494 529 1,341 956 (35)(6.6)%385 40.3 %
Operating lossOperating loss(409)(413)(754)(768)1.0 %14 1.8 %Operating loss(556)(409)(1,346)(754)(147)(35.9)%(592)(78.5)%
Adjusted operating loss (1)
Adjusted operating loss (1)
(369)(343)(672)(628)(26)(7.6)%(44)(7.0)%
Adjusted operating loss (1)
(555)(369)(860)(672)(186)(50.4)%(188)(28.0)%

(1)See “Segment Analysis” above in this report for a reconciliation of Corporate/Other segment operating loss (GAAP measure) to adjusted operating loss, which represents the Company’s principal measure of segment performance.

Commentary - Three Months Ended June 30, 20212022 vs. 20202021

Revenues
Revenues primarily relate to products for which the Company no longer solicits or accepts new customers, such as large case pensions and long-term care insurance products.
Total revenues increased $96decreased $72 million, or 111.6%39.6%, to $182$110 million in the three months ended June 30, 20212022 compared to the prior year primarily driven by higherlower net investment income primarily related tofrom private equity investments.investments and lower net realized capital gains in the three months ended June 30, 2022 compared to the prior year.

Adjusted operating loss
Adjusted operating loss increased $26$186 million in the three months ended June 30, 20212022 compared to the prior year. The increase wasyear primarily driven by higher employee benefit coststhe strengthening of reserves in the Company’s long-term care insurance business and incremental operating expenses associated with Company’s investments in transformation, partially offset by the increasedecreases in net investment income in the three months ended June 30, 2021 described above.

Commentary - Six Months Ended June 30, 20212022 vs. 20202021

Revenues
Total revenues increased $141decreased $81 million, or 80.1%25.6%, to $317$236 million in the six months ended June 30, 20212022 compared to the prior year primarily driven by higherlower net investment income primarily related tofrom private equity investments.investments and lower net realized capital gains in the six months ended June 30, 2022 compared to the prior year.

Adjusted operating loss
Adjusted operating loss increased $44$188 million in the six months ended June 30, 20212022 compared to the prior year. The increase wasyear primarily driven by higher employee benefit coststhe strengthening of reserves in the Company’s long-term care insurance business and incremental operating expenses associated with Company’s investments in transformation, partially offset by the increasedecreases in net investment income in the six months ended June 30, 2021 described above.

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53



Liquidity and Capital Resources

Cash Flows

The Company maintains a level of liquidity sufficient to allow it to meet its cash needs in the short-term. Over the long term, the Company manages its cash and capital structure to maximize shareholder return, maintain its financial condition and maintain flexibility for future strategic initiatives. The Company continuously assesses its regulatory capital requirements, working capital needs, debt and leverage levels, debt maturity schedule, capital expenditure requirements, dividend payouts, potential share repurchases and future investments or acquisitions. The Company believes its operating cash flows, commercial paper program, credit facilities, sale-leaseback program, as well as any potential future borrowings, will be sufficient to fund these future payments and long-term initiatives. As of June 30, 2021,2022, the Company had approximately $7.1$12.1 billion in cash and cash equivalents, $1.9approximately $5.8 billion of which was held by the parent company or nonrestricted subsidiaries.

The net change in cash, cash equivalents and restricted cash during the six months ended June 30, 20212022 and 20202021 was as follows:
Six Months Ended
June 30,
ChangeSix Months Ended
June 30,
Change
In millions, except percentagesIn millions, except percentages20212020$%In millions, except percentages20222021$%
Net cash provided by operating activitiesNet cash provided by operating activities$8,739 $10,424 $(1,685)(16.2)%Net cash provided by operating activities$9,006 $8,739 $267 3.1 %
Net cash used in investing activitiesNet cash used in investing activities(2,974)(2,930)(44)1.5 %Net cash used in investing activities(4,123)(2,974)(1,149)(38.6)%
Net cash provided by (used in) financing activities(6,558)1,697 (8,255)(486.4)%
Net increase (decrease) in cash, cash equivalents and restricted cash$(793)$9,191 $(9,984)(108.6)%
Net cash used in financing activitiesNet cash used in financing activities(5,111)(6,512)1,401 21.5 %
Net decrease in cash, cash equivalents and restricted cashNet decrease in cash, cash equivalents and restricted cash$(228)$(747)$519 69.5 %

Commentary

Net cash provided by operating activities decreasedincreased by $1.7 billion$267 million in the six months ended June 30, 20212022 compared to the prior year. The decreaseincrease was primarily due to items that favorably impacted operating cash flows inthe timing of payments during the six months ended June 30, 2020 that did not recur during the current year including: the deferral of quarterly estimated federal and state income tax payments normally due during the second quarter of 2020 until the third quarter of 2020, reduced benefit costs during the second quarter of 2020 due2022 compared to the deferral of elective procedures and other discretionary utilization in the Health Care Benefits segment as a result of the COVID-19 pandemic and the timing of payments and pricing actions during 2020 designed to recover the HIF, which was paid in the third quarter of 2020.prior year.
Net cash used in investing activities increased by $44 million$1.1 billion in the six months ended June 30, 20212022 compared to the prior year primarily due to increaseda reduction in restricted cash as a result of the sale of health savings account funds held on behalf of customers in conjunction with the sale of PayFlex, partially offset by lower net purchases of investments and property and equipment, largely offset by a decrease in cash used for acquisitions.the gross proceeds from the sale of PayFlex.
Net cash used in financing activities was $6.6decreased to $5.1 billion in the six months ended June 30, 20212022 compared to net cash provided by financing activities of $1.7$6.5 billion in the prior year. The decrease in cash provided byused in financing activities primarily related to increasedlower repayments of long-term debt during the six months ended June 30, 2022 compared to the prior year, partially offset by share repurchases in the six months ended June 30, 2021 compared to the prior year and the absence of proceeds from the issuance of $4.0 billion of senior notes in the six months ended June 30, 2020.2022.

Short-term Borrowings

Commercial Paper and Back-up Credit Facilities
The Company did not have any commercial paper outstanding as of June 30, 2021.2022. In connection with its commercial paper program, the Company maintains a $2.0 billion, five-year unsecured back-up revolving credit facility, which expires on May 17, 2023,16, 2025, a $2.0 billion, five-year unsecured back-up revolving credit facility, which expires on May 11, 2026, and a $2.0 billion, five-year unsecured back-up revolving credit facility, which expires on May 16, 2024, and a $2.0 billion, five-year unsecured back-up revolving credit facility, which expires on May 11, 2026.2027. The credit facilities allow for borrowings at various rates that are dependent, in part, on the Company’s public debt ratings and require the Company to pay a weighted average quarterly facility fee of approximately 0.03%, regardless of usage. As of June 30, 2021,2022, there were no borrowings outstanding under any of the Company’s back-up credit facilities.

Federal Home Loan Bank of Boston
A subsidiary of the Company is a member of the Federal Home Loan Bank of Boston (the “FHLBB”). As a member, the subsidiary has the ability to obtain cash advances, subject to certain minimum collateral requirements. The maximum
54


borrowing capacity available from the FHLBB as of June 30, 20212022 was approximately $985$930 million. As of June 30, 2021,2022, there were no outstanding advances from the FHLBB.


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Long-term Borrowings

In May 2022, the Company exercised the par call option on its outstanding 3.5% senior notes due July 2022 and redeemed for cash on hand the entire $1.5 billion aggregate principal amount.

On July 15, 2022, the Company announced that it will exercise the par call option on its outstanding 2.75% senior notes due November 2022 (issued by Aetna Inc.) and will redeem for cash on hand the entire $1.0 billion aggregate principal amount. The redemption is expected to occur on or about August 15, 2022.

On August 2, 2022, the Company announced that it will exercise the par call options on its outstanding 2.75% senior notes due December 2022 and 4.75% senior notes due December 2022 (including the unexchanged notes issued by Omnicare, Inc.) and will redeem for cash on hand the entire $1.25 billion and $399 million aggregate principal amounts, respectively. The redemptions are expected to occur on or about September 1, 2022.

Debt Covenants

The Company’s back-up revolving credit facilities and unsecured senior notes contain customary restrictive financial and operating covenants. These covenants do not include an acceleration of the Company’s debt maturities in the event of a downgrade in the Company’s credit ratings. The Company does not believe the restrictions contained in these covenants materially affect its financial or operating flexibility. As of June 30, 2021,2022, the Company was in compliance with all of its debt covenants.

Debt Ratings 

As of June 30, 2021,2022, the Company’s long-term debt was rated “Baa2” by Moody’s Investor Service, Inc. (“Moody’s”) and “BBB” by Standard & Poor’s Financial Services LLC (“S&P”), and its commercial paper program was rated “P-2” by Moody’s and “A-2” by S&P. The outlook on the Company’s long-term debt is “Stable” by Moody’s. In June 2021,Moody’s and “Positive” by S&P changed the outlook on the Company’s long-term debt from “Stable” to “Positive.”&P. In assessing the Company’s credit strength, the Company believes that both Moody’s and S&P considered, among other things, the Company’s capital structure and financial policies as well as its consolidated balance sheet, its historical acquisition activity and other financial information. Although the Company currently believes its long-term debt ratings will remain investment grade, it cannot guarantee the future actions of Moody’s and/or S&P. The Company’s debt ratings have a direct impact on its future borrowing costs, access to capital markets and new store operating lease costs.

Share Repurchase Program

The following share repurchase program has been authorized by CVS Health Corporation’s Board of Directors (the “Board”):
In billions
Authorization Date
AuthorizedRemaining as of
June 30, 2022
December 9, 2021 (“2021 Repurchase Program”)$10.0 $8.0 

The 2021 Repurchase Program permits the Company to effect repurchases from time to time through a combination of open market repurchases, privately negotiated transactions, accelerated share repurchase (“ASR”) transactions, and/or other derivative transactions. The 2021 Repurchase Program can be modified or terminated by the Board at any time.

During the six months ended June 30, 2022, the Company repurchased approximately 19.1 million shares of common stock for approximately $2.0 billion pursuant to the 2021 and 2020,Repurchase Program, including share repurchases under the ASR transaction described below. During the six months ended June 30, 2021, the Company did not repurchase any shares of its common stock. See Note 5 ‘‘Shareholders’ Equity’’

Pursuant to the unaudited condensed consolidated financial statementsauthorization under the 2021 Repurchase Program, the Company entered into a $1.5 billion fixed dollar ASR with Barclays Bank PLC (“Barclays”). Upon payment of the $1.5 billion purchase price on January 4, 2022, the Company received a number of shares of CVS Health Corporation’s common stock equal to 80% of the $1.5 billion notional amount of the ASR or approximately 11.6 million shares at a price of $103.34 per share, which were placed into treasury stock in January 2022. The ASR was accounted for additional information onas an initial treasury stock transaction for $1.2 billion and a forward contract for $0.3 billion. The forward contract was classified as an equity instrument and was recorded within capital surplus. In February 2022, the Company’s share repurchase program.Company received approximately 2.7 million shares of CVS Health Corporation’s common stock, representing the remaining 20% of the $1.5 billion notional amount of the ASR, thereby concluding the ASR. These shares were placed into treasury stock and the forward contract was reclassified from capital surplus to treasury stock in February 2022.
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At the time they were received, the initial and final receipt of shares resulted in an immediate reduction of the outstanding shares used to calculate the weighted average common shares outstanding for basic and diluted earnings per share.
Critical Accounting Policies

The Company prepares the unaudited condensed consolidated financial statements in conformity with generally accepted accounting principles, which require management to make certain estimates and apply judgment. Estimates and judgments are based on historical experience, current trends and other factors that management believes to be important at the time the unaudited condensed consolidated financial statements are prepared. On a regular basis, the Company reviews its accounting policies and how they are applied and disclosed in the unaudited condensed consolidated financial statements. While the Company believes the historical experience, current trends and other factors considered by management support the preparation of the unaudited condensed consolidated financial statements in conformity with generally accepted accounting principles, actual results could differ from estimates, and such differences could be material.

Recoverability of Goodwill

During 2020, the Company performed its required annual impairment test of goodwill. The results of this impairment test indicated that there was no impairment of goodwill as of the testing date. The goodwill impairment test resulted in the fair values of all of the Company’s reporting units exceeding their carrying values by significant margins, with the exception of the Commercial Business and LTC reporting units, which exceeded their carrying values by approximately 6% and 12%, respectively.

The fair value of the reporting units is estimated using a combination of a discounted cash flow method and a market multiple method. The determination of the fair value of the reporting units requires the Company to make significant assumptions and estimates. These assumptions and estimates primarily include the selection of appropriate peer group companies; control premiums and valuation multiples appropriate for acquisitions in the industries in which the Company competes; discount rates; terminal growth rates; and forecasts of revenue, operating income, depreciation and amortization, income taxes, capital expenditures and future working capital requirements. When determining these assumptions and preparing these estimates, the Company considers each reporting unit’s historical results and current operating trends; consolidated revenues, profitability and cash flow results and forecasts; and industry trends. The Company’s estimates can be affected by a number of factors, including general economic and regulatory conditions; the risk-free interest rate environment; the Company’s market capitalization; efforts of customers and payers to reduce costs, including their prescription drug costs, and/or increase member co-payments;
55


the continued efforts of competitors to gain market share, consumer spending patterns and the Company’s ability to achieve its revenue growth projections and execute on its cost reduction initiatives.

The LTC reporting unit has continued to face challenges that affect the Company’s ability to grow the LTC reporting unit’s business at the rate estimated when its 2020 goodwill impairment test was performed and may continue to do so. These challenges include lower net bed additions and the prolonged adverse impact of the COVID-19 pandemic, which resulted in more significant declines in occupancy rates experienced by the Company’s long-term care facility customers than previously anticipated. Some of the key assumptions included in the Company’s financial projections to determine the estimated fair value of the LTC reporting unit include client retention rates; occupancy rates in skilled nursing facilities; the financial health of skilled nursing facility customers; facility reimbursement pressures; the Company’s ability to extract cost savings from labor productivity and other initiatives; the geographies impacted and the severity and duration of COVID-19; COVID-19’s impact on health care utilization patterns; and the timing, scope and impact of stimulus legislation as well as other federal, state and local governmental responses to COVID-19. The fair value of the LTC reporting unit also is dependent on market multiples of peer group companies and the risk-free interest rate environment, which impacts the discount rate used in the discounted cash flow valuation method.

The COVID-19 pandemic continues to evolve. The impact COVID-19 will have on our businesses, operating results, cash flows and/or financial condition is uncertain, but the impact could be adverse and material. If the LTC reporting unit does not achieve its forecasts, it is reasonably possible in the near term that the goodwill of the LTC reporting unit could be deemed to be impaired by a material amount. As of June 30, 2021, the goodwill balance in the LTC reporting unit was $431 million.

For a full description of the Company’s other critical accounting policies, see “Critical Accounting Policies” in Item 7 “Management’s Discussion and Analysis of Financial Condition and Results of Operations” of the 20202021 Form 10-K.

Cautionary Statement Concerning Forward-Looking Statements

The Private Securities Litigation Reform Act of 1995 (the “Reform Act”) provides a “safe harbor” for forward-looking statements, so long as (1) those statements are identified as forward-looking and (2) the statements are accompanied by meaningful cautionary statements that identify important factors that could cause actual results to differ materially from those discussed in the statement. We want to take advantage of these safe harbor provisions.

Certain information contained in this Quarterly Report on Form 10-Q (this “report”) is forward-looking within the meaning of the Reform Act or SEC rules. This information includes, but is not limited to the forward-looking information in Management’s Discussion and Analysis of Financial Condition and Results of Operations (“MD&A”) included in Part I, Item 2 of this report. In addition, throughout this report and our other reports and communications, we use the following words or variations or negatives of these words and similar expressions when we intend to identify forward-looking statements:
·Anticipates·Believes·Can·Continue·Could
·Estimates·Evaluate·Expects·Explore·Forecast
·Guidance·Intends·Likely·May·Might
·Outlook·Plans·Potential·Predict·Probable
·Projects·Seeks·Should·View·Will

All statements addressing the future operating performance of CVS Health or any segment or any subsidiary and/or future events or developments, including statements relating to the projected impact of COVID-19 and its emerging new variants on the Company’s businesses, investment portfolio, operating results, cash flows and/or financial condition, statements relating to corporate strategy, statements relating to future revenue, operating income or adjusted operating income, earnings per share or adjusted earnings per share, Health Care Benefits segment business, sales results and/or trends, medical cost trends, medical membership, Medicare Part D membership, medical benefit ratios and/or operations, Pharmacy Services segment business, sales results and/or trends and/or operations, Retail/LTC segment business, sales results and/or trends and/or operations, incremental investment spending, interest expense, effective tax rate, weighted-average share count, cash flow from operations, net capital expenditures, cash available for debt repayment, integration synergies, net synergies, integration costs, enterprise modernization, transformation, leverage ratio, cash available for enhancing shareholder value, inventory reduction, turn rate and/or loss rate, debt ratings, the Company’s ability to attract or retain customers and clients, store development and/or relocations, new product development, and the impact of industry and regulatory developments as well as statements expressing optimism or pessimism about future operating results or events, are forward-looking statements within the meaning of the Reform Act.

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Forward-looking statements rely on a number of estimates, assumptions and projections concerning future events, and are subject to a number of significant risks and uncertainties and other factors that could cause actual results to differ materially from those statements. Many of these risks and uncertainties and other factors are outside our control. Certain of these risks and uncertainties and other factors are described under “Risk Factors” included in Part I, Item 1A of our Annual Report on Form 10-K for the fiscal year ended December 31, 2020;2021 and under “Risk Factors” included in Part II, Item 1A of this report; these are not the only risks and uncertainties we face. There can be no assurance that the Company has identified all the risks
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Form 10-Q Table of Contents
that affect it. Additional risks and uncertainties not presently known to the Company or that the Company currently believes to be immaterial also may adversely affect the Company’s businesses. If any of those risks or uncertainties develops into actual events, those events or circumstances could have a material adverse effect on the Company’s businesses, operating results, cash flows, financial condition and/or stock price, among other effects.

You should not put undue reliance on forward-looking statements. Any forward-looking statement speaks only as of the date of this report, and we disclaim any intention or obligation to update or revise forward-looking statements, whether as a result of new information, future events, uncertainties or otherwise.

Item 3.Quantitative and Qualitative Disclosures About Market Risk

The Company has not experienced any material changes in exposures to market risk since December 31, 2020.2021. See the information contained in Part II, Item 7A “Quantitative and Qualitative Disclosures About Market Risk” of the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 20202021 for a discussion of the Company’s exposures to market risk.

Item 4.Controls and Procedures

Evaluation of disclosure controls and procedures: The Company’s Chief Executive Officer and Chief Financial Officer, after evaluating the effectiveness of the design and operation of the Company’s disclosure controls and procedures (as defined in Securities Exchange Act Rules 13a‑15(f) and 15d‑15(f)) as of June 30, 2021,2022, have concluded that as of such date the Company’s disclosure controls and procedures were adequate and effective and designed to provide reasonable assurance that material information relating to the Company and its subsidiaries would be made known to such officers on a timely basis.

Changes in internal control over financial reporting: There has been no change in the Company’s internal control over financial reporting identified in connection with the evaluation required by paragraph (d) of Rule 13a-15 or Rule 15d-15 that occurred in the three months ended June 30, 20212022 that has materially affected, or is reasonably likely to materially affect, the Company’s internal control over financial reporting.

Part II.Other Information

Item 1.Legal Proceedings

The information contained in Note 810 ‘‘Commitments and Contingencies’’ contained in “Notes to Condensed Consolidated Financial Statements (Unaudited)” in Part I, Item 1 of this Quarterly Report on Form 10-Q is incorporated by reference herein.

Item 1A.Risk Factors

There have been no material changes to the “Risk Factors” disclosed in Part I, Item 1A of the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2020.2021. Those risk factors could adversely affect the Company’s businesses, operating results, cash flows and/or financial condition as well as the market price of the Company’sCVS Health Corporation’s common shares.

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Item 2.Unregistered Sales of Equity Securities and Use of Proceeds

(c) Stock Repurchases

The following table presents the total number of shares purchased in the three months ended June 30, 2021,2022, the average price paid per share and the approximate dollar value of shares that still could have been purchased at the end of the applicable fiscal period, pursuant to the share repurchase program authorized by CVS Health Corporation’s Board of Directors on November 2, 2016.December 9, 2021. See Note 57 ‘‘Shareholders’ Equity’’ contained in “Notes to Condensed Consolidated Financial Statements (Unaudited)” in Part I, Item 1 of this Quarterly Report on Form 10-Q for additional information.
Fiscal PeriodTotal Number
of Shares
Purchased
Average
Price Paid per
Share
Total Number of Shares
Purchased as Part of
Publicly Announced
Plans or Programs
Approximate Dollar
Value of Shares that
May Yet Be
Purchased Under the
Plans or Programs
April 1, 20212022 through April 30, 20212022— $— — $13,869,392,4468,000,000,137 
May 1, 20212022 through May 31, 20212022— $— — $13,869,392,4468,000,000,137 
June 1, 20212022 through June 30, 20212022— $— — $13,869,392,4468,000,000,137 
— — 
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Form 10-Q Table of Contents
Item 3.        Defaults Upon Senior Securities

None.

Item 4.        Mine Safety Disclosures

Not Applicable.

Item 5.        Other Information

None.
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Item 6. Exhibits

The exhibits listed in this Item 6 are filed as part of this Quarterly Report on Form 10-Q. Exhibits marked with an asterisk (*) are management contracts or compensatory plans or arrangements. Exhibits other than those listed are omitted because they are not required to be listed or are not applicable. Pursuant to Item 601(b)(4)(iii) of regulationRegulation S-K, the Registrant hereby agrees to furnish to the Securities and Exchange Commission a copy of any omitted instrument that is not required to be listed.

INDEX TO EXHIBITS
10Material Contracts
10.1*
10.210.1
10.2
10.3*
10.4*10.3
10.5*
10.6*
15Letter re: unaudited interim financial information
15.1
31Rule 13a-14(a)/15d-14(a) Certifications
31.1
31.2
32Section 1350 Certifications
32.1
32.2
101
101
The following materials from the CVS Health Corporation Quarterly Report on Form 10-Q for the three and six months ended June 30, 20212022 formatted in Inline XBRL: (i) the Condensed Consolidated Statements of Operations, (ii) the Condensed Consolidated Statements of Comprehensive Income, (iii) the Condensed Consolidated Balance Sheets, (iv) the Condensed Consolidated Statements of Cash Flows, (v) the Condensed Consolidated Statements of Shareholders’ Equity and (vi) the related 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.
104
104Cover Page Interactive Data File - The cover page from the Company's Quarterly Report on Form 10-Q for the quarter ended June 30, 2021,2022, formatted in Inline XBRL (included as Exhibit 101).

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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.


 CVS HEALTH CORPORATION
 


Date:August 4, 20213, 2022By:/s/ Shawn M. Guertin
 Shawn M. Guertin
 Executive Vice President and Chief Financial Officer