Cover
Cover - shares shares in Thousands | 3 Months Ended | |
Mar. 31, 2024 | Apr. 24, 2024 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Mar. 31, 2024 | |
Document Transition Report | false | |
Entity File Number | 001-31826 | |
Entity Registrant Name | CENTENE CORPORATION | |
Entity Incorporation, State or Country Code | DE | |
Entity Tax Identification Number | 42-1406317 | |
Entity Address, Address Line One | 7700 Forsyth Boulevard | |
Entity Address, City or Town | St. Louis, | |
Entity Address, State or Province | MO | |
Entity Address, Postal Zip Code | 63105 | |
City Area Code | 314 | |
Local Phone Number | 725-4477 | |
Title of 12(b) Security | Common Stock $0.001 Par Value | |
Trading Symbol | CNC | |
Security Exchange Name | NYSE | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Large Accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Shell Company | false | |
Entity Common Stock, Shares Outstanding | 533,656 | |
Entity Central Index Key | 0001071739 | |
Current Fiscal Year End Date | --12-31 | |
Document Fiscal Year Focus | 2024 | |
Document Fiscal Period Focus | Q1 | |
Amendment Flag | false |
CONSOLIDATED BALANCE SHEETS
CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions | Mar. 31, 2024 | Dec. 31, 2023 |
Assets, Current [Abstract] | ||
Cash and cash equivalents | $ 17,585 | $ 17,193 |
Premium and trade receivables | 16,824 | 15,532 |
Short-term investments | 2,082 | 2,459 |
Other current assets | 1,957 | 5,572 |
Total current assets | 38,448 | 40,756 |
Long-term investments | 16,496 | 16,286 |
Restricted deposits | 1,383 | 1,386 |
Property, software and equipment, net | 1,988 | 2,019 |
Goodwill | 17,558 | 17,558 |
Intangible assets, net | 5,928 | 6,101 |
Other long-term assets | 823 | 535 |
Total assets | 82,624 | 84,641 |
Current liabilities: | ||
Medical claims liability | 18,109 | 18,000 |
Accounts payable and accrued expenses | 12,130 | 16,420 |
Return of premium payable | 1,751 | 1,462 |
Unearned revenue | 681 | 715 |
Current portion of long-term debt | 113 | 119 |
Total current liabilities | 32,784 | 36,716 |
Long-term debt | 17,887 | 17,710 |
Deferred tax liability | 734 | 641 |
Other long-term liabilities | 4,155 | 3,618 |
Total liabilities | 55,560 | 58,685 |
Commitments and contingencies | ||
Redeemable noncontrolling interests | 16 | 19 |
Stockholders' equity: | ||
Preferred stock, $0.001 par value; authorized 10,000 shares; no shares issued or outstanding at March 31, 2024 and December 31, 2023 | 0 | 0 |
Common stock, $0.001 par value; authorized 800,000 shares; 619,173 issued and 536,383 outstanding at March 31, 2024, and 615,291 issued and 534,484 outstanding at December 31, 2023 | 1 | 1 |
Additional paid-in capital | 20,388 | 20,304 |
Accumulated other comprehensive (loss) | (630) | (652) |
Retained earnings | 13,206 | 12,043 |
Treasury stock, at cost (82,790 and 80,807 shares, respectively) | (6,007) | (5,856) |
Total Centene stockholders' equity | 26,958 | 25,840 |
Nonredeemable noncontrolling interest | 90 | 97 |
Total stockholders' equity | 27,048 | 25,937 |
Total liabilities, redeemable noncontrolling interests and stockholders' equity | $ 82,624 | $ 84,641 |
CONSOLIDATED BALANCE SHEETS (Pa
CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares | Mar. 31, 2024 | Dec. 31, 2023 |
Stockholders' equity | ||
Preferred stock, par value (in dollars per share) | $ 0.001 | $ 0.001 |
Preferred stock, shares authorized (in shares) | 10,000,000 | 10,000,000 |
Preferred stock, shares issued (in shares) | 0 | 0 |
Preferred stock, shares outstanding (in shares) | 0 | 0 |
Common stock, par value (in dollars per share) | $ 0.001 | $ 0.001 |
Common stock, shares authorized (in shares) | 800,000,000 | 800,000,000 |
Common stock, shares issued (in shares) | 619,173,000 | 615,291,000 |
Common stock, shares outstanding (in shares) | 536,383,000 | 534,484,000 |
Treasury stock (in shares) | 82,790,000 | 80,807,000 |
CONSOLIDATED STATEMENTS OF OPER
CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Millions | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Revenues: | ||
Premium and service revenues | $ 36,337 | $ 34,952 |
Premium tax | 4,070 | 3,937 |
Total revenues | 40,407 | 38,889 |
Expenses: | ||
Medical costs | 30,932 | 29,434 |
Cost of services | 669 | 870 |
Selling, general and administrative expenses | 3,218 | 3,011 |
Depreciation expense | 135 | 142 |
Amortization of acquired intangible assets | 173 | 183 |
Premium tax expense | 4,161 | 4,011 |
Impairment | 13 | 20 |
Total operating expenses | 39,301 | 37,671 |
Earnings from operations | 1,106 | 1,218 |
Other income (expense): | ||
Investment and other income | 545 | 353 |
Interest expense | (178) | (180) |
Earnings before income tax | 1,473 | 1,391 |
Income tax expense | 315 | 261 |
Net earnings | 1,158 | 1,130 |
Loss attributable to noncontrolling interests | 5 | 0 |
Net earnings attributable to Centene Corporation | $ 1,163 | $ 1,130 |
Net earnings per common share attributable to Centene Corporation: | ||
Basic earnings per common share (in dollars per share) | $ 2.17 | $ 2.05 |
Diluted earnings per common share (in dollars per share) | $ 2.16 | $ 2.04 |
Weighted average number of common shares outstanding: | ||
Basic (in shares) | 535,109 | 550,779 |
Diluted (in shares) | 538,060 | 553,845 |
Premium | ||
Revenues: | ||
Premium and service revenues | $ 35,529 | $ 33,825 |
Service | ||
Revenues: | ||
Premium and service revenues | $ 808 | $ 1,127 |
CONSOLIDATED STATEMENTS OF COMP
CONSOLIDATED STATEMENTS OF COMPREHENSIVE EARNINGS (LOSS) - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Statement of Comprehensive Income [Abstract] | ||
Net earnings | $ 1,158 | $ 1,130 |
Change in unrealized gain (loss) on investments | (81) | 253 |
Change in unrealized gain (loss) on investments, tax effect | 15 | (61) |
Change in unrealized gain (loss) on investments, net of tax | (66) | 192 |
Reclassification adjustment, net of tax | 88 | 2 |
Foreign currency translation adjustments, net of tax | 0 | 23 |
Other comprehensive earnings | 22 | 217 |
Comprehensive earnings | 1,180 | 1,347 |
Comprehensive loss attributable to noncontrolling interests | 5 | 0 |
Comprehensive earnings attributable to Centene Corporation | $ 1,185 | $ 1,347 |
CONSOLIDATED STATEMENTS OF STOC
CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Millions | Total | Common Stock | Additional Paid-in Capital | Accumulated Other Comprehensive Earnings (Loss) | Retained Earnings | Treasury Stock | Noncontrolling Interest |
Balance (in shares) at Dec. 31, 2022 | 607,847 | ||||||
Treasury stock (in shares) at Dec. 31, 2022 | 57,093 | ||||||
Balance at Dec. 31, 2022 | $ 24,181 | $ 1 | $ 20,060 | $ (1,132) | $ 9,341 | $ (4,213) | $ 124 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Net earnings (loss) | 1,130 | 1,130 | 0 | ||||
Other comprehensive earnings (loss), net of tax | 217 | 217 | |||||
Common stock issued for employee benefit plans (in shares) | 6,508 | ||||||
Common stock issued for employee benefit plans | 12 | 12 | |||||
Common stock repurchases (in shares) | 5,548 | ||||||
Common stock repurchases | (423) | $ (423) | |||||
Stock compensation expense | 61 | 61 | |||||
Purchase of redeemable noncontrolling interest | (12) | (12) | |||||
Balance (in shares) at Mar. 31, 2023 | 614,355 | ||||||
Treasury stock (in shares) at Mar. 31, 2023 | 62,641 | ||||||
Balance at Mar. 31, 2023 | $ 25,166 | $ 1 | 20,121 | (915) | 10,471 | $ (4,636) | 124 |
Balance (in shares) at Dec. 31, 2023 | 534,484 | 615,291 | |||||
Treasury stock (in shares) at Dec. 31, 2023 | 80,807 | 80,807 | |||||
Balance at Dec. 31, 2023 | $ 25,937 | $ 1 | 20,304 | (652) | 12,043 | $ (5,856) | 97 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Net earnings (loss) | 1,159 | 1,163 | (4) | ||||
Other comprehensive earnings (loss), net of tax | 22 | 22 | |||||
Common stock issued for employee benefit plans (in shares) | 3,882 | ||||||
Common stock issued for employee benefit plans | 14 | 14 | |||||
Common stock repurchases (in shares) | 1,983 | ||||||
Common stock repurchases | (151) | $ (151) | |||||
Stock compensation expense | 70 | 70 | |||||
Divestiture of noncontrolling interest | $ (3) | (3) | |||||
Balance (in shares) at Mar. 31, 2024 | 536,383 | 619,173 | |||||
Treasury stock (in shares) at Mar. 31, 2024 | 82,790 | 82,790 | |||||
Balance at Mar. 31, 2024 | $ 27,048 | $ 1 | $ 20,388 | $ (630) | $ 13,206 | $ (6,007) | $ 90 |
CONSOLIDATED STATEMENTS OF ST_2
CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (Parenthetical) - USD ($) $ in Millions | 3 Months Ended | |||
Mar. 31, 2024 | Mar. 31, 2023 | Dec. 31, 2023 | Dec. 31, 2022 | |
Par value (in dollars per share) | $ 0.001 | $ 0.001 | ||
Other comprehensive earning (loss), tax | $ (12) | $ 61 | ||
Common Stock | ||||
Par value (in dollars per share) | $ 0.001 | $ 0.001 | 0.001 | $ 0.001 |
Treasury Stock | ||||
Par value (in dollars per share) | $ 0.001 | $ 0.001 | $ 0.001 | $ 0.001 |
CONSOLIDATED STATEMENTS OF CASH
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Cash flows from operating activities: | ||
Net earnings | $ 1,158 | $ 1,130 |
Adjustments to reconcile net earnings to net cash (used in) provided by operating activities | ||
Depreciation and amortization | 308 | 325 |
Stock compensation expense | 70 | 61 |
Impairment | 13 | 20 |
Deferred income taxes | 104 | (159) |
(Gain) loss on divestitures, net | (98) | (79) |
Other adjustments, net | (2) | 7 |
Changes in assets and liabilities | ||
Premium and trade receivables | (1,211) | (1,938) |
Other assets | (474) | (315) |
Medical claims liabilities | 108 | 759 |
Unearned revenue | (34) | 1,919 |
Accounts payable and accrued expenses | (1,411) | 1,548 |
Other long-term liabilities | 1,013 | 970 |
Other operating activities, net | 0 | 21 |
Net cash (used in) provided by operating activities | (456) | 4,269 |
Cash flows from investing activities: | ||
Capital expenditures | (151) | (225) |
Purchases of investments | (1,317) | (1,619) |
Sales and maturities of investments | 1,441 | 1,148 |
Divestiture proceeds, net of divested cash | 879 | 443 |
Net cash provided by (used in) investing activities | 852 | (253) |
Cash flows from financing activities: | ||
Proceeds from long-term debt | 350 | 287 |
Payments and repurchases of long-term debt | (187) | 0 |
Common stock repurchases | (151) | (423) |
Proceeds from common stock issuances | 14 | 12 |
Purchase of noncontrolling interest | 0 | (58) |
Other financing activities, net | (3) | (1) |
Net cash provided by (used in) financing activities | 23 | (183) |
Effect of exchange rate changes on cash, cash equivalents and restricted cash | 6 | 2 |
Net increase in cash, cash equivalents and restricted cash and cash equivalents | 425 | 3,835 |
Cash, cash equivalents and restricted cash and cash equivalents, beginning of period | 17,452 | 12,330 |
Cash, cash equivalents and restricted cash and cash equivalents, end of period | 17,877 | 16,165 |
Supplemental disclosures of cash flow information: | ||
Interest paid | 155 | 144 |
Income taxes paid | 13 | 11 |
The following table provides a reconciliation of cash, cash equivalents and restricted cash and cash equivalents reported within the Consolidated Balance Sheets to the totals above: | ||
Cash and cash equivalents | 17,585 | 15,853 |
Restricted cash and cash equivalents, included in restricted deposits | 292 | 312 |
Total cash, cash equivalents and restricted cash and cash equivalents | $ 17,877 | $ 16,165 |
Organization and Operations
Organization and Operations | 3 Months Ended |
Mar. 31, 2024 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Organization and Operations | Organization and Operations Basis of Presentation The accompanying interim financial statements have been prepared under the presumption that users of the interim financial information have either read or have access to the audited financial statements included in the Annual Report on Form 10-K for the fiscal year ended December 31, 2023. The unaudited interim financial statements herein have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (SEC). Accordingly, footnote disclosures that would substantially duplicate the disclosures contained in the December 31, 2023 audited financial statements have been omitted from these interim financial statements, where appropriate. In the opinion of management, these financial statements reflect all adjustments, consisting only of normal recurring adjustments, which are necessary for a fair presentation of the results of the interim periods presented. Certain 2023 amounts in the consolidated financial statements and notes to the consolidated financial statements have been reclassified to conform to the 2024 presentation. These reclassifications have no effect on net earnings or stockholders' equity as previously reported. Accounting Guidance Not Yet Adopted In November 2023, the Financial Accounting Standards Board (FASB) issued an Accounting Standards Update (ASU) which is intended to improve reportable segment disclosure requirements, primarily through enhanced disclosures about significant expenses. The amendments will require public entities to disclose significant segment expenses that are regularly provided to the chief operating decision-maker and included within segment profit and loss. The new standard is effective for annual periods beginning after December 15, 2023, and for interim periods within fiscal years beginning after December 15, 2024. The Company is currently evaluating the effect of the new disclosure requirements. In December 2023, the FASB issued an ASU which includes amendments that further enhance income tax disclosures, primarily through standardization and disaggregation of rate reconciliation categories and income taxes paid by jurisdiction. The new standard is effective for annual periods beginning after December 15, 2024. The Company is currently evaluating the effect of the new disclosure requirements. In March 2024, the SEC adopted the final rule under SEC Release No. 33-11275, The Enhancement and Standardization of Climate-Related Disclosures for Investors. This rule will require disclosure of material climate-related risks and material direct greenhouse gas emissions from operations owned or controlled (Scope 1) and/or material indirect greenhouse gas emissions from purchased energy consumed in owned or controlled operations (Scope 2). Additionally, the rules require disclosure in the notes to the financial statements of the effects of severe weather events and other natural conditions, subject to certain materiality thresholds. The disclosure requirements will begin phasing in for reports and registration statements including financial information with respect to annual periods beginning in 2025. In April 2024, the SEC voluntarily stayed the final rule pending the completion of judicial review by the Court of Appeals for the Eighth Circuit. The Company is monitoring the development of litigation related to the SEC's rule, and is currently evaluating the effect of the new disclosure requirements. |
Acquisitions and Divestitures
Acquisitions and Divestitures | 3 Months Ended |
Mar. 31, 2024 | |
Business Combination and Asset Acquisition [Abstract] | |
Acquisitions and Divestitures | Acquisitions and Divestitures Magellan Specialty Health Divestiture During the first quarter of 2024, the Company recorded an additional gain on the previously reported divestiture of Magellan Specialty Health of $81 million for achievement of contingent consideration related to the sale, which is included in investment and other income in the Consolidated Statements of Operations. Circle Health Group Divestiture On August 28, 2023, the Company signed a definitive agreement to sell Circle Health Group (Circle Health), one of the U.K.'s largest independent hospital operators, which is included in the Other segment. In accordance with the signed definitive agreement in the third quarter of 2023, and subsequently updated in the fourth quarter of 2023, the Company recorded impairment charges related to goodwill associated with the pending divestiture totaling $292 million, or $258 million after-tax. In order to manage the foreign exchange risk on the sale price associated with the pending divestiture of Circle Health, in August 2023 the Company entered into a foreign currency swap agreement for a notional amount of $931 million, to sell £740 million. The swap agreement was formally designated and qualified as a cash flow hedge. The swap expired on the earlier of the divestiture closing date or March 28, 2024. The gain or loss due to changes in the fair value of the foreign currency swap was recorded in other comprehensive income until the Circle Health divestiture closed, at which time the gain or loss was recorded in earnings to the same line in the Consolidated Statement of Operations as the gain or loss on sale. On January 12, 2024, the Company completed the divestiture for $931 million. Upon closing the divestiture, the Company settled the foreign currency swap and recorded a corresponding gain of $10 million, which includes the cumulative translation adjustment previously recorded in accumulated other comprehensive income in the Consolidated Balance Sheet. The gain is included in investment and other income in the Consolidated Statements of Operations. The Company realized a net tax benefit of approximately $45 million in the first quarter of 2024 on the loss recognized on the divestiture. |
Short-term and Long-term Invest
Short-term and Long-term Investments, Restricted Deposits | 3 Months Ended |
Mar. 31, 2024 | |
Investments, Debt and Equity Securities [Abstract] | |
Short-term and Long-term Investments, Restricted Deposits | Short-term and Long-term Investments, Restricted Deposits Short-term and long-term investments and restricted deposits by investment type consist of the following ($ in millions): March 31, 2024 December 31, 2023 Amortized Cost Gross Gross Fair Value Amortized Cost Gross Gross Fair Value Debt securities: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 390 $ — $ (8) $ 382 $ 403 $ — $ (8) $ 395 Corporate securities 10,262 43 (476) 9,829 9,984 78 (461) 9,601 Restricted certificates of deposit 4 — — 4 4 — — 4 Restricted cash equivalents 292 — — 292 259 — — 259 Short-term time deposits 289 — — 289 746 — — 746 Municipal securities 4,182 13 (177) 4,018 4,135 21 (171) 3,985 Asset-backed securities 1,648 8 (31) 1,625 1,665 8 (35) 1,638 Residential mortgage-backed securities 1,511 2 (120) 1,393 1,503 7 (103) 1,407 Commercial mortgage-backed securities 1,167 4 (80) 1,091 1,149 5 (82) 1,072 Equity securities 16 — — 16 17 — — 17 Private equity investments 837 — — 837 833 — — 833 Life insurance contracts 185 — — 185 174 — — 174 Total $ 20,783 $ 70 $ (892) $ 19,961 $ 20,872 $ 119 $ (860) $ 20,131 The Company's investments are debt securities classified as available-for-sale with the exception of equity securities, certain private equity investments and life insurance contracts. Private equity investments include direct investments in private equity securities as well as private equity funds. The Company's investment policies are designed to provide liquidity, preserve capital and maximize total return on invested assets with a focus on high credit quality securities. The Company limits the size of investment in any single issuer other than U.S. treasury securities and obligations of U.S. government corporations and agencies. As of March 31, 2024, 99% of the Company's investments in rated securities carry an investment grade rating by nationally recognized statistical rating organizations. At March 31, 2024, the Company held certificates of deposit, equity securities, private equity investments and life insurance contracts, which did not carry a credit rating. Accrued interest income on available-for-sale debt securities was $161 million and $153 million at March 31, 2024 and December 31, 2023, respectively, and is included in other current assets in the Consolidated Balance Sheets. The Company's residential mortgage-backed securities are primarily issued by the Federal National Mortgage Association, Government National Mortgage Association or Federal Home Loan Mortgage Corporation, which carry implicit or explicit guarantees of the U.S. government. The Company's commercial mortgage-backed securities are primarily senior tranches with a weighted average rating of AA+ and a weighted average duration of 4 years at March 31, 2024. The fair value of available-for-sale debt securities with gross unrealized losses by investment type and length of time that individual securities have been in a continuous unrealized loss position were as follows ($ in millions): March 31, 2024 December 31, 2023 Less Than 12 Months 12 Months or More Less Than 12 Months 12 Months or More Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value U.S. Treasury securities and obligations of U.S. government corporations and agencies $ — $ 136 $ (8) $ 214 $ — $ 79 $ (8) $ 232 Corporate securities (14) 1,462 (462) 6,031 (6) 658 (455) 6,260 Municipal securities (9) 972 (168) 2,223 (4) 553 (167) 2,237 Asset-backed securities (2) 411 (29) 479 (2) 197 (33) 855 Residential mortgage-backed securities (6) 357 (114) 805 (2) 153 (101) 814 Commercial mortgage-backed securities (3) 145 (77) 744 (2) 114 (80) 754 Short-term time deposits — 3 — — — 31 — — Total $ (34) $ 3,486 $ (858) $ 10,496 $ (16) $ 1,785 $ (844) $ 11,152 As of March 31, 2024, the gross unrealized losses were generated from 4,915 positions out of a total of 6,742 positions. The change in fair value of available-for-sale debt securities is primarily a result of movement in interest rates subsequent to the purchase of the security. For each security in an unrealized loss position, the Company assesses whether it intends to sell the security or if it is more likely than not the Company will be required to sell the security before recovery of the amortized cost basis for reasons such as liquidity, contractual or regulatory purposes. If the security meets this criterion, the decline in fair value is recorded in earnings. The Company does not intend to sell these securities prior to maturity and it is not likely that the Company will be required to sell these securities prior to maturity; therefore, the Company did not record an impairment for these securities. In addition, the Company monitors available-for-sale debt securities for credit losses. Certain investments have experienced a decline in fair value due to changes in credit quality, market interest rates and/or general economic conditions. The Company recognizes an allowance when evidence demonstrates that the decline in fair value is credit related. Evidence of a credit-related loss may include rating agency actions, adverse conditions specifically related to the security or failure of the issuer of the security to make scheduled payments. The contractual maturities of short-term and long-term debt securities and restricted deposits are as follows ($ in millions): March 31, 2024 December 31, 2023 Investments Restricted Deposits Investments Restricted Deposits Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value One year or less $ 1,932 $ 1,906 $ 641 $ 639 $ 2,308 $ 2,284 $ 566 $ 564 One year through five years 7,848 7,518 488 465 7,738 7,431 527 504 Five years through ten years 4,038 3,832 281 267 3,905 3,735 298 283 Greater than ten years 178 175 13 12 155 154 34 35 Asset-backed securities 4,326 4,109 — — 4,317 4,117 — — Total $ 18,322 $ 17,540 $ 1,423 $ 1,383 $ 18,423 $ 17,721 $ 1,425 $ 1,386 Actual maturities may differ from contractual maturities due to call or prepayment options. Equity securities, private equity investments and life insurance contracts are excluded from the table above because they do not have a contractual maturity. The Company has an option to redeem substantially all of the securities included in the greater than ten years category listed above at amortized cost. |
Fair Value Measurements
Fair Value Measurements | 3 Months Ended |
Mar. 31, 2024 | |
Fair Value Disclosures [Abstract] | |
Fair Value Measurements | Fair Value Measurements Assets and liabilities recorded at fair value in the Consolidated Balance Sheets are categorized based upon observable or unobservable inputs used to estimate fair value. Level inputs are as follows: Level Input: Input Definition: Level I Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date. Level II Inputs other than quoted prices included in Level I that are observable for the asset or liability through corroboration with market data at the measurement date. Level III Unobservable inputs that reflect management's best estimate of what market participants would use in pricing the asset or liability at the measurement date. The following table summarizes fair value measurements by level at March 31, 2024, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 17,585 $ — $ — $ 17,585 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 59 $ — $ — $ 59 Corporate securities — 9,791 — 9,791 Municipal securities — 3,292 — 3,292 Short-term time deposits — 289 — 289 Asset-backed securities — 1,625 — 1,625 Residential mortgage-backed securities — 1,393 — 1,393 Commercial mortgage-backed securities — 1,091 — 1,091 Equity securities 14 2 — 16 Total investments $ 73 $ 17,483 $ — $ 17,556 Restricted deposits: Cash and cash equivalents $ 292 $ — $ — $ 292 U.S. Treasury securities and obligations of U.S. government corporations and agencies 323 — — 323 Corporate securities — 38 — 38 Certificates of deposit — 4 — 4 Municipal securities — 726 — 726 Total restricted deposits $ 615 $ 768 $ — $ 1,383 Total assets at fair value $ 18,273 $ 18,251 $ — $ 36,524 The following table summarizes fair value measurements by level at December 31, 2023, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 17,193 $ — $ — $ 17,193 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 62 $ — $ — $ 62 Corporate securities — 9,564 — 9,564 Municipal securities — 3,232 — 3,232 Short-term time deposits — 746 — 746 Asset backed securities — 1,638 — 1,638 Residential mortgage-backed securities — 1,407 — 1,407 Commercial mortgage-backed securities — 1,072 — 1,072 Equity securities 15 2 — 17 Total investments $ 77 $ 17,661 $ — $ 17,738 Restricted deposits: Cash and cash equivalents $ 259 $ — $ — $ 259 U.S. Treasury securities and obligations of U.S. government corporations and agencies 333 — — 333 Corporate securities — 37 — 37 Certificates of deposit — 4 — 4 Municipal securities — 753 — 753 Total restricted deposits $ 592 $ 794 $ — $ 1,386 Total assets at fair value $ 17,862 $ 18,455 $ — $ 36,317 Liabilities Accounts payable and accrued expenses: Foreign currency swap agreement $ — $ 13 $ — $ 13 Total liabilities at fair value $ — $ 13 $ — $ 13 The Company utilizes matrix-pricing services to estimate fair value for securities which are not actively traded on the measurement date. The Company designates these securities as Level II fair value measurements. In addition, the aggregate carrying amount of the Company's private equity investments and life insurance contracts, which approximates fair value, was $1,022 million and $1,007 million as of March 31, 2024 and December 31, 2023, respectively. |
Medical Claims Liability
Medical Claims Liability | 3 Months Ended |
Mar. 31, 2024 | |
Insurance [Abstract] | |
Medical Claims Liability | Medical Claims Liability The following table summarizes the change in medical claims liability for the three months ended March 31, 2024 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2024 $ 10,814 $ 3,612 $ 3,460 $ 114 $ 18,000 Less: Reinsurance recoverable 5 — 44 — 49 Balance, January 1, 2024, net 10,809 3,612 3,416 114 17,951 Incurred related to: Current year 20,179 5,495 5,884 373 31,931 Prior years (684) (156) (204) (5) (1,049) Total incurred 19,495 5,339 5,680 368 30,882 Paid related to: Current year 12,823 3,266 3,339 258 19,686 Prior years 6,993 2,050 1,973 108 11,124 Total paid 19,816 5,316 5,312 366 30,810 Plus: Premium deficiency reserve — 50 — — 50 Balance, March 31, 2024, net 10,488 3,685 3,784 116 18,073 Plus: Reinsurance recoverable 4 — 32 — 36 Balance, March 31, 2024 $ 10,492 $ 3,685 $ 3,816 $ 116 $ 18,109 The following table summarizes the change in medical claims liability for the three months ended March 31, 2023 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2023 $ 11,253 $ 3,431 $ 1,921 $ 140 $ 16,745 Less: Reinsurance recoverable 7 — 19 — 26 Balance, January 1, 2023, net 11,246 3,431 1,902 140 16,719 Incurred related to: Current year 20,813 5,163 4,177 418 30,571 Prior years (803) (155) (172) (7) (1,137) Total incurred 20,010 5,008 4,005 411 29,434 Paid related to: Current year 12,679 2,988 2,541 294 18,502 Prior years 6,834 2,145 1,063 132 10,174 Total paid 19,513 5,133 3,604 426 28,676 Balance, March 31, 2023, net 11,743 3,306 2,303 125 17,477 Plus: Reinsurance recoverable 9 — 18 — 27 Balance, March 31, 2023 $ 11,752 $ 3,306 $ 2,321 $ 125 $ 17,504 Reinsurance recoverables related to medical claims are included in premium and trade receivables. Changes in estimates of incurred claims for prior years are primarily attributable to reserving under moderately adverse conditions. Additionally, as a result of development within "Incurred related to: Prior years," the Company recorded $54 million and $159 million as a reduction to premium revenue in the three months ended March 31, 2024 and 2023, respectively, for minimum health benefits ratio (HBR) and other return of premium programs. Incurred but not reported (IBNR) plus expected development on reported claims as of March 31, 2024 was $12,311 million. Total IBNR plus expected development on reported claims represents estimates for claims incurred but not reported, development on reported claims and estimates for the costs necessary to process unpaid claims at the end of each period. The Company estimates its liability using actuarial methods that are commonly used by health insurance actuaries and meet Actuarial Standards of Practice. These actuarial methods consider factors such as historical data for payment patterns, cost trends, product mix, seasonality, utilization of healthcare services and other relevant factors. The Company reviews actual and anticipated experience compared to the assumptions used to establish medical costs. The Company establishes premium deficiency reserves if actual and anticipated experience indicates that existing policy liabilities together with the present value of future gross premiums will not be sufficient to cover the present value of future benefits, settlement and maintenance costs. For purposes of determining premium deficiencies, contracts are grouped in a manner consistent with the method of acquiring, servicing and measuring the profitability of such contracts and expected investment income is excluded. In December 2023, the Company recorded a premium deficiency reserve of $250 million related to the 2024 Medicare Advantage contract year, which was increased to $300 million in the first quarter of 2024 consistent with the intra-year flow of seasonality. |
Affordable Care Act
Affordable Care Act | 3 Months Ended |
Mar. 31, 2024 | |
Affordable Care Act [Abstract] | |
Affordable Care Act | Affordable Care Act The Affordable Care Act established risk spreading premium stabilization programs as well as a minimum annual medical loss ratio (MLR) and cost sharing reductions. The Company's net receivables (payables) for each of the programs are as follows ($ in millions): March 31, 2024 December 31, 2023 Risk adjustment receivable $ 1,124 $ 893 Risk adjustment payable (3,266) (2,553) Minimum medical loss ratio (237) (164) Cost sharing reduction receivable 18 — Cost sharing reduction payable (113) (114) |
Debt
Debt | 3 Months Ended |
Mar. 31, 2024 | |
Debt Disclosure [Abstract] | |
Debt | Debt Debt consists of the following ($ in millions): March 31, 2024 December 31, 2023 $2,500 million 4.25% Senior Notes due December 15, 2027 $ 2,396 $ 2,395 $2,300 million 2.45% Senior Notes due July 15, 2028 2,303 2,303 $3,500 million 4.625% Senior Notes due December 15, 2029 3,277 3,277 $2,000 million 3.375% Senior Notes due February 15, 2030 2,000 2,000 $2,200 million 3.00% Senior Notes due October 15, 2030 2,200 2,200 $2,200 million 2.50% Senior Notes due March 1, 2031 2,200 2,200 $1,300 million 2.625% Senior Notes due August 1, 2031 1,300 1,300 Total senior notes 15,676 15,675 Term Loan Facility 2,088 2,115 Revolving Credit Agreement 350 150 Finance leases and other 3 11 Debt issuance costs (117) (122) Total debt 18,000 17,829 Less: current portion (113) (119) Long-term debt $ 17,887 $ 17,710 |
Stockholders' Equity
Stockholders' Equity | 3 Months Ended |
Mar. 31, 2024 | |
Equity [Abstract] | |
Stockholders' Equity | Stockholders' Equity The Company's Board of Directors has authorized a stock repurchase program of the Company's common stock from time to time on the open market or through privately negotiated transactions. The Company is authorized to repurchase up to $10,000 million, inclusive of past authorizations. As of March 31, 2024, the Company had a remaining amount of $5,178 million available under the stock repurchase program. In April 2024, the Company repurchased an additional 2.7 million shares for $200 million. The following represents the Company's share repurchase activity ($ in millions, shares in thousands): Three Months Ended March 31, 2024 2023 Shares Cost Shares Cost Share buybacks 681 $ 51 4,852 $ 377 Income tax withholding 1,302 100 696 46 Total share repurchases 1,983 $ 151 5,548 $ 423 Shares repurchased for income tax withholding are shares withheld in connection with employee stock plans to meet applicable tax withholding requirements. These shares are typically included in the Company's treasury stock. |
Earnings Per Share
Earnings Per Share | 3 Months Ended |
Mar. 31, 2024 | |
Earnings Per Share [Abstract] | |
Earnings Per Share | Earnings Per Share The following table sets forth the calculation of basic and diluted net earnings per common share ($ in millions, except per share data in dollars and shares in thousands): Three Months Ended March 31, 2024 2023 Earnings attributable to Centene Corporation $ 1,163 $ 1,130 Shares used in computing per share amounts: Weighted average number of common shares outstanding 535,109 550,779 Common stock equivalents (as determined by applying the treasury stock method) 2,951 3,066 Weighted average number of common shares and potential dilutive common shares outstanding 538,060 553,845 Net earnings per common share attributable to Centene Corporation: Basic earnings per common share $ 2.17 $ 2.05 Diluted earnings per common share $ 2.16 $ 2.04 The calculation of diluted earnings per common share for the three months ended March 31, 2024 and 2023 excludes 684 thousand shares and 1,606 thousand shares, respectively, related to anti-dilutive stock options, restricted stock and restricted stock units. |
Segment Information
Segment Information | 3 Months Ended |
Mar. 31, 2024 | |
Segment Reporting [Abstract] | |
Segment Information | Segment Information The Company operates in four segments: (1) a Medicaid segment, (2) a Medicare segment, (3) a Commercial segment and (4) an Other segment. The Medicaid, Medicare and Commercial segments represent the government-sponsored or subsidized programs under which the Company offers managed healthcare services. The Other segment includes the Company's pharmacy operations, Envolve Benefit Options' vision and dental services, clinical healthcare, behavioral health, international operations, and corporate management companies, among others. The Company's international businesses, Operose Health Group (Operose Health) and Circle Health, were divested in December 2023 and January 2024, respectively. Factors used in determining the reportable business segments include the nature of operating activities, the existence of separate senior management teams and the type of information presented to the Company's chief operating decision-maker to evaluate all results of operations. The Company does not report total assets by segment since this is not a metric used to allocate resources or evaluate segment performance. Segment information for the three months ended March 31, 2024, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 21,438 $ 5,935 $ 7,750 $ 406 $ 35,529 Service 22 — 1 785 808 Premium and service revenues 21,460 5,935 7,751 1,191 36,337 Premium tax 4,070 — — — 4,070 Total external revenues 25,530 5,935 7,751 1,191 40,407 Internal revenues — — — 4,080 4,080 Eliminations — — — (4,080) (4,080) Total revenues $ 25,530 $ 5,935 $ 7,751 $ 1,191 $ 40,407 Medical costs $ 19,495 $ 5,389 $ 5,680 $ 368 $ 30,932 Cost of services $ 21 $ — $ — $ 648 $ 669 Gross margin (1) $ 1,944 $ 546 $ 2,071 $ 175 $ 4,736 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the three months ended March 31, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 22,227 $ 5,876 $ 5,252 $ 470 $ 33,825 Service — — — 1,127 1,127 Premium and service revenues 22,227 5,876 5,252 1,597 34,952 Premium tax 3,937 — — — 3,937 Total external revenues 26,164 5,876 5,252 1,597 38,889 Internal revenues — — — 3,867 3,867 Eliminations — — — (3,867) (3,867) Total revenues $ 26,164 $ 5,876 $ 5,252 $ 1,597 $ 38,889 Medical costs $ 20,010 $ 5,008 $ 4,005 $ 411 $ 29,434 Cost of services $ — $ — $ — $ 870 $ 870 Gross margin (1) $ 2,217 $ 868 $ 1,247 $ 316 $ 4,648 (1) Gross margin represents premium and service revenues less medical costs and cost of services. |
Contingencies
Contingencies | 3 Months Ended |
Mar. 31, 2024 | |
Commitments and Contingencies Disclosure [Abstract] | |
Contingencies | Contingencies The Company is routinely subjected to legal and regulatory proceedings in the normal course of business. These matters can include, without limitation: • periodic compliance and other reviews and investigations by various federal and state regulatory agencies with respect to requirements applicable to the Company's business, including, without limitation, those related to payment of out-of-network claims, compliance with CMS Medicare and Marketplace regulations, including risk adjustment and broker compensation, compliance with the False Claims Act, the calculation of minimum MLR and rebates related thereto, submissions to state agencies related to payments or state false claims acts, pre-authorization penalties, timely review of grievances and appeals, timely and accurate payment of claims, cybersecurity issues, including those related to the Company's or the Company's third-party vendors' information systems, and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and other federal and state fraud, waste and abuse laws; • litigation arising out of general business activities, such as tax matters, disputes related to healthcare benefits coverage or reimbursement, putative securities class actions, and medical malpractice, privacy, real estate, intellectual property, vendor disputes and employment-related claims; and • disputes regarding reinsurance arrangements, claims arising out of the acquisition or divestiture of various assets, class actions and claims relating to the performance of contractual and non-contractual obligations to providers, members, employer groups, vendors and others, including, but not limited to, the alleged failure to properly pay claims and challenges to the manner in which the Company processes claims, claims related to network adequacy and claims alleging that the Company has engaged in unfair business practices. Among other things, these matters may result in awards of damages, fines or penalties, which could be substantial, and/or could require changes to the Company's business. The Company intends to vigorously defend itself against legal and regulatory proceedings to which it is currently a party; however, these proceedings are subject to many uncertainties. In some of the cases pending against the Company, substantial non-economic or punitive damages are being sought. The Company records reserves and accrues costs for certain legal proceedings and regulatory matters to the extent that it determines an unfavorable outcome is probable and the amount of the loss can be reasonably estimated. While such reserves and accrued costs reflect the Company's best estimate of the probable loss for such matters, the recorded amounts may differ materially from the actual amount of any such losses. In some cases, no estimate of the possible loss or range of loss in excess of amounts accrued, if any, can be made because of the inherently unpredictable nature of legal and regulatory proceedings, which may be exacerbated by various factors, including but not limited to, they may involve indeterminate claims for monetary damages or may involve fines, penalties or punitive damages; present novel legal theories or legal uncertainties; involve disputed facts; represent a shift in regulatory policy; involve a large number of parties, claimants or regulatory bodies; are in the early stages of the proceedings; involve a number of separate proceedings and/or a wide range of potential outcomes; or result in a change of business practices. As of the date of this report, amounts accrued for legal proceedings and regulatory matters were not material, except for the reserve estimate as previously disclosed in the Company's 2023 Annual Report on Form 10-K with respect to claims or potential claims involving services provided by Envolve Pharmacy Solutions, Inc. (Envolve), as the Company's pharmacy benefits management (PBM) subsidiary. The Company has reached no-fault settlement agreements related to services previously provided by Envolve with the vast majority of states impacted. Such agreements have provided for payment amounts consistent with the initial reserve estimate established in the second quarter of 2021 related to this issue. It is possible that in a particular quarter or annual period the Company's financial condition, results of operations, cash flow and/or liquidity could be materially adversely affected by an ultimate unfavorable resolution of or development in legal and/or regulatory proceedings. The Company believes that the ultimate outcome of any of the regulatory and legal proceedings that are currently pending against it should not have a material adverse effect on financial condition, results of operations, cash flow or liquidity. |
Pay vs Performance Disclosure
Pay vs Performance Disclosure - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Pay vs Performance Disclosure | ||
Net earnings (loss) | $ 1,163 | $ 1,130 |
Insider Trading Arrangements
Insider Trading Arrangements | 3 Months Ended |
Mar. 31, 2024 | |
Trading Arrangements, by Individual | |
Rule 10b5-1 Arrangement Adopted | false |
Non-Rule 10b5-1 Arrangement Adopted | false |
Rule 10b5-1 Arrangement Terminated | false |
Non-Rule 10b5-1 Arrangement Terminated | false |
Organization and Operations (Po
Organization and Operations (Policies) | 3 Months Ended |
Mar. 31, 2024 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Basis of Presentation | Basis of Presentation The accompanying interim financial statements have been prepared under the presumption that users of the interim financial information have either read or have access to the audited financial statements included in the Annual Report on Form 10-K for the fiscal year ended December 31, 2023. The unaudited interim financial statements herein have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (SEC). Accordingly, footnote disclosures that would substantially duplicate the disclosures contained in the December 31, 2023 audited financial statements have been omitted from these interim financial statements, where appropriate. In the opinion of management, these financial statements reflect all adjustments, consisting only of normal recurring adjustments, which are necessary for a fair presentation of the results of the interim periods presented. Certain 2023 amounts in the consolidated financial statements and notes to the consolidated financial statements have been reclassified to conform to the 2024 presentation. These reclassifications have no effect on net earnings or stockholders' equity as previously reported. |
Accounting Guidance Not Yet Adopted | Accounting Guidance Not Yet Adopted In November 2023, the Financial Accounting Standards Board (FASB) issued an Accounting Standards Update (ASU) which is intended to improve reportable segment disclosure requirements, primarily through enhanced disclosures about significant expenses. The amendments will require public entities to disclose significant segment expenses that are regularly provided to the chief operating decision-maker and included within segment profit and loss. The new standard is effective for annual periods beginning after December 15, 2023, and for interim periods within fiscal years beginning after December 15, 2024. The Company is currently evaluating the effect of the new disclosure requirements. In December 2023, the FASB issued an ASU which includes amendments that further enhance income tax disclosures, primarily through standardization and disaggregation of rate reconciliation categories and income taxes paid by jurisdiction. The new standard is effective for annual periods beginning after December 15, 2024. The Company is currently evaluating the effect of the new disclosure requirements. In March 2024, the SEC adopted the final rule under SEC Release No. 33-11275, The Enhancement and Standardization of Climate-Related Disclosures for Investors. This rule will require disclosure of material climate-related risks and material direct greenhouse gas emissions from operations owned or controlled (Scope 1) and/or material indirect greenhouse gas emissions from purchased energy consumed in owned or controlled operations (Scope 2). Additionally, the rules require disclosure in the notes to the financial statements of the effects of severe weather events and other natural conditions, subject to certain materiality thresholds. The disclosure requirements will begin phasing in for reports and registration statements including financial information with respect to annual periods beginning in 2025. In April 2024, the SEC voluntarily stayed the final rule pending the completion of judicial review by the Court of Appeals for the Eighth Circuit. The Company is monitoring the development of litigation related to the SEC's rule, and is currently evaluating the effect of the new disclosure requirements. |
Short-term and Long-term Inve_2
Short-term and Long-term Investments, Restricted Deposits (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Investments, Debt and Equity Securities [Abstract] | |
Short-term and long-term investments and restricted deposits by investment type | Short-term and long-term investments and restricted deposits by investment type consist of the following ($ in millions): March 31, 2024 December 31, 2023 Amortized Cost Gross Gross Fair Value Amortized Cost Gross Gross Fair Value Debt securities: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 390 $ — $ (8) $ 382 $ 403 $ — $ (8) $ 395 Corporate securities 10,262 43 (476) 9,829 9,984 78 (461) 9,601 Restricted certificates of deposit 4 — — 4 4 — — 4 Restricted cash equivalents 292 — — 292 259 — — 259 Short-term time deposits 289 — — 289 746 — — 746 Municipal securities 4,182 13 (177) 4,018 4,135 21 (171) 3,985 Asset-backed securities 1,648 8 (31) 1,625 1,665 8 (35) 1,638 Residential mortgage-backed securities 1,511 2 (120) 1,393 1,503 7 (103) 1,407 Commercial mortgage-backed securities 1,167 4 (80) 1,091 1,149 5 (82) 1,072 Equity securities 16 — — 16 17 — — 17 Private equity investments 837 — — 837 833 — — 833 Life insurance contracts 185 — — 185 174 — — 174 Total $ 20,783 $ 70 $ (892) $ 19,961 $ 20,872 $ 119 $ (860) $ 20,131 |
Fair value of available-for-sale investments with gross unrealized losses by investment type and length of time | The fair value of available-for-sale debt securities with gross unrealized losses by investment type and length of time that individual securities have been in a continuous unrealized loss position were as follows ($ in millions): March 31, 2024 December 31, 2023 Less Than 12 Months 12 Months or More Less Than 12 Months 12 Months or More Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value U.S. Treasury securities and obligations of U.S. government corporations and agencies $ — $ 136 $ (8) $ 214 $ — $ 79 $ (8) $ 232 Corporate securities (14) 1,462 (462) 6,031 (6) 658 (455) 6,260 Municipal securities (9) 972 (168) 2,223 (4) 553 (167) 2,237 Asset-backed securities (2) 411 (29) 479 (2) 197 (33) 855 Residential mortgage-backed securities (6) 357 (114) 805 (2) 153 (101) 814 Commercial mortgage-backed securities (3) 145 (77) 744 (2) 114 (80) 754 Short-term time deposits — 3 — — — 31 — — Total $ (34) $ 3,486 $ (858) $ 10,496 $ (16) $ 1,785 $ (844) $ 11,152 |
Contractual maturities of short-term and long-term investments and restricted deposits | The contractual maturities of short-term and long-term debt securities and restricted deposits are as follows ($ in millions): March 31, 2024 December 31, 2023 Investments Restricted Deposits Investments Restricted Deposits Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value One year or less $ 1,932 $ 1,906 $ 641 $ 639 $ 2,308 $ 2,284 $ 566 $ 564 One year through five years 7,848 7,518 488 465 7,738 7,431 527 504 Five years through ten years 4,038 3,832 281 267 3,905 3,735 298 283 Greater than ten years 178 175 13 12 155 154 34 35 Asset-backed securities 4,326 4,109 — — 4,317 4,117 — — Total $ 18,322 $ 17,540 $ 1,423 $ 1,383 $ 18,423 $ 17,721 $ 1,425 $ 1,386 |
Fair Value Measurements (Tables
Fair Value Measurements (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Fair Value Disclosures [Abstract] | |
Assets and Liabilities, Based Upon Observable or Unobservable Inputs, Level Input Definitions | Assets and liabilities recorded at fair value in the Consolidated Balance Sheets are categorized based upon observable or unobservable inputs used to estimate fair value. Level inputs are as follows: Level Input: Input Definition: Level I Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date. Level II Inputs other than quoted prices included in Level I that are observable for the asset or liability through corroboration with market data at the measurement date. Level III Unobservable inputs that reflect management's best estimate of what market participants would use in pricing the asset or liability at the measurement date. |
Fair Value Measurements by Level for Assets and Liabilities Measured at Fair Value on a Recurring Basis | The following table summarizes fair value measurements by level at March 31, 2024, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 17,585 $ — $ — $ 17,585 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 59 $ — $ — $ 59 Corporate securities — 9,791 — 9,791 Municipal securities — 3,292 — 3,292 Short-term time deposits — 289 — 289 Asset-backed securities — 1,625 — 1,625 Residential mortgage-backed securities — 1,393 — 1,393 Commercial mortgage-backed securities — 1,091 — 1,091 Equity securities 14 2 — 16 Total investments $ 73 $ 17,483 $ — $ 17,556 Restricted deposits: Cash and cash equivalents $ 292 $ — $ — $ 292 U.S. Treasury securities and obligations of U.S. government corporations and agencies 323 — — 323 Corporate securities — 38 — 38 Certificates of deposit — 4 — 4 Municipal securities — 726 — 726 Total restricted deposits $ 615 $ 768 $ — $ 1,383 Total assets at fair value $ 18,273 $ 18,251 $ — $ 36,524 The following table summarizes fair value measurements by level at December 31, 2023, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 17,193 $ — $ — $ 17,193 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 62 $ — $ — $ 62 Corporate securities — 9,564 — 9,564 Municipal securities — 3,232 — 3,232 Short-term time deposits — 746 — 746 Asset backed securities — 1,638 — 1,638 Residential mortgage-backed securities — 1,407 — 1,407 Commercial mortgage-backed securities — 1,072 — 1,072 Equity securities 15 2 — 17 Total investments $ 77 $ 17,661 $ — $ 17,738 Restricted deposits: Cash and cash equivalents $ 259 $ — $ — $ 259 U.S. Treasury securities and obligations of U.S. government corporations and agencies 333 — — 333 Corporate securities — 37 — 37 Certificates of deposit — 4 — 4 Municipal securities — 753 — 753 Total restricted deposits $ 592 $ 794 $ — $ 1,386 Total assets at fair value $ 17,862 $ 18,455 $ — $ 36,317 Liabilities Accounts payable and accrued expenses: Foreign currency swap agreement $ — $ 13 $ — $ 13 Total liabilities at fair value $ — $ 13 $ — $ 13 |
Medical Claims Liability (Table
Medical Claims Liability (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Insurance [Abstract] | |
Schedule of change in medical claims liability | The following table summarizes the change in medical claims liability for the three months ended March 31, 2024 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2024 $ 10,814 $ 3,612 $ 3,460 $ 114 $ 18,000 Less: Reinsurance recoverable 5 — 44 — 49 Balance, January 1, 2024, net 10,809 3,612 3,416 114 17,951 Incurred related to: Current year 20,179 5,495 5,884 373 31,931 Prior years (684) (156) (204) (5) (1,049) Total incurred 19,495 5,339 5,680 368 30,882 Paid related to: Current year 12,823 3,266 3,339 258 19,686 Prior years 6,993 2,050 1,973 108 11,124 Total paid 19,816 5,316 5,312 366 30,810 Plus: Premium deficiency reserve — 50 — — 50 Balance, March 31, 2024, net 10,488 3,685 3,784 116 18,073 Plus: Reinsurance recoverable 4 — 32 — 36 Balance, March 31, 2024 $ 10,492 $ 3,685 $ 3,816 $ 116 $ 18,109 The following table summarizes the change in medical claims liability for the three months ended March 31, 2023 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2023 $ 11,253 $ 3,431 $ 1,921 $ 140 $ 16,745 Less: Reinsurance recoverable 7 — 19 — 26 Balance, January 1, 2023, net 11,246 3,431 1,902 140 16,719 Incurred related to: Current year 20,813 5,163 4,177 418 30,571 Prior years (803) (155) (172) (7) (1,137) Total incurred 20,010 5,008 4,005 411 29,434 Paid related to: Current year 12,679 2,988 2,541 294 18,502 Prior years 6,834 2,145 1,063 132 10,174 Total paid 19,513 5,133 3,604 426 28,676 Balance, March 31, 2023, net 11,743 3,306 2,303 125 17,477 Plus: Reinsurance recoverable 9 — 18 — 27 Balance, March 31, 2023 $ 11,752 $ 3,306 $ 2,321 $ 125 $ 17,504 |
Affordable Care Act (Tables)
Affordable Care Act (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Affordable Care Act [Abstract] | |
Schedule of net receivables (payables) related to the Affordable Care Act Programs | The Company's net receivables (payables) for each of the programs are as follows ($ in millions): March 31, 2024 December 31, 2023 Risk adjustment receivable $ 1,124 $ 893 Risk adjustment payable (3,266) (2,553) Minimum medical loss ratio (237) (164) Cost sharing reduction receivable 18 — Cost sharing reduction payable (113) (114) |
Debt (Tables)
Debt (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Debt Disclosure [Abstract] | |
Schedule of Debt | Debt consists of the following ($ in millions): March 31, 2024 December 31, 2023 $2,500 million 4.25% Senior Notes due December 15, 2027 $ 2,396 $ 2,395 $2,300 million 2.45% Senior Notes due July 15, 2028 2,303 2,303 $3,500 million 4.625% Senior Notes due December 15, 2029 3,277 3,277 $2,000 million 3.375% Senior Notes due February 15, 2030 2,000 2,000 $2,200 million 3.00% Senior Notes due October 15, 2030 2,200 2,200 $2,200 million 2.50% Senior Notes due March 1, 2031 2,200 2,200 $1,300 million 2.625% Senior Notes due August 1, 2031 1,300 1,300 Total senior notes 15,676 15,675 Term Loan Facility 2,088 2,115 Revolving Credit Agreement 350 150 Finance leases and other 3 11 Debt issuance costs (117) (122) Total debt 18,000 17,829 Less: current portion (113) (119) Long-term debt $ 17,887 $ 17,710 |
Stockholders' Equity (Tables)
Stockholders' Equity (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Equity [Abstract] | |
Share Repurchase Activity | The following represents the Company's share repurchase activity ($ in millions, shares in thousands): Three Months Ended March 31, 2024 2023 Shares Cost Shares Cost Share buybacks 681 $ 51 4,852 $ 377 Income tax withholding 1,302 100 696 46 Total share repurchases 1,983 $ 151 5,548 $ 423 |
Earnings Per Share (Tables)
Earnings Per Share (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Earnings Per Share [Abstract] | |
Calculation of Basic and Diluted Net Earnings Per Common Share | The following table sets forth the calculation of basic and diluted net earnings per common share ($ in millions, except per share data in dollars and shares in thousands): Three Months Ended March 31, 2024 2023 Earnings attributable to Centene Corporation $ 1,163 $ 1,130 Shares used in computing per share amounts: Weighted average number of common shares outstanding 535,109 550,779 Common stock equivalents (as determined by applying the treasury stock method) 2,951 3,066 Weighted average number of common shares and potential dilutive common shares outstanding 538,060 553,845 Net earnings per common share attributable to Centene Corporation: Basic earnings per common share $ 2.17 $ 2.05 Diluted earnings per common share $ 2.16 $ 2.04 |
Segment Information (Tables)
Segment Information (Tables) | 3 Months Ended |
Mar. 31, 2024 | |
Segment Reporting [Abstract] | |
Segment Information | Segment information for the three months ended March 31, 2024, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 21,438 $ 5,935 $ 7,750 $ 406 $ 35,529 Service 22 — 1 785 808 Premium and service revenues 21,460 5,935 7,751 1,191 36,337 Premium tax 4,070 — — — 4,070 Total external revenues 25,530 5,935 7,751 1,191 40,407 Internal revenues — — — 4,080 4,080 Eliminations — — — (4,080) (4,080) Total revenues $ 25,530 $ 5,935 $ 7,751 $ 1,191 $ 40,407 Medical costs $ 19,495 $ 5,389 $ 5,680 $ 368 $ 30,932 Cost of services $ 21 $ — $ — $ 648 $ 669 Gross margin (1) $ 1,944 $ 546 $ 2,071 $ 175 $ 4,736 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the three months ended March 31, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 22,227 $ 5,876 $ 5,252 $ 470 $ 33,825 Service — — — 1,127 1,127 Premium and service revenues 22,227 5,876 5,252 1,597 34,952 Premium tax 3,937 — — — 3,937 Total external revenues 26,164 5,876 5,252 1,597 38,889 Internal revenues — — — 3,867 3,867 Eliminations — — — (3,867) (3,867) Total revenues $ 26,164 $ 5,876 $ 5,252 $ 1,597 $ 38,889 Medical costs $ 20,010 $ 5,008 $ 4,005 $ 411 $ 29,434 Cost of services $ — $ — $ — $ 870 $ 870 Gross margin (1) $ 2,217 $ 868 $ 1,247 $ 316 $ 4,648 (1) Gross margin represents premium and service revenues less medical costs and cost of services. |
Acquisitions and Divestitures -
Acquisitions and Divestitures - Divestiture (Details) £ in Millions, $ in Millions | 3 Months Ended | 12 Months Ended | ||||
Jan. 12, 2024 USD ($) | Mar. 31, 2024 USD ($) | Mar. 31, 2023 USD ($) | Dec. 31, 2023 USD ($) | Aug. 31, 2023 USD ($) | Aug. 31, 2023 GBP (£) | |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||||
Gain (loss) on divestitures | $ 98 | $ 79 | ||||
Income tax benefit | (315) | $ (261) | ||||
Magellan Rx | Disposal Group, Disposed of by Sale, Not Discontinued Operations | ||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||||
Gain (loss) on divestitures | (81) | |||||
Circle Health | ||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||||
Gain (loss) on divestitures | 10 | |||||
Circle Health | Disposal Group, Disposed of by Sale, Not Discontinued Operations | ||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||||
Proceeds from sale of business | $ 931 | |||||
Income tax benefit | $ 45 | |||||
Circle Health | Disposal Group, Held-for-sale, Not Discontinued Operations | ||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||||
Goodwill impairment | $ 292 | |||||
Goodwill, impairment, net of tax | $ 258 | |||||
Currency Swap | ||||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||||
Notional amount | $ 931 | £ 740 |
Short-term and Long-term Inve_3
Short-term and Long-term Investments, Restricted Deposits - By Investment Type (Details) - USD ($) $ in Millions | Mar. 31, 2024 | Dec. 31, 2023 |
Debt Securities | ||
Gross Unrealized Gains | $ 70 | $ 119 |
Gross Unrealized Losses | (892) | (860) |
Equity securities | 16 | 17 |
Private equity investments | 837 | 833 |
Life insurance contracts | 185 | 174 |
Total, Amortized Cost | 20,783 | 20,872 |
Total, Fair Value | 19,961 | 20,131 |
U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Debt Securities | ||
Amortized Cost | 390 | 403 |
Gross Unrealized Gains | 0 | 0 |
Gross Unrealized Losses | (8) | (8) |
Fair Value | 382 | 395 |
Corporate securities | ||
Debt Securities | ||
Amortized Cost | 10,262 | 9,984 |
Gross Unrealized Gains | 43 | 78 |
Gross Unrealized Losses | (476) | (461) |
Fair Value | 9,829 | 9,601 |
Restricted certificates of deposit | ||
Debt Securities | ||
Amortized Cost | 4 | 4 |
Gross Unrealized Gains | 0 | 0 |
Gross Unrealized Losses | 0 | 0 |
Fair Value | 4 | 4 |
Restricted cash equivalents | ||
Debt Securities | ||
Amortized Cost | 292 | 259 |
Gross Unrealized Gains | 0 | 0 |
Gross Unrealized Losses | 0 | 0 |
Fair Value | 292 | 259 |
Short-term time deposits | ||
Debt Securities | ||
Amortized Cost | 289 | 746 |
Gross Unrealized Gains | 0 | 0 |
Gross Unrealized Losses | 0 | 0 |
Fair Value | 289 | 746 |
Municipal securities | ||
Debt Securities | ||
Amortized Cost | 4,182 | 4,135 |
Gross Unrealized Gains | 13 | 21 |
Gross Unrealized Losses | (177) | (171) |
Fair Value | 4,018 | 3,985 |
Asset-backed securities | ||
Debt Securities | ||
Amortized Cost | 1,648 | 1,665 |
Gross Unrealized Gains | 8 | 8 |
Gross Unrealized Losses | (31) | (35) |
Fair Value | 1,625 | 1,638 |
Residential mortgage-backed securities | ||
Debt Securities | ||
Amortized Cost | 1,511 | 1,503 |
Gross Unrealized Gains | 2 | 7 |
Gross Unrealized Losses | (120) | (103) |
Fair Value | 1,393 | 1,407 |
Commercial mortgage-backed securities | ||
Debt Securities | ||
Amortized Cost | 1,167 | 1,149 |
Gross Unrealized Gains | 4 | 5 |
Gross Unrealized Losses | (80) | (82) |
Fair Value | $ 1,091 | $ 1,072 |
Short-term and Long-term Inve_4
Short-term and Long-term Investments, Restricted Deposits - Narrative (Details) $ in Millions | 3 Months Ended | |
Mar. 31, 2024 USD ($) position | Dec. 31, 2023 USD ($) | |
Schedule Of Investments And Restricted Deposits By Type [Line Items] | ||
Accrued interest income | $ | $ 161 | $ 153 |
Positions from which gross unrealized losses were generated | 4,915 | |
Total investment positions | 6,742 | |
Commercial mortgage-backed securities | ||
Schedule Of Investments And Restricted Deposits By Type [Line Items] | ||
Investments recorded at fair value that carry rating of AAA Plus, weighted average (in years) | 4 years | |
Rated Securities | External Credit Rating, Investment Grade | Investment Securities | ||
Schedule Of Investments And Restricted Deposits By Type [Line Items] | ||
Percentage of investments in rated securities carry an investment grade rating by nationally recognized statistical rating organizations | 99% |
Short-term and Long-term Inve_5
Short-term and Long-term Investments, Restricted Deposits - Fair Value of Available-For-Sale Investments with Gross Unrealized Losses by Investment Type and Length of Time (Details) - USD ($) $ in Millions | Mar. 31, 2024 | Dec. 31, 2023 |
Unrealized Losses | ||
Less Than 12 Months | $ (34) | $ (16) |
12 Months or More | (858) | (844) |
Fair Value | ||
Fair Value, Less Than 12 Months | 3,486 | 1,785 |
Fair Value, 12 Months or More | 10,496 | 11,152 |
U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Unrealized Losses | ||
Less Than 12 Months | 0 | 0 |
12 Months or More | (8) | (8) |
Fair Value | ||
Fair Value, Less Than 12 Months | 136 | 79 |
Fair Value, 12 Months or More | 214 | 232 |
Corporate securities | ||
Unrealized Losses | ||
Less Than 12 Months | (14) | (6) |
12 Months or More | (462) | (455) |
Fair Value | ||
Fair Value, Less Than 12 Months | 1,462 | 658 |
Fair Value, 12 Months or More | 6,031 | 6,260 |
Municipal securities | ||
Unrealized Losses | ||
Less Than 12 Months | (9) | (4) |
12 Months or More | (168) | (167) |
Fair Value | ||
Fair Value, Less Than 12 Months | 972 | 553 |
Fair Value, 12 Months or More | 2,223 | 2,237 |
Asset-backed securities | ||
Unrealized Losses | ||
Less Than 12 Months | (2) | (2) |
12 Months or More | (29) | (33) |
Fair Value | ||
Fair Value, Less Than 12 Months | 411 | 197 |
Fair Value, 12 Months or More | 479 | 855 |
Residential mortgage-backed securities | ||
Unrealized Losses | ||
Less Than 12 Months | (6) | (2) |
12 Months or More | (114) | (101) |
Fair Value | ||
Fair Value, Less Than 12 Months | 357 | 153 |
Fair Value, 12 Months or More | 805 | 814 |
Commercial mortgage-backed securities | ||
Unrealized Losses | ||
Less Than 12 Months | (3) | (2) |
12 Months or More | (77) | (80) |
Fair Value | ||
Fair Value, Less Than 12 Months | 145 | 114 |
Fair Value, 12 Months or More | 744 | 754 |
Short-term time deposits | ||
Unrealized Losses | ||
Less Than 12 Months | 0 | 0 |
12 Months or More | 0 | 0 |
Fair Value | ||
Fair Value, Less Than 12 Months | 3 | 31 |
Fair Value, 12 Months or More | $ 0 | $ 0 |
Short-term and Long-term Inve_6
Short-term and Long-term Investments, Restricted Deposits - Contractual Maturities of Short-Term and Long-Term Investments and Restricted Deposits (Details) - USD ($) $ in Millions | Mar. 31, 2024 | Dec. 31, 2023 |
Investments | ||
Amortized Cost | ||
One year or less | $ 1,932 | $ 2,308 |
One year through five years | 7,848 | 7,738 |
Five years through ten years | 4,038 | 3,905 |
Greater than ten years | 178 | 155 |
Asset-backed securities | 4,326 | 4,317 |
Amortized Cost | 18,322 | 18,423 |
Fair Value | ||
One year or less | 1,906 | 2,284 |
One year through five years | 7,518 | 7,431 |
Five years through ten years | 3,832 | 3,735 |
Greater than ten years | 175 | 154 |
Asset-backed securities | 4,109 | 4,117 |
Fair Value | 17,540 | 17,721 |
Restricted Deposits | ||
Amortized Cost | ||
One year or less | 641 | 566 |
One year through five years | 488 | 527 |
Five years through ten years | 281 | 298 |
Greater than ten years | 13 | 34 |
Asset-backed securities | 0 | 0 |
Amortized Cost | 1,423 | 1,425 |
Fair Value | ||
One year or less | 639 | 564 |
One year through five years | 465 | 504 |
Five years through ten years | 267 | 283 |
Greater than ten years | 12 | 35 |
Asset-backed securities | 0 | 0 |
Fair Value | $ 1,383 | $ 1,386 |
Fair Value Measurements - Fair
Fair Value Measurements - Fair Value Measurements by Level for Assets and Liabilities Measured at Fair Value on a Recurring Basis (Details) - USD ($) $ in Millions | Mar. 31, 2024 | Dec. 31, 2023 |
Assets | ||
Cash and cash equivalents | $ 17,585 | $ 17,193 |
Investments: | ||
Equity securities | 16 | 17 |
Total assets at fair value | 36,524 | 36,317 |
Total liabilities at fair value | 13 | |
Accounts payable and accrued expenses: | Currency Swap | ||
Investments: | ||
Derivative liability | 13 | |
U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair value | 382 | 395 |
Corporate securities | ||
Investments: | ||
Fair value | 9,829 | 9,601 |
Municipal securities | ||
Investments: | ||
Fair value | 4,018 | 3,985 |
Short-term time deposits | ||
Investments: | ||
Fair value | 289 | 746 |
Asset-backed securities | ||
Investments: | ||
Fair value | 1,625 | 1,638 |
Residential mortgage-backed securities | ||
Investments: | ||
Fair value | 1,393 | 1,407 |
Commercial mortgage-backed securities | ||
Investments: | ||
Fair value | 1,091 | 1,072 |
Level I | ||
Assets | ||
Cash and cash equivalents | 17,585 | 17,193 |
Investments: | ||
Total assets at fair value | 18,273 | 17,862 |
Total liabilities at fair value | 0 | |
Level I | Accounts payable and accrued expenses: | Currency Swap | ||
Investments: | ||
Derivative liability | 0 | |
Level II | ||
Assets | ||
Cash and cash equivalents | 0 | 0 |
Investments: | ||
Total assets at fair value | 18,251 | 18,455 |
Total liabilities at fair value | 13 | |
Level II | Accounts payable and accrued expenses: | Currency Swap | ||
Investments: | ||
Derivative liability | 13 | |
Level III | ||
Assets | ||
Cash and cash equivalents | 0 | 0 |
Investments: | ||
Total assets at fair value | 0 | 0 |
Total liabilities at fair value | 0 | |
Level III | Accounts payable and accrued expenses: | Currency Swap | ||
Investments: | ||
Derivative liability | 0 | |
Investments | ||
Investments: | ||
Fair value | 17,540 | 17,721 |
Total investments | 17,556 | 17,738 |
Investments | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair value | 59 | 62 |
Investments | Corporate securities | ||
Investments: | ||
Fair value | 9,791 | 9,564 |
Investments | Municipal securities | ||
Investments: | ||
Fair value | 3,292 | 3,232 |
Investments | Short-term time deposits | ||
Investments: | ||
Fair value | 289 | 746 |
Investments | Asset-backed securities | ||
Investments: | ||
Fair value | 1,625 | 1,638 |
Investments | Residential mortgage-backed securities | ||
Investments: | ||
Fair value | 1,393 | 1,407 |
Investments | Commercial mortgage-backed securities | ||
Investments: | ||
Fair value | 1,091 | 1,072 |
Investments | Equity Securities | ||
Investments: | ||
Equity securities | 16 | 17 |
Investments | Level I | ||
Investments: | ||
Total investments | 73 | 77 |
Investments | Level I | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair value | 59 | 62 |
Investments | Level I | Corporate securities | ||
Investments: | ||
Fair value | 0 | 0 |
Investments | Level I | Municipal securities | ||
Investments: | ||
Fair value | 0 | 0 |
Investments | Level I | Short-term time deposits | ||
Investments: | ||
Fair value | 0 | 0 |
Investments | Level I | Asset-backed securities | ||
Investments: | ||
Fair value | 0 | 0 |
Investments | Level I | Residential mortgage-backed securities | ||
Investments: | ||
Fair value | 0 | 0 |
Investments | Level I | Commercial mortgage-backed securities | ||
Investments: | ||
Fair value | 0 | 0 |
Investments | Level I | Equity Securities | ||
Investments: | ||
Equity securities | 14 | 15 |
Investments | Level II | ||
Investments: | ||
Total investments | 17,483 | 17,661 |
Investments | Level II | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair value | 0 | 0 |
Investments | Level II | Corporate securities | ||
Investments: | ||
Fair value | 9,791 | 9,564 |
Investments | Level II | Municipal securities | ||
Investments: | ||
Fair value | 3,292 | 3,232 |
Investments | Level II | Short-term time deposits | ||
Investments: | ||
Fair value | 289 | 746 |
Investments | Level II | Asset-backed securities | ||
Investments: | ||
Fair value | 1,625 | 1,638 |
Investments | Level II | Residential mortgage-backed securities | ||
Investments: | ||
Fair value | 1,393 | 1,407 |
Investments | Level II | Commercial mortgage-backed securities | ||
Investments: | ||
Fair value | 1,091 | 1,072 |
Investments | Level II | Equity Securities | ||
Investments: | ||
Equity securities | 2 | 2 |
Investments | Level III | ||
Investments: | ||
Total investments | 0 | 0 |
Investments | Level III | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair value | 0 | 0 |
Investments | Level III | Corporate securities | ||
Investments: | ||
Fair value | 0 | 0 |
Investments | Level III | Municipal securities | ||
Investments: | ||
Fair value | 0 | 0 |
Investments | Level III | Short-term time deposits | ||
Investments: | ||
Fair value | 0 | 0 |
Investments | Level III | Asset-backed securities | ||
Investments: | ||
Fair value | 0 | 0 |
Investments | Level III | Residential mortgage-backed securities | ||
Investments: | ||
Fair value | 0 | 0 |
Investments | Level III | Commercial mortgage-backed securities | ||
Investments: | ||
Fair value | 0 | 0 |
Investments | Level III | Equity Securities | ||
Investments: | ||
Equity securities | 0 | 0 |
Restricted Deposits | ||
Investments: | ||
Fair value | 1,383 | 1,386 |
Restricted Deposits | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair value | 323 | 333 |
Restricted Deposits | Corporate securities | ||
Investments: | ||
Fair value | 38 | 37 |
Restricted Deposits | Municipal securities | ||
Investments: | ||
Fair value | 726 | 753 |
Restricted Deposits | Cash and cash equivalents | ||
Investments: | ||
Fair value | 292 | 259 |
Restricted Deposits | Certificates of deposit | ||
Investments: | ||
Fair value | 4 | 4 |
Restricted Deposits | Level I | ||
Investments: | ||
Fair value | 615 | 592 |
Restricted Deposits | Level I | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair value | 323 | 333 |
Restricted Deposits | Level I | Corporate securities | ||
Investments: | ||
Fair value | 0 | 0 |
Restricted Deposits | Level I | Municipal securities | ||
Investments: | ||
Fair value | 0 | 0 |
Restricted Deposits | Level I | Cash and cash equivalents | ||
Investments: | ||
Fair value | 292 | 259 |
Restricted Deposits | Level I | Certificates of deposit | ||
Investments: | ||
Fair value | 0 | 0 |
Restricted Deposits | Level II | ||
Investments: | ||
Fair value | 768 | 794 |
Restricted Deposits | Level II | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair value | 0 | 0 |
Restricted Deposits | Level II | Corporate securities | ||
Investments: | ||
Fair value | 38 | 37 |
Restricted Deposits | Level II | Municipal securities | ||
Investments: | ||
Fair value | 726 | 753 |
Restricted Deposits | Level II | Cash and cash equivalents | ||
Investments: | ||
Fair value | 0 | 0 |
Restricted Deposits | Level II | Certificates of deposit | ||
Investments: | ||
Fair value | 4 | 4 |
Restricted Deposits | Level III | ||
Investments: | ||
Fair value | 0 | 0 |
Restricted Deposits | Level III | U.S. Treasury securities and obligations of U.S. government corporations and agencies | ||
Investments: | ||
Fair value | 0 | 0 |
Restricted Deposits | Level III | Corporate securities | ||
Investments: | ||
Fair value | 0 | 0 |
Restricted Deposits | Level III | Municipal securities | ||
Investments: | ||
Fair value | 0 | 0 |
Restricted Deposits | Level III | Cash and cash equivalents | ||
Investments: | ||
Fair value | 0 | 0 |
Restricted Deposits | Level III | Certificates of deposit | ||
Investments: | ||
Fair value | $ 0 | $ 0 |
Fair Value Measurements - Narra
Fair Value Measurements - Narrative (Details) - USD ($) $ in Millions | Mar. 31, 2024 | Dec. 31, 2023 |
Fair Value Disclosures [Abstract] | ||
Aggregate carrying amount of life insurance contracts and equity investments, fair value | $ 1,022 | $ 1,007 |
Medical Claims Liability - Sche
Medical Claims Liability - Schedule of Change in Medical Claims Liability (Details) - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward] | ||
Balance, January 1 | $ 18,000 | $ 16,745 |
Less: Reinsurance recoverable | 49 | 26 |
Balance, January 1, net | 17,951 | 16,719 |
Incurred related to: | ||
Current year | 31,931 | 30,571 |
Prior years | (1,049) | (1,137) |
Total incurred | 30,882 | 29,434 |
Paid related to: | ||
Current year | 19,686 | 18,502 |
Prior years | 11,124 | 10,174 |
Total paid | 30,810 | 28,676 |
Plus: Premium deficiency reserve | 50 | |
Balance, March 31, net | 18,073 | 17,477 |
Plus: Reinsurance recoverable | 36 | 27 |
Balance, March 31 | 18,109 | 17,504 |
Medicaid | ||
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward] | ||
Balance, January 1 | 10,814 | 11,253 |
Less: Reinsurance recoverable | 5 | 7 |
Balance, January 1, net | 10,809 | 11,246 |
Incurred related to: | ||
Current year | 20,179 | 20,813 |
Prior years | (684) | (803) |
Total incurred | 19,495 | 20,010 |
Paid related to: | ||
Current year | 12,823 | 12,679 |
Prior years | 6,993 | 6,834 |
Total paid | 19,816 | 19,513 |
Plus: Premium deficiency reserve | 0 | |
Balance, March 31, net | 10,488 | 11,743 |
Plus: Reinsurance recoverable | 4 | 9 |
Balance, March 31 | 10,492 | 11,752 |
Medicare | ||
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward] | ||
Balance, January 1 | 3,612 | 3,431 |
Less: Reinsurance recoverable | 0 | 0 |
Balance, January 1, net | 3,612 | 3,431 |
Incurred related to: | ||
Current year | 5,495 | 5,163 |
Prior years | (156) | (155) |
Total incurred | 5,339 | 5,008 |
Paid related to: | ||
Current year | 3,266 | 2,988 |
Prior years | 2,050 | 2,145 |
Total paid | 5,316 | 5,133 |
Plus: Premium deficiency reserve | 50 | |
Balance, March 31, net | 3,685 | 3,306 |
Plus: Reinsurance recoverable | 0 | 0 |
Balance, March 31 | 3,685 | 3,306 |
Commercial | ||
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward] | ||
Balance, January 1 | 3,460 | 1,921 |
Less: Reinsurance recoverable | 44 | 19 |
Balance, January 1, net | 3,416 | 1,902 |
Incurred related to: | ||
Current year | 5,884 | 4,177 |
Prior years | (204) | (172) |
Total incurred | 5,680 | 4,005 |
Paid related to: | ||
Current year | 3,339 | 2,541 |
Prior years | 1,973 | 1,063 |
Total paid | 5,312 | 3,604 |
Plus: Premium deficiency reserve | 0 | |
Balance, March 31, net | 3,784 | 2,303 |
Plus: Reinsurance recoverable | 32 | 18 |
Balance, March 31 | 3,816 | 2,321 |
Other | ||
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward] | ||
Balance, January 1 | 114 | 140 |
Less: Reinsurance recoverable | 0 | 0 |
Balance, January 1, net | 114 | 140 |
Incurred related to: | ||
Current year | 373 | 418 |
Prior years | (5) | (7) |
Total incurred | 368 | 411 |
Paid related to: | ||
Current year | 258 | 294 |
Prior years | 108 | 132 |
Total paid | 366 | 426 |
Plus: Premium deficiency reserve | 0 | |
Balance, March 31, net | 116 | 125 |
Plus: Reinsurance recoverable | 0 | 0 |
Balance, March 31 | $ 116 | $ 125 |
Medical Claims Liability - Narr
Medical Claims Liability - Narrative (Details) - USD ($) $ in Millions | 3 Months Ended | ||
Mar. 31, 2024 | Mar. 31, 2023 | Dec. 31, 2023 | |
Insurance [Abstract] | |||
Amounts recorded as an adjustment to premium revenues related to minimum HBR and return of premium programs | $ 54 | $ 159 | |
Short-duration insurance contracts, Incurred but not reported and expected development on reported claims | 12,311 | ||
Medicare | |||
Segment Reporting Information [Line Items] | |||
Premium deficiency reserve liability | $ 300 | $ 250 |
Affordable Care Act - Net Recei
Affordable Care Act - Net Receivables (Payables) for Each of the Ongoing Programs (Details) - USD ($) $ in Millions | Mar. 31, 2024 | Dec. 31, 2023 |
Affordable Care Act [Abstract] | ||
Risk adjustment receivable | $ 1,124 | $ 893 |
Risk adjustment payable | (3,266) | (2,553) |
Minimum medical loss ratio | (237) | (164) |
Cost sharing reduction receivable | 18 | 0 |
Cost sharing reduction payable | $ (113) | $ (114) |
Debt - Schedule of Debt (Detail
Debt - Schedule of Debt (Details) - USD ($) | Mar. 31, 2024 | Dec. 31, 2023 |
Debt Instrument [Line Items] | ||
Total senior notes | $ 15,676,000,000 | $ 15,675,000,000 |
Finance leases and other | 3,000,000 | 11,000,000 |
Debt issuance costs | (117,000,000) | (122,000,000) |
Total debt | 18,000,000,000 | 17,829,000,000 |
Less: current portion | (113,000,000) | (119,000,000) |
Long-term debt | 17,887,000,000 | 17,710,000,000 |
Revolving Credit Agreement | ||
Debt Instrument [Line Items] | ||
Credit facility | 350,000,000 | 150,000,000 |
Term Loan Facility | ||
Debt Instrument [Line Items] | ||
Credit facility | 2,088,000,000 | 2,115,000,000 |
$2,500 million 4.25% Senior Notes due December 15, 2027 | Senior Notes | ||
Debt Instrument [Line Items] | ||
Debt, face amount | $ 2,500,000,000 | |
Interest rate | 4.25% | |
Senior notes | $ 2,396,000,000 | 2,395,000,000 |
$2,300 million 2.45% Senior Notes due July 15, 2028 | Senior Notes | ||
Debt Instrument [Line Items] | ||
Debt, face amount | $ 2,300,000,000 | |
Interest rate | 2.45% | |
Senior notes | $ 2,303,000,000 | 2,303,000,000 |
$3,500 million 4.625% Senior Notes due December 15, 2029 | Senior Notes | ||
Debt Instrument [Line Items] | ||
Debt, face amount | $ 3,500,000,000 | |
Interest rate | 4.625% | |
Senior notes | $ 3,277,000,000 | 3,277,000,000 |
$2,000 million 3.375% Senior Notes due February 15, 2030 | Senior Notes | ||
Debt Instrument [Line Items] | ||
Debt, face amount | $ 2,000,000,000 | |
Interest rate | 3.375% | |
Senior notes | $ 2,000,000,000 | 2,000,000,000 |
$2,200 million 3.00% Senior Notes due October 15, 2030 | Senior Notes | ||
Debt Instrument [Line Items] | ||
Debt, face amount | $ 2,200,000,000 | |
Interest rate | 3% | |
Senior notes | $ 2,200,000,000 | 2,200,000,000 |
$2,200 million 2.50% Senior Notes due March 1, 2031 | Senior Notes | ||
Debt Instrument [Line Items] | ||
Debt, face amount | $ 2,200,000,000 | |
Interest rate | 2.50% | |
Senior notes | $ 2,200,000,000 | 2,200,000,000 |
$1,300 million 2.625% Senior Notes due August 1, 2031 | Senior Notes | ||
Debt Instrument [Line Items] | ||
Debt, face amount | $ 1,300,000,000 | |
Interest rate | 2.625% | |
Senior notes | $ 1,300,000,000 | $ 1,300,000,000 |
Stockholders' Equity - Narrativ
Stockholders' Equity - Narrative (Details) - USD ($) shares in Thousands, $ in Millions | 1 Months Ended | 3 Months Ended | |
Apr. 26, 2024 | Mar. 31, 2024 | Mar. 31, 2023 | |
Equity, Class of Treasury Stock [Line Items] | |||
Stock repurchase program, authorized amount | $ 10,000 | ||
Stock repurchase program, remaining available | 5,178 | ||
Common stock repurchases | $ 151 | $ 423 | |
Subsequent Event | |||
Equity, Class of Treasury Stock [Line Items] | |||
Common stock repurchases (in shares) | 2,700 | ||
Common stock repurchases | $ 200 |
Stockholders' Equity - Share Re
Stockholders' Equity - Share Repurchase Activity (Details) - USD ($) shares in Thousands, $ in Millions | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Subsidiary, Sale of Stock [Line Items] | ||
Common stock repurchases | $ 151 | $ 423 |
Employee Stock Compensation Plan | ||
Subsidiary, Sale of Stock [Line Items] | ||
Income tax withholding (in shares) | 1,302 | 696 |
Income tax withholding | $ 100 | $ 46 |
Common Stock | ||
Subsidiary, Sale of Stock [Line Items] | ||
Share buybacks (in shares) | 681 | 4,852 |
Common stock repurchases (in shares) | 1,983 | 5,548 |
Share buybacks | $ 51 | $ 377 |
Common stock repurchases | $ 151 | $ 423 |
Earnings Per Share (Details)
Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Net Income (Loss) Attributable to Parent [Abstract] | ||
Earnings attributable to Centene Corporation | $ 1,163 | $ 1,130 |
Shares used in computing per share amounts: | ||
Weighted average number of common shares outstanding (in shares) | 535,109 | 550,779 |
Common stock equivalents (as determined by applying the treasury stock method) (in shares) | 2,951 | 3,066 |
Weighted average number of common shares and potential dilutive common shares outstanding (in shares) | 538,060 | 553,845 |
Net earnings per common share attributable to Centene Corporation: | ||
Basic earnings per common share (in dollars per share) | $ 2.17 | $ 2.05 |
Diluted earnings per common share (in dollars per share) | $ 2.16 | $ 2.04 |
Anti-dilutive restricted stock and restricted stock units excluded from the calculation of diluted earnings (loss) per common share (in shares) | 684 | 1,606 |
Segment Information (Details)
Segment Information (Details) - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2024 | Mar. 31, 2023 | |
Segment Reporting Information [Line Items] | ||
Premium and service revenues | $ 36,337 | $ 34,952 |
Premium tax | 4,070 | 3,937 |
Total external revenues | 40,407 | 38,889 |
Revenues | 40,407 | 38,889 |
Medical costs | 30,932 | 29,434 |
Cost of services | 669 | 870 |
Gross margin | 4,736 | 4,648 |
Operating Segments | ||
Segment Reporting Information [Line Items] | ||
Revenues | 4,080 | 3,867 |
Eliminations | ||
Segment Reporting Information [Line Items] | ||
Revenues | (4,080) | (3,867) |
Premium | ||
Segment Reporting Information [Line Items] | ||
Premium and service revenues | 35,529 | 33,825 |
Service | ||
Segment Reporting Information [Line Items] | ||
Premium and service revenues | 808 | 1,127 |
Premium and service revenues | ||
Segment Reporting Information [Line Items] | ||
Premium and service revenues | 36,337 | 34,952 |
Medicaid | ||
Segment Reporting Information [Line Items] | ||
Revenues | 25,530 | 26,164 |
Medical costs | 19,495 | 20,010 |
Cost of services | 21 | 0 |
Gross margin | 1,944 | 2,217 |
Medicaid | Operating Segments | ||
Segment Reporting Information [Line Items] | ||
Premium tax | 4,070 | 3,937 |
Total external revenues | 25,530 | 26,164 |
Revenues | 0 | 0 |
Medicaid | Eliminations | ||
Segment Reporting Information [Line Items] | ||
Revenues | 0 | 0 |
Medicaid | Premium | Operating Segments | ||
Segment Reporting Information [Line Items] | ||
Premium and service revenues | 21,438 | 22,227 |
Medicaid | Service | Operating Segments | ||
Segment Reporting Information [Line Items] | ||
Premium and service revenues | 22 | 0 |
Medicaid | Premium and service revenues | Operating Segments | ||
Segment Reporting Information [Line Items] | ||
Premium and service revenues | 21,460 | 22,227 |
Medicare | ||
Segment Reporting Information [Line Items] | ||
Revenues | 5,935 | 5,876 |
Medical costs | 5,389 | 5,008 |
Cost of services | 0 | 0 |
Gross margin | 546 | 868 |
Medicare | Operating Segments | ||
Segment Reporting Information [Line Items] | ||
Premium tax | 0 | 0 |
Total external revenues | 5,935 | 5,876 |
Revenues | 0 | 0 |
Medicare | Eliminations | ||
Segment Reporting Information [Line Items] | ||
Revenues | 0 | 0 |
Medicare | Premium | Operating Segments | ||
Segment Reporting Information [Line Items] | ||
Premium and service revenues | 5,935 | 5,876 |
Medicare | Service | Operating Segments | ||
Segment Reporting Information [Line Items] | ||
Premium and service revenues | 0 | 0 |
Medicare | Premium and service revenues | Operating Segments | ||
Segment Reporting Information [Line Items] | ||
Premium and service revenues | 5,935 | 5,876 |
Commercial | ||
Segment Reporting Information [Line Items] | ||
Revenues | 7,751 | 5,252 |
Medical costs | 5,680 | 4,005 |
Cost of services | 0 | 0 |
Gross margin | 2,071 | 1,247 |
Commercial | Operating Segments | ||
Segment Reporting Information [Line Items] | ||
Premium tax | 0 | 0 |
Total external revenues | 7,751 | 5,252 |
Revenues | 0 | 0 |
Commercial | Eliminations | ||
Segment Reporting Information [Line Items] | ||
Revenues | 0 | 0 |
Commercial | Premium | ||
Segment Reporting Information [Line Items] | ||
Premium and service revenues | 7,750 | 5,252 |
Commercial | Service | Operating Segments | ||
Segment Reporting Information [Line Items] | ||
Premium and service revenues | 1 | 0 |
Commercial | Premium and service revenues | Operating Segments | ||
Segment Reporting Information [Line Items] | ||
Premium and service revenues | 7,751 | 5,252 |
Other/Eliminations | ||
Segment Reporting Information [Line Items] | ||
Revenues | 1,191 | 1,597 |
Medical costs | 368 | 411 |
Cost of services | 648 | 870 |
Gross margin | 175 | 316 |
Other/Eliminations | Operating Segments | ||
Segment Reporting Information [Line Items] | ||
Premium tax | 0 | 0 |
Total external revenues | 1,191 | 1,597 |
Revenues | 4,080 | 3,867 |
Other/Eliminations | Eliminations | ||
Segment Reporting Information [Line Items] | ||
Revenues | (4,080) | (3,867) |
Other/Eliminations | Premium | Operating Segments | ||
Segment Reporting Information [Line Items] | ||
Premium and service revenues | 406 | 470 |
Other/Eliminations | Service | Operating Segments | ||
Segment Reporting Information [Line Items] | ||
Premium and service revenues | 785 | 1,127 |
Other/Eliminations | Premium and service revenues | Operating Segments | ||
Segment Reporting Information [Line Items] | ||
Premium and service revenues | $ 1,191 | $ 1,597 |