Elevance Health, Inc. (ELV)

Elevance Health reported third-quarter 2026 operating revenue of $50.4 billion on 21 October 2026, up 0.7 percent from a year earlier 1. Diluted earnings per share were $6.27 and adjusted earnings per share were $6.99, including a net non-operating benefit of $1.85 per share 1.

The benefit expense ratio, the share of premiums paid out for care, improved 70 basis points to 90.6 percent on better Medicare Advantage and Affordable Care Act (ACA) individual plan results 1.

The company raised its 2026 outlook to diluted earnings of at least $22.00 per share, adjusted earnings of at least $29.00 and operating cash flow of at least $6.5 billion 1. It said it expects at least 12 percent growth in adjusted earnings per share in 2027 from a baseline of at least $26.75 5.

Medical membership fell by 487 thousand from a year earlier to about 44.9 million, with losses in Medicaid, Medicare Advantage and risk-based employer plans 1. Operating revenue grew only because premium rates rose 2.

The Centers for Medicare & Medicaid Services (CMS) told the company on 13 July 2026 that no sanctions would be imposed over Medicare Advantage data 2. A Justice Department False Claims Act suit over similar data is still in discovery, due to end on 20 November 2026 2.

The company was called Anthem, Inc. until shareholders approved the name Elevance Health on 18 May 2022, and the change took effect on 27 June 2022 11. Its core is a licence from the Blue Cross and Blue Shield Association (BCBSA) to use the Blue names in set territories 3.

From December 2009 through December 2019 the company handed pharmacy benefit work, such as running pharmacy networks and processing prescription claims, to Express Scripts 12. It began moving members to its own unit, IngenioRx, in the second quarter of 2019 and finished by 1 January 2020 12.

On 28 February 2020 it completed its acquisition of Beacon Health Options, then the largest independently held behavioral health organization in the country 12. In 2021 it added myNEXUS, a home-based nursing management company, on 28 April and MMM, a Puerto Rico Medicare Advantage and Medicaid group, on 29 June 12.

Operating revenue was $170.2 billion in 2023, $175.2 billion in 2024 and $197.6 billion in 2025 3. Acquisitions fed part of that growth, starting with Paragon Healthcare's infusion centers, which joined CarelonRx in March 2024 3.

CareBridge, a value-based manager of home care for Medicaid members, was completed on 10 December 2024 3. Centers Plan for Healthy Living, a New York long-term care plan for Medicaid and dual-eligible members, followed on 31 December 2024 3.

Operating revenue rose 12.8 percent in 2025 on premium rate increases, recent acquisitions and Medicare Advantage growth, partly offset by Medicaid membership attrition 3. Net income attributable to shareholders fell 5.3 percent to $5,662 million because the Health Benefits segment earned less 3.

Over two years Medicaid membership fell from 10,503 thousand to 8,917 thousand and then 8,500 thousand, mainly as states rechecked who still qualified 3.

On 17 July 2025 the company cut its 2025 adjusted earnings outlook to about $30.00 a share, citing elevated medical cost trends in ACA plans and slower rate alignment in Medicaid 9. Adjusted earnings for 2025 came in at $30.29 per share against $33.04 a year earlier 8.

A settlement with provider plaintiffs in the Blue Cross Blue Shield antitrust case was paid in September 2025, and with lower earnings it cut operating cash flow to $4,290 million from $5,808 million 3.

On 28 January 2026 the company set its 2026 outlook at GAAP earnings of at least $22.30 per share and adjusted earnings of at least $25.50 8. On 27 February 2026 CMS announced it intended to suspend new Medicare Advantage enrollment over risk adjustment data for dates of service before April 2023 6.

The company recorded an accrual of about $935 million for the matter by 31 March 2026 and paid CMS $342 million on 27 May 2026 2. Its outlook then rose to at least $27.00 on 15 July 2026 and to at least $29.00 on 21 October 2026 101.

Health Benefits: the insurance plans

Health Benefits is the insurer, selling Individual, employer group, BlueCard, Medicare, Medicaid and Federal Employee Program coverage 3. On risk-based plans the company carries the medical costs, while fee-based customers pay for claims processing and care management 3.

Segment operating revenue was $167,094 million in 2025, up 11.2 percent 3. At the end of 2025 membership was 27,092 thousand in commercial fee-based plans, 8,500 thousand in Medicaid, 2,230 thousand in Medicare Advantage and 1,307 thousand in Individual plans 3.

In the third quarter of 2026 the segment's operating revenue was $43.4 billion and its operating gain $0.4 billion, a margin of 1.0 percent against 1.4 percent a year earlier 1. The company said the gain reflected targeted investments for its long-term operating model 1.

Individual ACA plans, sold on the public exchanges the law created, brought in $2,514 million of operating revenue in the third quarter 2. The CFO said the company expects to end the year with at least 1.2 million members in them 5.

Medicare Advantage and Medicaid

The company reshaped Medicare Advantage this year, which its 10-Q calls deliberate repositioning that held back revenue 2. The CFO said that work supports a full-year operating margin of at least 2 percent 5.

CMS rates plans from 1.0 to 5.0 Stars, and plans need 4.0 or more to qualify for bonus payments 2. About 49 percent of Medicare Advantage members are in plans the 2027 ratings put at 4.0 or higher, against about 55 percent under the 2026 ratings 2.

Medicaid cost trends stay elevated because of higher population acuity, meaning sicker members, and heavier use of services 2. Management said it views 2026 as the low point for Medicaid margin and expects improvement in 2027 5.

CarelonRx and Carelon Services

CarelonRx is the pharmacy services business, covering home delivery and specialty pharmacies, claims processing, formulary management, pharmacy networks and rebate administration 3. Its 2025 operating revenue was $43,400 million, up 20.7 percent 3.

CarelonRx hands certain core pharmacy services to CaremarkPCS Health, a CVS Health subsidiary, under an agreement running through 31 December 2027 3. The company can elect a three-year extension on the same terms 3.

Carelon Services combines physical, behavioral, pharmacy and social-care support for the company's own members and outside customers 3. Its 2025 operating revenue was $28,316 million, up 57.7 percent, mainly from the CareBridge acquisition and growth in risk-based services 3.

Both Carelon units together earned $19.3 billion of operating revenue and $0.9 billion of operating gain in the third quarter of 2026, a 4.7 percent margin against 4.2 percent a year earlier 1. Segment revenues overlap because services to the company's own plans are removed in consolidation 3.

People

Gail Boudreaux has been president and chief executive officer since November 2017, and Mark Kaye has been chief financial officer since November 2023 3. The company had about 97,100 employees at the end of 2025, 71,900 of them in the United States 3.

Peter Haytaian stepped down as head of Carelon on 4 May 2026 and serves as special advisor through 31 December 2026 7. Management said on 21 October 2026 that Jeff Park is joining as president of Carelon 5.

Rivals

The 10-K calls competition intense in national and local markets, with insurers competing on service quality, price, provider networks, digital tools and Star Ratings 3. It says the company is typically the largest participant in each of its Blue-branded markets 3.

Current problems

The Justice Department sued in March 2020, alleging the company submitted inaccurate diagnosis data to CMS and so received inflated Medicare Advantage payments 2. The company says it intends to defend the suit vigorously 2.

CMS announced in May 2025 that it would greatly increase the scale and pace of its Medicare Advantage risk adjustment audits, and the company says the outcome could hurt its results 2. Opt-out plaintiffs also keep suing over the Blue Cross Blue Shield licensing agreements 3.

The umbrella, in words

The company sells under three main brands: Anthem Blue Cross and Blue Shield, Wellpoint and Carelon 3. Anthem covers licensed Blue plans, Wellpoint covers non-Blue Medicare, Medicaid and commercial plans, and Carelon covers health services and pharmacy 3.

Exhibit 21 lists subsidiaries owned 50 percent or more as of 1 February 2026, among them Anthem Insurance Companies, Inc., Blue Cross of California, Carebridge Holding Company, LLC and Carelon Behavioral Health, Inc. 4. The list also shows BioPlus Specialty entities, which run specialty pharmacy and infusion 4.

The company owns about 40 percent of Augusta Topco Holdings, L.P. (Mosaic Health) and 40 percent of Project Freedom Holdings, LLC, the parent of Liberty Dental 2. For Liberty Dental it agreed to provide up to $250 million of preferred equity, of which $165 million had been paid by 30 September 2026 2.

Under a financing agreement the company agreed to give Mosaic Health a term loan of $200 million and a line of credit of up to $500 million 2.

The company leases its principal offices at 220 Virginia Avenue in Indianapolis, and most of its other locations are also leased 3. Vanguard Capital Management reported owning 7.13 percent of the common stock in its latest Schedule 13G 14.

The company expects 2026 diluted earnings per share of at least $22.00, adjusted earnings of at least $29.00 and operating cash flow of at least $6.5 billion 1. It reaffirmed on 10 September 2026 a benefit expense ratio outlook of 90.2 percent plus or minus 50 basis points 13.

For 2027 the CEO said she sees a path to at least 12 percent growth in adjusted earnings per share, from better Health Benefits margins, wider use of Carelon's services and efficiency 5. The CFO said more detail on the 2027 assumptions will come in January 5.

The Audit Committee declared a fourth-quarter dividend of $1.72 per share on 20 October 2026, payable on 18 December 2026 to holders of record on 4 December 2026 1. About $5.0 billion of share repurchase authority remained at 30 September 2026 1.

The CFO said near-term capital use will be intentionally disciplined, funding targeted investments in Carelon and staying opportunistic on repurchases, with selective acquisitions considered as they appear 5.

For the 2027 Medicare Advantage season the CEO said the company is emphasizing HMO plans and dual-eligible members 5. In Commercial it said it kept pricing discipline for 2027 5.

Fact discovery in the Justice Department suit is due to close on 20 November 2026 and expert discovery on 2 August 2027 2. Many Medicaid provisions of the federal budget law signed on 4 July 2025 take effect in 2027 and 2028 3.

CMS released the company's 2027 Star Ratings in October 2026, and they will set its Medicare Advantage payments in 2028 2. The company says it will keep investing in member experience, clinical quality and care provider engagement to improve them 5.

In June 2026 a federal court vacated several provisions of the 2025 ACA marketplace integrity rule, a decision under appeal, and in July 2026 it stayed parts of the 2027 payment rules while litigation continues 2.

The 10-K says pharmacy benefit manager reforms passed in February 2026 take effect thirty months after enactment, and Medicare Part D delinking from drug prices takes effect in 2028 3.

Past

Elevance Health's revenue grew from $85 billion in fiscal 2016 to $199 billion in fiscal 2025, up 9.9% a year, rising in 9 of 9 years and never falling from a peak Net income was positive in all 10 of those years Over the last three fiscal years to 2025, the diluted share count shrank about 2.6% a year, and dividends and buybacks returned about 69% of operating cash flow The company's filings since 2017 show no warning events: no bankruptcy or receivership notice, no debt default notice, no exchange listing notice, no restatement warning, no auditor change, no material cyber incident and no late-report notice 1

Present

In fiscal 2025 ended 2025-12-31, Elevance Health reported revenue of $199 billion and a profit of $5.7 billion The company earned about 13 cents of profit for every dollar of shareholders' money, owed about 64 cents per dollar of assets, and its gross profitability was about 146 cents per dollar of everything it owns Its revenue of $199 billion ranks in the top 25% by size among its industry family, with a net margin of 2.8% in the top 5% Chief executive Gail Boudreaux has held the title since 2017-11-28, 8.9 years The 19 officers and directors filing in the last fifteen months have been on record a median of 7.1 years 21

Future

A quarterly report for the quarter ending 2026-09-30 is due by 2026-11-09 An annual report for the fiscal year ending 2026-12-31 is due by 2027-03-01 The company's cash of $9.5 billion against debt of $31 billion leaves negative 17.5% of its assets as net cash, in the bottom 5% of its family Revenue grew 8.3% a year over the last three filed years against 9.9% over all 10, slowing, and the newest year grew 12.5% 31

How the company operates

Elevance Health operates as an insurance business, classed under Hospital & Medical Service Plans The company is based in Indianapolis, IN In filings from fiscal 2022 through 2025, the company tags all revenue under a single reportable segment, without breaking it into separate lines of business The annual report does not split revenue by line, so growth by line cannot be read 241

New moves

On 2026-10-21, Elevance Health filed a Form 8-K reporting results released under item 2.02 3