Elevance Health(US:ELV) Benzinga·2026-01-28 15:06Earnings Overview - Elevance Health reported fourth-quarter 2025 revenues of $49.3 billion, a 10% increase year over year, but below the consensus estimate of $49.82 billion [1] - The operating revenue for the full year 2025 was $197.6 billion, reflecting a 13% increase [1] - Adjusted earnings per share for the fourth quarter were $3.33, surpassing the consensus of $3.10 [2] Expense Ratios - The benefit expense ratio for the fourth quarter was 93.5%, an increase of 110 basis points, attributed to higher medical costs in Affordable Care Act plans and Medicare Part D seasonality [2] - For the full year, the benefit expense ratio was 90%, up 150 basis points year over year [2] - The operating expense ratio was 11% in the fourth quarter and 10.6% for the full year [3] Segment Performance - The Health Benefits segment generated operating revenue of $41.8 billion in Q4 2025, an 11% increase driven by higher premium yields and Medicare Advantage membership growth [4] - Medical membership totaled approximately 45.2 million as of December 31, 2025, a 1% decrease year over year due to Medicaid attrition [4] - Carelon's operating revenue was $18.7 billion, up 27%, driven by growth in CarelonRx and the acquisition of CareBridge [5] Future Guidance - For fiscal 2026, Elevance Health expects adjusted earnings to be at least $25.50 per share, below the Wall Street estimate of $26.90 [9] - The company forecasts a mid-single-digit decline in sales due to lower premiums and anticipates a benefit expense ratio of 90.2% +/- 50 basis points [9] - Year-end medical enrollment is projected to be between 43,175 and 43,875, down from 45,232 in 2025 [9] Market and Regulatory Environment - The company anticipates a significant decline in Medicare Advantage membership, projected to be in the high teens percentage range for 2026 [7] - Concerns were raised regarding the proposed payment rates for Medicare in 2027, which are expected to be significantly lower than anticipated [10]