Financial Data and Key Metrics Changes - The company reported adjusted EPS of $1.84 on $10.8 billion of premium revenue, which was below expectations [6][17] - The consolidated MCR for the quarter was 92.6%, reflecting a challenging medical cost environment [6][17] - Year-to-date, the consolidated MCR stands at 90.8% with an adjusted pre-tax margin of 2.7% [6] Business Line Data and Key Metrics Changes - In Medicaid, which represents 75% of total premium revenue, the MCR was reported at 92% with an adjusted pre-tax margin of 2.6% [7][17] - The Medicare segment reported a third quarter MCR of 93.6%, with higher utilization in high-acuity populations [7][17] - The Marketplace segment had a significantly higher MCR of 95.6%, driven by elevated utilization [7][17] Market Data and Key Metrics Changes - The company anticipates full-year premium revenue to increase to approximately $42.5 billion [8][22] - The adjusted EPS guidance for 2025 has been revised down to approximately $14 per share, reflecting a consolidated MCR of 91.3% [8][22] - The Medicaid MCR is expected to be 91.5% for the full year, which is above the high end of the long-term target range [9][22] Company Strategy and Development Direction - The company aims to surpass the $50 billion premium revenue mark in the coming years, with a focus on winning RFPs and pursuing M&A opportunities [14][72] - The 2026 outlook anticipates growth in existing markets and new Medicaid contracts, despite potential revenue headwinds from Marketplace pricing strategies [12][25] - The company is strategically focused on the dual-eligible segment in Medicare, which is expected to drive profitable growth [15][66] Management Comments on Operating Environment and Future Outlook - Management acknowledged the challenging medical cost environment and the impact on earnings, particularly in the Marketplace segment [6][10] - The company remains optimistic about future Medicaid rates keeping pace with medical cost trends, citing responsiveness from state partners [40][42] - Management believes that the current high medical cost trends will eventually stabilize, allowing for a return to target margins [59][62] Other Important Information - The company has a strong capital foundation, with RBC ratios at 340% and total subsidiary capital 70% above state minimums [20] - The company repurchased approximately 2.8 million shares at a cost of $500 million, indicating confidence in long-term value [21] - The embedded earnings are estimated at $8.65 per share, with expectations for realization over time [60][62] Q&A Session Summary Question: Can you elaborate on the drivers of ACA MCR pressure in the quarter? - Management indicated that the pressure was due to increased medical cost trends across all categories, with a higher percentage of special enrollment membership contributing to the trend [32][33] Question: Are you expecting Medicaid rates to be in excess of the 7% cost trend? - Management expressed optimism that rates will at least keep pace with the trend, citing responsiveness from states and a solid baseline for rate projections [39][41] Question: How does the expiration of subsidies affect your pricing assumptions for Marketplace? - Management stated that pricing is based on the expiration of subsidies, with a focus on achieving break-even or better margins [44][45] Question: What is the outlook for Medicare performance next year? - Management noted that the Medicare business is rejuvenating, particularly with the transition of MMPs to FIDEs and HIDEs, and expects slight margin erosion but overall stability [66][67] Question: How is the M&A pipeline developing? - Management highlighted a full pipeline of actionable opportunities, particularly among smaller health plans facing operational difficulties, and emphasized disciplined capital allocation [71][72]

Financial Data and Key Metrics Changes - The company reported adjusted earnings per share (EPS) of $6.08 on premium revenue of $10.6 billion for Q1 2025, reflecting strong operating metrics across all lines of business [8][26] - The consolidated Medical Care Ratio (MCR) was 89.2%, indicating effective medical cost management and an improving rate environment [9][26] - The adjusted pre-tax margin was 3.9%, with a 3% after-tax margin, showcasing strong financial performance [9] Business Line Data and Key Metrics Changes - In the Medicaid segment, the MCR was 90.3%, aligning with expectations, with moderate medical cost increases due to high-cost drugs and seasonal illnesses [10][26] - The Medicare segment reported an MCR of 88.3%, consistent with expectations, with medical cost trends adequately captured by rates and risk adjustments [10][27] - The Marketplace segment had a reported MCR of 81.7%, which was higher than expected due to prior year items, but normalized to approximately 77.7% when excluding these items [11][29] Market Data and Key Metrics Changes - The company successfully defended its position in Nevada for Medicaid contracts and was awarded a new contract in Illinois for a dual eligible special needs plan, projecting an incremental annual premium revenue of approximately $800 million [12][13] - The company anticipates achieving premium revenue targets of $46 billion in 2026 and at least $52 billion in 2027 [13] Company Strategy and Development Direction - The company aims to leverage its existing Medicaid footprint to serve high acuity, low-income Medicare beneficiaries, which is proving effective [11] - The acquisition pipeline remains strong, with a focus on capital deployment for accretive acquisitions, increasing embedded earnings from approximately $7.75 to $8.65 per share [14][40] - The company reaffirms its full-year 2025 premium revenue guidance of approximately $42 billion and adjusted EPS guidance of at least $24.50, reflecting an 8% year-over-year growth [15][38] Management's Comments on Operating Environment and Future Outlook - Management believes that any changes to the Medicaid program will be marginal in the near term, with confidence that membership volume and risk pool acuity will remain manageable [17][18] - The recent CMS final rate notice for Medicare Advantage is viewed positively, and the integration of Medicaid and Medicare is expected to benefit the company [20] - The company remains confident in its ability to achieve a long-term EPS growth target of 13% to 15% [24][40] Other Important Information - The company harvested approximately $110 million in subsidiary dividends, with a parent company cash balance of approximately $190 million at the end of the quarter [30] - The company repurchased approximately 1.7 million shares at a total cost of $500 million, maintaining a strong capital foundation [31] Q&A Session Summary Question: Can you expand on risk adjustment and member reconciliation dynamics? - Management explained that member reconciliation involved members who were not authorized to be in the plan, which was a one-time scrub by CMS [46][47] Question: What are the updated assumptions for rates and cost trends? - Management indicated that Medicaid rates were updated in Q1, leading to a full-year rate increase assumption of 5% [56][60] Question: How does the marketplace fit into long-term strategies? - Management emphasized the synergies between marketplace products and government-sponsored managed care, capturing members across various life circumstances [70][71] Question: Is the Washington backdrop impacting state discussions on rate updates? - Management stated that rate discussions are based on actuarial data and are not influenced by political discussions in Washington [78][79] Question: What are the effectuation rates and MLR for new members? - Management reported strong effectuation rates and indicated that MLR for new members is still being assessed due to the high percentage of new membership [82][84] Question: How is G&A progressing this year? - Management noted that G&A is expected to remain flat throughout the year, with a focus on maintaining operational efficiencies [92][93] Question: What is the outlook for Medicaid RFPs and integration? - Management expressed confidence in their competitive position for Medicaid RFPs, particularly with their integrated offerings [129][130]