General (Tables)

3 Months Ended

Mar. 31, 2021

General

Schedule of disaggregation of revenue by major service line, type of customer and timing of revenue recognition

	Three Months Ended March 31, 2020
	Healthcare		Pharmacy Management		Elimination		Total
Major Service Lines
Behavioral & Specialty Health
Risk-based, non-EAP	$	349,845	$	—	$	(90)	$	349,755
EAP risk-based		79,938		—		—		79,938
ASO		59,123		11,534		(83)		70,574
PBM, including dispensing		—		518,112		(4,567)		513,545
Medicare Part D		—		55,666		—		55,666
PBA		—		30,129		—		30,129
Formulary management		—		22,161		—		22,161
Other		—		611		—		611
Total net revenue	$	488,906	$	638,213	$	(4,740)	$	1,122,379
Type of Customer
Government	$	227,102	$	203,957	$	—	$	431,059
Non-government		261,804		434,256		(4,740)		691,320
Total net revenue	$	488,906	$	638,213	$	(4,740)	$	1,122,379
Timing of Revenue Recognition
Transferred at a point in time	$	—	$	573,778	$	(4,567)	$	569,211
Transferred over time		488,906		64,435		(173)		553,168
Total net revenue	$	488,906	$	638,213	$	(4,740)	$	1,122,379

	Three Months Ended March 31, 2021
	Healthcare		Pharmacy Management		Elimination		Total
Major Service Lines
Behavioral & Specialty Health
Risk-based, non-EAP	$	373,442	$	—	$	(86)	$	373,356
EAP risk-based		88,120		—		—		88,120
ASO		71,448		11,817		(75)		83,190
PBM, including dispensing		—		538,796		(3,399)		535,397
Medicare Part D		—		176		—		176
PBA		—		49,882		—		49,882
Formulary management		—		29,183		—		29,183
Other		—		2,345		—		2,345
Total net revenue	$	533,010	$	632,199	$	(3,560)	$	1,161,649
Type of Customer
Government	$	256,292	$	156,038	$	—	$	412,330
Non-government		276,718		476,161		(3,560)		749,319
Total net revenue	$	533,010	$	632,199	$	(3,560)	$	1,161,649
Timing of Revenue Recognition
Transferred at a point in time	$	—	$	538,972	$	(3,399)	$	535,573
Transferred over time		533,010		93,227		(161)		626,076
Total net revenue	$	533,010	$	632,199	$	(3,560)	$	1,161,649

Schedule of accounts receivable, contract assets and contract liabilities

	December 31,		March 31,
	2020		2021		$ Change		% Change
Accounts receivable	$	799,803	$	824,067	$	24,264		3.0%
Contract assets		3,566		4,678		1,112		31.2%
Contract liabilities - current		6,772		6,968		196		2.9%
Contract liabilities - long-term		11,073		11,453		380		3.4%

Schedule of customers generating in excess of ten percent of net revenues for respective segment

Segment	Term Date	2020		2021
Healthcare
Customer A	December 31, 2021	$	88,539	$	92,982
Customer B	December 31, 2022		49,438		55,486
Pharmacy Management
Customer C	March 31, 2024		98,617		88,651

Schedule of leases

	Three Months Ended March 31, 2021
Operating lease cost	$	2,408
Finance lease cost:
Amortization of right-of-use asset		707
Interest on lease liabilities		166
Total finance lease cost		873
Short-term lease cost		40
Variable lease cost		224
Total lease cost		3,545
Sublease income		(7)
Net lease cost	$	3,538

	March 31, 2021
Operating leases:
Other long-term assets	$	32,053
Accrued liabilities	$	10,597
Deferred credits and other long-term liabilities		33,626
Total operating lease liabilities	$	44,223
Finance leases:
Property and equipment, net	$	12,183
Current debt, finance lease and deferred financing obligations	$	4,455
Long-term debt, finance lease and deferred financing obligations		10,783
Total finance lease liabilities	$	15,238

	March 31, 2021
Weighted average remaining lease term years
Operating leases		4.98
Finance leases		3.52
Weighted average discount rate
Operating leases		3.18%
Finance leases		4.40%

Year ended March 31, 2021

Schedule of maturity dates of leases

	March 31, 2021
2021	$	11,819
2022		14,893
2023		12,399
2024		10,616
2025		5,358
2026 and beyond		5,556
Total lease payments		60,641
Less interest		(1,180)
Present value of lease liabilities	$	59,461

Schedule of fair value of financial assets and liabilities

	December 31, 2020
	Level 1		Level 2		Level 3		Total
Assets
Cash and cash equivalents (1)	$	—	$	679,554	$	—	$	679,554
Investments:
U.S. Government and agency securities		42,399		—		—		42,399
Corporate debt securities		—		99,749		—		99,749
Certificates of deposit		—		1,311		—		1,311
Total assets held at fair value	$	42,399	$	780,614	$	—	$	823,013

	March 31, 2021
	Level 1		Level 2		Level 3		Total
Assets
Cash and cash equivalents (2)	$	—	$	447,627	$	—	$	447,627
Investments:
U.S. Government and agency securities		332,403		—		—		332,403
Corporate debt securities		—		296,716		—		296,716
Certificates of deposit		—		1,311		—		1,311
Total assets held at fair value	$	332,403	$	745,654	$	—	$	1,078,057

(1) Excludes $464.9 million of cash held in bank accounts by the Company.

(2) Excludes $8.7 million of cash held in bank accounts by the Company.

Summary of short-term and long-term investments

	December 31, 2020
			Gross		Gross
	Amortized		Unrealized		Unrealized		Estimated
	Cost		Gains		Losses		Fair Value
U.S. Government and agency securities	$	42,389	$	11	$	(1)	$	42,399
Corporate debt securities		99,861		3		(115)		99,749
Certificates of deposit		1,311		—		—		1,311
Total investments at December 31, 2020	$	143,561	$	14	$	(116)	$	143,459

	March 31, 2021
			Gross		Gross
	Amortized		Unrealized		Unrealized		Estimated
	Cost		Gains		Losses		Fair Value
U.S. Government and agency securities	$	332,375	$	29	$	(1)	$	332,403
Corporate debt securities		296,833		14		(131)		296,716
Certificates of deposit		1,311		—		—		1,311
Total investments at March 31, 2021	$	630,519	$	43	$	(132)	$	630,430

Summary of maturity dates of investments

	Amortized		Estimated
	Cost		Fair Value
2021	$	625,439	$	625,350
2022		5,080		5,080
Total investments at March 31, 2021	$	630,519	$	630,430

Schedule of stock option activity

Summarized information related to the Company’s stock options for the three months ended March 31, 2021 is as follows:

		Weighted
		Average
		Exercise
	Options	Price
Outstanding, beginning of period	1,045,283	$	75.48
Granted	—		—
Forfeited	(19,960)		89.13
Exercised	(109,381)		68.26
Outstanding, end of period	915,942	$	76.05
Vested and expected to vest at end of period	914,068	$	76.07
Exercisable, end of period	816,244	$	77.24

Summarized information related to the Company’s nonvested restricted stock awards (“RSAs”) for the three months ended March 31, 2021 is as follows:

		Weighted
		Average
		Grant Date
	Shares	Fair Value
Outstanding, beginning of period	54,314	$	77.33
Awarded	—		—
Vested	—		—
Forfeited	—		—
Outstanding, ending of period	54,314		77.33

Summarized information related to the Company’s nonvested restricted stock units (“RSUs”) for the three months ended March 31, 2021 is as follows:

		Weighted
		Average
		Grant Date
	Shares	Fair Value
Outstanding, beginning of period	428,362	$	65.83
Awarded	275,619		92.85
Vested	(148,546)		67.77
Forfeited	(887)		70.40
Outstanding, ending of period	554,548		78.73

Schedule of nonvested restricted stock award activity

		Weighted
		Average
		Exercise
	Options	Price
Outstanding, beginning of period	1,045,283	$	75.48
Granted	—		—
Forfeited	(19,960)		89.13
Exercised	(109,381)		68.26
Outstanding, end of period	915,942	$	76.05
Vested and expected to vest at end of period	914,068	$	76.07
Exercisable, end of period	816,244	$	77.24

Schedule of nonvested restricted stock units

		Weighted
		Average
		Grant Date
	Shares	Fair Value
Outstanding, beginning of period	54,314	$	77.33
Awarded	—		—
Vested	—		—
Forfeited	—		—
Outstanding, ending of period	54,314		77.33

Schedule of nonvested restricted performance stock units

Summarized information related to the Company’s nonvested restricted performance stock units (“PSUs”) for the three months ended March 31, 2021 is as follows:

		Weighted
		Average
		Grant Date
	Shares	Fair Value
Outstanding, beginning of period	278,945	$	99.80
Awarded	—		—
Vested	—		—
Forfeited	(63,324)		141.61
Outstanding, end of period	215,621		87.51

Schedule of the components of debt and finance lease obligations

	December 31,		March 31,
	2020		2021
Senior Notes	$	359,632	$	359,656
Term loan		263,125		158,750
Other loan		2,154		2,154
Finance leases - land and equipment		16,359		15,238
Finance leases - software as service arrangements		1,298		1,288
Deferred loan costs		(4,192)		(3,861)
Total debt and finance lease obligations	$	638,376	$	533,225