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General (Tables)
9 Months Ended
Sep. 30, 2021
General  
Schedule of disaggregation of revenue by major service line, type of customer and timing of revenue recognition

Three Months Ended September 30, 2020

Healthcare

    

Pharmacy Management

    

Elimination

    

Total

Major Service Lines

Behavioral & Specialty Health

Risk-based, non-EAP

$

352,442

$

$

(95)

$

352,347

EAP risk-based

74,703

74,703

ASO

62,306

11,631

(50)

73,887

PBM, including dispensing

540,615

(5,117)

535,498

Medicare Part D

65,931

65,931

PBA

35,068

35,068

Formulary management

31,327

31,327

Other

1,356

1,356

Total net revenue

$

489,451

$

685,928

$

(5,262)

$

1,170,117

Type of Customer

Government

$

240,845

$

210,040

$

$

450,885

Non-government

248,606

475,888

(5,262)

719,232

Total net revenue

$

489,451

$

685,928

$

(5,262)

$

1,170,117

Timing of Revenue Recognition

Transferred at a point in time

$

$

606,546

$

(5,117)

$

601,429

Transferred over time

489,451

79,382

(145)

568,688

Total net revenue

$

489,451

$

685,928

$

(5,262)

$

1,170,117

Three Months Ended September 30, 2021

Healthcare

    

Pharmacy Management

    

Elimination

    

Total

Major Service Lines

Behavioral & Specialty Health

Risk-based, non-EAP

$

437,809

$

$

(78)

$

437,731

EAP risk-based

75,369

75,369

ASO

67,100

11,834

(97)

78,837

PBM, including dispensing

587,622

(3,324)

584,298

Medicare Part D

1,229

1,229

PBA

39,206

39,206

Formulary management

34,734

34,734

Other

2,714

2,714

Total net revenue

$

580,278

$

677,339

$

(3,499)

$

1,254,118

Type of Customer

Government

$

235,636

$

142,642

$

$

378,278

Non-government

344,642

534,697

(3,499)

875,840

Total net revenue

$

580,278

$

677,339

$

(3,499)

$

1,254,118

Timing of Revenue Recognition

Transferred at a point in time

$

$

588,851

$

(3,324)

$

585,527

Transferred over time

580,278

88,488

(175)

668,591

Total net revenue

$

580,278

$

677,339

$

(3,499)

$

1,254,118

Nine Months Ended September 30, 2020

Healthcare

    

Pharmacy Management

    

Elimination

    

Total

Major Service Lines

Behavioral & Specialty Health

Risk-based, non-EAP

$

1,046,486

$

$

(277)

$

1,046,209

EAP risk-based

232,060

232,060

ASO

180,832

35,436

(218)

216,050

PBM, including dispensing

1,558,211

(14,515)

1,543,696

Medicare Part D

178,308

178,308

PBA

96,008

96,008

Formulary management

78,550

78,550

Other

1,690

1,690

Total net revenue

$

1,459,378

$

1,948,203

$

(15,010)

$

3,392,571

Type of Customer

Government

$

690,340

$

622,986

$

$

1,313,326

Non-government

769,038

1,325,217

(15,010)

2,079,245

Total net revenue

$

1,459,378

$

1,948,203

$

(15,010)

$

3,392,571

Timing of Revenue Recognition

Transferred at a point in time

$

$

1,736,519

$

(14,515)

$

1,722,004

Transferred over time

1,459,378

211,684

(495)

1,670,567

Total net revenue

$

1,459,378

$

1,948,203

$

(15,010)

$

3,392,571

Nine Months Ended September 30, 2021

Healthcare

    

Pharmacy Management

    

Elimination

    

Total

Major Service Lines

Behavioral & Specialty Health

Risk-based, non-EAP

$

1,240,540

$

$

(256)

$

1,240,284

EAP risk-based

245,634

245,634

ASO

212,253

36,004

(224)

248,033

PBM, including dispensing

1,673,245

(10,331)

1,662,914

Medicare Part D

2,913

2,913

PBA

132,558

132,558

Formulary management

96,979

96,979

Other

7,220

7,220

Total net revenue

$

1,698,427

$

1,948,919

$

(10,811)

$

3,636,535

Type of Customer

Government

$

741,252

$

453,050

$

$

1,194,302

Non-government

957,175

1,495,869

(10,811)

2,442,233

Total net revenue

$

1,698,427

$

1,948,919

$

(10,811)

$

3,636,535

Timing of Revenue Recognition

Transferred at a point in time

$

$

1,676,158

$

(10,331)

$

1,665,827

Transferred over time

1,698,427

272,761

(480)

1,970,708

Total net revenue

$

1,698,427

$

1,948,919

$

(10,811)

$

3,636,535

Schedule of accounts receivable, contract assets and contract liabilities

Accounts receivable, contract assets and contract liabilities consisted of the following (in thousands, except percentages):

December 31,

    

September 30, 

    

    

 

2020

2021

$ Change

% Change

Accounts receivable

$

799,803

$

856,059

$

56,256

7.0%

Contract assets

3,566

8,114

4,548

127.5%

Contract liabilities - current

6,772

7,287

515

7.6%

Contract liabilities - long-term

11,073

11,290

217

2.0%

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

The following customers generated in excess of ten percent of net revenues from continuing operations for the respective segment for the nine months ended September 30, 2020 and 2021 (in thousands):

Segment

    

Term Date

    

2020

    

2021

 

Healthcare

Customer A

December 31, 2021

$

259,286

$

283,373

Customer B

December 31, 2024

147,177

300,450

Pharmacy Management

Customer C

March 31, 2024

284,697

247,786

Schedule of leases

The following table shows the components of lease expenses for the three and nine months ended September 30, 2021 (in thousands):

Three Months Ended

September 30, 2021

    

Nine Months Ended

September 30, 2021

    

Operating lease cost

$

2,292

$

7,040

Finance lease cost:

Amortization of right-of-use asset

471

1,743

Interest on lease liabilities

144

465

Total finance lease cost

615

2,208

Short-term lease cost

42

123

Variable lease cost

527

1,290

Total lease cost

3,476

10,661

Sublease income

(7)

Net lease cost

$

3,476

$

10,654

The following table shows the components of the lease assets and liabilities as of September 30, 2021 (in thousands):

September 30, 2021

Operating leases:

Other long-term assets

$

30,411

Accrued liabilities

$

10,994

Deferred credits and other long-term liabilities

32,063

Total operating lease liabilities

$

43,057

Finance leases:

Property and equipment, net

$

9,637

Current debt, finance lease and deferred financing obligations

$

4,493

Long-term debt, finance lease and deferred financing obligations

8,524

Total finance lease liabilities

$

13,017

The following table shows the weighted average remaining lease term and discount rate as of September 30, 2021:

September 30, 2021

Weighted average remaining lease term years

Operating leases

4.59

Finance leases

3.00

Weighted average discount rate

Operating leases

2.96%

Finance leases

4.41%

Supplemental cash flow information relating to leases is as follows (in thousands):

Nine months ended September 30, 2021

Cash paid for amounts included in the measurement of lease liabilities:

Operating cash flows from operating leases

$

10,483

Operating cash flows from finance leases

3,341

Financing cash flows from finance leases

465

Right-of-use asset obtained in exchange for new lease obligation

Operating leases

1,637

Finance leases

Schedule of maturity dates of leases

The maturity dates of the Company’s leases as of September 30, 2021 are summarized below (in thousands):

September 30, 2021

2021

$

4,334

2022

15,795

2023

13,178

2024

11,392

2025

6,085

2026 and beyond

6,171

Total lease payments

56,955

Less interest

(881)

Present value of lease liabilities

$

56,074

Schedule of fair value of financial assets and liabilities

In accordance with the fair value hierarchy described above, the following table shows the fair value of the Company’s assets that are required to be measured at fair value as of December 31, 2020 and September 30, 2021 (in thousands):

December 31, 2020

    

Level 1

    

Level 2

    

Level 3

    

Total

 

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

September 30, 2021

    

Level 1

    

Level 2

    

Level 3

    

Total

 

Cash and cash equivalents (2)

    

$

    

$

999,520

    

$

    

$

999,520

Investments:

U.S. Government and agency securities

 

16,530

 

 

 

16,530

Corporate debt securities

 

 

125,389

 

 

125,389

Taxable municipal bonds

12,299

12,299

Certificates of deposit

 

 

1,300

 

 

1,300

Total assets held at fair value

$

16,530

$

1,138,508

$

$

1,155,038

(1)Excludes $464.9 million of cash held in bank accounts by the Company.
(2)Excludes $38.9 million of cash held in bank accounts by the Company.
Summary of short-term and long-term investments The following is a summary of short-term and long-term investments at December 31, 2020 and September 30, 2021 (in thousands):

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

September 30, 2021

 

Gross

Gross

 

Amortized

Unrealized

Unrealized

Estimated

 

    

Cost

    

Gains

    

Losses

    

Fair Value

 

U.S. Government and agency securities

    

$

16,529

    

$

1

    

$

    

$

16,530

Corporate debt securities

 

125,452

 

 

(63)

 

125,389

Taxable municipal bonds

12,298

2

(1)

12,299

Certificates of deposit

1,300

 

 

 

1,300

Total investments at September 30, 2021

$

155,579

$

3

$

(64)

$

155,518

Summary of maturity dates of investments

The maturity dates of the Company’s investments as of September 30, 2021 are summarized below (in thousands):

    

Amortized

    

Estimated

 

    

Cost

    

Fair Value

 

2021

$

63,482

$

63,473

2022

92,097

92,045

Total investments at September 30, 2021

 

$

155,579

 

$

155,518

Schedule of stock option activity

Summarized information related to the Company’s stock options for the nine months ended September 30, 2021 is as follows:

Weighted

Average

Exercise

 

    

Options

    

Price

 

Outstanding, beginning of period

    

1,045,283

$

75.48

Granted

 

Forfeited

 

(34,683)

90.91

Exercised

 

(276,392)

 

64.25

Outstanding, end of period

 

734,208

$

78.98

Vested and expected to vest at end of period

 

733,266

$

79.00

Exercisable, end of period

 

650,420

$

80.71

Schedule of nonvested restricted stock award

Summarized information related to the Company’s nonvested restricted stock awards (“RSAs”) for the nine months ended September 30, 2021 is as follows:

Weighted

Average

Grant Date

    

Shares

    

Fair Value

    

Outstanding, beginning of period

    

54,314

    

$

77.33

    

Awarded

 

6,312

 

94.56

 

Vested

 

 

 

Forfeited

 

 

 

Outstanding, ending of period

 

60,626

79.13

 

Schedule of nonvested restricted stock units Summarized information related to the Company’s nonvested restricted stock units (“RSUs”) for the nine months ended September 30, 2021 is as follows:

Weighted

Average

Grant Date

    

Shares

    

Fair Value

    

Outstanding, beginning of period

    

428,362

$

65.83

    

Awarded

 

280,374

 

92.87

 

Vested

 

(160,092)

 

68.04

 

Forfeited

 

(18,188)

 

75.62

 

Outstanding, ending of period

 

530,456

79.12

Schedule of nonvested restricted performance stock units

Summarized information related to the Company’s nonvested restricted performance stock units (“PSUs”) for the nine months ended September 30, 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 The following table shows the components of debt and finance lease obligations, including the current component, at December 31, 2020 and September 30, 2021 (in thousands):

December 31,

    

September 30, 

2020

2021

Senior Notes

$

359,632

$

359,706

Term loan

263,125

150,000

Other loan

2,154

Finance leases - land and equipment

16,359

13,017

Finance leases - software as service arrangements

1,298

60

Deferred loan costs

(4,192)

(3,201)

Total debt and finance lease obligations

$

638,376

$

519,582