SEGMENT INFORMATION

12 Months Ended

Dec. 31, 2023

Segment Reporting [Abstract]

SEGMENT INFORMATION

SEGMENT INFORMATION

During December 2022, we realigned our businesses into two distinct segments: Insurance and CenterWell. The Insurance segment includes the businesses that were previously included in the Retail and Group and Specialty segments, as well as the Pharmacy Benefit Manager, or PBM, business which was previously included in the Healthcare Services segment. The CenterWell segment (formerly Healthcare Services) represents our payor-agnostic healthcare services offerings, including pharmacy solutions, primary care, and home solutions. In addition to the new segment classifications being utilized to assess performance and allocate resources, we believe this simpler structure will create greater collaboration across the Insurance and CenterWell businesses and will accelerate work that is underway to centralize and integrate operations within the organization. 2021 segment financial information was recast to conform to the 2022 presentation.

Our two reportable segments, Insurance and CenterWell, are based on a combination of the type of health plan customer and adjacent businesses centered on well-being solutions for our health plans and other customers, as described below. These segment groupings are consistent with information used by our Chief Executive Officer, the Chief Operating Decision Maker, to assess performance and allocate resources.

The Insurance segment consists of Medicare benefits, marketed to individuals or directly via group Medicare accounts, as well as our contract with CMS to administer the Limited Income Newly Eligible Transition, or LI-NET, prescription drug plan program and contracts with various states to provide Medicaid, dual eligible demonstration, and Long-Term Support Services benefits, which we refer to collectively as our state-based contracts. This segment also includes products consisting of employer group commercial fully-insured medical and specialty health insurance benefits marketed to individuals and employer groups, including dental, vision, and other supplemental health benefits, as well as administrative services only, or ASO. In addition, our Insurance segment includes our military services business, primarily our T-2017 East Region contract, as well as the operations of our PBM business.

The CenterWell segment includes our pharmacy solutions, primary care, and home solutions operations. The segment also includes our strategic partnerships with WCAS to develop and operate senior-focused, payor-agnostic, primary care centers, as well as our minority ownership interest in Gentiva Hospice operations. Services offered by this segment are designed to enhance the overall healthcare experience. These services may lead to lower utilization associated with improved member health and/or lower drug costs.

Our CenterWell intersegment revenues primarily relate to the operations of CenterWell Pharmacy (our mail-order pharmacy business), CenterWell Specialty Pharmacy, and retail pharmacies jointly located within CenterWell Senior Primary Care clinics.

In addition, our CenterWell intersegment revenues includes revenues earned by certain owned providers (CenterWell Senior Primary Care) derived from certain value-based arrangements with our health plans. Under these value-based arrangements, our owned providers enter into agreements with our health plans to stand ready to deliver, integrate, direct and control the administration and management of certain health care services for our members. In exchange, the owned provider receives a premium that is typically paid on a per-member per-month basis. These value-based arrangements represent a single performance obligation where revenues are recognized in the period in which we are obligated to provide integrated health care services to our members. Fee-for-service revenue is recognized at agreed upon rates, net of contractual allowances, as the performance obligation is completed on the date of service.

We present our consolidated results of operations from the perspective of the health plans. As a result, the cost of providing benefits to our members, whether provided via a third party provider or internally through a stand-alone subsidiary, is classified as benefits expense and excludes the portion of the cost for which the health plans do not bear responsibility, including member co-share amounts and government subsidies of $20.7 billion in 2023, $19.7 billion in 2022, and $18.1 billion in 2021. In addition, depreciation and amortization expense associated with certain businesses delivering benefits to our members, primarily associated with our primary care and pharmacy operations, are included with benefits expense. The amount of this expense was $138 million in 2023, $122 million in 2022, and $108 million in 2021.

Other than those described previously, the accounting policies of each segment are the same and are described in Note 2. Transactions between reportable segments primarily consist of sales of services rendered by our CenterWell segment, primarily pharmacy solutions, primary care, and home solutions, to our Insurance segment customers. Intersegment sales and expenses are recorded at fair value and eliminated in consolidation. Members served by our segments often use the same provider networks, enabling us in some instances to obtain more favorable contract terms with providers. Our segments also share indirect costs and assets. As a result, the profitability of each segment is interdependent. We allocate most operating expenses to our segments. Assets and certain corporate income and expenses are not allocated to the segments, including the portion of investment income not supporting segment operations, interest expense on corporate debt, and certain other corporate expenses. These items are managed at a corporate level. These corporate amounts are reported separately from our reportable segments and are included with intersegment eliminations in the tables presenting segment results below.

Premium and services revenues derived from our contracts with the federal government, as a percentage of our total premium and services revenues, were approximately 84% for 2023, 82% for 2022 and 83% for 2021.

	Insurance		CenterWell		Eliminations/ Corporate		Consolidated
	(in millions)
2023
External revenues
Premiums:
Individual Medicare Advantage	$	78,837	$	—	$	—	$	78,837
Group Medicare Advantage	6,869		—		—		6,869
Medicare stand-alone PDP	2,189		—		—		2,189
Total Medicare	87,895		—		—		87,895
Commercial fully-insured	3,527		—		—		3,527
Specialty benefits	1,007		—		—		1,007
Medicare Supplement	735		—		—		735
State-based contracts and other	8,108		—		—		8,108
Total premiums	101,272		—		—		101,272
Services revenue:
Home solutions	—		1,342		—		1,342
Primary care	—		842		—		842
Commercial ASO	237		—		—		237
Military services and other	763		—		—		763
Pharmacy solutions	—		849		—		849
Total services revenue	1,000		3,033		—		4,033
Total external revenues	102,272		3,033		—		105,305
Intersegment revenues
Services	31		4,921		(4,952)		—
Products	—		10,451		(10,451)		—
Intersegment revenues	31		15,372		(15,403)		—
Investment income	551		—		518		1,069
Total revenues	102,854		18,405		(14,885)		106,374
Operating expenses:
Benefits	89,100		—		(706)		88,394
Operating costs	10,408		16,791		(14,011)		13,188
Depreciation and amortization	692		210		(123)		779
Total operating expenses	100,200		17,001		(14,840)		102,361
Income (loss) from operations	2,654		1,404		(45)		4,013
Interest expense	—		3		490		493
Other expense, net	—		—		137		137
Income (loss) before income taxes and equity in net losses	2,654		1,401		(672)		3,383
Equity in net losses	(6)		(57)		—		(63)
Segment earnings (loss)	$	2,648	$	1,344	$	(672)	$	3,320
Net loss (income) attributable to noncontrolling interests	6		(1)		—		5
Segment earnings (loss) attributable to Humana	$	2,654	$	1,343	$	(672)	$	3,325

	Insurance		CenterWell		Eliminations/ Corporate		Consolidated
	(in millions)
2022
External revenues
Premiums:
Individual Medicare Advantage	$	65,591	$	—	$	—	$	65,591
Group Medicare Advantage	7,297		—		—		7,297
Medicare stand-alone PDP	2,269		—		—		2,269
Total Medicare	75,157		—		—		75,157
Commercial fully-insured	4,389		—		—		4,389
Specialty benefits	1,047		—		—		1,047
Medicare Supplement	743		—		—		743
State-based contracts and other	6,376		—		—		6,376
Total premiums	87,712		—		—		87,712
Services revenue:
Home solutions	—		2,333		—		2,333
Primary care	—		568		—		568
Commercial ASO	300		—		—		300
Military services and other	550		—		—		550
Pharmacy solutions	—		1,025		—		1,025
Total services revenue	850		3,926		—		4,776
Total external revenues	88,562		3,926		—		92,488
Intersegment revenues
Services	56		3,532		(3,588)		—
Products	—		9,841		(9,841)		—
Intersegment revenues	56		13,373		(13,429)		—
Investment income	223		8		151		382
Total revenues	88,841		17,307		(13,278)		92,870
Operating expenses:
Benefits	75,934		—		(244)		75,690
Operating costs	9,251		15,835		(12,415)		12,671
Depreciation and amortization	634		181		(106)		709
Total operating expenses	85,819		16,016		(12,765)		89,070
Income (loss) from operations	3,022		1,291		(513)		3,800
Gain on sale of Gentiva Hospice	—		(237)		—		(237)
Interest expense	—		—		401		401
Other expense, net	—		—		68		68
Income (loss) before income taxes and equity in net earnings (losses)	3,022		1,528		(982)		3,568
Equity in net earnings (losses)	18		(22)		—		(4)
Segment earnings (loss)	$	3,040	$	1,506	$	(982)	$	3,564
Net loss (income) attributable to noncontrolling interests	5		(1)		—		4
Segment earnings (loss) attributable to Humana	$	3,045	$	1,505	$	(982)	$	3,568

	Insurance		CenterWell		Eliminations/ Corporate		Consolidated
	(in millions)
2021
External revenues
Premiums:
Individual Medicare Advantage	$	58,654	$	—	$	—	$	58,654
Group Medicare Advantage	6,955		—		—		6,955
Medicare stand-alone PDP	2,371		—		—		2,371
Total Medicare	67,980		—		—		67,980
Commercial fully-insured	4,950		—		—		4,950
Specialty benefits	1,052		—		—		1,052
Medicare Supplement	731		—		—		731
State-based contracts and other	5,109		—		—		5,109
Total premiums	79,822		—		—		79,822
Services revenue:
Home solutions	—		1,166		—		1,166
Primary care	—		413		—		413
Commercial ASO	306		—		—		306
Military services and other	547		—		—		547
Pharmacy solutions	—		623		—		623
Total services revenue	853		2,202		—		3,055
Total external revenues	80,675		2,202		—		82,877
Intersegment revenues
Services	41		2,828		(2,869)		—
Products	—		9,024		(9,024)		—
Intersegment revenues	41		11,852		(11,893)		—
Investment income (loss)	214		4		(31)		187
Total revenues	80,930		14,058		(11,924)		83,064
Operating expenses:
Benefits	69,639		—		(440)		69,199
Operating costs	8,340		12,968		(11,187)		10,121
Depreciation and amortization	539		152		(95)		596
Total operating expenses	78,518		13,120		(11,722)		79,916
Income (loss) from operations	2,412		938		(202)		3,148
Interest expense	—		—		326		326
Other income, net	—		—		(532)		(532)
Income before income taxes and equity in net earnings	2,412		938		4		3,354
Equity in net earnings	—		65		—		65
Segment earnings	$	2,412	$	1,003	$	4	$	3,419
Net income attributable to noncontrolling interest	—		(1)		—		(1)
Segment earnings attributable to Humana	$	2,412	$	1,002	$	4	$	3,418