v3.26.1
Segment Information
 6 Months Ended
Jun. 30, 2026
Segment Reporting [Abstract]  
Segment Information Segment Information
We report our results of operations in the following four reportable segments: Health Benefits, CarelonRx, Carelon Services and Corporate & Other. An immaterial amount of our total consolidated revenues is derived from activities outside of the U.S. and Puerto Rico.
Our Health Benefits segment offers a comprehensive suite of health plans and services to our Individual, Employer Group risk-based, Employer Group fee-based, BlueCard®, Medicare, Medicaid and FEP® members. The Health Benefits segment offers health products on a full-risk basis; provides a broad array of administrative managed care services to our fee-based customers; and provides a variety of specialty and other insurance products and services such as stop loss, dental, vision and supplemental health insurance benefits.
Our CarelonRx segment includes our pharmacy services business. CarelonRx markets and offers pharmacy services to our affiliated health plan customers, as well as to external customers outside of the health plans we own. CarelonRx offers a comprehensive pharmacy services portfolio, which includes all core pharmacy services, such as home delivery and specialty pharmacies, claims adjudication, formulary management, pharmacy networks, rebate administration, a prescription drug database and member services, as well as infusion services and injectable therapies.
Our Carelon Services segment integrates physical, behavioral, and social services with the aim of delivering whole health affordably by offering a broad array of healthcare related services and capabilities to internal and external customers through our Carelon Health and Carelon Insights businesses. Carelon promotes affordability by managing complex areas of the healthcare system, leveraging data and insights to ensure members receive safe, appropriate, high-quality care and providers are reimbursed accurately and timely. Our approach to cost management relies on capabilities including provider enablement, value-based networks, member engagement, and utilization management. Our care delivery services primarily target serving chronic and complex populations by providing personalized care in the home and virtually.
Our Corporate & Other segment includes our businesses that do not individually meet the quantitative threshold for an operating segment, as well as corporate expenses not allocated to our other reportable segments.
We define operating revenues to include premiums, product revenue and service fees. Operating revenues are derived from premiums and fees received, primarily from the sale and administration of health benefits and pharmacy products and services. Operating gain is calculated as total operating revenue less benefit expense, cost of products sold and operating expense.
Affiliated operating revenues represent revenues or costs for services provided to our subsidiaries by CarelonRx and Carelon Services, in addition to certain administrative and other services provided by our international businesses, which are recorded at cost or management’s estimate of fair market value. These affiliated operating revenues are eliminated in our consolidated financial statements.
The accounting policies of the segments are consistent with those described in the summary of significant accounting policies in Note 2, “Basis of Presentation and Significant Accounting Policies,” except that all capitation risk arrangements are reported on a gross basis with an adjustment included in eliminations for capitated risk arrangements that are presented on a net basis under GAAP.
Our chief operating decision maker (the “CODM”) is our Chief Executive Officer. The CODM assesses the performance of our reportable segments based on operating gain or loss as defined above. The CODM evaluates net investment income, net gains (losses) on financial instruments, interest expense, depreciation and amortization expense, income taxes and assets, liabilities and equity on a consolidated basis, as these items are managed in a corporate shared service environment and are not the responsibility of segment operating management.
The CODM uses operating gain or loss, developed during the annual budget process, and updated during the periodic forecasting process, as a basis to assess performance and allocate operating and capital resources to each segment.
Financial data by reportable segment for the three and six months ended June 30, 2026 and 2025 is as follows:
Carelon
Health
Benefits		CarelonRxCarelon
Services		TotalCorporate
& Other		EliminationsTotal
Three Months Ended June 30, 2026
Premiums$40,647 $— $833 $833 $— $(201)$41,279 
Product revenue— 6,264 — 6,264 — — 6,264 
Service fees2,073 3 207 210 — — 2,283 
Operating revenue - unaffiliated42,720 6,267 1,040 7,307 — (201)49,826 
Operating revenue - affiliated— 4,983 6,935 11,918 6 (11,924)— 
Operating revenue - total$42,720 $11,250 $7,975 $19,225 $6 $(12,125)$49,826 
Benefit expense
$36,739 $— $6,743 $6,743 $6 $(6,464)$37,024 
Cost of products sold
— 10,473 — 10,473 — (4,981)5,492 
Operating expense
5,085 195 866 1,061 81 (680)5,547 
Operating gain (loss)$896 $582 $366 $948 $(81)$— $1,763 
Three Months Ended June 30, 2025
Premiums$39,710 $— $1,863 $1,863 $— $(302)$41,271 
Product revenue— 6,042 — 6,042 — — 6,042 
Service fees1,872 4 232 236 — — 2,108 
Operating revenue - unaffiliated41,582 6,046 2,095 8,141 — (302)49,421 
Operating revenue - affiliated— 4,597 5,346 9,943 232 (10,175)— 
Operating revenue - total$41,582 $10,643 $7,441 $18,084 $232 $(10,477)$49,421 
Benefit expense
$35,487 $— $6,290 $6,290 $8 $(5,079)$36,706 
Cost of products sold
— 9,884 — 9,884 — (4,591)5,293 
Operating expense
4,535 223 751 974 295 (807)4,997 
Operating gain (loss)$1,560 $536 $400 $936 $(71)$— $2,425 
Carelon
Health
Benefits		CarelonRxCarelon
Services		TotalCorporate
& Other		EliminationsTotal
Six Months Ended June 30, 2026
Premiums$81,099 $— $1,612 $1,612 $— $(408)$82,303 
Product revenue— 12,489 — 12,489 — — 12,489 
Service fees4,111 7 410 417 — — 4,528 
Operating revenue - unaffiliated85,210 12,496 2,022 14,518 — (408)99,320 
Operating revenue - affiliated— 9,354 13,318 22,672 10 (22,682)— 
Operating revenue - total$85,210 $21,850 $15,340 $37,190 $10 $(23,090)$99,320 
Benefit expense
$72,192 $— $12,829 $12,829 $15 $(12,397)$72,639 
Cost of products sold
— 20,303 — 20,303 — (9,348)10,955 
Operating expense
9,965 383 1,675 2,058 1,199 (1,345)11,877 
Operating gain (loss)$3,053 $1,164 $836 $2,000 $(1,204)$— $3,849 
Six Months Ended June 30, 2025
Premiums$79,298 $— $3,363 $3,363 $— $(503)$82,158 
Product revenue— 11,851 — 11,851 — — 11,851 
Service fees3,715 7 455 462 — — 4,177 
Operating revenue - unaffiliated83,013 11,858 3,818 15,676 — (503)98,186 
Operating revenue - affiliated— 8,901 10,159 19,060 397 (19,457)— 
Operating revenue - total$83,013 $20,759 $13,977 $34,736 $397 $(19,960)$98,186 
Benefit expense
$69,880 $— $11,609 $11,609 $18 $(9,489)$72,018 
Cost of products sold
— 19,168 — 19,168 — (8,892)10,276 
Operating expense
9,356 453 1,477 1,930 590 (1,579)10,297 
Operating gain (loss)$3,777 $1,138 $891 $2,029 $(211)$— $5,595 
A reconciliation of reportable segments’ operating revenue to the amounts of total revenues included in our consolidated statements of income for the three and six months ended June 30, 2026 and 2025 is as follows:
 Three Months Ended 
 June 30		Six Months Ended 
 June 30
 2026202520262025
Reportable segments’ operating revenue$49,826 $49,421 $99,320 $98,186 
Net investment income704 486 1,469 1,076 
Net losses on financial instruments(56)(131)(134)(595)
Total revenues$50,474 $49,776 $100,655 $98,667 
A reconciliation of reportable segments' operating gain to income before income tax expense included in our consolidated statements of income for the three and six months ended June 30, 2026 and 2025 is as follows:
 Three Months Ended 
 June 30		Six Months Ended 
 June 30
 2026202520262025
Income before income tax expense$1,937 $2,292 $4,241 $5,089 
Net investment income(704)(486)(1,469)(1,076)
Net losses on financial instruments56 131 134 595 
Interest expense364 341 721 685 
Amortization of other intangible assets110 147 222 302 
Reportable segments’ operating gain$1,763 $2,425 $3,849 $5,595