v3.26.3
Segment Information
 9 Months Ended
Sep. 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 nine months ended September 30, 2026 and 2025 is as follows:
Carelon
Health
Benefits		CarelonRxCarelon
Services		TotalCorporate
& Other		EliminationsTotal
Three Months Ended September 30, 2026
Premiums$41,282 $— $669 $669 $— $(247)$41,704 
Product revenue— 6,454 — 6,454 — — 6,454 
Service fees2,075 1 206 207 — — 2,282 
Operating revenue - unaffiliated43,357 6,455 875 7,330 — (247)50,440 
Operating revenue - affiliated— 5,144 6,833 11,977 6 (11,983)— 
Operating revenue - total$43,357 $11,599 $7,708 $19,307 $6 $(12,230)$50,440 
Benefit expense
$37,625 $— $6,521 $6,521 $6 $(6,373)$37,779 
Cost of products sold
— 10,779 — 10,779 — (5,139)5,640 
Operating expense
5,296 204 895 1,099 75 (718)5,752 
Operating gain (loss)$436 $616 $292 $908 $(75)$— $1,269 
Three Months Ended September 30, 2025
Premiums$40,304 $— $1,762 $1,762 $— $(275)$41,791 
Product revenue— 6,159 — $6,159 — — 6,159 
Service fees1,942 4 191 195 — — 2,137 
Operating revenue - unaffiliated42,246 6,163 1,953 8,116 — (275)50,087 
Operating revenue - affiliated— 4,834 5,371 10,205 149 (10,354)— 
Operating revenue - total$42,246 $10,997 $7,324 $18,321 $149 $(10,629)$50,087 
Benefit expense
$36,845 $— $6,349 $6,349 $4 $(5,058)$38,140 
Cost of products sold
— 10,209 — $10,209 — (4,829)5,380 
Operating expense
4,800 232 756 988 226 (742)5,272 
Operating gain (loss)$601 $556 $219 $775 $(81)$— $1,295 
Carelon
Health
Benefits		CarelonRxCarelon
Services		TotalCorporate
& Other		EliminationsTotal
Nine Months Ended September 30, 2026
Premiums$122,381 $— $2,281 $2,281 $— $(655)$124,007 
Product revenue— 18,943 — 18,943 — — 18,943 
Service fees6,186 8 616 624 — — 6,810 
Operating revenue - unaffiliated128,567 18,951 2,897 21,848 — (655)149,760 
Operating revenue - affiliated— 14,498 20,151 34,649 16 (34,665)— 
Operating revenue - total$128,567 $33,449 $23,048 $56,497 $16 $(35,320)$149,760 
Benefit expense
$109,817 $— $19,350 $19,350 $21 $(18,770)$110,418 
Cost of products sold
— 31,082 — 31,082 — (14,487)16,595 
Operating expense
15,261 587 2,570 3,157 1,274 (2,063)17,629 
Operating gain (loss)$3,489 $1,780 $1,128 $2,908 $(1,279)$— $5,118 
Nine Months Ended September 30, 2025
Premiums$119,602 $— $5,125 $5,125 $— $(778)$123,949 
Product revenue— 18,010 — $18,010 — — 18,010 
Service fees5,657 11 646 657 — — 6,314 
Operating revenue - unaffiliated125,259 18,021 5,771 23,792 — (778)148,273 
Operating revenue - affiliated— 13,735 15,530 29,265 546 (29,811)— 
Operating revenue - total$125,259 $31,756 $21,301 $53,057 $546 $(30,589)$148,273 
Benefit expense
$106,725 $— $17,958 $17,958 $22 $(14,547)$110,158 
Cost of products sold
— 29,377 — 29,377 — (13,721)15,656 
Operating expense
14,156 685 2,233 2,918 816 (2,321)15,569 
Operating gain (loss)$4,378 $1,694 $1,110 $2,804 $(292)$— $6,890 
A reconciliation of reportable segments’ operating revenue to the amounts of total revenues included in our consolidated statements of income for the three and nine months ended September 30, 2026 and 2025 is as follows:
Three Months Ended 
 September 30		Nine Months Ended 
 September 30
2026202520262025
Reportable segments’ operating revenue$50,440 $50,087 $149,760 $148,273 
Net investment income1,037 625 2,506 1,701 
Net losses on financial instruments(48)(1)(182)(596)
Total revenues$51,429 $50,711 $152,084 $149,378 
A reconciliation of reportable segments' operating gain to income before income tax expense included in our consolidated statements of income for the three and nine months ended September 30, 2026 and 2025 is as follows:
Three Months Ended 
 September 30		Nine Months Ended 
 September 30
2026202520262025
Income before income tax expense$1,794 $1,406 $6,035 $6,495 
Net investment income(1,037)(625)(2,506)(1,701)
Net losses on financial instruments48 1 182 596 
Interest expense358 351 1,079 1,036 
Amortization of other intangible assets106 162 328 464 
Reportable segments’ operating gain$1,269 $1,295 $5,118 $6,890