Notes to Consolidated Financial Statements
December 31, 2021
(In Millions, Except Per Share Data or As Otherwise Stated Herein)
1. Organization
References to the terms “we,” “our,” “us” or “Anthem” used throughout these Notes to Consolidated Financial Statements refer to Anthem, Inc., an Indiana corporation, and unless the context otherwise requires, its direct and indirect subsidiaries.
We are one of the largest health benefits companies in the United States in terms of medical membership, serving greater than 45 million medical members through our affiliated health plans as of December 31, 2021. We offer a broad spectrum of network-based managed care risk-based plans to Individual, Group, Medicaid and Medicare markets. In addition, we provide a broad array of managed care services to fee-based customers, including claims processing, stop loss insurance, provider network access, medical management, care management and wellness programs, actuarial services and other administrative services. We also provide services to the federal government in connection with our Federal Health Products & Services business, which administers the Federal Employees Health Benefits (“FEHB”) Program. We provide an array of specialty services both to our subsidiary health plans and also unaffiliated health plans, including pharmacy benefit management (“PBM”) services and dental, vision, life, disability and supplemental health insurance benefits, as well as integrated health services.
We are an independent licensee of the Blue Cross and Blue Shield Association (“BCBSA”), an association of independent health benefit plans. We serve our members as the Blue Cross licensee for California and as the Blue Cross and Blue Shield (“BCBS”) licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (in the New York City metropolitan area and upstate New York), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.) and Wisconsin. In a majority of these service areas, we do business as Anthem Blue Cross, Anthem Blue Cross and Blue Shield, and Empire Blue Cross Blue Shield or Empire Blue Cross. We also conduct business through arrangements with other BCBS licensees as well as other strategic partners. Through our subsidiaries, we also serve customers in numerous states and Puerto Rico as AIM Specialty Health, Amerigroup, Aspire Health, Beacon, CareMore, Freedom Health, HealthLink, HealthSun, MMM, Optimum HealthCare, Simply Healthcare, and/or UniCare. PBM services are offered through our IngenioRx, Inc. (“IngenioRx”) subsidiary. We are licensed to conduct insurance operations in all 50 states, the District of Columbia and Puerto Rico through our subsidiaries.
2. Basis of Presentation and Significant Accounting Policies
Basis of Presentation: The accompanying consolidated financial statements include the accounts of Anthem and its subsidiaries and have been prepared in conformity with U.S. generally accepted accounting principles (“GAAP”). All significant intercompany accounts and transactions have been eliminated in consolidation.
Certain of our subsidiaries operate outside of the United States and have functional currencies other than the U.S. dollar (“USD”). We translate the assets and liabilities of those subsidiaries to USD using the exchange rate in effect at the end of the period. We translate the revenues and expenses of those subsidiaries to USD using the average exchange rates in effect during the period. The net effect of these translation adjustments is included in “Foreign currency translation adjustments” in our consolidated statements of comprehensive income.
Reclassifications: Certain prior year amounts have been reclassified to conform to the current year presentation.
Use of Estimates: The preparation of consolidated financial statements in conformity with GAAP requires us to make estimates and assumptions that affect the amounts reported in our consolidated financial statements and accompanying notes. Our most significant estimate relates to estimates and judgments for medical claims payable. Actual results could differ from those estimates.
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Notes to Consolidated Financial Statements (continued)
Cash and Cash Equivalents: Cash and cash equivalents includes available cash and all highly liquid investments with maturities of three months or less when purchased. We control a number of bank accounts that are used exclusively to hold customer funds for the administration of customer benefits, and we have cash and cash equivalents on deposit to meet certain regulatory requirements. These amounts totaled $173 and $170 at December 31, 2021 and 2020, respectively, and are included in the cash and cash equivalents line on our consolidated balance sheets.
Investments: We classify fixed maturity securities in our investment portfolio as “available-for-sale” and report those securities at fair value. Certain fixed maturity securities are available to support current operations and, accordingly, we classify such investments as current assets without regard to their contractual maturity. Investments used to satisfy contractual, regulatory or other requirements are classified as long-term, without regard to contractual maturity.
Prior to 2020, our fixed maturity securities were evaluated for other-than-temporary impairment where credit-related impairments were presented within the other-than-temporary impairment losses recognized in our consolidated statements of income with an adjustment to the security’s amortized cost basis. Effective January 1, 2020, if a fixed maturity security is in an unrealized loss position and we have the intent to sell the fixed maturity security, or it is more likely than not that we will have to sell the fixed maturity security before recovery of its amortized cost basis, we write down the fixed maturity security’s cost basis to fair value and record an impairment loss in our consolidated statements of income. For impaired fixed maturity securities that we do not intend to sell or if it is more likely than not that we will not have to sell such securities, but we expect that we will not fully recover the amortized cost basis, we recognize the credit component of the impairment as an allowance for credit loss in our consolidated balance sheets and record an impairment loss in our consolidated statements of income. The non-credit component of the impairment is recognized in accumulated other comprehensive (loss) income. Furthermore, unrealized losses entirely caused by non-credit-related factors related to fixed maturity securities for which we expect to fully recover the amortized cost basis continue to be recognized in accumulated other comprehensive (loss) income.
The credit component of an impairment is determined primarily by comparing the net present value of projected future cash flows with the amortized cost basis of the fixed maturity security. The net present value is calculated by discounting our best estimate of projected future cash flows at the effective interest rate implicit in the fixed maturity security at the date of purchase. For mortgage-backed and asset-backed securities, cash flow estimates are based on assumptions regarding the underlying collateral, including prepayment speeds, vintage, type of underlying asset, geographic concentrations, default rates, recoveries and changes in value. For all other securities, cash flow estimates are driven by assumptions regarding probability of default, including changes in credit ratings and estimates regarding timing and amount of recoveries associated with a default.
For asset-backed securities included in fixed maturity securities, we recognize income using an effective yield based on anticipated prepayments and the estimated economic life of the securities. When estimates of prepayments change, the effective yield is recalculated to reflect actual payments to date and anticipated future payments. The net investment in the securities is adjusted to the amount that would have existed had the new effective yield been applied since the purchase date of the securities. Such adjustments are reported within net investment income.
The changes in fair value of our marketable equity securities are recognized in our results of operations within net gains and losses on financial instruments. Certain marketable equity securities are held to satisfy contractual obligations, and are reported under the caption “Other invested assets” in our consolidated balance sheets.
We have corporate-owned life insurance policies on certain participants in our deferred compensation plans and other members of management. The cash surrender value of the corporate-owned life insurance policies is reported under the caption “Other invested assets” in our consolidated balance sheets.
We use the equity method of accounting for investments in companies in which our ownership interest may enable us to influence the operating or financial decisions of the investee company. Our proportionate share of equity in net income of these unconsolidated affiliates is reported within net investment income. The equity method investments are reported under the caption “Other invested assets” in our consolidated balance sheets.
Investment income is recorded when earned. All securities sold resulting in investment realized gains and losses are recorded on the trade date. Realized gains and losses are determined on the basis of the cost or amortized cost of the specific securities sold.
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Notes to Consolidated Financial Statements (continued)
We participate in securities lending programs whereby marketable securities in our investment portfolio are transferred to independent brokers or dealers in exchange for cash and securities collateral. Under Financial Accounting Standards Board (“FASB”) guidance related to accounting for transfers and servicing of financial assets and extinguishments of liabilities, we recognize the collateral as an asset, which is reported in other current assets on our consolidated balance sheets, and we record a corresponding liability for the obligation to return the collateral to the borrower, which is reported in other current liabilities. The securities on loan are reported in the applicable investment category on our consolidated balance sheets. Unrealized gains or losses on securities lending collateral are included in accumulated other comprehensive income as a separate component of shareholders’ equity. The market value of loaned securities and that of the collateral pledged can fluctuate in non-synchronized fashions. To the extent the loaned securities’ value appreciates faster or depreciates slower than the value of the collateral pledged, we are exposed to the risk of the shortfall. As a primary mitigating mechanism, the loaned securities and collateral pledged are marked to market on a daily basis and the shortfall, if any, is collected accordingly. Secondarily, the collateral level is set at 102% of the value of the loaned securities, which provides a cushion before any shortfall arises. The investment of the cash collateral is subject to market risk, which is managed by limiting the investments to higher quality and shorter duration instruments.
Receivables: Receivables are reported net of amounts for expected credit losses. The allowance for doubtful accounts is based on historical collection trends, future forecasts and our judgment regarding the ability to collect specific accounts.
Premium receivables include the uncollected amounts from insured groups, individuals and government programs. Premium receivables are reported net of an allowance for doubtful accounts of $142 and $146 at December 31, 2021 and 2020, respectively.
Self-funded receivables include administrative fees, claims and other amounts due from fee-based customers. Self-funded receivables are reported net of an allowance for doubtful accounts of $50 and $54 at December 31, 2021 and 2020, respectively.
Other receivables include pharmacy rebates, provider advances, claims recoveries, reinsurance receivables, proceeds due from brokers on investment trades, accrued investment income and other miscellaneous amounts due to us. These receivables are reported net of an allowance for doubtful accounts of $648 and $374 at December 31, 2021 and 2020, respectively.
Income Taxes: We file a consolidated U.S. federal income tax return. Deferred income tax assets and liabilities are recognized for temporary differences between the financial statement and tax return basis of assets and liabilities based on enacted tax rates and laws and are reported net on our consolidated balance sheets. The deferred tax benefits of the deferred tax assets are recognized to the extent realization of such benefits is more likely than not. Deferred income tax expense or benefit generally represents the net change in deferred income tax assets and liabilities during the year, excluding the impact from amounts initially recorded for business combinations, if any, and amounts recorded to accumulated other comprehensive income. Current income tax expense represents the tax consequences of revenues and expenses currently taxable or deductible on various income tax returns for the year reported.
The Internal Revenue Code subjects a U.S. shareholder to tax on Global Intangible Low-Taxed Income (“GILTI”) earned by certain foreign subsidiaries. We have elected to account for GILTI tax in the year the tax is incurred.
We account for income tax contingencies in accordance with FASB guidance that contains a model to address uncertainty in tax positions and clarifies the accounting for income taxes by prescribing a minimum recognition threshold, which all income tax positions must achieve before being recognized in the financial statements.
Property and Equipment: Property and equipment is recorded at cost, net of accumulated depreciation. Depreciation is computed principally by the straight-line method over estimated useful lives ranging from fifteen to thirty-nine years for buildings and improvements, three to five years for computer equipment and software, and the lesser of the remaining life of the building lease, if any, or seven years for furniture and other equipment. Leasehold improvements are depreciated over the term of the related lease. Certain costs related to the development or purchase of internal-use software are capitalized and amortized over estimated useful lives ranging from three to ten years.
Goodwill and Other Intangible Assets: FASB guidance requires business combinations to be accounted for using the acquisition method of accounting, and it also specifies the types of acquired intangible assets that are required to be recognized and reported separately from goodwill. Goodwill represents the excess of the cost of acquisition over the fair
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Notes to Consolidated Financial Statements (continued)
value of net assets acquired. Other intangible assets represent the values assigned to customer relationships, provider and hospital networks, Blue Cross and Blue Shield and other trademarks, licenses and other agreements, such as non-compete agreements. Goodwill and other intangible assets are allocated to reportable segments based on the relative fair value of the components of the businesses acquired.
Goodwill and other intangible assets with indefinite lives are not amortized but are tested for impairment at least annually. Goodwill and other intangible assets are allocated to reporting units for purposes of the annual goodwill impairment test. Other intangible assets with indefinite lives, such as trademarks, are tested for impairment separately. We complete our annual impairment tests of existing goodwill and other intangible assets with indefinite lives during the fourth quarter of each year. Our impairment tests require us to make assumptions and judgments regarding the estimated fair value of our reporting units, including goodwill and other intangible assets with indefinite lives. Certain interim impairment tests are also performed when potential impairment indicators exist or changes in our business or other triggering events occur.
FASB guidance allows for qualitative assessments of whether it is more likely than not that the fair value of a reporting unit is less than its carrying amount for purposes of a goodwill impairment analysis and whether it is more likely than not that an indefinite-lived intangible asset is impaired for purposes of an indefinite-lived intangible asset impairment analysis. Estimated fair values developed based on our assumptions and judgments might be different if other reasonable assumptions and estimates were to be used. Qualitative analysis involves assessing situations and developments that could affect key drivers used to evaluate whether the fair value of our goodwill and indefinite-lived intangible assets are impaired. Our procedures include assessing our financial performance, macroeconomic conditions, industry and market considerations, various asset specific factors, and entity specific events.
Quantitative analysis must be performed if qualitative analyses are not conclusive. Entities also have the option to bypass the assessment of qualitative factors and proceed directly to performing quantitative analyses. Fair value for purposes of a quantitative goodwill impairment test is calculated using a blend of the projected income and market valuation approaches. The projected income approach is developed using assumptions about future revenue, expenses and net income derived from our internal planning process. Our assumed discount rate is based on our industry’s weighted-average cost of capital and reflects volatility associated with the cost of equity capital. Market valuations include market comparisons to publicly traded companies in our industry and are based on observed multiples of certain measures including revenue; earnings before interest, taxes, depreciation and amortization (“EBITDA”); and book value of invested capital.
A goodwill impairment loss is recognized to the extent that the carrying amount exceeds the asset’s fair value. This determination consists of a one step test comparing the fair value of a reporting unit, including goodwill, to its carrying amount. If the carrying amount of a reporting unit exceeds its fair value, an impairment loss is recognized. This goodwill impairment loss is equal to the excess of the reporting unit’s carrying amount over its fair value.
Fair value for purposes of a quantitative impairment test for indefinite-lived intangible assets is estimated using a projected income approach. We recognize an impairment loss when the estimated fair value of indefinite-lived intangible assets is less than the carrying value. If significant impairment indicators are noted relative to other intangible assets subject to amortization, we may be required to record impairment losses against future income.
Derivative Financial Instruments: We primarily invest in the following types of derivative financial instruments: interest rate swaps, futures, forward contracts, put and call options, collars, swaptions, embedded derivatives and warrants. Derivatives embedded within non-derivative instruments, such as options embedded in convertible fixed maturity securities, are bifurcated from the host instrument when the embedded derivative is not clearly and closely related to the host instrument. Our use of derivatives is limited by statutes and regulations promulgated by the various regulatory bodies to which we are subject, and by our own derivative policy. Our derivative use is generally limited to hedging purposes, on an economic basis, and we generally do not use derivative instruments for speculative purposes.
We have exposure to economic losses due to interest rate risk arising from changes in the level or volatility of interest rates. We attempt to mitigate our exposure to interest rate risk through active portfolio management, including rebalancing our existing portfolios of assets and liabilities, as well as changing the characteristics of investments to be purchased or sold in the future. In addition, derivative financial instruments are used to modify the interest rate exposure of certain liabilities or forecasted transactions. These strategies include the use of interest rate swaps and forward contracts, which are used to lock-
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Notes to Consolidated Financial Statements (continued)
in interest rates or to hedge, on an economic basis, interest rate risks associated with variable rate debt. We have used these types of instruments as designated hedges against specific liabilities.
All investments in derivatives are recorded as assets or liabilities at fair value. If certain correlation, hedge effectiveness and risk reduction criteria are met, a derivative may be specifically designated as a hedge of exposure to changes in fair value or cash flow. The accounting for changes in the fair value of a derivative depends on the intended use of the derivative and the nature of any hedge designation thereon. Amounts excluded from the assessment of hedge effectiveness, if any, are reported in results of operations immediately. If the derivative is not designated as a hedge, the gain or loss resulting from the change in the fair value of the derivative is recognized in results of operations in the period of change. Cash flows associated with the settlement of non-designated derivatives are shown on a net basis in investing activity in our consolidated statements of cash flow.
From time to time, we may also purchase derivatives to hedge, on an economic basis, our exposure to foreign currency exchange fluctuations associated with the operations of certain of our subsidiaries. We generally use futures or forward contracts for these transactions. We generally do not designate these contracts as hedges and, accordingly, the changes in fair value of these derivatives are recognized in results of operations immediately.
Credit exposure associated with non-performance by the counterparties to derivative instruments is generally limited to the uncollateralized fair value of the asset related to instruments recognized in the consolidated balance sheets. We attempt to mitigate the risk of non-performance by selecting counterparties with high credit ratings and monitoring their creditworthiness and by diversifying derivatives among multiple counterparties. At December 31, 2021, we believe there were no material concentrations of credit risk with any individual counterparty.
We generally enter into master netting agreements, which reduce credit risk by permitting net settlement of transactions with the same counterparty. Certain of our derivative agreements also contain credit support provisions that require us or the counterparty to post collateral if there are declines in the derivative fair value or our credit rating. The derivative assets and derivative liabilities are reported at their fair values net of collateral and netting by the counterparty.
Retirement Benefits: We recognize the funded status of pension and other postretirement benefit plans on the consolidated balance sheets based on fiscal-year-end measurements of plan assets and benefit obligations. Prepaid pension benefits represent prepaid costs related to defined benefit pension plans and are reported with other noncurrent assets. Postretirement benefits represent outstanding obligations for retiree medical, life, vision and dental benefits. Liabilities for pension and other postretirement benefits are reported with noncurrent assets, current liabilities and noncurrent liabilities based on the amount by which the actuarial present value of benefits payable in the next twelve months included in the benefit obligation exceeds the fair value of plan assets.
We determine the expected return on plan assets using the calculated value of plan assets, which recognizes changes in the fair value of plan assets in a systematic manner over three years. We apply a corridor approach to amortize unrecognized actuarial gains or losses. Under this approach, only accumulated net actuarial gains or losses in excess of 10% of the greater of the projected benefit obligation or the fair value of plan assets are amortized over the average remaining service or lifetime of the workforce as a component of net periodic benefit cost.
The discount rate reflects the current rate at which the pension liabilities could be effectively settled at the end of the year based on our most recent measurement date. We use the annual spot rate approach for setting our discount rate. Under the spot rate approach, individual spot rates from a full yield curve of published rates are used to discount each plan’s cash flows to determine the plan’s obligations.
The assumed healthcare cost trend rates used to measure the expected cost of other postretirement benefits are based on an initial assumed healthcare cost trend rate declining to an ultimate healthcare cost trend rate over a select number of years.
Medical Claims Payable: Liabilities for medical claims payable include estimated provisions for incurred but not paid claims on an undiscounted basis, as well as estimated provisions for expenses related to the processing of claims. Incurred but not paid claims include (1) an estimate for claims that are incurred but not reported, as well as claims reported to us but not yet processed through our systems; and (2) claims reported to us and processed through our systems but not yet paid.
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Notes to Consolidated Financial Statements (continued)
Liabilities for both claims incurred but not reported and reported but not yet processed through our systems are determined in the aggregate, employing actuarial methods that are commonly used by health insurance actuaries and meet Actuarial Standards of Practice. Our reserving practice for claim liabilities is to consistently recognize the appropriate amount of reserve within a level of confidence required by Actuarial Standards of Practice. We determine the amount of the liability for incurred but not paid claims by following a detailed actuarial process that uses both historical claim payment patterns as well as emerging medical cost trends to project our best estimate of claim liabilities. Under this process, historical paid claims data is formatted into “claim triangles,” which compare claim incurred dates to the dates of claim payments. This information is analyzed to create “completion factors” that represent the average percentage of total incurred claims that have been paid through a given date after being incurred. Completion factors are applied to claims paid through the period-end date to estimate the ultimate claim expense incurred for the period. Actuarial estimates of incurred but not paid claim liabilities are then determined by subtracting the actual paid claims from the estimate of the ultimate incurred claims.
For the most recent incurred months (typically the most recent two months), the percentage of claims paid for claims incurred in those months is generally low. This makes the completion factor methodology less reliable for such months. Therefore, incurred claims for recent months are not projected from historical completion and payment patterns; rather, they are projected by estimating the claims expense for those months based on recent claims expense levels and healthcare trend levels (“trend factors”).
We regularly review and set assumptions regarding cost trends and utilization when initially establishing claim liabilities. We continually monitor and adjust the claims liability and benefit expense based on subsequent paid claims activity. If it is determined that our assumptions regarding cost trends and utilization are materially different than actual results, our income statement and financial position could be impacted in future periods.
Premium deficiencies are recognized when it is probable that expected claims and administrative expenses will exceed future premiums on existing medical insurance contracts without consideration of investment income. Determination of premium deficiencies for longer duration life and disability contracts includes consideration of investment income. For purposes of premium deficiencies, contracts are deemed to be either short or long duration and are grouped in a manner consistent with our method of acquiring, servicing and measuring the profitability of such contracts. Once established, premium deficiencies are released commensurate with actual claims experience over the remaining life of the contract. No premium deficiencies were established at December 31, 2021 or 2020.
Benefit expense includes incurred medical claims as well as quality improvement expenses for our risk-based members. Quality improvement activities are those designed to improve member health outcomes, prevent hospital readmissions and improve patient safety. They also include expenses for wellness and health promotion provided to our members.
Other Policyholder Liabilities: Other policyholder liabilities include rate stabilization reserves associated with retrospectively rated insurance contracts and certain case-specific reserves. Other policyholder liabilities also include liabilities for premium refunds based upon the minimum medical loss ratio (“MLR”), the relative health risk of members, and other contractual or regulatory requirements. Rate stabilization reserves represent accumulated premiums that exceed what customers owe us based on actual claim experience. The timing of payment of these retrospectively rated refunds is based on the contractual terms with our customers and can vary from period to period based on the specific contractual requirements.
We are required to meet certain minimum MLR thresholds prescribed by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended (collectively the “ACA”). If we do not meet or exceed the minimum MLR thresholds specified by the ACA, we are required to pay rebates to certain customers. Minimum MLR rebates are calculated by subsidiary, state and applicable line of business in accordance with regulations issued by the Department of Health and Human Services (“HHS”). Such calculations are made using estimated calendar year medical loss expense and premiums, as defined by HHS.
We follow HHS guidelines for determining the types of expenses that may be included in our minimum MLR rebate calculations, which differ from benefit expense and premiums as reported in our consolidated financial statements prepared in conformity with GAAP. Certain amounts reported as expense in our consolidated GAAP financial statements may be reported as a reduction of premiums in accordance with HHS regulations. In addition, profit amounts included in our payments to third-party administrative service providers are recorded as benefit expense in our consolidated GAAP financial
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statements, while HHS does not allow for the inclusion of these expenses within the medical loss expense for purposes of calculating minimum MLR.
Reserves for Future Policy Benefits: Reserves for future policy benefits include liabilities for life and long-term disability insurance policy benefits based upon interest, mortality and morbidity assumptions from published actuarial tables, modified based upon our experience. Future policy benefits also include liabilities for insurance policies for which some of the premiums received in earlier years are intended to pay anticipated benefits to be incurred in future years. Future policy benefits are continually monitored and reviewed, and when reserves are adjusted, differences are reflected in benefit expense.
We believe that our liabilities for future policy benefits, along with future premiums received, are adequate to satisfy our ultimate benefit liability; however, these estimates are inherently subject to a number of variable circumstances. Consequently, the actual results could differ materially from the amounts recorded in our consolidated financial statements.
Revenue Recognition: Premiums for risk-based contracts are recognized as revenue over the period insurance coverage is provided, and, if applicable, net of amounts recognized for MLR rebates, risk adjustment, reinsurance and risk corridor under contractual premium stabilization arrangements, the ACA or other regulatory requirements. Premium payments from contracted government agencies are based on eligibility lists produced by the government agencies. Premiums related to the unexpired contractual coverage periods are reflected in the accompanying consolidated balance sheets as unearned income. Premiums include revenue adjustments for retrospectively rated contracts where revenue is based on the estimated loss experience of the contract. Premium rates for certain lines of business are subject to approval by the Department of Insurance of each respective state. Additionally, delays in annual premium rate changes from contracted government agencies require that we defer the recognition of any increases to the period in which the premium rates become final. The value of the impact can be significant in the period in which it is recognized depending on the magnitude of the premium rate increase, the membership to which it applies and the length of the delay between the effective date of the rate increase and the final contract date. Premium rate decreases are recognized in the period the change in premium rate becomes effective and the change in the rate is known, which may be prior to the period when the contract amendment affecting the rate is finalized.
Administrative fees and other revenue include revenue from certain group contracts that provide for the group to be at risk for all, or with supplemental insurance arrangements, a portion, of their claims experience. We charge these fee-based groups an administrative fee, which is based on the number of members in a group or the group’s claim experience. In addition, administrative fees and other revenue include amounts received for the administration of Medicare or certain other government programs. Under our fee-based arrangements, revenue is recognized as administrative services are performed. All benefit payments under these programs are excluded from benefit expense.
Product revenue includes revenue for services performed by our IngenioRx PBM for unaffiliated PBM customers. Unaffiliated PBM customers include our fee-based groups that have contracted with IngenioRx for PBM services and, beginning on January 1, 2020, third-party health plans. Product revenues and costs of goods sold for our affiliated health plans are eliminated in consolidation. Product revenue for PBM services is recognized using the gross method at the negotiated contract price when IngenioRx has concluded that it is the principal and it controls the services before prescription drugs are transferred to the customer. IngenioRx determined it is the principal due to its contractual rights to design and develop a listing of prescription drugs offered to the customer (formulary management); its control over establishing the pharmacy network available to the customer to have its prescription fulfilled (network management); and its discretion over establishing the pricing for prescription drugs. Overall, control over these activities indicate IngenioRx is primarily responsible for fulfilling the promise to provide PBM services. Product revenue includes ingredient costs (net of any rebates or discounts), including any co-payments made by or on behalf of the customer, and administrative fees. IngenioRx recognizes revenue when control of the prescription drugs is transferred to customers, in an amount it expects to be entitled to in exchange for the products or services provided.
For our non-risk-based contracts, we had no material contract assets, contract liabilities or deferred contract costs recorded on our consolidated balance sheet at December 31, 2021. Revenue recognized in 2021 and 2020 from performance obligations related to prior years, such as due to changes in transaction price, was not material. For contracts that have an original expected duration of greater than one year, revenue expected to be recognized in future periods related to unfulfilled contractual performance obligations and contracts with variable consideration related to undelivered performance obligations is not material.
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Notes to Consolidated Financial Statements (continued)
Cost of Products Sold: IngenioRx’s cost of products sold includes the cost of prescription drugs dispensed to unaffiliated PBM customers (net of rebates or discounts). This cost includes any co-payments made by or on behalf of the customer. Cost of products sold also includes per-claim administrative fees for prescription fulfillment by its vendor and certain IngenioRx direct costs related to sales and administration of customer contracts.
Share-Based Compensation: Our current compensation philosophy provides for share-based compensation, including stock options, restricted stock awards and an employee stock purchase plan. Stock options are granted for a fixed number of shares with an exercise price at least equal to the fair value of the shares at the date of the grant. Restricted stock awards are issued at the fair value of the stock on the grant date. The employee stock purchase plan allows for a purchase price per share which is 90% of the fair value of a share of common stock on the lower of the first or last trading day of the plan quarter. The employee stock purchase plan discount is recognized as compensation expense based on GAAP guidance. All other share-based payments to employees are recognized as compensation expense in our consolidated statements of income based on their fair values. Additionally, excess tax benefits, which result from actual tax benefits realized when awards vest or options are exercised exceeding deferred tax benefits previously recognized based on grant date fair value, are recognized as tax benefits in the consolidated statements of income.
Advertising and Marketing Costs: We use print, broadcast and other advertising to promote our products and to develop our corporate image. We market our products through direct marketing activities and an extensive network of independent agents, brokers and retail partnerships for Individual and Medicare customers, and for certain Group risk-based customers with a smaller employee base. Products for Group risk-based customers with a larger employee base are generally sold through independent brokers or consultants retained by the customer who work with industry specialists from our in-house sales force. In the Individual and Group markets, we offer products through state or federally facilitated marketplaces, or Public Exchanges, and off-exchange products. The cost of advertising and marketing for product promotion is expensed as incurred, while advertising and marketing costs associated with our corporate image are expensed when first aired. Total advertising and marketing expense was $588, $558 and $467 for the years ended December 31, 2021, 2020 and 2019, respectively.
Health Insurance Provider Fee: The ACA imposed an annual Health Insurance Provider Fee (“HIP Fee”) on health insurers that wrote certain types of health insurance on U.S. risks, which has been permanently repealed effective January 1, 2021. The HIP Fee was non-deductible for federal income tax purposes. Our affected products were priced to cover the increased selling, general and administrative and income tax expenses associated with the HIP Fee when it was in effect. The HIP Fee was suspended for 2019, resumed and increased to $15,523 for 2020 and was permanently eliminated beginning in 2021. For the year ended December 31, 2020, we recognized $1,570 as selling, general and administrative expense related to the HIP Fee. There was no corresponding HIP Fee expense for 2019 or 2021.
Leases: We lease office space and certain computer and related equipment under noncancelable operating leases. We determine whether an arrangement is or contains a lease at its inception. We recognize lease liabilities based on the present value of the minimum lease payments not yet paid by using the lease term, any amounts probable of being owed under any residual value guarantees and the discount rate determined at lease commencement. As our leases do not generally provide an implicit rate, we use our incremental secured borrowing rate commensurate with the underlying lease terms to determine the present value of our lease payments. Our lease liabilities may include amounts for options to extend or terminate a lease when it is reasonably certain that we will exercise that option. We recognize operating right-of-use (“ROU”) assets at an amount equal to the lease liability adjusted for prepaid or accrued rent, the remaining balance of any lease incentives and unamortized initial direct costs.
The operating lease liabilities are reported in other current liabilities and other noncurrent liabilities and the related ROU assets are reported in other noncurrent assets on our consolidated balance sheets. Lease expense for our operating leases is calculated on a straight-line basis over the lease term and is reported in selling, general and administrative expense on our consolidated statements of income. For our office space leases, we account for the lease and non-lease components (such as common area maintenance) as a single lease component. We also do not recognize a lease liability or ROU asset for our office space leases whose lease terms, at commencement, are twelve months or less and that do not include a purchase option or option to extend that we are reasonably certain to exercise.
We assess our ROU assets for impairment when there are indicators and compare the carrying amount of the ROU asset to its estimated undiscounted future cash flows. If the estimated undiscounted future cash flows are less than the carrying
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Notes to Consolidated Financial Statements (continued)
amount of the ROU asset, an impairment calculation is performed. An impairment loss is recorded for the difference of the ROU asset’s carrying value that exceeds its estimated discounted cash flows. During the years ended December 31, 2021 and 2020, we recorded $136 and $258, respectively, for impairment and abandonment of ROU assets. See Note 18, “Leases” for additional information about the ROU asset impairment and abandonment charges.
Earnings per Share: Earnings per share amounts, on a basic and diluted basis, have been calculated based upon the weighted-average common shares outstanding for the period.
Basic earnings per share excludes dilution and is computed by dividing income available to common shareholders by the weighted-average number of common shares outstanding for the period. Diluted earnings per share may include the dilutive effect of stock options, restricted stock and convertible debentures, using the treasury stock method. The treasury stock method assumes exercise of stock options and vesting of restricted stock, with the assumed proceeds used to purchase common stock at the average market price for the period. The difference between the number of shares assumed issued and the number of shares assumed purchased represents the dilutive shares.
Recently Adopted Accounting Guidance: In January 2021, the FASB issued Accounting Standards Update No. 2021-01, Reference Rate Reform (Topic 848) (“ASU 2021-01”). The amendments in ASU 2021-01 provide optional expedients and exceptions for applying GAAP to contract modifications and hedging relationships, subject to meeting certain criteria, that reference the London Interbank Offered Rate (“LIBOR”) or another reference rate expected to be discontinued because of the reference rate reform. The provisions must be applied at a Topic, Subtopic, or Industry Subtopic level for all transactions other than derivatives, which may be applied at a hedging relationship level. We adopted ASU 2021-01 on January 7, 2021, and the adoption did not have an impact on our consolidated financial position, results of operations or cash flows.
In October 2020, the FASB issued Accounting Standards Update No. 2020-08, Codification Improvements to Subtopic 310-20, Receivables—Nonrefundable Fees and Other Costs (“ASU 2020-08”). The amendments in ASU 2020-08 clarify when an entity should assess whether a callable debt security is within the scope of accounting guidance, which impacts the amortization period for nonrefundable fees and other costs. ASU 2020-08 became effective for interim and annual reporting periods beginning after December 15, 2020. The amendments are to be applied on a prospective basis as of the beginning of the period of adoption for existing or newly purchased callable debt securities. We adopted ASU 2020-08 on January 1, 2021, and the adoption did not have an impact on our consolidated financial position, results of operations or cash flows.
In August 2020, the FASB issued Accounting Standards Update No. 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity (“ASU 2020-06”). The amendments eliminate two of the three accounting models that require separate accounting for convertible features of debt securities, simplify the contract settlement assessment for equity classification, require the use of the if-converted method for all convertible instruments in the diluted earnings per share calculation and expand disclosure requirements. The amendments are effective for our annual and interim reporting periods beginning after December 15, 2021. We adopted ASU 2020-06 on January 1, 2022 and are using the modified retrospective transition method which resulted in an increase to our reported debt outstanding and a corresponding cumulative-effect reduction to opening retained earnings; the amounts are not material to our overall consolidated financial position. The adoption of ASU 2020-06 did not have an impact on our results of operations or our consolidated cash flows. Use of the if-converted method is not expected to have a material impact on our overall earnings per share calculation.
In December 2019, the FASB issued Accounting Standards Update No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes (“ASU 2019-12”). The amendments in ASU 2019-12 remove certain exceptions to the general principles in Accounting Standards Codification Topic 740. The amendments also clarify and amend existing guidance to improve consistent application. The amendments became effective for our annual reporting periods beginning after December 15, 2020. The transition method (retrospective, modified retrospective, or prospective basis) related to the amendments depends on the applicable guidance, and all amendments for which there is no transition guidance specified are to be applied on a prospective basis. We adopted ASU 2019-12 on January 1, 2021, and the adoption did not have an impact on our consolidated financial position, results of operations or cash flows.
In June 2016, the FASB issued Accounting Standards Update No. 2016-13, Financial Instruments—Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments (“ASU 2016-13”). ASU 2016-13 introduces a current
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
expected credit loss model for measuring expected credit losses for certain types of financial instruments held at the reporting date based on historical experience, current conditions and reasonable supportable forecasts. ASU 2016-13 replaces the incurred loss model for measuring expected credit losses, requires expected losses on available-for-sale debt securities to be recognized through an allowance for credit losses rather than as reductions in the amortized cost of the securities and provides for additional disclosure requirements. ASU 2016-13 requires a cumulative-effect adjustment to the opening balance of retained earnings on the balance sheet at the date of adoption and a prospective transition approach for debt securities for which an other-than-temporary impairment had been recognized before the adoption date. The effect of a prospective transition approach is to maintain the same amortized cost basis before and after the date of adoption. We adopted ASU 2016-13 on January 1, 2020, and recognized a cumulative-effect adjustment of $35 to our opening retained earnings for credit related allowances on receivables. The adoption did not have an impact on our consolidated statements of income or cash flows.
Recent Accounting Guidance Not Yet Adopted: In November 2020, the FASB issued Accounting Standards Update No. 2020-11, Financial Services—Insurance (Topic 944): Effective Date and Early Application (“ASU 2020-11”). The amendments in ASU 2020-11 make changes to the effective date and early application of Accounting Standards Update No. 2018-12, Financial Services—Insurance (Topic 944): Targeted Improvements to the Accounting for Long-Duration Contracts (“ASU 2018-12”) which was issued in November 2018. The amendments in ASU 2020-11 have extended the original effective date by one year and now the amendments are required for our interim and annual reporting periods beginning after December 15, 2022. The amendments in ASU 2018-12 make changes to a variety of areas to simplify or improve the existing recognition, measurement, presentation and disclosure requirements for long-duration contracts issued by an insurance entity. The amendments require insurers to annually review the assumptions they make about their policyholders and update the liabilities for future policy benefits if the assumptions change. The amendments also simplify the amortization of deferred contract acquisition costs and add new disclosure requirements about the assumptions insurers use to measure their liabilities and how they may affect future cash flows. The amendments related to the liability for future policy benefits for traditional and limited-payment contracts and deferred acquisition costs are to be applied to contracts in force as of the beginning of the earliest period presented, with an option to apply such amendments retrospectively with a cumulative-effect adjustment to the opening balance of retained earnings as of the earliest period presented. The amendments for market risk benefits are to be applied retrospectively. We are currently evaluating the effects the adoption of ASU 2020-11 and ASU 2018-12 will have on our consolidated financial position, results of operations, cash flows, and related disclosures.
There were no other new accounting pronouncements that were issued or became effective during the year ended December 31, 2021 that had, or are expected to have, a material impact on our financial position, results of operations, cash flows or financial statement disclosures.
3. Business Acquisitions
Completed Acquisitions
During the year ended December 31, 2021, the Company completed business combinations for total cash consideration of approximately $4,021. These acquisitions included myNEXUS, Inc. (“myNEXUS”), a comprehensive home-based nursing management company for payors, and MMM Holdings, LLC (“MMM”), including its Medicare Advantage plan, Medicaid plan, and other affiliated companies. The purchase price was allocated to the tangible and intangible net assets acquired based on management's final estimates of their fair values, of which $1,577 has been allocated to finite-lived intangible assets, $20 to indefinite-lived intangible assets, and $2,521 to goodwill. The majority of goodwill is not deductible for income tax purposes.
During the year ended December 31, 2020, the Company completed business combinations for total cash consideration of approximately $2,488. These acquisitions included Beacon Health Options, Inc. (“Beacon”) a behavioral health managed care organization. The purchase price was allocated to the tangible and intangible net assets acquired based on management's final estimates of their fair values, of which $868 was allocated to finite-lived intangible assets, $225 to indefinite-lived intangible assets, and $1,231 to goodwill. The majority of goodwill is not deductible for income tax purposes.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
Acquired tangible assets (liabilities) at the acquisition date were:
| | | | | | | | | | | |
| 2021 | | 2020 |
Cash, cash equivalents and short-term investments | $ | 808 | | | $ | 659 | |
Accounts receivable and other current assets | 295 | | | 282 | |
Property, equipment and other long-term assets | 102 | | | 296 | |
Medical claims and other policyholder liabilities payable | (571) | | | (580) | |
Accounts payable and other current liabilities | (179) | | | (257) | |
Other long-term liabilities | (6) | | | (49) | |
Total net tangible assets | $ | 449 | | | $ | 351 | |
The preliminary purchase price allocations for the various business combinations are subject to adjustment as valuation analyses, primarily related to intangible assets and contingent and tax liabilities, are finalized.
Acquisition date fair values and weighted-average useful lives assigned to intangible assets include:
| | | | | | | | | | | | | | | | | | | | | | | |
| 2021 | | 2020 |
| Fair Value | | Weighted Average Useful Life | | Fair Value | | Weighted Average Useful Life |
Customer relationships | $ | 1,313 | | | 13 years | | $ | 680 | | | 19 years |
Provider and hospital relationships | 5 | | | 15 years | | 94 | | | 20 years |
Other | 259 | | | 13 years | | 93 | | | 19 years |
State Medicaid Licenses | 20 | | | Indefinite | | 225 | | | Indefinite |
Total intangible assets | $ | 1,597 | | | | | $ | 1,092 | | | |
The results of operations and financial condition of acquired entities have been included in our consolidated results and the results of the corresponding operating segment as of the date of acquisition. Through December 31, 2021, the impact of the acquired entities on revenue and net earnings was not material. Unaudited pro forma revenues for the years ended December 31, 2021 and 2020 as if the acquisitions had occurred on January 1, 2020 were immaterial for both periods. The pro forma effects of the acquisitions on net earnings were immaterial for both years.
Pending Acquisition
On November 10, 2021, we announced our entrance into an agreement with Personal Touch Holding Corporation to acquire Integra Managed Care (“Integra”). Integra is a managed long-term care plan that serves New York state Medicaid members, enabling adults with long-term care needs and disabilities to live safely and independently in their own home. The acquisition is expected to close by the end of the second quarter of 2022 and is subject to standard closing conditions and customary approvals.
4. Business Optimization Initiatives
We believe that our properties are adequate and suitable for our business as presently conducted; however, we are continuing to evaluate our real estate strategy as it relates to the impact of the COVID-19 pandemic and the changing needs of a more hybrid remote and in-office workforce. As a result, during 2021, we identified additional reductions of office space and recorded a charge of $202 in selling, general and administrative expenses. This charge includes $136 for impairment and abandonment of operating-lease related ROU assets and $66 for impairment and abandonment of property and equipment. The charges recognized in the Commercial & Specialty Business, Government Business, IngenioRx and Other segments in 2021, were $108, $60, $1 and $33, respectively. See also Note 20, “Segment Information.”
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
During 2020, our management introduced enterprise-wide initiatives to optimize our business and, as a result, we recorded a charge of $653 in selling, general and administrative expenses. This charge included $258 for impairment and abandonment of operating-lease related ROU assets, $198 for impairment and abandonment of property and equipment and $197 for future payments for employee termination costs in connection with the repositioning and reskilling of our workforce. The charges recognized in the Commercial & Specialty Business, Government Business, IngenioRx and Other segments in 2020, were $311, $205, $4 and $133, respectively. See also Note 20, “Segment Information.” We believe these initiatives largely represent our progression towards becoming a more agile organization, including process automation and a reduction in our office space footprint.
A summary of the activity of the 2020 employee termination costs for the year ended December 31, 2021 and ending balance at December 31, 2021 is as follows:
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| Commercial & Specialty Business | | Government Business | | IngenioRx | | Other | | Total |
2020 Business Optimization Initiatives | | | | | | | | | |
Employee termination costs: | | | | | | | | | |
Liabilities for employee termination costs at January 1, 2021 | $ | 92 | | | $ | 88 | | | $ | 1 | | | $ | 6 | | | $ | 187 | |
Payments | (26) | | | (25) | | | — | | | (3) | | | (54) | |
Releases | (5) | | | (6) | | | — | | | — | | | (11) | |
Total liabilities for employee termination costs ending balance at December 31, 2021 | $ | 61 | | | $ | 57 | | | $ | 1 | | | $ | 3 | | | 122 | |
We expect the employee termination costs to be paid by the end of 2022.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
5. Investments
A summary of current and long-term fixed maturity securities, available-for-sale, at December 31, 2021 and 2020 is as follows:
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | |
| Cost or Amortized Cost | | Gross Unrealized Gains | | Gross Unrealized Losses | | Allowance For Credit Losses | | Estimated Fair Value |
| | | | |
December 31, 2021 | | | | | | | | | |
Fixed maturity securities: | | | | | | | | | |
United States Government securities | $ | 1,443 | | | $ | 7 | | | $ | (18) | | | $ | — | | | $ | 1,432 | |
Government sponsored securities | 65 | | | 4 | | | (1) | | | — | | | 68 | |
Foreign government securities | 353 | | | 7 | | | (13) | | | — | | | 347 | |
States, municipalities and political subdivisions, tax-exempt | 5,321 | | | 310 | | | (10) | | | — | | | 5,621 | |
Corporate securities | 12,044 | | | 401 | | | (78) | | | (4) | | | 12,363 | |
Residential mortgage-backed securities | 4,059 | | | 75 | | | (35) | | | (2) | | | 4,097 | |
Commercial mortgage-backed securities | 65 | | | 2 | | | (3) | | | — | | | 64 | |
Other securities | 2,907 | | | 24 | | | (24) | | | — | | | 2,907 | |
Total fixed maturity securities | $ | 26,257 | | | $ | 830 | | | $ | (182) | | | $ | (6) | | | $ | 26,899 | |
| | | | | | | | | |
| | | | | | | | | |
December 31, 2020 | | | | | | | | | |
Fixed maturity securities: | | | | | | | | | |
United States Government securities | $ | 765 | | | $ | 11 | | | $ | (2) | | | $ | — | | | $ | 774 | |
Government sponsored securities | 63 | | | 6 | | | — | | | — | | | 69 | |
Foreign government securities | 290 | | | 17 | | | (2) | | | — | | | 305 | |
States, municipalities and political subdivisions, tax-exempt | 5,185 | | | 395 | | | (1) | | | — | | | 5,579 | |
Corporate securities | 10,233 | | | 697 | | | (31) | | | (7) | | | 10,892 | |
Residential mortgage-backed securities | 4,208 | | | 154 | | | (17) | | | — | | | 4,345 | |
Commercial mortgage-backed securities | 73 | | | 3 | | | (4) | | | — | | | 72 | |
Other securities | 1,937 | | | 33 | | | (11) | | | — | | | 1,959 | |
Total fixed maturity securities | $ | 22,754 | | | $ | 1,316 | | | $ | (68) | | | $ | (7) | | | $ | 23,995 | |
| | | | | | | | | |
| | | | | | | | | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
For fixed maturity securities in an unrealized loss position at December 31, 2021 and 2020, the following table summarizes the aggregate fair values and gross unrealized losses by length of time those securities have continuously been in an unrealized loss position.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| Less than 12 Months | | 12 Months or Greater |
| Number of Securities | | Estimated Fair Value | | Gross Unrealized Loss | | Number of Securities | | Estimated Fair Value | | Gross Unrealized Loss |
(Securities are whole amounts) | | | | | | | | | | | |
December 31, 2021 | | | | | | | | | | | |
Fixed maturity securities: | | | | | | | | | | | |
United States Government securities | 51 | | | $ | 990 | | | $ | (11) | | | 27 | | | $ | 176 | | | $ | (7) | |
Government sponsored securities | — | | | — | | | — | | | 1 | | | 1 | | | (1) | |
Foreign government securities | 188 | | | 143 | | | (8) | | | 68 | | | 41 | | | (5) | |
States, municipalities and political subdivisions, tax-exempt | 281 | | | 634 | | | (9) | | | 8 | | | 16 | | | (1) | |
Corporate securities | 1,846 | | | 3,310 | | | (57) | | | 403 | | | 485 | | | (21) | |
Residential mortgage-backed securities | 692 | | | 1,967 | | | (26) | | | 125 | | | 173 | | | (9) | |
Commercial mortgage-backed securities | 2 | | | 4 | | | (1) | | | 4 | | | 8 | | | (2) | |
Other securities | 511 | | | 1,707 | | | (19) | | | 50 | | | 85 | | | (5) | |
Total fixed maturity securities | 3,571 | | | $ | 8,755 | | | $ | (131) | | | 686 | | | $ | 985 | | | $ | (51) | |
| | | | | | | | | | | |
| | | | | | | | | | | |
December 31, 2020 | | | | | | | | | | | |
Fixed maturity securities: | | | | | | | | | | | |
United States Government securities | 27 | | | $ | 301 | | | $ | (2) | | | — | | | $ | — | | | $ | — | |
Government sponsored securities | — | | | — | | | — | | | 1 | | | — | | | — | |
Foreign government securities | 55 | | | 35 | | | (2) | | | 9 | | | 4 | | | — | |
States, municipalities and political subdivisions, tax-exempt | 36 | | | 57 | | | (1) | | | 1 | | | 3 | | | — | |
Corporate securities | 646 | | | 765 | | | (20) | | | 150 | | | 169 | | | (11) | |
Residential mortgage-backed securities | 224 | | | 442 | | | (8) | | | 90 | | | 110 | | | (9) | |
Commercial mortgage-backed securities | 6 | | | 16 | | | (1) | | | 3 | | | 4 | | | (3) | |
Other securities | 207 | | | 509 | | | (5) | | | 79 | | | 179 | | | (6) | |
Total fixed maturity securities | 1,201 | | | $ | 2,125 | | | $ | (39) | | | 333 | | | $ | 469 | | | $ | (29) | |
| | | | | | | | | | | |
| | | | | | | | | | | |
Below are discussions by security type for unrealized losses and credit losses as of December 31, 2021:
Corporate securities: An allowance for credit losses on certain retail, travel and entertainment, energy, and basic materials sector fixed maturity corporate securities has been determined based on qualitative and quantitative factors including credit rating, decline in fair value and industry condition along with other available market data. With multiple risk factors present, these securities were reviewed for expected future cash flow to determine the portion of unrealized losses that were credit related and to record an allowance for credit losses. Unrealized losses on our other corporate securities were largely due to market conditions relating to the COVID-19 pandemic; however, qualitative factors did not indicate a credit loss as of December 31, 2021. We do not intend to sell these investments and it is likely we will not have to sell these investments prior to maturity or recovery of amortized cost.
Residential mortgage-backed securities: An allowance for credit loss was established on certain residential mortgage-backed securities. Notification of maturity and coupon default, as well as a significant and sustained decline in fair value, were factors to indicate a credit loss. No other mortgage securities had material unrealized losses or qualitative factors to indicate a credit loss. We do not intend to sell these investments and it is likely we will not be required to sell these investments prior to maturity or recovery of amortized cost.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
As for the remaining securities shown in the table above, unrealized losses on these securities have not been recognized into income because we do not intend to sell these investments and it is likely that we will not be required to sell these investments prior to their anticipated recovery. The decline in fair value is largely due to changes in interest rates and other market conditions. We have evaluated these securities for any change in credit rating and have determined that no allowance is necessary. The fair value is expected to recover as the securities approach maturity.
The tables below present a roll-forward by major security type of the allowance for credit losses on fixed maturity securities available-for-sale held at period end for the years ended December 31, 2021, and 2020:
| | | | | | | | | | | | | | | | | | | | | | | | |
Year Ended December 31, 2021 | | | Corporate Securities | | Residential Mortgage-backed Securities | | | | Total |
Allowance for credit losses: | | | | | | | | | |
| Beginning balance | | | $ | 7 | | | $ | — | | | | | $ | 7 | |
| Additions for securities for which no previous expected credit losses were recognized | | | 1 | | | — | | | | | 1 | |
| | | | | | | | | | |
| Securities sold during the period | | | (2) | | | — | | | | | (2) | |
| | | | | | | | | | |
| (Decreases) increases to the allowance for credit losses on securities | | | (2) | | | 2 | | | | | — | |
| | | | | | | | | | |
| | | | | | | | | | |
Total allowance for credit losses | | | $ | 4 | | | $ | 2 | | | | | $ | 6 | |
| | | | | | | | | | | | | | | | | | | | | | | | | |
Year Ended December 31, 2020 | | | | Corporate Securities | | | | Foreign Government Securities | | Total |
Allowance for credit losses: | | | | | | | | | | |
| Beginning balance | | | | $ | — | | | | | $ | — | | | $ | — | |
| Additions for securities for which no previous expected credit losses were recognized | | | | 64 | | | | | 1 | | | 65 | |
| | | | | | | | | | | |
| Securities sold during the period | | | | (17) | | | | | (1) | | | (18) | |
| | | | | | | | | | | |
| Decreases to the allowance for credit losses on securities | | | | (40) | | | | | — | | | (40) | |
| | | | | | | | | | | |
| | | | | | | | | | | |
Total allowance for credit losses | | | | $ | 7 | | | | | $ | — | | | $ | 7 | |
The amortized cost and fair value of fixed maturity securities at December 31, 2021, by contractual maturity, are shown below. Expected maturities may differ from contractual maturities because the issuers of the securities may have the right to prepay obligations.
| | | | | | | | | | | |
| Amortized Cost | | Estimated Fair Value |
Due in one year or less | $ | 719 | | | $ | 720 | |
Due after one year through five years | 6,570 | | | 6,717 | |
Due after five years through ten years | 8,967 | | | 9,156 | |
Due after ten years | 5,877 | | | 6,145 | |
Mortgage-backed securities | 4,124 | | | 4,161 | |
Total fixed maturity securities | $ | 26,257 | | | $ | 26,899 | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
Equity Securities
A summary of current equity securities at December 31, 2021 and 2020 is as follows:
| | | | | | | | | | | |
| December 31, 2021 | | December 31, 2020 |
Equity Securities: | | | |
Exchange traded funds | $ | 1,750 | | | $ | 1,154 | |
Fixed maturity mutual funds | — | | | 144 | |
Common equity securities | 42 | | | 201 | |
Private equity securities | 89 | | | 60 | |
Total | $ | 1,881 | | | $ | 1,559 | |
Investment Income
The major categories of net investment income for the years ended December 31, 2021, 2020 and 2019 are as follows:
| | | | | | | | | | | | | | | | | |
| 2021 | | 2020 | | 2019 |
Fixed maturity securities | $ | 755 | | | $ | 725 | | | $ | 721 | |
Equity securities | 43 | | | 71 | | | 100 | |
Cash equivalents | 5 | | | 28 | | | 64 | |
Other invested assets | 616 | | | 91 | | | 149 | |
Investment income | 1,419 | | | 915 | | | 1,034 | |
Investment expenses | (41) | | | (38) | | | (29) | |
Net investment income | $ | 1,378 | | | $ | 877 | | | $ | 1,005 | |
Investment Gains
Net investment gains (losses) for the years ended December 31, 2021, 2020 and 2019 are as follows:
| | | | | | | | | | | | | | | | | |
| 2021 | | 2020 | | 2019 |
Net gains (losses): | | | | | |
Fixed maturity securities: | | | | | |
Gross realized gains from sales | $ | 170 | | | $ | 175 | | | $ | 125 | |
Gross realized losses from sales | (44) | | | (105) | | | (59) | |
Impairment recoveries (losses) recognized in income | 1 | | | (7) | | | (13) | |
Net gains on fixed maturity securities | 127 | | | 63 | | | 53 | |
Equity securities: | | | | | |
Gross gains | 37 | | | 269 | | | 147 | |
Gross losses | (108) | | | (75) | | | (84) | |
Net (losses) gains on equity securities | (71) | | | 194 | | | 63 | |
Other investments: | | | | | |
Gross gains | 293 | | | 18 | | | 3 | |
Gross losses | (22) | | | — | | | (1) | |
Impairment losses recognized in income | (16) | | | (91) | | | (34) | |
Net gains (losses) on other investments | 255 | | | (73) | | | (32) | |
Net gains on investments | $ | 311 | | | $ | 184 | | | $ | 84 | |
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Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
The gains and losses related to equity securities for the years ended December 31, 2021, 2020, and 2019 are as follows:
| | | | | | | | | | | | | | | | | | | | |
| | 2021 | | 2020 | | 2019 |
Net (losses) gains recognized on equity securities | | $ | (71) | | | $ | 194 | | | $ | 63 | |
Less: Net realized (losses) gains recognized on equity securities sold during the period | | (73) | | | 61 | | | 39 | |
Unrealized gains recognized in income on equity securities still held at December 31 | | $ | 2 | | | $ | 133 | | | $ | 24 | |
A primary objective in the management of our fixed maturity and equity portfolios is to maximize total return relative to underlying liabilities and respective liquidity needs. In achieving this goal, assets may be sold to take advantage of market conditions or other investment opportunities as well as tax considerations. Sales will generally produce realized gains and losses. In the ordinary course of business, we may sell securities at a loss for a number of reasons, including, but not limited to: (i) changes in the investment environment; (ii) expectations that the fair value could deteriorate further; (iii) desire to reduce exposure to an issuer or an industry; (iv) changes in credit quality; or (v) changes in expected cash flow.
Total proceeds from sales, maturities, calls or redemptions of fixed maturity securities was $10,565, $11,122 and $8,351 for the years ended December 31, 2021, 2020 and 2019, respectively.
A significant judgment in the valuation of investments is the determination of when a credit loss has occurred. We follow a consistent and systematic process for recognizing impairments on securities that sustain credit declines in value. We have established a committee responsible for the impairment review process. The decision to impair a security incorporates both quantitative criteria and qualitative information. The impairment review process considers a number of factors including, but not limited to: (i) the extent to which the fair value is less than book value, (ii) the financial condition and near term prospects of the issuer, (iii) our intent and ability to retain impaired investments for a period of time sufficient to allow for any anticipated recovery in fair value, (iv) our intent to sell or the likelihood that we will need to sell a fixed maturity security before recovery of its amortized cost basis, (v) whether the debtor is current on interest and principal payments, (vi) the reasons for the decline in value (i.e., credit event compared to liquidity, general credit spread widening, currency exchange rate or interest rate factors) and (vii) general market conditions and industry or sector specific factors. For securities that are deemed to be credit impaired, an allowance is created.
Investment securities are exposed to various risks, such as interest rate, market and credit. Due to the level of risk associated with certain investment securities and the level of uncertainty related to changes in the value of investment securities, it is possible that changes in these risk factors in the near term could have a material adverse impact on our results of operations or shareholders’ equity.
At December 31, 2021 and 2020, there were no individual investments that exceeded 10% of shareholders’ equity.
At December 31, 2021 and 2020, there were two and three, respectively, fixed maturity investments that did not produce income during the years then ended.
As of December 31, 2021 and 2020, we had committed approximately $1,558 and $1,320, respectively, to future capital calls from various third-party investments in exchange for an ownership interest in the related entities.
At December 31, 2021 and 2020, securities with carrying values of approximately $632 and $562, respectively, were deposited by our insurance subsidiaries under requirements of regulatory authorities.
Accrued Investment Income
Accrued investment income totaled $205 and $188, at December 31, 2021 and 2020, respectively. We recognize accrued investment income under the caption “Other receivables” on our consolidated balance sheets.
Securities Lending Programs
The fair value of the collateral received at the time of the securities lending transactions amounted to $2,155 and $1,199 at December 31, 2021 and 2020, respectively. The value of the collateral represented 102% of the market value of the securities on loan at each of December 31, 2021 and 2020.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
We recognize the collateral as an asset under the caption “Other current assets” in our consolidated balance sheets, and we recognize a corresponding liability for the obligation to return the collateral to the borrower under the caption “Other current liabilities.” The securities on loan are reported in the applicable investment category on our consolidated balance sheets.
At December 31, 2021 and 2020, the remaining contractual maturities of our securities lending transactions included overnight and continuous transactions of cash for $1,874 and $1,056, respectively, and United States Government securities for $281 and $143, respectively.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
6. Derivative Financial Instruments
We primarily invest in the following types of derivative financial instruments: interest rate swaps, futures, forward contracts, put and call options, collars, swaptions, embedded derivatives and warrants. We also enter into master netting agreements which reduce credit risk by permitting net settlement of transactions. At December 31, 2021 and 2020, we had received collateral of $18 and $37, respectively, related to our derivative financial instruments.
A summary of the aggregate contractual or notional amounts and estimated fair values related to derivative financial instruments at December 31, 2021 and 2020 is as follows:
| | | | | | | | | | | | | | | | | | | | | | | |
| Contractual/ Notional Amount | | Balance Sheet Location | | Estimated Fair Value |
| Asset | | (Liability) |
December 31, 2021 | | | | | | | |
Hedging instruments | | | | | | | |
Interest rate swaps - fixed to floating | $ | 825 | | | Other assets/other liabilities | | $ | 23 | | | $ | (5) | |
| | | | | | | |
| | | | | | | |
| | | | | | | |
Non-hedging instruments | | | | | | | |
Interest rate swaps | 119 | | | Equity securities/other assets/other liabilities | | — | | | (5) | |
Options | 100 | | | Other assets/other liabilities | | — | | | — | |
Collars | 19 | | | Equity securities | | 21 | | | (17) | |
Futures | 344 | | | Equity securities | | 3 | | | (2) | |
Subtotal non-hedging | 582 | | | Subtotal non-hedging | | 24 | | | (24) | |
Total derivatives | $ | 1,407 | | | Total derivatives | | 47 | | | (29) | |
| | | Amounts netted | | (21) | | | 21 | |
| | | Net derivatives | | $ | 26 | | | $ | (8) | |
| | | | | | | |
December 31, 2020 | | | | | | | |
Hedging instruments | | | | | | | |
Interest rate swaps - fixed to floating | $ | 575 | | | Other assets/other liabilities | | $ | 37 | | | $ | — | |
| | | | | | | |
Non-hedging instruments | | | | | | | |
Interest rate swaps | 27 | | | Equity securities | | — | | | — | |
| | | | | | | |
Futures | 183 | | | Equity securities | | 6 | | | (5) | |
Subtotal non-hedging | 210 | | | Subtotal non-hedging | | 6 | | | (5) | |
Total derivatives | $ | 785 | | | Total derivatives | | 43 | | | (5) | |
| | | Amounts netted | | — | | | — | |
| | | Net derivatives | | $ | 43 | | | $ | (5) | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
Fair Value Hedges
We have entered into various interest rate swap contracts to convert a portion of our interest rate exposure on our long-term debt from fixed rates to floating rates. The floating rates payable on all of our fair value hedges are benchmarked to the LIBOR. A summary of our outstanding fair value hedges at December 31, 2021 and 2020 is as follows:
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Type of Fair Value Hedges | | Year Entered Into | | Outstanding Notional Amount | | Interest Rate Received | | Expiration Date |
| 2021 | | 2020 | |
Interest rate swap | | 2021 | | $ | 150 | | | $ | — | | | 2.550 | | % | | September 15, 2030 |
Interest rate swap | | 2021 | | 100 | | | — | | | 2.250 | | | | November 15, 2029 |
Interest rate swap | | 2020 | | 75 | | | 75 | | | 4.101 | | | | September 1, 2027 |
Interest rate swap | | 2018 | | 50 | | | 50 | | | 4.101 | | | | September 1, 2027 |
Interest rate swap | | 2018 | | 450 | | | 450 | | | 3.300 | | | | January 15, 2023 |
Total notional amount outstanding | | | | $ | 825 | | | $ | 575 | | | | | | |
The following amounts were recorded on our consolidated balance sheets related to cumulative basis adjustments for fair value hedges at December 31, 2021 and 2020: | | | | | | | | | | | | | | | | | | | | | | | | | | |
Balance Sheet Classification in Which Hedged Item is Included | | Carrying Amount of Hedged Liability | | Cumulative Amount of Fair Value Hedging Adjustment Included in the Carrying Amount of the Hedged Liability |
| 2021 | | 2020 | | 2021 | | 2020 |
Current portion of long term-debt | | $ | 1,599 | | | $ | 700 | | | $ | 23 | | | $ | 37 | |
Long-term debt | | 21,157 | | | 19,335 | | | (5) | | | — | |
Cash Flow Hedges
We have entered into a series of forward starting pay fixed interest rate swaps with the objective of eliminating the variability of cash flows in the interest payments on future financings that were anticipated at the time of entering into the swaps. During 2021 and 2020, swaps in the notional amount of $450 and $725, respectively, were terminated.
The unrecognized loss for all expired and terminated cash flow hedges included in accumulated other comprehensive loss, net of tax, was $239 and $250 at December 31, 2021 and 2020, respectively. As of December 31, 2021, the total amount of amortization over the next twelve months for all cash flow hedges is estimated to increase interest expense by approximately $13. No amounts were excluded from effectiveness testing.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
Non-Hedging Derivatives
A summary of the effect of non-hedging derivatives on our consolidated statements of income for the years ended December 31, 2021, 2020 and 2019 is as follows:
| | | | | | | | | | | | | | |
Type of Non-hedging Derivatives | | Income Statement Location of Gain (Loss) Recognized | | Derivative Gain (Loss) Recognized |
Year ended December 31, 2021 | | | | |
| | | | |
Interest rate swaps | | Net gains on financial instruments | | $ | (4) | |
Collars | | Net gains on financial instruments | | 4 | |
Futures | | Net gains on financial instruments | | 7 | |
| | | | |
Total | | | | $ | 7 | |
Year ended December 31, 2020 | | | | |
Interest rate swaps | | Net gains on financial instruments | | $ | (1) | |
Options | | Net gains on financial instruments | | (5) | |
Futures | | Net gains on financial instruments | | 4 | |
Total | | | | $ | (2) | |
Year ended December 31, 2019 | | | | |
| | | | |
Interest rate swaps | | Net gains on financial instruments | | $ | 1 | |
Options | | Net gains on financial instruments | | (8) | |
Futures | | Net gains on financial instruments | | (10) | |
Total | | | | $ | (17) | |
7. Fair Value
Assets and liabilities recorded at fair value in the consolidated balance sheets are categorized based upon the level of judgment associated with the inputs used to measure their fair value. Level inputs, as defined by FASB guidance for fair value measurements and disclosures, are as follows:
| | | | | | | | |
Level Input: | | Input Definition: |
Level I | | Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date. |
Level II | | Inputs other than quoted prices included in Level I that are observable for the asset or liability through corroboration with market data at the measurement date. |
Level III | | Unobservable inputs that reflect management’s best estimate of what market participants would use in pricing the asset or liability at the measurement date. |
The following methods, assumptions and inputs were used to determine the fair value of each class of the following assets and liabilities recorded at fair value in the consolidated balance sheets:
Cash equivalents: Cash equivalents primarily consist of highly rated money market funds with maturities of three months or less, and are purchased daily at par value with specified yield rates. Due to the high ratings and short-term nature of the funds, we designate all cash equivalents as Level I.
Fixed maturity securities, available-for-sale: Fair values of available-for-sale fixed maturity securities are based on quoted market prices, where available. These fair values are obtained primarily from third-party pricing services, which generally use Level I or Level II inputs for the determination of fair value to facilitate fair value measurements and disclosures. Level II securities primarily include corporate securities, securities from states, municipalities and political subdivisions, mortgage-backed securities, United States Government securities, foreign government securities, and certain other asset-backed securities. For securities not actively traded, the pricing services may use quoted market prices of comparable instruments or discounted cash flow analyses, incorporating inputs that are currently observable in the markets
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
for similar securities. We have controls in place to review the pricing services’ qualifications and procedures used to determine fair values. In addition, we periodically review the pricing services’ pricing methodologies, data sources and pricing inputs to ensure the fair values obtained are reasonable. Inputs that are often used in the valuation methodologies include, but are not limited to, broker quotes, benchmark yields, credit spreads, default rates and prepayment speeds. We also have certain fixed maturity securities, primarily corporate debt securities, that are designated Level III securities. For these securities, the valuation methodologies may incorporate broker quotes or discounted cash flow analyses using assumptions for inputs such as expected cash flows, benchmark yields, credit spreads, default rates and prepayment speeds that are not observable in the markets.
Equity securities: Fair values of equity securities are generally designated as Level I and are based on quoted market prices. For certain equity securities, quoted market prices for the identical security are not always available, and the fair value is estimated by reference to similar securities for which quoted prices are available. These securities are designated Level II. We also have certain equity securities, including private equity securities, for which the fair value is estimated based on each security’s current condition and future cash flow projections. Such securities are designated Level III. The fair values of these private equity securities are generally based on either broker quotes or discounted cash flow projections using assumptions for inputs such as the weighted-average cost of capital, long-term revenue growth rates and earnings before interest, taxes, depreciation and amortization, and/or revenue multiples that are not observable in the markets.
Securities lending collateral: Fair values of securities lending collateral are based on quoted market prices, where available. These fair values are obtained primarily from third-party pricing services, which generally use Level I or Level II inputs for the determination of fair value, to facilitate fair value measurements and disclosures.
Derivatives: Fair values are based on the quoted market prices by the financial institution that is the counterparty to the derivative transaction. We independently verify prices provided by the counterparties using valuation models that incorporate market observable inputs for similar derivative transactions. Derivatives are designated as Level II securities. Derivatives presented within the fair value hierarchy table below are presented on a gross basis and not on a master netting basis by counterparty.
In addition, the following methods and assumptions were used to determine the fair value of each class of pension benefit plan assets and other benefit plan assets not defined above (see Note 11, “Retirement Benefits,” for fair values of benefit plan assets):
Mutual funds: Fair values are based on quoted market prices, which represent the net asset value (“NAV”) of the shares held.
Partnership investments: Fair values are estimated based on the plan’s proportionate share of the undistributed partners’ capital as reported in audited financial statements of the partnership. In accordance with FASB guidance, certain investments that are measured at fair value using the NAV per share as a practical expedient or the fair value measurement alternative have been classified in the fair value hierarchy. The fair value amounts presented are intended to permit reconciliation of the fair value hierarchy to the total investments of the master trust.
Commingled fund: Fair value is based on NAV per fund share, primarily derived from the quoted prices in active markets on the underlying equity securities.
Contract with insurance company: Fair value of the contract in the insurance company general investment account is determined by the insurance company based on the fair value of the underlying investments of the account.
Investment in DOL 103-12 trust: Fair value is based on the plan’s proportionate share of the fair value of investments held by the trust, qualified as a Department of Labor Regulation 2520.103-12 entity (“DOL 103-12 trust”) as reported in the audited financial statements of the trust, where the trustee applies fair value measurements to the underlying investments of the trust.
Life insurance contracts: Fair value is based on the cash surrender value of the policies as reported by the insurer.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
A summary of fair value measurements by level for assets and liabilities measured at fair value on a recurring basis at December 31, 2021 and 2020 is as follows: | | | | | | | | | | | | | | | | | | | | | | | |
| Level I | | Level II | | Level III | | Total |
December 31, 2021 | | | | | | | |
Assets: | | | | | | | |
Cash equivalents | $ | 2,415 | | | $ | — | | | $ | — | | | $ | 2,415 | |
Fixed maturity securities, available-for-sale: | | | | | | | |
United States Government securities | — | | | 1,432 | | | — | | | 1,432 | |
Government sponsored securities | — | | | 68 | | | — | | | 68 | |
Foreign government securities | — | | | 347 | | | — | | | 347 | |
States, municipalities and political subdivisions, tax-exempt | — | | | 5,621 | | | — | | | 5,621 | |
Corporate securities | — | | | 12,027 | | | 336 | | | 12,363 | |
Residential mortgage-backed securities | — | | | 4,092 | | | 5 | | | 4,097 | |
Commercial mortgage-backed securities | — | | | 64 | | | — | | | 64 | |
Other securities | — | | | 2,888 | | | 19 | | | 2,907 | |
Total fixed maturity securities, available-for-sale | — | | | 26,539 | | | 360 | | | 26,899 | |
Equity securities: | | | | | | | |
Exchange traded funds | 1,750 | | | — | | | — | | | 1,750 | |
| | | | | | | |
Common equity securities | 8 | | | 34 | | | — | | | 42 | |
Private equity securities | — | | | — | | | 89 | | | 89 | |
Total equity securities | 1,758 | | | 34 | | | 89 | | | 1,881 | |
Other invested assets - common equity securities | 138 | | | — | | | — | | | 138 | |
Securities lending collateral | — | | | 2,155 | | | — | | | 2,155 | |
Derivatives - other assets | — | | | 19 | | | — | | | 19 | |
Total assets | $ | 4,311 | | | $ | 28,747 | | | $ | 449 | | | $ | 33,507 | |
Liabilities: | | | | | | | |
Derivatives - other liabilities | $ | — | | | $ | (1) | | | $ | — | | | $ | (1) | |
Total liabilities | $ | — | | | $ | (1) | | | $ | — | | | $ | (1) | |
| | | | | | | |
December 31, 2020 | | | | | | | |
Assets: | | | | | | | |
Cash equivalents | $ | 3,163 | | | $ | — | | | $ | — | | | $ | 3,163 | |
Fixed maturity securities, available-for-sale: | | | | | | | |
United States Government securities | — | | | 774 | | | — | | | 774 | |
Government sponsored securities | — | | | 69 | | | — | | | 69 | |
Foreign government securities | — | | | 305 | | | — | | | 305 | |
States, municipalities and political subdivisions, tax-exempt | — | | | 5,579 | | | — | | | 5,579 | |
Corporate securities | — | | | 10,567 | | | 325 | | | 10,892 | |
Residential mortgage-backed securities | — | | | 4,343 | | | 2 | | | 4,345 | |
Commercial mortgage-backed securities | — | | | 72 | | | — | | | 72 | |
Other securities | — | | | 1,954 | | | 5 | | | 1,959 | |
Total fixed maturity securities, available-for-sale | — | | | 23,663 | | | 332 | | | 23,995 | |
Equity securities: | | | | | | | |
Exchange traded funds | 1,154 | | | — | | | — | | | 1,154 | |
Fixed maturity mutual funds | — | | | 144 | | | — | | | 144 | |
Common equity securities | 171 | | | 30 | | | — | | | 201 | |
Private equity securities | — | | | — | | | 60 | | | 60 | |
Total equity securities | 1,325 | | | 174 | | | 60 | | | 1,559 | |
| | | | | | | |
Securities lending collateral | — | | | 1,199 | | | — | | | 1,199 | |
Derivatives | — | | | 43 | | | — | | | 43 | |
Total assets | $ | 4,488 | | | $ | 25,079 | | | $ | 392 | | | $ | 29,959 | |
Liabilities: | | | | | | | |
Derivatives | $ | — | | | $ | (5) | | | $ | — | | | $ | (5) | |
Total liabilities | $ | — | | | $ | (5) | | | $ | — | | | $ | (5) | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
A reconciliation of the beginning and ending balances of assets measured at fair value on a recurring basis using Level III inputs for the years ended December 31, 2021, 2020 and 2019 is as follows:
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| Corporate Securities | | Residential Mortgage- backed Securities | | | | Other Securities | | Equity Securities | | Total |
Year ended December 31, 2021 | | | | | | | | | | | |
Beginning balance at January 1, 2021 | $ | 325 | | | $ | 2 | | | | | $ | 5 | | | $ | 60 | | | $ | 392 | |
Total gains (losses): | | | | | | | | | | | |
Recognized in net income | 2 | | | — | | | | | — | | | 17 | | | 19 | |
Recognized in accumulated other comprehensive income | 3 | | | — | | | | | — | | | — | | | 3 | |
Purchases | 179 | | | 4 | | | | | 17 | | | 16 | | | 216 | |
Sales | (18) | | | — | | | | | — | | | (4) | | | (22) | |
Settlements | (157) | | | — | | | | | — | | | — | | | (157) | |
Transfers into Level III | 3 | | | — | | | | | — | | | — | | | 3 | |
Transfers out of Level III | (1) | | | (1) | | | | | (3) | | | — | | | (5) | |
Ending balance at December 31, 2021 | $ | 336 | | | $ | 5 | | | | | $ | 19 | | | $ | 89 | | | $ | 449 | |
Change in unrealized gains or losses included in net income related to assets still held at December 31, 2021 | $ | — | | | $ | — | | | | | $ | — | | | $ | 18 | | | $ | 18 | |
| | | | | | | | | | | |
Year ended December 31, 2020 | | | | | | | | | | | |
Beginning balance at January 1, 2020 | $ | 303 | | | $ | 2 | | | | | $ | 7 | | | $ | 85 | | | $ | 397 | |
Total gains (losses): | | | | | | | | | | | |
Recognized in net income | (3) | | | — | | | | | — | | | (19) | | | (22) | |
Recognized in accumulated other comprehensive income | (5) | | | — | | | | | — | | | — | | | (5) | |
Purchases | 85 | | | — | | | | | — | | | 16 | | | 101 | |
Sales | (19) | | | — | | | | | — | | | (22) | | | (41) | |
Settlements | (44) | | | — | | | | | (2) | | | — | | | (46) | |
Transfers into Level III | 10 | | | — | | | | | — | | | — | | | 10 | |
Transfers out of Level III | (2) | | | — | | | | | — | | | — | | | (2) | |
Ending balance at December 31, 2020 | $ | 325 | | | $ | 2 | | | | | $ | 5 | | | $ | 60 | | | $ | 392 | |
Change in unrealized gains or losses included in net income related to assets still held at December 31, 2020 | $ | — | | | $ | — | | | | | $ | — | | | $ | (19) | | | $ | (19) | |
| | | | | | | | | | | |
Year ended December 31, 2019 | | | | | | | | | | | |
Beginning balance at January 1, 2019 | $ | 287 | | | $ | 6 | | | | | $ | 17 | | | $ | 313 | | | $ | 623 | |
Total gains (losses): | | | | | | | | | | | |
Recognized in net income | (7) | | | — | | | | | — | | | (6) | | | (13) | |
Recognized in accumulated other comprehensive loss | 3 | | | — | | | | | — | | | — | | | 3 | |
Purchases | 122 | | | — | | | | | 2 | | | 65 | | | 189 | |
Sales | (22) | | | — | | | | | — | | | (79) | | | (101) | |
Settlements | (71) | | | (2) | | | | | (6) | | | — | | | (79) | |
Transfers into Level III | — | | | — | | | | | 3 | | | 2 | | | 5 | |
Transfers out of Level III | (9) | | | (2) | | | | | (9) | | | (210) | | | (230) | |
Ending balance at December 31, 2019 | $ | 303 | | | $ | 2 | | | | | $ | 7 | | | $ | 85 | | | $ | 397 | |
Change in unrealized gains or losses included in net income related to assets still held at December 31, 2019 | $ | — | | | $ | — | | | | | $ | — | | | $ | 6 | | | $ | 6 | |
There were no individually material transfers into or out of Level III during the years ended December 31, 2021, 2020 or 2019.
Certain assets and liabilities are measured at fair value on a nonrecurring basis; that is, the instruments are not measured at fair value on an ongoing basis but are subject to fair value adjustments only in certain circumstances. As disclosed in Note 3, “Business Acquisitions,” we completed our acquisitions of myNEXUS and MMM during the second quarter of 2021, as well as our acquisition of Beacon during the first quarter of 2020. The net assets acquired in our acquisitions of myNEXUS,
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
MMM and Beacon and resulting goodwill and other intangible assets were recorded at fair value primarily using Level III inputs. The majority of assets acquired and liabilities assumed were recorded at their carrying values as of the respective date of acquisition, as their carrying values approximated their fair values due to their short-term nature. The fair values of goodwill and other intangible assets acquired in our acquisitions of myNEXUS, MMM and Beacon were internally estimated based on the income approach. The income approach estimates fair value based on the present value of the cash flows that the assets could be expected to generate in the future. We developed internal estimates for the expected cash flows and discount rate in the present value calculation. Other than the assets acquired and liabilities assumed in our acquisitions of myNEXUS, MMM and Beacon described above, there were no material assets or liabilities measured at fair value on a nonrecurring basis during the years ended December 31, 2021 or 2020.
Our valuation policy is determined by members of our treasury and accounting departments. Whenever possible, our policy is to obtain quoted market prices in active markets to estimate fair values for recognition and disclosure purposes. Where quoted market prices in active markets are not available, fair values are estimated using discounted cash flow analyses, broker quotes, unobservable inputs or other valuation techniques. These techniques are significantly affected by our assumptions, including discount rates and estimates of future cash flows. The use of assumptions for unobservable inputs for the determination of fair value involves a level of judgment and uncertainty. Changes in assumptions that reasonably could have been different at the reporting date may result in a higher or lower determination of fair value. Changes in fair value measurements, if significant, may affect performance of cash flows.
Potential taxes and other transaction costs are not considered in estimating fair values. Our valuation policy is generally to obtain quoted prices for each security from third-party pricing services, which are derived through recently reported trades for identical or similar securities making adjustments through the reporting date based upon available market observable information. As we are responsible for the determination of fair value, we perform analysis on the prices received from the pricing services to determine whether the prices are reasonable estimates of fair value. This analysis is performed by our internal treasury personnel who are familiar with our investment portfolios, the pricing services engaged and the valuation techniques and inputs used. Our analysis includes procedures such as a review of month-to-month price fluctuations and price comparisons to secondary pricing services. There were no adjustments to quoted market prices obtained from the pricing services during the years ended December 31, 2021, 2020 or 2019.
In addition to the preceding disclosures on assets recorded at fair value in the consolidated balance sheets, FASB guidance also requires the disclosure of fair values for certain other financial instruments for which it is practicable to estimate fair value, whether or not such values are recognized in the consolidated balance sheets.
Non-financial instruments such as real estate, property and equipment, other current assets, deferred income taxes, intangible assets and certain financial instruments, such as policy liabilities, are excluded from the fair value disclosures. Therefore, the fair value amounts cannot be aggregated to determine our underlying economic value.
The carrying amounts reported in the consolidated balance sheets for cash, premium receivables, self-funded receivables, other receivables, unearned income, accounts payable and accrued expenses, and certain other current liabilities approximate fair value because of the short-term nature of these items. These assets and liabilities are not listed in the table below.
The following methods and assumptions were used to estimate the fair value of each class of financial instrument that is recorded at its carrying value on the consolidated balance sheets:
Other invested assets: Other invested assets primarily include our investments in limited partnerships, joint ventures and other non-controlled corporations and mortgage loans, as well as the cash surrender value of corporate-owned life insurance policies. Investments in limited partnerships, joint ventures and other non-controlled corporations are carried at our share in the entities’ undistributed earnings, which approximates fair value. Mortgage loans are carried at amortized cost, which approximates fair value. The carrying value of corporate-owned life insurance policies represents the cash surrender value as reported by the respective insurer, which approximates fair value.
Short-term borrowings: The fair value of our short-term borrowings is based on quoted market prices for the same or similar debt, or if no quoted market prices were available, on the current market interest rates estimated to be available to us for debt of similar terms and remaining maturities.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
Long-term debt—commercial paper: The carrying amount for commercial paper approximates fair value, as the underlying instruments have variable interest rates at market value.
Long-term debt—senior unsecured notes and surplus notes: The fair values of our notes are based on quoted market prices in active markets for the same or similar debt, or, if no quoted market prices are available, on the current market observable rates estimated to be available to us for debt of similar terms and remaining maturities.
Long-term debt—convertible debentures: The fair value of our convertible debentures is based on the quoted market price in the active private market in which the convertible debentures trade.
A summary of the estimated fair values by level of each class of financial instrument that is recorded at its carrying value on our consolidated balance sheets at December 31, 2021 and 2020 is as follows:
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| Carrying Value | | Estimated Fair Value |
| Level I | | Level II | | Level III | | Total |
December 31, 2021 | | | | | | | | | |
Assets: | | | | | | | | | |
Other invested assets | $ | 5,087 | | | $ | — | | | $ | — | | | $ | 5,087 | | | $ | 5,087 | |
Liabilities: | | | | | | | | | |
Debt: | | | | | | | | | |
Short-term borrowings | 275 | | | — | | | 275 | | | — | | | 275 | |
Commercial paper | 300 | | | — | | | 300 | | | — | | | 300 | |
Notes | 22,384 | | | — | | | 25,150 | | | — | | | 25,150 | |
Convertible debentures | 72 | | | — | | | 687 | | | — | | | 687 | |
| | | | | | | | | |
December 31, 2020 | | | | | | | | | |
Assets: | | | | | | | | | |
Other invested assets | $ | 4,285 | | | $ | — | | | $ | — | | | $ | 4,285 | | | $ | 4,285 | |
Liabilities: | | | | | | | | | |
Debt: | | | | | | | | | |
| | | | | | | | | |
Commercial paper | 250 | | | — | | | 250 | | | — | | | 250 | |
Notes | 19,677 | | | — | | | 23,307 | | | — | | | 23,307 | |
Convertible debentures | 108 | | | — | | | 712 | | | — | | | 712 | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
8. Income Taxes
The components of deferred income taxes at December 31, 2021 and 2020 are as follows:
| | | | | | | | | | | |
| 2021 | | 2020 |
Deferred income tax assets: | | | |
| | | |
Accrued expenses | $ | 511 | | | $ | 588 | |
| | | |
Bad debt reserves | 246 | | | 143 | |
Insurance reserves | 156 | | | 187 | |
| | | |
| | | |
Lease liabilities | 216 | | | 204 | |
Retirement liabilities | 170 | | | 205 | |
Deferred compensation | 35 | | | 31 | |
Federal and state operating loss carryforwards | 201 | | | 274 | |
Other | 207 | | | 113 | |
Subtotal | 1,742 | | | 1,745 | |
Less: valuation allowance | (212) | | | (84) | |
Total deferred income tax assets | 1,530 | | | 1,661 | |
Deferred income tax liabilities: | | | |
U.S. federal and state intangible assets | 2,071 | | | 2,073 | |
Non-U.S. intangible assets | 452 | | | — | |
Capitalized software | 777 | | | 670 | |
Depreciation and amortization | 45 | | | 37 | |
Investment basis | 295 | | | 407 | |
Retirement assets | 314 | | | 260 | |
Lease right-of-use asset | 126 | | | 131 | |
Prepaid expenses | 152 | | | 102 | |
| | | |
Total deferred income tax liabilities | 4,232 | | | 3,680 | |
Net deferred income tax liabilities | $ | 2,702 | | | $ | 2,019 | |
Deferred tax liabilities, net totaled $2,702 and $2,019 at December 31, 2021 and 2020, respectively in our consolidated balance sheet. We recognized $103 and $0 of deferred tax asset under the caption “Other noncurrent assets” at December 31, 2021 and 2020, respectively. We recognized $2,805 and $2,019 of deferred tax liability under the caption “Deferred tax liabilities, net” at December 31, 2021 and 2020.
As of December 31, 2021, and as a result of acquisitions during the year, we established U.S. deferred taxes for undistributed earnings from certain non-U.S. subsidiaries, which are included in the Investment basis component above. As of December 31, 2020, our undistributed earnings from all non-U.S. subsidiaries were intended to be indefinitely reinvested in non-U.S. operations, and therefore no U.S. deferred taxes were recorded.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
Significant components of the provision for income taxes for the years ended December 31, 2021, 2020 and 2019 consist of the following:
| | | | | | | | | | | | | | | | | |
| 2021 | | 2020 | | 2019 |
Current tax expense: | | | | | |
Federal | $ | 1,485 | | | $ | 1,731 | | | $ | 1,019 | |
State and local | 165 | | | 461 | | | 84 | |
Total current tax expense | 1,650 | | | 2,192 | | | 1,103 | |
Deferred tax expense (benefit) | 180 | | | (526) | | | 75 | |
Total income tax expense | $ | 1,830 | | | $ | 1,666 | | | $ | 1,178 | |
State and local current tax expense is reported gross of federal benefit in the preceding table, and includes amounts related to audit settlements, uncertain tax positions, state tax credits and true up of prior years’ tax. Such items are included on a net of federal tax basis in multiple lines in the following rate reconciliation table.
A reconciliation of income tax expense recorded in the consolidated statements of income and amounts computed at the statutory federal income tax rate for the years ended December 31, 2021, 2020 and 2019 is as follows:
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| 2021 | | 2020 | | 2019 |
| Amount | | Percent | | Amount | | Percent | | Amount | | Percent |
Amount at statutory rate | $ | 1,664 | | | 21.0 | % | | $ | 1,310 | | | 21.0 | % | | $ | 1,257 | | | 21.0 | % |
State and local income taxes net of federal tax expense/benefit | 258 | | | 3.3 | | | 235 | | | 3.8 | | | 138 | | | 2.3 | |
Tax exempt interest and dividends received deduction | (22) | | | (0.3) | | | (22) | | | (0.4) | | | (24) | | | (0.4) | |
HIP fee | — | | | — | | | 330 | | | 5.3 | | | — | | | — | |
Basis adjustments from recent acquisitions | — | | | — | | | (110) | | | (1.8) | | | — | | | — | |
Other, net | (70) | | | (0.9) | | | (77) | | | (1.2) | | | (193) | | | (3.2) | |
Total income tax expense | $ | 1,830 | | | 23.1 | % | | $ | 1,666 | | | 26.7 | % | | $ | 1,178 | | | 19.7 | % |
During the year ended December 31, 2021, we recognized income tax expense of $1,830, or $7.41 per diluted share. The HIP Fee payment was eliminated beginning in 2021.
During the year ended December 31, 2020, we recognized income tax expense of $1,666, or $6.55 per diluted share, which included income tax expense of $330, or $1.30 per diluted share as a result of the non-tax deductibility of the HIP Fee payment, which was reinstated for 2020.
During the year ended December 31, 2019, we recognized income tax expense of $1,178, or $4.53 per diluted share. The HIP Fee payment was suspended for 2019.
The change in the carrying amount of gross unrecognized tax benefits from uncertain tax positions for the years ended December 31, 2021 and 2020 is as follows:
| | | | | | | | | | | |
| 2021 | | 2020 |
Balance at January 1 | $ | 249 | | | $ | 146 | |
Additions based on: | | | |
Tax positions related to current year | 10 | | | 76 | |
Tax positions related to prior years | 17 | | | 40 | |
Reductions based on: | | | |
| | | |
Tax positions related to prior years | (5) | | | (13) | |
| | | |
Balance at December 31 | $ | 271 | | | $ | 249 | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
The table above excludes interest, net of related tax benefits, which is treated as income tax expense (benefit) under our accounting policy. The interest is included in the amounts described in the following paragraph.
The amount of unrecognized tax benefits that would impact our effective tax rate in future periods, if recognized, was $250 and $227 at December 31, 2021 and 2020, respectively. Also included in the table above, at December 31, 2021, is $2 that would be recognized as an adjustment to additional paid-in capital, which would not affect our effective tax rate. In addition to the contingent liabilities included in the table above, we filed protective state income tax refund claims of approximately $310 during 2017. There were no equivalent protective state income tax refund claims filed in 2021, 2020 or 2019.
For the year ended December 31, 2021, we recognized a net interest expense of $9. For the years ended December 31, 2020 and 2019, we recognized a net interest expense (benefit) of $7 and ($11), respectively. We had accrued approximately $42 and $33 for the payment of interest at December 31, 2021 and 2020, respectively.
As of December 31, 2021, as further described below, certain tax years remain open to examination by the Internal Revenue Service (“IRS”) and various state and local authorities. As a result of these examinations and discussions with taxing agencies, we have recorded amounts for uncertain tax positions. It is anticipated that the amount of unrecognized tax benefits will change in the next twelve months due to possible settlements of audits and changes in temporary items. However, the ultimate resolution of these items is dependent on the completion of negotiations with various taxing authorities. While it is difficult to determine when other tax settlements will actually occur, it is reasonably possible that one could occur in the next twelve months and our unrecognized tax benefits could change within a range of approximately ($14) to ($105).
We are a member of the IRS Compliance Assurance Process (“CAP”). The objective of CAP is to reduce taxpayer burden and uncertainty while assuring the IRS of the accuracy of tax returns prior to filing, thereby reducing or eliminating the need for post-filing examinations.
As of December 31, 2021, the IRS examination of our 2021 tax year continues to be in process.
In certain states, we pay premium taxes in lieu of state income taxes. Premium taxes are reported in selling, general and administrative expense.
At December 31, 2021, we had federal net operating loss carryforwards of $181 that will expire beginning 2032 through 2041 and $153 that have an indefinite carryforward period; state net operating loss carryforwards expire beginning 2022 through 2041, with some having an indefinite carryforward period.
Income taxes receivable totaled $173 and $262 at December 31, 2021 and 2020, respectively. We recognize the income tax receivable as an asset under the caption “Other current assets” in our consolidated balance sheets.
During 2021, 2020 and 2019, federal income taxes paid totaled $1,299, $1,790 and $1,403, respectively.
9. Property and Equipment
A summary of property and equipment at December 31, 2021 and 2020 is as follows:
| | | | | | | | | | | |
| 2021 | | 2020 |
Computer software, purchased and internally developed | $ | 6,115 | | | $ | 5,247 | |
Computer equipment, furniture and other equipment | 1,314 | | | 1,218 | |
Leasehold improvements | 641 | | | 671 | |
Building and improvements | 172 | | | 174 | |
Land and improvements | 17 | | | 17 | |
Property and equipment, gross | 8,259 | | | 7,327 | |
Accumulated depreciation and amortization | (4,340) | | | (3,844) | |
Property and equipment, net | $ | 3,919 | | | $ | 3,483 | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
Depreciation expense for 2021, 2020 and 2019 was $136, $176 and $147, respectively. Amortization expense on computer software and leasehold improvements for 2021, 2020 and 2019 was $532, $462 and $528, respectively, which includes amortization expense on computer software, both purchased and internally developed, for 2021, 2020 and 2019 of $485, $412 and $450, respectively. Capitalized costs related to the internal development of software of $5,626 and $4,783 at December 31, 2021 and 2020, respectively, are reported with computer software.
Impairment of property and equipment for the years ended December 31, 2021 and 2020 was $73 and $198, respectively, which is included in selling, general and administrative expenses. Included in these amounts was impairment of property and equipment related to our activities as disclosed in Note 4, “Business Optimization Initiatives.” For the years ended December 31, 2021 and 2020, we recorded impairment charges for property and equipment related to these initiatives of $66 and $198, respectively.
10. Goodwill and Other Intangible Assets
A summary of the change in the carrying amount of goodwill for our segments (see Note 20, “Segment Information”) for 2021 and 2020 is as follows:
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| Commercial and Specialty Business | | Government Business | | IngenioRx | | Other | | Total |
Balance as of January 1, 2020 | $ | 11,551 | | | $ | 8,279 | | | $ | — | | | $ | 670 | | | $ | 20,500 | |
| | | | | | | | | |
Acquisitions and adjustments | 42 | | | 52 | | | 48 | | | 1,049 | | | 1,191 | |
Balance as of December 31, 2020 | 11,593 | | | 8,331 | | | 48 | | | 1,719 | | | 21,691 | |
Acquisitions and adjustments | — | | | 2,018 | | | 11 | | | 508 | | | 2,537 | |
Balance as of December 31, 2021 | $ | 11,593 | | | $ | 10,349 | | | $ | 59 | | | $ | 2,227 | | | $ | 24,228 | |
Accumulated impairment as of December 31, 2021 | $ | — | | | $ | — | | | $ | — | | | $ | — | | | $ | — | |
As required by FASB guidance, we completed annual impairment tests of existing goodwill and other intangible assets with indefinite lives during 2021, 2020 and 2019. We perform these annual impairment tests during the fourth quarter. FASB guidance also requires interim impairment testing to be performed when potential impairment indicators exist. These tests involve the use of estimates related to the fair value of goodwill and intangible assets with indefinite lives and require a significant degree of management judgment and the use of subjective assumptions. Qualitative testing procedures include assessing our financial performance, macroeconomic conditions, industry and market considerations, various asset specific factors and entity specific events. For quantitative testing, the fair values are estimated using the projected income and market valuation approaches, incorporating Level III internal estimates for inputs, including, but not limited to, revenue projections, income projections, cash flows and discount rates. We did not incur any impairment losses in 2021, 2020 or 2019, as the estimated fair values of our reporting units were substantially in excess of their carrying values.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
The components of other intangible assets as of December 31, 2021 and 2020 are as follows:
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| 2021 | | 2020 |
Gross Carrying Amount | | Accumulated Amortization | | Net Carrying Amount | | Gross Carrying Amount | | Accumulated Amortization | | Net Carrying Amount |
Intangible assets with finite lives: | | | | | | | | | | | |
Customer relationships | $ | 5,598 | | | $ | (3,236) | | | $ | 2,362 | | | $ | 5,180 | | | $ | (3,766) | | | $ | 1,414 | |
Provider and hospital relationships | 324 | | | (129) | | | 195 | | | 323 | | | (114) | | | 209 | |
Other | 610 | | | (141) | | | 469 | | | 444 | | | (177) | | | 267 | |
Total | 6,532 | | | (3,506) | | | 3,026 | | | 5,947 | | | (4,057) | | | 1,890 | |
Intangible assets with indefinite lives: | | | | | | | | | | | |
Blue Cross and Blue Shield and other trademarks | 6,299 | | | — | | | 6,299 | | | 6,299 | | | — | | | 6,299 | |
State Medicaid licenses | 1,290 | | | — | | | 1,290 | | | 1,216 | | | — | | | 1,216 | |
Total | 7,589 | | | — | | | 7,589 | | | 7,515 | | | — | | | 7,515 | |
Other intangible assets | $ | 14,121 | | | $ | (3,506) | | | $ | 10,615 | | | $ | 13,462 | | | $ | (4,057) | | | $ | 9,405 | |
Intangible assets, along with the related accumulated amortization, are removed from the table above at the end of the fiscal year in which they become fully amortized.
As of December 31, 2021, the estimated amortization expense for each of the five succeeding years is as follows: 2022, $483; 2023, $429; 2024, $369; 2025, $317; and 2026, $264.
11. Retirement Benefits
We sponsor various non-contributory employee defined benefit plans through certain subsidiaries.
The Anthem Cash Balance Plan A and the Anthem Cash Balance Plan B are cash balance pension plans covering certain eligible employees of the affiliated companies that participate in these plans. Effective January 1, 2006, benefits were curtailed, with the result that most participants stopped accruing benefits but continue to earn interest on benefits accrued prior to the curtailment. Certain participants subject to collective bargaining and certain other participants who met grandfathering rules continued to accrue benefits. Participants who did not receive credits and/or benefit accruals were included in the Anthem Cash Balance Plan A, while employees who were still receiving credits and/or benefits participated in the Anthem Cash Balance Plan B. Effective January 1, 2019, benefits under the Anthem Cash Balance Plan B were curtailed. All grandfathered participants no longer have pay credits added to their accounts but continue to earn interest on existing account balances. Participants continue to earn years of pension service for vesting purposes. Several pension plans acquired through various corporate mergers and acquisitions were merged into these plans in prior years.
The Employees’ Retirement Plan of Blue Cross of California (the “BCC Plan”) is a defined benefit pension plan that covers eligible employees of Blue Cross of California who are covered by a collective bargaining agreement. Effective January 1, 2007, benefits were curtailed under the BCC Plan with the result that no Blue Cross of California employees hired or rehired after December 31, 2006 are eligible to participate in the BCC Plan.
All of the plans’ assets consist primarily of equity securities, fixed maturity securities, investment funds and cash. The funding policies for all plans are to contribute amounts at least sufficient to meet the minimum funding requirements set forth in the Employee Retirement Income Security Act of 1974, as amended (“ERISA”), as further amended by the Pension Protection Act of 2006, and in accordance with income tax regulations, plus such additional amounts as are necessary to provide assets sufficient to meet the benefits to be paid to plan participants.
The following tables disclose consolidated “pension benefits,” which include the defined benefit pension plans described above, and consolidated “other benefits,” which include postretirement health and welfare benefits including medical, vision and dental benefits offered to certain employees. Calculations were computed using assumptions at the December 31 measurement dates.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
The reconciliation of the benefit obligation is as follows:
| | | | | | | | | | | | | | | | | | | | | | | |
| Pension Benefits | | Other Benefits |
| 2021 | | 2020 | | 2021 | | 2020 |
Benefit obligation at beginning of year | $ | 2,009 | | | $ | 1,880 | | | $ | 399 | | | $ | 423 | |
Service cost | — | | | — | | | 1 | | | 1 | |
Interest cost | 34 | | | 47 | | | 5 | | | 10 | |
Plan participant contributions | — | | | — | | | 17 | | | 18 | |
Actuarial (gain) loss | (33) | | | 219 | | | (31) | | | (15) | |
Settlements | (90) | | | (80) | | | — | | | — | |
Benefits paid | (61) | | | (57) | | | (48) | | | (38) | |
Benefit obligation at end of year | $ | 1,859 | | | $ | 2,009 | | | $ | 343 | | | $ | 399 | |
The changes in the fair value of plan assets are as follows:
| | | | | | | | | | | | | | | | | | | | | | | |
| Pension Benefits | | Other Benefits |
| 2021 | | 2020 | | 2021 | | 2020 |
Fair value of plan assets at beginning of year | $ | 2,186 | | | $ | 2,026 | | | $ | 391 | | | $ | 367 | |
Actual return on plan assets | 174 | | | 290 | | | 33 | | | 33 | |
Employer contributions | 7 | | | 7 | | | — | | | 11 | |
Plan participant contributions | — | | | — | | | 17 | | | 18 | |
Settlements | (90) | | | (80) | | | (29) | | | — | |
Benefits paid | (61) | | | (57) | | | (41) | | | (38) | |
Fair value of plan assets at end of year | $ | 2,216 | | | $ | 2,186 | | | $ | 371 | | | $ | 391 | |
The net amount included in the consolidated balance sheets is as follows:
| | | | | | | | | | | | | | | | | | | | | | | |
| Pension Benefits | | Other Benefits |
| 2021 | | 2020 | | 2021 | | 2020 |
Noncurrent assets | $ | 415 | | | $ | 248 | | | $ | 28 | | | $ | — | |
Current liabilities | (6) | | | (6) | | | — | | | — | |
Noncurrent liabilities | (52) | | | (65) | | | — | | | (8) | |
Net amount at December 31 | $ | 357 | | | $ | 177 | | | $ | 28 | | | $ | (8) | |
The net amounts included in accumulated other comprehensive income (loss) that have not been recognized as components of net periodic benefit costs are as follows:
| | | | | | | | | | | | | | | | | | | | | | | |
| Pension Benefits | | Other Benefits |
| 2021 | | 2020 | | 2021 | | 2020 |
Net actuarial loss (gain) | $ | 625 | | | $ | 749 | | | $ | (36) | | | $ | 3 | |
Prior service credit | — | | | — | | | (8) | | | (12) | |
Net amount before tax at December 31 | $ | 625 | | | $ | 749 | | | $ | (44) | | | $ | (9) | |
The accumulated benefit obligation for the defined benefit pension plans was $1,857 and $2,007 at December 31, 2021 and 2020, respectively.
As of December 31, 2021, certain pension plans had accumulated benefit obligations in excess of plan assets. Such plans had accumulated benefit obligation and fair value of plan assets of $56 and $0, respectively. In addition, certain plans had
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
projected benefit obligations in excess of plan assets. Such plans had projected benefit obligation and fair value of plan assets of $107 and $49, respectively.
The weighted-average assumptions used in calculating the benefit obligations for all plans are as follows:
| | | | | | | | | | | | | | | | | | | | | | | |
| Pension Benefits | | Other Benefits |
| 2021 | | 2020 | | 2021 | | 2020 |
Discount rate | 2.70 | % | | 2.24 | % | | 2.49 | % | | 1.99 | % |
Rate of compensation increase | 3.00 | % | | 3.00 | % | | 3.00 | % | | 3.00 | % |
Expected rate of return on plan assets | 5.02 | % | | 6.72 | % | | 6.43 | % | | 6.60 | % |
Interest crediting rate | 3.82 | % | | 3.82 | % | | 1.56 | % | | 0.87 | % |
The components of net periodic benefit credit included in the consolidated statements of income are as follows:
| | | | | | | | | | | | | | | | | |
| 2021 | | 2020 | | 2019 |
Pension Benefits | | | | | |
| | | | | |
Interest cost | $ | 34 | | | $ | 47 | | | $ | 62 | |
Expected return on assets | (134) | | | (138) | | | (138) | |
Recognized actuarial loss | 25 | | | 24 | | | 17 | |
| | | | | |
Settlement loss | 26 | | | 29 | | | 9 | |
Net periodic benefit credit | $ | (49) | | | $ | (38) | | | $ | (50) | |
| | | | | |
Other Benefits | | | | | |
Service cost | $ | 1 | | | $ | 1 | | | $ | 1 | |
Interest cost | 5 | | | 10 | | | 15 | |
Expected return on assets | (26) | | | (25) | | | (22) | |
Recognized actuarial loss | — | | | — | | | 2 | |
Amortization of prior service credit | (4) | | | (7) | | | (12) | |
Net periodic benefit credit | $ | (24) | | | $ | (21) | | | $ | (16) | |
During the years ended December 31, 2021, 2020 and 2019, we incurred total settlement losses of $26, $29 and $9, respectively, as lump-sum payments exceeded the service cost and interest cost components of net periodic benefit cost for certain of our plans.
The weighted-average assumptions used in calculating the net periodic benefit cost for all plans are as follows:
| | | | | | | | | | | | | | | | | |
| 2021 | | 2020 | | 2019 |
Pension Benefits | | | | | |
Discount rate | 2.24 | % | | 3.11 | % | | 4.15 | % |
Rate of compensation increase | 3.00 | % | | 3.00 | % | | 3.00 | % |
Expected rate of return on plan assets | 6.72 | % | | 7.33 | % | | 7.44 | % |
Interest crediting rate | 3.82 | % | | 3.82 | % | | 3.83 | % |
| | | | | |
Other Benefits | | | | | |
Discount rate | 1.99 | % | | 2.93 | % | | 4.04 | % |
Rate of compensation increase | 3.00 | % | | 3.00 | % | | 3.00 | % |
Expected rate of return on plan assets | 6.60 | % | | 7.00 | % | | 7.00 | % |
Interest crediting rate | 0.87 | % | | 1.81 | % | | 3.12 | % |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
The assumed healthcare cost trend rates used to measure the expected cost of pre-Medicare (those who are not currently eligible for Medicare benefits) other benefits at our December 31, 2021 measurement date was 7.00% for 2022, with a gradual decline to 4.50% by the year 2033. The assumed healthcare cost trend rates used to measure the expected cost of post-Medicare (those who are currently eligible for Medicare benefits) other benefits at our December 31, 2021 measurement date was 5.50% for 2022, with a gradual decline to 4.50% by the year 2033. These estimated trend rates are subject to change in the future.
Plan assets include a diversified mix of equity securities, investment grade fixed maturity securities and other types of investments across a range of sectors and levels of capitalization to maximize long-term return for a prudent level of risk. The weighted-average target allocation for pension benefit plan assets is 44% equity securities, 48% fixed maturity securities, and 8% to all other types of investments. Equity securities primarily include a mix of domestic securities, foreign securities and mutual funds invested in equities. Fixed maturity securities primarily include treasury securities, corporate bonds and asset-backed investments issued by corporations and the U.S. government. Other types of investments primarily include insurance contracts designed specifically for employee benefit plans and a commingled fund comprised primarily of equity securities. As of December 31, 2021, there were no significant concentrations of investments in the pension benefit assets or other benefit assets. No plan assets were invested in Anthem common stock.
The partnerships hold various types of underlying assets such as real estate and investments in oil and gas companies. Generally, the partnership interests are not redeemable and are transferable only with the consent of the general partner. Unfunded commitments related to all partnership interests totaled approximately $3 at each of December 31, 2021 and 2020.
Pension benefit assets and other benefit assets recorded at fair value are categorized based upon the level of judgment associated with the inputs used to measure their fair value.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
The fair values of our pension benefit assets and other benefit assets by asset category and level inputs at December 31, 2021, excluding cash, investment income receivable and amounts due to/from brokers, resulting in a net asset of $48, and excluding estimated claims settlements to be paid from other benefit assets of ($29), are as follows (see Note 7, “Fair Value,” for additional information regarding the definition of level inputs): | | | | | | | | | | | | | | | | | | | | | | | |
| Level I | | Level II | | Level III | | Total |
December 31, 2021 | | | | | | | |
Pension Benefit Assets: | | | | | | | |
Equity securities: | | | | | | | |
U.S. securities | $ | 682 | | | $ | — | | | $ | — | | | $ | 682 | |
Foreign securities | 204 | | | — | | | — | | | 204 | |
Mutual funds | 49 | | | — | | | — | | | 49 | |
Fixed maturity securities: | | | | | | | |
Government securities | — | | | 395 | | | — | | | 395 | |
Corporate securities | — | | | 379 | | | — | | | 379 | |
Asset-backed securities | — | | | 98 | | | — | | | 98 | |
Other types of investments: | | | | | | | |
| | | | | | | |
Commingled fund | — | | | 106 | | | — | | | 106 | |
Insurance company contracts | — | | | — | | | 179 | | | 179 | |
| | | | | | | |
Total pension benefit assets at fair value | $ | 935 | | | $ | 978 | | | $ | 179 | | | 2,092 | |
Partnership investments | | | | | | | 78 | |
Total pension benefit assets | | | | | | | $ | 2,170 | |
| | | | | | | |
Other Benefit Assets: | | | | | | | |
Equity securities: | | | | | | | |
U.S. securities | $ | 10 | | | $ | — | | | $ | — | | | $ | 10 | |
Foreign securities | 2 | | | — | | | — | | | 2 | |
Mutual funds | 24 | | | — | | | — | | | 24 | |
Fixed maturity securities: | | | | | | | |
Government securities | — | | | 4 | | | — | | | 4 | |
Corporate securities | — | | | 4 | | | — | | | 4 | |
Asset-backed securities | — | | | 3 | | | — | | | 3 | |
Other types of investments: | | | | | | | |
| | | | | | | |
Commingled fund | — | | | 2 | | | — | | | 2 | |
Life insurance contracts | — | | | — | | | 338 | | | 338 | |
Investment in DOL 103-12 trust | — | | | 11 | | | — | | | 11 | |
Total other benefit assets | $ | 36 | | | $ | 24 | | | $ | 338 | | | $ | 398 | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
The fair values of our pension benefit assets and other benefit assets by asset category and level inputs at December 31, 2020, excluding cash, investment income receivable and amounts due to/from brokers, resulting in a net asset of $64, are as follows: | | | | | | | | | | | | | | | | | | | | | | | |
| Level I | | Level II | | Level III | | Total |
December 31, 2020 | | | | | | | |
Pension Benefit Assets: | | | | | | | |
Equity securities: | | | | | | | |
U.S. securities | $ | 710 | | | $ | — | | | $ | — | | | $ | 710 | |
Foreign securities | 238 | | | — | | | — | | | 238 | |
Mutual funds | 42 | | | — | | | — | | | 42 | |
Fixed maturity securities: | | | | | | | |
Government securities | — | | | 237 | | | — | | | 237 | |
Corporate securities | — | | | 394 | | | — | | | 394 | |
Asset-backed securities | — | | | 137 | | | — | | | 137 | |
Other types of investments: | | | | | | | |
| | | | | | | |
Commingled fund | — | | | 112 | | | — | | | 112 | |
Insurance company contracts | — | | | — | | | 189 | | | 189 | |
| | | | | | | |
Total pension benefit assets at fair value | $ | 990 | | | $ | 880 | | | $ | 189 | | | 2,059 | |
Partnership investments | | | | | | | 74 | |
Total pension benefit assets | | | | | | | $ | 2,133 | |
| | | | | | | |
Other Benefit Assets: | | | | | | | |
Equity securities: | | | | | | | |
U.S. securities | $ | 9 | | | $ | — | | | $ | — | | | $ | 9 | |
Foreign securities | 3 | | | — | | | — | | | 3 | |
Mutual funds | 23 | | | — | | | — | | | 23 | |
Fixed maturity securities: | | | | | | | |
Government securities | — | | | 2 | | | — | | | 2 | |
Corporate securities | — | | | 4 | | | — | | | 4 | |
Asset-backed securities | — | | | 3 | | | — | | | 3 | |
Other types of investments: | | | | | | | |
| | | | | | | |
Commingled fund | — | | | 2 | | | — | | | 2 | |
Life insurance contracts | — | | | — | | | 323 | | | 323 | |
Investment in DOL 103-12 trust | — | | | 11 | | | — | | | 11 | |
Total other benefit assets | $ | 35 | | | $ | 22 | | | $ | 323 | | | $ | 380 | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
A reconciliation of the beginning and ending balances of plan assets measured at fair value using Level III inputs for the years ended December 31, 2021, 2020 and 2019 is as follows: | | | | | | | | | | | | | | | | | | | | | |
| | | | | Insurance Company Contracts | | Life Insurance Contracts | | Total |
Year ended December 31, 2021 | | | | | | | | | |
Beginning balance at January 1, 2021 | | | | | $ | 189 | | | $ | 323 | | | $ | 512 | |
Actual return on plan assets relating to assets still held at the reporting date | | | | | (6) | | | 26 | | | 20 | |
Purchases | | | | | 5 | | | — | | | 5 | |
Sales | | | | | (9) | | | (11) | | | (20) | |
| | | | | | | | | |
Ending balance at December 31, 2021 | | | | | $ | 179 | | | $ | 338 | | | $ | 517 | |
| | | | | | | | | |
Year ended December 31, 2020 | | | | | | | | | |
Beginning balance at January 1, 2020 | | | | | $ | 175 | | | $ | 294 | | | $ | 469 | |
Actual return on plan assets relating to assets still held at the reporting date | | | | | 7 | | | 29 | | | 36 | |
Purchases | | | | | 15 | | | — | | | 15 | |
Sales | | | | | (8) | | | — | | | (8) | |
| | | | | | | | | |
Ending balance at December 31, 2020 | | | | | $ | 189 | | | $ | 323 | | | $ | 512 | |
| | | | | | | | | |
Year ended December 31, 2019 | | | | | | | | | |
Beginning balance at January 1, 2019 | | | | | $ | 166 | | | $ | 249 | | | $ | 415 | |
Actual return on plan assets relating to assets still held at the reporting date | | | | | 12 | | | 45 | | | 57 | |
Purchases | | | | | 6 | | | — | | | 6 | |
Sales | | | | | (9) | | | — | | | (9) | |
Ending balance at December 31, 2019 | | | | | $ | 175 | | | $ | 294 | | | $ | 469 | |
There were no other transfers into or out of Level III during the years ended December 31, 2021, 2020 or 2019.
Our current funding strategy is to fund an amount at least equal to the minimum required funding as determined under ERISA with consideration of maximum tax deductible amounts. We may elect to make discretionary contributions up to the maximum amount deductible for income tax purposes. For the years ended December 31, 2021, 2020 and 2019, no material contributions were necessary to meet ERISA required funding levels. However, during each of the years ended December 31, 2021, 2020 and 2019, we made tax deductible discretionary contributions to the pension benefit plans of $7, $7, and $4, respectively. Employer contributions to other benefit plans represent discretionary contributions and do not include payments to retirees for current benefits.
Our estimated future payments for pension benefits and other benefits, which reflect expected future service, as appropriate, are as follows:
| | | | | | | | | | | |
| Pension Benefits | | Other Benefits |
2022 | $ | 131 | | | $ | 32 | |
2023 | 127 | | | 31 | |
2024 | 123 | | | 30 | |
2025 | 119 | | | 28 | |
2026 | 117 | | | 27 | |
2027 - 2031 | 539 | | | 112 | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
In addition to the defined benefit plans, we maintain the Anthem 401(k) Plan, which is a qualified defined contribution plan covering substantially all employees. Voluntary employee contributions are matched by us subject to certain limitations. Contributions made by us totaled $241, $221 and $201 during 2021, 2020 and 2019, respectively.
12. Medical Claims Payable
A reconciliation of the beginning and ending balances for medical claims payable, by segment (see Note 20, “Segment Information”), for the year ended December 31, 2021 is as follows:
| | | | | | | | | | | | | | | | | | | | | | | |
| Commercial & Specialty Business | | Government Business | | Other | | Total |
Gross medical claims payable, beginning of year | $ | 3,294 | | | $ | 7,646 | | | $ | 195 | | | $ | 11,135 | |
Ceded medical claims payable, beginning of year | (13) | | | (33) | | | — | | | (46) | |
Net medical claims payable, beginning of year | 3,281 | | | 7,613 | | | 195 | | | 11,089 | |
Business combinations and purchase adjustments | — | | | 375 | | | 45 | | | 420 | |
Net incurred medical claims: | | | | | | | |
Current year | 28,132 | | | 70,670 | | | 1,638 | | | 100,440 | |
Prior years redundancies | (465) | | | (1,222) | | | (16) | | | (1,703) | |
Total net incurred medical claims | 27,667 | | | 69,448 | | | 1,622 | | | 98,737 | |
Net payments attributable to: | | | | | | | |
Current year medical claims | 24,502 | | | 62,233 | | | 1,421 | | | 88,156 | |
Prior years medical claims | 2,612 | | | 6,054 | | | 163 | | | 8,829 | |
Total net payments | 27,114 | | | 68,287 | | | 1,584 | | | 96,985 | |
Net medical claims payable, end of year | 3,834 | | | 9,149 | | | 278 | | | 13,261 | |
Ceded medical claims payable, end of year | 13 | | | 8 | | | — | | | 21 | |
Gross medical claims payable, end of year | $ | 3,847 | | | $ | 9,157 | | | $ | 278 | | | $ | 13,282 | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
A reconciliation of the beginning and ending balances for medical claims payable, by segment, for the year ended December 31, 2020 is as follows:
| | | | | | | | | | | | | | | | | | | | | | | |
| Commercial & Specialty Business | | Government Business | | Other | | Total |
Gross medical claims payable, beginning of year | $ | 3,039 | | | $ | 5,608 | | | $ | — | | | $ | 8,647 | |
Ceded medical claims payable, beginning of year | (14) | | | (19) | | | — | | | (33) | |
Net medical claims payable, beginning of year | 3,025 | | | 5,589 | | | — | | | 8,614 | |
Business combinations and purchase adjustments | — | | | 141 | | | 198 | | | 339 | |
Net incurred medical claims: | | | | | | | |
Current year | 24,894 | | | 58,912 | | | 1,288 | | | 85,094 | |
Prior years redundancies | (375) | | | (262) | | | — | | | (637) | |
Total net incurred medical claims | 24,519 | | | 58,650 | | | 1,288 | | | 84,457 | |
Net payments attributable to: | | | | | | | |
Current year medical claims | 21,736 | | | 51,602 | | | 1,291 | | | 74,629 | |
Prior years medical claims | 2,527 | | | 5,165 | | | — | | | 7,692 | |
Total net payments | 24,263 | | | 56,767 | | | 1,291 | | | 82,321 | |
Net medical claims payable, end of year | 3,281 | | | 7,613 | | | 195 | | | 11,089 | |
Ceded medical claims payable, end of year | 13 | | | 33 | | | — | | | 46 | |
Gross medical claims payable, end of year | $ | 3,294 | | | $ | 7,646 | | | $ | 195 | | | $ | 11,135 | |
A reconciliation of the beginning and ending balances for medical claims payable, by segment, for the year ended December 31, 2019 is as follows:
| | | | | | | | | | | | | | | | | | | |
| Commercial & Specialty Business | | Government Business | | | | Total |
Gross medical claims payable, beginning of year | $ | 2,586 | | | $ | 4,680 | | | | | $ | 7,266 | |
Ceded medical claims payable, beginning of year | (10) | | | (24) | | | | | (34) | |
Net medical claims payable, beginning of year | 2,576 | | | 4,656 | | | | | 7,232 | |
| | | | | | | |
Net incurred medical claims: | | | | | | | |
Current year | 25,942 | | | 52,753 | | | | | 78,695 | |
Prior years redundancies | (190) | | | (310) | | | | | (500) | |
Total net incurred medical claims | 25,752 | | | 52,443 | | | | | 78,195 | |
Net payments attributable to: | | | | | | | |
Current year medical claims | 23,026 | | | 47,268 | | | | | 70,294 | |
Prior years medical claims | 2,277 | | | 4,242 | | | | | 6,519 | |
Total net payments | 25,303 | | | 51,510 | | | | | 76,813 | |
Net medical claims payable, end of year | 3,025 | | | 5,589 | | | | | 8,614 | |
Ceded medical claims payable, end of year | 14 | | | 19 | | | | | 33 | |
Gross medical claims payable, end of year | $ | 3,039 | | | $ | 5,608 | | | | | $ | 8,647 | |
Amounts incurred related to prior years vary from previously estimated liabilities as the claims are ultimately settled. Liabilities at any period-end are continually reviewed and re-estimated as information regarding actual claims payments, or runout, becomes known. This information is compared to the originally established year end liability. Negative amounts reported for incurred medical claims related to prior years result from claims being settled for amounts less than originally estimated. The prior year redundancy of $1,703 shown above for the year ended December 31, 2021 represents an estimate
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
based on paid claim activity from January 1, 2021 to December 31, 2021. Medical claim liabilities are usually described as having a “short tail,” which means that they are generally paid within twelve months of the member receiving service from the provider. Accordingly, the majority of the $1,703 redundancy relates to claims incurred in calendar year 2020.
The following table provides a summary of the two key assumptions having the most significant impact on our incurred but not paid liability estimates for the years ended December 31, 2021, 2020 and 2019, which are the completion and trend factors. These two key assumptions can be influenced by utilization levels, unit costs, mix of business, benefit plan designs, provider reimbursement levels, processing system conversions and changes, claim inventory levels, claim processing patterns, claim submission patterns and operational changes resulting from business combinations. The impact from COVID-19 on healthcare utilization and medical claims submission patterns has increased estimation uncertainty on our incurred but not reported liability at December 31, 2021. Slowdowns in claims submission patterns and increases in utilization levels for COVID-19 testing and treatment during the fourth quarter of 2021 are the primary factors that lead to the increased estimation uncertainty.
| | | | | | | | | | | | | | | | | |
| Favorable Developments by Changes in Key Assumptions |
| 2021 | | 2020 | | 2019 |
Assumed trend factors | $ | (1,429) | | | $ | (599) | | | $ | (325) | |
Assumed completion factors | (274) | | | (38) | | | (175) | |
Total | $ | (1,703) | | | $ | (637) | | | $ | (500) | |
The favorable development recognized in 2021 resulted primarily from trend factors in late 2020 developing more favorably than originally expected as well as a smaller but significant contribution from completion factor development.
The favorable development recognized in 2020 resulted primarily from trend factors in late 2019 developing more favorably than originally expected as well as a smaller contribution from completion factor development.
The favorable development recognized in 2019 resulted from trend and completion factors developing more favorably than originally expected as well as a smaller but significant contribution from completion factor development.
The reconciliation of net incurred medical claims to benefit expense included in the consolidated statements of income is as follows:
| | | | | | | | | | | | | | | | | | | | |
| | Years Ended December 31 |
| | 2021 | | 2020 | | 2019 |
Net incurred medical claims: | | | | | | |
Commercial & Specialty Business | | $ | 27,667 | | | $ | 24,519 | | | $ | 25,752 | |
Government Business | | 69,448 | | | 58,650 | | | 52,443 | |
Other | | 1,622 | | | 1,288 | | | — | |
Total net incurred medical claims | | 98,737 | | | 84,457 | | | 78,195 | |
Quality improvement and other claims expense | | 3,908 | | | 3,588 | | | 3,591 | |
Benefit expense | | $ | 102,645 | | | $ | 88,045 | | | $ | 81,786 | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
Incurred claims development, net of reinsurance, for the Commercial & Specialty Business for the years ended December 31, 2021, 2020 and 2019 is as follows:
| | | | | | | | | | | | | | | | | | | | |
Commercial & Specialty Business | | Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance |
| | 2019 | | 2020 | | |
Claim Years | | (Unaudited) | | (Unaudited) | | 2021 |
2019 & Prior | | $ | 28,328 | | | $ | 27,953 | | | $ | 28,249 | |
2020 | | | | 24,894 | | | 24,133 | |
2021 | | | | | | 28,132 | |
Total | | | | | | $ | 80,514 | |
Paid claims development, net of reinsurance, for the Commercial & Specialty Business for the years ended December 31, 2021, 2020 and 2019 is as follows:
| | | | | | | | | | | | | | | | | | | | |
Commercial & Specialty Business | | Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance |
| | 2019 | | 2020 | | |
Claim Years | | (Unaudited) | | (Unaudited) | | 2021 |
2019 & Prior | | $ | 25,303 | | | $ | 27,830 | | | $ | 28,216 | |
2020 | | | | 21,736 | | | 23,962 | |
2021 | | | | | | 24,502 | |
Total | | | | | | $ | 76,680 | |
At December 31, 2021, the total of incurred but not reported liabilities plus expected development on reported claims for the Commercial & Specialty Business was $33, $171 and $3,630 for the claim years 2019 and prior, 2020 and 2021, respectively.
At December 31, 2021, the cumulative number of reported claims for the Commercial & Specialty Business was 91, 80 and 80 for the claim years 2019 and prior, 2020 and 2021, respectively.
Incurred claims development, net of reinsurance, for the Government Business as of and for the years ended December 31, 2021, 2020 and 2019 is as follows:
| | | | | | | | | | | | | | | | | | | | |
Government Business | | Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance |
| | 2019 | | 2020 | | |
Claim Years | | (Unaudited) | | (Unaudited) | | 2021 |
2019 & Prior | | $ | 57,099 | | | $ | 56,837 | | | $ | 56,537 | |
2020 | | | | 59,053 | | | 58,131 | |
2021 | | | | | | 71,045 | |
Total | | | | | | $ | 185,713 | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
Paid claims development, net of reinsurance, for the Government Business as of and for the years ended December 31, 2021, 2020 and 2019 is as follows:
| | | | | | | | | | | | | | | | | | | | |
Government Business | | Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance |
| | 2019 | | 2020 | | |
Claim Years | | (Unaudited) | | (Unaudited) | | 2021 |
2019 & Prior | | $ | 51,510 | | | $ | 56,675 | | | $ | 56,447 | |
2020 | | | | 51,602 | | | 57,884 | |
2021 | | | | | | 62,233 | |
Total | | | | | | $ | 176,564 | |
At December 31, 2021, the total of incurred but not reported liabilities plus expected development on reported claims for the Government Business was $90, $247 and $8,812 for the claim years 2019 and prior, 2020 and 2021, respectively.
At December 31, 2021, the cumulative number of reported claims for the Government Business was 253, 263 and 300 for the claim years 2019 and prior, 2020 and 2021, respectively.
Incurred claims development, net of reinsurance, for Other as of and for the years ended December 31, 2021, 2020 and 2019 is as follows:
| | | | | | | | | | | | | | | | | | | | |
Other | | Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance |
| | 2019 | | 2020 | | |
Claim Years | | (Unaudited) | | (Unaudited) | | 2021 |
2019 & Prior | | $ | — | | | $ | — | | | $ | — | |
2020 | | | | 1,486 | | | 1,470 | |
2021 | | | | | | 1,683 | |
Total | | | | | | $ | 3,153 | |
Paid claims development, net of reinsurance, for Other as of and for the years ended December 31, 2021, 2020 and 2019 is as follows:
| | | | | | | | | | | | | | | | | | | | |
Other | | Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance |
| | 2019 | | 2020 | | |
Claim Years | | (Unaudited) | | (Unaudited) | | 2021 |
2019 & Prior | | $ | — | | | $ | — | | | $ | — | |
2020 | | | | 1,291 | | | 1,454 | |
2021 | | | | | | 1,421 | |
Total | | | | | | $ | 2,875 | |
At December 31, 2021, the total of incurred but not reported liabilities plus expected development on reported claims for Other was $0, $16 and $262 for the claim years 2019 and prior, 2020 and 2021, respectively.
At December 31, 2021, the cumulative number of reported claims for Other was 0, 28, and 25 for the claim years 2019 and prior, 2020 and 2021, respectively.
The information about incurred claims development, paid claims development and cumulative number of reported claims for the years ended December 31, 2019 and 2020 for our Commercial & Specialty Business, Government Business and Other, is unaudited and presented as supplementary information.
The cumulative number of reported claims for each claim year for our Commercial & Specialty Business, Government Business and Other have been developed using historical data captured by our claim payment systems. The provided claim
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
amounts are not a precise tool for understanding utilization of medical services. They could be impacted by a variety of factors, including changes in provider billing practices, provider reimbursement arrangements, mix of services, benefit design or processing systems. The cumulative number of reported claims has been provided to comply with FASB accounting standards and is not used by management in its claims analysis. Our cumulative number of reported claims may not be comparable to similar measures reported by other health benefits companies.
The reconciliation of the Commercial & Specialty Business, Government Business and Other incurred and paid claims development information for the three years ended December 31, 2021, reflected in the tables above, to the consolidated ending balance for medical claims payable included in the consolidated balance sheet, as of December 31, 2021, is as follows:
| | | | | | | | | | | | | | | | | | | | | | | |
| Commercial & Specialty Business | | Government Business | | Other | | Total |
Cumulative incurred claims and allocated claim adjustment expenses, net of reinsurance | $ | 80,514 | | | $ | 185,713 | | | $ | 3,153 | | | $ | 269,380 | |
Less: Cumulative paid claims and allocated claim adjustment expenses, net of reinsurance | 76,680 | | | 176,564 | | | 2,875 | | | 256,119 | |
Net medical claims payable, end of year | 3,834 | | | 9,149 | | | 278 | | | 13,261 | |
Ceded medical claims payable, end of year | 13 | | | 8 | | | — | | | 21 | |
Insurance lines other than short duration | — | | | 236 | | | — | | | 236 | |
Gross medical claims payable, end of year | $ | 3,847 | | | $ | 9,393 | | | $ | 278 | | | $ | 13,518 | |
13. Debt
Short-term Borrowings
We are a member, through certain subsidiaries, of the Federal Home Loan Bank of Indianapolis, the Federal Home Loan Bank of Cincinnati, the Federal Home Loan Bank of Atlanta and the Federal Home Loan Bank of New York, (collectively, the “FHLBs”). As a member we have the ability to obtain short-term cash advances, subject to certain minimum collateral requirements. At December 31, 2021 and 2020, $275 and $0, respectively, were outstanding under our short-term FHLB borrowings. Outstanding short-term FHLB borrowings at December 31, 2021 had fixed interest rates of 0.180%.
Through certain subsidiaries, we have entered into multiple 364-day lines of credit (the “Subsidiary Credit Facilities”) with separate lenders for general corporate purposes. The Subsidiary Credit Facilities provide combined credit of up to $200. The interest rate on each line of credit is based on the LIBOR rate plus a predetermined rate. Our ability to borrow under the lines of credit is subject to compliance with certain covenants. At each of December 31, 2021 and 2020, $0 was outstanding under our Subsidiary Credit Facilities.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
Long-term Debt
The carrying value of long-term debt at December 31, 2021 and 2020 consists of the following:
| | | | | | | | | | | |
| 2021 | | 2020 |
Senior unsecured notes: | | | |
3.700%, due 2021 | $ | — | | | $ | 700 | |
2.950%, due 2022 | 749 | | | 749 | |
3.125%, due 2022 | 850 | | | 848 | |
3.300%, due 2023 | 1,014 | | | 1,027 | |
0.450%, due 2023 | 499 | | | — | |
3.350%, due 2024 | 848 | | | 847 | |
3.500%, due 2024 | 797 | | | 796 | |
2.375%, due 2025 | 1,253 | | | 1,253 | |
1.500%, due 2026 | 745 | | | — | |
3.650%, due 2027 | 1,592 | | | 1,591 | |
4.101%, due 2028 | 1,251 | | | 1,257 | |
2.875%, due 2029 | 820 | | | 819 | |
2.250%, due 2030 | 1,089 | | | 1,089 | |
2.550%, due 2031 | 992 | | | — | |
5.950%, due 2034 | 334 | | | 334 | |
5.850%, due 2036 | 396 | | | 396 | |
6.375%, due 2037 | 364 | | | 366 | |
5.800%, due 2040 | 114 | | | 114 | |
4.625%, due 2042 | 859 | | | 873 | |
4.650%, due 2043 | 974 | | | 978 | |
4.650%, due 2044 | 767 | | | 779 | |
5.100%, due 2044 | 548 | | | 565 | |
4.375%, due 2047 | 1,387 | | | 1,387 | |
4.550%, due 2048 | 839 | | | 839 | |
3.700%, due 2049 | 812 | | | 811 | |
3.125%, due 2050 | 987 | | | 987 | |
3.600%, due 2051 | 1,232 | | | — | |
4.850%, due 2054 | 247 | | | 247 | |
Surplus note: | | | |
9.000%, due 2027 | 25 | | | 25 | |
Senior convertible debentures: | | | |
2.750%, due 2042 | 72 | | | 108 | |
Variable rate debt: | | | |
Commercial paper program | 300 | | | 250 | |
Total long-term debt | 22,756 | | | 20,035 | |
Current portion of long-term debt | (1,599) | | | (700) | |
Long-term debt, less current portion | $ | 21,157 | | | $ | 19,335 | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
All debt is a direct obligation of Anthem, Inc., except for the surplus note, the FHLB borrowings and the Subsidiary Credit Facilities.
We generally issue senior unsecured notes (“Notes”) for long-term borrowing purposes. Certain of these Notes may have a call feature that allows us to redeem the Notes at any time at our option and/or a put feature that allows a Note holder to redeem the Notes upon the occurrence of both a change in control event and a downgrade of the Notes below an investment grade rating.
On May 15, 2021, we redeemed the $700 outstanding principal balance of our 3.700% Notes due August 15, 2021 at a redemption price equal to 100% of the aggregate principal amount of the notes being redeemed, plus accrued and unpaid interest.
On March 17, 2021, we issued $500 aggregate principal amount of 0.450% Notes due 2023 (the “2023 Notes”), $750 aggregate principal amount of 1.500% Notes due 2026 (the “2026 Notes”), $1,000 aggregate principal amount of 2.550% Notes due 2031 (the “2031 Notes”) and $1,250 aggregate principal amount of 3.600% Notes due 2051 (the “2051 Notes”) under our shelf registration statement. Interest on the 2023 Notes, 2026 Notes, 2031 Notes and 2051 Notes is payable semiannually in arrears on March 15 and September 15 of each year, commencing September 15, 2021. We used the net proceeds for working capital and general corporate purposes, including, but not limited to, the funding of acquisitions, repayment of short-term and long-term debt and the repurchase of our common stock pursuant to our share repurchase program.
Additionally, during the year ended December 31, 2021, we repurchased $52 of outstanding principal amount of certain other senior unsecured notes, plus applicable premium for early redemption plus accrued and unpaid interest, for cash totaling $67. We recognized a loss on extinguishment of debt of $15 for the repurchase of these notes.
On November 23, 2020, we repaid, at maturity, the $900 outstanding balance of our 2.500% senior unsecured notes. On August 17, 2020, we repaid, at maturity, the $700 outstanding balance of our 4.350% senior unsecured notes.
Additionally, during the year ended December 31, 2020, we repurchased $79 of outstanding principal amount of certain other senior unsecured notes, plus applicable premium for early redemption plus accrued and unpaid interest, for cash totaling $109. We recognized a loss on extinguishment of debt of $30 for the repurchase of these notes.
On May 5, 2020, we issued $400 aggregate principal amount of additional senior notes pursuant to a reopening of our existing 2.375% Notes due 2025 (the “2025 Notes”), $1,100 aggregate principal amount of 2.250% Notes due 2030 (the “2030 Notes”), and $1,000 aggregate principal amount of 3.125% Notes due 2050 (the “2050 Notes”) under our shelf registration statement. The 2025 Notes constitute an additional issuance of our 2.375% notes due 2025, of which $850 aggregate principal amount was issued on September 9, 2019. Interest on the 2025 Notes is deemed to have accrued from January 15, 2020 and is payable semi-annually in arrears on January 15 and July 15 of each year, commencing July 15, 2020. Interest on the 2030 Notes and 2050 Notes is payable semi-annually in arrears on May 15 and November 15 of each year, commencing November 15, 2020. The proceeds were used for working capital and general corporate purposes, including, but not limited to, repayment of short-term and long-term debt, repurchase of our common stock pursuant to our share repurchase program and to fund acquisitions.
On September 9, 2019, we issued $850 aggregate principal amount of the 2025 Notes, $825 aggregate principal amount of 2.875% Notes due 2029 (the “2029 Notes”), and $825 aggregate principal amount of 3.700% Notes due 2049 (the “2049 Notes”) under our shelf registration statement. Interest on the 2025 Notes is payable semi-annually in arrears on January 15 and July 15 of each year, commencing January 15, 2020. Interest on the 2029 Notes and the 2049 Notes is payable semi-annually in arrears on March 15 and September 15 each year, commencing March 15, 2020. The proceeds were used for working capital and general corporate purposes, including, but not limited to, the repurchase of our common stock pursuant to our share repurchase program, repayment of short-term and long-term debt and to fund acquisitions.
On August 15, 2019, we repaid, at maturity, the $850 outstanding balance of our 2.250% senior unsecured notes.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
The surplus note is an unsecured obligation of Anthem Insurance Companies, Inc. (“Anthem Insurance”), a wholly owned subsidiary, and is subordinate in right of payment to all of Anthem Insurance’s existing and future indebtedness. Any payment of interest or principal on the surplus note may be made only with the prior approval of the Indiana Department of Insurance (“IDOI”) and only out of capital and surplus funds of Anthem Insurance that the IDOI determines to be available for the payment under Indiana insurance laws.
We have a senior revolving credit facility (the “5-Year Facility”) with a group of lenders for general corporate purposes. The 5-Year Facility provides credit up to $2,500 and matures in June 2024. On June 3, 2021, we terminated our 364-day senior revolving credit facility, which was scheduled to mature in June 2021 (the “prior 364-Day Facility”), and entered into a new 364-day senior revolving credit facility (the “new 364-Day Facility,” and together with the 5-Year Facility, the “Credit Facilities”) with a group of lenders for general corporate purposes. The new 364-Day Facility provides for credit in the amount of $1,000 and matures in June 2022. Our ability to borrow under these credit facilities is subject to compliance with certain covenants, including covenants requiring us to maintain a defined debt-to-capital ratio of not more than 60%, subject to increase in certain circumstances set forth in the applicable credit agreement. As of December 31, 2021, our debt-to-capital ratio, as defined and calculated under the credit facilities, was 38.9%. We do not believe the restrictions contained in any of our credit facility covenants materially affect our financial or operating flexibility. As of December 31, 2021, we were in compliance with all of the debt covenants under these credit facilities. There were no amounts outstanding under the prior 364-Day Facility or the new 364-day Facility at any time during the years ended December 31, 2021 or the year ended December 31, 2020. At December 31, 2021 and December 31, 2020, there were no amounts outstanding under our 5-Year Facility.
We have an authorized commercial paper program of up to $3,500, the proceeds of which may be used for general corporate purposes. At December 31, 2021, we had $300 outstanding under our commercial paper program with a weighted-average interest rate of 0.150%. At December 31, 2020, we had $250 outstanding under our commercial paper program with a weighted-average interest rate of 0.160%. Commercial paper borrowings have been classified as long-term debt at December 31, 2021 and 2020, as our general practice and intent is to replace short-term commercial paper outstanding at expiration with additional short-term commercial paper for an uninterrupted period extending for more than one year, and we have the ability to redeem our commercial paper with borrowings under the senior revolving credit facilities described above.
Convertible Debentures
On October 9, 2012, we issued $1,500 of senior convertible debentures (the “Debentures”) in a private offering to qualified institutional buyers pursuant to Rule 144A under the Securities Act of 1933, as amended (the “Securities Act”). The Debentures are governed by an indenture dated as of October 9, 2012 between us and The Bank of New York Mellon Trust Company, N.A., as trustee (the “Indenture”). The Debentures bear interest at a rate of 2.750% per year, payable semi-annually in arrears in cash on April 15 and October 15 of each year, and mature on October 15, 2042, unless earlier redeemed, repurchased or converted into shares of common stock at the applicable conversion rate. The Debentures also have a contingent interest feature that will require us to pay additional interest based on certain thresholds and for certain events, as defined in the Indenture, beginning on October 15, 2022.
Holders may convert their Debentures at their option prior to the close of business on the business day immediately preceding April 15, 2042, only under the following circumstances: (1) during any fiscal quarter if the last reported sale price of our common stock for at least 20 trading days during a period of 30 consecutive trading days ending on the last trading day of the preceding fiscal quarter is greater than or equal to 130% of the applicable conversion price on each applicable trading day; (2) during the five business day period after any 10 consecutive trading day period (the “measurement period”) in which the trading price per $1,000 (whole dollars) principal amount of Debentures for each trading day of that measurement period was less than 98% of the product of the last reported sale price of our common stock and the applicable conversion rate on each such day; (3) if we call any or all of the Debentures for redemption, at any time prior to the close of business on the third scheduled trading day prior to the redemption date; or (4) upon the occurrence of specified corporate events, as defined in the Indenture. On and after April 15, 2042 and until the close of business on the third scheduled trading day immediately preceding the Debentures’ maturity date of October 15, 2042, holders may convert their Debentures into common stock at any time irrespective of the preceding circumstances. The Debentures are redeemable at our option at any time on or after October 20, 2022, upon the occurrence of certain events, as defined in the Indenture.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
Upon conversion of the Debentures, we will deliver cash up to the aggregate principal amount of the Debentures converted. With respect to any conversion obligation in excess of the aggregate principal amount of the Debentures converted, we have the option to settle the excess with cash, shares of our common stock or a combination thereof based on a daily conversion value, determined in accordance with the Indenture. The initial conversion rate for the Debentures was 13.2319 shares of our common stock per Debenture, which represented a 25% conversion premium based on the closing price of $60.46 per share of our common stock on October 2, 2012 (the date the Debentures’ terms were finalized) and is equivalent to an initial conversion price of $75.575 per share of our common stock.
During the year ended December 31, 2021, $54 aggregate principal amount of the Debentures was surrendered for conversion by certain holders in accordance with the terms and provisions of the Indenture. We elected to settle the excess of the principal amount of the conversions with cash for total payments of $302. We recognized a loss on the extinguishment of debt related to the Debentures of $6, based on the fair values of the debt on the conversion settlement dates. During the year ended December 31, 2020, $56 aggregate principal amount of the Debentures was surrendered for conversion by certain holders in accordance with the terms and provisions of the Indenture. We elected to settle the excess of the principal amount of the conversions with cash for total payments of $222. We recognized a loss on the extinguishment of debt related to the Debentures of $6, based on the fair values of the debt on the conversion settlement dates. During the year ended December 31, 2019, we repurchased $15 of the aggregate principal balance of the Debentures. In addition, $57 aggregate principal amount of the Debentures was surrendered for conversion by certain holders in accordance with the terms and provisions of the Indenture. We elected to settle the excess of the principal amount of the repurchases and conversions with cash for total payments of $273. We recognized a loss on the extinguishment of debt related to the Debentures of $2.
As of December 31, 2021, our common stock was last traded at a price of $463.54 per share. If the remaining Debentures had been converted or matured at December 31, 2021, we would have been obligated to pay the principal of the Debentures plus an amount in cash or shares equal to $584. The Debentures and underlying shares of our common stock have not been and will not be registered under the Securities Act, or any state securities laws, and may not be offered or sold in the United States absent registration or an applicable exemption from registration requirements.
We have accounted for the Debentures in accordance with the cash conversion guidance in FASB guidance for debt with conversion and other options. As a result, the value of the embedded conversion option, net of deferred taxes and equity issuance costs, has been bifurcated from its debt host and recorded as a component of additional paid-in capital in our consolidated balance sheets.
The following table summarizes, at December 31, 2021, the related balances, conversion rate and conversion price of the Debentures:
| | | | | |
Outstanding principal amount | $ | 105 | |
Unamortized debt discount | $ | 32 | |
Net debt carrying amount | $ | 72 | |
Equity component carrying amount | $ | 38 | |
Conversion rate (shares of common stock per $1,000 of principal amount) | 14.2080 | |
Effective conversion price (per $1,000 of principal amount) | $ | 70.3829 | |
The remaining amortization period of the unamortized debt discount as of December 31, 2021 is approximately 21 years. The unamortized discount will be amortized into interest expense using the effective interest method based on an effective interest rate of 5.130%, which represents the market interest rate for a comparable debt instrument that does not have a conversion feature. During the years ended December 31, 2021, 2020 and 2019, we recognized $4, $6 and $9, respectively, of interest expense related to the Debentures, of which $3, $5 and $7, respectively, represented interest expense recognized at the stated interest rate of 2.750% and $1, $1 and $2, respectively, represented interest expense resulting from amortization of the debt discount.
Interest paid on our total outstanding debt during 2021, 2020 and 2019 was $822, $794, and $755, respectively.
We were in compliance with all applicable covenants under all of our outstanding debt agreements at December 31, 2021 and 2020.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
Future maturities of all long-term debt outstanding at December 31, 2021 are as follows: 2022, $1,899; 2023, $1,513; 2024, $1,645; 2025, $1,253; 2026, $745 and thereafter, $15,701.
14. Commitments and Contingencies
Litigation and Regulatory Proceedings
In the ordinary course of business, we are defendants in, or parties to, a number of pending or threatened legal actions or proceedings. To the extent a plaintiff or plaintiffs in the following cases have specified in their complaint or in other court filings the amount of damages being sought, we have noted those alleged damages in the descriptions below. With respect to the cases described below, we contest liability and/or the amount of damages in each matter and believe we have meritorious defenses.
Where available information indicates that it is probable that a loss has been incurred as of the date of the consolidated financial statements and we can reasonably estimate the amount of that loss, we accrue the estimated loss by a charge to income. In many proceedings, however, it is difficult to determine whether any loss is probable or reasonably possible. In addition, even where loss is possible or an exposure to loss exists in excess of the liability already accrued with respect to a previously identified loss contingency, it is not always possible to reasonably estimate the amount of the possible loss or range of loss.
With respect to many of the proceedings to which we are a party, we cannot provide an estimate of the possible losses, or the range of possible losses in excess of the amount, if any, accrued, for various reasons, including but not limited to some or all of the following: (i) there are novel or unsettled legal issues presented, (ii) the proceedings are in early stages, (iii) there is uncertainty as to the likelihood of a class being certified or decertified or the ultimate size and scope of the class, (iv) there is uncertainty as to the outcome of pending appeals or motions, (v) there are significant factual issues to be resolved, and/or (vi) in many cases, the plaintiffs have not specified damages in their complaint or in court filings. For those legal proceedings where a loss is probable, or reasonably possible, and for which it is possible to reasonably estimate the amount of the possible loss or range of losses, we currently believe that the range of possible losses, in excess of established reserves is, in the aggregate, from $0 to approximately $250 at December 31, 2021. This estimated aggregate range of reasonably possible losses is based upon currently available information taking into account our best estimate of such losses for which such an estimate can be made.
Blue Cross Blue Shield Antitrust Litigation
We are a defendant in multiple lawsuits that were initially filed in 2012 against the BCBSA and Blue Cross and/or Blue Shield licensees (the “Blue plans”) across the country. Cases filed in twenty-eight states were consolidated into a single, multi-district proceeding captioned In re Blue Cross Blue Shield Antitrust Litigation that is pending in the United States District Court for the Northern District of Alabama (the “Court”). Generally, the suits allege that the BCBSA and the Blue plans have conspired to horizontally allocate geographic markets through license agreements, best efforts rules that limit the percentage of non-Blue revenue of each plan, restrictions on acquisitions, rules governing the BlueCard® and National Accounts programs and other arrangements in violation of the Sherman Antitrust Act (“Sherman Act”) and related state laws. The cases were brought by two putative nationwide classes of plaintiffs, health plan subscribers and providers.
In April 2018, the Court issued an order on the parties’ cross motions for partial summary judgment, determining that the defendants’ aggregation of geographic market allocations and output restrictions are to be analyzed under a per se standard of review, and the BlueCard® program and other alleged Section 1 Sherman Act violations are to be analyzed under the rule of reason standard of review. The Court also found that there remain genuine issues of material fact as to whether the defendants operate as a single entity with regard to the enforcement of the Blue Cross Blue Shield trademarks. In April 2019, the plaintiffs filed motions for class certification, which defendants opposed.
The BCBSA and Blue plans have approved a settlement agreement and release (the “Subscriber Settlement Agreement”) with the subscriber plaintiffs. If approved by the Court, the Subscriber Settlement Agreement will require the defendants to make a monetary settlement payment, our portion of which is estimated to be $594, and will contain certain terms imposing non-monetary obligations including (i) eliminating the “national best efforts” rule in the BCBSA license agreements (which rule limits the percentage of non-Blue revenue permitted for each Blue plan) and (ii) allowing for some large national employers with self-funded benefit plans to request a bid for insurance coverage from a second Blue plan in addition to the
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
local Blue plan. As of December 31, 2021, the liability balance accrued for our estimated payment obligation was $507, net of payments made.
In November 2020, the Court issued an order preliminarily approving the Subscriber Settlement Agreement, following which members of the subscriber class were provided notice of the Subscriber Settlement Agreement and an opportunity to opt out of the class. All terms of the Subscriber Settlement Agreement are subject to final approval by the Court. The deadline for objections to the settlement as well as the deadline for those who wish to opt-out from the settlement was in July 2021 and a small number of subscribers submitted valid opt outs by the deadline. The claims deadline was in November 2021 and in excess of eight thousand claims were submitted. A final approval hearing was held in October 2021. The Court took the request for approval under advisement and requested supplemental briefing that has been submitted. If the Court grants approval of the Subscriber Settlement Agreement, and after all appellate rights have expired or have been exhausted in a manner that affirms the Court’s final order and judgment, the defendants’ payment and non-monetary obligations under the Subscriber Settlement Agreement will become effective.
In October 2020, after the Court lifted the stay as to the provider litigation, provider plaintiffs filed a renewed motion for class certification, which defendants opposed. In March 2021, the Court issued an order terminating the pending motion for class certification until the Court determines the standard of review applicable to providers’ claims. In May 2021, the defendants and provider plaintiffs filed renewed standard of review motions, which are now fully briefed. In June 2021, the parties filed summary judgment motions not critically dependent on class certification, which are now fully briefed and no decision has been rendered. We intend to continue to vigorously defend the provider suit, which we believe is without merit; however, its ultimate outcome cannot be presently determined.
Blue Cross of California Taxation Litigation
In July 2013, our California affiliate Blue Cross of California (doing business as Anthem Blue Cross) (“BCC”) was named as a defendant in a California taxpayer action filed in Los Angeles County Superior Court (the “Superior Court”) captioned Michael D. Myers v. State Board of Equalization, et al. This action was brought under a California statute that permits an individual taxpayer to sue a governmental agency when the taxpayer believes the agency has failed to enforce governing law. Plaintiff contends that BCC, a licensed Health Care Service Plan, is an “insurer” for purposes of taxation despite acknowledging it is not an “insurer” under regulatory law. At the time, under California law, “insurers” were required to pay a gross premiums tax (“GPT”) calculated as 2.35% on gross premiums. As a licensed Health Care Service Plan, BCC has paid the California Corporate Franchise Tax (“CFT”), the tax paid by California businesses generally. Plaintiff contends that BCC must pay the GPT rather than the CFT, and seeks a writ of mandate directing the taxing agencies to collect the GPT and an order requiring BCC to pay GPT back taxes, interest, and penalties for the eight-year period prior to the filing of the complaint.
Because the GPT is constitutionally imposed in lieu of certain other taxes, BCC has filed protective tax refund claims with the City of Los Angeles, the California Department of Health Care Services and the Franchise Tax Board to protect its rights to recover certain taxes previously paid should BCC eventually be determined to be subject to the GPT for the tax periods at issue in the litigation.
In March 2018, the Superior Court denied BCC's motion for judgment on the pleadings and similar motions brought by other entities. BCC filed a motion for summary judgment with the Superior Court, which was heard in October 2020. In December 2020, the Superior Court granted BCC’s motion for summary judgment, dismissing the plaintiff's lawsuit. In November 2021, the plaintiff appealed the order granting our motion for summary judgment. Our responding brief is due in February 2022. We estimate that the appeal will be heard some time in 2022. We intend to vigorously defend the appeal of this lawsuit.
Express Scripts, Inc. Pharmacy Benefit Management Litigation
In March 2016, we filed a lawsuit against Express Scripts, Inc. (“Express Scripts”), our vendor at the time for PBM services, captioned Anthem, Inc. v. Express Scripts, Inc., in the U.S. District Court for the Southern District of New York. The lawsuit seeks to recover over $14,800 in damages for pharmacy pricing that is higher than competitive benchmark pricing under the agreement between the parties (the “ESI PBM Agreement”), over $158 in damages related to operational breaches, as well as various declarations under the ESI PBM Agreement, including that Express Scripts: (i) breached its obligation to negotiate in good faith and to agree in writing to new pricing terms; (ii) was required to provide competitive
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
benchmark pricing to us through the term of the ESI PBM Agreement; (iii) has breached the ESI PBM Agreement; and (iv) is required under the ESI PBM Agreement to provide post-termination services, at competitive benchmark pricing, for one year following any termination.
Express Scripts has disputed our contractual claims and is seeking declaratory judgments: (i) regarding the timing of the periodic pricing review under the ESI PBM Agreement, and (ii) that it has no obligation to ensure that we receive any specific level of pricing, that we have no contractual right to any change in pricing under the ESI PBM Agreement and that its sole obligation is to negotiate proposed pricing terms in good faith. In the alternative, Express Scripts claims that we have been unjustly enriched by its payment of $4,675 at the time we entered into the ESI PBM Agreement. In March 2017, the court granted our motion to dismiss Express Scripts’ counterclaims for (i) breach of the implied covenant of good faith and fair dealing, and (ii) unjust enrichment with prejudice. The only remaining claims are for breach of contract and declaratory relief. In August 2021, Express Scripts filed a motion for summary judgment, which we opposed. Express Scripts’ motion for summary judgment is now fully briefed and no decision has been rendered. We intend to vigorously pursue our claims and defend against any counterclaims, which we believe are without merit; however, the ultimate outcome cannot be presently determined.
In re Express Scripts/Anthem ERISA Litigation
We are a defendant in a class action lawsuit that was initially filed in June 2016 against Anthem, Inc. and Express Scripts, which has been consolidated into a single multi-district lawsuit captioned In Re Express Scripts/Anthem ERISA Litigation, in the U.S. District Court for the Southern District of New York. The consolidated complaint was filed by plaintiffs against Express Scripts and us on behalf of all persons who are participants in or beneficiaries of any ERISA or non-ERISA healthcare plan from December 1, 2009 to December 31, 2019 in which we provided prescription drug benefits through the ESI PBM Agreement and paid a percentage based co-insurance payment in the course of using that prescription drug benefit. The plaintiffs allege that we breached our duties, either under ERISA or with respect to the implied covenant of good faith and fair dealing implied in the health plans, (i) by failing to adequately monitor Express Scripts’ pricing under the ESI PBM Agreement, (ii) by placing our own pecuniary interest above the best interests of our insureds by allegedly agreeing to higher pricing in the ESI PBM Agreement in exchange for the purchase price for our NextRx PBM business, and (iii) with respect to the non-ERISA members, by negotiating and entering into the ESI PBM Agreement that was allegedly detrimental to the interests of such non-ERISA members. Plaintiffs seek to hold us and Express Scripts jointly and severally liable and to recover all losses suffered by the proposed class, equitable relief, disgorgement of alleged ill-gotten gains, injunctive relief, attorney’s fees and costs and interest.
In April 2017, we filed a motion to dismiss the claims brought against us, and it was granted, without prejudice, in January 2018. Plaintiffs pursued an appeal with the United States Court of Appeals for the Second Circuit (the “Second Circuit”). In December 2020, the Second Circuit affirmed the trial court’s order dismissing the ERISA complaint. Plaintiffs filed a Petition for Rehearing and Rehearing En Banc, which was denied. Plaintiffs filed a writ of certiorari with the United States Supreme Court, which we opposed. In December 2021, the United States Supreme Court requested that the Solicitor General submit a brief “expressing the views of the United States” as to whether the Court should grant plaintiffs’ writ. We intend to vigorously defend this suit, which we believe is without merit; however, its ultimate outcome cannot be presently determined.
Medicare Risk Adjustment Litigation
In March 2020, the U.S. Department of Justice (“DOJ”) filed a civil lawsuit against Anthem, Inc. in the U.S. District Court for the Southern District of New York in a case captioned United States v. Anthem, Inc. The DOJ’s suit alleges, among other things, that we falsely certified the accuracy of the diagnosis data we submitted to the Centers for Medicare and Medicaid Services (“CMS”) for risk-adjustment purposes under Medicare Part C and knowingly failed to delete inaccurate diagnosis codes. The DOJ further alleges that, as a result of these purported acts, we caused CMS to calculate the risk-adjustment payments based on inaccurate diagnosis information, which enabled us to obtain unspecified amounts of payments in Medicare funds in violation of the False Claims Act. The DOJ filed an amended complaint in July 2020, alleging the same causes of action but revising some of its allegations. In September 2020, we filed a motion to transfer the lawsuit to the Southern District of Ohio, a motion to dismiss part of the lawsuit, and a motion to strike certain allegations in the amended complaint. The motions are fully briefed and no decision has been rendered. We intend to continue to vigorously defend this suit, which we believe is without merit; however, the ultimate outcome cannot be presently determined.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
Investigations of CareMore and HealthSun
With the assistance of outside counsel, we are conducting investigations of risk-adjustment practices involving data submitted to CMS (unrelated to our retrospective chart review program) at CareMore Health Plans, Inc. (“CareMore”), one of our California subsidiaries, and HealthSun Health Plans, Inc. (“HealthSun”), one of our Florida subsidiaries. Our CareMore investigation has resulted in the termination of CareMore’s relationship with one contracted provider in California. Our HealthSun investigation has focused on risk adjustment practices initiated prior to our acquisition of HealthSun in December 2017 that continued after the acquisition. We have voluntarily self-disclosed the existence of both of our investigations to CMS and the Criminal and Civil Divisions of the DOJ. We are cooperating with the ongoing investigations of the Criminal and Civil Divisions of the DOJ related to these risk adjustment practices, and have entered into a tolling agreement with the Civil Division of the DOJ related to its investigation. We are analyzing the scope of potential data corrections to be submitted to CMS and have begun to submit data corrections to CMS. We have also asserted indemnity claims for escrowed funds under the HealthSun purchase agreement for, among other things, breach of healthcare and financial representation provisions, based on the conduct discovered during our investigation. In the fourth quarter of 2021, we resolved matters with both groups of sellers related to our indemnity claims for escrowed funds under the HealthSun purchase agreement based on conduct discovered during our investigation.
Other Contingencies
From time to time, we and certain of our subsidiaries are parties to various legal proceedings, many of which involve claims for coverage encountered in the ordinary course of business. We, like Health Maintenance Organizations (“HMOs”) and health insurers generally, exclude certain healthcare and other services from coverage under our HMO, Preferred Provider Organizations and other plans. We are, in the ordinary course of business, subject to the claims of our enrollees arising out of decisions to restrict or deny reimbursement for uncovered services. The loss of even one such claim, if it results in a significant punitive damage award, could have a material adverse effect on us. In addition, the risk of potential liability under punitive damage theories may increase significantly the difficulty of obtaining reasonable reimbursement of coverage claims.
In addition to the lawsuits described above, we are also involved in other pending and threatened litigation of the character incidental to our business, and are from time to time involved as a party in various governmental investigations, audits, reviews and administrative proceedings. These investigations, audits, reviews and administrative proceedings include routine and special inquiries by state insurance departments, state attorneys general, the U.S. Attorney General and subcommittees of the U.S. Congress. Such investigations, audits, reviews and administrative proceedings could result in the imposition of civil or criminal fines, penalties, other sanctions and additional rules, regulations or other restrictions on our business operations. Any liability that may result from any one of these actions, or in the aggregate, could have a material adverse effect on our consolidated financial position or results of operations.
Contractual Obligations and Commitments
In March 2020, we entered into an agreement with a vendor for information technology infrastructure and related management and support services through June 2025. The new agreement supersedes certain prior agreements for such services and includes provisions for additional services not provided under those agreements. Our remaining commitment under this agreement at December 31, 2021 is approximately $1,051. We will have the ability to terminate the agreement upon the occurrence of certain events, subject to early termination fees.
In the second quarter of 2019, we began using our pharmacy benefits manager IngenioRx to market and offer PBM services to our affiliated health plan customers, as well as to external customers outside of the health plans we own. The comprehensive prescription benefits management services portfolio includes, but is not limited to, formulary management, pharmacy networks, prescription drug database, member services and mail order capabilities. IngenioRx delegates certain PBM administrative functions, such as claims processing and prescription fulfillment, to CaremarkPCS Health, L.L.C., which is a subsidiary of CVS Health Corporation, pursuant to a five-year agreement. With IngenioRx, we retain the responsibilities for clinical and formulary strategy and development, member and employer experiences, operations, sales, marketing, account management and retail network strategy.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
Vulnerability from Concentrations
Financial instruments that potentially subject us to concentrations of credit risk consist primarily of cash equivalents, investment securities, premium receivables and instruments held through hedging activities. All investment securities are managed by professional investment managers within policies authorized by our Board of Directors. Such policies limit the amounts that may be invested in any one issuer and prescribe certain investee company criteria. Concentrations of credit risk with respect to premium receivables are limited due to the large number of employer groups that constitute our customer base in the states in which we conduct business. As of December 31, 2021, there were no significant concentrations of financial instruments in a single investee, industry or geographic location.
15. Capital Stock
Stock Incentive Plans
Our Board of Directors has adopted the 2017 Anthem Incentive Compensation Plan (“2017 Incentive Plan”), which has been approved by our shareholders. The term of the 2017 Incentive Plan is such that no awards may be granted on or after May 18, 2027. The 2017 Incentive Plan gives authority to the Compensation Committee of the Board of Directors to make incentive awards to our non-employee directors, employees and consultants, consisting of stock options, stock, restricted stock, restricted stock units, cash-based awards, stock appreciation rights, performance shares and performance units. The 2017 Incentive Plan limits the number of available shares for issuance to 37.5 shares, subject to adjustment as set forth in the 2017 Incentive Plan.
Stock options are granted for a fixed number of shares with an exercise price at least equal to the fair value of the shares at the grant date. Stock options vest over three years in equal annual installments and generally have a term of ten years from the grant date.
Certain option grants contain provisions whereby the employee continues to vest in the award subsequent to termination due to retirement. Our attribution method for newly granted awards considers all vesting and other provisions, including retirement eligibility, in determining the requisite service period over which the fair value of the awards will be recognized.
Awards of restricted stock or restricted stock units are issued at the fair value of the stock on the grant date and may also include one or more performance measures that must be met for the award to vest. For restricted stock or restricted stock units without performance measures, the restrictions lapse in three equal annual installments. Restricted stock or restricted stock units with performance measures vest in three year installments. Performance units issued in 2021 will vest in 2024, based on certain revenue and earnings targets over the three year period of 2021 to 2023. Performance units issued in 2020 will vest in 2023, based on certain revenue and earnings targets over the three year period of 2020 to 2022. Performance units issued in 2019 will vest in 2022, based on certain revenue and earnings targets over the three year period of 2019 to 2021.
For the years ended December 31, 2021, 2020 and 2019, we recognized share-based compensation expense of $255, $283 and $294, respectively, as well as related tax benefits of $65, $74 and $78, respectively.
A summary of stock option activity for the year ended December 31, 2021 is as follows:
| | | | | | | | | | | | | | | | | | | | | | | |
| Number of Shares | | Weighted-Average Option Price per Share | | Weighted-Average Remaining Contractual Life (Years) | | Aggregate Intrinsic Value |
Outstanding at January 1, 2021 | 3.1 | | | $ | 230.00 | | | | | |
Granted | 0.7 | | | 315.30 | | | | | |
Exercised | (0.7) | | | 201.05 | | | | | |
Forfeited or expired | (0.2) | | | 287.81 | | | | | |
Outstanding at December 31, 2021 | 2.9 | | | 255.50 | | | 6.78 | | $ | 599 | |
Exercisable at December 31, 2021 | 1.5 | | | 215.40 | | | 5.45 | | $ | 364 | |
The intrinsic value of options exercised during the years ended December 31, 2021, 2020 and 2019 amounted to $121, $147 and $188, respectively. We recognized tax benefits of $32, $40 and $52 during the years ended December 31, 2021,
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
2020 and 2019, respectively, from option exercises and disqualifying dispositions. During the years ended December 31, 2021, 2020 and 2019, we received cash of $148, $129 and $143, respectively, from exercises of stock options.
The total fair value of restricted stock awards that vested during the years ended December 31, 2021, 2020 and 2019 was $287, $335 and $245, respectively.
A summary of the status of nonvested restricted stock activity, including restricted stock units and performance units, for the year ended December 31, 2021 is as follows:
| | | | | | | | | | | |
| Restricted Stock Shares and Units | | Weighted-Average Grant Date Fair Value per Share |
Nonvested at January 1, 2021 | 1.3 | | | $ | 272.51 | |
Granted | 1.0 | | | 317.70 | |
Vested | (0.9) | | | 245.48 | |
Forfeited | (0.1) | | | 290.87 | |
Nonvested at December 31, 2021 | 1.3 | | | 299.65 | |
During the year ended December 31, 2021, we granted approximately 0.3 restricted stock units that are contingent upon us achieving certain revenue and earnings targets over the three year period of 2021 to 2023. These grants have been included in the activity shown above, but will be subject to adjustment at the end of 2023, based on results in the three year period.
As of December 31, 2021, the total remaining unrecognized compensation expense related to nonvested stock options and restricted stock, including restricted stock units and performance units, amounted to $33 and $165, respectively, which will be amortized over the weighted-average remaining requisite service periods of 10 months and 13 months, respectively.
As of December 31, 2021, there were approximately 15.8 shares of common stock available for future grants under the 2017 Incentive Plan.
Fair Value
We use a binomial lattice valuation model to estimate the fair value of all stock options granted. Expected volatility assumptions used in the binomial lattice model are based on an analysis of implied volatilities of publicly traded options on our stock and historical volatility of our stock price. The risk-free interest rate is derived from the U.S. Treasury strip rates at the time of the grant. The expected term of the options was derived from the outputs of the binomial lattice model, which incorporates post-vesting forfeiture assumptions based on an analysis of historical data. The dividend yield was based on our estimate of future dividend yields. Similar groups of employees that have dissimilar exercise behavior are considered separately for valuation purposes. We utilize the multiple-grant approach for recognizing compensation expense associated with each separately vesting portion of the share-based award.
The following weighted-average assumptions were used to estimate the fair values of options granted during the years ended December 31, 2021, 2020 and 2019:
| | | | | | | | | | | | | | | | | |
| 2021 | | 2020 | | 2019 |
Risk-free interest rate | 1.44 | % | | 1.30 | % | | 2.69 | % |
Volatility factor | 30.00 | % | | 26.00 | % | | 25.00 | % |
Dividend yield (annual) | 1.50 | % | | 1.40 | % | | 1.00 | % |
Weighted-average expected life (years) | 5.50 | | 4.30 | | 4.40 |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
The following weighted-average fair values were determined for the years ending December 31, 2021, 2020 and 2019:
| | | | | | | | | | | | | | | | | |
| 2021 | | 2020 | | 2019 |
Options granted during the year | $ | 79.91 | | | $ | 54.05 | | | $ | 68.66 | |
Restricted stock awards granted during the year | 317.70 | | | 272.37 | | | 305.88 | |
The binomial lattice option-pricing model requires the input of highly subjective assumptions including the expected stock price volatility. Because our stock option grants have characteristics significantly different from those of traded options, and because changes in the subjective input assumptions can materially affect the fair value estimate, in our opinion, existing models do not necessarily provide a reliable single measure of the fair value of our stock option grants.
Employee Stock Purchase Plan
We have registered 14.0 shares of common stock for the Employee Stock Purchase Plan (the “Stock Purchase Plan”), which is intended to provide a means to encourage and assist employees in acquiring a stock ownership interest in Anthem. Pursuant to the terms of the Stock Purchase Plan, an eligible employee is permitted to purchase no more than $25,000 (actual dollars) worth of stock in any calendar year, based on the fair value of the stock at the end of each plan quarter. Employees become participants by electing payroll deductions from 1% to 15% of gross compensation. Once purchased, the stock is accumulated in the employee’s investment account. The Stock Purchase Plan allows participants to purchase shares of our common stock at a discounted price per share of 90% of the fair value of a share of common stock on the lower of the first or last trading day of the plan quarter purchase period. The Stock Purchase Plan discount was recognized as compensation expense for the year ended December 31, 2021, based on GAAP guidance. There were 0.1 shares issued during the year ended December 31, 2021. As of December 31, 2021, 4.5 shares were available for issuance under the Stock Purchase Plan.
Use of Capital and Stock Repurchase Program
We regularly review the appropriate use of capital, including acquisitions, common stock and debt security repurchases and dividends to shareholders. The declaration and payment of any dividends or repurchases of our common stock or debt is at the discretion of our Board of Directors and depends upon our financial condition, results of operations, future liquidity needs, regulatory and capital requirements and other factors deemed relevant by our Board of Directors.
A summary of the cash dividend activity for the years ended December 31, 2021 and 2020 is as follows:
| | | | | | | | | | | | | | | | | | | | | | | | | | |
Declaration Date | | Record Date | | Payment Date | | Cash Dividend per Share | | Total |
Year ended December 31, 2021 | | | | | | |
January 26, 2021 | | March 10, 2021 | | March 25, 2021 | | $ | 1.13 | | | $ | 277 | |
April 20, 2021 | | June 10, 2021 | | June 25, 2021 | | 1.13 | | | 278 | |
July 20, 2021 | | September 10, 2021 | | September 24, 2021 | | 1.13 | | | 276 | |
October 19, 2021 | | December 3, 2021 | | December 21, 2021 | | 1.13 | | | 273 | |
| | | | | | | | |
Year ended December 31, 2020 | | | | | | |
January 28, 2020 | | March 16, 2020 | | March 27, 2020 | | $ | 0.95 | | | $ | 240 | |
April 28, 2020 | | June 10, 2020 | | June 25, 2020 | | 0.95 | | | 242 | |
July 28, 2020 | | September 10, 2020 | | September 25, 2020 | | 0.95 | | | 238 | |
October 27, 2020 | | December 7, 2020 | | December 22, 2020 | | 0.95 | | | 234 | |
On January 25, 2022, our Audit Committee declared a quarterly cash dividend to shareholders of $1.28 per share on the outstanding shares of our common stock. This quarterly dividend is payable on March 25, 2022 to the shareholders of record as of March 10, 2022.
Under our Board of Directors’ authorization, we maintain a common stock repurchase program. On January 26, 2021, our Audit Committee, pursuant to authorization granted by the Board of Directors, authorized a $5,000 increase to our
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
common stock repurchase program. Repurchases may be made from time to time at prevailing market prices, subject to certain restrictions on volume, pricing and timing. The repurchases are effected from time to time in the open market, through negotiated transactions, including accelerated share repurchase agreements, and through plans designed to comply with Rule 10b5-1 under the Securities Exchange Act of 1934, as amended. Our stock repurchase program is discretionary, as we are under no obligation to repurchase shares. We repurchase shares under the program when we believe it is a prudent use of capital. The excess cost of the repurchased shares over par value is charged on a pro rata basis to additional paid-in capital and retained earnings.
A summary of common stock repurchases for the years ended December 31, 2021 and 2020 is as follows:
| | | | | | | | | | | | | | | |
| | | Years Ended December 31 |
| 2021 | | 2020 |
Shares repurchased | | | 5.1 | | | 9.4 | |
Average price per share | | | $ | 371.46 | | | $ | 286.35 | |
Aggregate cost | | | $ | 1,900 | | | $ | 2,700 | |
Authorization remaining at end of year | | | $ | 4,192 | | | $ | 1,092 | |
We expect to utilize the remaining authorized amount over a multi-year period, subject to market and industry conditions.
For additional information regarding the use of capital for debt security repurchases, see Note 13, “Debt.”
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
16. Accumulated Other Comprehensive (Loss) Income
A reconciliation of the components of accumulated other comprehensive (loss) income at December 31, 2021, 2020, and 2019 is as follows:
| | | | | | | | | | | | | | | | | |
| 2021 | | 2020 | | 2019 |
Net unrealized investment gains: | | | | | |
Beginning of year balance | $ | 949 | | | $ | 521 | | | $ | (159) | |
Other comprehensive (loss) income before reclassifications, net of tax benefit (expense) of $121, $(160), and $(198), respectively | (357) | | | 478 | | | 695 | |
Amounts reclassified from accumulated other comprehensive income, net of tax benefit (expense) of $27, $(13), and $(4), respectively | (100) | | | (50) | | | (15) | |
Other comprehensive (loss) income | (457) | | | 428 | | | 680 | |
End of year balance | 492 | | | 949 | | | 521 | |
| | | | | |
Non-credit components of impairments on investments: | | | | | |
Beginning of year balance | (2) | | | (2) | | | (2) | |
Other comprehensive income, net of tax (expense) benefit of $(1), $0,and $0, respectively | 2 | | | — | | | — | |
End of year balance | — | | | (2) | | | (2) | |
| | | | | |
Net cash flow hedges: | | | | | |
Beginning of year balance | (250) | | | (262) | | | (246) | |
Other comprehensive income (loss), net of tax (expense) benefit of $(3), $(3), and $4, respectively | 11 | | | 12 | | | (16) | |
End of year balance | (239) | | | (250) | | | (262) | |
| | | | | |
Pension and other postretirement benefits: | | | | | |
Beginning of year balance | (552) | | | (551) | | | (577) | |
Other comprehensive income (loss), net of tax expense of $(36), $(2), and $(9), respectively | 123 | | | (1) | | | 26 | |
End of year balance | (429) | | | (552) | | | (551) | |
| | | | | |
Foreign currency translation adjustments: | | | | | |
Beginning of year balance | 5 | | | (2) | | | (2) | |
Other comprehensive (loss) income, net of tax benefit (expense) of $2, $(2), and $0 | (9) | | | 7 | | | — | |
End of year balance | (4) | | | 5 | | | (2) | |
| | | | | |
Total: | | | | | |
Total beginning of year accumulated other comprehensive income (loss) | 150 | | | (296) | | | (986) | |
Total other comprehensive (loss) income, net of tax benefit (expense) of $110, $(154), and $(199), respectively | (330) | | | 446 | | | 690 | |
Total other comprehensive loss attributable to noncontrolling interests, net of tax benefit of $1, $0, and $0, respectively | 2 | | | — | | | — | |
Total end of year accumulated other comprehensive (loss) income | $ | (178) | | | $ | 150 | | | $ | (296) | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
17. Reinsurance
We reinsure certain risks with other companies and assume risk from other companies. We remain primarily liable to policyholders under ceded insurance contracts and are contingently liable for amounts recoverable from reinsurers in the event that such reinsurers do not meet their contractual obligations.
A summary of direct, assumed and ceded premiums earned for the years ended December 31, 2021, 2020 and 2019 is as follows:
| | | | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | |
| | | 2021 | | | | 2020 | | | | 2019 |
Direct | | | $ | 113,149 | | | | $ | 100,832 | | | | $ | 91,131 |
Assumed | | | 4,298 | | | | 3,356 | | | | 3,087 |
Ceded | | | (74) | | | | (79) | | | | (45) |
Net premiums | | | $ | 117,373 | | | | $ | 104,109 | | | | $ | 94,173 |
Percentage—assumed to net premiums | | | 3.7 | % | | | | 3.2 | % | | | | 3.3 | % |
The difference between written premiums and earned premiums is immaterial in each of the years presented above.
A summary of net premiums earned by segment (see Note 20, “Segment Information”) for the years ended December 31, 2021, 2020 and 2019 is as follows:
| | | | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | |
| | | 2021 | | | | 2020 | | | | 2019 |
Reportable segments: | | | | | | | | | | | |
Commercial & Specialty Business | | | $ | 33,209 | | | | | $ | 31,471 | | | | | $ | 31,944 | |
Government Business | | | 82,520 | | | | | 71,188 | | | | | 62,229 | |
Other | | | 1,644 | | | | | 1,450 | | | | | — | |
Net premiums | | | $ | 117,373 | | | | | $ | 104,109 | | | | | $ | 94,173 | |
The effect of reinsurance on benefit expense for the years ended December 31, 2021, 2020 and 2019 is as follows:
| | | | | | | | | | | | | | | | | |
| 2021 | | 2020 | | 2019 |
Direct | $ | 99,007 | | | $ | 85,168 | | | $ | 79,110 | |
Assumed | 3,719 | | | 2,967 | | | 2,733 | |
Ceded | (81) | | | (90) | | | (57) | |
Net benefit expense | $ | 102,645 | | | $ | 88,045 | | | $ | 81,786 | |
The effect of reinsurance on certain assets and liabilities at December 31, 2021 and 2020 is as follows:
| | | | | | | | | | | |
| 2021 | | 2020 |
Policy liabilities, assumed | $ | 500 | | | $ | 490 | |
Unearned income, assumed | 96 | | | 85 | |
Premiums payable, ceded | 14 | | | 12 | |
Premiums receivable, assumed | 248 | | | 347 | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
18. Leases
We lease office space and certain computer and related equipment using noncancelable operating leases. Our leases have remaining lease terms of 1 year to 13 years.
The information related to our leases is as follows:
| | | | | | | | | | | | | | | | | |
| Balance Sheet Location | | December 31, 2021 | | December 31, 2020 |
Operating Leases | | | | | |
Right-of-use assets | Other noncurrent assets | | $ | 628 | | | $ | 646 | |
Lease liabilities, current | Other current liabilities | | 133 | | | 110 | |
Lease liabilities, noncurrent | Other noncurrent liabilities | | 864 | | | 847 | |
| | | | | | | | | | | | | | | | | |
| Years Ended December 31 |
| 2021 | | 2020 | | 2019 |
Lease Expense | | | | | |
Operating lease expense | $ | 261 | | $ | 438 | | | $ | 198 | |
Short-term lease expense | 45 | | 50 | | | 46 | |
Sublease income | (4) | | (9) | | | (16) | |
Total lease expense | $ | 302 | | $ | 479 | | | $ | 228 | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
Our activities as disclosed in Note 4, “Business Optimization Initiatives”, include reducing our office space footprint. As a result, we performed an interim impairment test during the years ended December 31, 2021 and 2020 and recorded impairment charges of $136 and $258, respectively, for impairment and abandonment of ROU assets which are included in the operating lease expense shown above.
| | | | | | | | | | | | | | | | | | |
| | | | Years Ended December 31 |
| | | | 2021 | | 2020 |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | | |
Other information | | | | | |
Operating cash paid for amounts included in the measurement of lease liabilities, operating leases | | | $ | 198 | | $ | 207 |
Right-of-use assets obtained in exchange for new lease liabilities, operating leases | | | $ | 334 | | $ | 384 |
Weighted average remaining lease term in years, operating leases | | | 7 | | 7 |
Weighted average discount rate, operating leases | | | 2.69 | % | | 3.21 | % |
At December 31, 2021, future lease payments for noncancelable operating leases with initial or remaining terms of one year or more are as follows:
| | | | | |
2022 | $ | 211 | |
2023 | 193 | |
2024 | 165 | |
2025 | 126 | |
2026 | 90 | |
Thereafter | 307 | |
Total future minimum payments | $ | 1,092 | |
Less imputed interest | (95) | |
Total lease liabilities | $ | 997 | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
19. Earnings per Share
The denominator for basic and diluted earnings per share at December 31, 2021, 2020 and 2019 is as follows:
| | | | | | | | | | | | | | | | | |
| 2021 | | 2020 | | 2019 |
Denominator for basic earnings per share—weighted-average shares | 243.8 | | | 250.8 | | | 255.5 | |
Effect of dilutive securities—employee stock options, non-vested restricted stock awards, convertible debentures and equity units | 3.0 | | | 3.5 | | | 4.8 | |
Denominator for diluted earnings per share | 246.8 | | | 254.3 | | | 260.3 | |
During the years ended December 31, 2021, 2020 and 2019, weighted-average shares related to certain stock options of 0.2, 1.2 and 0.6, respectively, were excluded from the denominator for diluted earnings per share because the stock options were anti-dilutive.
During the years ended December 31, 2021, 2020 and 2019, we issued approximately 0.3, 0.3 and 0.2 restricted stock units, respectively, of which vesting was contingent upon us meeting certain earnings targets. Contingent restricted stock units are excluded from the denominator for diluted earnings per share and are included only if and when the contingency is met. The 2021 contingent restricted stock units are being measured over the three year period of 2021 through 2023, the 2020 contingent restricted stock units are being measured over the three year period of 2020 through 2022 and the 2019 contingent restricted stock units are being measured over the three year period of 2019 through 2021. Contingent restricted stock units generally vest in March of the year following each measurement period.
20. Segment Information
Beginning in 2020, IngenioRx met the quantitative threshold for a reportable segment based on the FASB guidance. The results of our operations are now described through four reportable segments: Commercial & Specialty Business, Government Business, IngenioRx and Other.
Our Commercial & Specialty Business segment offers plans and services to our Individual, Group risk-based, Group fee-based and BlueCard® members. The Commercial & Specialty Business 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 dental, vision, life, disability and supplemental health insurance benefits.
Our Government Business segment includes our Medicare and Medicaid businesses, National Government Services (“NGS”) and services provided to the federal government in connection with the FEHB business.
Our IngenioRx segment includes our PBM business. IngenioRx markets and offers PBM services to our affiliated health plan customers, as well as to external customers outside of the health plans we own. IngenioRx has a comprehensive PBM services portfolio, which includes services such as formulary management, pharmacy networks, prescription drug database, member services and mail order capabilities.
Our Other segment includes our Diversified Business Group, which is our health services business focused on lowering the cost and improving the quality of healthcare by enabling and creating new care delivery and payment models, with a special emphasis on serving those with complex and chronic conditions. This segment also includes certain eliminations and corporate expenses not allocated to our other reportable segments.
We define operating revenues to include premium income, product revenue and administrative fees and other revenues. Operating revenues are derived from premiums and fees received, primarily from the sale and administration of health benefit and pharmacy products and services. Operating gain is calculated as total operating revenue less benefit expense, cost of products sold and selling, general and administrative expense.
Affiliated revenues represent revenues or costs for services provided to our subsidiaries by IngenioRx and our Diversified Business Group, as well as certain back-office services provided by our international businesses, and are recorded at cost or management’s estimate of fair market value. These affiliated revenues are eliminated in consolidation.
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
Through our participation in various federal government programs, we generated approximately 20.7%, 20.3% and 20.7% of our total consolidated revenues from agencies of the U.S. government for the years ended December 31, 2021, 2020, and 2019, respectively. These revenues are contained in the Government Business segment.
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 certain shared administrative expenses for each segment are recognized on a pro rata allocated basis, which in the aggregate approximates the consolidated expense. Any difference between the allocated expenses and actual consolidated expense is included in other expenses not allocated to reportable segments. We evaluate performance of the reportable segments based on operating gain or loss as defined above. We evaluate net investment income, net gains (losses) on financial instruments, interest expense, amortization expense, gain or loss on extinguishment of debt, income taxes and assets and liabilities on a consolidated basis, as these items are managed in a corporate shared service environment and are not the responsibility of segment operating management.
For our 2019 segment reporting, operating gain generated from IngenioRx activities was allocated and included in our Commercial & Specialty Business and Government Business based upon their utilization of those services, which aligns with the method by which we assessed the 2019 operating performance of our reportable segments. Beginning January 1, 2020, we are managing the operating performance of each of our segments on a standalone basis. Prior year 2019 allocations were not restated to conform to the 2020 presentation; however, operating margins for IngenioRx were approximately 8% in 2019.
Financial data by reportable segment for the years ended December 31, 2021, 2020 and 2019 is as follows:
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| Commercial & Specialty Business | | Government Business | | IngenioRx | | Other | | Eliminations | | Total |
Year ended December 31, 2021 | | | | | | | | | | | |
Operating revenue - unaffiliated | $ | 38,809 | | | $ | 82,919 | | | 12,655 | | | $ | 2,560 | | | $ | — | | | $ | 136,943 | |
Operating revenue - affiliated | — | | | — | | | 12,776 | | | 7,690 | | | (20,466) | | | — | |
Operating gain (loss) | 2,753 | | | 3,061 | | | 1,684 | | | (9) | | | — | | | 7,489 | |
Depreciation and amortization of property and equipment | — | | | — | | | — | | | 668 | | | — | | | 668 | |
Year ended December 31, 2020 | | | | | | | | | | | |
Operating revenue - unaffiliated | $ | 36,699 | | | $ | 71,572 | | | 10,384 | | | $ | 2,153 | | | $ | — | | | $ | 120,808 | |
Operating revenue - affiliated | — | | | — | | | 11,527 | | | 3,904 | | | (15,431) | | | — | |
Operating gain (loss) | 2,681 | | | 2,444 | | | 1,361 | | | (126) | | | — | | | 6,360 | |
Depreciation and amortization of property and equipment | — | | | — | | | — | | | 638 | | | — | | | 638 | |
Year ended December 31, 2019 | | | | | | | | | | | |
Operating revenue - unaffiliated | $ | 37,421 | | | $ | 62,632 | | | 2,007 | | | $ | 1,081 | | | $ | — | | | $ | 103,141 | |
Operating revenue - affiliated | — | | | — | | | 3,395 | | | 1,212 | | | (4,607) | | | — | |
Operating gain (loss) | 4,032 | | | 2,056 | | | — | | | (89) | | | — | | | 5,999 | |
Depreciation and amortization of property and equipment | — | | | — | | | — | | | 675 | | | — | | | 675 | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
The major product revenues for each of the reportable segments for the years ended December 31, 2021, 2020 and 2019 are as follows:
| | | | | | | | | | | | | | | | | |
| 2021 | | 2020 | | 2019 |
Commercial & Specialty Business | | | | | |
Managed care products | $ | 31,564 | | | $ | 29,815 | | | $ | 30,311 | |
Managed care services | 5,711 | | | 5,296 | | | 5,451 | |
Dental/Vision products and services | 1,363 | | | 1,231 | | | 1,302 | |
Other | 171 | | | 357 | | | 357 | |
Total Commercial & Specialty Business | 38,809 | | | 36,699 | | | 37,421 | |
Government Business | | | | | |
Managed care products | 82,519 | | | 71,188 | | | 62,229 | |
Managed care services | 400 | | | 384 | | | 403 | |
Total Government Business | 82,919 | | | 71,572 | | | 62,632 | |
IngenioRx | | | | | |
Pharmacy products and services | 25,431 | | | 21,911 | | | 5,402 | |
Other | | | | | |
Integrated health services | 9,645 | | | 5,787 | | | 2,149 | |
Other | 605 | | | 270 | | | 144 | |
Total Other Business | 10,250 | | | 6,057 | | | 2,293 | |
Eliminations | | | | | |
Eliminations | (20,466) | | | (15,431) | | | (4,607) | |
Total product revenues | $ | 136,943 | | | $ | 120,808 | | | $ | 103,141 | |
The classification between managed care products and managed care services in the above table primarily distinguishes between the levels of risk assumed. Managed care products represent insurance products where we bear the insurance risk, whereas managed care services represent product offerings where we provide claims adjudication and other administrative services to the customer, but the customer principally bears the insurance risk.
Asset, liability and equity details by reportable segment have not been disclosed, as we do not internally report such information.
A reconciliation of reportable segments’ operating revenue to the amounts of total revenues included in our consolidated statements of income for the years ended December 31, 2021, 2020 and 2019 is as follows:
| | | | | | | | | | | | | | | | | |
| 2021 | | 2020 | | 2019 |
Reportable segments’ operating revenues | $ | 136,943 | | | $ | 120,808 | | | $ | 103,141 | |
Net investment income | 1,378 | | | 877 | | | 1,005 | |
Net gains on financial instruments | 318 | | | 182 | | | 67 | |
Total revenues | $ | 138,639 | | | $ | 121,867 | | | $ | 104,213 | |
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
A reconciliation of reportable segments’ operating gain to income before income tax expense included in our consolidated statements of income for the years ended December 31, 2021, 2020 and 2019 is as follows:
| | | | | | | | | | | | | | | | | |
| 2021 | | 2020 | | 2019 |
Reportable segments’ operating gain | $ | 7,489 | | | $ | 6,360 | | | $ | 5,999 | |
Net investment income | 1,378 | | | 877 | | | 1,005 | |
Net gains on financial instruments | 318 | | | 182 | | | 67 | |
Interest expense | (798) | | | (784) | | | (746) | |
Amortization of other intangible assets | (441) | | | (361) | | | (338) | |
Loss on extinguishment of debt | (21) | | | (36) | | | (2) | |
Income before income tax expense | $ | 7,925 | | | $ | 6,238 | | | $ | 5,985 | |
21. Related Party Transactions
We have an equity investment in APC Passe, LLC, which offers Medicaid products in Arkansas. During the years ended December 31, 2021 and 2020, in the normal course of business, we assumed premiums of $462 and $446, respectively, from APC Passe, LLC, which is included in our total assumed premiums (see Note 17, “Reinsurance”).
22. Statutory Information
The majority of our insurance and HMO subsidiaries report their accounts in conformity with accounting practices prescribed or permitted by state insurance regulatory authorities, commonly referred to as statutory accounting, which vary in certain respects from GAAP. However, certain of our insurance and HMO subsidiaries, including BCC, Blue Cross of California Partnership Plan, Inc., Golden West Health Plan, Inc., Beacon Health Options of California, Inc. and CareMore Health Plan are regulated by the California Department of Managed Health Care (“DMHC”) and report their accounts in conformity with GAAP (these entities are collectively referred to as the “DMHC regulated entities”). Typical differences of GAAP reporting as compared to statutory reporting are the recognition of all assets including those that are non-admitted for statutory purposes and recognition of all deferred tax assets without regard to statutory limits. The National Association of Insurance Commissioners (“NAIC”) developed a codified version of the statutory accounting principles, designed to foster more consistency among the states for accounting guidelines and reporting. Prescribed statutory accounting practices are set forth in a variety of publications of the NAIC as well as state laws, regulations and general administrative rules.
Our statutory basis insurance and HMO subsidiaries are subject to risk-based capital (“RBC”) requirements. RBC is a method developed by the NAIC to determine the minimum amount of statutory capital appropriate for an insurance company or HMO to support its overall business operations in consideration of its size and risk profile. The formula for determining the amount of RBC specifies various factors, weighted based on the perceived degree of risk, which are applied to certain financial balances and financial activity. Below minimum RBC requirements are classified within certain levels, each of which requires specified corrective action. Additionally, the DMHC regulated entities are subject to capital and solvency requirements as prescribed by the DMHC. As of December 31, 2021 and 2020, all of our regulated subsidiaries exceeded the minimum applicable mandatory RBC requirements and/or capital and solvency requirements of their applicable governmental regulator.
The statutory RBC necessary to satisfy regulatory requirements of our statutory basis insurance and HMO subsidiaries was approximately 6,962 and $5,800 as of December 31, 2021 and 2020, respectively. The tangible net equity required for the DMHC regulated entities was approximately $690 and $600 as of December 31, 2021 and 2020, respectively. Statutory-basis capital and surplus of our insurance and HMO subsidiaries and capital and surplus of our other regulated subsidiaries, excluding the DMHC regulated entities, was 16,178 and $13,717 at December 31, 2021 and 2020, respectively. GAAP equity of the DMHC regulated entities was $3,886 and $3,851 at December 31, 2021 and 2020, respectively.
Our ability to pay dividends and credit obligations is significantly dependent on receipt of dividends from our subsidiaries. The payment of dividends to us by our insurance and HMO subsidiaries without prior approval of the insurance departments of each subsidiary’s domiciliary jurisdiction is limited by formula. Dividends in excess of these amounts are subject to prior approval by the respective state insurance departments or the DMHC. During 2021, our insurance and HMO
Anthem, Inc.
Notes to Consolidated Financial Statements (continued)
subsidiaries paid aggregate cash dividends of $3,134 to the parent company, including cash dividends which required prior approval from regulatory authorities. We currently estimate that approximately $3,000 of dividends will be paid to the parent company in 2022.