重塑健康保险公司业绩的三大主要趋势

Healthinsurerfinancialpulse

Summer2026

WepresenttheSummer2026editionofourHealthInsurerFinancialPulsenewsletter.ThiseditionofPulseincludesthereportedannualstatutoryfinancialexperienceforhealthinsurersthrough2025,highlightsfrompublic

companies’Q12026financialstatements,marketcapitalizationforpubliccompaniesandstatutorycapital/

Risk-BasedCapital(RBC)trends,andrecentcapitalmanagementandreinsuranceactivity.Ouraimistokeepyouabreastofkeymarkettrendsanddynamicsthatimpacthealthinsurerfinancialresultsandprofitability.Wehopeyouenjoythenewsletterandfinditinformative.PleaselookforournexteditioninFall2026.

2025statutoryfinancialsrevealmargindeteriorationinIndividual,Group,Medicare,andMedicaidmarkets

Market-widepre-taxmarginsdecreasedin2025to-0.9%,withincreasedlossratiosinalllinesofbusinessexceptforMedicaidManagedCarecomparedwith2024.

Largepubliccompanies’Q12026financialperformanceimproves

Totalenrollmenthasdroppedconsiderably,whileunweightedaveragereportedprofitmarginsincreasedfromQ12025toQ12026ascarriersfocusonmarginimprovementovermembershipgrowth.

2025RBCratiosshowsignificantdeclinecomparedwith2021

Between2021and2025,RBCratiosofhealthcompaniesdecreasedbyalmost100percentagepoints,asAuthorizedControlLevel(ACL)amountsgrewmorequicklythanTotalAdjustedCapital(TAC),likelyduetohigherlossratios.

Overall,carriersofalltypesshowedsignificantdecreasesintheirRBCratiosin2024and2025.

Capitalmanagementandreinsurance

Inthissection,wediscussthepotentialimpactsofproposedchangestotheHealthRisk-BasedCapital(HRBC)

framework,specificallyaroundunderwritingriskandmanagedcarecreditcomponents.Wealsodiscusspotentialcapitalsolutionstohelpwithstandfinancialheadwinds.

Inthisissue

Healthinsurerfinancialsbymarket3

Largepubliccompanies’financialperformance

8

Marketcapitalization:Statutorycapital/RBCtrends

14

Capitalmanagementandreinsurance

17

©OliverWyman

Healthinsurerfinancialsbymarket

Wesummarizetheprofitabilitytrendsofcarrierswithfullyear2025reportedstatutoryfinancialinformation.1WealsosummarizeenrollmentandlossratiotrendsintheIndividual,Group,Medicare,andMedicaidmarkets.Overall,pre-taxmarginsdecreasedin2025to-0.9%,withincreasedlossratiosinalllinesofbusinessexceptforMedicaidManagedCarecomparedto2024.

Allmarkets

Commercial,Medicare,Medicaid,andother

Profitmargin

Marginsin2025decreasedforpubliccompaniesandnon-publicBlues,andincreasedforother

healthcarriers.

Publiccompaniesdecreasedfrom1.6%in2024to1.1%in2025.Non-publicBluesandotherhealthcarriersreportednegativemarginsat-3.6%

and-1.9%,respectively.

Allhealthcarriers

Public

companies

Non-

publicblues

Otherhealthcarriers

20202021

Allmarketspre-taxprofitmargin

2020to2025/publicvs.bluesvs.other

Pre-taxprofitmargin(as%ofpremium)

6

4

2

0

-2

-4

-6202020212022202320242025

2022202320242025

Publiccompanies

4.9%

3.5%

4.1%

3.2%

1.6%

0.9%

Non-publicblues

3.4%

0.2%

0.5%

0.5%

-1.8%

-3.6%

Otherhealthcarriers

2.9%

-0.1%

0.8%

-0.1%

-2.5%

-1.9%

Allhealthcarriers

4.0%

1.7%

2.3%

1.7%

-0.3%

-0.9%

1.NAIChealthblanksonly.ExcludesNAICLife/Accident/Health,NAICP&C,andCADMHCfilers.Dataanomaliesandinconsistencieswereadjustedforallperiods.IndividualmarketPremiumPMPMandLossRatiosin2020areimpactedbyreportedamountsfortheACARiskCorridorprogramduetoSupremeCourtdecisionMaineCommunityHealthOptionsv.UnitedStates.DataasofMay2026.

©OliverWyman

3

Groupmarket1

PremiumsPMPM

GrouppremiumsPMPMincreasedin2025,withaveragemarketpremiumsreaching$617PMPM,anincrease

of6.3%from2024.Publiccompanies’premiumssawthegreatestincreasein2025(7.4%)whileotherhealthcarrierssawthesmallestincrease(5.7%).

Public

Non

Otherhealth

Allhealth

companies

publicblues

carriers

carriers

Enrollment2

Enrollmentinthecomprehensivefully-insuredgroup

marketdecreasedin2025,continuingthenegativetrendseeninthelastfewyears.

Publiccompanies’enrollmentdecreasedthemost(8.9%),withnon-publicBluesandotherhealthcarriersboth

closertotheoverallgroupmarketdecreaseof4.8%.

202020212022202320242025

29.1

28.2

27.1

26.2

25.0

23.8

CommercialgrouppremiumsPMPM

Publicvs.bluevs.other

PremiumPMPM($)

800

600

400

200

0

202020212022202320242025

Commercialgroupenrollment

Publicvs.bluevs.other

Coveredlives(inmillions)

30

20

10

0

202020212022202320242025

Lossratio

The2025reportedlossratioof89.9%isanincreaseof1.9%relativeto2024.Publiccompanies(+2.4%)andnon-publicBlues(+2.6%)drovetheoverallincrease,whileotherhealthcarrierssawlittlechange(-0.1%).

Commercialgrouplossratio

Publicvs.bluevs.other

Lossratio(%)

100

90

80

70202020212022202320242025

202020212022202320242025

Publiccompanies

81.9%

84.3%

82.9%

81.1%

83.2%

85.6%

Non-publicblues

82.7%

88.8%

86.2%

86.6%

88.8%

91.4%

Otherhealthcarriers

85.7%

90.7%

89.2%

89.6%

89.7%

89.6%

Allhealthcarriers

83.3%

88.3%

86.3%

86.3%

88.0%

89.9%

1.NAIChealthblanksonly.ExcludesNAICLife/Accident/Health,NAICP&C,andCADMHCFilers.Dataanomaliesandinconsistencieswereadjustedforallperiods.DataasofMay2026.

2.Someofthemarketenrollmentisnotincluded,mostnotablythoseinsuredbyLife/Accident/Healthstatutoryfilers,whichneedstobeconsideredwhenreviewingthischartandothersinthisreport.

©OliverWyman

4

Individualmarket1

PremiumsPMPM2

IndividualpremiumsPMPMincreasedin2025,with

reportedaverageindividualmarketpremiumsof$566PMPM,anincreaseof2.4%from2024.

Publiccompanies(5.7%)reportedthelargestincreasefollowedbynon-publicBlues(2.0%),whileotherhealthcarriersexperiencedaslightdecrease(-0.4%).

Public

companies

Non-

publicblues

Otherhealthcarriers

Allhealthcarriers

ComprehensiveindividualpremiumsPMPM

Publicvs.bluevs.other

PremiumPMPM($)

700

600

500

400

202020212022202320242025

Enrollment3

Overallenrollmentincreasedanaverageof3.0%in2025relativeto2024.

Publiccompaniesandotherhealthcarriersboth

increasedby6.2%,offsetbynon-publicBlues’decreaseof4.2%.

2020

2021

2022

2023

2024

2025

12.5

13.4

15.1

17.1

21.8

22.5

Lossratio2

Reportedlossratiosin2025increasedsignificantlyto93.4%,up8.1%from2024.Allcarriertypesincreasedbetween7.0%and8.9%,withpubliccompanies

reportingthelowestlossratioat89.8%andnon-publicBluesreportingthehighestat97.4%.

20202021

Comprehensiveindividualenrollment

Publicvs.bluevs.other

Coveredlives(inmillions)

25

20

15

10

5

0

202020212022202320242025

Comprehensiveindividuallossratio

Publicvs.bluevs.other

Lossratio(%)

100

90

80

70202020212022202320242025

2022202320242025

Publiccompanies

72.6%

83.2%

80.7%

80.9%

81.1%

89.8%

Non-publicblues

73.3%

86.8%

85.5%

84.7%

88.5%

97.4%

Otherhealthcarriers

79.8%

92.9%

92.9%

89.1%

87.2%

94.2%

Allhealthcarriers

74.8%

87.5%

86.5%

84.4%

85.3%

93.4%

1.NAIChealthblanksonly.ExcludesNAICLife/Accident/Health,NAICP&C,andCADMHCFilers.Dataanomaliesandinconsistencieswereadjustedforallperiods.DataasofMay2026.

2.PremiumPMPMandLossRatiosin2020areimpactedbyreportedamountsfortheACARiskCorridorprogramduetoSupremeCourtdecisionMaineCommunityHealthOptionsv.UnitedStates.

3.Someofthemarketenrollmentisnotincluded,mostnotablythoseinsuredbyLife/Accident/Healthstatutoryfilers,whichneedstobeconsideredwhenreviewingthischartandothersinthisreport.

©OliverWyman

5

MedicareAdvantage1

Enrollment2

EnrollmentgrowthintheMedicareAdvantage(MA)

marketcontinuedin2025,withtheoveralltrendof

gradualincreasesdrivenbypopulationdemographics

andthecontinuedpopularityofMAplans.Growth

betweencompanytypeswasrelativelyeven,withpubliccompaniesseeinga6.4%increaseover2025,non-publicBlues(7.6%),andotherhealthcarriers(3.0%).

202020212022202320242025

18.3

20.2

21.2

21.8

23.3

24.6

Allhealthcarriers

Public

companies

Non-

publicblues

Otherhealthcarriers

Lossratio

Reportedlossratiosin2025increasedto90.9%,a1.1%increasefrom2024.Theincreaseisfairlyevenacross

companytypes,withnon-publicBluesincreasingat1.8%,publiccompaniesat1.2%,andotherhealthcarriersat0.5%.

Medicareenrollment

Publicvs.bluevs.other

Coveredlives(inmillions)

30

20

10

0

202020212022202320242025

Medicarelossratio

Publicvs.bluevs.other

Lossratio(%)

100

90

80

70

2020

2021

20222023

20242025

2020

2021

2022

2023

2024

2025

Publiccompanies

82.1%

85.8%

84.8%

85.7%

88.2%

89.4%

Non-publicblues

82.8%

89.7%

90.0%

92.4%

95.0%

96.8%

Otherhealthcarriers

86.3%

90.7%

90.5%

91.0%

92.6%

93.1%

Allhealthcarriers

82.9%

87.1%

86.4%

87.4%

89.8%

90.9%

1.NAIChealthblanksonly.ExcludesNAICLife/Accident/Health,NAICP&C,andCADMHCFilers.Dataanomaliesandinconsistencieswereadjustedforallperiods.DataasofMay2026.

2.Someofthemarketenrollmentisnotincluded,mostnotablythoseinsuredbyLife/Accident/Healthstatutoryfilers,whichneedstobeconsideredwhenreviewingthischartandothersinthisreport.

©OliverWyman

6

Medicaidmanagedcare1

Enrollment2

Enrollmentdecreasedsignificantlyby9.8%ininsuredManagedMedicaidprogramsin2025comparedwith2024.Publiccompaniessawthelowestdecreaseat

5.4%,followedbynon-publicBluesat7.6%andotherhealthcarriersat18.1%.

202020212022202320242025

47.5

54.9

61.1

61.8

52.7

47.5

Public

Non-

Otherhea

lth

Allhealth

compa

nies

publicblues

carriers

carriers

Medicaidenrollment

Publicvs.bluevs.other

Coveredlives(inmillions)

80

60

40

20

0

202020212022202320242025

Lossratio

Reportedlossratiosin2025decreasedto90.7%,a0.5%decreasefrom2024.Otherhealthcarriersdrovethe

decreaseat2.4%,whilenon-publicBluesandpubliccompaniessawsmallincreases.

Medicaidlossratio

Publicvs.bluevs.other

Lossratio(%)

100

95

90

85

80202020212022202320242025

202020212022202320242025

Publiccompanies

84.0%

85.4%

86.4%

87.7%

89.7%

89.9%

Non-publicblues

87.6%

88.8%

88.4%

89.0%

92.7%

93.0%

Otherhealthcarriers

87.8%

87.2%

85.4%

87.5%

93.2%

90.8%

Allhealthcarriers

85.7%

86.5%

86.4%

87.9%

91.2%

90.7%

1.NAIChealthblanksonly.ExcludesNAICLife/Accident/Health,NAICP&C,andCADMHCFilers.Dataanomaliesandinconsistencieswereadjustedforallperiods.DataasofMay2026.

2.Someofthemarketenrollmentisnotincluded,mostnotablythoseinsuredbyLife/Accident/Healthstatutoryfilers,whichneedstobeconsideredwhenreviewingthischartandothersinthisreport.

©OliverWyman

7

Largepubliccompanies,financialperformance

Wereviewedlargepubliccompanies’profitabilityasofQ12026fortheirinsuredbusinessandnotedthat

unweightedaveragereportedprofitmarginsincreasedfromQ12025toQ12026,withallcarriersexceptforUnitedHealthcareseeinganincreaseinmargininthefirstquarterof2026.

Netincometrends—insuredbusiness

Overall,theunweightedaverageprofitmargin(netincome/premium)forthefourinsurersof6.5%is5.5%higherthantheQ42025unweightedaverageof1.0%,and1.2%higherthantheQ12025unweightedaverageof5.3%,drivenbyincreasesforAetnaCVSHealthandCigna.

UnitedHealthcarehadanetprofitmargininQ12026of5.7%,whichwasinlinewiththeirprofitmarginof5.8%in

Q12025andwellaheadofQ42025,wheretheybrokeeven,largelydrivenbyaprioritizationofmarginrecoveryandproductstabilitywithadeliberatetrade-offonmembershipgrowth.

Elevance’sprofitmargindecreasedby0.9%fromQ12025toQ12026,generallydrivenbyanincreaseinnon-benefitexpense.

AetnaCVSHealth’sprofitmarginincreasedby2.6%fromQ12025toQ12026,seeinganetprofitmarginof5.9%inQ12026duetoimprovedperformanceinthegovernmentbusinessandtheabsenceofthe$448millionpremiumdeficiencyreserverecordedwithintheindividualexchangeproductlineintheprioryear.

Cigna’sprofitmarginwas10.8%inQ12026,anincreaseof3.2%comparedwithQ12025,mainlydrivenbylower

healthcarecostsrelatedtothedivestingoftheirMedicareAdvantage,MedicareIndividualStand-AlonePrescriptionDrugPlans,MedicareandOtherSupplementalBenefitsbusinesses.

HealthCareEstimatedNetIncome(as%ofPremium)—Insuredbusiness

Q12023–Q12026

Netincome(percentofpremium)

12

8

4

0

-4

Q1

2023

Q2Q3Q4Q1

2024

Q2Q3Q4Q1

2025

Q2Q3Q4Q1

2026

CignaAetnaCVShealthElevanceUnitedhealthcareUnweightedaverage

©OliverWyman

8

Medicallossratio

Elevatedcosttrendsimpactedthebusinessessignificantlyin2025;however,Q12026showedsomeimprovement.Overall,theunweightedaveragelossratiowas1.4%lowerinQ12026at83.8%comparedwithQ12025at85.2%.CignaandAetnaCVSHealthbothsawdecreasesofover2.0%comparedwithQ12025.

InQ12026,reportedlossratioswere84.6%forAetnaCVSHealth,79.8%forCigna,86.8%forElevance,and83.9%forUnitedHealthcare.

Medicallossratio

Q12023–Q12026

Lossratio(%)

100

95

90

85

80

75

70

Q1

2023

Q2Q3Q4Q1

2024

Q2Q3Q4Q1

2025

Q2Q3Q4Q1

2026

CignaAetnaCVShealthElevanceUnitedhealthcareUnweightedaverage

Estimatedoperatingexpenseratio

Operatingexpenseratios(operatingexpense/premium)increasedslightlybetweenQ12025(7.1%)andQ12026(7.3%)afterconsecutiveyearsofdecliningtrend.BothAetnaCVSHealth(-0.3%)andCigna(-2.2%)reporteddecreases,whileElevance(2.2%)andUnitedHealthcare(1.1%)increased.Notably,Elevancereporteditshighestoperatingexpenseratio(8.1%)sinceQ32023(8.2%)andiswellaboveitshistoricalaverage.

Operatingexpenseratio

Q12023–Q12026

Operatingexpenseratio(%)

12

10

8

6

4

2

0

Q1

2023

Q2Q3Q4Q1

2024

Q2Q3Q4Q1

2025

Q2Q3Q4Q1

2026

CignaAetnaCVShealthElevanceUnitedhealthcareUnweightedaverage

©OliverWyman

9

Earningshighlights:Q12026earningsreleasesandcalltranscripts

Utilization

ManycarrierscommentedontheutilizationtrendstheysawduringQ12026,notingthatoverallutilizationisinlinewithorslightlybelowexpectations.

•AetnaCVSHealth:Reportedmedicalbenefitratioof84.6%inthequarter,lowerthanexpectationsduetofavorableprioryeardevelopment.Theyexpectthefull-yearMBRtobeintherangeof90.0%to91.0%.

•Centene:Endedthequarterwithahealthbenefit

ratioof87.3%.MedicaidsawareductioninitsHBR

of0.5%from93.6%inQ12025to93.1%inQ12026.

ThecombinedMedicareAdvantageandPDPsegmentexperiencedanHBRof84.9%,lowerthananticipated.

Notably,PDPsawlowerthanexpectedspecialtydrugtrend.Overalltrendsremainhigh,specificallywithinbehavioralhealthandhomehealthcare.

Finally,theQ12026HBRinMarketplacebusinesswasheightenedduetohigherthanexpectedutilizationwithinSilver-tierenrollment,whichCentenebelieveswillbeoffsetbyfavorableriskadjustmentresults.

•Cigna:Medicalcareratiowasbelowexpectationsinthequarterat79.8%,drivenbylowerfluvolumesandweather-relatedcaredeferrals.Thefull-yearMCRis

stillexpectedtobeintherangeof83.7%to84.7%.NotedthattheyareseeingahigherpercentageofindividualexchangemembersenrollinginBronzeplans,whichresultsinalowerfirstquarterMCRduetohighercost-sharing.

•Elevance:Elevanceexperiencedaconsolidated

benefitexpenseratioof86.8%withinthequarter.

Thisresult,whichwasbelowexpectations,isduetofavorableclaimsexperienceandseasonalimpactswithinIndividualACAbusiness,whereahigher

percentageofmembershiphasenrolledinBronzeplansthatareassociatedwithhighercostsinthesecondhalfoftheyearduetotheplandesign.

•Humana:Reportedabenefitexpenseratioof89.4%forthequarter,anincreaseof240basispoints

versusQ12025duetotheMedicareStarRatings

revenueheadwind,theeffectoftheindividualMA

membershipgrowthduringthemostrecentannualelectionperiod,andlowerfavorableprior-period

medicalclaimsreservedevelopmentinthe2026quartercomparedwith2025.

•Molina:Reportedabusiness-widemedicalcostratioof91.1%forthequarter,anincreaseof190

basispointscomparedwithQ12025,reflectingthecontinuedhighmedicalcosttrendenvironment.

TheMedicareMCRforthequarterwas89.8%,whichwasinlinewithexpectationsbut150basispoints

aboveQ12025duetochangingproductmixasMMPmembersweretransitionedintointegratedduals

products.TheMarketplaceMCRforthequarter

increasedby370basispointsto85.4%compared

with81.7%inQ12025,drivenbychangesinestimateforprioryearriskadjustmentandcontinuedCMS

programintegrityinitiatives.TheMedicaidMCRwas92.0%inthequartercomparedto90.3%inQ12025,anincreaseof170basispointsreflectinghighlevelsofutilization,thoughtheoveralltrendwasfavorabletoexpectations.

•UnitedHealthcare:Reportedamedicalcareratio

of83.9%forthequarter,reflectinga90basispoint

decreasesinceQ12025andinlinewithexpectations.Thedecreasewasdrivenbyfavorablereserve

developmentandalignmentofcosttrendswith

pricingtrends.UnitedHealthcarenotedthatthey

continuetoseehigherutilizationinMedicareas

experiencedin2025.Inaddition,theyalsohighlightedhightrendandinsufficientfundinginMedicaid

whichisexpectedtodampenmarginsinthatlineofbusiness.

Membership:CommercialandMedicaid

Duringtheirearningscalls,mostcarriersprovidedinsightintotheiryear-to-datemembership

performance.Mostcarriersfocusedonmarginimprovementovermembershipgrowth.

•AetnaCVSHealth:Thequarterconcludedwitha

medicalmembershipofapproximately26.0million,adecreaseofapproximately0.6millionmemberscomparedtoQ42025duetotheirexitingfrom

theIndividualExchangebusinessslightlyoffsetbygrowthinCommercialfee-basedmembership.

•Centene:Endedthequarterwithapproximately12.4millionMedicaidmembers,aslightdecreasefrom

thepriorquarter.Marketplaceendedthequarterwithjustunder3.6millionmembers,adropof

almost2.0millionfromthepriorquarter.Notably,Centeneexpectstoendtheyearwithalittleover3millionMarketplacemembers.

©OliverWyman

10

•Cigna:Q12026endedwithapproximately

18.3millionmedicalcustomers,anincreaseof

about0.3millionsinceQ12025,primarilyduetocustomergrowthwithintheMiddleMarketand

Selectmarketsegments.Theyalsonotedthat

theyareplanningtoexittheIndividualExchangebusinessatyear-endaspartofastrategicshapingoftheirportfolio.

•Elevance:Endedthequarterwithmedical

membershipofapproximately45.4million

members,anincreaseofapproximately0.2millioncomparedtothepriorquarter.Theincrease

wasdrivenbygrowthincommercialfee-based

membershipandhigherenrollmentinIndividualACApartiallyoffsetbydeclinesinMedicare

Advantage,EmployerGroupRisk,andMedicaid.Expecttoendthesecondquarterwith1.2millionIndividualACAmembers;however,duetonovel

marketdynamicsandameaningfulshiftinproductmixcausedbytheexpirationoftheenhanced

premiumtaxcredits,theyarenotyetrevisingtheirfull-yearoutlookof0.9millionmemberswithin

thissegment.

•Humana:Thequarterendedwithapproximately

17.7millionmembers,anincreaseofroughly

2.9millionfromQ12025.Thisgainwasdrivenbyanincreaseofapproximately1.2millionmembersinIndividualMedicareAdvantageandabout

1.4millionmembersinPDP.

•Molina:Endedthequarterwithabout5.0million

members,adecreaseofover400,000memberssincetheendoftheprioryear.Thedecreaseisprimarily

drivenbyMarketplaceenrollmentwhichdecreased

from600,000atyear-end2025to300,000attheendofthequarter.Molinaexpectstoendtheyearwith

around250,000membersinthissegment.Itwas

notedthatmostofthemembersintheMarketplacebusinessarerenewingmembersandconcentratedinthesilvertier.

•UnitedHealthcare:UnitedHealthcaremembership

decreasedbyabout700,000memberssinceyear-end2025,endingthequarterat49.1millionmembers

drivenbyplannedcontractionintheMedicare

Advantage.Overall,MedicareAdvantagedecreasedbyabout1.0millionmemberssinceyear-end2025andthereisanexpectationforalossofanadditional300,000beforetheendof2026.

Thechartbelowdisplaysthechangesinreported

enrollmentforthe13mostrecentquartersfor

CommercialandMedicaidforasetofpubliccompanieswherecountswereavailableonaconsistentbasis.In

thequarter,totalCommercialmembershipdecreasedbyabout1.6million,whileMedicaidmembershipdecreasedbyapproximately500,000.SeeingthereductioninbothCommercialandMedicaidinthesamequarterisan

unusualresultrelativetohistoricaltrendsandislargelydrivenbyACAmarketparticipationanddynamics.

Membership

Q12023–Q12026

Membership(inmillions)

50

45

40

35

30

10095

——一

90

85

80Q1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4Q1

2023202420252026

CommercialMedicaid

Q1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4Q12023202420252026

©OliverWyman

11

Marketcapitalization

CapitalizationofhealthplansthroughMay2026

Year-over-yearchangesinmarketcapitalization2023-2026

BetweenQ12023andQ12026,thecombinedmarketcapitalizationofthesevenpublichealthcarecompanieswetrackshowedasignificantdeclineof38.1%.Duringthesameperiod,theS&P500Indexgrewby58.9%,outpacingthehealthcarecompaniesby96.9%.ItisimportanttonotethatasignificantportionofthemarketcapitalizationdivergenceofhealthcarefirmscomparedtotheS&P500Indexcanbeattributedtothepastyear.FromQ12025toQ12026,themarketcapitalizationofthesevenpubliccompaniesdroppedby38.1%,whiletheS&P500Indexincreasedby16.3%overthesameperiod.

Marketcapitalization—Publichealthcarecompanies

MarketcapitalizationinbillionsS&P500Index

$1,500

$1,250

$1,000

$750

$500

$250

$0

6,529

5,2545,612

4,109

42

100

103

121

42

61

32

18

35

30

16

85

95

76

109

89

21

98

16

7

91

70

64

456

441

479

246

Q12023Q12024Q12025Q12026

7,000

6,000

5,000

4,000

3,000

2,000

1,000

0

UnitedhealthcareElevanceCignaAetnaCVSHealthMolina.CenteneHumanaS&P500

Notes:Q12025toQ12026capitalizationgrowth.S&P500:+16.3%,PublicHealthcarecompanies:-38.1%

©OliverWyman

12

Q42025vs.Q12026marketcapitalization

FromQ42025toQ12026,allsevenpublichealthcarecompanieswemonitorexperienceddeclinesinmarketcapitalization.Cignaexperiencedaslightdropwitha4.3%decrease,whichwasinlinewiththe4.6%declineexperiencedbytheS&P500inthequarter.AetnaCVSHealthreflectedamoderatelosswitha9.3%decline.

Centene,Elevance,Molina,andUnitedHealthcarefacedmoresignificantdropsof20.4%,17.5%,22.2%,and17.9%,respectively.Humanasufferedthemostsubstantialloss,withitsmarketcapitalizationplummetingby32.4%.

Changeinmarketcapitalization—publichealthcarecompanies

Q42025–Q12026

-4.6

S&P500Index

-32.4

-20.4

-22.2

-9.3

-4.3

-17.5-17.9

HumanaCentene

Molina

CVShealth(Aetna)Cig