Strong Membership Growth
Grew ~1,000,000 members (≈20%) in AEP; management expects individual Medicare Advantage (MA) membership to grow ≈25% for full-year 2026. New sales composition: >70% switchers (typically better economics), ~30% bounce-back members, and >75% of new sales from higher lifetime value channels (≈10 percentage point improvement YoY).
Improved Retention and Onboarding Metrics
Retention rate improved by over 500 basis points year-over-year. Early onboarding indicators showed reduced complaints to Medicare YoY, improved transactional Net Promoter Score, and higher completion rates for health risk assessments (HRAs) — all positive for STARS and member experience.
Solid 2025 Financial Results and EPS Beat
Reported adjusted EPS of $17.14 for 2025, in line with expectations and above initial guidance (~$16.25). Insurance segment full-year benefit ratio 90.4%, slightly better than guidance.
Capital Efficiency and Funding Position
Premium growth expected ~40% from 2024–2026, while statutory capital requirements projected to rise by <20% due to capital optimization. Management noted capital improvements that offset over $3 billion of capital requirements from '24–'26; debt-to-cap expected to remain largely flat.
Operating Efficiency & Transformation Momentum
Expect significant improvement in consolidated operating cost ratio for 2026 driven by operating leverage from membership/revenue growth, tactical cost-cutting (supplier consolidation, early retirement program), outsourcing and automation. Management expects these transformation benefits to accelerate in 2027–2028.
CenterWell & Medicaid Growth
CenterWell contributions turning positive (CenterWell Pharmacy tailwind vs prior decline). Medicaid footprint expanded to 13 states (including Georgia and Texas planned launches), and management expects continued J-curve progress in Medicaid and CenterWell clinics.
Clear Path to Long-Term Margin Targets
Management reiterates goal to 'unlock earnings potential by 2028' and expects a doubling of individual MA pretax margin in 2026 when normalized for STARS outcomes; anchored planning to 75th percentile STARS for long‑term targets.
Key Leadership and Strategic Moves
Aaron Martin joined as President of Medicare Advantage in January; company pursuing a strategic primary care acquisition and intends to fund select small/mid M&A via noncore asset sales.