Full-Year Premium Revenue and YoY Growth
Reported full-year premium revenue of $43.1 billion, representing 11% year-over-year growth; Q4 premium revenue was $10.7 billion.
Embedded Earnings and RFP Pipeline
Embedded earnings increased to over $11.00 per share (from $8.65), including a $4.50 contribution from the Florida CMS win; active RFP pipeline of ~$50 billion of opportunities.
Major Medicaid Contract Wins
Historic Florida Children's Medical Services contract (~$6 billion annual run-rate) plus wins/renewals (e.g., Wisconsin), with Georgia and Texas additions — combined new/announced Medicaid premium > $9 billion.
High RFP Win Rates
Achieved ~90% win rate on renewals representing $14 billion retained revenue and ~80% win rate on new contracts representing $20 billion of new revenue.
Medicaid Business Scale and Relative Margin Strength
Flagship Medicaid represents ~75% of premium; full-year Medicaid pretax margin 2.8% with reported Medicaid MCR 91.8% (Q4 reported 93.5%, adjusted 92.3% after removing retro items); management states Medicaid margins are industry-leading by 300-400 bps vs peers.
2026 Guidance with Underlying Earnings Disclosure
2026 guidance: premium revenue ~ $42 billion and adjusted EPS at least $5; management reports underlying EPS (after known one-time burdens) of ~ $7.50 per share, and highlights 3 upside levers (moderating Medicaid trend, off-cycle rate adjustments, Medicare/Marketplace upside).
Balance Sheet and Capital Actions
Harvested ~$337 million of subsidiary dividends; parent company cash ~$223 million; RBC ratio 305% ( >50% above state minimums); closed $850 million senior notes due 2031; debt = 3.7x TTM EBITDA; debt-to-cap ~49%.
Operational Discipline on G&A
Adjusted G&A ratio improved modestly: 6.9% in Q4 and 6.5% for full year; 2026 guidance targets 6.4% reflecting cost management and some implementation offsets.