Elevance Health Inc.

What does Elevance Health own?

Elevance Health owns Anthem Blue Cross Blue Shield health insurance plans operating in 14 states, the Wellpoint subsidiary brand, and the Carelon health services brand including CarelonRx (pharmacy benefits management) and Carelon Services (behavioural health, care management, and risk-based solutions). The company also offers dental insurance through Anthem Dental Plans and Blue Cross Blue Shield Dental. Elevance was formerly known as Anthem until rebranding in June 2022.

Is Elevance Health publicly traded?

Yes. Elevance Health is listed on the New York Stock Exchange under the ticker symbol ELV. The company has been publicly traded since 2004, when it IPO'd under the name Anthem with ticker ANTM. The ticker changed to ELV in June 2022 when the company rebranded to Elevance Health. Major institutional shareholders include Vanguard Group, BlackRock, and State Street Corporation. The company returned $4.1 billion of capital to shareholders in 2025.

Who founded Elevance Health?

Elevance Health was formed through decades of mergers among Blue Cross and Blue Shield organisations, beginning in 1946. The current corporate structure resulted from the 2004 merger of Anthem and WellPoint Health Networks, which brought multiple state Blue Cross Blue Shield plans under a single entity. The company adopted the Anthem name in 2004 and rebranded to Elevance Health in June 2022 under CEO Gail Boudreaux's leadership.

Where is Elevance Health headquartered?

Elevance Health is headquartered in Indianapolis, Indiana, USA. The company operates Blue Cross Blue Shield plans in 14 states and serves approximately 45 million medical members across the United States. The company employs approximately 100,000 people. Carelon, the company's health services subsidiary, operates pharmacy benefits management, behavioural health, and care management services.

What is Elevance Health's annual revenue?

Elevance reported $197.6 billion in operating revenue for FY2025, a 12.8% increase from $175.2 billion in FY2024. Premium revenue was $164.6 billion, product revenue was $24.5 billion, and service fees were $8.5 billion. Shareholders' net income was $5.66 billion, with GAAP diluted EPS of $25.21. For FY2026, the company projects total operating revenue to decline in the low single digits, with GAAP diluted EPS of at least $22.30 and adjusted diluted EPS of at least $25.50.

Why is Elevance Health exiting Medicaid markets?

Elevance is exiting Medicaid markets where it cannot achieve sustainable margins due to elevated medical cost trends and state rate updates that have not kept pace with the higher acuity of remaining members after pandemic-era redetermination. The company exited the Washington, D.C. Medicaid market in August 2025 and expects to exit additional markets over 12 to 18 months. Medicaid is expected to operate at a -1.75% operating margin in 2026. CEO Gail Boudreaux stated that "Medicaid participation has to make strategic and financial sense for us within our diversified portfolio."

What is the DOJ lawsuit against Elevance Health about?

In May 2025, the US Department of Justice filed a False Claims Act complaint against Elevance Health, CVS Health (Aetna), and Humana, alleging the insurers paid hundreds of millions of dollars in illegal kickbacks to insurance brokers eHealth, GoHealth, and SelectQuote from 2016 through at least 2021 in exchange for Medicare Advantage enrolments. The DOJ alleges brokers directed beneficiaries to plans that paid the most in kickbacks regardless of suitability. The case is ongoing, and the claims are allegations only with no determination of liability.

Elevance Health traces its origins to 1946 when Blue Cross and Blue Shield organisations began merging to create statewide health insurance plans in the United States. These mergers created some of the largest non-profit health insurance providers in individual states.

In 2004, the company adopted the Anthem name and became publicly traded on the New York Stock Exchange under the ticker ANTM. The initial public offering brought together multiple state Blue Cross Blue Shield organisations under a single corporate structure. Also in 2004, Anthem acquired WellPoint Health Networks in a $16.5 billion merger, creating the largest health insurance company in the United States at the time. The combined entity operated Blue Cross Blue Shield plans in 14 states.

Throughout the 2000s and 2010s, Anthem expanded through acquisitions and organic growth. The company invested in pharmacy benefits management, behavioural health services, and care coordination capabilities. In 2018, under CEO Gail Boudreaux who joined that year, Anthem launched its whole health strategy, focusing on integrated care delivery and addressing social determinants of health beyond traditional insurance.

In June 2022, Anthem changed its name to Elevance Health and its stock ticker from ANTM to ELV. The rebranding reflected the company's evolution from a traditional health insurer into a broader health services organisation. The Carelon brand was introduced for the company's health services operations, including pharmacy benefits management, behavioural health, and care management.

The post-pandemic period presented challenges for Elevance. Medicaid redetermination, which resumed in 2023 after being paused during the COVID-19 pandemic, led to membership attrition as healthier beneficiaries left the programme. State rate updates did not keep pace with the higher acuity of remaining members, putting pressure on Medicaid margins. In 2024 and 2025, elevated medical cost trends in Medicaid and Affordable Care Act health plans reduced profitability.

In 2025, Elevance began exiting unprofitable Medicaid markets. The company announced its departure from the Washington, D.C. Medicaid market effective August 2025, affecting 250,000 enrollees. CEO Gail Boudreaux stated the company expects to exit additional Medicaid markets over the next 12 to 18 months "where we do not see a path to sustainable performance." Medicaid is expected to operate at a -1.75% operating margin in 2026.

In February 2026, Elevance announced management changes to simplify decision-making. CFO Mark Kaye expanded his responsibilities to include oversight of Carelon. Felicia Norwood assumed responsibility for the consolidated Health Benefits organisation. Peter Haytaian announced his transition from the Carelon presidency effective 4 May 2026.

In Q1 2026, Elevance raised its full-year guidance. In Q2 2026, the company raised guidance again, with operating cash flow guidance increased to at least $6.0 billion. The company is making one-time investments in the back half of 2026 to improve medical cost trend detection, simplify patient experience, and expand Carelon services. Management expects to return to at least 12% adjusted EPS growth in 2027 off the 2026 earnings baseline.

For FY2026, Elevance projects GAAP diluted EPS of at least $22.30 and adjusted diluted EPS of at least $25.50. Total operating revenue is expected to decline in the low single digits, driven by a mid single digit decline in premium revenue due to Medicaid and Medicare Advantage membership reductions, partially offset by mid single digit growth in product revenue and service fees.

Elevance Health maintains a sustainability programme focused on environmental responsibility, healthcare accessibility, and corporate governance. The company achieved its 100% renewable electricity target in 2021, four years ahead of schedule.

Environmental Performance:

• Renewable Energy: Achieved 100% renewable electricity for operations in 2021
• Net Zero Target: Pursuing net zero emissions across Scope 1, 2, and 3 emissions
• Supplier Engagement: Engaging with strategic suppliers to set science-based GHG emissions reduction targets
• Governance: Environmental policy and strategy overseen by the Governance Committee of the Board of Directors

Social Responsibility:

• Elevance Health Foundation: Supports disaster relief organisations and provides financial support to communities during difficult times
• Climate and Workforce Health: Participates in the National Commission on Climate and Workforce Health to address climate-related health risks
• Healthcare Accessibility: Focus on addressing social determinants of health through its whole health strategy

Governance:

• Compliance Programmes: Comprehensive compliance programmes addressing healthcare regulations including HIPAA, ACA requirements, and state insurance regulations
• Data Privacy: Maintains data privacy and security standards under healthcare regulations
• Transparency: Publishes annual Impact Report and Form 10-K with SEC

Elevance is not a certified B Corporation. The company's sustainability reporting follows standard ESG frameworks. The tension between profitability and healthcare accessibility remains an ongoing challenge, particularly as the company exits Medicaid markets that serve low-income populations.

Elevance Health has received recognition for environmental leadership, healthcare innovation, and corporate responsibility. The company does not prominently feature consumer-facing awards in its investor communications, as its primary customers are employers, government programmes, and individual policyholders rather than retail consumers.

The company achieved its 100% renewable electricity target in 2021, four years ahead of schedule. Elevance has been recognised for its environmental leadership through its commitment to net zero emissions and science-based targets.

Elevance has received workplace recognition for diversity and inclusion programmes, employee wellness initiatives, and corporate culture. The company has also been recognised for digital health solutions and integrated care models through its Carelon subsidiary.

In the healthcare quality domain, Elevance's Medicare Advantage plans have historically received high star ratings from CMS, though the company lost a legal challenge over its 2025 star ratings, which will result in the loss of over $375 million in potential bonus payments.

Elevance Health operates in the highly regulated US healthcare industry and faces significant scrutiny regarding healthcare pricing, regulatory compliance, and market practices.

DOJ False Claims Act Complaint (May 2025):

The US Department of Justice filed a complaint under the False Claims Act against Elevance Health, CVS Health (Aetna), and Humana, alleging the insurers paid hundreds of millions of dollars in illegal kickbacks to insurance brokers eHealth, GoHealth, and SelectQuote from 2016 through at least 2021. The DOJ alleges the brokers directed Medicare beneficiaries to plans offered by insurers that paid the most in kickbacks, regardless of plan suitability. The DOJ also alleges that Aetna and Humana conspired with brokers to discriminate against disabled Medicare beneficiaries perceived as less profitable. The case is ongoing, and the claims are allegations only with no determination of liability.

Medicare Star Ratings Lawsuit:

Elevance lost a legal challenge over its 2025 Medicare quality ratings. Judge Mark T. Pittman of the US District Court for the Northern District of Texas ruled against Elevance's argument that CMS should have rounded its 3.749565 star rating up to 4 stars. The ruling means Elevance will miss out on over $375 million in potential Medicare Advantage bonus payments. The company had previously argued that a single bungled "secret shopper" phone call cost it $190 million by depressing its star rating.

Ghost Network Lawsuits:

Carelon Behavioral Health faces a proposed class-action lawsuit filed in April 2025 in the US District Court for the Southern District of New York, alleging the company knowingly maintained inaccurate directories of mental health providers, referred to as "ghost networks." Three New York State Health Insurance Program members alleged Carelon maintained a "grossly inaccurate" directory of physicians and therapists. This is the second ghost network lawsuit in less than a year against Elevance subsidiaries. In October 2024, two Anthem Blue Cross Blue Shield members sued alleging the health plan maintained ghost networks with "almost no" mental health providers in New York that accept Anthem BCBS.

Medicaid Market Exits:

Elevance is exiting Medicaid markets where it cannot achieve sustainable margins, starting with Washington, D.C. (effective August 2025, affecting 250,000 enrollees). CEO Gail Boudreaux said the company expects to exit additional Medicaid markets over 12 to 18 months. This has drawn scrutiny regarding the role of private insurers in the Medicaid programme and the impact on low-income beneficiaries. Medicaid is expected to operate at a -1.75% operating margin in 2026.

Healthcare Pricing Scrutiny:

Elevance faces ongoing scrutiny regarding healthcare costs and pricing transparency. Regulators and consumers examine insurance premiums, medical cost trends, and reimbursement rates. The company operates under HIPAA, ACA requirements, and state insurance regulations. The benefit expense ratio of 90.0% in FY2025 (up 150 basis points from FY2024) reflects elevated medical cost trends that have put pressure on profitability and premium pricing.