CENTENE CORPORATION REPORTS 2025 RESULTS AND ANNOUNCES 2026 GUIDANCE

-- 2025 Full Year GAAP Diluted Loss Per Share of $(13.53); Adjusted Diluted Earnings Per Share of $2.08 --

-- 2026 Adjusted Diluted Earnings Per Share Guidance of Greater than $3.00 --

ST. LOUIS, Feb. 6, 2026 /PRNewswire/ -- Centene Corporation (NYSE: CNC) (the Company) announced today its financial results for the fourth quarter and year ended December 31, 2025. In summary, the 2025 fourth quarter and full year results were as follows:

2025 Results

Full Year

Total revenues (in millions)

$ 49,725

$ 194,777

Premium and service revenues (in millions)

$ 44,727

$ 174,581

Health benefits ratio

94.3 %

91.9 %

SG&A expense ratio

7.5 %

7.4 %

Adjusted SG&A expense ratio (1)

7.5 %

7.4 %

GAAP diluted loss per share

$ (2.24)

$ (13.53)

Adjusted diluted earnings (loss) per share (1)

$ (1.19)

$ 2.08

Total cash flow provided by operations (in millions)

$ 437

$ 5,088

(1)

Represents a non-GAAP financial measure. A full reconciliation of the adjusted diluted earnings (loss) per share and adjusted selling, general and administrative (SG&A) expenses is shown in the Non-GAAP Financial Presentation section of this release.

"We are pleased to end a challenging year carrying positive momentum from the extensive and decisive actions taken in the back half of 2025 with the goal of restoring Marketplace profitability and stabilizing the trajectory of our Medicaid business," said Chief Executive Officer of Centene, Sarah M. London. "As we look to 2026, we are positioned to deliver meaningful margin improvement and renewed adjusted diluted EPS growth. We expect full year 2026 adjusted diluted EPS to be greater than $3.00, marking important progress toward restoring the enterprise's embedded earnings power all while continuing to work to provide access to affordable, high-quality care for our members."

Other Events

Awards & Community Engagement

Membership

The following table sets forth membership by line of business:

December 31,

2025

2024

Traditional Medicaid (1)

10,932,600

11,408,100

High Acuity Medicaid (2)

1,585,800

1,595,400

Total Medicaid

12,518,400

13,003,500

Marketplace

5,541,400

4,382,100

Individual and Commercial Group (3)

452,500

431,400

Total Commercial

5,993,900

4,813,500

Medicare (4)

1,002,600

1,110,900

Medicare Prescription Drug Plan (PDP)

8,118,600

6,925,700

Total at-risk membership

27,633,500

25,853,600

TRICARE eligibles

—

2,747,000

Total

27,633,500

28,600,600

(1)

Membership includes Temporary Assistance for Needy Families (TANF), Medicaid Expansion, Children's Health Insurance Program (CHIP), Foster Care and Behavioral Health.

(2)

Membership includes Aged, Blind, or Disabled (ABD), Intellectual and Developmental Disabilities (IDD), Long-Term Services and Supports (LTSS) and Medicare-Medicaid Plans (MMP) Duals.

(3)

Membership includes Commercial Group, Individual Coverage Health Reimbursement Arrangement (ICHRA) and Other Off-Exchange Individual.

(4)

Membership includes Medicare Advantage and Medicare Supplement.

Premium and Service Revenues

The following table sets forth supplemental revenue information ($ in millions):

Three Months Ended December 31,

Year Ended December 31,

2025

2024

% Change

2025

2024

% Change

Medicaid

$ 23,045

$ 20,825

11 %

$ 90,238

$ 83,851

8 %

Commercial

10,792

8,723

24 %

42,003

33,702

25 %

Medicare (1)

9,610

5,476

75 %

37,210

23,032

62 %

Other

1,280

1,272

1 %

5,130

4,920

4 %

Total premium and service revenues

$ 44,727

$ 36,296

23 %

$ 174,581

$ 145,505

20 %

(1)

Medicare includes Medicare Advantage, Medicare PDP and Medicare Supplement.

Statement of Operations: Three Months Ended December 31, 2025

Statement of Operations: Year Ended December 31, 2025

Balance Sheet

At December 31, 2025, the Company had cash, investments and restricted deposits of $38.8 billion and maintained $400 million of cash available for general corporate use. Medical claims liabilities totaled $20.5 billion. The Company's days in claims payable (DCP) was 46 days, a decrease of two days as compared to the third quarter of 2025, driven by the impact of state-directed payments and the elimination of the Medicare Advantage premium deficiency reserve. Total debt was $17.4 billion, which included no borrowings on the $4.0 billion Revolving Credit Facility at year end.

Outlook

Please refer to the Forward-Looking Statements, which should be reviewed in conjunction with the Company's 2026 outlook.

For its 2026 fiscal year, the Company's guidance is as follows.

Full Year 2026

GAAP diluted EPS

> $1.98

Adjusted diluted EPS (1)

> $3.00

(1) A full reconciliation of adjusted diluted EPS is shown in the Non-GAAP Financial Presentation section of this release.

Full Year 2026

Low

High

Total revenues (in billions)

$ 186.5

$ 190.5

Premium and service revenues (in billions)

$ 170.0

$ 174.0

HBR

90.9 %

91.7 %

SG&A expense ratio

7.1 %

7.7 %

Adjusted SG&A expense ratio (2)

7.1 %

7.7 %

Effective tax rate

27.0 %

28.0 %

Adjusted effective tax rate (3)

26.0 %

27.0 %

Diluted shares outstanding (in millions)

495.6

498.6

(2) Adjusted SG&A expense ratio excludes acquisition and divestiture related expenses of approximately $300 thousand.

(3) Adjusted effective tax rate excludes income tax effects of adjustments of approximately $161 million to $164 million.

For additional guidance details, please see the 2026 Guidance Presentation, which can be accessed on the Company's website at www.centene.com, under the Investors section.

Conference Call

As previously announced, the Company will host a conference call Friday, February 6, 2026, at 9:00 a.m. ET to review the financial results for the fourth quarter and year ended December 31, 2025.

Investors and other interested parties are invited to listen to the conference call by dialing 1-877-883-0383 in the U.S. and Canada; +1-412-902-6506 from abroad, including the following Elite Entry Number: 2815529 to expedite caller registration; or via a live, audio webcast on the Company's website at www.centene.com, under the Investors section.

A webcast replay will be available for on-demand listening shortly following the completion of the call for the next 12 months or until 11:59 p.m. ET on Tuesday, February 9, 2027, at the aforementioned URL. In addition, a digital audio playback will be available until 9 a.m. ET on Friday, February 13, 2026, by dialing 1-877-344-7529 in the U.S., 1-855-669-9658 in Canada, or +1-412-317-0088 from abroad, and entering access code 3210284.

Non-GAAP Financial Presentation

The Company is providing certain non-GAAP financial measures in this release as the Company believes that these figures are helpful in allowing investors to more accurately assess the ongoing nature of the Company's operations and measure the Company's performance more consistently across periods. The Company uses the presented non-GAAP financial measures internally in evaluating the Company's performance and for planning purposes, by allowing management to focus on period-to-period changes in the Company's core business operations, and in determining employee incentive compensation. Therefore, the Company believes that this information is meaningful in addition to the information contained in the GAAP presentation of financial information. The Company strongly encourages investors to review its consolidated financial statements and publicly filed reports in their entirety and cautions investors that the non-GAAP financial measures used by the Company may differ from similar measures used by other companies, even when similar terms are used to identify such measures. The presentation of non-GAAP financial measures is not intended to be considered in isolation or as a substitute for the financial information prepared and presented in accordance with GAAP.

Specifically, the Company believes the presentation of non-GAAP financial measures that excludes amortization of acquired intangible assets, acquisition and divestiture related expenses, as well as other items, allows investors to develop a more meaningful understanding of the Company's core performance over time.

The tables below provide reconciliations of non-GAAP items ($ in millions, except per share data):

Three Months Ended

December 31,

Year Ended

December 31,

2025

2024

2025

2024

GAAP net earnings (loss) attributable to Centene

$ (1,101)

$ 283

$ (6,674)

$ 3,305

Amortization of acquired intangible assets

169

173

685

692

Acquisition and divestiture related expenses

Other adjustments (1)

513

(20)

7,328

(117)

Income tax effects of adjustments (2)

(167)

(39)

(315)

(209)

Adjusted net earnings (loss)

$ (583)

$ 404

$ 1,028

$ 3,753

(1)

Other adjustments include the following pre-tax items:

2025:

(a)

for the three months ended December 31, 2025: Magellan Health impairment of $513 million, exit costs related

to the wind-down of certain contracts in the Other segment of $13 million, a favorable adjustment to the gain on

sale of Magellan Rx of $12 million, and net gain on debt extinguishment of $1 million;

(b)

for the twelve months ended December 31, 2025: goodwill impairment of $6,723 million, Magellan Health

impairment of $513 million, intangible asset impairment related to the wind-down of certain contracts in the Other

segment of $55 million, exit costs related to the wind-down of certain contracts in the Other segment of

$22 million, a net loss on real estate transactions of $18 million, a favorable adjustment to the gain on sale of

Magellan Rx of $2 million and net gain on debt extinguishment of $1 million.

2024:

(a)

for the three months ended December 31, 2024: gain on the sale of Collaborative Health Systems (CHS) of

$17 million and net gain on the sale of property of $3 million;

(b)

for the twelve months ended December 31, 2024: net gain on the previously reported divestiture of Magellan

Specialty Health due to the achievement of contingent consideration and finalization of working capital

adjustments of $83 million, net gain on the sale of property of $24 million, gain on the previously reported

divestiture of Circle Health of $20 million, gain on the sale of CHS of $17 million, Health Net Federal Services

asset impairment due to the 2024 final ruling on the TRICARE Managed Care Support Contract of $14 million,

severance costs due to a restructuring of $13 million, an additional loss on the divestiture of our Spanish and

Central European businesses of $7 million and gain on the previously reported divestiture of HealthSmart due to

the finalization of working capital adjustments of $7 million.

(2)

The income tax effects of adjustments are based on the effective income tax rates applicable to each adjustment. The three and

twelve months ended December 31, 2025, include a tax benefit of $4 million related to tax adjustments on previously reported

divestitures and impacts of the One Big Beautiful Bill Act (OBBBA). The twelve months ended December 31, 2024 include

a tax benefit of $1 million related to tax adjustments on previously reported divestitures.

Three Months

Ended December 31,

Year Ended

December 31,

Annual Guidance

December 31, 2026

2025

2024

2025

2024

GAAP diluted earnings (loss) per share attributable to

Centene

$ (2.24)

$ 0.56

$ (13.53)

$ 6.31

greater than $1.98

Amortization of acquired intangible assets

0.34

1.39

1.32

~$1.34

Acquisition and divestiture related expenses

0.01

0.16

~$—

Other adjustments (3)

1.04

(0.04)

14.86

(0.22)

~$0.01

Income tax effects of adjustments (4)

(0.34)

(0.07)

(0.64)

(0.40)

~$(0.33)

Effect of basic to diluted shares (5)

—

(0.01)

—

~$—

Adjusted diluted earnings (loss) per share

$ (1.19)

$ 0.80

$ 2.08

$ 7.17

greater than $3.00

(3)

Other adjustments include the following pre-tax items:

2026:

(a)

for the twelve months ended December 31, 2026, an estimated: $0.01 per share ($0.01 after-tax) net loss on debt

extinguishment.

2025:

(a)

for the three months ended December 31, 2025: Magellan Health impairment of $1.04 per share ($0.79 after-tax),

exit costs related to the wind-down of certain contracts in the Other segment of $0.03 per share ($0.02 after-tax),

and a favorable adjustment to the gain on sale of Magellan Rx of $0.03 per share ($0.02 after-tax);

(b)

for the twelve months ended December 31, 2025: goodwill impairment of $13.63 per share ($13.62 after-tax),

Magellan Health impairment of $1.04 per share ($0.79 after-tax), intangible asset impairment related to the wind-

down of certain contracts in the Other segment of $0.11 per share ($0.08 after-tax), exit costs related to the wind-

down of certain contracts in the Other segment of $0.04 per share ($0.03 after-tax), a net loss on real estate

transactions of $0.04 per share ($0.03 after-tax).

2024:

(a)

for the three months ended December 31, 2024: gain on the sale of CHS of $0.03 per share ($0.02 after-tax) and

net gain on the sale of property of $0.01 per share ($0.01 after-tax);

(b)

for the twelve months ended December 31, 2024: net gain on the previously reported divestiture of Magellan

Specialty Health due to the achievement of contingent consideration and finalization of working capital

adjustments of $0.16 per share ($0.12 after-tax), net gain on the sale of property of $0.04 per share ($0.03 after-

tax), gain on the previously reported divestiture of Circle Health of $0.04 per share ($0.12 after-tax), gain on the

sale of CHS of $0.03 per share ($0.02 after-tax), Health Net Federal Services asset impairment due to the 2024

final ruling on the TRICARE Managed Care Support Contract of $0.03 per share ($0.02 after-tax), severance

costs due to a restructuring of $0.02 per share ($0.01 after-tax), an additional loss on the divestiture of our Spanish

and Central European businesses of $0.01 per share ($0.01 after-tax) and gain on the previously reported

divestiture of HealthSmart due to the finalization of working capital adjustments of $0.01 per share ($0.01 after-

tax).

(4)

The income tax effects of adjustments are based on the effective income tax rates applicable to each adjustment. The three and

twelve months ended December 31, 2025, include a tax benefit of $0.01 related to tax adjustments on previously reported

divestitures and impacts of the OBBBA.

(5)

Reflects the $0.00 and $0.01 impact of using 493,042 thousand and 494,502 thousand shares in the calculation of adjusted

diluted EPS for the three and twelve months ended December 31, 2025, respectively. The additional 1,509 thousand and

1,386 thousand shares for the three and twelve months ended December 31, 2025, respectively, were excluded from the

calculation of the GAAP net loss per share and related adjustments due to their anti-dilutive effect.

Three Months Ended

December 31,

Year Ended

December 31,

2025

2024

2025

2024

GAAP selling, general and administrative expenses

$ 3,370

$ 3,231

$ 12,904

$ 12,400

Less:

Acquisition and divestiture related expenses

Restructuring costs

—

Real estate transaction costs

—

Adjusted selling, general and administrative

expenses

$ 3,354

$ 3,224

$ 12,876

$ 12,305

To provide clarity on the way management defines certain key metrics and ratios, the Company is providing a description of how the metric or ratio is calculated as follows:

In addition, the following terms are defined as follows:

About Centene Corporation

Centene Corporation, a Fortune 500 company, is a leading healthcare enterprise that is committed to helping people live healthier lives. The Company takes a local approach – with local brands and local teams – to provide fully integrated, high-quality, and cost-effective services to government-sponsored and commercial healthcare programs, focusing on under-insured individuals. Centene offers affordable and high-quality products to more than 1 in 15 individuals across the nation, including Medicaid and Medicare members (including Medicare Prescription Drug Plans) as well as individuals and families served by the Health Insurance Marketplace.

Centene uses its investor relations website to publish important information about the Company, including information that may be deemed material to investors. Financial and other information about Centene is routinely posted and is accessible on Centene's investor relations website, https://investors.centene.com.

Forward-Looking Statements

All statements, other than statements of current or historical fact, contained in this press release are forward-looking statements. Without limiting the foregoing, forward-looking statements often use words such as "believe," "anticipate," "plan," "expect," "estimate," "predict," "intend," "seek," "target," "goal," "potential," "may," "will," "would," "could," "should," "can," "continue" and other similar words or expressions (and the negative thereof). Our 2026 full year guidance outlined in the section titled "Outlook" is a forward-looking statement. Centene Corporation and its subsidiaries (Centene, the Company, our or we) intends such forward-looking statements to be covered by the safe-harbor provisions for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995, and we are including this statement for purposes of complying with these safe-harbor provisions. In particular, these statements include, without limitation, statements about our expected future operating or financial performance, changes in laws and regulations, market opportunity, expectations concerning pricing actions, competition, expected contract start dates and terms, expected activities in connection with completed and future acquisitions and dispositions, our investments and the adequacy of our available cash resources. These forward-looking statements reflect our current views with respect to future events and are based on numerous assumptions and assessments made by us in light of our experience and perception of historical trends, current conditions, business strategies, operating environments, future developments and other factors we believe appropriate. By their nature, forward-looking statements involve known and unknown risks and uncertainties and are subject to change because they relate to events and depend on circumstances that will occur in the future, including economic, regulatory, competitive and other factors that may cause our or our industry's actual results, performance or achievements to be materially different from any future results, performance, or achievements expressed or implied by these forward-looking statements. These statements are not guarantees of future performance and are subject to risks, uncertainties and assumptions. All forward-looking statements included in this press release are based on information available to us on the date hereof. Except as may be otherwise required by law, we undertake no obligation to update or revise the forward-looking statements included in this press release, whether as a result of new information, future events, or otherwise, after the date hereof. You should not place undue reliance on any forward-looking statements, as actual results may differ materially from projections, estimates, or other forward-looking statements due to a variety of important factors, variables and events including, but not limited to: our ability to design and price products that are competitive and/or actuarially sound; our ability to accurately predict and effectively manage health benefits and other operating expenses and reserves, including fluctuations in medical costs; rate cuts, insufficient rate changes or other payment reductions or delays by government payors affecting our government businesses; the effect of social, economic, and political conditions, geopolitical events and state and federal policies, including the amount and terms of state and federal funding for government-sponsored healthcare programs, including as a result of changes in U.S. presidential administrations or Congress; changes in federal or state laws or regulations, including changes with respect to income tax reform or government healthcare programs as well as changes with respect to the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act (collectively referred to as the ACA) and any regulations enacted thereunder, including the timing and terms of renewal or modification of the enhanced advance premium tax credits or program integrity initiatives that could have the effect of reducing membership or profitability of our products; unanticipated increased healthcare costs, including due to changes in consumer and provider behaviors, inflation and tariffs; our ability to maintain or achieve improvement in the Centers for Medicare and Medicaid Services (CMS) Star ratings and maintain or achieve improvement in other quality scores in each case that could impact revenue and future growth; competition, including for providers, broker distribution networks, contract reprocurements and organic growth; our ability to adequately anticipate demand and timely provide for operational resources to maintain service level requirements in compliance with the terms of our contracts and state and federal regulations; our ability to comply with the terms of our contracts and state and federal regulations and our ability to effectively oversee our third-party vendors to comply with the terms of their contracts with us and state and federal regulations; our ability to manage our information systems effectively; disruption, unexpected costs, or similar risks from business transactions, including acquisitions, divestitures, and changes in our relationships with third-party vendors; impairments to real estate, investments, goodwill and intangible assets; changes in senior management, loss of one or more key personnel or an inability to attract, hire, integrate and retain skilled personnel; membership and revenue declines or unexpected trends; changes in healthcare practices, new technologies, and advances in medicine; our ability to effectively and ethically use artificial intelligence and machine learning in compliance with applicable laws; changes in macroeconomic conditions, including inflation, interest rates and volatility in the financial markets; negative public perception of the Company and the managed care industry; uncertainty concerning government shutdowns, debt ceilings or funding; tax matters; disasters, climate-related incidents, acts of war or aggression or major epidemics; changes in expected contract start dates and terms; changes in provider, broker, vendor, state federal and other contracts and delays in the timing of regulatory approval of contracts, including due to protests and our ability to timely comply with any such changes to our contractual requirements or manage any unexpected delays in regulatory approval of contracts; the expiration, suspension, or termination of our contracts with federal or state governments (including, but not limited to, Medicaid, Medicare or other customers); the difficulty of predicting the timing or outcome of legal or regulatory audits, investigations, proceedings or matters including, but not limited to, our ability to resolve claims and/or allegations on acceptable terms, or at all, or whether additional claims, reviews or investigations will be brought; challenges to our contract awards; cyber-attacks or other data security incidents or our failure to comply with applicable privacy, data or security laws and regulations; the exertion of management's time and our resources, and other expenses incurred and business changes required in connection with complying with the terms of our contracts and the undertakings in connection with any regulatory, governmental, or third-party consents or approvals for acquisitions or dispositions; any changes in expected closing dates, estimated purchase price, or accretion for acquisitions or dispositions; losses in our investment portfolio; restrictions and limitations in connection with our indebtedness; a downgrade of our corporate family rating, issuer rating or credit rating of our indebtedness; the availability of debt and equity financing on terms that are favorable to us and risks and uncertainties discussed in the reports that Centene has filed with the Securities and Exchange Commission (SEC). This list of important factors is not intended to be exhaustive. We discuss certain of these matters more fully, as well as certain other factors that may affect our business operations, financial condition, and results of operations, in our filings with the SEC, including our annual report on Form 10-K, quarterly reports on Form 10-Q and current reports on Form 8-K. Due to these important factors and risks, we cannot give assurances with respect to our future performance, including without limitation our ability to maintain adequate premium levels or our ability to control our future medical and selling, general and administrative costs.

CENTENE CORPORATION AND SUBSIDIARIES

CONSOLIDATED BALANCE SHEETS

(In millions, except shares in thousands and per share data in dollars)

December 31, 2025

December 31, 2024

(Unaudited)

ASSETS

Current assets:

Cash and cash equivalents

$ 17,888

$ 14,063

Premium and trade receivables

18,105

19,713

Short-term investments

2,432

2,622

Other current assets

1,945

1,601

Total current assets

40,370

37,999

Long-term investments

17,035

17,429

Restricted deposits

1,412

1,390

Property, software and equipment, net

2,037

2,067

Goodwill

10,835

17,558

Intangible assets, net

4,530

5,409

Other long-term assets

528

593

Total assets

$ 76,747

$ 82,445

LIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND

STOCKHOLDERS' EQUITY

Current liabilities:

Medical claims liability

$ 20,544

$ 18,308

Accounts payable and accrued expenses

13,774

13,174

Return of premium payable

1,592

2,008

Unearned revenue

736

661

Current portion of long-term debt

110

Total current liabilities

36,696

34,261

Long-term debt

17,351

18,423

Deferred tax liability

833

684

Other long-term liabilities

1,811

2,567

Total liabilities

56,691

55,935

Commitments and contingencies

Redeemable noncontrolling interests

Stockholders' equity:

Preferred stock, $0.001 par value; authorized 10,000 shares; no shares issued or

outstanding at December 31, 2025 and December 31, 2024

—

Common stock, $0.001 par value; authorized 800,000 shares; 623,463 issued and

491,757 outstanding at December 31, 2025, and 620,195 issued and 495,907

outstanding at December 31, 2024

Additional paid-in capital

20,777

20,562

Accumulated other comprehensive (loss)

(58)

(504)

Retained earnings

8,674

15,348

Treasury stock, at cost (131,706 and 124,288 shares, respectively)

(9,441)

(8,997)

Total Centene stockholders' equity

19,953

26,410

Nonredeemable noncontrolling interest

Total stockholders' equity

20,033

26,500

Total liabilities, redeemable noncontrolling interests and stockholders' equity

$ 76,747

$ 82,445

CENTENE CORPORATION AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF OPERATIONS

(In millions, except shares in thousands and per share data in dollars)

(Unaudited)

Three Months Ended

December 31,

Year Ended

December 31,

2025

2024

2025

2024

Revenues:

Premium

$ 43,978

$ 35,519

$ 171,556

$ 142,303

Service

749

777

3,025

3,202

Premium and service revenues

44,727

36,296

174,581

145,505

Premium tax

4,998

4,509

20,196

17,566

Total revenues

49,725

40,805

194,777

163,071

Expenses:

Medical costs

41,489

31,809

157,702

125,707

Cost of services

680

688

2,670

2,729

Selling, general and administrative expenses

3,370

3,231

12,904

12,400

Depreciation expense

160

141

590

549

Amortization of acquired intangible assets

169

173

685

692

Premium tax expense

5,089

4,588

20,538

17,806

Impairment

513

—

7,311

Total operating expenses

51,470

40,630

202,400

159,896

Earnings (loss) from operations

(1,745)

175

(7,623)

3,175

Other income (expense):

Investment and other income

369

344

1,572

1,784

Debt extinguishment

—

Interest expense

(168)

(172)

(678)

(702)

Earnings (loss) before income tax

(1,543)

347

(6,728)

4,257

Income tax (benefit) expense

(443)

(51)

963

Net earnings (loss)

(1,100)

280

(6,677)

3,294

(Earnings) loss attributable to noncontrolling interests

(1)

Net earnings (loss) attributable to Centene Corporation

$ (1,101)

$ 283

$ (6,674)

$ 3,305

Net earnings (loss) per common share attributable to Centene Corporation:

Basic earnings (loss) per common share

$ (2.24)

$ 0.57

$ (13.53)

$ 6.33

Diluted earnings (loss) per common share

$ (2.24)

$ 0.56

$ (13.53)

$ 6.31

Weighted average number of common shares outstanding:

Basic

491,533

500,424

493,116

521,790

Diluted

491,533

501,978

493,116

523,744

CENTENE CORPORATION AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS

(In millions, unaudited)

Year Ended December 31,

2025

2024

Cash flows from operating activities:

Net earnings (loss)

$ (6,677)

$ 3,294

Adjustments to reconcile net earnings (loss) to net cash provided by operating activities

Depreciation and amortization

1,275

1,241

Stock compensation expense

204

212

Impairment

7,311

(Gain) on debt extinguishment

(1)

—

Deferred income taxes

(60)

(Gain) loss on divestitures, net

(2)

(120)

Changes in assets and liabilities

Premium and trade receivables

1,480

(4,333)

Other assets

(230)

Medical claims liabilities

2,336

368

Unearned revenue

(54)

Accounts payable and accrued expenses

(657)

(528)

Other long-term liabilities

(46)

(70)

Other operating activities, net

Net cash provided by operating activities

5,088

154

Cash flows from investing activities:

Capital expenditures

(767)

(644)

Purchases of investments

(4,541)

(7,183)

Sales and maturities of investments

5,780

5,785

Divestiture proceeds, net of divested cash

—

990

Net cash provided by (used in) investing activities

472

(1,052)

Cash flows from financing activities:

Proceeds from long-term debt

750

1,300

Payments and repurchases of long-term debt

(1,895)

(622)

Common stock repurchases

(475)

(3,124)

Proceeds from common stock issuances

Purchase of noncontrolling interest

(19)

—

Other financing activities, net

(19)

(6)

Net cash (used in) financing activities

(1,621)

(2,406)

Effect of exchange rate changes on cash, cash equivalents and restricted cash

—

Net increase (decrease) in cash, cash equivalents and restricted cash and cash equivalents

3,939

(3,296)

Cash and cash equivalents reclassified (to) from held for sale

(138)

—

Cash, cash equivalents and restricted cash and cash equivalents, beginning of period

14,156

17,452

Cash, cash equivalents and restricted cash and cash equivalents, end of period

$ 17,957

$ 14,156

Supplemental disclosures of cash flow information:

Interest paid

$ 647

$ 688

Income taxes paid, net

$ 448

$ 1,002

The following table provides a reconciliation of cash, cash equivalents and restricted cash and cash equivalents reported within the Consolidated

Balance Sheets to the totals above:

December 31,

2025

2024

Cash and cash equivalents

$ 17,888

$ 14,063

Restricted cash and cash equivalents, included in restricted deposits

Total cash, cash equivalents and restricted cash and cash equivalents

$ 17,957

$ 14,156

CENTENE CORPORATION

SUPPLEMENTAL FINANCIAL DATA

2025

2024

MEMBERSHIP

Traditional Medicaid (1)

10,932,600

11,115,400

11,227,400

11,369,400

11,408,100

High Acuity Medicaid (2)

1,585,800

1,591,000

1,592,300

1,589,400

1,595,400

Total Medicaid

12,518,400

12,706,400

12,819,700

12,958,800

13,003,500

Marketplace

5,541,400

5,828,100

5,862,800

5,626,000

4,382,100

Individual and Commercial Group (3)

452,500

447,900

449,700

448,200

431,400

Total Commercial

5,993,900

6,276,000

6,312,500

6,074,200

4,813,500

Medicare (4)

1,002,600

1,013,200

1,026,900

1,043,200

1,110,900

Medicare PDP

8,118,600

7,972,500

7,845,800

7,867,800

6,925,700

Total at-risk membership

27,633,500

27,968,100

28,004,900

27,944,000

25,853,600

TRICARE eligibles

—

2,747,000

Total

27,633,500

27,968,100

28,004,900

27,944,000

28,600,600

(1)

Membership includes TANF, Medicaid Expansion, CHIP, Foster Care and Behavioral Health.

(2)

Membership includes ABD, IDD, LTSS and MMP Duals.

(3)

Membership includes Commercial Group, ICHRA and Other Off-Exchange Individual.

(4)

Membership includes Medicare Advantage and Medicare Supplement.

NUMBER OF EMPLOYEES

61,100

60,900

60,300

60,400

60,500

DAYS IN CLAIMS PAYABLE

CASH, INVESTMENTS AND RESTRICTED DEPOSITS (in millions)

Regulated

$ 37,289

$ 37,574

$ 36,403

$ 35,922

$ 34,433

Unregulated

1,478

1,259

1,086

1,042

1,071

Total

$ 38,767

$ 38,833

$ 37,489

$ 36,964

$ 35,504

DEBT TO CAPITALIZATION

46.5 %

45.5 %

39.0 %

39.5 %

41.2 %

OPERATING RATIOS

Three Months Ended

December 31,

Year Ended

December 31,

2025

2024

2025

2024

HBR

94.3 %

89.6 %

91.9 %

88.3 %

SG&A expense ratio

7.5 %

8.9 %

7.4 %

8.5 %

Adjusted SG&A expense ratio

7.5 %

8.9 %

7.4 %

8.5 %

HBR BY PRODUCT

Three Months Ended

December 31,

Year Ended

December 31,

2025

2024

2025

2024

Medicaid

93.0 %

93.4 %

93.7 %

92.5 %

Commercial

95.4 %

81.8 %

87.9 %

77.3 %

Medicare (5)

96.1 %

86.7 %

92.0 %

88.7 %

(5)

Medicare includes Medicare Advantage, Medicare PDP and Medicare Supplement.

MEDICAL CLAIMS LIABILITY

The changes in medical claims liability are summarized as follows (in millions):

Balance, December 31, 2024

$ 18,308

Less: Reinsurance recoverables

Balance, December 31, 2024, net

18,243

Incurred related to:

Current period

160,109

Prior periods

(2,315)

Total incurred

157,794

Paid related to:

Current period

140,691

Prior periods

14,677

Total paid

155,368

Plus: Premium deficiency reserve

(92)

Plus: Divestitures

(109)

Balance, December 31, 2025, net

20,468

Plus: Reinsurance recoverables

Balance, December 31, 2025

$ 20,544

Centene's claims reserving process utilizes a consistent actuarial methodology to estimate Centene's ultimate liability. Any reduction in the "Incurred related to: Prior periods" amount may be offset as Centene actuarially determines the "Incurred related to: Current period." Additionally, approximately $93 million was recorded as a reduction to premium revenues resulting from development within "Incurred related to: Prior periods" due to minimum HBR and other return of premium programs.

The amount of the "Incurred related to: Prior periods" above represents favorable development and includes the effects of reserving under moderately adverse conditions, new markets where we use a conservative approach in setting reserves during the initial periods of operations, receipts from other third-party payors related to coordination of benefits and lower medical utilization and cost trends for dates of service December 31, 2024, and prior.

SOURCE Centene Corporation