Humana 2015 Annual Report Download - page 60
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52
Retail Segment
Change
2015 2014 Members Percentage
Membership:
Medical membership:
Individual Medicare Advantage 2,753,400 2,427,900 325,500 13.4 %
Group Medicare Advantage 484,100 489,700 (5,600) (1.1)%
Medicare stand-alone PDP 4,557,900 3,994,000 563,900 14.1 %
Total Retail Medicare 7,795,400 6,911,600 883,800 12.8 %
Individual commercial (a) 1,057,700 1,148,100 (90,400) (7.9)%
State-based Medicaid 373,700 316,800 56,900 18.0 %
Total Retail medical members 9,226,800 8,376,500 850,300 10.2 %
Individual specialty membership (b) 1,153,100 1,165,800 (12,700) (1.1)%
(a) Individual commercial medical membership includes Medicare Supplement members.
(b) Specialty products include dental, vision, and other supplemental health and financial protection products.
Members included in these products may not be unique to each product since members have the ability to enroll
in multiple products.
Change
2015 2014 Dollars Percentage
(in millions)
Premiums and Services Revenue:
Premiums:
Individual Medicare Advantage $ 29,526 $ 25,782 $ 3,744 14.5 %
Group Medicare Advantage 5,588 5,490 98 1.8 %
Medicare stand-alone PDP 3,846 3,404 442 13.0 %
Total Retail Medicare 38,960 34,676 4,284 12.4 %
Individual commercial 4,243 3,265 978 30.0 %
State-based Medicaid 2,341 1,255 1,086 86.5 %
Individual specialty 261 256 5 2.0 %
Total premiums 45,805 39,452 6,353 16.1 %
Services 9 39 (30) (76.9)%
Total premiums and services revenue $ 45,814 $ 39,491 $ 6,323 16.0 %
Income before income taxes $ 930 $ 1,339 $ (409) (30.5)%
Benefit ratio 86.7% 84.9% 1.8 %
Operating cost ratio 11.2% 11.6% (0.4)%
Pretax Results
• Retail segment pretax income was $930 million in 2015, a decrease of $409 million, or 30.5%, compared to
2014 primarily driven by an increase in the benefit ratio for 2015, including the impact of recognizing a
premium deficiency reserve of approximately $176 million for certain of our individual commercial medical
products for the 2016 coverage year, partially offset by a decline in the operating cost ratio, Medicare Advantage
membership growth, and higher investment income year-over-year.