CENTENE CORPORATION REPORTS THIRD QUARTER 2026 RESULTS
-- Third Quarter GAAP Diluted Loss Per Share of $(0.14); Adjusted Diluted Earnings Per Share of $0.58 --
-- Increases 2026 GAAP Diluted EPS Guidance: Greater than $3.46 & Adjusted Diluted EPS Greater than $5.20 --
ST. LOUIS, Oct. 27, 2026 /PRNewswire/ -- Centene Corporation (NYSE: CNC) (the Company) announced today its financial results for the third quarter ended September 30, 2026. In summary, the 2026 third quarter results were as follows:
Total revenues (in millions)
$ 50,647
Premium and service revenues (in millions)
$ 45,105
Health benefits ratio
92.7 %
SG&A expense ratio
7.2 %
Adjusted SG&A expense ratio (1)
6.5 %
GAAP diluted loss per share
$ (0.14)
Adjusted diluted earnings per share (1)
$ 0.58
Total cash flow (used in) operations (in millions)
$ (3,669)
(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.
"Solid underlying fundamentals within our core businesses have powered a faster recovery to our earnings trajectory than previously anticipated," said Chief Executive Officer of Centene, Sarah M. London. "We are pleased with the progress our teams have made in delivering increased margin to power our mission of transforming the health of the communities we serve, one person at a time. We remain focused on a strong finish to 2026 and building on this progress in 2027."
Membership
The following table sets forth membership by line of business:
September 30,
2026
2025
Traditional Medicaid (1)
10,544,300
11,115,400
High Acuity Medicaid (2)
1,351,600
1,591,000
Total Medicaid
11,895,900
12,706,400
Marketplace
3,403,300
5,828,100
Individual and Commercial Group (3)
497,400
447,900
Total Commercial
3,900,700
6,276,000
Medicare (4)
954,400
1,013,200
Medicare Prescription Drug Plan (PDP)
8,947,200
7,972,500
Total at-risk membership
25,698,200
27,968,100
(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. The Company operated MMPs through December 31, 2025. In 2026 these members are included in Medicare as a result of the Centers for Medicare and Medicaid Services (CMS) transition to Dual Eligible Special Needs Plans (D-SNP) based integration.
(3)
Membership includes Commercial Group, CHOICE Arrangements (formerly Individual Coverage Health Reimbursement Arrangement, or ICHRA) and Other Off-Exchange Individual.
(4)
Membership includes Medicare Advantage, Medicare Supplement, and Applicable Integrated Plans (AIPs) as a result of the CMS transition to D-SNP based integration in 2026.
Premium and Service Revenues
The following table sets forth supplemental revenue information ($ in millions):
Three Months Ended September 30,
2026
2025
% Change
Medicaid
$ 24,039
$ 23,171
4 %
Commercial
8,700
10,992
(21) %
Medicare (1)
11,263
9,391
20 %
Other
1,103
1,344
(18) %
Total premium and service revenues
$ 45,105
$ 44,898
0.5 %
(1)
Medicare includes Medicare Advantage, Medicare PDP and Medicare Supplement.
Statement of Operations: Three Months Ended September 30, 2026
Balance Sheet
At September 30, 2026, the Company had cash, investments and restricted deposits of $39.9 billion and maintained $175 million of cash available for general corporate use. Medical claims liabilities totaled $21.5 billion. The Company's days in claims payable (DCP) was 48 days, an increase of one day as compared to the second quarter of 2026.
During the third quarter of 2026, the Company repurchased $558 million of the Company's par value senior notes due 2027 and 2028. Following the senior note repurchase, total debt was $15.5 billion, which included no borrowings on the $4.0 billion Revolving Credit Facility at quarter end. In October 2026, the debt repurchase program was increased by $2.0 billion and subsequently the Company repurchased the remaining $569 million of its par value Senior Notes due 2027. With the increase and subsequent repurchase, there was $1.9 billion available under the senior note debt repurchase program as of October 27, 2026.
Outlook
Please refer to the Forward-Looking Statements, which should be reviewed in conjunction with the Company's 2026 outlook.
The Company is updating its 2026 GAAP diluted EPS guidance floor to greater than $3.46 and its 2026 adjusted diluted EPS guidance floor to greater than $5.20. Additionally, the Company is decreasing its HBR guidance range to 90.4% to 91.1% and its interest expense guidance range to $600 million to $620 million.
The Company's annual guidance for 2026 is as follows and will be discussed further on our conference call:
Full Year 2026
GAAP diluted EPS
> $3.46
Adjusted diluted EPS (1)
> $5.20
(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)
$ 196.5
$ 200.5
Premium and service revenues (in billions)
$ 173.0
$ 177.0
HBR
90.4 %
91.1 %
SG&A expense ratio
7.2 %
7.8 %
Adjusted SG&A expense ratio (2)
6.9 %
7.5 %
Effective tax rate
26.5 %
27.5 %
Adjusted effective tax rate (3)
25.5 %
26.5 %
Diluted shares outstanding (in millions)
497.0
500.0
(2) Adjusted SG&A expense ratio excludes severance costs due to enterprise optimization and contract exits of
approximately $355 million to $405 million, enterprise optimization third-party vendor costs of approximately
$85 million to $115 million and acquisition and divestiture related expenses of approximately $1 million.
(3) Adjusted effective tax rate excludes income tax effects of adjustments of approximately $266 million to
$270 million.
Conference Call
As previously announced, the Company will host a conference call Tuesday, October 27, 2026, at 8:30 a.m. ET to review the financial results for the third quarter ended September 30, 2026.
Investors and other interested parties are invited to listen to the conference call by dialing 1-877-883-0383 (toll free) in the U.S. and Canada; +1-412-902-6506 (toll) from abroad, including the following Elite Entry Number: 1565730 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, October 26, 2027, at the aforementioned URL. In addition, a digital audio playback will be available until 9 a.m. ET on Tuesday, November 3, 2026, by dialing 1-855-669-9658 (toll free) in North America, or +1-412-317-0088 (toll) from abroad, and entering access code 581422.
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
September 30,
Nine Months Ended
September 30,
2026
2025
2026
2025
GAAP net earnings (loss) attributable to Centene
$ (71)
$ (6,631)
$ 2,561
$ (5,573)
Amortization of acquired intangible assets
161
170
488
516
Acquisition and divestiture related expenses
—
—
—
1
Other adjustments (1)
307
6,754
360
6,815
Income tax effects of adjustments (2)
(107)
(48)
(199)
(148)
Adjusted net earnings
$ 290
$ 245
$ 3,210
$ 1,611
(1) Other adjustments include the following pre-tax items:
2026:
(a)
for the three months ended September 30, 2026: severance costs due to enterprise optimization and contract exits of $276 million, enterprise optimization third-party vendor costs of $35 million, a net gain on real estate transactions of $18 million, an additional loss associated with a prior divestiture of $15 million, and a net gain on debt extinguishment of $1 million;
(b)
for the nine months ended September 30, 2026: severance costs due to enterprise optimization and contract exits of $294 million, enterprise optimization third-party vendor costs of $85 million, a net gain on real estate transactions of $22 million, an additional loss associated with a prior divestiture of $15 million, a gain on sale of a provider network in the Other segment of $10 million, and a net gain on debt extinguishment of $2 million.
2025:
(a)
for the three months ended September 30, 2025: goodwill impairment of $6,723 million, real estate impairment of $22 million, and exit costs related to the wind-down of certain contracts in the Other segment of $9 million;
(b)
for the nine months ended September 30, 2025: goodwill impairment of $6,723 million, intangible asset impairment related to the wind-down of certain contracts in the Other segment of $55 million, a net loss on real estate transactions of $18 million, a reduction to the previously reported gain on the sale of Magellan Rx of $10 million, and exit costs related to the wind-down of certain contracts in the Other segment of $9 million.
(2)
The income tax effects of adjustments are based on the effective income tax rates applicable to each adjustment. The three and nine months ended September 30, 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).
Three Months Ended
September 30,
Nine Months Ended
September 30,
Annual Guidance
December 31, 2026
2026
2025
2026
2025
GAAP diluted earnings (loss) per share attributable to Centene
$ (0.14)
$ (13.50)
$ 5.15
$ (11.29)
greater than $3.46
Amortization of acquired intangible assets
0.33
0.35
0.98
1.05
~$1.30
Other adjustments (3)
0.62
13.75
0.72
13.81
~$0.98
Income tax effects of adjustments (4)
(0.22)
(0.10)
(0.40)
(0.30)
~$(0.54)
Effect of basic to diluted shares (5)
(0.01)
—
—
(0.01)
~$—
Adjusted diluted EPS
$ 0.58
$ 0.50
$ 6.45
$ 3.26
greater than $5.20
(3) Other adjustments include the following pre-tax items:
2026:
(a)
for the three months ended September 30, 2026: severance costs due to enterprise optimization and contract exits of $0.56 per share ($0.42 after-tax), enterprise optimization third-party vendor costs of $0.07 per share ($0.06 after-tax), a net gain on real estate transactions of $0.04 per share ($0.03 after-tax), and an additional loss associated with a prior divestiture of $0.03 per share ($0.03 after-tax);
(b)
for the nine months ended September 30, 2026: severance costs due to enterprise optimization and contract exits of $0.59 per share ($0.45 after-tax), enterprise optimization third-party vendor costs of $0.17 per share ($0.13 after-tax), a net gain on real estate transactions of $0.05 per share ($0.04 after-tax), an additional loss associated with a prior divestiture of $0.03 per share ($0.03 after-tax), and a gain on sale of a provider network in the Other segment of $0.02 per share ($0.02 after-tax);
(c)
for the year ended December 31, 2026, an estimated: $0.76 per share ($0.57 after-tax) of severance costs due to enterprise optimization and contract exits, $0.22 per share ($0.17 after-tax) of enterprise optimization third-party vendor costs, $0.01 per share ($0.01 after-tax) net gain on real estate transactions, $0.03 per share ($0.03 after-tax) of an additional loss associated with a prior divestiture, and $0.02 per share ($0.01 after-tax) gain on sale of a provider network in the Other segment.
2025:
(a)
for the three months ended September 30, 2025: goodwill impairment of $13.69 per share ($13.67 after-tax), real estate impairment of $0.04 per share ($0.04 after-tax), and exit costs related to the wind-down of certain contracts in the Other segment of $0.02 per share ($0.02 after-tax);
(b)
for the nine months ended September 30, 2025: goodwill impairment of $13.62 per share ($13.61 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), a net loss on real estate transactions of $0.04 per share ($0.03 after-tax), a reduction to the previously reported gain on the sale of Magellan Rx of $0.02 per share ($0.02 after-tax), and exit costs related to the wind-down of certain contracts in the Other segment of $0.02 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 nine months ended September 30, 2025, include a tax benefit of $0.01 per share, related to tax adjustments on previously reported divestitures and impacts of the OBBBA.
(5)
Reflects the $0.01 impact of using 499,436 thousand shares in the calculation of adjusted diluted EPS for the three months ended September 30, 2026. The additional 5,293 thousand shares for the three months ended September 30, 2026, were excluded from the calculation of the GAAP net loss per share and related adjustments due to their anti-dilutive effect.
Reflects the $0.00 and $0.01 impact of using 491,636 thousand and 494,763 thousand shares in the calculation of adjusted diluted EPS for the three and nine months ended September 30, 2025, respectively. The additional 495 thousand and 1,119 thousand shares for the three and nine months ended September 30, 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
September 30,
Nine Months Ended
September 30,
2026
2025
2026
2025
GAAP selling, general and administrative expenses
$ 3,235
$ 3,145
$ 9,735
$ 9,534
Less:
Acquisition and divestiture related expenses
—
—
—
1
Severance
276
9
294
9
Enterprise optimization costs
35
—
85
—
Real estate transaction costs
—
2
—
2
Adjusted selling, general and administrative expenses
$ 2,924
$ 3,134
$ 9,356
$ 9,522
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 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, including our estimated severance costs in connection with the voluntary separation program, 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 (eAPTCs) 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 successfully execute on our enterprise optimization initiatives, including any separation programs; 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 (SG&A) costs.
CENTENE CORPORATION AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
(In millions, except shares in thousands and per share data in dollars)
September 30,
2026
December 31,
2025
(Unaudited)
ASSETS
Current assets:
Cash and cash equivalents
$ 20,700
$ 17,888
Premium and trade receivables
20,329
18,105
Short-term investments
2,886
2,432
Other current assets
1,546
1,945
Total current assets
45,461
40,370
Long-term investments
14,794
17,035
Restricted deposits
1,470
1,412
Property, software and equipment, net
2,109
2,037
Goodwill
10,835
10,835
Intangible assets, net
4,042
4,530
Other long-term assets
569
528
Total assets
$ 79,280
$ 76,747
LIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND
STOCKHOLDERS' EQUITY
Current liabilities:
Medical claims liability
$ 21,495
$ 20,544
Accounts payable and accrued expenses
15,459
13,796
Return of premium payable
1,346
1,592
Unearned revenue
680
736
Current portion of long-term debt
88
50
Total current liabilities
39,068
36,718
Long-term debt
15,454
17,351
Deferred tax liability
719
833
Other long-term liabilities
1,732
1,789
Total liabilities
56,973
56,691
Commitments and contingencies
Redeemable noncontrolling interests
24
23
Stockholders' equity:
Preferred stock, $0.001 par value; authorized 10,000 shares; no shares issued or
outstanding at September 30, 2026 and December 31, 2025
—
—
Common stock, $0.001 par value; authorized 800,000 shares; 626,679 issued and
494,973 outstanding at September 30, 2026, and 623,463 issued and 491,757
outstanding at December 31, 2025
1
1
Additional paid-in capital
20,926
20,777
Accumulated other comprehensive (loss)
(514)
(58)
Retained earnings
11,235
8,674
Treasury stock, at cost (131,706 and 131,706 shares, respectively)
(9,441)
(9,441)
Total Centene stockholders' equity
22,207
19,953
Nonredeemable noncontrolling interest
76
80
Total stockholders' equity
22,283
20,033
Total liabilities, redeemable noncontrolling interests and stockholders' equity
$ 79,280
$ 76,747
CENTENE CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF OPERATIONS
(In millions, except shares in thousands and per share data in dollars)
(Unaudited)
Three Months Ended
September 30,
Nine Months Ended
September 30,
2026
2025
2026
2025
Revenues:
Premium
$ 44,370
$ 44,126
$ 131,839
$ 127,578
Service
735
772
2,296
2,276
Premium and service revenues
45,105
44,898
134,135
129,854
Premium tax
5,542
4,792
20,035
15,198
Total revenues
50,647
49,690
154,170
145,052
Expenses:
Medical costs
41,128
40,902
118,460
116,213
Cost of services
675
651
2,106
1,990
Selling, general and administrative expenses
3,235
3,145
9,735
9,534
Depreciation expense
138
147
411
430
Amortization of acquired intangible assets
161
170
488
516
Premium tax expense
5,617
4,886
20,218
15,449
Impairment
—
6,743
—
6,798
Total operating expenses
50,954
56,644
151,418
150,930
Earnings (loss) from operations
(307)
(6,954)
2,752
(5,878)
Other income (expense):
Investment and other income
333
450
1,175
1,203
Gain on debt extinguishment
1
—
2
—
Interest expense
(149)
(170)
(466)
(510)
Earnings (loss) before income tax
(122)
(6,674)
3,463
(5,185)
Income tax (benefit) expense
(57)
(42)
902
392
Net earnings (loss)
(65)
(6,632)
2,561
(5,577)
(Earnings) loss attributable to noncontrolling interests
(6)
1
—
4
Net earnings (loss) attributable to Centene Corporation
$ (71)
$ (6,631)
$ 2,561
$ (5,573)
Net earnings (loss) per common share attributable to Centene Corporation:
Basic earnings (loss) per common share
$ (0.14)
$ (13.50)
$ 5.19
$ (11.29)
Diluted earnings (loss) per common share
$ (0.14)
$ (13.50)
$ 5.15
$ (11.29)
Weighted average number of common shares outstanding:
Basic
494,143
491,141
493,351
493,644
Diluted
494,143
491,141
497,643
493,644
CENTENE CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
(In millions, unaudited)
Nine Months Ended
September 30,
2026
2025
Cash flows from operating activities:
Net earnings (loss)
$ 2,561
$ (5,577)
Adjustments to reconcile net earnings (loss) to net cash provided by operating activities
Depreciation and amortization
899
946
Stock compensation expense
178
146
Impairment
—
6,798
(Gain) loss on debt extinguishment
(2)
—
Deferred income taxes
35
13
(Gain) loss on divestitures, net
15
10
Changes in assets and liabilities
Premium and trade receivables
(2,262)
(3,338)
Other assets
403
(245)
Medical claims liabilities
1,024
3,176
Unearned revenue
(56)
(5)
Accounts payable and accrued expenses
1,178
2,681
Other long-term liabilities
163
38
Other operating activities, net
151
8
Net cash provided by operating activities
4,287
4,651
Cash flows from investing activities:
Capital expenditures
(568)
(554)
Purchases of investments
(3,511)
(3,765)
Sales and maturities of investments
4,728
4,131
Divestiture proceeds, net of divested cash
3
—
Net cash provided by (used in) investing activities
652
(188)
Cash flows from financing activities:
Proceeds from long-term debt
—
750
Payments and repurchases of long-term debt
(1,872)
(1,708)
Common stock repurchases
(57)
(473)
Proceeds from common stock issuances
26
29
Purchase of noncontrolling interest
—
(19)
Other financing activities, net
(3)
(13)
Net cash (used in) financing activities
(1,906)
(1,434)
Net increase in cash, cash equivalents and restricted cash and cash equivalents
3,033
3,029
Cash and cash equivalents reclassified (to) held for sale
(103)
—
Cash, cash equivalents and restricted cash and cash equivalents, beginning of period
17,957
14,156
Cash, cash equivalents and restricted cash and cash equivalents, end of period
$ 20,887
$ 17,185
Supplemental disclosures of cash flow information:
Interest paid
$ 438
$ 458
Income taxes paid, net
$ 15
$ 540
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:
September 30,
2026
2025
Cash and cash equivalents
$ 20,700
$ 17,058
Restricted cash and cash equivalents, included in restricted deposits
187
127
Total cash, cash equivalents and restricted cash and cash equivalents
$ 20,887
$ 17,185
CENTENE CORPORATION
SUPPLEMENTAL FINANCIAL DATA
Q3
Q2
Q1
Q4
Q3
2026
2026
2026
2025
2025
MEMBERSHIP
Traditional Medicaid (1)
10,544,300
10,745,800
10,923,100
10,932,600
11,115,400
High Acuity Medicaid (2)
1,351,600
1,364,900
1,503,800
1,585,800
1,591,000
Total Medicaid
11,895,900
12,110,700
12,426,900
12,518,400
12,706,400
Marketplace
3,403,300
3,494,700
3,582,200
5,541,400
5,828,100
Individual and Commercial Group (3)
497,400
497,000
481,000
452,500
447,900
Total Commercial
3,900,700
3,991,700
4,063,200
5,993,900
6,276,000
Medicare (4)
954,400
980,000
1,002,200
1,002,600
1,013,200
Medicare PDP
8,947,200
8,803,000
8,780,600
8,118,600
7,972,500
Total at-risk membership
25,698,200
25,885,400
26,272,900
27,633,500
27,968,100
(1) Membership includes TANF, Medicaid Expansion, CHIP, Foster Care and Behavioral Health.
(2) Membership includes ABD, IDD, LTSS and MMPs. The Company operated MMPs through December 31, 2025. In 2026 these members are included in
Medicare as a result of the CMS transition to D-SNP based integration.
(3) Membership includes Commercial Group, CHOICE Arrangements (formerly ICHRA) and Other Off-Exchange Individual.
(4) Membership includes Medicare Advantage, Medicare Supplement and AIPs as a result of the CMS transition to D-SNP based integration in 2026.
NUMBER OF EMPLOYEES
53,900
59,800
61,000
61,100
60,900
DAYS IN CLAIMS PAYABLE
48
47
48
46
48
CASH, INVESTMENTS AND RESTRICTED DEPOSITS (in millions)
Regulated
$ 38,425
$ 43,015
$ 40,239
$ 37,289
$ 37,574
Unregulated
1,425
1,831
1,533
1,478
1,259
Total
$ 39,850
$ 44,846
$ 41,772
$ 38,767
$ 38,833
DEBT TO CAPITALIZATION
41.1 %
41.6 %
43.2 %
46.5 %
45.5 %
OPERATING RATIOS
Three Months Ended
September 30,
Nine Months Ended
September 30,
2026
2025
2026
2025
HBR
92.7 %
92.7 %
89.9 %
91.1 %
SG&A expense ratio
7.2 %
7.0 %
7.3 %
7.3 %
Adjusted SG&A expense ratio
6.5 %
7.0 %
7.0 %
7.3 %
HBR BY PRODUCT
Three Months Ended
September 30,
Nine Months Ended
September 30,
2026
2025
2026
2025
Medicaid
93.6 %
93.4 %
93.6 %
93.9 %
Commercial
89.0 %
89.9 %
80.9 %
85.3 %
Medicare (5)
93.8 %
94.3 %
89.5 %
90.6 %
(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, September 30, 2025
$ 21,493
Less: Reinsurance recoverables
73
Balance, September 30, 2025, net
21,420
Incurred related to:
Current period
161,795
Prior periods
(1,564)
Total incurred
160,231
Paid related to:
Current period
141,483
Prior periods
18,332
Total paid
159,815
Plus: Premium deficiency reserve
(282)
Plus: Divestitures
(109)
Balance, September 30, 2026, net
21,445
Plus: Reinsurance recoverables
50
Balance, September 30, 2026
$ 21,495
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 $51 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 September 30, 2025, and prior.
SOURCE Centene Corporation