Anthem — Business Overview
What does Elevance Health do?
Elevance Health is one of the largest health insurers in the United States, serving about 45.2 million medical members as of December 31, 2025. The company offers a broad range of health insurance plans — including commercial, Medicare, and Medicaid — along with pharmacy services and other healthcare management capabilities. It operates primarily under the well-known Blue Cross and Blue Shield (BCBS) brand across 14 states, and also under the Wellpoint, Simply Healthcare, and Carelon brands in other markets.
The company operates through four reportable segments:
| Segment | What It Does |
|---|---|
| Health Benefits | Core health insurance plans for individuals, employers, Medicare, Medicaid, and federal employees. The largest segment by far. |
| CarelonRx | Pharmacy benefit management (PBM) — helps manage prescription drug costs and access for affiliated and external health plans. Includes home delivery, specialty pharmacy, and infusion centers. |
| Carelon Services | Integrated health services including behavioral health, care management, post-acute care (care after a hospital stay), utilization management, and data analytics. Serves both Elevance's own plans and outside clients. |
| Corporate & Other | Smaller businesses below reporting thresholds plus unallocated corporate expenses. |
How does Elevance Health make money?
The primary revenue stream is risk-based insurance premiums — money collected upfront from members or government programs in exchange for covering their healthcare costs. When actual medical costs come in below what was priced in, Elevance earns a profit on the spread; when costs run high, the company absorbs the difference. This is the core of the Health Benefits segment.
Two additional revenue streams come from services rather than insurance risk. For large employers that prefer to self-fund their own health claims (called fee-based or administrative services only (ASO) arrangements), Elevance charges administrative fees to handle claims processing, network access, and care management. Separately, CarelonRx and Carelon Services generate fees from pharmacy benefit management and healthcare services — both from Elevance's own health plans and from external, unaffiliated customers. Approximately 32% of total consolidated revenues in 2025 came from U.S. government agencies (primarily Medicare and Medicaid programs).
What market does Elevance Health operate in?
Elevance competes in the U.S. managed care (health insurance) industry, which covers commercial employer-sponsored coverage, individually purchased plans, and government programs like Medicare (for seniors) and Medicaid (for lower-income populations). This is a massive, highly regulated market where enrollment trends, healthcare cost inflation, and government reimbursement rates largely determine profitability.
Several structural forces shape the industry's direction. An aging U.S. population is expanding Medicare enrollment. Medicaid is subject to political and funding shifts — notably, the post-COVID "Medicaid redetermination" process that began in 2023 required states to remove ineligible enrollees, directly affecting membership levels. The Affordable Care Act's (ACA) enhanced subsidies for Public Exchange plans drove significant individual market growth from 2021 to 2025, but those subsidies expired at the end of 2025, which may reduce enrollment going forward. Rising drug costs, advances in medical technology, and behavioral health demands all contribute to persistent medical cost inflation — a key challenge for all health insurers.
Who are Elevance Health's main competitors?
The managed care industry is highly competitive, with a mix of large national players and regional insurers. Major competitors include UnitedHealth Group, Cigna, Aetna (a CVS Health subsidiary), Humana (particularly in Medicare), and Centene (particularly in Medicaid and public exchange markets). In pharmacy services, CarelonRx competes against CVS Caremark, Express Scripts (an Evernorth/Cigna company), and OptumRx (UnitedHealth) — all substantially larger PBM (pharmacy benefit manager) operations.
Elevance's most distinctive competitive advantage is its exclusive BCBS licensing rights across 14 states. The BCBS brand is widely recognized and trusted, particularly important when competing for large, multi-state employer groups. Through the BlueCard program, BCBS members traveling or working outside their home state can still access in-network care — a practical benefit that reinforces the brand's stickiness. Elevance claims to be the largest participant in most of the markets where it holds a BCBS license. The company also points to its provider network scale (giving it favorable negotiated rates), its data and analytics capabilities through Carelon Insights, and its shift toward value-based care (payment models that reward health outcomes rather than volume of services) as longer-term competitive differentiators.
Where does Elevance Health operate?
Elevance Health is almost entirely a U.S.-focused business. It is licensed to conduct insurance operations in all 50 states, the District of Columbia, and Puerto Rico. Its BCBS-branded health plans are concentrated in 14 states, including California, New York, Georgia, Indiana, Ohio, Virginia, and Wisconsin, among others. The Medicaid business spans 24 states plus the District of Columbia, Florida, and Puerto Rico. In 2025, the company expanded Public Exchange offerings into Florida, Maryland, and Texas under the Wellpoint and Simply Healthcare brands.
The company does maintain an international workforce, but generates a negligible amount of revenue outside the U.S. As of December 31, 2025, approximately 25,200 of its roughly 97,100 total employees are based internationally — primarily providing technology, analytics, and back-office support through Carelon Insights subsidiaries. The filing explicitly states that international revenues are immaterial to consolidated results, so there is no meaningful geopolitical or currency exposure to flag.