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Humana beat and affirmed. The affirmed guide implies the second half hands back $8.91 of adjusted EPS, and 600,000 members lose their plan in 2027 to fix the margin.

CALL 2026-07-29 · 8:00A ET READ PUBLISHED 2026-07-30 · 7:00A ET FULL ANNOTATED TRANSCRIPT ↗
The One Thing

Humana has booked $17.91 of adjusted EPS in six months against a full-year guide of 'at least $9.00'. Affirming that guide means the second half gives back about $8.91. The hard half of 2026 has not happened yet.

Top 5 Takeaways5 takeaways · every bullet sourced · 1 from post-call coverage
  1. Adjusted EPS of $7.61 beat, but $17.91 is already booked against a full-year guide of 'at least $9.00'. H2 gives back $8.91.
    Filed8-K 2026-07-29 · EX-99.1 · FY 2026 guidance
  2. Humana exits plans covering ~600,000 MA members in 2027 — half its year-to-date individual MA growth — to buy margin.
  3. Benefit ratio 91.2% and Q3 guided above 94%. The full-year 92.75% guide needs a materially worse second half.
    Filed8-K 2026-07-29 · EX-99.2 · Insurance Segment; EX-99.3 · seasonality
  4. Stars decides 2028 revenue: Humana goes dark in August, CMS publishes in October, and management withheld its threshold estimates.
  5. Shares fell about 6–7% on the day. The Street read an affirmed guide as a downgrade against sector expectations.
    CoveragePost-call coverage · Reuters, StockStory 2026-07-29
The NumbersReported · published precision · every figure sourced
MetricQ2 2026Prior yrYoYFY Guide
Revenue$40.9B$32.4B+26.2%≥$160B FY
Adjusted EPS beat ~$7.23 cons.$7.61$6.27+21.4%
Diluted EPS (GAAP)$5.73$4.51+27.1%
Adjusted EPS · six months 199% of the full-year guide$17.91$17.85+0.3%≥$9.00 FY
Insurance benefit ratio Q3 guided 'slightly above 94%'91.2%89.9%+1.3pp92.75% ±25bp
Adj. operating cost ratio9.7%10.9%-1.2pp10.0% ±25bp GAAP
Favorable prior-period development YTD $442M vs $638M$53M$161M-$108M
Days in claims payable 33.9 at Mar 3133.136.5-3.4 days
Individual MA members +1,204K YTD6.45M5.23M+23.4%≈+25% FY
Stand-alone PDP members +1,139K YTD, ahead of guide3.95M2.43M+62.6%≈+1.0M FY
Individual MA premium PMPM against 7–8% assumed cost trend$1,493$1,452+2.8%
CMS-actual MA enrollment company-reported total MA 7.18M at Jun 307.17M5.81M+23.4%
Insurance income from ops$820M$766M+7.0%≈breakeven FY
CenterWell adj. income from ops revenue $6.8B, +22.6%$514M$404M+27.2%$1.5B–$2.0B FY
FY26 adjusted EPS guide FY25 actual $17.14≥$9.00≥$9.00Affirmed
FY26 GAAP EPS guide put/call and value-creation charges≥$6.52≥$8.36-$1.84Cut
CMS ROWS ARE GROUND TRUTH, INDEPENDENT OF COMPANY REPORTING · PRECISION PER BRAND SPEC
Claims vs. Numbers4 checked · 1 confirmed · 3 open
Management said
we are executing and delivering results in line with expectations and remain on track to double our individual MA pretax margin this year, excluding the Stars headwind
TRANSCRIPT · CFO Celeste Mellet · prepared remarks
The numbers say Open
Insurance segment FY26 income from ops guided ≈ breakeven (GAAP)
The doubling is measured on a base that strips out the Star Ratings cut. On the reported basis Humana still guides the whole Insurance segment to roughly breakeven for the year, on $155B of revenue. Both sentences can be true at once. Only one of them is the number CMS pays on.
8-K 2026-07-29 · EX-99.2 · FY 2026 Guidance
Transcript context
CEOJIM RECHTIN · President and Chief Executive Officer · turn 3

Thanks, Lisa. Good morning, everyone. Thank you for joining us. Today’s headlines are we are pleased with our year-to-date performance. We continue to be tracking to expectations. We expect that our approach to 2027 MA bids will drive solid progress against our goal of delivering a sustainable pre-tax margin of at least 3% in 2028. We believe we are on track to meet our Investor Day commitments, including our Stars commitments. We will host a virtual investor update on December 10th to discuss the meaningful progress we have made towards those commitments. At that point, we will have full visibility into bonus year 2028 Stars and some preliminary insights into 2027 membership expectations. As usual, I will frame my comments today around the four drivers of our business: product and experience, which drive customer retention and growth; clinical excellence, which delivers clinical outcomes and medical margin; highly efficient operations; and capital allocation and growth in both CenterWell and Medicaid. Let’s start with product and experience. Our 2026 member growth trajectory is on track, and our membership, both the new and returning membership, is performing as expected. As we look ahead to 2027, our number one priority in MA bids was to make the necessary margin progression to remain on track to deliver our 2028 commitment of returning to a sustainable margin of at least 3%. We must drive sustainable earnings and appropriate returns to be able to provide excellent health outcomes and service for our members and our patients. We expect our targeted margin expansion in 2027 to be driven by our ongoing focus on clinical excellence and operating efficiency work, combined with adjustments to our plan mix and benefits, which Celeste will touch on in a moment. Turning to clinical excellence, our outlook on bonus year 2028, or BY28 Stars, remains unchanged. We continue to be confident we are on the right track to return to top quartile Stars results in BY28. I want to remind everybody that at our Investor Day, we defined top quartile Stars results as per member per month Stars revenue that is 10% above our peer group median. Stars revenue PMPM considers the quality bonus and the percentage of rebate retained at each Star level. We use this metric because Stars revenue PMPM is what is important from a competitive perspective. Going forward, you will hear us focus on Stars revenue PMPM instead of solely on the percent of members in 4-plus Star plans. Turning to our Stars performance. Over the last 18 months, we have said that we were making strong operational progress. I’m truly proud of how our Stars organization and the broader enterprise has risen to this challenge. Now that the measurement period for BY28 is complete, we are pleased to be able to share some tangible examples to demonstrate the progress. I would point you to Appendix A within our posted remarks. This slide shows the rate of improvement achieved in BY28 as compared to the previous four years for a selection of 12 HEDIS and patient safety metrics. We have de-identified the metrics for competitive reasons. What I want you to take away from this slide is that our rate of improvement outpaced, and in many places meaningfully outpaced, the historical CAGR across 11 of the 12 measures. While we do not intend to share this detail every year, we wanted to share today as it demonstrates that the operational changes and the investments we have made in our Stars program over the last year and a half are driving the intended results. We are driven by our North Star to improve health outcomes for our members with the goal of achieving top quartile results on a sustainable basis. As you know, we don’t know industry thresholds, so while we feel good about our substantial progress, we cannot guarantee an outcome in October. As a reminder, we will go into our annual Stars blackout period as soon as we receive the plan preview information from CMS beginning in August until the final data is released by CMS in October. For BY29 Stars, we have maintained momentum with our member engagement efforts. Consistent with Q1, we remain 5% ahead of last year’s quality improvement rate on a per member basis in key HEDIS metrics at the end of Q2. Regarding our new members, we continue to remain encouraged by their performance to date as their engagement levels remain in line and on some measures higher than renewing members. Let me turn to highly efficient operations. I mentioned last quarter that we were making good progress on our operating model changes. Our goals have been threefold. First, to be simpler, leaner and faster, so driving efficiencies while reducing friction for our customers. Second, to lead on innovation, leveraging automation and AI and the best performing vendors. Third, to attract the best talent and ensure effective performance management. Let me provide examples to bring these changes to life. We are centralizing certain operations to simplify process and reduce variability in outcomes. One example is utilization management, where we centralize 11 markets into one team. This is driving G&A savings, but it is also creating a more consistent experience for providers and members. We are also expanding outsourcing while improving vendor performance. This year, we increased outsourcing in our finance and HR functions while we also continued to advance vendor optimization efforts in IT. We are also in the early stages of transforming select other vendor relationships from tactical labor-based engagements into strategic partnerships that can deliver greater business value and capabilities. Finally, we integrated our CarePlus operations. CarePlus is a legacy health plan acquisition that we integrated into our core platforms to eliminate redundancy, which drives greater value and scale while maintaining our reputable CarePlus brand in Florida. All in, we have made considerable progress in the first half of the year. Our operating model efforts have yielded hundreds of millions of dollars in value so far in 2026. Finally, let me turn to capital allocation. As we have previously noted, we have been pursuing non-core asset divestitures. We recently announced an agreement to divest our minority interest in Gentiva, which is valued at approximately $900 million. This divestiture will largely fund our recent acquisition of MaxHealth. We also continue to expand our Medicaid platform with the recent award of a statewide Illinois Medicaid managed care contract. That contract is set to go live in January of 2027, I’d like to note that Humana was the only new entrant awarded, along with five incumbents. In conclusion, we are performing as expected in 2026. Our member growth is expected to further fuel our ability to unlock the earnings potential of the business. We’re making good progress on Stars. We expect to make meaningful progress on MA margin expansion in 2027, and we remain on track to hit our investor day commitments in 2028. Before I turn it over to Celeste, I would like to highlight our announcement this morning that Paul Smith and Fred Crawford will join Humana’s Board of Directors. Paul is the Chief Commercial Officer at Anthropic, where he leads commercial strategy and global go-to-market operations. Paul brings over 30 years of experience leading global organizations through major technology transitions. Fred has deep financial and operational experience, having spent more than 30 years in the insurance and banking industries. Fred was the Chief Financial Officer of three publicly traded insurers, and most recently served as the President and Chief Operating Officer at Aflac until his retirement in 2024. Paul and Fred will complement our board’s expertise well, bringing a unique perspective that will be invaluable as we advance along our journey of becoming a consumer healthcare company. With that, I will turn it to Celeste for a few remarks before we go to Q&A.

CFOCELESTE MELLET · Chief Financial Officer · turn 4

Thank you, Jim. I will start with our comments on our 2026 performance and 2027 MA bid approach before touching on continued progress on balance sheet efficiency and capital optimization. Starting with 2026. Based on available information to date, cost trends are in line with our expectations for both new and existing members. As a reminder, we assume 2026 cost trend would be in the high single digit range or 7%-8%, inclusive of both medical and pharmacy. There are certain areas where we have seen slight favorability, particularly in the inpatient space. Based on approximately four months of completed claims data, favorability has been more heavily concentrated in members engaged with value-based providers. While the risk-sharing nature of these agreements limit the favorability that flows through to our financials, it is positive for our provider partners, and we believe an additional proof point of broader stabilization in the MA trend environment. As Jim described, our transformation and operating model work is driving the intended result. Our 2Q consolidated operating cost ratio is down 120 basis points year-over-year, and we continue to expect a full year reduction of approximately 150 basis points. Taken together, we are executing and delivering results in line with expectations and remain on track to double our individual MA pretax margin this year, excluding the Stars headwind. I will now touch on our 2027 MA bids. As Jim mentioned, our number one priority was to make the necessary progress to remain on track to deliver on our 2028 commitment of returning to a sustainable margin of at least 3%. We expect meaningful progress toward our 2028 margin goal next year, with actual 2027 results shaped by our final membership size and composition. Our expected margin expansion in 2027 will benefit from our ongoing clinical excellence and operating efficiency work, as well as benefit adjustments and targeted plan exits. While it remains too early to provide many specifics regarding our bid strategy, let me provide some perspective on our approach to plan exits. To reduce benefit disruption, we will use plan exits to prioritize higher performing plans, including those with greater value-based care penetration. This approach is aligned with bid priority number 2, which is to retain as many members as possible while making the changes necessary to drive the intended margin expansion. For 2027, we anticipate these plan exits will impact approximately 600,000 members, though we will work to recapture a significant portion of that volume as we did in 2025. Turning to capital deployment and balance sheet. We have continued our efforts to increase the efficiency of our balance sheet and fortify our foundation, including the establishment of $1.5 billion in contingent capital facilities utilizing pre-capitalized trust securities or PCAPS, enhancing our access to low-cost long-term liquidity. We are the first in the health payer space to utilize this innovative product. We have also maintained a prudent capital deployment approach, including pursuing non-core asset divestitures. As Jim mentioned, we recently announced an agreement to divest our minority interest in Gentiva, which is valued at approximately $900 million and expected to close in the fourth quarter. More broadly, our capital and balance sheet efficiency efforts are delivering results. We continue to evaluate pipeline of initiatives to further strengthen the balance sheet and improve our capital efficiency. Before going to Q&A, let me reiterate what Jim started with. We are pleased with our year-to-date performance. We expect to make meaningful progress on margin expansion in 2027. We are executing on our investor day commitments and delivering on the earnings power and value of the company. I will now turn the call back to Lisa to start the Q&A.

CFOCELESTE MELLET · Chief Financial Officer · turn 8

Yeah. Justin, we’re not going to comment on the specific progress from 2026 to 2027, in part because ultimately where we land will be driven by the membership size and composition. As you know, we have a portfolio. There are some product with higher margin, some with mid margin. We do expect to make significant progress in 2027 versus 2026 and well on our path to 2028. In terms of what is embedded in our bids, we continue to assume trends in line with what we’re seeing this year. Although as you know the drug trend continues to be high and will tick modestly higher next year based on current expectations given the health technology pipeline or the new drugs that will be released. Of course, as we always do, we build in effectively contingency into our bids Because we’re doing it well in advance, six months before the next year, and you have a whole year to get through to account for things moving in any direction. We believe we are well-positioned to make significant progress, and look forward to this year’s AEP.

OPEN AT THIS PASSAGE IN FULL TRANSCRIPT ↗
Management said
Based on available information to date, cost trends are in line with our expectations for both new and existing members.
TRANSCRIPT · CFO Celeste Mellet · prepared remarks
The numbers say Open
Insurance benefit ratio 91.2%, +1.3pp YoY; Q3 guided 'slightly above 94%'
In line with plan is not the same as improving. The benefit ratio is up 1.3pp, Q3 is guided above 94% and the full year to 92.75%. Mellet's evidence is roughly four months of completed claims on a book that grew 23% in six months, and favorable prior-period development fell $108M year over year. The forecast is holding. The costs are not.
8-K 2026-07-29 · EX-99.2 · Insurance Segment; EX-99.3 · Earnings Seasonality
Transcript context
CFOCELESTE MELLET · Chief Financial Officer · turn 4

Thank you, Jim. I will start with our comments on our 2026 performance and 2027 MA bid approach before touching on continued progress on balance sheet efficiency and capital optimization. Starting with 2026. Based on available information to date, cost trends are in line with our expectations for both new and existing members. As a reminder, we assume 2026 cost trend would be in the high single digit range or 7%-8%, inclusive of both medical and pharmacy. There are certain areas where we have seen slight favorability, particularly in the inpatient space. Based on approximately four months of completed claims data, favorability has been more heavily concentrated in members engaged with value-based providers. While the risk-sharing nature of these agreements limit the favorability that flows through to our financials, it is positive for our provider partners, and we believe an additional proof point of broader stabilization in the MA trend environment. As Jim described, our transformation and operating model work is driving the intended result. Our 2Q consolidated operating cost ratio is down 120 basis points year-over-year, and we continue to expect a full year reduction of approximately 150 basis points. Taken together, we are executing and delivering results in line with expectations and remain on track to double our individual MA pretax margin this year, excluding the Stars headwind. I will now touch on our 2027 MA bids. As Jim mentioned, our number one priority was to make the necessary progress to remain on track to deliver on our 2028 commitment of returning to a sustainable margin of at least 3%. We expect meaningful progress toward our 2028 margin goal next year, with actual 2027 results shaped by our final membership size and composition. Our expected margin expansion in 2027 will benefit from our ongoing clinical excellence and operating efficiency work, as well as benefit adjustments and targeted plan exits. While it remains too early to provide many specifics regarding our bid strategy, let me provide some perspective on our approach to plan exits. To reduce benefit disruption, we will use plan exits to prioritize higher performing plans, including those with greater value-based care penetration. This approach is aligned with bid priority number 2, which is to retain as many members as possible while making the changes necessary to drive the intended margin expansion. For 2027, we anticipate these plan exits will impact approximately 600,000 members, though we will work to recapture a significant portion of that volume as we did in 2025. Turning to capital deployment and balance sheet. We have continued our efforts to increase the efficiency of our balance sheet and fortify our foundation, including the establishment of $1.5 billion in contingent capital facilities utilizing pre-capitalized trust securities or PCAPS, enhancing our access to low-cost long-term liquidity. We are the first in the health payer space to utilize this innovative product. We have also maintained a prudent capital deployment approach, including pursuing non-core asset divestitures. As Jim mentioned, we recently announced an agreement to divest our minority interest in Gentiva, which is valued at approximately $900 million and expected to close in the fourth quarter. More broadly, our capital and balance sheet efficiency efforts are delivering results. We continue to evaluate pipeline of initiatives to further strengthen the balance sheet and improve our capital efficiency. Before going to Q&A, let me reiterate what Jim started with. We are pleased with our year-to-date performance. We expect to make meaningful progress on margin expansion in 2027. We are executing on our investor day commitments and delivering on the earnings power and value of the company. I will now turn the call back to Lisa to start the Q&A.

CFOCELESTE MELLET · Chief Financial Officer · turn 12

Yeah. As a reminder, our all-in trend assumption for this year is high single digits or 7%-8%, so a little bit lower on the medical cost and then in the double digit on drug costs. As we called out, things are within the range, though we are seeing favorability, particularly on inpatient, and we are seeing both lower admits per thousand and lower unit costs on those admits. It’s both the P and the Q on inpatient costs that are down. I’ll turn it over to Jim on site of service.

CFOCELESTE MELLET · Chief Financial Officer · turn 28

Appreciate the question. We did guide to 7%-8% cost trend. My understanding is that some of our peers guided to significantly higher cost trend. I can’t speak to what they’re seeing other than we are in line with the range with some favorability. We also continue to build prudent reserves. We continue to be prudently reserved, especially versus the beginning of the year. We have built significant reserves this year. We have a lot of data. We continue to look at data through the end of July, in fact. It’s fairly consistent, and our goal is to deliver on our commitment to you in terms of our 2026 results, and more importantly, continue to make progress on our 2028 commitments, really focused on the long term. Obviously, we need to deliver on the short term to do that. In terms of margin progression next year, we’re not going to get into a lot of specifics around the bids. As we talked about, ultimately where we land will depend on the membership size and composition. We are working on reducing cost of care more broadly. Jim talked extensively about site of care, really focused on clinical innovation. We continue to drive our transformation, which gives us nice lift. We obviously made adjustments to the benefit. We talked about the plan exits. You do get a natural lift in terms of what we call accurate diagnosis. There isn’t anything unusual in terms of what we’re doing. We’re obviously working to mitigate the chart review item that was included in the rate notice, and we’re making good progress there, but otherwise, nothing unusual from the MRA perspective.

OPEN AT THIS PASSAGE IN FULL TRANSCRIPT ↗
Management said
For 2027, we anticipate these plan exits will impact approximately 600,000 members, though we will work to recapture a significant portion of that volume as we did in 2025.
TRANSCRIPT · CFO Celeste Mellet · prepared remarks
The numbers say Confirmed
600,000 = 9.3% of 6.45M individual MA members, and half the 1,204K added YTD
One in eleven individual MA members loses a plan. Humana added 1,204,000 individual MA members in six months and will hand half of that back to price the rest. Recapture is a plan, not a number: the only evidence offered is that it worked in 2025. Exits target lower-performing plans, so the members released are the ones Humana priced worst.
8-K 2026-07-29 · EX-99.2 P.S-11 · Membership Detail
Transcript context
CFOCELESTE MELLET · Chief Financial Officer · turn 4

Thank you, Jim. I will start with our comments on our 2026 performance and 2027 MA bid approach before touching on continued progress on balance sheet efficiency and capital optimization. Starting with 2026. Based on available information to date, cost trends are in line with our expectations for both new and existing members. As a reminder, we assume 2026 cost trend would be in the high single digit range or 7%-8%, inclusive of both medical and pharmacy. There are certain areas where we have seen slight favorability, particularly in the inpatient space. Based on approximately four months of completed claims data, favorability has been more heavily concentrated in members engaged with value-based providers. While the risk-sharing nature of these agreements limit the favorability that flows through to our financials, it is positive for our provider partners, and we believe an additional proof point of broader stabilization in the MA trend environment. As Jim described, our transformation and operating model work is driving the intended result. Our 2Q consolidated operating cost ratio is down 120 basis points year-over-year, and we continue to expect a full year reduction of approximately 150 basis points. Taken together, we are executing and delivering results in line with expectations and remain on track to double our individual MA pretax margin this year, excluding the Stars headwind. I will now touch on our 2027 MA bids. As Jim mentioned, our number one priority was to make the necessary progress to remain on track to deliver on our 2028 commitment of returning to a sustainable margin of at least 3%. We expect meaningful progress toward our 2028 margin goal next year, with actual 2027 results shaped by our final membership size and composition. Our expected margin expansion in 2027 will benefit from our ongoing clinical excellence and operating efficiency work, as well as benefit adjustments and targeted plan exits. While it remains too early to provide many specifics regarding our bid strategy, let me provide some perspective on our approach to plan exits. To reduce benefit disruption, we will use plan exits to prioritize higher performing plans, including those with greater value-based care penetration. This approach is aligned with bid priority number 2, which is to retain as many members as possible while making the changes necessary to drive the intended margin expansion. For 2027, we anticipate these plan exits will impact approximately 600,000 members, though we will work to recapture a significant portion of that volume as we did in 2025. Turning to capital deployment and balance sheet. We have continued our efforts to increase the efficiency of our balance sheet and fortify our foundation, including the establishment of $1.5 billion in contingent capital facilities utilizing pre-capitalized trust securities or PCAPS, enhancing our access to low-cost long-term liquidity. We are the first in the health payer space to utilize this innovative product. We have also maintained a prudent capital deployment approach, including pursuing non-core asset divestitures. As Jim mentioned, we recently announced an agreement to divest our minority interest in Gentiva, which is valued at approximately $900 million and expected to close in the fourth quarter. More broadly, our capital and balance sheet efficiency efforts are delivering results. We continue to evaluate pipeline of initiatives to further strengthen the balance sheet and improve our capital efficiency. Before going to Q&A, let me reiterate what Jim started with. We are pleased with our year-to-date performance. We expect to make meaningful progress on margin expansion in 2027. We are executing on our investor day commitments and delivering on the earnings power and value of the company. I will now turn the call back to Lisa to start the Q&A.

ANALYSTSELL-SIDE · Kevin Fischbeck · turn 24

Great, thanks. Just talk a little bit more about the bidding strategy for next year. Obviously, this year you guys kept benefits stable. For next year, you’re talking about exiting markets. Why that change in exiting markets next year versus not doing it this year? Is there anything related to Star Ratings as far as how you chose what markets you’d be exiting and the membership losses that would be there? I guess just a little more color on what it means to be targeting kind of high value plans. Thanks.

CFOCELESTE MELLET · Chief Financial Officer · turn 25

As we’ve talked about in the past, we have a multi-year approach to membership and benefits, and think across several years. More importantly, from year to year and over the longer term, we look at specific underwriting margin targets at the plan level and continuously monitor benefit design, costs, and the revenue to drive profitability. Funding is really important, and increasingly we’re very much focused on the capital returns of the plan. We take into account that certain states have much higher capital rates. Value-based care has lower capital associated with it, while fee for service is higher capital. Obviously, you’re going to adjust pricing to generate the return. As you know, markets have been super dynamic in the last year. We look at this every year. We did push harder on this this year to let us make the margin progress that we need to and to protect our highest value plan. I would think about it as the plan with the highest return. Rather than cut more uniformly across the board, really remove or cut off the lower tail of profitability and return to ensure we can protect and retain the members and the benefits associated with our high value plans. As I called out, we expect to capture a similar portion as we did in 2025. If you remember, it was just over 40%. The majority of the plan exits were in plans with three and a half or lower ratings for BY27. I wouldn’t really think about this as a Star Ratings item. As you know, we are focused on returning to top quartile Star Ratings on a sustainable basis. This isn’t really a Stars item.

OPEN AT THIS PASSAGE IN FULL TRANSCRIPT ↗
Management said
our rate of improvement outpaced, and in many places meaningfully outpaced, the historical CAGR across 11 of the 12 measures
TRANSCRIPT · CEO Jim Rechtin · prepared remarks
The numbers say Open
FY26 adjusted EPS guide ≥$9.00 against FY25 actual $17.14
Humana beat its own history on twelve measures it chose and de-identified. Cut points are set by competitors, and Rechtin declined to share Humana's threshold estimates. The BY2026 Stars cut is what takes guidance from $17.14 to $9.00; BY2028 is the recovery trade. CMS releases the answer in October, and Humana goes dark in August.
8-K 2026-07-29 · EX-99.1 · FY 2026 Earnings Guidance
Transcript context
CEOJIM RECHTIN · President and Chief Executive Officer · turn 3

Thanks, Lisa. Good morning, everyone. Thank you for joining us. Today’s headlines are we are pleased with our year-to-date performance. We continue to be tracking to expectations. We expect that our approach to 2027 MA bids will drive solid progress against our goal of delivering a sustainable pre-tax margin of at least 3% in 2028. We believe we are on track to meet our Investor Day commitments, including our Stars commitments. We will host a virtual investor update on December 10th to discuss the meaningful progress we have made towards those commitments. At that point, we will have full visibility into bonus year 2028 Stars and some preliminary insights into 2027 membership expectations. As usual, I will frame my comments today around the four drivers of our business: product and experience, which drive customer retention and growth; clinical excellence, which delivers clinical outcomes and medical margin; highly efficient operations; and capital allocation and growth in both CenterWell and Medicaid. Let’s start with product and experience. Our 2026 member growth trajectory is on track, and our membership, both the new and returning membership, is performing as expected. As we look ahead to 2027, our number one priority in MA bids was to make the necessary margin progression to remain on track to deliver our 2028 commitment of returning to a sustainable margin of at least 3%. We must drive sustainable earnings and appropriate returns to be able to provide excellent health outcomes and service for our members and our patients. We expect our targeted margin expansion in 2027 to be driven by our ongoing focus on clinical excellence and operating efficiency work, combined with adjustments to our plan mix and benefits, which Celeste will touch on in a moment. Turning to clinical excellence, our outlook on bonus year 2028, or BY28 Stars, remains unchanged. We continue to be confident we are on the right track to return to top quartile Stars results in BY28. I want to remind everybody that at our Investor Day, we defined top quartile Stars results as per member per month Stars revenue that is 10% above our peer group median. Stars revenue PMPM considers the quality bonus and the percentage of rebate retained at each Star level. We use this metric because Stars revenue PMPM is what is important from a competitive perspective. Going forward, you will hear us focus on Stars revenue PMPM instead of solely on the percent of members in 4-plus Star plans. Turning to our Stars performance. Over the last 18 months, we have said that we were making strong operational progress. I’m truly proud of how our Stars organization and the broader enterprise has risen to this challenge. Now that the measurement period for BY28 is complete, we are pleased to be able to share some tangible examples to demonstrate the progress. I would point you to Appendix A within our posted remarks. This slide shows the rate of improvement achieved in BY28 as compared to the previous four years for a selection of 12 HEDIS and patient safety metrics. We have de-identified the metrics for competitive reasons. What I want you to take away from this slide is that our rate of improvement outpaced, and in many places meaningfully outpaced, the historical CAGR across 11 of the 12 measures. While we do not intend to share this detail every year, we wanted to share today as it demonstrates that the operational changes and the investments we have made in our Stars program over the last year and a half are driving the intended results. We are driven by our North Star to improve health outcomes for our members with the goal of achieving top quartile results on a sustainable basis. As you know, we don’t know industry thresholds, so while we feel good about our substantial progress, we cannot guarantee an outcome in October. As a reminder, we will go into our annual Stars blackout period as soon as we receive the plan preview information from CMS beginning in August until the final data is released by CMS in October. For BY29 Stars, we have maintained momentum with our member engagement efforts. Consistent with Q1, we remain 5% ahead of last year’s quality improvement rate on a per member basis in key HEDIS metrics at the end of Q2. Regarding our new members, we continue to remain encouraged by their performance to date as their engagement levels remain in line and on some measures higher than renewing members. Let me turn to highly efficient operations. I mentioned last quarter that we were making good progress on our operating model changes. Our goals have been threefold. First, to be simpler, leaner and faster, so driving efficiencies while reducing friction for our customers. Second, to lead on innovation, leveraging automation and AI and the best performing vendors. Third, to attract the best talent and ensure effective performance management. Let me provide examples to bring these changes to life. We are centralizing certain operations to simplify process and reduce variability in outcomes. One example is utilization management, where we centralize 11 markets into one team. This is driving G&A savings, but it is also creating a more consistent experience for providers and members. We are also expanding outsourcing while improving vendor performance. This year, we increased outsourcing in our finance and HR functions while we also continued to advance vendor optimization efforts in IT. We are also in the early stages of transforming select other vendor relationships from tactical labor-based engagements into strategic partnerships that can deliver greater business value and capabilities. Finally, we integrated our CarePlus operations. CarePlus is a legacy health plan acquisition that we integrated into our core platforms to eliminate redundancy, which drives greater value and scale while maintaining our reputable CarePlus brand in Florida. All in, we have made considerable progress in the first half of the year. Our operating model efforts have yielded hundreds of millions of dollars in value so far in 2026. Finally, let me turn to capital allocation. As we have previously noted, we have been pursuing non-core asset divestitures. We recently announced an agreement to divest our minority interest in Gentiva, which is valued at approximately $900 million. This divestiture will largely fund our recent acquisition of MaxHealth. We also continue to expand our Medicaid platform with the recent award of a statewide Illinois Medicaid managed care contract. That contract is set to go live in January of 2027, I’d like to note that Humana was the only new entrant awarded, along with five incumbents. In conclusion, we are performing as expected in 2026. Our member growth is expected to further fuel our ability to unlock the earnings potential of the business. We’re making good progress on Stars. We expect to make meaningful progress on MA margin expansion in 2027, and we remain on track to hit our investor day commitments in 2028. Before I turn it over to Celeste, I would like to highlight our announcement this morning that Paul Smith and Fred Crawford will join Humana’s Board of Directors. Paul is the Chief Commercial Officer at Anthropic, where he leads commercial strategy and global go-to-market operations. Paul brings over 30 years of experience leading global organizations through major technology transitions. Fred has deep financial and operational experience, having spent more than 30 years in the insurance and banking industries. Fred was the Chief Financial Officer of three publicly traded insurers, and most recently served as the President and Chief Operating Officer at Aflac until his retirement in 2024. Paul and Fred will complement our board’s expertise well, bringing a unique perspective that will be invaluable as we advance along our journey of becoming a consumer healthcare company. With that, I will turn it to Celeste for a few remarks before we go to Q&A.

ANALYSTSELL-SIDE · Stephen Baxter · turn 15

Hi. Thanks. I wanted to ask about the stars color you provided, so appreciate the commentary and the progress you’re making. For these metrics that you provided, I believe this is a subset of HEDIS and patient safety measures. Could you expand a little bit on how these metrics were selected and kind of how confident we can be this is representative of the broader performance? Then if there was going to be a line on this chart for your peer group average, which is what you’re ultimately trying to outperform, what would the trends look like in that context? Would you still have outperformance versus the peer group average that ultimately is going to dictate the cut points? Thank you.

CEOJIM RECHTIN · President and Chief Executive Officer · turn 16

Yes, happy to tackle that question. I’m going to kind of step back and hit a few things around stars. Then I’ll answer the questions that you posed there directly. The first thing I want to say is I just want to emphasize that there’s no change in our tone this quarter versus the last quarter, the quarter before that, or frankly, our tone dating all the way back to the investor day. We feel good about our operational progress, we have the inherent unknown of thresholds that we all have to wrestle with. What we’re trying to do here is simply provide a little bit more nuance or color so that you understand why our tone has been what it is. There are two things that are driving us as an organization. You could think of it as twin North Stars in a way. The first is we should be closing every single gap we possibly can because it’s the right thing for our members. That is the motivation that drives our teams every day. The second is that we need, at a minimum, to be hitting top quartile stars results, because that is what’s required to be competitive in the marketplace. I want to reemphasize that we were very deliberate a year and a half or a year ago, back in June of 2025, at our investor day around defining what top quartile means. Top quartile is measured on a per member, per month basis. It is stars revenue, taking into account each of the different Star Ratings. The reason that that is important is because when you look at the operational performance that we’ve had, we know that there’s going to be some variation in thresholds. We know that some are going to end up a little bit higher than we expect, some are going to end up a little bit lower than we expect. That metric does two things. One, you look back historically and you know that if you hit that metric, which is 10% above the median player among our top five competitors. That if you hit that, you know historically that says, hey, you’re competitive in the marketplace. This type of operational progress gives us confidence that even if we are off on some thresholds, we have multiple paths to get to that PMPM number that we need to get to. We have multiple ways to get there. There is inherently some threshold uncertainty, but we walk away with confidence that we can navigate that uncertainty because of the metric we know we need to hit and because of the operational progress that you’re seeing. Specifically, the question around why these metrics. The answer, honestly, is very simple. These are the metrics that we have clear longitudinal data over the last five years to be able to compare. There’s some metrics that simply came in or out of the program during that five-year period. We don’t have consistent operational data. There is some data where we don’t have hard data at this point. Really the survey data is held by CMS. We don’t have the same level of visibility. We have some metrics where frankly, we’re even getting an early read from CMS, and we’re not going to share that data because that data is private between us and CMS at this point. There’s no magic to these numbers other than these are the metrics that we have good longitudinal data on and can share. We do believe they’re representative. When you look at the program broadly, we believe that these metrics are representative of our performance broadly. Again, based on everything that we know today, there are obviously some things that we don’t know, but based on everything we know today, we feel good that this is a pretty representative sample. To your last question around thresholds, we’re not going to share our internal estimates around thresholds, but I would point back to the comment that I made earlier. We have looked at thresholds a number of different ways, and we do believe that this operational progress puts us in a good place that even if we have some surprises on thresholds, which inevitably we will have some, we will have navigated to a place that is consistent with our commitment. Now, of course, we can’t guarantee that. Everybody knows that. We feel pretty good. We feel confident that we have put ourselves in a position to land where we need to land. That’s how we’re thinking about it, and that’s why we wanted to share this data. Hit two last things. We’re not going to share this data every year, I just want to be clear, but we have put so much time, energy investment. This is so important to the business right now that we thought it was important that we give you this color. Second, we are about to walk into the blackout period. As soon as we do get plan preview data from CMS, I just want to remind everybody, we’re going to go dark until the final results are actually released by CMS. That’s where we’re at on Stars.

OPEN AT THIS PASSAGE IN FULL TRANSCRIPT ↗
Guidance Language DeltaFY 2026 guidance · Apr 29, 2026 (1Q26 release) → FY 2026 guidance · Jul 29, 2026 (2Q26 release)
FY 2026 guidance · Apr 29, 2026 (1Q26 release)

GAAP EPS 'at least $8.36'; Adjusted EPS 'at least $9.00'. Insurance segment benefit ratio 92.75% plus or minus 25 basis points. Consolidated operating cost ratio 10.0% plus or minus 25 basis points. Individual Medicare Advantage membership growth of approximately 25 percent.

Humana 1Q26 earnings release, Apr 29 2026 · FY 2026 Earnings Guidance table (humana.gcs-web.com)
FY 2026 guidance · Jul 29, 2026 (2Q26 release)

GAAP EPS 'at least $6.52' (previously 'at least $8.36'); Adjusted EPS 'at least $9.00'. Insurance segment benefit ratio 92.75% plus or minus 25 basis points. Consolidated operating cost ratio 10.0% plus or minus 25 basis points. Individual Medicare Advantage membership growth of approximately 25 percent.

8-K 2026-07-29 · EX-99.1 FY 2026 Earnings Guidance; EX-99.2 FY 2026 Guidance grid

One line moved. The $1.84 GAAP cut is put/call remeasurement on the CenterWell primary-care partnership swinging from -$0.28 to +$1.47, plus value-creation charges rising to $1.27 and a $0.17 impairment. Nothing operating changed: the benefit ratio, cost ratio and membership guides are April's, which are February's. With $17.91 of adjusted EPS already booked, affirming 'at least $9.00' is a statement about what the second half gives back.

Q&A Pressure Map13 analyst questions
2027 MA bids & the path to 3% margin
Cost trend & benefit ratio
Stars: BY28 progress & thresholds
IBNR & reserve adequacy
Part D & CMS policy change
Balance sheet & P-Caps
Cost cutting & Dec 10 investor update
ENGAGED   DEFLECTED — deflections are where next quarter's questions live
Thread Postings4 threads advanced
Margin

TT — Humana buys 2027 margin by exiting plans for 600,000 members. Growth is over; the book gets pruned.

Distribution

TT — 600,000 Humana members shop in AEP 2027. Brokers get the volume; rivals get the switchers Humana wants back.

Stars

TT — Humana shared 12 self-selected HEDIS measures and withheld its threshold estimates. October decides whether BY28 recovery is real.

Structure

TT — Humana added 3.1M members in a year while guiding earnings down 47%. Scale arrived before the margin did.

What You Can Control

Humana will exit plans covering roughly 600,000 MA members for 2027 and says it will try to recapture a significant portion. You will see exactly which plans before Humana's retention machine reaches those members: CMS publishes the 2027 landscape files in late September and non-renewal notices go out by early October, ahead of AEP (Oct 15–Dec 7). Build the target list now. Pull Humana's individual MA contracts from the CPSC file — 6.45M members, 50% in PPO/PFFS and only 64% in value-based arrangements, down from 68% a year ago. Mellet said exits will 'prioritize higher performing plans, including those with greater value-based care penetration', so the exposed members sit in the non-value-based 36%. Rank your counties by Humana PPO share, flag the ones thin on value-based penetration, and put licensed capacity there for October. The same list tells you where to defend: Humana is pricing to keep the members it wants, so the ones it releases are the ones it priced worst.

The DocumentsEverything this read is built from
The full call, speaker-attributed and segmented, with Tally's margin notes. Humana publishes prepared remarks as an 8-K exhibit and runs a Q&A-only live call, so the exchanges exist nowhere on its own IR site.
52 turns
EPS, the benefit-ratio headline and the FY 2026 guidance table with the GAAP-to-Adjusted bridge. The source for the $6.52 / $9.00 split.
8 PP.
Segment results, the prior-period development and DCP disclosure, the FY guidance grid, membership detail (S-11) and premium PMPM by product (S-12).
15 STAT PP.
Management's written narrative, including Q3 seasonality (adjusted EPS ≈ -$1.00, Insurance benefit ratio slightly above 94%) and Appendix A, the de-identified BY2028 Stars chart.
6 PP.
Filed the afternoon of the call. The IBNR roll-forward is where Mellet's 'basically flat from last quarter' gets a number. Not yet in the document store.
NOT CAPTURED
Contract-level MA enrollment, independent of company reporting. May 2026 shows 7,172,278 Humana MA members against 7.18M reported at June 30 — the ground-truth row in The Numbers, and the file to build the county target list from.
CSV · 2026-05