# CVS Health Corporation (NYSE: CVS) — Business, Risks and Management's Discussion Sources: the Annual Report on Form 10-K for the fiscal year ended December 31, 2025 (accession 0000064803-26-000010, filed February 10, 2026); the Quarterly Report on Form 10-Q for the quarter ended June 30, 2026 (accession 0000064803-26-000098, filed August 5, 2026); and the Current Reports on Form 8-K noted in the sections below. --- ## Business *From the FY2025 Form 10-K, accession 0000064803-26-000010.* CVS Health is a diversified U.S. health care company that sells health insurance, manages pharmacy benefits, dispenses prescriptions and delivers primary and in-home care. It describes itself as a leading health solutions company "building a world of health around every consumer it serves." As of December 31, 2025 it operated approximately 9,000 retail locations and more than 1,000 walk-in and primary care medical clinics, its pharmacy benefit manager served approximately 87 million plan members, and its insurance business served an estimated more than 37 million people. Revenue is overwhelmingly domestic and concentrated in three operating businesses: pharmacy benefit management and health services (Health Services, $190.4 billion of FY2025 revenue before eliminations), retail pharmacy and front store (Pharmacy & Consumer Wellness, $139.4 billion) and health insurance premiums (Health Care Benefits, $143.4 billion). Total FY2025 revenues were $402.1 billion. Programs funded by the U.S. federal government are a structural dependency: Health Care Benefits revenues from the federal government were approximately 20% of consolidated total revenues in each of 2025, 2024 and 2023, and CMS contracts for Medicare-eligible individuals accounted for about 79% of federal-government revenue in 2025. The company reports four segments: Health Care Benefits, Health Services, Pharmacy & Consumer Wellness and Corporate/Other. Its stated strategy is to be "America's most trusted health care company," organized around simplifying health care experiences, improving engagement, lowering costs and delivering better outcomes through an integrated model. It is incorporated in Delaware and headquartered in Woonsocket, Rhode Island; there were 1,272,211,063 shares of common stock outstanding as of February 4, 2026. ### Health Care Benefits (Aetna) Insurance and administrative-services health benefits, sold through employer groups, government-sponsored programs and individuals. Products span commercial medical (POS, PPO, HMO, indemnity, HSAs and consumer-directed plans, medical stop-loss for self-insured employers, plus dental, behavioral health, vision and employee-assistance products) and government medical (Medicare Advantage, Medicare Supplement, stand-alone Medicare Part D prescription drug plans, Medicaid and CHIP management, and dual-eligible demonstration programs). The company distinguishes "Insured" products, where it takes all or most of the medical-cost risk, from "ASC" administrative-services contracts, where the plan sponsor does. Scale and reach as of December 31, 2025: network-based Medicare Advantage HMO/PPO plans in 44 states and Washington, D.C.; PDP plans in all 50 states and Washington, D.C.; Medicare Supplement in 49 states and Washington, D.C.; Medicaid/CHIP services in 15 states; a nationwide provider network of approximately 2.0 million participating providers. Total medical membership was 26.6 million (10.9 million Insured, 15.7 million ASC), plus 4.0 million stand-alone PDP members. The company sold Insured plans on the individual public health insurance exchanges through the year ended December 31, 2025 and **exited every state in which Aetna operated on the Public Exchanges effective January 2026**. Pricing is largely set in advance: commercial Insured contracts generally run one year at a fixed premium rate that cannot be reopened for unanticipated cost increases; Medicare Advantage and PDP revenue comes from annual CMS contracts paying risk-adjusted capitation. Star ratings are a direct earnings lever — plans need 4.0 stars or better (out of 5) for bonus payments. Based on December 2025 membership, more than 81% of Medicare Advantage members were in plans rated at least 4.0 stars for 2026, down from 88% at 2025 star ratings based on December 2024 membership. Segment operating income is seasonal: benefit costs generally rise through the year as members work through deductibles, and fourth-quarter operating expenses are highest because of plan-year readiness and Medicare annual-enrollment marketing. ### Health Services (CVS Caremark, Signify Health, Oak Street Health, Cordavis) The pharmacy benefit manager plus the care-delivery assets. PBM services include plan design and administration, formulary management (governed by the CVS Caremark National Pharmacy and Therapeutics Committee), retail pharmacy network management, specialty and mail-order pharmacy, clinical and disease-management programs, medical-benefit management through the NovoLogix preauthorization tool, and administrative services for 340B covered entities. The segment operates a group purchasing organization that negotiates manufacturer pricing and rebates, and Cordavis, a wholly owned subsidiary that works with manufacturers to commercialize and co-produce biosimilars. The retail pharmacy network comprises approximately 63,000 pharmacies (about 34,500 chain, including CVS locations, and 28,500 independent). In FY2025 the PBM filled or managed 1.9 billion prescriptions on a 30-day-equivalent basis. Care delivery: Oak Street Health operated 246 value-based primary care centers across 27 states at December 31, 2025, caring for approximately 500,000 patients under capitated contracts with health plans and CMS; the company had value-based relationships with over 25 payors, including each of the top 5 national payors by Medicare Advantage patients. Signify Health performed more than 3.5 million in-home health evaluations in FY2025; Medicare Advantage plans are roughly 85% of IHE volume, under contracts with 46 health plans including 24 of the 50 largest Medicare Advantage plans. More than 800 MinuteClinic locations were in operation. The company substantially exited two CMS provider-enablement programs during the first quarter of 2025 — ACO REACH (voluntary termination effective March 31, 2025) and the Medicare Shared Savings Program (MSSP operations divested to Wellvana Health, LLC in March 2025). ### Pharmacy & Consumer Wellness (CVS Pharmacy) Retail and infusion pharmacy plus front-store merchandise. Approximately 9,000 retail locations at December 31, 2025, alongside online pharmacy sites, retail specialty stores, compounding pharmacies and infusion/enteral-nutrition branches. The segment filled 1.8 billion prescriptions on a 30-day-equivalent basis in FY2025 and dispensed approximately 28.5% of all U.S. retail pharmacy prescriptions. Pharmacy is over three-fourths of segment revenue; front store carries roughly 4,500 proprietary-brand products that were about 20% of front-store revenue in 2025, and the ExtraCare loyalty program (plus the paid ExtraCare Plus subscription) anchors front-store marketing. The segment also performs pharmacy fulfillment for Health Services' specialty and mail-order business in exchange for an intersegment administrative fee. Substantially all pharmacy revenue comes from PBMs, managed care organizations, government programs, employers and other third-party payors; no single payor was 10% or more of consolidated revenue in 2025, 2024 or 2023. Footprint activity in 2025: 87 locations opened, 5 relocated and 243 closed, taking total stores from 9,135 to 8,979; 221 of the closures executed the store-closing plan announced with the third-quarter 2024 enterprise restructuring. Long-term care pharmacy (Omnicare) operations were part of this segment until the Omnicare entities were deconsolidated in September 2025. ### Corporate/Other and other structure Corporate/Other holds management and administrative expense, acquisition-related integration costs, and run-off products no longer sold — large case pensions and long-term care insurance. Generic pharmaceutical sourcing runs through Red Oak Sourcing, LLC, a 50/50 venture with Cardinal Health that negotiates generic supply contracts for both owners and holds no inventory. The company employs more than 300,000 colleagues. ### Regulation The business is regulated at nearly every layer, and the 10-K devotes most of Item 1's back half to it: the ACA (minimum medical loss ratios, benefit-design mandates, rating limits, premium-rate review); Medicare and Medicaid regulation, audits, star ratings and payment rates; the 340B drug pricing program; anti-remuneration (anti-kickback) and false-claims laws; antitrust and unfair competition; privacy and confidentiality (HIPAA plus a growing patchwork of state privacy, cybersecurity and AI regulation such as the CCPA and New York DFS rules); consumer protection and price-transparency laws; pharmacy and professional licensure; telehealth; state insurance, HMO and insurance-holding-company regulation including dividend restrictions and NAIC risk-based capital; ERISA and preemption; PBM-specific legislation covering network access, pharmacy pricing, formulary and plan design; corporate-practice-of-medicine restrictions; and anti-corruption laws. Regulators can suspend or revoke licenses, exclude the company from government programs, limit marketing, assess fines and restrict acquisitions or dispositions. --- ## Risk factors *Condensed from Item 1A of the FY2025 Form 10-K, accession 0000064803-26-000010.* **Business and operating risks** - **Forecasting medical cost.** Premiums on Insured products are priced in advance for a fixed period, generally twelve months (Individual Medicare revenue rests on bids submitted in June of the prior year), and cost increases above projection cannot be recovered in-period. Small differences between predicted and actual health care cost as a percentage of premium revenue produce large swings in segment results. Drivers cited include utilization of Medicare supplemental benefits, membership turnover, fraud, mandated benefit changes, an aging population, medical technology, specialty and ultra-high-cost drugs, influenza severity, clusters of high-cost cases and extreme weather. - **Claim reserves may prove insufficient.** A large portion of claims is not submitted until after the quarter in which care is delivered, so health care costs payable is an estimate highly sensitive to submission and processing patterns, membership turnover and product mix. The 10-K points to its own recent experience: a $448 million premium deficiency reserve on the individual exchange line in Q1 2025 and a $471 million reserve on Group Medicare Advantage in Q2 2025. - **Adverse economic conditions.** Inflation, high interest rates, weak consumer confidence, unemployment and supply-chain disruption can raise utilization and unit cost, depress drug utilization and front-store demand, push customers to reduce workforces (COBRA members carry a materially higher MBR than the overall commercial book), impair the investment portfolio and increase interest expense. - **Intense competition in every segment.** Health Care Benefits bids against national carriers, Blue Cross Blue Shield licensees, provider-owned plans and new entrants, with Original Medicare the largest competitor in Medicare products and customers able to move freely. Health Services competes with Prime Therapeutics, MedImpact, Cigna's Express Scripts and UnitedHealth's Optum Rx; retail competes with Walgreens, Walmart, Amazon, supermarkets and clubs. The PBM industry is in price compression from client demands for lower prices, pricing guarantees and greater rebate pass-through, and marketplace and regulatory change has curtailed retail "spread" pricing — trends the company expects to continue. Direct-to-consumer drug sales by manufacturers are flagged as a growing channel that bypasses pharmacies and PBMs. - **Product mix.** Insured products that carry more risk are generally more profitable than ASC, but ASC keeps gaining share, and government programs carry lower margins than commercial Insured business. - **Health care delivery businesses face distinct risks**: recruiting and retaining clinicians, concentration in a few key health-plan customers, capitated contracts where actual cost can exceed the fixed fee, dependence on Medicare and Medicare Advantage reimbursement, risk-adjustment data accuracy, geographic concentration of primary care centers, and corporate-practice-of-medicine laws that constrain control of affiliated physician groups. - **Reputation and public perception**, amplified by the public debates over drug pricing, PBMs and Medicare Advantage. - **Retail customer relationships and drug economics** — customer loyalty, merchandise selection, proprietary-brand product liability and recall exposure, limited-distribution specialty drug access, and reimbursement pressure on generics. - **Acquisitions, joint ventures and divestitures** may not perform as projected, may carry unanticipated liabilities, may impair goodwill, may require debt or equity issuance and may pressure credit ratings. **Operations** - **Data governance, IT failure and cyberattack.** The company states plainly that it and its vendors "have experienced and continue to experience cyberattacks" and can give no assurance of detecting, preventing or containing future attacks. Use of AI is called out as adding exposure to cybersecurity, data-privacy, legal, regulatory and operational risk. The company reports no material cybersecurity incident during FY2025 and is in material compliance with applicable privacy and cybersecurity standards; its program is assessed against HIPAA, NIST 800-53, SOC 1, SOC 2 Type 2, HITRUST, PCI DSS and NAIC standards, it maintains a Cybersecurity Incident Response Plan under the CISO and Chief Privacy Officer, and it annually purchases cyber insurance. - Product liability, recall, professional liability and personal injury; competition for talent and executive succession; dependence on internal sales staff and third-party brokers (including regulatory exposure for broker marketing practices); failure of the businesses to collaborate effectively; payment-related fraud and theft risk; and business-continuity hazards at the company and its vendors. **Public policy, legal and regulatory** - **Policy change is the dominant regulatory risk.** Named exposures include changes to Medicare, Medicare Advantage and the ACA; 340B program changes; drug reimbursement, pricing, purchasing and importation rules; PBM legislation, including state laws that would prohibit pharmacy licensure for PBM-affiliated pharmacies; claims-processing and billing rules; immigration and patent law; and tariffs and trade policy. Laws in Arkansas, Louisiana, North Dakota and Oklahoma have attempted to limit PBM practices and are in litigation, and ERISA and Medicare Part D preemption are being challenged in several states. - **Medicare rates and audits.** The final 2026 Medicare Advantage rates implied an average industry revenue increase of 7.16% including a 2.10% risk-score trend (5.06% excluding it). The January 26, 2026 advance notice for 2027 implied 2.54% including a 2.45% risk-score trend — only 0.09% excluding it. In May 2025 CMS announced it would audit every Medicare Advantage contract each payment year and complete payment years 2018–2024 by early 2026, without detailing claim selection or methodology. RADV audits, OIG audits and DOJ civil investigative demands on diagnosis-code submission are ongoing. - **Medicaid funding.** The "Working Families Tax Cut Act," formerly the "One Big Beautiful Bill Act," of 2025 changes Medicaid eligibility rules and financing in ways the company expects to reduce eligibility (particularly expansion populations) and state funding, affecting benefits and payment rates. - **Medicare Part D redesign** under the Inflation Reduction Act shifts more claim liability from the government to plans and reduces flexibility in designing competitive offerings. - **Litigation and government investigations** are described as routine and material in aggregate, including class actions and qui tam suits, with damages that may not be insured and punitive damages that generally are not. Conviction or an adverse False Claims Act decision can bring suspension or exclusion from government programs. - **Premium rate approval and minimum MLR rebates.** Rate filings require state approval and are subject to ACA review above federal thresholds; minimum MLR rules cap achievable margin in commercial Insured, Medicare Advantage and Medicaid books while leaving the company exposed to higher-than-priced medical cost. A Medicare Advantage or Part D contract that pays minimum MLR rebates three years running cannot enroll new members, and five years running is terminated by CMS. - **Vertical integration** invites added regulatory and public scrutiny; **employer-related legislation** and union organizing can raise labor cost. - **Pricing benchmarks.** Replacement of AWP or WAC, wider adoption of Actual Acquisition Cost in Medicaid fee-for-service, or volatility in CMS's National Average Drug Acquisition Cost could change reimbursement and rebate economics. **Financial** - **Credit ratings and capital deployment.** At December 31, 2025 long-term debt was rated Baa3 (Moody's, Stable outlook), BBB (S&P, Negative) and BBB (Fitch, Negative), with commercial paper at P-3, A-2 and F2. - **Goodwill and intangible impairment**, tested annually or on triggering events using discounted cash flow and market multiple methods. - **Investment portfolio exposure** to rates, credit spreads and market disruption across debt securities, mortgage loans and alternatives. **Manufacturer, provider, supplier and vendor relationships** — market availability, pricing, supplier concentration and safety profiles of the drugs and products purchased and sold, and continuing provider and supplier consolidation that can raise cost and competition. --- ## Management's discussion — fiscal year 2025 *From Item 7 of the FY2025 Form 10-K, accession 0000064803-26-000010.* FY2025 was a year in which the insurance business recovered sharply while a $5.7 billion goodwill write-off in care delivery overwhelmed GAAP earnings. **Consolidated.** Total revenues rose $29.3 billion, or 7.8%, to $402.1 billion, with growth in all operating segments. Operating expenses rose $3.3 billion, or 7.8%, to $45.0 billion, driven by approximately $1.2 billion of legacy litigation charges tied to two court decisions on past business practices, a $320 million opioid litigation charge for a change in the accrual, $288 million of pre-tax losses on Accountable Care assets, and increased investment in colleagues and capabilities. Operating income fell $3.9 billion, or 45.3%, to $4.66 billion, principally on a $5.7 billion goodwill impairment in the Health Care Delivery reporting unit and the $1.2 billion of legacy litigation charges, partly offset by improved Health Care Benefits performance and the absence of roughly $1.2 billion of prior-year restructuring charges. Interest expense rose $161 million, or 5.4%, to $3.1 billion on December 2024 and August 2025 note issuances. A $483 million gain on deconsolidation of subsidiary arose from Omnicare. The effective tax rate fell to 19.1% from 25.4% because of a worthless-stock deduction on the bankrupt subsidiary (a net tax benefit of approximately $1.9 billion in the aggregate), partly offset by the non-deductible goodwill impairment and legacy litigation charges. Net income attributable to CVS Health was $1,768 million, down $2,846 million or 61.7%. Consolidated adjusted operating income — the company's principal segment measure, excluding intangible amortization, net realized capital gains and losses and items management judges outside the ordinary course — was $14,443 million, up from $11,976 million. **Health Care Benefits.** Revenues rose $12.7 billion, or 9.7%, to $143.4 billion, led by the Government business and largely reflecting the Inflation Reduction Act's effect on Medicare Part D. Government premiums grew 16.9% to $103.4 billion while commercial premiums fell 8.8% to $31.4 billion. The medical benefit ratio improved 130 basis points to 91.2% from 92.5% on better underlying Government performance and higher favorable prior-year development. Operating expenses rose 3.5% to $18.6 billion on business-operations investment. GAAP operating income swung to $1,793 million from a $984 million loss; adjusted operating income rose $2.6 billion to $2,939 million from $307 million. Total medical membership fell 504,000 to 26.59 million, reflecting declines in the individual exchange and Government lines partly offset by growth in commercial ASC; stand-alone PDP membership fell to 4.04 million from 4.88 million. **Health Services.** Revenues rose $16.8 billion, or 9.7%, to $190.4 billion on pharmacy drug mix and brand inflation, partly offset by continued pharmacy client price improvements. Pharmacy network revenue rose 11.0% to $101.8 billion and mail and specialty rose 11.9% to $79.3 billion, while pharmacy claims processed slipped 0.9% to 1,900.7 million on a 30-day-equivalent basis. Operating expenses rose $787 million, or 24.4%, on a $291 million litigation charge, $288 million of Accountable Care losses and an $83 million Health Care Delivery clinic closure charge. GAAP operating income collapsed 96.8% to $220 million because of the goodwill impairment. Adjusted operating income slipped $92 million, or 1.3%, to $7,151 million, as client price improvements and a higher medical benefit ratio in care delivery outweighed better purchasing economics and drug mix. **Goodwill impairment detail.** Through 2025 the Health Care Delivery reporting unit continued to face persistent elevated utilization. A new management team finalized strategic changes in the third quarter, deciding to open fewer new primary care clinics in 2026 and annually thereafter and to close certain existing Oak Street Health clinics in 2026; the changes were presented to the Board in September 2025. Updated projections triggered an interim impairment test showing fair value below carrying value, producing the $5.7 billion charge in the third quarter. Lower peer-group market multiples contributed. After the charge, fair value and carrying value of the reporting unit were equal; at the fourth-quarter annual test the unit's fair value exceeded carrying value by approximately 3%, while the other reporting units cleared by significant margins. **Pharmacy & Consumer Wellness.** Revenues rose $14.9 billion, or 11.9%, to $139.4 billion on drug mix and prescription volume, including incremental volume from the Rite Aid prescription file acquisitions, partly offset by reimbursement pressure and recent generic introductions. Pharmacy revenue rose 14.7% to $115.5 billion; front store fell 0.3% to $21.5 billion. Prescriptions filled rose 5.4% to 1,808.8 million on a 30-day-equivalent basis. Pharmacy same-store sales rose 18.0%, helped by mix including branded GLP-1 drugs and an 8.0% rise in same-store prescription volume; front-store same-store sales rose 1.2%. Operating expenses rose $1.3 billion, or 6.5%, on $929 million of litigation charges relating to the Omnicare long-term care business and increased investment. GAAP operating income rose 1.9% to $4,860 million; adjusted operating income rose $266 million, or 4.6%, to $6,040 million. **Corporate/Other.** Revenues of $484 million rose $33 million on higher net investment income. Adjusted operating loss widened $339 million, or 25.1%, to $1,687 million on increased investment in colleagues and capabilities. **The charges, itemized.** The FY2025 reconciliation from GAAP operating income to adjusted operating income excludes intangible amortization of $1,976 million, net realized capital losses of $44 million, acquisition-related integration costs of $117 million (Signify Health and Oak Street Health), the $5,725 million goodwill impairment, an $83 million Health Care Delivery clinic closure charge, the $320 million opioid litigation charge, $10 million of office real estate optimization charges, $1,220 million of legacy litigation charges and $288 million of Accountable Care losses. The legacy litigation charges came from two decisions: an April 2025 jury verdict against Omnicare and CVS Health under the federal False Claims Act on Omnicare dispensing practices from 2010 (pre-acquisition; Omnicare was acquired in 2015) through 2018, with damages found only against Omnicare, which drove a $387 million charge in Q1 2025 plus a $542 million charge in Q2 2025 for statutory penalties (both in Pharmacy & Consumer Wellness); and a June 2025 decision finding certain subsidiaries liable over PBM direct and indirect remuneration reporting for two clients from 2010 through 2016, a practice since modified, producing a $291 million charge in Q2 2025 (Health Services). **Acquisitions and dispositions in 2025.** In May 2025 the company agreed to acquire the prescription files of certain Rite Aid pharmacies and to acquire and operate certain Rite Aid stores in Idaho, Oregon and Washington for total consideration of $465 million; the closings completed in the third quarter of 2025, with $285 million recorded as customer-relationship intangibles amortized over a weighted-average 10 years. In March 2025 the MSSP operations were divested to Wellvana Health, LLC at a $236 million pre-tax loss including removal of $342 million of intangibles and goodwill, with immaterial consideration; ACO REACH wind-down cost $52 million. On September 22, 2025 Omnicare, LLC and certain subsidiaries voluntarily initiated Chapter 11 proceedings; the company determined it no longer controlled them and deconsolidated them that day, recording the $483 million gain. The retained equity investment in the Omnicare entities carried both a carrying value and a fair value of zero. **Trends management flagged for 2026.** Utilization was expected to persist at elevated levels, and utilization beyond current elevated levels may pressure Health Care Benefits and the Health Services care-delivery assets. The company continues to share a larger portion of manufacturer rebates, fees and discounts with clients, typically offers minimum pricing guarantees it cannot always achieve, faces increasing manufacturer pressure on rebate calculation and collection, and has seen its ability to offer retail "spread" pricing limited — trends it expects to continue. Tariffs, inflation and labor dynamics could raise cost and disrupt supply. Consumer spend management and a shift to value, grocery and digital retailers could lower front-store sales. On regulation, exposure to Medicare and Medicaid funding and policy, and PBM legislation proposed or enacted in a majority of states and federally, could affect the ability to do business on commercially reasonable terms and to standardize PBM products across state lines. **Liquidity and capital.** Cash and cash equivalents were approximately $8.5 billion at December 31, 2025, about $2.8 billion of it at the parent or non-restricted subsidiaries. Operating cash flow rose $1.5 billion to $10,639 million on payment and receipt timing and better Health Care Benefits performance. Investing outflows fell $1.7 billion to $5,871 million on higher investment sales and maturities, partly offset by cash for the Rite Aid prescription files; gross capital expenditure was approximately $2.8 billion in both 2025 and 2024, with about 77% of 2025 capex for technology, digital and other strategic initiatives and 23% for stores, fulfillment and support facilities. Financing outflows widened $3.8 billion to $4,940 million on higher commercial paper repayment and lower senior note issuance. No commercial paper was outstanding at year-end 2025 (versus $2.1 billion at 4.98% a year earlier), and nothing was drawn on the three $2.5 billion five-year back-up revolvers. On August 15, 2025 the company issued $750 million of 5.0% notes due September 2032, $1.5 billion of 5.45% notes due September 2035, $1.25 billion of 6.2% notes due September 2055 and $500 million of 6.25% notes due September 2065, for approximately $4.0 billion net, used to repay existing indebtedness including commercial paper and for general corporate purposes. Contractual obligations at year-end totalled $141.5 billion, including $63.7 billion of long-term debt principal, $44.0 billion of interest on it, $19.4 billion of operating lease liabilities and $4.0 billion of opioid settlement obligations. No shares were repurchased in 2025; $10.0 billion remained under the 2022 program and $1.5 billion under the 2021 program. The quarterly dividend was $0.665 per share in both 2025 and 2024, and the company said it expects to maintain $0.665 per share throughout 2026. The maximum dividend payable by insurance and HMO subsidiaries without regulatory approval was $3.8 billion in aggregate, and all insurance and HMO subsidiaries were above risk-based-capital action levels. --- ## Current quarter — second quarter 2026 *From the Form 10-Q for the quarter ended June 30, 2026, accession 0000064803-26-000098. Guidance and the segment measures noted as such are from the earnings release furnished as Exhibit 99.1 to the Form 8-K dated August 5, 2026, accession 0000064803-26-000097.* The recovery visible in FY2025's insurance results accelerated. Total revenues rose $7.2 billion, or 7.3%, to $106,096 million for the three months ended June 30, 2026, with growth across all operating segments. Operating expenses fell $166 million, or 1.5%, to $11,046 million, primarily because $833 million of prior-year legacy litigation charges did not repeat, partly offset by continued business investment and the expense of supporting higher volume from the Rite Aid asset acquisitions. Operating income nearly doubled, up $2.3 billion or 97.5% to $4,703 million, on improved performance across all operating segments plus the absence of those charges. The effective tax rate was 24.7% against 38.5% a year earlier, the change driven by the absence of the non-deductible legacy litigation charges. Net income attributable to CVS Health was $2,979 million and diluted earnings per share $2.31, against $1,021 million and $0.80. Adjusted operating income was $5,157 million, up 35.4%, and Adjusted EPS was $2.58 against $1.81. For the six months: revenues rose $13.0 billion, or 6.7%, to $206,522 million; operating expenses fell $244 million, or 1.1%, on the absence of $1.2 billion of legacy litigation charges and $288 million of pre-tax Accountable Care losses, partly offset by business investment, Rite Aid volume support cost and the retroactive effect of a change in a state law on non-income taxes; operating income rose $3.6 billion, or 63.0%, to $9,383 million; the effective tax rate was 24.8% against 34.5%; net income attributable to CVS Health was $5,922 million and diluted EPS $4.61, against $2,800 million and $2.21. Adjusted operating income was $10,307 million and Adjusted EPS $5.16. **Health Care Benefits.** Revenues rose $1.3 billion, or 3.5%, to $37,538 million, driven by the Government business and partly offset by the exit of the individual exchange business in 2026. The medical benefit ratio improved to 87.4% from 89.9%, on better underlying Government performance and the absence of the prior year's $471 million Group Medicare Advantage premium deficiency reserve. Operating expenses rose $139 million, or 3.1%, on increased business investment. Adjusted operating income rose $1.1 billion, or 85.5%, to $2,426 million. Medical membership of 26.0 million at June 30, 2026 was unchanged from March 31, 2026 and down approximately 700,000 from a year earlier, reflecting the exchange exit partly offset by higher commercial ASC membership. For the six months the MBR was 86.0% against 88.6%, and adjusted operating income rose 65.6% to $5,467 million, with the improvement partly offset by lower favorable prior-period development. Prior years' health care costs payable estimates developed favorably by $1.2 billion in the six months, and days claims payable were 41.7 at June 30, 2026, down 1.2 days from March 31, 2026. A $15 million premium deficiency reserve was recorded in the second quarter of 2026 on one state's Medicaid line, and no others in the three or six months. **Health Services.** Revenues rose $5.3 billion, or 11.5%, to $51,795 million on pharmacy drug mix and brand inflation, partly offset by continued pharmacy client price improvements; pharmacy network revenue was $26,617 million and mail and specialty $22,577 million. Operating expenses fell $236 million, or 20.2%, on the absence of the prior year's $291 million legacy litigation charge. Adjusted operating income rose $158 million, or 10.0%, to $1,733 million, on improved purchasing economics, drug mix and modest improvement in the care-delivery business, partly offset by client price improvements. Pharmacy claims processed were 473.0 million, consistent with the prior year on a 30-day-equivalent basis. Six-month revenues rose 11.3% to $100,032 million while adjusted operating income rose only $44 million to $3,222 million. **Pharmacy & Consumer Wellness.** Revenues rose $235 million to $33,816 million — described as a slight increase — with drug mix, prescription volume including the Rite Aid asset acquisitions completed in the third quarter of 2025, and brand inflation largely offset by regulatory-related price reductions on certain drugs, recent generic introductions and reimbursement pressure. Pharmacy same-store sales rose 2.9%, on drug mix, a 7.0% increase in same-store prescription volume on a 30-day-equivalent basis and brand inflation; front-store same-store sales rose 1.0%. Operating expenses fell $168 million, or 3.2%, on the absence of the prior year's $542 million legacy litigation charge, partly offset by business investment and Rite Aid volume support. Adjusted operating income rose $137 million, or 10.2%, to $1,475 million on core pharmacy strength and Rite Aid contribution, partly offset by business investment and consumer dynamics. Prescriptions filled rose 4.3% on a 30-day-equivalent basis to 457.0 million, driven by Rite Aid prescription file volume and higher utilization and held back by the absence of long-term care pharmacy volume after the Omnicare deconsolidation in September 2025. **Corporate/Other.** Revenues rose $51 million, or 53.1%, to $147 million on higher net investment income from private equity and equity fund investments and higher average fixed income holdings. Adjusted operating loss widened $64 million, or 15.5%, on increased business investment; for the six months it widened $311 million, or 41.9%, largely on the retroactive state non-income tax law change and business investment. **Trends and uncertainties management named for the quarter.** Utilization persisted at elevated levels in the second quarter of 2026. The federal 340B environment "remains dynamic" and may continue to affect Health Services. Heightened geopolitical tension could raise the likelihood of an economic slowdown, market volatility, supply-chain cost or disruption, rate moves or cyberattacks. The remainder of the trends and uncertainties disclosure is unchanged from the FY2025 Form 10-K. **Medicare update.** On April 6, 2026 CMS issued its final notice for 2027 Medicare Advantage payment rates, implying an expected average industry revenue increase of 2.48%, excluding CMS's estimate of Medicare Advantage risk score trend — up from the 0.09% on that same basis implied by CMS's January 26, 2026 advance notice. **Liquidity.** Cash and cash equivalents were approximately $11.3 billion at June 30, 2026, about $2.7 billion at the parent or non-restricted subsidiaries, against $8.5 billion at December 31, 2025. Six-month operating cash flow was $10,594 million, up $4.1 billion year over year on payment and receipt timing and improved Health Care Benefits performance. Investing outflows rose $972 million to $2,758 million on higher net investment purchases. Financing outflows rose $3.5 billion to $5,011 million on higher long-term debt repayment ($3,287 million versus $762 million) and the absence of prior-year commercial paper proceeds; dividends paid were $1,725 million. Long-term debt was $59,452 million with $1,958 million current, against $60,502 million and $4,068 million at year-end. Total assets were $253,768 million and total shareholders' equity $79,899 million. No commercial paper was outstanding, nothing was drawn on the three $2.5 billion five-year back-up revolvers — which now expire in May 2029, 2030 and 2031 following amendments dated May 22, 2026 — and there were no Federal Home Loan Bank of Boston advances against approximately $1.3 billion of capacity. The company was in compliance with all debt covenants. Ratings at June 30, 2026 were BBB (Fitch), Baa3 (Moody's) and BBB (S&P), with commercial paper at F2, P-3 and A-2; the outlook was Negative at Fitch and Stable at Moody's, and in May 2026 S&P moved its long-term outlook from Negative to Stable. No shares were repurchased in the six months ended June 30, 2026 or 2025, leaving approximately $11.5 billion available. The quarterly dividend declared was $0.665 per share, $1.33 for the six months, unchanged year over year. **Guidance.** With the second-quarter release the company raised full-year 2026 guidance: GAAP diluted EPS to $6.84–$7.04 from $6.24–$6.44; Adjusted EPS to $7.90–$8.10 from $7.30–$7.50; and cash flow from operations to at least $11.5 billion from at least $9.5 billion. Projected total revenues are at least $414.0 billion. The reconciliation implies projected net income attributable to CVS Health of $8,810–$9,065 million on 1,289 million weighted-average diluted shares, with add-backs of $1,730 million of intangible amortization, $29 million of net realized capital losses and $80 million of acquisition-related integration costs, less a $463 million tax effect. Management attributed the raise to increases in the Health Care Benefits and Pharmacy & Consumer Wellness segments "while maintaining a cautious view for the remainder of the year in light of continued elevated cost trends and the potential for macro headwinds." **Operational items disclosed with the quarter.** The company launched a GLP-1 support offering across CVS Pharmacy and MinuteClinic, including a $29 MinuteClinic virtual visit for evaluation and, where clinically appropriate, prescription, and participation in the CMS Medicare GLP-1 Bridge program running through December 31, 2027 under which eligible Medicare beneficiaries can access certain GLP-1 medications for $50 per month. CVS Caremark expanded GLP-1 options on its most common commercial formularies. Agentic AI is being deployed in Aetna and CVS Caremark call centers, and Aetna launched a second-generation Claims Assist Manager that it says cuts processing time by over 20% for complex claims requiring manual review. **Litigation and contingencies as of June 30, 2026.** The remaining accrual for opioid litigation matters was approximately $3.4 billion. Forty-five states, the District of Columbia and all eligible U.S. territories participate in the settlement resolving substantially all opioid claims by participating states and subdivisions; separate agreements cover Florida, West Virginia, New Mexico and Nevada, and a third-party-payor agreement awaits class approval. Maryland has not participated, and litigation continues with certain non-participating subdivisions including the City of Philadelphia, hospitals and other private parties; in May 2026 a Florida state court entered a directed verdict for the company and other defendants in a case brought by a group of Florida hospitals, after a December 2025 mistrial, and plaintiffs have appealed. In December 2024 the DOJ intervened in a qui tam action in the District of Rhode Island alleging Controlled Substances Act and False Claims Act violations over controlled-substance prescriptions filled at CVS Pharmacy locations nationwide. In the Behnke PBM reporting case the court entered judgment of $291 million after trebling and penalties, reserved in FY2025 and now on appeal to the Third Circuit. In the Bassan/Omnicare case the $165 million for which CVS Health was found jointly and severally liable remained a balance-sheet liability at June 30, 2026. Usual-and-customary pricing suits continue, including state false-claims act claims by several attorneys general in an intervened complaint filed in April 2025 and unsealed in May 2025. PBM rebate and drug-pricing suits have largely been consolidated into multi-district litigation in the District of New Jersey, and Claritev/MultiPlan out-of-network repricing suits into multi-district litigation in the Northern District of Illinois; a new putative class action by Caremark clients (Roofers Union Welfare Trust Fund) filed in March 2026 alleges failure to pass through certain Zinc Health Services payments. Securities and derivative litigation over Health Care Benefits profitability disclosures remains pending in the Southern District of New York and Rhode Island. There were no material changes to the risk factors disclosed in the FY2025 Form 10-K. --- ## Subsequent events *Post-period developments disclosed in the Form 10-Q for the quarter ended June 30, 2026 (accession 0000064803-26-000098) and in Current Reports on Form 8-K filed after the quarter end.* **Proposed FTC settlement, July 2026.** In July 2026 the company and the Federal Trade Commission announced a proposed settlement agreement that would resolve all of the FTC's outstanding investigations related to the company's PBM and affiliated pharmacy businesses, including rebate, pharmacy network, contract and vertical integration issues. The proposed settlement is subject to a public comment period, after which the FTC will decide whether to issue a final order approving it. The FTC has halted its litigation against the company pending that outcome. The underlying matter is the FTC's September 2024 administrative complaint against the three largest PBMs and their affiliated group purchasing organizations, including subsidiaries of the company, alleging anti-competitive and unfair practices that "artificially" increased insulin costs. **Omnicare bankruptcy agreements with the DOJ, July 2026.** In July 2026 CVS Health Corporation entered into agreements with the U.S. Department of Justice and the Unsecured Creditors' Committee in the Omnicare Chapter 11 proceeding. The agreements remain subject to Bankruptcy Court approval and to the closing of the sale of Omnicare's assets, among other conditions. Under them the DOJ will receive a minimum of $440 million from Omnicare and CVS Health Corporation combined. CVS Health Corporation will pay $130 million to the DOJ within two weeks of the agreements' effective date, at which point both CVS Health Corporation's and Omnicare's appeals will be dismissed. Omnicare will transfer to the DOJ any proceeds from the sale or liquidation of assets in its estate remaining after payment of all senior claims. If the DOJ has not received at least $310 million in payments from Omnicare by March 15, 2028, CVS Health Corporation will guarantee collection of any portion of that $310 million not satisfied by March 31, 2028. **Board changes, August 2026.** Larry M. Robbins, chief executive of Glenview and a director since 2024 who served on the Audit and Public Policy and External Affairs Committees, resigned from the Board effective August 13, 2026, with the company stating the resignation was not the result of any disagreement over its operations, policies or practices. On August 17, 2026 the Board appointed Teresa Heitsenrether — Executive Vice President and Chief Data & Analytics Officer of JPMorgan Chase & Co. and a member of its Operating Committee — to the Board effective November 18, 2026, determining her independent under NYSE rules and the company's governance guidelines (Form 8-K dated August 17, 2026, accession 0001193125-26-354096).