HUMANA (HUM) Company Report

Humana is optimizing distribution by refining high-value channels, pulling back on co-op and regular marketing, and ending relationships with lower-quality brokers, including its largest call center, to enhance STARS and profitability.
Retention is tracking well with plan-to-plan switches materially lower year-over-year; full clarity won’t emerge until the final two weeks of AEP, after product repricing over the past two years had temporarily increased attrition.
The V28 coding update has transformed new-to-agent Medicare members from a loss-making segment to a profitable one by improving initial risk scores.
Humana anticipates a $3 billion+ revenue headwind in 2026 driven by STARS relief and other non-operating factors, which it plans to offset through disciplined investments, fixed-cost leverage, and intercompany PBM benefits via CenterWell.

6 days ago

Transcript

Humana discusses AEP season strategies at Wolfe Research Healthcare Conference

HUM

Guidance Update

Humana has pulled back and optimized co-op and regular marketing in certain areas during this Medicare Advantage open enrollment season, with further distribution refinements planned, while preserving existing commission structures to date.
The company is strategically refining its distribution mix—assessing channels by lifetime value, STARS ratings, Medicare complaints and onboarding performance—and has parted ways with lower-value brokers, including its largest call center, to “average up” distribution quality.
Retention remains strong but final results won’t be known until season’s end, as roughly one-third of enrollments occur in the last two weeks; early CMS data suggest improved retention and a material decline in plan-to-plan switching year over year.
Humana plans to report detailed fourth-quarter membership trends on its Q4 earnings call but may provide an interim update if necessary, following its proactive STARS ratings release earlier this year.
CFO Celeste Mellet flagged a $3 billion revenue headwind for 2026 from STARS relief and non-operating factors, and is evaluating investments, fixed-cost leverage and CenterWell pharmacy synergies to offset this impact.

6 days ago

Transcript

Humana outlines AEP strategy and membership growth outlook

HUM

Guidance Update

Humana is monitoring 2026 open enrollment, pulling back on co-op and digital marketing but holding commissions constant for now, while refining high-value distribution channels to optimize membership quality.
Distribution strategy: Humana has refined its channels, prioritizing brokers based on metrics like lifetime value, STARS, and complaints, and has ended relationships with its largest call center to improve membership profitability.
Humana’s product positioning remains in line to below peers in most of its top 25 markets, with membership growth broadly distributed across non-DSNP segments.
Facing a $3 billion revenue headwind in 2026, Humana is balancing investment plans and fixed-cost leverage opportunities, including intercompany revenue benefits to CenterWell from increased membership.
Humana expects 2026 coverage of GLP-1 therapies under CMS’s new demo, but implementation details, member impact, and premium implications remain unclear.

6 days ago

Transcript

Humana reports Q3 2025 earnings

HUM

Earnings

Guidance Update

Demand Weakening

Adjusted EPS was $3.24, beating consensus by 11% but down 22% year-over-year.
Revenues grew 11.4% to $32.65 billion, led by premiums up 9.9% to $30.7 billion and services revenues up 45.1% to $1.6 billion.
Net income declined 59.6% year-over-year to $194 million, while total medical membership fell 8.3% to approximately 15 million, with Medicare Advantage membership expected to decrease by about 425,000 in 2025.
The company reaffirmed 2025 adjusted EPS guidance of around $17, citing cost-control measures and a focus on Medicare business growth by 2028.

Nov 5, 2025, 7:59 PM

Bloomberg

Humana announces Q3 2025 results

HUM

Earnings

Guidance Update

M&A

Humana delivered solid Q3 performance and reaffirmed full-year 2025 adjusted EPS outlook of approximately $17.
Individual Medicare Advantage pretax margin target of at least 3% over time; new sales at the high end of expected AEP range with focus on maximizing customer lifetime value and retention.
Operational initiatives, including technology improvements to improve call accuracy and response times, expected to generate over $100 million in savings, and progress on selling non-core assets and acquiring The Villages Health.
Capital strategy: no additional share repurchases planned beyond Q2 buybacks, debt-to-cap ratio at 40.3%, and prudent capital deployment prioritizing small- to mid-sized provider M&A.

Nov 5, 2025, 1:00 PM

Transcript

Humana reports Q3 2025 results

HUM

Earnings

Guidance Update

M&A

Solid Q3 performance with results in line with expectations and reaffirmation of full-year adjusted EPS outlook of ~$17 for 2025
Medicare AEP new individual sales at the high end of expectations; management focusing on customer retention and lifetime value, with dynamic controls to manage growth and protect member experience
STARS update: Bonus year 2027 results disappointing but as planned; bonus year 2028 shows meaningful improvement, including 600,000 more care gaps closed, on track to return to top-quartile by 2028
Operational and capital actions: partnerships with Genpact and AI initiatives targeting >$100 M in savings; sale of non-core assets and planned acquisition of The Villages Health; debt-to-capital at 40.3% and no additional share repurchases in 2025
Financial trends: medical cost trends in line with expectations; invested an incremental $150 M in Q3 into transformation and clinical excellence

Nov 5, 2025, 1:00 PM

Transcript

Humana affirms full-year guidance and reports transformation progress in Q3 2025

HUM

Earnings

Guidance Update

M&A

Reaffirmed full-year 2025 adjusted EPS outlook of ~$17 while committing ~$150 million in incremental investments to accelerate transformation and Stars improvements.
Continued operational momentum as Q4 2024 gains carried into 2025, closing 600,000 more care gaps year-over-year, and targeting a return to top-quartile Stars by bonus year 2028.
Entered a partnership with Genpact and deployed an agentic AI platform to streamline finance and call-center operations, expected to yield >$100 million in savings over the coming years.
Executed capital allocation moves, including the sale of Enclara Pharmacia and pending acquisition of The Villages Health; ended Q3 with a 40.3% debt-to-capital ratio (down from 40.7%), targeting ~40%, and no additional share repurchases beyond Q2 2025.

Nov 5, 2025, 1:00 PM

Transcript

Humana reports Q3 2025 earnings and revises FY 2025 guidance

HUM

Earnings

Guidance Update

Humana delivered Q3 2025 GAAP EPS of $1.62 and Adjusted EPS of $3.24, with YTD Adjusted EPS of $21.10
Revised FY 2025 GAAP EPS guidance to approximately $12.26 (from $13.77), while affirming Adjusted EPS guidance of approximately $17.00
Q3 2025 Insurance segment benefit ratio was 91.1%, in line with guidance, and FY 2025 benefit ratio guidance remains 90.1%–90.5%
Updated FY 2025 individual Medicare Advantage membership decline guidance to approximately 425,000 members, improved from a prior expectation of up to 500,000
CenterWell Primary Care grew by 56,600 patients (nearly 15%) compared to December 31, 2024, and CenterWell Pharmacy volumes exceeded expectations

Nov 5, 2025, 11:11 AM

8-K

Humana reports Q3 2025 financial results

HUM

Earnings

Guidance Update

Humana reported 3Q25 GAAP EPS of $1.62 and Adjusted EPS of $3.24; YTD GAAP EPS was $16.43 and Adjusted EPS was $21.10.
Updated FY 2025 GAAP EPS guidance to approximately $12.26 (down from $13.77) and affirmed Adjusted EPS guidance of approximately $17.00; Insurance segment benefit ratio expected at 90.1%–90.5%.
Now anticipate a decline of approximately 425,000 Medicare Advantage members in 2025 (versus prior guidance of up to 500,000), driven by stronger retention and better sales.
CenterWell saw 56,600 new patients (nearly 15% growth vs. Dec 31, 2024) and continued robust pharmacy volume increases in 3Q25.

Nov 5, 2025, 11:00 AM

Press Release

Humana Inc. under securities fraud investigation

HUM

Legal Proceedings

Grabar Law Office is investigating whether certain Humana officers and directors breached fiduciary duties through false or misleading statements about the company’s business and operations.
Shareholders who acquired HUM shares before July 27, 2022 and still hold them may seek corporate reforms, return of funds, and a court-approved incentive award at no cost.
The complaint alleges Humana downplayed pressures on adjusted EPS from increased medical costs driven by pent-up demand as COVID concerns abated.

Nov 3, 2025, 2:18 PM

Press Release

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