Elevance Health, Inc.

Previous wording

Results of operations, cost of care trends, investment yields and other measures for the three and six months ended June 30, 2026 are not necessarily indicative of the results and trends that may be expected for the full year ending December 31, 2026, or any other period.

Current wording

Results of operations, cost of care trends, investment yields and other measures for the three and nine months ended September 30, 2026 are not necessarily indicative of the results and trends that may be expected for the full year ending December 31, 2026, or any other period.

Previous wording

Medical Cost Trends: Our medical cost trends are primarily driven by changes in the utilization of services across all provider types and the unit cost of these services. We work to mitigate these trends through various medical management programs such as care and condition management, program integrity and specialty pharmacy management and utilization management, as well as benefit design changes. There are many drivers of medical cost trends that can cause variance from our estimates, such as changes in the level and mix of services utilized, regulatory changes, aging of the population, health status and other demographic characteristics of our members, epidemics, pandemics, advances in medical technology, new high-cost prescription drugs, including increased utilization of specialty pharmaceuticals, new indications of existing prescription drugs, provider contracting inflation, labor costs and healthcare fraud, waste and abuse.

Current wording

Medical Cost Trends: Our medical cost trends are primarily driven by changes in the utilization of services across all provider types and the unit cost of these services. We work to mitigate these trends through various medical management programs such as care and condition management, program integrity and specialty pharmacy management and utilization management, as well as benefit design changes. There are many drivers of medical cost trends that can cause variance from our estimates, such as changes in the level and mix of services utilized, regulatory changes, aging of the population, health status and other demographic characteristics of our members, epidemics, pandemics, advances in medical technology, new high-cost prescription drugs, including increased utilization of specialty pharmaceuticals, new indications of existing prescription drugs, provider contracting inflation, provider reimbursement levels, labor costs and healthcare fraud, waste and abuse.

Previous wording

Membership shifts from Medicaid into our Individual ACA (as defined below) business following the redetermination process that began in April 2023, together with lower membership effectuation rates, particularly in geographies with high concentrations of highly subsidized members, have driven a market-wide increase in morbidity, resulting in elevated medical cost trends. Medicaid cost trends remain elevated due to higher population acuity and increased utilization of services. In response, we are working on program improvements in partnership with the states, strengthening care and provider network management, optimizing our clinical strategy to improve effectiveness and enhancing payment integrity to manage costs.

Current wording

Membership shifts from Medicaid into our Individual ACA (as defined below) business following the redetermination process that began in April 2023, together with lower membership effectuation rates, particularly in geographies with high concentrations of highly subsidized members, have driven a market-wide increase in morbidity, resulting in elevated medical cost trends. Medicaid cost trends remain elevated due to higher population acuity and increased utilization of services. In response, we are working on program improvements in partnership with the states, strengthening care and provider network management, optimizing our clinical strategy to improve effectiveness and enhancing payment integrity to manage costs. We expect the impact of these initiatives to build over time as implementation progresses and the initiatives mature.

Previous wording

CarelonRx delegates certain core pharmacy services to CaremarkPCS Health, L.L.C., which is a subsidiary of CVS Health Corporation (“CVS”), pursuant to an agreement (the “CVS Agreement”) with the current contractual term extending through December 31, 2027. We can elect to have CVS continue to provide services to us for a three-year extension period on the same terms and conditions as in the current CVS Agreement in the event of a termination or non-renewal by either party.

Current wording

CarelonRx delegates certain core pharmacy services to CaremarkPCS Health, L.L.C. (“CVS”), which is a subsidiary of CVS Health Corporation, pursuant to an agreement (“CVS Agreement”). CarelonRx has entered into a new five-year agreement with CVS that continues the CVS relationship under updated terms beginning January 1, 2027 through December 31, 2031, subject to certain early termination rights. In the event of a termination by CarelonRx or non-renewal by either party, CarelonRx can elect to have CVS provide transition services for a period of at least 18-months.

Previous wording

In May 2026, the U.S. Department of Health and Human Services, Labor, and the Treasury (collectively, the “Tri-Agencies”) issued final regulations updating the federal Independent Dispute Resolution (“IDR”) process used to determine compensation to be paid by health plans to out-of-network providers in certain scenarios under the No Surprises Act. The regulations are primarily procedural in nature and address the operations and administration of the IDR process. Additional regulatory guidance or rulemakings are possible, and changes resulting from any such guidance or rulemakings, as well as current and potential litigation, arbitration proceedings, and government audits related to the IDR and No Surprises Act, could have an adverse effect on our business, cash flows, results of operations and financial condition.

Current wording

In May 2026, the U.S. Department of Health and Human Services, Labor, and the Treasury (collectively, the “Tri-Agencies”) issued final regulations updating the federal Independent Dispute Resolution (“IDR”) process used to determine compensation to be paid by health plans to out-of-network providers in certain scenarios under the No Surprises Act. The regulations modify certain procedures and requirements governing the operation and administration of the IDR process. Additional regulatory guidance or rulemakings are possible, and changes resulting from any such guidance or rulemakings, as well as current and potential litigation, arbitration proceedings, and government audits related to the IDR and No Surprises Act, have had and could continue to have an adverse effect on our Commercial business, cash flows, results of operations and financial condition.

Previous wording

In February 2026, Congress passed the Consolidated Appropriations Act of 2026, which includes pharmacy benefit manager reforms requiring pharmacy benefit managers to remit all rebates, fees (other than bona fide service fees), and other remuneration received from entities such as manufacturers and group purchasing organizations to commercial plan sponsors, and to provide detailed commercial claims reporting, effective 30 months after enactment. The legislation also imposes extensive reporting requirements and delinks pharmacy benefit manager compensation in Medicare Part D by prohibiting pharmacy benefit managers from receiving remuneration related to Part D drugs in any form other than bona fide service fees that cannot be based on a drug’s price, effective in 2028. There continues to be the potential that similar or additional legislation may be adopted at the state or federal level.

Current wording

In February 2026, Congress passed the Consolidated Appropriations Act of 2026, which includes pharmacy benefit manager reforms requiring pharmacy benefit managers to remit all rebates, fees (other than bona fide service fees), and other remuneration received from entities such as manufacturers and group purchasing organizations to commercial plan sponsors, and to provide detailed commercial claims reporting, effective 30 months after enactment. The legislation also imposes extensive reporting requirements and delinks pharmacy benefit manager compensation in Medicare Part D by prohibiting pharmacy benefit managers from receiving remuneration related to Part D drugs in any form other than bona fide service fees that cannot be based on a drug’s price, effective in 2028. There continues to be the potential that similar or additional legislation may be adopted at the state or federal level. These requirements, as well as any similar or additional legislative or regulatory changes, could have an adverse effect on our business, cash flows, results of operations and financial condition.

Previous wording

In addition, in June 2025, the Centers for Medicare and Medicaid Services (“CMS”)finalized the Marketplace Integrity and Affordability Regulation, which modifies the Public Exchange open enrollment period beginning in plan year 2027 and eligibility for PTCs, among other requirements. In September 2025, a federal court delayed the effective dates for several provisions of the Marketplace Integrity and Affordability Regulation pending the resolution of ongoing litigation challenging the legality of those provisions. Also, in September 2025, CMS issued guidance modifying eligibility requirements for ACA catastrophic plans.

Current wording

In addition, in June 2025, the Centers for Medicare and Medicaid Services (“CMS”)finalized the Marketplace Integrity and Affordability Regulation, which modifies the open enrollment period for all Exchanges beginning in plan year 2027 and eligibility for PTCs, among other requirements. In August 2025, a federal court stayed certain provisions of the regulation, and in June 2026, vacated several provisions, a decision that is currently under appeal. In May 2026, CMS finalized the Notice of Benefit and Payment Parameters for 2027, effective July 2026, which establishes additional Public Exchange enrollment and eligibility requirements, among other changes. Certain provisions of the 2027 regulation were stayed by a federal court in July 2026 pending ongoing litigation.

Previous wording

Pursuant to CMS’ Medicare Advantage Star Ratings system, CMS annually awards between 1.0 and 5.0 Stars to Medicare Advantage plans based on performance in several categories. Plans must have a Star Rating of 4.0 or higher to qualify for bonus payments. Our 2025 Star Ratings, which are used for payment year 2026, reflect that approximately 40% of our Medicare Advantage members were enrolled in plans rated at least 4.0 Stars or higher. CMS released our 2026 Star Ratings in October 2025, which will be used to determine our Medicare Advantage bonus payments in 2027. Our 2026 Star Ratings reflect that approximately 59% of our Medicare Advantage members are enrolled in plans rated at least 4.0 Stars or higher, or the equivalent.

Current wording

Pursuant to CMS’ Medicare Advantage Star Ratings system, CMS annually awards between 1.0 and 5.0 Stars to Medicare Advantage plans based on performance in several categories. Plans must have a Star Rating of 4.0 or higher to qualify for bonus payments. Our 2026 Star Ratings, which are used for payment year 2027, reflect that approximately 55% of our Medicare Advantage members were enrolled in plans rated at least 4.0 Stars or higher at the time of the rating. CMS released our 2027 Star Ratings in October 2026, which will be used to determine our Medicare Advantage payments in 2028. Our 2027 Star Ratings reflect that approximately 49% of our current Medicare Advantage members are enrolled in plans that will be rated at least 4.0 Stars or higher. Membership changes during the Medicare Advantage enrollment periods may cause this number to fluctuate.

Previous wording

From June 30, 2025 to June 30, 2026, total medical membership declined by 1.5%. This was driven by attrition in Medicaid membership, primarily as a result of eligibility redeterminations, and decreases in our Medicare Advantage, Employer Group Risk-Based and FEP® businesses. These decreases were partially offset by increases in our Employer Group Fee-Based business.

Current wording

From September 30, 2025 to September 30, 2026, total medical membership declined by 1.1%. This was driven by attrition in Medicaid membership, primarily as a result of eligibility redeterminations, and decreases in our Medicare Advantage, Commercial Risk-Based and FEP® businesses. These decreases were partially offset by an increase in our Commercial Fee-Based business.

Previous wording

Operating revenue for the three months ended June 30, 2026 was $49,826, an increase of $405, or 0.8%, from the three months ended June 30, 2025. Operating revenue for the six months ended June 30, 2026 was $99,320, an increase of $1,134, or 1.2%, from the six months ended June 30, 2025. The increases for the three and six months ended June 30, 2026 were primarily the result of premium rate increases in our Health Benefits segment in recognition of medical cost trends and growth in CarelonRx product revenues, partially offset by membership attrition.

Current wording

Operating revenue for the three months ended September 30, 2026 was $50,440, an increase of $353, or 0.7%, from the three months ended September 30, 2025. Operating revenue for the nine months ended September 30, 2026 was $149,760, an increase of $1,487, or 1.0%, from the nine months ended September 30, 2025. The increases for the three and nine months ended September 30, 2026 were primarily the result of premium rate increases in our Health Benefits segment in recognition of medical cost trends and growth in CarelonRx product revenues, partially offset by lower Medicare Advantage, Medicaid, and Employer Group Risk-Based membership.

Previous wording

-39- segments. The decrease was partially offset by increased net investment income, decreased net losses on financial instruments and decreased income tax expense. The decrease in net income for the six months ended June 30, 2026 was primarily due to the loss contingency accrual for our best estimate of the identified potential exposure for the resubmission of certain historical Medicare Advantage risk adjustment data within our Corporate & Other segment and a decrease in operating gain in our Health Benefits and Carelon Services segments. The decrease was partially offset by decreased net losses on financial instruments, increased net investment income and decreased income tax expense.

Current wording

-39- was $4,592, a decrease of $523, or 10.2%, from the nine months ended September 30, 2025. The increase in shareholders’ net income for the three months ended September 30, 2026 was primarily due to increased investment income and lower amortization of other intangible assets. The increase was partially offset by an increase in income tax expense. The decrease in shareholders’ net income for the nine months ended September 30, 2026 was primarily due to the loss contingency accrual for our best estimate of the identified potential exposure for the resubmission of certain historical Medicare Advantage risk adjustment data within our Corporate & Other segment and a decrease in operating gain in our Health Benefits segment. The decrease was partially offset by an increase in investment income and a decrease in net losses on financial instruments.

Previous wording

Our fully-diluted shareholders’ earnings per share (“EPS”) was $6.71 for the three months ended June 30, 2026, which represented a 13.1% decrease from EPS of $7.72 for the three months ended June 30, 2025. Our EPS was $14.73 for the six months ended June 30, 2026, which represented a 15.0% decrease from EPS of $17.33 for the six months ended June 30, 2025. The decreases in EPS for both periods resulted primarily from decreased shareholders' net income, partially offset by the impact of fewer diluted shares outstanding.

Current wording

Our fully-diluted shareholders’ earnings per share (“EPS”) was $6.27 for the three months ended September 30, 2026, which represented a 17.9% increase from EPS of $5.32 for the three months ended September 30, 2025. Our EPS was $21.01 for the nine months ended September 30, 2026, which represented a 7.3% decrease from EPS of $22.67 for the nine months ended September 30, 2025. The increase in EPS for the three months ended September 30, 2026 resulted primarily from increased shareholders’ net income and the impact of fewer diluted shares outstanding. The decrease in EPS for the nine months ended September 30, 2026 resulted primarily from decreased shareholders’ net income, partially offset by the impact of fewer diluted shares outstanding.

Previous wording

Operating cash flow for the six months ended June 30, 2026 and 2025 was $6,245 and $3,071, respectively. The increase in net cash provided by operating activities was primarily due to favorable working capital impacts, partially offset by lower shareholders’ net income for the six months ended June 30, 2026.

Current wording

Operating cash flow for the nine months ended September 30, 2026 and 2025 was $7,512 and $4,206, respectively. The increase in net cash provided by operating activities was primarily due to favorable working capital impacts, partially offset by lower shareholders’ net income for the nine months ended September 30, 2026.

Previous wording

The decrease in medical membership was primarily driven by attrition in Medicaid membership, primarily as a result of eligibility redeterminations, and decreases in our Medicare Advantage, Employer Group Risk-Based and FEP® businesses. These decreases were partially offset by increases in our Employer Group Fee-Based business.

Current wording

The decrease in medical membership was primarily driven by attrition in Medicaid membership, primarily as a result of eligibility redeterminations, and decreases in our Medicare Advantage, Commercial Risk-Based and FEP® businesses. These decreases were partially offset by an increase in our Commercial Fee-Based business.

Previous wording

Our consolidated summarized results of operations and other financial information for the three and six months ended June 30, 2026 and 2025 are as follows:

Current wording

Our consolidated summarized results of operations and other financial information for the three and nine months ended September 30, 2026 and 2025 are as follows:

Previous wording

2 Benefit expense ratio represents benefit expense as a percentage of premium revenue. Premiums for the three months ended June 30, 2026 and 2025 were $41,279 and $41,271, respectively. Premiums for the six months ended June 30, 2026 and 2025 were $82,303 and $82,158, respectively.

Current wording

2 Benefit expense ratio represents benefit expense as a percentage of premium revenue. Premiums for the three months ended September 30, 2026 and 2025 were $41,704 and $41,791, respectively. Premiums for the nine months ended September 30, 2026 and 2025 were $124,007 and $123,949, respectively.

Previous wording

Net investment income increased primarily due to higher income from alternative investments, partially offset by lower income from fixed maturity securities.

Current wording

Net investment income increased primarily due to higher income from alternative investments.

Previous wording

Net losses on financial instruments decreased due to lower impairment on other invested assets and lower realized losses on sales of financial instruments.

Current wording

Net losses on financial instruments increased due to higher realized losses on sales of financial instruments, partially offset by changes in other invested asset balances.

Previous wording

Benefit expense increased primarily due to higher medical costs across all lines of business within our Health Benefits segment, with the exception of Medicare. These increases were partially offset by decreases in Carelon Services benefit expense related to the partial termination and modification of a care delivery services contract with an unaffiliated customer.

Current wording

Benefit expense decreased primarily due to decreased Carelon Services benefit expense related to the partial termination and modification of a care delivery services contract with an unaffiliated customer. This decrease was partially offset by higher medical costs across most lines of business within our Health Benefits segment.

Previous wording

Our operating expense ratio increased primarily due to targeted investments to support and strengthen our workforce and accelerate technology adoption, an increase in expenses to address regulatory matters and an increase in premium tax expenses and assessments.

Current wording

Operating expense increased primarily due to increases in targeted investments to accelerate technology adoption, an increase in premium tax expenses and assessments and an increase in expenses to address regulatory matters.

Previous wording

Operating expense increased primarily due to increases in targeted investments to support and strengthen our workforce and accelerate technology adoption, an increase in expenses to address regulatory matters and an increase in premium tax expenses and assessments.

Current wording

Our operating expense ratio increased primarily due to increases in targeted investments to accelerate technology adoption, an increase in premium tax expenses and assessments and an increase in expenses to address regulatory matters.

Previous wording

Our shareholders’ net income as a percentage of total revenues decreased in the three months ended June 30, 2026 as compared to the three months ended June 30, 2025 as a result of all factors discussed above.

Current wording

Our shareholders’ net income as a percentage of total revenues increased in the three months ended September 30, 2026 as compared to the three months ended September 30, 2025 as a result of all factors discussed above.

Previous wording

Net investment income increased primarily due to higher income from alternative investments, partially offset by lower income from fixed maturity securities.

Current wording

Net investment income increased primarily due to higher income from alternative investments.

Previous wording

Net losses on financial instruments decreased due to lower impairment on other invested assets and lower realized losses on sales of financial instruments.

Current wording

Net losses on financial instruments decreased due to changes in other invested asset balances and lower realized losses on sales of financial instruments.

Previous wording

Our benefit expense ratio increased primarily as a result of expected elevated medical cost trend in our Medicaid and Medicare businesses, partially offset by improved performance in our Individual ACA business.

Current wording

Our benefit expense ratio increased primarily due to elevated medical cost trend in our Medicaid business, partially offset by improved performance in our Individual ACA and Medicare programs and decreases in Carelon Services benefit expense related to the partial termination and modification of a care delivery services contract with an unaffiliated customer.

Previous wording

Our operating expense ratio increased primarily due to the loss contingency accrual for our best estimate of the identified potential exposure for the resubmission of certain historical Medicare Advantage risk adjustment data, increases in targeted

Current wording

Our operating expense ratio increased primarily due to the loss contingency accrual for our best estimate of the identified potential exposure for the resubmission of certain historical Medicare Advantage risk adjustment data, increases in targeted investments to support and strengthen our workforce and accelerate technology adoption and increases related to the Transformation Program.

Previous wording

Our shareholders’ net income as a percentage of total revenues decreased in the six months ended June 30, 2026 as compared to six months ended June 30, 2025 as a result of all factors discussed above.

Current wording

Our shareholders’ net income as a percentage of total revenues decreased in the nine months ended September 30, 2026 as compared to nine months ended September 30, 2025 as a result of all factors discussed above.

Previous wording

The following table presents a summary of the reportable segment financial information for the three and six months ended June 30, 2026 and 2025:

Current wording

The following table presents a summary of the reportable segment financial information for the three and nine months ended September 30, 2026 and 2025:

Previous wording

The following table summarizes the operating revenues for our Commercial, Medicare, Medicaid and FEP®lines of business within our Health Benefits segment for the three and six months ended June 30, 2026 and 2025:

Current wording

The following table summarizes the operating revenues for our Commercial, Medicare, Medicaid and FEP®lines of business within our Health Benefits segment for the three and nine months ended September 30, 2026 and 2025:

Previous wording

1 Operating revenue within our Commercial line of business related to our Individual ACA plans was $2,720 and $2,328 for the three months ended June 30, 2026 and 2025, respectively. Operating revenue within our Commercial line of business related to our Individual ACA plans was $5,260 and $4,689 for the six months ended June 30, 2026 and 2025, respectively.

Current wording

1 Operating revenue within our Commercial line of business related to our Individual ACA plans was $2,514 and $2,358 for the three months ended September 30, 2026 and 2025, respectively. Operating revenue within our Commercial line of business related to our Individual ACA plans was $7,774 and $7,047 for the nine months ended September 30, 2026 and 2025, respectively.

Previous wording

Operating gain decreased primarily as a result of higher overall medical costs and increases in targeted investments to support and strengthen our workforce and accelerate technology adoption, partially offset by higher operating revenue.

Current wording

Operating gain decreased primarily as a result of higher overall medical costs and increases in operating expenses, primarily due to targeted investments to accelerate technology adoption, partially offset by higher operating revenue.

Previous wording

Operating revenue increased primarily due to the continued expansion of risk-based capabilities in our specialty care solutions and behavioral health services. These increases were partially offset by decreases related to the partial termination and modification of a care delivery services contract with an unaffiliated customer and fewer post-acute solutions services provided as a result of lower Medicare membership.

Current wording

Operating revenue increased primarily due to the continued expansion of risk-based capabilities in our specialty care solutions and behavioral health services. These increases were partially offset by decreases related to the partial termination and modification of a care delivery services contract with an unaffiliated customer.

Previous wording

The decrease in operating gain was primarily driven by less favorable results on certain contracts and lower health plan membership within our post acute solutions services, lower health plan membership and seasonality related to the launch of risk-based capabilities in our specialty care solutions business. The decrease was partially offset by improved performance in our behavioral health business and the expansion of CareBridge.

Current wording

The increase in operating gain was primarily driven by improved performance and expansion in our specialty care and home-based care services. These increases were partially offset by less favorable results on certain contracts within our behavioral health services.

Previous wording

Operating loss increased primarily due to an increase in unallocated corporate expenses.

Current wording

Operating loss decreased primarily due to a decrease in unallocated corporate expenses.

Previous wording

Operating gain decreased primarily due to higher overall medical costs and increases in targeted investments to support and strengthen our workforce and accelerate technology adoption, partially offset by higher operating revenue.

Current wording

Operating gain decreased primarily due to higher overall medical costs and increases in operating expenses primarily due to targeted investments to support and strengthen our workforce and accelerate technology adoption, partially offset by higher operating revenue.

Previous wording

Operating revenue increased primarily due to higher average revenue per prescription, partially offset by a negative change in product mix and lower prescription volumes.

Current wording

Operating revenue increased primarily due to higher average revenue per prescription, partially offset by a change in product mix and lower prescription volumes.

Previous wording

Operating revenue increased primarily due to the continued expansion of risk-based capabilities in our specialty care solutions and behavioral health services. These increases were partially offset by decreases related to the partial termination and modification of a care delivery services contract with an unaffiliated customer and fewer post-acute solutions services provided as a result of lower Medicare membership.

Current wording

Operating revenue increased primarily due to the continued expansion of risk-based capabilities in our specialty care solutions and behavioral health services. These increases were partially offset by decreases related to the partial termination and modification of a care delivery services contract with an unaffiliated customer.

Previous wording

The decrease in operating gain was primarily driven by less favorable results on certain contracts and lower health plan membership within our post-acute solutions services, partially offset by improved performance in Carelon Insights.

Current wording

The increase in operating gain was primarily driven by the continued expansion and improved performance within our specialty care and home-based care services. The increase was partially offset by less favorable results on certain contracts and lower health plan membership within our post-acute solutions services.

Previous wording

The most subjective accounting estimate in our consolidated financial statements is our liability for medical claims payable. Our accounting policies related to medical claims payable are discussed in the references cited above. As of June 30, 2026, our critical accounting policies and estimates related to medical claims payable have not changed from those described in our 2025 Annual Report on Form 10-K. For a reconciliation of the beginning and ending balance for medical claims payable for the six months ended June 30, 2026 and 2025, see Note 8, “Medical Claims Payable,” of the Notes to Consolidated Financial Statements included in Part I, Item 1 of this Quarterly Report on Form 10-Q.

Current wording

The most subjective accounting estimate in our consolidated financial statements is our liability for medical claims payable. Our accounting policies related to medical claims payable are discussed in the references cited above. As of September 30, 2026, our critical accounting policies and estimates related to medical claims payable have not changed from those described in our 2025 Annual Report on Form 10-K. For a reconciliation of the beginning and ending balance for medical claims payable for the nine months ended September 30, 2026 and 2025, see Note 8, “Medical Claims Payable,” of the Notes to Consolidated Financial Statements included in Part I, Item 1 of this Quarterly Report on Form 10-Q.

Previous wording

The following table provides a summary of the two key assumptions having the most significant impact on our incurred but not paid liability estimates for the six months ended June 30, 2026 and 2025, which are the trend and completion factors. These two key assumptions can be influenced by utilization levels, unit costs, mix of business, benefit plan designs, provider reimbursement levels, processing system conversions and changes, claim inventory levels, claim processing patterns, claim submission patterns and operational changes resulting from business combinations.

Current wording

The following table provides a summary of the two key assumptions having the most significant impact on our incurred but not paid liability estimates for the nine months ended September 30, 2026 and 2025, which are the trend and completion factors. These two key assumptions can be influenced by utilization levels, unit costs, mix of business, benefit plan designs, provider reimbursement levels, processing system conversions and changes, claim inventory levels, claim processing patterns, claim submission patterns and operational changes resulting from business combinations.