Elevance Health (ELV) raised its full-year 2026 adjusted diluted earnings guidance to at least $29.00 a share, from at least $27.00 after the second quarter, and lifted diluted EPS guidance to at least $22.00 from at least $20.10. Operating cash flow guidance rose to at least $6.5 billion from at least $6.0 billion.

The health insurer reported third-quarter operating revenue of $50.4 billion, up 0.7% from a year earlier, after 0.8% growth in the second quarter and 1.5% in the first. Diluted EPS was $6.27, including a $1.85 a share net non-operating benefit. Adjusted diluted EPS was $6.99.

President and Chief Executive Officer Gail K. Boudreaux said the company remains confident in delivering at least 12% growth in adjusted diluted earnings per share in 2027 from a higher earnings baseline of at least $26.75, which excludes non-recurring net investment income, other non-operating items, and targeted one-time investments.

Operating gain was $1.3 billion and operating margin 2.5%, down 10 basis points from 2.6% a year earlier. Adjusted operating gain was $1.3 billion and adjusted operating margin 2.7%, unchanged. The benefit expense ratio improved 70 basis points to 90.6% from 91.3%, which the company attributed to better Medicare Advantage and Individual ACA performance. The operating expense ratio rose 90 basis points to 11.4%; the adjusted operating expense ratio rose 90 basis points to 11.3%, which the company said principally reflected targeted, one-time investments in capabilities.

Health Benefits operating revenue was $43.4 billion, up 2.6% from $42.2 billion a year earlier, on higher premium yields and service fees, partially offset by lower Medicare Advantage, Medicaid, and Employer Group risk membership. Health Benefits operating gain fell 27.5% to $436 million from $601 million, and operating margin compressed 40 basis points to 1.0% from 1.4%. The company said the gain decline reflected targeted investments that were only partially offset by the benefit-expense-ratio improvement.

Carelon operating revenue was $19.3 billion, up 5% from $18.3 billion a year earlier. Carelon operating gain rose 17% to $0.9 billion from $0.8 billion, and operating margin expanded to 4.7% from 4.2%, which the company attributed to Carelon Services risk-based solutions and improved specialty pharmacy profitability. CarelonRx operating revenue was $11.6 billion, with operating gain of $616 million and margin of 5.3%. Carelon Services operating revenue was $7.7 billion, with operating gain of $292 million and margin of 3.8%.

Medical membership was 44.9 million as of September 30, 2026, down 1.1% from 45.4 million a year earlier. Medicare Advantage membership fell 15.5% to 1.90 million, Medicaid 4.9% to 8.22 million, and Employer Group risk-based 6.9% to 3.37 million. Employer Group fee-based membership rose 1.9% to 21.01 million. CarelonRx quarterly adjusted scripts were 82.6 million. Carelon Services consumers served were 91.0 million.

Net investment income was $1.04 billion, up 65.9% from $625 million a year earlier. The quarter also included a $1.85 a share net non-operating benefit. Operating cash flow was $1.3 billion in the quarter, up $0.1 billion from the year-ago quarter on favorable working capital. Parent-company cash and investments totaled approximately $2.4 billion as of September 30, 2026.

The company repurchased 0.8 million shares for $330 million at a weighted average $398.75 and paid a $1.72 quarterly dividend, leaving about $5.0 billion of remaining repurchase authorization. The Audit Committee declared a fourth-quarter dividend of $1.72 a share, payable December 18, 2026.