Elevance Health Inc. (ELV): History, Ownership, Mission, How It Works & Makes Money

When you look at the healthcare landscape, how is Elevance Health Inc. (ELV), a company serving over 109 million consumers, managing to grow in such a dynamic environment?

The third quarter 2025 operating revenue of $50.1 billion, a 12% year-over-year jump, certainly grabs attention, but it also raises questions about margin pressure and the sustainability of that growth.

You defintely need to understand the engine under the hood, especially how their Carelon segment, which posted an impressive $18.3 billion in Q3 2025 operating revenue, is driving the shift from traditional health benefits to a more integrated, whole-health approach.

Let's unpack the mission, ownership structure, and the mechanics of how this healthcare giant actually makes money, so you can make a truly informed investment decision based on the full-year adjusted diluted EPS guidance of approximately $30.00.

Elevance Health Inc. (ELV) History

You need to understand the roots of Elevance Health Inc. to grasp its current strategy, especially as it navigates the post-pandemic healthcare landscape and the complexities of government programs. The company you see today is the result of a massive 2004 merger, and its evolution shows a clear trend: moving beyond just being a health insurer to becoming a diversified health services provider.

Given Company's Founding Timeline

Year established

The corporate entity that became Elevance Health was formally established in 2004 as WellPoint, Inc. This was a merger of equals between two major players, Anthem, Inc., and WellPoint Health Networks Inc. The roots of its predecessors, however, go back much further, with Anthem tracing its history to 1946.

Original location

The headquarters were established in Indianapolis, Indiana, following the 2004 merger, and this location remains the central hub for the company's operations today.

Founding team members

The merger was spearheaded by the leadership teams of the two merging companies. Key figures included Larry Glasscock, who was CEO of Anthem and became the President and CEO of the newly formed WellPoint, Inc., and Leonard Schaeffer, who led WellPoint Health Networks. Their combined vision created the largest health insurer in the U.S. at the time.

Initial capital/funding

The formation of WellPoint, Inc. was a significant transaction, structured as a merger of equals valued at approximately $16.4 billion in 2004. Since both were already substantial public companies, the initial capital was derived from their decades of pre-existing operations and capital bases.

Given Company's Evolution Milestones

Given Company's Transformative Moments

The biggest inflection point wasn't a success story, but a failure: the blocked merger with Cigna in 2017. That event forced the company to stop relying on mega-mergers for growth and instead build its own diversified health services portfolio, which is why we're seeing the current focus on Carelon and other non-insurance businesses. This pivot is defintely what drives their strategy today.

The 2022 rebrand to Elevance Health was a clear signal to the market that the company was moving past the legacy image of Anthem, Inc. and its Blue Cross Blue Shield core, which still covers 46 million medical members as of June 2025.

Look at the 2025 numbers to see the impact of this strategy. The company is guiding for a full-year 2025 adjusted diluted earnings per share (EPS) of approximately $30.00, which is a strong number built on a massive revenue base. The operating revenue for the trailing 12 months ending September 30, 2025, hit a staggering $194.82 billion. That's a huge machine, and it's getting more complex.

The company is also actively managing capital, returning $3.3 billion to shareholders year-to-date through September 30, 2025, via dividends and share repurchases. This steady return of capital shows management's confidence, even with a benefit expense ratio guided to be around 90.0% for the full fiscal year 2025. That ratio-the percentage of premiums paid out for medical care-is the key metric to watch for profitability.

• Pivot to Health Services: The creation and expansion of the Carelon brand, which houses their pharmacy benefit management (PBM) and health services, is a major shift.
• Medicaid Expansion: The Amerigroup acquisition cemented their position in government-sponsored programs, an area that now faces new pressures from eligibility reverifications.
• Rebranding: The 2022 name change was more than cosmetic; it was a commitment to a 'whole health' model, aiming to integrate medical, pharmacy, and behavioral health services.

If you want to dive deeper into the current financial performance and valuation, you should check out Breaking Down Elevance Health Inc. (ELV) Financial Health: Key Insights for Investors.

Elevance Health Inc. (ELV) Ownership Structure

Elevance Health Inc. is a publicly traded healthcare giant, so its ownership is widely distributed, but it's heavily controlled by large institutional investors. This structure means the company's strategic direction is defintely influenced by the voting power of major asset managers like Vanguard Group Inc. and BlackRock, Inc., who prioritize long-term, stable returns.

Elevance Health Inc.'s Current Status

As of November 2025, Elevance Health Inc. (ELV) is a public company, trading on the New York Stock Exchange (NYSE) under the ticker ELV. This status requires significant transparency and adherence to strict financial reporting standards, which is great for you as an investor.

The company maintains a massive scale in the US healthcare market, with a market capitalization hovering between $70.623 billion and $74 billion. For the 2025 fiscal year, the company's total revenue stood at approximately $195 billion (Trailing Twelve Months), with Q3 2025 operating revenue reported at $50.1 billion, representing a 12% year-over-year increase. This sheer size, plus the reaffirmed 2025 earnings guidance, signals an operational stability that is key to its valuation.

Elevance Health Inc.'s Ownership Breakdown

The control of Elevance Health Inc. is overwhelmingly concentrated among institutional shareholders, which is typical for a company of this size and stability. What this means is that the day-to-day share price movement is often driven by large-scale fund flows, not small-investor sentiment.

Here's the quick math: nearly nine out of every ten shares are held by professional money managers. The largest single institutional holder is Vanguard Group Inc., owning about 10.35% of the company, which translates to roughly 23.00 million shares valued at about $7.49 billion. This huge institutional stake provides a strong base of long-term capital, but it also means management must constantly align with the interests of these large, powerful shareholders.

Elevance Health Inc.'s Leadership

The company is steered by a seasoned executive team, with decades of collective experience in the complex healthcare and insurance sectors. This stability in the C-suite is a big factor in the company's ability to execute on its strategy, especially in navigating regulatory shifts.

• Gail K. Boudreaux: President and Chief Executive Officer (CEO). She has led the company since 2017 and is responsible for the overall strategy of simplifying healthcare and improving lives. In 2024, her total compensation was approximately $20.5 million.
• Mark Kaye: Executive Vice President and Chief Financial Officer (CFO). He manages the company's financial strategy, reporting, and capital allocation.
• Peter D. Haytaian: Executive Vice President and President of Carelon and CarelonRx. He oversees the strategic direction and growth of the company's diversified services, including its in-house pharmacy benefit manager (PBM), CarelonRx.
• Felicia Norwood: Executive Vice President and President of Government Health Benefits. She leads the critical Medicare and Medicaid segments, which account for a substantial portion of the company's members.

The Board of Directors, chaired by Ramey Peru, includes recent appointments like Steve Collis, who joined in August 2025, bringing his expertise in the pharmaceutical supply chain to the Audit and Finance Committees. Understanding the leadership's focus is important; you can see their core principles in the Mission Statement, Vision, & Core Values of Elevance Health Inc. (ELV).

Elevance Health Inc. (ELV) Mission and Values

Elevance Health Inc.'s purpose is to improve the health of humanity, moving beyond the traditional payer model to become a lifetime trusted health partner for its 109 million consumers. This commitment, grounded in core values like Integrity and Innovation, shapes their strategy to prioritize whole-person care over just managing claims.

Elevance Health's Core Purpose

You're looking at a healthcare giant, but you need to see what drives their non-financial decisions. Elevance Health's cultural DNA is built on five core values-Integrity, Innovation, Excellence, Caring, and Inclusion-that guide their strategic shift from a health benefits organization to a comprehensive health partner. This focus means they are defintely looking at long-term, sustainable health outcomes, not just short-term cost control.

Official mission statement

The company's mission is centered on a clear, active purpose: to improve the health of humanity. This isn't just a plaque on the wall; it drives their investments in services like Carelon, which focuses on behavioral and complex care. They aim to reimagine the health system by adopting a whole-health approach (addressing physical, behavioral, and social needs) to enhance outcomes, equity, and accessibility.

• Improve Lives and Communities: Making a positive impact on well-being.
• Simplifying Healthcare: Making the complex system easier to navigate.
• Expecting More: Committing to continuous improvement in care delivery.
• Reimagining the Health System: Transforming the healthcare experience through innovation.

Vision statement

Elevance Health's vision is about transforming healthcare into a system that is fundamentally different-more personalized and easier to access. They are striving for a future where everyone has a real opportunity to lead a healthier life, addressing social drivers of health like food access and housing stability. This is a critical trend for all investors to watch in the healthcare space; it's where the next wave of value is being created.

• Deliver personalized, accessible healthcare solutions.
• Transform healthcare by addressing social drivers of health.
• Envision healthcare as more Personalized, Proactive, and Affordable.

To be fair, this vision requires massive capital deployment. For the full year 2025, the company reaffirmed its adjusted diluted earnings per share (EPS) guidance to be between $34.15 and $34.85, which shows they are balancing mission with disciplined financial execution. You can dig deeper into this balance in Exploring Elevance Health Inc. (ELV) Investor Profile: Who's Buying and Why?

Elevance Health slogan/tagline

The company's tagline, 'Advancing Health Beyond Healthcare,' succinctly captures their strategy to move past traditional insurance boundaries. It's a clean one-liner that tells you exactly where they are investing their focus and capital.

Here's the quick math: In the third quarter of 2025 alone, Elevance Health reported revenue of $50.09 billion, which demonstrates the scale they are using to fund these 'beyond healthcare' initiatives, like integrating food-as-medicine programs with primary care.

Elevance Health Inc. (ELV) How It Works

Elevance Health operates as a diversified health benefits company, primarily making money by underwriting (taking on the risk) and administering health insurance plans for over 45.4 million medical members as of September 30, 2025. Its operational framework is split between its core Health Benefits insurance business and its integrated health services division, Carelon, which is a significant growth engine, driving $18.3 billion in operating revenue in Q3 2025.

Given Company's Product/Service Portfolio

Given Company's Operational Framework

Elevance Health's operational framework is built on two primary, interconnected segments: Health Benefits and Carelon. The Health Benefits segment collects premiums and fees, managing the medical costs for its members. The Carelon segment, which includes CarelonRx and Carelon Services, provides the clinical and administrative services that help control those medical costs and drive better health outcomes.

This integrated model is the core of how they deliver value. CarelonRx, for example, manages the pharmacy spend-a massive cost center-by negotiating drug prices and managing formularies (lists of covered drugs). This directly impacts the Health Benefits segment's benefit expense ratio, which Elevance Health targets at approximately 90.0% for the full year 2025. The entire enterprise is focused on a whole-health approach, meaning they look beyond just physical illness to behavioral and social factors, which ultimately lowers long-term costs.

• Risk Management: Pricing insurance premiums to cover expected medical expenses and administrative costs, aiming for a profitable medical loss ratio (MLR).
• Integrated Care Delivery: Using Carelon Services for specialized clinical domains like behavioral health and palliative care to coordinate treatment and avoid costly, fragmented care.
• Digital Enablement: Deploying AI-enabled digital tools, like the Sydney Health platform, to simplify member access to care and personalize health management.
• Capital Discipline: Reaffirming a full-year 2025 adjusted diluted Earnings Per Share (EPS) guidance of approximately $30.00, showing a focus on managing costs despite elevated medical trends in certain markets.

Given Company's Strategic Advantages

The company's ability to thrive in a complex, regulated market comes down to a few clear strategic advantages. Honestly, their scale and reach are defintely the biggest ones, but the shift to an integrated services model is what really changes the game for investors. You can check out more on their core beliefs at Mission Statement, Vision, & Core Values of Elevance Health Inc. (ELV).

• Blue Cross Blue Shield Brand Power: Operating as a Blue Cross Blue Shield licensee in 14 states provides instant, deep-rooted market trust and a massive provider network advantage.
• Diversified Revenue Streams: The two-segment structure-insurance (Health Benefits) and services (Carelon)-diversifies earnings and provides a hedge against regulatory changes impacting one side of the business. Carelon's operating revenue grew by a significant 33% in Q3 2025, showing this strategy is working.
• Value-Based Care Leadership: Shifting from fee-for-service to value-based care partnerships, where providers are paid for patient outcomes, not just volume, aligns incentives and controls costs long-term.
• Data and Technology Integration: Leveraging the HealthOS platform to share data across the enterprise, which speeds up approvals and reduces administrative burden for both members and providers.

Elevance Health Inc. (ELV) How It Makes Money

Elevance Health Inc. makes money primarily by collecting premiums from its members for health insurance coverage and then managing the medical costs associated with those plans, plus a rapidly growing revenue stream from providing health services, including pharmacy benefits management (PBM), to both its own members and external clients.

Elevance Health Inc.'s Revenue Breakdown

You need to look at Elevance Health's revenue through two major lenses: the core insurance business (Health Benefits) and the diversified health services arm (Carelon). For the third quarter of 2025, the company reported total operating revenue of $50.1 billion.

Note: Carelon's segment revenue of $18.3 billion includes sales to the Health Benefits segment, which is why the two percentages sum to more than 100% of the total $50.1 billion operating revenue. This is how a vertically integrated model works.

Business Economics

The economic engine for Elevance Health is built on disciplined underwriting-setting premiums high enough to cover expected medical claims and administrative costs, while still remaining competitive. It's a constant balancing act. The core profitability metric here is the benefit expense ratio (BER), which is the percentage of premiums paid out for medical claims.

• Pricing Discipline: For 2025, the company priced its commercial plans based on an expectation that medical cost trends would remain above historical averages. They are not guessing; they are pricing for reality.
• Medicare Advantage Growth: Growth in Medicare Advantage (MA) membership is a key revenue driver, offsetting membership losses in the Medicaid business due to ongoing eligibility reverifications. This shift is defintely strategic.
• Carelon's Leverage: The Carelon segment, which includes the pharmacy benefits manager (PBM) CarelonRx, is the fastest-growing part of the business, with operating revenue up 33% year-over-year in Q3 2025. This diversification provides a crucial margin buffer against rising medical costs in the core insurance business.

What this estimate hides is the acute sensitivity to medical cost inflation; a small rise in the BER can significantly cut into earnings, which is why the market watches that number so closely. The company's strategy is to use its own services arm, Carelon, to help manage and control those costs internally.

Elevance Health Inc.'s Financial Performance

Looking at the full-year 2025 guidance, the numbers tell a clear story of strong revenue growth but persistent margin pressure from elevated medical costs, especially in the government-sponsored programs like Medicare. You can get a deeper dive into these numbers here: Breaking Down Elevance Health Inc. (ELV) Financial Health: Key Insights for Investors

• Adjusted EPS: The full-year 2025 adjusted diluted earnings per share (EPS) guidance was reaffirmed at approximately $30.00 as of November 2025.
• Benefit Expense Ratio (BER): The full-year 2025 BER is projected to be approximately 90.0%. This means 90 cents of every premium dollar is expected to be paid out in medical claims.
• Operating Cash Flow: Full-year 2025 operating cash flow is projected to be approximately $6.0 billion, a critical measure of the company's financial flexibility.
• Capital Returns: The company continues to deploy capital, repurchasing 2.9 million shares for $875 million in the third quarter of 2025 and paying a quarterly dividend of $1.71 per share. That is a clear sign of management confidence in future cash generation.

Here's the quick math: with a BER of 90.0%, the operating margin on the insurance business is thin, which makes the growth and higher-margin services from Carelon absolutely vital for overall profitability.

Elevance Health Inc. (ELV) Market Position & Future Outlook

Elevance Health Inc. is focused on disciplined execution and managing costs in a volatile market, positioning itself as a diversified healthcare leader with a massive member base and a growing health services arm, Carelon. The company is guiding toward a 2025 adjusted diluted earnings per share of approximately $30.00, a figure that reflects the ongoing pressure from elevated medical costs in government-subsidized plans.

Competitive Landscape

The US health insurance market is highly consolidated, and Elevance Health is a top-tier player, though it trails the market leader, UnitedHealth Group, in overall size. To be fair, Elevance Health's strength lies in its expansive Blue Cross Blue Shield (BCBS) network, which gives it a significant commercial footprint across 14 states.

Opportunities & Challenges

The company is making smart, strategic shifts to control what it can, especially in the Medicare space. They are exiting underperforming Medicare Advantage (MA) plans and the standalone Part D market, which will impact around 150,000 MA members, but this move frees up capital to focus on higher-margin areas like Dual-Special Needs Plans (D-SNP). Plus, the Carelon health services segment continues to be a bright spot, outperforming expectations.

Industry Position

Elevance Health is defintely a powerhouse, serving approximately 45.6 million medical members as of mid-2025, which makes it the second-largest US health insurer by membership. While they are not as vertically integrated as UnitedHealth Group with its massive Optum division, Elevance Health's strategy is to grow its own health services segment, Carelon, which already served 97.3 million consumers in the second quarter of 2025.

The company's full-year 2025 benefit expense ratio is projected to be around 90.0%, meaning 90 cents of every premium dollar is expected to be paid out in medical claims. This ratio is a key metric, and managing it is crucial given the elevated medical cost trends affecting the entire industry. The market volatility, driven by cost pressures and policy shifts, means investors need to look closely at the underlying business segments. You can see a deeper dive into the ownership structure here: Exploring Elevance Health Inc. (ELV) Investor Profile: Who's Buying and Why?

• Total operating revenue for the third quarter of 2025 hit $50.1 billion, up 12.0% from the prior year.
• The company is targeting $1 billion in annual revenue from digital solutions by the end of 2025.
• Elevance Health's commercial business, with 27.1 million members, provides a stable counterbalance to the turbulent government-sponsored markets.