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Form 8-K/A Cigna Corp For: Dec 20

March 8, 2019 5:07 PM
SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 8-K/A
(Amendment No. 1)

CURRENT REPORT
Pursuant to Section 13 or 15(d) of the
Securities Exchange Act of 1934

Date of Report (Date of earliest event reported) December 20, 2018

Cigna Corporation
 (Exact name of registrant as specified in its charter)


Delaware
(State or other jurisdiction of incorporation)
001-38769
(Commission File Number)
82-4991898
 (IRS Employer
Identification No.)

900 Cottage Grove Road
Bloomfield, Connecticut 06002
(Address of principal executive offices)  (Zip Code)

Registrant’s telephone number, including area code:

(860) 226-6000

Not Applicable
(Former name or former address, if changed since last report)

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

[ ]  Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
[ ]  Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
[ ]  Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
[ ]  Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (17 CFR §230.405) or Rule 12b-2 of the Securities Exchange Act of 1934 (17 CFR §240.12b-2).

Emerging growth company

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.





On December 20, 2018, Cigna Corporation (the "Company" or “Cigna”) filed a Current Report on Form 8-K (the "Form 8-K") in connection with the completion, on December 20, 2018, of the previously announced merger, pursuant to which Cigna Holding Company (formerly Cigna Corporation) (“Old Cigna”) and Express Scripts Holding Company (“Express Scripts”) became direct wholly owned subsidiaries of the Company (the “Merger”).

This Current Report on Form 8-K/A is being filed to amend the Form 8-K to provide the financial statements and pro forma financial information described below, in accordance with the requirements of Item 9.01 of Form 8-K.  The pro forma financial information included in this Form 8-K/A has been presented for informational purposes only, as required by Form 8-K.  It does not purport to represent the actual results of operations that Old Cigna and Express Scripts would have achieved had the companies been combined during the periods presented in the pro forma financial information and is not intended to project the future results of operations that the combined company may achieve after the Merger.  Except as described above, all other information in the Company’s Current Report on Form 8-K filed on December 20, 2018 remains unchanged.

Item 9.01 Financial Statements and Exhibits.

   
(a)
Financial Statements of Business Acquired.

The audited consolidated balance sheet of Express Scripts as of December 31, 2017 and December 31, 2016 and consolidated statements of operations, comprehensive income, changes in stockholders' equity and cash flows for each of the three years ended December 31, 2017, 2016 and 2015 and related notes are included as Exhibit 99.1 to this Form 8-K/A.

The unaudited consolidated balance sheet of Express Scripts as of September 30, 2018 and consolidated statements of operations, comprehensive income, changes in stockholders' equity and cash flows for the three and nine months ended September 30, 2018 and 2017 and related notes are included as Exhibit 99.2 to this Form 8-K/A.

   
(b)
Pro Forma Financial Information.

The required unaudited pro forma combined financial information of Old Cigna and Express Scripts as of and for the nine months ended September 30, 2018 and the year ended December 31, 2017 are included as Exhibit 99.3.

   
(d)
Exhibits.

Exhibit No.
Description
23.1
99.1
99.2
99.3




SIGNATURE

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

 
Cigna Corporation
 
 
Date: March 8, 2019
By: /s/ Eric P. Palmer
 
Eric P. Palmer
 
Executive Vice President and
 
Chief Financial Officer






CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
We hereby consent to the incorporation by reference in the Registration Statements on Form S-8 (Nos. 333-228930 and 333-228931) of Cigna Corporation of our report dated February 27, 2018 relating to the financial statements of Express Scripts Holding Company, which appears in this Current Report on Form 8-K/A.

/s/ PricewaterhouseCoopers LLP

St. Louis, Missouri
March 8, 2019
Exhibit 99.1

Explanatory Note
 
Set forth below in this Exhibit 99.1 are the historical audited consolidated balance sheet of Express Scripts Holding Company as of December 31, 2017 and December 31, 2016 and consolidated statements of operations, comprehensive income, changes in stockholders' equity and cash flows for each of the three years ended December 31, 2017, 2016 and 2015.  Unless the context otherwise requires, references to the terms “we,” “our,” or “us” used throughout this Exhibit 99.1 refer to Express Scripts Holding Company and its consolidated subsidiaries.
1




Report of Independent Registered Public Accounting Firm

To the Board of Directors and Stockholders of Express Scripts Holding Company

Opinion on the Financial Statements

We have audited the accompanying consolidated balance sheet of Express Scripts Holding Company and its subsidiaries (the “Company”) as of December 31, 2017 and 2016, and the related consolidated statements of operations, comprehensive income, changes in stockholders’ equity, and cash flows for each of the three years in the period ended December 31, 2017, including the related notes (collectively referred to as the “consolidated financial statements”).

In our opinion, the consolidated financial statements present fairly, in all material respects, the financial position of the Company as of December 31, 2017 and 2016, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 2017 in conformity with accounting principles generally accepted in the United States of America.

Basis for Opinion

These consolidated financial statements are the responsibility of the Company's management. Our responsibility is to express an opinion on the Company’s consolidated financial statements based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audits of these consolidated financial statements in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement, whether due to error or fraud.

Our audits included performing procedures to assess the risks of material misstatement of the consolidated financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the consolidated financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements. We believe that our audits provide a reasonable basis for our opinion.


/s/ PricewaterhouseCoopers LLP
St. Louis, Missouri
February 27, 2018

We have served as the Company’s auditor since 1991.


2


EXPRESS SCRIPTS HOLDING COMPANY
CONSOLIDATED BALANCE SHEET
 
December 31,
(in millions)
2017
 
2016
Assets
     
Current assets:
     
Cash and cash equivalents
$
2,309.6
   
$
3,077.2
 
Receivables, net
7,056.3
   
7,062.1
 
Inventories
2,124.9
   
1,959.0
 
Prepaid expenses and other current assets
466.3
   
265.1
 
Total current assets
11,957.1
   
12,363.4
 
Property and equipment, net
551.3
   
607.0
 
Computer software, net
814.9
   
712.6
 
Goodwill
31,099.7
   
29,277.8
 
Other intangible assets, net
9,625.9
   
8,636.9
 
Other assets
206.9
   
147.2
 
Total assets
$
54,255.8
   
$
51,744.9
 
       
Liabilities and stockholders’ equity
     
Current liabilities:
     
Claims and rebates payable
$
10,188.5
   
$
8,836.9
 
Accounts payable
3,755.7
   
3,875.7
 
Accrued expenses
2,869.3
   
2,993.2
 
Short-term debt and current maturities of long-term debt
1,032.9
   
722.3
 
Total current liabilities
17,846.4
   
16,428.1
 
Long-term debt
14,981.5
   
14,846.0
 
Deferred taxes
2,562.4
   
3,603.3
 
Other liabilities
740.2
   
623.7
 
Total liabilities
36,130.5
   
35,501.1
 
Commitments and contingencies (Note 11)
     
Stockholders’ equity:
     
Preferred stock, 15.0 shares authorized, $0.01 par value per share; and no shares issued and outstanding
   
 
Common stock, 2,985.0 shares authorized, $0.01 par value per share; shares issued: 862.3 and 857.5, respectively; shares outstanding: 564.4 and 605.5, respectively
8.6
   
8.6
 
Additional paid-in capital
23,537.8
   
23,233.6
 
Accumulated other comprehensive loss
(2.9
)
 
(12.3
)
Retained earnings
16,318.6
   
11,801.2
 
 
39,862.1
   
35,031.1
 
Common stock in treasury at cost, 297.9 and 252.0 shares, respectively
(21,742.5
)
 
(18,795.1
)
Total Express Scripts stockholders’ equity
18,119.6
   
16,236.0
 
Non-controlling interest
5.7
   
7.8
 
Total stockholders’ equity
18,125.3
   
16,243.8
 
Total liabilities and stockholders’ equity
$
54,255.8
   
$
51,744.9
 
See accompanying Notes to Consolidated Financial Statements
3

EXPRESS SCRIPTS HOLDING COMPANY
CONSOLIDATED STATEMENT OF OPERATIONS
 
Year Ended December 31,
(in millions, except per share data)
2017
 
2016
 
2015
Revenues(1)
$
100,064.6
   
$
100,287.5
   
$
101,751.8
 
Cost of revenues(1)
91,302.5
   
91,667.0
   
93,349.9
 
Gross profit
8,762.1
   
8,620.5
   
8,401.9
 
Selling, general and administrative
3,268.1
   
3,532.7
   
4,062.6
 
Operating income
5,494.0
   
5,087.8
   
4,339.3
 
Other (expense) income:
         
Interest income and other
42.9
   
34.1
   
24.8
 
Interest expense and other
(607.9
)
 
(694.8
)
 
(500.3
)
 
(565.0
)
 
(660.7
)
 
(475.5
)
Income before income taxes
4,929.0
   
4,427.1
   
3,863.8
 
Provision for income taxes
397.3
   
999.5
   
1,364.3
 
Net income
4,531.7
   
3,427.6
   
2,499.5
 
Less: Net income attributable to non-controlling interest
14.3
   
23.2
   
23.1
 
Net income attributable to Express Scripts
$
4,517.4
   
$
3,404.4
   
$
2,476.4
 
           
Weighted-average number of common shares outstanding during the period:
         
Basic
580.1
   
626.9
   
689.0
 
Diluted
583.4
   
631.4
   
695.3
 
Earnings per share:
         
Basic
7.79
   
5.43
   
3.59
 
Diluted
7.74
   
5.39
   
3.56
 
(1)
Includes retail pharmacy co-payments of $8,241.3 million, $8,569.2 million and $9,170.0 million for the years ended December 31, 2017, 2016 and 2015, respectively.
See accompanying Notes to Consolidated Financial Statements
4

EXPRESS SCRIPTS HOLDING COMPANY
CONSOLIDATED STATEMENT OF COMPREHENSIVE INCOME
 
Year Ended December 31,
(in millions)
2017
 
2016
 
2015
Net income
$
4,531.7
   
$
3,427.6
   
$
2,499.5
 
Other comprehensive income (loss):
         
Foreign currency translation adjustment
9.4
   
1.7
   
(16.1
)
Comprehensive income
4,541.1
   
3,429.3
   
2,483.4
 
Less: Comprehensive income attributable to non-controlling interest
14.3
   
23.2
   
23.1
 
Comprehensive income attributable to Express Scripts
$
4,526.8
   
$
3,406.1
   
$
2,460.3
 
See accompanying Notes to Consolidated Financial Statements
5

EXPRESS SCRIPTS HOLDING COMPANY
CONSOLIDATED STATEMENT OF CHANGES IN STOCKHOLDERS’ EQUITY
 
Number
of
Shares
 
Amount
(in millions)
Common
Stock
 
Common
Stock
 
Additional
Paid-in
Capital
 
Accumulated Other Comprehensive (Loss) Income
 
Retained
Earnings
 
Treasury
Stock
 
Non-
Controlling
Interest
 
Total
Balance at December 31, 2014
848.6
   
$
8.5
   
$
22,671.4
   
$
2.1
   
$
5,920.4
   
$
(8,548.2
)
 
$
9.8
   
$
20,064.0
 
Net income
   
   
   
   
2,476.4
   
   
23.1
   
2,499.5
 
Other comprehensive loss
   
   
   
(16.1
)
 
   
   
   
(16.1
)
Treasury stock acquired
   
   
(825.0
)
 
   
   
(4,675.0
)
 
   
(5,500.0
)
Common stock issued under employee plans, net of forfeitures and stock redeemed for taxes
5.9
   
   
(30.0
)
 
   
   
   
   
(30.0
)
Amortization of unearned compensation under employee plans
   
   
117.1
   
   
   
   
   
117.1
 
Exercise of stock options
   
   
213.2
   
   
   
   
   
213.2
 
Tax benefit relating to employee stock compensation
   
   
58.0
   
   
   
   
   
58.0
 
Distributions to non-controlling interest
   
   
   
   
   
   
(25.2
)
 
(25.2
)
Balance at December 31, 2015
854.5
   
$
8.5
   
$
22,204.7
   
$
(14.0
)
 
$
8,396.8
   
$
(13,223.2
)
 
$
7.7
   
$
17,380.5
 
Net income
   
   
   
   
3,404.4
   
   
23.2
   
3,427.6
 
Other comprehensive income
   
   
   
1.7
   
   
   
   
1.7
 
Treasury stock acquired
   
   
825.0
   
   
   
(5,571.9
)
 
   
(4,746.9
)
Common stock issued under employee plans, net of forfeitures and stock redeemed for taxes
3.0
   
0.1
   
(9.8
)
 
   
   
   
   
(9.7
)
Amortization of unearned compensation under employee plans
   
   
107.0
   
   
   
   
   
107.0
 
Exercise of stock options
   
   
95.5
   
   
   
   
   
95.5
 
Tax benefit relating to employee stock compensation
   
   
11.2
   
   
   
   
   
11.2
 
Distributions to non-controlling interest
   
   
   
   
   
   
(23.1
)
 
(23.1
)
Balance at December 31, 2016
857.5
   
$
8.6
   
$
23,233.6
   
$
(12.3
)
 
$
11,801.2
   
$
(18,795.1
)
 
$
7.8
   
$
16,243.8
 
Net income
   
   
   
   
4,517.4
   
   
14.3
   
4,531.7
 
Other comprehensive income
   
   
   
9.4
   
   
   
   
9.4
 
Treasury stock acquired
   
   
   
   
   
(2,947.4
)
 
   
(2,947.4
)
Issuance of common shares in connection with acquisitions
2.0
   
   
124.5
   
   
   
   
   
124.5
 
Common stock issued under employee plans, net of forfeitures and stock redeemed for taxes
2.8
   
   
(12.9
)
 
   
   
   
   
(12.9
)
Amortization of unearned compensation under employee plans
   
   
99.6
   
   
   
   
   
99.6
 
Exercise of stock options
   
   
93.0
   
   
   
   
   
93.0
 
Distributions to non-controlling interest, net of contributions
   
   
   
   
   
   
(16.4
)
 
(16.4
)
Balance at December 31, 2017
862.3
   
$
8.6
   
$
23,537.8
   
$
(2.9
)
 
$
16,318.6
   
$
(21,742.5
)
 
$
5.7
   
$
18,125.3
 
See accompanying Notes to Consolidated Financial Statements
6

EXPRESS SCRIPTS HOLDING COMPANY
CONSOLIDATED STATEMENT OF CASH FLOWS
 
Year Ended December 31,
(in millions)
2017
 
2016
 
2015
Cash flows from operating activities:
         
Net income
$
4,531.7
   
$
3,427.6
   
$
2,499.5
 
Adjustments to reconcile net income to net cash provided by operating activities:
         
Depreciation and amortization
1,802.0
   
2,154.6
   
2,359.1
 
Deferred income taxes
(1,678.9
)
 
(497.4
)
 
(462.1
)
Employee stock-based compensation expense
99.6
   
107.0
   
117.1
 
Other, net
43.3
   
(36.2
)
 
(46.3
)
Changes in operating assets and liabilities
         
Receivables
55.9
   
(374.0
)
 
(770.3
)
Inventories
(166.7
)
 
64.1
   
90.1
 
Other current and noncurrent assets
(172.5
)
 
(137.5
)
 
78.3
 
Claims and rebates payable
1,114.9
   
(560.8
)
 
909.5
 
Accounts payable
(126.8
)
 
436.4
   
318.3
 
Accrued expenses
(241.7
)
 
404.2
   
(142.7
)
Other current and noncurrent liabilities
90.5
   
(68.6
)
 
(102.2
)
Net cash flows provided by operating activities
5,351.3
   
4,919.4
   
4,848.3
 
Cash flows from investing activities:
         
Acquisitions, net of cash acquired
(3,501.1
)
 
   
 
Capital expenditures for property and equipment and computer software
(267.4
)
 
(330.4
)
 
(295.9
)
Net cash proceeds from the sale of business
85.3
   
   
 
Other, net
(7.4
)
 
(21.5
)
 
27.4
 
Net cash used in investing activities
(3,690.6
)
 
(351.9
)
 
(268.5
)
Cash flows from financing activities:
         
Treasury stock acquired
(2,938.0
)
 
(4,746.9
)
 
(5,500.0
)
Proceeds from long-term debt, net of discounts
1,398.9
   
5,986.8
   
5,500.0
 
Repayment of long-term debt
(1,125.0
)
 
(5,932.5
)
 
(3,390.8
)
Commercial paper borrowings, net
194.8
   
   
 
Net proceeds from employee stock plans
81.0
   
87.2
   
183.1
 
Other, net
(44.9
)
 
(72.4
)
 
(9.3
)
Net cash used in financing activities
(2,433.2
)
 
(4,677.8
)
 
(3,217.0
)
Effect of foreign currency translation adjustment
4.9
   
1.2
   
(9.1
)
Net (decrease) increase in cash and cash equivalents
(767.6
)
 
(109.1
)
 
1,353.7
 
Cash and cash equivalents at beginning of year
3,077.2
   
3,186.3
   
1,832.6
 
Cash and cash equivalents at end of year
$
2,309.6
   
$
3,077.2
   
$
3,186.3
 
Supplemental data:
         
Cash paid during the year for:
         
Income tax payments, net of refunds
$
2,074.9
   
$
1,543.0
   
$
1,802.2
 
Interest
595.6
   
509.9
   
518.1
 
See accompanying Notes to Consolidated Financial Statements
7

EXPRESS SCRIPTS HOLDING COMPANY
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
1. Summary of significant accounting policies
Organization and operations. We are the largest independent pharmacy benefit management (“PBM”) company in the United States, providing healthcare management and administration services on behalf of clients that include managed care organizations, health insurers, third-party administrators, employers, union-sponsored benefit plans, workers’ compensation plans and government health programs. We report segments on the basis of the products and services we offer and have determined we have two reportable segments: PBM and Other Business Operations. Our integrated PBM services include clinical solutions, Express Scripts SafeGuardRx, specialized pharmacy care, home delivery pharmacy services, specialty pharmacy services, retail network pharmacy administration, benefit design consultation, drug utilization review, drug formulary management, Medicare, Medicaid and Public Exchange offerings, administration of a group purchasing organization, Inside Rx and digital consumer health and drug information. Through our Other Business Operations segment, we provide specialty pharmaceuticals distribution services and medical benefit management services. Medical benefit management services are provided by CareCore National Group, LLC and its affiliates d/b/a eviCore healthcare (“eviCore”), which we acquired on December 15, 2017. See Note 3 - Acquisitions and divestiture for further description.
Prior to December 27, 2017, our Other Business Operations segment also included consulting services for pharmaceutical and biotechnology manufacturers to collect scientific evidence to guide the safe, effective and affordable use of medicines. These services were provided by United BioSource Holdings, Inc. (“UBC”) which we sold on December 27, 2017. See Note 3 - Acquisitions and divestiture for further description.
Basis of presentation. The consolidated financial statements include our accounts and those of our consolidated subsidiaries. All significant intercompany accounts and transactions have been eliminated. Investments in affiliated companies 20% to 50% owned are accounted for under the equity method. Certain amounts in prior years have been reclassified to conform to the current year presentation. The preparation of the consolidated financial statements conforms to accounting principles generally accepted in the United States (“GAAP”) and requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Actual amounts could differ from those estimates and assumptions.
Cash and cash equivalents. Cash and cash equivalents include cash on hand and investments with original maturities of three months or less.
Receivables, net. Included within “Receivables, net” are the following, which are reflected net of our allowance for doubtful accounts, customer credit allowances, and contractual allowances:
 
December 31,
(in millions)
2017
 
2016
Trade receivables, net of total reserves and allowances of $466.6 million and $389.8 million, respectively
$
4,101.6
   
$
4,140.3
 
Pharmaceutical manufacturers receivables, net of contractual allowance for certain rebates receivable of $414.1 million and $257.9 million, respectively
2,580.8
   
2,242.6
 
Other receivables
373.9
   
679.2
 
Total receivables, net
$
7,056.3
   
$
7,062.1
 
The receivables balances primarily include amounts due from clients, third-party payors, members and pharmaceutical manufacturers. Below is a description of our receivables balances from clients, third-party payors and members. See “Rebate accounting” for a description of our rebates receivable from pharmaceutical manufacturers. Based on our revenue recognition policies described below, certain receivables are unbilled at the end of each period. As of December 31, 2017 and 2016, unbilled receivables were $676.3 million and $705.8 million, respectively. Unbilled receivables are typically billed to PBM clients within 30 days based on the contractual billing schedule agreed upon with the client. Unbilled receivables for medical benefit management services represent amounts due from clients at contracted rates, and are billed once settlement provisions for capitated risk contract terms are met, at least annually.

8


Our reserves for credit loss in receivables is our allowance for doubtful accounts of $95.3 million and $75.0 million for the years ended December 31, 2017 and 2016, respectively. This estimate is based on the current status of each customer’s receivable balance as well as current economic and market conditions. Our allowance for doubtful accounts also reflects amounts associated with member premiums for our Medicare Part D product offerings. Receivables are written off against the allowances only upon determination such amounts are not recoverable and all collection attempts have failed. We regularly review and analyze the adequacy of these allowances based on a variety of factors, including the age of the outstanding receivable and the collection history. When circumstances related to specific collection patterns change, estimates of the recoverability of receivables are adjusted.
As of December 31, 2017 and 2016, we have contractual allowances of $206.2 million and $115.2 million, respectively, included in our contractual allowance for certain receivables from third-party payors based upon the payment terms specified in the related contractual agreements with payors. The estimated reimbursement amounts are calculated on a payor-specific basis based on the best information available regarding management’s interpretation of the contract terms and are recorded as a reduction of receivables and revenues at the time revenue is recognized. As of December 31, 2017 and 2016, we also have customer credit allowances of $165.1 million and $199.6 million, respectively, which include discounts and claims adjustments issued to the customers in the form of client credits. Refer to our “Revenue recognition - PBM” section below for more information regarding these estimates that reduce revenue.
Gross receivables have been reduced by 11.1% and 8.5% at December 31, 2017 and 2016, respectively, related to our allowance for doubtful accounts, contractual allowances for certain receivables from third-party payors, contractual allowances for discounts and claims adjustments issued to the customers in the form of client credits, and contractual allowances for certain rebates receivable with manufacturers. Refer to our “Rebate accounting” section below for further description of our contractual allowances for certain pharmaceutical manufacturer receivables.
Inventories. Inventories consist of prescription drugs and medical supplies which are stated at the lower of first-in first-out cost or net realizable value.
Property and equipment. Property and equipment is carried at cost and is depreciated using the straight-line method over estimated useful lives of 7 years for furniture and 3 to 5 years for equipment. Buildings are amortized on a straight-line basis over estimated useful lives of 10 to 35 years. Leasehold improvements are amortized on a straight-line basis over the remaining term of the lease or the useful life of the asset, whichever is shorter. Expenditures for repairs, maintenance and renewals are charged to operations as incurred. Expenditures that improve an asset or extend its estimated useful life are capitalized. When properties are retired or otherwise disposed of, the related cost and accumulated depreciation are removed from the accounts and any gain or loss is included in income.
Computer software. Computer software includes acquired (through business combinations), purchased and internally developed software. Costs for internally developed software incurred during the preliminary project stage are expensed as incurred. Qualifying costs incurred during the application development stage are capitalized. Once the project is substantially complete and ready for its intended use, these costs are amortized on a straight-line basis, which approximates the pattern of benefit, over periods from 3 to 10 years. Acquired software is initially recorded at fair value using the cost approach and is amortized on a straight-line basis, which approximates the pattern of benefit, over 5 years.
Impairment of long-lived assets. We evaluate whether events and circumstances have occurred which indicate the remaining estimated useful life of long-lived assets may warrant revision or the remaining balance of an asset may not be recoverable. The measurement of possible impairment is based on a comparison of the fair value of the related assets to the carrying value using discount rates that reflect the inherent risk of the underlying business. Impairment losses, if any, would be recorded to the extent the carrying value of the assets exceeds the implied fair value resulting from this calculation.
Goodwill. Goodwill is evaluated for impairment annually during the fourth quarter or when events or circumstances occur indicating goodwill might be impaired. Goodwill impairment testing guidance provides an option to first assess qualitative factors to determine whether it is more likely than not the fair value of a reporting unit is less than its carrying amount. We determine reporting units for the purpose of evaluating goodwill valuation based on component parts of our business one level below the segment level. Our reporting units represent businesses for which discrete financial information is available and reviewed regularly by segment management. When performing a qualitative assessment, we consider various events and circumstances in evaluating whether it is more likely than not the fair value of a reporting unit is less than its carrying amount and whether a quantitative impairment test is necessary. In 2017, we performed a qualitative assessment for approximately 99% of our goodwill as of December 31, 2017.

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When performing the quantitative impairment test, the measurement of possible impairment is based on a comparison of the fair value of each reporting unit to the carrying value of each reporting unit’s net assets, including goodwill. We record an impairment charge to the extent the carrying value of goodwill exceeds the implied fair value of goodwill resulting from this calculation. This valuation process involves assumptions based on management’s best estimates and judgments, which approximate the market conditions experienced for our reporting units at the time the impairment assessment is made. Actual results may differ from these estimates due to the inherent uncertainty involved in such estimates.
No impairment existed for any of our reporting units during the years ended December 31, 2017, 2016 or 2015.
Other intangible assets. Other intangible assets include customer contracts, customer relationships and trade names. Customer contracts and relationships and trade names are valued at fair market value when acquired using the income approach. Intangible assets, excluding legacy Express Scripts, Inc. (“ESI”) trade names which have an indefinite life, are being amortized using a modified pattern of benefit method over an estimated useful life of 10 to 20 years for customer contracts and relationships and 6 to 10 years for trade names. The weighted-average amortization period of intangible assets subject to amortization is 16 years. See Note 6 - Goodwill and other intangible assets for further description of other intangible assets.
We evaluate the recoverability of intangible assets with finite lives whenever events or changes in circumstances indicate the carrying value of an intangible may not be recoverable. In the event this occurs, an impairment loss is recognized to the extent the carrying value exceeds fair value based on undiscounted cash flows.
We have a 10-year contract with Anthem Inc. (“Anthem”) under which we provide pharmacy benefit management services to Anthem and its designated affiliates (the “PBM agreement”). When we executed our agreement with Anthem in 2009, we considered the overall structure of the agreement and the nature of our relationship with Anthem, including the complexity of the service level required, and attributed a reasonable likelihood of renewal at the end of its term in 2019. Accordingly, we amortized the agreement using a modified pattern of benefit over an estimated useful life of 15 years. However, the sequence of events regarding our relationship with Anthem, culminating in the filing of a lawsuit by Anthem on March 21, 2016, increased the likelihood of either non-renewal or renewal on substantially different terms such that, beginning in March 2016, we began amortizing our agreement with Anthem over the remaining term of the contract (i.e., using a life of 10 years from the time the agreement was executed in 2009). Therefore, the intangible asset amortization associated with the Anthem agreement will run through the remaining term of the contract at the end of 2019, reducing the previous amortization period by 5 years. This change increased intangible asset amortization by $126.7 million and $105.6 million for 2017 and 2016, respectively, relative to the previous amortization schedule.
Self-insurance accruals. We may maintain insurance coverage for claims that arise in the normal course of business. Where insurance coverage is not available or is not cost-effective, we maintain self-insurance accruals to reduce our exposure to future claims, legal costs, settlements, and judgments once such costs become both probable and estimable. Self-insured losses are accrued based on estimates of the aggregate liability for the costs of uninsured claims incurred using certain standard insurance industry actuarial assumptions (see Note 11 - Commitments and contingencies). It is not possible to predict with certainty the outcome of these claims, and we can give no assurances any losses, in excess of our insurance and any self-insurance accruals, will not be material.
Fair value of financial instruments. Authoritative Financial Accounting Standards Board (“FASB”) guidance regarding fair value measurement establishes a three-tier fair value hierarchy, which prioritizes the inputs used in measuring fair value. These tiers include: Level 1, defined as observable inputs such as quoted prices in active markets for identical assets or liabilities; Level 2, defined as inputs other than quoted prices for similar assets and liabilities in active markets that are either directly or indirectly observable; and Level 3, defined as unobservable inputs for which little or no market data exists, therefore requiring an entity to develop its own assumptions.

9

Although GAAP guidance allows a company to elect to measure eligible financial assets and financial liabilities at fair value. we have not elected to account for any of our eligible items using the fair value option. See Note 2 - Fair value measurements for a description of the fair values of our financial instruments.
Revenue recognition - PBM. Revenues from our PBM segment are earned by dispensing prescriptions from our home delivery and specialty pharmacies, processing claims for prescriptions filled by retail pharmacies in our networks, and providing services to drug manufacturers, including administration of discount programs (see also “Rebate accounting” below).
Revenues from dispensing prescriptions from our home delivery pharmacies are recorded when drugs are shipped. At the time of shipment, our earnings process is complete; the obligation of our customer to pay for the drugs is fixed and, due to the nature of the product, the member may not return the drugs or receive a refund.
Revenues from our specialty pharmacies are from providing medications/pharmaceuticals for diseases that rely on high-cost injectable, infused, oral or inhaled drugs which have sensitive handling and storage needs and providing fertility pharmaceuticals to providers and patients. Specialty revenues earned by our PBM segment are recognized at the point of shipment. At the time of shipment, we have performed substantially all of our obligations under our customer contracts and do not experience a significant level of reshipments. Appropriate reserves are recorded for discounts and contractual allowances which are estimated based on historical collections over a recent period. Any differences between our estimates and actual collections are reflected in operations in the period in which payment is received. Historically, adjustments to our original estimates have not been material. Differences may affect the amount and timing of our revenues for any period if actual performance varies from our estimates. Allowances for returns are estimated based on historical return trends and are not material.
Revenues from our PBM segment are also derived from the distribution of pharmaceuticals requiring special handling or packaging where we have been selected by the pharmaceutical manufacturer as part of a limited distribution network. These revenues include management fees received from these programs.
Revenues related to the dispensing of prescription drugs by retail pharmacies in our networks consist of the prescription price (ingredient cost plus dispensing fee) negotiated with our clients, including the portion to be settled directly by the member (co-payment), plus any associated fees for services. These revenues are recognized when the claim is processed. When we independently have a contractual obligation to pay our network pharmacy providers for benefits provided to our clients’ members, we act as a principal in the arrangement and we include the total prescription price as revenues. Although we generally do not have credit risk with respect to retail co-payments, the primary indicators of gross treatment are present. When a prescription is presented by a member to a retail pharmacy within our network, we are solely responsible for confirming member eligibility, performing drug utilization review, reviewing for drug-to-drug interactions, performing clinical intervention which may involve a call to the member’s physician, communicating plan provisions to the pharmacy, directing payment to the pharmacy and billing the client for the amount it is contractually obligated to pay us for the prescription dispensed, as specified within our client contracts. We also provide benefit design and formulary consultation services to clients. We have separately negotiated contractual relationships with our clients and with network pharmacies, and under our contracts with pharmacies we assume the credit risk of our clients’ ability to pay for drugs dispensed by these pharmacies to clients’ members. We, not our clients, are obligated to pay the retail pharmacies in our networks the contractually agreed upon amount for the prescription dispensed, as specified within our provider contracts. These factors indicate we are a principal and, as such, we record the total prescription price contracted with clients in revenues.
If we merely administer a client’s network pharmacy contracts to which we are not a party and under which we do not assume credit risk, we record only our management fee as revenues. For these clients, we earn a management fee for collecting payments from the client and remitting the corresponding amount to the pharmacies in the client’s network. In these transactions we act as a conduit for the client. Because we are not the principal in these transactions, drug ingredient cost is not included in our revenues or our cost of revenues.


10


In retail pharmacy transactions, amounts paid to pharmacies and amounts charged to clients are always exclusive of the applicable co-payment. Retail pharmacy co-payments, which we instructed retail pharmacies to collect from members, are included in revenues and cost of revenues.
Many of our contracts contain terms whereby we make certain financial and performance guarantees, including the minimum level of discounts or rebates a client may receive, generic utilization rates and various service guarantees. These clients may be entitled to the payment of performance penalties if we fail to meet a financial or service guarantee. Actual performance is compared to the guarantee for each measure throughout the period and accruals are recorded as an offset to revenues if we determine our performance against the guarantee indicates a potential liability. These estimates are adjusted to actual when the guarantee period ends and we have either met the guaranteed rate or paid amounts to clients. Historically, adjustments to our original estimates have not been material.
Revenue recognition - Other Business Operations. Revenues from our Other Business Operations segment are earned from the distribution of specialty pharmaceuticals and medical supplies to providers, clinics and hospitals, performance-oriented fees paid by specialty pharmacy manufacturers and medical benefit management services. Prior to the sale of UBC on December 27, 2017, revenues from our Other Business Operations also included fee-for-service arrangements from late-stage clinical trials, risk management and drug safety services.
For contracts in which we are distributing prescription drugs, revenues are recognized at the point of shipment. At the time of shipment, we have performed substantially all of our obligations under our customer contracts and do not experience a significant level of reshipments. Receivables are recorded at the net realizable value and there are no material allowances.
Since our acquisition of eviCore on December 15, 2017, Other Business Operations includes revenues from medical benefits management contracts, through which we provide innovative solutions that include utilization management using evidence based criteria, analytics, patient transparency and site of service management as well as access to certain provider specialty networks for our clients and their members. The activity involves developing clinical review criteria for provider inquiries, assessing medical necessity of treatment, and maintaining a network of providers. In some medical benefits management contracts, we earn a per-member-per month fee which is earned over the period in which our client’s eligible members are entitled to service, and in other contracts we are paid a per-claim fee for the services we provide which is earned as services are rendered. We are responsible for confirming member eligibility, performing program utilization review, potentially directing payment to the provider and accepting the financial risk of loss associated with services rendered, as specified within our client contracts. We have the ability to influence contractual fees with clients and possess the financial risk of loss in certain contractual obligations. These factors indicate we are the principal and, as such, we record gross fees contracted with clients in revenues. Certain arrangements also include provisions that require us to share with the client the costs or profits of the program in the event medical claims experience is above or below certain specified targets as set forth in the respective contract.
Rebate accounting. We administer a rebate program through which we receive rebates and administrative fees from pharmaceutical manufacturers. Rebates and administrative fees earned for the administration of this program, performed in conjunction with claims processing and home delivery services provided to clients, are recorded as a reduction of cost of revenues and the portion of the rebate and administrative fees payable to clients is treated as a reduction of revenues. The portion of rebates and administrative fees payable to clients is estimated based on historical and/or anticipated sharing percentages as defined within our contracts with clients. These estimates are adjusted to actual when amounts are paid to clients subsequent to collections from pharmaceutical manufacturers; historically, these adjustments have not been material. We pay all or a contractually agreed upon portion of such rebates to our clients. We record rebates and administrative fees receivable from the manufacturer and payable to clients when the prescriptions covered under contractual agreements with the manufacturers are dispensed; these amounts are not dependent upon future pharmaceutical sales. Included in receivables, net is a contractual allowance for certain rebates receivable from manufacturers of $414.1 million and $257.9 million as of December 31, 2017 and 2016, respectively.
Medicare Part D product offerings. Our revenues include premiums associated with our Medicare Part D prescription drug plan (“PDP”) risk-based product offerings. These products involve prescription dispensing for beneficiaries enrolled in Medicare Part D Prescription Drug Program (“Medicare Part D”) plans sponsored by us pursuant to our contracts with the Centers for Medicare & Medicaid Services (“CMS”). We also offer numerous customized benefit plan designs to Employer-Sponsored Group Waiver Plans under our Medicare Part D PDP product offerings.


11

The Medicare Part D PDP premiums are determined based on our annual bid and related contractual arrangements with CMS and are primarily comprised of amounts received from CMS as part of a direct subsidy and an additional subsidy from CMS for low-income member premiums, as well as premium payments received from members. These premiums are recognized ratably to revenues over the period in which members are entitled to receive benefits. Premiums received in advance of the applicable benefit period are deferred and recorded in accrued expenses on the consolidated balance sheet. There is a possibility the annual costs of drugs may be higher or lower than premium revenues. As a result, CMS provides a risk corridor adjustment for the standard drug benefit that compares our actual annual drug costs incurred to the targeted premiums in our CMS-approved bid. Based on the risk corridor, we will receive from CMS additional premium amounts or be required to refund to CMS previously received premium amounts. We calculate the risk corridor adjustment based on drug cost experience and record an adjustment to revenues with a corresponding receivable from or payable to CMS reflected on the consolidated balance sheet.
In addition to Medicare Part D PDP premiums, there are certain co-payments and deductibles (the “cost share”) due from members based on prescription orders by those members, some of which are subsidized by CMS in cases of low-income membership. Non-low income members received a cost share benefit under the coverage gap discount program with brand pharmaceutical manufacturers. For subsidies received in advance, the amount is deferred and recorded in accrued expenses on the consolidated balance sheet. Any cost share due from members, pharmaceutical manufacturers or CMS, or premiums due from members, is accrued and recorded in receivables, net, on the consolidated balance sheet. After the end of the contract year and based on actual annual drug costs incurred, cost share amounts are reconciled with CMS and the corresponding receivable or payable is settled. The cost share is treated consistently with other co-payments derived from providing PBM services, as a component of revenues on the consolidated statement of operations.
Our cost of revenues includes the cost of drugs dispensed by our home delivery pharmacies or retail network for members covered under our Medicare Part D PDP product offerings. These amounts are recorded at cost as incurred. We receive a catastrophic reinsurance subsidy from CMS for approximately 80% of costs incurred by individual members in excess of the individual annual out-of-pocket maximum. The subsidy is reflected as an offsetting credit to cost of revenues to the extent catastrophic costs are incurred. Catastrophic reinsurance subsidy amounts received in advance are deferred and recorded in accrued expenses on the consolidated balance sheet. Any catastrophic reinsurance subsidies due from CMS are accrued and recorded in receivables, net, on the consolidated balance sheet. After the end of the contract year and based on actual annual drug costs incurred, catastrophic reinsurance amounts are reconciled with CMS and the corresponding receivable or payable is settled.
Cost of revenues. Cost of revenues includes product costs, network pharmacy claims costs, co-payments and other direct costs associated with dispensing prescriptions, including shipping and handling (see also “Revenue recognition” and “Rebate accounting”).
Our cost of revenues includes medical claims expense related to eviCore. Such expenses are recognized in the period in which the client’s eligible members receive healthcare services. Medical claims expense includes the cost of medical claims incurred and paid, and an estimate of medical claims payable that includes ultimate net cost for medical claims reported but not yet paid, as well as reserves for estimated incurred but not reported medical claims and related loss adjustment expenses.
We estimate the medical claims liability based upon historical data, including the period between the date services are rendered and the date medical claims are reported and paid, enrollment data, utilization statistics for authorized healthcare services, contractual provisions with clients and other relevant factors. The medical claims liability estimates are refined as experience develops and adjustments, both favorable and unfavorable, to prior period estimates are reflected in the consolidated statement of operations in the period in which such estimates are revised.
Income taxes. Deferred tax assets and liabilities are recognized based on temporary differences between financial statement basis and tax basis of assets and liabilities using presently enacted tax rates. We account for uncertainty in income taxes as described in Note 8 - Income taxes. All deferred tax assets and liabilities are classified as long-term. Deferred tax assets are evaluated to ensure the asset will be realized. To the extent we do not consider it more likely than not that a deferred tax asset will be recovered, a valuation allowance is established.



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Net income attributable to non-controlling interest. Net income attributable to non-controlling interest represents the share of net income allocated to members of our consolidated affiliates.
Employee stock-based compensation. Grant-date fair values of stock options are estimated using a Black-Scholes valuation model and grant-date fair values of restricted stock units and performance shares are estimated based on the grant-date stock price. Compensation expense is reduced based on estimated forfeitures with adjustments recorded at the time of vesting for actual forfeitures. Forfeitures are estimated based on experience. We use an accelerated method of recognizing compensation cost for awards. Unearned compensation relating to these awards is amortized to non-cash compensation expense over the estimated vesting periods. See Note 10 - Employee benefit plans and stock-based compensation plans for more information regarding stock-based compensation plans.
Earnings per share. Basic earnings per share (“EPS”) is computed using the weighted-average number of common shares outstanding during the period. Diluted EPS is computed in the same manner as basic EPS, but adds the number of additional common shares that would have been outstanding for the period if the potential dilutive common shares had been issued. All shares are calculated under the “treasury stock” method. Following is the reconciliation between the number of weighted-average shares used in the basic and diluted EPS calculations as of December 31, 2017, 2016 and 2015:
(in millions)
2017
 
2016
 
2015
Weighted-average number of common shares outstanding during the
period – basic
580.1
   
626.9
   
689.0
 
Dilutive common stock equivalents:(1)
         
Outstanding stock options, stock-settled stock appreciation rights, restricted stock units and executive deferred compensation units
3.3
   
4.5
   
6.3
 
Weighted-average number of common shares outstanding during the
period – diluted
583.4
   
631.4
   
695.3
 
(1)
Excludes equity awards of 9.2 million, 8.0 million and 2.4 million for the years ended December 31, 2017, 2016 and 2015, respectively, because the effect is anti-dilutive.
Foreign currency translation. The financial statements of our foreign subsidiaries are translated into United States dollars using the exchange rate at each balance sheet date for assets and liabilities and a weighted-average exchange rate for each period for revenues, expenses, gains and losses. The functional currency for our foreign subsidiaries is the local currency and cumulative translation adjustments (debit balances of $2.9 million and $12.3 million at December 31, 2017 and 2016, respectively) are recorded within the “accumulated other comprehensive loss” component of stockholders’ equity.
Comprehensive income (loss). Comprehensive income (loss) includes foreign currency translation adjustments. We recognized foreign currency translation income (loss) of $9.4 million, $1.7 million and $(16.1) million for the years ended December 31, 2017, 2016 and 2015, respectively.
Adopted new accounting guidance. In January 2017, the FASB issued Accounting Standards Update (“ASU”) 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business. The ASU contains new guidance to assist reporting entities in evaluating whether transactions should be accounted for as acquisitions (or disposals) of assets or businesses. We have elected to early adopt this guidance. This standard did not have a material impact on our consolidated financial statements.
In January 2017, the FASB issued ASU 2017-04, Simplifying the Accounting for Goodwill Impairment. The ASU simplifies the accounting for goodwill impairment by removing Step 2 of the goodwill impairment test, which required a hypothetical purchase price allocation. A goodwill impairment will now be determined by Step 1, comparing the amount by which a reporting unit’s carrying value exceeds its fair value, not to exceed the carrying amount of goodwill. We have elected to early adopt this guidance. This standard did not have a material impact on our consolidated financial statements.


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In March 2016, the FASB issued ASU 2016-09, Improvements to Employee Share-Based Payment Accounting, which amends Accounting Standards Codification (“ASC”) Topic 718, Compensation – Stock Compensation. The new standard simplifies the accounting for stock-based compensation, including amendments on how both taxes related to stock-based compensation and cash payments made to taxing authorities are recorded, changing the threshold to qualify for equity classification and allowing an entity-wide accounting policy election to either estimate the number of awards expected to vest or account for forfeitures as they occur. Excess tax benefits were historically recorded in additional paid-in capital. Upon adoption on January 1, 2017, net excess tax benefits, which are immaterial for the year ended December 31, 2017, are prospectively recognized as income tax expense on our consolidated statement of operations and prospectively recognized as an operating activity on our consolidated statement of cash flows for the year ended December 31, 2017. Prior periods have not been retrospectively adjusted for adoption of this standard. We have also elected to continue to estimate the number of awards expected to vest. The remaining amendments to this standard, as noted above, are either not applicable or do not change our current accounting practices and thus do not impact our consolidated financial statements, including our consolidated statement of cash flows.
New accounting guidance not yet adopted. In August 2016, FASB issued ASU 2016-15, Statement of Cash Flows (Topic 230), Classification of Certain Cash Receipts and Cash Payments. The guidance addresses the classification of cash flow related to (1) debt prepayment or extinguishment costs, (2) settlement of zero-coupon debt instruments or other debt instruments with coupon rates that are insignificant in relation to the effective interest rate of the borrowing, (3) contingent consideration payments made after a business combination, (4) proceeds from the settlement of insurance claims, (5) proceeds from the settlement of corporate-owned life insurance, including bank-owned life insurance, (6) distributions received from equity method investees and (7) beneficial interests in securitization transactions. The guidance also clarifies how the predominance principle should be applied when cash receipts and cash payments have aspects of more than one class of cash flows. The guidance will generally be applied retrospectively and is effective for financial statements issued for annual reporting periods beginning after December 15, 2017. In November 2016, the FASB issued ASU 2016-18, Statement of Cash Flows (Topic 230), Restricted Cash. This guidance requires amounts generally described as restricted cash and restricted cash equivalents be included with cash and cash equivalents when reconciling the beginning-of-period and end-of-period total amounts shown on the statement of cash flows. The guidance will be applied retrospectively and is effective for financial statements issued for annual reporting periods beginning after December 15, 2017. We have substantially completed our review of these standards and believe they will move the presentation of debt extinguishment costs from an operating activity to a financing activity, but do not expect any other significant impact on our consolidated financial statements.
In February 2016, FASB issued ASU 2016-02, Leases (ASC Topic 842), which supersedes ASC Topic 840, Leases. This ASU is intended to increase transparency and comparability of organizations by recognizing lease assets and lease liabilities on the balance sheet and disclosing key information about leasing arrangements. The new guidance is effective for financial statements issued for annual reporting periods beginning after December 15, 2018, and early application is permitted. We are currently evaluating the impact of this standard on our consolidated financial statements.
In May 2014, FASB issued ASU 2014-09, Revenue from Contracts with Customers (ASC Topic 606), which supersedes ASC Topic 605, Revenue Recognition. The new standard requires companies to recognize revenues upon transfer of goods or services to customers in amounts that reflect the consideration which the company expects to receive in exchange for those goods or services. In July 2015, the FASB delayed the effective date of the standard by one year. The new guidance is effective for financial statements issued for annual reporting periods beginning after December 15, 2017. We have substantially completed evaluation of our PBM and Other Business Operations segments and have determined adoption of the new standard will not have a significant impact on our consolidated financial statements. We are in the process of finalizing our revised disclosures. While we previously anticipated full retrospective application upon adoption, as a result of the acquisition of eviCore, we now anticipate modified retrospective application upon adoption.
2. Fair value measurements
Cash and cash equivalents include cash and investments in AAA-rated money market mutual funds with original maturities of less than 90 days. Cash and cash equivalents are stated at cost, which approximates fair value. These investments are classified within Level 1 of the fair value hierarchy because they are valued using quoted prices in active markets. The fair values of receivables, claims and rebates payable and accounts payable approximate carrying values due to the short-term maturities of these instruments.


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The fair values, which approximate the carrying values, of our 2015 five-year term loan (Level 2) and commercial paper borrowings (Level 2) (as defined in Note 7 - Financing) were estimated using the current market rates for debt with similar maturities. The fair values of our senior notes are $14,215.7 million and $13,041.4 million as of December 31, 2017 and 2016, respectively, were estimated based on observable market information (Level 2). See Note 7 - Financing for further description of the carrying values of our debt.
The risk of nonperformance is considered in determining the fair values of liabilities. Nonperformance risk refers to the risk the obligation will not be fulfilled and affects the value at which the liability would be transferred to a market participant. This risk did not have a material impact on the fair values of our liabilities.
3. Acquisitions and divestiture
eviCore acquisition. On December 15, 2017, we acquired 100% of eviCore, a leading provider of integrated medical benefit management solutions that drive cost reductions and improved quality care outcomes. eviCore manages benefits in categories including radiology, cardiology, musculoskeletal disorders, post-acute care and medical oncology, and contracts with health plans and commercial clients to promote the appropriate use of healthcare services. As a result of the acquisition, the Company is able to establish a platform in the growing medical benefit management market and expects to broaden its ability to drive value in the use of specialty medications, which are used to treat complex and chronic conditions, and comprise the most expensive and fastest-growing portion of pharmaceutical spend. eviCore will continue to operate as a standalone business within the Company.
The acquisition-date fair value of the consideration transferred consisted of the following:
(in millions)
 
Cash
$
3,632.5
 
Deferred consideration
13.4
 
Total consideration
$
3,645.9
 
The total consideration transferred was primarily funded through cash on hand, as well as issuance of senior notes and commercial paper. See Note 7 - Financing for further details.
We executed a contingent arrangement with certain equity holders, who are key employees of eviCore, in which $81.1 million will be paid 50% upon each of the second and third anniversaries of the effective date of the merger. The employment arrangements provide payments are forfeited if the employee voluntarily terminates prior to the anniversary dates. The payments will be accrued as post combination services are rendered and included as compensation costs within “Selling, general, and administrative” expense in our consolidated statement of operations.
The consolidated statement of operations for the year ended December 31, 2017, includes eviCore’s revenues of $119.4 million and net income of $167.5 million, for the period subsequent to the acquisition date. Net income includes transaction expenses, amortization expense and $212.1 million of tax benefit from the federal tax reform enacted on December 22, 2017.


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The following represents the unaudited pro forma consolidated income statement as if eviCore had been included in the consolidated results of the Company’s operations for the years ended December 31, 2017 and 2016. These amounts have been calculated after applying the Company’s accounting policies and adjusting the results of eviCore to reflect the additional depreciation and amortization that would have been charged assuming the fair value adjustments to intangible assets, redemption of debt outstanding and transaction costs incurred had been applied as of January 1, 2016, together with the consequential tax effects.
 
Year Ended December 31,
(in millions, except per share data)
2017
 
2016
Total revenues
$
102,305.4
   
$
102,115.5
 
Net income attributable to Express Scripts
4,586.1
   
3,283.9
 
Basic earnings per share
7.91
   
5.23
 
Diluted earnings per share
$
7.86
   
$
5.20
 
Pro forma net income for the year ended December 31, 2016, includes $82.5 million related to transaction and integration costs incurred in connection with the acquisition.
The following table summarizes the estimated fair values of the assets acquired and liabilities assumed at the acquisition date.
(in millions)
Amounts
Recognized as of
Acquisition Date
Current assets
$
494.7
 
Property and equipment
15.2
 
Computer software
89.7
 
Goodwill
1,703.3
 
Acquired intangible assets
2,328.8
 
Other noncurrent assets
2.9
 
Current liabilities
(387.4
)
Deferred income taxes
(592.3
)
Other noncurrent liabilities
(9.0
)
Total
$
3,645.9
 
A portion of the excess of purchase price over tangible net assets acquired has been allocated to intangible assets. The acquired intangible assets have been valued using an income approach, which includes unobservable inputs such as assumptions regarding revenues, gross profit, growth rates and discount rates based on the forecasted business plan, economic projections, anticipated future cash flows and marketplace data. The acquired intangible assets are amortized on a basis that approximates the pattern of benefit:
 
Asset Value (in millions)
 
Weighted-average
amortization
period (in years)
Trade name
$
56.1
   
10.0
Customer relationships
2,272.7
   
20.0
Total intangibles
$
2,328.8
   
19.8
The excess of purchase price over tangible net assets and identified intangible assets acquired, $1,703.3 million, has been allocated to goodwill. The goodwill recognized as part of the acquisition is reported under our Other Business Operations segment and primarily reflects future economic benefits expected to arise from the Company’s growth within the medical benefit management market and the assembled workforce acquired. Approximately $397.0 million of the goodwill recognized is expected to be deductible for income tax purposes.


16

myMatrixx acquisition. In May 2017, we completed the acquisition of myMatrixx for approximately $250.0 million, which included both cash and the issuance of common shares. The acquisition is not material to our consolidated financial statements.
UBC divestiture. In December 2017, we sold UBC for approximately $150.0 million, the proceeds of which included both cash and a note receivable. We recorded a $17.7 million loss on disposal which is reported within “Interest expense and other” on our consolidated statement of operations for the year ended December 31, 2017.

4. Property and equipment
Property and equipment consists of the following:
 
December 31,
(in millions)
2017
 
2016
Land and buildings
$
195.3
   
$
184.7
 
Furniture
74.5
   
70.4
 
Equipment(1)
543.5
   
801.4
 
Leasehold improvements
290.8
   
240.5
 
Total property and equipment
1,104.1
   
1,297.0
 
Accumulated depreciation(1)
(552.8
)
 
(690.0
)
Property and equipment, net
$
551.3
   
$
607.0
 
(1)
Includes gross assets of $50.3 million and $51.3 million and accumulated depreciation of $31.5 million and $21.2 million related to capital lease assets as of December 31, 2017 and 2016, respectively.
Total depreciation expense for the years ended December 31, 2017, 2016 and 2015 was $134.6 million, $149.0 million and $180.0 million, respectively.
5. Computer software
Computer software includes acquired (through business combinations), purchased and internally developed:
 
December 31,
(in millions)
2017
 
2016
Computer software
$
1,401.6
   
$
1,986.1
 
Accumulated amortization
(586.7
)
 
(1,273.5
)
Computer software, net
$
814.9
   
$
712.6
 
Total amortization expense for the years ended December 31, 2017, 2016 and 2015 was $205.4 million, $172.8 million and $448.2 million, respectively.
Following is a summary of the expected aggregate amortization of computer software as of December 31, 2017 (in millions):
Year Ended December 31,
Future Amortization
2018
$
218.0
 
2019
167.0
 
2020
108.0
 
2021
64.0
 
2022
28.0
 



17


6. Goodwill and other intangible assets
Following is a summary of our goodwill and other intangible assets for our two reportable segments, PBM and Other Business Operations.
 
December 31, 2017
 
December 31, 2016
(in millions)
Gross Carrying Amount
 
Accumulated Amortization
 
Net Carrying Amount
 
Gross Carrying Amount
 
Accumulated Amortization
 
Net Carrying Amount
Goodwill
                     
PBM
$
29,434.9
   
$
(107.0
)
 
$
29,327.9
   
$
29,287.2
   
$
(106.8
)
 
$
29,180.4
 
Other Business Operations
1,771.8
   
   
1,771.8
   
97.4
   
   
97.4
 
 
$
31,206.7
   
$
(107.0
)
 
$
31,099.7
   
$
29,384.6
   
$
(106.8
)
 
$
29,277.8
 
Other intangible assets
                     
PBM
                     
Customer contracts(1)(2)
$
17,579.0
   
$
(10,378.4
)
 
$
7,200.6
   
$
17,570.5
   
$
(9,083.4
)
 
$
8,487.1
 
Trade names(1)
232.5
   
(128.8
)
 
103.7
   
226.6
   
(105.9
)
 
120.7
 
Miscellaneous(2)
   
   
   
8.7
   
(8.2
)
 
0.5
 
 
17,811.5
   
(10,507.2
)
 
7,304.3
   
17,805.8
   
(9,197.5
)
 
8,608.3
 
Other Business Operations
                     
Customer relationships(3)
2,272.7
   
(7.0
)
 
2,265.7
   
39.4
   
(29.4
)
 
10.0
 
Trade names(3)
56.1
   
(0.2
)
 
55.9
   
35.7
   
(17.1
)
 
18.6
 
 
2,328.8
   
(7.2
)
 
2,321.6
   
75.1
   
(46.5
)
 
28.6
 
Total other intangible assets
$
20,140.3
   
$
(10,514.4
)
 
$
9,625.9
   
$
17,880.9
   
$
(9,244.0
)
 
$
8,636.9
 
(1)
Changes in the gross carrying amount of PBM customer contracts and trade names represent the acquisition of myMatrixx Holdings, Inc. in May 2017. The acquisition is not material to our consolidated financial statements.
(2)
Changes in the gross carrying amount of PBM customer contracts and miscellaneous intangible assets and related accumulated amortization reflect the write-off of fully amortized assets.
(3)
Changes in gross carrying amount of Other Business Operations customer contracts and trade names represent the acquisition of eviCore in December 2017 and the sale of UBC in December 2017. For further details on these transactions, see Note 3 - Acquisitions and divestiture.
Following is a summary of the change in the net carrying value of goodwill by reportable segment:
(in millions)
PBM
 
Other Business Operations
 
Total
Balance at December 31, 2015
$
29,179.9
   
$
97.4
   
$
29,277.3
 
Foreign currency translation
0.5
   
   
0.5
 
Balance at December 31, 2016
$
29,180.4
   
$
97.4
   
$
29,277.8
 
Acquisitions
146.1
   
1,703.3
   
1,849.4
 
Divestiture
   
(28.9
)
 
(28.9
)
Foreign currency translation
1.4
   
   
1.4
 
Balance at December 31, 2017
$
29,327.9
   
$
1,771.8
   
$
31,099.7
 
The aggregate amount of amortization expense of other intangible assets was $1,462.0 million, $1,832.8 million and $1,730.9 million for the years ended December 31, 2017, 2016 and 2015, respectively.


18


Included in total amortization expense is $221.7 million, $200.5 million and $95.1 million for the years ended December 31, 2017, 2016 and 2015, respectively, related to our 10-year contract with Anthem to provide PBM services to members of the affiliated health plans of Anthem, which amounts are included as an offset to revenues. When we executed our agreement with Anthem in 2009, we considered the overall structure of the agreement and the nature of our relationship with Anthem, including the complexity of the service level required, and attributed a reasonable likelihood of renewal at the end of its term in 2019. Accordingly, we amortized the agreement using a modified pattern of benefit over an estimated useful life of 15 years. However, the sequence of events regarding our relationship with Anthem, culminating in the filing of a lawsuit by Anthem on March 21, 2016, increased the likelihood of either non-renewal or renewal on substantially different terms such that, beginning in March 2016, we began amortizing our agreement with Anthem over the remaining term of the contract (i.e., using a life of 10 years from the time the agreement was executed in 2009). Therefore, the intangible asset amortization associated with the Anthem agreement will run through the remaining term of the contract at the end of 2019, reducing the previous amortization period by 5 years. This change increased intangible asset amortization by $126.7 million and $105.6 million for 2017 and 2016, respectively, relative to the previous amortization schedule.
Following is a summary of the expected aggregate amortization of other intangible assets as of December 31, 2017 (in millions):
Year Ended December 31,
 
Future Amortization
2018
 
$
1,615.0
 
2019
 
1,600.0
 
2020
 
928.0
 
2021
 
955.0
 
2022
 
734.0
 




19


7. Financing
Our debt, issued by us, ESI and Medco, net of unamortized discounts, premiums and financing costs, consists of:
           
December 31,
           
2017
 
2016
   
Issuer
 
Basis Points(1)
 
Carrying Amount (in millions)
Commercial paper
               
$3,500.0 million, commercial paper program(2)
 
Express Scripts
 
N/A
 
$
194.8
   
$
 
Senior notes(3)
               
$500.0 million, 1.250% senior notes paid June 2017
 
Express Scripts
 
10
   
   
499.6
 
$1,200.0 million, 7.125% senior notes due March 2018(4)
 
Medco
 
50
   
838.1
   
868.8
 
$1,000.0 million, 2.250% senior notes due June 2019(4)
 
Express Scripts
 
15
   
997.1
   
995.1
 
$500.0 million, 7.250% senior notes due June 2019(4)
 
ESI
 
50
   
336.7
   
336.2
 
$500.0 million, 4.125% senior notes due September 2020(4)
 
Medco
 
25
   
502.9
   
504.0
 
$500.0 million, 2.600% senior notes due November 2020(4)
 
Express Scripts
 
15
   
496.9
   
 
$400.0 million, floating rate senior notes due November 2020(5)
 
Express Scripts
 
N/A
 
397.6
   
 
$500.0 million, 3.300% senior notes due February 2021(4)
 
Express Scripts
 
35
   
496.9
   
495.9
 
$1,250.0 million, 4.750% senior notes due November 2021(4)
 
Express Scripts
 
45
   
1,241.6
   
1,239.5
 
$1,000.0 million, 3.900% senior notes due February 2022(4)
 
Express Scripts
 
40
   
987.0
   
984.1
 
$500.0 million, 3.050% senior notes due November 2022(4)
 
Express Scripts
 
15
   
495.2
   
 
$1,000.0 million, 3.000% senior notes due July 2023(4)
 
Express Scripts
 
25
   
993.6
   
992.5
 
$1,000.0 million, 3.500% senior notes due June 2024(4)
 
Express Scripts
 
20
   
989.8
   
988.3
 
$1,500.0 million, 4.500% senior notes due February 2026(4)
 
Express Scripts
 
45
   
1,483.1
   
1,481.2
 
$1,500.0 million, 3.400% senior notes due March 2027(6)
 
Express Scripts
 
30
   
1,489.8
   
1,488.7
 
$700.0 million, 6.125% senior notes due November 2041(4)
 
Express Scripts
 
50
   
444.2
   
444.0
 
$1,500.0 million, 4.800% senior notes due July 2046(4)
 
Express Scripts
 
40
   
1,483.6
   
1,483.0
 
Total senior notes
         
13,674.1
   
12,800.9
 
Term loan
               
$3,000.0 million, term loan due April 2020(7)
 
Express Scripts
 
N/A
 
2,145.5
   
2,767.4
 
Total debt
         
16,014.4
   
15,568.3
 
Short-term debt and current maturities of long-term debt
               
$3,500.0 million, commercial paper program(2)
 
Express Scripts
 
N/A
 
194.8
   
 
$500.0 million, 1.250% senior notes paid June 2017
 
Express Scripts
 
10
 
   
499.6
 
$1,200.0 million, 7.125% senior notes due March 2018(3)(4)
 
Medco
 
50
 
838.1
   
 
$3,000.0 million, term loan due April 2020(7)
 
Express Scripts
 
N/A
 
   
222.7
 
Total short-term debt and current maturities of long-term debt
         
1,032.9
   
722.3
 
Total long-term debt
         
$
14,981.5
   
$
14,846.0
 
(1)
All senior notes, except for the 2020 Floating Rate Senior Notes as defined below, are redeemable prior to maturity at a price equal to the greater of (1) 100% of the aggregate principal amount of any notes being redeemed; or (2) the sum of the present values of the remaining scheduled payments of principal and interest on the notes being redeemed discounted to the redemption date on a semiannual basis (assuming a 360-day year consisting of twelve 30-day months) at the treasury rate plus the basis points as indicated, plus in each case, unpaid interest on the notes being redeemed accrued to the redemption date. The 2020 Floating Rate Senior Notes are redeemable prior to maturity at any time on or after December 3, 2018, at a redemption price equal to 100% of the principal amount of the note being redeemed plus accrued and unpaid interest on the principal amount being redeemed.
(2)
The commercial paper program (defined below) had weighted-average daily short-term borrowings of $220.1 million outstanding at an average interest rate of 1.49% from the inception of the program on October 27, 2017 through December 31, 2017.
(3)
All senior notes are jointly and severally and fully and unconditionally (subject to certain customary release provisions, including sale, exchange, transfer or liquidation of the guarantor subsidiary) guaranteed on a senior unsecured basis by Express Scripts, ESI and Medco. See Note 15 - Condensed consolidating financial information regarding the modification of our subsidiary guarantors.
(4)
Senior notes require interest to be paid semi-annually, commencing six months subsequent to issuance.
(5)
Senior notes had an average interest rate of 2.23% since the issuance of the note through December 31, 2017.
(6)
Senior notes require interest to be paid semi-annually in March and September.
(7)
The 2015 five-year term loan (defined below) had an average interest rate of 2.30% and 1.80% for the years ended December 31, 2017 and 2016, respectively. At December 31, 2017, no amounts under the 2015 five-year term loan are current maturities of long-term debt due to the early repayment described below.


20

Bank credit facilities. In April 2015, we entered into a credit agreement (the “credit agreement”) providing for a five-year $2.0 billion revolving credit facility (the “2015 revolving facility”), a two-year $2.5 billion term loan (the “2015 two-year term loan”) and a five-year $3.0 billion term loan (the “2015 five-year term loan”). We used the proceeds, which included $1.1 billion drawn on the 2015 revolving facility, to repay our 2011 term loan, terminate the commitments under our 2011 revolving facility, enter into an accelerated share repurchase agreement and for other general corporate purposes. In 2016, we completed the repayment of the 2015 two-year term loan. We make quarterly principal payments on the 2015 five-year term loan and in November 2017, we repaid $400.0 million under the 2015 five-year term loan and at December 31, 2017, no amounts under the 2015 five-year term loan were considered current maturities of long-term debt.
In October 2017, we modified our existing credit agreement to increase our 2015 revolving facility to $3.5 billion and extended the termination date to October 2022 (the “2022 revolving facility”). The existing 2015 five-year term loan remains substantially unchanged, except for the modification of subsidiary guarantors, as described in Note 15 - Condensed consolidating financial information. The 2022 revolving facility was increased in conjunction with establishing a commercial paper program, as described below. At December 31, 2017, no amounts were drawn under the 2022 revolving facility. See below for activity under the commercial paper program as of December 31, 2017.
The credit agreement requires interest to be paid, at our option, at LIBOR or an adjusted base rate, plus, applicable margin. The applicable margin over LIBOR ranges from 0.805% to 1.300% for the 2022 revolving facility, depending on our credit ratings and consolidated leverage ratio, and ranges from 1.000% to 1.500% for the 2015 five-year term loan, depending on our consolidated leverage ratio. The applicable margin over the adjusted base rate ranges from 0.000% to 0.300% for the 2022 revolving facility and 0.000% to 0.500% for the 2015 five-year term loan. We are required to pay commitment fees on the 2022 revolving facility, which range from 0.070% to 0.200% of the revolving loan commitments, depending on our credit ratings and consolidated leverage ratio.
As of December 31, 2017, we had two additional credit agreements, each providing for an uncommitted revolving credit facility: $150.0 million executed August 2015 and amended most recently in May 2017 with a termination date of May 2018, and $130.0 million executed May 2017 with a termination date of May 2018. As of December 31, 2017, no amounts were drawn under either facility. In April 2017, we terminated a separate $130.0 million uncommitted revolving credit facility executed December 2014 and amended October 2015 and April 2016. In February 2018, we terminated our $130.0 million uncommitted revolving credit facility.
Commercial paper. In October 2017, in conjunction with modifying our existing credit agreement, we established a commercial paper program, under which we may issue short-term, unsecured commercial paper notes from time to time on a private placement basis up to a maximum aggregate amount outstanding at any time of $3.5 billion. The commercial paper program does not increase our borrowing capacity as it is fully backed by our 2022 revolving credit facility. The commercial paper notes will be jointly and severally and fully and unconditionally guaranteed on a senior unsecured basis by ESI, Medco and us. The proceeds of the commercial paper notes are expected to be used for general corporate purposes, including, among other items, the repayment of indebtedness and other short-term liquidity needs. There were $194.8 million in commercial paper borrowings outstanding as of December 31, 2017, which reduced the amounts available on the 2022 revolving facility.


21

Senior notes. In November 2017, we issued senior notes (the “November 2017 Senior Notes”) consisting of:
$500.0 million aggregate principal amount of 2.600% senior notes due November 2020
$400.0 million aggregate principal amount of floating rate senior notes due November 2020 (“2020 Floating Rate Senior Notes”)
$500.0 million aggregate principal amount of 3.050% senior notes due November 2022
The 2020 Floating Rate Senior Notes bear interest at a floating rate equal to the three-month LIBOR plus 0.750% and will pay interest quarterly beginning on March 1, 2018, until November 30, 2020. We used the net proceeds from the sale of the November 2017 Senior Notes to (i) repay $400.0 million in outstanding principal amount of the 2015 five-year term loan, (ii) fund a portion of the purchase price of the Company’s acquisition of eviCore and (iii) for general corporate purposes.
In July 2016, we issued senior notes (the “July 2016 Senior Notes”) consisting of:
$1.0 billion aggregate principal amount of 3.000% senior notes due July 2023
$1.5 billion aggregate principal amount of 3.400% senior notes due March 2027
$1.5 billion aggregate principal amount of 4.800% senior notes due July 2046
We used a portion of the net proceeds from the sale of the July 2016 Senior Notes for the following:
To repay $1.5 billion of our $2.5 billion aggregate principal 2015 two-year term loan.
To complete a tender offer for $1,104.8 million and redeem the remaining $395.2 million of our $1.5 billion aggregate principal amount of 2.650% senior notes due February 2017.
To complete a tender offer for $368.6 million of our $1.2 billion aggregate principal amount of 7.125% senior notes due March 2018, $162.6 million of our $500.0 million aggregate principal amount of 7.250% senior notes due June 2019 and $251.3 million of our $700.0 million aggregate principal amount of 6.125% senior notes due November 2041.
In each of the above instances, we wrote off the associated amount of discounts, premiums and financing costs. Total cash payments related to the above, excluding accrued interest, were $3,919.6 million, which included approximately $136.0 million of repayment costs. We used the remaining proceeds for general corporate purposes.
In February 2016, we issued senior notes (the “February 2016 Senior Notes”) consisting of:
$500.0 million aggregate principal amount of 3.300% senior notes due February 2021
$1.5 billion aggregate principal amount of 4.500% senior notes due February 2026
We used the net proceeds from the sale of the February 2016 Senior Notes to (i) complete a tender offer and follow-on redemption of our 3.125% senior notes due May 2016 (which were fully redeemed in April 2016), (ii) enter into an accelerated share repurchase agreement and (iii) for general corporate purposes.
In March 2016, we completed the tender offer for $934.7 million of our $1.5 billion aggregate principal amount of 3.125% senior notes due May 2016 using the proceeds of the February 2016 Senior Notes, and wrote off the associated amount of discounts and financing costs. In April 2016, we completed the redemption of the remaining $565.3 million aggregate principal. Total cash payments, excluding accrued interest, related to these notes were $1,506.7 million, which included $6.7 million of repayment costs.


22

Financing costs. Following is the gross amount recognized and the related weighted-average period of amortization of our financing costs at issuance or amendment date:
 
Financing costs
(in millions)
 
Weighted-average period of amortization (in years)
June 2009 Senior Notes(1)
$
13.3
   
5.2
November 2011 Senior Notes(2)
29.9
   
12.1
February 2012 Senior Notes(3)
22.5
   
6.2
June 2014 Senior Notes(4)
18.6
   
6.6
February 2016 Senior Notes
16.0
   
8.8
July 2016 Senior Notes
33.0
   
17.0
November 2017 Senior Notes
9.3
   
3.7
2015 credit agreement, as amended
14.3
   
4.0
(1)
Includes $500.0 million, 7.250% senior notes due June 2019.
(2)
Includes $1,250.0 million, 4.750% senior notes due November 2021 and $700.0 million, 6.125% senior notes due November 2041.
(3)
Includes $1.0 billion, 3.900% senior notes due February 2022.
(4)
Includes $500.0 million, 1.250% senior notes due June 2017, $1.0 billion, 2.250% senior notes due June 2019, and $1.0 billion, 3.500% senior notes due June 2024.
Covenants. Our bank financing arrangements and senior notes contain certain customary covenants that restrict our ability to incur additional indebtedness, create or permit liens on assets and engage in mergers or consolidations. The covenants related to bank financing arrangements also include, among other things, a maximum leverage ratio. The 7.125% senior notes due 2018 are also subject to an interest rate adjustment in the event of a downgrade in the ratings to below investment grade. At December 31, 2017, we were in compliance with all covenants associated with our debt instruments.
Schedule of maturities. Following is a schedule of maturities of our short-term commercial paper and our long-term debt, excluding unamortized discounts, premiums and financing costs, as of December 31, 2017 (in millions):
Year Ended December 31,
Maturities of Debt
2018
$
1,026.4
 
2019
2,512.4
 
2020
2,375.0
 
2021
1,750.0
 
2022
1,500.0
 
Thereafter
6,948.7
 
Total
$
16,112.5
 
8. Income taxes
On December 22, 2017 (the “Enactment Date”), H.R. 1, originally known as the Tax Cuts and Jobs Act, was enacted. The new law (Public Law No. 115-97 hereinafter referred to as the “Tax Act”) includes significant changes to the U.S. corporate income tax system including, but not limited to, lowering the statutory corporate tax rate from 35% to 21%, eliminating certain deductions, imposing a mandatory one-time tax on accumulated earnings of foreign subsidiaries, introducing new tax regimes, and changing how foreign earnings are subject to U.S. tax. The Tax Act also enhanced and extended through 2026 the option to claim accelerated depreciation deductions on qualified property. The majority of the provisions in the Tax Act are effective January 1, 2018.


23

In response to the Tax Act, the Securities and Exchange Commission (“SEC”) issued guidance on accounting for the effects of the Tax Act. As required under the guidance, we have recorded a provisional tax benefit for the impact of the Tax Act of approximately $1,381.0 million during the fourth quarter of 2017. This amount is primarily comprised of the provisional remeasurement of federal net deferred tax liabilities resulting from the permanent reduction in the U.S. statutory corporate tax rate to 21% from 35%, after taking into account the mandatory one-time tax on the accumulated earnings of our foreign subsidiaries (“the Transition Tax”). The amount of this Transition Tax is not material. As we complete our analysis of the Tax Act, collect and prepare necessary data, and interpret any additional guidance issued by the U.S. Treasury Department, the IRS, and other standard-setting bodies, we may make adjustments to the provisional amounts. Those adjustments may materially impact our provision for income taxes in the period in which the adjustments are made.
In addition, we are still evaluating the Global Intangible Low Tax Income (“GILTI”) provisions of the Tax Act and their impact, if any, on our consolidated financial statements, including whether we adopt an accounting policy to treat such taxes as a current-period expense when incurred or whether such amounts should be factored into our measurement of deferred taxes. As a result, we have not included an estimate of the tax expense/benefit related to this item for the period ended December 31, 2017.
The provision for income taxes consists of the following:
 
Year Ended December 31,
(in millions)
2017
 
2016
 
2015
Income (loss) before income taxes:
         
United States
$
4,921.6
   
$
4,422.6
   
$
3,870.6
 
Foreign
7.4
   
4.5
   
(6.8
)
Total
$
4,929.0
   
$
4,427.1
   
$
3,863.8
 
Current provision:
         
Federal
$
1,991.9
   
$
1,456.2
   
$
1,722.0
 
State
79.3
   
37.9
   
102.7
 
Foreign
5.0
   
2.8
   
1.7
 
Total current provision
2,076.2
   
1,496.9
   
1,826.4
 
Deferred benefit:
         
Federal
(1,677.3
)
 
(392.6
)
 
(429.0
)
State
(1.6
)
 
(104.7
)
 
(32.9
)
Foreign
   
(0.1
)
 
(0.2
)
Total deferred benefit
(1,678.9
)
 
(497.4
)
 
(462.1
)
Total current and deferred provision
$
397.3
   
$
999.5
   
$
1,364.3
 


24

The Tax Act requires Express Scripts include in 2017 federal taxable income its pro-rata share of undistributed and previously untaxed post-1986 foreign earnings. Accordingly, we have included a discrete tax charge of $4.7 million in our 2017 tax provision. This amount is a provisional estimate for the Transition Tax as described above. We no longer consider our foreign earnings to be indefinitely reinvested and have recorded a provision for United States federal and state income taxes thereon. In previous years, we considered our foreign earnings to be indefinitely reinvested, and accordingly had not recorded a provision for United States federal and state income taxes thereon.
A reconciliation of the statutory federal income tax rate and the effective tax rate follows (the effect of foreign taxes on the effective tax rate for 2017, 2016 and 2015 is not material):
 
Year Ended December 31,
 
2017
 
2016
 
2015
Statutory federal income tax rate
35.0
%
 
35.0
%
 
35.0
%
State taxes, net of federal benefit
2.1
   
0.4
   
0.7
 
Non-controlling interest
(0.1
)
 
(0.2
)
 
(0.2
)
Impact of the Tax Act
(28.0
)
 
   
 
Recognition of previously unrecognized PolyMedica Corporation (Liberty) tax benefit
   
(11.6
)
 
 
Other, net
(0.9
)
 
(1.0
)
 
(0.2
)
Effective tax rate
8.1
%
 
22.6
%
 
35.3
%
During 2017, we recognized a net discrete benefit of $1,402.4 million primarily attributable to the deferred tax implications of the Tax Act. During 2016, we recognized a net discrete benefit of $633.9 million primarily attributable to changes in our unrecognized tax benefits as a result of our realization of the previously unrecognized PolyMedica Corporation (Liberty) tax benefit, various state audit settlements, lapses in statutes of limitations, and deferred tax implications of newly enacted state laws and filing methodologies.
The deferred tax assets and liabilities recorded in our consolidated balance sheet are as follows:
 
December 31,
(in millions)
2017
 
2016
Deferred tax assets:
     
Allowance for doubtful accounts
$
10.4
   
$
11.1
 
Note premium
3.6
   
24.7
 
Tax attributes
164.9
   
72.6
 
Equity compensation
95.4
   
148.5
 
Accrued expenses
149.6
   
293.4
 
Benefit of uncertain tax positions
67.1
   
132.4
 
Other
38.0
   
47.8
 
Gross deferred tax assets
529.0
   
730.5
 
Less valuation allowance
124.0
   
31.2
 
Net deferred tax assets
405.0
   
699.3
 
Deferred tax liabilities:
     
Depreciation, property and computer software differences
(187.4
)
 
(278.6
)
Goodwill and intangible assets
(2,365.4
)
 
(3,945.6
)
Outside basis difference in eviCore
(357.0
)
 
 
Other
(27.5
)
 
(47.3
)
Gross deferred tax liabilities
(2,937.3
)
 
(4,271.5
)
Net deferred tax liabilities
$
(2,532.3
)
 
$
(3,572.2
)

25


Deferred taxes were classified in the consolidated balance sheet as follows:
 
December 31,
(in millions)
2017
 
2016
Other assets
$
30.1
   
$
31.1
 
Deferred taxes
(2,562.4
)
 
(3,603.3
)
Net deferred tax liabilities
$
(2,532.3
)
 
$
(3,572.2
)
As part of the acquisition of eviCore described in Note 3 - Acquisitions and divestiture, we acquired a number of partnerships, now wholly-owned, resulting in differences in book and tax basis. Accordingly, as of December 31, 2017, we have a deferred tax liability of $357.0 million. As of December 31, 2017, we have deferred tax assets for federal and state capital loss carryforwards related to the sale of UBC of approximately $87.8 million and $15.6 million, respectively, as well as deferred tax assets for federal, and state net operating loss carryforwards of approximately $17.5 million and $44.0 million, respectively. The federal and state capital loss carryforwards, if otherwise not utilized, will expire in 2022. The federal and state net operating loss carryforwards, if otherwise not utilized, will expire between 2018 and 2035. We have provided a valuation allowance, primarily related to the utilization of the capital loss generated by the sale of UBC, of $124.0 million against these deferred tax assets. During 2017, our valuation allowance related to federal and state capital loss carryforwards and federal and state net operating losses increased by $92.8 million of which $14.7 million affected our tax rate.
A reconciliation of our beginning and ending amount of unrecognized tax benefits is as follows:
(in millions)
2017
 
2016
 
2015
Balance at beginning of year
$
538.0
   
$
1,038.4
   
$
1,117.2
 
Additions for tax positions related to prior years
153.3
   
102.5
   
55.8
 
Reductions for tax positions related to prior years(1)
(62.6
)
 
(630.8
)
 
(112.7
)
Additions for tax positions related to the current year
99.1
   
72.7
   
45.7
 
Reductions attributable to settlements with taxing authorities
(7.7
)
 
(18.1
)
 
(14.3
)
Reductions as a result of a lapse of the applicable statute of limitations
(31.7
)
 
(26.7
)
 
(53.3
)
Balance at end of year
$
688.4
   
$
538.0
   
$
1,038.4
 
(1)
Amounts for 2016 include reductions related to a claimed loss in 2012 on the divestiture of PolyMedica Corporation (Liberty).
All but an immaterial amount of our unrecognized tax benefits of $688.4 million would impact our effective tax rate, if recognized.
During 2016, we resolved the tax treatment of our 2012 divestiture of PolyMedica Corporation (Liberty). Accordingly, we recognized a net tax benefit of approximately $511.0 million, which impacted our effective tax rate.
We also reached final settlement on various state examinations. These state settlements resulted in a reduction to our unrecognized tax benefits of $7.7 million, none of which impacted our effective tax rate. In addition, as a result of these settlements, we reduced our prior year gross state tax positions by $41.5 million, which resulted in a net tax benefit of approximately $27.0 million that impacted our effective rate.
We recorded a benefit of $5.9 million of interest and penalties to the provision for income taxes in our consolidated statement of operations for the year ended December 31, 2017, as compared to a benefit of $26.8 million and $4.4 million for the years ended December 31, 2016 and 2015, respectively. This resulted in $82.8 million and $88.5 million of accrued interest and penalties in our consolidated balance sheet at December 31, 2017 and 2016, respectively.
We are subject to examination by various federal, state and local tax authorities. With few exceptions, we are no longer subject to tax examinations by tax authorities for years before 2010. The Internal Revenue Service is currently examining ESI’s 2010 and 2011 and Express Scripts’s combined 2012-2015 consolidated United States federal income tax returns. Our federal income tax audit uncertainties primarily relate to both the valuation and timing of deductions, while various state income tax audit uncertainties primarily relate to the attribution of overall taxable income to those states. We have taken positions in certain taxing jurisdictions for which it is reasonably possible the total amounts of unrecognized tax benefits may decrease up to $170.7 million within the next twelve months due to the conclusion of various examinations as well as lapses in various statutes of limitations.


26

9. Common stock
Treasury share repurchases. Including the shares received under the 2016 and 2015 ASR Agreements (described below) we repurchased 45.9 million, 74.4 million and 55.1 million shares for $2,947.4 million, $5,571.9 million and $4,675.0 million during the years ended December 31, 2017, 2016 and 2015, respectively. Shares repurchased during the year ended December 31, 2017 includes 0.1 million shares for $9.4 million not yet settled as of December 31, 2017. In each of December 2017 and 2016, the Board of Directors of the Company approved an increase in the authorized number of shares that may be purchased under the share repurchase program, originally announced in 2013, by 45.0 million and 65.0 million shares, respectively, for a total authorization of 375.0 million shares (including shares previously purchased) of our common stock, as adjusted for any subsequent stock split, stock dividend or similar transaction. As of December 31, 2017, there were 78.3 million shares remaining under the share repurchase program. Share repurchases during 2017 were made pursuant to Rule 10b5-1 plans implemented on February 15, 2017 (the “February 2017 Rule 10b5-1 plan”), July 26, 2017 (the “July 2017 Rule 10b5-1 plan”) and November 28, 2017 (the “November 2017 Rule 10b5-1 plan”), as well as through open market purchases. The February 2017 Rule 10b5-1 plan was completed on June 30, 2017, the July 2017 Rule 10b5-1 plan was completed on October 9, 2017 and the November 2017 Rule 10b5-1 plan remained active as of December 31, 2017. There is no limit on the duration of the share repurchase program as authorized by the Board of Directors of the Company. Additional share repurchases, if any, will be made through open market purchases, Rule 10b5-1 plans, accelerated share repurchases, privately negotiated transactions or other transactions in such amounts and at such times as we deem appropriate based upon prevailing market and business conditions and other factors.
Accelerated share repurchases. In February 2016, we entered into an accelerated share repurchase agreement (the “2016 ASR Agreement”) to repurchase shares of our common stock for an aggregate initial payment of $2,800.0 million. Under the terms of the 2016 ASR Agreement, upon payment of the initial payment we received an initial delivery of 32.1 million shares of our common stock at a price of $69.69 per share, which represented, based on the closing share price of our common stock on February 25, 2016, approximately 80% of the initial payment. The final purchase price per share and the final number of shares received were determined using the arithmetic mean of the daily volume-weighted average price per share of our common stock (the “VWAP”) over the executed term of the 2016 ASR Agreement. In August 2016, we settled the 2016 ASR Agreement and received 6.2 million additional shares, resulting in a total of 38.3 million shares received under the 2016 ASR Agreement.
The 2016 ASR Agreement was accounted for as an initial treasury stock transaction and a forward stock purchase contract. We initially recorded an increase to treasury stock of $2,240.0 million and a decrease to additional paid-in capital of $560.0 million. The $560.0 million recorded as additional paid-in capital was reclassified to treasury stock upon settlement of the 2016 ASR Agreement in August 2016. The forward stock purchase contract was classified as an equity instrument and was deemed to have a fair value of zero at the effective date of the 2016 ASR Agreement. The initial delivery of shares resulted in an immediate reduction of the outstanding shares used to calculate the weighted-average common shares outstanding for basic and diluted net income per share on the effective date of the 2016 ASR Agreement.
In April 2015, as part of our previously announced share repurchase program, we entered into an agreement to repurchase shares of our common stock for an aggregate initial payment of $5,500.0 million under an accelerated share repurchase agreement (the “2015 ASR Agreement”). Under the terms of the 2015 ASR Agreement, upon payment of the initial payment, we received an initial delivery of 55.1 million shares of our common stock at a price of $84.79 per share, which represented, based on the closing share price of our common stock on April 29, 2015, approximately 85% of the initial payment. The final purchase price per share and the final number of shares received was determined using the arithmetic mean of the daily VWAP over the executed term of the 2015 ASR Agreement. In January 2016, we settled the 2015 ASR Agreement and received 9.1 million additional shares, resulting in a total of 64.2 million shares received under the 2015 ASR Agreement.


27

The 2015 ASR Agreement was accounted for as an initial treasury stock transaction and a forward stock purchase contract. We initially recorded an increase to treasury stock of $4,675.0 million and a decrease to additional paid-in capital of $825.0 million. The $825.0 million recorded as additional paid-in capital was reclassified to treasury stock upon completion of the 2015 ASR Agreement in January 2016. The forward stock purchase contract was classified as an equity instrument and was deemed to have a fair value of zero at the effective date of the 2015 ASR Agreement. The initial delivery of shares resulted in an immediate reduction of the outstanding shares used to calculate the weighted-average common shares outstanding for basic and diluted net income per share on the effective date of the 2015 ASR Agreement.
10. Employee benefit plans and stock-based compensation plans
Retirement savings plans. We sponsor a retirement saving plan (“401(k) Plan”) under Section 401(k) of the Internal Revenue Code for substantially all of our full-time and part-time employees. Under the 401(k) Plan, eligible employees may elect to contribute up to 50% of their salary, and we match up to 6% of the employees’ compensation contributed to the 401(k) Plan for substantially all employees after one year of service.
For the years ended December 31, 2017, 2016 and 2015, we had contribution expense of approximately $76.4 million, $76.7 million and $69.8 million, respectively. Contributions under the plan are subject to aggregate limits required under the Internal Revenue Code.
Employee stock purchase plan. We offer an employee stock purchase plan (the “ESPP”) that qualifies under Section 423 of the Internal Revenue Code and permits all domestic employees, excluding certain management level employees, to purchase shares of our common stock. Participating employees may contribute up to 10% of their salary to purchase common stock at the end of each monthly participation period at a purchase price equal to 95% of the fair market value of our common stock on the last business day of the participation period. Approximately 210,000, 224,000 and 183,000 shares of our common stock were issued under the ESPP during the years ended December 31, 2017, 2016 and 2015, respectively. Our common stock reserved for future employee purchases under the ESPP is approximately 1.0 million shares at December 31, 2017.
Stock-based compensation plans in general. In March 2016, our Board of Directors adopted the Express Scripts Holding Company 2016 Long-Term Incentive Plan (the “2016 LTIP”), which was approved by our stockholders in May 2016 and authorizes the grant of various equity awards with various terms to our officers, members of our Board of Directors and other key employees. The 2016 LTIP was approved by our stockholders and became effective on May 4, 2016. Under the 2016 LTIP, we may issue stock options, stock appreciation rights (“SARs”), restricted stock awards, restricted stock units, performance share awards and other types of awards. The maximum number of shares available for awards under the 2016 LTIP is 33.0 million. As of December 31, 2017, there are 30.2 million shares of our common stock available for issuance under the 2016 LTIP. The maximum term of stock options, SARs, restricted stock awards, restricted stock units and performance shares granted under the 2016 LTIP is 10 years.
Effective May 4, 2016, no additional awards will be granted under the 2011 Long-Term Incentive Plan (the “2011 LTIP”), the Accredo Health 2002 Long-Term Incentive Plan (the “Accredo Plan”), the ESI 2000 Long-Term Incentive Plan (the “2000 LTIP”) or the Medco 2002 Stock Incentive Plan (the “2002 SIP”) (except to settle awards outstanding under these plans), all of which authorized the grant of various equity awards with various terms to our officers, members of our Board of Directors and other key employees. However, the terms of these plans will continue to govern awards outstanding under these plans.
The provisions of the 2016 LTIP, 2011 LTIP, the Accredo Plan, the 2000 LTIP and the 2002 SIP (collectively, the “stock incentive plans”) allow employees to use shares to cover tax withholdings on stock awards (a feature which has also been approved by the Compensation Committee of our Board of Directors). Upon vesting of restricted stock units and performance shares, employees have taxable income subject to statutory withholding requirements. The number of shares issued to employees may be reduced by the number of shares having a market value equal to the statutory withholding requirements for federal, state and local tax purposes. Awards are settled by issuance of new shares. The maximum term of stock options, restricted stock units and performance shares is generally 10 years. The tax benefit related to employee stock compensation recognized during the years ended December 31, 2017, 2016 and 2015 was $34.9 million, $24.2 million and $41.3 million, respectively.


28

As of January 1, 2017, under ASU 2016-09, excess tax benefits are prospectively recognized as income tax expense on our consolidated statement of operations and prospectively recognized as an operating activity on our consolidated statement of cash flows for the year ended December 31, 2017. Prior periods have not been retrospectively adjusted for adoption of this standard. We have also elected to continue to estimate the number of awards expected to vest. The remaining amendments to this standard, as noted in Note 1 - Summary of significant accounting policies, are either not applicable or do not change our current accounting practices and thus do not impact our consolidated financial statements, including our consolidated statement of cash flows.
Restricted stock units and performance shares. We have issued restricted stock units to certain officers, directors and employees and performance shares to certain officers and employees under our stock-based compensation plans. Restricted stock units generally have three-year graded vesting and performance shares generally have three-year cliff vesting. Awards are subject to accelerated vesting under certain specified circumstances, including upon a change in control and termination, and are also subject to forfeiture without consideration upon termination of employment under certain circumstances. The number of performance shares that ultimately vest is dependent upon achieving specific performance targets. The original grant of performance shares is subject to a multiplier of up to 2.5 based on the achievement of certain performance metrics.
As of December 31, 2017 and 2016, unearned compensation related to restricted stock units and performance shares was $65.5 million and $44.5 million, respectively. We recorded pre-tax compensation expense related to restricted stock units and performance shares of $74.2 million, $60.2 million and $71.1 million in the years ended December 31, 2017, 2016 and 2015, respectively. The fair value of restricted stock units and performance shares vested during the years ended December 31, 2017, 2016 and 2015 was $61.9 million, $56.3 million and $80.6 million, respectively. The weighted-average remaining recognition period for restricted stock units and performance shares is 2.0 years.
A summary of the status of restricted stock units and performance shares as of December 31, 2017, and changes during the year ended December 31, 2017, is presented below.
 
Shares
(in millions)
 
Weighted-Average Grant Date Fair Value Per Share
Outstanding at beginning of year
1.9
   
$
75.04
 
Granted
1.7
   
67.54
 
Other(1)
0.1
   
77.01
 
Released
(0.9
)
 
76.18
 
Forfeited/cancelled
(0.3
)
 
70.08
 
Outstanding at end of year
2.5
   
70.12
 
Vested and deferred at end of year
0.1
   
71.40
 
Non-vested at end of year
2.4
   
$
70.09
 
(1)
Represents additional performance shares issued above the original grant for achieving certain performance metrics.
Stock options. We have issued stock options to certain officers, directors and employees under our stock-based compensation plans to purchase shares of our common stock at fair market value on the date of grant. Stock options generally have three-year graded vesting.
As of December 31, 2017 and 2016, unearned compensation related to stock options was $14.4 million and $34.5 million, respectively. We recorded pre-tax compensation expense related to stock options of $25.4 million, $46.8 million and $46.0 million in the years ended December 31, 2017, 2016 and 2015, respectively. The weighted-average remaining recognition period for stock options is 1.5 years.


29

A summary of the status of stock options as of December 31, 2017, and changes during the year ended December 31, 2017, is presented below.
 
Shares
(in millions)
 
Weighted-Average Exercise Price Per Share
 
Weighted-Average Remaining Contractual Life (in years)
 
Aggregate Intrinsic Value (in millions)(1)
Outstanding at beginning of year
19.5
   
$
61.02
         
Granted
0.8
   
66.85
         
Exercised
(2.3
)
 
46.35
         
Forfeited/cancelled
(0.8
)
 
75.65
         
Outstanding at end of year
17.2
   
62.56
   
4.5
 
$
237.4
 
Awards exercisable at end of year
13.3
   
$
59.83
   
3.4
 
$
220.1
 
(1)
Amount by which the market value of the underlying stock exceeds the exercise price of the stock option.
For the years ended December 31, 2017, 2016 and 2015, the net excess/(shortfall) tax benefits related to stock options exercised during the year was $(0.9) million, $13.0 million and $58.2 million, respectively. Upon adoption of ASU 2016-09 on January 1, 2017, excess tax benefits are prospectively recognized as operating cash flow for the year ended December 31, 2017, and as financing cash flow for the years ended December 31, 2016 and 2015 in our consolidated statement of cash flows.
The fair value of stock options granted was estimated on the date of grant using a Black-Scholes multiple option-pricing model with the following weighted-average assumptions:
 
Year Ended December 31,
 
2017
 
2016
 
2015
Expected life of option
3-5 years
 
3-5 years
 
3-5 years
Risk-free interest rate
1.5%-2.1%
 
0.9%-1.9%
 
1.0%-1.7%
Expected volatility of stock
21%-23%
 
20%-25%
 
19%-26%
Expected dividend yield
None
 
None
 
None
Weighted-average volatility of stock
22.4%
 
22.3%
 
24.0%

The Black-Scholes model requires subjective assumptions, including future stock price volatility and expected time to exercise, which greatly affect the calculated values. The expected term and forfeiture rate of stock options is derived from historical data of employee exercises and post-vesting employment termination behavior as well as expected behavior on outstanding stock options. The risk-free rate is based on the United States Treasury rates in effect during the corresponding period of grant. The expected volatility is based on historical volatility of our stock price. These factors could change in the future, which would affect the stock-based compensation expense recognized in future periods.
Cash proceeds and intrinsic value related to total stock options exercised and weighted-average fair value of stock options granted during the years ended December 31, 2017, 2016 and 2015 are provided in the following table:
 
Year Ended December 31,
(in millions, except per share data)
2017
 
2016
 
2015
Proceeds from stock options exercised
$
93.0
   
$
95.5
   
$
213.2
 
Intrinsic value of stock options exercised
49.3
   
71.1
   
212.8
 
Weighted-average fair value per share of options granted during the year
$
13.89
   
$
13.76
   
$
18.03
 

30

11. Commitments and contingencies
Lease agreements. We have entered into noncancellable agreements to lease certain offices, distribution facilities and operating equipment with terms from one to eleven years. The majority of our lease agreements include renewal options to extend the agreements from one to five years. Rental expense under the office and distribution facilities leases in the years ended December 31, 2017, 2016 and 2015 was $69.3 million, $62.9 million and $62.5 million, respectively. The future minimum lease payments, including interest, due under noncancellable leases as of December 31, 2017 are shown below (in millions):
Year Ended December 31,
Minimum Operating Lease Payments
 
Minimum Capital Lease Payments
2018
$
62.2
   
$
23.0
 
2019
50.9
   
8.3
 
2020
45.6
   
3.2
 
2021
37.6
   
2.8
 
2022
27.8
   
2.9
 
Thereafter
42.6
   
8.7
 
Total
$
266.7
   
$
48.9
 
Purchase commitments. As of December 31, 2017, we have certain required future purchase commitments for materials, supplies, services and fixed assets related to the normal course of business. We do not expect potential payments under these provisions to materially affect results of operations or financial condition based upon reasonably likely outcomes derived by reference to experience and current business plans. These future purchase commitments as of December 31, 2017 are summarized below (in millions):
Year Ended December 31,
Future Purchase
Commitments
2018
$
81.8
 
2019
63.2
 
2020
8.2
 
2021
4.9
 
2022
 
Thereafter
 
Total
$
158.1
 
Other contingencies. For the year ended December 31, 2017, approximately 54% of the total dollar value of our pharmaceutical purchases were through one wholesaler. We believe alternative sources are readily available. Except for customer concentration described in Note 13 - Segment information, we believe no other concentration risks exist at December 31, 2017. See Note 3 - Acquisitions and divestiture for description of a contingent arrangement with certain equity holders, who are key employees of eviCore.
Legal contingencies. We are subject to various legal proceedings, investigations, government inquiries and claims pending against us or our subsidiaries, including, but not limited to, those relating to regulatory, commercial, employment and employee benefits. We record accruals for certain of our outstanding legal proceedings, investigations and claims when we believe it is probable a liability will be incurred and the amount of loss can be reasonably estimated. On a quarterly basis, we evaluate developments in legal proceedings, investigations and claims that could affect the amount of any accrual, as well as any developments that would make a loss both probable and reasonably estimable.


31

We record self-insurance accruals based on estimates of the aggregate liability of claim costs (including defense costs) in excess of our insurance coverage. The majority of these claims are legal claims and our liability estimate is primarily related to the cost to defend these claims. We do not accrue for settlements, judgments, monetary fines or penalties until such amounts are probable and estimable. If the range of possible loss is broad, and no amount within the range is more likely than any other, the liability accrual is based on the low end of the range.
When a loss contingency is not believed to be both probable and estimable, we do not establish an accrued liability. However, if the loss (or an additional loss in excess of the accrual) is believed to be at least a reasonable possibility and material, we disclose an estimate of the possible loss or range of loss, if such estimate can be made, or disclose an estimate cannot be made.
The legal proceedings, investigations, government inquiries and claims pending against us or our subsidiaries include, among others, multi-district litigation, class action lawsuits, antitrust allegations, qui tam lawsuits (“whistleblower” actions) and various governmental inquiries and informational subpoenas.
The assessment of whether a loss is probable and reasonably estimable involves a series of complex judgments about future events. We are often unable to estimate a range of loss due to significant uncertainties, particularly where (i) the damages sought are unspecified or indeterminate; (ii) the proceedings are in the early stages; (iii) the matters involve novel or unsettled legal theories or a large number of parties; (iv) class action status may be sought and certified; (v) it is questionable whether asserted claims or allegations will survive dispositive motion practice; (vi) the impact of discovery on the legal process is unknown; (vii) the settlement posture of the parties has not been determined and/or (viii) in the case of certain government agency investigations, whether a sealed qui tam lawsuit has been filed and whether the government agency makes a decision to intervene in the lawsuit following investigation. Accordingly, for many proceedings, we are currently unable to estimate the loss or a range of possible loss.
For a limited number of proceedings, we may be able to reasonably estimate the possible range of loss in excess of any accruals. However, we believe such proceedings, individually and in the aggregate, when finally resolved, are not reasonably likely to have a material adverse effect on our cash flow or financial condition. We also believe any amount that could be reasonably estimated in excess of accruals, if any, for such proceedings is not material. However, an unexpected adverse resolution of one or more of such matters could have a material adverse effect on our results of operations in a particular quarter or fiscal year. For purposes of this Note 11, the “Company” refers to Express Scripts Holding Company and its subsidiaries if named as defendants or identified as the subjects in the matters described below.
We cannot predict the timing or outcome of the matters described below:
Jerry Beeman, et al. v. Caremark, et al. Plaintiffs allege that the Company and the other defendants failed to comply with statutory obligations to provide California clients with the results of a bi-annual survey of retail drug prices. On November 14, 2016, the district court denied plaintiffs’ motion for class certification, holding that the proposed class representatives and counsel were inadequate to represent a class. On October 6, 2017, defendants moved for sanctions against plaintiffs for destroying evidence and requested the case be dismissed with prejudice, which the court granted on January 4, 2018, and plaintiffs are appealing.
In re: PBM Antitrust Litigation. The following two cases involving the Company were transferred to the United States District Court for the Eastern District of Pennsylvania: Brady Enterprises, Inc., et al. v. Medco Health Solutions, Inc., and North Jackson Pharmacy, Inc., et al. v. Express Scripts, Inc., et al. Plaintiffs assert claims for violation of the Sherman Antitrust Act. The court has entered an order denying class certification in the Brady case and decertifying the class against the Company in the North Jackson case. These cases have been administratively closed on the court’s docket.
Anthem, Inc. v. Express Scripts, Inc. Anthem, Inc. (for purposes of this Note 11, “Anthem”) filed this lawsuit alleging various breach of contract claims against the Company relating to the parties’ rights and obligations under the periodic pricing review section of the pharmacy benefit management agreement between the parties, including allegations that the Company failed to negotiate new pricing concessions in good faith, as well as various alleged service issues. Anthem requests the court enter declaratory judgment that the Company is required to provide Anthem competitive benchmark pricing, that Anthem can terminate the agreement, and that the Company is required to provide Anthem with post-termination services at competitive benchmark pricing for one year following any termination by Anthem. Anthem claims it is entitled to $13.0 billion in additional pricing concessions over the remaining term of the agreement as well as $1.8 billion for one year following any contract termination by Anthem, and $150.0 million in damages for service issues (for purposes of this Note 11, “Anthem’s Allegations”). On April 19, 2016, in response to Anthem’s complaint, the Company filed its answer denying Anthem’s Allegations in their entirety and asserting affirmative defenses and counterclaims against Anthem. The court subsequently granted Anthem’s motion to dismiss two of six counts of the Company’s amended counterclaims.


32


In re Express Scripts Holdings Company Securities Litigation. Plaintiff filed this putative securities class action complaint on behalf of all persons or entities that purchased or otherwise acquired the Company’s publicly traded common stock between February 24, 2015 and March 21, 2016, and alleges the Company and named individuals violated Sections 10(b) and 20(a) of the Exchange Act and Rule 10b-5 by carrying out a scheme to defraud the investing public. Plaintiff seeks compensatory damages in favor of plaintiff and other class members, attorneys’ fees and costs, and equitable relief. Plaintiff adopts many of Anthem’s Allegations in support of their claim. On August 1, 2017, the court granted the Company’s motion to dismiss the complaint in its entirety. On August 30, 2017, Plaintiff filed an amended complaint alleging similar claims. On November 20, 2017, defendants filed a motion to dismiss the second amended complaint, which has been fully briefed and is ripe for the court’s consideration.
M. Scott Brewer, et al., in their capacities as Trustees for the Carpenters Pension Fund of West Virginia, derivatively on behalf of Express Scripts Holding Company v. Maura C. Breen, et al. Plaintiffs filed this stockholder derivative lawsuit alleging certain current and former officers and directors of the Company breached fiduciary duties and were unjustly enriched and also asserting a claim for corporate waste. Plaintiffs adopt many of Anthem’s Allegations in support of their claim. Plaintiffs seek damages on behalf of the Company from the individual defendants, an accounting by the individual defendants for all damages, profits, special benefits and unjust enrichment and imposition of a constructive trust, judgment directing the Company to take all necessary actions to reform and improve its corporate governance and internal control procedures, punitive damages, and an award of attorneys’ fees and costs. As of August 21, 2017, defendants’ motion to stay or dismiss was fully briefed and ripe for the court’s consideration. On January 23, 2018, the court granted defendants’ motion to dismiss the case in its entirety without prejudice. Plaintiffs have until February 28, 2018 to file an amended complaint.
Randy Green v. George Paz, et al. Plaintiff alleges certain current and former officers and directors of the Company breached fiduciary duties and were unjustly enriched. Plaintiff adopts many of Anthem’s Allegations in support of his claims that individual defendants breached fiduciary duties of loyalty, good faith, fair dealing, and candor, which caused the Company to issue false and misleading statements regarding the Company’s relationship with Anthem, and for contribution to and indemnification of the Company in connection with all claims that have been, are, or may in the future be asserted against the Company because of the individual defendants’ wrongdoing. On June 12, 2017, the court stayed this action until resolution of the Carpenters derivative action, described above, in the United States District Court for the Southern District of New York.
Missouri State Action (Circuit Court of St. Louis County, State of Missouri). The following three cases have been consolidated in Missouri state court: Abraham Neufeld, derivatively on behalf of nominal defendant Express Scripts Holding Company v. George Paz, et al.; Robert Jessup, derivatively on behalf of Express Scripts Holding Company v. Timothy Wentworth, et al.; and Richard Weisglas, derivatively on behalf of Express Scripts Holding Company v. Express Scripts Holding Company, George Paz, et al. These cases were consolidated on December 21, 2016, and on April 13, 2017, plaintiffs filed a consolidated amended complaint. Plaintiffs’ consolidated amended complaint alleges certain current and former officers and directors of the Company breached fiduciary duties and were unjustly enriched, and that certain defendants engaged in “insider selling.” Plaintiffs adopt many of Anthem’s Allegations in support of their claims that the individual defendants breached fiduciary duties of loyalty, good faith, candor, and due care, which caused the Company to issue false and misleading statements regarding the Company’s relationship with Anthem. Plaintiffs seek damages on behalf of the Company from the individual defendants, equitable relief, and attorneys’ fees and costs. On August 11, 2017, the court stayed this action until resolution of the Carpenters derivative action, described above, in the United States District Court for the Southern District of New York.


33


Kurt Wilson v. George Paz, et al. Plaintiff alleges that certain current and former officers and directors of the Company breached fiduciary duties, were unjustly enriched, committed abuse of control and gross mismanagement, and that certain defendants engaged in “insider selling.” Plaintiff adopts many of Anthem’s Allegations in support of the claims that the individual defendants breached fiduciary duties of loyalty, good faith, candor, and due care, which caused the Company to issue false and misleading statements regarding the Company’s relationship with Anthem. Plaintiff seeks damages on behalf of the Company from the individual defendants, equitable relief, and attorneys’ fees and costs. On December 8, 2017, the court stayed this action until resolution of the Carpenters derivative action, described above, in the United States District Court for the Southern District of New York.
In re Express Scripts/Anthem ERISA Litigation (consolidating John Doe One and John Doe Two v. Express Scripts, Inc. and Karen Burnett, Brendan Farrell, and Robert Shullich v. Express Scripts, Inc. and Anthem, Inc.). Plaintiffs filed a Second Amended Consolidated Class Action Complaint on behalf of health plan beneficiaries who are enrolled in health care plans that are insured or administered by Anthem. Plaintiffs allege that the Company and Anthem breached fiduciary duties and otherwise violated their legal obligations under ERISA, that the Company engaged in mail fraud, wire fraud and other racketeering activity through its invoicing system with Anthem, that the Company breached its contract with Anthem, that plaintiffs are entitled to equitable relief under theories including unjust enrichment, that the Company violated unfair and deceptive trade practices statutes, that Anthem breached the covenant of good faith and fair dealing implied in health plans, and that ESI violated the anti-discrimination provisions of the Affordable Care Act. Plaintiffs adopt many of Anthem’s Allegations in support of their claim. Plaintiffs seek compensatory damages, declaratory relief, equitable relief and attorneys’ fees and costs. The Company’s motion to dismiss was granted on January 5, 2018 and plaintiffs are appealing.
MSP Recovery Claims, Series, LLC, et al. v. CVS Health Corporation, et al. Plaintiffs allege, inter alia, that the defendants entered into “exclusionary” agreements that granted exclusive formulary placement for certain analog insulin products in return for higher rebate payments and that these agreements had the effect of driving up analog insulin costs for the putative class members. Plaintiffs assert claims for purported RICO violations, common law fraud and unjust enrichment. Plaintiffs seek treble damages, equitable relief and attorneys’ fees and costs. On January 19, 2018, plaintiffs voluntarily dismissed this case.
Jeanine Prescott, et al. v. CVS Health Corporation, et al. Plaintiffs allege, inter alia, that the defendants entered into “exclusionary” agreements that granted exclusive formulary placement for certain blood glucose test strips in return for higher rebate payments. The complaint alleges that these agreements had the effect of driving up the costs of such test strips for the putative class members and violated RICO, ERISA and the competition and consumer protection laws of various states. Plaintiffs seek treble damages, equitable relief and attorneys’ fees and costs. On November 28, 2017, the court granted the motion of certain defendants, including the Company, to transfer this action to the United States District Court for the District of New Jersey.
Michael Bewley, et al. v. CVS Health Corporation, et al. Plaintiffs allege, inter alia, that the defendants entered into “exclusionary” agreements that granted exclusive formulary placement for certain glucagon products in return for higher rebate payments. The complaint alleges that these agreements had the effect of driving up the costs of such products for the putative class members and violated Sections 1 and 3 of the Sherman Act, RICO, ERISA and the competition and consumer protection laws of various states, U.S. territories and the District of Columbia. Plaintiffs seek treble damages, equitable relief and attorneys’ fees and costs. On November 7, 2017, the court granted defendants’ motion to transfer this action to the United States District Court for the District of New Jersey.
Elan and Adam Klein, et al. v. Prime Therapeutics, LLC; Express Scripts Holding Co.; Express Scripts, Inc.; Medco Health Solutions, Inc.; CVS Health Corp.; Caremark, L.L.C.; Caremark Rx, L.L.C.; and CaremarkPCS Health, L.L.C. Plaintiffs allege that defendants violated legal obligations under ERISA by negotiating increasingly large rebates from Mylan, which allegedly caused an increase in the price of EpiPen products. Plaintiffs further allege that defendants retained a significant portion of rebates, rather than passing them on to class members (who are participants in, or beneficiaries of, health insurance plans governed by ERISA who purchased EpiPen products). The Company moved to dismiss Plaintiffs’ claims, and Plaintiffs recently responded by filing an amended complaint. The case is subject to a conditional order transferring the proceedings to a Kansas federal court for centralization with a multidistrict litigation, In re: EpiPen (Epinephrine Injection, USP) Marketing, Sales Practices & Antitrust Litigation, MDL No. 2785 (J.P.M.L). The Company has filed a motion to vacate the conditional transfer order, which was granted. Klein and Brannon have been consolidated and plaintiffs have until April 2, 2018 to file a consolidated complaint.


34


Traci Brannon, Lindsey Rizzo, and Jamie Herr v. Express Scripts Holding Company, Express Scripts, Inc., UnitedHealth Group, Inc., OptumRx, Inc., and Prime Therapeutics, LLC. Plaintiffs make similar allegations to those in the Klein complaint described above. The case is subject to a pending request to consolidate the proceedings into a multidistrict litigation also pending in Kansas federal court, In re: EpiPen (Epinephrine Injection, USP) Marketing, Sales Practices & Antitrust Litigation, MDL No. 2785 (J.P.M.L). The Company successfully opposed consolidation and the case was transferred to the United States District Court for the District of Minnesota. Klein and Brannon have been consolidated and plaintiffs have until April 2, 2018 to file a consolidated complaint.
Frank Barnett, et al. v. Novo Nordisk, Inc., Eli Lilly and Company, Sanofi-Aventis U.S., LLC, Express Scripts Holding Company, Express Scripts, Inc., CVS Health Corp., and UnitedHealth Group, Inc., OptumRx, Inc. Plaintiffs allege, inter alia, that the defendants entered into “exclusionary” agreements that granted exclusive formulary placement for certain analog insulin products in return for higher rebate payments. The complaint alleges that these agreements had the effect of driving up analog insulin costs for the putative class members and violated Sections 1 and 3 of the Sherman Act, the Racketeer Influenced and Corrupt Organizations Act (“RICO”) and the competition and consumer protection laws of various states, U.S. territories, and the District of Columbia. Plaintiffs seek treble damages, equitable relief and attorneys’ fees and costs. This action has been consolidated with the related Boss and Christensen actions (described below) and a third related action In re Insulin Pricing Litigation. On December 26, 2017, interim class counsel filed a consolidated amended complaint under the In re Insulin Pricing Litigation docket that no longer names the PBM Defendants as defendants.
Julia Boss, et al. v. CVS Health Corporation, Caremark Rx, LLC, Express Scripts Holding Company, Express Scripts, Inc., UnitedHealth Group, Inc., OptumRx, Inc., Sanofi-Aventis U.S. LLC, Novo Nordisk Inc., and Eli Lilly and Company. Plaintiffs allege similar allegations to those alleged in the Barnett complaint described above. In addition, plaintiffs also allege that defendants violated ERISA. Plaintiffs seek treble damages, equitable relief and attorneys’ fees and costs. As explained above, this action has been consolidated with the Barnett, Christensen and In re Insulin Pricing Litigation actions, and interim class counsel has filed a consolidated amended complaint that no longer names the PBM Defendants as defendants.
Scott Christensen, et al. v. Novo Nordisk, Inc., Eli Lilly and Company, Sanofi-Aventis U.S., LLC, Express Scripts Holding Company, Express Scripts, Inc., CVS Health Corp., and UnitedHealth Group, Inc., OptumRx, Inc. Plaintiffs allege similar allegations to those alleged in the Barnett complaint described above. Plaintiffs seek treble damages, equitable relief and attorneys’ fees and costs. As explained above, this action has been consolidated with the Barnett, Boss and In re Insulin Pricing Litigation actions, and interim class counsel has filed a consolidated amended complaint that no longer names the PBM Defendants as defendants.
City of Rockford and Acument Global Technologies, Inc. v. Mallinckrodt ARD, Inc., f/k/a Questcor Pharmaceuticals, Inc., Mallinckrodt plc, Express Scripts Holding Company, Express Scripts, Inc., CuraScript, Inc., d/b/a CuraScript, SD, Accredo Health Group, Inc., and United BioSource Corporation. Plaintiffs filed a second amended complaint on behalf of a putative class of third party payors for Acthar and their beneficiaries alleging that Mallinckrodt ARD, Inc. and Mallinckrodt plc (for purposes of this Note 11, collectively “Mallinckrodt”), the manufacturer of Acthar, an adrenocorticotropic hormone (“ACTH”), unlawfully maintained a monopoly in an alleged market for ACTH drugs by, inter alia, acquiring its only potential competitor. Plaintiffs also allege that Mallinckrodt and ESI fixed the price of Acthar, and that alleged agreements involving CuraScript, Inc., Accredo Health Group, Inc., and United BioSource Corporation unlawfully restrain trade. Plaintiffs assert claims under Sections 1 and 2 of the Sherman Act, various state antitrust laws, and RICO, as well as claims for common law fraud and unjust enrichment. Further, the City of Rockford (“Rockford”) alleges that ESI breached its PBM Services Agreement with Rockford and asserts claims for breach of contract, promissory estoppel, and breach of the implied covenant of good faith and fair dealing, and also seeks a declaratory judgment. Plaintiffs seek treble damages, equitable relief, and attorneys’ fees and costs. On January 22, 2018, the Company defendants filed a motion to dismiss the second amended complaint.


35


MSP Recovery Claims, Series LLC, MAO-MSO Recovery II, LLC, MSP Recovery, LLC, MSPA Claims 1, LLC v. Mallinckrodt Ard, Inc., f/k/a Questcor Pharmaceuticals, Inc., Mallinckrodt PLC, and United BioSource Corporation. Plaintiffs make similar allegations to those in the Rockford complaint filed in Illinois in April 2017. Pursuant to the terms of the Company’s agreement providing for the sale of UBC, the Company has agreed to indemnify UBC for, and retain the responsibility for the defense of, this action. On January 17, 2018, the court granted defendants’ motion to transfer the case from the Central District of California to the Northern District of Illinois, where the Rockford case is pending. On February 23, 2018, UBC filed a motion to dismiss the complaint.
We are the subject of various qui tam matters, including:
Health Choice Alliance, LLC, on behalf of the United States of America, et al. v. Eli Lilly and Company, Inc., Healthstar Communications, Inc., VMS Biomarketing, Covance, Inc., and United Biosource Corporation. A lawsuit was filed against Eli Lilly and Company, Inc. (“Lilly”) and its vendors, including UBC, regarding services Lilly engaged them to provide with respect to insulin drugs Humalog and Humulin and osteoporosis drug Forteo (collectively, the “Lilly Products”). Pursuant to the terms of the Company’s agreement providing for the sale of UBC, the Company has agreed to indemnify UBC for, and retain the responsibility for the defense of, this action. The relator claims that: (1) Healthstar Communications, Inc. and VMS Biomarketing assisted Lilly in providing in-kind remuneration to prescribers in the form of free nursing services to induce such prescribers to prescribe the Lilly Products; (2) Lilly contracted with and paid remuneration to nurse educators to recommend the Lilly Products; and (3) Covance, Inc. and UBC assisted Lilly in providing in-kind remuneration to prescribers in the form of reimbursement support services that saved prescribers administrative expenses, which services were provided to induce such prescribers to prescribe the Lilly Products. The relator alleges these were kickbacks that violated the federal Anti-Kickback Statute. The relator alleges that the defendants violated the federal False Claims Act and state false claims acts by submitting claims for payment for the Lilly Products to government health programs, including Medicare and Medicaid, that were rendered false by virtue of the violations of the federal Anti-Kickback Statute. The relator seeks treble damages, civil penalties and restitution. On January 12, 2018, plaintiffs filed a first amended complaint. On February 21, 2018, UBC filed a motion to dismiss the first amended complaint.
United States ex. rel. Steve Greenfield, et al. v. Medco Health Solutions, Inc., Accredo Health Group, Inc., and Hemophilia Health Services, Inc. The complaint alleges defendants violated the federal False Claims Act, the Anti-Kickback Statute, the Civil Monetary Penalty Statute and various state and local false claims statutes. The court granted the Company’s motion for summary judgment and Greenfield appealed the decision. On January 19, 2018, the Court of Appeals for the Third Circuit affirmed summary judgment.
United States of America ex. rel. Shane Lager v. CSL Behring, LLC, CSL Limited, Accredo Health, Inc., and Coram LLC. The complaint alleged the Company violated the federal False Claims Act. The court granted the Company’s motion to dismiss and Lager appealed the decision. On May 5, 2017, the United States Court of Appeals for the Eighth Circuit affirmed the dismissal.
We have received and intend to cooperate with various subpoenas or other requests from government agencies seeking information and have included descriptions of certain specific requests below:
Insulin/Epinephrine Pricing Investigations. The Company has received inquiries from various state Attorneys General offices in connection with pending investigations into potential unfair and deceptive acts or practices related to the pricing, reimbursement and rebates for insulin and epinephrine products and possible contracts, combinations or conspiracies in restraint of trade in the setting of prices for insulin and epinephrine products.


36


Opioids Investigations. The Company received a request for information from the Office of Attorney General of New York regarding steps taken by the Company to fight opioid abuse in connection with a pending investigation into opioid-related deaths, overdoses, and hospitalizations.
Relationships with Pharmaceutical Manufacturers. The Company has received inquiries relating to its contractual relationships with pharmaceutical manufacturers.
Investigations under the federal False Claims Act and most state false claims acts may be initiated by the applicable government investigative body or by a qui tam relator’s filing of a complaint under court seal. If a qui tam relator’s complaint remained under seal, applicable law would restrict our ability to disclose such a fact.
In addition to the foregoing matters there have arisen various legal proceedings, government investigations, inquiries and audits or claims in the ordinary course of our business now pending against us or our subsidiaries. The effect of these actions on future financial results is not subject to reasonable estimation because the proceedings are in early stages and/or considerable uncertainty exists about the outcomes. Where insurance coverage is not available for such claims, or is not cost-effective, we maintain self-insurance accruals to reduce our exposure to future legal costs, settlements and judgments related to uninsured claims. Our self-insured accruals are based on estimates of the aggregate liability for the costs of uninsured claims incurred and the retained portion of insured claims using certain actuarial assumptions followed in the insurance industry and our experience. It is not possible to predict with certainty the outcome of these claims, and we can give no assurance that any losses in excess of our insurance and any self-insurance accruals will not be material.

12. Enterprise value initiative
In the third quarter of 2017, we launched a multi-year, enterprise-wide value initiative (“EVI”) to transform our organization through the end of 2021, in part due to the decision by Anthem not to renew our contract, which expires at the end of 2019. We are investing to deliver an improved experience with better engagement and greater efficiency and evolve the way we do business with patients, providers and our clients. Our EVI is currently estimated to incur a cost of approximately $600.0 million to $650.0 million, which is expected to be incurred through 2021.
Beginning in the third quarter of 2017, we have incurred incremental costs within the PBM Segment in order to achieve the future benefit of our enterprise-wide initiative. There were no such comparable costs throughout 2016. The components of these incremental costs are detailed below.
 
Year Ended December 31,
(in millions)
2017
Consulting and contingent labor
$
34.6
 
Severance and related benefit costs
6.9
 
Accelerated depreciation
0.9
 
Site closures
0.4
 
Total EVI Costs
$
42.8
 
Of the total EVI costs reflected above, $5.0 million and $37.8 million is reflected in the “Cost of revenues” and “Selling, general and administrative”, respectively, within our consolidated statement of operations.
We did not have material liabilities related to our enterprise value initiative as of December 31, 2017 or 2016.
13. Segment information
We report segments on the basis of the products and services we offer and have determined we have two reportable segments: PBM and Other Business Operations. Within the Other Business Operations segment, we have aggregated three operating segments (CuraScript Specialty Distribution, eviCore, and UBC), that do not meet the quantitative and qualitative criteria to be separately reported. eviCore was acquired on December 15, 2017, and UBC was sold on December 27, 2017.


37

Operating income is the measure used by our chief operating decision maker to assess the performance of each of our operating segments. The following table presents information about our reportable segments, including a reconciliation of operating income to income before income taxes for the respective years ended December 31.
(in millions)
PBM(1)
 
Other Business Operations(2)
 
Total
2017
         
Product revenues:
         
Network revenues(3)
$
49,562.2
   
$
   
$
49,562.2
 
Home delivery and specialty revenues(4)
44,334.2
   
   
44,334.2
 
Other revenues(5)
   
4,361.8
   
4,361.8
 
Service revenues
1,363.6
   
442.8
   
1,806.4
 
Total revenues
95,260.0
   
4,804.6
   
100,064.6
 
Depreciation and amortization expense
1,769.7
   
32.3
   
1,802.0
 
Operating income
5,407.0
   
87.0
   
5,494.0
 
Interest income and other
       
42.9
 
Interest expense and other
       
(607.9
)
Income before income taxes
       
4,929.0
 
Capital expenditures
248.1
   
19.3
   
267.4
 
2016
         
Product revenues:
         
Network revenues(3)
$
51,402.5
   
$
   
$
51,402.5
 
Home delivery and specialty revenues(4)
43,685.6
   
   
43,685.6
 
Other revenues(5)
   
3,538.4
   
3,538.4
 
Service revenues(6)
1,421.4
   
239.6
   
1,661.0
 
Total revenues(6)
96,509.5
   
3,778.0
   
100,287.5
 
Depreciation and amortization expense
2,124.1
   
30.5
   
2,154.6
 
Operating income(6)
5,080.0
   
7.8
   
5,087.8
 
Interest income and other
       
34.1
 
Interest expense and other
       
(694.8
)
Income before income taxes
       
4,427.1
 
Capital expenditures
307.9
   
22.5
   
330.4
 
2015
         
Product revenues:
         
Network revenues(3)
$
56,472.6
   
$
   
$
56,472.6
 
Home delivery and specialty revenues(4)
40,830.1
   
   
40,830.1
 
Other revenues(5)
   
2,453.7
   
2,453.7
 
Service revenues
1,657.6
   
337.8
   
1,995.4
 
Total revenues
98,960.3
   
2,791.5
   
101,751.8
 
Depreciation and amortization expense
2,328.7
   
30.4
   
2,359.1
 
Operating income
4,262.2
   
77.1
   
4,339.3
 
Interest income and other
       
24.8
 
Interest expense and other
       
(500.3
)
Income before income taxes
       
3,863.8
 
Capital expenditures
269.1
   
26.8
   
295.9
 

(1)
Includes the results of operations for myMatrixx subsequent to acquisition on May 15, 2017.
(2)
Includes the results of operations for eviCore subsequent to acquisition on December 15, 2017 and results of operations for UBC prior to its sale on December 27, 2017.
(3)
Includes retail pharmacy co-payments of $8,241.3 million, $8,569.2 million and $9,170.0 million for the years ended December 31, 2017, 2016 and 2015, respectively.
(4)
Includes revenues related to drugs we distribute to other PBMs’ clients under limited distribution contracts with pharmaceutical manufacturers and Freedom Fertility claims.
(5)
Includes revenues related to drugs distributed through patient assistance programs, which was sold on December 27, 2017.
(6)
Other Business Operations service revenues, total revenues and operating income as of December 31, 2016 includes an adjustment made in 2016 to decrease revenues and operating income by $86.1 million related to years prior to 2016. We recognized the cumulative effect of this correction within our consolidated statement of operations in the fourth quarter of 2016. This adjustment was not considered material to any prior period presented.


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PBM product revenues consist of revenues from the sale of prescription drugs by retail pharmacies in our retail pharmacy networks, revenues from the dispensing of prescription drugs from our home delivery pharmacies and revenues from the sale of certain fertility and specialty drugs. Our PBM revenues collected are primarily comprised of total prescription price, which includes a negotiated price with the client, member co-payments, fees-for-service and offsets to revenues we consider client discounts, which include manufacturer rebates and administrative fees payable to clients, obligations under financial and service guarantees to clients and pricing discounts. Other Business Operations product revenues primarily consist of distribution of specialty pharmaceuticals. PBM service revenues include fees for the administration of formulary management processing for certain client contracts that do not include claims adjudication and the dispensing of prescription drugs; as well as other fee-for-service arrangements, such as medication counseling services and certain specialty services. Other Business Operations service revenues include revenues related to medical benefit management services as of December 15, 2017, the date of the acquisition of eviCore, and, prior to the sale of UBC on December 27, 2017, also included revenues related to data analytics and research.
Following is the summary of total assets by reportable segment:
 
December 31,
(in millions)
2017
 
2016
PBM
$
48,562.6
   
$
50,432.7
 
Other Business Operations
5,693.2
   
1,312.2
 
Total assets
$
54,255.8
   
$
51,744.9
 
Following are the revenues from our clients representing 10% or greater of our consolidated revenues for each respective period:
 
December 31,
 
2017
 
2016
 
2015
Anthem
19
%
 
17
%
 
16
%
Department of Defense
12
%
 
12
%
 
13
%
Revenues earned by our international businesses totaled $110.6 million, $98.3 million and $82.0 million for the years ended December 31, 2017, 2016 and 2015, respectively. All other revenues were earned in the United States. Long-lived assets of our international businesses (consisting primarily of computer software) totaled $29.7 million and $24.1 million as of December 31, 2017 and 2016, respectively. All other long-lived assets are domiciled in the United States.


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14. Quarterly financial data (unaudited)
Following is a presentation of our unaudited quarterly financial data:
 
Quarters
(in millions, except per share data)
First
 
Second(1)
 
Third
 
Fourth(2)
Fiscal 2017
             
Revenues(3)
$
24,654.9
   
$
25,347.5
   
$
24,683.4
   
$
25,378.8
 
Cost of revenues(3)
22,782.2
   
23,186.3
   
22,445.7
   
22,888.3
 
Gross profit
1,872.7
   
2,161.2
   
2,237.7
   
2,490.5
 
Selling, general and administrative
818.1
   
782.6
   
759.3
   
908.1
 
Operating income
1,054.6
   
1,378.6
   
1,478.4
   
1,582.4
 
Net income(4)
550.3
   
805.5
   
845.0
   
2,330.9
 
Less: Net income attributable to non-controlling interest
4.0
   
3.7
   
3.3
   
3.3
 
Net income attributable to Express Scripts(4)
$
546.3
   
$
801.8
   
$
841.7
   
$
2,327.6
 
Basic earnings per share attributable to Express Scripts(4)
$
0.91
   
$
1.38
   
$
1.47
   
$
4.12
 
Diluted earnings per share attributable to Express Scripts(4)
$
0.90
   
$
1.37
   
$
1.46
   
$
4.10
 
Fiscal 2016
             
Revenues(3)(5)
$
24,791.8
   
$
25,222.3
   
$
25,410.1
   
$
24,863.3
 
Cost of revenues(3)
22,944.8
   
23,061.1
   
23,136.0
   
22,525.1
 
Gross profit
1,847.0
   
2,161.2
   
2,274.1
   
2,338.2
 
Selling, general and administrative
906.2
   
904.9
   
858.1
   
863.5
 
Operating income(5)
940.8
   
1,256.3
   
1,416.0
   
1,474.7
 
Net income(4)
532.2
   
727.1
   
728.5
   
1,439.8
 
Less: Net income attributable to non-controlling interest
6.1
   
6.4
   
5.6
   
5.1
 
Net income attributable to Express Scripts(4)
$
526.1
   
$
720.7
   
$
722.9
   
$
1,434.7
 
Basic earnings per share attributable to Express Scripts(4)
$
0.82
   
$
1.14
   
$
1.16
   
$
2.36
 
Diluted earnings per share attributable to Express Scripts(4)
$
0.81
   
$
1.13
   
$
1.15
   
$
2.34
 
(1)
Due to the structure of the Anthem contract, certain additional PBM revenues and operating income related to Anthem were realized in the second quarters of each of 2017 and 2016 of $52.6 million and $106.6 million, respectively. Includes the results of operations for myMatrixx subsequent to its acquisition on May 15, 2017.
(2)
Includes the results of operations for eviCore subsequent to its acquisition on December 15, 2017, and results of operations for UBC prior to its divestiture on December 27, 2017.
(3)
Includes retail pharmacy co-payments of $2,466.3 million and $2,541.0 million for the three months ended March 31, 2017 and 2016, respectively, $2,017.6 million and $2,136.4 million for the three months ended June 30, 2017 and 2016, respectively, $1,925.8 million and $2,008.5 million for the three months ended September 30, 2017 and 2016, respectively, and $1,831.6 million and $1,883.3 million for the three months ended December 31, 2017 and 2016, respectively.
(4)
During the fourth quarter of 2017, as of result of federal tax reform legislation enacted on December 22, 2017, we have revalued our deferred tax assets and liabilities to reflect the reduction in the federal tax rate. This revaluation caused an increase in earnings of approximately $1,381.0 million. During the fourth quarter of 2016, we resolved the tax treatment of our 2012 divestiture of PolyMedica Corporation (Liberty) and recognized a net tax benefit of approximately $511.0 million.
(5)
Other Business Operations for the three months ended December 31, 2016 includes an adjustment made in 2016 to decrease revenues and operating income by $102.6 million, of which $86.1 million related to years prior to 2016 and $16.5 million related to interim 2016 period revenues. We recognized the cumulative effect of this correction within our consolidated statement of operations in the fourth quarter of 2016. This adjustment was not considered material to any prior period presented.
40

15. Condensed consolidating financial information
The senior notes issued by ESI, Medco and us are jointly and severally and fully and unconditionally (subject to certain customary release provisions, including sale, exchange, transfer or liquidation of the guarantor subsidiary) guaranteed by ESI, Medco and us, as applicable. The following condensed consolidating financial information has been prepared in accordance with the requirements for presentation of such information. The condensed consolidating financial information presented below is not indicative of what the financial position, results of operations or cash flows would have been had each of the entities operated as an independent company during the periods for various reasons, including, but not limited to, intercompany transactions and integration of systems.
On October 26, 2017, the Company entered into an Amendment and Restatement Agreement with ESI, Medco, the lenders party thereto, Citibank, N.A., as administrative agent, and Credit Suisse AG, Cayman Islands Branch, as administrative agent under the Company’s existing credit agreement, which amended and restated the Company’s existing credit agreement (as amended and restated, the “Credit Agreement”). The Credit Agreement provides for a five-year revolving loan facility in an aggregate principal amount of $3.5 billion and continues an existing five-year term loan in an outstanding aggregate principal amount of $2,625.0 million.
In connection with entering into the Credit Agreement, on October 26, 2017, the Company sent a notice to the respective trustees under the indentures governing the Company’s outstanding senior notes (including notes issued by ESI and Medco) that, effective as of October 26, 2017, simultaneously with the closing of the Credit Agreement, each of the guarantors under such indentures, other than the Company, ESI and Medco, as applicable, was automatically released from all of its respective obligations under such indentures and its respective guarantees of the outstanding senior notes of the Company, ESI and Medco issued thereunder. As such, the historical subsidiary guarantors have been combined with the historical subsidiary non-guarantors, to reflect the new subsidiary non-guarantor presentation effective as of October 26, 2017, as shown below. The condensed consolidating financial information is presented separately for:
(i)
Express Scripts (the Parent Company), the issuer of certain guaranteed obligations;
(ii)
ESI, guarantor, the issuer of additional guaranteed obligations;
(iii)
Medco, guarantor, the issuer of additional guaranteed obligations;
(iv)
Non-guarantor subsidiaries, on a combined basis;
(v)
Consolidating entries and eliminations representing adjustments to (a) eliminate intercompany transactions between or among Express Scripts, ESI, Medco and the non-guarantor subsidiaries, (b) eliminate the investments in our subsidiaries and (c) record consolidating entries; and
(vi)
Express Scripts and subsidiaries on a consolidated basis.
In 2017, as part of an ongoing reorganization since 2015, certain subsidiaries have been merged within the structure defined above through non-cash transfers. The 2017 reorganizations qualified as a transfer of assets and are reflected prospectively in the condensed consolidating balance sheet, statement of operations and statement of cash flows. These events had no impact on our consolidated balance sheet, consolidated statement of operations or consolidated statement of cash flows.
In conjunction with the ongoing reorganization, during 2017, we executed certain intercompany agreements and transfer pricing agreements effective retrospectively to January 1, 2017. These intercompany agreements resulted in increased operating expenses for our non-guarantors and reduced operating expenses for ESI in the condensed consolidating statement of operations for the year ended December 31, 2017, as well as increased interest expense for Medco and our non-guarantors and reduced interest expense for Express Scripts. The transfer pricing agreements resulted in increased revenues and operating expenses for ESI, Medco and our non-guarantors with a resulting increase in the eliminations column. These events had no impact on our consolidated balance sheet, consolidated statement of operations or consolidated statement of cash flows.

41


Condensed Consolidating Balance Sheet

(in millions)
Express Scripts Holding Company
 
Express Scripts, Inc.
 
Medco Health Solutions, Inc.
 
Non-Guarantors
 
Eliminations
 
Consolidated
As of December 31, 2017
                     
Cash and cash equivalents
$
1,031.0
   
$
114.5
   
$
   
$
1,164.1
   
$
   
$
2,309.6
 
Receivables, net
   
3,740.9
   
971.3
   
2,344.1
   
   
7,056.3
 
Other current assets
   
350.7
   
2.1
   
2,238.4
   
   
2,591.2
 
Total current assets
1,031.0
   
4,206.1
   
973.4
   
5,746.6
   
   
11,957.1
 
Property and equipment, net
   
166.1
   
3.2
   
382.0
   
   
551.3
 
Computer software, net
   
640.0
   
   
174.9
   
   
814.9
 
Investments in subsidiaries
52,546.3
   
14,350.2
   
8,926.0
   
   
(75,822.5
)
 
 
Intercompany
   
847.1
   
2,531.5
   
17,624.0
   
(21,002.6
)
 
 
Goodwill
   
3,122.4
   
22,609.9
   
5,367.4
   
   
31,099.7
 
Other intangible assets, net
   
449.5
   
5,917.1
   
3,259.3
   
   
9,625.9
 
Other assets
8.2
   
112.6
   
80.3
   
42.7
   
(36.9
)
 
206.9
 
Total assets
$
53,585.5
   
$
23,894.0
   
$
41,041.4
   
$
32,596.9
   
$
(96,862.0
)
 
$
54,255.8
 
Claims and rebates payable
$
   
$
7,389.4
   
$
2,574.3
   
$
224.8
   
$
   
$
10,188.5
 
Accounts payable
   
840.3
   
34.0
   
2,881.4
   
   
3,755.7
 
Accrued expenses
126.6
   
1,192.7
   
272.7
   
1,277.3
   
   
2,869.3
 
Short-term debt and current maturities of long-term debt
194.8
   
   
838.1
   
   
   
1,032.9
 
Total current liabilities
321.4
   
9,422.4
   
3,719.1
   
4,383.5
   
   
17,846.4
 
Long-term debt
14,141.9
   
336.7
   
502.9
   
   
   
14,981.5
 
Intercompany
21,002.6
   
   
   
   
(21,002.6
)
 
 
Deferred taxes
   
   
1,392.2
   
1,207.1
   
(36.9
)
 
2,562.4
 
Other liabilities
   
457.1
   
258.4
   
24.7
   
   
740.2
 
Non-controlling interest
   
   
   
5.7
   
   
5.7
 
Express Scripts stockholders’ equity
18,119.6
   
13,677.8
   
35,168.8
   
26,975.9
   
(75,822.5
)
 
18,119.6
 
Total liabilities and stockholders’ equity
$
53,585.5
   
$
23,894.0
   
$
41,041.4
   
$
32,596.9
   
$
(96,862.0
)
 
$
54,255.8
 
                       
As of December 31, 2016
                     
Cash and cash equivalents
$
583.5
   
$
1,234.2
   
$
4.4
   
$
1,255.1
   
$
   
$
3,077.2
 
Receivables, net
   
3,595.8
   
878.7
   
2,587.6
   
   
7,062.1
 
Other current assets
   
194.3
   
   
2,029.8
   
   
2,224.1
 
Total current assets
583.5
   
5,024.3
   
883.1
   
5,872.5
   
   
12,363.4
 
Property and equipment, net
   
205.0
   
3.4
   
398.6
   
   
607.0
 
Computer software, net
   
621.1
   
   
91.5
   
   
712.6
 
Investments in subsidiaries
44,372.3
   
11,248.2
   
9,068.3
   
   
(64,688.8
)
 
 
Intercompany
   
   
1,606.5
   
14,663.7
   
(16,270.2
)
 
 
Goodwill
   
3,122.4
   
22,609.9
   
3,545.5
   
   
29,277.8
 
Other intangible assets, net
   
682.2
   
6,924.5
   
1,030.2
   
   
8,636.9
 
Other assets
7.1
   
173.5
   
25.0
   
46.9
   
(105.3
)
 
147.2
 
Total assets
$
44,962.9
   
$
21,076.7
   
$
41,120.7
   
$
25,648.9
   
$
(81,064.3
)
 
$
51,744.9
 
Claims and rebates payable
$
   
$
6,182.3
   
$
2,654.6
   
$
   
$
   
$
8,836.9
 
Accounts payable
   
1,118.2
   
42.5
   
2,715.0
   
   
3,875.7
 
Accrued expenses
125.0
   
1,147.2
   
368.4
   
1,352.6
   
   
2,993.2
 
Short-term debt and current maturities of long-term debt
722.3
   
   
   
   
   
722.3
 
Total current liabilities
847.3
   
8,447.7
   
3,065.5
   
4,067.6
   
   
16,428.1
 
Long-term debt
13,137.0
   
336.2
   
1,372.8
   
   
   
14,846.0
 
Intercompany
14,742.6
   
1,527.6
   
   
   
(16,270.2
)
 
 
Deferred taxes
   
   
2,468.9
   
1,239.7
   
(105.3
)
 
3,603.3
 
Other liabilities
   
378.4
   
228.0
   
17.3
   
   
623.7
 
Non-controlling interest
   
   
   
7.8
   
   
7.8
 
Express Scripts stockholders’ equity
16,236.0
   
10,386.8
   
33,985.5
   
20,316.5
   
(64,688.8
)
 
16,236.0
 
Total liabilities and stockholders’ equity
$
44,962.9
   
$
21,076.7
   
$
41,120.7
   
$
25,648.9
   
$
(81,064.3
)
 
$
51,744.9
 


42


Condensed Consolidating Statement of Operations

(in millions)
Express Scripts Holding Company
 
Express Scripts, Inc.
 
Medco Health Solutions, Inc.
 
Non-Guarantors
 
Eliminations
 
Consolidated
For the year ended December 31, 2017
                   
Revenues
$
   
$
69,006.3
   
$
19,323.7
   
$
63,170.4
   
$
(51,435.8
)
 
$
100,064.6
 
Operating expenses
   
68,674.4
   
18,901.2
   
58,430.8
   
(51,435.8
)
 
94,570.6
 
Operating income
   
331.9
   
422.5
   
4,739.6
   
   
5,494.0
 
Other (expense) income:
                     
Interest (expense) income and other, net
(509.0
)
 
7.1
   
(56.0
)
 
(7.1
)
 
   
(565.0
)
Intercompany interest income (expense)
512.2
   
(97.5
)
 
(158.6
)
 
(256.1
)
 
   
 
Other (expense) income, net
3.2
   
(90.4
)
 
(214.6
)
 
(263.2
)
 
   
(565.0
)
Income before income taxes
3.2
   
241.5
   
207.9
   
4,476.4
   
   
4,929.0
 
Provision (benefit) for income taxes
2.0
   
73.6
   
(688.2
)
 
1,009.9
   
   
397.3
 
Income before equity in earnings of subsidiaries
1.2
   
167.9
   
896.1
   
3,466.5
   
   
4,531.7
 
Equity in earnings of subsidiaries
4,516.2
   
2,845.8
   
438.9
   
   
(7,800.9
)
 
 
Net income
$
4,517.4
   
$
3,013.7
   
$
1,335.0
   
$
3,466.5
   
$
(7,800.9
)
 
$
4,531.7
 
Less: Net income attributable to non-controlling interest
   
   
   
14.3
   
   
14.3
 
Net income attributable to Express Scripts
4,517.4
   
3,013.7
   
1,335.0
   
3,452.2
   
(7,800.9
)
 
4,517.4
 
Other comprehensive income
9.4
   
9.4
   
   
9.4
   
(18.8
)
 
9.4
 
Comprehensive income attributable to Express Scripts
$
4,526.8
   
$
3,023.1
   
$
1,335.0
   
$
3,461.6
   
$
(7,819.7
)
 
$
4,526.8
 
For the year ended December 31, 2016
               
Revenues
$
   
$
39,265.7
   
$
24,395.0
   
$
41,666.1
   
$
(5,039.3
)
 
$
100,287.5
 
Operating expenses
   
36,484.0
   
23,160.5
   
40,594.5
   
(5,039.3
)
 
95,199.7
 
Operating income
   
2,781.7
   
1,234.5
   
1,071.6
   
   
5,087.8
 
Other (expense) income:
                     
Interest expense and other, net
(546.7
)
 
(61.9
)
 
(51.2
)
 
(0.9
)
 
   
(660.7
)
Intercompany interest income (expense)
312.2
   
(156.1
)
 
   
(156.1
)
 
   
 
Other expense, net
(234.5
)
 
(218.0
)
 
(51.2
)
 
(157.0
)
 
   
(660.7
)
Income (loss) before income taxes
(234.5
)
 
2,563.7
   
1,183.3
   
914.6
   
   
4,427.1
 
Provision (benefit) for income taxes
(85.6
)
 
952.7
   
(81.3
)
 
213.7
   
   
999.5
 
Income (loss) before equity in earnings of subsidiaries
(148.9
)
 
1,611.0
   
1,264.6
   
700.9
   
   
3,427.6
 
Equity in earnings (loss) of subsidiaries
3,553.3
   
1,080.5
   
(402.8
)
 
   
(4,231.0
)
 
 
Net income
$
3,404.4
   
$
2,691.5
   
$
861.8
   
$
700.9
   
$
(4,231.0
)
 
$
3,427.6
 
Less: Net income attributable to non-controlling interest
   
   
   
23.2
   
   
23.2
 
Net income attributable to Express Scripts
3,404.4
   
2,691.5
   
861.8
   
677.7
   
(4,231.0
)
 
3,404.4
 
Other comprehensive income
1.7
   
1.7
   
   
1.7
   
(3.4
)
 
1.7
 
Comprehensive income attributable to Express Scripts
$
3,406.1
   
$
2,693.2
   
$
861.8
   
$
679.4
   
$
(4,234.4
)
 
$
3,406.1
 
                       
For the year ended December 31, 2015
               
Revenues
$
   
$
39,582.1
   
$
30,137.6
   
$
36,215.6
   
$
(4,183.5
)
 
$
101,751.8
 
Operating expenses
   
37,272.4
   
28,940.4
   
35,383.2
   
(4,183.5
)
 
97,412.5
 
Operating income
   
2,309.7
   
1,197.2
   
832.4
   
   
4,339.3
 
Other (expense) income:
                     
Interest expense and other, net
(341.7
)
 
(75.7
)
 
(53.5
)
 
(4.6
)
 
   
(475.5
)
Intercompany interest income (expense)
281.2
   
(140.6
)
 
   
(140.6
)
 
   
 
Other expense, net
(60.5
)
 
(216.3
)
 
(53.5
)
 
(145.2
)
 
   
(475.5
)
Income (loss) before income taxes
(60.5
)
 
2,093.4
   
1,143.7
   
687.2
   
   
3,863.8
 
Provision (benefit) for income taxes
(22.0
)
 
767.1
   
427.4
   
191.8
   
   
1,364.3
 
Income (loss) before equity in earnings of subsidiaries
(38.5
)
 
1,326.3
   
716.3
   
495.4
   
   
2,499.5
 
Equity in earnings (loss) of subsidiaries
2,514.9
   
1,052.1
   
(579.8
)
 
   
(2,987.2
)
 
 
Net income
$
2,476.4
   
$
2,378.4
   
$
136.5
   
$
495.4
   
$
(2,987.2
)
 
$
2,499.5
 
Less: Net income attributable to non-controlling interest
   
   
   
23.1
   
   
23.1
 
Net income attributable to Express Scripts
2,476.4
   
2,378.4
   
136.5
   
472.3
   
(2,987.2
)
 
2,476.4
 
Other comprehensive loss
(16.1
)
 
(16.1
)
 
   
(16.1
)
 
32.2
   
(16.1
)
Comprehensive income attributable to Express Scripts
$
2,460.3
   
$
2,362.3
   
$
136.5
   
$
456.2
   
$
(2,955.0
)
 
$
2,460.3
 


43


Condensed Consolidating Statement of Cash Flows

(in millions)
Express Scripts Holding Company
 
Express Scripts, Inc.
 
Medco Health Solutions, Inc.
 
Non-Guarantors
 
Eliminations
 
Consolidated
For the year ended December 31, 2017
Net cash flows provided by operating activities
$
4.8
   
$
1,601.3
   
$
509.3
   
$
3,475.1
   
$
(239.2
)
 
$
5,351.3
 
Cash flows from investing activities:
                     
Acquisitions, net of cash acquired
(3,378.4
)
 
(122.7
)
 
   
   
   
(3,501.1
)
Capital expenditures for property and equipment and computer software
   
(187.7
)
 
   
(79.7
)
 
   
(267.4
)
Net cash proceeds from the sale of business
   
   
85.3
   
   
   
85.3
 
Other, net
   
(16.5
)
 
1.9
   
7.2
   
   
(7.4
)
Net cash (used in) provided by investing activities
(3,378.4
)
 
(326.9
)
 
87.2
   
(72.5
)
 
   
(3,690.6
)
Cash flows from financing activities:
                     
Treasury stock acquired
(2,938.0
)
 
   
   
   
   
(2,938.0
)
Proceeds from long-term debt, net of discounts
1,398.9
   
   
   
   
   
1,398.9
 
Repayment of long-term debt
(1,125.0
)
 
   
   
   
   
(1,125.0
)
Commercial paper borrowings, net
194.8
   
   
   
   
   
194.8
 
Net proceeds from employee stock plans
81.0
   
   
   
   
   
81.0
 
Other, net
(13.2
)
 
(33.6
)
 
   
(237.3
)
 
239.2
   
(44.9
)
Net intercompany transactions
6,222.6
   
(2,360.5
)
 
(600.9
)
 
(3,261.2
)
 
   
 
Net cash (used in) provided by financing activities
3,821.1
   
(2,394.1
)
 
(600.9
)
 
(3,498.5
)
 
239.2
   
(2,433.2
)
Effect of foreign currency translation adjustment
   
   
   
4.9
   
   
4.9
 
Net (decrease) increase in cash and cash equivalents
447.5
   
(1,119.7
)
 
(4.4
)
 
(91.0
)
 
   
(767.6
)
Cash and cash equivalents at beginning of year
583.5
   
1,234.2
   
4.4
   
1,255.1
   
   
3,077.2
 
Cash and cash equivalents at end of year
$
1,031.0
   
$
114.5
   
$
   
$
1,164.1
   
$
   
$
2,309.6
 
                       
For the year ended December 31, 2016
Net cash flows provided by (used in) operating activities
$
(14.7
)
 
$
2,946.7
   
$
964.6
   
$
1,259.8
   
$
(237.0
)
 
$
4,919.4
 
Cash flows from investing activities:
                     
Capital expenditures for property and equipment and computer software
   
(232.1
)
 
   
(98.3
)
 
   
(330.4
)
Other, net
   
(12.2
)
 
2.1
   
(11.4
)
 
   
(21.5
)
Net cash (used in) provided by investing activities
   
(244.3
)
 
2.1
   
(109.7
)
 
   
(351.9
)
Cash flows from financing activities:
                     
Treasury stock acquired
(4,746.9
)
 
   
   
   
   
(4,746.9
)
Proceeds from long-term debt, net of discounts
5,986.8
   
   
   
   
   
5,986.8
 
Repayment of long-term debt
(3,901.3
)
 
(1,662.6
)
 
(368.6
)
 
   
   
(5,932.5
)
Net proceeds from employee stock plans
87.2
   
   
   
   
   
87.2
 
Other, net
(49.3
)
 
810.1
   
4.5
   
(1,074.7
)
 
237.0
   
(72.4
)
Net intercompany transactions
3,221.7
   
(2,573.0
)
 
(601.1
)
 
(47.6
)
 
   
 
Net cash (used in) provided by financing activities
598.2
   
(3,425.5
)
 
(965.2
)
 
(1,122.3
)
 
237.0
   
(4,677.8
)
Effect of foreign currency translation adjustment
   
   
   
1.2
   
   
1.2
 
Net (decrease) increase in cash and cash equivalents
583.5
   
(723.1
)
 
1.5
   
29.0
   
   
(109.1
)
Cash and cash equivalents at beginning of year
   
1,957.3
   
2.9
   
1,226.1
   
   
3,186.3
 
Cash and cash equivalents at end of year
$
583.5
   
$
1,234.2
   
$
4.4
   
$
1,255.1
   
$
   
$
3,077.2
 
                       
For the year ended December 31, 2015
Net cash flows provided by (used in) operating activities
$
(12.0
)
 
$
2,581.4
   
$
1,146.0
   
$
1,176.4
   
$
(43.5
)
 
$
4,848.3
 
Cash flows from investing activities:
                     
Capital expenditures for property and equipment and computer software
   
(193.6
)
 
   
(102.3
)
 
   
(295.9
)
Other, net
   
20.1
   
   
7.3
   
   
27.4
 
Net cash used in investing activities
   
(173.5
)
 
   
(95.0
)
 
   
(268.5
)
Cash flows from financing activities:
                     
Treasury stock acquired
(5,500.0
)
 
   
   
   
   
(5,500.0
)
Proceeds from long-term debt, net of discounts
5,500.0
   
   
   
   
   
5,500.0
 
Repayment of long-term debt
(2,890.8
)
 
   
(500.0
)
 
   
   
(3,390.8
)
Net proceeds from employee stock plans
183.1
   
   
   
   
   
183.1
 
Other, net
(28.0
)
 
21.9
   
36.3
   
(83.0
)
 
43.5
   
(9.3
)
Net intercompany transactions
2,747.7
   
(1,428.5
)
 
(679.9
)
 
(639.3
)
 
   
 
Net cash (used in) provided by financing activities
12.0
   
(1,406.6
)
 
(1,143.6
)
 
(722.3
)
 
43.5
   
(3,217.0
)
Effect of foreign currency translation adjustment
   
   
   
(9.1
)
 
   
(9.1
)
Net increase in cash and cash equivalents
   
1,001.3
   
2.4
   
350.0
   
   
1,353.7
 
Cash and cash equivalents at beginning of year
   
956.0
   
0.5
   
876.1
   
   
1,832.6
 
Cash and cash equivalents at end of year
$
   
$
1,957.3
   
$
2.9
   
$
1,226.1
   
$
   
$
3,186.3
 

44
Exhibit 99.2

Explanatory Note
 
Set forth below in this Exhibit 99.2 are the historical unaudited consolidated balance sheet of Express Scripts Holding Company as of September 30, 2018 and consolidated statements of operations, comprehensive income, changes in stockholders' equity and cash flows for the three and nine months ended September 30, 2018 and 2017.  Unless the context otherwise requires, references to the terms “we,” “our,” or “us” used throughout this Exhibit 99.2 refer to Express Scripts Holding Company and its consolidated subsidiaries.
1


EXPRESS SCRIPTS HOLDING COMPANY
Unaudited Consolidated Balance Sheet

(in millions)
September 30, 2018
 
December 31, 2017
Assets
     
Current assets:
     
Cash and cash equivalents
$
3,705.7
   
$
2,309.6
 
Receivables, net
7,824.1
   
7,056.3
 
Inventories
2,168.9
   
2,124.9
 
Prepaid expenses and other current assets
653.5
   
466.3
 
Total current assets
14,352.2
   
11,957.1
 
Property and equipment, net
490.9
   
551.3
 
Computer software, net
827.5
   
814.9
 
Goodwill
31,110.5
   
31,099.7
 
Other intangible assets, net
8,425.5
   
9,625.9
 
Other assets
235.0
   
206.9
 
Total assets
$
55,441.6
   
$
54,255.8
 
       
Liabilities and stockholders’ equity
     
Current liabilities:
     
Claims and rebates payable
$
10,190.2
   
$
10,188.5
 
Accounts payable
4,412.9
   
3,755.7
 
Accrued expenses
2,067.0
   
2,869.3
 
Short-term debt and current maturities of long-term debt
2,021.3
   
1,032.9
 
Total current liabilities
18,691.4
   
17,846.4
 
Long-term debt
12,974.2
   
14,981.5
 
Deferred taxes
2,347.8
   
2,562.4
 
Other liabilities
855.4
   
740.2
 
Total liabilities
34,868.8
   
36,130.5
 
Commitments and contingencies (Note 12)
     
Stockholders’ equity:
     
Preferred stock, 15.0 shares authorized, $0.01 par value per share; no shares issued and outstanding
   
 
Common stock, 2,985.0 shares authorized, $0.01 par value; shares issued: 866.9 and 862.3, respectively; shares outstanding: 563.6 and 564.4, respectively
8.7
   
8.6
 
Additional paid-in capital
23,826.8
   
23,537.8
 
Accumulated other comprehensive loss
(6.5
)
 
(2.9
)
Retained earnings
18,890.7
   
16,318.6
 
 
42,719.7
   
39,862.1
 
Common stock in treasury at cost, 303.3 and 297.9 shares, respectively
(22,153.8
)
 
(21,742.5
)
Total Express Scripts stockholders’ equity
20,565.9
   
18,119.6
 
Non-controlling interest
6.9
   
5.7
 
Total stockholders’ equity
20,572.8
   
18,125.3
 
Total liabilities and stockholders’ equity
$
55,441.6
   
$
54,255.8
 
See accompanying Notes to Unaudited Consolidated Financial Statements
2

EXPRESS SCRIPTS HOLDING COMPANY
Unaudited Consolidated Statement of Operations

 
Three Months Ended
 September 30,
 
Nine Months Ended
 September 30,
(in millions, except per share data)
2018
 
2017
 
2018
 
2017
Revenues
$
25,563.2
   
$
24,683.4
   
$
75,974.4
   
$
74,685.8
 
Cost of revenues
23,211.8
   
22,445.7
   
69,539.4
   
68,414.2
 
Gross profit
2,351.4
   
2,237.7
   
6,435.0
   
6,271.6
 
Selling, general and administrative
862.8
   
759.3
   
2,672.6
   
2,360.0
 
Operating income
1,488.6
   
1,478.4
   
3,762.4
   
3,911.6
 
Other (expense) income:
             
Interest income and other
13.0
   
13.6
   
33.8
   
28.7
 
Interest expense and other
(151.0
)
 
(147.7
)
 
(456.3
)
 
(439.9
)
 
(138.0
)
 
(134.1
)
 
(422.5
)
 
(411.2
)
Income before income taxes
1,350.6
   
1,344.3
   
3,339.9
   
3,500.4
 
Provision for income taxes
276.8
   
499.3
   
760.8
   
1,299.6
 
Net income
1,073.8
   
845.0
   
2,579.1
   
2,200.8
 
Less: Net income attributable to non-controlling interest
2.2
   
3.3
   
7.0
   
11.0
 
Net income attributable to Express Scripts
$
1,071.6
   
$
841.7
   
$
2,572.1
   
$
2,189.8
 
               
Weighted-average number of common shares outstanding during the period:
             
Basic
562.9
   
571.8
   
562.5
   
585.1
 
Diluted
567.9
   
574.7
   
566.8
   
588.4
 
Earnings per share:
             
Basic
$
1.90
   
$
1.47
   
$
4.57
   
$
3.74
 
Diluted
$
1.89
   
$
1.46
   
$
4.54
   
$
3.72
 
See accompanying Notes to Unaudited Consolidated Financial Statements


3

EXPRESS SCRIPTS HOLDING COMPANY
Unaudited Consolidated Statement of Comprehensive Income

 
Three Months Ended
 September 30,
 
Nine Months Ended
 September 30,
(in millions)
2018
 
2017
 
2018
 
2017
Net income
$
1,073.8
   
$
845.0
   
$
2,579.1
   
$
2,200.8
 
Other comprehensive income (loss):
             
Foreign currency translation adjustment
1.5
   
3.7
   
(3.6
)
 
8.4
 
Comprehensive income
1,075.3
   
848.7
   
2,575.5
   
2,209.2
 
Less: Comprehensive income attributable to non-controlling interest
2.2
   
3.3
   
7.0
   
11.0
 
Comprehensive income attributable to Express Scripts
$
1,073.1
   
$
845.4
   
$
2,568.5
   
$
2,198.2
 
See accompanying Notes to Unaudited Consolidated Financial Statements

4

EXPRESS SCRIPTS HOLDING COMPANY
Unaudited Consolidated Statement of Changes in Stockholders’ Equity

 
Number
of Shares
 
Amount
(in millions)
Common Stock
 
Common Stock
 
Additional
Paid-in Capital
 
Accumulated Other
Comprehensive Loss
 
Retained Earnings
 
Treasury Stock
 
Non-controlling Interest
 
Total
Balance at December 31, 2017
862.3
   
$
8.6
   
$
23,537.8
   
$
(2.9
)
 
$
16,318.6
   
$
(21,742.5
)
 
$
5.7
   
$
18,125.3
 
Net income
   
   
   
   
2,572.1
   
   
7.0
   
2,579.1
 
Other comprehensive loss
   
   
   
(3.6
)
 
   
   
   
(3.6
)
Treasury stock acquired
   
   
   
   
   
(411.3
)
 
   
(411.3
)
Changes in stockholders’ equity related to employee stock plans
4.6
   
0.1
   
289.0
   
   
   
   
   
289.1
 
Distributions to non-controlling interest, net of contributions
   
   
   
   
   
   
(5.8
)
 
(5.8
)
Balance at September 30, 2018
866.9
   
$
8.7
   
$
23,826.8
   
$
(6.5
)
 
$
18,890.7
   
$
(22,153.8
)
 
$
6.9
   
$
20,572.8
 
See accompanying Notes to Unaudited Consolidated Financial Statements

5

EXPRESS SCRIPTS HOLDING COMPANY
Unaudited Consolidated Statement of Cash Flows

 
Nine Months Ended
 September 30,
(in millions)
2018
 
2017
Cash flows from operating activities:
     
Net income
$
2,579.1
   
$
2,200.8
 
Adjustments to reconcile net income to net cash provided by operating activities:
     
Depreciation and amortization
1,500.2
   
1,344.2
 
Deferred income taxes
(207.3
)
 
(247.5
)
Employee stock-based compensation expense
89.7
   
78.0
 
Other, net
20.7
   
24.2
 
Changes in operating assets and liabilities:
     
Receivables
(792.5
)
 
161.2
 
Inventories
(44.1
)
 
(93.8
)
Other current and noncurrent assets
(187.1
)
 
(88.8
)
Claims and rebates payable
(0.4
)
 
642.6
 
Accounts payable
680.1
   
475.4
 
Accrued expenses
(750.9
)
 
(659.3
)
Other noncurrent liabilities
100.8
   
144.5
 
Net cash flows provided by operating activities
2,988.3
   
3,981.5
 
Cash flows from investing activities:
     
Capital expenditures for property and equipment and computer software
(241.3
)
 
(177.3
)
Acquisitions, net of cash acquired
(26.4
)
 
(122.7
)
Other, net
(28.3
)
 
(11.3
)
Net cash used in investing activities
(296.0
)
 
(311.3
)
Cash flows from financing activities:
     
Repayment of long-term debt
(831.4
)
 
(650.0
)
Treasury stock acquired
(420.7
)
 
(2,735.7
)
Net proceeds from employee stock plans
198.9
   
51.3
 
Commercial paper repayments, net
(195.0
)
 
 
Other, net
(43.4
)
 
(22.5
)
Net cash used in financing activities
(1,291.6
)
 
(3,356.9
)
Effect of foreign currency translation adjustment
(4.6
)
 
5.4
 
Net increase in cash and cash equivalents
1,396.1
   
318.7
 
Cash and cash equivalents at beginning of period
2,309.6
   
3,077.2
 
Cash and cash equivalents at end of period
$
3,705.7
   
$
3,395.9
 
See accompanying Notes to Unaudited Consolidated Financial Statements
6

EXPRESS SCRIPTS HOLDING COMPANY
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS
Note 1 - Summary of significant accounting policies
Our significant accounting policies, normally included in financial statements prepared in conformity with generally accepted accounting principles, have been omitted from this Form 10-Q pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”). We believe the disclosures contained in this Form 10-Q are adequate to fairly state the information when read in conjunction with the Notes to the Consolidated Financial Statements included in our consolidated financial statements for the year ended December 31, 2017, included in Item 8 - Consolidated Financial Statements and Supplementary Data, included in our Annual Report on Form 10-K filed with the SEC on February 27, 2018. For a description of our accounting policies, refer to the Notes to the Consolidated Financial Statements included therein.
We believe the accompanying unaudited consolidated financial statements reflect all adjustments (consisting of only normal recurring adjustments) necessary to state fairly the unaudited consolidated balance sheet as of September 30, 2018, the consolidated balance sheet as of December 31, 2017, the unaudited consolidated statement of operations and unaudited consolidated statement of comprehensive income for each of the three and nine months ended September 30, 2018 and 2017, the unaudited consolidated statement of changes in stockholders’ equity for the nine months ended September 30, 2018, and the unaudited consolidated statement of cash flows for the nine months ended September 30, 2018 and 2017. Certain amounts in the prior year have been reclassified to conform to the current year presentation. Operating results for the three and nine months ended September 30, 2018 are not necessarily indicative of the results that may be expected for the year ending December 31, 2018.
Subsequent to December 15, 2017, the date of acquisition, our Other Business Operations segment includes medical benefit management services provided by CareCore National Group, LLC and its affiliates d/b/a eviCore healthcare (“eviCore”). See Note 5 - Acquisition for further description. Prior to December 27, 2017, our Other Business Operations segment also included consulting services for pharmaceutical and biotechnology manufacturers to collect scientific evidence to guide the safe, effective and affordable use of medicines. These services were provided by United BioSource Holdings, Inc. (“UBC”), which we sold on December 27, 2017.
On March 8, 2018, we entered into an Agreement and Plan of Merger, as amended by Amendment No. 1, dated as of June 27, 2018, and as it may be further amended from time to time (the “Merger Agreement”), with Cigna Corporation (“Cigna”) and certain subsidiaries of Cigna whereby Cigna will acquire Express Scripts Holding Company (“Express Scripts” or the “Company”) in a cash and stock transaction valued on announcement at approximately $67.0 billion, including Cigna’s assumption of approximately $15.0 billion in Express Scripts debt. The merger consideration per share of Company common stock will consist of (i) 0.2434 of a fully paid and nonassessable share of common stock of the combined company and (ii) the right to receive $48.75 in cash, without interest. Upon closing of the transaction, Cigna stockholders are expected to own approximately 64% of the combined company and Express Scripts stockholders are expected to own approximately 36%. Consummation of the mergers is subject to certain customary conditions, including approval by the holders of a majority of the outstanding shares of Company common stock entitled to vote on the adoption of the Merger Agreement and approval by the holders of a majority of the outstanding shares of Cigna common stock entitled to vote on the adoption of the Merger Agreement (the shares of common stock of the combined company to be issued in the merger having been approved for listing on the New York Stock Exchange), the receipt of certain necessary governmental and regulatory approvals without the imposition of Burdensome Conditions (as defined in the Merger Agreement), the lack of any pending action or proceeding instituted by certain governmental entities to enjoin, restrain or prohibit the merger, and the receipt by each of the Company and Cigna of certain tax opinions. At a special meeting of stockholders held on August 24, 2018, Express Scripts’ stockholders approved the adoption of the Merger Agreement. Also on August 24, 2018, Cigna’s stockholders approved the adoption of the Merger Agreement. On September 17, 2018, the U.S. Department of Justice (the “DOJ”) cleared the pending merger, terminating the applicable waiting period under the Hart-Scott-Rodino Antitrust Improvements Act of 1976. The transaction remains subject to certain state regulatory approvals and filings required in connection with the transaction, including clearances from certain departments of insurance and the satisfaction of all closing conditions. The mergers are expected to be completed by December 31, 2018. Until the closing, we will continue to operate as an independent company.


7

Adopted new accounting guidance. In May 2014, the Financial Accounting Standards Board (“FASB”) issued ASU 2014-09, Revenue from Contracts with Customers (ASC Topic 606), which supersedes ASC Topic 605, Revenue Recognition. The new standard requires companies to recognize revenues upon transfer of goods or services to customers in amounts that reflect the consideration the company expects to receive in exchange for those goods or services. We adopted ASC Topic 606, as of January 1, 2018, using the modified retrospective method applied to all contracts. The effect of initially applying the new revenue standard did not result in an opening balance adjustment to retained earnings as of the beginning of the earliest comparative period presented; however, it did result in an increase to both revenues and cost of revenues beginning with the period ended March 31, 2018. The following are the impacts of the new revenue standard upon adoption:
results in reclassifications between revenues and cost of revenues,
provides new guidance for evaluating performance obligations, which affects how we interpret the nature of our promises to customers, the control we have in PBM arrangements, and the principal-agent analysis, and results in changing recognition of certain contracts from net to gross, and
requires non-cash consideration associated with a certain contract where the client replenishes inventory to be recognized at fair value.
These changes resulted in an increase to both revenues and cost of revenues of $849.4 million and $2,433.5 million for the three and nine months ended September 30, 2018, respectively, with no impact to gross profit.
In August 2016, the FASB issued ASU 2016-15, Statement of Cash Flows (Topic 230), Classification of Certain Cash Receipts and Cash Payments. The guidance addresses the classification of cash flow related to (1) debt prepayment or extinguishment costs, (2) settlement of zero-coupon debt instruments or other debt instruments with coupon rates that are insignificant in relation to the effective interest rate of the borrowing, (3) contingent consideration payments made after a business combination, (4) proceeds from the settlement of insurance claims, (5) proceeds from the settlement of corporate-owned life insurance, including bank-owned life insurance, (6) distributions received from equity method investees and (7) beneficial interests in securitization transactions. The guidance also clarifies how the predominance principle should be applied when cash receipts and cash payments have aspects of more than one class of cash flows. The guidance is effective for financial statements issued for annual reporting periods beginning after December 15, 2017, and applied retrospectively. In November 2016, the FASB issued ASU 2016-18, Statement of Cash Flows (Topic 230), Restricted Cash. This guidance requires amounts generally described as restricted cash and restricted cash equivalents be included with cash and cash equivalents when reconciling the beginning-of-period and end-of-period total amounts shown on the statement of cash flows. We adopted these ASUs effective January 1, 2018, retrospectively, with no significant impact on our consolidated financial statements for the three and nine months ended September 30, 2018 and 2017. In certain historical periods, debt extinguishment costs were reclassified from an operating activity to a financing activity as a result of adoption.
New accounting guidance not yet adopted. In February 2016, the FASB issued ASU 2016-02, Leases (ASC Topic 842), which supersedes ASC Topic 840, Leases. This ASU is intended to increase transparency and comparability of organizations by recognizing lease assets and liabilities on the balance sheet and disclosing key information about leasing arrangements. The new guidance is effective for financial statements issued for annual reporting periods beginning after December 15, 2018, and early application is permitted. We are currently evaluating the impact of this standard on our consolidated financial statements.
Note 2 - Revenue
Revenues are recognized when control of the promised goods or services is transferred to our customers, in an amount that reflects the consideration we expect to be entitled to in exchange for those goods or services.
Revenue recognition - PBM. Revenues from our PBM segment are earned by dispensing prescriptions from our home delivery and specialty pharmacies, processing claims for prescriptions filled by retail pharmacies in our networks, and providing services to drug manufacturers, including administration of discount programs (see also “Rebate accounting” below).


8

Our PBM contracts with customers generally obligate us to provide prescription drugs to the client’s members through multiple distribution methods, including retail network, home delivery, and specialty pharmacies as needed. We provide a service of integrating the goods and services selected by our clients into one overall output for which the client has contracted. Thus, PBM contracts generally contain a single performance obligation. We have elected the practical expedient to account for shipping and handling as a fulfillment activity. The nature of our performance obligation is to stand ready to process claims, dispense prescription drugs, and provide other services over the contractual period (generally three years). The quantity or timing of the service provided is in the control of our clients’ members. As such, our performance obligation forms a series of distinct periods of time over which we stand ready to perform. Our performance obligation is satisfied as we complete each period’s (day’s) obligations.
Consideration from PBM contracts is variable in nature because fees are based on services provided to members and claims processed, which can vary from period to period and are outside of our control. Fees are invoiced to our clients either on a periodic basis (e.g., monthly) or as service is provided (e.g., based on volume of claims processed or other service provided) and payment terms are generally due within 30 days. Variable consideration in our PBM contracts meets the criteria to be allocated to the distinct period of time to which it occurs because (i) it is related to the activities performed to satisfy the performance obligation during that period and (ii) it represents the value provided to our customers over the contract term.
Revenues related to dispensing prescription drugs by retail pharmacies in our networks consist of the prescription price (ingredient cost plus dispensing fee) negotiated with our clients, including the portion to be settled directly by the member (co-payment), plus any associated fees for services. The variable consideration associated with retail network transactions is recognized as revenue when claims are adjudicated. We act as a principal in the arrangement and we include the total prescription price as revenues. Through adjudication, we control the process of dispensing the drug even though physical delivery is provided by a retail network pharmacy. When a prescription is presented by a member to a retail pharmacy within our network, we are solely responsible for confirming member eligibility, performing drug utilization review, reviewing for drug-to-drug interactions, performing clinical intervention which may involve a call to the member’s physician, communicating plan provisions to the pharmacy, directing payment to the pharmacy and billing the client for the amount it is contractually obligated to pay us for the prescription dispensed, as specified within our client contracts. We also provide benefit design and formulary consultation services to clients. We have separately negotiated contractual relationships with our clients and with network pharmacies. These factors indicate we have control over the transaction before the prescription is transferred to the member and, thus, that we are acting as a principal. As such, we record the total prescription price contracted with clients in revenues.
In retail pharmacy transactions, amounts paid to pharmacies and amounts charged to clients are always exclusive of the applicable co-payment. Retail pharmacy co-payments, which we instruct retail pharmacies to collect from members, are included in our revenues and our cost of revenues.
When prescriptions are dispensed from our home delivery pharmacies, control of the prescription transfers and revenue is recognized when drugs are shipped. At the time of shipment, our earnings process is complete; the obligation of our customer to pay for the drugs is fixed and, due to the nature of the product, the member may not return the drugs or receive a refund.
Revenues from our specialty pharmacies are from providing medications/pharmaceuticals for diseases that rely upon high-cost injectable, infused, oral or inhaled drugs which have sensitive handling and storage needs and from providing fertility pharmaceuticals to providers and patients. Control of specialty revenues earned by our PBM segment transfers to the customer at the point of shipment. At the time of shipment, we have performed substantially all of our obligations under our customer contracts and do not experience a significant level of reshipments. Appropriate reserves are recorded for discounts and contractual allowances, which represent variable consideration and are estimated based on collection experience. Any differences between our estimates and actual collections are reflected in operations in the period in which payment is received. Historically, adjustments to our original estimates have not been material. Differences may affect the amount and timing of our revenues for any period if actual performance varies from our estimates. Allowances for returns are estimated based on historical return trends and are not material.


9

Revenues from our PBM segment are also derived from the distribution of pharmaceuticals requiring special handling or packaging where we have been selected by the pharmaceutical manufacturer as part of a limited distribution network. These revenues include management fees received from these programs.
Many of our contracts contain terms whereby we make certain financial and performance guarantees, including the minimum level of discounts or rebates a client may receive, generic utilization rates and various service guarantees. These clients may be entitled to the payment of performance penalties if we fail to meet a financial or service guarantee. Actual performance is compared to the guarantee for each measure throughout the period and accruals are recorded as an offset to revenues if we determine our performance against the guarantee indicates a probable contract liability. These estimates are adjusted to actual when the guarantee period ends and we have either met the guaranteed rate or paid amounts to clients. Historically, adjustments to our original estimates have not been material.
Revenue recognition - Other Business Operations. Revenues from our Other Business Operations segment are earned from the distribution of specialty pharmaceuticals and medical supplies to providers, clinics and hospitals and performance-oriented fees paid by specialty pharmacy manufacturers. Revenues from our Other Business Operations segment are also earned through integrated medical benefit management solutions that drive cost reductions and improved quality care outcomes. Prior to the sale of UBC on December 27, 2017, revenues from our Other Business Operations also included fee-for-service arrangements earned from late-stage clinical trials, risk management and drug safety services associated with UBC.
For contracts in which we are distributing prescription drugs, control transfers to the customer and revenues are recognized at the point of shipment. At the time of shipment, we have performed substantially all of our obligations under our customer contracts and historically have not experienced a significant level of reshipments. Receivables are recorded at the net realizable value and there are no material reserves or allowances.
Since our acquisition of eviCore on December 15, 2017, Other Business Operations includes revenues from medical benefits management contracts, through which we provide innovative solutions that include utilization management using evidence based criteria, analytics, patient transparency and site of service management as well as access to certain provider specialty networks for our clients and their members. The activity involves developing clinical review criteria for provider inquiries, assessing medical necessity of treatment, and maintaining a network of providers. In some medical benefits management contracts, we earn a per-member-per month fee which is earned over the period in which our client’s eligible members are entitled to service, and in other contracts we are paid a per-claim fee for the services we provide which is earned as services are rendered. We are responsible for confirming member eligibility, performing program utilization review, potentially directing payment to the provider and accepting the financial risk of loss associated with services rendered, as specified within our client contracts. We have the ability to influence contractual fees with clients and possess the financial risk of loss in certain contractual obligations. These factors indicate we are the principal and, as such, we record gross fees contracted with clients in revenues.
We provide a significant service of integrating the goods and services selected by our clients into one overall output for which the client has contracted. Thus, medical benefit management contracts generally contain a single performance obligation. The nature of our performance obligation is to stand ready to provide services over the contractual period (generally three years), but the quantity or timing of the service provided is in the control of our clients’ members. Also, our performance obligation forms a series of distinct periods of time over which we stand ready to perform. Our performance obligation is satisfied as we complete each period’s (day’s) obligations.
Consideration from medical benefits management contracts is variable in nature because fees are based on member enrollment, credits due to clients and reimbursement of provider costs, all of which can vary from period to period. We have control over pricing. Contractual fees are invoiced to our clients monthly and payment terms are generally due within 30 days. The variable consideration in our medical benefits management contracts meets the criteria to be allocated to the distinct period of time to which it relates because (i) it is due to the activities performed to satisfy the performance obligation during that period and (ii) it represents the consideration to which we expect to be entitled. However, consideration impacted by more than one distinct period of service (e.g., annual credits due to clients) is estimated and allocated to the entire period to which performance relates.


10

Certain arrangements in our medical benefit management contracts include provisions that require us to share with the client the costs or profits of the program in the event medical claims experience is above or below certain specified targets as set forth in the respective contract. The final settlement is dependent on each distinct day’s performance within the annual measurement period, but cannot be allocated to specific days until the full measurement period has occurred and performance can be assessed. As such, this is a form of variable consideration estimated at contract inception and updated through the measurement period (i.e. the contract year), to the extent the risk of reversal does not exist and the consideration is not constrained. The estimated profits and costs are recognized net in revenues.
Rebate accounting. We administer a rebate program through which we receive rebates and administrative fees from pharmaceutical manufacturers. If rebates are provided in conjunction with claims processing and home delivery services provided to clients in PBM contracts, they are not considered distinct within the contract from claim processing and other PBM services. Rebates are considered a form of variable consideration. Rebates and administrative fees earned for the administration of this program are recorded as a reduction of cost of revenues and the portion of the rebate and administrative fees payable to clients is treated as a reduction of revenues. The portion of rebates and administrative fees payable to clients is calculated based on historical and/or anticipated sharing percentages as defined within our contracts with clients. These payables are adjusted to actual when amounts are paid to clients subsequent to collections from pharmaceutical manufacturers; historically, these adjustments have not been material. We pay all or a contractually agreed upon portion of such rebates to our clients. We record rebates and administrative fees receivable from the manufacturer and payable to clients when the prescriptions covered under contractual agreements with the manufacturers are dispensed; this is the period to which this variable consideration relates and to which it is allocated, and rebate amounts are not dependent upon future purchases with the pharmaceutical company. If rebates are provided in a contract with a customer that does not include claims processing, our performance obligation is to arrange for the customer to receive rebates from pharmaceutical manufacturers. Rebates and administrative fees for these services are recorded in revenue, net of rebates and administrative fees payable to the customer. Reserves for estimated uncollectible rebates from the manufacturers are included in accounts receivable.


11

Disaggregated revenue. The following table disaggregates our revenue by product and service, distribution method, and segment:
(in millions)
PBM(1)
 
Other Business Operations(2)
 
Total
For the three months ended September 30, 2018
         
Product revenues:
         
Network revenues(3)(4)
$
12,525.6
   
$
   
$
12,525.6
 
Home delivery and specialty revenues(4)(5)
10,915.7
   
   
10,915.7
 
Other revenues
   
1,107.8
   
1,107.8
 
Product revenues
23,441.3
   
1,107.8
   
24,549.1
 
Service revenues
314.4
   
699.7
   
1,014.1
 
Total revenues
23,755.7
   
1,807.5
   
25,563.2
 
For the three months ended September 30, 2017
         
Product revenues:
         
Network revenues(3)
$
12,182.9
   
$
   
$
12,182.9
 
Home delivery and specialty revenues(5)
10,948.3
   
   
10,948.3
 
Other revenues(6)
   
1,130.2
   
1,130.2
 
Product revenues
23,131.2
   
1,130.2
   
24,261.4
 
Service revenues
341.9
   
80.1
   
422.0
 
Total revenues
23,473.1
   
1,210.3
   
24,683.4
 
For the nine months ended September 30, 2018
         
Product revenues:
         
Network revenues(3)(4)
$
37,392.2
   
$
   
$
37,392.2
 
Home delivery and specialty revenues(4)(5)
32,505.8
   
   
32,505.8
 
Other revenues
   
3,151.8
   
3,151.8
 
Product revenues
69,898.0
   
3,151.8
   
73,049.8
 
Service revenues
920.0
   
2,004.6
   
2,924.6
 
Total revenues
70,818.0
   
5,156.4
   
75,974.4
 
For the nine months ended September 30, 2017
         
Product revenues:
         
Network revenues(3)
$
36,982.2
   
$
   
$
36,982.2
 
Home delivery and specialty revenues(5)
33,142.5
   
   
33,142.5
 
Other revenues(6)
   
3,270.5
   
3,270.5
 
Product revenues
70,124.7
   
3,270.5
   
73,395.2
 
Service revenues
1,041.4
   
249.2
   
1,290.6
 
Total revenues
71,166.1
   
3,519.7
   
74,685.8
 
(1)
Includes the results of operations for myMatrixx subsequent to acquisition on May 15, 2017.
(2)
Includes the results of operations for eviCore subsequent to acquisition on December 15, 2017, and results of operations for UBC prior to sale on December 27, 2017.
(3)
Includes retail pharmacy co-payments of $1,945.6 million and $1,925.8 million for the three months ended September 30, 2018 and 2017, respectively, and $6,492.5 million and $6,409.7 million for the nine months ended September 30, 2018 and 2017, respectively.
(4)
Includes the impact of the increase to both network revenues and cost of revenues of $691.2 million and $2,033.6 million for the three and nine months ended September 30, 2018, respectively, and the increase to both home delivery and specialty revenues and cost of revenues of $158.2 million and $399.9 million for the three and nine months ended September 30, 2018, respectively, related to the adoption of ASC Topic 606 effective January 1, 2018.
(5)
Includes home delivery and specialty, including drugs we distribute to other PBMs’ clients under limited distribution contracts with pharmaceutical manufacturers, and Freedom Fertility claims.
(6)
Includes other revenues related to drugs distributed through patient assistance programs, which were disposed of as part of the sale of UBC on December 27, 2017.


12

Contract balances. Contract liabilities for PBM contracts arise due to financial and performance guarantees we have made to our clients. We measure our performance against these guarantees throughout the period and recognize a contract liability as indicated by our performance. Guarantees also fluctuate based on the timing of payments. Our contract liability balance was $791.2 million and $785.6 million as of September 30, 2018 and December 31, 2017, respectively, and are presented within the “Accrued expenses” line item of the consolidated balance sheet.
Contract liability balances also arise when we receive set-up fees or other up-front fees from our customers. This is generally uncommon, but may occur in some cases when we onboard a new client. Upfront fees are recognized as revenue over the contract term (generally three years).
We have no material contract asset balances as of September 30, 2018, or December 31, 2017.
Transaction price allocated to remaining performance obligations. As described above, our performance obligation forms a series of distinct periods of time over which we stand ready to perform, and is satisfied as we complete our obligation. Our contracts with PBM customers generally have a term of three years, while our specialty distribution contracts generally have a term of less than 30 days because each sale of prescription drugs is a separate contract. Our contracts to manage medical benefits and provide utilization management services generally have a term of three years. Since the remaining variable consideration will be allocated to a wholly unsatisfied promise that forms part of a single performance obligation recognized under the series guidance, we have applied the optional exemption to exclude this disclosure.
Note 3 - Fair value measurements
Authoritative guidance regarding fair value measurement establishes a three-tier fair value hierarchy, which prioritizes the inputs used in measuring fair value. These tiers include: Level 1, defined as observable inputs such as quoted prices in active markets for identical assets or liabilities; Level 2, defined as inputs other than quoted prices for similar assets and liabilities in active markets that are either directly or indirectly observable; and Level 3, defined as unobservable inputs for which little or no market data exists, therefore requiring an entity to develop its own assumptions.
Cash and cash equivalents include cash and investments in AAA-rated money market mutual funds with original maturities of less than 90 days. Cash and cash equivalents are stated at cost, which approximates fair value. These investments are classified within Level 1 of the fair value hierarchy because they are valued using quoted prices in active markets. The fair values of receivables, claims and rebates payable and accounts payable approximate carrying values due to the short-term maturities of these instruments.
The fair values, which approximate the carrying values, of our 2015 five-year term loan (Level 2) and commercial paper borrowings (Level 2) (as defined in Note 8 - Financing) were estimated using the current market rates for debt with similar maturities. The fair values of our senior notes, which are estimated based on observable market information (Level 2), were $12,799.9 million and $14,215.7 million as of September 30, 2018 and December 31, 2017, respectively. See Note 8 - Financing for further description of the carrying values of our debt. In determining the fair values of liabilities, we took into consideration the risk of nonperformance. Nonperformance risk refers to the risk the obligation will not be fulfilled and affects the value at which the liability would be transferred to a market participant. This risk did not have a material impact on the fair values of our liabilities.

13

Note 4 - Receivables, net

Included within “Receivables, net” are the following, which are reflected net of our allowance for doubtful accounts, customer credit allowances and contractual allowances:
(in millions)
September 30, 2018
 
December 31, 2017
Trade receivables, net of total reserves and allowances of $467.8 million and $466.6 million, respectively
$
4,070.4
   
$
4,101.6
 
Pharmaceutical manufacturers receivables, net of contractual allowances for certain rebates receivable of $442.7 million and $414.1 million, respectively
3,287.2
   
2,580.8
 
Other receivables
466.5
   
373.9
 
Total receivables, net
$
7,824.1
   
$
7,056.3
 

Note 5 - Acquisition
eviCore acquisition. Effective December 15, 2017, we acquired 100% of eviCore, a leading provider of integrated medical benefit management solutions that drive cost reductions and improved quality care outcomes, for approximately $3.6 billion. eviCore manages benefits in categories including radiology, cardiology, musculoskeletal disorders, post-acute care and medical oncology, and contracts with health plans and commercial clients to promote the appropriate use of healthcare services. eviCore is reported within our Other Business Operations segment.
We executed a contingent arrangement with certain equity holders, who are key employees of eviCore, in which $81.1 million will be paid 50% upon each of the second and third anniversaries of the effective date of the acquisition. The payments provided by the employment arrangements are forfeited if the employee voluntarily terminates prior to the anniversary dates. The payments are accrued over the three-year period as post combination services are rendered and included as compensation costs within “Selling, general, and administrative” expense in our consolidated statement of operations.
The consolidated statement of operations for the three and nine months ended September 30, 2018 includes eviCore’s revenues of $699.7 million and $2,004.6 million, respectively, and net loss of $1.8 million and $4.1 million, respectively. Net loss includes amortization expense of $14.1 million and $34.4 million related to the contingent arrangement described above for the three and nine months ended September 30, 2018, respectively.
The following represents the unaudited pro forma consolidated income statement as if eviCore had been included in the consolidated results of the Company’s operations for the three and nine months ended September 30, 2017. These amounts have been calculated after applying the Company’s accounting policies and adjusting the results of eviCore to reflect the additional depreciation and amortization that would have been charged assuming the fair value adjustments to intangible assets, redemption of debt outstanding and transaction costs incurred had been applied as of January 1, 2016, together with the consequential tax effects.
(in millions, except per share data)
For the three
months ended
September 30, 2017
 
For the nine
months ended
September 30, 2017
Total revenues
$
25,349.1
   
$
76,415.5
 
Net income attributable to Express Scripts
837.7
   
2,174.6
 
Basic earnings per share
1.47
   
3.72
 
Diluted earnings per share
$
1.46
   
$
3.70
 


14

The following table summarizes the estimated fair values of the assets acquired and liabilities assumed at the acquisition date.
(in millions)
Amounts
Recognized as of
Acquisition Date
Current assets
$
494.7
 
Property and equipment
15.2
 
Computer software
89.7
 
Goodwill
1,708.9
 
Acquired intangible assets
2,328.8
 
Other noncurrent assets
2.9
 
Current liabilities
(387.4
)
Deferred income taxes
(592.3
)
Other noncurrent liabilities
(9.0
)
Total
$
3,651.5
 

A portion of the excess of purchase price over tangible net assets acquired has been allocated to intangible assets. The acquired intangible assets have been valued using an income approach, which includes unobservable inputs such as assumptions regarding revenues, gross profit, growth rates and discount rates based on the forecasted business plan, economic projections, anticipated future cash flows and marketplace data. The acquired intangible assets are amortized on a basis that approximates the pattern of benefit:
 
Asset Value (in
millions)
 
Weighted-
average
amortization
period (in years)
Trade name
$
56.1
   
10.0
Customer relationships
2,272.7
   
20.0
Total intangibles
$
2,328.8
   
19.8
The excess of purchase price over tangible net assets and identified intangible assets acquired, $1,708.9 million, has been allocated to goodwill. The goodwill recognized as part of the acquisition is reported under our Other Business Operations segment and primarily reflects future economic benefits expected to arise from the Company’s growth within the medical benefit management market and the assembled workforce acquired. Approximately $397.0 million of the goodwill recognized is expected to be deductible for income tax purposes. Purchase accounting has been finalized in relation to this acquisition.
Note 6 - Goodwill and other intangible assets
Following is a summary of our goodwill and other intangible assets for our two reportable segments, PBM and Other Business Operations.


15

 
September 30, 2018
 
December 31, 2017
(in millions)
Gross Carrying Amount
 
Accumulated Amortization
 
Net Carrying Amount
 
Gross Carrying Amount
 
Accumulated Amortization
 
Net Carrying Amount
Goodwill
                     
PBM
$
29,434.2
   
$
(106.9
)
 
$
29,327.3
   
$
29,434.9
   
$
(107.0
)
 
$
29,327.9
 
Other Business Operations
1,783.2
   
   
1,783.2
   
1,771.8
   
   
1,771.8
 
 
$
31,217.4
   
$
(106.9
)
 
$
31,110.5
   
$
31,206.7
   
$
(107.0
)
 
$
31,099.7
 
Other intangible assets
                     
PBM
                     
Customer contracts
$
17,530.3
   
$
(11,395.2
)
 
$
6,135.1
   
$
17,579.0
   
$
(10,378.4
)
 
$
7,200.6
 
Trade names
232.5
   
(146.3
)
 
86.2
   
232.5
   
(128.8
)
 
103.7
 
 
17,762.8
   
(11,541.5
)
 
6,221.3
   
17,811.5
   
(10,507.2
)
 
7,304.3
 
Other Business Operations
                     
Customer relationships
2,282.5
   
(130.3
)
 
2,152.2
   
2,272.7
   
(7.0
)
 
2,265.7
 
Trade names
56.7
   
(4.7
)
 
52.0
   
56.1
   
(0.2
)
 
55.9
 
 
2,339.2
   
(135.0
)
 
2,204.2
   
2,328.8
   
(7.2
)
 
2,321.6
 
Total other intangible assets
$
20,102.0
   
$
(11,676.5
)
 
$
8,425.5
   
$
20,140.3
   
$
(10,514.4
)
 
$
9,625.9
 
Following is a summary of the change in the net carrying value of goodwill by reportable segment:
(in millions)
PBM
 
Other Business Operations
 
Total
Balance at December 31, 2017
$
29,327.9
   
$
1,771.8
   
$
31,099.7
 
Acquisitions(1)
   
11.4
   
11.4
 
Foreign currency translation
(0.6
)
 
   
(0.6
)
Balance at September 30, 2018
$
29,327.3
   
$
1,783.2
   
$
31,110.5
 
(1)
Represents the acquisition of a company in the first quarter of 2018 (which is not material to our consolidated financial statements) and an adjustment associated with net working capital for the eviCore acquisition. Purchase accounting has been finalized for both the acquisition of eviCore in the fourth quarter of 2017 and the acquisition in the first quarter of 2018.
The aggregate amount of amortization expense of other intangible assets was $403.5 million and $366.1 million for the three months ended September 30, 2018 and 2017, respectively, and $1,210.9 million and $1,092.6 million for the nine months ended September 30, 2018 and 2017, respectively.
Included in total amortization expense is $55.4 million for each of the three months ended September 30, 2018 and 2017, and $166.2 million for each of the nine months ended September 30, 2018 and 2017, related to our 10-year contract with Anthem, Inc. (“Anthem”) to provide PBM services to members of the affiliated health plans of Anthem, which is included as an offset to revenues.
The weighted-average amortization period of intangible assets subject to amortization is 16 years, and by major intangible asset class is 10 to 20 years for customer contracts and relationships and 4 to 10 years for trade names (excluding legacy Express Scripts, Inc. (“ESI”) trade names which have an indefinite life).


16

Note 7 - Earnings per share
Basic EPS is computed using the weighted-average number of common shares outstanding during the period. Diluted EPS is computed in the same manner as basic EPS, but adds the number of additional common shares that would have been outstanding for the period if the dilutive potential common shares had been issued. All shares are calculated under the “treasury stock” method. Following is the reconciliation between the number of weighted-average shares used in the basic and diluted EPS calculations:
 
Three Months Ended
 September 30,
 
Nine Months Ended
 September 30,
(in millions)
2018
 
2017
 
2018
 
2017
Weighted-average number of common shares outstanding during the period—basic
562.9
   
571.8
   
562.5
   
585.1
 
Dilutive common stock equivalents:(1)
             
Outstanding stock options, restricted stock units and executive deferred compensation units
5.0
   
2.9
   
4.3
   
3.3
 
Weighted-average number of common shares outstanding during the period—diluted
567.9
   
574.7
   
566.8
   
588.4
 
(1)
Excludes equity award shares of 1.1 million and 9.2 million for the three months ended September 30, 2018 and 2017, respectively, and 3.1 million and 9.2 million for the nine months ended September 30, 2018 and 2017, respectively, because the effect is anti-dilutive.
17

Note 8 - Financing
Our debt, issued by ESI, Medco Health Solutions, Inc. (“Medco”) and us, net of unamortized discounts, premiums and financing costs, consists of:
           
September 30, 2018
 
December 31, 2017
Long-term Debt
 
Issuer
 
Basis Points(1)
 
Carrying Amount (in millions)
Commercial paper
               
$3,500.0 million, commercial paper program(2)
 
Express Scripts
 
N/A
 
$
   
$
194.8
 
Senior notes(3)
               
$1,200.0 million, 7.125% senior notes due March 2018(4)
 
Medco
 
50
   
   
838.1
 
$1,000.0 million, 2.250% senior notes due June 2019(4)
 
Express Scripts
 
15
   
998.6
   
997.1
 
$500.0 million, 7.250% senior notes due June 2019(4)
 
ESI
 
50
   
337.1
   
336.7
 
$500.0 million, 4.125% senior notes due September 2020(4)
 
Medco
 
25
   
502.2
   
502.9
 
$500.0 million, 2.600% senior notes due November 2020(4)
 
Express Scripts
 
15
   
497.7
   
496.9
 
$400.0 million, floating rate senior notes due November 2020(5)
 
Express Scripts
 
N/A
 
398.2
   
397.6
 
$500.0 million, 3.300% senior notes due February 2021(4)
 
Express Scripts
 
35
   
497.6
   
496.9
 
$1,250.0 million, 4.750% senior notes due November 2021(4)
 
Express Scripts
 
45
   
1,243.1
   
1,241.6
 
$1,000.0 million, 3.900% senior notes due February 2022(4)
 
Express Scripts
 
40
   
989.3
   
987.0
 
$500.0 million, 3.050% senior notes due November 2022(4)
 
Express Scripts
 
15
   
495.9
   
495.2
 
$1,000.0 million, 3.000% senior notes due July 2023(4)
 
Express Scripts
 
25
   
994.5
   
993.6
 
$1,000.0 million, 3.500% senior notes due June 2024(4)
 
Express Scripts
 
20
   
990.9
   
989.8
 
$1,500.0 million, 4.500% senior notes due February 2026(4)
 
Express Scripts
 
45
   
1,484.6
   
1,483.1
 
$1,500.0 million, 3.400% senior notes due March 2027(6)
 
Express Scripts
 
30
   
1,490.6
   
1,489.8
 
$700.0 million, 6.125% senior notes due November 2041(4)
 
Express Scripts
 
50
   
444.3
   
444.2
 
$1,500.0 million, 4.800% senior notes due July 2046(4)
 
Express Scripts
 
40
   
1,484.0
   
1,483.6
 
Total senior notes
         
12,848.6
   
13,674.1
 
Term loan
               
$3,000.0 million, term loan due April 2020(7)
 
Express Scripts
 
N/A
 
2,146.9
   
2,145.5
 
Total debt
         
14,995.5
   
16,014.4
 
Current maturities of debt
               
$3,500.0 million, commercial paper program(2)
 
Express Scripts
 
N/A
 
   
194.8
 
$1,200.0 million, 7.125% senior notes due March 2018(3)(4)
 
Medco
 
50
 
   
838.1
 
$1,000.0 million, 2.250% senior notes due June 2019(3)(4)
 
Express Scripts
 
15
   
998.6
   
 
$500.0 million, 7.250% senior notes due June 2019(3)(4)
 
ESI
 
50
   
337.1
   
 
$3,000.0 million, term loan due April 2020(7)
 
Express Scripts
 
N/A
 
685.6
   
 
Total short-term debt and current maturities of long-term debt
         
2,021.3
   
1,032.9
 
Total long-term debt
         
$
12,974.2
   
$
14,981.5
 
(1)
All senior notes, except for the floating rate senior notes due November 2020, are redeemable prior to maturity at a price equal to the greater of (1) 100% of the aggregate principal amount of any notes being redeemed; or (2) the sum of the present values of the remaining scheduled payments of principal and interest on the notes being redeemed discounted to the redemption date on a semiannual basis (assuming a 360-day year consisting of twelve 30-day months) at the treasury rate plus the basis points as indicated, plus in each case, unpaid interest on the notes being redeemed accrued to the redemption date. The floating rate senior notes due November 2020 are redeemable prior to maturity at any time on or after December 3, 2018, at a redemption price equal to 100% of the principal amount of the notes being redeemed plus accrued and unpaid interest on the principal amount being redeemed.
(2)
The commercial paper program (defined below) had weighted-average daily short-term borrowings of $129.4 million and $220.1 million and an average interest rate of 1.83% and 1.49% from January 1, 2018 through March 31, 2018 and from inception of the program through December 31, 2017, respectively. There were no borrowings under the commercial paper program in the second and third quarters of 2018.
(3)
All senior notes are jointly and severally and fully and unconditionally (subject to certain customary release provisions, including sale, exchange, transfer or liquidation of the guarantor subsidiary) guaranteed on a senior unsecured basis by Express Scripts, ESI and Medco.
(4)
Senior notes require interest to be paid semi-annually, commencing six months subsequent to issuance.
(5)
The floating rate senior notes due November 2020 require interest to be paid quarterly beginning on March 1, 2018, until November 30, 2020, and had an average interest rate of 2.80% and 2.23% from January 1, 2018 through September 30, 2018 and from inception of the note through December 31, 2017, respectively.
(6)
Senior notes require interest to be paid semi-annually in March and September.
(7)
The 2015 five-year term loan (defined below) had an average interest rate of 3.02% and 2.30% as of September 30, 2018 and December 31, 2017, respectively.


18

Merger Agreement with Cigna. The Merger Agreement with Cigna limits our ability to incur additional indebtedness or to modify any of the terms of our outstanding debt obligations. The Merger Agreement generally provides that until closing or termination of the Merger Agreement, we cannot, without Cigna’s consent (which shall not be unreasonably withheld, conditioned or delayed), incur, assume, endorse, guarantee or otherwise become liable for, or modify the terms of, any indebtedness or issue or sell any debt securities or calls, options, warrants or other rights to acquire any debt securities, subject to certain exceptions.
Bank credit facilities. We have a credit agreement which includes a $3.5 billion revolving facility (the “2022 revolving facility”) and a five-year $3.0 billion term loan (the “2015 five-year term loan”). At September 30, 2018, no amounts were drawn under the 2022 revolving facility. At September 30, 2018, $685.6 million of the 2015 five-year term loan which includes a proportionate amount of unamortized financing costs were considered current maturities of long-term debt.
The credit agreement requires interest to be paid, at our option, at LIBOR or an adjusted base rate, plus applicable margin. The applicable margin over LIBOR ranges from 0.805% to 1.300% for the 2022 revolving facility, depending on our credit ratings and consolidated leverage ratio, and ranges from 1.000% to 1.500% for the 2015 five-year term loan, depending on our consolidated leverage ratio. The applicable margin over the adjusted base rate ranges from 0.000% to 0.300% for the 2022 revolving facility, and 0.000% to 0.500% for the 2015 five-year term loan. We are required to pay commitment fees on the 2022 revolving facility, which range from 0.070% to 0.200% of the revolving loan commitments, depending on our credit ratings and consolidated leverage ratio.
In February 2018, a $130.0 million uncommitted revolving credit facility was terminated and in May 2018, a $150.0 million uncommitted credit agreement expired.
Commercial paper. We have a commercial paper program under which we may issue short-term, unsecured commercial paper notes from time to time on a private placement basis up to a maximum aggregate amount outstanding at any time of $3.5 billion. The commercial paper program does not increase our borrowing capacity as it is fully backed by our 2022 revolving facility. The commercial paper notes are jointly and severally and fully and unconditionally guaranteed on a senior unsecured basis by ESI, Medco and us. There were no commercial paper notes outstanding as of September 30, 2018.
Covenants. Our bank financing arrangements and senior notes contain certain customary covenants that restrict our ability to incur additional indebtedness, create or permit liens on assets and engage in mergers or consolidations. The covenants related to bank financing arrangements also include, among other things, a maximum leverage ratio. See above for description of the impact of the Merger Agreement on our financing activities. At September 30, 2018, we were in compliance with all covenants associated with our debt instruments.

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Note 9 - Income taxes
Our effective tax rate attributable to Express Scripts decreased to 20.5% and 22.8% for the three and nine months ended September 30, 2018, respectively, from 37.2% for each of the same periods in 2017, primarily due to the impact of the reduction in federal corporate statutory rates from 35% to 21% due to federal tax reform legislation (the “Tax Act”) enacted on December 22, 2017, and changes in discrete tax items.
We recognized net discrete benefits of $41.5 million and $25.8 million for the three and nine months ended September 30, 2018, respectively, compared to net discrete charges of $5.8 million and $15.5 million for the same periods in 2017. Our 2018 net discrete benefits primarily relate to changes in our unrecognized tax benefits as a result of lapses in statutes of limitations. Our 2017 net discrete charges primarily relate to additions in our unrecognized tax benefits on prior year tax positions and a revaluation of our deferred tax attributes due to changes in effective tax rates offset by a reduction in our unrecognized tax benefits due to settlement of prior year examinations and prior year claims.
As of December 31, 2017, we recorded estimated provisional adjustments associated with the impacts of the remeasurement of federal net deferred tax liabilities resulting from the permanent reduction in the federal corporate tax rate to 21% and the mandatory one-time tax on accumulated earnings of our foreign subsidiaries. We have not made any additional measurement period adjustments related to these items during the three or nine months ended September 30, 2018, but we could make adjustments to the provisional amounts in the future based on any additional guidance issued by the U.S. Treasury Department, the Internal Revenue Service or other standard-setting bodies.

Note 10 - Common stock
There were no repurchases of the Company’s common stock during the third quarter of 2018. However, we repurchased 5.4 million shares for $411.3 million during the nine months ended September 30, 2018, and 11.5 million and 43.3 million shares for $712.8 million and $2,770.2 million during the three and nine months ended September 30, 2017, respectively. As of September 30, 2018, there were 72.9 million shares remaining under our share repurchase program. Share repurchases, made during the nine months ended September 30, 2018, were made pursuant to a Rule 10b5-1 plan implemented on November 28, 2017 (the “November 2017 Rule 10b5-1 plan”). The November 2017 Rule 10b5-1 plan was terminated on March 8, 2018. Share repurchases, made during the three and nine months ended September 30, 2017, were made pursuant to Rule 10b5-1 plans implemented on February 15, 2017 (the “February 2017 Rule 10b5-1 plan”) and July 26, 2017 (the “July 2017 Rule 10b5-1 plan”), as well as through open market purchases. The February 2017 Rule 10b5-1 plan was completed on June 30, 2017, and the July 2017 Rule 10b5-1 plan was completed on October 9, 2017. Pursuant to the Merger Agreement with Cigna, we may not, without Cigna’s consent, repurchase shares (subject to limited exceptions related to equity awards) until closing or termination of the Merger Agreement.
Note 11 - Stock-based compensation plans
Under the 2016 Long-Term Incentive Plan (the “2016 LTIP”), we may issue stock options, stock appreciation rights (“SARs”), restricted stock awards, restricted stock units, performance shares and other types of awards. The maximum number of shares available for awards under the 2016 LTIP is 33.0 million. The maximum term of stock options, SARs, restricted stock awards, restricted stock units and performance shares granted under the 2016 LTIP is 10 years.
Effective May 4, 2016, no additional awards may be granted under the 2011 Long-Term Incentive Plan (the “2011 LTIP”), the Accredo Health, Incorporated 2002 Long-Term Incentive Plan (the “Accredo Plan”), the ESI 2000 Long-Term Incentive Plan (the “2000 LTIP”) or the Medco 2002 Stock Incentive Plan (the “2002 SIP”) (except to settle awards outstanding under these plans), all of which previously authorized the grant of various equity awards with various terms to our officers, members of our Board of Directors and other key employees. However, the terms of these plans will continue to govern awards outstanding under these plans.

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The provisions of the 2016 LTIP, the 2011 LTIP, the Accredo Plan, the 2000 LTIP and the 2002 SIP (collectively, the “stock incentive plans”) allow employees to use shares to cover tax withholdings on equity awards (a feature which has been approved by the Compensation Committee of our Board of Directors). Upon vesting of restricted stock units and performance shares, employees have taxable income subject to statutory withholding requirements. The number of shares issued to employees may be reduced by the number of shares having a market value equal to the statutory withholding requirements for federal, state and local tax purposes.
Under the stock incentive plans, we have issued stock options, restricted stock units and performance shares. All such awards are settled by issuance of new shares. Awards granted under the stock incentive plans are subject to accelerated vesting under certain specified circumstances, including upon a change in control and termination, and are also subject to forfeiture without consideration upon termination of employment under certain circumstances. The maximum term of stock options, restricted stock units and performance shares is generally 10 years.
We recognized stock-based compensation expense of $29.0 million and $25.9 million for the three months ended September 30, 2018 and 2017, respectively, and $89.7 million and $78.0 million in the nine months ended September 30, 2018 and 2017, respectively. Unamortized stock-based compensation expense as of September 30, 2018 was $12.7 million for stock options and $100.7 million for restricted stock units and performance shares.
Stock options. During the nine months ended September 30, 2018, we granted 0.8 million stock options with a weighted-average fair market value of $16.27 per share. Stock options granted generally have three-year graded vesting. There were no stock options issued during the three months ended September 30, 2018 or 2017.
The fair value of stock options granted was estimated on the date of grant using a Black-Scholes multiple option-pricing model with the following weighted-average assumptions:
 
Nine Months Ended
 September 30,
 
2018
 
2017
Expected life of option
3-5 years
 
3-5 years
Risk-free interest rate
2.4%-2.7%
 
1.5%-2.1%
Expected volatility of stock
21%-24%
 
21%-23%
Expected dividend yield
None
 
None
The Black-Scholes model requires subjective assumptions, including future stock price volatility and expected time to exercise, which greatly affect the calculated values. The expected term and forfeiture rate of stock options granted is derived from historical data of employee exercises and post-vesting employment termination behavior as well as expected behavior on outstanding stock options. The risk-free rate is based on the United States Treasury rates in effect during the corresponding period of grant. The expected volatility is based on the historical volatility of our stock price. These factors could change in the future, which would affect the stock-based compensation expense recognized in future periods.
Restricted stock units and performance shares. During the nine months ended September 30, 2018, we granted 1.7 million restricted stock units and performance shares with a weighted-average fair market value of $73.73 per share. Restricted stock units generally have three-year graded vesting. Performance shares generally have three-year cliff vesting. The number of performance shares that ultimately vest is dependent upon the achievement of specific performance metrics. The original grant of performance shares is subject to a multiplier of up to 2.5 based on the achievement of the performance metrics. Due to the achievement of certain performance metrics, during the nine months ended September 30, 2018, 0.1 million shares of common stock were issued in settlement of performance shares granted in March 2015.


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Note 12 - Commitments and contingencies
We are subject to various legal proceedings, investigations, government inquiries and claims pending against us or our subsidiaries, including, but not limited to, those relating to regulatory, commercial, employment and employee benefits. We record accruals for certain of our outstanding legal proceedings, investigations and claims when we believe it is probable a liability will be incurred and the amount of loss can be reasonably estimated. On a quarterly basis, we evaluate developments in legal proceedings, investigations and claims that could affect the amount of any accrual, as well as any developments that would make a loss both probable and reasonably estimable.
We record self-insurance accruals based on estimates of the aggregate liability of claim costs (including defense costs) in excess of our insurance coverage. The majority of these claims are legal claims and our liability estimate is primarily related to the cost to defend these claims. We do not accrue for settlements, judgments, monetary fines or penalties until such amounts are probable and estimable. If the range of possible loss is broad, and no amount within the range is more likely than any other, the liability accrual is based on the low end of the range.
When a loss contingency is not believed to be both probable and estimable, we do not establish an accrued liability. However, if the loss (or an additional loss in excess of the accrual) is believed to be at least a reasonable possibility and material, we disclose an estimate of the possible loss or range of loss, if such estimate can be made, or disclose an estimate cannot be made.
The legal proceedings, investigations, government inquiries and claims pending against us or our subsidiaries include, among others, multi-district litigation, class action lawsuits, antitrust allegations, qui tam lawsuits (“whistleblower” actions) and various governmental inquiries and informational subpoenas.
The assessment of whether a loss is probable and reasonably estimable involves a series of complex judgments about future events. We are often unable to estimate a range of loss due to significant uncertainties, particularly where (i) the damages sought are unspecified or indeterminate; (ii) the proceedings are in the early stages; (iii) the matters involve novel or unsettled legal theories or a large number of parties; (iv) class action status may be sought and certified; (v) it is questionable whether asserted claims or allegations will survive dispositive motion practice; (vi) the impact of discovery on the legal process is unknown; (vii) the settlement posture of the parties has not been determined and/or (viii) in the case of certain government agency investigations, whether a sealed qui tam lawsuit has been filed and whether the government agency makes a decision to intervene in the lawsuit following investigation. Accordingly, for many proceedings, we are currently unable to estimate the loss or a range of possible loss.
For a limited number of proceedings, we may be able to reasonably estimate the possible range of loss in excess of any accruals. However, we believe such proceedings, individually and in the aggregate, when finally resolved, are not reasonably likely to have a material adverse effect on our cash flow or financial condition. We also believe any amount that could be reasonably estimated in excess of accruals, if any, for such proceedings is not material. However, an unexpected adverse resolution of one or more of such matters could have a material adverse effect on our results of operations in a particular quarter or fiscal year. For purposes of this Note 12, the “Company” refers to Express Scripts Holding Company and its subsidiaries if named as defendants or identified as the subjects in the matters described below.
We cannot predict the timing or outcome of the matters described below:
Jerry Beeman, et al. v. Caremark, et al. Plaintiffs allege that the Company and the other defendants failed to comply with statutory obligations to provide California clients with the results of a bi-annual survey of retail drug prices. On November 14, 2016, the district court denied plaintiffs’ motion for class certification, holding that the proposed class representatives and counsel were inadequate to represent a class. On October 6, 2017, defendants moved for sanctions against plaintiffs for destroying evidence, requesting the case be dismissed with prejudice, which the court granted on January 4, 2018. On August 21, 2018, plaintiffs filed an appellate brief. On October 22, 2018, appellees’ brief was filed.


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Anthem, Inc. v. Express Scripts, Inc. Anthem, Inc. (for purposes of this Note 12, “Anthem”) filed this lawsuit alleging various breach of contract claims against the Company relating to the parties’ rights and obligations under the periodic pricing review section of the pharmacy benefit management agreement between the parties, including allegations that the Company failed to negotiate new pricing concessions in good faith, as well as various alleged service issues. Anthem requests the court enter declaratory judgment that the Company is required to provide Anthem competitive benchmark pricing, that Anthem can terminate the agreement, and that the Company is required to provide Anthem with post-termination services at competitive benchmark pricing for one year following any termination by Anthem. Anthem claims it is entitled to $13.0 billion in additional pricing concessions over the remaining term of the agreement as well as $1.8 billion for one year following any contract termination by Anthem, and $150.0 million in damages for service issues (for purposes of this Note 12, “Anthem’s Allegations”). On April 19, 2016, in response to Anthem’s complaint, the Company filed its answer denying Anthem’s Allegations in their entirety and asserting affirmative defenses and counterclaims against Anthem. The court subsequently granted Anthem’s motion to dismiss two of six counts of the Company’s amended counterclaims.
In re Express Scripts Holding Company Securities Litigation. Plaintiff filed this putative securities class action complaint on behalf of all persons or entities that purchased or otherwise acquired the Company’s publicly traded common stock between February 24, 2015 and March 21, 2016, and alleges the Company and named individuals violated Sections 10(b) and 20(a) of the Securities Exchange Act of 1934 (“the “Exchange Act”) and Rule 10b-5 thereunder by carrying out a scheme to defraud the investing public. Plaintiff seeks compensatory damages in favor of plaintiff and other class members, attorneys’ fees and costs, and equitable relief. Plaintiff adopts many of Anthem’s Allegations in support of their claim. On August 1, 2017, the court granted the Company’s motion to dismiss the complaint in its entirety. On August 30, 2017, Plaintiff filed an amended complaint alleging similar claims, and defendants moved to dismiss. On May 22, 2018, the court granted defendants’ motion to dismiss. On September 10, 2018, plaintiffs filed an appellate brief.
M. Scott Brewer, et al., in their capacities as Trustees for the Carpenters Pension Fund of West Virginia, derivatively on behalf of Express Scripts Holding Company v. Maura C. Breen, et al. (“Carpenters”). Plaintiffs filed this stockholder derivative lawsuit alleging certain current and former officers and directors of the Company breached fiduciary duties and were unjustly enriched and also asserting a claim for corporate waste. Plaintiffs adopted many of Anthem’s Allegations in support of their claim. Plaintiffs sought damages on behalf of the Company from the individual defendants; an accounting by the individual defendants for all damages, profits, special benefits and unjust enrichment and imposition of a constructive trust; judgment directing the Company to take all necessary actions to reform and improve its corporate governance and internal control procedures; punitive damages; and an award of attorneys’ fees and costs. On January 23, 2018, the court granted defendants’ motion to dismiss the case in its entirety without prejudice. Plaintiffs filed an amended complaint on February 28, 2018. On May 18, 2018, plaintiffs filed a stipulated notice of voluntary dismissal and the court entered an order dismissing the case on May 21, 2018.
Randy Green v. George Paz, et al. Plaintiff alleges certain current and former officers and directors of the Company breached fiduciary duties and were unjustly enriched. Plaintiff adopts many of Anthem’s Allegations in support of his claims that individual defendants breached fiduciary duties of loyalty, good faith, fair dealing, and candor, which caused the Company to issue false and misleading statements regarding the Company’s relationship with Anthem, and for contribution to and indemnification of the Company in connection with all claims that have been, are, or may in the future be asserted against the Company because of the individual defendants’ wrongdoing. On June 12, 2017, the court stayed this action until resolution of the Carpenters derivative action, described above, in the United States District Court for the Southern District of New York. On October 1, 2018, the court consolidated the Green action and the Elow action described below and ordered that the consolidated action remain stayed pending completion of the Cigna-Express Scripts transaction.
Missouri State Action (Circuit Court of St. Louis County, State of Missouri). The following three cases have been consolidated in Missouri state court: Abraham Neufeld, derivatively on behalf of nominal defendant Express Scripts Holding Company v. George Paz, et al.; Robert Jessup, derivatively on behalf of Express Scripts Holding Company v. Timothy Wentworth, et al.; and Richard Weisglas, derivatively on behalf of Express Scripts Holding Company v. Express Scripts Holding Company, George Paz, et al. These cases were consolidated on December 21, 2016, and on April 13, 2017, plaintiffs filed a consolidated amended complaint. Plaintiffs’ consolidated amended complaint alleges certain current and former officers and directors of the Company breached fiduciary duties and were unjustly enriched, and that certain defendants engaged in “insider selling.” Plaintiffs adopt many of Anthem’s Allegations in support of their claims that the individual defendants breached fiduciary duties of loyalty, good faith, candor, and due care, which caused the Company to issue false and misleading statements regarding the Company’s relationship with Anthem. Plaintiffs seek damages on behalf of the Company from the individual defendants, equitable relief, and attorneys’ fees and costs. On August 11, 2017, the court stayed this action until resolution of the Carpenters derivative action, described above, in the United States District Court for the Southern District of New York. On August 1, 2018, plaintiffs filed a notice of voluntary dismissal, and the court entered an order dismissing the consolidated action on August 6, 2018.


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Kurt Wilson v. George Paz, et al. Plaintiff alleges that certain current and former officers and directors of the Company breached fiduciary duties, were unjustly enriched, committed abuse of control and gross mismanagement, and that certain defendants engaged in “insider selling.” Plaintiff adopts many of Anthem’s Allegations in support of the claims that the individual defendants breached fiduciary duties of loyalty, good faith, candor, and due care, which caused the Company to issue false and misleading statements regarding the Company’s relationship with Anthem. Plaintiff seeks damages on behalf of the Company from the individual defendants, equitable relief, and attorneys’ fees and costs. On December 8, 2017, the court stayed this action until resolution of the Carpenters derivative action, described above, in the United States District Court for the Southern District of New York. On July 24, 2018, plaintiff filed a notice of voluntary dismissal, and the court entered an order dismissing the case on July 30, 2018.
Clifford Elow, et al. v. George Paz, et al. Plaintiff alleges that certain current and former officers and directors of the Company breached fiduciary duties, caused the Company to waste assets, and violated Section 10(b) of the Exchange Act and SEC Rule 10b-5 in connection with stock repurchases. Plaintiff adopts many of Anthem’s Allegations in support of his claims that individual defendants breached fiduciary duties of loyalty, good faith, fair dealing, and candor, which caused the Company to issue false and misleading statements regarding the Company’s relationship with Anthem, as well as his claims that the individual defendants failed to properly oversee management of the Anthem agreement and relationship. Plaintiff seeks damages on behalf of the Company from the individual defendants, corporate governance reform, and attorneys’ fees and costs. On October 1, 2018, the court consolidated the Green action described above and the Elow action and ordered that the consolidated action remain stayed pending completion of the Cigna-Express Scripts transaction.
In re Express Scripts/Anthem ERISA Litigation (consolidating John Doe One and John Doe Two v. Express Scripts, Inc. and Karen Burnett, Brendan Farrell, and Robert Shullich v. Express Scripts, Inc. and Anthem, Inc.). Plaintiffs filed a Second Amended Consolidated Class Action Complaint on behalf of health plan beneficiaries who are enrolled in health care plans that are insured or administered by Anthem. Plaintiffs allege that the Company and Anthem breached fiduciary duties and otherwise violated their legal obligations under ERISA, that the Company engaged in mail fraud, wire fraud and other racketeering activity through its invoicing system with Anthem, that the Company breached its contract with Anthem, that plaintiffs are entitled to equitable relief under theories including unjust enrichment, that the Company violated unfair and deceptive trade practices statutes, that Anthem breached the covenant of good faith and fair dealing implied in health plans, and that ESI violated the anti-discrimination provisions of the Affordable Care Act. Plaintiffs adopt many of Anthem’s Allegations in support of their claim. Plaintiffs seek compensatory damages, declaratory relief, equitable relief and attorneys’ fees and costs. The Company’s motion to dismiss was granted on January 5, 2018. On April 11, 2018, plaintiffs filed an appellate brief. On May 2, 2018, an amicus brief in support of appellants was filed by the American Association of Retired Persons and National Employment Lawyers Association. On May 30, 2018, appellees’ briefs were filed. On June 20, 2018, an amicus brief in support of appellees was filed by Pharmaceutical Care Management Association, Association of Health Insurance Plans, and the Chamber of Commerce. On July 5, 2018, appellants filed a reply brief, and the appeal is now fully briefed. The court held oral argument on October 19, 2018 and we await the court’s decision.


24


Jeanine Prescott, et al. v. CVS Health Corporation, et al. Plaintiffs allege, inter alia, that the defendants entered into “exclusionary” agreements that granted exclusive formulary placement for certain blood glucose test strips in return for higher rebate payments. The complaint alleges that these agreements had the effect of driving up the costs of such test strips for the putative class members and violated RICO, ERISA and the competition and consumer protection laws of various states. Plaintiffs seek treble damages, equitable relief and attorneys’ fees and costs. On November 28, 2017, the court granted the motion of certain defendants, including the Company, to transfer this action to the United States District Court for the District of New Jersey.
Michael Bewley, et al. v. CVS Health Corporation, et al. Plaintiffs allege, inter alia, that the defendants entered into “exclusionary” agreements that granted exclusive formulary placement for certain glucagon products in return for higher rebate payments. The complaint alleges that these agreements had the effect of driving up the costs of such products for the putative class members and violated Sections 1 and 3 of the Sherman Act, RICO, ERISA and the competition and consumer protection laws of various states, U.S. territories and the District of Columbia. Plaintiffs seek treble damages, equitable relief and attorneys’ fees and costs. On November 7, 2017, the court granted defendants’ motion to transfer this action to the United States District Court for the District of New Jersey.
In re: EpiPen ERISA Litigation. Plaintiffs filed a consolidated class action complaint on April 2, 2018, alleging that defendants violated legal obligations under ERISA by negotiating increasingly large rebates from Mylan, which allegedly caused an increase in the price of EpiPen products. Plaintiffs further allege that defendants retained a significant portion of rebates, rather than passing them on to class members (who are participants in, or beneficiaries of, health insurance plans governed by ERISA who purchased EpiPen products). On June 1, 2018, defendants filed a motion to dismiss, which was granted in part and denied in part on October 26, 2018.
City of Rockford and Acument Global Technologies, Inc. v. Mallinckrodt ARD, Inc., f/k/a Questcor Pharmaceuticals, Inc., Mallinckrodt plc, Express Scripts Holding Company, Express Scripts, Inc., CuraScript, Inc., d/b/a CuraScript, SD, Accredo Health Group, Inc., and United BioSource Corporation. Plaintiffs filed a second amended complaint on behalf of a putative class of third party payors for Acthar and their beneficiaries alleging that Mallinckrodt ARD, Inc. and Mallinckrodt plc (for purposes of this Note 12, collectively “Mallinckrodt”), the manufacturer of Acthar, an adrenocorticotropic hormone (“ACTH”), unlawfully maintained a monopoly in an alleged market for ACTH drugs by, inter alia, acquiring its only potential competitor. Plaintiffs also allege that Mallinckrodt and the Company fixed the price of Acthar, and that alleged agreements involving CuraScript, Inc., Accredo Health Group, Inc., and United BioSource Corporation unlawfully restrain trade. Plaintiffs assert claims under Sections 1 and 2 of the Sherman Act, various state antitrust laws, and RICO, as well as claims for common law fraud and unjust enrichment. Further, the City of Rockford (“Rockford”) alleges that the Company breached its PBM Services Agreement with Rockford and asserts claims for breach of contract, promissory estoppel, and breach of the implied covenant of good faith and fair dealing, and also seeks a declaratory judgment. Plaintiffs seek treble damages, equitable relief, and attorneys’ fees and costs. On January 22, 2018, the Company defendants filed a motion to dismiss the second amended complaint, which has been fully briefed and we await the court’s ruling.
MSP Recovery Claims, Series LLC, MAO-MSO Recovery II, LLC, MSP Recovery, LLC, MSPA Claims 1, LLC v. Mallinckrodt Ard, Inc., f/k/a Questcor Pharmaceuticals, Inc., Mallinckrodt PLC, and United BioSource Corporation. (“UBC”). Plaintiffs make similar allegations to those in the Rockford complaint filed in April 2017. Pursuant to the terms of the Company’s agreement providing for the sale of UBC, the Company has agreed to indemnify UBC for, and retain the responsibility for the defense of, this action. On February 23, 2018, UBC filed a motion to dismiss the complaint, which has been fully briefed and we await the court’s ruling.
We are the subject of shareholder securities cases relating to the proposed merger with Cigna, including:
Abraham Neufeld, et al, v. Express Scripts Holding Company, et al.; Lawrence Zucker, et al. v. Express Scripts Holding Company, et al.; Walter Stern, et al. v. Express Scripts Holding Company, et al.; Kurt Wilson, et al. v. Express Scripts Holding Company, et al.; Phillip Buckingham, et al. v. Express Scripts Holding Company, et al.; and Robert Wolfe, et al. v. Express Scripts Holding Company, et al. Plaintiffs filed putative class action complaints against Express Scripts and the members of its board of directors alleging the registration statements filed in connection with the mergers of Express Scripts and Cigna omitted material information in violation of Sections 14(a) and 20(a) of the Exchange Act, rendering the registration statements false and misleading. Among other remedies, the complaints seek to enjoin the Express Scripts special meeting and the closing of the mergers, as well as damages, costs and attorneys’ fees. On August 29, 2018, plaintiff in the Stern action filed a notice of voluntary dismissal, and the court closed the case on August 30, 2018. On October 17, 2018, plaintiff in the Wilson action filed a notice of voluntary dismissal, and the court closed the case on October 17, 2018.


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We are the subject of various qui tam matters, including:
Health Choice Alliance, LLC, on behalf of the United States of America, et al. v. Eli Lilly and Company, Inc., Healthstar Communications, Inc., VMS Biomarketing, Covance, Inc., Covance Market Access Services, Inc., and United Biosource Corporation. A lawsuit was filed against Eli Lilly and Company, Inc. (“Lilly”) and its vendors, including UBC, regarding services Lilly engaged them to provide with respect to insulin drugs Humalog and Humulin and osteoporosis drug Forteo (collectively, the “Lilly Products”). Pursuant to the terms of the Company’s agreement providing for the sale of UBC, the Company has agreed to indemnify UBC for, and retain the responsibility for the defense of, this action. The relator claims that: (1) Healthstar Communications, Inc. and VMS Biomarketing assisted Lilly in providing in-kind remuneration to prescribers in the form of free nursing services to induce such prescribers to prescribe the Lilly Products; (2) Lilly contracted with and paid remuneration to nurse educators to recommend the Lilly Products; and (3) Covance, Inc. and UBC assisted Lilly in providing in-kind remuneration to prescribers in the form of reimbursement support services that saved prescribers administrative expenses, which services were provided to induce such prescribers to prescribe the Lilly Products. The relator alleges these were kickbacks that violated the federal Anti-Kickback Statute. The relator alleges that the defendants violated the federal False Claims Act and state false claims acts by submitting claims for payment for the Lilly Products to government health programs, including Medicare and Medicaid, that were rendered false by virtue of the violations of the federal Anti-Kickback Statute. The relator seeks treble damages, civil penalties and restitution. On January 12, 2018, plaintiffs filed a first amended complaint. On February 21, 2018, UBC filed a motion to dismiss the first amended complaint. On August 10, 2018, the court entered an order adopting the magistrate’s Report and Recommendation dismissing relator’s claims without prejudice. On September 12, 2018, relator filed a second amended complaint, adding Covance Market Access Services, Inc. as a defendant and alleging the same theories.
We have received and intend to cooperate with various subpoenas or other requests from government agencies seeking information and have included descriptions of certain specific requests below:
Insulin/Epinephrine Pricing Investigations. The Company has received inquiries from various state Attorneys General offices in connection with pending investigations into potential unfair and deceptive acts or practices related to the pricing, reimbursement and rebates for insulin and epinephrine products and possible contracts, combinations or conspiracies in restraint of trade in the setting of prices for insulin and epinephrine products.
Opioids Investigations. The Company received a request for information from the Office of Attorney General of New York regarding steps taken by the Company to fight opioid abuse in connection with a pending investigation into opioid-related deaths, overdoses, and hospitalizations.
Relationships with Pharmaceutical Manufacturers. The Company has received inquiries relating to its contractual relationships with pharmaceutical manufacturers.
Investigations under the federal False Claims Act and most state false claims acts may be initiated by the applicable government investigative body or by a qui tam relator’s filing of a complaint under court seal. If a qui tam relator’s complaint remained under seal, applicable law would restrict our ability to disclose such a fact.
In addition to the foregoing matters there have arisen various legal proceedings, government investigations, inquiries and audits or claims in the ordinary course of our business now pending against us or our subsidiaries. The effect of these actions on future financial results is not subject to reasonable estimation because the proceedings are in early stages and/or considerable uncertainty exists about the outcomes. Where insurance coverage is not available for such claims, or is not cost-effective, we maintain self-insurance accruals to reduce our exposure to future legal costs, settlements and judgments related to uninsured claims. Our self-insured accruals are based on estimates of the aggregate liability for the costs of uninsured claims incurred and the retained portion of insured claims using certain actuarial assumptions followed in the insurance industry and our experience. It is not possible to predict with certainty the outcome of these claims, and we can give no assurance that any losses in excess of our insurance and any self-insurance accruals will not be material.


26


Note 13 - Enterprise value initiative
In the third quarter of 2017, we launched a multi-year, enterprise-wide value initiative (“EVI”) to transform our organization through the end of 2021, in part due to the decision by Anthem not to renew our contract, which expires at the end of 2019. We are investing to deliver an improved experience with better engagement and greater efficiency and evolve the way we do business with patients, providers and our clients. Our EVI is currently estimated to incur a cost of approximately $600.0 million to $650.0 million, which is expected to be incurred through 2021. EVI reflects Express Scripts as an independent company and does not incorporate any impacts of closing the Cigna transaction.
We incurred incremental costs within the PBM segment to achieve the future benefit of our enterprise value initiative. The components of these incremental costs are detailed below.
 
Three Months Ended
 September 30,
 
Nine Months Ended
 September 30,
(in millions)
2018
 
2017
 
2018
 
2017
Consulting and temporary labor
$
20.4
   
$
19.6
   
$
46.8
   
$
19.6
 
Severance and related benefit costs
1.1
   
3.3
   
23.9
   
3.3
 
Accelerated depreciation
0.6
   
0.4
   
2.0
   
0.4
 
Site closures
3.0
   
   
6.0
   
 
Technology
3.1
   
   
12.8
   
 
Total EVI costs
$
28.2
   
$
23.3
   
$
91.5
   
$
23.3
 
Of the total EVI costs above, $7.2 million and $39.9 million are reflected in “Cost of revenues” within our consolidated statement of operations for the three and nine months ended September 30, 2018, respectively, as is $2.4 million for each of the three and nine months ended September 30, 2017. The costs above include $21.0 million and $51.6 million reflected in “Selling, general and administrative,” within our consolidated statement of operations for the three and nine months ended September 30, 2018, respectively, and $20.9 million for each of the three and nine months ended September 30, 2017.
In addition to the costs noted above, we have capitalized $31.6 million of software development expenditures as of September 30, 2018; no costs were capitalized as of December 31, 2017.

Total pre-tax charges related to our enterprise value initiative since the inception of the initiative through September 30, 2018 have totaled approximately $134.3 million.
We did not have material liabilities related to our enterprise value initiative as of September 30, 2018 or December 31, 2017.


27

Note 14 - Segment information
We report segments on the basis of products and services offered and have determined we have two reportable segments: PBM and Other Business Operations. Within the Other Business Operations segment, we have aggregated two operating segments (CuraScript Specialty Distribution and eviCore) that do not meet the quantitative and qualitative criteria to be separately reported. eviCore was acquired on December 15, 2017. Prior to UBC’s sale on December 27, 2017, the Other Business Operations segment also aggregated our UBC operating segment.
Operating income is the measure used by our chief operating decision maker to assess the performance of each of our operating segments. Following is information about our reportable segments, including a reconciliation of operating income to income before income taxes for the three and nine months ended September 30, 2018 and 2017.
(in millions)
PBM(1)
 
Other Business Operations(2)
 
Total
For the three months ended September 30, 2018
         
Product revenues(3)(4)
$
23,441.3
   
$
1,107.8
   
$
24,549.1
 
Service revenues
314.4
   
699.7
   
1,014.1
 
Total revenues
23,755.7
   
1,807.5
   
25,563.2
 
Depreciation and amortization expense
443.8
   
53.9
   
497.7
 
Operating income
1,459.7
   
28.9
   
1,488.6
 
Interest income and other
       
13.0
 
Interest expense and other
       
(151.0
)
Income before income taxes
       
1,350.6
 
Capital expenditures
62.1
   
3.4
   
65.5
 
For the three months ended September 30, 2017
         
Product revenues(3)
$
23,131.2
   
$
1,130.2
   
$
24,261.4
 
Service revenues(5)
341.9
   
80.1
   
422.0
 
Total revenues
23,473.1
   
1,210.3
   
24,683.4
 
Depreciation and amortization expense
443.5
   
5.9
   
449.4
 
Operating income
1,456.3
   
22.1
   
1,478.4
 
Interest income and other
       
13.6
 
Interest expense and other
       
(147.7
)
Income before income taxes
       
1,344.3
 
Capital expenditures
67.8
   
4.2
   
72.0
 
For the nine months ended September 30, 2018
         
Product revenues(3)(4)
$
69,898.0
   
$
3,151.8
   
$
73,049.8
 
Service revenues
920.0
   
2,004.6
   
2,924.6
 
Total revenues
70,818.0
   
5,156.4
   
75,974.4
 
Depreciation and amortization expense
1,342.7
   
157.5
   
1,500.2
 
Operating income
3,670.8
   
91.6
   
3,762.4
 
Interest income and other
       
33.8
 
Interest expense and other
       
(456.3
)
Income before income taxes
       
3,339.9
 
Capital expenditures
218.0
   
23.3
   
241.3
 
For the nine months ended September 30, 2017
         
Product revenues(3)
$
70,124.7
   
$
3,270.5
   
$
73,395.2
 
Service revenues(5)
1,041.4
   
249.2
   
1,290.6
 
Total revenues
71,166.1
   
3,519.7
   
74,685.8
 
Depreciation and amortization expense
1,326.3
   
17.9
   
1,344.2
 
Operating income
3,855.8
   
55.8
   
3,911.6
 
Interest income and other
       
28.7
 
Interest expense and other
       
(439.9
)
Income before income taxes
       
3,500.4
 
Capital expenditures
164.9
   
12.4
   
177.3
 

(1)
Includes the results of operations for myMatrixx Holdings, Inc. (“myMatrixx”) subsequent to acquisition on May 15, 2017.
(2)
Includes the results of operations for eviCore subsequent to acquisition on December 15, 2017, and results of operations for UBC prior to sale on December 27, 2017.
(3)
Includes retail pharmacy co-payments of $1,945.6 million and $1,925.8 million for the three months ended September 30, 2018 and 2017, respectively, and $6,492.5 million and $6,409.7 million for the nine months ended September 30, 2018 and 2017, respectively. Includes home delivery and specialty, including drugs we distribute to other PBMs’ clients under limited distribution contracts with pharmaceutical manufacturers and Freedom Fertility claims.
(4)
Includes the impact of the increase to both revenues and cost of revenues of $849.4 million and $2,433.5 million for the three and nine months ended September 30, 2018, respectively, related to the adoption of ASC Topic 606 effective January 1, 2018.
(5)
Includes other revenues related to drugs distributed through patient assistance programs, which were disposed of as part of the sale of UBC on December 27, 2017.

28


PBM product revenues consist of revenues from the sale of prescription drugs by retail pharmacies in our retail pharmacy networks, revenues from the dispensing of prescription drugs from our home delivery pharmacies and revenues from the sale of certain fertility and specialty drugs. Our PBM revenues collected are primarily comprised of total prescription price, which includes a negotiated price with the client, member co-payments, fees-for-service and offsets to revenues we consider client discounts, which include manufacturer rebates and administrative fees payable to clients, obligations under financial and service guarantees to clients and pricing discounts. Other Business Operations product revenues primarily consist of distribution of specialty pharmaceuticals. PBM service revenues include fees for the administration of formulary management processing for certain client contracts that do not include claims adjudication and the dispensing of prescription drugs; as well as other fee-for-service arrangements, such as medication counseling services and certain specialty services. Other Business Operations service revenues include revenues related to medical benefit management services beginning on December 15, 2017, the date of the acquisition of eviCore, and, prior to the sale of UBC on December 27, 2017, also included revenues related to data analytics and research.
We have contracts with Anthem and the United States Department of Defense which represent 18% and 12%, respectively, of consolidated revenues for each of the three and nine months ended September 30, 2018.
29


Note 15 - Condensed consolidating financial information
The senior notes issued by ESI, Medco and us are jointly and severally and fully and unconditionally (subject to certain customary release provisions, including sale, exchange, transfer or liquidation of the guarantor subsidiary) guaranteed by ESI, Medco and us, as applicable. The following condensed consolidating financial information has been prepared in accordance with the requirements for presentation of such information. The condensed consolidating financial information presented below is not indicative of what the financial position, results of operations or cash flows would have been had each of the entities operated as an independent company during the periods for various reasons, including, but not limited to, intercompany transactions and integration of systems.
As described in Note 8 - Financing, we have a credit agreement which was amended on October 26, 2017. In connection with entering into the credit agreement, the Company sent a notice to the respective trustees under the indentures governing the Company’s outstanding senior notes (including notes issued by ESI and Medco) that, effective as of October 26, 2017, simultaneously with closing the credit agreement, each of the guarantors under such indentures, other than the Company, ESI and Medco, as applicable, was automatically released from all of its respective obligations under such indentures and its respective guarantees of the outstanding senior notes of the Company, ESI and Medco issued thereunder. As such, the historical subsidiary guarantors have been combined with the historical subsidiary non-guarantors, to reflect the new subsidiary non-guarantor presentation, as shown below. The condensed consolidating financial information is presented separately for:
(i)
Express Scripts, the issuer of certain guaranteed obligations;
(ii)
ESI, guarantor, the issuer of additional guaranteed obligations;
(iii)
Medco, guarantor, the issuer of additional guaranteed obligations;
(iv)
Non-guarantor subsidiaries, on a combined basis;
(v)
Consolidating entries and eliminations representing adjustments to (a) eliminate intercompany transactions between or among Express Scripts, ESI, Medco and the non-guarantor subsidiaries, (b) eliminate the investments in our subsidiaries and (c) record consolidating entries; and
(vi)
Express Scripts and subsidiaries on a consolidated basis.
In conjunction with the ongoing reorganization, during 2017, we executed certain intercompany agreements effective retrospectively to January 1, 2017. These intercompany agreements resulted in changes in interest expense among Express Scripts, ESI, Medco and our non-guarantors. These events had no impact on our consolidated balance sheet, consolidated statement of operations or consolidated statement of cash flows.
30

Condensed Consolidating Balance Sheet
(in millions)
Express
Scripts
Holding
Company
 
Express Scripts,
Inc.
 
Medco Health Solutions,
Inc.
 
Non-Guarantors
 
Eliminations
 
Consolidated
As of September 30, 2018
Cash and cash equivalents
$
3,284.4
   
$
44.3
   
$
   
$
377.0
   
$
   
$
3,705.7
 
Receivables, net
   
4,117.8
   
773.7
   
2,932.6
   
   
7,824.1
 
Other current assets
   
492.0
   
   
2,330.4
   
   
2,822.4
 
Total current assets
3,284.4
   
4,654.1
   
773.7
   
5,640.0
   
   
14,352.2
 
Property and equipment, net
   
137.1
   
3.1
   
350.7
   
   
490.9
 
Computer software, net
   
655.5
   
   
172.0
   
   
827.5
 
Investments in subsidiaries
55,794.2
   
16,678.2
   
9,264.1
   
   
(81,736.5
)
 
 
Intercompany
   
1,823.3
   
1,837.6
   
20,602.8
   
(24,263.7
)
 
 
Goodwill
   
3,122.4
   
22,609.9
   
5,378.2
   
   
31,110.5
 
Other intangible assets, net
   
276.2
   
5,161.9
   
2,987.4
   
   
8,425.5
 
Other assets
7.0
   
140.8
   
93.1
   
50.8
   
(56.7
)
 
235.0
 
Total assets
$
59,085.6
   
$
27,487.6
   
$
39,743.4
   
$
35,181.9
   
$
(106,056.9
)
 
$
55,441.6
 
Claims and rebates payable
$
   
$
7,996.6
   
$
1,927.3
   
$
266.3
   
$
   
$
10,190.2
 
Accounts payable
   
1,072.6
   
24.0
   
3,316.3
   
   
4,412.9
 
Accrued expenses
99.7
   
1,116.1
   
151.4
   
699.8
   
   
2,067.0
 
Short-term debt and current maturities of long-term debt
1,684.2
   
337.1
   
   
   
   
2,021.3
 
Total current liabilities
1,783.9
   
10,522.4
   
2,102.7
   
4,282.4
   
   
18,691.4
 
Long-term debt
12,472.1
   
   
502.1
   
   
   
12,974.2
 
Intercompany
24,263.7
   
   
   
   
(24,263.7
)
 
 
Deferred taxes
   
   
1,204.0
   
1,200.5
   
(56.7
)
 
2,347.8
 
Other liabilities
   
543.6
   
270.1
   
41.7
   
   
855.4
 
Non-controlling interest
   
   
   
6.9
   
   
6.9
 
Express Scripts stockholders’ equity
20,565.9
   
16,421.6
   
35,664.5
   
29,650.4
   
(81,736.5
)
 
20,565.9
 
Total liabilities and stockholders’ equity
$
59,085.6
   
$
27,487.6
   
$
39,743.4
   
$
35,181.9
   
$
(106,056.9
)
 
$
55,441.6
 
                       
As of December 31, 2017
Cash and cash equivalents
$
1,031.0
   
$
114.5
   
$
   
$
1,164.1
   
$
   
$
2,309.6
 
Receivables, net
   
3,740.9
   
971.3
   
2,344.1
   
   
7,056.3
 
Other current assets
   
350.7
   
2.1
   
2,238.4
   
   
2,591.2
 
Total current assets
1,031.0
   
4,206.1
   
973.4
   
5,746.6
   
   
11,957.1
 
Property and equipment, net
   
166.1
   
3.2
   
382.0
   
   
551.3
 
Computer software, net
   
640.0
   
   
174.9
   
   
814.9
 
Investments in subsidiaries
52,546.3
   
14,350.2
   
8,926.0
   
   
(75,822.5
)
 
 
Intercompany
   
847.1
   
2,531.5
   
17,624.0
   
(21,002.6
)
 
 
Goodwill
   
3,122.4
   
22,609.9
   
5,367.4
   
   
31,099.7
 
Other intangible assets, net
   
449.5
   
5,917.1
   
3,259.3
   
   
9,625.9
 
Other assets
8.2
   
112.6
   
80.3
   
42.7
   
(36.9
)
 
206.9
 
Total assets
$
53,585.5
   
$
23,894.0
   
$
41,041.4
   
$
32,596.9
   
$
(96,862.0
)
 
$
54,255.8
 
Claims and rebates payable
$
   
$
7,389.4
   
$
2,574.3
   
$
224.8
   
$
   
$
10,188.5
 
Accounts payable
   
840.3
   
34.0
   
2,881.4
   
   
3,755.7
 
Accrued expenses
126.6
   
1,192.7
   
272.7
   
1,277.3
   
   
2,869.3
 
Short-term debt and current maturities of long-term debt
194.8
   
   
838.1
   
   
   
1,032.9
 
Total current liabilities
321.4
   
9,422.4
   
3,719.1
   
4,383.5
   
   
17,846.4
 
Long-term debt
14,141.9
   
336.7
   
502.9
   
   
   
14,981.5
 
Intercompany
21,002.6
   
   
   
   
(21,002.6
)
 
 
Deferred taxes
   
   
1,392.2
   
1,207.1
   
(36.9
)
 
2,562.4
 
Other liabilities
   
457.1
   
258.4
   
24.7
   
   
740.2
 
Non-controlling interest
   
   
   
5.7
   
   
5.7
 
Express Scripts stockholders’ equity
18,119.6
   
13,677.8
   
35,168.8
   
26,975.9
   
(75,822.5
)
 
18,119.6
 
Total liabilities and stockholders’ equity
$
53,585.5
   
$
23,894.0
   
$
41,041.4
   
$
32,596.9
   
$
(96,862.0
)
 
$
54,255.8
 
                       

31

Condensed Consolidating Statement of Operations and Comprehensive Income
(in millions)
Express Scripts Holding Company
 
Express Scripts,
Inc.
 
Medco Health Solutions,
Inc.
 
Non-Guarantors
 
Eliminations
 
Consolidated
For the three months ended September 30, 2018
Revenues
$
   
$
17,717.5
   
$
4,051.7
   
$
16,316.9
   
$
(12,522.9
)
 
$
25,563.2
 
Operating expenses
   
17,696.9
   
3,910.3
   
14,990.3
   
(12,522.9
)
 
24,074.6
 
Operating income
   
20.6
   
141.4
   
1,326.6
   
   
1,488.6
 
Other (expense) income:
                     
Interest (expense) income and other, net
(134.0
)
 
2.3
   
(5.0
)
 
(1.3
)
 
   
(138.0
)
Intercompany interest income (expense)
139.0
   
(69.5
)
 
(45.5
)
 
(24.0
)
 
   
 
Other (expense) income, net
5.0
   
(67.2
)
 
(50.5
)
 
(25.3
)
 
   
(138.0
)
Income (loss) before income taxes
5.0
   
(46.6
)
 
90.9
   
1,301.3
   
   
1,350.6
 
Provision (benefit) for income taxes
1.2
   
(43.8
)
 
23.8
   
295.6
   
   
276.8
 
Income (loss) before equity in earnings of subsidiaries
3.8
   
(2.8
)
 
67.1
   
1,005.7
   
   
1,073.8
 
Equity in earnings of subsidiaries
1,067.8
   
919.3
   
86.4
   
   
(2,073.5
)
 
 
Net income
1,071.6
   
916.5
   
153.5
   
1,005.7
   
(2,073.5
)
 
1,073.8
 
Less: Net income attributable to non-controlling interest
   
   
   
2.2
   
   
2.2
 
Net income attributable to Express Scripts
1,071.6
   
916.5
   
153.5
   
1,003.5
   
(2,073.5
)
 
1,071.6
 
Other comprehensive income
1.5
   
1.5
   
   
1.5
   
(3.0
)
 
1.5
 
Comprehensive income attributable to Express Scripts
$
1,073.1
   
$
918.0
   
$
153.5
   
$
1,005.0
   
$
(2,076.5
)
 
$
1,073.1
 
                       
For the three months ended September 30, 2017
Revenues
$
   
$
17,032.6
   
$
4,787.9
   
$
15,633.9
   
$
(12,771.0
)
 
$
24,683.4
 
Operating expenses
   
16,988.4
   
4,708.8
   
14,278.8
   
(12,771.0
)
 
23,205.0
 
Operating income
   
44.2
   
79.1
   
1,355.1
   
   
1,478.4
 
Other (expense) income:
                     
Interest (expense) income and other, net
(127.6
)
 
1.7
   
(7.1
)
 
(1.1
)
 
   
(134.1
)
Intercompany interest income (expense)
48.0
   
(24.0
)
 
   
(24.0
)
 
   
 
Other expense, net
(79.6
)
 
(22.3
)
 
(7.1
)
 
(25.1
)
 
   
(134.1
)
Income (loss) before income taxes
(79.6
)
 
21.9
   
72.0
   
1,330.0
   
   
1,344.3
 
Provision (benefit) for income taxes
(28.2
)
 
7.1
   
28.8
   
491.6
   
   
499.3
 
Income (loss) before equity in earnings of subsidiaries
(51.4
)
 
14.8
   
43.2
   
838.4
   
   
845.0
 
Equity in earnings of subsidiaries
893.1
   
768.7
   
66.4
   
   
(1,728.2
)
 
 
Net income
841.7
   
783.5
   
109.6
   
838.4
   
(1,728.2
)
 
845.0
 
Less: Net income attributable to non-controlling interest
   
   
   
3.3
   
   
3.3
 
Net income attributable to Express Scripts
841.7
   
783.5
   
109.6
   
835.1
   
(1,728.2
)
 
841.7
 
Other comprehensive income
3.7
   
3.7
   
   
3.7
   
(7.4
)
 
3.7
 
Comprehensive income attributable to Express Scripts
$
845.4
   
$
787.2
   
$
109.6
   
$
838.8
   
$
(1,735.6
)
 
$
845.4
 
                       
For the nine months ended September 30, 2018
Revenues
$
   
$
52,322.5
   
$
12,513.1
   
$
47,800.9
   
$
(36,662.1
)
 
$
75,974.4
 
Operating expenses
   
52,110.5
   
12,210.9
   
44,552.7
   
(36,662.1
)
 
72,212.0
 
Operating income
   
212.0
   
302.2
   
3,248.2
   
   
3,762.4
 
Other (expense) income:
                     
Interest (expense) income and other, net
(404.2
)
 
2.9
   
(20.4
)
 
(0.8
)
 
   
(422.5
)
Intercompany interest income (expense)
413.5
   
(206.8
)
 
(134.7
)
 
(72.0
)
 
   
 
Other (expense) income, net
9.3
   
(203.9
)
 
(155.1
)
 
(72.8
)
 
   
(422.5
)
Income before income taxes
9.3
   
8.1
   
147.1
   
3,175.4
   
   
3,339.9
 
Provision (benefit) for income taxes
2.0
   
(36.2
)
 
32.1
   
762.9
   
   
760.8
 
Income before equity in earnings of subsidiaries
7.3
   
44.3
   
115.0
   
2,412.5
   
   
2,579.1
 
Equity in earnings of subsidiaries
2,564.8
   
2,225.4
   
184.6
   
   
(4,974.8
)
 
 
Net income
2,572.1
   
2,269.7
   
299.6
   
2,412.5
   
(4,974.8
)
 
2,579.1
 
Less: Net income attributable to non-controlling interest
   
   
   
7.0
   
   
7.0
 
Net income attributable to Express Scripts
2,572.1
   
2,269.7
   
299.6
   
2,405.5
   
(4,974.8
)
 
2,572.1
 
Other comprehensive loss
(3.6
)
 
(3.6
)
 
   
(3.6
)
 
7.2
   
(3.6
)
Comprehensive income attributable to Express Scripts
$
2,568.5
   
$
2,266.1
   
$
299.6
   
$
2,401.9
   
$
(4,967.6
)
 
$
2,568.5
 
                       
For the nine months ended September 30, 2017
Revenues
$
   
$
51,684.3
   
$
14,305.8
   
$
46,618.7
   
$
(37,923.0
)
 
$
74,685.8
 
Operating expenses
   
51,468.0
   
14,039.1
   
43,190.1
   
(37,923.0
)
 
70,774.2
 
Operating income
   
216.3
   
266.7
   
3,428.6
   
   
3,911.6
 
Other (expense) income:
                     
Interest (expense) income and other, net
(381.3
)
 
1.9
   
(28.2
)
 
(3.6
)
 
   
(411.2
)
Intercompany interest income (expense)
147.0
   
(73.5
)
 
   
(73.5
)
 
   
 
Other expense, net
(234.3
)
 
(71.6
)
 
(28.2
)
 
(77.1
)
 
   
(411.2
)
Income (loss) before income taxes
(234.3
)
 
144.7
   
238.5
   
3,351.5
   
   
3,500.4
 
Provision (benefit) for income taxes
(84.8
)
 
51.5
   
110.0
   
1,222.9
   
   
1,299.6
 
Income (loss) before equity in earnings of subsidiaries
(149.5
)
 
93.2
   
128.5
   
2,128.6
   
   
2,200.8
 
Equity in earnings of subsidiaries
2,339.3
   
2,010.2
   
107.4
   
   
(4,456.9
)
 
 
Net income
2,189.8
   
2,103.4
   
235.9
   
2,128.6
   
(4,456.9
)
 
2,200.8
 
Less: Net income attributable to non-controlling interest
   
   
   
11.0
   
   
11.0
 
Net income attributable to Express Scripts
2,189.8
   
2,103.4
   
235.9
   
2,117.6
   
(4,456.9
)
 
2,189.8
 
Other comprehensive income
8.4
   
8.4
   
   
8.4
   
(16.8
)
 
8.4
 
Comprehensive income attributable to Express Scripts
$
2,198.2
   
$
2,111.8
   
$
235.9
   
$
2,126.0
   
$
(4,473.7
)
 
$
2,198.2
 

32


Condensed Consolidating Statement of Cash Flows
(in millions)
Express Scripts Holding Company
 
Express Scripts,
Inc.
 
Medco Health Solutions,
Inc.
 
Non-Guarantors
 
Eliminations
 
Consolidated
For the nine months ended September 30, 2018
Net cash flows provided by (used in) operating activities
$
(20.2
)
 
$
835.1
   
$
144.0
   
$
2,126.9
   
$
(97.5
)
 
$
2,988.3
 
Cash flows from investing activities:
                     
Capital expenditures for property and equipment and computer software
   
(186.0
)
 
   
(55.3
)
 
   
(241.3
)
Acquisitions, net of cash acquired
   
(5.6
)
 
   
(20.8
)
 
   
(26.4
)
Other, net
   
3.7
   
(2.5
)
 
(13.7
)
 
(15.8
)
 
(28.3
)
Net cash used in investing activities
   
(187.9
)
 
(2.5
)
 
(89.8
)
 
(15.8
)
 
(296.0
)
Cash flows from financing activities:
                     
Repayment of long-term debt
   
   
(831.4
)
 
   
   
(831.4
)
Treasury stock acquired
(420.7
)
 
   
   
   
   
(420.7
)
Net proceeds from employee stock plans
198.9
   
   
   
   
   
198.9
 
Commercial paper repayments, net
(195.0
)
 
   
   
   
   
(195.0
)
Other, net
   
(7.3
)
 
   
(149.4
)
 
113.3
   
(43.4
)
Net intercompany transactions
2,690.4
   
(710.1
)
 
689.9
   
(2,670.2
)
 
   
 
Net cash (used in) provided by financing activities
2,273.6
   
(717.4
)
 
(141.5
)
 
(2,819.6
)
 
113.3
   
(1,291.6
)
Effect of foreign currency translation adjustment
   
   
   
(4.6
)
 
   
(4.6
)
Net increase (decrease) in cash and cash equivalents
2,253.4
   
(70.2
)
 
   
(787.1
)
 
   
1,396.1
 
Cash and cash equivalents at beginning of period
1,031.0
   
114.5
   
   
1,164.1
   
   
2,309.6
 
Cash and cash equivalents at end of period
$
3,284.4
   
$
44.3
   
$
   
$
377.0
   
$
   
$
3,705.7
 
                       
For the nine months ended September 30, 2017
Net cash flows provided by (used in) operating activities
$
(174.8
)
 
$
868.3
   
$
1,066.5
   
$
2,408.8
   
$
(187.3
)
 
$
3,981.5
 
Cash flows from investing activities:
                     
Capital expenditures for property and equipment and computer software
   
(128.0
)
 
   
(49.3
)
 
   
(177.3
)
Acquisitions, net of cash acquired
   
(122.7
)
 
   
   
   
(122.7
)
Other, net
   
(15.3
)
 
   
4.0
   
   
(11.3
)
Net cash used in investing activities
   
(266.0
)
 
   
(45.3
)
 
   
(311.3
)
Cash flows from financing activities:
                     
Repayment of long-term debt
(650.0
)
 
   
   
   
   
(650.0
)
Treasury stock acquired
(2,735.7
)
 
   
   
   
   
(2,735.7
)
Net proceeds from employee stock plans
51.3
   
   
   
   
   
51.3
 
Other, net
   
(19.0
)
 
   
(190.8
)
 
187.3
   
(22.5
)
Net intercompany transactions
4,202.5
   
(263.3
)
 
(1,070.9
)
 
(2,868.3
)
 
   
 
Net cash (used in) provided by financing activities
868.1
   
(282.3
)
 
(1,070.9
)
 
(3,059.1
)
 
187.3
   
(3,356.9
)
Effect of foreign currency translation adjustment
   
   
   
5.4
   
   
5.4
 
Net increase (decrease) in cash and cash equivalents
693.3
   
320.0
   
(4.4
)
 
(690.2
)
 
   
318.7
 
Cash and cash equivalents at beginning of period
583.5
   
1,234.2
   
4.4
   
1,255.1
   
   
3,077.2
 
Cash and cash equivalents at end of period
$
1,276.8
   
$
1,554.2
   
$
   
$
564.9
   
$
   
$
3,395.9
 

33

Exhibit 99.3

UNAUDITED PRO FORMA COMBINED FINANCIAL INFORMATION

On December 20, 2018, Cigna Corporation (the “Company” or “Cigna”) closed the previously announced merger pursuant to which Cigna Holding Company (formerly Cigna Corporation) (“Old Cigna") and Express Scripts Holding Company (“Express Scripts”) became direct wholly owned subsidiaries of Cigna (the “Merger”).

The unaudited pro forma condensed combined statements of income for the nine months ended September 30, 2018 and the year ended December 31, 2017 combine the consolidated statements of income of Old Cigna and Express Scripts for such periods, giving effect to the Merger as if it had occurred on January 1, 2017, the first day of the fiscal year ended December 31, 2017.  The unaudited pro forma condensed combined balance sheet as of September 30, 2018, combines the consolidated balance sheets of Old Cigna and Express Scripts as of such date, giving effect to the Merger as if it had occurred on September 30, 2018.  The consolidated financial information has been adjusted in the unaudited pro forma condensed combined financial statements to give effect to pro forma events that are (i) directly attributable to the Merger, (ii) factually supportable, and (iii) with respect to the statements of income, expected to have a continuing impact on the Company’s results.  The unaudited pro forma condensed combined financial statements should be read in conjunction with the accompanying notes to the unaudited pro forma condensed combined financial statements.  In addition, the unaudited pro forma condensed combined financial information was derived from, and should be read in conjunction with, the following historical consolidated financial statements and accompanying notes:

separate audited historical consolidated financial statements of Old Cigna as of, and for the year ended, December 31, 2017, and the related notes included in Old Cigna’s Annual Report on Form 10-K for the year ended December 31, 2017;

separate audited historical consolidated financial statements of Express Scripts as of, and for the year ended, December 31, 2017, and the related notes included in Express Scripts’ Annual Report on Form 10-K for the year ended December 31, 2017;

separate unaudited historical consolidated financial statements of Old Cigna as of, and for the nine months ended, September 30, 2018, and the related notes included in Old Cigna’s Quarterly Report on Form 10-Q for the nine months ended September 30, 2018; and

separate unaudited historical consolidated financial statements of Express Scripts as of, and for the nine months ended, September 30, 2018, and the related notes included in Express Scripts’ Quarterly Report on Form 10-Q for the nine months ended September 30, 2018.

The unaudited pro forma condensed combined financial information has been prepared by the Company using the acquisition method of accounting in accordance with U.S. generally accepted accounting principles, which we refer to as GAAP.  Old Cigna has been treated as the acquirer in the Merger for accounting purposes.  Accordingly, consideration paid by Cigna to complete the Merger has been allocated to identifiable assets and liabilities of Express Scripts based on estimated fair values as of the closing date of the Merger.  Management made an allocation of the consideration transferred to the assets acquired and liabilities assumed based on management’s valuation of the fair value of tangible and intangible assets acquired and liabilities assumed.  Accordingly, the pro forma adjustments related to the allocation of consideration transferred are preliminary and have been presented solely for the purpose of providing unaudited pro forma condensed combined financial statements in this Current Report on Form 8-K/A.  The Company intends to finalize the acquisition accounting as soon as practicable within the required measurement period, but in no event later than one year from December 20, 2018.

The unaudited pro forma condensed combined financial information has been presented for informational purposes only.  The unaudited pro forma condensed combined financial information does not purport to represent the actual results of operations that Old Cigna and Express Scripts would have achieved had the companies been combined during the periods presented in the unaudited pro forma condensed combined financial statements and is not intended to project the future results of operations that the combined company may achieve after the Merger.  The unaudited pro forma condensed combined financial information does not reflect any projected cost savings, or restructuring or integration-related costs to achieve potential cost savings.  Assumptions underlying the pro forma adjustments are described in the accompanying notes, which should be read in conjunction with the unaudited pro forma condensed combined financial statements.
1



Unaudited Pro Forma Condensed Combined Statement of Income for the Nine Months Ended September 30, 2018

       
Note 4
 
Note 7
   
(In millions, except per share amounts)
 
Old Cigna
 
Express Scripts
 
Pro Forma Acquisition Adjustments
Ref
 
Pro Forma Financing Adjustments
Ref
 
Pro Forma Combined
For the nine months ended September 30, 2018
 
 
 
 
 
 
 
 
 
 
Revenues
 
 
 
 
 
 
 
 
 
 
 
 
Premiums
$
27,005
$
772
$
-
 
$
-
 
$
27,777
Pharmacy revenues
 
2,222
 
74,691
 
166
 A
 
-
 
 
77,079
Fees and other revenues
 
4,087
 
1,304
 
-
 
 
-
 
 
5,391
Net investment income
 
1,036
 
34
 
-
 
 
(13)
 E
 
1,057
Net realized investment (losses)
 
(36)
 
-
 
-
 
 
-
 
 
(36)
TOTAL REVENUES
 
34,314
 
76,801
 
166
 
 
(13)
 
 
111,268
Benefits and expenses
 
 
 
 
 
 
 
 
 
 
 
 
Global Health Care medical costs
 
16,098
 
862
 
-
 
 
-
 
 
16,960
Other benefit expenses
 
4,322
 
-
 
-
 
 
-
 
 
4,322
Pharmacy costs
 
1,776
 
69,456
 
-
 
 
-
 
 
71,232
Other operating expenses
 
8,672
 
2,105
 
(609)
 B
 
706
 F
 
10,874
Amortization of other acquired intangible assets
 
99
 
1,045
 
425
 C
 
-
 
 
1,569
TOTAL BENEFITS AND EXPENSES
 
30,967
 
73,468
 
(184)
 
 
706
 
 
104,957
Income before income taxes
 
3,347
 
3,333
 
350
 
 
(719)
 
 
6,311
TOTAL INCOME TAXES
 
854
 
761
 
(39)
 D
 
(151)
 G
 
1,425
SHAREHOLDERS' NET INCOME
$
2,493
$
2,572
$
389
 
$
(568)
 
$
4,886
Shareholders' net income per share
 
 
 
 
 
 
 
 
 
 
Basic
$
10.28
 
 
 
   
 
   
$
12.86
Diluted
$
10.14
 
 
 
   
 
   
$
12.68
Weighted average shares outstanding (Note 9)
 
 
 
 
 
 
 
 
 
 
Basic
 
242.4
 
 
 
   
 
   
 
379.8
Diluted
 
245.7
 
 
 
 
 
 
 
 
 
385.2

See the accompanying notes to the unaudited pro forma condensed combined financial statements which are an integral part of these statements.  The pro forma adjustments shown above are explained in Note 7.  Old Cigna amounts reflect a reclassification of income (loss) from noncontrolling interests to other operating expenses due to immateriality.  Express Scripts amounts reflect reclassifications described in Note 4.
2

Unaudited Pro Forma Condensed Combined Statement of Income for the Year Ended December 31, 2017

                         
       
Note 4
 
Note 7
   
(In millions, except per share amounts)
 
Old Cigna
 
Express Scripts
 
Pro Forma Acquisition Adjustments
Ref
 
Pro Forma Financing Adjustments
Ref
 
Pro Forma Combined
For the year ended December 31, 2017
 
 
 
 
 
 
 
 
 
 
Revenues
 
 
 
 
 
 
 
 
 
 
 
 
Premiums
$
32,491
$
907
$
-
 
$
-
 
$
33,398
Pharmacy revenues
 
2,979
 
98,314
 
222
 A
 
-
 
 
101,515
Fees and other revenues
 
5,110
 
1,997
 
-
 
 
-
 
 
7,107
Net investment income
 
1,226
 
42
 
-
 
 
-
 E
 
1,268
Net realized investment gains
 
237
 
-
 
-
 
 
-
 
 
237
TOTAL REVENUES
 
42,043
 
101,260
 
222
 
 
-
 
 
143,525
Benefits and expenses
 
 
 
 
 
 
 
 
 
 
 
 
Global Health Care medical costs
 
19,824
 
885
 
-
 
 
-
 
 
20,709
Other benefit expenses
 
5,439
 
-
 
-
 
 
-
 
 
5,439
Pharmacy costs
 
2,456
 
91,539
 
-
 
 
-
 
 
93,995
Other operating expenses
 
10,598
 
2,682
 
(293)
 B
 
983
 F
 
13,970
Amortization of other acquired intangible assets
 
115
 
1,240
 
1,628
 C
 
-
 
 
2,983
TOTAL BENEFITS AND EXPENSES
 
38,432
 
96,346
 
1,335
 
 
983
 
 
137,096
Income before income taxes
 
3,611
 
4,914
 
(1,113)
 
 
(983)
 
 
6,429
TOTAL INCOME TAXES
 
1,374
 
397
 
(390)
 D
 
(344)
 G
 
1,037
SHAREHOLDERS' NET INCOME
$
2,237
$
4,517
$
(723)
 
$
(639)
 
$
5,392
Shareholders' net income per share
 
 
 
 
 
 
 
 
 
 
Basic
$
8.92
 
 
 
   
 
   
$
13.89
Diluted
$
8.77
 
 
 
   
 
   
$
13.67
Weighted average shares outstanding (Note 9)
 
 
 
 
 
 
 
 
 
 
Basic
 
250.9
 
 
 
   
 
   
 
388.3
Diluted
 
255.1
 
 
 
 
 
 
 
 
 
394.3

See the accompanying notes to the unaudited pro forma condensed combined financial statements which are an integral part of these statements.  The pro forma adjustments shown above are explained in Note 7.  Old Cigna amounts reflect a reclassification of income (loss) from noncontrolling interests to other operating expenses due to immateriality.  Express Scripts amounts reflect reclassifications described in Note 4.
3


Unaudited Pro Forma Condensed Combined Balance Sheet as of September 30, 2018

 
Note 4
 
Note 8
   
 
 
Old Cigna
 
Express Scripts
 
Pro Forma Acquisition Adjustments
Ref
 
Pro Forma Financing Adjustments
Ref
 
Pro Forma Combined
(In millions, except per share amounts)
 
 
 
 
 
 
 
 
 
 
 
 
As of September 30, 2018
 
 
 
 
 
 
 
 
 
Assets
 
 
 
 
 
 
 
 
 
 
 
 
Investments
 
 
 
 
 
 
 
 
 
 
 
 
   Fixed maturities, at fair value
$
23,268
$
-
$
-
 
$
-
 
$
23,268
   Equity securities
 
579
 
-
 
-
   
-
   
579
   Commercial mortgage loans
 
1,867
 
-
 
-
   
-
   
1,867
   Policy loans
 
1,421
 
-
 
-
   
-
   
1,421
   Other long-term investments
 
1,739
 
-
 
-
   
-
   
1,739
   Short-term investments
 
102
 
-
 
-
 
 
-
 
 
102
Total investments
$
28,976
$
-
$
-
 
$
-
 
$
28,976
Cash and cash equivalents
 
24,032
 
3,706
 
(27,579)
H
 
2,351
U
 
2,510
Premiums, accounts and notes receivable, net
 
3,609
 
7,824
 
-
   
-
   
11,433
Reinsurance recoverables
 
5,780
 
-
 
-
   
-
   
5,780
Deferred policy acquisition costs
 
2,217
 
-
 
-
   
-
   
2,217
Property and equipment
 
1,559
 
1,319
 
1,615
I
 
-
   
4,493
Goodwill
 
6,129
 
31,111
 
5,368
J
 
-
   
42,608
Other intangibles
 
379
 
8,425
 
30,300
K
 
-
   
39,104
Other assets
 
1,981
 
3,057
 
(7)
L
 
-
   
5,031
Separate account assets
 
8,162
 
-
 
-
   
-
   
8,162
TOTAL ASSETS
$
82,824
$
55,442
$
9,697
 
$
2,351
 
$
150,314
Liabilities
 
 
 
 
 
 
 
 
 
 
 
 
Total insurance and contractholder liabilities
$
26,618
$
-
$
-
 
$
-
 
$
26,618
Accounts payable, accrued expenses and other liabilities
 
7,571
 
17,533
 
991
M
 
-
   
26,095
Deferred tax liabilities, net
 
(132)
 
2,348
 
4,862
N
 
-
   
7,078
Short-term debt
 
9
 
2,021
 
-
   
-
   
2,030
Long-term debt
 
25,041
 
12,974
 
(33)
O
 
2,351
V
 
40,333
Separate account liabilities
 
8,162
 
-
 
-
   
-
   
8,162
TOTAL LIABILITIES
$
67,269
$
34,876
$
5,820
 
$
2,351
 
$
110,316
Shareholders’ equity
 
 
 
 
 
 
 
 
 
 
 
 
Common stock
$
74
$
9
$
(79)
P
$
-
 
$
4
Additional paid-in capital
 
2,985
 
23,827
 
923
Q
 
-
   
27,735
Accumulated other comprehensive loss
 
(1,857)
 
(7)
 
7
R
 
-
   
(1,857)
Retained earnings
 
18,474
 
18,891
 
(23,249)
S
 
-
   
14,116
Less:  treasury stock, at cost
 
(4,121)
 
(22,154)
 
26,275
T
 
-
 
 
-
TOTAL SHAREHOLDERS' EQUITY
$
15,555
$
20,566
$
3,877
 
$
-
 
$
39,998
   Total liabilities and equity
$
82,824
$
55,442
$
9,697
 
$
2,351
 
$
150,314

See the accompanying notes to the unaudited pro forma condensed combined financial statements which are an integral part of these statements.  The pro forma adjustments shown above are explained in Note 8.  Old Cigna and Express Scripts amounts reflect reclassifications described in Note 4.


4


NOTES TO THE UNAUDITED PRO FORMA CONDENSED COMBINED FINANCIAL STATEMENTS

1.
Description of Transaction

On December 20, 2018, Cigna Corporation (the “Company” or “Cigna”) closed the previously announced Merger (as defined below) contemplated by the Agreement and Plan of Merger, dated as of March 8, 2018, as amended by Amendment No. 1, dated as of June 27, 2018 (the “Merger Agreement”), by and among Cigna Holding Company (formerly Cigna Corporation), a Delaware corporation (“Old Cigna”), Express Scripts Holding Company, a Delaware corporation (“Express Scripts”), the Company (formerly Halfmoon Parent, Inc.), a Delaware corporation and a direct wholly owned subsidiary of Old Cigna prior to the Merger, Halfmoon I, Inc., a Delaware corporation and a direct wholly owned subsidiary of Cigna prior to the Merger (“Merger Sub 1”), and Halfmoon II, Inc., a Delaware corporation and a direct wholly owned subsidiary of Cigna prior to the Merger (“Merger Sub 2” and, together with Merger Sub 1, the “Merger Subs”).

At the effective time of the Merger on December 20, 2018 (the “Effective Time”), in accordance with the Merger Agreement, (a) Merger Sub 1 merged with and into Old Cigna (the “Cigna Merger”), with Old Cigna surviving the Cigna Merger as a direct wholly owned subsidiary of Cigna, and (b) Merger Sub 2 merged with and into Express Scripts (the “Express Scripts Merger” and, together with the Cigna Merger, the “Merger”), with Express Scripts surviving the Express Scripts Merger as a direct wholly owned subsidiary of Cigna.  As a result of the Merger, Old Cigna and Express Scripts became direct wholly owned subsidiaries of Cigna.
As provided in the Merger Agreement, at the Effective Time, each share of Express Scripts common stock issued and outstanding immediately prior to the Effective Time (other than shares of Express Scripts common stock (a) held by Express Scripts as treasury shares, (b) owned by Old Cigna or by direct or indirect wholly owned subsidiaries of Express Scripts or Old Cigna (including Cigna and the Merger Subs)) was converted automatically into (1) 0.2434 of a share of Cigna common stock (the “Stock Consideration”) and (2) the right to receive $48.75 in cash, without interest, subject to applicable withholding taxes (the “Cash Consideration” and together with the Stock Consideration, the “Express Scripts Merger Consideration”).  No fractional shares of Cigna common stock were issued in the Merger, and Express Scripts stockholders received cash in lieu of any fractional shares of Cigna common stock.
Additionally, at the Effective Time, each Express Scripts stock option, Express Scripts restricted stock unit (“RSU”) award (other than any such award held by a non-employee director) and Express Scripts deferred unit that was outstanding immediately prior to the Effective Time was converted into an equivalent Cigna award.  Each Express Scripts performance share unit award with a performance period commencing prior to 2018 that was outstanding immediately prior to the Effective Time generally vested at the level of performance determined by the compensation committee of the Express Scripts Board of Directors and each 2018 Express Scripts performance share unit award vested at the maximum level of performance and, in each case, were cancelled in exchange for the right to receive the Express Scripts Merger Consideration with respect to each underlying share of Express Scripts common stock.  Each Express Scripts RSU award held by a non-employee director was cancelled in exchange for a cash payment in an amount equal to the Express Scripts Merger Consideration with respect to each underlying share of Express Scripts common stock.
At the Effective Time, each share of Old Cigna common stock issued and outstanding immediately prior to the Effective Time (other than the excluded Old Cigna shares) was converted automatically into one fully paid and nonassessable share of Cigna common stock.

Additionally, at the Effective Time, each Old Cigna stock option, Old Cigna restricted stock award, Old Cigna RSU award, Old Cigna strategic performance share award and Old Cigna deferred unit outstanding immediately prior to the Effective Time was converted into an equivalent Cigna award.

2.
Basis of Presentation

The unaudited pro forma condensed combined financial statements were prepared using the acquisition method of accounting and are based on the historical consolidated financial statements of Old Cigna and Express Scripts for the year ended December 31, 2017 and as of and for the nine months ended September 30, 2018.  Historical results will reflect non-recurring items and, for the nine months ended September 30, 2018, business seasonality.  The acquisition method of accounting is based on ASC 805, Business Combinations, and uses the fair value concepts defined in ASC 820, Fair Value Measurement.
ASC 805 requires, among other things, that most assets acquired and liabilities assumed be recognized at their fair values as of the acquisition date.  ASC 820 defines the term “fair value,” sets forth the valuation requirements for any asset or liability measured at fair value, expands related disclosure requirements and specifies a hierarchy of valuation techniques based on the nature of the inputs used to develop the fair value measures.  Fair value is defined in ASC 820 as “the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date.”  This is an exit price concept for the valuation of the asset or liability.  In addition, market participants are assumed to be buyers and sellers in the principal (or the most advantageous) market for the asset or liability.  Fair value measurements for an asset assume the highest and best use by these market participants.  As a result of these standards, Cigna may be required to record the fair value of assets which are not intended to be used or sold and/or to value assets at fair value measures that do not reflect Cigna’s intended use of those assets.  Many of these fair value measurements can be highly subjective, and it is possible that other professionals, applying reasonable judgment to the same facts and circumstances, could develop and support a range of alternative estimated amounts.

5

Under the acquisition method of accounting, the assets acquired and liabilities assumed were recorded upon completion of the Merger, primarily at their respective fair values and added to those of Old Cigna.  Financial statements and reported results of operations of Cigna issued after completion of the Merger will reflect these values, but will not be retroactively restated to reflect the historical financial position or results of operations of Express Scripts.
Under ASC 805, acquisition-related transaction costs (e.g., advisory, legal and other professional fees) are not included as a component of consideration transferred but are accounted for as expenses in the periods in which such costs are incurred.  Acquisition-related transaction costs incurred by Cigna include fees related to a bridge financing commitment and agreement, legal and advisory fees.  Total acquisition-related transaction costs incurred by Cigna and Express Scripts in 2018 are $700 million and $600 million, respectively.  During the nine months ended September 30, 2018, Old Cigna incurred $260 million before-tax and Express Scripts incurred $47 million before-tax of acquisition-related transaction costs, which have been excluded from the pro forma combined income statement for the nine months ended September 30, 2018.  During the year ended December 31, 2017, Old Cigna and Express Scripts did not incur any material acquisition-related transaction costs.
The unaudited pro forma condensed combined balance sheet as of September 30, 2018 is required to include adjustments which give effect to events that are directly attributable to the Merger regardless of whether they are expected to have a continuing impact on the combined results or are non-recurring.  Therefore, acquisition-related transaction costs incurred by Cigna and Express Scripts subsequent to September 30, 2018 of $433 million and $558 million, respectively, are reflected as a pro forma adjustment to the unaudited pro forma condensed combined balance sheet as of September 30, 2018, and are presented as an increase to accrued expenses and other current liabilities and an after-tax decrease to retained earnings.

3.
Accounting Policies
The Company completed a review of the accounting policies of Express Scripts to determine if differences in accounting policies require restatement or reclassification of results of operations or reclassification of assets or liabilities to conform to the Company’s accounting policies and classification.  The pro forma statement of income includes adjustments conforming Express Scripts’ accounting policies to Cigna's accounting policies for pharmacy services provided to Medicare Part D beneficiaries that resulted in an increase to both pharmacy revenues and pharmacy and other service costs of approximately $0.8 billion for the nine months ended September 30, 2018 and $1.2 billion for the year ended December 31, 2017.  The Company is not aware of any material differences between the accounting policies of the Company and Express Scripts that would continue to exist subsequent to the application of purchase accounting.

4.
Reclassification Adjustments

Income Statement Reclassifications:  The following tables summarize certain reclassifications made to the Express Scripts historical income statements to conform to the pro forma income statement presentation:

     
Reclassification Adjustments
 
     
for the nine months ended September 30, 2018
 
(In millions)
 
Express Scripts
Historical
Presentation
 
Express Scripts
Historical in Pro Forma
Presentation
 
Express Scripts Revenues (as reported)
$
75,974
       
 
Premiums
     
$
772
 
 
Pharmacy revenues
       
74,691
 
 
Fees and other revenues
       
1,304
 
   
Total
$
75,974
 
$
76,767
 (1)
                 
Express Scripts Cost of Revenues (as reported)
$
69,539
       
 
Pharmacy Costs
     
$
69,456
 
 
Global Health Care medical costs
       
862
 
   
Total
$
69,539
 
$
70,318
 (1), (2)
                 
Express Scripts Other Operating Expense
           
Selling, general and administrative (as reported)
$
2,673
       
Interest expense and other (as reported)
 
456
       
Net income attributable to non-controlling interest (as reported)
 
7
       
 
Other operating expense
     
$
2,105
 
 
Amortization of other acquired intangible assets
 
 
 
 
1,045
 
   
Total
$
3,136
 
$
3,150
 (2)


6


     
Reclassification Adjustments
 
     
for the year ended December 31, 2017
 
(In millions)
 
Express Scripts Historical Presentation
 
Express Scripts Historical in Pro Forma Presentation
 
Express Scripts Revenues (as reported)
$
100,065
       
 
Premiums
     
$
907
 
 
Pharmacy revenues
       
98,314
 
 
Fees and other revenues
       
1,997
 
   
Total
$
100,065
 
$
101,218
 (1)
                 
Express Scripts Cost of Revenues (as reported)
$
91,303
       
 
Pharmacy Costs
     
$
91,539
 
 
Global Health Care medical costs
       
885
 
   
Total
$
91,303
 
$
92,424
 (1), (2)
                 
Express Scripts Other Operating Expense
           
Selling, general and administrative (as reported)
$
3,268
       
Interest expense and other (as reported)
 
608
       
Net income attributable to non-controlling interest (as reported)
 
14
       
 
Other operating expense
     
$
2,682
 
 
Amortization of other acquired intangible assets
 
 
 
 
1,240
 
   
Total
$
3,890
 
$
3,922
 (2)

(1)
The increases in revenues of $793 million for the nine months ended September 30, 2018 and $1,153 for the year ended December 31, 2017 represent a reclassification of amounts associated with pharmacy services provided to Medicare Part D beneficiaries from cost of revenues to revenues.
(2)
The decreases in cost of revenues of $14 million for the nine months ended September 30, 2018 and $32 million for the year ended December 31, 2017 represent the reclassification of medical benefit management services expenses and Medicare Part D administrative expenses from cost of revenues to operating expenses.

Balance Sheet Reclassifications: The following table summarizes certain reclassifications made to the Old Cigna historical balance sheet to conform to the pro forma balance sheet presentation:

     
Reclassification Adjustments
     
As of September 30, 2018
(In millions)
 
Old Cigna Historical Presentation
 
 
Old Cigna Pro Forma Presentation
Old Cigna Deferred Policy Acquisition Costs (as reported)
$
2,350
     
Old Cigna Other Assets, Including Other Intangibles (as reported)
 
2,227
     
Other intangibles
     
$
379
Deferred policy acquisition costs
       
2,217
Other assets
 
 
 
 
1,981
   
Total
$
4,577
 
$
4,577
   
`
         
Old Cigna Deferred Taxes
     
Deferred tax assets, net (as reported)
$
132
     
Deferred tax liabilities, net
 
 
 
$
(132)
   
Total
$
132
 
$
(132)
               
Old Cigna Redeemable Noncontrolling Interests
     
Redeemable noncontrolling interests (as reported)
$
30
     
Accounts payable, accrued expenses and other liabilities (as reported)
 
7,541
     
Accounts payable, accrued expenses and other liabilities
 
 
 
$
7,571
 
 
Total
$
7,571
 
$
7,571

7


The following table summarizes certain reclassifications made to the Express Scripts historical balance sheet to conform to the pro forma balance sheet presentation:

     
Reclassification Adjustments
     
As of September 30, 2018
(In millions)
 
Express Scripts Historical Presentation
 
 
Express Scripts Historical in Pro Forma Presentation
Express Scripts Other Assets, Prepaid Expenses and Other Current Assets and Inventories
     
Inventories (as reported)
$
2,169
     
Prepaid expenses and other current assets (as reported)
 
653
     
Other assets (as reported)
 
235
     
 
Other assets
 
 
 
$
3,057
   
Total
$
3,057
 
$
3,057
               
Express Scripts Property and Equipment
         
Property and equipment, net (as reported)
$
491
     
Computer software, net (as reported)
 
828
     
 
Property and equipment
 
 
 
$
1,319
   
Total
$
1,319
 
$
1,319
               
Express Scripts Accounts Payable, Accrued Expenses and Other Liabilities
         
Accounts payable (as reported)
$
4,413
     
Accrued expenses (as reported)
 
2,067
     
Other liabilities (as reported)
 
856
     
Non-controlling interest (as reported)
 
7
     
Claims and rebates payable (as reported)
 
10,190
     
 
Accounts payable, accrued expenses and other liabilities
     
$
17,533
   
Total
$
17,533
 
$
17,533


5.
Merger Consideration

The components of the consideration transferred to effect the acquisition of Express Scripts are:

         
 
 
 
 
 (Millions, except per
common stock data)
Total consideration
 
 
 
 
 
Cash consideration (as detailed below)
$
27,579
 
 
Common stock consideration (as detailed below)
 
24,745
 
 
Fair value of other stock-based awards - portion assigned to service period prior to the Merger
 
479
 
 
Noncontrolling interest
 
7
 
Total merger consideration
$
52,810
 
 
 
 
 
Cash consideration
 
 
 
 
 
Express Scripts common stock outstanding
 
564.3
 
 
Multiplied by merger agreement cash consideration per share paid to Express Scripts stockholders
$
48.75
 
 
Cash consideration paid to Express Scripts stockholders
$
27,510
 
 
Cash paid in lieu of fractional shares
 
4
 
 
Cash consideration paid to holders of Express Scripts performance share units and other equity holders
 
65
 
Total cash consideration
$
27,579
 
 
 
 
 
Stock consideration
 
 
 
 
 
Express Scripts common stock outstanding
 
564.3
 
 
Multiplied by merger agreement per share exchange ratio
 
0.2434
 
 
Stock issued to Express Scripts stockholders
 
137.3
 
 
Stock issued to holders of Express Scripts performance share units
 
0.3
 
Total stock issued to Express Scripts stockholders
 
137.6
 
Multiplied by per share price of Cigna common stock on December 20, 2018
$
179.80
 
Total stock consideration
$
24,745



8


6.
Purchase Price Allocation

The Company completed the acquisition of Express Scripts for total merger consideration of approximately $52.8 billion.  The acquisition of Express Scripts has been accounted for as a business combination, under the acquisition method of accounting, which results in acquired assets and assumed liabilities being measured at their estimated fair values as of the merger closing date.  Goodwill is measured as the excess of consideration transferred over the fair values of the assets acquired and liabilities assumed.

As of completion of the Merger, identifiable intangible assets are required to be measured at fair value, and these acquired assets could include assets that are not intended to be used or sold or that are intended to be used in a manner other than their highest and best use.  For purposes of these unaudited pro forma condensed combined financial statements and consistent with the ASC 820 requirements for fair value measurements, it is assumed that all assets will be used, and that all acquired assets will be used in a manner that represents the highest and best use of those acquired assets, but it is not assumed that any market participant synergies will be achieved.

The following summarizes the estimate of the assets acquired and the liabilities assumed by Cigna giving effect to the Merger as if it had occurred on September 30, 2018, and includes a reconciliation to the total consideration transferred:

         
(In millions)
 
 
 
As of September 30, 2018
Cash and cash equivalents
 
$
1,560
Receivables
 
 
7,824
Property and equipment
 
 
491
Goodwill
 
 
36,479
Other identifiable intangible assets
 
 
 
41,168
Other assets acquired
 
 
3,049
Long-term debt, including current portion
 
 
12,816
Deferred income tax liabilities
 
 
7,420
Other liabilities assumed
 
 
17,525
Total
 
$
52,810

Some of the more significant assumptions inherent in the development of intangible asset values, from the perspective of a market participant, include, but are not limited to: the amount and timing of projected future cash flows (including revenue and profitability); the discount rate selected to measure the risks inherent in the future cash flows; the assessment of the asset’s life cycle; and the competitive trends impacting the asset.  The fair value of Express Scripts’ identifiable intangible assets and their useful lives have been preliminarily estimated as follows:

         
(Dollars in millions)
 
Estimated Fair Value
Estimated Useful Life (Years)
Amortization method
 
 
 
 
 
 
Customer relationships
 $
30,210
14 - 29
 Cash flow trended
Internal-use software
 
2,443
3 - 7
 Straight Line
Trade name - Express Scripts
 
8,400
N/A
 Indefinite
Trade name - other
 
115
10
 Straight Line
 
Total identifiable intangible assets with finite lives
$
41,168
 
 
           

9



As of completion of the Merger, Cigna has established net deferred tax liabilities as part of the accounting for the Merger.  The pro forma adjustment to record the effect of deferred taxes was computed using the statutory rate of 21% as follows:
         
(In millions)
 
 
Deferred Tax Adjustments
Fair value adjustments of assets to be acquired and liabilities to be assumed
 
 
 
 
Fair value of identified intangible assets acquired
$
38,725
 
 
Fair value of internally developed software acquired
 
2,443
 
 
Fair value of debt assumed
 
(33)
 
 
Total fair value adjustment
 
41,135
Fair value of stock-based compensation included in merger consideration
 
 
 
 
Total fair value adjustment
 
479
Total fair value adjustment of assets and liabilities and stock based compensation
 
41,614
Applicable tax rate
 
 
21%
Net deferred tax liabilities
$
8,739
         

7.
Unaudited Pro Forma Condensed Combined Statement of Income Adjustments

       
Ref
Increase (decrease) for the period ended
September 30, 2018
 
Increase (decrease) for the year ended
Dec. 31, 2017
Acquisition adjustments
(In millions)
           
 
Revenues
               
   
Pharmacy revenues
           
     
To eliminate Express Scripts' amortization expense recorded as offset to revenues
A
 $
166
 
 $
222
 
Expenses
             
   
Other operating expenses
           
     
To record stock compensation expense associated with the conversion of Express Scripts’ stock based awards to Cigna stock based awards
 
 $
  (55)
 
 $
(11)
     
To eliminate Express Scripts' historical capitalized software amortization expense
   
(186)
   
(205)
     
To eliminate historical amortization of debt issuance costs and net debt discounts and premiums of assumed Express Scripts debt
   
  (14)
   
(15)
     
To eliminate historical transaction costs incurred by Old Cigna and Express Scripts in 2018
   
(307)
   
                             -
     
To eliminate historical interest expense on Express Scripts term loan
   
  (47)
   
   (62)
     
Total adjustments to other operating expenses
B
 $
(609)
 
 $
(293)
   
Amortization of other acquired intangible assets
           
     
To eliminate Express Scripts' other intangible asset amortization expense
 
 $
(1,045)
 
 $
(1,240)
     
To record estimated transaction-related other acquired intangible assets amortization
 
 
1,470
 
 
2,868
     
Total adjustments to other amortization of other acquired intangible assets
C
 $
425
 
 $
1,628
   
Total income taxes
           
     
To reflect the income tax impact of acquisition adjustments at 21% in 2018 and 35% in 2017
D
 $
(39)
 
 $
(390)
10


       
Ref
Increase (decrease) for the period ended
September 30, 2018
 
Increase (decrease) for the year ended
Dec. 31, 2017
Financing adjustments
(In millions)
           
   
Net investment income
           
     
To eliminate net investment income earned in 2018 on proceeds from
the issuance of debt prior to the completion of the Merger
E
 
(13)
     
 
Expenses
             
   
Other operating expenses
           
     
To record estimated interest expense on newly issued debt*
 
 $
695
 
 $
968
     
To record amortization of debt issuance costs on newly issued debt
 
 
11
 
 
15
     
Total adjustments to other operating expenses
F
 $
706
 
 $
983
   
Total income taxes
           
     
To reflect the income tax impact of financing adjustments at 21% in 2018 and 35% in 2017
G
 $
(151)
 
 $
(344)

* Additional interest expense associated with the $20.0 billion of long-term fixed rate or floating rate debt issued in the third quarter of 2018, and a $3.0 billion term loan and $1.5 billion of commercial paper issued in the fourth quarter of 2018 to partially fund the Merger.

11


Items not adjusted in the unaudited pro forma condensed combined statement of income

There were no material intercompany balances between Express Scripts and Old Cigna for the nine months ended September 30, 2018 or the year ended December 31, 2017 in the above pro forma income statements.


8.
Unaudited Pro Forma Condensed Combined Balance Sheet Adjustments
 
 
       
Ref
 
Increase (decrease) at September 30, 2018
Acquisition adjustments
(In millions)
     
 
Assets
     
   
Cash and cash equivalents
     
     
To record the cash portion of the merger consideration
H
$
(27,579)
   
Property and equipment
     
     
To eliminate Express Scripts historical capitalized software
 
$
(828)
     
To record estimated fair value of acquired internal-use software
   
2,443
       
I
$
1,615
   
Goodwill
     
     
To eliminate Express Scripts historical goodwill
 
$
(31,111)
     
To record estimated transaction goodwill
   
36,479
     
Total adjustments to goodwill
J
$
5,368
   
Other intangibles
     
     
To eliminate Express Scripts historical intangible assets
   
(8,425)
     
To record estimated fair value of intangible assets acquired
   
38,725
     
Total adjustments to other intangibles
K
$
30,300
   
Other assets
     
     
To eliminate historical unamortized debt issuance costs of revolving line of credit
L
$
(7)
 
Liabilities
     
   
Accounts payable, accrued expenses and other liabilities
     
     
To accrue estimated transaction costs for Old Cigna
 
$
433
     
To accrue estimated transaction costs for Express Scripts
   
558
     
Total adjustments to accounts payable, accrued expenses and other liabilities
M
$
991
   
Deferred tax liabilities, net
     
     
Total adjustments to deferred tax liabilities, net
N
$
4,862
   
Long-term debt
     
     
To adjust the fair value of assumed Express Scripts debt
O
$
(33)
             
 
Shareholders' equity
     
   
Common Stock
     
     
Total adjustments to common stock from elimination of Express Scripts historical common stock, elimination of Old Cigna historical treasury stock and issuance of Cigna common stock
P
$
(79)
   
Additional paid-in capital
     
     
Total adjustments to additional paid-in capital from elimination of Express Scripts historical paid-in capital, elimination of Old Cigna historical treasury stock, issuance of Cigna common stock and issuance of replacement common stock-based awards
Q
$
923
   
Accumulated other comprehensive loss
     
     
To eliminate Express Scripts accumulated other comprehensive loss
R
$
7
   
Retained Earnings
     
     
To eliminate Express Scripts historical retained earnings
 
$
(18,891)
     
To record elimination of old Cigna historical treasury stock canceled upon closing of the Merger
   
(3,577)
     
To record estimated transaction costs incurred, net of tax
   
(781)
     
Total adjustments to retained earnings
S
$
(23,249)
   
Treasury Stock
     
     
To eliminate Express Scripts historical treasury stock
 
$
22,154
     
To eliminate Old Cigna historical treasury stock canceled upon closing of Merger
   
4,121
     
Total adjustments to treasury stock from elimination of Express Scripts historical balance and elimination of Old Cigna historical treasury stock canceled upon closing of the Merger
T
$
26,275
             
       
Ref
 
Increase (decrease) at September 30, 2018
Financing adjustments
(In millions)
     
 
Assets
       
   
Cash and cash equivalents
     
     
To establish incremental Cigna debt to effect the Merger
 
$
4,497
     
To pay off outstanding Express Scripts' term loan
   
(2,146)
     
Total adjustments to cash and cash equivalents
U
$
2,351
 
Liabilities
       
   
Long-term debt
     
     
To establish incremental Cigna debt to effect the mergers
 
$
4,497
     
To pay off outstanding Express Scripts' term loan
   
(2,146)
     
Total adjustments to long-term debt
V
$
2,351

12

Items not adjusted in the unaudited pro forma condensed combined balance sheet
There were no material intercompany balances between Express Scripts and Old Cigna as of September 30, 2018 to be eliminated in the above pro forma balance sheet.

9.
Combined Weighted-Average Basic and Diluted Shares

The unaudited pro forma combined basic and diluted earnings per share calculations are based on the combined weighted-average basic and diluted shares of the Company as if the Merger closed on January 1, 2017.

The table below contains details of the amounts included in the denominator for basic and diluted earnings per share calculations.
         
(In millions)
 
Nine Months Ended
September 30, 2018
 
Year Ended
December 31, 2017
Old Cigna's weighted-average shares to compute basic EPS*
 
242.4
 
250.9
Express Scripts' converted outstanding shares and performance units**
 
137.4
 
137.4
Pro forma weighted-average basic shares outstanding
 
379.8
 
388.3
Dilutive effect of Old Cigna's outstanding stock-based awards*
 
3.3
 
4.2
Dilutive effect of Express Scripts' converted stock-based awards**
 
2.1
 
1.8
Pro forma weighted average diluted shares
 
385.2
 
394.3
 
* As reported in Old Cigna's Form 10-Q for the nine months ended September 30, 2018 and Annual Report on Form 10-K for the year ended December 31, 2017.
** Assumes the Merger closed on January 1, 2017.
       



13

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