Elevance Health, Inc. (NYSE: ELV) has reported its fourth quarter and full year 2025 results, with operating revenue reaching $49.3 billion in the fourth quarter, representing a 10 percent increase over the prior year period. Full year operating revenue for 2025 amounted to $197.6 billion, reflecting a 13 percent increase from the previous year. The company's diluted EPS for the fourth quarter of 2025 stood at $2.47, while adjusted diluted EPS was $3.33. For the full year 2025, diluted EPS amounted to $25.21, with adjusted diluted EPS at $30.29.
In terms of operating gain, the company reported $0.3 billion for the fourth quarter of 2025, a decrease from the $0.7 billion reported in the same period of 2024. For the full year 2025, operating gain was $7.2 billion, down from $7.9 billion in 2024. The adjusted operating gain for the full year 2025 was $7.5 billion, a decrease from the $9.3 billion reported in 2024.
The operating expense ratio was reported at 11.0 percent for the fourth quarter and 10.6 percent for the full year. On an adjusted basis, the corresponding operating expense ratios were 10.8 percent and 10.5 percent. The benefit expense ratio increased to 93.5 percent in the fourth quarter and 90.0 percent for the full year, reflecting elevated medical cost trends.
Operating revenue for the Health Benefits segment reached $41.8 billion in the fourth quarter of 2025, showing an 11 percent increase from the same period in 2024. For the full year 2025, operating revenue for this segment was $167.1 billion, up 11 percent from 2024. The segment reported an adjusted operating loss of $0.2 billion in the fourth quarter of 2025 and an adjusted operating gain of $4.2 billion for the full year.
Within the Carelon segment, operating revenue for the fourth quarter of 2025 amounted to $18.7 billion, marking a 27 percent increase from the same period in 2024. For the full year 2025, operating revenue for this segment was $71.7 billion, up 33 percent from 2024. The adjusted operating gain for Carelon totaled $0.6 billion in the fourth quarter and $3.4 billion for the full year, representing a 10 percent increase from the previous year.
The company returned $4.1 billion of capital to shareholders in 2025 and reaffirmed its long-term earnings algorithm while recalibrating segment margin targets. Additionally, Elevance Health projected its full year 2026 GAAP diluted EPS to be at least $22.30, with projected adjusted diluted EPS to be at least $25.50.
Elevance Health, Inc. serves approximately 104 million consumers through a diverse portfolio of industry-leading medical, pharmacy, behavioral, clinical, home health, and complex care solutions. Today the company's shares have moved -1.85% to a price of $374.87. For the full picture, make sure to review Elevance Health's 8-K report.
