Molina Healthcare
34 named things its latest annual report says its results depend on, each in the company's own words. 16 of them are also named by other companies we've read.
Customers
Washington State Health Care Authority
earns from · approximately $4,194 million, or 13%, of consolidated Medicaid premium revenuenamed as a riskOur Washington Medicaid contract represented approximately $4,194 million, or 13%, of consolidated Medicaid premium revenue in 2025.Business (Item 1)
California Department of Health Care Services
earns from · approximately $4,170 million, or 13%, of our consolidated Medicaid premium revenuenamed as a riskOur California Medicaid contracts represented premium revenue of approximately $4,170 million, or 13%, of our consolidated Medicaid premium revenue in 2025.Business (Item 1)
Florida Agency for Health Care Administration
earns from · approximately 120,000 enrolleesWe are the sole plan selected and expect to serve approximately 120,000 enrollees.Business (Item 1)
Virginia Department of Medical Assistance Services
earns fromnamed as a riskAs result, our contracts with DMAS terminated effective June 30, 2025.Business (Item 1)
Texas Health and Human Services Commission
earns fromOur new contract for the Texas STAR+PLUS program commenced on September 1, 2024, retaining our entire existing footprint in each of Bexar, Dallas, El Paso, Harris, Hidalgo, Jefferson, Northeast Texas, and Tarrant service areas and grew our market share.Business (Item 1)
Suppliers
CVS Caremark
depends onnamed as a riskFurther, our principal pharmacy benefit manager, or PBM, Caremark, is party to certain lawsuits and putative class actions regarding its drug pricing practices and its rebate arrangements with drug manufacturers.Risk factors (Item 1A)
IT infrastructure outsourcing vendor
depends onnamed as a riskWe are party to a master services agreement with a third party vendor who manages certain of our information technology infrastructure services including, among other things, our information technology operations, end-user services, and data centers.Risk factors (Item 1A)
Other companies
ConnectiCare Holding Company, Inc.
$350 millionThe purchase price for the transaction was $350 million.Business (Item 1)
Competitors
Centene Corporation
competes withOur primary competitor for low-income Marketplace membership is Centene Corporation.Business (Item 1)
Also named by CI
UnitedHealth Group Inc.
competes withOur primary competitors in the Medicaid managed care industry include Centene Corporation, CVS Health Corporation, Elevance Health, Inc., UnitedHealth Group Inc., and large not-for-profit healthcare organizations.Business (Item 1)
Humana, Inc.
competes withThe Medicare market is highly competitive across the country, with large competitors, such as CVS Health Corporation, Humana, Inc., and UnitedHealth Group Inc.Business (Item 1)
Places
Texas
concentrated in · approximately $5,735 million, or 18%, of consolidated Medicaid premium revenuenamed as a riskOur Texas Medicaid contracts represented approximately $5,735 million, or 18%, of consolidated Medicaid premium revenue in 2025.Business (Item 1)
Also named by ABR, AFRM, ALLY, AN, ASO, ASTS, ATO, AXP and 70 more
New York
concentrated in · approximately $3,221 million, or 10%, of our consolidated Medicaid premium revenuenamed as a riskOur New York Medicaid contracts represented premium revenue of approximately $3,221 million, or 10%, of our consolidated Medicaid premium revenue in 2025.Business (Item 1)
Also named by ABR, AXP, BJ, BPOP, BRO, BWA, CHE, CINF and 12 more
California, New York, Texas and Washington
concentrated in · $17.3 billion, or approximately 54% of total Medicaid premium revenuenamed as a riskMeasured by Medicaid premium revenue by health plan, our top four health plans were in California, New York, Texas, and Washington, with aggregate Medicaid premium revenue of $17.3 billion, or approximately 54% of total Medicaid premium revenue, in the year ended December 31, 2025.Risk factors (Item 1A)
Long Beach, California
operates innamed as a riskIn addition, some of our health plans’ claims are processed in Long Beach, California.Risk factors (Item 1A)
Also named by RKLB
Hazards
Hurricanes (Florida, South Carolina, Texas)
concentrated innamed as a riskFor example, natural disasters, such as a major earthquake or wildfire in California, or a major hurricane affecting Florida, South Carolina, or Texas, could have a significant impact on the health of a large number of our covered members.Risk factors (Item 1A)
Also named by AIG, AN, ASO, BAC, BBY, BJ, BPOP, BRO and 89 more
Southern California earthquake and wildfire
operates innamed as a riskIf a major earthquake or wildfire were to strike near our location in Southern California, our corporate functions and claims processing could be impaired for an unforeseen period of time.Risk factors (Item 1A)
Commodities and inputs
Pharmaceuticals
exposed to its pricenamed as a riskBearing the high costs of new specialty drugs or the high cost inflation of generic drugs without an appropriate rate adjustment or other reimbursement mechanism would have an adverse impact on our financial condition and results of operations.Risk factors (Item 1A)
Also named by CHE
Regulators
State departments of insurance (dividend restrictions)
subject to · $985 million and $997 million in dividendsnamed as a riskOur parent company received $985 million and $997 million in dividends from our regulated health plan subsidiaries during 2025 and 2024, respectively.Risk factors (Item 1A)
Also named by PSA
Centers for Medicare & Medicaid Services (CMS)
subject tonamed as a riskThese audits could result in significant adjustments in payments made to our health plans, particularly if it is an audit which involves extrapolation, which could adversely affect our financial condition and results of operations.Risk factors (Item 1A)
Also named by A, ABT, AMGN, AXGN, BAX, BWIN, CNC, COO and 23 more
California Department of Managed Health Care
subject toOur health plans are generally licensed by the insurance departments in the states in which they operate, except for our California health plans, which are licensed by the California Department of Managed Health Care, and one of our New York health plans, which is licensed as a prepaid health services plan by the New York State Department of Health.Business (Item 1)
Laws and programs
One Big Beautiful Bill Act (OBBBA)
subject to · 15% to 20% by 2029 on 1.2 million membersnamed as a riskWe currently estimate the reduction in enrollment will be in the range of 15% to 20% by 2029 on 1.2 million members in our Medicaid Expansion population, and any acuity shifts should be modest and gradual.Business (Item 1)
Also named by AA, ABR, ADI, ADM, ALB, AMAT, AMGN, AMKR and 121 more
Medicare
earns from · $6,235 millionnamed as a riskAmounts payable to us under the MAPD contracts are subject to annual revision by CMS, including any federal budget cuts or tax changes applicable to Medicare.Business (Item 1)
Also named by ABT, ARWR, AXGN, BAX, BDX, BMY, BSX, CAH and 48 more
Medicaid
earns from · 75% of our consolidated premium revenuenamed as a riskOur Medicaid premium revenue constituted 75% of our consolidated premium revenue in the year ended December 31, 2025.Business (Item 1)
Also named by ABBV, ABT, ARE, ARWR, BAX, BMY, BSX, CHE and 39 more
Medicare Advantage Part D (MAPD)
earns from · approximately $1,566 million, or 25% of Medicare segment premium revenuenamed as a riskOur MAPD contracts represented approximately 117,000 members and approximately $1,566 million, or 25% of Medicare segment premium revenue in 2025.Business (Item 1)
CMS Medicare Star Ratings
subject to · Approximately 50% of our 2026 Medicare premium revenue is not impacted by Star Ratingsnamed as a riskApproximately 50% of our 2026 Medicare premium revenue is not impacted by Star Ratings.Business (Item 1)
ACA Marketplace
earns from · approximately 50%named as a riskThis would represent an estimated Marketplace premium revenue decrease of approximately 50% in 2026, in an effort towards restoring our target margins.Business (Item 1)
Medicare-Medicaid Plans (MMP) transition to D-SNP
subject to · $1.9 billion in total revenuenamed as a riskFive other states (Illinois, Michigan, Ohio, South Carolina, and Texas) transitioned their current MMP contracts to integrated D-SNP contracts on January 1, 2026, totaling $1.9 billion in total revenue.Business (Item 1)
Medicaid eligibility redeterminations
subject to · approximately 675,000 membersnamed as a riskFollowing the end of the COVID-19 public health emergency, we lost approximately 675,000 members due to eligibility redeterminations.Risk factors (Item 1A)
California Consumer Privacy Act (CCPA)
subject tonamed as a riskFor instance, the California Privacy Protection Agency’s new regulations under the CCPA regarding the use of automated decision-making went into effect on January 1, 2026.Risk factors (Item 1A)
Also named by AAP, AIOT, AKAM, ALL, APP, AYI, BAC, BBSI and 69 more
HIPAA
subject tonamed as a riskWe have experienced HIPAA breaches in the past, including breaches affecting over 500 individuals.Risk factors (Item 1A)
Also named by AFL, BAX, BBSI, CI, DHR, DOC, DOCN, DOCU and 19 more
False Claims Act
subject tonamed as a riskIf we are subject to liability under a qui tam or other actions, our business, financial condition, cash flows, or results of operations could be adversely affected.Risk factors (Item 1A)
Also named by ACN, ASTS, CDW, CHE, CI, CVS, DGX, FLR and 13 more
No Surprises Act
subject tonamed as a riskThere have been lawsuits challenging portions of the No Surprises Act in federal courts, particularly related to the use of the qualifying payment amount in the IDR process, which may result in an increase in rates we must pay to out-of-network providers.Risk factors (Item 1A)
Marketplace Program Integrity and Affordability Rule
subject tonamed as a riskHHS expects the regulation to reduce Marketplace enrollment in 2026 predominantly in states that did not expand Medicaid.Business (Item 1)