Centene Corporation announced unaudited consolidated earnings results for the second quarter and six months ended June 30, 2018. For the quarter, total revenues were $14,181 million against $11,954 million of prior year period. The increase over prior year was due to growth in the Health Insurance Marketplace business in 2018, acquisitions, expansions and new programs in many of their states in 2017 and 2018, and the reinstatement of the health insurer fee in 2018. Total revenues also increased by approximately $500 million associated with pass through payments from the State of California received in the second quarter that were recorded in premium tax revenue and premium tax expense. Earnings from operations were $489 million against $438 million of prior year period. Earnings from continuing operations, before income tax expense was $474 million compared to $421 million a year ago. Net earnings attributable to the company were $300 million or $1.50 per diluted share against $254 million or $1.44 per diluted share of prior year period. Adjusted net earnings were $360 million compared to $280 million a year ago. Adjusted Diluted EPS from continuing operations were $1.80 compared to $1.59 a year ago. Total cash flow used in operations was $526 million.

For the six months, the company's total revenues were $27,375 million against $23,678 million of prior year period. Earnings from operations were $1,029 million against $678 million of prior year period. Earnings from continuing operations, before income tax expense was $987 million compared to $640 million a year ago. Net earnings attributable to the company were $640 million or $3.39 per diluted share against $393 million or $2.23 per diluted share of prior year period. Net cash from operating activities was $1,320 million compared to $942 million a year ago. Capital expenditures were $362 million compared to $181 million a year ago. Adjusted net earnings were $746 million compared to $477 million a year ago. Adjusted Diluted EPS from continuing operations were $3.96 compared to $2.71 a year ago.

The company provided earning guidance for the full year 2018. The company have increased 2018 annual adjusted diluted earnings per share guidance by $0.03 to reflect the performance in the second quarter. And it have updated annual GAAP EPS guidance for the following items: first, an increase of $0.03 per diluted share, reflecting the performance for the second quarter; second, a decrease of $0.12 per diluted share to reflect the impact of the retroactive minimum medical loss ratio changes recognized in the second quarter under California's Medicaid expansion program; finally, a decrease of $0.03 per diluted share to reflect an increase in acquisition-related expenses associated with the Fidelis Care acquisition. The updated full year 2018 guidance is as follows: total revenues of $59.2 billion to $60 billion; GAAP diluted earnings per share of $4.25 to $4.57; adjusted diluted earnings per share of $6.80 to $7.16; HBR of 85.9% to 86.4%; SG&A ratio of 10.2% to 10.7%; adjusted SG&A ratio of 9.4% to 9.9%; and effective tax rate of 34% to 36%; and diluted shares outstanding of 198.7 million to 199.7 million shares. On a run rate basis, The company expects Fidelis to add over $11 billion in revenue and over $500 million in adjusted EBITDA, including net synergies.