“You could see eight points of swing between the first and the fourth quarter as you think about the progression of earnings and the progression of MBRs there, and that’s on the total of Aetna.”

In context

“. Tom Cowhey: Thanks Erin. Yes, I did have some comments about seasonality in the prepared remarks. We think it’s going to be more of a 55/45 first half/second half split this year, and the primary driver of the seasonality change is healthcare benefits, and it’s really that IRA impact, but also don’t forget the PDR kind of messes a little bit with the cadence of earnings in 2024 - hopefully something we won’t have to deal with again. But as you think about the Inflation Reduction impacts to the Part D premium, we now get that premium upfront and monthly and we no longer have the same level of reinsurance protection, particularly at the back part of the year, so your MBRs for the Aetna business, they’re going to be lowest in the first quarter and they’re going to be highest in the fourth. You could see eight points of swing between the first and the fourth quarter as you think about the progression of earnings and the progression of MBRs there, and that’s on the total of Aetna. The second and the third quarters will probably be more similar to each other, but there will be a little bit more pressure in the third quarter than the second. But as you think about that change in cadence of earnings, I would highlight that’s a good proxy for how to think about re-sloping it, given the PDP impacts on our book in particular. Operator: Thank you. We now have Ann Hynes with Mizuho Securities. Ann Hynes: Great, thank you. Can you remind us with CostVantage, what is the headwind to growth the first year of the implementation, and when would you expect that to turn positive for you? Also, I know CostVantage is only focused on commercial contracts right now. Do you eventually believe it will impact Medicare contracts, and if so, what’s the timing on that? Thanks. David Joyner”