Shares of the Indianapolis company at last check were off 2.7% to $290.91.
Anthem covers more than 42 million people in several states. It also runs a pharmacy benefits management business called IngenioRx.
The company reported net income of $222 million, or 87 cents a share, down from $1.18 billion, or $4.55, in the year-earlier quarter.
The latest adjusted earnings came to $4.20 a share, beating the FactSet estimate of $4.12.
Operating revenue, which excludes investment gains and losses, totaled $30.65 billion, up 16% from a year earlier, driven by higher premium revenue due to growth in Medicaid and Medicare.
Analysts expected $29.86 billion in revenue, according to FactSet.
The company expects full-year adjusted net income to exceed $22.30 a share. The FactSet survey pegs the consensus analyst estimate at $22.46.
For the quarter, Anthem reported an operating loss in the commercial and specialty business segment of $234 million, compared with an operating gain of $924 million a year ago.
The swing to a loss was due largely to accrual and business-optimization charges from a litigation settlement related to the Blue Cross Blue Shield Association of America.
Last month, Blue Cross Blue Shield reportedly reached a tentative $2.7 billion antitrust settlement to resolve claims that the insurance group’s member companies conspired to limit competition and boost prices for policyholders,
The decrease was also attributed to costs associated with actions taken to support members in response to the pandemic and coronavirus related care, as well as the shift of pharmacy earnings to IngenioRx, the company said. Those factors were offset partly by deferred health-care utilization due to the covid-19 pandemic.
Selling, general and administrative costs climbed 55%, due partly to the litigation as well as the return of a health insurance tax.