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Centene

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FY2015 Annual Report · Centene
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2015
Annual Review

TRANSFORMING THE HEALTH OF THE COMMUNITY, ONE PERSON AT A TIME

Our collective experience, collaborative spirit and distinctive purpose 
firmly position us as an undeniable leader in today’s rapidly evolving 
healthcare environment. 

CENTENE CORPORATION

Centene Corporation is a diversified, multi-national healthcare enterprise  
that provides a portfolio of services to government-sponsored healthcare 
programs, focusing on under-insured and uninsured individuals. Centene 
offers unique, cost-effective coverage solutions for low-income populations 
through locally based health plans and a wide range of specialty services.

TABLE OF CONTENTS

 Letter from the Chairman
 Selected Awards & Recognition
 Company & Financial Summary

1  2015 at a Glance
2 
5 
6 
8  2015 Highlights
10   Our Portfolio of Healthcare Solutions
16   Transforming the Health of Our Community 
17   One Person at a Time 
18   Quarterly Financial Information
19   Selected Financial Information
20 Corporate Information

AT A GLANCE

$21.3 BILLION
in premium and service revenues

4,800 JOBS
added in 2015

5.1 MILLION
managed care membership

 $2.89*
diluted earnings per share  
(EPS)

 $3.03* 
diluted EPS  
(excluding $0.14 of Health Net  
merger related costs)

* From continuing operations

 TRANSFORMING THE HEALTH OF THE COMMUNITY, ONE PERSON AT A TIMEOur collective experience, collaborative spirit and distinctive purpose firmly position us as an undeniable leader in today’s rapidly evolving healthcare environment.  2  CENTENE CORPORATION

Letter From The Chairman

3

MICHAEL F. NEIDORFF 
Chairman, President & 
Chief Executive Officer

LETTER FROM THE CHAIRMAN

As we look back on 2015, Centene finds itself at a transformative juncture in its history. 
Our success continues to be driven by strong, balanced results in each of our business 
segments and reflects the strength of our foundational diversification strategy. 
Investments in people, capabilities and technology have led us to consistently deliver 
strong performance with an industry-leading growth rate. Our subsidiaries and suite of 
products continue to generate great opportunities. We have added and expanded 
contracts in existing markets, grown geographically, acquired new business, and added 
new capabilities and offerings. By being relentless in sustaining and enhancing the 
discipline and agility that has shaped—and continues to shape— our success, Centene is 
poised to become the largest Medicaid managed care organization in the country.  

Centene’s membership grew 26% to 5.1 million managed care members in 2015. Premium 
and service revenues and adjusted earnings per share both increased 36% over 2014.   
We also saw total shareholder return of 27%, resulting in a five-year compound annual 
growth rate of 39%. This success has been achieved in a year in which geo-political and 
macro-economic challenges resulted in a flat equity market.

GROWTH AND EXPANSION:
We saw notable growth in existing markets such as Florida, Illinois, Indiana, Louisiana, 
Mississippi, Ohio and Texas.  We entered the state of Michigan with the close of our 
acquisition of Fidelis.  We also entered the state of Oregon through the acquisition of 
Agate Resources, the parent company of Trillium Health Plan, marking Centene’s 23rd 
state of operations. Our life and health management capabilities were expanded through 
our acquisition of LiveHealthier.  

Our health plans across the country continue to reflect our commitment to providing 
local, culturally sensitive care in the communities we serve. The number of awards 
recognizing Centene over the past year illustrates our dedication. And, our Health Care 
Enterprise and Specialty companies continue to integrate and innovate in exciting ways  
to better serve our members, help control costs, and provide an additional platform for 
growth. In 2015, we continued to build on our successful Health Insurance Marketplace 
business by expanding our participation in certain regions of Illinois, Oregon and 
Wisconsin. In addition, Centurion began providing comprehensive correctional  
healthcare services in two new states, Mississippi and Vermont, bringing the total  
number of states served to five.

#4

FORTUNE MAGAZINE IDENTIFIED  
CENTENE AS NO. 4 ON ITS LIST OF THE  
100 FASTEST GROWING COMPANIES IN  
ITS SEPTEMBER ISSUE.

HEALTH PLANS BY  
PREMIUM SIZE

Less than $300 Million

$300 Million - $1 Billion

Greater than $1 Billion

2010

2015

3

3

1

7

7

6

We also provide correctional healthcare services in 
Minnesota, Tennessee and Vermont, not included in 
the table above, for a total of 23 states in 2015.

Internationally, our strategic investments in Ribera Salud in Spain and The Practice  
Group in the United Kingdom generated new opportunities and add to the diversification 
and expertise of our overall portfolio. Together, these international businesses provide 
services to more than 850,000 individuals. We are now of a size and scale to explore 
targeted international opportunities further without hindering our ability to pursue and 
integrate growth opportunities in the U.S.   

We continue to design and invest in information systems and innovative care 
management programs that give us greater access and speed to data. This enables  
us to make real time decisions and better manage healthcare costs. To expand our 
capabilities, in 2016, Centene invested in a data analytics business, Interpreta.  
Combining Centene’s expertise in managing large, diverse and medically complex 
populations with Interpreta’s experience using real-time clinical and genomic analytics 
will enable us to develop an integrated patient care platform in an effort to streamline 
workflow, customize care and mitigate adverse events.

HEALTH NET ACQUISITION:
Centene’s biggest news in 2015 was our announcement of the transformative acquisition 
of California-based Health Net. This acquisition will result in significant membership 
growth and expanded capabilities in Arizona, California, Oregon and Washington.   
Bringing Health Net into our portfolio will increase and enhance our presence in the 
California Medicaid program, which is the nation’s largest with more than 12 million 
beneficiaries. When combined with our current market leadership in Florida and Texas, 
Centene will be a leader in three of the largest Medicaid markets in the country. In 
addition, Centene will significantly expand its managed long-term support services,  
one of the largest and fastest growing segments of the market.

The Health Net acquisition is an important step in our strategy to increase scale, as well 
as drive further diversification across markets and products—specifically with the 
addition of government-sponsored programs including Medicare, TRICARE and Veterans 
Affairs, along with the commercial market in California. Health Net will provide the 
capabilities, scale and quality profile needed to expand our opportunities in the Medicare 
space beyond the duals. Health Net’s Medicare experience is complementary to Centene’s 
commitment to low income and high acuity populations. The addition of Health Net’s 
Medicare Advantage expertise, including its 4 STAR quality rating, will also create 
significant opportunities across our markets. 

4  CENTENE CORPORATION

Letter From The Chairman / Selected Awards & Recognition

5

LETTER FROM THE CHAIRMAN (continued)

The transaction will also increase Centene’s scale and geographic and product diversity, 
positioning it as one of the largest providers of Medicaid, Medicare Advantage and other 
government-sponsored programs in the country. Historically, we have successfully 
leveraged our pipeline and captured additional revenue through diversification, and we 
plan to continue this strategy. With additional products and capabilities from Health Net, 
our growth pipeline is bigger than ever before. 

OUR PEOPLE:
I have long maintained that it is our people that set Centene apart and continue to drive 
our success. We are committed to investing in our employees, as well as bringing on  
new talent and expertise. In 2015, we added 4,800 new employees including expanding 
our senior leadership team with the appointment of Dr. Ken Yamaguchi as Chief Medical 
Officer and Marcela Manjarrez Hawn as Chief Communications Officer for Centene.  

Also in 2015, Centene announced William Scheffel’s intention to retire as Chief Financial 
Officer in early 2016. The Board designated Jeffrey Schwaneke as Chief Financial Officer 
going forward. Jeff joined Centene in 2008 and has held primary responsibilities for  
the accounting, treasury and financial reporting functions and has proven to be a solid 
financial leader for our company. Therefore, he was a natural choice for this role.

In closing, Centene’s collective experience, collaborative spirit and distinctive purpose 
firmly position us as an undeniable leader in today’s rapidly evolving healthcare 
environment. Whether through government-sponsored managed care plans or newly 
emerging avenues, our discipline, agility and versatility continue to allow us to develop  
the best solutions for the right opportunities.

Sincerely,

MICHAEL F. NEIDORFF  
Chairman, President & Chief Executive Officer

2015 SELECTED 
AWARDS & 
RECOGNITION

CASE IN POINT 
PLATINUM AWARDS

•  Asthma  

Management  
Program

•  Integrated Case 
Management

•  Pregnancy Specialty 
Care Management 
Program 

•  Emergency 

Department's  
Diversion Program

•  Nurse Call  

Center Program

HERMES CREATIVE AWARD, PLATINUM  
“My Care Planner” Book Series

HERMES CREATIVE AWARD, GOLD  
“Darby Boingg Meets Chrys and the Mums” Book Series

HERMES CREATIVE AWARD, GOLD 
“The Gunky Bacteria Brothers” Book Series

AUBURN UNIVERSITY ANTI-BULLYING  
CORPORATE HERO AWARD 
“No Bullying Zone” Campaign

MODERN HEALTHCARE MARKETING IMPACT AWARD,  
COMMUNITY OUTREACH CAMPAIGN OF THE YEAR  
“No Bullying Zone” Campaign
MEDICAID HEALTH PLANS OF AMERICA BEST PRACTICES 
COMPENDIUM, LONG TERM SERVICES AND SUPPORTS AWARD 
Home-Based Primary Care Program
MEDICAID HEALTH PLANS OF AMERICA BEST PRACTICES 
COMPENDIUM, MATERNAL HEALTH AWARD 
“Addiction in Pregnancy” Program

INCREASING SCALE & DIVERSIFICATION

2-YEAR MEMBERSHIP GROWTH - 77%  
(2013 - 2015)

HEALTH PLANS & PROGRAM PARTICIPATION 
(per state, as of December 31)

2015

16
15
10
6
9
1
5
11
12

TANF/CHIP

ABD

D-SNP/MMP

LTSS/IDD

Medicaid Expansion

Medicare Advantage

Correctional Care

Foster Care

Health Insurance  
Marketplace

5.1M
2015

4.1M
2014

2.9M
2013

KEY DRIVERS OF 2015 MEMBERSHIP GROWTH

•  Product and geographic expansions in Arizona, 
Florida, Louisiana, Mississippi, South Carolina  
and Texas

•  The acquisition of Agate Resources, Inc.,  

the parent company of Trillium, our Oregon 
health plan

•  The commencement of The Healthy Indiana Plan 

(HIP 2.0) in Indiana

•  The commencement of Health Insurance 

Marketplaces in certain regions of Illinois,  
Oregon and Wisconsin
• Organic growth in Illinois
•  The commencement of correctional healthcare 
service contracts in Mississippi and Vermont

8631000102010 6  CENTENE CORPORATION

Company & Financial Summary

7

FINANCIAL HIGHLIGHTS FROM  
CONTINUING OPERATIONS
(in millions)

2015

2014

2013

Premium & Service Revenues

$ 21,265

$ 15,667

$ 10,526

Net Earnings (1)

Total Assets

 356

7,339

 268

5,824

161

3,519

2012

$ 7,682

89

2,764

2011

$ 5,052

120

2,182

(1) Attributable to Centene Corporation

PREMIUM & SERVICE REVENUES  
(in millions)

NET EARNINGS (1)  
(in millions)

MANAGED CARE MEMBERSHIP 
(in thousands)

21,265

15,667

10,526

7,682

5,052

$25,000

$20,000

$15,000

$10,000

$5,000

$0

356

268

$400

$320

$240

161

$160

120

89

$80

$0

6,000

4,800

3,600

2,400

1,809

1,200

0

5,108

4,061

2,880

2,582

'11

'12

'13

'14

'15

'11

'12

'13

'14

'15

'11

'12

'13

'14

'15

(1)  Attributable to Centene Corporation

CURRENT MARKETS AND IMPLEMENTATIONS
(by state and solution)

CENTENE AND HEALTH NET
In July 2015, Centene announced an 
agreement to acquire Health Net to create 
one of the largest government-sponsored 
healthcare providers in the country.  
The addition of Health Net’s business  
will increase our capabilities and broaden 
the diversity of our offerings — including 
TRICARE, Veterans Affairs and Commercial  
— and geographic reach, particularly in  
the western region which, includes the 
California Medicaid program — the largest 
in the country.

States with expanded operations  
upon completion of the merger  
with Health Net

GROUP & PRODUCT SOLUTIONS BY STATE (upon completion of the Health Net merger)

   MEDICAID/CHIP 
Arizona, Arkansas (Private Option), California, 
Florida, Georgia, Illinois, Indiana, Kansas,  
Louisiana, Massachusetts, Mississippi, Missouri,  
Nebraska*, New Hampshire, Ohio, Oregon, 
South Carolina, Texas, Washington, Wisconsin

   ABD NON-DUAL 
Arizona, California, Florida, Illinois, Indiana,  
Kansas, Louisiana, Mississippi, Nebraska*,  
New Hampshire, Ohio, Oregon, South Carolina, 
Texas, Washington, Wisconsin

   ABD DUAL-ELIGIBLE  
Arizona, California, Florida, Kansas, Nebraska*, 
New Hampshire, Ohio, Oregon, Texas, Wisconsin

   LONG-TERM SERVICES AND SUPPORTS  
Arizona, California, Florida, Illinois, Kansas,  
New Hampshire*, Ohio, Texas

   FOSTER CARE 
California, Florida, Indiana, Kansas, Louisiana,  
Mississippi, Missouri, Nebraska*, New Hampshire, 
Oregon, Texas, Washington

   MEDICARE SNP 
Arizona, California, Florida, Georgia, Ohio,  
Oregon, Texas, Wisconsin

   MEDICAID-MEDICARE PLANS 
California, Illinois, Michigan, Ohio,  
South Carolina, Texas

*   Correctional Care contract in Florida expected to commence in Q2 2016. Managed Care Contract in Nebraska 

expected to commence in Q1 2017. Long-term Services and Supports for New Hampshire scheduled to commence 
in Q3 2016.

   CORRECTIONAL HEALTHCARE  
California, Florida*, Massachusetts, Minnesota, 
Mississippi, Tennessee, Vermont

   HEALTH INSURANCE MARKETPLACE 
Arizona, Arkansas, California, Florida, Georgia, 
Illinois, Indiana, Massachusetts, Mississippi,  
New Hampshire, Ohio, Oregon, Texas,  
Washington, Wisconsin

8  CENTENE CORPORATION

2015 Highlights

9

Q1

Q2

Q3

Q4

Centene announced that its health and 
wellness subsidiary received a three-year 
Wellness and Health Promotion 
Accreditation renewal from the National 
Committee for Quality Assurance (NCQA).

MARCH 
Superior HealthPlan began operating  
under an expanded STAR+PLUS contract  
with the Texas Health and Human Services 
Commission (HHSC) to include nursing 
facility benefits.  The company also began 
operating under a new contract with the 
Texas HHSC and the Centers for Medicare 
and Medicaid Services to serve dual-eligible 
members in three counties as part of the 
state's dual demonstration program.

Centene’s national multilingual nurse triage 
and health education subsidiary received full 
Health Call Center Accreditation from URAC.

APRIL
Centene announced the appointment of 
Marcela Manjarrez Hawn to Senior Vice 
President and Chief Communications Officer, 
and the appointment of Ken Yamaguchi, 
M.D., to Executive Vice President and Chief  
Medical Officer.

Centene’s health and wellness subsidiary, 
Nurtur, received full Disease Management 
Accreditation renewal from URAC.

MAY
Centene's Florida subsidiary was awarded  
a new contract by the Florida Healthy Kids 
Corporation to manage healthcare services 
for children ages 5 through 18 in all 11 regions 
of Florida, commencing in the fourth quarter 
of 2015.

Centene completed the acquisition of Fidelis 
SecureCare of Michigan Inc. Fidelis began 
operating under a new contract with the 
Michigan Department of Community Health 
and the Centers for Medicare and Medicaid 
Services to provide integrated healthcare 
services to members who are dually eligible 
for Medicare and Medicaid in Macomb and 
Wayne counties.

JANUARY
Centene signed a definitive agreement to 
acquire Agate Resources Inc., a diversified 
holding company that offers an array of 
healthcare products and services to  
Oregon residents.

Centene acquired the remaining 79% of 
LiveHealthier, Inc. – a provider of technology 
and service-based health management 
solutions.

Centene expanded its participation in Health 
Insurance Marketplaces to include members 
in certain regions of Illinois and Wisconsin.

FEBRUARY 
Centurion began operating under a new 
contract with the Vermont Department of 
Corrections to provide comprehensive 
correctional healthcare services.

Centene’s Indiana subsidiary began 
operating under an expanded contract to 
provide Medicaid services under the state's 
Healthy Indiana Plan 2.0 program.

Centene’s South Carolina subsidiary began 
operating under a new contract to serve 
dual-eligible members as part of the state's 
dual demonstration program.

Louisiana Healthcare Connections began 
operating under a new contract to serve 
Bayou Health (Medicaid) beneficiaries.

Superior HealthPlan was awarded a contract 
to continue to serve STAR Health (Foster 
Care) Medicaid recipients.

JULY
Centene's Mississippi subsidiary, Magnolia 
Health, began operating under a two-year 
CHIP contract with the state of Mississippi.

Centurion began operating under a new 
contract with the Mississippi Department of 
Corrections to provide comprehensive 
correctional healthcare services.

Centene announced a definitive merger 
agreement with Health Net under which 
Centene will acquire all of the issued and 
outstanding shares of Health Net, subject  
to regulatory approval.

AUGUST
Centene's subsidiary was selected by the 
Washington State Health Care Authority as 
the sole provider for the Apple Health Foster 
Care contract, expected to commence in 
2016, pending regulatory approvals.

SEPTEMBER
Centene completed the acquisition of Agate 
Resources Inc., a diversified holding 
company that offers primarily Medicaid and 
other healthcare products and services to 
Oregon residents through Trillium 
Community Health Plan.

Peach State Health Plan was selected to 
serve Medicaid recipients through a contract 
renewal expected to start in July 2016, 
pending regulatory approvals.

OCTOBER
Sunshine Health began operating under a 
two-year, statewide contract to manage 
healthcare services for children ages 5 
through 18 in all 11 regions of Florida.

Centene's subsidiary, Cenpatico Integrated 
Care, in partnership with University of 
Arizona Health n operating under a contract 
to be the Regional Behavioral Health 
Authority for the new southern geographic 
service area.

Superior HealthPlan was awarded a contract, 
expected to start in the second half of 2016, 
by the Texas Health and Human Services 
Commission to serve seven delivery areas for 
STAR Kids Medicaid recipients, more than 
any other successful bidder. 

Centene announced that shareholders voted 
overwhelmingly to approve Centene's 
pending merger with Health Net.

NOVEMBER
Centene announced national recognition by 
Modern Healthcare and Advertising Age for 
its anti-bullying campaign, “No Bullying 
Zone,” receiving the Gold Award for 
Community Outreach Campaign of the Year 
at Modern Healthcare's Marketing Impact 
Awards.

DECEMBER
Centene announced that two of its 
programs, the Home-Based Primary Care 
Program and the Addiction in Pregnancy 
Program, were recognized by Medicaid 
Health Plans of America with Best Practices  
Awards which honor Medicaid health plans 
for exemplary programs that have improved 
the health of Medicaid enrollees by ensuring 
high-quality care.

10  CENTENE CORPORATION

OUR PORTFOLIO OF HEALTHCARE SOLUTIONS

Centene's experience has taught us that every individual and every 
community faces unique challenges. In our ongoing effort to transform 
the health of our communities, one person at a time, we continue to 
broaden our service offerings to address areas that we believe have 
been traditionally underserved. Our multi-line approach allows us  
to improve quality of care and health outcomes, while helping to 
manage medical costs and diversify our revenues.

23

IN 2015, WE SERVED MANAGED CARE 
MEMBERS IN 23 STATES THROUGH OVER 
200 LOCALIZED PRODUCT SOLUTIONS.

THROUGH OUR EXTENSIVE PORTFOLIO  
OF CUSTOMIZED SOLUTIONS, CENTENE IS 
ADDRESSING THE HEALTHCARE CHALLENGES  
OF TODAY AND TOMORROW.

MEDICAID/CHIP
LONG-TERM SERVICES AND SUPPORTS
MEDICARE SNP
HEALTH INSURANCE MARKETPLACE
MEDICAID-MEDICARE
ABD NON-DUAL ELIGIBLE
ABD DUAL ELIGIBLE
FOSTER CARE
CORRECTIONAL HEALTHCARE
PHARMACY SOLUTIONS

BEHAVIORAL AND  
SPECIALTY THERAPIES
LIFE & HEALTH MANAGEMENT
MANAGED VISION
DENTAL BENEFITS
CARE MANAGEMENT SOFTWARE
IN-HOME HEALTH SERVICES
I/DD SUPPORT SERVICES  
AND THERAPIES
TELEHEALTH

  12  CENTENE CORPORATION

Our Portfolio of Healthcare Solutions

13

MEDICAID/CHIP 
Since 1984, our expertise has helped maximize the effectiveness of 
state Medicaid programs by managing care of chronic illnesses and 
reducing inappropriate emergency room visits, inpatient days and 
high-cost interventions. In 2015, Centene health plans continued to 
integrate case management, education, outreach and incentives 
through targeted programs such as Start Smart for Your Baby®. 
Additional programming included health education and outreach 
specifically for children and teens, as well as helping members 
manage conditions such as sickle cell or diabetes.

FOSTER CARE 
Centene has almost a decade of experience providing comprehensive 
services for children and youth in foster care. Centene health plans 
hold the contracts for three of the four exclusive statewide managed 
care programs for children in foster care in the United States —  
in Texas, Florida and Washington. In addition, our subsidiary in 
Mississippi is the state health plan of choice for its fully integrated, 
statewide foster care managed care program. We also provide 
specialized managed care services to support adoption populations  
in Indiana, Missouri and Kansas.

MEDICARE 
Whether due to age, disability or income, individuals who are 
eligible for Medicare often require additional care and support 
services. Centene currently offers dual-eligible special needs plans 
(D-SNP) to these individuals in eight states. We are also 
participating in the Dual Demonstration programs in five states. 
With the addition of Health Net, we are well-positioned for growth 
opportunities in the Medicare landscape.

150,000

MEMBERS WERE ENROLLED IN OUR AWARD- 
WINNING START SMART FOR YOUR BABY PROGRAM 
IN 2015, HELPING TO GIVE MORE MOTHERS AND 
BABIES A HEALTHY START IN THEIR LIFE TOGETHER.

75,000

INDIVIDUALS RECEIVED MANAGED  
CARE THROUGH LONG-TERM CARE OR  
INTELLECTUALLY AND DEVELOPMENTALLY  
DISABLED PROGRAMS IN 2015.

83,000

FOSTER CARE AND ADOPTION ASSISTANCE 
ENROLLEES WERE SERVED BY CENTENE 
HEALTH PLANS IN 2015.

LTSS AND I/DD 
Centene’s experience and integrated approach to care management 
are helping states address the increasingly complex needs of 
individuals requiring long-term services and supports (LTSS).  
Centene currently manages LTSS in seven states for individuals 
diverse in age and disability, including elders with chronic conditions 
and individuals with physical disabilities, intellectual/developmental 
disabilities and brain injuries. Our comprehensive approach includes 
24-hour telephone clinical support, integrated behavioral health 
programs, home modifications, attendant care, emergency alert 
systems and equipment to help with mobility.

HEALTH INSURANCE MARKETPLACE  
Our Ambetter plans are designed to be affordable, comprehensive 
solutions for lower-income individuals and families who may not 
qualify for Medicaid or other government coverage. Initially launched  
in 2014, we nearly doubled our marketplace membership in 2015, 
offering coverage and benefits through health insurance marketplaces 
in 13 states as of January 2016.

CORRECTIONAL HEALTHCARE
Our proven managed care principles are helping states deliver new 
levels of clinical efficacy and cost efficiency for correctional systems 
through Centurion — a joint venture between Centene and MHM 
Services Inc. In 2015, Centurion expanded its services via new 
contracts with the Vermont Department of Corrections and the 
Mississippi Department of Corrections. A new contract with the  
state of Florida is also expected to commence in the second quarter 
of 2016.

 14  CENTENE CORPORATION

SOPHISTICATED INNOVATIONS FOR  
TODAY'S HEALTHCARE CHALLENGES
In 2015, our Health Care Enterprise 
companies continued to demonstrate  
value to an expansive external client 
base—including payors, providers and state 
partners—as well as Centene’s own health 
plans, by focusing on solutions for a myriad 
of distinct healthcare challenges. Such 
solutions include improving adherence to 
Hepatitis C medications, providing rapid 
crisis response services to members with 
behavioral health needs and intellectual 
and developmental disabilities, reducing 
preventable hospital readmissions, and 
improving integrated case management.

Our Health Care Enterprise companies  
focus on addressing critical areas within  
the healthcare system.

IN-HOME PRIMARY CARE & SERVICES
I/DD SUPPORT SERVICES & THERAPIES
SPECIALTY PHARMACY SOLUTIONS
SOFTWARE FOR INTEGRATED  
CASE MANAGEMENT
DATA ANALYTICS

BETTER CARE THROUGH INTEGRATED SPECIALTY SOLUTIONS

In 2015, we launched Envolve, a new brand that 
brings together our extensive portfolio of 
specialty healthcare solutions and achieve  
a level of integration that’s unparalleled in 
healthcare. Envolve represents our family of 
health solutions working together to make 
healthcare simpler, more effective and more 
accessible for everyone.

Envolve leverages our collective expertise in 
behavioral health management, telehealth 
services, life and health management, pharmacy 
benefits management, specialty pharmacy,  
dental benefits management, managed  
vision, and more, to provide integrated and 
comprehensive healthcare for members.  
We’ve made it our mission to provide healthcare 
that’s more accessible, and as a united brand, 
we are able to provide services that are more 
effective and more efficient for clients and 
members alike.

Envolve Pharmacy Solutions services will 
transform the traditional pharmacy benefit 
delivery model through innovative, flexible 
solutions and customized care management. 
We will improve outcomes for patients living 
with complex conditions by focusing on 
comprehensive solutions for patients.

Envolve PeopleCare services will focus on 
individual health management through 
education and empowerment. Through 
behavioral health, nurse triage, telehealth,  
and health, wellness and disease guidance 
programs, we will help transform lives.

Envolve Benefit Options services will extend the 
reach of dental and vision benefits. These fully 
integrated health services are customizable  
to govern costs while offering the highest care 
to the communities we serve.

  
 
 
16  CENTENE CORPORATION

Transforming the Health of Our Community / One Person at a Time

17

TRANSFORMING THE HEALTH OF OUR COMMUNITY

ONE PERSON AT A TIME

We take our commitment to the local communities  
we serve seriously. The expansion of our operations 
in Texas exemplifies Centene’s ability to address a full 
range of issues as states seek to maximize the quality 
and effectiveness of healthcare coverage – especially  
for some of their most vulnerable citizens.

Launched in 1999 under a single Medicaid 
contract, our subsidiary, Superior HealthPlan, 
partners with the state to care for the unique 
needs of people as diverse as adults and 
children with disabilities, children within 
the foster care system, and low-income 
families. Some chronically ill, elderly or 
disabled people qualify for both Medicaid 
and Medicare and are served through a Dual 
Eligible Special Need Plan. And, in 2014, 
we began offering affordable coverage with 
our Ambetter plan through the Texas Health 
Insurance Marketplace for individuals and 
families who may not qualify for Medicaid.

Of course, a comprehensive spectrum of 
healthcare solutions is needed to effectively 
address all our members’ health needs, 
improve outcomes and control medical costs. 
As in each of our states, through integration 
with Envolve and our Health Care Enterprises, 
we can offer our members in Texas cost-
effective access to prescription drugs, 
behavioral healthcare, case management, 
vision care and much more. In addition, 
our clinical and health education programs 
and services help members manage certain 
illnesses or health issues.

Whether through an in-person home visit 
or over the phone, our dedicated team in 
Texas helps members get healthy and stay 
healthy. Superior’s MemberConnections™ 
representatives empower members to take 
better care of their health by assisting with 
challenges like transportation, or even 
helping members obtain food, housing, 
clothing and utility services.

At Centene, being local isn’t just about 
where we have offices. It’s about being active 
within our community. To serve this mission, 
Superior has established Superior Community 
Ambassadors who are liaisons between 
Superior and the Texas communities it  
serves. These ambassadors attend health 
fairs, work with local schools and agencies, 
and champion important health initiatives. 

Another way Superior actively participates in 
the communities it serves is by offering grants 
to providers and community organizations 
that promote the health and well-being of 
Texans. In these ways and more, Superior 
HealthPlan demonstrates our commitment to 
transforming the health of our communities.

1 MILLION

SUPERIOR HEALTHPLAN SERVED 
75,000 MEMBERS IN TEXAS IN  
2001. TODAY, WE SERVE NEARLY  
1 MILLION TEXANS.

INTEGRATED CASE MANAGEMENT  
FOR PERSONALIZED PHYSICAL  
AND BEHAVIORAL CARE  
Doug, a California Health & Wellness member,  
was referred to our behavioral health case 
management team by a hospital emergency 
department diversion program. Doug was 
having a tough time with depression, PTSD 
(post-traumatic stress disorder) and alcohol 
abuse. He was also stressed out about an 
enlarged prostate and said his chronic 
breathing problems made life very difficult. 

Because we believe in addressing each 
person’s unique health needs, we tailored  
our approach to Doug’s situation. After he  
was enrolled in personal case management 
programs to help him with his physical and 
behavioral health needs, Doug successfully 
quit drinking, attended regular counseling 
appointments to reduce depression and  
PTSD symptoms, and got a power wheelchair.  
He has also made great progress with his 
breathing issues and is now off oxygen.

Our case manager continues to help Doug 
manage his ongoing physical and behavioral 
health needs. Grateful for his California Health 
& Wellness coverage and care team, Doug says 
that without the regular support he receives 
from his health plan, he would not be sober  
or doing as well as he is.

HELPING A MEMBER NAVIGATE THE  
AMERICAN HEALTHCARE SYSTEM DESPITE 
LANGUAGE BARRIERS
Zeya immigrated to the United States from 
Burma. She did not speak English and was 
cared for by her daughter, who also did not 
speak English. Neither of them understood 
the American healthcare system or how 
health insurance works. Zeya suffered from 
depression, heart disease and chronic pain, 
but language and cultural barriers challenged 
access to the medical and behavioral health 
services she needed.

Laura, a program coordinator at MHS Health 
Wisconsin, persisted in helping Zeya, even 
though she struggled to follow directions for 
care and appointments at first. Laura enrolled 
Zeya with U.S. Medical Management for 
doctor house calls, scheduled appointments 
and arranged for a translator at the home visit.

Despite frequent reminders, Zeya continued 
to miss appointments. MHS Health Wisconsin 
understands the value of connecting with  
our members and providing the care they 
need, so Laura continued her efforts – 
rescheduling visits and trying to connect with 
Zeya, each time using a translator.  Zeya and 
her daughter were invited to come to one of 
our weekly Care Day events, where Laura was  
able to fill out a health assessment for Zeya.

Today, Zeya has scheduled visits with her  
new primary care doctor, behavioral health 
specialist and a dentist.  She also has a 
personal care worker who helps her with  
daily tasks.

 18  CENTENE CORPORATION

Selected Financial Information

19

QUARTERLY SELECTED FINANCIAL INFORMATION

SELECTED FINANCIAL INFORMATION

AMOUNTS ATTRIBUTABLE  
TO CENTENE CORPORATION  
COMMON SHAREHOLDERS

NET EARNINGS (LOSS) PER COMMON SHARE  
ATTRIBUTABLE TO CENTENE CORPORATION

AMOUNTS ATTRIBUTABLE  
TO CENTENE CORPORATION  
COMMON SHAREHOLDERS

NET EARNINGS (LOSS) PER COMMON SHARE  
ATTRIBUTABLE TO CENTENE CORPORATION

Total revenues
Earnings from continuing operations, 
net of income tax expense
Discontinued operations, 
net of income tax expense (benefit)
Net earnings

Basic:
Continuing operations
Discontinued operations
Basic earnings per common share

Diluted:
Continuing operations
Discontinued operations
Diluted earnings per common share

Total revenues
Earnings from continuing operations, 
net of income tax expense
Discontinued operations, 
net of income tax expense (benefit)
Net earnings

Basic:
Continuing operations
Discontinued operations
Basic earnings per common share

Diluted:
Continuing operations
Discontinued operations
Diluted earnings per common share

For the Quarter Ended, 2015 
(in millions, except share data) (unaudited)

March 31  
$5,131  

June 30  
$5,506  

September 30  

$5,821

December 31
$6,302

$64  

(1)  
$63  

$0.54  
(0.01)  
$0.53  

$0.52  
(0.01)  
$0.51

$88  

—  
$88  

$0.74  
—  
$0.74  

$0.72  
—  
$0.72  

$92  

1
$93  

$0.77  
0.01
$0.78  

$0.75  
0.01
$0.76  

$112

(1)
$111

$0.94
(0.01)
$0.93

$0.91
(0.01)
$0.90

For the Quarter Ended, 2014 
(in millions, except share data) (unaudited)

March 31  

June 30  

September 30  

December 31

$3,460  

$4,023  

$4,352  

$4,725

$34  

(1)  
$33  

$0.30  
(0.01)  
$0.29  

$0.29  
(0.01)  
$0.28  

$47  

2  
$49  

$0.41  
0.01  
$0.42  

$0.39  
0.02  
$0.41  

$81

1
$82  

$0.69  
0.01
$0.70  

$0.67  
0.01
$0.68  

$106

1
$107

$0.90
0.01
$0.91

$0.87
0.01
$ 0.88

REVENUES

EXPENSES

OTHER INCOME (EXPENSE)

AMOUNTS ATTRIBUTABLE TO CENTENE  
CORPORATION COMMON SHAREHOLDERS

NET EARNINGS (LOSS) PER COMMON SHARE 
ATTRIBUTABLE TO CENTENE CORPORATION

WEIGHTED AVERAGE NUMBER OF  
COMMON SHARES OUTSTANDING

CONSOLIDATED BALANCE SHEET DATA

Premium
Service
  Premium and service revenues
Premium tax and health insurer fee

Total Revenues

Medical costs
Cost of services
General and administrative expenses
Premium tax expense
Health insurer fee expense
Total operating expenses
  Earnings from operations
Investment and other income
Debt extinguishment costs
Interest expense
  Earnings from continuing  
  operations, before income  

tax expense

Income tax expense
  Earnings from continuing operations,  
  net of income tax expense
  Discontinued operations, net of income  
tax expense (benefit) of $(1), $1, $2, $(48) 

     and $(4) respectively
  Net earnings (loss)
(Earnings) loss attributable  
to noncontrolling interests
  Net earnings attributable  
to Centene Corporation

Earnings from continuing operations, 
net of income tax expense
Discontinued operations, net of 
income tax expense (benefit)
  Net earnings

Basic:
Continuing operations
Discontinued operations
Basic earnings per common share

Diluted:
Continuing operations
Discontinued operations
Diluted earnings per common share
Basic
Diluted

Year Ended December 31  
(in millions, except share data)

2015  
$19,389  
1,876  
21,265  
1,495  
22,760  
17,242  
1,621
1,826  
1,151
215 
22,055  
705  
35  
—  

(43)

2014  
$14,198  
1,469  
15,667  
893  
16,560  
12,678  
1,280  
1,314  
698  
126  
16,096  
464  
28  
—  

(35)

697  
339  

457  
196  

358  

261

2013  
$10,153  
373  
10,526  
337  
10,863  
8,995  
327  
931
333  
—  
10,586  
277  
19  
—  

(27)

269  
107  

162  

4  
166  

2012  
$7,569  
113  
7,682  
428  
8,110  
6,781

88  
705  
428  
—  
8,002  
108  
35  
—  

(20)

123  
47  

76  

(87)
(11)

13  

$2  

2011
$4,948
104
5,052
159
5,211
4,191
78
578
161
—
5,008
203
13
(8)
(20)

188
71

117

(9)
108

3

$111

3  
264  

(1)
357  

(2)

7  

(1)

$355  

$271

$165  

$356  

$268  

$161

$89  

$120

(1)
$355  

3  

$271

$2.99  
(0.01)
$2.98  

$2.30  
0.03  
$2.33  

4  
$165  

$1.49  
0.03  
$1.52  

(87)

$2  

$0.86  
(0.84)  
$0.02  

(9)
$111

$1.20
(0.09)
$1.11

$2.89  
(0.01)
$2.88  

$1.15
(0.09)
$1.06
  119,100,744   116,345,764  108,253,090   103,018,732   100,397,908
 123,066,370   120,360,212   112,494,346   107,428,750   104,948,476

$0.83  
(0.81)  
$0.02  

$2.23  
0.02  
$2.25  

$1.43  
0.04  
$1.47  

Cash and cash equivalents (1)
Investments and restricted deposits (1)
Total assets
Medical claims liability (1)
Long term debt (1)
Total stockholders’ equity

$1,760  
2,218  
7,339  
2,298  
1,216  
2,168  

$1,610  
1,557  
5,824  
1,723  
874  
1,743  

$974  
941
3,519  
1,112  
655  
1,243  

$746  
727  
2,764  
815  
526  
954  

$494
653
2,182
519
341
936

(1) From continuing operations

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
20  CENTENE CORPORATION

CORPORATE INFORMATION

The graph below compares the cumulative total stockholder return 
on our common stock for the period from December 31, 2010, to 
December 31, 2015, with the cumulative total return of the New York 
Stock Exchange Composite Index and the Standard & Poor’s 
Supercomposite Managed Healthcare Index over the same period. 
The graph assumes an investment of $100 on December 31, 2010,  
in our common stock (at the last reported sale price on such day), 
the New York Stock Exchange Composite Index and the Standard  
& Poor’s Supercomposite Managed Healthcare Index and assumes  
the reinvestment of any dividends.

STOCK PERFORMANCE GRAPH  
(in dollars)

$600

$500

$400

$300

$200

$100

$0

'10

'11

'12

'13

'14

'15

 Centene Corporation  
 S&P Supercomposite Managed Healthcare Index  
 New York Stock Exchange Composite Index 

BOARD OF DIRECTORS

MICHAEL F. NEIDORFF 
Chairman, President and CEO,  
Centene Corporation

ORLANDO AYALA 
Chairman and Corporate Vice President of 
Emerging Businesses for Microsoft Corporation

ROBERT K. DITMORE 
Former President and COO,  
United Healthcare Corporation

FREDERICK H. EPPINGER 
Director, President and CEO,  
The Hanover Insurance Group, Inc.

RICHARD A. GEPHARDT 
CEO and President of Gephardt Group LLC;  
Former Majority Leader of the U.S. House  
of Representatives

PAMELA A. JOSEPH 
Retired Vice Chairman, Payment Services  
of U.S. Bancorp, Chairman and CEO,  
Elavon, Inc.

JOHN R. ROBERTS 
Retired Regional Managing Partner,  
Arthur Andersen LLP

DAVID L. STEWARD 
Founder and Chairman,  
World Wide Technology, Inc.

TOMMY G. THOMPSON 
Chairman and CEO of Thompson Holdings;  
Former Health and Human Services Secretary;  
Former Governor of Wisconsin

FORM 10-K Centene has filed an Annual Report on Form 10-K for the year ended December 31, 2015, with the Securities and Exchange Commission. Stockholders may obtain a copy of this report, without charge,  by writing:Investor Relations Centene Corporation  7700 Forsyth Boulevard  St. Louis, MO 63105www.centene.comTRANSFER AGENTBroadridge Corporate Issuer Solutions, Inc. Broadridge Corporate Issuer SolutionsP.O. Box 1342Brentwood, NY 11717 855-627-5087 www.broadridge.com/TransferAgentANNUAL MEETINGThe Annual Meeting of Stockholders will be  held on Tuesday, April 26, 2016, at 10 a.m.  at Centene Corporation, 7700 Forsyth Blvd.,  St. Louis, MO 63105 in the Auditorium,  314-725-4477. CASH DIVIDEND POLICYCentene has not paid any dividends on its common stock and expects that its earnings will continue to be retained for use in the operation and expansion  of its business.OTHER INFORMATIONIncluded in this 2015 Annual Review are financial and operating highlights and summary financial statements. For complete financial statements, including notes, please refer to the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2015, filed with the Securities and Exchange Commission (the “2015 Form 10-K”),  which also includes Management’s Discussion and Analysis of Financial Condition and Results of Operations. This 2015 Annual Review, together with our 2015 Form 10-K, constitute our annual report  to security holders for purposes of Rule 14a-3(b) of the Securities Exchange Act of 1934, as amended. Our 2015 Form 10-K may be obtained by accessing the investor section of our company’s website at www.centene.com, or by going to the SEC’s website at www.sec.gov.NON-GAAP FINANCIAL PRESENTATIONThe Company is providing certain non-GAAP financial measures in this report as the Company believes that these figures are helpful in allowing individuals to more accurately assess the ongoing nature of the Company's operations and measure the Company's performance more consistently.  The Company uses the presented non-GAAP financial measures internally to allow management to focus on period-to-period changes in the Company's core business operations. Therefore, the Company believes that this information is meaningful in addition to the information contained in the GAAP presentation of financial information. The presentation of this additional non-GAAP financial information is not intended to be considered in isolation or as a substitute for the financial information prepared and presented in accordance with GAAP.COMMON STOCK INFORMATIONCentene common stock is traded and quoted on  the New York Stock Exchange under the symbol “CNC.” All share, per share and stock price information presented in this Annual Review has been adjusted for Centene’s two-for-one stock  split on February 2, 2015.CAUTIONARY STATEMENT ON FORWARD-LOOKING STATEMENTS All statements,  other than statements of current or historical fact, contained in this 2015 Annual Review  are forward-looking statements. We have attempted to identify these statements by terminology including “believe,” “anticipate,” “plan,” “expect,” “estimate,” “intend,”  “seek,” “target,” “goal,” “may,” “will,” “would,” “could,” “should,” “can,” “continue”  and other similar words or expressions in connection with, among other things, any discussion of future operating or financial performance. In particular, these statements include statements about our market opportunity, our growth strategy, competition, expected activities and future acquisitions, including our proposed merger with Health Net, Inc. (Health Net) (Proposed Merger), investments and the adequacy of our available cash resources.  Readers are cautioned that matters subject to forward-looking statements involve known and unknown risks and uncertainties, including economic, regulatory, competitive and other factors that may cause our or our industry's actual results, levels  of activity, performance or achievements to be materially different from any future results, levels of activity, performance or achievements expressed or implied by these forward-looking statements. These statements are not guarantees of future performance and are subject to risks, uncertainties and assumptions. All forward-looking statements included  in this 2015 Annual Review are based on information available to us on the date of this  2015 Annual Review and we undertake no obligation to update or revise the forward- looking statements included in this filing, whether as a result of new information, future events or otherwise, after the date of this filing. Actual results may differ from projections or estimates due to a variety of important factors applicable to both us and Health  Net, including but not limited to (i) our ability to accurately predict and effectively  manage health benefits and other operating expenses and reserves; (ii) competition;  (iii) membership and revenue projections; (iv) timing of regulatory contract approval;  (v) changes in healthcare practices; (vi) changes in federal or state laws or regulations, including the Patient Protection and Affordable Care Act and the Health Care and  Education Affordability Reconciliation Act and any regulations enacted thereunder;  (vii) changes in expected contract start dates; (viii) changes in expected closing dates, estimated purchase price and accretion for acquisitions; (ix) inflation; (x) foreign currency fluctuations; (xi) provider and state contract changes; (xii) new technologies; (xiii) advances in medicine; (xiv) reduction in provider payments by governmental payors; (xv) major epidemics; (xvi) disasters and numerous other factors affecting the delivery and cost of healthcare; (xvii) the expiration, cancellation or suspension of our or Health Net's managed care contracts by federal or state governments (including but not limited to Medicare  and Medicaid); (xviii) the outcome of our or Health Net's pending legal proceedings; (xix) availability of debt and equity financing, on terms that are favorable to us; (xx) our ability  to adequately price products on federally-facilitated and state-based Health Insurance Marketplaces; (xxi) changes in economic, political and market conditions; (xxii) the ultimate closing date of the Proposed Merger; (xxiii) the possibility that the expected synergies and value creation from the Proposed Merger will not be realized, or will not be realized within the expected time period; (xxiv) the risk that acquired businesses will not be integrated successfully; (xxv) disruption from the Proposed Merger making it more difficult to maintain business and operational relationships; (xxvi) the risk that unexpected costs related to the Proposed Merger will be incurred; and (xxvii) the possibility that the Proposed Merger does not close, including, but not limited to, due to the failure to satisfy the closing conditions thereto. We disclaim any current intention or obligation to update or revise any forward-looking statements, whether as a result of new information, future events or otherwise.  Due to these important factors and risks, we cannot give assurances with respect to our future premium levels or our ability to control our future medical costs. Please refer to Item A “Risk Factors” of Part I of the Company's Annual Report on Form 10-K filed with the SEC  on February 22, 2016 for a further discussion of these and other important factors that  could cause actual results to differ from expectations.STOCK PRICE2016*20152014HighLowHighLowHighLowFirst Quarter$ 68.42$ 47.36$ 71.66$ 51.73$ 33.18$ 28.44Second Quarter$ 82.18$ 61.85$38.84$ 27.56Third Quarter$ 83.00$ 50.93$ 41.99$ 35.49Fourth Quarter$ 67.53$ 51.75$54.24$37.53*Stock price through February 17, 2016 23

COMMON STOCK INFORMATION
Centene common stock is traded and quoted on  
the New York Stock Exchange under the symbol 
“CNC.” All share, per share and stock price 
information presented in this Annual Review has 
been adjusted for Centene’s two-for-one stock  
split on February 2, 2015.

STOCK 
PRICE

First 
Quarter
Second 
Quarter
Third 
Quarter
Fourth 
Quarter

2016*

2015

2014

High

Low

High

Low

High

Low

$ 68.42 $ 47.36 $ 71.66 $ 51.73

$ 33.18 $ 28.44

$ 82.18 $ 61.85 $38.84 $ 27.56

$ 83.00 $ 50.93 $ 41.99 $ 35.49

$ 67.53 $ 51.75 $54.24 $37.53

*Stock price through February 17, 2016

FORM 10-K 
Centene has filed an Annual Report on Form 10-K 
for the year ended December 31, 2015, with the 
Securities and Exchange Commission. Stockholders 
may obtain a copy of this report, without charge,  
by writing:

Investor Relations 
Centene Corporation  
7700 Forsyth Boulevard  
St. Louis, MO 63105

www.centene.com

TRANSFER AGENT
Broadridge Corporate Issuer Solutions, Inc. 
Broadridge Corporate Issuer Solutions
P.O. Box 1342
Brentwood, NY 11717 

855-627-5087 

www.broadridge.com/TransferAgent

ANNUAL MEETING
The Annual Meeting of Stockholders will be  
held on Tuesday, April 26, 2016, at 10 a.m.  
at Centene Corporation, 7700 Forsyth Blvd.,  
St. Louis, MO 63105 in the Auditorium,  
314-725-4477. 

CASH DIVIDEND POLICY
Centene has not paid any dividends on its common 
stock and expects that its earnings will continue to 
be retained for use in the operation and expansion  
of its business.

OTHER INFORMATION
Included in this 2015 Annual Review are financial 
and operating highlights and summary financial 
statements. For complete financial statements, 
including notes, please refer to the Company’s 
Annual Report on Form 10-K for the fiscal year 
ended December 31, 2015, filed with the Securities 
and Exchange Commission (the “2015 Form 10-K”),  
which also includes Management’s Discussion 
and Analysis of Financial Condition and Results of 
Operations. This 2015 Annual Review, together with 
our 2015 Form 10-K, constitute our annual report  
to security holders for purposes of Rule 14a-3(b) of 
the Securities Exchange Act of 1934, as amended. 
Our 2015 Form 10-K may be obtained by accessing 
the investor section of our company’s website at 
www.centene.com, or by going to the SEC’s website 
at www.sec.gov.

NON-GAAP FINANCIAL PRESENTATION
The Company is providing certain non-GAAP 
financial measures in this report as the Company 
believes that these figures are helpful in allowing 
individuals to more accurately assess the ongoing 
nature of the Company's operations and measure 
the Company's performance more consistently.  
The Company uses the presented non-GAAP 
financial measures internally to allow management 
to focus on period-to-period changes in the 
Company's core business operations. Therefore, 
the Company believes that this information 
is meaningful in addition to the information 
contained in the GAAP presentation of financial 
information. The presentation of this additional 
non-GAAP financial information is not intended to 
be considered in isolation or as a substitute for the 
financial information prepared and presented in 
accordance with GAAP.

CAUTIONARY STATEMENT ON FORWARD-LOOKING STATEMENTS All statements,  
other than statements of current or historical fact, contained in this 2015 Annual Review  
are forward-looking statements. We have attempted to identify these statements by 
terminology including “believe,” “anticipate,” “plan,” “expect,” “estimate,” “intend,”  
“seek,” “target,” “goal,” “may,” “will,” “would,” “could,” “should,” “can,” “continue”  
and other similar words or expressions in connection with, among other things, any 
discussion of future operating or financial performance. In particular, these statements 
include statements about our market opportunity, our growth strategy, competition, 
expected activities and future acquisitions, including our proposed merger with Health Net, 
Inc. (Health Net) (Proposed Merger), investments and the adequacy of our available cash 
resources.  Readers are cautioned that matters subject to forward-looking statements 
involve known and unknown risks and uncertainties, including economic, regulatory, 
competitive and other factors that may cause our or our industry's actual results, levels  
of activity, performance or achievements to be materially different from any future results, 
levels of activity, performance or achievements expressed or implied by these forward-
looking statements. These statements are not guarantees of future performance and are 
subject to risks, uncertainties and assumptions. All forward-looking statements included  
in this 2015 Annual Review are based on information available to us on the date of this  
2015 Annual Review and we undertake no obligation to update or revise the forward- 
looking statements included in this filing, whether as a result of new information, future 
events or otherwise, after the date of this filing. Actual results may differ from projections 
or estimates due to a variety of important factors applicable to both us and Health  
Net, including but not limited to (i) our ability to accurately predict and effectively  
manage health benefits and other operating expenses and reserves; (ii) competition;  
(iii) membership and revenue projections; (iv) timing of regulatory contract approval;  
(v) changes in healthcare practices; (vi) changes in federal or state laws or regulations, 
including the Patient Protection and Affordable Care Act and the Health Care and  

Education Affordability Reconciliation Act and any regulations enacted thereunder;  
(vii) changes in expected contract start dates; (viii) changes in expected closing dates, 
estimated purchase price and accretion for acquisitions; (ix) inflation; (x) foreign currency 
fluctuations; (xi) provider and state contract changes; (xii) new technologies; (xiii) advances 
in medicine; (xiv) reduction in provider payments by governmental payors; (xv) major 
epidemics; (xvi) disasters and numerous other factors affecting the delivery and cost of 
healthcare; (xvii) the expiration, cancellation or suspension of our or Health Net's managed 
care contracts by federal or state governments (including but not limited to Medicare  
and Medicaid); (xviii) the outcome of our or Health Net's pending legal proceedings; (xix) 
availability of debt and equity financing, on terms that are favorable to us; (xx) our ability  
to adequately price products on federally-facilitated and state-based Health Insurance 
Marketplaces; (xxi) changes in economic, political and market conditions; (xxii) the ultimate 
closing date of the Proposed Merger; (xxiii) the possibility that the expected synergies and 
value creation from the Proposed Merger will not be realized, or will not be realized within 
the expected time period; (xxiv) the risk that acquired businesses will not be integrated 
successfully; (xxv) disruption from the Proposed Merger making it more difficult to maintain 
business and operational relationships; (xxvi) the risk that unexpected costs related to the 
Proposed Merger will be incurred; and (xxvii) the possibility that the Proposed Merger does 
not close, including, but not limited to, due to the failure to satisfy the closing conditions 
thereto. We disclaim any current intention or obligation to update or revise any forward-
looking statements, whether as a result of new information, future events or otherwise.  
Due to these important factors and risks, we cannot give assurances with respect to our 
future premium levels or our ability to control our future medical costs. Please refer to Item 
A “Risk Factors” of Part I of the Company's Annual Report on Form 10-K filed with the SEC  
on February 22, 2016 for a further discussion of these and other important factors that  
could cause actual results to differ from expectations.

22  CENTENE CORPORATIONBOARD OF DIRECTORSMICHAEL F. NEIDORFF Chairman, President and CEO,  Centene CorporationORLANDO AYALA Chairman and Corporate Vice President of Emerging Businesses for Microsoft CorporationROBERT K. DITMORE Former President and COO,  United Healthcare CorporationFREDERICK H. EPPINGER Director, President and CEO,  The Hanover Insurance Group, Inc.RICHARD A. GEPHARDT CEO and President of Gephardt Group LLC;  Former Majority Leader of the U.S. House  of RepresentativesPAMELA A. JOSEPH Retired Vice Chairman, Payment Services  of U.S. Bancorp, Chairman and CEO,  Elavon, Inc.JOHN R. ROBERTS Retired Regional Managing Partner,  Arthur Andersen LLPDAVID L. STEWARD Founder and Chairman,  World Wide Technology, Inc.TOMMY G. THOMPSON Chairman and CEO of Thompson Holdings;  Former Health and Human Services Secretary;  Former Governor of WisconsinThe graph below compares the cumulative total stockholder return on our common stock for the period from December 31, 2010, to December 31, 2015, with the cumulative total return of the New York Stock Exchange Composite Index and the Standard & Poor’s Supercomposite Managed Healthcare Index over the same period. The graph assumes an investment of $100 on December 31, 2010,  in our common stock (at the last reported sale price on such day), the New York Stock Exchange Composite Index and the Standard  & Poor’s Supercomposite Managed Healthcare Index and assumes  the reinvestment of any dividends.CORPORATE INFORMATION$0STOCK PERFORMANCE GRAPH  (in dollars)$600$500$400$300$200$100'10'12'11'13'14'15 Centene Corporation   S&P Supercomposite Managed Healthcare Index   New York Stock Exchange Composite Index  7700 Forsyth Boulevard 
St. Louis, MO 63105, U.S.A. 
1-314-725-4477 

www.centene.com