Thank you for joining today. We're at the Bank of America Financial Services Conference 2025. This session is going to be Aflac. We're really pleased. We have our esteemed Chairman and CEO Dan Amos, and Vice President of Capital Markets, David Young. You know, Dan has a good amount of prepared remarks that he's going to give, but I always like to give a little preamble. There's some debate around this, but we can say for certain that Dan is the second longest serving CEO in the Fortune 250. Some people can guess who the longest serving CEO is. He's a pretty famous guy. I'd like to point out that a dollar invested with Dan over the last 35.5 years has compounded at a 16-17% clip annually, and that gentleman from Omaha was a very good investor, only about 14%-15%.
Dan's clearly outperformed the S&P 500 for a very long time. Unless you think this is something that was given to Aflac, you know, in the 1990s, over the last five years, stocks up 120% compared to the S&P 500 up 95%, and that Omaha stock just 108%. Nothing ill about Omaha at all, but I just want to point that out. You know, Dan will talk to us a little bit, but it's not just about being good, it's also about doing good. And the Aflac Cancer and Blood Disorders Center for children in Atlanta has raised over $185 million for that cause, doing wonderful things. And there's other wonderful things that Dan and Aflac have brought to light, which I'm sure we'll talk about. Dan received the Salute to Greatness Award from the Dr. Martin Luther King Jr. Center in Atlanta, and he's been at Aflac for a very long time. I have my own personal story. I'd just like to mention that when I was 24, I wasn't even a real analyst. I was just a back office person who was sent to the Aflac Investor Day to learn the story. And today, when you go to the Financial Outlook for Aflac, you get the comic stylings of Max Brodén. But back then, there was real entertainment, and there was The Amazing Kreskin was there. And I'm not even a real analyst. I'm 24 years old. I sat down at a table, and Dan never sits on ceremony, and he sat next to me after I was already there. And, you know, instantly, like, it's always amazing just, you know, who knows who you're sitting next to. And it's been, you know, a long time.
My hair's gotten a lot grayer over that period of time, but I appreciate that moment, Dan. And it's been an amazing story for you and Aflac, and I hope you can share some of the magic here today.
Well, thank you, Josh, and good morning, everyone. It's a pleasure to be here with all of you. I'd like to make a brief presentation addressing our business in the United States and in Japan. Then I'll hand off to David to conclude on the consensus of our EPS, our earnings per share, the liquidity, our capital management, before we open up for questions from Josh and any of you that you might want. Before I begin, I'll say that we're making a forward-looking statement, which could be affected by risk factors listed here in our 10-K form. I will also refer to the non-GAAP measures, which can be found along with the reconciliations in the appendix of the presentations in our fourth quarter earnings per share release. Please familiarize yourself with these items, which you'll find with other helpful disclosures at our investors.aflac.com.
Now, I've basically covered the things I had to do from a legal standpoint. Aflac Incorporated, through its subsidiaries and operations in the two largest insurance markets in the world, the United States and Japan. Our policies have helped provide financial protection and peace of mind for nearly seven decades to millions of policyholders and customers. In the United States, Aflac is the number one provider of supplemental health insurance. In Japan, Aflac Life Insurance is the leading provider of cancer and medical insurance in terms of policies in force. In 2024, we celebrated our 50th year of operation in Japan, where we pioneered cancer insurance. Our core business focuses on developing supplemental health insurance policies that consumers need. These policies have helped offset rising out-of-pocket expenses not covered by major medical insurance in the U.S. or the national healthcare system in Japan.
For many years, Aflac's strategy in Japan and in the United States has remained straightforward and consistent. Our supplemental policies are designed to pay fixed cash benefits directly to the insured, regardless of any other insurance they might have. Because the benefits are fixed at the policy issuance rather than open-ended, these benefits are not subject to inflation. As time passes, individuals also find the need to update or enhance their coverage to keep up with inflation and the medical expenses or trends not covered under their current coverage. We also offer other voluntary health life products that complement our core offerings and fit the needs for consumers. In Japan, this includes Tsumitasu, our latest life insurance product that offers an asset formation and options such as nursing care. In the United States, this includes Network Dental and Vision, as well as Group Life and Disability.
Equally important is we want to be there where the customers want to purchase insurance. As a result, we sell policies through multiple distribution channels: our associates, brokers, and other financial services companies with whom we partner. We also sell our policies directly in some cases. Ultimately, this strategy yields new accounts, sales, and customers. Now, let me turn to Aflac Japan, which accounts for 55% of Aflac Incorporated's adjusted revenues and 77% of their total assets. While focusing on Third Sector, we also continue and consider Japan's demographics. In doing so, our product strategy is to offer a full product lineup, excuse me, that fits the needs of customers throughout all stages of life, given the aging society, acquiring younger customers critical to the success of Aflac Japan. We were encouraged by the continued momentum of Tsumitasu.
We believe the asset formation component of Tsumitasu appeals to younger customers in Japan. Our strong sales in Japan reflect the success of our agencies have had selling the product. As the pioneer of cancer insurance and the leading third sector insurer, we also aim to sell these Tsumitasu product policyholders a medical product or a cancer product. The level of concurrent third sector sales steadily grew, reaching above 25%. Our latest cancer insurance product, Wings, was launched in stages in 2022. Therefore, we're planning a staged launch through our distribution channels of our new cancer insurance product between March and April of this year. This new product includes our unique Yorisou consultation program and support service, along with insurance coverage that offers enhanced protection before, during, and after cancer treatment.
It also features flexible coverage and introduces a new plan for children, thus providing more comprehensive protection for the customers. Additionally, we are also looking for opportunities to optimize our broad distribution channels of agencies, alliance partners, and banks to help provide financial protection to the Japanese consumers. At the same time, we're working hard to support each channel. Aflac Japan is strengthening our sales promotion with exclusive and Aflac-preferred agencies, which are the mainstay of our business in Japan today. As part of our strategic alliance with Japan Post, we continue to share best practices and broaden our sales support at Japan Post and Japan Post Insurance. Looking ahead, we continue to explore all avenues of growth sales in 2025. Now, let me highlight Aflac Japan's 2024 performance. As you can see, Third Sector policies made up more than 82% of Aflac Japan's net earned premiums.
In 2024, adjusted revenues declined 2.3% to JPY 1.5 trillion. Pre-tax adjusted earnings increased 15.5% to JPY 520 billion. As a result, Aflac Japan produced an extremely strong pre-tax profit margin of 36%, which is the highest I've ever remembered it. I looked and saw back 30 years. One of the consistent key contributions to Aflac Japan's strong financial results is its premium persistency, which was 93.4% for 2024. I'm also pleased that Aflac Japan's 5.8% year-over-year sales increase, which included a 9% sales increase in the fourth quarter. Now, let me turn to Aflac U.S. In the U.S., we hold the number one position in the worksite selling our core supplemental health insurance products. These policies help protect individuals from the rising out-of-pocket expense costs that major medical insurance does not cover.
Our individual and group supplemental health insurance products provide employers with more comprehensive benefit solutions and offer to their employees. At the same time, these supplemental health insurance products provide policyholders with cash when they need it most. This is so important because, despite changes in the healthcare environment, no major medical plan, not even the best, is designed to cover all the out-of-pocket expenses. In fact, according to the Workplace Trends Survey conducted by Kantar, more than half of the American population or workers would not be able to pay more than $1,000 of out-of-pocket expenses when an unexpected medical event occurs. And what's even sadder is that nearly a quarter cannot afford even $500 of out-of-pocket expenses. I believe that is a demonstration that the need for our products we offer is as strong or stronger today than it has ever been before.
We have focused on updating our products to ensure that our policyholders understand the value of the products that are provided. When people experience the value of our products firsthand, we believe it enhances product persistency, which both benefits our policyholders and lowers our expenses. Our product portfolio consists largely of critical care, cancer, accident, disability, and hospital indemnity products that allow us to meet the consumer's needs. Aflac U.S. further strengthens and diversified its portfolio with Aflac Group Life, Absence Management, and Disability, and Aflac's Dental and Vision products. We continue to scale these newer voluntary products and leverage them to further penetrate accounts, grow revenues, and open opportunities to sell our core supplemental products. Aflac U.S. built this leading position in supplemental insurance by marketing to individuals through agents, primarily at the Worksite in small businesses under 100 employees.
We also know that employment markets, consumer habits, and buying preferences have evolved over time. As part of our strategy to be where customers want to purchase insurance, Aflac U.S. has expanded its reach to larger cases through Aflac Group. Aflac Group products allow brokers to service larger employers with 100 or more employees who may be located across multiple state lines. In addition, we have direct and digital channels that provide access to Aflac's products as buying behavior changes to improve access to Aflac. In the U.S., the working population has more than 181 million people in it. Of this, more than 112 million individuals work in businesses that Aflac is not offered by their employer. Furthermore, of the 32.6 million who do have access to Aflac through their employer, 25 million do not currently have Aflac policies.
With a market-leading position and 27% market share of the supplemental health insurance market in the workplace, we see a growth opportunity for Aflac U.S. We are working with our strategic partners and sales force to increase penetration of our current accounts and provide access to more people at the Worksite. We continue to execute on our growth strategy to increase penetration with a diverse product mix and multi-channel sales force enabled by the best-in-class experience model in terms of service. Aflac U.S. also generated solid overall financial results in 2024. Total adjusted revenues increased 1.8% to $6.7 billion. Our pre-tax adjusted earnings was $1.4 billion for the year, a decline of 5.5%. Aflac U.S. produced strong pre-tax profit margins of 21.1% for the full year. Sales were lower than expected in the fourth quarter, leading to a 1% decline for the year.
However, persistency improved by 70 basis points to 79.3% as we continue to focus on more profitable growth through the strongest underwriting discipline that we've been using. At the same time, we're engaging with agents and brokers following the stabilization of the network dental products that we offer. As always, we will continue prudent approach to our management team and maintaining our strong pre-tax margins. We have also been focused on increasing persistency growth through profitable earned premium programs. We have been updating our products to ensure that policyholders continue to realize the value of our products. We know that when the people experience the value of our products, it increases the persistency, which benefits our policyholders and lowers our overall expenses. Now, I'll turn the program over to David to wrap up on the results of our liquidity and capital management. David?
Thank you, Dan.
Now, when we look at our consolidated results, Aflac Incorporated delivered very strong earnings for the year. Net earnings per diluted share for 2024 were $963, up 23.8%, and adjusted earnings per diluted share of $7.21 were the best in company history and up 15.7%. However, we believe that viewing our results, excluding the impact of foreign currency, is the most meaningful way to assess our financial performance. By doing so, you get a better understanding of Aflac's underlying profitability, regardless of whether the yen helped us or hurt us. For the full year, the average yen-dollar exchange rate was 150.97 versus 140.57 a year ago. When adjusting for the impact of the yen, adjusted earnings per diluted share increased 18.6% to $7.39.
We are pleased with the proactive steps that we have taken in recent years to defend our cash flow and deployable capital against a weakening yen with our enterprise corporate hedging program. We believe that we are well hedged on an economic basis for moves of the yen-dollar exchange rate by the combination of holding $22.9 billion of unhedged U.S. dollar assets in the Japan General account, approximately $1.8 billion in foreign currency forwards at the holding company, and approximately 60% of our debt in yen. We use these tools to both calibrate the total level of the program and use the tool with the best risk-adjusted return on capital to optimize the risk-reward of the total program. As a result, we believe that this program also reduces the cost of equity capital, improving shareholder value creation.
At the same time, we have maintained our ongoing commitment to prudent liquidity and capital management. At the end of 2024, we had nearly $4.1 billion of unencumbered holding company liquidity, which was $2.3 billion above our minimum balance. Our statutory capital ratios remained strong, and we ended the year with an SMR above 1,150% and an estimated ESR above 270% in Japan. While not finalized, we estimated the combined RBC in the U.S. to be greater than 650%. Our capital ratios demonstrate our commitment to maintaining financial strength and flexibility on behalf of our policyholders, shareholders, and bondholders. We intend to continue prudently managing our liquidity and capital to preserve the strength of our capital and cash flows.
In the fourth quarter of 2022, we announced our internal reinsurance strategy and outlined how we intended to execute a series of transactions to drive reduced risk, better balance sheet efficiency, and ultimately a higher ROE for the group. Since then, we have executed three transactions between Aflac Japan and Aflac Re Bermuda, as well as a novation of a block previously ceded to a third party. We estimate that we have already achieved 100 to 200 basis points run rate ROE enhancement that we expected this strategy to deliver when we introduced it. To date, we have ceded approximately 6% of Aflac Japan's asset base to Aflac Re Bermuda and still think it is reasonable to expect us to cede about 10% of Aflac Japan's asset base to Aflac Re Bermuda over time. Therefore, we still have significant capacity relative to our 10% internal cap.
At the end of 2024, we reported book value per share of $47.45 and adjusted book value per share excluding foreign currency remeasurement of $42.46, which increased 3.2%. As a result, we reported an ROE for the year of 22.6% and 17.3% excluding foreign currency remeasurement, which was an acceptable spread to our cost of capital. 2024 marked 42 consecutive years of increasing our dividend. We treasure our track record of dividend growth and remain committed to extending it. The board put us on a path to continue this record when it increased the first quarter 2025 dividend 16% to $0.58 per share. We have remained tactical in our approach to share repurchase, deploying $2.8 billion in capital to repurchase more than 30 million of our shares in 2024. Combined with dividends, this means we delivered $3.9 billion back to shareholders in 2024.
At the same time, we have maintained our position among companies with the highest return on capital and lowest cost of capital in the industry. We believe in the underlying strengths of our business and our potential for continued growth in Japan and the U.S., and we are well positioned as we work toward achieving long-term growth for our shareholders while also ensuring we deliver on our promise to our policyholders. In summary, our objective is to maintain our strong capital position while producing stable earnings and strong cash flows. We believe that in both Japan and the United States, our market-leading position, powerful brand, strong distribution, and innovative products will provide support toward this objective. As we work toward our objectives and goals, we have confidence in our business model and fundamental need for our products, and most importantly, the future success of Aflac.
With that, Josh, I think we'll open up to questions. Thank you.
Thank you. So we can take some questions. I'll start, and if anyone has a question, raise your hand. We'll get to you. So I always like the slide, the pies within the pies. It always tells me a story of what's going on. I feel in that U.S. market, there's the possibility of selling to more employers, better penetrating the employees within individual employers and among people who are already Aflac customers, and having them buy more product. I mean, I know it's each and all sort of strategy to do those things. What's easier for Aflac to do? Where's the success being seen right now in terms of pushing that growth on those three strategies?
Well, our strength comes from our distribution channel, and ultimately, it's always easier to enroll in the existing accounts than it is setting up a new account. And the reason for that is, I call it kind of a cocoon where it's just protected. We can sell better products at a better price and have higher persistency within an account. And the reason is, within an account, you're going to have younger people, you're going to have healthier people, and you're going to have the employer saying, "I recommend this because it's on payroll deduction." And the way it's deducted from their checking accounts, they tend to keep it longer. So an example would be short-term disability. We can't sell short-term disability on an individual basis at almost any price because of the adverse selection you get from it. You're going to get older, sicker people.
And you got the employer pushing them to come back to work. On the other hand, if they're self-employed, there's no one pushing them back. So definitely, it's the enrollment within the accounts where it's easier to grow our business. Part of that's due to turnover in terms of the employee leaving the account, going somewhere else to work. But the majority of it is just getting in and seeing new customers that come in and what they offer, and that'll grow our business. But when you're selling to new accounts, you have to go through a process that's sometimes a little bit harder to get the payroll deduction slot. But once you get that, you'll enroll much better.
So then we do have one question in the audience here, and we can get to it, and then we can continue.
Go right ahead.
In the individual issued part of the marketplace, you have your incredible distribution machine. In the group side, you have to commonly work through the broker channel. Is the opportunity in that space to become even a more significant player, to have a stronger presence amongst the broker community? I'm trying to figure out what's the sort of the unlock within the group space.
Absolutely. We have been concentrating the last five years on growing our business with the group. We've been establishing new products by acquiring the dental and vision, by acquiring the PLADS business. PLADS business, we don't write any accounts below 5,000. So that's the way we're operating and the way we're trying to do it. So yes, by all means. At the same time, there's really very little competition at the under 50 accounts in terms of size.
They're mainly, as you can imagine, everybody's always wanting to get the big account. And the little ones can make up great persistency. One difference in little accounts compared to the big accounts is we lose the small accounts. It's not lapsation of the individuals within the account, it's that the accounts go out of business for some reason. So we have higher turnover, whereas on the big side of the accounts that are, let's just call them over 100, those accounts all tend to stay in business longer, and you don't run into that. But we are definitely working on the broker business, and it counts for a little over half of our business today. We're at peak employment, I think, in this country.
It's been peak employment for a while. That's good for sales because there's a lot of people employed who can buy Aflac products. Makes it harder for you to compete for talent to sell Aflac products, though.
It is harder to recruit in full employment because all of our salespeople are commission-driven. One thing you find in different sales organizations is if it's commission-driven, then you'll have some really high-income people because they're not supplementing the income of the failures that make it. So if you have a draw or have a modest salary with a potential for bonus, all the people that fail, that amount of money, you've got to take off the top end up here to do that. So your super brokers that you were talking about, they don't want to do business with anybody. They want to get the highest commissions they can get. So they like our structure and the way we do it. But yes, it does have some impact.
We offset it by trying to, interestingly enough, in our sales force, my favorite recruit, and I did it for 10 years, was always school teachers. They were highly paid. I mean, they were low-paid, highly educated, and generally had three months during the summer that you could have them try to see if they liked it. And then if they did, they could come to work, and if they didn't, they could go back and teach. And so that worked out. And interestingly enough, probably won't surprise you, coaches even did better, male or female, because they were motivational in style.
Do you think an argument can be made if we do go into a higher unemployment period of time that the better recruiting could offset the declining employee benefit sales that would be almost indifferent?
It has in the past. And so yes, I think it will.
Even going back to the 1970s, when we were small, we generally found that one offset the other to a great degree. So yes, I do think it won't be affected to any great degree. Can it be some, of course, but not significant?
I don't really believe in disparaging any people, especially people I don't know. But the federal government seems to be urging to just employ a significant portion of their population through some initiatives that Elon Musk has planned. Do you think there's an opportunity to find some people who would like to sell some Aflac product in this?
I do. And they're talking about some of the diverse candidates and things that they're laying off different places. We're always looking for qualified people, no matter who they are. If they can do the job, we're very interested. So yes, I do. And we'll work hard.
With change comes opportunity. And that's what we want to be as an opportunistic company that goes out and keeps their name in front of the public, that we're interested in hiring them.
I've asked this question before because there's a hobby horse for me. One of the first things that you did when you became CEO of Aflac is you brought the duck to life. And the duck is a really powerful brand. I tend to view in my view of the world, there are four great insurance brands in the United States, and Aflac is one of them in terms of customer recognition. Is the duck being adequately utilized? I can go to Progressive or Geico or Allstate's websites and buy disability insurance, but I can't go to Aflac and buy auto insurance.
And I'm not asking you to get into the auto insurance market, but I'm wondering if the duck should be selling some high-quality auto insurance made by somebody else.
Well, we are not opposed to reviewing anything. What I think is that we need to be successful in what we bought and have focused our money on. And that is we need to be well-known in the dental business. We need to be well-known in the broker community. I don't like hearing that, by the way, because I want all the brokers to know who we are and what we do and we work that. I want to be well-known in the PLADS business and the group business that we're selling. But certainly, we would look at something.
Remember, when you do a joint venture or anything of that kind, you also are not going to ever do business with the others. So you've got to be careful who you set up with and what you do. But we keep an open mind on that. And I would add that we are very protective of the brand that's built over time. We've had great success with that. But we have actually partnered with another reputable brand USAA, where you can go to their site as a member of USAA and buy Aflac policies.
Aflac products, yeah. So you say we should be focused on the things that we've invested in so far and what you're known for and whatnot. Obviously, the dominant product in Japan is the cancer insurance.
To what extent is the brand associated with the other products you're selling in Japan and the ability to get in the mind share of the Japanese customer that Aflac is not simply a cancer insurance business?
I think the medical insurance business certainly has proven to be a great success with us. If you go back, just for a little quick background, when we got licensed in Japan, they treated us like a drug company and decided that this cancer product, you deserve the right to have an exclusive for seven years. And then at the end of that time, they started allowing, I was trying to think, foreign companies to sell and small insurance companies. And then in 2021, they deregulated, I'm sorry, 2001, they deregulated the whole market and anybody could get into it.
When that happened, everybody thought we were going to be in big trouble, that the big life insurance companies were going to put us out of business. Not only didn't we not get in trouble, but we ended up cutting a deal with Dai-ichi Life, and they ended up selling for us, and then the banks and the brokers. But in addition to that, we became the number one seller of medical insurance. They thought we would lose our market share to them. We ended up taking the market share away from the other companies that were the leaders and became the leader ourselves. So I would argue today, all the Japanese consumers, because we've got 90% name recognition, they see us as a cancer insurance company. They also see us as a medical company. But our challenge is the younger people.
What do we do about the younger people? How do we get them on board? Our product that we're selling now is a relatively low in terms of expense product, but it gets their foot in the door for the younger people. If we get them on, then we can add medical or we can sell the cancer product. This new product that we're introducing, they can copy it. We expect that to happen at some point in time. To me, what drives our success is our operating expense ratio. If you're the low-cost producer, then you can ultimately give a better product at a better price and ultimately give a good return to the shareholders. That's what we're trying to do.
Thank you for being here today.
Appreciate all your insights, and I hope everyone has a good day meeting with investors. Thank the audience for being here, and we will continue with the next session after a little bit of a break. Thank you.
Thank you. Thank you, Josh.