Western Region Operations and Government Contracts Segments Produce
Combined Net Income of $58.5 Million, or $0.72 Per Diluted Share
Health Plan Enrollment Climbs 24.7 Percent Year-over-Year, and
Surpasses 3 Million Members, Driven by Continued Medicaid Growth from
Expansion and Commercial Growth from Individual Exchanges
Company Enters into Master Services Agreement with Cognizant: Health
Net Expects $150 to $200 Million in Annual G&A and Depreciation Expense
Savings by 2017
Company Website:
http://www.healthnet.com
LOS ANGELES -- (Business Wire)
Health Net, Inc. (NYSE: HNT) today announced a 2014 third quarter GAAP
net loss of $8.9 million, or a loss of $0.11 per share, compared with
GAAP net income of $66.8 million, or $0.83 per diluted share, for the
third quarter of 2013.
The company announced today in a separate press release that it has
entered into a master services agreement with a wholly owned subsidiary
of Cognizant Technology Solutions Corporation (NASDAQ: CTSH)
(Cognizant), a leading provider of information technology, consulting
and business process services.
Health Net previously announced on August 6, 2014, that it had signed a
Letter of Intent with Cognizant as part of Health Net’s commitment to
address Health Net’s scale issue and reduce administrative costs.
The GAAP net loss resulted from approximately $106 million of expenses
incurred in the third quarter of 2014 related to the company’s new
master services agreement with Cognizant. The $106 million is comprised
of an approximately $85 million, non-cash, impairment of the company’s
information technology assets that will be sold to Cognizant upon
completion of the transaction and approximately $21 million in other
transaction-related and other expenses.
“We believe the Cognizant transaction will help us address our scale
issue and enhance Health Net’s product development and service
capabilities. This in turn should strengthen our competitive position
for the long term,” explained Jay Gellert, Health Net’s chief executive
officer.
“The transaction-related costs incurred in the third quarter were
consistent with our earlier guidance regarding the cash impact of such
transaction expenses,” he added.
The company’s Western Region Operations (Western Region) and Government
Contracts segments produced combined net income of $0.72 per diluted
share in the third quarter of 2014 compared with $0.83 per diluted share
in the third quarter of 2013. The company’s third quarter of 2013
benefited by approximately $32 million in pretax income, or
approximately $0.25 per diluted share, from favorable California
Medicaid rate adjustments primarily for seniors and persons with
disabilities members related to prior periods.
Highlights from the third quarter of 2014 include:
-
The company’s Western Region health plans enrollment grew by
24.7 percent, or approximately 609,000 members, at September 30, 2014
compared with enrollment at September 30, 2013, and grew by
5.3 percent, or approximately 156,000 members, at September 30, 2014
compared with enrollment at June 30, 2014;
-
Medicaid enrollment grew 11.5 percent sequentially and 39.0 percent
between September 30, 2013 and September 30, 2014. The expansion of
Medicaid eligibility under the Affordable Care Act (ACA) continued to
drive this growth in Arizona and California;
-
The company’s commercial and Medicaid lines of business continued to
benefit from favorable underlying health care cost trends. Commercial
medical costs per member per month (PMPM) declined by 0.7 percent in
the third quarter of 2014 compared with the third quarter of 2013;
-
In the third quarter of 2014, operating cash flow was approximately
$588 million as the company received a fourth monthly Medi-Cal payment
of approximately $300 million and reserves for claims and other
settlements increased by approximately $245 million;
-
Reserves for claims and other settlements rose by 75.0 percent in the
third quarter of 2014 compared with the third quarter of 2013, and by
16.5 percent when compared with the second quarter of 2014; and
-
The company resumed its share repurchases in the third quarter. The
company repurchased 3 million shares from September 10, 2014 through
October 20, 2014, at a total cost of approximately $138 million.
“We are very pleased that our operating momentum continued in the third
quarter, driven by improvements in several key areas,” said Gellert.
“Overall health plan enrollment topped 3 million members as Medicaid
enrollment exceeded expectations with further growth from expansion
lives and also from traditional Medicaid eligibles. The commercial MCR
improved year-over-year, helped by a favorable mix and ongoing moderate
cost trends,” he added.
“We continued to implement the duals eligible demonstration pilots in
Los Angeles and San Diego counties. Enrollment growth has been somewhat
slower than expected, similar to the early roll out of Medicaid
expansion. We are confident the program will work well over time. We
will remain conservative in our expectations but aggressive in our
execution,” Gellert noted.
CONSOLIDATED RESULTS
Health Net’s total revenues increased 36.6 percent in the third quarter
of 2014 to $3.8 billion from $2.8 billion in the third quarter of 2013.
Health plan services premium revenues of approximately $3.6 billion in
the third quarter of 2014 increased by 39.3 percent compared with the
third quarter of 2013.
Health plan services expenses increased by 41.3 percent to approximately
$3.1 billion in the third quarter of 2014 compared with the third
quarter of 2013.
WESTERN REGION OPERATIONS SEGMENT
Health Plan Membership
Total enrollment in the Western Region at September 30, 2014 was
approximately 3.1 million members, an increase of 24.7 percent from
enrollment at September 30, 2013.
Total enrollment in the company’s California health plans at
September 30, 2014 was approximately 2.7 million members, an increase of
20.7 percent from enrollment at September 30, 2013.
Western Region commercial enrollment at September 30, 2014 was
approximately 1.2 million, an increase of 11.7 percent compared with
enrollment at September 30, 2013.
Membership in tailored network products represented 51.7 percent of the
company’s Western Region commercial membership at September 30, 2014
compared with 36.8 percent at September 30, 2013.
“Health Net’s success with our tailored network strategy is a key factor
driving our success in the exchanges,” said Jim Woys, Health Net’s chief
financial and operating officer and interim treasurer. “We continue to
expect tailored network enrollment to be greater than 50 percent at
December 31, 2014.”
Enrollment in the company’s Medicare Advantage (MA) plans in the Western
Region at September 30, 2014 was approximately 271,000 members, an
increase of 13.4 percent compared with enrollment of approximately
239,000 members at September 30, 2013.
Medicaid enrollment in California increased 31.9 percent to
approximately 1.5 million members at September 30, 2014 compared with
approximately 1.1 million members at September 30, 2013.
Dual eligibles enrollment at September 30, 2014 was approximately 9,000,
an increase of 350.0 percent compared with enrollment at June 30, 2014.
Revenues
Total revenues for the Western Region for the third quarter of 2014 were
approximately $3.6 billion compared with approximately $2.6 billion in
the third quarter of 2013.
Net investment income for the Western Region was approximately
$11.0 million in the third quarter of 2014 compared with approximately
$12.0 million in the second quarter of 2014 and $11.3 million in the
third quarter of 2013.
Health Plan Services Expenses
Health plan services expenses in the Western Region were approximately
$3.1 billion in the third quarter of 2014 compared with approximately
$2.2 billion in the third quarter of 2013.
Commercial Premium Yield and Health Care Cost
Trends
In the Western Region, commercial premiums PMPM decreased by 0.3 percent
to approximately $386 in the third quarter of 2014 compared with
approximately $387 in the third quarter of 2013.
Commercial health care costs PMPM in the Western Region decreased by
0.7 percent to approximately $323 in the third quarter of 2014 compared
with approximately $326 in the third quarter of 2013.
“Health care cost trends remained moderate in the third quarter,” said
Woys. “We also benefited from a significant and favorable shift in our
commercial business mix as individual enrollment grew while large group
business continued to decline, as intended.”
Medical Care Ratios (MCR)
The health plan services MCR in the Western Region was 85.5 percent in
the third quarter of 2014 compared with 84.3 percent in the third
quarter of 2013.
The Western Region commercial MCR was 83.9 percent in the third quarter
of 2014 compared with 84.2 percent in the third quarter of 2013 and
82.3 percent in the second quarter of 2014.
The MA MCR in the Western Region was 90.8 percent in the third quarter
of 2014 compared with 89.9 percent in the third quarter of 2013.
The Medicaid MCR was 84.2 percent in the third quarter of 2014 compared
with 79.4 percent in the third quarter of 2013.
General and Administrative (G&A) and Selling
Expenses
G&A expenses in the Western Region were $353.4 million in the third
quarter of 2014 compared with $267.1 million in the third quarter of
2013 and $342.0 million in the second quarter of 2014. The G&A expense
ratio was 9.7 percent in the third quarter of 2014 compared with
10.2 percent in the third quarter of 2013 and 10.5 percent in the second
quarter of 2014.
The G&A expense ratio in the Western Region also declined sequentially
and year-over-year in the third quarter of 2014. “We remain focused on
continued improvement in our administrative efficiency as we pursue the
required regulatory approval of our Cognizant agreement,” stated Woys.
GOVERNMENT CONTRACTS SEGMENT
Government Contracts revenues in the third quarter of 2014 were
$146.2 million compared with $149.3 million in the third quarter of 2013.
Government Contracts expenses in the third quarter of 2014 were
$123.6 million compared with $125.8 million in the third quarter of 2013.
BALANCE SHEET
Cash and investments as of September 30, 2014 were approximately
$2.8 billion compared with approximately $2.3 billion as of
September 30, 2013.
Reserves for claims and other settlements as of September 30, 2014 were
$1.7 billion compared with $990.2 million as of September 30, 2013 and
$1.5 billion as of June 30, 2014. Approximately 61.8 percent of the
sequential increase in reserves for claims and other settlements was the
result of an increase in incurred but not reported (IBNR) reserves.
Days claims payable (DCP) for the third quarter of 2014 was 51.4 days
compared with 41.5 days in the third quarter of 2013 and 49.0 days in
the second quarter of 2014.
On an adjusted1 basis, DCP for the third quarter of 2014 was
65.3 days compared with 61.1 days in the third quarter of 2013 and
64.4 days in the second quarter of 2014.
The company’s debt-to-total capital ratio was 22.1 percent as of
September 30, 2014 compared with 23.8 percent as of September 30, 2013
and 21.5 percent as of June 30, 2014.
CASH FLOW FROM OPERATIONS
Operating cash flow was approximately $588.0 million in the third
quarter of 2014.
“Our strong operating cash flow was primarily the result of the receipt
of a fourth Medi-Cal payment of approximately $300 million in the
quarter and a $245 million increase in reserves for claims and other
settlements,” said Woys.
The company noted that cash at the parent was approximately $271 million
at September 30, 2014.
STOCK REPURCHASE UPDATE
During the third quarter of 2014, Health Net repurchased approximately
1.5 million shares of its common stock for approximately $69.0 million
at an average price of $46.54 per share. At September 30, 2014,
approximately $211.0 million of authorization under the company’s
existing $400 million share repurchase program remained.
“We continue to believe that share repurchase is our best option at this
time for capital deployment,” Gellert explained.
“We are updating our guidance for weighted-average fully diluted shares
outstanding in 2014 to approximately 81 million shares from our prior
guidance of 80 million shares,” he added.
2014 GUIDANCE
The company is revising GAAP earnings per diluted share to at least
$1.95 from at least $3.00 for the full year 2014, due to the impact of
incurred and expected costs related to the Cognizant transaction. The
company also is raising the Western Region and Government Contracts
earnings per share to at least $2.25 from at least $2.22 for the full
year 2014.
The table included in this release provides specific 2014 guidance
metrics, including updates to expectations for large group, small group,
individual, Medicare Advantage, Medicaid, dual eligibles and total
health plan membership; commercial, Medicare Advantage, state health
plans, dual eligibles, total health plans and total consolidated
revenues; the Medicaid MCR; tax rates; weighted-average fully diluted
shares outstanding; GAAP earnings per diluted share (EPS); and Western
Region and Government Contracts EPS.
CONFERENCE CALL
As previously announced, Health Net will discuss the company’s third
quarter 2014 financial results during a conference call on Monday,
November 3, 2014, beginning at approximately 11:00 a.m. Eastern time.
The live conference call should be accessed at least 15 minutes prior to
its start with the following numbers:
(877) 407-4019 (Live – Domestic Toll-Free)
|
|
|
|
|
(877) 660-6853 (Replay – Domestic Toll-Free)
|
(201) 689-8337 (Live – International)
| | | | |
(201) 612-7415 (Replay – International)
|
| | | | |
|
The access code for the live conference call and replay is 13591799. A
replay of the conference call will be available through November 8,
2014. A live webcast and replay of the conference call also will be
available at www.healthnet.com
under “Investor Relations.” The conference call webcast is open to all
interested parties. Anyone listening to the company’s conference call or
webcast will be presumed to have read Health Net’s Annual Report on
Form 10-K for the year ended December 31, 2013, and Quarterly Reports on
Form 10-Q for the quarterly periods ended March 31, 2014 and June 30,
2014, and other reports filed by Health Net from time to time with the
Securities and Exchange Commission.
ABOUT HEALTH NET
Health Net, Inc. is a publicly traded managed care organization that
delivers managed health care services through health plans and
government-sponsored managed care plans. Its mission is to help people
be healthy, secure and comfortable. Health Net provides and administers
health benefits to approximately 5.9 million individuals across the
country through group, individual, Medicare (including the Medicare
prescription drug benefit commonly referred to as “Part D”), Medicaid,
U.S. Department of Defense, including TRICARE, and Veterans Affairs
programs. Through its subsidiaries, Health Net also offers behavioral
health, substance abuse and employee assistance programs, managed health
care products related to prescription drugs, managed health care product
coordination for multi-region employers, and administrative services for
medical groups and self-funded benefits programs.
For more information on Health Net, Inc., please visit the company’s
website at www.healthnet.com.
CAUTIONARY STATEMENTS
The company and its representatives may from time to time make written
and oral forward-looking statements within the meaning of the Private
Securities Litigation Reform Act (“PSLRA”) of 1995, including statements
in this and other press releases, in presentations, filings with the
Securities and Exchange Commission (“SEC”), reports to stockholders and
in meetings with investors and analysts. All statements in this press
release, other than statements of historical information provided
herein, including the guidance for future periods and the assumptions
underlying such projections, may be deemed to be forward-looking
statements and as such are intended to be covered by the safe harbor for
“forward-looking statements” provided by PSLRA. These statements are
based on management’s analysis, judgment, belief and expectation only as
of the date hereof, and are subject to changes in circumstances and a
number of risks and uncertainties. Without limiting the foregoing, the
guidance as to expected future period results and statements including
the words “believes,” “anticipates,” “plans,” “expects,” “may,”
“should,” “could,” “estimate,” “intend,” “feels,” “will,” “projects” and
other similar expressions are intended to identify forward-looking
statements. Actual results could differ materially from those expressed
in, or implied or projected by the forward-looking information and
statements due to, among other things, health care reform and other
increased government participation in and taxation or regulation of
health benefits and managed care operations, including but not limited
to the implementation of the Patient Protection and Affordable Care Act
and the Health Care and Education Reconciliation Act of 2010
(collectively, the "ACA") and related fees, assessments and taxes; the
company’s ability to successfully participate in California’s
Coordinated Care Initiative, which is subject to a number of risks
inherent in untested health care initiatives and requires the company to
adequately predict the costs of providing benefits to individuals that
are generally among the most chronically ill within each of Medicare and
Medi-Cal and implement delivery systems for benefits with which the
company has limited operating experience; the company’s ability to
successfully participate in the federal and state health insurance
exchanges under the ACA, which have experienced technical challenges in
implementation and which involve uncertainties related to the mix and
volume of business that could negatively impact the adequacy of our
premium rates and may not be sufficiently offset by the risk
apportionment provisions of the ACA; increasing health care costs,
including but not limited to costs associated with the introduction of
new treatments or therapies; our ability to reduce administrative
expenses while maintaining targeted levels of service and operating
performance, including through our master services agreement with
Cognizant; whether we receive required regulatory approvals for
Cognizant’s provision of services to us and any conditions imposed in
order to obtain such regulatory approvals; our ability to recognize the
intended cost savings and other intended benefits of the Cognizant
transaction; and the risk that Cognizant may not perform contracted
functions and services in a timely, satisfactory and compliant manner;
negative prior period claims reserve developments; rate cuts and other
risks and uncertainties affecting the company’s Medicare or Medicaid
businesses; the company’s ability to successfully participate in
Arizona’s Medicaid program; trends in medical care ratios; membership
declines or negative changes in our health care product mix; unexpected
utilization patterns or unexpectedly severe or widespread illnesses; the
timing of collections on amounts receivable from state and federal
governments and agencies, including collections of amounts owed under
the T-3 contract; litigation costs; regulatory issues with federal and
state agencies including, but not limited to, the California Department
of Managed Health Care, the Centers for Medicare & Medicaid Services,
the Office of Civil Rights of the U.S. Department of Health and Human
Services and state departments of insurance; operational issues; changes
in economic or market conditions; failure to effectively oversee our
third-party vendors; noncompliance by the company or the company’s
business associates with any privacy laws or any security breach
involving the misappropriation, loss or other unauthorized use or
disclosure of confidential information; impairment of the company’s
goodwill or other intangible assets; investment portfolio impairment
charges; volatility in the financial markets; and general business and
market conditions. Additional factors that could cause actual results to
differ materially from those reflected in the forward-looking statements
include, but are not limited to, the risks discussed in the “Risk
Factors” section included within the company’s most recent Annual Report
on Form 10-K and subsequent Quarterly Reports on Form 10-Q filed with
the SEC and the other risks discussed in the company’s filings with the
SEC. Readers are cautioned not to place undue reliance on these
forward-looking statements. Except as may be required by law, the
company undertakes no obligation to address or publicly update any of
its guidance, the assessment of the underlying assumptions or
forward-looking statements to reflect events or circumstances that arise
after the date of this release.
The financial information presented in this press release is unaudited
and is subject to change as a result of subsequent events or
adjustments, if any, arising prior to the filing of the company’s
Quarterly Report on Form 10-Q for the quarterly period ended September
30, 2014.
1 For a reconciliation of adjusted days claims payable to the
comparable GAAP financial measure, see “Management’s Discussion and
Analysis of Financial Condition and Results of Operations – Results of
Operations – Days Claims Payable” in the company’s Form 10-Q for the
quarter ended September 30, 2014, and Item 2.02 in the company’s
Form 8-K filed with the Securities and Exchange Commission on
November 3, 2014.
|
Health Net, Inc. |
2014 GAAP Guidance (1) |
|
|
|
|
|
| |
|
|
| |
MEMBERSHIP | | | | Current | | | | Previous |
|
|
|
| (updated 11/3/14) |
|
|
| (as of 8/6/14) |
| | | | | | | |
|
| | | | Enrollment | | | | Enrollment |
| | | | at 12/31/2014 |
|
|
| at 12/31/2014 |
Commercial | | | | | | | | |
Large Group
| | | |
551,000
| | | |
560,000
|
Small Group
| | | |
298,000
| | | |
280,000
|
Individual
| | | |
364,000
| | | |
380,000
|
| | | | | | | |
|
Total Commercial
| | | |
1,213,000
| | | |
1,220,000
|
| | | | | | | |
|
Medicare Advantage | | | |
278,000
| | | |
260,000
|
| | | | | | | |
|
Medicaid | | | |
1,726,000
| | | |
1,585,000
|
| | | | | | | |
|
Dual Eligibles | | | |
20,000
| | | |
38,000
|
| | | | | | | |
|
Total Health Plan Membership | | | |
3,233,000
| | | |
3,103,000
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| | | | | | | |
|
Premium Revenues |
|
|
| FY2014 |
|
|
| FY2014 |
| | | | | | | |
|
Commercial
| | | |
$5.5 billion
| | | |
$5.6 billion
|
Medicare Advantage
| | | |
$3.1 billion
| | | |
$3.0 billion
|
State Health Plans
| | | |
$4.9 billion
| | | |
$4.5 billion
|
Dual Eligibles
| | | |
$130 million
| | | |
$342 million
|
Total Health Plans
| | | |
$13.6 billion
| | | |
$13.4 billion
|
| | | | | | | |
|
Total Consolidated Revenues | | | | $14.2 billion | | | | $14.0 billion |
| | | | | | | |
|
Medical Care Ratios (MCR) |
|
|
| FY2014 |
|
|
| FY2014 |
| | | | | | | |
|
Commercial
| | | |
83.0%
| | | |
83.0%
|
Medicare Advantage
| | | |
90.9%
| | | |
90.9%
|
Medicaid
| | | |
82.9%
| | | |
83.6%
|
Dual Eligibles
| | | |
86.5%
| | | |
86.5%
|
| | | | | | | |
|
| | | | | | | |
|
G&A Expense Ratio | | | |
10.8%
| | | |
10.8%
|
| | | | | | | |
|
| | | | | | | |
|
Tax Rate(2) | | | |
28.0%
| | | |
31.1%
|
| | | | | | | |
|
Western Region and Government Contracts Tax Rate(3) | | | |
51.1%
| | | |
51.5%
|
| | | | | | | |
|
Weighted-average fully diluted shares outstanding | | | |
80.8 million
| | | |
80 million
|
| | | | | | | |
|
GAAP Earnings per Diluted Share (EPS)(2) | | | |
At least $1.95
| | | |
At least $3.00
|
| | | | | | | |
|
Western Region and Government Contracts EPS(3) | | | |
At least $2.25
| | | |
At least $2.22
|
|
|
|
|
|
|
|
|
|
|
(1) All guidance metrics are approximations
|
(2) Includes a $72.6 million tax benefit
|
(3) Excludes the $72.6 million tax benefit
|
|
|
|
Health Net, Inc. | |
Enrollment Data - By State | |
(In thousands) | |
|
|
| |
|
| |
|
| |
|
| Change from |
|
| | | | | | | | | | | | June 30, 2014 |
|
| September 30, 2013 |
|
| | | September 30, | | | June 30, | | | September 30, | | | Increase/ |
|
| % |
|
| Increase/ |
|
| % | |
|
|
| 2014 |
|
| 2014 |
|
| 2013 |
|
| (Decrease) |
|
| Change |
|
| (Decrease) |
|
| Change |
|
California
| | | | | | | | | | | | | | | | | | | | | | |
Large Group
| | |
477
| | |
492
| | |
576
| | |
(15
|
)
| | |
(3.0
|
)%
| | |
(99
|
)
| | |
(17.2
|
)%
|
Small Group
| | |
243
| | |
240
| | |
241
| | |
3
| | | |
1.3
|
%
| | |
2
| | | |
0.8
|
%
|
Individual
| | |
269
|
|
|
272
|
|
|
105
|
|
|
(3
|
)
|
|
|
(1.1
|
)%
|
|
|
164
|
|
|
|
156.2
|
%
|
Commercial Risk
| | |
989
| | |
1,004
| | |
922
| | |
(15
|
)
| | |
(1.5
|
)%
| | |
67
| | | |
7.3
|
%
|
Medicare Advantage
| | |
169
| | |
162
| | |
149
| | |
7
| | | |
4.3
|
%
| | |
20
| | | |
13.4
|
%
|
Medi-Cal
| | |
1,485
| | |
1,359
| | |
1,126
| | |
126
| | | |
9.3
|
%
| | |
359
| | | |
31.9
|
%
|
Dual Eligibles
|
|
|
9
|
|
|
2
|
|
|
0
|
|
|
7
|
|
|
|
350.0
|
%
|
|
|
9
|
|
|
|
0.0
|
%
|
Total California
|
|
|
2,652
|
|
|
2,527
|
|
|
2,197
|
|
|
125
|
|
|
|
4.9
|
%
|
|
|
455
|
|
|
|
20.7
|
%
|
| | | | | | | | | | | | | | | | | | | | | |
|
Arizona
| | | | | | | | | | | | | | | | | | | | | | |
Large Group
| | |
45
| | |
48
| | |
59
| | |
(3
|
)
| | |
(6.3
|
)%
| | |
(14
|
)
| | |
(23.7
|
)%
|
Small Group
| | |
44
| | |
43
| | |
40
| | |
1
| | | |
2.3
|
%
| | |
4
| | | |
10.0
|
%
|
Individual
| | |
97
|
|
|
99
|
|
|
14
|
|
|
(2
|
)
|
|
|
(2.0
|
)%
|
|
|
83
|
|
|
|
592.9
|
%
|
Commercial Risk
| | |
186
| | |
190
| | |
113
| | |
(4
|
)
| | |
(2.1
|
)%
| | |
73
| | | |
64.6
|
%
|
Medicare Advantage
| | |
46
| | |
46
| | |
43
| | |
0
| | | |
0.0
|
%
| | |
3
| | | |
7.0
|
%
|
Medicaid
|
|
|
80
|
|
|
45
|
|
|
0
|
|
|
35
|
|
|
|
77.8
|
%
|
|
|
80
|
|
|
|
0.0
|
%
|
Total Arizona
|
|
|
312
|
|
|
281
|
|
|
156
|
|
|
31
|
|
|
|
11.0
|
%
|
|
|
156
|
|
|
|
100.0
|
%
|
| | | | | | | | | | | | | | | | | | | | | |
|
Northwest
| | | | | | | | | | | | | | | | | | | | | | |
Large Group
| | |
28
| | |
28
| | |
24
| | |
0
| | | |
0.0
|
%
| | |
4
| | | |
16.7
|
%
|
Small Group
| | |
23
| | |
25
| | |
39
| | |
(2
|
)
| | |
(8.0
|
)%
| | |
(16
|
)
| | |
(41.0
|
)%
|
Individual
| | |
4
|
|
|
4
|
|
|
3
|
|
|
0
|
|
|
|
0.0
|
%
|
|
|
1
|
|
|
|
33.3
|
%
|
Commercial Risk
| | |
55
| | |
57
| | |
66
| | |
(2
|
)
| | |
(3.5
|
)%
| | |
(11
|
)
| | |
(16.7
|
)%
|
Medicare Advantage
|
|
|
56
|
|
|
54
|
|
|
47
|
|
|
2
|
|
|
|
3.7
|
%
|
|
|
9
|
|
|
|
19.1
|
%
|
Total Northwest
|
|
|
111
|
|
|
111
|
|
|
113
|
|
|
0
|
|
|
|
0.0
|
%
|
|
|
(2
|
)
|
|
|
(1.8
|
)%
|
| | | | | | | | | | | | | | | | | | | | | |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total Health Plan Enrollment | | | | | | | | | | | | | | | | | | | | | | |
Large Group
| | |
550
| | |
568
| | |
659
| | |
(18
|
)
| | |
(3.2
|
)%
| | |
(109
|
)
| | |
(16.5
|
)%
|
Small Group
| | |
310
| | |
308
| | |
320
| | |
2
| | | |
0.6
|
%
| | |
(10
|
)
| | |
(3.1
|
)%
|
Individual
| | |
370
|
|
|
375
|
|
|
122
|
|
|
(5
|
)
|
|
|
(1.3
|
)%
|
|
|
248
|
|
|
|
203.3
|
%
|
Commercial Risk
| | |
1,230
| | |
1,251
| | |
1,101
| | |
(21
|
)
| | |
(1.7
|
)%
| | |
129
| | | |
11.7
|
%
|
Medicare Advantage
| | |
271
| | |
262
| | |
239
| | |
9
| | | |
3.4
|
%
| | |
32
| | | |
13.4
|
%
|
Medi-Cal/Medicaid
| | |
1,565
| | |
1,404
| | |
1,126
| | |
161
| | | |
11.5
|
%
| | |
439
| | | |
39.0
|
%
|
Dual Eligibles
| | |
9
|
|
|
2
|
|
|
0
|
|
|
7
|
|
|
|
350.0
|
%
|
|
|
9
|
|
|
|
0.0
|
%
|
Western Region Operations |
|
|
3,075
|
|
|
2,919
|
|
|
2,466
|
|
|
156
|
|
|
|
5.3
|
%
|
|
|
609
|
|
|
|
24.7
|
%
|
| | | | | | | | | | | | | | | | | | | | | |
|
| | | | | | | | | | | | | | | | | | | | | |
|
TRICARE - North Contract Eligibles |
|
|
2,849
|
|
|
2,849
|
|
|
2,865
|
|
|
0
|
|
|
|
0.0
|
%
|
|
|
(16
|
)
|
|
|
(0.6
|
)%
|
|
|
|
|
Health Net, Inc. | |
Enrollment Data - Line of Business | |
(In thousands) | |
|
|
| |
|
| |
|
| |
|
| Change from |
|
| | | | | | | | | | | | June 30, 2014 |
|
| September 30, 2013 |
|
| | | September 30, | | | June 30, | | | September 30, | | | Increase/ |
|
| % |
|
| Increase/ |
|
| % | |
|
|
| 2014 |
|
| 2014 |
|
| 2013 |
|
| (Decrease) |
|
| Change |
|
| (Decrease) |
|
| Change |
|
| | | | | | | | | | | | | | | | | | | | | |
|
Large Group
| | | | | | | | | | | | | | | | | | | | | | |
California
| | |
477
| | |
492
| | |
576
| | |
(15
|
)
| | |
(3.0
|
)%
| | |
(99
|
)
| | |
(17.2
|
)%
|
Arizona
| | |
45
| | |
48
| | |
59
| | |
(3
|
)
| | |
(6.3
|
)%
| | |
(14
|
)
| | |
(23.7
|
)%
|
Northwest
| | |
28
|
|
|
28
|
|
|
24
|
|
|
0
|
|
|
|
0.0
|
%
|
|
|
4
|
|
|
|
16.7
|
%
|
| | |
550
|
|
|
568
|
|
|
659
|
|
|
(18
|
)
|
|
|
(3.2
|
)%
|
|
|
(109
|
)
|
|
|
(16.5
|
)%
|
| | | | | | | | | | | | | | | | | | | | | |
|
Small Group
| | | | | | | | | | | | | | | | | | | | | | |
California
| | |
243
| | |
240
| | |
241
| | |
3
| | | |
1.3
|
%
| | |
2
| | | |
0.8
|
%
|
Arizona
| | |
44
| | |
43
| | |
40
| | |
1
| | | |
2.3
|
%
| | |
4
| | | |
10.0
|
%
|
Northwest
| | |
23
|
|
|
25
|
|
|
39
|
|
|
(2
|
)
|
|
|
(8.0
|
)%
|
|
|
(16
|
)
|
|
|
(41.0
|
)%
|
| | |
310
|
|
|
308
|
|
|
320
|
|
|
2
|
|
|
|
0.6
|
%
|
|
|
(10
|
)
|
|
|
(3.1
|
)%
|
| | | | | | | | | | | | | | | | | | | | | |
|
Individual
| | | | | | | | | | | | | | | | | | | | | | |
California
| | |
269
| | |
272
| | |
105
| | |
(3
|
)
| | |
(1.1
|
)%
| | |
164
| | | |
156.2
|
%
|
Arizona
| | |
97
| | |
99
| | |
14
| | |
(2
|
)
| | |
(2.0
|
)%
| | |
83
| | | |
592.9
|
%
|
Northwest
| | |
4
|
|
|
4
|
|
|
3
|
|
|
0
|
|
|
|
0.0
|
%
|
|
|
1
|
|
|
|
33.3
|
%
|
| | |
370
|
|
|
375
|
|
|
122
|
|
|
(5
|
)
|
|
|
(1.3
|
)%
|
|
|
248
|
|
|
|
203.3
|
%
|
| | | | | | | | | | | | | | | | | | | | | |
|
Commercial Risk
| | | | | | | | | | | | | | | | | | | | | | |
California
| | |
989
| | |
1,004
| | |
922
| | |
(15
|
)
| | |
(1.5
|
)%
| | |
67
| | | |
7.3
|
%
|
Arizona
| | |
186
| | |
190
| | |
113
| | |
(4
|
)
| | |
(2.1
|
)%
| | |
73
| | | |
64.6
|
%
|
Northwest
| | |
55
|
|
|
57
|
|
|
66
|
|
|
(2
|
)
|
|
|
(3.5
|
)%
|
|
|
(11
|
)
|
|
|
(16.7
|
)%
|
| | |
1,230
|
|
|
1,251
|
|
|
1,101
|
|
|
(21
|
)
|
|
|
(1.7
|
)%
|
|
|
129
|
|
|
|
11.7
|
%
|
| | | | | | | | | | | | | | | | | | | | | |
|
Medicare Advantage
| | | | | | | | | | | | | | | | | | | | | | |
California
| | |
169
| | |
162
| | |
149
| | |
7
| | | |
4.3
|
%
| | |
20
| | | |
13.4
|
%
|
Arizona
| | |
46
| | |
46
| | |
43
| | |
0
| | | |
0.0
|
%
| | |
3
| | | |
7.0
|
%
|
Northwest
| | |
56
|
|
|
54
|
|
|
47
|
|
|
2
|
|
|
|
3.7
|
%
|
|
|
9
|
|
|
|
19.1
|
%
|
| | |
271
|
|
|
262
|
|
|
239
|
|
|
9
|
|
|
|
3.4
|
%
|
|
|
32
|
|
|
|
13.4
|
%
|
| | | | | | | | | | | | | | | | | | | | | |
|
Medi-Cal/Medicaid
| | | | | | | | | | | | | | | | | | | | | | |
California
| | |
1,485
| | |
1,359
| | |
1,126
| | |
126
| | | |
9.3
|
%
| | |
359
| | | |
31.9
|
%
|
Arizona
| | |
80
|
|
|
45
|
|
|
0
|
|
|
35
|
|
|
|
77.8
|
%
|
|
|
80
|
|
|
|
0.0
|
%
|
| | |
1,565
|
|
|
1,404
|
|
|
1,126
|
|
|
161
|
|
|
|
11.5
|
%
|
|
|
439
|
|
|
|
39.0
|
%
|
| | | | | | | | | | | | | | | | | | | | | |
|
Dual Eligibles
| | |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
California
| | |
9
|
|
|
2
|
|
|
0
|
|
|
7
|
|
|
|
350.0
|
%
|
|
|
9
|
|
|
|
0.0
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total Health Plan Enrollment | | | | | | | | | | | | | | | | | | | | | | |
Large Group
| | |
550
| | |
568
| | |
659
| | |
(18
|
)
| | |
(3.2
|
)%
| | |
(109
|
)
| | |
(16.5
|
)%
|
Small Group
| | |
310
| | |
308
| | |
320
| | |
2
| | | |
0.6
|
%
| | |
(10
|
)
| | |
(3.1
|
)%
|
Individual
| | |
370
|
|
|
375
|
|
|
122
|
|
|
(5
|
)
|
|
|
(1.3
|
)%
|
|
|
248
|
|
|
|
203.3
|
%
|
Commercial Risk
| | |
1,230
| | |
1,251
| | |
1,101
| | |
(21
|
)
| | |
(1.7
|
)%
| | |
129
| | | |
11.7
|
%
|
Medicare Advantage
| | |
271
| | |
262
| | |
239
| | |
9
| | | |
3.4
|
%
| | |
32
| | | |
13.4
|
%
|
Medi-Cal/Medicaid
| | |
1,565
| | |
1,404
| | |
1,126
| | |
161
| | | |
11.5
|
%
| | |
439
| | | |
39.0
|
%
|
Dual Eligibles
| | |
9
|
|
|
2
|
|
|
0
|
|
|
7
|
|
|
|
350.0
|
%
|
|
|
9
|
|
|
|
0.0
|
%
|
Western Region Operations |
|
|
3,075
|
|
|
2,919
|
|
|
2,466
|
|
|
156
|
|
|
|
5.3
|
%
|
|
|
609
|
|
|
|
24.7
|
%
|
| | | | | | | | | | | | | | | | | | | | | |
|
| | | | | | | | | | | | | | | | | | | | | |
|
TRICARE - North Contract Eligibles |
|
|
2,849
|
|
|
2,849
|
|
|
2,865
|
|
|
0
|
|
|
|
0.0
|
%
|
|
|
(16
|
)
|
|
|
(0.6
|
)%
|
|
|
|
Health Net, Inc. |
Consolidated Statements of Operations |
($ in thousands, except per share data) |
|
|
|
|
|
Quarter Ended
|
|
|
|
Quarter Ended
|
|
|
|
Quarter Ended
|
| | | |
September 30,
| | | |
June 30,
| | | |
September 30,
|
REVENUES: | | | |
2014
| | | |
2014
| | | |
2013
|
Health plan services premiums
| | | |
$
|
3,631,617
| | | | |
$
|
3,261,878
| | | | |
$
|
2,606,754
|
Government contracts
| | | | |
146,183
| | | | | |
154,083
| | | | | |
149,342
|
Net investment income
| | | | |
10,964
| | | | | |
12,043
| | | | | |
11,276
|
Administrative services fees and other income
| | | |
|
1,106
|
| | | |
|
(6,612
|
)
| | | |
|
7,659
|
Total revenues
| | | |
|
3,789,870
|
| | | |
|
3,421,392
|
| | | |
|
2,775,031
|
| | | | | | | | | | | |
|
EXPENSES: | | | | | | | | | | | | |
Health plan services
| | | | |
3,104,010
| | | | | |
2,763,179
| | | | | |
2,196,561
|
Government contracts
| | | | |
124,403
| | | | | |
133,208
| | | | | |
125,334
|
General and administrative
| | | | |
373,623
| | | | | |
344,734
| | | | | |
267,683
|
Selling
| | | | |
66,111
| | | | | |
64,002
| | | | | |
59,498
|
Depreciation and amortization
| | | | |
6,500
| | | | | |
9,641
| | | | | |
9,402
|
Interest
| | | | |
7,810
| | | | | |
7,826
| | | | | |
7,973
|
Asset impairment
| | | |
|
84,690
|
| | | |
-
| | | |
-
|
Total expenses
| | | |
|
3,767,147
|
| | | |
|
3,322,590
|
| | | |
|
2,666,451
|
Income from operations before income taxes
| | | | |
22,723
| | | | | |
98,802
| | | | | |
108,580
|
Income tax provision (benefit)
| | | |
|
31,662
|
| | | |
|
(22,065
|
)
| | | |
|
41,740
|
Net (loss) income
| | | |
$
|
(8,939
|
)
| | | |
$
|
120,867
|
| | | |
$
|
66,840
|
| | | | | | | | | | | |
|
Net (loss) income per share:
| | | | | | | | | | | | |
Basic
| | | |
$
|
(0.11
|
)
| | | |
$
|
1.51
| | | | |
$
|
0.84
|
Diluted
| | | |
$
|
(0.11
|
)
| | | |
$
|
1.49
| | | | |
$
|
0.83
|
| | | | | | | | | | | |
|
Weighted average shares outstanding:
| | | | | | | | | | | | |
Basic
| | | | |
80,235
| | | | | |
80,250
| | | | | |
79,432
|
Diluted
| | | | |
80,235
| | | | | |
81,218
| | | | | |
80,441
|
|
|
Health Net, Inc. |
Condensed Consolidated Balance Sheets |
(Amounts in thousands, except ratio data) |
|
|
|
|
|
September 30,
|
|
|
|
June 30,
|
|
|
|
September 30,
|
| | | |
2014
| | | |
2014
| | | |
2013
|
ASSETS | | | | | | | | | | | | |
Current Assets
| | | | | | | | | | | | |
Cash and cash equivalents
| | | |
$
|
1,114,558
| | | | |
$
|
603,097
| | | | |
$
|
686,139
| |
Investments - available for sale
| | | | |
1,664,830
| | | | | |
1,668,943
| | | | | |
1,580,032
| |
Premiums receivable, net
| | | | |
579,515
| | | | | |
849,089
| | | | | |
343,502
| |
Amounts receivable under government contracts
| | | | |
143,662
| | | | | |
193,043
| | | | | |
194,820
| |
Other receivables
| | | | |
307,369
| | | | | |
183,795
| | | | | |
69,885
| |
Deferred taxes
| | | | |
71,434
| | | | | |
81,293
| | | | | |
78,257
| |
Assets held for sale
| | | | |
50,000
| | | | | |
-
| | | | | |
-
| |
Other assets
| | | |
|
157,066
|
| | | |
|
259,878
|
| | | |
|
103,685
|
|
Total current assets
| | | | |
4,088,434
| | | | | |
3,839,138
| | | | | |
3,056,320
| |
Property and equipment, net
| | | | |
92,193
| | | | | |
209,385
| | | | | |
195,954
| |
Goodwill
| | | | |
558,886
| | | | | |
565,886
| | | | | |
565,886
| |
Other intangible assets, net
| | | | |
12,526
| | | | | |
13,229
| | | | | |
14,699
| |
Deferred taxes
| | | | |
34,580
| | | | | |
9,530
| | | | | |
3,394
| |
Investments - available for sale - noncurrent
| | | | |
3,055
| | | | | |
652
| | | | | |
52,637
| |
Other noncurrent assets
| | | |
|
173,230
|
| | | |
|
139,205
|
| | | |
|
152,611
|
|
Total Assets
| | | |
$
|
4,962,904
|
| | | |
$
|
4,777,025
|
| | | |
$
|
4,041,501
|
|
| | | | | | | | | | | |
|
LIABILITIES AND STOCKHOLDERS' EQUITY | | | | | | | | | | | | |
Current Liabilities
| | | | | | | | | | | | |
Reserves for claims and other settlements
| | | |
$
|
1,733,307
| | | | |
$
|
1,488,322
| | | | |
$
|
990,195
| |
Health care and other costs payable under government contracts
| | | | |
62,796
| | | | | |
94,195
| | | | | |
55,532
| |
Unearned premiums
| | | | |
125,363
| | | | | |
130,905
| | | | | |
129,081
| |
Accounts payable and other liabilities
| | | |
|
540,968
|
| | | |
|
496,349
|
| | | |
|
544,704
|
|
Total current liabilities
| | | | |
2,462,434
| | | | | |
2,209,771
| | | | | |
1,719,512
| |
Senior notes payable
| | | | |
399,453
| | | | | |
399,402
| | | | | |
399,248
| |
Deferred taxes
| | | | |
-
| | | | | |
22,376
| | | | | |
1,746
| |
Borrowings under revolving credit facility
| | | | |
100,000
| | | | | |
100,000
| | | | | |
100,000
| |
Other noncurrent liabilities
| | | |
|
235,393
|
| | | |
|
223,595
|
| | | |
|
220,404
|
|
Total Liabilities
| | | |
|
3,197,280
|
| | | |
|
2,955,144
|
| | | |
|
2,440,910
|
|
| | | | | | | | | | | |
|
Stockholders' Equity
| | | | | | | | | | | | |
Common stock
| | | | |
152
| | | | | |
152
| | | | | |
150
| |
Additional paid-in capital
| | | | |
1,432,513
| | | | | |
1,406,768
| | | | | |
1,370,744
| |
Treasury common stock, at cost
| | | | |
(2,272,180
|
)
| | | | |
(2,197,890
|
)
| | | | |
(2,179,503
|
)
|
Retained earnings
| | | | |
2,604,363
| | | | | |
2,613,302
| | | | | |
2,443,895
| |
Accumulated other comprehensive income (loss)
| | | |
|
776
|
| | | |
|
(451
|
)
| | | |
|
(34,695
|
)
|
Total Stockholders' Equity
| | | |
|
1,765,624
|
| | | |
|
1,821,881
|
| | | |
|
1,600,591
|
|
Total Liabilities and Stockholders' Equity
| | | |
$
|
4,962,904
|
| | | |
$
|
4,777,025
|
| | | |
$
|
4,041,501
|
|
| | | | | | | | | | | |
|
Debt-to-Total Capital Ratio
| | | | |
22.1
|
%
| | | | |
21.5
|
%
| | | | |
23.8
|
%
|
|
|
Health Net, Inc. |
Condensed Consolidated Statements of Cash Flows |
(Amounts in thousands) |
|
|
|
|
|
Quarter Ended
|
|
|
|
Quarter Ended
|
|
|
|
Quarter Ended
|
| | | |
September 30,
| | | |
June 30,
| | | |
September 30,
|
| | | |
2014
| | | |
2014
| | | |
2013
|
| | | | | | | | | | | |
|
CASH FLOWS FROM OPERATING ACTIVITIES: | | | | | | | | | | | | |
Net (loss) income
| | | |
$
|
(8,939
|
)
| | | |
$
|
120,867
| | | | |
$
|
66,840
| |
Adjustments to reconcile net (loss) income to net cash provided by
(used in) operating activities:
| | | | | | | | | | | | |
Amortization and depreciation
| | | | |
6,500
| | | | | |
9,641
| | | | | |
9,402
| |
Share-based compensation expense
| | | | |
6,109
| | | | | |
6,536
| | | | | |
6,511
| |
Deferred income taxes
| | | | |
(38,231
|
)
| | | | |
(14,653
|
)
| | | | |
5,573
| |
Excess tax benefits from share-based compensation
| | | | |
(241
|
)
| | | | |
(357
|
)
| | | | |
(21
|
)
|
Asset impairment
| | | | |
84,690
| | | | | |
-
| | | | | |
-
| |
Net realized gain on sale on investments
| | | | |
(346
|
)
| | | | |
(1,928
|
)
| | | | |
(370
|
)
|
Other changes
| | | | |
7,264
| | | | | |
6,364
| | | | | |
8,040
| |
Changes in assets and liabilities:
| | | | | | | | | | | | |
Premiums receivable and unearned premiums
| | | | |
264,032
| | | | | |
(395,553
|
)
| | | | |
240,580
| |
Other current assets, receivables and noncurrent assets
| | | | |
(34,671
|
)
| | | | |
(69,421
|
)
| | | | |
(1,528
|
)
|
Amounts receivable/payable under government contracts
| | | | |
12,369
| | | | | |
(492
|
)
| | | | |
2,013
| |
Reserves for claims and other settlements
| | | | |
244,985
| | | | | |
336,364
| | | | | |
(22,891
|
)
|
Accounts payable and other liabilities
| | | |
|
44,434
|
| | | |
|
(11,118
|
)
| | | |
|
(11,954
|
)
|
Net cash provided by (used in) operating activities
| | | |
|
587,955
|
| | | |
|
(13,750
|
)
| | | |
|
302,195
|
|
| | | | | | | | | | | |
|
CASH FLOWS FROM INVESTING ACTIVITIES: | | | | | | | | | | | | |
Sales of investments
| | | | |
104,628
| | | | | |
125,751
| | | | | |
80,380
| |
Maturities of investments
| | | | |
21,064
| | | | | |
19,210
| | | | | |
21,396
| |
Purchases of investments
| | | | |
(133,014
|
)
| | | | |
(102,873
|
)
| | | | |
(92,602
|
)
|
Purchases of property and equipment
| | | | |
(18,439
|
)
| | | | |
(12,519
|
)
| | | | |
(15,831
|
)
|
Sales and purchases of restricted investments and other
| | | |
|
2,002
|
| | | |
|
(2,777
|
)
| | | |
|
(2,108
|
)
|
Net cash (used in) provided by investing activities
| | | |
|
(23,759
|
)
| | | |
|
26,792
|
| | | |
|
(8,765
|
)
|
| | | | | | | | | | | |
|
CASH FLOWS FROM FINANCING ACTIVITIES: | | | | | | | | | | | | |
Proceeds from exercise of stock options and employee stock purchases
| | | | |
14,945
| | | | | |
2,726
| | | | | |
2,469
| |
Repurchases of common stock
| | | | |
(57,168
|
)
| | | | |
(1,226
|
)
| | | | |
(105
|
)
|
Excess tax benefits from share-based compensation
| | | | |
241
| | | | | |
357
| | | | | |
21
| |
Borrowings under financing arrangements
| | | | |
-
| | | | | |
-
| | | | | |
-
| |
Repayment of borrowings under financing arrangements
| | | | |
-
| | | | | |
-
| | | | | |
(25,000
|
)
|
Net increase (decrease) in checks outstanding, net of deposits
| | | | |
-
| | | | | |
(713
|
)
| | | | |
(99,394
|
)
|
Customer funds administered
| | | |
|
(10,753
|
)
| | | |
|
(148,113
|
)
| | | |
|
235,100
|
|
Net cash (used in) provided by financing activities
| | | |
|
(52,735
|
)
| | | |
|
(146,969
|
)
| | | |
|
113,091
|
|
| | | | | | | | | | | |
|
Net increase (decrease) in cash and cash equivalents
| | | | |
511,461
| | | | | |
(133,927
|
)
| | | | |
406,521
| |
Cash and cash equivalents, beginning of period
| | | |
|
603,097
|
| | | |
|
737,024
|
| | | |
|
279,618
|
|
Cash and cash equivalents, end of period
| | | |
$
|
1,114,558
|
| | | |
$
|
603,097
|
| | | |
$
|
686,139
|
|
|
|
Health Net, Inc. |
SEGMENT INFORMATION |
($ in thousands, except per share and PMPM data) |
|
The following table presents Health Net's operating segment
information.
|
|
|
| |
|
Quarter Ended September 30, 2014
|
|
|
Quarter Ended June 30, 2014
|
|
|
Quarter Ended September 30, 2013
|
| | | | | | | | | |
|
| | | |
Western Region
|
|
Government
|
|
Corporate/
| | | |
Western Region
|
|
Government
|
|
Corporate/
| | | |
Western Region
|
|
Government
|
|
Corporate/
|
| |
| | | |
Operations1 |
|
Contracts2 |
|
Other4 |
|
Consolidated
| | |
Operations1 |
|
Contracts2 |
|
Other5 |
|
Consolidated
| | |
Operations1 |
|
Contracts2 |
|
Other3 |
|
Consolidated
|
| | | | | | | | |
| | | | | | | | |
| | | | | | | | | | |
|
Commercial premiums
| |
$
|
1,430,769
| | | | | | |
$
|
1,430,769
| | | |
$
|
1,377,460
| | | | | | |
$
|
1,377,460
| | | |
$
|
1,279,834
| | | | | | |
$
|
1,279,834
|
|
Medicare premiums
| | |
763,327
| | | | | | | |
763,327
| | | | |
757,194
| | | | | | | |
757,194
| | | | |
685,340
| | | | | | | |
685,340
|
|
Medicaid premiums
| | |
1,397,732
| | | | | | | |
1,397,732
| | | | |
1,121,912
| | | | | | | |
1,121,912
| | | | |
641,580
| | | | | | | |
641,580
|
|
Dual Eligibles premiums
| |
|
39,789
|
|
|
|
|
|
|
|
39,789
|
| | |
|
5,312
|
|
|
|
|
|
|
|
5,312
|
| | |
|
0
|
|
|
|
|
|
|
|
0
|
|
Health plan services premiums
| | |
3,631,617
| | | | | | | |
3,631,617
| | | | |
3,261,878
| | | | | | | |
3,261,878
| | | | |
2,606,754
| | | | | | | |
2,606,754
|
|
Government contracts
| | | | |
146,183
| | | | |
146,183
| | | | | | |
154,083
| | | | |
154,083
| | | | | | |
149,342
| | | | |
149,342
|
|
Net investment income
| | |
10,964
| | | | | | | |
10,964
| | | | |
12,043
| | | | | | | |
12,043
| | | | |
11,276
| | | | | | | |
11,276
|
|
Administrative services fees and other income
| |
|
1,106
|
|
|
|
|
|
|
|
1,106
|
| | |
|
(6,612
|
)
|
|
|
|
|
|
|
(6,612
|
)
| | |
|
7,659
|
|
|
|
|
|
|
|
7,659
|
|
Total revenues
| | |
3,643,687
| | | |
146,183
| | | | |
3,789,870
| | | | |
3,267,309
| | | |
154,083
| | | | |
3,421,392
| | | | |
2,625,689
| | | |
149,342
| | | | |
2,775,031
|
|
Health plan services
| | |
3,104,010
| | | | | | | |
3,104,010
| | | | |
2,763,179
| | | | | | | |
2,763,179
| | | | |
2,196,561
| | | | | | | |
2,196,561
|
|
Government contracts
| | | | |
123,571
| | |
832
| | | |
124,403
| | | | | | |
132,634
| | |
574
| | | |
133,208
| | | | | | |
125,841
| | |
(507
|
)
| | |
125,334
|
| |
Premium tax
| | |
53,417
| | | | | | | |
53,417
| | | | |
31,930
| | | | | | | |
31,930
| | | | |
33,399
| | | | | | | |
33,399
|
| |
Health insurer fee
| | |
31,947
| | | | | | | |
31,947
| | | | |
37,844
| | | | | | | |
37,844
| | | | |
-
| | | | | | | |
-
|
| |
Other ACA fees
| | |
26,643
| | | | | | | |
26,643
| | | | |
22,546
| | | | | | | |
22,546
| | | | |
552
| | | | | | | |
552
|
| |
Administrative expenses
| |
|
241,352
|
|
|
|
|
|
20,264
|
|
|
|
261,616
|
| | |
|
249,665
|
|
|
|
|
|
2,749
|
|
|
|
252,414
|
| | |
|
233,135
|
|
|
|
|
|
597
|
|
|
|
233,732
|
|
Total general and administrative
| | |
353,359
| | | | | |
20,264
| | | |
373,623
| | | | |
341,985
| | | | | |
2,749
| | | |
344,734
| | | | |
267,086
| | | | | |
597
| | | |
267,683
|
|
Selling
| | |
66,111
| | | | | | | |
66,111
| | | | |
64,002
| | | | | | | |
64,002
| | | | |
59,498
| | | | | | | |
59,498
|
|
Depreciation and amortization
| | |
6,500
| | | | | | | |
6,500
| | | | |
9,641
| | | | | | | |
9,641
| | | | |
9,402
| | | | | | | |
9,402
|
|
Interest
| | |
7,810
| | | | | | | |
7,810
| | | | |
7,826
| | | | | | | |
7,826
| | | | |
7,973
| | | | | | | |
7,973
|
|
Asset impairment
| |
|
|
|
|
|
84,690
|
|
|
|
84,690
|
| | |
|
|
|
|
|
|
| | |
|
|
|
|
|
|
|
|
Total expenses
| |
|
3,537,790
|
|
|
|
123,571
|
|
|
105,786
|
|
|
|
3,767,147
|
| | |
|
3,186,633
|
|
|
|
132,634
|
|
|
3,323
|
|
|
|
3,322,590
|
| | |
|
2,540,520
|
|
|
|
125,841
|
|
|
90
|
|
|
|
2,666,451
|
|
Income (loss) from operations before income taxes
| | |
105,897
| | | |
22,612
| | |
(105,786
|
)
| | |
22,723
| | | | |
80,676
| | | |
21,449
| | |
(3,323
|
)
| | |
98,802
| | | | |
85,169
| | | |
23,501
| | |
(90
|
)
| | |
108,580
|
|
Income tax provision (benefit)
| |
|
61,085
|
|
|
|
8,918
|
|
|
(38,341
|
)
|
|
|
31,662
|
| | |
|
42,874
|
|
|
|
8,942
|
|
|
(73,881
|
)
|
|
|
(22,065
|
)
| | |
|
32,184
|
|
|
|
9,591
|
|
|
(35
|
)
|
|
|
41,740
|
|
Income (loss) from operations
| |
$
|
44,812
|
|
|
$
|
13,694
|
|
$
|
(67,445
|
)
|
|
$
|
(8,939
|
)
| | |
$
|
37,802
|
|
|
$
|
12,507
|
|
$
|
70,558
|
|
|
$
|
120,867
|
| | |
$
|
52,985
|
|
|
$
|
13,910
|
|
$
|
(55
|
)
|
|
$
|
66,840
|
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
|
|
Basic earnings (loss) per share
| |
$
|
0.56
| | |
$
|
0.17
| |
$
|
(0.84
|
)
| |
$
|
(0.11
|
)
| | |
$
|
0.47
| | |
$
|
0.16
| |
$
|
0.88
| | |
$
|
1.51
| | | |
$
|
0.67
| | |
$
|
0.18
| |
$
|
-
| | |
$
|
0.84
|
|
Diluted earnings (loss) per share
| |
$
|
0.55
| | |
$
|
0.17
| |
$
|
(0.84
|
)
| |
$
|
(0.11
|
)
| | |
$
|
0.47
| | |
$
|
0.15
| |
$
|
0.87
| | |
$
|
1.49
| | | |
$
|
0.66
| | |
$
|
0.17
| |
$
|
-
| | |
$
|
0.83
|
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
|
|
Basic weighted average shares outstanding
| | |
80,235
| | | |
80,235
| | |
80,235
| | | |
80,235
| | | | |
80,250
| | | |
80,250
| | |
80,250
| | | |
80,250
| | | | |
79,432
| | | |
79,432
| | |
79,432
| | | |
79,432
|
|
Diluted weighted average shares outstanding
| | |
81,513
| | | |
81,513
| | |
80,235
| | | |
80,235
| | | | |
81,218
| | | |
81,218
| | |
81,218
| | | |
81,218
| | | | |
80,441
| | | |
80,441
| | |
79,432
| | | |
80,441
|
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
|
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
|
|
Pretax margin
| | |
2.9
|
%
| | | | | | | | | |
2.5
|
%
| | | | | | | | | |
3.2
|
%
| | | | | | |
|
Commercial premium yield
| | |
-0.3
|
%
| | | | | | | | | |
-0.4
|
%
| | | | | | | | | |
2.6
|
%
| | | | | | |
|
Commercial premium PMPM
| |
$
|
385.67
| | | | | | | | | |
$
|
378.91
| | | | | | | | | |
$
|
386.69
| | | | | | | |
|
Commercial health care cost trend
| | |
-0.7
|
%
| | | | | | | | | |
-3.4
|
%
| | | | | | | | | |
-0.3
|
%
| | | | | | |
|
Commercial health care cost PMPM
| |
$
|
323.43
| | | | | | | | | |
$
|
311.85
| | | | | | | | | |
$
|
325.62
| | | | | | | |
|
Commercial MCR
| | |
83.9
|
%
| | | | | | | | | |
82.3
|
%
| | | | | | | | | |
84.2
|
%
| | | | | | |
|
Medicare Advantage MCR
| | |
90.8
|
%
| | | | | | | | | |
90.9
|
%
| | | | | | | | | |
89.9
|
%
| | | | | | |
|
Medicaid MCR
| | |
84.2
|
%
| | | | | | | | | |
83.6
|
%
| | | | | | | | | |
79.4
|
%
| | | | | | |
|
Dual Eligibles MCR
| | |
87.4
|
%
| | | | | | | | | |
60.0
|
%
| | | | | | | | | |
-
| | | | | | | |
|
Health plan services MCR
| | |
85.5
|
%
| | | | | | | | | |
84.7
|
%
| | | | | | | | | |
84.3
|
%
| | | | | | |
|
Administrative expense ratio
| | |
6.6
|
%
| | | | | | | | | |
7.7
|
%
| | | | | | | | | |
8.9
|
%
| | | | | | |
|
Total G&A expense ratio
| | |
9.7
|
%
| | | | | | | | | |
10.5
|
%
| | | | | | | | | |
10.2
|
%
| | | | | | |
|
Selling costs ratio
| | |
1.8
|
%
| | | | | | | | | |
2.0
|
%
| | | | | | | | | |
2.3
|
%
| | | | | | |
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
|
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
|
1
| |
Includes the operations of the company's commercial, Medicare,
Medicaid and Dual Eligibles health plans in California, Arizona,
Oregon and Washington, as well as the operations of the company's
health and life insurance companies, primarily in Arizona,
California, Oregon and Washington, and the operations of the
company's behavioral health and pharmaceutical services
subsidiaries in several states including California, Arizona and
Oregon.
|
| |
|
2
| |
Includes administrative services provided under the T-3 Managed Care
Support Contract for the TRICARE North Region and other health
care-related Department of Defense and Veterans Affairs government
contracts.
|
| |
|
3
| |
Includes litigation reserve true-up related to previous accrual for
lawsuit and related legal expenses. Also includes reserve true-up
related to previous accrual for severance expenses.
|
| |
|
4
| |
Includes primarily costs related to the company's entrance into a
master services agreement and related asset purchase agreement with
Cognizant and asset impairment of $84.7 million.
|
| |
|
5
| |
Includes $72.6 million income tax benefit. Also includes severance
expense.
|
|
|
Health Net, Inc. |
Reconciliation of Reserves for Claims and Other Settlements |
($ in millions) |
|
| |
|
|
| Health Plan Services |
| | | | |
YTD 9/2014
|
|
|
|
FY 2013
|
|
|
|
FY 2012
|
| | | | | | | | | | | | |
|
Reserve for claims (a), beginning of period
| | | |
$
|
807.4
| | | | |
$
|
808.7
| | | | |
$
|
720.8
|
Incurred claims related to:
| | | | | | | | | | | | |
|
Current Year (f)
| | | | |
4,121.1
| | | | | |
4,666.0
| | | | | |
4,950.9
|
|
Prior Years (c)
| | | |
|
(16.9
|
)
| | | |
|
(56.2
|
)
| | | |
|
34.5
|
Total Incurred (b)
| | | | |
4,104.2
| | | | | |
4,609.8
| | | | | |
4,985.4
|
| | | | | | | | | | | | |
|
Paid claims related to:
| | | | | | | | | | | | |
|
Current Year
| | | | |
2,988.9
| | | | | |
3,872.5
| | | | | |
4,156.6
|
|
Prior Years
| | | |
|
760.0
|
| | | |
|
738.6
|
| | | |
|
740.9
|
Total Paid (b)
| | | |
|
3,748.9
|
| | | |
|
4,611.1
|
| | | |
|
4,897.5
|
| | | | | | | | | | | | |
|
| | | | | | | | | | | | |
|
Reserve for claims (a), end of period
| | | | |
1,162.7
| | | | | |
807.4
| | | | | |
808.7
|
Add:
| | | | | | | | | | | | | |
Claims Payable (d)
| | | | |
129.4
| | | | | |
67.0
| | | | | |
91.6
|
Other (e)
| | | | |
441.2
| | | | | |
109.7
| | | | | |
137.7
|
| | | | |
| | | |
| | | |
|
| | | | | | | | | | | | |
|
Reserves for claims and other settlements, end of period
| | | |
$
|
1,733.3
|
| | | |
$
|
984.1
|
| | | |
$
|
1,038.0
|
|
|
|
|
(a)
|
Consists of incurred but not reported claims and received but
unprocessed claims and reserves for loss adjustment expenses.
|
|
|
(b)
|
Includes medical claims only. Capitation, pharmacy and other
payments including provider settlements are not included.
|
|
|
(c)
|
This line represents the change in reserves attributable to the
difference between the original estimate of incurred claims for
prior years and the revised estimate. Negative amounts in this line
represent favorable development in estimated prior years' health
care costs. Positive amounts in this line represent unfavorable
development in estimated prior years' health care costs. For a
detailed description of reserve development for the nine months
ended September 30, 2014, see Note 2 to the Consolidated Financial
Statements in the company's Quarterly Report on Form 10-Q for the
quarter ended September 30, 2014. For a detailed description of
reserve development for fiscal years 2013 and 2012, see Note 2 to
the Consolidated Financial Statements in the company's Annual Report
on Form 10-K for the year ended December 31, 2013.
|
|
|
(d)
|
Includes amount accrued for litigation and regulatory-related
expenses.
|
|
|
(e)
|
Includes accrued capitation, shared risk settlements, provider
incentives and other reserve items.
|
|
|
(f)
|
Our IBNR estimate also includes a provision for adverse deviation,
which is an estimate for known environmental factors that are
reasonably likely to affect the required level of IBNR reserves.
Such amounts were $77 million, $53 million and $53 million as of
September 30, 2014, December 31, 2013, and December 31, 2012,
respectively.
|
|
|
Contacts:
Investor Contact:
The Abernathy MacGregor Group
David Olson
818-917-1469
dwo@abmac.com
or
Media
Contact:
Health Net, Inc.
Brad Kieffer
818-676-6833
brad.kieffer@healthnet.com
Source: Health Net, Inc.
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