Delaware | 001-31826 | 42-1406317 | ||
(State or Other Jurisdiction of Incorporation) | (Commission File Number) | (IRS Employer Identification No.) |
7700 Forsyth Blvd. St. Louis, Missouri | 63105 | |
(Address of Principal Executive Offices) | (Zip Code) |
CENTENE CORPORATION | ||||
Date: | October 25, 2016 | By: | /s/ Jeffrey A. Schwaneke | |
Jeffrey A. Schwaneke Executive Vice President & Chief Financial Officer |
Exhibit Number | Description | |
99.1 | Press release* of Centene Corporation issued October 25, 2016, as to financial results for the third quarter ended September 30, 2016. |
* | The press release is being furnished pursuant to Item 2.02, and shall not be deemed to be “filed” for purposes of Section 18 of the Securities Exchange of 1934, as amended. |
Contact: | Investor Relations Inquiries |
Edmund E. Kroll, Jr. | |
Senior Vice President, Finance & Investor Relations | |
(212) 759-0382 | |
Media Inquiries | |
Marcela Manjarrez-Hawn | |
Senior Vice President and Chief Communications Officer | |
(314) 445-0790 |
GAAP diluted EPS | $ | 0.84 | |
Health Net acquisition related expenses | 0.12 | ||
Amortization of acquired intangible assets | 0.15 | ||
Adjusted diluted EPS | 1.11 | ||
2015 risk adjustment charge | 0.05 | ||
Total | $ | 1.16 |
• | We reduced our estimate of the costs associated with the substance abuse claims from $50 million to $35 million for the period from March 24, 2016 through December 31, 2016. We continue to review substance abuse claim submissions and have lowered our estimate based on our experience through the third quarter. This adjustment had no impact on earnings. |
• | As previously disclosed, we finalized our 2017 product design and premium rate filing with the California Department of Insurance associated with the individual preferred provider organization (PPO) and exclusive provider organization products. We believe the final product design and rate adjustments will attract a balanced mix of membership to ensure the product is competitive. Additionally, we continue to identify medical management and network initiatives to further improve performance. |
• | We will exit the Arizona individual PPO business, effective January 1, 2017, which represents approximately $32 million of the $70 million 2016 Arizona individual premium deficiency reserve. Additionally, we will be the only carrier in Maricopa County and will continue our presence in Pima County for 2017. For 2017, based on our product designs and rate increases, we expect the Arizona Health Insurance Marketplace to operate within our normal marketplace margins. |
• | We have taken various rate and product design actions in the small group business and continue to expect our Medicare and Arizona Medicaid business to be profitable in 2017. |
Total revenues (in millions) | $ | 10,846 | ||
Health benefits ratio | 87.0 | % | ||
General & administrative expense ratio | 9.2 | % | ||
General & administrative expense ratio, excluding Health Net acquisition related expenses | 9.1 | % | ||
GAAP diluted EPS | $ | 0.84 | ||
Adjusted diluted EPS | $ | 1.11 | ||
Total cash flow provided by operations (in millions) | $ | 480 |
• | September 30, 2016 managed care membership of 11.4 million, an increase of 6.6 million members, or 137% compared to the third quarter of 2015. |
• | Total revenues for the third quarter of 2016 of $10.8 billion, representing 86% growth compared to the third quarter of 2015. |
• | Health benefits ratio of 87.0% for the third quarter of 2016, compared to 89.0% in the third quarter of 2015. |
• | General and administrative expense ratio of 9.2%, or 9.1% excluding Health Net acquisition related expenses for the third quarter of 2016, compared to 8.4% in the third quarter of 2015. |
• | Operating cash flow of $480 million for the third quarter of 2016, or 3.3x net earnings. |
• | Diluted EPS for the third quarter of 2016 of $0.84, or $1.11 of Adjusted diluted EPS. Both third quarter amounts included a charge of $0.05 associated with a revised reconciliation of the 2015 risk adjustment. In comparison, diluted EPS for the third quarter of 2015 was $0.75, or $0.87 Adjusted diluted EPS. |
• | In October 2016, our subsidiary, Home State Health, was selected to provide managed care services to MO HealthNet Managed Care beneficiaries. Under the new contract, Home State Health expects to serve MO HealthNet Managed Care beneficiaries in all 114 counties in Missouri. The contract is expected to commence May 1, 2017, pending regulatory approval. |
• | In September 2016, the Alabama legislature approved the funding needed to create its regional care organization (RCO) structure. Our subsidiary, AHA Administrative Services, has contracted with five nonprofit RCOs in Alabama to provide management services. Operations are expected to commence July 1, 2017. |
• | In August 2016, our Pennsylvania subsidiary, Pennsylvania Health & Wellness, was selected by the department of Human Services and Aging to serve enrollees in the Community HealthChoices program statewide. Expected contract commencement dates vary by zone, starting July 2017, and will be fully implemented by January 2019, pending regulatory approval. |
• | In October 2016, our Kansas subsidiary, Sunflower Health Plan, received Accreditation with a Commendable status from the National Committee for Quality Assurance. |
• | In August 2016, our subsidiaries, Envolve, Inc. and Envolve PeopleCare received honors at this year’s National Health Information Awards. Envolve, Inc. received the merit award for the pamphlet Brush with Wisdom, while Envolve PeopleCare’s Raising Well campaign won gold in the Health Information Program category. |
September 30, | |||||
2016 | 2015 | ||||
Arizona | 601,500 | 223,600 | |||
Arkansas | 57,700 | 40,900 | |||
California | 3,004,500 | 183,900 | |||
Florida | 732,700 | 486,500 | |||
Georgia | 498,000 | 406,700 | |||
Illinois | 236,700 | 211,300 | |||
Indiana | 289,600 | 276,700 | |||
Kansas | 145,100 | 137,500 | |||
Louisiana | 455,600 | 358,800 | |||
Massachusetts | 45,300 | 63,700 | |||
Michigan | 2,100 | 6,600 | |||
Minnesota | 9,400 | 9,400 | |||
Mississippi | 313,900 | 301,000 | |||
Missouri | 104,700 | 88,400 | |||
New Hampshire | 78,400 | 71,900 | |||
New Mexico | 7,100 | — | |||
Ohio | 319,500 | 308,100 | |||
Oregon | 218,400 | 99,800 | |||
South Carolina | 119,700 | 104,800 | |||
Tennessee | 21,600 | 20,200 | |||
Texas | 1,041,600 | 976,500 | |||
Vermont | 1,700 | 1,500 | |||
Washington | 240,500 | 208,600 | |||
Wisconsin | 75,100 | 78,100 | |||
Total at-risk membership | 8,620,400 | 4,664,500 | |||
TRICARE eligibles | 2,815,700 | — | |||
Non-risk membership | — | 169,900 | |||
Total | 11,436,100 | 4,834,400 |
September 30, | |||||
2016 | 2015 | ||||
Medicaid: | |||||
TANF, CHIP & Foster Care | 5,583,900 | 3,719,900 | |||
ABD & LTC | 754,900 | 473,700 | |||
Behavioral Health | 465,300 | 216,700 | |||
Commercial | 1,365,600 | 155,600 | |||
Medicare & Duals | 300,900 | 39,300 | |||
Correctional | 149,800 | 59,300 | |||
Total at-risk membership | 8,620,400 | 4,664,500 | |||
TRICARE eligibles | 2,815,700 | — | |||
Non-risk membership | — | 169,900 | |||
Total | 11,436,100 | 4,834,400 |
• | For the third quarter of 2016, total revenues increased 86% to $10.8 billion from $5.8 billion in the comparable period in 2015 and decreased sequentially from $10.9 billion in the second quarter of 2016. The increase over prior year was primarily as a result of the acquisition of Health Net, as well as the impact from expansions and new programs in many of our states in 2015 and 2016 and growth in the Health Insurance Marketplace business in 2016. The decrease in revenue over the second quarter of 2016 is primarily a result of lower commercial membership driven by Health Insurance Marketplace attrition and lower California Medicaid membership driven by the state's annual eligibility redetermination process, partially offset by increased revenue due to the commencement of Medicaid expansion in Louisiana. |
• | HBR of 87.0% for the third quarter of 2016 represents a decrease from 89.0% in the comparable period in 2015 and an increase from 86.6% in the second quarter of 2016. The year over year HBR decrease is primarily attributable to the acquisition of Health Net, which operates at a lower HBR due to a greater mix of commercial business. The sequential increase is due to normal seasonality. |
• | G&A expense ratio of 9.2%, or 9.1% excluding Health Net acquisition related expenses, for the third quarter of 2016, compared to 8.4%, or 8.1% excluding Health Net acquisition related expenses, in the third quarter of 2015. The increase in the G&A expense ratio is primarily attributable to the addition of the Health Net business, which operates at a higher G&A ratio due to a greater mix of commercial and Medicare business. |
• | Diluted EPS for the third quarter of 2016 of $0.84, or $1.11 of Adjusted diluted EPS, both including a $0.05 diluted EPS charge related to a revised reconciliation of the 2015 risk adjustment under the ACA in connection with our Health Insurance Marketplace business. In comparison, diluted EPS for the third quarter of 2015 was $0.75, or $0.87 Adjusted diluted EPS. |
Days in claims payable, June 30, 2016 | 43 | ||
Payment of annual provider risk share settlement | (1 | ) | |
Timing of claims payments | (1 | ) | |
Days in claims payable, September 30, 2016 | 41 | ||
Full Year 2016 | |||||||||
Low | High | ||||||||
Total revenues (in billions) | $ | 39.4 | $ | 40.0 | |||||
GAAP diluted EPS | $ | 2.73 | $ | 2.83 | |||||
Adjusted diluted EPS (1) | $ | 4.28 | $ | 4.38 | |||||
HBR | 87.0 | % | 87.5 | % | |||||
G&A expense ratio | 9.4 | % | 9.9 | % | |||||
G&A expense ratio, excluding acquisition related costs (2) | 9.0 | % | 9.5 | % | |||||
Effective tax rate | 54.5 | % | 56.5 | % | |||||
Diluted shares outstanding (in millions) | 162.5 | 163.5 | |||||||
Three Months Ended September 30, | Nine Months Ended September 30, | ||||||||||||||||
2016 | 2015 | 2016 | 2015 | ||||||||||||||
GAAP general and administrative expenses | $ | 940 | $ | 458 | $ | 2,611 | $ | 1,291 | |||||||||
Health Net acquisition related expenses | 10 | 18 | 224 | 20 | |||||||||||||
General and administrative expenses, excluding Health Net acquisition related expenses | $ | 930 | $ | 440 | $ | 2,387 | $ | 1,271 | |||||||||
GAAP net earnings from continuing operations | $ | 146 | $ | 92 | $ | 300 | $ | 244 | |||||||||
Health Net acquisition related expenses | 10 | 18 | 224 | 20 | |||||||||||||
Amortization of acquired intangible assets | 43 | 6 | 95 | 18 | |||||||||||||
Income tax effects of adjustments (1) | (5 | ) | (9 | ) | (106 | ) | (14 | ) | |||||||||
Adjusted net earnings from continuing operations | $ | 194 | $ | 107 | $ | 513 | $ | 268 | |||||||||
Three Months Ended September 30, | Nine Months Ended September 30, | Annual Guidance December 31, 2016 | |||||||||||||||
2016 | 2015 | 2016 | 2015 | ||||||||||||||
GAAP diluted EPS | $ | 0.84 | $ | 0.75 | $ | 1.89 | $ | 1.99 | $2.73 - $2.83 | ||||||||
Health Net acquisition related expenses (2) | 0.12 | 0.09 | 0.98 | 0.10 | $1.00 - $1.05 | ||||||||||||
Amortization of acquired intangible assets (3) | 0.15 | 0.03 | 0.36 | 0.09 | $0.50 - $0.55 | ||||||||||||
Adjusted diluted EPS | $ | 1.11 | $ | 0.87 | $ | 3.23 | $ | 2.18 | $4.28 - $4.38 |
(2) | The Health Net acquisition related expenses per diluted share presented above are net of the income tax benefit (expense) of $(0.06) and $0.05 for the three months ended September 30, 2016 and 2015, respectively, and $0.44 and $0.06 for the nine months ended September 30, 2016 and 2015, respectively; and estimated $0.37 to $0.41 for the year ended December 31, 2016. |
(3) | The amortization of acquired intangible assets per diluted share presented above are net of the income tax benefit of $0.09 and $0.02 for the three months ended September 30, 2016 and 2015, respectively, and $0.23 and $0.05 for the nine months ended September 30, 2016 and 2015, respectively; and estimated $0.31 to $0.35 for the year ended December 31, 2016. |
September 30, 2016 | December 31, 2015 | ||||||
(Unaudited) | |||||||
ASSETS | |||||||
Current assets: | |||||||
Cash and cash equivalents | $ | 2,982 | $ | 1,760 | |||
Premium and related receivables | 3,445 | 1,279 | |||||
Short term investments | 406 | 176 | |||||
Other current assets | 922 | 390 | |||||
Total current assets | 7,755 | 3,605 | |||||
Long term investments | 4,568 | 1,927 | |||||
Restricted deposits | 137 | 115 | |||||
Property, software and equipment, net | 725 | 518 | |||||
Goodwill | 4,730 | 842 | |||||
Intangible assets, net | 1,566 | 155 | |||||
Other long term assets | 153 | 177 | |||||
Total assets | $ | 19,634 | $ | 7,339 | |||
LIABILITIES AND STOCKHOLDERS’ EQUITY | |||||||
Current liabilities: | |||||||
Medical claims liability | $ | 3,767 | $ | 2,298 | |||
Accounts payable and accrued expenses | 3,187 | 976 | |||||
Return of premium payable | 651 | 207 | |||||
Unearned revenue | 573 | 143 | |||||
Current portion of long term debt | 845 | 5 | |||||
Total current liabilities | 9,023 | 3,629 | |||||
Long term debt | 3,744 | 1,216 | |||||
Other long term liabilities | 995 | 170 | |||||
Total liabilities | 13,762 | 5,015 | |||||
Commitments and contingencies | |||||||
Redeemable noncontrolling interests | 148 | 156 | |||||
Stockholders’ equity: | |||||||
Preferred stock, $0.001 par value; authorized 10,000,000 shares; no shares issued or outstanding at September 30, 2016 and December 31, 2015 | — | — | |||||
Common stock, $0.001 par value; authorized 400,000,000 shares; 176,467,825 issued and 170,860,752 outstanding at September 30, 2016, and 126,855,477 issued and 120,342,981 outstanding at December 31, 2015 | — | — | |||||
Additional paid-in capital | 4,154 | 956 | |||||
Accumulated other comprehensive earnings (loss) | 46 | (10 | ) | ||||
Retained earnings | 1,655 | 1,358 | |||||
Treasury stock, at cost (5,607,073 and 6,512,496 shares, respectively) | (145 | ) | (147 | ) | |||
Total Centene stockholders’ equity | 5,710 | 2,157 | |||||
Noncontrolling interest | 14 | 11 | |||||
Total stockholders’ equity | 5,724 | 2,168 | |||||
Total liabilities and stockholders’ equity | $ | 19,634 | $ | 7,339 |
Three Months Ended September 30, | Nine Months Ended September 30, | ||||||||||||||
2016 | 2015 | 2016 | 2015 | ||||||||||||
Revenues: | |||||||||||||||
Premium | $ | 9,625 | $ | 4,983 | $ | 25,299 | $ | 13,974 | |||||||
Service | 590 | 480 | 1,603 | 1,434 | |||||||||||
Premium and service revenues | 10,215 | 5,463 | 26,902 | 15,408 | |||||||||||
Premium tax and health insurer fee | 631 | 358 | 1,794 | 1,050 | |||||||||||
Total revenues | 10,846 | 5,821 | 28,696 | 16,458 | |||||||||||
Expenses: | |||||||||||||||
Medical costs | 8,376 | 4,433 | 22,072 | 12,475 | |||||||||||
Cost of services | 504 | 413 | 1,386 | 1,234 | |||||||||||
General and administrative expenses | 940 | 458 | 2,611 | 1,291 | |||||||||||
Amortization of acquired intangible assets | 43 | 6 | 95 | 18 | |||||||||||
Premium tax expense | 512 | 274 | 1,460 | 794 | |||||||||||
Health insurer fee expense | 129 | 54 | 333 | 161 | |||||||||||
Total operating expenses | 10,504 | 5,638 | 27,957 | 15,973 | |||||||||||
Earnings from operations | 342 | 183 | 739 | 485 | |||||||||||
Other income (expense): | |||||||||||||||
Investment and other income | 33 | 8 | 80 | 27 | |||||||||||
Interest expense | (57 | ) | (11 | ) | (142 | ) | (32 | ) | |||||||
Earnings from continuing operations, before income tax expense | 318 | 180 | 677 | 480 | |||||||||||
Income tax expense | 171 | 87 | 376 | 234 | |||||||||||
Earnings from continuing operations, net of income tax expense | 147 | 93 | 301 | 246 | |||||||||||
Discontinued operations, net of income tax benefit | (1 | ) | 1 | (3 | ) | — | |||||||||
Net earnings | 146 | 94 | 298 | 246 | |||||||||||
(Earnings) attributable to noncontrolling interests | (1 | ) | (1 | ) | (1 | ) | (2 | ) | |||||||
Net earnings attributable to Centene Corporation | $ | 145 | $ | 93 | $ | 297 | $ | 244 | |||||||
Amounts attributable to Centene Corporation common shareholders: | |||||||||||||||
Earnings from continuing operations, net of income tax expense | $ | 146 | $ | 92 | $ | 300 | $ | 244 | |||||||
Discontinued operations, net of income tax benefit | (1 | ) | 1 | (3 | ) | — | |||||||||
Net earnings | $ | 145 | $ | 93 | $ | 297 | $ | 244 | |||||||
Net earnings (loss) per common share attributable to Centene Corporation: | |||||||||||||||
Basic: | |||||||||||||||
Continuing operations | $ | 0.85 | $ | 0.77 | $ | 1.93 | $ | 2.05 | |||||||
Discontinued operations | — | 0.01 | (0.02 | ) | — | ||||||||||
Basic earnings per common share | $ | 0.85 | $ | 0.78 | $ | 1.91 | $ | 2.05 | |||||||
Diluted: | |||||||||||||||
Continuing operations | $ | 0.84 | $ | 0.75 | $ | 1.89 | $ | 1.99 | |||||||
Discontinued operations | (0.01 | ) | 0.01 | (0.02 | ) | — | |||||||||
Diluted earnings per common share | $ | 0.83 | $ | 0.76 | $ | 1.87 | $ | 1.99 | |||||||
Weighted average number of common shares outstanding: | |||||||||||||||
Basic | 170,774,587 | 119,121,524 | 155,680,769 | 118,970,853 | |||||||||||
Diluted | 174,312,416 | 123,131,810 | 158,960,068 | 122,904,476 |
Nine Months Ended September 30, | |||||||
2016 | 2015 | ||||||
Cash flows from operating activities: | |||||||
Net earnings | $ | 298 | $ | 246 | |||
Adjustments to reconcile net earnings to net cash provided by operating activities | |||||||
Depreciation and amortization | 189 | 82 | |||||
Stock compensation expense | 112 | 48 | |||||
Deferred income taxes | (17 | ) | (14 | ) | |||
Gain on contingent consideration | (2 | ) | (37 | ) | |||
Goodwill and intangible adjustment | — | 28 | |||||
Changes in assets and liabilities | |||||||
Premium and related receivables | (906 | ) | (360 | ) | |||
Other current assets | (81 | ) | (103 | ) | |||
Medical claims liabilities | 15 | 394 | |||||
Unearned revenue | 301 | (104 | ) | ||||
Accounts payable and accrued expenses | 99 | 209 | |||||
Other long term liabilities | 156 | 101 | |||||
Other operating activities, net | 91 | (33 | ) | ||||
Net cash provided by operating activities | 255 | 457 | |||||
Cash flows from investing activities: | |||||||
Capital expenditures | (211 | ) | (101 | ) | |||
Purchases of investments | (1,528 | ) | (1,077 | ) | |||
Sales and maturities of investments | 955 | 418 | |||||
Investments in acquisitions, net of cash acquired | (848 | ) | (16 | ) | |||
Other investing activities, net | — | 7 | |||||
Net cash used in investing activities | (1,632 | ) | (769 | ) | |||
Cash flows from financing activities: | |||||||
Proceeds from borrowings | 6,956 | 1,305 | |||||
Payment of long term debt | (4,257 | ) | (910 | ) | |||
Common stock repurchases | (29 | ) | (9 | ) | |||
Purchase of noncontrolling interest | (14 | ) | — | ||||
Debt issue costs | (59 | ) | (4 | ) | |||
Other financing activities, net | 1 | (15 | ) | ||||
Net cash provided by financing activities | 2,598 | 367 | |||||
Effect of exchange rate changes on cash and cash equivalents | 1 | — | |||||
Net increase in cash and cash equivalents | 1,222 | 55 | |||||
Cash and cash equivalents, beginning of period | 1,760 | 1,610 | |||||
Cash and cash equivalents, end of period | $ | 2,982 | $ | 1,665 | |||
Supplemental disclosures of cash flow information: | |||||||
Interest paid | $ | 113 | $ | 28 | |||
Income taxes paid | $ | 394 | $ | 229 | |||
Equity issued in connection with acquisitions | $ | 3,105 | $ | 12 |
Q3 | Q2 | Q1 | Q4 | Q3 | ||||||||||||
2016 | 2016 | 2016 | 2015 | 2015 | ||||||||||||
MANAGED CARE MEMBERSHIP BY STATE | ||||||||||||||||
Arizona | 601,500 | 597,700 | 607,000 | 440,900 | 223,600 | |||||||||||
Arkansas | 57,700 | 52,800 | 50,700 | 41,900 | 40,900 | |||||||||||
California | 3,004,500 | 3,097,600 | 3,125,400 | 186,000 | 183,900 | |||||||||||
Florida | 732,700 | 726,200 | 660,800 | 510,400 | 486,500 | |||||||||||
Georgia | 498,000 | 493,300 | 495,500 | 408,600 | 406,700 | |||||||||||
Illinois | 236,700 | 234,700 | 239,100 | 207,500 | 211,300 | |||||||||||
Indiana | 289,600 | 291,000 | 290,300 | 282,100 | 276,700 | |||||||||||
Kansas | 145,100 | 144,800 | 141,100 | 141,000 | 137,500 | |||||||||||
Louisiana | 455,600 | 375,300 | 381,200 | 381,900 | 358,800 | |||||||||||
Massachusetts | 45,300 | 47,100 | 52,400 | 61,500 | 63,700 | |||||||||||
Michigan | 2,100 | 2,200 | 2,600 | 4,800 | 6,600 | |||||||||||
Minnesota | 9,400 | 9,500 | 9,500 | 9,600 | 9,400 | |||||||||||
Mississippi | 313,900 | 323,800 | 328,300 | 302,200 | 301,000 | |||||||||||
Missouri | 104,700 | 102,900 | 100,000 | 95,100 | 88,400 | |||||||||||
New Hampshire | 78,400 | 79,700 | 81,500 | 71,400 | 71,900 | |||||||||||
New Mexico | 7,100 | 7,100 | — | — | — | |||||||||||
Ohio | 319,500 | 319,000 | 314,000 | 302,700 | 308,100 | |||||||||||
Oregon | 218,400 | 221,500 | 209,000 | 98,700 | 99,800 | |||||||||||
South Carolina | 119,700 | 113,700 | 107,700 | 104,000 | 104,800 | |||||||||||
Tennessee | 21,600 | 20,800 | 20,100 | 20,000 | 20,200 | |||||||||||
Texas | 1,041,600 | 1,037,000 | 1,036,700 | 983,100 | 976,500 | |||||||||||
Vermont | 1,700 | 1,600 | 1,500 | 1,700 | 1,500 | |||||||||||
Washington | 240,500 | 239,700 | 226,500 | 209,400 | 208,600 | |||||||||||
Wisconsin | 75,100 | 76,100 | 78,400 | 77,100 | 78,100 | |||||||||||
Total at-risk membership | 8,620,400 | 8,615,100 | 8,559,300 | 4,941,600 | 4,664,500 | |||||||||||
TRICARE eligibles | 2,815,700 | 2,815,700 | 2,819,700 | — | — | |||||||||||
Non-risk membership | — | — | 161,400 | 166,300 | 169,900 | |||||||||||
Total | 11,436,100 | 11,430,800 | 11,540,400 | 5,107,900 | 4,834,400 | |||||||||||
Medicaid: | ||||||||||||||||
TANF, CHIP & Foster Care | 5,583,900 | 5,541,200 | 5,464,200 | 3,763,400 | 3,719,900 | |||||||||||
ABD & LTC | 754,900 | 757,500 | 757,600 | 478,600 | 473,700 | |||||||||||
Behavioral Health | 465,300 | 455,800 | 456,500 | 456,800 | 216,700 | |||||||||||
Commercial | 1,365,600 | 1,423,400 | 1,518,900 | 146,100 | 155,600 | |||||||||||
Medicare & Duals | 300,900 | 300,700 | 303,100 | 37,400 | 39,300 | |||||||||||
Correctional | 149,800 | 136,500 | 59,000 | 59,300 | 59,300 | |||||||||||
Total at-risk membership | 8,620,400 | 8,615,100 | 8,559,300 | 4,941,600 | 4,664,500 | |||||||||||
TRICARE eligibles | 2,815,700 | 2,815,700 | 2,819,700 | — | — | |||||||||||
Non-risk membership | — | — | 161,400 | 166,300 | 169,900 | |||||||||||
Total | 11,436,100 | 11,430,800 | 11,540,400 | 5,107,900 | 4,834,400 | |||||||||||
NUMBER OF EMPLOYEES | 29,400 | 28,900 | 28,000 | 18,200 | 17,100 |
Q3 | Q2 | Q1 | Q4 | Q3 | ||||||||||||||||
2016 | 2016 | 2016 | 2015 | 2015 | ||||||||||||||||
DAYS IN CLAIMS PAYABLE (a) | 41 | 43 | 66 | 44 | 45 | |||||||||||||||
(a) Days in claims payable is a calculation of medical claims liabilities at the end of the period divided by average claims expense per calendar day for such period. On a pro-forma basis, DCP for Q1 2016 was 42, reflecting adjusted medical costs to include a full quarter of Health Net operations. | ||||||||||||||||||||
CASH, INVESTMENTS AND RESTRICTED DEPOSITS (in millions) | ||||||||||||||||||||
Regulated | $ | 7,825 | $ | 7,324 | $ | 7,682 | $ | 3,900 | $ | 3,834 | ||||||||||
Unregulated | 268 | 196 | 139 | 78 | 91 | |||||||||||||||
Total | $ | 8,093 | $ | 7,520 | $ | 7,821 | $ | 3,978 | $ | 3,925 | ||||||||||
DEBT TO CAPITALIZATION | 44.5 | % | 44.8 | % | 44.6 | % | 36.0 | % | 38.4 | % | ||||||||||
DEBT TO CAPITALIZATION EXCLUDING NON-RECOURSE DEBT (b) | 44.1 | % | 44.4 | % | 44.3 | % | 34.7 | % | 37.1 | % | ||||||||||
(b) The non-recourse debt represents the Company's mortgage note payable ($65 million at September 30, 2016). | ||||||||||||||||||||
Debt to capitalization is calculated as follows: total debt divided by (total debt + total equity). |
Three Months Ended September 30, | Nine Months Ended September 30, | ||||||||||
2016 | 2015 | 2016 | 2015 | ||||||||
Health benefits ratio | 87.0 | % | 89.0 | % | 87.2 | % | 89.3 | % | |||
General & administrative expense ratio | 9.2 | % | 8.4 | % | 9.7 | % | 8.4 | % | |||
General & administrative expense ratio, excluding Health Net acquisition related expenses | 9.1 | % | 8.1 | % | 8.9 | % | 8.2 | % |
Balance, September 30, 2015 | $ | 2,144 | ||
Acquisitions | 1,453 | |||
Incurred related to: | ||||
Current period | 27,094 | |||
Prior period | (255 | ) | ||
Total incurred | 26,839 | |||
Paid related to: | ||||
Current period | 24,807 | |||
Prior period | 1,862 | |||
Total paid | 26,669 | |||
Balance, September 30, 2016 | $ | 3,767 |
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