-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, H8Lfpn8VDEg6hTVTuKDmsUgKFE+M87LOBGU8qccHKYtINkMJx83qx4Y6AnQVt46x JAwsjpxCOZY5I7V1D+FECw== 0001157523-06-007601.txt : 20060731 0001157523-06-007601.hdr.sgml : 20060731 20060731060201 ACCESSION NUMBER: 0001157523-06-007601 CONFORMED SUBMISSION TYPE: 8-K PUBLIC DOCUMENT COUNT: 3 CONFORMED PERIOD OF REPORT: 20060731 ITEM INFORMATION: Results of Operations and Financial Condition ITEM INFORMATION: Regulation FD Disclosure ITEM INFORMATION: Financial Statements and Exhibits FILED AS OF DATE: 20060731 DATE AS OF CHANGE: 20060731 FILER: COMPANY DATA: COMPANY CONFORMED NAME: HUMANA INC CENTRAL INDEX KEY: 0000049071 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 610647538 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 8-K SEC ACT: 1934 Act SEC FILE NUMBER: 001-05975 FILM NUMBER: 06989462 BUSINESS ADDRESS: STREET 1: 500 W MAIN ST CITY: LOUISVILLE STATE: KY ZIP: 40202 BUSINESS PHONE: 5025801000 MAIL ADDRESS: STREET 1: 500 W. MAIN ST CITY: LOUISVILLE STATE: KY ZIP: 40202 FORMER COMPANY: FORMER CONFORMED NAME: EXTENDICARE INC DATE OF NAME CHANGE: 19740404 FORMER COMPANY: FORMER CONFORMED NAME: HERITAGE HOUSE OF AMERICA INC DATE OF NAME CHANGE: 19671129 8-K 1 a5198400.htm HUMANA INC. Humana Inc.


UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, DC  20549
 
 
FORM 8-K
 
CURRENT REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE
SECURITIES EXCHANGE ACT OF 1934
 
 
Date of report (Date of earliest event reported)    July 31, 2006
 
Humana Inc.
(Exact Name of Registrant as Specified in Its Charter)
 
Delaware
(State or Other Jurisdiction of Incorporation)
 
1-5975
61-0647538
(Commission File Number)
(IRS Employer Identification No.)
 
 
500 West Main Street, Louisville, KY
40202
(Address of Principal Executive Offices)
 (Zip Code)
 
502-580-1000
(Registrant's Telephone Number, Including Area Code)
 
 
(Former Name or Former Address, if Changed Since Last Report)
 
      Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions (see General Instruction A.2. below):
 
      o    Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
 
      o    Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
 
      o    Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
 
      o    Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))
 


 

 
Item 2.02   Results of Operations and Financial Condition.
Item 7.01   Regulation FD Disclosure.
 
                  An earnings release for the period ended June 30, 2006 and guidance for 2006 was issued by Humana Inc. this morning, a copy of which is attached hereto as Exhibit 99 and is incorporated herein by reference.
 
 
Item 9.01   Financial Statements and Exhibits.
 
(d)   Exhibits:
 
Exhibit No.
Description
 
     
99
Earnings Release and Stat Pages  
 

 
SIGNATURES
 
          Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this Report to be signed on its behalf by the undersigned hereunto duly authorized.
 
     
  HUMANA INC.
 
 
 
 
 
 
  By:   /s/  Arthur P. Hipwell
 
Arthur P. Hipwell
  Senior Vice President
  and General Counsel
   
   
   
Date: July 31, 2006  
 

 
INDEX TO EXHIBITS
 
Exhibit No.
Description
 
     
99
Earnings Release and Stat Pages  
EX-99 2 a5198400ex99.htm EXHIBIT 99
Exhibit 99

 
n e w s r e l e a s e
  Humana Inc.
 
500 West Main Street
 
P.O. Box 1438
 
Louisville, KY 40201-1438
 
http://www.humana.com
 
FOR MORE INFORMATION CONTACT:

Regina Nethery
Humana Investor Relations
(502) 580-3644
e-mail: Rnethery@humana.com
 
 
     
Tom Noland
Humana Corporate Communications
(502) 580-3674
e-mail: Tnoland@humana.com
   
 

Humana Inc. Reports Second Quarter 2006 Financial Results
including Earnings per Share of $0.53

·       
EPS for second quarter up 8 percent versus prior year
·       
Consolidated revenues up 52 percent to $5.41 billion
·       
Medical membership exceeds 11 million
·       
Full-year cash flow guidance raised


LOUISVILLE, KY (July 31, 2006) - Humana Inc. (NYSE:HUM) today reported $0.53 in diluted earnings per common share (EPS) for the quarter ended June 30, 2006 (2Q06), $0.19 per share higher than the mid-point of the company’s prior guidance. On a year-over-year basis, the 2Q06 EPS is 8 percent higher than the company’s EPS for the quarter ended June 30, 2005 (2Q05) of $0.49 (a). The upside in the quarter was a combination of better-than-expected performance in the company’s Medicare Advantage, commercial and TRICARE business lines, partially offset by profit margins in its Prescription Drug Plans (PDPs) moving to the low end of the projected range.

The company continues to estimate EPS for the year ending December 31, 2006 (FY06E) in the range of $2.82 to $2.88 versus $1.79 (a) for the year ended December 31, 2005 (FY05), a growth rate of approximately 60 percent. In addition to the impact of changes associated with second quarter performance, this forecast has been revised to reflect management’s updated expectations for Medicare marketing costs in the latter half of 2006. In order to maximize 2007 Medicare growth opportunities, the company now anticipates its second-half 2006 Medicare marketing costs to be approximately $0.15 per share higher than it had previously forecast.
 
“Strong results in our Medicare Advantage, Commercial and TRICARE businesses combined to produce second-quarter earnings that significantly surpassed our expectations,” said Michael B. McCallister, Humana’s president and chief executive officer. “We’re on track to grow revenues by 50 percent this year as we enhance our reputation as the consumer leader in health benefits and expand our Medicare business into a long-term growth engine.”
 
1

 
For the six months ended June 30, 2006 (1H06) the company reported $1.03 in EPS compared to $1.14 (a) for the six months ended June 30, 2005 (1H05). The year-over-year decline in year-to-date results was expected given the change in the quarterly pattern of 2006 earnings primarily driven by the introduction of the company’s stand-alone Medicare PDPs in January 2006. Higher Medicare administrative costs in 1H06 versus 1H05 also contributed to the decline in earnings from the 2005 period. Given these factors, earnings are expected to increase in the second half of the year compared to the same period in 2005.

Revenues - 2Q06 consolidated revenues rose 52 percent to $5.41 billion from $3.55 billion in 2Q05, with total premium and administrative services fees also up 52 percent compared to the prior year’s quarter. These increases were primarily the result of higher enrollment in the company’s Medicare Advantage plans and new 2006 revenues from stand-alone PDPs for Medicare beneficiaries.

1H06 consolidated revenues rose 46 percent to $10.11 billion from $6.93 billion in 1H05 with total premium and administrative services fees up 45 percent compared to the prior year’s period, also primarily driven by enrollment in the company’s Medicare Advantage plans and stand-alone PDPs.

Medical costs - The company’s medical expense ratio (medical expenses as a percent of premium revenue or MER) of 85.1 percent in 2Q06 was 130 basis points higher than that for 2Q05 as year-over-year improvement in this metric for the Commercial Segment was offset by a higher Government Segment MER. The higher MER in the Government Segment primarily results from the introduction of the stand-alone PDP results in 2006, as described more fully in the Government Segment results discussion below.

The consolidated MER for 1H06 of 84.4 percent was 60 basis points higher than the 1H05 consolidated MER of 83.8 percent, driven by the same factors affecting the 2Q06 MER.

Selling, general, & administrative (SG&A) expenses - The company’s consolidated SG&A expense ratio (SG&A expenses as a percent of premiums plus administrative services fees or SG&A expense ratio) decreased to 13.7 percent for 2Q06 from 14.0 percent (a) in 2Q05. This resulted primarily from growth in revenues which began to outpace the related increase in administrative spending on a consolidated basis during the quarter. The consolidated SG&A ratio improved 240 basis points compared to the first quarter of 2006 for this reason.

The SG&A expense ratio for 1H06 of 14.8 percent was 70 basis points higher than the 1H05 ratio of 14.1 percent (a) due to the increase in SG&A expenses associated with the Medicare expansion in the first quarter of 2006 coupled with an increase in the percentage of Commercial medical members in ASO accounts. The increase in the Medicare administrative costs results from the build out of infrastructure and support functions in advance of the anticipated continued escalation in enrollment as well as sales and marketing spending occurring in a more concentrated 2006 Medicare selling season.
 
2


Government Segment Results Summary

Pretax results:
·     
Government Segment pretax earnings were $98.0 million in 2Q06 compared to $102.5 million (a) in 2Q05. This decline was anticipated because Medicare stand-alone PDP offerings changed the company’s quarterly pattern of earnings for 2006 given the medical expense patterns associated with PDP benefit designs.
·     
For 1H06, pretax earnings for the Government Segment of $119.6 million were $53.4 million, or 31 percent lower than 1H05 pretax earnings for the segment of $173.0 million (a) with the first half results also impacted primarily by the new PDP offerings in 2006.

Enrollment:
·     
Medicare Advantage membership rose to 959,800 at June 30, 2006, an increase of 485,500, or 102 percent, from June 30, 2005 and 218,600, or 29 percent, from March 31, 2006. The company’s expanded participation in various Medicare products and markets combined with the company’s increased sales and marketing efforts for these programs led to the higher membership level.
·     
July 2006 Medicare Advantage membership approximated 990,000. The company now expects Medicare Advantage membership will approximate 1 million at December 31, 2006.
·     
Membership in the company’s stand-alone PDPs totaled 3,458,800 at June 30, 2006, a sequential increase of 1.5 million, or 77 percent, primarily driven by strong sales during the final two weeks of the open enrollment period which ended on May 15, 2006. The company now anticipates stand-alone PDP membership of approximately 3.5 million at the end of 2006. The significant PDP membership growth during May is not anticipated to substantially increase the company’s net earnings for 2006. This is primarily due to the front-loaded pattern of medical spend generally associated with PDP members and the shortened time frame during which such spending would occur for these members through the remainder of 2006 given their enrollment timing.
·     
As expected, TRICARE membership of 2,874,500 at June 30, 2006 was essentially unchanged from March 31, 2006. The company also anticipates no material change in TRICARE membership during 2006 compared to year-end 2005.
·     
Medicaid membership of 418,500 at June 30, 2006 declined 59,400 from June 30, 2005 and 8,500 from March 31, 2006 due primarily to the non-renewal of the Illinois Medicaid contract in the third quarter of 2005 and a continuing shift of eligible Puerto Rico Medicaid members to the Medicare program.

Revenues:
·     
Medicare Advantage premiums of $2.11 billion in 2Q06 increased 93 percent compared to $1.09 billion in 2Q05, primarily the result of higher enrollment, increases in per-member revenues from CMS, and the expanded geography across which Medicare Advantage products were offered. Medicare Advantage premiums per member increased 2 percent year over year during 2Q06, primarily resulting from the increase in per-member revenues from CMS, combined with an increase in the percentage of Medicare Advantage members in the company’s Private Fee-For-Service products together with a more diverse geographic mix than in the prior year. At June 30, 2006, approximately 46 percent of the company’s Medicare Advantage members were in Private Fee-For-Service plans versus 11 percent at June 30, 2005.
·     
Medicare PDP premiums added $801.8 million in new revenues in 2Q06 versus 2Q05.
 
3

 
·     
TRICARE premiums and administrative services fees during 2Q06 of $668.8 million compared to $626.6 million in 2Q05. The year-over-year increase primarily reflects a higher reimbursement for claims incurred in 2Q06 combined with revenue from favorable performance for the second option period which concluded on March 31, 2006.

Medical Expenses:
·     
The Government Segment MER increased 220 basis points to 86.0 percent in 2Q06 compared to 83.8 percent in the prior year’s quarter. The increase is primarily the result of the establishment of the stand-alone PDPs in January 2006. The MER for the company’s PDP business was 92.7 percent for 2Q06.
·     
The MER for stand-alone PDP offerings over each of the interim reporting periods is impacted by the recognition of benefit costs as incurred under each plan’s provisions. Different PDP designs offered by the company result in varying levels of coverage through each of the different layers of beneficiary cost responsibility. The company now anticipates an MER for the full year for its stand-alone PDPs in the range of 86 percent to 89 percent, with MER improvement expected in each quarter sequentially throughout the remainder of the year. Variables that may impact the quarterly MER for the stand-alone PDPs primarily include: (1) the timing of member enrollment, (2) the PDP offering chosen by the member, and (3) the speed with which members move through their deductibles.

SG&A Expenses:
·     
The Government Segment’s SG&A expense ratio for 2Q06 of 11.5 percent was 90 basis points higher than that for 2Q05 of 10.6 percent (a) primarily driven by expenses associated with the infrastructure build out of the company’s expanded Medicare offerings. In particular, marketing expenses and service costs per member were higher year over year. On a sequential basis, the segment’s SG&A ratio improved 230 basis points primarily due to the administrative cost leverage provided by revenues associated with higher average membership for this segment.
·     
The company anticipates that its SG&A expense ratio for the second half of 2006 will improve over that for 1H06 as marketing expenses decline during the Medicare Advantage lock-in period that began July 1, 2006, and the average membership associated with the Medicare expansion increases throughout the year, providing more leverage against administrative costs.
 
4


Commercial Segment Results Summary

Pretax results:
·     
Results for the Commercial Segment during 2Q06 reflect pretax income of $42.3 million compared to $22.3 million (a) in 2Q05. Commercial Segment operating earnings in 2Q06 primarily reflect year-over-year improvements in medical cost utilization trends and the company’s commitment to underwriting discipline.
·     
For 1H06, pretax earnings for the Commercial Segment of $152.0 million were $83.5 million, or 122 percent higher than 1H05 pretax earnings for the segment of $68.5 million (a) primarily reflecting the same drivers which impacted 2Q06 earnings performance combined with higher-than-average capital gains in the first quarter of 2006.

Enrollment:
·     
Commercial Segment medical membership of 3,313,900 at June 30, 2006 increased approximately 114,200, or 4 percent, from June 30, 2005 and 54,500, or 2 percent, from March 31, 2006. The sequential increase in Commercial Segment medical membership was primarily the result of the company’s acquisition of CHA Health on May 1, 2006.
·     
Membership in the company’s Smart plans and other consumer offerings increased year over year to 416,400 at June 30, 2006, representing approximately 13 percent of Commercial medical membership compared to 11 percent at June 30, 2005 and 13 percent at March 31, 2006.

Revenues:
·     
Premiums and administrative services fees for the Commercial Segment decreased 1 percent to $1.64 billion in 2Q06 compared to $1.66 billion in the prior year’s quarter, as an increase in administrative services fees resulting from a 21 percent increase in ASO membership was more than offset by lower premiums due to declines in at-risk enrollment.
·     
Commercial Segment medical premiums for fully insured groups increased approximately 5.5 percent on a per-member basis during 2Q06 compared to 2Q05. This increase primarily includes the effect of a greater percentage of the company’s fully-insured group block being weighted towards small groups, as its large group business becomes more weighted towards ASO. Premium yield and medical cost trends for the small group business generally include a higher level of benefit buy-downs versus larger employers. The company anticipates the FY06 range of increase in commercial premiums for fully insured group membership to be in the range of the expected increase in per-member medical costs.

Medical Expenses:
·     
In 2Q06, the Commercial Segment MER of 82.9 percent was 90 basis points lower than the 2Q05 MER of 83.8 percent, again primarily reflecting improving medical cost utilization trends and the company’s commitment to underwriting discipline.
·     
Per-member medical costs for commercial fully insured group accounts are now forecasted to rise in the range of 5.5 to 6.5 percent during 2006, including the effect of a greater percentage of the company’s fully-insured groups being weighted towards small employers, as discussed above.
·     
The company continues to project individual components of commercial medical cost trend for 2006 will approximate as follows: inpatient hospital utilization - flat to 1 percent; inpatient and outpatient hospital rates - upper single digits; outpatient hospital utilization - low to mid single digits; physician - mid single digits; and pharmacy - high single digits to low double digits.
 
5

 
SG&A Expenses:
·   
The Commercial Segment SG&A expense ratio of 18.8 percent for 2Q06 compares to 17.7 percent (a) in 2Q05, primarily the result of lower average fully-insured medical enrollment and an increase in the percentage of commercial medical membership related to ASO to 43 percent in 2Q06 versus 37 percent in the prior year. On a sequential basis, the segment’s SG&A ratio improved 160 basis points primarily due to progressively higher administrative cost leverage.
 
6


Cash Flows from Operations

Cash flows provided by operations for 2Q06 of $534.9 million compared to $179.3 million (a) in 2Q05. The company also evaluates operating cash flows on a non-GAAP basis (b)(c).

Cash flows from operations
($ in millions)
 
2Q06
2Q05(a)
1H06
1H05(a)
 
GAAP cash flows provided by operations
$534.9
$179.3
 
 
$1,542.8
 
 
$274.9
 
Timing of premium payment from CMS (c)
(257.2)
 
 
(1,031.7)
 
 
19.8
Non-GAAP cash flows provided by operations (b) (c)
$277.7
$179.3
 
 
$511.1
 
 
$294.7

Non-GAAP cash flows provided by operations rose to $277.7 million in 2Q06 from $179.3 million in 2Q05 driven by growth in the company’s Medicare operations. The company now expects that cash flows from operations for 2006 will be in the range of $850 million to $950 million driven by expected higher earnings over the prior year together with anticipated changes in working capital.

Footnotes

(a)  
In accordance with Generally Accepted Accounting Principles (GAAP), Humana adopted the retrospective method for implementing new stock option accounting rules on January 1, 2006. Consequently, prior period results in this news release have been adjusted to retrospectively reflect the expensing of stock options.
(b)  
The Company has included certain financial measures that are not in accordance with GAAP within this news release. The company believes that these non-GAAP measures, when presented in conjunction with comparable GAAP measures, are useful to both management and its investors in analyzing the company's ongoing business and operating performance. Internally, management uses these non-GAAP financial measures as indicators of business performance, as well as for operational planning and decision making purposes. Non-GAAP financial measures should be considered in addition to, but not as a substitute for, or superior to, financial measures prepared in accordance with GAAP.
(c)  
When reviewing and analyzing Humana’s operating cash flows, company management applies the CMS premium payment in each month to match the corresponding disbursements. To do otherwise distorts meaningful analysis of the company’s operating cash flow. Therefore, decisions such as management’s forecasting and business plans regarding cash flow use this non-GAAP financial measure.
 
7

 
Conference Call & Virtual Slide Presentation

Humana will host a conference call, as well as a virtual slide presentation, at 9:00 a.m. eastern time today to discuss its financial results for the quarter and the company’s expectations for future earnings. A live virtual presentation (audio with slides) may be accessed via Humana’s Investor Relations page at www.humana.com. The company suggests web participants sign on approximately 15 minutes in advance of the call. The company also suggests web participants visit the site well in advance of the call to run a system test and to download any free software needed to view the presentation.

All parties interested in the audio-only portion of the conference call are invited to dial 888-625-7430. No password is required. The company suggests participants dial in approximately ten minutes in advance of the call. For those unable to participate in the live event, the virtual presentation archive will be available in the Presentations section of the Investor Relations page at www.humana.com.

Cautionary Statement

This news release contains forward-looking statements. The forward-looking statements herein are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Forward-looking statements may be significantly impacted by certain risks and uncertainties described in the following documents filed by Humana with the Securities and Exchange Commission.
·  
Form 10-K for the year ended December 31, 2005,
·  
Form 10-Q for the quarter ended March 31, 2006,
·  
Form 8-Ks filed during May, June, and July 2006.

About Humana

Humana Inc., headquartered in Louisville, Ky., is one of the nation’s largest publicly traded health benefits companies, with over 11 million medical members. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals.

Over its 45-year history, Humana has consistently seized opportunities to meet changing customer needs. Today, the company is a leader in consumer engagement, providing guidance that leads to lower costs and a better health plan experience throughout its diversified customer portfolio.

More information regarding Humana is available to investors via the Investor Relations page of the company’s Web site at www.humana.com, including copies of:
 
·                     
Annual report to stockholders;
·                     
Securities and Exchange Commission filings;
·                     
Most recent investor conference presentation;
·                     
Quarterly earnings news releases;
·                     
Replay of most recent earnings release conference call;
·                     
Calendar of events (includes upcoming earnings conference call dates, times, and access number, as well as planned interaction with research analysts and institutional investors);
·                     
Corporate Governance information.
 
8


Humana Inc.
GAAP Earnings Guidance Points
For the year ending December 31, 2006
As of July 31, 2006
Diluted earnings per common share
Full year: $2.82 to $2.88
Third quarter 2006: $0.95 to $1.00
Revenues
Consolidated: $21 billion to $22 billion
Medicare Advantage: $8.5 billion to $9.0 billion
Medicare stand-alone PDPs: $2.8 billion to $3.2 billion
TRICARE: $2.5 billion to $2.9 billion
Commercial: $6.5 billion to $7.0 billion
Year-end medical membership
Medicare Advantage: approximately 1 million
Medicare stand-alone PDPs: approximately 3.5 million
TRICARE: No material change from prior year
Medicaid: Down approximately 40,000 from prior year
Commercial: Up approximately 140,000 to 150,000 from prior year including the benefit of members acquired via
                     the CHA Health acquisition
Medical costs
Medicare stand-alone PDPs: MER in the range of 86% to 89%
Commercial fully insured groups: Medical cost trends in the range of 5.5% to 6.5%; premium yields in line with
                     medical cost trends
Selling, general & administrative expenses
Consolidated SG&A expense ratio of 13% to 14%
Pretax results
(1)excluding allocation of investment and other income and interest expense
Medicare Advantage: 3% to 5% pretax margin(1)
Medicare stand-alone PDPs: Approximately 1% pretax margin(1) 
TRICARE: Approximately 3% to 4% pretax margin(1)
Commercial Segment: $200 million to $240 million
Cash flows from operations
$850 million to $950 million
Capital expenditures
$155 million to $165 million
Effective tax rate
Approximately 35% to 37%
Weighted average shares outstanding used to compute diluted earnings per
        common share
Approximately 168 million
 
9

 
 



Statistical Schedules
And
Supplementary Information
2Q06 Earnings Release



S-1

 
   
   
 
Humana Inc.
 
Statistical Schedules and Supplementary Information
 
2Q06 Earnings Release
     
 
Contents
 
     
 
Page
Description
     
 
S-3
 
S-4
 
S-5
 
S-6
 
S-7
 
S-8
 
S-9
 
S-10
 
S-11
 
S-12
 
S-13
 
S-14
 
S-15
 
S-16-17
 
S-18
 
S-2

 
2Q06 Consolidated Statements of Income
In thousands, except per common share results
               
               
   
Three Months Ended June 30,
       
         
Dollar
Percentage
 
   
2006
2005 (A)
 
Change
Change
 
Revenues:
             
Premiums
 
$5,264,475
$3,446,019
 
$1,818,456
52.8%
 
Administrative services fees
 
83,711
66,655
 
17,056
25.6%
 
Investment income
 
50,567
31,131
 
19,436
62.4%
 
Other income
 
8,416
2,556
 
5,860
229.3%
 
Total revenues
 
5,407,169
3,546,361
 
1,860,808
52.5%
 
Operating expenses:
             
Medical
 
4,479,501
2,888,509
 
1,590,992
55.1%
 
Selling, general and administrative
 
733,863
490,919
 
242,944
49.5%
 
Depreciation
 
31,613
24,815
 
6,798
27.4%
 
Other intangible amortization
 
4,983
6,948
 
(1,965)
-28.3%
 
Total operating expenses
 
5,249,960
3,411,191
 
1,838,769
53.9%
 
Income from operations
 
157,209
135,170
 
22,039
16.3%
 
Interest expense
 
16,887
10,322
 
6,565
63.6%
 
Income before income taxes
 
140,322
124,848
 
15,474
12.4%
 
Provision for income taxes
 
50,833
43,436
 
7,397
17.0%
 
Net income
 
$89,489
$81,412
 
$8,077
9.9%
 
               
Basic earnings per common share
 
$0.55
$0.50
 
$0.05
10.0%
 
Diluted earnings per common share
 
$0.53
$0.49
 
$0.04
8.2%
 
               
Shares used in computing basic earnings per common share
 
163,706
161,492
       
Shares used in computing diluted earnings per common share
 
167,536
165,149
       
 
S-3

 
YTD Consolidated Statements of Income
In thousands, except per common share results
 
             
               
   
Six Months Ended June 30,
       
         
Dollar
Percentage
 
   
2006
2005 (A)
 
Change
Change
 
Revenues:
             
Premiums
 
$9,785,961
$6,736,834
 
$3,049,127
45.3%
 
Administrative services fees
 
162,389
130,168
 
$32,221
24.8%
 
Investment income
 
149,469
61,342
 
$88,127
143.7%
 
Other income
 
13,715
5,242
 
$8,473
161.6%
 
Total revenues
 
10,111,534
6,933,586
 
$3,177,948
45.8%
 
Operating expenses:
             
Medical
 
8,263,427
5,642,242
 
$2,621,185
46.5%
 
Selling, general and administrative
 
1,474,749
969,959
 
$504,790
52.0%
 
Depreciation
 
61,465
49,621
 
$11,844
23.9%
 
Other intangible amortization
 
10,037
11,391
 
($1,354)
-11.9%
 
Total operating expenses
 
9,809,678
6,673,213
 
$3,136,465
47.0%
 
Income from operations
 
301,856
260,373
 
$41,483
15.9%
 
Interest expense
 
30,326
18,845
 
$11,481
60.9%
 
Income before income taxes
 
271,530
241,528
 
$30,002
12.4%
 
Provision for income taxes
 
98,326
53,381
 
$44,945
84.2%
 
Net income
 
$173,204
$188,147
 
($14,943)
-7.9%
 
         
 
 
Basic earnings per common share
 
$1.06
$1.17
 
($0.11)
-9.4%
 
Diluted earnings per common share
 
$1.03
$1.14
 
($0.11)
-9.6%
 
             
Shares used in computing basic earnings per common share
 
163,411
161,202
       
Shares used in computing diluted earnings per common share
 
167,430
164,823
       
 
S-4

 
Consolidated Balance Sheets 
Dollars in thousands, except share amounts
 
               
   
June 30,
March 31,
December 31,
 
Sequential Change
 
   
2006
2006
2005 (A)
 
Dollar
Percent
 
Assets
               
Current assets:
               
Cash and cash equivalents
 
$2,258,464
$1,843,405
$732,016
       
Investment securities
 
2,998,440
2,623,009
2,354,904
       
Receivables, net:
 
             
Premiums
 
767,610
763,061
723,190
       
Administrative services fees
 
14,842
21,652
15,462
       
Securities lending collateral
 
240,849
250,322
47,610
       
Other
 
778,821
517,877
333,004
       
Total current assets
 
7,059,026
6,019,326
4,206,186
 
$1,039,700
17.3%
 
Property and equipment
 
505,721
498,267
484,412
       
Other assets:
               
Long-term investment securities
 
387,362
374,583
391,035
       
Goodwill
 
1,307,650
1,265,176
1,264,575
       
Other
 
576,841
540,668
523,406
       
Total other assets
 
2,271,853
2,180,427
2,179,016
       
Total assets
 
$9,836,600
$8,698,020
$6,869,614
 
$1,138,580
13.1%
 
                 
Liabilities and Stockholders' Equity
               
Current liabilities:
               
Medical and other expenses payable
 
$2,457,643
$2,169,489
$1,909,682
       
Trade accounts payable and accrued expenses
 
1,102,919
871,231
560,550
       
Book overdraft
 
271,824
275,587
280,005
       
Securities lending payable
 
240,849
250,322
47,610
       
Unearned revenues
 
1,170,278
920,678
120,489
       
Current portion of long-term debt
 
299,941
300,231
301,254
       
Total current liabilities
 
5,543,454
4,787,538
3,219,590
 
$755,916
15.8%
 
Long-term debt
 
784,399
601,225
513,790
       
Other long-term liabilities
 
849,952
741,498
627,360
       
Total liabilities
 
7,177,805
6,130,261
4,360,740
 
$1,047,544
17.1%
 
Commitments and contingencies
               
Stockholders' equity:
               
Preferred stock, $1 par; 10,000,000 shares authorized, none issued
 
-
-
-
       
Common stock, $0.16 2/3 par; 300,000,000 shares authorized; 
               
181,012,456 issued at June 30, 2006
 
30,170
30,085
29,843
       
Capital in excess of par value
 
1,285,399
1,264,161
1,235,888
       
Retained earnings
 
1,594,879
1,505,390
1,421,675
       
Accumulated other comprehensive (loss) income
 
(43,352)
(28,408)
24,832
       
Treasury stock, at cost, 15,948,235 shares at June 30, 2006
 
(208,301)
(203,469)
(203,364)
       
Total stockholders' equity
 
2,658,795
2,567,759
2,508,874
 
$91,036
3.5%
 
Total liabilities and stockholders' equity
 
$9,836,600
$8,698,020
$6,869,614
 
$1,138,580
13.1%
 
                 
Debt to total capitalization ratio
 
29.0%
26.0%
24.5%
       
 
S-5

 
2Q06 Consolidated Statements of Cash Flows 
Dollars in thousands
               
               
   
Three Months Ended June 30,
       
         
Dollar
Percentage
 
   
2006
2005 (A)
 
Change
Change
 
Cash flows from operating activities
             
Net income
 
$89,489
$81,412
       
Adjustments to reconcile net income to net cash provided by operating activities:
 
           
Depreciation and amortization
 
36,596
31,763
       
Stock-based compensation
 
8,471
7,646
       
Provision for deferred income taxes
 
2,479
3,124
       
Changes in operating assets and liabilities excluding the effects of acquisitions:
 
           
Receivables
 
3,104
(19,825)
       
Other assets
 
(174,050)
(20,154)
       
Medical and other expenses payable
 
266,956
131,501
       
Other liabilities
 
57,967
(13,949)
       
Unearned revenues
 
244,661
(22,535)
       
Other
 
(818)
304
       
Net cash provided by operating activities
 
534,855
179,287
 
$355,568
198.3%
 
               
Cash flows from investing activities
             
Acquisitions, net of cash acquired
 
(25,818)
(4,627)
       
Purchases of property and equipment
 
(36,712)
(31,034)
       
Proceeds from sales of property and equipment
 
18
30
       
Purchases of investment securities
 
(594,890)
(531,234)
       
Proceeds from maturities of investment securities
 
100,289
131,947
       
Proceeds from sales of investment securities
 
152,855
325,329
       
Change in securities lending collateral
 
9,473
49,680
       
Net cash used in investing activities
 
(394,785)
(59,909)
 
($334,876)
-559.0%
 
               
Cash flows from financing activities
             
Receipts from CMS contract deposits
 
550,868
-
       
Withdrawals from CMS contract deposits
 
(462,981)
-
       
Repayments under credit agreement
 
(300,000)
(25,000)
       
Proceeds from issuance of senior notes
 
498,545
-
       
Debt issue costs
 
(3,825)
-
       
Change in book overdraft
 
(3,763)
(10,248)
       
Change in securities lending payable
 
(9,473)
(49,680)
       
Common stock repurchases
 
(4,832)
(315)
       
Tax benefit from stock-based compensation
 
5,252
2,570
       
Proceeds from stock option exercises and other
 
5,198
6,821
       
Net cash provided by (used in) financing activities
 
274,989
(75,852)
 
$350,841
462.5%
 
               
Increase in cash and cash equivalents
 
415,059
43,526
       
Cash and cash equivalents at beginning of period
 
1,843,405
560,264
       
               
Cash and cash equivalents at end of period
 
$2,258,464
$603,790
       
               
 
S-6

 
 
YTD Consolidated Statements of Cash Flows
 
Dollars in thousands
 
   
             
   
Six Months Ended June 30,
       
         
Dollar
Percentage
 
   
2006
2005 (A)
 
Change
Change
 
Cash flows from operating activities
             
Net income
 
$173,204
$188,147
       
Adjustments to reconcile net income to net cash provided by (used in) operating activities:
 
           
Depreciation and amortization
 
71,502
61,012
       
Stock-based compensation
 
15,051
14,370
       
(Benefit) provision for deferred income taxes
 
(1,226)
11,186
       
Changes in operating assets and liabilities excluding the effects of acquisitions:
 
           
Receivables
 
(42,957)
(26,250)
       
Other assets
 
(359,300)
(28,514)
       
Medical and other expenses payable
 
526,763
218,166
       
Other liabilities
 
172,719
(117,906)
       
Unearned revenues
 
1,044,850
(44,951)
       
Other
 
(57,778)
(400)
       
Net cash provided by operating activities
 
1,542,828
274,860
 
$1,267,968
461.3%
 
               
Cash flows from investing activities
             
Acquisitions, net of cash acquired
 
(25,931)
(352,726)
       
Purchases of property and equipment
 
(81,973)
(67,227)
       
Proceeds from sales of property and equipment
 
2,156
38
       
Purchases of investment securities
 
(2,258,548)
(1,245,605)
       
Proceeds from maturities of investment securities
 
1,010,397
393,612
       
Proceeds from sales of investment securities
 
712,685
759,835
       
Change in securities lending collateral
 
(193,239)
842
       
Net cash used in investing activities
 
(834,453)
(511,231)
 
($323,222)
-63.2%
 
               
Cash flows from financing activities
             
Receipts from CMS contract deposits
 
1,045,062
-
       
Withdrawals from CMS contract deposits
 
(736,425)
-
       
Borrowings under credit agreement
 
100,000
294,000
       
Repayments under credit agreement
 
(300,000)
(50,000)
       
Proceeds from issuance of senior notes
 
498,545
-
       
Debt issue costs
 
(3,825)
-
       
Change in book overdraft
 
(8,181)
(9,567)
       
Change in securities lending payable
 
193,239
(842)
       
Common stock repurchases
 
(4,937)
(1,691)
       
Tax benefit from stock-based compensation
 
13,656
6,225
       
Proceeds from stock option exercises and other
 
20,939
21,957
       
Net cash provided by financing activities
 
818,073
260,082
 
$557,991
214.5%
 
               
Increase in cash and cash equivalents
 
1,526,448
23,711
       
Cash and cash equivalents at beginning of period
 
732,016
580,079
       
               
Cash and cash equivalents at end of period
 
$2,258,464
$603,790
       
               
 
S-7

 
2005 Quarters Adjusted to Reflect Retrospective Application of Expensing Stock Options
In thousands, except per common share results
                                 
                                 
 
1Q05
 
2Q05
 
3Q05
 
4Q05
 
 
Reported
 
Adjusted (A)
 
Reported
 
Adjusted (A)
 
Reported
 
Adjusted (A)
 
Reported
 
Adjusted (A)
 
                                 
Revenues
$3,387,225
 
$3,387,225
 
$3,546,361
 
$3,546,361
 
$3,821,461
 
$3,821,461
 
$3,663,080
 
$3,663,080
 
                                 
Pretax income (loss):
                               
Government
$72,224
 
$70,472
 
$104,092
 
$102,531
 
$89,557
 
$87,868
 
$57,395
 
$55,805
 
Commercial
49,463
 
46,208
 
25,215
 
22,317
 
(18,053)
 
(21,190)
 
41,821
 
38,869
 
Consolidated
$121,687
 
$116,680
 
$129,307
 
$124,848
 
$71,504
 
$66,678
 
$99,216
 
$94,674
 
                                 
Net income
$109,795
 
$106,735
 
$84,137
 
$81,412
 
$49,944
 
$46,807
 
$64,607
 
$61,776
 
                                 
Diluted earnings per common share
$0.67
 
$0.65
 
$0.51
 
$0.49
 
$0.30
 
$0.28
 
$0.39
 
$0.37
 
                                 
Shares used in computing diluted earnings per
                               
common share
164,179
 
164,496
 
164,908
 
165,149
 
166,037
 
166,076
 
166,371
 
166,521
 
 
                               
                                 
SG&A expense ratio:
                               
Government
10.8%
 
10.9%
 
10.6%
 
10.6%
 
13.1%
 
13.2%
 
15.5%
 
15.6%
 
Commercial
17.6%
 
17.8%
 
17.5%
 
17.7%
 
20.0%
 
20.2%
 
18.1%
 
18.3%
 
Consolidated
14.1%
 
14.3%
 
13.8%
 
14.0%
 
16.2%
 
16.3%
 
16.7%
 
16.9%
 
                                 
Total assets
$6,149,593
 
$6,149,593
 
$6,277,907
 
$6,277,907
 
$6,832,421
 
$6,832,421
 
$6,869,614
 
$6,869,614
 
Total liabilities
$3,949,788
 
$3,916,471
 
$3,961,719
 
$3,927,862
 
$4,466,451
 
$4,432,166
 
$4,395,509
 
$4,360,740
 
Total stockholders' equity
$2,199,805
 
$2,233,122
 
$2,316,188
 
$2,350,045
 
$2,365,970
 
$2,400,255
 
$2,474,105
 
$2,508,874
 
                                 
Net cash provided by (used in) operating activities
$99,228
 
$95,573
 
$181,857
 
$179,287
 
$591,039
 
$586,006
 
($246,497)
 
($250,784)
 
Net cash used in investing activities
($451,322)
 
($451,322)
 
($59,909)
 
($59,909)
 
($96,395)
 
($96,395)
 
($159,650)
 
($159,650)
 
Net cash provided by (used in) financing activities
$332,279
 
$335,934
 
($78,422)
 
($75,852)
 
($119,498)
 
($114,465)
 
$159,227
 
$163,514
 
                                 
 
S-8

 
2003 Through 2005 Adjusted to Reflect Retrospective Application of Expensing Stock Options
In thousands, except per common share results
                           
                           
   
For the year ended
 
For the year ended
 
For the year ended
 
   
December 31, 2005
 
December 31, 2004
 
December 31, 2003
 
   
Reported
 
Adjusted (A)
 
Reported
 
Adjusted (A)
 
Reported
 
Adjusted (A)
 
                           
Revenues
 
$14,418,127
 
$14,418,127
 
$13,104,325
 
$13,104,325
 
$12,226,311
 
$12,226,311
 
                           
Pretax income:
                         
Government
 
$323,268
 
$316,676
 
$273,840
 
$269,063
 
$223,706
 
$221,240
 
Commercial
 
98,446
 
86,204
 
142,010
 
130,315
 
121,010
 
114,973
 
Consolidated
 
$421,714
 
$402,880
 
$415,850
 
$399,378
 
$344,716
 
$336,213
 
                           
Net income
 
$308,483
 
$296,730
 
$280,012
 
$269,947
 
$228,934
 
$223,739
 
                           
Diluted earnings per common share
 
$1.87
 
$1.79
 
$1.72
 
$1.66
 
$1.41
 
$1.38
 
   
 
                     
Shares used in computing diluted earnings per common share
 
165,374
 
165,560
 
162,456
 
162,905
 
161,960
 
162,406
 
                           
SG&A expense ratio:
                         
Government
 
12.6%
 
12.7%
 
12.2%
 
12.3%
 
13.4%
 
13.5%
 
Commercial
 
18.3%
 
18.5%
 
16.4%
 
16.5%
 
16.9%
 
17.0%
 
Consolidated
 
15.3%
 
15.4%
 
14.5%
 
14.6%
 
15.4%
 
15.4%
 
                           
Total assets
 
$6,869,614
 
$6,869,614
 
$5,657,617
 
$5,657,617
 
$5,379,814
 
$5,379,814
 
Total liabilities
 
$4,395,509
 
$4,360,740
 
$3,567,493
 
$3,533,369
 
$3,543,865
 
$3,510,842
 
Total stockholders' equity
 
$2,474,105
 
$2,508,874
 
$2,090,124
 
$2,124,248
 
$1,835,949
 
$1,868,972
 
   
 
     
 
             
Net cash provided by operating activities
 
$625,627
 
$610,082
 
$347,809
 
$344,061
 
$413,140
 
$397,921
 
Net cash used in investing activities
 
($767,276)
 
($767,276)
 
($624,081)
 
($624,081)
 
($382,837)
 
($382,837)
 
Net cash provided by (used in) financing activities
 
$293,586
 
$309,131
 
($75,053)
 
($71,305)
 
$179,744
 
$194,963
 
                           
 
S-9


Key Income Statement Ratios and Segment Operating Results
Dollars in thousands
 
                           
   
Three Months Ended June 30,
       
Six Months Ended June 30,
       
                           
           
Percentage
         
Percentage
 
   
2006
2005 (A)
 
Difference
Change
 
2006
2005 (A)
 
Difference
Change
 
Medical expense ratio
                         
Government Segment
 
86.0%
83.8%
 
2.2%
   
85.8%
84.4%
 
1.4%
   
Commercial Segment
 
82.9%
83.8%
 
-0.9%
   
81.5%
83.0%
 
-1.5%
   
Consolidated
 
85.1%
83.8%
 
1.3%
   
84.4%
83.8%
 
0.6%
   
                           
Selling, general, and administrative expense ratio
                         
Government Segment
 
11.5%
10.6%
 
0.9%
   
12.5%
10.8%
 
1.7%
   
Commercial Segment
 
18.8%
17.7%
 
1.1%
   
19.6%
17.7%
 
1.9%
   
Consolidated
 
13.7%
14.0%
 
-0.3%
   
14.8%
14.1%
 
0.7%
   
                           
                           
Detail of Pretax Income
                         
Government Segment
 
$97,981
$102,531
 
($4,550)
-4.4%
 
$119,553
$173,003
 
($53,450)
-30.9%
 
Commercial Segment
 
42,341
22,317
 
20,024
89.7%
 
151,977
68,525
 
83,452
121.8%
 
Consolidated
 
$140,322
$124,848
 
$15,474
12.4%
 
$271,530
$241,528
 
$30,002
12.4%
 
                           
Detail of Pretax Margins
                         
Government Segment
 
2.6%
5.5%
 
-2.9%
   
1.8%
4.9%
 
-3.1%
   
Commercial Segment
 
2.5%
1.3%
 
1.2%
   
4.5%
2.0%
 
2.5%
   
Consolidated
 
2.6%
3.5%
 
-0.9%
   
2.7%
3.5%
 
-0.8%
   
                           
 
S-10

 
 
Membership Detail
 
In thousands
 
   
                       
   
Ending
 
Ending
 
Year-over-year Change
 
Ending
 
Sequential Change
 
   
June 30, 2006
Average - 2Q06
June 30, 2005
 
Amount
Percent
 
March 31, 2006
 
Amount
Percent
 
Medical Membership:
                         
Government Segment:
                         
Medicare Advantage - HMO
 
457.0
453.8
418.0
 
39.0
9.3%
 
443.7
 
13.3
3.0%
 
Medicare Advantage - PPO
 
64.6
54.7
3.7
 
60.9
1645.9%
 
35.4
 
29.2
82.5%
 
Medicare Advantage - PFFS
 
438.2
379.7
52.6
 
385.6
733.1%
 
262.1
 
176.1
67.2%
 
Total Medicare Advantage
 
959.8
888.2
474.3
 
485.5
102.4%
 
741.2
 
218.6
29.5%
 
Medicare - PDP - Standard
 
2,066.5
1,755.4
-
 
2,066.5
100.0%
 
1,289.2
 
777.3
60.3%
 
Medicare - PDP - Enhanced
 
977.2
743.8
-
 
977.2
100.0%
 
421.0
 
556.2
132.1%
 
Medicare - PDP - Complete
 
415.1
355.0
-
 
415.1
100.0%
 
248.8
 
166.3
66.8%
 
Total Medicare stand-alone PDPs
 
3,458.8
2,854.2
-
 
3,458.8
100.0%
 
1,959.0
 
1,499.8
76.6%
 
Total Medicare
 
4,418.6
3,742.4
474.3
 
3,944.3
831.6%
 
2,700.2
 
1,718.4
63.6%
 
TRICARE insured
 
1,732.6
1,732.0
1,733.6
 
(1.0)
-0.1%
 
1,724.7
 
7.9
0.5%
 
TRICARE ASO
 
1,141.9
1,141.8
1,142.8
 
(0.9)
-0.1%
 
1,149.3
 
(7.4)
-0.6%
 
Total TRICARE
 
2,874.5
2,873.8
2,876.4
 
(1.9)
-0.1%
 
2,874.0
 
0.5
0.0%
 
Medicaid
 
418.5
422.2
477.9
 
(59.4)
-12.4%
 
427.0
 
(8.5)
-2.0%
 
Total Government Segment
 
7,711.6
7,038.4
3,828.6
 
3,883.0
101.4%
 
6,001.2
 
1,710.4
28.5%
 
Commercial Segment:
                         
Fully insured medical:
 
                       
Group
 
1,716.4
1,707.9
1,873.7
 
(157.3)
-8.4%
 
1,695.1
 
21.3
1.3%
 
Individual
 
170.0
167.7
144.0
 
26.0
18.1%
 
163.1
 
6.9
4.2%
 
Medicare supplement
 
6.7
6.4
3.6
 
3.1
86.1%
 
6.0
 
0.7
11.7%
 
Total fully insured medical
 
1,893.1
1,882.0
2,021.3
 
(128.2)
-6.3%
 
1,864.2
 
28.9
1.6%
 
ASO
 
1,420.8
1,411.5
1,178.4
 
242.4
20.6%
 
1,395.2
 
25.6
1.8%
 
Total Commercial Segment
 
3,313.9
3,293.5
3,199.7
 
114.2
3.6%
 
3,259.4
 
54.5
1.7%
 
                           
Total medical membership
 
11,025.5
10,331.9
7,028.3
 
3,997.2
56.9%
 
9,260.6
 
1,764.9
19.1%
 
                           
                           
Specialty Membership (all Commercial Segment)
                         
Dental - fully insured
 
955.6
954.2
893.7
 
61.9
6.9%
 
950.6
 
5.0
0.5%
 
Dental - ASO
 
496.5
496.8
488.9
 
7.6
1.6%
 
494.7
 
1.8
0.4%
 
Total dental
 
1,452.1
1,451.0
1,382.6
 
69.5
5.0%
 
1,445.3
 
6.8
0.5%
 
Group life
 
427.2
427.0
437.1
 
(9.9)
-2.3%
 
421.3
 
5.9
1.4%
 
Short-term disability
 
15.6
15.7
16.4
 
(0.8)
-4.9%
 
15.7
 
(0.1)
-0.6%
 
Total specialty membership
 
1,894.9
1,893.7
1,836.1
 
58.8
3.2%
 
1,882.3
 
12.6
0.7%
 
                           
 
S-11

 
2Q06 Premiums and Administrative Services Fees Detail
Dollars in thousands, except per member per month
                     
               
Per Member per Month (B)
 
   
Three Months Ended June 30,
       
Three Months Ended June 30,
 
         
Dollar
Percentage
       
   
2006
2005
 
Change
Change
 
2006
2005
 
Premium revenues
                   
Government Segment:
                   
Medicare Advantage
 
$2,109,406
$1,092,442
 
$1,016,964
93.1%
 
$792
$780
 
Medicare stand-alone PDPs
 
801,755
-
 
801,755
100.0%
 
$94
-
 
Total Medicare
 
2,911,161
1,092,442
 
1,818,719
166.5%
       
TRICARE insured (C)
 
657,627
611,179
 
46,448
7.6%
 
$127
$117
 
Medicaid
 
129,158
134,730
 
(5,572)
-4.1%
 
$102
$94
 
Total Government Segment premiums
 
3,697,946
1,838,351
 
1,859,595
101.2%
       
Commercial Segment:
                   
Fully insured medical
 
1,464,646
1,512,278
 
(47,632)
-3.1%
 
$259
$249
 
Specialty
 
101,883
95,390
 
6,493
6.8%
 
$21
$20
 
Total Commercial Segment premiums
 
1,566,529
1,607,668
 
(41,139)
-2.6%
       
Total premium revenues
 
$5,264,475
$3,446,019
 
$1,818,456
52.8%
       
                     
                     
Administrative services fees
                   
Government segment (TRICARE-related) (C)
 
$11,144
$15,392
 
($4,248)
-27.6%
 
$3
$4
 
Commercial segment
 
72,567
51,263
 
21,304
41.6%
 
$13
$10
 
Total administrative services fees
 
$83,711
$66,655
 
$17,056
25.6%
       
                     
 
S-12

 
 
YTD Premiums and Administrative Services Fees Detail
 
Dollars in thousands, except per member per month
 
                     
               
Per Member per Month (B)
 
   
Six Months Ended June 30,
       
Six Months Ended June 30,
 
         
Dollar
Percentage
       
   
2006
2005
 
Change
Change
 
2006
2005
 
Premium revenues
                   
Government Segment:
                   
Medicare Advantage
 
$3,830,249
$2,075,583
 
$1,754,666
84.5%
 
$808
$783
 
Medicare stand-alone PDPs
 
1,316,912
-
 
1,316,912
100.0%
 
$96
-
 
Total Medicare
 
5,147,161
2,075,583
 
3,071,578
148.0%
       
TRICARE insured (C)
 
1,258,381
1,173,507
 
84,874
7.2%
 
$121
$112
 
Medicaid
 
258,625
269,144
 
(10,519)
-3.9%
 
$101
$94
 
Total Government Segment premiums
 
6,664,167
3,518,234
 
3,145,933
89.4%
       
Commercial Segment:
                   
Fully insured medical
 
2,918,578
3,029,672
 
(111,094)
-3.7%
 
$259
$247
 
Specialty
 
203,216
188,928
 
14,288
7.6%
 
$21
$20
 
Total Commercial Segment premiums
 
3,121,794
3,218,600
 
(96,806)
-3.0%
       
Total premium revenues
 
$9,785,961
$6,736,834
 
$3,049,127
45.3%
       
                     
                     
Administrative services fees
                   
Government segment (TRICARE-related) (C)
 
$22,335
$28,794
 
($6,459)
-22.4%
 
$3
$4
 
Commercial segment
 
140,054
101,374
 
38,680
38.2%
 
$12
$10
 
Total administrative services fees
 
$162,389
$130,168
 
$32,221
24.8%
       
                     
 
S-13

 
 
Percentage of Ending Membership under Capitation Arrangements
 
                       
                       
   
Government Segment
Commercial Segment
   
June 30, 2006
 
Medicare Advantage
Medicare stand-alone PDPs
TRICARE
Medicaid
Total Govt. Segment
Fully insured
ASO
Total Comm. Segment
Total Medical Membership
 
                       
Capitated HMO hospital system based (D)
 
3.4%
-
-
-
0.4%
1.8%
-
1.1%
0.6%
 
Capitated HMO physician group based (D)
 
2.5%
-
-
34.7%
2.2%
1.7%
-
1.0%
1.8%
 
Risk-sharing (E)
 
27.9%
-
-
64.6%
7.0%
2.3%
-
1.3%
5.3%
 
All other membership
 
66.2%
100.0%
100.0%
0.7%
90.4%
94.2%
100.0%
96.6%
92.3%
 
Total medical membership
 
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
 
                       
June 30, 2005
                     
                       
Capitated HMO hospital system based (D)
 
7.6%
-
-
3.1%
1.3%
2.7%
-
1.7%
1.5%
 
Capitated HMO physician group based (D)
 
4.9%
-
-
35.5%
5.0%
2.4%
-
1.5%
3.4%
 
Risk-sharing (E)
 
46.1%
-
-
55.3%
12.6%
2.5%
-
1.6%
7.6%
 
All other membership
 
41.4%
-
100.0%
6.1%
81.1%
92.4%
100.0%
95.2%
87.5%
 
Total medical membership
 
100.0%
-
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
 
 
S-14

 
Detail of Medical and Other Expenses Payable Balance and Year-to-Date Changes
Dollars in thousands
 
                 
   
June 30,
March 31,
December 31,
 
Sequential Change
 
   
2006
2006
2005
 
Dollar
Percent
 
Detail of medical and other expenses payable
               
IBNR and other medical expenses payable (F)
 
$1,580,587
$1,313,806
$1,125,205
 
$266,781
20.3%
 
TRICARE IBNR (G)
 
316,251
346,774
409,413
 
(30,523)
-8.8%
 
TRICARE other medical expenses payable (H)
 
92,963
90,073
88,443
 
2,890
3.2%
 
Unprocessed claim inventories (I)
 
193,700
185,300
148,200
 
8,400
4.5%
 
Processed claim inventories (J)
 
128,926
83,945
83,635
 
44,981
53.6%
 
Payable to pharmacy benefit administrator (K)
 
145,216
149,591
54,786
 
(4,375)
-2.9%
 
Total medical and other expenses payable
 
$2,457,643
$2,169,489
$1,909,682
 
$288,154
13.3%
 
                 
                 
                 
   
Six Months Ended
Year Ended
         
   
June 30, 2006
December 31, 2005
         
Year-to-date changes in medical and other
expenses payable
               
 
 
             
                 
Balances at January 1
 
$1,909,682
$1,422,010
         
                 
Acquisitions
 
21,198
37,375
         
                 
Incurred related to:
 
             
Current year (L)
 
8,449,662
11,765,662
         
Prior years - non-TRICARE (L)
 
(118,602)
(72,868)
         
Prior years - TRICARE (M)
 
(83,464)
(41,324)
         
Total incurred
 
8,247,596
11,651,470
         
                 
Paid related to:
 
             
Current year
 
(6,708,473)
(9,979,449)
         
Prior years
 
(1,012,360)
(1,221,724)
         
Total paid
 
(7,720,833)
(11,201,173)
         
                 
Balances at end of period
 
$2,457,643
$1,909,682
         
                 
 
S-15

 
 
 
Medical Claims Reserves Statistics
             
             
 
Receipt Cycle Time (N)
             
   
2006
2005
Change
Percentage Change
 
 
1st Quarter Average
16.1
16.6
(0.5)
-3.0%
 
 
2nd Quarter Average
15.8
15.9
(0.1)
-0.6%
 
 
3rd Quarter Average
-
16.7
N/A
N/A
 
 
4th Quarter Average
-
16.9
N/A
N/A
 
 
Full Year Average
15.9
16.5
(0.6)
-3.6%
 
             
             
             
 
Unprocessed Claims Inventories
             
 
Date
Estimated Valuation (000's)
Claim Item Counts
Number of Days on Hand
   
 
6/30/2004
$98,100
387,000
3.7
   
 
9/30/2004
$122,300
453,300
4.4
   
 
12/31/2004
$115,300
394,400
3.7
   
 
3/31/2005
$111,200
393,200
3.6
   
 
6/30/2005
$119,500
443,600
4.0
   
 
9/30/2005
$136,700
512,800
4.7
   
 
12/31/2005
$148,200
498,400
4.6
   
 
3/31/2006
$185,300
683,900
5.6
   
 
6/30/2006
$193,700
702,000
4.8
   
 
S-16

 
Humana Inc.
Medical Claims Reserves Statistics (Continued)
                 
                 
 
Days in Claims Payable (O) (P)
 
Quarter Ended
Days in Claim Payable (DCP)
Annual
Change
Percentage
 Change
DCP Excluding Capitation
Annual
Change
Percentage
Change
 
 
6/30/2004
47.4
(0.5)
-1.0%
54.1
(2.1)
-3.7%
 
 
9/30/2004
51.8
4.6
9.7%
59.1
4.6
8.4%
 
 
12/31/2004
49.5
3.3
7.1%
54.8
1.6
3.0%
 
 
3/31/2005
50.5
3.1
6.5%
56.1
1.8
3.3%
 
 
6/30/2005
52.8
5.4
11.4%
58.6
4.5
8.3%
 
 
9/30/2005
54.0
2.2
4.2%
60.8
1.7
2.9%
 
 
12/31/2005
60.3
10.8
21.8%
66.6
11.8
21.5%
 
 
3/31/2006
59.1
8.6
17.0%
65.5
9.4
16.8%
 
 
6/30/2006
59.5
6.7
12.7%
65.5
6.9
11.8%
 
                 
 
Year-to-Date Change in Days in Claims Payable (P) (Q)
                 
       
2006
2005
     
 
DCP - 4th quarter of prior year
60.3
49.5
     
 
Components of year-to-date change in DCP:
         
 
Change in claims receipt cycle time
(2.5)
0.2
     
 
Change in unprocessed claims inventories
1.1
1.0
     
 
Change in processed claims inventories
1.1
(0.4)
     
 
Change in TRICARE reserve balances
(5.5)
3.9
     
 
Change in pharmacy payment cutoff
-
1.5
     
 
Growth in Medicare PFFS membership
4.4
1.2
     
 
Growth in individual membership
0.8
0.9
     
 
Change in provider payables under risk arrangements
1.2
1.4
     
 
All other
(1.4)
1.1
     
 
DCP - current quarter
59.5
60.3
     
                 
 
S-17

 
Footnotes to Statistical Schedules and Supplementary Information
2Q06 Earnings Release
 
 
Footnote
 
(A)
Adjusted to include stock-based compensation expense. Under SFAS 123R, which the company adopted effective January 1, 2006 using the modified retrospective method, stock-based compensation expense is recognized based on the grant date fair value over the vesting period.
(B)
Computed based on average membership for the period (i.e., monthly ending membership during the period divided by the number of months in the period).
(C)
TRICARE revenues are not contracted on a per member basis.
(D)
In a limited number of circumstances, the company contracts with hospitals and physicians to accept financial risk for a defined set of HMO membership. In transferring this risk, the company prepays these providers a monthly fixed-fee per member to coordinate substantially all of the medical care for their capitated HMO membership, including some health benefit administrative functions and claims processing. For these capitated HMO arrangements, the company generally agrees to reimbursement rates that target a medical expense ratio ranging from 82% to 89%. Providers participating in hospital-based capitated HMO arrangements generally receive a monthly payment for all of the services within their system for their HMO membership. Providers participating in physician-based capitated HMO arrangements generally have subcontracted specialist physicians and are responsible for reimbursing such hospitals and physicians for services rendered to their HMO membership.
(E)
In some circumstances, the company contracts with physicians under risk-sharing arrangements whereby physicians have assumed some level of risk for all or a portion of the medical costs of their HMO membership. Although these arrangements do include capitation payments for services rendered, the company processes substantially all of the claims under these arrangements.
(F)
IBNR represents an estimate of medical expenses payable for claims incurred but not reported (IBNR) at the balance sheet date. The level of IBNR is primarily impacted by membership levels, medical claim trends and the receipt cycle time, which represents the length of time between when a claim is initially incurred and when the claim form is received (i.e. a shorter time span results in lower reserves for claims IBNR). Other medical expenses payable includes amounts payable to providers under capitation arrangements.
(G)
TRICARE IBNR decreased due to favorable development as more fully discussed in Footnote M below.
(H)
TRICARE other medical expenses payable may include liabilities to subcontractors and/or risk share payables to the Department of Defense. The level of these balances may fluctuate from period to period due to the timing of payment (cutoff) and whether or not the balances are payables or receivables (receivables from the Department of Defense are classified as receivables in the company's balance sheet).
(I)
Unprocessed claim inventories represent the estimated valuation of claims received but not yet fully processed. TRICARE claim inventories are not included in this amount as an independent third party administrator processes all TRICARE medical claims on the company's behalf. Reserves for TRICARE unprocessed claims inventory are included in TRICARE IBNR.
(J)
Processed claim inventories represent the estimated valuation of processed claims that are in the post-claim-adjudication process, which consists of administrative functions such as audit and check batching and handling.
(K)
The balance due to the company's pharmacy benefit administrator fluctuates as a result of the number of business days in the last payment cycle of the month. Payment cycles are every 10 days (10th & 20th of month) and the last day of the month.
(L)
The impact of any change in "incurred related to prior years" claims is offset as the company re-establishes such amounts in the "incurred related to current year".
(M)
Changes in estimates of TRICARE incurred claims for prior years recognized during 2006 and 2005 resulted primarily from claim costs and utilization levels developing favorably from the levels originally estimated for the second half of the prior year. As a result of substantial risk-sharing provisions with the Department of Defense and with subcontractors, any resulting impact on operations from the change in estimates of incurred related to prior years is substantially reduced, whether positive or negative.
(N)
The receipt cycle time measures the average length of time between when a claim was initially incurred and when the claim form was received. Receipt cycle time data for the company’s largest claim processing platforms representing approximately 82% of the company's fully insured claims volume. Pharmacy claims are excluded from this measurement.
(O)
A common metric for monitoring medical claim reserve levels relative to the medical claims expense is days in claims payable, or DCP, which represents the medical claim liabilities at the end of the period divided by average medical expenses per day in the quarterly period. Since the company has some providers under capitation payment arrangements (which do not require a medical claim IBNR reserve), the company has also summarized this metric excluding capitation expense.
(P)
Excludes the impact of Medicare stand-alone PDPs.
(Q)
DCP fluctuates due to a number of issues, the more significant of which are detailed in the rollforward of DCP from the fourth quarter of the prior year. Growth in certain product lines can also impact DCP for the quarter since a provision for claims would not have been recorded for members that had not yet enrolled earlier in the quarter, yet those members would have a provision and corresponding reserve recorded upon enrollment later in the quarter.

S-18
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