-----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, HmbRlqwE6bNczqC3jUBXsCwVZVeR/WAHm5Q6rIQsZsiabXzKPPGSzTaanSxk5nq7 jA5kprXi36N16vpSYU+uWA== 0001157523-07-010327.txt : 20071029 0001157523-07-010327.hdr.sgml : 20071029 20071029060327 ACCESSION NUMBER: 0001157523-07-010327 CONFORMED SUBMISSION TYPE: 8-K PUBLIC DOCUMENT COUNT: 3 CONFORMED PERIOD OF REPORT: 20070930 ITEM INFORMATION: Results of Operations and Financial Condition ITEM INFORMATION: Regulation FD Disclosure ITEM INFORMATION: Financial Statements and Exhibits FILED AS OF DATE: 20071029 DATE AS OF CHANGE: 20071029 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: 071194917 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 a5529802.htm HUMANA INC. 8-K a5529802.htm
 

 
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)    September 30, 2007
 
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 September 30, 2007 and guidance for 2007 and 2008 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/  Kathleen Pellegrino                               
 
             
Kathleen Pellegrino
 
             
Vice President, Acting General Counsel
 
 
Dated:    October 29, 2007
 
INDEX TO EXHIBITS
 
Exhibit No.
Description
   
99
Earnings Release and Stat Pages
 
EX-99 2 a5529802-ex99.htm EXHIBIT 99 a5529802-ex99.htm
 
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 Reports Third Quarter 2007 Financial Results

·    
EPS for third quarter 2007 of $1.78 including $0.25 per share from items not expected to recur in future periods
·    
2007 EPS guidance revised to $4.75 to $4.80 including $0.25 per share described above
·    
2008 EPS projected to be $5.30 to $5.50


LOUISVILLE, KY (October 29, 2007) – Humana Inc. (NYSE: HUM) today reported financial results for the quarter ended September 30, 2007 (3Q07) including diluted earnings per common share (EPS) of $1.78, significantly above the company’s previous guidance for 3Q07 EPS of $1.45 to $1.50.  The company earned $0.95 per share for the quarter ended September 30, 2006 (3Q06).  The company’s 3Q07 EPS included earnings of $0.25 per share(a) that are not anticipated to recur in future periods. The company’s 3Q07 performance was also $0.05 per share better than expected due to ongoing improvements in the company’s Commercial operations and stand-alone Medicare Prescription Drug Plans (PDPs) that are expected to positively impact fourth quarter 2007 and full-year 2008 results.

The company now estimates EPS for the year ending December 31, 2007 (FY07E) will be in the range of $4.75 to $4.80 versus $2.90 for the year ended December 31, 2006 (FY06).  The company also projects its EPS for the year ending December 31, 2008 (FY08E) to be in the range of $5.30 to $5.50, an increase of 10 to 16 percent over FY07E EPS, or 16 to 22 percent(a)(c) versus the non-GAAP EPS for FY07E.

“Strong performance in both our business segments fueled a successful third quarter,” said Michael B. McCallister, Humana's president and chief executive officer. “Most importantly, the quarter positioned us well to extend our industry-leading growth in both revenues and earnings through 2008 and beyond.”

For the nine months ended September 30, 2007 (YTD07) the company reported $3.48 in EPS compared to $1.98 for the nine months ended September 30, 2006 (YTD06).  Results for YTD07 on a non-GAAP basis were $3.23 per diluted share(a)(c).  Results for YTD06 included approximately $0.19 per share of venture capital gains that did not recur in YTD07.  The year-over-year increase in YTD07 financial results was primarily due to better operating performance in both business segments.
 
1

 
 
Revenues– 3Q07 consolidated revenues rose 12 percent to $6.32 billion from $5.65 billion in 3Q06, with total premium and administrative services fees up 11 percent compared to the prior year’s quarter. This year-over-year increase was primarily driven by higher average Medicare membership versus 3Q06.

YTD07 consolidated revenues rose 20 percent to $18.95 billion from $15.76 billion in YTD06 with total premium and administrative services fees up 20 percent compared to the prior year’s period, also primarily driven by higher average enrollment in the company’s Medicare plans.

Medical costs– The 3Q07 consolidated medical expense ratio (medical expenses as a percent of premium revenues or MER) of 81.3 percent was 280 basis points lower than the 3Q06 MER of 84.1 percent, the combined result of a 360 basis point decline in the Government Segment MER (including a 150 basis point benefit from favorable prior year claims development(a)) and a 70 basis point decline in the Commercial Segment MER.

The consolidated MER for YTD07 of 83.8 percent was 50 basis points lower than the YTD06 consolidated MER of 84.3 percent, substantially due to the same factors driving the year-over-year improvement in 3Q07.

Selling, general, & administrative (SG&A) expenses– The 3Q07 consolidated SG&A expense ratio (SG&A expenses as a percent of premiums, administrative services fees and other revenue) increased 20 basis points to 13.3 percent for 3Q07 from 13.1 percent in 3Q06.  The year-over-year increase was primarily the result of a higher SG&A expense ratio in both of the company’s business segments.

The SG&A expense ratio for YTD07 of 13.2 percent was 100 basis points lower than that for YTD06 of 14.2 percent primarily driven by efficiency and productivity gains associated with higher average medical membership year to date.


Government Segment Results

Pretax results:
·    
Government Segment pretax earnings were $416.3 million in 3Q07 compared to $207.0 million in 3Q06.  This segment’s pretax earnings for 3Q07 on a non-GAAP basis were $347.4 million(a)(c). As expected, the year-over-year improvement in segment pretax earnings primarily reflects a more normal MER pattern for the Part D benefit for 2007 as well as administrative cost efficiency associated with higher average Medicare medical membership.  The extended enrollment period for this benefit during 2006 distorted the claims pattern associated with the beneficiaries’ progression through the Part D benefit stages in the prior year.
·    
For YTD07, pretax earnings for the Government Segment of $723.0 million increased by $396.4 million, or 121 percent versus YTD06 pretax earnings for the segment of $326.6 million, primarily reflecting the same factors impacting the year-over-year comparison for the third quarter.
 
2

 
 
Enrollment:
·    
Medicare Advantage membership grew to 1,138,000 at September 30, 2007, an increase of 145,000, or 15 percent, from September 30, 2006 and less than 1 percent versus June 30, 2007.  Average Medicare Advantage membership for 3Q07 was up 15 percent compared to that for 3Q06.  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 year over year.
·    
Membership in the company’s stand-alone PDPs totaled 3,459,700 at September 30, 2007 compared to 3,521,000 at September 30, 2006 and 3,440,100 at June 30, 2007.
·    
TRICARE membership of 2,857,400 at September 30, 2007 was essentially unchanged from both September 30, 2006 and June 30, 2007.
·    
Medicaid membership of 566,600 at September 30, 2007 increased 154,000 from September 30, 2006 due primarily to the award of a new Puerto Rico regional ASO contract during the fourth quarter of 2006, partially offset by eligible Puerto Rico Medicaid members choosing to move into the Medicare Advantage program. Medicaid membership was essentially unchanged compared to the June 30, 2007 total of 567,600.

Premiums and administrative services fees:
·    
Medicare Advantage premiums of $2.83 billion in 3Q07 increased 19 percent compared to $2.37 billion in 3Q06, primarily the result of higher average membership.
·    
Medicare stand-alone Part D premiums of $890.4 million in 3Q07 increased 5 percent compared to $851.4 million in 3Q06, primarily the result of annual rate increases and changes in premiums associated with Part D risk-share accruals.
·    
TRICARE premiums and administrative services fees during 3Q07 increased $81.0 million to $731.8 million compared to $650.8 million in 3Q06.

Medical Expenses:
·    
The Government Segment MER decreased 360 basis points to 81.4 percent in 3Q07 compared to 85.0 percent in the prior year’s quarter.  This decrease reflects a more normalized MER pattern for the Medicare Part D benefit for 2007 as well as the impact of favorable prior year claims development.  The extended enrollment period for this benefit during the prior year distorted the claims pattern associated with the beneficiaries’ progression through the Part D benefit stages in 2006.
·    
During 3Q07 the company realized approximately $68.9 million in favorable prior year claims development that it does not anticipate recurring in future periods, with approximately $54.0 million related to Medicare Part D claims and the remainder associated with TRICARE claims. The Medicare Part D development primarily related to the resolution of first-year Part D implementation matters including enrollment discrepancies and the related impact on claim estimates.  The remainder of this favorable prior year claims development primarily related to the adjustment of certain TRICARE reserves as a result of the settlement of claims payment accuracy provisions for prior option periods.
 
3



SG&A Expenses:
·  
The Government Segment’s SG&A expense ratio for 3Q07 of 10.2 percent was 10 basis points higher than that for 3Q06 of 10.1 percent.  This segment’s SG&A expense ratio increased 20 basis points on a sequential basis as lower SG&A expenses were slightly outpaced by adjustments to revenues associated with risk adjustment and Part D risk-share accruals.

Commercial Segment Results

Pretax results:
·    
Commercial Segment pretax earnings were $62.2 million in 3Q07 compared to $42.4 million in 3Q06. Commercial Segment operating earnings in 3Q07 continue to reflect the company’s commitment to underwriting discipline and strategic growth in select lines of business.
·    
For YTD07, pretax earnings for the Commercial Segment of $207.4 million were $13.1 million, or 7 percent higher than YTD06 pretax earnings for the segment of $194.3 million primarily reflecting the same factors driving year-over-year improvement for 3Q07.

Enrollment:
·    
Commercial Segment medical membership of 3,299,100 at September 30, 2007 was essentially unchanged from both September 30, 2006 and June 30, 2007.
·    
Membership in strategic areas of commercial growth rose as follows during 3Q07 compared to 3Q06: Individual product membership increased 28 percent, Smart plans and other consumer offerings grew 27 percent, Small Group business membership was up 2 percent, and ASO business was 1 percent higher than the prior year.

Premiums and administrative services fees:
·    
Premiums and administrative services fees for the Commercial Segment increased 2 percent to $1.61 billion in 3Q07 compared to $1.58 billion in the prior year’s quarter, primarily due to the effect of per-member premium increases being partially offset by lower average fully insured group membership.
·    
Commercial Segment medical premiums for fully-insured groups increased approximately 6 percent on a per-member basis during 3Q07 compared to 3Q06.

Medical Expenses:
·    
In 3Q07, the Commercial Segment MER of 81.0 percent was 70 basis points lower than the 3Q06 MER of 81.7 percent, primarily reflecting an increase in the percentage of Individual and Small Group members comprising our fully insured book, improving medical cost utilization trends, and the company’s continued commitment to underwriting discipline.

SG&A Expenses:
·  
The Commercial Segment SG&A expense ratio of 21.8 percent for 3Q07 compares to 20.5 percent in 3Q06, primarily the combined result of higher average Individual, and ASO membership and administrative costs associated with increased business for the company’s mail order pharmacy.  Average Individual product membership rose 25 percent and average ASO membership increased 2 percent versus the prior year’s quarter.
 
4

 
Balance Sheet

·    
Cash and cash equivalents declined $1.14 billion or 31 percent sequentially.  The early receipt of the July Medicare premium payment from the Centers for Medicare and Medicaid Services (CMS) during June 2007 resulted in the receipt of only two months of premium from CMS during the third quarter of 2007.  This timing also resulted in a corresponding sequential decline in unearned premium revenues during 3Q07.
·    
Unearned revenues of $177.1 million decreased 87 percent from the June 30, 2007 balance of $1.36 billion also due to the timing of the receipts of Medicare premiums from CMS.
·    
Debt-to-total capitalization at September 30, 2007 was 25.7 percent, down 40 basis points from June 30, 2007 due primarily to higher capitalization associated with 3Q07 earnings.
·    
The company’s working capital at September 30, 2007 included approximately $721.8 million in net Part D risk-share payables to CMS associated with the company’s Medicare Advantage and stand-alone PDP offerings.  Approximately $725.5 million of this net liability related to Part D plan offerings for the year ended December 31, 2006.
·    
Days in claims payable excluding the impact of Medicare stand-alone PDPs were up slightly to 63.4 days at September 30, 2007 from 62.4 days at June 30, 2007.
 
Cash Flows from Operations

Cash flows used in operations for 3Q07 of $637.7 million compared to cash flows used in operations of $391.0 million in 3Q06.
 
Cash flows from operations
($ in millions)
 
3Q07
   
3Q06
   
YTD07
   
YTD06
 
Cash flows provided by operations in
accordance with Generally Accepted
Accounting Principles (GAAP)
  $ (637.7 )   $ (391.0 )   $
1,414.1
    $
1,151.8
 
                                 
Timing of premium payment from CMS(b)
   
1,175.3
     
1,031.8
     
     
 
                                 
Non-GAAP cash flows provided by operations(b)(c)
  $
537.6
    $
640.8
    $
1,414.1
    $
1,151.8
 
 
The company also evaluates operating cash flows on a non-GAAP basis(b)(c).  Non-GAAP cash flows provided by operations declined to $537.6 million(b)(c) in 3Q07 from $640.8 million(b)(c) in 3Q06 driven primarily by changes in working capital more than offsetting the impact of higher operating earnings.

Footnotes

(a)
As described more fully in the “Government Segment Results – Medical Expenses” section of this press release during 3Q07 the company realized pretax earnings of approximately $68.9 million ($0.25 per share) associated with the resolution of favorable claims development in its Government Segment related to prior year issues that are not anticipated to recur in future periods. A reconciliation of GAAP to non-GAAP amounts related to this favorable development and the company’s reason for this non-GAAP disclosure are included in the statistical pages of this earnings press release.
 
5


 
(b)
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.
(c)
The company believes that these non-GAAP measures, when presented in conjunction with the 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.
 
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 may be accessed via the Historical Webcasts & Presentations section of the Investor Relations page at www.humana.com.
 
Cautionary Statement

This news release contains statements and earnings guidance points that are forward-looking.  The forward-looking items herein are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995.  Forward-looking items 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, 2006,
·    
Form 10-Qs for the quarters ended March 31, 2007 and June 30, 2007,
·    
Form 8-Ks filed during 2007.
 
About Humana

Humana Inc., headquartered in Louisville, Kentucky, is one of the nation’s largest publicly traded health benefits companies, with approximately 11.3 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.
 
6


 
Over its 46-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 reports to stockholders;
·  Securities and Exchange Commission filings;
·  Most recent investor conference presentations;
·  Quarterly earnings news releases;
·  Replay of most recent earnings release conference calls;
·  Calendar of events (includes upcoming earnings conference call dates and times, as well as planned interaction with research analysts and institutional investors);
·  Corporate Governance information.
 
 
7


Humana Inc. – Earnings Guidance Points as of October 29, 2007
             
(in accordance with
Generally Accepted
Accounting Principles)
 
For the year ending December 31, 2007
 
 
For the year ending December 31, 2008*
*assumes closing of pending KMG America
(“KMG”) acquisition in late 2007
 
 
Comments
Diluted earnings per common share (EPS)
 
Full year 2007: $4.75 to $4.80
4Q07: $1.27 to $1.32
 
Full year 2008: $5.30 to $5.50
 
 
2007 EPS includes $0.25 per share of earnings that are not anticipated to recur in 2008
Revenues
 
Consolidated revenues: Approximately $25 billion
 
Consolidated revenues: $28 billion to $30 billion 
   
             
   
Premiums and ASO fees:
Medicare Advantage:  Approximately $11 billion;
Medicare stand-alone PDPs:  Approximately $3.5 billion;
TRICARE:  Approximately $3 billion;
 
Premiums and ASO fees:
Medicare Advantage:  $13 billion to $14 billion;
Medicare stand-alone PDPs:  Approximately $3.4 billion;
TRICARE:  $3.1 billion to $3.3 billion;
 
 
   
Commercial:  Approximately $6.5 billion
 
Commercial:  $7.2 billion to $7.7 billion
 
2008 includes $200 million for KMG premiums & fees 
             
   
Investment income: Approximately $305 million 
 
Investment income: $360 million to $380 million 
 
2008 includes $20 million for KMG investment income
             
   
Other revenue: $150 million to $155 million
 
Other revenue: $200 million to $250 million
 
Other revenue primarily relates to revenues associated with the company’s mail order pharmacy; related administrative costs are in SG&A expenses
 
8

 
             
(in accordance with
Generally Accepted
Accounting Principles)
 
For the year ending December 31, 2007
 
 
For the year ending December 31, 2008*
*assumes closing of pending KMG America
(“KMG”) acquisition in late 2007
 
Comments
Ending medical membership (fully-insured and ASO combined)
 
Medicare Advantage: Up approximately 130,000 from prior year
 
Medicare Advantage: Up 200,000 to 250,000 from prior year
   
             
   
Medicare stand-alone PDPs: 3.4 million to 3.5 million 
 
Medicare stand-alone PDPs: 3.1 million to 3.2 million 
   
             
   
TRICARE: No material change from prior year 
 
TRICARE: No material change from prior year 
   
             
   
Medicaid:  No material change from prior year 
 
Medicaid:  No material change from prior year 
   
             
   
Commercial: Up approximately 50,000 from prior year
 
Commercial: Up approximately 50,000 to 75,000 from prior
year
   
Medical costs
 
Total Medicare products: MER of approximately 83%
 
Total Medicare products: MER in the range of 83% to 84%
 
Medicare Advantage and stand-alone PDP combined
             
   
Commercial fully-insured groups:  Medical cost trends in the range of 4.5% to 5.0%; premium yields in line with medical cost trends
 
Commercial fully-insured groups:  Medical cost trends and premium yields in line with prior year
   
             
   
Secular Commercial medical cost trend components as follows:  inpatient hospital utilization – flat to 1 percent; inpatient and outpatient hospital rates – mid to upper single digits; outpatient hospital utilization – low to mid single digits; physician – mid single digits; and pharmacy – high single to low double digits.
 
Secular Commercial medical cost trend components:  no
material change from 2007
   
 
9

 
             
(in accordance with
Generally Accepted
Accounting Principles)
 
For the year ending December 31, 2007
 
 
For the year ending December 31, 2008*
*assumes closing of pending KMG America
(“KMG”) acquisition in late 2007
 
Comments
Selling, general & administrative expenses
 
Consolidated SG&A expense ratio of 13.5% to 14%
 
Consolidated SG&A expense ratio of 13.5% to 14%
 
SG&A expenses as a percent of premiums, administrative costs, and other revenue
Depreciation & amortization
 
Approximately $180 million
 
$215 million to $220 million
 
   
Interest expense
 
Approximately $70 million
 
 
$85 million to $90 million
 
   
Pretax results
 
 
Total Medicare products: Operating margin of approximately 5%
 
Total Medicare products: Operating margin of approximately 5%
 
Medicare Advantage and stand-alone PDP combined
             
   
TRICARE: Operating margin of approximately 4%
 
TRICARE: Operating margin of 2.5% to 3.5% 
   
             
   
Commercial Segment: Pretax earnings of $240 million to $250 million
 
Commercial Segment: Pretax earnings of $280 million to $300 million
 
Net investment income is included in segment-level totals only
             
Cash flows from operations
 
$1.2 billion to $1.4 billion
 
$1.5 billion to $1.8 billion
   
Capital expenditures
 
Approximately $220 million
 
Approximately $225 million
   
Effective tax rate
 
36% to 37%
 
36% to 37%
   
Shares used in computing full-year EPS
 
Approximately 170 million
 
Approximately 173 million
   
 
10

 
 
 
 
Humana Inc.
Statistical Schedules
And
Supplementary Information
3Q07 Earnings Release
 
S-1

 
 
Humana Inc.
 
Statistical Schedules and Supplementary Information
 
3Q07 Earnings Release
     
 
Contents
 
     
 
Page
Description
     
 
S-3-4
Consolidated Statements of Income
 
S-5
Consolidated Balance Sheets
 
S-6-7
Consolidated Statements of Cash Flows
 
S-8
Key Income Statement Ratios and Segment Operating Results
 
S-9
Membership Detail
 
S-10-11
Premiums and Administrative Services Fees Detail
 
S-12
Percentage of Ending Membership under Capitation Arrangements
 
S-13-15
Medical Claims Reserves
 
S-16
GAAP to Non-GAAP Reconciliation
 
S-17
Footnotes
 
 
S-2

 
Humana Inc.
                       
Consolidated Statements of Income
                       
In thousands, except per common share results
                       
                         
   
Three Months Ended September 30,
             
               
Dollar
   
Percentage
 
   
2007
   
2006
   
Change
   
Change
 
Revenues:
                       
Premiums
  $
6,092,841
    $
5,486,368
    $
606,473
      11.1 %
Administrative services fees
   
101,531
     
86,332
     
15,199
      17.6 %
Investment income
   
82,362
     
62,474
     
19,888
      31.8 %
Other revenue
   
42,850
     
14,610
     
28,240
      193.3 %
    Total revenues
   
6,319,584
     
5,649,784
     
669,800
      11.9 %
Operating expenses:
                               
Medical
   
4,953,862
     
4,616,002
     
337,860
      7.3 %
Selling, general and administrative
   
829,023
     
729,722
     
99,301
      13.6 %
Depreciation
   
37,771
     
32,562
     
5,209
      16.0 %
Other intangible amortization
   
4,479
     
5,115
      (636 )     -12.4 %
    Total operating expenses
   
5,825,135
     
5,383,401
     
441,734
      8.2 %
Income from operations
   
494,449
     
266,383
     
228,066
      85.6 %
Interest expense
   
15,947
     
17,009
      (1,062 )     -6.2 %
Income before income taxes
   
478,502
     
249,374
     
229,128
      91.9 %
Provision for income taxes
   
176,124
     
90,176
     
85,948
      95.3 %
Net income
  $
302,378
    $
159,198
    $
143,180
      89.9 %
                                 
Basic earnings per common share
  $
1.81
    $
0.97
    $
0.84
      86.6 %
Diluted earnings per common share
  $
1.78
    $
0.95
    $
0.83
      87.4 %
                                 
Shares used in computing basic earnings per common share
   
167,188
     
164,387
                 
Shares used in computing diluted earnings per common share
   
170,051
     
168,376
                 
 
S-3

 
Humana Inc.
                       
Consolidated Statements of Income
                       
In thousands, except per common share results
                       
                         
   
Nine Months Ended September 30,
             
               
Dollar
   
Percentage
 
   
2007
   
2006
   
Change
   
Change
 
Revenues:
                       
Premiums
  $
18,320,654
    $
15,272,329
    $
3,048,325
      20.0 %
Administrative services fees
   
294,488
     
248,721
     
45,767
      18.4 %
Investment income
   
227,941
     
211,943
     
15,998
      7.5 %
Other revenue
   
108,111
     
28,325
     
79,786
      281.7 %
    Total revenues
   
18,951,194
     
15,761,318
     
3,189,876
      20.2 %
Operating expenses:
                               
Medical
   
15,358,280
     
12,879,429
     
2,478,851
      19.2 %
Selling, general and administrative
   
2,476,092
     
2,204,471
     
271,621
      12.3 %
Depreciation
   
122,100
     
94,027
     
28,073
      29.9 %
Other intangible amortization
   
14,478
     
15,152
      (674 )     -4.4 %
    Total operating expenses
   
17,970,950
     
15,193,079
     
2,777,871
      18.3 %
Income from operations
   
980,244
     
568,239
     
412,005
      72.5 %
Interest expense
   
49,931
     
47,335
     
2,596
      5.5 %
Income before income taxes
   
930,313
     
520,904
     
409,409
      78.6 %
Provision for income taxes
   
339,848
     
188,502
     
151,346
      80.3 %
Net income
  $
590,465
    $
332,402
    $
258,063
      77.6 %
                                 
Basic earnings per common share
  $
3.55
    $
2.03
    $
1.52
      74.9 %
Diluted earnings per common share
  $
3.48
    $
1.98
    $
1.50
      75.8 %
                                 
Shares used in computing basic earnings per common share
   
166,538
     
163,736
                 
Shares used in computing diluted earnings per common share
   
169,535
     
167,746
                 
 
S-4

 
Humana Inc.               
Consolidated Balance Sheets            ;    
Dollars in thousands, except share amounts             
   
September 30,
   
June 30,
   
December 31,
   
Sequential Change
 
   
2007
   
2007
   
2006
   
Dollar
   
Percent
 
Assets
                             
Current assets:
                             
Cash and cash equivalents
  $
2,585,670
    $
3,720,769
    $
1,740,304
             
Investment securities
   
3,475,300
     
3,323,536
     
3,192,273
             
Receivables, net:
                                   
    Premiums
   
685,242
     
685,479
     
667,657
             
    Administrative services fees
   
12,556
     
12,074
     
13,284
             
Securities lending collateral
   
830,589
     
1,346,065
     
627,990
             
Other
   
1,612,467
     
1,318,003
     
1,091,465
             
    Total current assets
   
9,201,824
     
10,405,926
     
7,332,973
    $ (1,204,102 )     -11.6 %
Property and equipment, net
   
570,798
     
569,412
     
545,004
                 
Other assets:
                                       
Long-term investment securities
   
420,769
     
400,775
     
414,877
                 
Goodwill
   
1,330,585
     
1,330,585
     
1,310,631
                 
Other
   
548,530
     
628,267
     
524,011
                 
    Total other assets
   
2,299,884
     
2,359,627
     
2,249,519
                 
Total assets
  $
12,072,506
    $
13,334,965
    $
10,127,496
    $ (1,262,459 )     -9.5 %
                                         
Liabilities and Stockholders' Equity
                                       
Current liabilities:
                                       
Medical and other expenses payable
  $
2,881,329
    $
2,954,146
    $
2,488,261
                 
Trade accounts payable and accrued expenses
   
2,253,504
     
2,084,463
     
1,626,658
                 
Book overdraft
   
253,356
     
289,646
     
293,605
                 
Securities lending payable
   
830,589
     
1,346,065
     
627,990
                 
Unearned revenues
   
177,080
     
1,355,017
     
155,298
                 
    Total current liabilities
   
6,395,858
     
8,029,337
     
5,191,812
    $ (1,633,479 )     -20.3 %
Long-term debt
   
1,292,858
     
1,189,570
     
1,269,100
                 
Other long-term liabilities
   
644,913
     
740,560
     
612,698
                 
    Total liabilities
   
8,333,629
     
9,959,467
     
7,073,610
    $ (1,625,838 )     -16.3 %
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 185,973,713 issued at
September 30, 2007  
30,995
     
30,833
     
30,491
                 
Capital in excess of par value
   
1,462,953
     
1,422,370
     
1,357,077
                 
Retained earnings
   
2,499,563
     
2,197,185
     
1,909,098
                 
Accumulated other comprehensive loss
    (11,042 )     (38,112 )     (13,205 )                
Treasury stock, at cost, 16,541,384 shares at
September 30, 2007
    (243,592 )     (236,778 )     (229,575 )                
    Total stockholders' equity
   
3,738,877
     
3,375,498
     
3,053,886
    $
363,379
      10.8 %
Total liabilities and stockholders' equity
  $
12,072,506
    $
13,334,965
    $
10,127,496
    $ (1,262,459 )     -9.5 %
                                         
Debt-to-total capitalization ratio
    25.7 %     26.1 %     29.4 %                
 
S-5

 
Humana Inc.
Consolidated Statements of Cash Flows
Dollars in thousands
 
   
Three Months Ended September 30,
             
               
Dollar
   
Percentage
 
   
2007
   
2006
   
Change
   
Change
 
Cash flows from operating activities
                       
Net income
  $
302,378
    $
159,198
             
Adjustments to reconcile net income to net cash used in
operating activities:
                           
    Depreciation and amortization
   
42,250
     
37,677
             
    Stock-based compensation
   
10,604
     
9,350
             
    (Benefit) provision for deferred income taxes
    (9,168 )    
23,495
             
Changes in operating assets and liabilities excluding
                           
the effects of acquisitions:
                           
Receivables
    (245 )    
37,448
             
Other assets
   
69,395
      (29,713 )            
Medical and other expenses payable
    (72,817 )    
105,300
             
Other liabilities
   
200,732
     
293,274
             
Unearned revenues
    (1,177,937 )     (1,023,958 )            
Other
    (2,845 )     (3,088 )            
Net cash used in operating activities
    (637,653 )     (391,017 )   $ (246,636 )     -63.1 %
                                 
Cash flows from investing activities
                               
Acquisitions, net of cash acquired
    (501 )     (431 )                
Purchases of property and equipment
    (41,339 )     (54,629 )                
Proceeds from sales of property and equipment
   
11,862
     
7,296
                 
Purchases of investment securities
    (758,695 )     (1,246,843 )                
Proceeds from maturities of investment securities
   
321,304
     
467,620
                 
Proceeds from sales of investment securities
   
328,275
     
506,870
                 
Change in securities lending collateral
   
515,476
      (676,476 )                
Net cash provided by (used in) investing activities
   
376,382
      (996,593 )   $
1,372,975
      137.8 %
                                 
Cash flows from financing activities
                               
Receipts from CMS contract deposits
   
464,703
     
382,787
                 
Withdrawals from CMS contract deposits
    (885,541 )     (634,437 )                
Borrowings under credit agreement
   
475,000
     
150,000
                 
Repayments under credit agreement
    (400,000 )    
-
                 
Repayment of senior notes
   
-
      (300,000 )                
Debt issue costs
   
-
      (1,971 )                
Change in book overdraft
    (36,290 )    
9,420
                 
Change in securities lending payable
    (515,476 )    
676,476
                 
Common stock repurchases
    (6,814 )     (10,633 )                
Tax benefit from stock-based compensation
   
12,272
     
17,135
                 
Proceeds from stock option exercises and other
   
18,318
     
21,603
                 
Net cash (used in) provided by financing activities
    (873,828 )    
310,380
    $ (1,184,208 )     -381.5 %
                                 
Decrease in cash and cash equivalents
    (1,135,099 )     (1,077,230 )                
Cash and cash equivalents at beginning of period
   
3,720,769
     
2,258,464
                 
                                 
Cash and cash equivalents at end of period
  $
2,585,670
    $
1,181,234
                 
 
S-6

 
Humana Inc.
Consolidated Statements of Cash Flows
Dollars in thousands
 
   
Nine Months Ended September 30,
             
               
Dollar
   
Percentage
 
   
2007
   
2006
   
Change
   
Change
 
Cash flows from operating activities
                       
Net income
  $
590,465
    $
332,402
             
Adjustments to reconcile net income to net cash provided by
operating activities:
                           
Depreciation and amortization
   
136,578
     
109,179
             
Stock-based compensation
   
30,868
     
24,401
             
(Benefit) provision for deferred income taxes
    (33,179 )    
22,269
             
Changes in operating assets and liabilities excluding
                           
the effects of acquisitions:
                           
Receivables
    (16,857 )     (5,509 )            
Other assets
    (57,072 )     (389,013 )            
Medical and other expenses payable
   
393,068
     
632,063
             
Other liabilities
   
335,155
     
465,993
             
Unearned revenues
   
21,782
     
20,892
             
Other
   
13,286
      (60,866 )            
Net cash provided by operating activities
   
1,414,094
     
1,151,811
    $
262,283
      22.8 %
                                 
Cash flows from investing activities
                               
Acquisitions, net of cash acquired
    (27,506 )     (26,362 )                
Purchases of property and equipment
    (156,056 )     (136,602 )                
Proceeds from sales of property and equipment
   
15,934
     
9,452
                 
Purchases of investment securities
    (2,631,990 )     (3,505,391 )                
Proceeds from maturities of investment securities
   
1,091,260
     
1,478,017
                 
Proceeds from sales of investment securities
   
1,254,878
     
1,219,555
                 
Change in securities lending collateral
    (202,599 )     (869,715 )                
Net cash used in investing activities
    (656,079 )     (1,831,046 )   $
1,174,967
      64.2 %
                                 
Cash flows from financing activities
                               
Receipts from CMS contract deposits
   
1,948,062
     
1,427,849
                 
Withdrawals from CMS contract deposits
    (2,109,523 )     (1,370,862 )                
Borrowings under credit agreement
   
1,185,000
     
250,000
                 
Repayments under credit agreement
    (1,160,000 )     (300,000 )                
Proceeds from issuance of senior notes
   
-
     
498,545
                 
Repayment of senior notes
   
-
      (300,000 )                
Debt issue costs
   
-
      (5,796 )                
Change in book overdraft
    (40,249 )    
1,239
                 
Change in securities lending payable
   
202,599
     
869,715
                 
Common stock repurchases
    (14,017 )     (15,570 )                
Tax benefit from stock-based compensation
   
26,826
     
30,791
                 
Proceeds from stock option exercises and other
   
48,653
     
42,542
                 
Net cash provided by financing activities
   
87,351
     
1,128,453
    $ (1,041,102 )     -92.3 %
                                 
Increase in cash and cash equivalents
   
845,366
     
449,218
                 
Cash and cash equivalents at beginning of period
   
1,740,304
     
732,016
                 
                                 
Cash and cash equivalents at end of period
  $
2,585,670
    $
1,181,234
                 
 
S-7

 
Humana Inc.
Key Income Statement Ratios and Segment Operating Results
Dollars in thousands
 
      
Three Months Ended September 30,
               
Nine Months Ended September 30,
             
                                                    
                        
Percentage
                     
Percentage
 
      
2007
   
2006
   
Difference
   
Change
   
2007
   
2006
   
Difference
   
Change
 
Medical expense ratio
                                               
Government Segment
    81.4 %     85.0 %     -3.6 %           85.0 %     85.5 %     -0.5 %      
Commercial Segment
    81.0 %     81.7 %     -0.7 %           80.4 %     81.6 %     -1.2 %      
Consolidated
    81.3 %     84.1 %     -2.8 %           83.8 %     84.3 %     -0.5 %      
                                                                
Selling, general, and administrative    
                                                   
   expense ratio 
                                                           
Government Segment
    10.2 %     10.1 %     0.1 %           10.3 %     11.6 %     -1.3 %      
Commercial Segment
    21.8 %     20.5 %     1.3 %           21.4 %     19.8 %     1.6 %      
Consolidated
    13.3 %     13.1 %     0.2 %           13.2 %     14.2 %     -1.0 %      
                                                                
                                                                
Detail of Pretax Income
                                                           
Government Segment
  $
416,299
    $
207,004
    $
209,295
      101.1 %   $
722,954
    $
326,557
    $
396,397
      121.4 %
Commercial Segment
   
62,203
     
42,370
     
19,833
      46.8 %    
207,359
     
194,347
     
13,012
      6.7 %
Consolidated
  $
478,502
    $
249,374
    $
229,128
      91.9 %   $
930,313
    $
520,904
    $
409,409
      78.6 %
                                                                    
Detail of Pretax Margins
                                                               
Government Segment
    9.0 %     5.1 %     3.9 %             5.2 %     3.0 %     2.2 %        
Commercial Segment
    3.7 %     2.6 %     1.1 %             4.2 %     3.9 %     0.3 %        
Consolidated
    7.6 %     4.4 %     3.2 %             4.9 %     3.3 %     1.6 %        
 
S-8

 
Humana Inc.
Membership Detail
In thousands
 
   
Ending
September 30,
         
Ending
September 30,
   
Year-over-year
Change
   
Ending
June 30,
   
Sequential
Change
 
   
2007
   
Average - 3Q07
   
2006
   
Amount
   
Percent
   
2007
   
Amount
   
Percent
 
Medical Membership:
                                               
Government Segment:
                                               
Medicare Advantage - HMO
   
451.7
     
452.4
     
455.4
      (3.7 )     -0.8 %    
452.4
      (0.7 )     -0.2 %
Medicare Advantage - PPO
   
71.1
     
69.5
     
71.1
     
0.0
      0.0 %    
66.9
     
4.2
      6.3 %
Medicare Advantage - PFFS
   
615.2
     
616.5
     
466.5
     
148.7
      31.9 %    
614.4
     
0.8
      0.1 %
    Total Medicare Advantage
   
1,138.0
     
1,138.4
     
993.0
     
145.0
      14.6 %    
1,133.7
     
4.3
      0.4 %
Medicare - PDP - Standard
   
2,148.9
     
2,146.9
     
2,081.7
     
67.2
      3.2 %    
2,131.0
     
17.9
      0.8 %
Medicare - PDP - Enhanced
   
1,085.1
     
1,081.5
     
1,021.6
     
63.5
      6.2 %    
1,075.9
     
9.2
      0.9 %
Medicare - PDP - Complete
   
225.7
     
228.0
     
417.7
      (192.0 )     46.0 %    
233.2
      (7.5 )     -3.2 %
    Total Medicare stand-alone PDPs
   
3,459.7
     
3,456.4
     
3,521.0
      (61.3 )     1.7 %    
3,440.1
     
19.6
      0.6 %
        Total Medicare
   
4,597.7
     
4,594.8
     
4,514.0
     
83.7
      1.9 %    
4,573.8
     
23.9
      0.5 %
TRICARE insured
   
1,720.4
     
1,720.4
     
1,721.3
      (0.9 )     -0.1 %    
1,717.6
     
2.8
      0.2 %
TRICARE ASO
   
1,137.0
     
1,137.2
     
1,141.4
      (4.4 )     -0.4 %    
1,150.6
      (13.6 )     -1.2 %
    Total TRICARE
   
2,857.4
     
2,857.6
     
2,862.7
      (5.3 )     -0.2 %    
2,868.2
      (10.8 )     -0.4 %
Medicaid insured
   
383.8
     
383.8
     
412.6
      (28.8 )     -7.0 %    
384.9
      (1.1 )     -0.3 %
Medicaid ASO
   
182.8
     
184.0
     
-
     
182.8
      100.0 %    
182.7
     
0.1
      0.1 %
    Total Medicaid
   
566.6
     
567.8
     
412.6
     
154.0
      37.3 %    
567.6
      (1.0 )     -0.2 %
Total Government Segment
   
8,021.7
     
8,020.2
     
7,789.3
     
232.4
      3.0 %    
8,009.6
     
12.1
      0.2 %
Commercial Segment:
                                                               
Fully-insured medical:
                                                               
    Group
   
1,530.2
     
1,530.1
     
1,597.1
      (66.9 )     -4.2 %    
1,533.0
      (2.8 )     -0.2 %
    Individual
   
223.7
     
216.5
     
175.4
     
48.3
      27.5 %    
205.0
     
18.7
      9.1 %
    Medicare supplement
   
11.3
     
10.2
     
7.4
     
3.9
      52.7 %    
8.3
     
3.0
      36.1 %
Total fully-insured medical
   
1,765.2
     
1,756.8
     
1,779.9
      (14.7 )     -0.8 %    
1,746.3
     
18.9
      1.1 %
ASO
   
1,533.9
     
1,546.1
     
1,512.0
     
21.9
      1.4 %    
1,532.4
     
1.5
      0.1 %
Total Commercial Segment
   
3,299.1
     
3,302.9
     
3,291.9
     
7.2
      0.2 %    
3,278.7
     
20.4
      0.6 %
                                                                 
Total medical membership
   
11,320.8
     
11,323.1
     
11,081.2
     
239.6
      2.2 %    
11,288.3
     
32.5
      0.3 %
                                                                 
                                                                 
Specialty Membership (all Commercial Segment)
                                                         
Dental - fully-insured
   
974.7
     
975.6
     
960.5
     
14.2
      1.5 %    
978.1
      (3.4 )     -0.3 %
Dental - ASO
   
499.3
     
503.9
     
488.2
     
11.1
      2.3 %    
499.9
      (0.6 )     -0.1 %
    Total dental
   
1,474.0
     
1,479.5
     
1,448.7
     
25.3
      1.7 %    
1,478.0
      (4.0 )     -0.3 %
Group life
   
444.3
     
442.7
     
436.1
     
8.2
      1.9 %    
439.8
     
4.5
      1.0 %
Short-term disability
   
11.8
     
11.9
     
14.9
      (3.1 )     -20.8 %    
12.2
      (0.4 )     -3.3 %
Total specialty membership
   
1,930.1
     
1,934.1
     
1,899.7
     
30.4
      1.6 %    
1,930.0
     
0.1
      0.0 %
 
S-9

 
Humana Inc.            
Premiums and Administrative Services Fees Detail         
Dollars in thousands, except per member per month           

 
 
 
   
 
   
 
   
 
   
Per Member per Month (A)
 
 
 
Three Months Ended September 30,
   
 
   
 
   
Three Months Ended September 30,
 
 
 
 
   
 
   
Dollar
   
Percentage
   
 
   
 
 
 
 
2007
   
2006
   
Change
   
Change
   
2007
   
2006
 
Premium revenues
 
 
   
 
   
 
   
 
   
 
   
 
 
Government Segment:
 
 
   
 
   
 
   
 
   
 
   
 
 
Medicare Advantage
  $
2,825,587
    $
2,366,206
    $
459,381
      19.4 %   $
827
    $
799
 
Medicare stand-alone PDPs
   
890,420
     
851,398
     
39,022
      4.6 %   $
86
    $
82
 
    Total Medicare
   
3,716,007
     
3,217,604
     
498,403
      15.5 %                
TRICARE insured (B)
   
714,173
     
639,657
     
74,516
      11.6 %   $
138
    $
124
 
Medicaid insured
   
135,609
     
128,018
     
7,591
      5.9 %   $
118
    $
103
 
Total Government Segment premiums
   
4,565,789
     
3,985,279
     
580,510
      14.6 %                
Commercial Segment:
                                               
Fully-insured medical
   
1,418,884
     
1,397,945
     
20,939
      1.5 %   $
269
    $
260
 
Specialty
   
108,168
     
103,144
     
5,024
      4.9 %   $
22
    $
21
 
Total Commercial Segment premiums
   
1,527,052
     
1,501,089
     
25,963
      1.7 %                
Total premium revenues
  $
6,092,841
    $
5,486,368
    $
606,473
      11.1 %                
 
                                               
 
                                               
Administrative services fees
                                               
TRICARE ASO (B)
  $
17,675
    $
11,136
    $
6,539
      58.7 %   $
5
    $
3
 
Medicaid ASO
   
2,165
     
-
     
2,165
      100.0 %   $
4
     
-
 
Total Government Segment
   
19,840
     
11,136
     
8,704
      78.2 %                
Commercial Segment
   
81,691
     
75,196
     
6,495
      8.6 %   $
13
    $
12
 
Total administrative services fees
  $
101,531
    $
86,332
    $
15,199
      17.6 %                
 
S-10

 
Humana Inc.
 
Premiums and Administrative Services Fees Detail
 
Dollars in thousands, except per member per month
 

 
 
 
   
 
   
 
   
 
   
Per Member per Month (A)
 
 
 
Nine Months Ended September 30,
   
 
   
 
   
Nine Months Ended September 30,
 
 
 
 
   
 
   
Dollar
   
Percentage
   
 
   
 
 
 
 
2007
   
2006
   
Change
   
Change
   
2007
   
2006
 
Premium revenues
 
 
   
 
   
 
   
 
   
 
   
 
 
Government Segment:
 
 
   
 
   
 
   
 
   
 
   
 
 
Medicare Advantage
  $
8,372,736
    $
6,196,455
    $
2,176,281
      35.1 %   $
828
    $
805
 
Medicare stand-alone PDPs
   
2,848,105
     
2,168,310
     
679,795
      31.4 %   $
91
    $
90
 
    Total Medicare
   
11,220,841
     
8,364,765
     
2,856,076
      34.1 %                
TRICARE insured (B)
   
2,166,428
     
1,898,038
     
268,390
      14.1 %   $
140
    $
122
 
Medicaid insured
   
397,420
     
386,643
     
10,777
      2.8 %   $
115
    $
101
 
Total Government Segment premiums
   
13,784,689
     
10,649,446
     
3,135,243
      29.4 %                
Commercial Segment:
                                               
Fully-insured medical
   
4,211,771
     
4,316,523
      (104,752 )     -2.4 %   $
269
    $
259
 
Specialty
   
324,194
     
306,360
     
17,834
      5.8 %   $
22
    $
21
 
Total Commercial Segment premiums
   
4,535,965
     
4,622,883
      (86,918 )     -1.9 %                
Total premium revenues
  $
18,320,654
    $
15,272,329
    $
3,048,325
      20.0 %                
 
                                               
 
                                               
Administrative services fees
                                               
TRICARE ASO (B)
  $
47,504
    $
33,471
    $
14,033
      41.9 %   $
5
    $
3
 
Medicaid ASO
   
6,397
     
-
     
6,397
      100.0 %   $
4
     
-
 
Total Government Segment
   
53,901
     
33,471
     
20,430
      61.0 %                
Commercial Segment
   
240,587
     
215,250
     
25,337
      11.8 %   $
13
    $
12
 
Total administrative services fees
  $
294,488
    $
248,721
    $
45,767
      18.4 %                
 
S-11

 
Humana Inc.
 
 
Percentage of Ending Membership under Capitation Arrangements
 
 

 
 
Government Segment
   
Commercial Segment
   
 
 
September 30, 2007
 
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 (C)
    2.4 %    
-
     
-
     
-
      0.3 %     1.4 %    
-
      0.8 %     0.5 %
Capitated HMO physician group based (C)
    2.0 %    
-
     
-
      26.5 %     2.2 %     1.5 %    
-
      0.8 %     1.8 %
Risk-sharing (D)
    24.2 %    
-
     
-
      40.8 %     6.3 %     1.5 %    
-
      0.8 %     4.7 %
All other membership
    71.4 %     100.0 %     100.0 %     32.7 %     91.2 %     95.6 %     100.0 %     97.6 %     93.0 %
    Total medical membership
    100.0 %     100.0 %     100.0 %     100.0 %     100.0 %     100.0 %     100.0 %     100.0 %     100.0 %
 
                                                                       
September 30, 2006
                                                                       
 
                                                                       
Capitated HMO hospital system based (C)
    3.1 %    
-
     
-
     
-
      0.4 %     1.9 %    
-
      1.0 %     0.6 %
Capitated HMO physician group based (C)
    2.4 %    
-
     
-
      34.8 %     2.2 %     1.8 %    
-
      1.0 %     1.8 %
Risk-sharing (D)
    27.8 %    
-
     
-
      64.5 %     7.0 %     1.4 %    
-
      0.8 %     5.1 %
All other membership
    66.7 %     100.0 %     100.0 %     0.7 %     90.4 %     94.9 %     100.0 %     97.2 %     92.5 %
    Total medical membership
    100.0 %     100.0 %     100.0 %     100.0 %     100.0 %     100.0 %     100.0 %     100.0 %     100.0 %
 
S-12

 
Humana Inc.
Detail of Medical and Other Expenses Payable Balance and Year-to-Date Changes
Dollars in thousands

 
 
September 30,
   
June 30,
   
December 31,
 
 
 
2007
   
2007
   
2006
 
Detail of medical and other expenses payable
 
 
   
 
   
 
 
IBNR and other medical expenses payable (E)
  $
2,017,742
    $
2,028,722
    $
1,686,051
 
TRICARE IBNR (F)
   
323,667
     
308,112
     
318,583
 
TRICARE other medical expenses payable (G)
   
89,447
     
100,975
     
94,699
 
Unprocessed claim inventories (H)
   
224,000
     
211,300
     
218,400
 
Processed claim inventories (I)
   
108,593
     
142,171
     
115,424
 
Payable to pharmacy benefit administrator (J)
   
117,880
     
162,866
     
55,104
 
Total medical and other expenses payable
  $
2,881,329
    $
2,954,146
    $
2,488,261
 
 
                       
 
                       
 
 
Nine Months Ended
   
Nine Months Ended
   
Year Ended
 
 
 
September 30, 2007
   
September 30, 2006
   
December 31, 2006
 
Year-to-date changes in medical and other
                       
expenses payable
                       
 
                       
Balances at January 1
  $
2,488,261
    $
1,909,682
    $
1,909,682
 
 
                       
Acquisitions
   
-
     
21,198
     
21,198
 
 
                       
Incurred related to:
                       
    Current year (K)
   
15,656,377
     
13,163,725
     
17,696,654
 
    Prior years - non-TRICARE (K)
    (215,747 )     (173,223 )     (178,998 )
    Prior years - TRICARE (L)
    (82,350 )     (111,073 )     (96,452 )
Total incurred
   
15,358,280
     
12,879,429
     
17,421,204
 
 
                       
Paid related to:
                       
    Current year
    (13,310,165 )     (11,193,784 )     (15,532,079 )
    Prior years
    (1,655,047 )     (1,053,582 )     (1,331,744 )
Total paid
    (14,965,212 )     (12,247,366 )     (16,863,823 )
 
                       
Balances at end of period
  $
2,881,329
    $
2,562,943
    $
2,488,261
 
 
 
S-13

 
Medical Claims Reserves Statistics

Receipt Cycle Time (M)
                   
   
2007
   
2006
   
Change
   
Percentage
Change
 
1st Quarter Average
   
15.6
     
16.1
      (0.5 )     -3.1 %
2nd Quarter Average
   
15.6
     
15.8
      (0.2 )     -1.3 %
3rd Quarter Average
   
15.9
     
16.0
      (0.1 )     -0.6 %
4th Quarter Average
   
-
     
15.8
   
N/A
   
N/A
 
Full Year Average
   
15.7
     
15.9
      (0.2 )     -1.3 %
                                 
                                 
                                 
Unprocessed Claims Inventories
                         
                                 
Date
 
Estimated Valuation
(000's)
   
Claim Item
Counts
   
Number of
Days on Hand
         
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
         
9/30/2006
  $
187,900
     
623,900
     
5.4
         
12/31/2006
  $
218,400
     
757,700
     
6.1
         
3/31/2007
  $
222,300
     
747,200
     
5.5
         
6/30/2007
  $
211,300
     
751,600
     
4.9
         
9/30/2007
  $
224,000
     
819,100
     
6.1
         
 
S-14

 
Medical Claims Reserves Statistics (Continued)

Days in Claims Payable (N)
                               
Quarter Ended
 
Days in Claim
Payable (DCP)
   
Annual
Change
   
Percentage
Change
   
DCP Excluding
Capitation
   
Annual
Change
   
Percentage
Change
 
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 %
9/30/2006
   
61.2
     
7.2
      13.3 %    
67.1
     
6.3
      10.4 %
12/31/2006
   
60.2
      (0.1 )     -0.2 %    
66.5
      (0.1 )     -0.2 %
3/31/2007
   
62.0
     
2.9
      4.9 %    
67.8
     
2.3
      3.5 %
6/30/2007
   
62.4
     
2.9
      4.9 %    
69.7
     
4.2
      6.4 %
9/30/2007
   
63.4
     
2.2
      3.6 %    
70.5
     
3.4
      5.1 %
                                                 
Year-to-Date Change in Days in Claims Payable (O)
                                 
                   
2007
   
2006
                 
DCP - 4th quarter of prior year
             
60.2
     
60.3
                 
Components of year-to-date change in DCP:
                                         
Change in claims receipt cycle time
              (0.6 )     (1.6 )                
Change in unprocessed claims inventories
             
0.1
     
1.7
                 
Change in processed claims inventories
              (0.2 )    
0.8
                 
Change in TRICARE reserve balances
             
-
      (2.1 )                
Change in pharmacy payment cutoff
             
-
      (1.3 )                
Change in provider payables under risk arrangements
     
2.7
     
1.9
                 
    All other
                   
1.2
     
0.5
                 
DCP - current quarter
                   
63.4
     
60.2
                 
 
S-15

 
Humana Inc.    
                               
GAAP to non-GAAP Reconcilation                                
In thousands, except per common share results                               
 
                         
   
3Q07
   
3Q07 YTD
   
Forecasted EPS and Growth Rate
       
   
Pretax
 Income
   
EPS
   
Pretax
 Income
   
EPS
   
2007
   
2008
   
Growth
Rate
 
Consolidated
                                         
GAAP
  $
478,502
    $
1.78
    $
930,313
    $
3.48
    $
4.75 to $4.80
    $
5.30 to $5.50
      10%-16 %
                                                         
Non-GAAP adjustment for favorable prior year claims development
  $ (68,878 )   $ (0.25 )   $ (68,878 )   $ (0.25 )   $ (0.25 )    
-
         
                                                         
Non-GAAP (P)
  $
409,624
    $
1.53
    $
861,435
    $
3.23
    $
4.50 to $4.55
    $
5.30 to $5.50
      16%-22 %
 
   
3Q07
   
3Q07 YTD
   
Government Segment
 
Pretax Income
   
Pretax Income
   
GAAP
  $
416,299
    $
722,954
   
                   
Non-GAAP adjustment for favorable prior year claims development
  $ (68,878 )   $ (68,878 )  
                   
Non-GAAP (P)
  $
347,421
    $
654,076
   
 
S-16

 
 
Footnotes to Statistical Schedules and Supplementary Information
3Q07 Earnings Release
 
 
Footnote
(A)
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).
(B)
TRICARE revenues are not contracted on a per-member basis.
(C)
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.  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 physicians and hospitals for services rendered to their HMO membership.
(D)
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.
(E)
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.
(F)
TRICARE IBNR primarily fluctuates due to medical expense inflation and changes in the utilization of benefits.
(G)
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).
(H)
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.
(I)
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.
(J)
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.
(K)
Amounts incurred related to prior years vary from previously estimated liabilities as the claims ultimately are settled. Negative amounts reported for incurred related to prior years result from claims being ultimately settled for amounts less than originally estimated (favorable development). There were no changes in the approach used to determine our estimate of claim reserves during the quarter.
(L)
Changes in estimates of TRICARE incurred claims for prior years result 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.
(M)
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 our largest claim processing platforms represents 70% to 75% of the company's fully-insured claims volume. Pharmacy claims are excluded from this measurement.
(N)
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. In addition, this calculation excludes the impact of the company's stand-alone PDP business.
(O)
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. This analysis excludes the impact of Medicare stand-alone PDPs upon DCP.
(P)
These non-GAAP numbers exclude favorable development in the Government Segment related to prior year matters of approximately $68.9 million, or $0.25 per diluted share, that are not expected to recur in future periods.  The favorable claims development resulted from 1) the resolution of first year (2006) Part D implementation matters including enrollment discrepancies and the related impact on claims estimates ($54.0 million, or $0.20 per share) and 2) the adjustment of TRICARE reserves as a result of the settlement of the claims payment accuracy provision for prior option periods under the South contract ($14.9 million, or $0.05 per share). The company believes that these non-GAAP measures, when presented in conjunction with the 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.  These 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.

S-17
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-----END PRIVACY-ENHANCED MESSAGE-----