-----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, M3eVwg42flVnFXV2/CmtN5Y/+N4kxM2s0YGOPti+HIYI2yeI/4tpKt6P4c8LK6eq lG4fOdUukFh/Vln2YEJlxQ== 0001157523-09-007506.txt : 20091102 0001157523-09-007506.hdr.sgml : 20091102 20091102060403 ACCESSION NUMBER: 0001157523-09-007506 CONFORMED SUBMISSION TYPE: 8-K PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20091102 ITEM INFORMATION: Results of Operations and Financial Condition ITEM INFORMATION: Regulation FD Disclosure ITEM INFORMATION: Financial Statements and Exhibits FILED AS OF DATE: 20091102 DATE AS OF CHANGE: 20091102 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: 091149605 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 a6088230.htm HUMANA INC. 8-K


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)     November 2, 2009

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):

Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

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 was issued by Humana Inc. this morning reporting financial results for the period ended September 30, 2009, 2009 earnings guidance and financial projections for 2010, 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 Statistical 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/ Steven E. McCulley

 

Steven E. McCulley

Vice President and Controller

(Principal Accounting Officer)

 
 
 
 

Dated:

November 2, 2009

INDEX TO EXHIBITS

Exhibit No.

Description

 
 

99

Earnings Release and Statistical Pages

EX-99 2 a6088230ex99.htm EXHIBIT 99

Exhibit 99

Humana Reports Third Quarter Financial Results, Provides 2010 Financial Guidance

  • Reaffirms 2009 EPS guidance of approximately $6.15
  • 2009 YTD cash flows from operations of over $1.1 billion
  • Medicare operations continue to perform well
  • TRICARE contract protest upheld by GAO
  • Commercial results continue to be impacted by general economy

LOUISVILLE, Ky.--(BUSINESS WIRE)--November 2, 2009--Humana Inc. (NYSE: HUM) today reported diluted earnings per common share (EPS) for the quarter ended September 30, 2009 (3Q09) of $1.78, consistent with management’s guidance of $1.75 to $1.80. The company earned $1.09 per share for the quarter ended September 30, 2008 (3Q08) which reflected $0.40 per share in realized losses primarily associated with other-than-temporary impairments in investments and sales of distressed financial institution securities. The 3Q08 results also included high stand-alone Prescription Drug Plan (PDP) claim expenses.

For the nine months ended September 30, 2009 (YTD09) the company reported $4.67 in EPS compared to $2.79 in EPS for the nine months ended September 30, 2008 (YTD08). The YTD08 results reflected both high stand-alone PDP claim expenses and lower investment income primarily due to significant realized losses on investments.

“Our results this quarter reflect continued solid performance in our Government businesses, offsetting continuing challenges in our Commercial Segment,” said Michael B. McCallister, president and chief executive officer of Humana. “We continue to anticipate consolidated results in line with our previous expectations and thus are reaffirming our 2009 EPS guidance.”


The company anticipates EPS of approximately $6.15 for the year ending December 31, 2009 (FY09). Looking ahead to the year ending December 31, 2010 (FY10), the company projects EPS to be in the range of $5.05 to $5.25. The 2010 estimate includes military services EPS between breakeven and $0.10 per share (including the impact of asset write-downs and other charges) and excludes any potential impact from pending health legislation or regulatory reform.

"Looking to 2010, we're forecasting substantial net-new Medicare Advantage member growth, attributable to both large-group and individual customers," McCallister said. "In addition, as we've said in the past, we target an overall Medicare pretax operating margin of approximately 5 percent, which next year will include a significant increase in group membership, a traditionally lower margin business, a moderating margin for our stand-alone PDPs, and an individual Medicare margin that approximates the overall target. We also anticipate stabilizing our Commercial operating results with administrative cost reductions and continuation of pricing actions."

TRICARE Update

As previously disclosed, on July 22, 2009, Humana Military Healthcare Services (HMHS), a wholly owned subsidiary of the company, filed a protest with the Government Accountability Office (GAO) in connection with the award of the third generation TRICARE program contract for the South Region to another contractor. In its protest, Humana cited discrepancies between the award criteria and procedures prescribed in the request for proposals issued by the Department of Defense (DoD) and those that appear to have been used by the DoD in making its contractor selection. On October 28, 2009, the company learned that the GAO had upheld HMHS’ protest. Humana anticipates the GAO will publicly release a detailed version of its protest decision expeditiously to include the grounds for the decision and the nature of relief recommended by the GAO to the DoD. At this time, Humana is not able to determine what actions the DoD will take in response to recommendations by the GAO, nor can it determine whether or not the protest decision by the GAO will have any effect upon the ultimate disposition of the contract award, and therefore whether or not the protest decision is material.

Consolidated Highlights

Revenues – 3Q09 consolidated revenues rose 8 percent to $7.72 billion from $7.15 billion in 3Q08, with total premium and administrative services fees up 7 percent compared to the prior year’s quarter. The increase in premiums and administrative services fees primarily reflects an increase in both average Medicare Advantage membership and per-member premiums for these products.

Consolidated revenues for YTD09 rose 9 percent to $23.33 billion from $21.46 billion for YTD08 with total premiums and administrative services fees up 8 percent compared to the prior year’s period, also driven primarily by the increases in average Medicare Advantage enrollment and per-member premiums.


Benefit expenses – The 3Q09 consolidated benefit ratio (benefit expenses as a percent of premium revenues) of 82.1 percent decreased from 83.1 percent for the prior year’s quarter, as expected. This 100 basis point decrease was primarily driven by a decrease of 220 basis points in the Government Segment, partially offset by a 250 basis point increase in the Commercial Segment benefit ratio.

The consolidated benefit ratio for YTD09 of 83.1 percent was 180 basis points lower than the YTD08 consolidated benefit ratio of 84.9 percent, reflecting a 250 basis point decrease in the Government Segment’s benefit ratio year over year while the Commercial Segment’s benefit ratio was unchanged YTD09 compared to YTD08.

Selling, general, & administrative (SG&A) expenses – The 3Q09 consolidated SG&A expense ratio (SG&A expenses as a percent of premiums, administrative services fees and other revenue) of 13.7 percent remained unchanged from 3Q08. The YTD09 consolidated SG&A expense ratio of 13.5 percent increased 10 basis points from the YTD08 ratio of 13.4 percent.

Government Segment Results

Pretax results:

  • Government segment pretax income of $474.5 million in 3Q09 compares to $271.7 million in 3Q08. This increase was primarily driven by lower PDP claim expenses, an 11 percent increase in average Medicare Advantage membership, the implementation of member premiums for most of the company’s Medicare Advantage products, and higher investment income.

Enrollment:

  • Medicare Advantage membership grew to 1,514,800 at September 30, 2009, an increase of 146,800 members, or 11 percent, from September 30, 2008, and up 78,900, or 5 percent, versus December 31, 2008. As of September 30, 2009, approximately 62 percent of the company’s Medicare Advantage members were in network-based products versus 49 percent at September 30, 2008 and 51 percent at December 31, 2008.
  • Membership in the company’s stand-alone PDPs totaled 1,960,400 at September 30, 2009 compared to 3,089,000 at September 30, 2008 and 3,066,600 at December 31, 2008. Both the year-over-year and year-to-date membership declines resulted primarily from attrition associated with low-income seniors opting to join competitor plans with lower or no member premiums as well as stand-alone PDP members choosing Medicare Advantage plans. For 2009, the company realigned its stand-alone PDP premium and benefit designs to correspond with its prescription drug claims experience.
  • Military services membership at September 30, 2009 of 3,015,100 was up approximately 2 percent from 2,953,900 at September 30, 2008 and 2,964,700 at December 31, 2008.

Premiums and administrative services fees:

  • Medicare Advantage premiums of $4.14 billion in 3Q09 increased 18 percent compared to $3.50 billion in 3Q08, primarily the combined result of an 11 percent increase in average Medicare Advantage membership and the introduction of member premiums for most of the company’s Medicare Advantage products.

  • Medicare stand-alone PDP premiums of $578.1 million in 3Q09 decreased 26 percent compared to $782.9 million in 3Q08, reflecting a 36 percent decline in average membership year over year primarily due to members choosing competitor offerings given the premium and benefit design changes discussed above.
  • Military services premiums and administrative services fees during 3Q09 increased $30.7 million, or 4 percent, to $818.8 million compared to $788.1 million in 3Q08.

Benefit Expenses:

  • The Government Segment benefit ratio decreased 220 basis points to 81.9 percent in 3Q09 compared to 84.1 percent in the prior year’s quarter, primarily driven by a 340 basis point decline in the Medicare benefit ratio with decreases in both the Medicare Advantage and stand-alone PDP benefit ratios.

SG&A Expenses:

  • The Government Segment’s SG&A expense ratio of 10.2% remained unchanged from 3Q08.

Commercial Segment Results

Pretax results:

  • The Commercial Segment had a pretax loss of $5.2 million in 3Q09 compared to pretax income of $11.2 million in 3Q08 primarily driven by higher benefit expenses as a percent of premiums and lower average medical membership, partially offset by higher investment income.

Enrollment:

  • Commercial Segment medical membership declined to 3,426,900 at September 30, 2009, a decrease of 127,100, or 4 percent, from 3,554,000 at September 30, 2008 and a decline of 193,900, or 5 percent, from 3,620,800 at December 31, 2008. The decline during 2009 primarily reflected the impact of the economic recession and increased unemployment across various of the company’s fully-insured group medical lines of business as well as the loss of two large ASO accounts totaling approximately 95,400 members on January 1, 2009.
  • The company’s individual product line has continued to grow steadily, with membership of 358,800, up 13 percent at September 30, 2009 compared to 316,800 at September 30, 2008 and up 10 percent from 325,100 at December 31, 2008.
  • Membership in Commercial Segment specialty products (a) of 7,262,900 at September 30, 2009 increased 8 percent from 6,727,400 at September 30, 2008 and 7 percent from 6,817,000 at December 31, 2008.

Premiums and administrative services fees:

  • Premiums and administrative services fees for the Commercial Segment decreased 1 percent to $1.87 billion in 3Q09 compared to $1.88 billion in the prior year’s quarter, reflecting a 4 percent decline in average medical membership year over year.
  • Commercial Segment medical premiums for fully-insured group accounts increased approximately 5 percent on a per-member basis during 3Q09 compared to 3Q08.

Benefit Expenses:

  • In 3Q09, the Commercial Segment benefits ratio of 82.7 percent increased 250 basis points versus the 3Q08 benefit ratio of 80.2 percent, as an increase in per-member premiums was more than offset by higher utilization primarily associated with the general economy (aging of small group membership, higher utilization prior to termination, and increased COBRA participation) as well as the impact of the H1N1 virus.

SG&A Expenses:

  • The Commercial Segment SG&A expense ratio of 24.0 percent for 3Q09 compares to 23.0 percent in 3Q08, primarily driven by increases in certain of the segment’s businesses that carry a higher administrative expense load such as mail-order pharmacy and individual medical products.

Balance Sheet

  • At September 30, 2009, the company had cash, cash equivalents, and investment securities of $8.67 billion, up 17 percent from $7.41 billion in such assets at June 30, 2009.
  • Debt-to-total capitalization at September 30, 2009 was 23.2 percent, down 180 basis points from 25.0 percent at June 30, 2009 due primarily to the favorable operating results during 3Q09.

Cash Flows from Operations

Cash flows provided by operations for 3Q09 of $940.1 million compared to cash flows provided by operations of $577.3 million in 3Q08 with the increase primarily due to higher net income as well as the positive impact of changes in working capital accounts.

Share Repurchase Program

In the third quarter of 2008, the company’s Board of Directors authorized the repurchase of up to $250 million of the company’s common shares exclusive of shares repurchased in connection with employee stock plans. Due to volatility in the financial markets, the company has not repurchased any shares under the third quarter 2008 authorization. The share repurchase program expires on December 31, 2009.

Footnote

(a) The Commercial Segment provides a full range of insured specialty products including dental, vision and other supplemental products. Members included in these products may not be unique to each product since members have the ability to enroll in multiple products. Other supplemental benefits include life, disability, and fixed benefit products including cancer and critical illness policies.


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 at least 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 at least 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 includes forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. When used in investor presentations, press releases, Securities and Exchange Commission (SEC) filings, and in oral statements made by or with the approval of one of our executive officers, the words or phrases like “expects,” “anticipates,” “believes,” “intends,” “likely will result,” “estimates,” “projects” or variations of such words and similar expressions are intended to identify such forward-looking statements. These forward-looking statements are not guarantees of future performance and are subject to risks, uncertainties, and assumptions, including, among other things, information set forth in the “Risk Factors” section of our SEC filings, a summary of which includes but is not limited to the following:

  • If Humana does not design and price its products properly and competitively, if the premiums Humana charges are insufficient to cover the cost of health care services delivered to its members, or if its estimates of benefits payable or future policy benefits payable based upon its estimates of future benefit claims are inadequate, Humana’s profitability could be materially adversely affected. Humana estimates the costs of its benefit expense payments, and designs and prices its products accordingly, using actuarial methods and assumptions based upon, among other relevant factors, claim payment patterns, medical cost inflation, and historical developments such as claim inventory levels and claim receipt patterns. These estimates, however, involve extensive judgment, and have considerable inherent variability that is extremely sensitive to payment patterns and changes in medical cost trends.
  • If Humana fails to effectively implement its operational and strategic initiatives, including its Medicare initiatives, the company’s business could be materially adversely affected.
  • If Humana fails to properly maintain the integrity of its data, to strategically implement new information systems, or to protect Humana’s proprietary rights to its systems, the company’s business could be materially adversely affected.
  • Humana is involved in various legal actions, which, if resolved unfavorably to Humana, could result in substantial monetary damages. Increased litigation and negative publicity could increase the company’s cost of doing business.
  • Humana's business activities are subject to substantial government regulation. New laws or regulations, or changes in existing laws or regulations or their enforcement, could increase the company's cost of doing business and could materially affect its business, profitability and financial condition. In addition, as a government contractor, the comapny is exposed to additional risks that could adversely affect its business or its willingness to participate in government health care programs.

  • Any failure to manage administrative costs could hamper Humana’s profitability.
  • Any failure by Humana to manage acquisitions and other significant transactions successfully could have a material adverse effect on its financial results, business and prospects.
  • If Humana fails to develop and maintain satisfactory relationships with the providers of care to its members, the company’s business could be adversely affected.
  • Humana’s mail order pharmacy business is highly competitive and subjects it to regulations in addition to those the company faces with its core health benefits businesses.
  • Humana’s ability to obtain funds from its subsidiaries is restricted.
  • Downgrades in Humana’s debt ratings, should they occur, may adversely affect its business, results of operations and financial condition.
  • Changes in economic conditions could adversely affect Humana’s business and results of operations.
  • The securities and credit markets may experience volatility and disruption, which could adversely affect the company’s business.
  • Given the current economic climate, Humana’s stock and the stock of other companies in the insurance industry may be increasingly subject to stock price and trading volume volatility.

In making forward-looking statements, Humana is not undertaking to address or update them in future filings or communications regarding its business or results. In light of these risks, uncertainties, and assumptions, the forward-looking events discussed herein may or may not occur. There also may be other risks that we are unable to predict at this time. Any of these risks and uncertainties may cause actual results to differ materially from the results discussed in the forward-looking statements.

Humana advises investors to read the following documents as filed by the company with the SEC for further discussion both of the risks it faces and its historical performance:

  • Form 10-K for the year ended December 31, 2008;
  • Form 10-Q for the quarters ended March 31, 2009 and June 30, 2009;
  • Form 8-Ks filed during 2009.

About Humana

Humana Inc., headquartered in Louisville, Kentucky, is one of the nation’s largest publicly traded health and supplemental benefits companies, with approximately 10.3 million medical members and approximately 7.3 million specialty-benefit members. Humana is a full-service benefits solutions company, offering a wide array of health and supplemental benefit plans for employer groups, government programs and individuals.

Over its 48-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;
  • Replays of most recent earnings release conference calls;
  • Calendar of events (including upcoming earnings conference call dates and times, as well as planned interaction with research analysts and institutional investors);
  • Corporate Governance information.

 
 
 

Humana Inc. – Earnings Guidance Points as of November 2, 2009

 
(in accordance with     For the year ending December 31, 2009     For the year ending December 31, 2010     Comments
Generally Accepted
Accounting
Principles (GAAP))                  
Diluted earnings per Full year 2009: approximately $6.15 Full year 2010: $5.05 to $5.25 EPS estimates for 2009 and 2010 exclude
common share (EPS) impact of potential future share

 

repurchases
2010 estimate includes military services
EPS between breakeven and $0.10 per
share and excludes any potential impact
from pending health insurance
                  legislation or regulatory reform
Revenues Consolidated revenues: approximately $31 Consolidated revenues: $32 billion to $34
billion billion
 
Premiums and ASO fees: Premiums and ASO fees:
Medicare Advantage: $16.4 billion to Medicare Advantage: $18 billion to $19
$16.5 billion billion
Medicare stand-alone PDPs: Medicare stand-alone PDPs:
approximately $2.4 billion $2.8 billion to $2.9 billion

 

Military services: $3.5 billion to $3.6 Military services: $2.9 billion to $3.0

2010 Military Services assumes a 10/01/10

billion; billion;

transition date for TRICARE contract

Commercial Segment: approximately Commercial Segment: $7.4 billion to $7.6
$7.5 billion billion
 
Consolidated investment income: $290 Consolidated investment income: $320
million to $300 million million to $335 million
 
Consolidated other revenue: approximately

Consolidated other revenue: $265 million to

      $245 million    

$275 million

     
Ending medical Medicare Advantage: up approximately Medicare Advantage: up 180,000 to 240,000

Includes fully-insured group and individual

membership 65,000 from prior year from prior year

Medicare Advantage members and

approximately 29,000 ASO group Medicare
Advantage Members in 2010.
 
Medicare stand-alone PDPs: down 1.15 Medicare stand-alone PDPs: up 150,000 to 2010 includes approximately 131,000 low-
million from prior year 200,000 from prior year income members associated with a CMS
demonstration project.
 
Military services: no material change Military services: down approximately 3 Fully-insured and ASO combined; assumes
from prior year million from prior year 10/1/10 transition for TRICARE contract
 
Medicaid: down approximately 72,000 from

Medicaid: no material change from prior year

2009 expected decline in Medicaid
prior year

 

membership relates to a contract assumed
in connection with the FY08 Cariten
Healthcare acquisition that terminated
effective December 31, 2008.
 
Commercial: down approximately 200,000 Commercial: down 135,000 to 145,000 from Fully-insured and ASO combined
      from prior year     prior year      
Benefit ratios and Government Segment benefit ratio in the Government Segment benefit ratio in the Medicare, Medicaid, and Military Services
benefit expense trend range of 83.5% to 84.0% range of 85% to 86% combined
components
Medicare benefit ratio in the range of Medicare benefit ratio in the range of 84% Medicare Advantage and Stand-Alone PDP
82.0% to 83.0% to 85% combined
 
Commercial Segment benefit ratio in the Commercial Segment benefit ratio in the Medical and Specialty combined
range of 80% to 81% range of 79% to 81%
 
Commercial group fully insured secular Commercial group fully insured secular

Commercial group fully insured secular trends

benefit expense trend components: benefit expense trend components:

of approximately 7% for 2009 and 8% for

inpatient hospital utilization – relatively

inpatient hospital utilization – low single

2010 represent the underlying percentage

flat; inpatient and outpatient hospital

digits; inpatient and outpatient hospital

change in total medical expenses which

rates – mid to upper single digits;

rates – upper single digits; outpatient

excludes the impact of benefit changes and

outpatient hospital utilization – mid

hospital utilization – mid single digits;

business, product, and demographic mix.

single digits; physician – mid single

physician – mid single digits; pharmacy –

 

digits; pharmacy – mid single digits

mid single digits

     

 

           
Selling, general & 13.5% to 14.0% 13% to 14% SG&A expenses as a percent of premiums,

administrative

administrative services fees, and other

expense ratio

revenue
 
2010 estimate includes approximately $100
                  million in administrative cost reductions
Depreciation & $240 million to $245 million $260 million to $265 million
amortization                  
Interest expense     $105 million to $110 million     $105 million to $110 million      
Government Segment

Medicare operating margin: approximately 6.5%

Medicare operating margin: approximately 5.0% Medicare Advantage & stand-alone PDP combined
operating results

 

(Line-of-business-level

Military services: operating earnings of

Military services: operating earnings of

2010 military services earnings include the

results exclude the

approximately $110 million to $115 million

breakeven to $25 million

anticipated impact of the write-down of

impact of investment

goodwill and other charges related to the

income and interest

termination of the South Region contract

expense)

               

of $50 million to $75 million

Commercial Segment Approximately $120 million $125 million to $175 million Segment-level results include the impact of
pretax earnings                 investment income and interest expense
Cash flows from $1.3 billion to $1.5 billion $1.1 billion to $1.3 billion
operations                  
Capital expenditures     Approximately $175 million     Approximately $200 million      
Effective tax rate     Approximately 35%     Approximately 36%      
Shares used in Approximately 169 million Approximately 170 million Excludes impact of potential future share
computing full-year repurchases
EPS                  

 
 
 

Humana Inc.

Statistical Schedules

And

Supplementary Information

3Q09 Earnings Release

 
 
 

S-1


 
 
 
Humana Inc.
Statistical Schedules and Supplementary Information
3Q09 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 Investments
S-14-16 Benefits Payable
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
2009 2008 Change Change
Revenues:
Premiums $ 7,444,122 $ 6,991,569 $ 452,553 6.5 %
Administrative services fees 133,732 114,401 19,331 16.9 %
Investment income (loss) 74,861 (16,773 ) 91,634

546.3

%
Other revenue   64,104   58,973     5,131   8.7 %
Total revenues   7,716,819   7,148,170     568,649   8.0 %
Operating expenses:
Benefits 6,111,351 5,810,613 300,738 5.2 %
Selling, general and administrative 1,047,773 979,223 68,550 7.0 %
Depreciation 52,897 46,371 6,526 14.1 %
Other intangible amortization   9,191   9,755     (564 ) -5.8 %
Total operating expenses   7,221,212   6,845,962     375,250   5.5 %
Income from operations 495,607 302,208 193,399 64.0 %
Interest expense   26,259   19,348     6,911   35.7 %
Income before income taxes 469,348 282,860 186,488 65.9 %
Provision for income taxes   167,829   99,852     67,977   68.1 %
Net income $ 301,519 $ 183,008   $ 118,511   64.8 %
 
Basic earnings per common share $ 1.80 $ 1.10 $ 0.70 63.6 %
Diluted earnings per common share $ 1.78 $ 1.09 $ 0.69 63.3 %
 
Shares used in computing basic earnings per common share 167,404 166,647
Shares used in computing diluted earnings per common share 169,246 168,578
 
 
 

S-3


       
 
 
Humana Inc.
Consolidated Statements of Income
In thousands, except per common share results
 
Nine Months Ended September 30,
Dollar Percentage
2009 2008 Change Change
Revenues:
Premiums $ 22,557,943 $ 20,810,922 $ 1,747,021 8.4 %
Administrative services fees 368,308 339,344 28,964 8.5 %
Investment income 219,745 154,007 65,738 42.7 %
Other revenue   181,373   154,463   26,910 17.4 %
Total revenues   23,327,369   21,458,736   1,868,633 8.7 %
Operating expenses:
Benefits 18,748,206 17,667,129 1,081,077 6.1 %
Selling, general and administrative 3,115,918 2,845,709 270,209 9.5 %
Depreciation 152,250 133,469 18,781 14.1 %
Other intangible amortization   28,330   27,073   1,257 4.6 %
Total operating expenses   22,044,704   20,673,380   1,371,324 6.6 %
Income from operations 1,282,665 785,356 497,309 63.3 %
Interest expense   79,605   53,554   26,051 48.6 %
Income before income taxes 1,203,060 731,802 471,258 64.4 %
Provision for income taxes   414,044   258,728   155,316 60.0 %
Net income $ 789,016 $ 473,074 $ 315,942 66.8 %
 
Basic earnings per common share $ 4.72 $ 2.83 $ 1.89 66.8 %
Diluted earnings per common share $ 4.67 $ 2.79 $ 1.88 67.4 %
 
Shares used in computing basic earnings per common share 167,250 167,328
Shares used in computing diluted earnings per common share 168,858 169,392
 
 
 

S-4


         
 
 
Humana Inc.
Consolidated Balance Sheets
Dollars in thousands, except share amounts
 
  September 30, June 30, December 31, Sequential Change
2009   2009   2008 Dollar Percent
Assets
Current assets:
Cash and cash equivalents $1,452,006 $1,585,109 $1,970,423
Investment securities 5,899,385 4,583,423 4,203,538
Receivables, net:
Premiums 765,039 1,265,986 777,672
Administrative services fees 11,489 10,928 12,010
Securities lending invested collateral 176,692 270,120 402,399
Other 936,217   1,056,798   1,030,000
Total current assets 9,240,828 8,772,364 8,396,042 $468,464 5.3%
Property and equipment, net 679,010 691,414 711,492
Other assets:
Long-term investment securities 1,319,319 1,240,197 1,011,904
Goodwill 1,992,924 1,992,924 1,963,111
Other 969,706   987,490   959,211
Total other assets 4,281,949   4,220,611   3,934,226
Total assets $14,201,787   $13,684,389   $13,041,760 $517,398 3.8%
 
Liabilities and Stockholders' Equity
Current liabilities:
Benefits payable $3,365,481 $3,411,197 $3,205,579
Trade accounts payable and accrued expenses 1,532,810 1,351,689 1,077,027
Book overdraft 199,384 153,853 224,542
Securities lending payable 189,774 305,008 438,699
Unearned revenues 219,789   244,855   238,098
Total current liabilities 5,507,238 5,466,602 5,183,945 $40,636 0.7%
Long-term debt 1,680,424 1,682,654 1,937,032
Future policy benefits payable 1,171,904 1,154,317 1,164,758
Other long-term liabilities 294,018   322,538   298,835
Total liabilities 8,653,584   8,626,111   8,584,570 $27,473 0.3%
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; 189,102,289 issued at September 30, 2009

31,517 31,478 31,309
Capital in excess of par value 1,625,525 1,604,979 1,574,245
Retained earnings 4,178,952 3,877,433 3,389,936
Accumulated other comprehensive income (loss) 83,536 (86,556) (175,243)
Treasury stock, at cost, 19,269,815 shares at September 30, 2009 (371,327)   (369,056)   (363,057)
Total stockholders' equity 5,548,203   5,058,278   4,457,190 $489,925 9.7%
Total liabilities and stockholders' equity $14,201,787   $13,684,389   $13,041,760 $517,398 3.8%
 
Debt-to-total capitalization ratio 23.2% 25.0% 30.3%
 
 
 

S-5


 
 
 
Humana Inc.
Consolidated Statements of Cash Flows
Dollars in thousands
 
    Three Months Ended September 30,    
  Dollar Percentage
2009   2008 Change Change
Cash flows from operating activities
Net income $ 301,519 $ 183,008
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization 62,088 56,126
Net realized capital (gains) losses (4,184 ) 92,285
Stock-based compensation 15,796 14,670
Provision (benefit) for deferred income taxes 12,072 (31,983 )

Changes in operating assets and liabilities excluding the effects of acquisitions:

Receivables 500,386 290,065
Other assets 30,545 28,280
Benefits payable (45,716 ) (43,830 )
Other liabilities 87,766 (19,893 )
Unearned revenues (25,066 ) 3,359
Other   4,905       5,188  
Net cash provided by operating activities   940,111       577,275   $ 362,836 62.9 %
 
Cash flows from investing activities
Acquisitions, net of cash acquired (69 ) 3,746
Purchases of property and equipment (39,533 ) (67,500 )
Purchases of investment securities (2,451,044 ) (1,557,997 )
Proceeds from maturities of investment securities 197,796 144,216
Proceeds from sales of investment securities 1,152,495 1,462,238
Change in securities lending collateral   115,234       264,795  
Net cash (used in) provided by investing activities   (1,025,121 )     249,498   ($1,274,619 ) -510.9 %
 
Cash flows from financing activities
Receipts from CMS contract deposits 499,987 585,551
Withdrawals from CMS contract deposits (481,123 ) (728,707 )
Debt issue costs - (1,182 )
Change in book overdraft 45,531 (40,285 )
Change in securities lending payable (115,234 ) (264,795 )
Common stock repurchases (2,271 ) (11,106 )
Excess tax benefit from stock-based compensation 1,473 450
Proceeds from stock option exercises and other   3,544       1,559  
Net cash used in financing activities   (48,093 )     (458,515 ) $ 410,422 89.5 %
 
(Decrease)/increase in cash and cash equivalents (133,103 ) 368,258
Cash and cash equivalents at beginning of period   1,585,109       1,174,642  
 
Cash and cash equivalents at end of period $ 1,452,006     $ 1,542,900  
 
 
 

S-6


       
 
 
Humana Inc.
Consolidated Statements of Cash Flows
Dollars in thousands
 
  Nine Months Ended September 30,
Dollar Percentage
2009   2008 Change Change
Cash flows from operating activities
Net income $ 789,016 $ 473,074
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization 180,580 160,542
Net realized capital (gains) losses (13,734 ) 73,436
Stock-based compensation 48,818 41,835
Benefit for deferred income taxes (22,753 ) (21,411 )

Changes in operating assets and liabilities excluding the effects of acquisitions:

Receivables 6,247 (93,320 )
Other assets 11,718 (166,931 )
Benefits payable 159,902 337,632
Other liabilities (10,681 ) (124,368 )
Unearned revenues (18,309 ) (9,098 )
Other   16,687       14,346  
Net cash provided by operating activities   1,147,491       685,737   $ 461,754 67.3 %
 
Cash flows from investing activities
Acquisitions, net of cash acquired (12,436 ) (262,347 )
Purchases of property and equipment (122,135 ) (179,545 )
Purchases of investment securities (5,290,819 ) (5,082,141 )
Proceeds from maturities of investment securities 802,331 418,563
Proceeds from sales of investment securities 2,903,936 4,111,640
Change in securities lending collateral   248,925       801,518  
Net cash used in investing activities   (1,470,198 )     (192,312 ) ($1,277,886 ) -664.5 %
 
Cash flows from financing activities
Receipts from CMS contract deposits 1,534,629 1,774,381
Withdrawals from CMS contract deposits (1,204,536 ) (1,807,952 )
Borrowings under credit agreement - 425,000
Repayments under credit agreement (250,000 ) (1,225,000 )
Proceeds from issuance of senior notes - 749,247
Debt issue costs - (6,662 )
Change in book overdraft (25,158 ) (11,546 )
Change in securities lending payable (248,925 ) (801,518 )
Common stock repurchases (8,270 ) (105,767 )
Excess tax benefit from stock-based compensation 1,717 9,794
Proceeds from stock option exercises and other   4,833       9,045  
Net cash used in financing activities   (195,710 )     (990,978 ) $ 795,268 80.3 %
 
Decrease in cash and cash equivalents (518,417 ) (497,553 )
Cash and cash equivalents at beginning of period   1,970,423       2,040,453  
 
Cash and cash equivalents at end of period $ 1,452,006     $ 1,542,900  
 
 
 

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
2009   2008 Difference   Change 2009   2008 Difference   Change
Benefit ratio
Government Segment 81.9 % 84.1 % -2.2 % 84.3 % 86.8 % -2.5 %
Commercial Segment 82.7 % 80.2 % 2.5 % 79.4 % 79.4 % 0.0 %
Consolidated 82.1 % 83.1 % -1.0 % 83.1 % 84.9 % -1.8 %
 

Selling, general, and administrative expense ratio (A)

Government Segment 10.2 % 10.2 % 0.0 % 10.0 % 10.1 % -0.1 %
Commercial Segment 24.0 % 23.0 % 1.0 % 23.9 % 22.3 % 1.6 %
Consolidated 13.7 % 13.7 % 0.0 % 13.5 % 13.4 % 0.1 %
 
Investment income (loss)
Government Segment $ 44,936 ($6,163 ) $ 51,099

829.1

% $ 132,894 $ 80,930 $ 51,964 64.2 %
Commercial Segment   29,925       (10,610 )   40,535  

382.0

%   86,851       73,077     13,774   18.8 %
Consolidated $ 74,861       ($16,773 ) $ 91,634  

546.3

% $ 219,745     $ 154,007   $ 65,738   42.7 %
 
Interest expense
Government Segment $ 17,447 $ 6,969 $ 10,478 150.4 % $ 50,160 $ 18,084 $ 32,076 177.4 %
Commercial Segment   8,812       12,379     (3,567 ) -28.8 %   29,445       35,470     (6,025 ) -17.0 %
Consolidated $ 26,259     $ 19,348   $ 6,911   35.7 % $ 79,605     $ 53,554   $ 26,051   48.6 %
 
Detail of pretax income (loss)
Government Segment $ 474,501 $ 271,701 $ 202,800 74.6 % $ 1,045,277 $ 517,913 $ 527,364 101.8 %
Commercial Segment   (5,153 )     11,159     (16,312 ) -146.2 %   157,783       213,889     (56,106 ) -26.2 %
Consolidated $ 469,348     $ 282,860   $ 186,488   65.9 % $ 1,203,060     $ 731,802   $ 471,258   64.4 %
 
Detail of pretax margins
Government Segment 8.2 % 5.2 % 3.0 % 6.0 % 3.3 % 2.7 %
Commercial Segment -0.3 % 0.6 % -0.9 % 2.7 % 3.7 % -1.0 %
Consolidated 6.1 % 4.0 % 2.1 % 5.2 % 3.4 % 1.8 %
 
 
 

S-8


             
 
 
Humana Inc.
Membership Detail

In thousands

 
  Ending Average 3Q09 Ending Year-over-year Change Ending Sequential Change
September 30, 2009       September 30, 2008 Amount   Percent June 30, 2009 Amount   Percent
Medical Membership:
Government Segment:
Medicare Advantage - HMO 591.0 589.7 502.3 88.7 17.7 % 586.1 4.9 0.8 %
Medicare Advantage - PPO 348.0 345.3 171.0 177.0 103.5 % 338.9 9.1 2.7 %
Medicare Advantage - PFFS 575.8   575.6   694.7 (118.9 ) -17.1 % 574.8 1.0   0.2 %
Total Medicare Advantage 1,514.8   1,510.6   1,368.0 146.8   10.7 % 1,499.8 15.0   1.0 %
Medicare - PDP - Standard 751.8 757.8 1,495.7 (743.9 ) -49.7 % 771.5 (19.7 ) -2.6 %
Medicare - PDP - Enhanced 1,087.3 1,089.9 1,433.8 (346.5 ) -24.2 % 1,095.6 (8.3 ) -0.8 %
Medicare - PDP - Complete 121.3 122.5 159.5 (38.2 ) -23.9 % 124.9 (3.6 ) -2.9 %
Total Medicare stand-alone PDPs 1,960.4   1,970.2   3,089.0 (1,128.6 ) -36.5 % 1,992.0 (31.6 ) -1.6 %
Total Medicare 3,475.2   3,480.8   4,457.0 (981.8 ) -22.0 % 3,491.8 (16.6 ) -0.5 %
Military services insured 1,754.3 1,753.6 1,734.4 19.9 1.1 % 1,753.4 0.9 0.1 %
Military services ASO 1,260.8   1,256.2   1,219.5 41.3   3.4 % 1,254.9 5.9   0.5 %
Total military services 3,015.1   3,009.8   2,953.9 61.2   2.1 % 3,008.3 6.8   0.2 %
Medicaid insured 399.8 397.5 385.1 14.7 3.8 % 393.6 6.2 1.6 %
Medicaid ASO -   -   177.3 (177.3 ) -100.0 % - 0.0   0.0 %
Total Medicaid 399.8   397.5   562.4 (162.6 ) -28.9 % 393.6 6.2   1.6 %
Total Government Segment 6,890.1   6,888.1   7,973.3 (1,083.2 ) -13.6 % 6,893.7 (3.6 ) -0.1 %
Commercial Segment:
Fully-insured medical:
Group 1,474.1 1,477.5 1,596.0 (121.9 ) -7.6 % 1,499.6 (25.5 ) -1.7 %
Individual 358.8 355.0 316.8 42.0 13.3 % 347.2 11.6 3.3 %
Medicare supplement 27.8   26.9   18.4 9.4   51.1 % 24.9 2.9   11.6 %
Total fully-insured medical 1,860.7 1,859.4 1,931.2 (70.5 ) -3.7 % 1,871.7 (11.0 ) -0.6 %
ASO 1,566.2   1,567.3   1,622.8 (56.6 ) -3.5 % 1,576.2 (10.0 ) -0.6 %
Total Commercial Segment 3,426.9   3,426.7   3,554.0 (127.1 ) -3.6 % 3,447.9 (21.0 ) -0.6 %
 
Total medical membership 10,317.0   10,314.8   11,527.3 (1,210.3 ) -10.5 % 10,341.6 (24.6 ) -0.2 %
 
Specialty Membership
Dental - fully-insured 2,631.7 2,508.1 2,578.6 53.1 2.1 % 2,446.7 185.0 7.6 %
Dental - ASO 1,197.4   1,053.2   1,062.7 134.7   12.7 % 980.3 217.1   22.1 %
Total dental 3,829.1 3,561.3 3,641.3 187.8 5.2 % 3,427.0 402.1 11.7 %
Vision 2,427.3 2,415.2 2,188.9 238.4 10.9 % 2,376.1 51.2 2.2 %
Other supplemental benefits (B) 1,006.5   1,002.2   897.2 109.3   12.2 % 987.3 19.2   1.9 %
Total specialty membership 7,262.9   6,978.7   6,727.4 535.5   8.0 % 6,790.4 472.5   7.0 %
 
 
 

S-9


           
 
 
Humana Inc.
Premiums and Administrative Services Fees Detail
Dollars in thousands, except per member per month
 
Per Member per Month (C)
Three Months Ended September 30, Three Months Ended September 30,
Dollar Percentage
2009   2008 Change   Change 2009   2008
Premium revenues
Government Segment:
Medicare Advantage $ 4,135,198 $ 3,497,568 $ 637,630 18.2 % $ 912 $ 858
Medicare stand-alone PDPs   578,142     782,855   (204,713 ) -26.1 % $ 98 $ 84
Total Medicare 4,713,340 4,280,423 432,917 10.1 %
Military services insured (D) 796,126 771,560 24,566 3.2 % $ 151 $ 148
Medicaid insured   162,896     152,069   10,827   7.1 % $ 137 $ 131
Total Government Segment premiums   5,672,362     5,204,052   468,310   9.0 %
Commercial Segment:

Fully-insured medical (group and individual)

1,540,442 1,559,120 (18,678 ) -1.2 % $ 276 $ 269
Specialty   231,318     228,397   2,921   1.3 % $ 12 $ 12
Total Commercial Segment premiums   1,771,760     1,787,517   (15,757 ) -0.9 %
Total premium revenues $ 7,444,122   $ 6,991,569 $ 452,553   6.5 %
 
Administrative services fees
Military services ASO (D) $ 22,690 $ 16,581 $ 6,109 36.8 % $ 6 $ 5
Other government ASO 15,257 4,588

 

10,669 232.5 %
Commercial Segment   95,785     93,232   2,553   2.7 % $ 12 $ 12
Total administrative services fees $ 133,732   $ 114,401 $ 19,331   16.9 %
 
 
 

S-10


           
 
 
Humana Inc.
Premiums and Administrative Services Fees Detail
Dollars in thousands, except per member per month
 
Per Member per Month (C)
Nine Months Ended September 30, Nine Months Ended September 30,
Dollar Percentage
2009   2008 Change   Change 2009   2008
Premium revenues
Government Segment:
Medicare Advantage $ 12,340,786 $ 10,157,109 $ 2,183,677 21.5 % $ 922 $ 860
Medicare stand-alone PDPs   1,812,638     2,562,925   (750,287 ) -29.3 % $ 99 $ 91
Total Medicare 14,153,424 12,720,034 1,433,390 11.3 %
Military services insured (D) 2,591,605 2,389,195 202,410 8.5 % $ 165 $ 153
Medicaid insured   480,085     437,725   42,360   9.7 % $ 136 $ 126
Total Government Segment premiums   17,225,114     15,546,954   1,678,160   10.8 %
Commercial Segment:

Fully-insured medical (group and individual)

4,643,204 4,566,632 76,572 1.7 % $ 274 $ 267
Specialty   689,625     697,336   (7,711 ) -1.1 % $ 12 $ 13
Total Commercial Segment premiums   5,332,829     5,263,968   68,861   1.3 %
Total premium revenues $ 22,557,943   $ 20,810,922 $ 1,747,021   8.4 %
 
Administrative services fees
Military services ASO (D) $ 63,140 $ 51,582 $ 11,558 22.4 % $ 6 $ 5
Other government ASO 18,295 11,749

 

6,546 55.7 %
Commercial Segment   286,873     276,013   10,860   3.9 % $ 12 $ 11
Total administrative services fees $ 368,308   $ 339,344 $ 28,964   8.5 %
 
 
 

S-11


                 
 
 
Humana Inc.
Percentage of Ending Membership under Capitation Arrangements
 
 
Government Segment Commercial Segment
September 30, 2009 Medicare Advantage  

Medicare

stand-alone PDPs

  Military Services   Medicaid  

Total Govt.

Segment

  Fully-insured   ASO  

Total Comm.

Segment

 

Total Medical

Membership

 
Capitated HMO hospital system based (E) 1.9 % - - - 0.4 % 1.2 % - 0.7 % 0.5 %
Capitated HMO physician group based (E) 3.2 % - - 29.3 % 2.4 % 1.5 % - 0.8 % 1.9 %
Risk-sharing (F) 18.8 % - - 69.9 % 8.2 % 1.0 % - 0.6 % 5.7 %
All other membership 76.1 %   100.0 %   100.0 %   0.8 %   89.0 %   96.3 %   100.0 %   97.9 %   91.9 %
Total medical membership 100.0 %   100.0 %   100.0 %   100.0 %   100.0 %   100.0 %   100.0 %   100.0 %   100.0 %
 
September 30, 2008
 
Capitated HMO hospital system based (E) 1.9 % - - - 0.3 % 1.3 % - 0.7 % 0.4 %
Capitated HMO physician group based (E) 3.5 % - - 26.3 % 2.5 % 1.4 % - 0.8 % 1.9 %
Risk-sharing (F) 20.0 % - - 41.6 % 6.4 % 1.3 % - 0.7 % 4.7 %
All other membership 74.6 %   100.0 %   100.0 %   32.1 %   90.8 %   96.0 %   100.0 %   97.8 %   93.0 %
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. Fair value
Investments                    
Dollars in thousands
      9/30/2009           6/30/2009           12/31/2008
Investment Portfolio:
Cash & cash equivalents $       1,452,006 $       1,585,109 $       1,970,423
Investment securities $ 5,899,385 4,583,423 4,203,538
Long-term investment securities $       1,319,319                   1,240,197                   1,011,904
Total investment portfolio $       8,670,710           $       7,408,729           $       7,185,865
 
Duration (G)         3.55                   3.37                   3.39
Average Credit Rating AA+           AA+           AA+
 
Securities Lending Invested Collateral Portfolio:
Cash & cash equivalents $ 40,975 $ 61,374 $ 46,693
Certificates of deposit / bank notes $ 52,275 71,413 167,973
Corporate floating rate $ 24,978 48,964 55,341
Asset-backed securities $       58,464                   88,369                   132,392
$       176,692           $       270,120           $       402,399
 
Average Credit Rating AA+           AA+           AA+
 
Investment Portfolio Detail:
Cash and cash equivalents $       1,452,006           $       1,585,109           $       1,970,423
U.S. Government and agency obligations
U.S. Treasury and agency obligations $ 1,253,636 $ 593,174 $ 599,898
U.S. Government residential mortgage-backed 1,420,491 1,094,271 1,283,482
U.S. Government commercial mortgage-backed $       27,554                   25,093                   14,223
Total U.S. Government and agency obligations $       2,701,681                   1,712,538                   1,897,603
Tax-exempt municipal securities
Pre-refunded 416,694 481,440 694,797
Insured 575,417 570,596 452,427
Other 1,001,409 731,076 468,585
Auction rate securities         71,792                   72,718                   73,653
Total tax-exempt municipal securities         2,065,312                   1,855,830                   1,689,462
Residential mortgage-backed
Prime residential mortgages 132,043 301,836 339,665
Alt-A residential mortgages 3,895 3,977 5,939
Sub-prime residential mortgages         1,564                   1,562                   1,704
Total residential mortgage-backed $       137,502                   307,375                   347,308
Commercial mortgage-backed         275,963                   259,373                   260,299
Asset-backed securities         155,234                   152,469                   144,370
Corporate securities
Financial services 686,256 495,981 356,816
Other         1,170,002                   1,014,128                   484,581
Total corporate securities 1,856,258 1,510,109 841,397
Redeemable preferred stocks 21,643 21,124 19,702
Non-redeemable preferred stocks 706 685 11,228
Common stocks         4,405                   4,117                   4,073
Total investment portfolio $       8,670,710           $       7,408,729           $       7,185,865
 
 
 

S-13


     
 
 
Humana Inc.
Detail of Benefits Payable Balance and Year-to-Date Changes
Dollars in thousands
 
September 30, 2009   June 30, 2009   December 31, 2008
Detail of benefits payable
IBNR and other benefits payable (H) $ 2,436,947 $ 2,448,633 $ 2,216,909
Unprocessed claim inventories (I) 317,100 258,000 247,200
Processed claim inventories (J) 112,790 199,978 190,445
Payable to pharmacy benefit administrator (K)   187,771       161,200       244,228  
Benefits payable, excluding military services 3,054,608 3,067,811 2,898,782
 
Military services IBNR (L) 313,796 300,583 248,492
Other military services benefits payable (M)   (2,923 )     42,803       58,305  
Military services benefits payable   310,873       343,386       306,797  
Total Benefits Payable $ 3,365,481     $ 3,411,197     $ 3,205,579  
 
 
 
Nine Months Ended Nine Months Ended Year Ended
September 30, 2009   September 30, 2008   December 31, 2008

Year-to-date changes in benefits payable, excluding military services (N)

 
Balances at January 1 $ 2,898,782 $ 2,355,461 $ 2,355,461
 
Acquisitions - 34,122 96,021
 
Incurred related to:
Current year 16,639,799 15,769,075 21,092,135
Prior years (O)   (221,887 )     (230,461 )     (268,027 )
Total incurred   16,417,912       15,538,614       20,824,108  
 
Paid related to:
Current year (14,707,443 ) (13,692,050 ) (18,832,301 )
Prior years   (1,554,643 )     (1,523,293 )     (1,544,507 )
Total paid   (16,262,086 )     (15,215,343 )     (20,376,808 )
 
Balances at end of period $ 3,054,608     $ 2,712,854     $ 2,898,782  
 
 
 
Nine Months Ended Nine Months Ended Year Ended
September 30, 2009   September 30, 2008   December 31, 2008
Summary of Consolidated Benefit Expense:
Total benefit expense incurred, per above $ 16,417,912 $ 15,538,614 $ 20,824,108
Military services benefit expense 2,279,918 2,098,059 2,819,787
Future policy benefit expense (P)   50,376       30,456       64,338  
Consolidated Benefit Expense $ 18,748,206     $ 17,667,129     $ 23,708,233  
 
 
 

S-14


 
 
 
Humana Inc.
Benefits Payable Statistics (Q)
         
 
Receipt Cycle Time (R)
2009   2008   Change     Percentage Change
1st Quarter Average 14.8 15.1 (0.3 ) -2.0 %
2nd Quarter Average 14.0 15.0 (1.0 ) -6.7 %
3rd Quarter Average 13.7 15.2 (1.5 ) -9.9 %
4th Quarter Average   -   14.6   N/A   N/A
Full Year Average   14.1   15.0   (0.9 ) -6.0 %
 
 
 
Unprocessed Claims Inventories
 
Date   Estimated Valuation (000's)   Claim Item Counts   Number of Days on Hand
9/30/2007 $ 224,000 819,100 6.1
12/31/2007 $ 213,400 683,500 5.0
3/31/2008 $ 212,000 673,000 4.4
6/30/2008 $ 228,700 742,800 4.6
9/30/2008 $ 293,600 946,500 6.0
12/31/2008 $ 247,200 745,500 4.3
3/31/2009 $ 258,800 740,600 4.2
6/30/2009   $ 258,000   709,900   4.0  
9/30/2009   $ 317,100   856,500   4.9  
 
 
 

S-15


 
 
 
Humana Inc.
Benefits Payable Statistics (Continued) (Q)
             
 
Days in Claims Payable (S)
 
Quarter Ended  

Days in Claims

Payable (DCP)

 

Change Last 4

Quarters

  Percentage Change  

DCP Excluding

Capitation

 

Change Last 4

Quarters

  Percentage Change
9/30/2007 61.8 4.3 7.5 % 70.2 5.9 9.2 %
12/31/2007 60.2 3.9 6.9 % 68.3 4.3 6.7 %
3/31/2008 56.9 (2.4 ) -4.0 % 63.3 (2.7 ) -4.1 %
6/30/2008 57.2 (2.8 ) -4.7 % 63.3 (5.2 ) -7.6 %
9/30/2008 58.1 (3.7 ) -6.0 % 65.1 (5.1 ) -7.3 %
12/31/2008 59.4 (0.8 ) -1.3 % 66.5 (1.8 ) -2.6 %
3/31/2009 54.6 (2.3 ) -4.0 % 60.9 (2.4 ) -3.8 %
6/30/2009   56.1   (1.1 )   -1.9 %   61.5     (1.8 )   -2.8 %
9/30/2009   56.2   (1.9 )   -3.3 %   62.7     (2.4 )   -3.7 %
 
 
 
Year-to-Date Change in Days in Claims Payable (T)
2009   2008
DCP - beginning of period 59.4 60.2
Components of change in DCP:
Internal versus outsourced claims processing cycle times - (3.2 )
Change in unprocessed claims inventories 0.6 1.5
Change in processed claims inventories (1.5 ) (0.3 )
Change in pharmacy payment cutoff (1.3 ) (0.2 )
Impact of Cariten acquisition in 4Q08 (0.9 ) -
All other (0.1 )   0.1  
DCP - end of period 56.2     58.1  
 
 
 

S-16


 
 
 
Humana Inc.
Footnotes to Statistical Schedules and Supplementary Information
3Q09 Earnings Release
 
(A) The selling, general and administrative (SG&A) expense ratio is defined as SG&A expenses as a percent of premiums, administrative services fees and other revenue.
(B) Other supplemental benefits include life, disability, and fixed benefit products including cancer and critical illness policies.
(C) 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).
(D) Military services revenues are generally not contracted on a per-member basis.
(E) 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 benefit 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.
(F) 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 benefit expenses 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.
(G) Duration is the time-weighted average of the present value of the bond portfolio cash flow.
(H) IBNR represents an estimate of benefit expenses payable for claims incurred but not reported (IBNR) at the balance sheet date. The level of IBNR is primarily impacted by membership levels, benefit 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 benefits payable includes amounts payable to providers under capitation arrangements.
(I) Unprocessed claim inventories represent the estimated valuation of claims received but not yet fully processed.
(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) Military services IBNR primarily fluctuates due to benefit expense inflation and changes in the utilization of benefits. Amount includes unprocessed inventories as an independent third party administrator processes all military services benefit claims on the company's behalf.
(M) Other military benefits 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).
(N) The table excludes activity associated with military services benefits payable, because the federal government bears a substantial portion of the risk associated with financing the cost of health benefits. More specifically, the risk-sharing provisions of the military services contracts with the federal government and with subcontractors effectively limit profits and losses when actual claim experience varies from the targeted claim amount negotiated annually. As a result of these contract provisions, the impact of changes in estimates for prior year military services benefits payable are substantially offset by the associated changes in estimates of revenue from health care services reimbursements. As such, any impact on the company's results of operations is reduced substantially, whether positive or negative.
(O) 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 the company's estimate of claim reserves during the quarter.
(P) Future policy benefit expense has a related liability classified as a long-term liability on the balance sheet.
(Q) Benefits reserves statistics represents fully-insured medical claims data and excludes military services claims data and specialty benefits.
(R) 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 represent approximately 95% of the company's fully-insured claims volume. Pharmacy and specialty claims, including dental, vision and other supplemental benefits, are excluded from this measurement.
(S) A common metric for monitoring benefits payable levels relative to the benefit expense is days in claims payable, or DCP, which represents the benefits payable at the end of the period divided by average benefit expenses per day in the quarterly period. Since the company has some providers under capitation payment arrangements (which do not require a benefits payable IBNR reserve), the company has also summarized this metric excluding capitation expense. In addition, this calculation excludes the impact of the company's military services and stand-alone PDP business.
(T) DCP fluctuates due to a number of issues, the more significant of which are detailed in this rollforward. 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 military services and Medicare stand-alone PDPs upon DCP.
 
 
 

S-17

CONTACT:
Humana Inc.
Investor Relations:
Regina Nethery, 502-580-3644
Rnethery@humana.com
or
Corporate Communications:
Tom Noland, 502-580-3674
Tnoland@humana.com

-----END PRIVACY-ENHANCED MESSAGE-----