EX-99.1 2 dex991.htm PRESS RELEASE DATED MAY 3, 2005 Press Release dated May 3, 2005

Exhibit 99.1

 

LOGO          

Health Net, Inc.

21650 Oxnard Street

Woodland Hills, CA 91367

818.676.6000

800.291.6911

www.healthnet.com

 

Contacts: David Olson

818.676.6978

david.w.olson@healthnet.com

 

Michael Engelhard

818.676.7620

michael.engelhard@healthnet.com

 

HEALTH NET REPORTS NET INCOME

OF $21 MILLION OR $.19 PER DILUTED SHARE

 

Company Settles Physician Class Action Lawsuits and

Records Related Charge of Approximately $66 Million

 

Improvements in Health Plan MCR and Administrative Ratio Highlight Results

 

LOS ANGELES, May 3, 2005 – Health Net, Inc. (NYSE: HNT) today announced 2005 first quarter net income per diluted share of $.19 compared with net income per diluted share of $.13 in the first quarter of 2004.


Included in the results for the first quarter of 2005 is the full effect of a $67,042,000 pretax charge, or $.36 per diluted share after tax, for severance benefits and litigation costs associated with the settlement of the physician class action lawsuits.

 

Health Net reported net income of $21,348,000 in the first quarter of 2005 compared to net income of $15,012,000 in the first quarter of 2004.

 

“We are pleased with our progress. Our earnings performance in the first quarter of 2005 showed substantial improvement over the prior year, consistent with our expectations,” said Jay Gellert, president and chief executive officer of Health Net. “We remain confident regarding the balance of 2005 and believe there are opportunities for future growth.

 

“We also are pleased that we have settled the physician class action lawsuits. We look forward to continuing improved relations with our physician partners,” Gellert added.

 

Positive developments for the first quarter of 2005 included:

 

    Commercial revenue per member per month (PMPM) increased by approximately 11 percent in the first quarter of 2005 compared to the first quarter of 2004, consistent with the company’s expectations, representing the fourth straight quarter of accelerating yields;

 

    Commercial health care costs PMPM rose 6.9 percent;

 

    Health Net’s Health Plan Medical Care Ratio (MCR) was 85.0 percent, a 260 basis point improvement compared with 87.6 percent reported in the first quarter of 2004;

 

    The Administrative Ratio declined by 50 basis points in the first quarter of 2005 to 9.5 percent compared with 10.0 percent in the first quarter 2004 as a result of the company’s ongoing efforts to monitor administrative expenses and adjusting to enrollment declines;

 

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    Cash flow from operations of $95,151,000 for the first quarter of 2005 compared to a use of cash of $154,575,000 in the first quarter of 2004; and

 

    Settlement of physician class action lawsuits.

 

Revenues

 

Health Net’s total revenues decreased slightly in the first quarter of 2005 to $2,911,745,000 from $2,924,752,000 in the first quarter of 2004. Health plan services revenues, including revenues from the company’s Commercial, Medicare and Medicaid health plans, also declined slightly to $2,397,689,000 in the first quarter of 2005 compared to $2,404,355,000 in the first quarter of 2004 as lower health plan enrollment almost completely offset improved yields.

 

The reduction in health plan services revenue was primarily a result of lower health plan enrollment in the first quarter of 2005 compared to the first quarter of 2004. Commercial enrollment, including both at-risk and Administrative Services Only (ASO) membership, was down 3.3 percent in the first quarter of 2005 compared with the fourth quarter of 2004. This lower enrollment almost completely offset higher commercial and Medicare premium yields across the company’s health plans.

 

In the first quarter of 2005, the overall health plan revenue PMPM, including commercial, Medicare and Medicaid enrollment, rose 9.3 percent compared to the same period in 2004. Commercial premium yields climbed 11.0 percent compared to the first quarter of 2004.

 

“The premium yields we achieved in the first quarter of 2005 were in line with our expectations and position us well for the remainder of 2005,” said Buddy Piszel, chief financial officer of Health Net. “This marks the fourth straight quarter of increasing yields, an indication that our pricing is having the desired effect.

 

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“Our commitment to disciplined pricing resulted in lower commercial enrollment in the first quarter of 2005. We believe that, by year-end, our commercial enrollment will be slightly above the level seen at the end of the first quarter of 2005, excluding New Jersey,” Piszel added.

 

In the first quarter of 2005, Health Net’s Government contracts revenue declined 1.4 percent from the first quarter of 2004, falling by $7,238,000 to $496,710,000. “This decline resulted from the transition to the TRICARE North Region contract and the absence of any revenues from prior TRICARE contracts,” noted Piszel.

 

Health Plan Health Care Costs

 

The health plan MCR decreased to 85.0 percent in the first quarter of 2005 from 87.6 percent in the first quarter of 2004. This decrease in the health plan MCR reflects the impact of better health care cost performance and the absence of negative prior period reserve developments.

 

Overall PMPM health plan health care costs rose by 5.9 percent in the first quarter of 2005 compared to the first quarter of 2004. Commercial health care costs PMPM rose by 6.9 percent over the same period.

 

Non-GAAP Health Plan Health Care Costs

 

Health Net evaluates health care cost trends on a GAAP and non-GAAP basis. Given the charges recorded in the first quarter of 2004, Health Net believes it is important to examine health care costs on a non-GAAP basis to best determine underlying trends. “Subtracting the provider settlement and prior period reserve development from last year’s health care costs, you would see a total PMPM health care cost increase of 7.7 percent in the first quarter of 2005. Implicit in that increase is a commercial PMPM increase of 8.8 percent,” Piszel commented.

 

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A table outlining the impact of provider settlements, net prior period reserve development and other one-time items, to the first quarter of 2004 income statement is attached to this release.

 

Government Contracts Health Care Costs

 

The Government contracts cost ratio rose by 120 basis points to 96.6 percent for the first quarter of 2005 compared to the first quarter of 2004. “We are now responsible for paying claims for active duty personnel who get care in the private sector and this added $40 million in costs and revenues,” Piszel noted.

 

“We also saw higher claims related to Operation Iraqi Freedom. We are pursuing recovery from the Department of Defense on these higher costs, in line with the terms of the contract,” he added.

 

Administrative Expenses

 

In the first quarter of 2005, total general, administrative and depreciation expenses decreased by $14,685,000 to $226,783,000 compared to expenses of $241,468,000 in the first quarter of 2004. “The administrative ratio continues to reflect our desire to keep these costs low,” commented Piszel. “However, we do expect to see the absolute levels of spending increase in the second half of 2005 as expenses for Medicare-related and other commercial marketing activities increase.”

 

Health Net’s selling expenses decreased by $6,304,000 to $57,273,000 in the first quarter of 2005 compared with $63,577,000 in the same period in 2004, consistent with the decline in Small Group and Individual enrollment over the same periods. The selling costs ratio was 2.4 percent for the first quarter of 2005, compared with 2.6 percent in the same period last year.

 

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Balance Sheet Highlights

 

Cash and investments as of March 31, 2005 were $1,895,602,000 compared with $1,782,102,000 as of December 31, 2004.

 

The TRICARE receivable increased by $4,964,000 from the end of the fourth quarter of 2004 to $134,447,000 as of March 31, 2005, consistent with seasonal patterns.

 

Debt decreased by $8,779,000 from December 31, 2004 to $388,981,000 as of March 31, 2005, primarily due to the mark-to-market adjustment of the interest rate swap contracts, with a corresponding increase in other noncurrent liabilities that reflects the mark-to-market value of the swap. The company’s debt-to-total capital ratio was 22.9 percent as of March 31, 2005 compared to 23.8 percent as of December 31, 2004.

 

Reserves for claims and other settlements decreased by $14,006,000 to $1,155,291,000 at March 31, 2005 from $1,169,297,000 at December 31, 2004. The Incurred But Not Reported (IBNR) portion of the reserves rose 4 percent sequentially.

 

The company paid out approximately $38 million in the first quarter of 2005 for provider settlements associated with the charge taken in the fourth quarter of 2004, which was the primary cause of the total reduction in reserves. The company had remaining provider settlement reserves, associated with the charge taken in the fourth quarter of 2004, of approximately $100 million as of March 31, 2005 and approximately $138 million as of December 31, 2004.

 

Interest expense was $2,171,000 higher in the first quarter of 2005 compared to the first quarter of 2004 due to a step up in the interest rate on the company’s senior notes resulting from the rating agency downgrade of the company’s senior unsecured debt rating in the third quarter of 2004 and higher market interest rates in the first quarter 2005 compared to rates in the first quarter of 2004.

 

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Days claims payable (DCP) increased to 51.4 days for the first quarter of 2005 compared to 44.7 days for the fourth quarter of 2004 and 45.2 days in the first quarter of 2004, a reflection of provider-related reserves recorded in the fourth quarter of 2004. Excluding provider settlement reserves related to the charge taken in the fourth quarter of 2004 and excluding capitation expenses, DCP increased by 0.4 days for the first quarter of 2005 to 61.4 days compared to 61.0 days for the fourth quarter of 2004.

 

Cash Flow

 

Cash flow provided by operations in the first quarter of 2005 amounted to $95,151,000 compared to cash flow used in operations of $154,575,000 in the first quarter of 2004.

 

Medicare

 

Health Net continues to be a major Medicare participant with more than 169,000 members in its Medicare Advantage plans. The company has filed applications with the Center for Medicare and Medicaid Services to participate in additional Medicare programs like the Part D drug benefit, the stand-alone Part D drug benefit, and both regional and local PPO plans.

 

“We have a team focused on finding the best potential Medicare opportunities for Health Net in the areas we serve,” Piszel added.

 

Outlook

 

Health Net believes its earnings per diluted share for the full year 2005 will be $1.94 to $2.14, including the effect of the physician class action settlement charge. Excluding the charge, the full year earnings per diluted share range would be between $2.30 and $2.50. The company believes that its earnings per diluted share in the second quarter of 2005 will be between $.50 and $.55.

 

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“We are reiterating our full year guidance despite having to absorb additional G&A expenditures for Medicare modernization, implementation of the business practice changes required by the physician class action settlement agreement and a higher than expected diluted share count,” Piszel commented.

 

“For the full year, we continue to believe that commercial enrollment will be up modestly overall from the end of the first quarter of this year, excluding New Jersey, with membership gains in key markets in the second half of the year,” he added.

 

The company’s effective tax rate in the first quarter of 2005 was 34.0 percent as the company realized a tax-related benefit related to the final settlement of a small subsidiary that was sold in February 2005. The company expects its effective tax rate to rise to 38.9 percent for the full year of 2005.

 

Conference Call

 

As previously announced, Health Net will discuss the company’s first quarter 2005 results during a conference call with investors on Tuesday, May 3, 2005, at approximately 11:00 a.m. EST. To listen to the call, please dial 719.457.2728, code 5350704. A live webcast and replay of the conference call also will be available at www.healthnet.com. The conference call webcast is open to all interested parties. A replay of the conference call will be available following the call on Tuesday, May 3, 2005 through May 7, 2005, by dialing 719.457.0820, code 5350704. Anyone listening to the company’s conference call will be presumed to have read Health Net’s Annual Report on Form 10-K for the year ended December 31, 2004, and other reports filed by the company from time to time with the Securities and Exchange Commission.

 

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About Health Net

 

Health Net, Inc. is among the nation’s largest publicly traded managed health care companies. Its mission is to help people be healthy, secure and comfortable. The company’s HMO, POS, insured PPO and government contracts subsidiaries provide health benefits to approximately 6.5 million individuals in 27 states and the District of Columbia through group, individual, Medicare, Medicaid and TRICARE programs. Health Net’s subsidiaries also offer managed health care products related to behavioral health and prescription drugs, and offer managed health care product coordination for multi-region employers and administrative services for medical groups and self-funded benefits programs.

 

For more information on Health Net, Inc., please visit the company’s Web site at www.healthnet.com.

 

Cautionary Statements

 

Certain matters discussed in this release contain forward-looking statements within the meaning of Section 21E of the Securities Exchange Act of 1934, as amended, and Section 27A of the Securities Act of 1933, as amended, that involve a number of risks and uncertainties. All statements, other than statements of historical information provided herein, may be deemed to be forward-looking statements. These statements are based on management’s analysis, judgment, belief and expectation only as of the date hereof, and are subject to uncertainty and changes in circumstances. Without limiting the foregoing, the words “believes,” “anticipates,” “plans,” “expects,” “may,” “should,” “could,” “estimate,” “intend” and other similar expressions are intended to identify forward-looking statements. Actual results could differ materially due to, among other things, rising health care costs, negative prior period claims reserve developments, trends in medical care ratios, issues relating to provider contracts, operational issues, health care

 

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reform and general business conditions. Additional factors that could cause actual results to differ materially from those reflected in the forward-looking statements include, but are not limited to, the risks discussed in the “Risk Factors” section included within the company’s most recent Annual Report on Form 10-K filed with the SEC and the risks discussed in the company’s other periodic filings with the SEC. Readers are cautioned not to place undue reliance on these forward-looking statements. The company undertakes no obligation to publicly revise these forward-looking statements to reflect events or circumstances that arise after the date of this release.

 

# # #

 

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Health Net, Inc.

Condensed Consolidated Statements of Operations

(Amounts in thousands, except per share and ratio data)

 

     First Quarter
Ended
March 31,
2004


   

Second Quarter
Ended

June 30,

2004


    Third Quarter
Ended
September 30,
2004


    Fourth Quarter
Ended
December 31,
2004


    First Quarter
Ended
March 31,
2005


 

REVENUES:

                                        

Health plan services premiums

   $ 2,404,355     $ 2,398,943     $ 2,393,160     $ 2,363,786     $ 2,397,689  

Government contracts

     503,948       504,317       525,783       487,823       496,710  

Net investment income

     15,201       13,818       14,750       14,378       15,763  

Other income

     1,248       1,737       1,540       1,606       1,583  
    


 


 


 


 


Total revenues

     2,924,752       2,918,815       2,935,233       2,867,593       2,911,745  
    


 


 


 


 


EXPENSES:

                                        

Health plan services

     2,107,087       2,062,277       2,022,870       2,221,404 (f)     2,036,873  

Government contracts

     480,905       478,927       501,628       466,138       479,974  

General and administrative

     231,485       214,244       207,187       235,564 (f)     215,227  

Selling

     63,577       59,993       60,410       56,137       57,273  

Depreciation

     9,983       10,424       10,487       10,532       11,556  

Amortization

     606       606       789       861       861  

Interest

     8,438       7,304       8,044       9,347       10,609  
    


 


 


 


 


       2,902,081       2,833,775       2,811,415       2,999,983       2,812,373  

Litigation settlement, asset impairments and restructuring charges

     —         17,402 (b)     5,172 (b)     10,319 (e)     67,042 (g)

(Gain) loss on sale of businesses

     (1,875 )(a)     —         400 (c)     305 (d)     —    
    


 


 


 


 


Total expenses

     2,900,206       2,851,177       2,816,987       3,010,607       2,879,415  
    


 


 


 


 


Income (loss) from continuing operations before income taxes

     24,546       67,638       118,246       (143,014 )     32,330  

Income tax provision (benefit)

     9,534       26,272       46,391       (57,385 )     10,982 (h)
    


 


 


 


 


Net income (loss)

   $ 15,012     $ 41,366     $ 71,855     $ (85,629 )     21,348  
    


 


 


 


 


Basic earnings (loss) per share

   $ 0.13     $ 0.37     $ 0.64     $ (0.77 )   $ 0.19  

Diluted earnings (loss) per share

   $ 0.13     $ 0.36     $ 0.64     $ (0.77 )   $ 0.19  

Weighted average shares outstanding:

                                        

Basic

     112,600       112,574       111,440       110,844       111,544  

Diluted

     114,342       113,460       112,397       110,844       113,235  

Health plan services MCR

     87.6 %     86.0 %     84.5 %     94.0 %     85.0 %

Government contracts cost ratio

     95.4 %     95.0 %     95.4 %     95.6 %     96.6 %

Administrative ratio ((G&A+Dep) / (HP serv rev + Other income))

     10.0 %     9.4 %     9.1 %     10.4 %     9.5 %

Selling costs ratio (Selling costs / HP serv rev)

     2.6 %     2.5 %     2.5 %     2.4 %     2.4 %

Days claims payable

     45.2       46.6       46.2       44.7       51.4  

Effective tax rate

     38.84 %     38.84 %     39.23 %     40.13 %     33.97 %

Health plan services premiums PMPM

   $ 212.21     $ 215.98     $ 219.09     $ 222.30     $ 231.84  

Health plan services costs PMPM

   $ 185.97     $ 185.67     $ 185.19     $ 208.91     $ 196.96  

 

 

Page 11


Health Net, Inc.

Condensed Consolidated Balance Sheets

(Amounts in thousands, except ratio data)

 

     March 31,
2004


    June 30,
2004


    September 30,
2004


    December 31,
2004


    March 31,
2005


 

ASSETS

                                        

Current Assets

                                        

Cash and cash equivalents

   $ 684,782     $ 467,565     $ 622,903     $ 722,102     $ 765,842  

Investments - available for sale

     1,042,021       1,153,222       1,082,969       1,060,000       1,129,760  

Premiums receivable, net

     186,178       151,619       118,201       118,521       124,041  

Amounts receivable under government contracts

     121,037       128,960       136,335       129,483       134,447  

Incurred but not reported (IBNR) health care costs receivable under TRICARE North contract

     —         —         114,618       173,951       216,740  

Other receivables

     94,469       93,920       102,494       92,435       82,401  

Deferred taxes

     40,827       40,652       41,162       98,659       106,150  

Other assets

     92,404       103,907       99,578       97,163       112,044  
    


 


 


 


 


Total current assets

     2,261,718       2,139,845       2,318,260       2,492,314       2,671,425  

Property and equipment, net

     186,700       186,570       185,291       184,643       183,176  

Goodwill, net

     723,595       723,595       723,595       723,595       723,595  

Other intangible assets, net

     19,313       21,505       22,716       21,855       20,993  

Deferred taxes

     41,409       41,868       18,327       23,737       24,917  

Other noncurrent assets

     214,894       282,258       249,912       207,050       163,732  
    


 


 


 


 


Total Assets

   $ 3,447,629     $ 3,395,641     $ 3,518,101     $ 3,653,194     $ 3,787,838  
    


 


 


 


 


LIABILITIES AND STOCKHOLDERS’ EQUITY

                                        

Current Liabilities

                                        

Reserves for claims and other settlements

   $ 1,069,247     $ 1,042,831     $ 990,240     $ 1,169,297     $ 1,155,291  

Health care and other costs payable under government contracts

     233,331       216,816       201,494       119,219       128,570  

IBNR health care costs payable under TRICARE North contract

     —         —         114,618       173,951       216,740  

Unearned premiums

     95,614       85,894       78,832       139,766       115,859  

Accounts payable and other liabilities

     272,000       254,453       296,782       258,923       348,068  
    


 


 


 


 


Total current liabilities

     1,670,192       1,599,994       1,681,966       1,861,156       1,964,528  

Senior notes payable

     406,603       384,220       401,750       397,760       388,981  

Other noncurrent liabilities

     78,958       95,243       81,657       121,398       126,471  
    


 


 


 


 


Total Liabilities

     2,155,753       2,079,457       2,165,373       2,380,314       2,479,980  
    


 


 


 


 


Stockholders’ Equity

                                        

Common stock and additional paid-in capital

     794,602       798,432       805,426       811,426       834,412  

Restricted common stock

     6,027       5,855       6,483       7,188       7,859  

Unearned compensation

     (3,624 )     (3,121 )     (3,999 )     (4,110 )     (4,095 )

Treasury common stock, at cost

     (577,484 )     (580,634 )     (632,926 )     (632,926 )     (632,926 )

Retained earnings

     1,066,788       1,108,154       1,180,009       1,094,380       1,115,728  

Accumulated other comprehensive income (loss)

     5,567       (12,502 )     (2,265 )     (3,078 )     (13,120 )
    


 


 


 


 


Total Stockholders’ Equity

     1,291,876       1,316,184       1,352,728       1,272,880       1,307,858  
    


 


 


 


 


Total Liabilities and Stockholders’ Equity

   $ 3,447,629     $ 3,395,641     $ 3,518,101     $ 3,653,194     $ 3,787,838  
    


 


 


 


 


Debt-to-Total Capital Ratio

     23.9 %     22.6 %     22.9 %     23.8 %     22.9 %

 

Page 12


Health Net, Inc.

Condensed Consolidated Statements of Cash Flows

(Amounts in thousands)

 

     First Quarter
Ended
March 31,
2004


   

Second Quarter
Ended

June 30,

2004


    Third Quarter
Ended
September 30,
2004


    Fourth Quarter
Ended
December 31,
2004


    First Quarter
Ended
March 31,
2005


 

CASH FLOWS FROM OPERATING ACTIVITIES:

                                        

Net income (loss)

   $ 15,012     $ 41,366     $ 71,855     $ (85,629 )   $ 21,348  

Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities:

                                        

Amortization and depreciation

     10,589       11,030       11,276       11,393       12,417  

(Gain) loss on sale of businesses

     (1,875 )     —         400       305       —    

Asset impairments

     —         —         —         5,916       —    

Other changes

     (898 )     1,518       546       2,803       3,189  

Changes in assets and liabilities, net of the effects of dispositions:

                                        

Premiums receivable and unearned premiums

     (130,211 )     24,839       26,356       60,614       (29,427 )

Other receivables, deferred taxes and other assets

     4,718       515       5,140       (96,872 )     (6,685 )

Amounts receivable/payable under government contracts

     (52,787 )     (24,438 )     (22,697 )     (75,423 )     4,387  

Reserves for claims and other settlements

     42,962       (26,416 )     (52,591 )     179,057       (14,006 )

Accounts payable and other liabilities

     (42,085 )     (15,900 )     44,267       433       103,928  
    


 


 


 


 


Net cash (used in) provided by operating activities

     (154,575 )     12,514       84,552       2,597       95,151  
    


 


 


 


 


CASH FLOWS FROM INVESTING ACTIVITIES:

                                        

Sales of investments

     125,015       65,320       79,438       12,751       23,090  

Maturities of investments

     112,345       84,102       30,632       47,171       13,777  

Purchases of investments

     (186,289 )     (284,446 )     (22,774 )     (4,846 )     (125,650 )

Purchases of property and equipment

     (5,853 )     (10,045 )     (9,178 )     (12,870 )     (10,392 )

Cash received (paid) from the sale of businesses

     11,026       —         (400 )     486       1,949  

Sales and purchases of restricted investments and other

     (49,279 )     (84,552 )     39,307       48,697       29,246  
    


 


 


 


 


Net cash provided by (used in) investing activities

     6,965       (229,621 )     117,025       91,389       (67,980 )
    


 


 


 


 


CASH FLOWS FROM FINANCING ACTIVITIES:

                                        

Proceeds from exercise of stock options and employee stock purchases

     4,785       3,040       6,053       5,213       16,569  

Repurchases of common stock

     (33,264 )     (3,150 )     (52,292 )     —         —    
    


 


 


 


 


Net cash (used in) provided by financing activities

     (28,479 )     (110 )     (46,239 )     5,213       16,569  
    


 


 


 


 


Net (decrease) increase in cash and cash equivalents

     (176,089 )     (217,217 )     155,338       99,199       43,740  

Cash and cash equivalents, beginning of period

     860,871       684,782       467,565       622,903       722,102  
    


 


 


 


 


Cash and cash equivalents, end of period

   $ 684,782     $ 467,565     $ 622,903     $ 722,102     $ 765,842  
    


 


 


 


 


 

Page 13


Health Net, Inc.

Notes to Condensed Consolidated Statements of Operations

 

Notes:

 

(a) Pretax $1.9 million gain on the sales of our Subacute subsidiaries.
(b) Pretax severance and related benefit costs related to our workforce reduction announced in May 2004.
(c) Pretax $0.4 million additional loss on the sale of our Florida health plan resulting from the stock purchase and reinsurance settlement agreements dated September 30, 2004.
(d) Pretax $0.3 million additional loss on the sale of Denticare and Vision.
(e) Pretax $10.3 million asset impairments and restructuring charges due to the following:

$5.9 million asset impairment charge taken on certain investments and fixed assets

$2.7 million for severance and related benefit costs related to our workforce reduction announced in May 2004

$1.7 million for lease termination costs

(f) Includes pretax $158 million provider dispute charge and related legal costs of $11 million.
(g) Pretax $67.0 million litigation settlement and restructuring charges due to the following:

$65.6 million litigation settlement

$1.4 million for severance and related benefit costs related to our workforce reduction announced in May 2004.

(h) Includes $2.2 million of income tax benefit related to the sale of a small subsidiary.

 

Page 14


HEALTH NET, INC.

Medical Covered Lives at March 31, 2005

(in Thousands)

 

    Commercial -Large Group*

 

Commercial -Small

Group & Individual


  Commercial Risk Subtotal

  ASO

  Commercial Subtotal

    03/05

  12/04

  03/04

  03/05

  12/04

  03/04

  03/05

  12/04

  03/04

  03/05

  12/04

  03/04

  03/05

  12/04

  03/04

Arizona

  66   74   70   54   55   52   120   129   122   —     —     —     120   129   122

California

  1,113   1,101   1,194   433   459   524   1,546   1,560   1,718   7   3   3   1,552   1,564   1,721

Connecticut

  182   192   202   38   41   44   220   233   246   48   51   52   268   284   298

New Jersey

  71   98   133   98   111   147   169   210   279   18   18   18   188   228   297

New York

  124   144   157   106   108   114   230   252   271   21   7   7   251   259   277

Oregon

  103   105   91   34   33   31   137   138   121   1   1   —     138   139   121
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Total

  1,659   1,714   1,846   763   808   912   2,422   2,523   2,758   95   81   79   2,516   2,603   2,837
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Year over Year

      (10)%           (16)%           (12)%           20%           (11)%    

Sequential

      (3)%           (6)%           (4)%           18%           (3)%    
    Medicare Risk

  Medicaid

  Health Plan Total

                       
    03/05

  12/04

  03/04

  03/05

  12/04

  03/04

  03/05

  12/04

  03/04

                       

Arizona

  32   35   36   —     —     —     152   164   158                        

California

  93   95   98   696   696   691   2,341   2,355   2,510                        

Connecticut

  27   27   27   93   94   98   388   405   423                        

New Jersey

  —     —     —     42   42   44   229   270   341                        

New York

  6   6   5   —     —     —     256   265   283                        

Oregon

  12   9   3   —     —     —     150   148   124                        
   
 
 
 
 
 
 
 
 
                       

Total

  169   171   169   831   831   833   3,517   3,605   3,840                        
   
 
 
 
 
 
 
 
 
                       

Year over Year

      (0)%           (0)%           (8)%                            

Sequential

      (1)%           (0)%           (2)%                            
    03/05

  12/04

  03/04

                                               

TRICARE

                                                           

Previous TRICARE Contracts **

  —     —     1,477                                                

North Contract ***

  2,941   2,929   —                                                  
   
 
 
                                               

Total TRICARE

  2,941   2,929   1,477                                                

* Commercial Large Group includes Medicare Supplement
** Includes only Tricare eligible for which we have health care risk
*** Includes Tricare eligible for which we have health care risk, and those for which we provide Administrative Services Only (ASO), primarily active duty

 

Page 15


Health Net, Inc.

Reconciliation of Reserve For Claims And Other Settlements

(In thousands)

 

     Health Plan Services

 
     Q1 2005

    Year 2004

   Year 2003

 

Reserve for claims (a), beginning of period

   $ 794,614     $ 777,059    $ 787,317  

Divested health plans (b)

     —         —        (5,119 )

Incurred claims related to:

                       

Current Year

     1,329,557       5,048,289      4,487,698  

Prior Years (d)

     (29,555 )     8,769      (33,812 )
    


 

  


Total Incurred (c)

     1,300,002       5,057,058      4,453,886  

Paid claims related to:

                       

Current Year

     757,454       4,286,929      3,738,599  

Prior Years

     510,213       752,574      720,426  
    


 

  


Total Paid (c)

     1,267,667       5,039,503      4,459,025  

Reserve for claims (a), end of period

     826,949       794,614      777,059  

Add:

                       

Claims Payable

     239,461       288,331      167,361  

Other (e)

     88,881       86,352      80,130  
    


 

  


Reserves for claims and other settlements, end of period

   $ 1,155,291     $ 1,169,297    $ 1,024,550  
    


 

  



(a) Consists of incurred but not reported claims and received but unprocessed claims and reserves for loss adjustment expenses.
(b) Adjustment for 2003 consists primarily of reductions in reserves for claims resulting from the sales of our dental and vision plans.
(c) Includes medical claims only. Capitation, pharmacy and other payments including provider settlements are not included.
(d) The change in “incurred related to prior years” claims was offset by an increase in the “incurred related to current year” claims amount.
(e) Includes accrued capitation, shared risk settlements, provider incentives and other reserve items.

 

Page 16


Health Net, Inc. (a)

Consolidated Statements of Operations

(Amounts in thousands, except for earnings per share)

 

    

First Quarter
Ended March 31,
2004

(Actual)


    Impact of
Selected Costs
Recorded in the
First Quarter
Ended March 31,
2004


 

REVENUES

              

Health plan services premiums

   $ 2,404,355        

Government contracts

     503,948        

Investment income

     15,201        

Other income

     1,248        
    


 

Total revenues

     2,924,752     —    
    


 

EXPENSES

              

Health plan services

     2,107,087     (43,479 )

Government contracts

     480,905        

General and administrative

     231,485     (2,713 )

Selling

     63,577        

Depreciation

     9,983        

Amortization

     606        

Interest

     8,438        

Asset impairment and restructuring charges

     —       —    

Net (gain) loss on sale of businesses and properties

     (1,875 )   1,875  
    


 

Total expenses

     2,900,206     (44,317 )
    


 

Income before income taxes and cumulative effect of a change in accounting principle

     24,546     44,317  

Income tax provision

     9,534        
    


     

Net income

     15,012        
    


     

Basic earnings (loss) per share

   $ 0.13        

Diluted earnings (loss) per share

   $ 0.13        

Weighted average shares outstanding

              

Basic

     112,600        

Diluted Shares

     114,342        

(a) This table presents the company’s consolidated statement of operations for the first quarter of 2004 (column 1), and the impact of provider settlement expenses, net prior period reserve developments, and other one-time items to the consolidated statement of operations for the first quarter of 2004 (column 2).

 

Page 17