-----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, J+Cl4ahQCxn4UGiAIhVShjDvny5XlAt4D2TeEW05G4QQTsiXIpjkurVaC3ZvCjAD mGptEbIHc5RLyy6SrUrLGA== 0001193125-06-016756.txt : 20060201 0001193125-06-016756.hdr.sgml : 20060201 20060201080411 ACCESSION NUMBER: 0001193125-06-016756 CONFORMED SUBMISSION TYPE: 8-K PUBLIC DOCUMENT COUNT: 3 CONFORMED PERIOD OF REPORT: 20060201 ITEM INFORMATION: Results of Operations and Financial Condition ITEM INFORMATION: Financial Statements and Exhibits FILED AS OF DATE: 20060201 DATE AS OF CHANGE: 20060201 FILER: COMPANY DATA: COMPANY CONFORMED NAME: HEALTH NET INC CENTRAL INDEX KEY: 0000916085 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 954288333 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 8-K SEC ACT: 1934 Act SEC FILE NUMBER: 001-12718 FILM NUMBER: 06567818 BUSINESS ADDRESS: STREET 1: 21650 OXNARD ST CITY: WOODLAND HILLS STATE: CA ZIP: 91367 BUSINESS PHONE: 8186766000 MAIL ADDRESS: STREET 1: 225 N MAIN ST CITY: PUEBLO STATE: CO ZIP: 81003 FORMER COMPANY: FORMER CONFORMED NAME: FOUNDATION HEALTH SYSTEMS INC DATE OF NAME CHANGE: 19970513 FORMER COMPANY: FORMER CONFORMED NAME: HEALTH SYSTEMS INTERNATIONAL INC DATE OF NAME CHANGE: 19940207 FORMER COMPANY: FORMER CONFORMED NAME: HN MANAGEMENT HOLDINGS INC/DE/ DATE OF NAME CHANGE: 19931213 8-K 1 d8k.htm FORM 8-K Form 8-K

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, D.C. 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): FEBRUARY 1, 2006

 

HEALTH NET, INC.

(Exact Name of Registrant as Specified in Charter)

 

Delaware   1-12718   95-4288333

(State or other Jurisdiction of

Incorporation)

  (Commission File Number)  

(IRS Employer

Identification No.)

 

21650 Oxnard Street

Woodland Hills, California 91367

(Address of Principal Executive Offices) (Zip Code)

 

(818) 676-6000

(Registrant’s telephone number, including area code)

 

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:

 

¨ 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))

 



Section 2- Financial Information

 

Item 2.02 Results of Operations and Financial Condition.

 

On February 1, 2006, Health Net, Inc. (the “Company”) issued a press release announcing its earnings for the quarter and year ended December 31, 2005. The press release discloses certain financial information, such as days claims payable and earnings per share, that is considered non-GAAP financial information. The Company believes this non-GAAP financial information provides useful information to both management and investors by excluding certain expenses and other one-time items that are not indicative of our core operating results. Management refers to this financial information to facilitate internal and external comparisons to the Company’s historical operating results and for forecasting purposes. This non-GAAP financial information should be considered in addition to, not as a substitute for financial information prepared in accordance with GAAP. As used herein, “GAAP” refers to accounting principles generally accepted in the United States.

 

The press release is attached hereto as Exhibit 99.1 and hereby incorporated in this Item 2.02 by reference.

 

Section 9- Financial Statements and Exhibits

 

Item 9.01 Financial Statements and Exhibits.

 

(c) Exhibits

 

99.1    Press Release dated February 1, 2006 announcing results for the quarter and year ended December 31, 2005 for Health Net, Inc.


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.

 

Date: February 1, 2006

 

HEALTH NET, INC.
By:  

/s/ B. Curtis Westen

   

B. Curtis Westen

Senior Vice President, General

Counsel and Secretary

EX-99.1 2 dex991.htm PRESS RELEASE DATED FEBRUARY 1, 2006 Press Release dated February 1, 2006

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 $77 MILLION, OR $.65 PER DILUTED SHARE

 

Lower Medical Costs Drive Improved Performance

 

LOS ANGELES, February 1, 2006 – Health Net, Inc. (NYSE: HNT) today announced 2005 fourth quarter net income per diluted share of $.65 compared with a net loss per diluted share of $.77 in the fourth quarter of 2004.

 

Health Net reported net income of $76,669,000 in the fourth quarter of 2005 compared to a net loss of $85,629,000 in the fourth quarter of 2004. The fourth quarter of


2004 included the following pretax charges and expenses, which reduced that quarter’s pretax income by an aggregate of $252 million:

 

    $169 million for the settlement of provider disputes and related legal costs;

 

    $65 million of expenses for reserve strengthening; and

 

    $18 million in asset impairment and restructuring charges and other expenses.

 

Positive developments for the fourth quarter of 2005 included:

 

    Pretax margin was 4.3 percent, continuing the sequential improvement that started in the first quarter of 2005, and reflecting the company’s focus on this important measure. Pretax margin for the full year of 2005 was 3.2 percent compared to 0.6 percent for the full year of 2004.

 

    Commercial Per Member Per Month (PMPM) yields increased by 9.7 percent in the fourth quarter of 2005 compared to the fourth quarter of 2004. Full year commercial premium yields increased in 2005 by 10.9 percent, up from 8.4 percent recorded for the full year of 2004.

 

    Health Net’s Health Plan Medical Care Ratio (MCR) was 82.5 percent, a 1,150 basis point improvement compared to the 94.0 percent reported in the fourth quarter of 2004, and a 90 basis point improvement compared to the 83.4 percent reported in the third quarter of 2005, as inpatient hospital utilization fell in most of the company’s health plans; and

 

   

The company’s debt-to-total capital ratio was 19.6 percent in the fourth quarter of 2005, a 420 basis point improvement compared to the 23.8 percent reported in the fourth quarter of 2004, and a 110 basis point improvement

 

2


compared to the 20.7 percent reported in the third quarter of 2005. This is the first time that this ratio has been below 20 percent in more than five years.

 

“In 2005, Health Net met virtually every target for improved performance we set for ourselves. These fourth quarter results further reinforce the progress we’ve made – including significant progress in improving margins and health care costs alike,” said Jay Gellert, president and chief executive officer of Health Net. “With strong franchises across multiple geographies – in commercial, Medicare, Medicaid, TRICARE and the behavioral health business – we believe we have the diverse business platform in place to deliver continued, improved results.”

 

Revenues

 

Health Net’s total revenues increased 2.9 percent in the fourth quarter of 2005 to $2,950,158,000 from $2,867,593,000 in the fourth quarter of 2004. Health plan services premiums were essentially flat at $2,367,057,000 in the fourth quarter of 2005 compared to $2,363,786,000 in the fourth quarter of 2004. In the fourth quarter of 2005, Health Net’s Government contracts revenue rose 14.9 percent from the fourth quarter of 2004, increasing by $72,668,000 to $560,491,000. Government contracts revenue declined by $79,135,000 in the fourth quarter of 2005 compared to the third quarter of 2005. “This sequential decline was due primarily to the seasonality of the TRICARE business,” said Buddy Piszel, executive vice president and chief financial officer of Health Net.

 

In the fourth quarter of 2005, the overall health plan revenue PMPM, including commercial, Medicare and Medicaid revenue, rose 8.5 percent compared to the same period in 2004. Commercial premium yields climbed 9.7 percent in the fourth quarter of 2005 compared to the fourth quarter of 2004 and by 10.9 percent for the full year 2005 compared to the full year of 2004.

 

3


“The premium yields we achieved in the fourth quarter of 2005 were consistent with our expectations as pricing more closely reflected improving health care cost trends,” noted Piszel.

 

Total health plan enrollment fell by approximately 43,000 members, or 1.3 percent, in the fourth quarter of 2005 compared to the third quarter of 2005. In the same period, Medicare enrollment rose by approximately 2,000 members while Medicaid enrollment decreased by approximately 3,000 members. Commercial enrollment, including both at-risk and Administrative Services Only (ASO) membership, declined by approximately 42,000 members, or 1.7 percent, in the fourth quarter of 2005 compared to the third quarter of 2005.

 

For the full year 2005, total health plan enrollment declined by approximately 221,000 members, or 6.1 percent. “The rate of decline in our commercial enrollment continues to ease and we are seeing encouraging signs beginning to emerge as product introductions and pricing actions show promise for stability and growth in the second half of 2006,” Piszel said.

 

Health Care Costs

 

The health plan MCR improved to 82.5 percent in the fourth quarter of 2005 from 94.0 percent in the fourth quarter of 2004 and improved by 90 basis points compared to the third quarter of 2005. The sequential decrease in the health plan MCR reflects improved inpatient hospital utilization.

 

4


Overall PMPM health plan health care costs declined by 4.8 percent in the fourth quarter of 2005 compared to the fourth quarter of 2004. Commercial health care costs PMPM declined by 6.5 percent over the same period. These year-over-year results were impacted by the health care cost-related charges taken in the fourth quarter of 2004.

 

The Government contracts cost ratio of 95.6 percent in the fourth quarter of 2005 was unchanged from the fourth quarter of 2004 and represented an improvement of 50 basis points compared to the third quarter of 2005. “This margin was consistent with our expectations for the fourth quarter and should continue at approximately this level in 2006,” Piszel noted. The pretax margin remained steady despite revenue fluctuations in 2005.

 

Medicare

 

The company is the fifth largest Medicare Advantage contractor in the United States based on enrollment, with approximately 174,000 members in its Medicare Advantage plans at the end of the fourth quarter of 2005. In January 2006, Medicare Advantage added more than 8,500 new members. “We are pleased by the acceleration in our Medicare Advantage enrollment growth,” commented Piszel.

 

The company began offering the new Part D prescription drug benefit to seniors in 10 states on January 1, 2006. “We are very pleased by the response to our Part D plans and enrollment is ahead of expectations,” said Gellert. “We are proud to have enrolled in excess of 220,000 dual-eligible members to date. Our target was to enroll 30,000 stand-alone Part D members by year-end 2006, and we are ahead of schedule in meeting that goal. Initiating this program was a significant effort and Health Net associates are working diligently to ensure that all Part D members who need their prescriptions receive them.”

 

5


Administrative Expenses

 

In the fourth quarter of 2005, total general, administrative and depreciation expenses increased by $24,409,000 to $270,263,000 compared to expenses of $245,854,000 in the third quarter of 2005 and increased by $24,167,000 compared to $246,096,000 in the fourth quarter of 2004. “The increase in spending during the quarter was due to increased Medicare-related spending and commercial advertising supporting the annual open enrollment period,” commented Piszel.

 

Health Net’s selling expenses decreased by $2,937,000 to $53,200,000 in the fourth quarter of 2005 compared with $56,137,000 in the same period in 2004, a reflection of the decline in Small Group and Individual enrollment over the same periods. The selling costs ratio was 2.2 percent for the fourth quarter of 2005 compared with 2.4 percent in the same period last year.

 

Balance Sheet Highlights

 

Cash and investments as of December 31, 2005 were $2,106,303,000 compared with $2,178,586,000 as of September 30, 2005.

 

Reserves for claims and other settlements decreased by $17,677,000 to $1,040,171,000 at December 31, 2005 from $1,057,848,000 at September 30, 2005. This includes a $21.3 million reduction for provider settlements paid during the fourth quarter of 2005.

 

Days claims payable (DCP), excluding provider settlement reserves related to the charge taken in the fourth quarter of 2004 and capitation expenses, increased by 2.4 days for the fourth quarter of 2005 to 63.5 days compared to 61.1 days for the third quarter of 2005. On a reported basis, DCP were 49.4 days for the fourth quarter of 2005 compared to

 

6


48.8 days in the third quarter of 2005. A table reconciling the calculation of DCP is included in the notes to the Condensed Consolidated Statements of Operations attached to this release.

 

“We are very pleased that our reserve position continued to strengthen as we moved through 2005. We believe the increase in days claims payable and favorable development in the roll-forward table both demonstrate that we have a strong reserve posture,” Piszel said.

 

The company’s debt-to-total capital ratio was 19.6 percent as of December 31, 2005 compared to 20.7 percent as of September 30, 2005.

 

Interest expense was nearly unchanged in the fourth quarter of 2005 compared with the third quarter of 2005. Compared with the fourth quarter of 2004, interest expense was $2,343,000 higher due to higher market interest rates.

 

Cash Flow

 

Operating cash flow was a negative $67,808,000 in the fourth quarter of 2005 compared to positive operating cash flow of $2,597,000 in the fourth quarter of 2004. The company only received two monthly Medicare payments from the Centers for Medicare & Medicaid Services (CMS) in the fourth quarter of 2005. Had the company received three CMS monthly payments in the fourth quarter of 2005, cash flow would have been positive for the quarter on a reported basis. Operating cash flow for the full year 2005 was $191,394,000 compared to a negative $54,912,000 for the full year 2004. The transition to the new TRICARE North contract and higher levels of paid claims throughout the year negatively impacted cash flow in 2004.

 

7


Universal Care Acquisition

 

On January 5, 2006, Health Net announced that it entered into a definitive agreement to acquire Universal Care, Inc.’s health plan assets. Upon closing of this acquisition, Health Net expects to add approximately 75,000 commercial members, 5,000 Medicare Advantage members, and 20,000 Healthy Family members. The acquisition is expected to close in the first half of 2006, subject to customary closing conditions.

 

Outlook

 

Health Net believes its earnings per diluted share for the full year 2006 will be between $2.90 and $3.10. The 2006 earnings per diluted share guidance reflects anticipated costs of between $.10 and $.12 per diluted share for expensing stock options.

 

Conference Call

 

As previously announced, Health Net will discuss the company’s fourth quarter and year-end 2005 results during a conference call scheduled on Wednesday, February 1, 2006, at approximately 11:00 a.m. Eastern Time. To listen to the call, please dial 800.946.0782, code 8447467. 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 from February 1, 2006 through February 5, 2006, by dialing 888.203.1112, code 8447467. Anyone listening to the company’s conference call will be presumed to have read Health Net’s reports filed from time to time with the Securities and Exchange Commission.

 

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

 

8


company’s HMO, POS, insured PPO and government contracts subsidiaries provide health benefits to approximately 6.3 million individuals in 27 states and the District of Columbia through group, individual, Medicare, Medicaid and TRICARE and Veterans Affairs programs. Health Net’s behavioral health subsidiary, MHN, provides mental health benefits to approximately 7.3 million individuals in all 50 states. The company’s subsidiaries also offer managed health care products related to 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

 

This release contains 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, litigation costs, operational issues, health care reform and general

 

9


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.

 

#     #     #

 

[Six pages of tables follow]

 

10


Health Net, Inc.

Condensed Consolidated Statements of Operations

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

 

     Fourth Quarter
Ended
December 31,
2004


    First Quarter
Ended
March 31,
2005


   

Second Quarter
Ended

June 30,

2005


    Third Quarter
Ended
September 30,
2005


    Fourth Quarter
Ended
December 31,
2005


 

REVENUES:

                                        

Health plan services premiums

   $ 2,363,786     $ 2,397,689     $ 2,390,679     $ 2,398,100     $ 2,367,057  

Government contracts

     487,823       496,710       610,656       639,626       560,491  

Net investment income

     14,378       15,763       17,213       19,536       20,239  

Other income

     1,606       1,583       1,309       1,511       2,371  
    


 


 


 


 


Total revenues

     2,867,593       2,911,745       3,019,857       3,058,773       2,950,158  
    


 


 


 


 


                                          

EXPENSES:

                                        

Health plan services

     2,221,404 (a)     2,036,873       2,023,174       2,000,661       1,952,309  

Government contracts

     466,138       479,974       580,685       614,794       535,800  

General and administrative

     235,564 (a)     215,227       233,723       241,847       266,043  

Selling

     56,137       57,273       56,082       55,000       53,200  

Depreciation

     10,532       11,556       10,467       4,007       4,220  

Amortization

     861       861       861       861       861  

Interest

     9,347       10,609       10,543       11,789       11,690  
    


 


 


 


 


       2,999,983       2,812,373       2,915,535       2,928,959       2,824,123  

Litigation, asset impairments and restructuring charges

     10,319 (b)     67,042 (d)     16,237 (f)     —         —    

Loss on sale of businesses

     305 (c)     —         —         —         —    
    


 


 


 


 


Total expenses

     3,010,607       2,879,415       2,931,772       2,928,959       2,824,123  
    


 


 


 


 


(Loss) income from continuing operations before income taxes

     (143,014 )     32,330       88,085       129,814       126,035  

Income tax (benefit) provision

     (57,385 )     10,982 (e)     34,522       51,609       49,366  
    


 


 


 


 


Net (loss) income

   $ (85,629 )     21,348       53,563       78,205       76,669  
    


 


 


 


 


Basic (loss) earnings per share

   $ (0.77 )   $ 0.19     $ 0.48     $ 0.69     $ 0.67  

Diluted (loss) earnings per share

   $ (0.77 )   $ 0.19     $ 0.47     $ 0.67     $ 0.65  

Weighted average shares outstanding:

                                        

Basic

     110,844       111,544       112,451       113,371       114,276  

Diluted

     110,844       113,235       114,851       116,543       117,902  

Pretax margin

     N/A       1.1 %     2.9 %     4.2 %     4.3 %

Health plan services MCR

     94.0 %     85.0 %     84.6 %     83.4 %     82.5 %

Government contracts cost ratio

     95.6 %     96.6 %     95.1 %     96.1 %     95.6 %

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

     10.4 %     9.5 %     10.2 %     10.2 %     11.4 %

Selling costs ratio (Selling costs / HP serv rev)

     2.4 %     2.4 %     2.3 %     2.3 %     2.2 %

Days claims payable (g)

     44.7       51.4       49.9       48.8       49.4  

Days claims payable (excluding capitation and provider settlements) (g)

     59.2       59.9       60.3       61.1       63.5  

Effective tax rate

     40.13 %     33.97 %     39.19 %     39.76 %     39.17 %

Health plan services premiums PMPM

   $ 222.30     $ 231.84     $ 235.03     $ 240.10     $ 241.13  

Health plan services costs PMPM

   $ 208.91     $ 196.96     $ 198.90     $ 200.31     $ 198.88  

 

11


Health Net, Inc.

Condensed Consolidated Balance Sheets

(Amounts in thousands, except ratio data)

 

     December 31,
2004


    March 31,
2005


    June 30,
2005


    September 30,
2005


    December 31,
2005


 

ASSETS

                                        

Current Assets

                                        

Cash and cash equivalents

   $ 722,102     $ 765,842     $ 939,057     $ 1,027,848     $ 742,485  

Investments - available for sale

     1,060,000       1,129,760       1,060,936       1,150,738       1,363,818  

Premiums receivable, net

     118,521       124,041       119,776       127,020       132,019  

Amounts receivable under government contracts

     129,483       134,447       139,540       122,295       122,796  

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

     173,951       216,740       184,214       263,329       265,517  

Other receivables

     92,435       82,401       89,437       85,873       79,572  

Deferred taxes

     98,659       106,150       100,277       110,445       93,899  

Other assets

     97,163       112,044       118,904       107,618       111,512  
    


 


 


 


 


Total current assets

     2,492,314       2,671,425       2,752,141       2,995,166       2,911,618  

Property and equipment, net

     184,643       183,176       103,314       112,218       125,773  

Goodwill, net

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

Other intangible assets, net

     21,855       20,993       20,132       19,271       18,409  

Deferred taxes

     23,737       24,917       26,941       29,527       31,060  

Other noncurrent assets

     207,050       163,732       148,647       143,555       130,267  
    


 


 


 


 


Total Assets

   $ 3,653,194     $ 3,787,838     $ 3,774,770     $ 4,023,332     $ 3,940,722  
    


 


 


 


 


                                          

LIABILITIES AND STOCKHOLDERS’ EQUITY

                                        

Current Liabilities

                                        

Reserves for claims and other settlements

   $ 1,169,297     $ 1,155,291     $ 1,065,465     $ 1,057,848     $ 1,040,171  

Health care and other costs payable under government contracts

     119,219       128,570       131,909       62,778       62,536  

IBNR health care costs payable under TRICARE North contract

     173,951       216,740       184,214       263,329       265,517  

Unearned premiums

     139,766       115,859       97,038       218,527       106,586  

Accounts payable and other liabilities

     258,923       348,068       385,995       404,362       364,266  
    


 


 


 


 


Total current liabilities

     1,861,156       1,964,528       1,864,621       2,006,844       1,839,076  

Senior notes payable

     397,760       388,981       400,659       391,106       387,954  

Other noncurrent liabilities

     121,398       126,471       116,824       123,376       124,617  
    


 


 


 


 


Total Liabilities

     2,380,314       2,479,980       2,382,104       2,521,326       2,351,647  
    


 


 


 


 


Stockholders’ Equity

                                        

Common stock and additional paid-in capital

     811,426       834,412       857,513       894,984       906,926  

Restricted common stock

     7,188       7,859       7,505       7,164       6,883  

Unearned compensation

     (4,110 )     (4,095 )     (3,423 )     (2,748 )     (2,137 )

Treasury common stock, at cost

     (632,926 )     (632,926 )     (632,926 )     (633,153 )     (633,375 )

Retained earnings

     1,094,380       1,115,728       1,169,291       1,247,496       1,324,165  

Accumulated other comprehensive loss

     (3,078 )     (13,120 )     (5,294 )     (11,737 )     (13,387 )
    


 


 


 


 


Total Stockholders’ Equity

     1,272,880       1,307,858       1,392,666       1,502,006       1,589,075  
    


 


 


 


 


Total Liabilities and Stockholders’ Equity

   $ 3,653,194     $ 3,787,838     $ 3,774,770     $ 4,023,332     $ 3,940,722  
    


 


 


 


 


Debt-to-Total Capital Ratio

     23.8 %     22.9 %     22.3 %     20.7 %     19.6 %

 

12


Health Net, Inc.

Condensed Consolidated Statements of Cash Flows

(Amounts in thousands)

 

     Fourth Quarter
Ended
December 31,
2004


    First Quarter
Ended
March 31,
2005


   

Second Quarter
Ended

June 30,

2005


    Third Quarter
Ended
September 30,
2005


    Fourth Quarter
Ended
December 31,
2005


 

CASH FLOWS FROM OPERATING ACTIVITIES:

                                        

Net (loss) income

   $ (85,629 )   $ 21,348     $ 53,563     $ 78,205     $ 76,669  

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

                                        

Amortization and depreciation

     11,393       12,417       11,328       4,868       5,081  

Loss on sale of businesses

     305       —         —         —         —    

Asset impairments

     5,916       —         —         —         —    

Other changes

     2,803       3,189       3,100       3,229       3,032  

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

                                        

Premiums receivable and unearned premiums

     60,614       (29,427 )     (14,556 )     114,245       (116,940 )

Other receivables, deferred taxes and other assets

     (96,872 )     (6,685 )     (14,336 )     4,901       18,476  

Amounts receivable/payable under government contracts

     (75,423 )     4,387       (1,754 )     (51,886 )     (743 )

Reserves for claims and other settlements

     179,057       (14,006 )     (89,826 )     (7,617 )     (17,677 )

Accounts payable and other liabilities

     433       103,928       41,761       28,826       (35,706 )
    


 


 


 


 


Net cash provided by (used in) operating activities

     2,597       95,151       (10,720 )     174,771       (67,808 )
    


 


 


 


 


CASH FLOWS FROM INVESTING ACTIVITIES:

                                        

Sales of investments

     12,751       23,090       184,483       13,283       179,102  

Maturities of investments

     47,171       13,777       38,653       20,215       41,037  

Purchases of investments

     (4,846 )     (125,650 )     (143,776 )     (126,917 )     (437,250 )

Proceeds from sale of property and equipment

     195       33       79,395       417       —    

Purchases of property and equipment

     (13,065 )     (10,425 )     (7,441 )     (13,242 )     (17,738 )

Cash received from the sale of businesses

     486       1,949       —         —         —    

Sales and purchases of restricted investments and other

     48,697       29,246       13,460       (8,840 )     9,093  
    


 


 


 


 


Net cash provided by (used in) investing activities

     91,389       (67,980 )     164,774       (115,084 )     (225,756 )
    


 


 


 


 


CASH FLOWS FROM FINANCING ACTIVITIES:

                                        

Proceeds from exercise of stock options and employee stock purchases

     5,213       16,569       19,161       29,331       8,423  

Repurchases of common stock

     —         —         —         (227 )     (222 )
    


 


 


 


 


Net cash provided by financing activities

     5,213       16,569       19,161       29,104       8,201  
    


 


 


 


 


Net increase (decrease) in cash and cash equivalents

     99,199       43,740       173,215       88,791       (285,363 )

Cash and cash equivalents, beginning of period

     622,903       722,102       765,842       939,057       1,027,848  
    


 


 


 


 


Cash and cash equivalents, end of period

   $ 722,102     $ 765,842     $ 939,057     $ 1,027,848     $ 742,485  
    


 


 


 


 


 

13


Health Net, Inc.

Notes to Condensed Consolidated Statements of Operations

 

Notes:

 

(a) Health plan services expense reflects a pretax charge of $158 million for estimated costs to settle provider disputes and general and administrative expense reflects a pretax charge of $11 million for related legal costs.

 

(b) Pretax $10.3 million charge for asset impairments and restructuring charges include 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

 

(c) Pretax $0.3 million additional loss on the sale of Denticare and Vision subsidiaries.

 

(d) Pretax $67.0 million charge for litigation settlement and restructuring charges included the following:

$65.6 million related to settlement of the MDL physician-class lawsuit

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

 

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

 

(f) Pretax $15.9 million charge representing total estimated legal defense costs associated with the AmCareco case, and $0.3 million for severance and related benefit costs related to our workforce reduction announced in May 2004

 

(g)

 

Calculation of Days Claims Payable (Excluding Capitation and Provider Settlements)

 

          Q4 2004

    Q1 2005

    Q2 2005

    Q3 2005

    Q4 2005

 
          (Dollars in thousands)  
    

Reserve for Claims and Other Settlements

   $ 1,169,297     $ 1,155,291     $ 1,065,465     $ 1,057,848     $ 1,040,171  
    

Less: Capitation Payable and Provider Settlements

     (203,753 )     (169,733 )     (132,795 )     (105,154 )     (95,422 )
         


 


 


 


 


    

Adjusted Reserve for Claims and Other Settlements

   $ 965,544     $ 985,558     $ 932,670     $ 952,694     $ 944,749  
(1)   

Average Reserve for Claims and Other Settlements

   $ 1,079,769     $ 1,162,294     $ 1,110,378     $ 1,061,657     $ 1,049,010  
(2)   

Average Adjusted Reserve for Claims and Other Settlements

   $ 941,408     $ 975,551     $ 959,114     $ 942,682     $ 948,722  
(3)   

Health Plan Services Cost

     2,221,404       2,036,873       2,023,174       2,000,661       1,952,309  
    

Less: Capitation Expense and Provider Settlements

     (757,496 )     (571,593 )     (576,367 )     (580,791 )     (578,504 )
         


 


 


 


 


(4)   

Adjusted Health Plan Services Cost

   $ 1,463,908     $ 1,465,280     $ 1,446,807     $ 1,419,870     $ 1,373,805  
(5)   

Number of Days in Period

     92       90       91       92       92  
= (1) / (3) * (5) Days Claims Payable      44.7       51.4       49.9       48.8       49.4  
= (2) / (4) * (5) Days Claims Payable (Excl. Capitation &
    Provider Settlements)
     59.2       59.9       60.3       61.1       63.5  

 

14


HEALTH NET, INC.

Medical Covered Lives at December 31, 2005

(in Thousands)

 

     Commercial - Large Group*

  

Commercial - Small

Group & Individual


  

Commercial

Risk Subtotal


   ASO

  

Commercial

Subtotal


     12/05

   09/05

   12/04

   12/05

   09/05

   12/04

   12/05

   09/05

   12/04

   12/05

   09/05

   12/04

   12/05

   09/05

   12/04

Arizona

   69    69    74    48    50    55    117    119    129    —      —      —      117    119    129

California

   1,083    1,088    1,101    373    391    459    1,457    1,478    1,560    7    7    3    1,464    1,485    1,564

Connecticut

   176    177    192    30    32    41    207    209    233    69    69    51    276    278    284

New Jersey

   53    61    98    74    83    111    127    145    210    20    18    18    147    163    228

New York

   116    116    144    102    103    108    218    218    252    20    20    7    238    239    259

Oregon

   102    102    105    37    36    33    138    138    138    —      —      1    138    138    139
    
  
  
  
  
  
  
  
  
  
  
  
  
  
  

Total

   1,599    1,612    1,714    664    695    808    2,264    2,307    2,523    116    115    81    2,380    2,422    2,603
    
  
  
  
  
  
  
  
  
  
  
  
  
  
  

Year over Year

        (7)%              (18)%              (10)%              44%              (9)%     

Sequential

        (1)%              (4)%              (2)%              1%              (2)%     

 

     Medicare Risk

   Medicaid

   Health Plan Total

     12/05

   09/05

   12/04

   12/05

   09/05

   12/04

   12/05

   09/05

   12/04

Arizona

   31    31    35    —      —      —      148    149    164

California

   93    94    95    698    703    696    2,255    2,282    2,355

Connecticut

   27    26    27    88    90    94    391    394    405

New Jersey

   —      —      —      44    40    42    191    203    270

New York

   7    6    6    —      —      —      244    245    265

Oregon

   16    15    9    —      —      —      155    154    148
    
  
  
  
  
  
  
  
  

Total

   174    172    171    830    833    831    3,384    3,427    3,605
    
  
  
  
  
  
  
  
  

Year over Year

        2%              (0)%              (6)%     

Sequential

        1%              (0)%              (1)%     

 

     12/05

   09/05

   12/04

TRICARE **

   2,962    2,962    2,929

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

 

15


Health Net, Inc.

Reconciliation of Reserves for Claims and Other Settlements

(In thousands)

 

     Health Plan Services

 
     Year 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

     5,130,415       5,048,289      4,487,698  

Prior Years (d)

     (114,540 )     8,769      (33,812 )
    


 

  


Total Incurred (c )

     5,015,875       5,057,058      4,453,886  

Paid claims related to:

                       

Current Year

     4,401,247       4,286,929      3,738,599  

Prior Years

     640,505       752,574      720,426  
    


 

  


Total Paid (c )

     5,041,752       5,039,503      4,459,025  

Reserve for claims (a), end of period

     768,737       794,614      777,059  

Add:

                       

Claims Payable

     177,233       288,331      167,361  

Other (e)

     94,201       86,352      80,130  
    


 

  


Reserves for claims and other settlements, end of period

   $ 1,040,171     $ 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) Our liabilities are estimated within a confidence level required under actuarial standards of practice. As such, a change in “incurred claims related to prior years” will be offset by maintaining a consistent level of confidence within the estimate of “incurred claims related to current years.” Therefore, a change, which is offset in this manner, would not indicate that health care services were lower than previously estimated.
(e) Includes accrued capitation, shared risk settlements, provider incentives and other reserve items.

 

16

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