-----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, L+X+/Dzuf8a33ifJ8i1mt4t41hnc47Vhpb0zEAn92OYllKsg9bLjJmbETIdNIsK0 Ea/TuMRFdah4p0BhRpXNZQ== 0001193125-08-019838.txt : 20080205 0001193125-08-019838.hdr.sgml : 20080205 20080205083118 ACCESSION NUMBER: 0001193125-08-019838 CONFORMED SUBMISSION TYPE: 8-K PUBLIC DOCUMENT COUNT: 4 CONFORMED PERIOD OF REPORT: 20080205 ITEM INFORMATION: Results of Operations and Financial Condition ITEM INFORMATION: Financial Statements and Exhibits FILED AS OF DATE: 20080205 DATE AS OF CHANGE: 20080205 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: 08574183 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 5, 2008

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 5, 2008, Health Net, Inc. (the “Company”) issued a press release announcing its earnings for the quarter and year ended December 31, 2007. 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 presentation of non-GAAP financial information is useful to investors because it excludes certain expenses and other one-time items that are not indicative of our core operating results. Management refers to the various non-GAAP financial measures included in the press release 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 5, 2008 announcing results for the quarter and year ended December 31, 2007 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 5, 2008

 

HEALTH NET, INC.
By:   /s/ Linda V. Tiano
  Linda V. Tiano
  Senior Vice President, General
  Counsel and Secretary
EX-99.1 2 dex991.htm PRESS RELEASE DATED FEBRUARY 5, 2008 Press Release dated February 5, 2008

Exhibit 99.1

 

LOGO      Health Net, Inc.  
     21650 Oxnard Street  
     Woodland Hills, CA 91367  
     818.676.6000  
     800.291.6911  
     www.healthnet.com  

LOGO

      

 

Investor      
Contacts:    David Olson    Angie McCabe
   818.676.6978    818.676.8692
   david.w.olson@healthnet.com    angeline.c.mccabe@healthnet.com
Media      
Contact:    Margita Thompson   
   818.676.7912   
   margita.n.thompson@healthnet.com   
     
     

HEALTH NET REPORTS FOURTH QUARTER NET INCOME

OF $123.4 MILLION, OR $1.10 PER DILUTED SHARE

SMALL GROUP AND INDIVIDUAL MEMBERSHIP INCREASES

10.5 PERCENT IN 2007 COMPARED TO 2006

COMPANY REPURCHASED 4.3 MILLION SHARES FOR $230 MILLION IN 2007

LOS ANGELES, February 5, 2008 – Health Net, Inc. (NYSE:HNT) today announced 2007 fourth quarter net income of $123.4 million, or $1.10 per diluted share, compared with 2006 fourth quarter net income of $84.8 million, or $0.72 per diluted share.

For the full year 2007, Health Net reported net income of $200.2 million, or $1.76 per diluted share. Included in the full year 2007 results is the full effect of $296.8 million pretax, or $216.0 million after-tax, charges incurred in the third quarter of 2007 as a result of Health Net reaching an agreement in principle to settle three class action lawsuits known as the McCoy, Wachtel and Scharfman lawsuits; the proposed resolution of regulatory issues with the New Jersey Department of Banking and Insurance; and other litigation matters.


The pretax charges are accounted for in two parts:

 

   

$201.5 million is included in third quarter of 2007 health plan services expenses for claims-related matters, class disbursements and remediations; and

 

   

$95.3 million is included in the third quarter of 2007 general and administrative (G&A) expenses related to attorneys’ fees, regulatory fines and estimated liability for litigation unrelated to the class action lawsuits.

A table outlining the allocation of the pretax charges in the third quarter of 2007 to the appropriate line items in the full year 2007 income statement is attached to this release.

Fourth Quarter and Full Year 2007 Highlights

Following are key highlights for the fourth quarter and full year of 2007:

 

   

Small group and individual membership increased 10.5 percent to 770,000 members as of December 31, 2007 compared to December 31, 2006;

 

   

Medicare Advantage enrollment increased 18.6 percent to 236,000 members as of December 31, 2007 compared to December 31, 2006;

 

   

Medicare Part D enrollment increased 3.8 percent sequentially and 26.3 percent year-over-year to 379,000 members at December 31, 2007;

 

   

Health Net repurchased 353,459 shares during the fourth quarter of 2007, bringing its total share repurchases for the full year 2007 to 4.3 million shares at an average price of $53.24. The company has approximately $346 million in remaining repurchase authority; and

 

   

Operating cash flow was $257.0 million in the fourth quarter of 2007 compared to $147.5 million in the fourth quarter of 2006. For the full year 2007, operating cash flow was $605.5 million compared to $286.2 million for the full year 2006.

“We are very pleased with our performance in the fourth quarter and for the full year 2007,” said Jay Gellert, president and chief executive officer of Health Net, Inc. “Our results highlight our strategy of shifting our commercial business to the small and mid-markets, focusing on Medicare growth opportunities and managing expenses.”

 

2


Membership

Total health plan enrollment as of December 31, 2007 was approximately 3.8 million members, an increase of 55,000 members, or 1.5 percent, compared to December 31, 2006, and a sequential increase of 8,000 members.

Commercial risk enrollment declined by 26,000 members, or 1.2 percent, to approximately 2.2 million members as of December 31, 2007 compared to December 31, 2006, and increased slightly compared to September 30, 2007. Administrative Services Only (ASO) membership decreased by 41,000 members, or 37.6 percent, to nearly 68,000 members as of December 31, 2007 compared to December 31, 2006. Sequentially, ASO membership decreased by 22,000 members, or 24.4 percent, primarily in the company’s Northeast region.

Enrollment in the company’s Medicare Advantage plans grew by 37,000 members, or 18.6 percent, to 236,000 members during the 12 months ended December 31, 2007. During the fourth quarter of 2007, Medicare Advantage membership decreased by 3,000 members, or 1.3 percent. Membership in the company’s Medicare Part D plans as of December 31, 2007 was 379,000, an increase of 79,000 members, or 26.3 percent, from December 31, 2006. Medicare Part D membership increased by 14,000 members, or 3.8 percent, during the fourth quarter of 2007.

“Enrollment growth in 2007 was consistent with our strategy of growing the smaller end of the market while maintaining pricing discipline,” said Gellert. “As a result, the small group and individual segment grew by 10.5 percent during the year. Commercial new sales in California exceeded 50,000 members for the seventh consecutive quarter. In addition, our Medicare Advantage and Medicare Part D membership both experienced excellent growth during the year.”

Medicaid enrollment at December 31, 2007 was 846,000 members, an increase of 6,000 members, or approximately 1.0 percent, since December 31, 2006. During the fourth quarter of 2007, Medicaid enrollment increased by 17,000 members, or 2.1 percent.

Revenues, Health Care Costs and G&A Expenses

Health Net’s total revenues increased 11.7 percent in the fourth quarter of 2007 to $3.6 billion from $3.2 billion in the fourth quarter of 2006. Health plan services premium

 

3


revenues increased 11.4 percent to $2.9 billion in the fourth quarter of 2007 compared to $2.6 billion in the fourth quarter of 2006.

Health Net’s Government contracts revenues increased 13.5 percent in the fourth quarter of 2007 to $619.4 million from $545.9 million in the fourth quarter of 2006. The quarter-over-quarter increase was driven by higher revenues and health care costs in 2007 compared to the same period in 2006.

The health plan services medical care ratio (MCR) was 82.6 percent in the fourth quarter of 2007 compared to 81.7 percent in the fourth quarter of 2006. The MCR was 89.8 percent in the third quarter of 2007 including the impact of the $201.5 million health plan services expenses charge, and 82.9 percent in the third quarter of 2007 excluding the impact of the charge.

The commercial MCR of 81.8 percent in the fourth quarter of 2007 improved by 60 basis points compared to the fourth quarter of 2006. Including the impact of the charge, the commercial MCR was 93.2 percent in the third quarter of 2007. Excluding the impact of the charge, the commercial MCR was 82.7 percent in the third quarter of 2007.

In the fourth quarter of 2007, commercial premium yields on a per member per month (PMPM) basis increased by 11.8 percent compared to the 2006 fourth quarter.

Including the impact from the health plan services expenses charge, PMPM commercial health care costs for the full year 2007 increased by 12.5 percent compared to the full year 2006. Total PMPM commercial health care costs increased by 11.0 percent in the fourth quarter of 2007 compared to the fourth quarter of 2006.

“Compared to the full year 2006, commercial premium yields PMPM increased by 9.2 percent for the full year 2007 while commercial health care costs increased by 8.9 percent PMPM excluding the impact of the charges,” said Gellert.

The Government contracts cost ratio was 89.9 percent in the fourth quarter of 2007 compared to 93.6 percent in the fourth quarter of 2006. “Our Federal Services division, which consists of our Northern Region TRICARE Contract, Veterans Administration business and rapidly growing family counseling business with the Department of Defense, had another solid quarter,” said Jim Woys, Health Net’s chief operating officer and president of the Government and Specialty Services division. “We are honored to serve our military men and women and their families, and this year, we are celebrating our 20th anniversary in providing the military access to quality health care in partnership with our military counterparts.”

 

4


Total G&A expense was $307.1 million in the fourth quarter of 2007 compared with $301.9 million in the fourth quarter of 2006. “Our focus on expense management resulted in a 100 basis point improvement from 11.5 percent in the fourth quarter of 2006 to 10.5 percent in the fourth quarter of 2007 in our G&A expense ratio,” said Joseph C. Capezza, Health Net’s chief financial officer. “As we implement our G&A repositioning strategy in order to achieve greater cost savings and become more competitive, we expect the G&A ratio to decrease further in 2008.”

Health Net’s selling expenses of $90.3 million in the fourth quarter of 2007 increased by approximately $24.0 million compared to the fourth quarter of 2006. “As a result of our strategy of growing the individual and small and mid-size employer group segments and strengthening our relationships with the agents and brokers who sell our products, our selling expense ratio in the fourth quarter of 2007 increased 60 basis points,” said Capezza.

Balance Sheet

Cash and investments as of December 31, 2007 were $2.6 billion compared with $2.1 billion as of December 31, 2006.

Reserves for claims and other settlements increased by $251.6 million to $1.3 billion at December 31, 2007 from December 31, 2006, and include $201.5 million of reserves for the charges incurred in the third quarter of 2007 relating to class action litigation settlement, regulatory matters and other litigation expenses.

Days claims payable (DCP), including provider and other claim settlements, capitation payments and Medicare Part D expenses, increased by 5.1 days to 49.9 days in the fourth quarter of 2007 compared to 44.8 days in the fourth quarter of 2006 and increased by 8.0 days compared to the third quarter of 2007.

Excluding provider and other claim settlements, capitation payments and Medicare Part D, DCP in the fourth quarter of 2007 decreased by 4.3 days to 54.9 days compared to the 2006 fourth quarter and increased by 0.2 days sequentially (see footnote (a) in the Notes to Consolidated Financial Statements in the accompanying tables).

“The minor sequential change in DCP from the third quarter to the fourth quarter of 2007 reflects our reserves stability,” said Capezza. “We expect DCP to continue to remain stable in 2008 and beyond.”

 

5


The company’s debt-to-total capital ratio was 22.5 percent as of December 31, 2007 compared to 21.9 percent as of December 31, 2006 and 18.5 percent on September 30, 2007.

Interest expense decreased by $2.4 million in the fourth quarter of 2007 compared to the fourth quarter of 2006 as a result of refinancing activities with lower interest rates during 2007.

Cash Flow

Operating cash flow in the 2007 fourth quarter, which includes an extra monthly payment of $56.0 million from the Department of Health Services (DHS) for California Medicaid that should have been received in September 2007, was approximately $257.0 million, or 1.9 times net income plus depreciation and amortization, compared to $147.5 million in the fourth quarter of 2006. Operating cash flow for the full year 2007 was $605.5 million compared to $286.2 million for the full year 2006. “Excluding the extra DHS monthly payment, operating cash flow during the fourth quarter of 2007 was approximately $201.0 million, which is 1.5 times net income plus depreciation and amortization,” said Capezza. “Our strong cash flow is another affirmation of the quality of our earnings.”

Outlook

Health Net expects full year 2008 earnings per diluted share of $4.14 to $4.17 based on expected diluted weighted average shares outstanding of 109 million shares, with 38 percent of earnings per diluted share occurring in the first half of 2008. Therefore, the company expects earnings per diluted share of $0.67 based on a share count of approximately 112 million shares in the first quarter of 2008 with an expected G&A ratio of 10. 7 percent. Health Net expects the G&A ratios in subsequent quarters in 2008 to average less than 10.0 percent.

Conference Call

As previously announced, Health Net will discuss the company’s fourth quarter and full year 2007 results during a conference call on Tuesday, February 5, 2008, beginning at approximately 11:00 a.m. Eastern time. To listen to the call, please dial 877.874.1565, code7064474. 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 5, 2008 through February 9, 2008, by dialing

 

6


888.203.1112, code 7064474. 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, 2006, Quarterly Reports on Form 10-Q for the quarters ended March 31, 2007, June 30, 2007 and September 30, 2007, and other reports filed by the company 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 company’s health plans and government contracts subsidiaries provide health benefits to approximately 6.6 million individuals across the country through group, individual, Medicare, Medicaid and TRICARE and Veterans Affairs programs. Health Net’s behavioral health subsidiary, MHN, provides mental health benefits to approximately 7.0 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

Health Net, Inc. and its representatives may from time to time make written and oral forward-looking statements, including statements contained in news releases, in Health Net’s filings with the Securities and Exchange Commission, in the company’s reports to shareholders and in meetings with investors and analysts, 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

 

7


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, regulatory fines, operational issues, health care 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 and subsequent Quarterly Reports on Form 10-Q filed 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.

# # #

[Eight pages of tables follow]

 

8


Health Net, Inc.

Consolidated Statements of Operations

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

 

      Quarter Ended
December 31,
2006
    Year Ended
December 31,
2006
    Quarter Ended
September 30,
2007
    Quarter Ended
December 31,
2007
    Year Ended
December 31,
2007
 

REVENUES:

          

Health plan services premiums

   $ 2,619,222     $ 10,364,740     $ 2,930,151     $ 2,916,718     $ 11,435,314  

Government contracts

     545,906       2,376,014       660,394       619,423       2,501,677  

Net investment income

     28,229       111,042       29,298       31,630       120,176  

Administrative services fees and other income

     14,816       56,554       12,085       15,482       51,104  
                                        

Total revenues

     3,208,173       12,908,350       3,631,928       3,583,253       14,108,271  
                                        
          

EXPENSES:

          

Health plan services

     2,139,063       8,600,443       2,631,211       2,409,332       9,762,896  

Government contracts

     511,077       2,234,535       613,345       556,648       2,307,610  

General and administrative

     301,927       1,165,313       397,168       307,099       1,265,555  

Selling

     66,353       245,304       91,524       90,332       327,827  

Depreciation

     6,216       21,541       7,956       8,816       30,282  

Amortization

     1,092       4,050       4,782       4,782       12,700  

Interest

     10,093       51,179       7,401       7,712       32,497  
                                        
     3,035,821       12,322,365       3,753,387       3,384,721       13,739,367  

Litigation costs

     37,093       37,093       —         —         —    

Debt refinancing

     —         70,095       —         —         —    
                                        
     3,072,914       12,429,553       3,753,387       3,384,721       13,739,367  

Income from operations before income taxes

     135,259       478,797       (121,459 )     198,532       368,904  

Income tax provision (benefit)

     50,474       149,484       (17,614 )     75,149       168,751  
                                        

Net income

   $ 84,785     $ 329,313     $ (103,845 )   $ 123,383     $ 200,153  
                                        

Basic earnings per share

   $ 0.74     $ 2.86     $ (0.93 )   $ 1.12     $ 1.80  

Diluted earnings per share

   $ 0.72     $ 2.78     $ (0.93 )   $ 1.10     $ 1.76  

Weighted average shares outstanding:

          

Basic

     114,841       115,128       111,111       110,087       111,316  

Diluted

     117,707       118,310       111,111       112,255       113,829  

Pretax margin

     4.2 %     3.7 %     -3.3 %     5.5 %     2.6 %

Health plan services MCR

     81.7 %     83.0 %     89.8 %     82.6 %     85.4 %

Government contracts cost ratio

     93.6 %     94.0 %     92.9 %     89.9 %     92.2 %

G&A expense ratio

     11.5 %     11.2 %     13.5 %     10.5 %     11.0 %

Selling costs ratio

     2.5 %     2.4 %     3.1 %     3.1 %     2.9 %

Days claims payable (a)

     44.8       44.3       41.9       49.9       43.9  

Days claims payable - adjusted (a)

     59.2       59.4       54.7       54.9       54.1  

Effective tax rate

     37.3 %     31.2 %     14.5 %     37.9 %     45.7 %

Health plan services premiums PMPM

   $ 243.82     $ 243.70     $ 267.64     $ 266.88     $ 263.54  

Health plan services costs PMPM

   $ 199.12     $ 202.22     $ 240.33     $ 220.45     $ 225.00  


Health Net, Inc.

Consolidated Statements of Operations

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

Note:

This table presents the company’s consolidated operations for the year ended December 31, 2007 and the charges recorded in the consolidated statement of operations for the quarter ended September 30, 2007. Management believes that the presentation of certain financial information in the attached press release (such as MCR, health care costs and G&A expenses), excluding the charges that were recorded in the third quarter of 2007, all of which is non-GAAP financial information, is important to investors as it excludes one-time items that are not indicative of our core operating results. This non-GAAP financial information should be considered in addition to, not as a substitute for, financial information prepared in accordance with GAAP.

 

     As Reported
Year Ended
December 31,
2007
    Impact of
Selected Costs
Recorded in the
Quarter Ended
September 30,
2007
    Excluding
Impact of
Selected Costs
Recorded in the
Quarter Ended
September 30,
2007
 

REVENUES:

      

Health plan services premiums

   $ 11,435,314       $ 11,435,314  

Government contracts

     2,501,677         2,501,677  

Net investment income

     120,176         120,176  

Administrative services fees and other income

     51,104         51,104  
                        

Total revenues

     14,108,271         14,108,271  
                        

EXPENSES:

      

Health plan services

     9,762,896     $ 201,449       9,561,447  

Government contracts

     2,307,610         2,307,610  

General and administrative

     1,265,555       95,308       1,170,247  

Selling

     327,827         327,827  

Depreciation

     30,282         30,282  

Amortization

     12,700         12,700  

Interest

     32,497         32,497  
                        
     13,739,367       296,757       13,442,610  

Income from operations before income taxes

     368,904       (296,757 )     665,661  

Income tax benefit

     168,751 (a)     (80,777 )     249,528  
                        

Net income

   $ 200,153     $ (215,980 )   $ 416,133  
                        

Basic earnings per share

   $ 1.80     $ (1.94 )   $ 3.74  

Diluted earnings per share

   $ 1.76     $ (1.90 )   $ 3.66  

Weighted average shares outstanding:

      

Basic

     111,316         111,316  

Diluted

     113,829         113,829  

Pretax margin

     2.6 %     -2.1 %     4.7 %

Health plan services MCR

     85.4 %     1.8 %     83.6 %

Government contracts cost ratio

     92.2 %     —         92.2 %

G&A expense ratio

     11.0 %     0.8 %     10.2 %

Selling costs ratio

     2.9 %     —         2.9 %

Effective tax rate

     45.7 %     8.3 %     37.5 %

Note

 

(a) Includes $26.2 million of tax asset write-off related to the charge.


Health Net, Inc.

Consolidated Balance Sheet

(Amounts in thousands, except ratio data)

 

     December 31,
2006
    September 30,
2007
    December 31,
2007
 

ASSETS

      

Current Assets

      

Cash and cash equivalents

   $ 704,806     $ 698,889     $ 1,007,017  

Investments - available for sale

     1,416,038       1,472,717       1,557,278  

Premiums receivable, net

     177,625       299,705       264,691  

Amounts receivable under government contracts

     199,569       174,647       189,976  

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

  

 

272,961

 

 

 

295,241

 

 

 

266,767

 

Other receivables

     230,865       100,528       72,518  

Deferred taxes

     54,702       148,990       132,818  

Other assets

     161,280       203,928       210,039  
                        

Total current assets

     3,217,846       3,394,645       3,701,104  

Property and equipment, net

     151,184       170,353       178,758  

Goodwill, net

     751,949       751,949       751,949  

Other intangible assets, net

     42,835       114,424       109,386  

Deferred taxes

     33,137       45,223       47,765  

Other noncurrent assets

     100,071       143,639       144,093  
                        

Total Assets

   $ 4,297,022     $ 4,620,233     $ 4,933,055  
                        

LIABILITIES AND STOCKHOLDERS’ EQUITY

      

Current Liabilities

      

Reserves for claims and other settlements

   $ 1,048,796     $ 1,313,104     $ 1,300,432  

Health care and other costs payable under government contracts

     52,384       52,472       69,014  

IBNR health care costs payable under TRICARE North contract

     272,961       295,241       266,767  

Unearned premiums

     164,099       187,958       176,981  

Loans payable

     200,000       —         35,000  

Accounts payable and other liabilities

     371,263       400,878       457,367  
                        

Total current liabilities

     2,109,503       2,249,653       2,305,561  

Senior notes payable

     —         398,020       398,071  

Loans payable

     300,000       —         112,363  

Other noncurrent liabilities

     108,554       213,376       235,022  
                        

Total Liabilities

     2,518,057       2,861,049       3,051,017  
                        

Stockholders’ Equity

      

Common stock and additional paid-in capital

     1,028,018       1,141,432       1,151,395  

Treasury common stock, at cost

     (891,294 )     (1,104,904 )     (1,123,750 )

Retained earnings

     1,653,478       1,732,170       1,855,553  

Accumulated other comprehensive loss

     (11,237 )     (9,514 )     (1,160 )
                        

Total Stockholders’ Equity

     1,778,965       1,759,184       1,882,038  
                        

Total Liabilities and Stockholders’ Equity

   $ 4,297,022     $ 4,620,233     $ 4,933,055  
                        

Debt-to-Total Capital Ratio

     21.9 %     18.5 %     22.5 %


Health Net, Inc.

Consolidated Statements of Cash Flows

(Amounts in thousands)

 

     Quarter Ended
December 31,
2006
    Year Ended
December 31,
2006
    Quarter Ended
September 30,
2007
    Quarter Ended
December 31,
2007
     Year Ended
December 31,
2007
 

CASH FLOWS FROM OPERATING ACTIVITIES:

           

Net income (loss)

   $ 84,785     $ 329,313     $ (103,845 )   $ 123,383      $ 200,153  

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

           

Amortization and depreciation

     7,308       25,591       12,738       13,598        42,982  

Debt refinancing charge

     —         70,095       —         —          —    

Share-based compensation expense

     5,294       20,115       6,072       6,457        24,298  

Other changes

     1,583       13,624       120       (3,498 )      (7,955 )

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

           

Premiums receivable and unearned premiums

     80,802       11,907       (320,490 )     24,037        (74,184 )

Other receivables, deferred taxes and other assets

     (131,634 )     (127,066 )     (66,147 )     38,884        45,154  

Amounts receivable/payable under government contracts

     (35,499 )     (86,925 )     53,431       1,213        26,223  

Reserves for claims and other settlements

     13,422       8,624       228,643       (12,672 )      251,636  

Accounts payable and other liabilities

     121,409       20,952       58,310       65,565        97,175  
                                         

Net cash provided by (used in) operating activities

     147,470       286,230       (131,168 )     256,967        605,482  
                                         

CASH FLOWS FROM INVESTING ACTIVITIES:

           

Sales of investments

     144,021       464,787       94,682       242,421        807,649  

Maturities of investments

     37,424       113,125       41,493       65,606        213,833  

Purchases of investments

     (200,611 )     (635,611 )     (173,198 )     (397,611 )      (1,180,854 )

Proceeds from sale of property and equipment

     —         4,242       —         —          96,748  

Purchases of property and equipment

     (23,978 )     (72,807 )     (14,485 )     (17,342 )      (64,850 )

Cash paid for acquisition of assets and businesses

     —         (73,999 )     —         —          (80,277 )

Purchases and Sales of restricted investments and other

     (1,982 )     15,384       9,991       7,127        (22,444 )
                                         

Net cash used in investing activities

     (45,126 )     (184,879 )     (41,517 )     (99,799 )      (230,195 )
                                         

CASH FLOWS FROM FINANCING ACTIVITIES:

           

Proceeds from exercise of stock options and employee stock purchases

     23,883       70,294       27,496       2,525        72,622  

Repurchases of common stock

     (250,671 )     (253,502 )     (135,384 )     (27,052 )      (232,220 )

Excess tax benefits from share-based compensation

     3,881       11,889       3,312       487        17,987  

Borrowings under financing arrangements

     —         497,334       —         175,000        668,535  

Repayment of borrowings under financing arrangements

     —         (465,045 )     —         —          (600,000 )
                                         

Net cash (used in) provided by financing activities

     (222,907 )     (139,030 )     (104,576 )     150,960        (73,076 )
                                         

Net (decrease) increase in cash and cash equivalents

     (120,563 )     (37,679 )     (277,261 )     308,128        302,211  

Cash and cash equivalents, beginning of period

     825,369       742,485       976,150       698,889        704,806  
                                         

Cash and cash equivalents, end of period

   $ 704,806     $ 704,806     $ 698,889     $ 1,007,017      $ 1,007,017  
                                         


Health Net, Inc.

Notes to Consolidated Financial Statements

Notes:

 

(a) Management believes that days claims payable (excluding capitation, provider and other claim settlements and Medicare Part D), a non-GAAP financial measure, provides useful information to investors because, in excluding those health care costs for which no or minimal reserves are maintained, it is a more accurate reflection of days claims payable calculated from claims-based reserves than is days claims payable, which does not exclude such costs. This non-GAAP financial information should be considered in addition to, not as a substitute for, financial information prepared in accordance with GAAP. The following table provides a reconciliation of the differences between days claims payable (excluding capitation, provider and other claim settlements and Medicare Part D) and days claims payable, the most directly comparable financial measure calculated and presented in accordance with GAAP:

 

     Q4 2006     FY 2006     Q3 2007     Q4 2007      FY 2007  
     (Dollars in millions)  

Reserve for Claims and Other Settlements

   $ 1,048.8     $ 1,048.8     $ 1,313.1     $ 1,300.4      $ 1,300.4  

Less: Capitation Payable, Provider and Other Claim Settlements and Medicare Part D

     (85.3 )     (85.3 )     (290.7 )     (299.3 )      (299.3 )
                                         

Adjusted Reserve for Claims and Other Settlements

     963.5       963.5       1,022.4       1,001.1        1,001.1  

(1) Average Reserve for Claims and Other Settlements

     1,042.1       1,044.5       1,198.8       1,306.8        1,174.6  

(2) Average Adjusted Reserve for Claims and Other Settlements

     949.2       954.2       1,004.0       1,011.8        982.3  

(3) Health Plan Services Cost

     2,139.1       8,600.4       2,631.2       2,409.3        9,762.9  

Less: Capitation Payable, Provider and Other Claim Settlements and Medicare Part D

     (662.8 )     (2,735.4 )     (942.0 )     (715.2 )      (3,129.7 )
                                         

(4) Adjusted Health Plan Services Cost

     1,476.3       5,865.0       1,689.2       1,694.1        6,633.2  

(5) Number of Days in Period

     92       365       92       92        365  

= (1) / (3) * (5) Days Claims Payable

     44.8       44.3       41.9       49.9        43.9  

= (2) / (4) * (5) Days Claims Payable - Adjusted

     59.2       59.4       54.7       54.9        54.1  


Health Net, Inc.

Enrollment Data - By State

(In thousands)

 

                    Change from  
                    September 30, 2007     December 31, 2006  
     Dec 31,
2007
   Sept 30,
2007
   Dec 31,
2006
   Increase/
(Decrease)
     %
Change
    Increase/
(Decrease)
     %
Change
 

California

                   

Large Group

   991    992    1,064    (1 )    (0.1 )%   (73 )    (6.9 )%

Small Group and Individual

   477    477    419    0      0.0 %   58      13.8 %
                                         

Commercial Risk

   1,468    1,469    1,483    (1 )    (0.1 )%   (15 )    (1.0 )%

ASO

   6    5    6    1      20.0 %   0      0.0 %
                                         

Total Commercial

   1,474    1,474    1,489    0      0.0 %   (15 )    (1.0 )%

Medicare Advantage

   112    112    104    0      0.0 %   8      7.7 %

Medi-Cal

   712    698    710    14      2.0 %   2      0.3 %
                                         

Total California

   2,298    2,284    2,303    14      0.6 %   (5 )    (0.2 )%
                                         

Connecticut

                   

Large Group

   136    138    153    (2 )    (1.4 )%   (17 )    (11.1 )%

Small Group and Individual

   25    26    30    (1 )    (3.8 )%   (5 )    (16.7 )%
                                         

Commercial Risk

   161    164    183    (3 )    (1.8 )%   (22 )    (12.0 )%

ASO

   32    54    67    (22 )    (40.7 )%   (35 )    (52.2 )%
                                         

Total Commercial

   193    218    250    (25 )    (11.5 )%   (57 )    (22.8 )%

Medicare Advantage

   45    44    34    1      2.3 %   11      32.4 %

Medicaid

   90    87    84    3      3.4 %   6      7.1 %
                                         

Total Connecticut

   328    349    368    (21 )    (6.0 )%   (40 )    (10.9 )%
                                         

New York

                   

Large Group

   116    114    122    2      1.8 %   (6 )    (4.9 )%

Small Group and Individual

   118    117    102    1      0.9 %   16      15.7 %
                                         

Commercial Risk

   234    231    224    3      1.3 %   10      4.5 %

ASO

   13    13    17    0      0.0 %   (4 )    (23.5 )%
                                         

Total Commercial

   247    244    241    3      1.2 %   6      2.5 %

Medicare Advantage

   3    9    6    (6 )    (66.7 )%   (3 )    (50.0 )%
                                         

Total New York

   250    253    247    (3 )    (1.2 )%   3      1.2 %
                                         

New Jersey

                   

Large Group

   30    30    44    0      0.0 %   (14 )    (31.8 )%

Small Group and Individual

   60    60    59    0      0.0 %   1      1.7 %
                                         

Commercial Risk

   90    90    103    0      0.0 %   (13 )    (12.6 )%

ASO

   17    18    19    (1 )    (5.6 )%   (2 )    (10.5 )%
                                         

Total Commercial

   107    108    122    (1 )    (0.9 )%   (15 )    (12.3 )%

Medicaid

   44    44    46    0      0.0 %   (2 )    (4.3 )%
                                         

Total New Jersey

   151    152    168    (1 )    (0.7 )%   (17 )    (10.1 )%
                                         

Arizona

                   

Large Group

   81    81    75    0      0.0 %   6      8.0 %

Small Group and Individual

   56    55    50    1      1.8 %   6      12.0 %
                                         

Commercial Risk

   137    136    125    1      0.7 %   12      9.6 %

Medicare Advantage

   51    49    35    2      4.1 %   16      45.7 %
                                         

Total Arizona

   188    185    160    3      1.6 %   28      17.5 %
                                         

Oregon

                   

Large Group

   101    98    96    3      3.1 %   5      5.2 %

Small Group and Individual

   34    35    37    (1 )    (2.9 )%   (3 )    (8.1 )%
                                         

Commercial Risk

   135    133    133    2      1.5 %   2      1.5 %

Medicare Advantage

   21    21    20    0      0.0 %   1      5.0 %
                                         

Total Oregon

   156    154    153    2      1.3 %   3      2.0 %
                                         

Other States

                   

Medicare Advantage

   4    4    0    0      0.0 %   4      0.0 %
                                         

Medicare PDP (stand-alone)

   379    365    300    14      3.8 %   79      26.3 %
                                         

Total Health Plan Enrollment

                   

Large Group

   1,455    1,453    1,554    2      0.1 %   (99 )    (6.4 )%

Small Group and Individual

   770    770    697    0      0.0 %   73      10.5 %
                                         

Commercial Risk

   2,225    2,223    2,251    2      0.1 %   (26 )    (1.2 )%

ASO

   68    90    109    (22 )    (24.4 )%   (41 )    (37.6 )%
                                         

Total Commercial

   2,293    2,313    2,360    (20 )    (0.9 )%   (67 )    (2.8 )%

Medicare Advantage

   236    239    199    (3 )    (1.3 )%   37      18.6 %

Medicare PDP (stand-alone)

   379    365    300    14      3.8 %   79      26.3 %

Medi-Cal/Medicaid

   846    829    840    17      2.1 %   6      0.7 %
                                         

Total Health Plans

   3,754    3,746    3,699    8      0.2 %   55      1.5 %
                                         

TRICARE - North Contract Eligibles

   2,895    2,913    2,930    (18 )    (0.6 )%   (35 )    (1.2 )%
                                         


Health Net, Inc.

Enrollment Data - Line of Business

(In thousands)

 

                    Change from  
                    September 30, 2007     December 31, 2006  
     Dec 31,
2007
   Sept 30,
2007
   Dec 31,
2006
   Increase/
(Decrease)
     %
Change
    Increase/
(Decrease)
     %
Change
 

Large Group

                   

California

   991    992    1,064    (1 )    (0.1 )%   (73 )    (6.9 )%

Connecticut

   136    138    153    (2 )    (1.4 )%   (17 )    (11.1 )%

New York

   116    114    122    2      1.8 %   (6 )    (4.9 )%

New Jersey

   30    30    44    0      0.0 %   (14 )    (31.8 )%

Arizona

   81    81    75    0      0.0 %   6      8.0 %

Oregon

   101    98    96    3      3.1 %   5      5.2 %
                                         
   1,455    1,453    1,554    2      0.1 %   (99 )    (6.4 )%
                                         

Small Group and Individual

                   

California

   477    477    419    0      0.0 %   58      13.8 %

Connecticut

   25    26    30    (1 )    (3.8 )%   (5 )    (16.7 )%

New York

   118    117    102    1      0.9 %   16      15.7 %

New Jersey

   60    60    59    0      0.0 %   1      1.7 %

Arizona

   56    55    50    1      1.8 %   6      12.0 %

Oregon

   34    35    37    (1 )    (2.9 )%   (3 )    (8.1 )%
                                         
   770    770    697    0      0.0 %   73      10.5 %
                                         

Commercial Risk

                   

California

   1,468    1,469    1,483    (1 )    (0.1 )%   (15 )    (1.0 )%

Connecticut

   161    164    183    (3 )    (1.8 )%   (22 )    (12.0 )%

New York

   234    231    224    3      1.3 %   10      4.5 %

New Jersey

   90    90    103    0      0.0 %   (13 )    (12.6 )%

Arizona

   137    136    125    1      0.7 %   12      9.6 %

Oregon

   135    133    133    2      1.5 %   2      1.5 %
                                         
   2,225    2,223    2,251    2      0.1 %   (26 )    (1.2 )%
                                         

ASO

                   

California

   6    5    6    1      20.0 %   0      0.0 %

Connecticut

   32    54    67    (22 )    (40.7 )%   (35 )    (52.2 )%

New York

   13    13    17    0      0.0 %   (4 )    (23.5 )%

New Jersey

   17    18    19    (1 )    (5.6 )%   (2 )    (10.5 )%
                                         
   68    90    109    (22 )    (24.4 )%   (41 )    (37.6 )%

Total Commercial

                   

California

   1,474    1,474    1,489    0      0.0 %   (15 )    (1.0 )%

Connecticut

   193    218    250    (25 )    (11.5 )%   (57 )    (22.8 )%

New York

   247    244    241    3      1.2 %   6      2.5 %

New Jersey

   107    108    122    (1 )    (0.9 )%   (15 )    (12.3 )%

Arizona

   137    136    125    1      0.7 %   12      9.6 %

Oregon

   135    133    133    2      1.5 %   2      1.5 %
                                         
   2,293    2,313    2,360    (20 )    (0.9 )%   (67 )    (2.8 )%

Medicare Advantage

                   

California

   112    112    104    0      0.0 %   8      7.7 %

Connecticut

   45    44    34    1      2.3 %   11      32.4 %

New York

   3    9    6    (6 )    (66.7 )%   (3 )    (50.0 )%

Arizona

   51    49    35    2      4.1 %   16      45.7 %

Oregon

   21    21    20    0      0.0 %   1      5.0 %

Other States

   4    4    0    0      0.0 %   4      0.0 %
                                         
   236    239    199    (3 )    (1.3 )%   37      18.6 %

Medi-Cal/Medicaid

                   

California

   712    698    710    14      2.0 %   2      0.3 %

Connecticut

   90    87    84    3      3.4 %   6      7.1 %

New Jersey

   44    44    46    0      0.0 %   (2 )    (4.3 )%
                                         
   846    829    840    17      2.1 %   6      0.7 %

Medicare PDP (stand-alone)

   379    365    300    14      3.8 %   79      26.3 %
                                         

Total Health Plan Enrollment

                   

Large Group

   1,455    1,453    1,554    2      0.1 %   (99 )    (6.4 )%

Small Group and Individual

   770    770    697    0      0.0 %   73      10.5 %
                                         

Commercial Risk

   2,225    2,223    2,251    2      0.1 %   (26 )    (1.2 )%

ASO

   68    90    109    (22 )    (24.4 )%   (41 )    (37.6 )%
                                         

Total Commercial

   2,293    2,313    2,360    (20 )    (0.9 )%   (67 )    (2.8 )%

Medicare Advantage

   236    239    199    (3 )    (1.3 )%   37      18.6 %

Medicare PDP (stand-alone)

   379    365    300    14      3.8 %   79      26.3 %

Medi-Cal/Medicaid

   846    829    840    17      2.1 %   6      0.7 %
                                         

Total Health Plans

   3,754    3,746    3,699    8      0.2 %   55      1.5 %
                                         

TRICARE - North Contract Eligibles

   2,895    2,913    2,930    (18 )    (0.6 )%   (35 )    (1.2 )%
                                         


Health Net, Inc.

Reconciliation of Reserves for Claims and Other Settlements

(In millions)

 

     Health Plan Services  
     Year 2007    Year 2006     Year 2005  

Reserve for claims (a), beginning of period

   $ 754.2    $ 768.7     $ 794.6  

Incurred claims related to:

       

Current Year

     5,790.7      5,222.0       5,130.4  

Prior Years (c)

     0.6      (77.3 )     (114.5 )
                       

Total Incurred (b)

     5,791.3      5,144.7       5,015.9  

Paid claims related to:

       

Current Year

     4,972.3      4,485.7       4,401.3  

Prior Years

     734.5      673.5       640.5  
                       

Total Paid (b)

     5,706.8      5,159.2       5,041.8  

Reserve for claims (a), end of period

     838.7      754.2       768.7  

Add:

       

Claims Payable (d)

     365.7      203.9       177.2  

Other (e)

     96.0      90.7       94.3  
                       

Reserves for claims and other settlements, end of period

   $ 1,300.4    $ 1,048.8     $ 1,040.2  
                       

 

(a) Consists of incurred but not reported claims and received but unprocessed claims and reserves for loss adjustment expenses.
(b) Includes medical claims only. Capitation, pharmacy and other payments including provider settlements are not included.
(c) This line represents the change in reserves attributable to the difference between the original estimate of incurred claims for prior years and the revised estimate. In developing the revised estimate, there have been no changes in the approach used to determine the key actuarial assumptions, which are the completion factor and medical cost trend. Claims liabilities are estimated under actuarial standards of practice and generally accepted accounting principles. The majority of the reserve balance held at each quarter-end is associated with the most recent months’ incurred services because these are the services for which the fewest claims have been paid. The majority of the adjustments to reserves relate to variables and uncertainties associated with actuarial assumptions. The degree of uncertainty in the estimates of incurred claims is greater for the most recent months’ incurred services. Revised estimates for prior years are determined in each quarter based on the most recent updates of paid claims for prior years.
(d) Includes amount accrued for litigation and regulatory-related expenses.
(e) Includes accrued capitation, shared risk settlements, provider incentives and other reserve items.
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