-----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, Ohf2jScLO+DIZVzC6z5svB+ZErUEr7hlKWr6Y+LD+Nls7TZYTq5RuP9kD4mcH5Uf 9/KvF3TS9mMpkgEvj7fvzg== 0001193125-08-096416.txt : 20080430 0001193125-08-096416.hdr.sgml : 20080430 20080430083108 ACCESSION NUMBER: 0001193125-08-096416 CONFORMED SUBMISSION TYPE: 8-K PUBLIC DOCUMENT COUNT: 4 CONFORMED PERIOD OF REPORT: 20080430 ITEM INFORMATION: Results of Operations and Financial Condition ITEM INFORMATION: Financial Statements and Exhibits FILED AS OF DATE: 20080430 DATE AS OF CHANGE: 20080430 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: 08787925 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): APRIL 30, 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 April 30, 2008, Health Net, Inc. (the “Company”) issued a press release announcing its earnings for the quarter ended March 31, 2008. The press release discloses certain financial information 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, and by adjusting for certain items related to timing. 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 April 30, 2008 announcing results for the quarter ended March 31, 2008 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: April 30, 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 Press Release

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       Media   
Contact:    Angie McCabe    Contact:    Margita Thompson
   818.676.8692       818.676.7912
   angeline.c.mccabe@healthnet.com       margita.thompson@healthnet.com

HEALTH NET REPORTS A LOSS OF $0.33 PER SHARE

FOR THE FIRST QUARTER OF 2008 AND REVISES 2008 OUTLOOK

THE COMPANY RECORDED $82.4 MILLION IN LEGAL AND

OPERATIONS STRATEGY-RELATED CHARGES IN THE FIRST QUARTER OF 2008

OPERATING RESULTS IMPACTED BY

ADVERSE PRIOR PERIOD DEVELOPMENT AND AN ACTIVE FLU SEASON

LOS ANGELES, April 30, 2008 – Health Net, Inc. (NYSE: HNT) today announced a loss of $35.7 million, or $0.33 per share, in the first quarter of 2008. Net income for the first quarter of 2007 was $88.6 million, or $0.77 per diluted share.

Included in the results for the first quarter of 2008 is the full effect of $82.4 million pretax, or $53.8 million after-tax, legal and operations strategy-related charges.

Excluding the charges, earnings per diluted share were $0.16 in the first quarter of 2008, lower than previous guidance primarily due to adverse prior period development and an active flu season.

The company also announced that it is revising full-year 2008 guidance to a range of $2.47 to $2.65 per diluted share, which includes the impact of the charges taken in the first quarter of 2008 and anticipated pretax operations strategy-related charges of between $67 million and $87 million the company expects to take in the remainder of 2008. Excluding these charges, the company currently expects to earn between $3.45 and $3.55 per diluted share in 2008. Previous 2008 guidance, excluding the impact of any charges, was $4.14 to $4.17 per diluted share.

 


Factors contributing to the revised 2008 full-year guidance are:

 

   

Unusual seasonal physician and hospital utilization patterns, primarily in the fourth quarter of 2007, resulted in $50 million pretax of adverse prior period development.

 

   

Higher than expected utilization in both Medicare Advantage and Medicare Part D stand-alone (PDP) plans resulted in a $24 million pretax impact in the first quarter of 2008. The company expects that the full year 2008 impact on earnings will be approximately $40 million pretax. The company expects to address this performance in its 2009 Medicare bid that will be submitted in June 2008.

 

   

An unusually active flu season during the first quarter of 2008 resulted in a $20 million pretax impact on earnings.

 

   

Due to a proposed substantial rate cut by the State of California for the company’s Medi-Cal plans, the company expects pretax income to be approximately $15 to $20 million lower in the second half of 2008 than previously planned. This rate reduction is scheduled for implementation on July 1, 2008.

 

   

A higher than planned effective tax rate of 39.5 percent due to a changing business mix is expected to impact operating earnings excluding charges by approximately $0.06 per diluted share for the full year 2008.

“The results we experienced in the first quarter of 2008 caused us to lower our previous guidance,” said Jay Gellert, president and chief executive officer of Health Net. “Most of the negative factors impacted the first quarter of 2008. Despite the challenges we face in our Medicare and Medicaid businesses and the impact of the flu this year, we believe we can resume earnings growth in the second half of 2008 compared to the second half of 2007.”

Primarily due to the recording of the adverse prior period development in the first quarter of 2008, the relationship between commercial yields and costs was negative in the period. However, the company believes that this relationship will be positive in each of the remaining three quarters of 2008 when compared with the same periods in 2007.

“We remain focused on disciplined pricing, and as a result, we expect to achieve a positive spread between the commercial premium yield and cost trend in the remaining three quarters of 2008.” said Gellert.

 

2


“While our strategy is to grow the smaller end of the market, we expect to be somewhat less active in the individual segment. In addition, we are maintaining our pricing discipline, and as the economy slows further, we expect commercial enrollment growth to decline by three to four percent in 2008 compared to 2007,” continued Gellert. The company had previously guided to a decline of one percent in commercial enrollment in 2008 compared to 2007.

The full-year per diluted share earnings estimates are based on a projected weighted average share count for the full year of 2008 of approximately 105.5 to 107 million diluted shares compared with the 108 to 110 million diluted shares for the full year that was incorporated into prior guidance.

Legal and Operations Strategy-Related Charges

The company recorded the following pretax charges totaling $82.4 million in the first quarter of 2008:

 

   

Approximately $43.2 million, which is included in health plan services expenses, represents estimated liability for litigation and regulatory actions related to the company’s rescission practices in Arizona and California and additional liability calculated in connection with the execution of the settlement agreement in the McCoy, Wachtel and Scharfman lawsuits which the company previously disclosed.

 

   

Approximately $35.8 million, which is included in general and administrative (G&A) expenses and primarily covers severance and other costs associated with Health Net’s previously announced operations strategy which is aimed at achieving substantial reductions in G&A expenses over the next three years. A portion of this amount also covers estimated legal fees and fines associated with the company’s rescission practices. The company expects that any future operations strategy-related charges in 2008 will be included in G&A expenses.

 

   

Approximately $3.4 million, which is included in other income, covers the estimated loss on the sale of assets of a small, non-core subsidiary.

Share Repurchase

Health Net repurchased approximately 3.2 million shares of its common stock at an average price of $44.64 per share in the first quarter of 2008.

 

3


“We were an active purchaser of our stock in first quarter of 2008. We have $204 million in remaining repurchase authority, and we hope to continue repurchasing shares throughout 2008, consistent with our strong belief in the company’s long-term prospects,” noted Joseph Capezza, Health Net’s chief financial officer.

Revenues, Health Care Costs and G&A Expenses Including the Charges

Health Net’s total revenues increased 11.9 percent in the first quarter of 2008 to $3.8 billion from $3.4 billion in the first quarter of 2007. Health plan services premium revenues increased 12.4 percent to $3.1 billion in the first quarter of 2008 compared to $2.8 billion in the first quarter of 2007. The company’s Government contracts revenues increased 9.3 percent in the first quarter of 2008 to $664.4 million from $608.0 million in the first quarter of 2007.

Including the $43.2 million health plan services expenses charge, the health plan medical care ratio (MCR) was 89.3 percent in the first quarter of 2008, and the commercial MCR was 88.5 percent.

Including the impact from the health plan services expenses charges, per member per month (PMPM) commercial health care costs increased by 17.3 percent in the first quarter of 2008 compared to the first quarter of 2007.

The Government contracts cost ratio was 96.0 percent in the first quarter of 2008 compared to 93.3 percent in the first quarter of 2007. “We expect that Government contracts ratio will be approximately 94.5 percent for the full year of 2008. Although this is higher than our 2007 performance which was a result of both a health care cost underrun and a favorable settlement of a claim from Option Period 1, it represents a return to more normal levels,” said Jim Woys, Health Net’s chief operating officer. “We are honored and privileged to continue our current supportive role in the TRICARE program. We also are excited about the opportunity to compete in the TRICARE reprocurement, and we believe we are well positioned to continue to assist the Department of Defense in advancing its future TRICARE goals to even higher levels of performance excellence.”

Including the $39.2 million in operations strategy-related charges, of which $35.8 million was included in G&A expenses, total G&A expense was $352.3 million in the first quarter of 2008 compared with $291.3 million in the first quarter of 2007.

 

4


Health Net’s selling expenses of $86.6 million in the first quarter of 2008 increased by $17.5 million compared to the first quarter of 2007. “As a result of our focus on growing the smaller end of the commercial market, our selling expense ratio increased by 30 basis points quarter-over-quarter,” said Gellert.

Health Care Costs and G&A Expenses Excluding the Charges1

Excluding the $43.2 million health plan services expenses charge in the first quarter of 2008:

 

   

The commercial premium yield on a PMPM basis increased 10.2 percent in the first quarter of 2008 compared to the first quarter of 2007 (health plan premiums were unaffected by the charges). Commercial health care costs would have increased by 14.4 percent on a PMPM basis in the first quarter of 2008 compared to the first quarter of 2007 including the adverse prior period development for the second half of 2007.

 

   

The health plan MCR would have been 87.9 percent for the first quarter of 2008.

 

   

The commercial MCR for the first quarter of 2008 would have been 86.3 percent compared to 83.2 percent in the first quarter of 2007, and 81.8 percent in the fourth quarter of 2007. The MCR in the first quarter of 2008 was primarily driven by the adverse prior period development.

Excluding the impact of the $35.8 million operations strategy-related charge, G&A expenses would have been $316.5 million in the first quarter of 2008, resulting in a G&A expense ratio of 10.1 percent.

“Excluding the impact of the operations strategy-related charge, the G&A expense ratio in the first quarter improved by 30 basis points from the 2007 first quarter and 70 basis points from the fourth quarter of 2007 as we continue to focus on managing our expenses,” said Capezza. “For the full year of 2008, we expect the G&A expense ratio to improve by approximately 20 to 30 basis points compared to the full year of 2007 as we begin to realize the positive impact of our operations strategy in the second half of 2008.”

 

 

1

See the financial schedule attached to this release for reconciliation of this information to the comparable GAAP financial measure.

 

5


Membership

Total health plan enrollment as of March 31, 2008 was nearly 3.9 million members, an increase of 203,000 members, or 5.5 percent, compared to March 31, 2007. Sequentially, total health plan enrollment grew by 111,000 members, or 3.0 percent, from December 31, 2007.

Commercial risk enrollment increased by 3,000 members, or 0.1 percent, to approximately 2.2 million members as of March 31, 2008 compared to March 31, 2007. Sequentially, commercial risk enrollment decreased by 45,000 members, or 2.0 percent, since December 31, 2007. Administrative Services Only (ASO) membership decreased by 38,000 members, or 39.6 percent, to 58,000 members as of March 31, 2008 compared to March 31, 2007. Sequentially, ASO membership declined by 10,000, or 14.7 percent, from December 31, 2007, consistent with the company’s strategy to de-emphasize this segment.

Enrollment in the company’s Medicare Advantage plans grew by 53,000 members, or by 23.8 percent, to 276,000 members at the end of the first quarter of 2008 compared to the end of the first quarter of 2007. Sequentially, Medicare Advantage membership grew by 40,000 members, or 16.9 percent, from December 31, 2007. Membership in the company’s Medicare PDP plans was 522,000 at the end of the first quarter of 2008, an increase of 181,000 members, or 53.1 percent, compared to the end of the first quarter of 2007. Sequentially, PDP membership grew by 143,000 members, or 37.7 percent, from December 31, 2007.

Medicaid enrollment at March 31, 2008 was 829,000 members, an increase of 4,000 members, or 0.5 percent, from March 31, 2007. Sequentially, Medicaid membership decreased by 17,000 members, or 2.0 percent, from December 31, 2007.

Balance Sheet

Cash and investments as of March 31, 2008 were $2.4 billion compared with $2.3 billion as of March 31, 2007.

Reserves for claims and other settlements as of March 31, 2008 were $1.4 billion compared with $1.1 billion as of March 31, 2007. Reserves for claims and other settlements as of March 31, 2008 include $43.2 million of reserves for the legal charge. Reserves for claims and other settlements increased by $130.3 million from December 31, 2007 to March 31, 2008.

Days claims payable (DCP), including provider and other claims settlements (which includes the first quarter 2008 legal charges), capitation payments and Medicare Part D

 

6


expenses, for the first quarter of 2008 increased by 3.3 days to 44.6 days compared to 41.3 days in the first quarter of 2007, and decreased sequentially by 5.3 days compared to the fourth quarter of 2007.

Excluding provider and other claim settlements (which includes the first quarter 2008 legal charges), capitation payments and Medicare Part D, DCP in the first quarter of 2008 decreased by 1.5 days to 52.9 days compared to the first quarter of 2007, and decreased by 2.0 days sequentially.2   This is a seasonal pattern that the company has experienced in previous years.

The company’s debt-to-total capital ratio was 27.5 percent as of March 31, 2008 compared to 22.5 percent as of December 31, 2007 and 17.7 percent as of March 31, 2007. The increase in the debt-to-total capital ratio is due to a $100 million draw on the company’s revolving credit facility combined with the impact of the charges and prior period development in the first quarter 2008.

Interest expense increased by $1.1 million in the first quarter of 2008 compared to the first quarter of 2007. The increase primarily is due to the $175 million financing facility that the company secured in late 2007. This imputed interest is offset by other income related to the same financing facility.

Cash Flow

Operating cash flow was negative $117.3 million in the first quarter of 2008. This amount reflects a $160 million payment related to the McCoy, Wachtel and Scharfman lawsuits and was fully reserved for in the third quarter of 2007.

2008 Guidance

Including the impact of operations strategy-related charges, the company expects to earn between $0.48 and $0.61 per diluted share in the second quarter of 2008. Excluding the impact of these charges, the company expects to earn between $0.77 to $0.79 per diluted share in the second quarter of 2008.

 

 

2

See footnote (a) in the Notes to Consolidated Financial Statements in the financial schedules attached to this release for a reconciliation of this information to the comparable GAAP financial measure.

 

7


The table below updates previously issued full-year 2008 guidance on a number of operating metrics.

2008 Revised Outlook

 

     Revised Guidance   Comment

Year-end Membership

 

Commercial Risk: -3% to -4%

Medicaid: flat

Medicare Advantage: +20% to 25%

PDP: +40% to 45%

 

Previously: flat to -1%

Unchanged

Unchanged

Unchanged

Consolidated Revenues

  $15 to $16 billion   Unchanged

Commercial Yields

  8.0%   Unchanged

Commercial

Health Care Cost Trends*

 

8.0%

(Includes prior period development booked in 1Q08)

  Previously: 30 to 50 bps lower than premium yield

Selling Cost Ratio

Government Contracts Ratio

G&A Expense Ratio*

 

~ 2.8%

~ 94.5%

~ 10.0%

 

Unchanged

Unchanged

Unchanged

Tax Rate*

  ~ 39.5%   Previously: 38.5%

Shares Outstanding

  105.5-107 million   Previously: 108-110 million

EPS*

  $3.45 - $3.55   Previously: $4.14 - $4.17

 

* Excludes the impact of litigation and operations strategy-related charges.

 

8


Conference Call

As previously announced, Health Net will discuss the company’s first quarter 2008 results during a conference call on Wednesday, April 30, 2008, beginning at approximately 11:00 a.m. Eastern time. The conference call should be accessed at least 15 minutes prior to its start with the following numbers:

 

877.795.3604 (Domestic)

   888.203.1112 (Replay – Domestic)

719.325.4761 (International)

   719.457.0820 (Replay – International)

The access code for both the live conference call and the replay is 1842215. A replay of the conference call will be available through May 5, 2008. A live webcast and replay of the conference call also will be available at www.healthnet.com under “Investor Relations.” The conference call webcast is open to all interested parties. 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, 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 6.8 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 6.9 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

All statements in this press release, other than statements of historical information provided herein, including but not limited to the guidance for future periods included herein and the assumptions underlying such projections, may be deemed to be forward-looking statements and as such are subject to a number of risks and uncertainties. These statements are based on

 

9


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 guidance as to expected future period results and statements including 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, unexpected utilization patterns or unexpectedly severe or widespread illnesses, membership declines, rate cuts affecting our Medicare or Medicaid business, issues relating to provider contracts, litigation costs, regulatory issues, 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 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 its guidance, the assessment of the underlying assumptions or any of its forward-looking statements to reflect events or circumstances that arise after the date of this release.

# # #

[Eight pages of tables follow]

 

10


Health Net, Inc.

Enrollment Data - By State

(In thousands)

 

                    Change from  
                    December 31, 2007     March 31, 2007  
     March 31,
2008
   Dec 31,
2007
   March 31,
2007
   Increase/
(Decrease)
        %
Change
    Increase/
(Decrease)
        %
Change
 

California

                 

Large Group

   984    991    1,009    (7 )   (0.7 )%   (25 )   (2.5 )%

Small Group and Individual

   468    477    413    (9 )   (1.9 )%   55     13.3 %
                                       

Commercial Risk

   1,452    1,468    1,422    (16 )   (1.1 )%   30     2.1 %

ASO

   5    6    5    (1 )   (16.7 )%   0     0.0 %
                                       

Total Commercial

   1,457    1,474    1,427    (17 )   (1.2 )%   30     2.1 %

Medicare Advantage

   123    112    108    11     9.8 %   15     13.9 %

Medi-Cal

   720    712    694    8     1.1 %   26     3.7 %
                                       

Total California

   2,300    2,298    2,229    2     0.1 %   71     3.2 %
                                       

Connecticut

                 

Large Group

   127    136    143    (9 )   (6.6 )%   (16 )   (11.2 )%

Small Group and Individual

   25    25    29    0     0.0 %   (4 )   (13.8 )%
                                       

Commercial Risk

   152    161    172    (9 )   (5.6 )%   (20 )   (11.6 )%

ASO

   26    32    57    (6 )   (18.8 )%   (31 )   (54.4 )%
                                       

Total Commercial

   178    193    229    (15 )   (7.8 )%   (51 )   (22.3 )%

Medicare Advantage

   54    45    40    9     20.0 %   14     35.0 %

Medicaid

   65    90    85    (25 )   (27.8 )%   (20 )   (23.5 )%
                                       

Total Connecticut

   297    328    354    (31 )   (9.5 )%   (57 )   (16.1 )%
                                       

New York

                 

Large Group

   105    116    116    (11 )   (9.5 )%   (11 )   (9.5 )%

Small Group and Individual

   113    118    109    (5 )   (4.2 )%   4     3.7 %
                                       

Commercial Risk

   218    234    225    (16 )   (6.8 )%   (7 )   (3.1 )%

ASO

   11    13    15    (2 )   (15.4 )%   (4 )   (26.7 )%
                                       

Total Commercial

   229    247    240    (18 )   (7.3 )%   (11 )   (4.6 )%

Medicare Advantage

   6    3    8    3     100.0 %   (2 )   (25.0 )%
                                       

Total New York

   235    250    248    (15 )   (6.0 )%   (13 )   (5.2 )%
                                       

New Jersey

                 

Large Group

   25    30    36    (5 )   (16.7 )%   (11 )   (30.6 )%

Small Group and Individual

   58    60    61    (2 )   (3.3 )%   (3 )   (4.9 )%
                                       

Commercial Risk

   83    90    97    (7 )   (7.8 )%   (14 )   (14.4 )%

ASO

   16    17    19    (1 )   (5.9 )%   (3 )   (15.8 )%
                                       

Total Commercial

   99    107    116    (8 )   (7.5 )%   (17 )   (14.7 )%

Medicaid

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

Total New Jersey

   143    151    162    (8 )   (5.3 )%   (19 )   (11.7 )%
                                       

Arizona

                 

Large Group

   85    81    78    4     4.9 %   7     9.0 %

Small Group and Individual

   54    56    52    (2 )   (3.6 )%   2     3.8 %
                                       

Commercial Risk

   139    137    130    2     1.5 %   9     6.9 %

Medicare Advantage

   62    51    45    11     21.6 %   17     37.8 %
                                       

Total Arizona

   201    188    175    13     6.9 %   26     14.9 %
                                       

Oregon

                 

Large Group

   101    101    96    0     0.0 %   5     5.2 %

Small Group and Individual

   35    34    35    1     2.9 %   0     0.0 %
                                       

Commercial Risk

   136    135    131    1     0.7 %   5     3.8 %

Medicare Advantage

   22    21    20    1     4.8 %   2     10.0 %
                                       

Total Oregon

   158    156    151    2     1.3 %   7     4.6 %
                                       

Other States

                 

Medicare Advantage

   9    4    2    5     125.0 %   7     350.0 %
                                       

Medicare PDP (stand-alone)

   522    379    341    143     37.7 %   181     53.1 %
                                       

Total Health Plan Enrollment

                 

Large Group

   1,427    1,455    1,478    (28 )   (1.9 )%   (51 )   (3.5 )%

Small Group and Individual

   753    770    699    (17 )   (2.2 )%   54     7.7 %
                                       

Commercial Risk

   2,180    2,225    2,177    (45 )   (2.0 )%   3     0.1 %

ASO

   58    68    96    (10 )   (14.7 )%   (38 )   (39.6 )%
                                       

Total Commercial

   2,238    2,293    2,273    (55 )   (2.4 )%   (35 )   (1.5 )%

Medicare Advantage

   276    236    223    40     16.9 %   53     23.8 %

Medicare PDP (stand-alone)

   522    379    341    143     37.7 %   181     53.1 %

Medi-Cal/Medicaid

   829    846    825    (17 )   (2.0 )%   4     0.5 %
                                       

Total Health Plans

   3,865    3,754    3,662    111     3.0 %   203     5.5 %
                                       

TRICARE - North Contract Eligibles

   2,895    2,895    2,930    0     0.0 %   (35 )   (1.2 )%
                                       


Health Net, Inc.

Enrollment Data - Line of Business

(In thousands)

 

                    Change from  
                    December 31, 2007     March 31, 2007  
     March 31,
2008
   Dec 31,
2007
   March 31,
2007
   Increase/
(Decrease)
        %
Change
    Increase/
(Decrease)
        %
Change
 

Large Group

                 

California

   984    991    1,009    (7 )   (0.7 )%   (25 )   (2.5 )%

Connecticut

   127    136    143    (9 )   (6.6 )%   (16 )   (11.2 )%

New York

   105    116    116    (11 )   (9.5 )%   (11 )   (9.5 )%

New Jersey

   25    30    36    (5 )   (16.7 )%   (11 )   (30.6 )%

Arizona

   85    81    78    4     4.9 %   7     9.0 %

Oregon

   101    101    96    0     0.0 %   5     5.2 %
                                       
   1,427    1,455    1,478    (28 )   (1.9 )%   (51 )   (3.5 )%
                                       

Small Group and Individual

                 

California

   468    477    413    (9 )   (1.9 )%   55     13.3 %

Connecticut

   25    25    29    0     0.0 %   (4 )   (13.8 )%

New York

   113    118    109    (5 )   (4.2 )%   4     3.7 %

New Jersey

   58    60    61    (2 )   (3.3 )%   (3 )   (4.9 )%

Arizona

   54    56    52    (2 )   (3.6 )%   2     3.8 %

Oregon

   35    34    35    1     2.9 %   0     0.0 %
                                       
   753    770    699    (17 )   (2.2 )%   54     7.7 %
                                       

Commercial Risk

                 

California

   1,452    1,468    1,422    (16 )   (1.1 )%   30     2.1 %

Connecticut

   152    161    172    (9 )   (5.6 )%   (20 )   (11.6 )%

New York

   218    234    225    (16 )   (6.8 )%   (7 )   (3.1 )%

New Jersey

   83    90    97    (7 )   (7.8 )%   (14 )   (14.4 )%

Arizona

   139    137    130    2     1.5 %   9     6.9 %

Oregon

   136    135    131    1     0.7 %   5     3.8 %
                                       
   2,180    2,225    2,177    (45 )   (2.0 )%   3     0.1 %
                                       

ASO

                 

California

   5    6    5    (1 )   (16.7 )%   0     0.0 %

Connecticut

   26    32    57    (6 )   (18.8 )%   (31 )   (54.4 )%

New York

   11    13    15    (2 )   (15.4 )%   (4 )   (26.7 )%

New Jersey

   16    17    19    (1 )   (5.9 )%   (3 )   (15.8 )%
                                       
   58    68    96    (10 )   (14.7 )%   (38 )   (39.6 )%

Total Commercial

                 

California

   1,457    1,474    1,427    (17 )   (1.2 )%   30     2.1 %

Connecticut

   178    193    229    (15 )   (7.8 )%   (51 )   (22.3 )%

New York

   229    247    240    (18 )   (7.3 )%   (11 )   (4.6 )%

New Jersey

   99    107    116    (8 )   (7.5 )%   (17 )   (14.7 )%

Arizona

   139    137    130    2     1.5 %   9     6.9 %

Oregon

   136    135    131    1     0.7 %   5     3.8 %
                                       
   2,238    2,293    2,273    (55 )   (2.4 )%   (35 )   (1.5 )%

Medicare Advantage

                 

California

   123    112    108    11     9.8 %   15     13.9 %

Connecticut

   54    45    40    9     20.0 %   14     35.0 %

New York

   6    3    8    3     100.0 %   (2 )   (25.0 )%

Arizona

   62    51    45    11     21.6 %   17     37.8 %

Oregon

   22    21    20    1     4.8 %   2     10.0 %

Other States

   9    4    2    5     125.0 %   7     350.0 %
                                       
   276    236    223    40     16.9 %   53     23.8 %

Medi-Cal/Medicaid

                 

California

   720    712    694    8     1.1 %   26     3.7 %

Connecticut

   65    90    85    (25 )   (27.8 )%   (20 )   (23.5 )%

New Jersey

   44    44    46    0     0.0 %   (2 )   (4.3 )%
                                       
   829    846    825    (17 )   (2.0 )%   4     0.5 %

Medicare PDP (stand-alone)

   522    379    341    143     37.7 %   181     53.1 %
                                       

Total Health Plan Enrollment

                 

Large Group

   1,427    1,455    1,478    (28 )   (1.9 )%   (51 )   (3.5 )%

Small Group and Individual

   753    770    699    (17 )   (2.2 )%   54     7.7 %
                                       

Commercial Risk

   2,180    2,225    2,177    (45 )   (2.0 )%   3     0.1 %

ASO

   58    68    96    (10 )   (14.7 )%   (38 )   (39.6 )%
                                       

Total Commercial

   2,238    2,293    2,273    (55 )   (2.4 )%   (35 )   (1.5 )%

Medicare Advantage

   276    236    223    40     16.9 %   53     23.8 %

Medicare PDP (stand-alone)

   522    379    341    143     37.7 %   181     53.1 %

Medi-Cal/Medicaid

   829    846    825    (17 )   (2.0 )%   4     0.5 %
                                       

Total Health Plans

   3,865    3,754    3,662    111     3.0 %   203     5.5 %
                                       

TRICARE - North Contract Eligibles

   2,895    2,895    2,930    0     0.0 %   (35 )   (1.2 )%
                                       


Health Net, Inc.

Consolidated Statements of Operations

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

 

     Quarter Ended
March 31,
2007
    Quarter Ended
December 31,
2007
    Quarter Ended
March 31,
2008
 

REVENUES:

      

Health plan services premiums

   $ 2,777,259     $ 2,916,718     $ 3,122,988  

Government contracts

     607,995       619,423       664,449  

Net investment income

     31,364       31,630       35,371  

Administrative services fees and other income

     12,294       15,482       13,948  
                        
     3,428,912       3,583,253       3,836,756  
                        

EXPENSES:

      

Health plan services

     2,341,074       2,409,332       2,788,403  

Government contracts

     567,099       556,648       637,577  

General and administrative

     291,285       317,099       352,278  

Selling

     69,129       90,332       86,592  

Depreciation and amortization

     7,633       13,598       12,279  

Interest

     9,560       7,712       10,657  
                        
     3,285,780       3,394,721       3,887,786  

Income (loss) from operations before income taxes

     143,132       188,532       (51,030 )

Income tax provision (benefit)

     54,547       71,605       (15,350 )
                        

Net income (loss)

   $ 88,585     $ 116,927     $ (35,680 )
                        

Basic earnings (loss) per share

   $ 0.79     $ 1.06     $ (0.33 )

Diluted earnings (loss) per share

   $ 0.77     $ 1.04     $ (0.33 )

Weighted average shares outstanding:

      

Basic

     111,970       110,087       109,232  

Diluted

     114,759       112,255       109,232  

Pretax margin

     4.2 %     5.3 %     -1.3 %

Health plan services MCR

     84.3 %     82.6 %     89.3 %

Government contracts cost ratio

     93.3 %     89.9 %     96.0 %

G&A expense ratio

     10.4 %     10.8 %     11.2 %

Selling costs ratio

     2.5 %     3.1 %     2.8 %

Days claims payable (a)

     41.3       49.9       44.6  

Days claims payable - adjusted (a)

     54.4       54.9       52.9  

Effective tax rate

     38.1 %     38.0 %     30.1 %

Health plan services premiums PMPM

   $ 259.35     $ 266.88     $ 277.17  

Health plan services costs PMPM

   $ 218.62     $ 220.45     $ 247.48  


Health Net, Inc.

Reconciliation of Non-GAAP Financial Measures

Operating Results Excluding Legal and Operations Strategy-Related Charges

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

Note:

This table presents the company's consolidated operations for the quarter ended March 31, 2008 and the charges recorded in the consolidated statement of operations for the quarter ended March 31, 2008. Management believes that the presentation of certain financial information in the attached press release (such as Administrative service fees and other income, Health plan services costs, General and administrative expense, Income (loss) before income taxes, Income tax provision (benefit), Net income (loss), Basic and diluted earnings (loss) per share, Pretax margin, MCR, and G&A expense ratio), excluding the charges that were recorded in the quarter ended March 31, 2008, 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
Quarter Ended
March 31,
2008
    Impact of Legal
and Operations
Strategy-Related
Charges
    Excluding
Impact of Legal
and Operations
Strategy-Related
Charges
 

REVENUES:

      

Health plan services premiums

   $ 3,122,988       $ 3,122,988  

Government contracts

     664,449         664,449  

Net investment income

     35,371         35,371  

Administrative services fees and other income

     13,948       (3,400 )     17,348  
                        
     3,836,756       (3,400 )     3,840,156  
                        

EXPENSES:

      

Health plan services

     2,788,403     $ 43,196       2,745,207  

Government contracts

     637,577         637,577  

General and administrative

     352,278       35,823       316,455  

Selling

     86,592         86,592  

Depreciation and amortization

     12,279         12,279  

Interest

     10,657         10,657  
                        
     3,887,786       79,019       3,808,767  

(Loss) income from operations before income taxes

     (51,030 )     (82,419 )     31,389  

Income tax (benefit) provision

     (15,350 )     (28,624 )     13,274  
                        

Net (loss) income

   $ (35,680 )   $ (53,795 )   $ 18,115  
                        

Basic (loss) earnings per share

   $ (0.33 )   $ (0.50 )   $ 0.17  

Diluted (loss) earnings per share

   $ (0.33 )   $ (0.49 )   $ 0.16  

Weighted average shares outstanding:

      

Basic

     109,232         109,232  

Diluted

     109,232         111,195  

Pretax margin

     -1.3 %     -2.1 %     0.8 %

Health plan services MCR

     89.3 %     1.4 %     87.9 %

Government contracts cost ratio

     96.0 %     —         96.0 %

G&A expense ratio

     11.2 %     1.1 %     10.1 %

Selling costs ratio

     2.8 %     —         2.8 %

Effective tax rate

     30.1 %     -12.2 %     42.3 %


Health Net, Inc.

Consolidated Statements of Cash Flows

(Amounts in thousands)

 

     Quarter Ended
March 31,
2007
    Quarter Ended
December 31,
2007
    Quarter Ended
March 31,
2008
 

CASH FLOWS FROM OPERATING ACTIVITIES:

      

Net income (loss)

   $ 88,585     $ 116,927     $ (35,680 )

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

      

Amortization and depreciation

     7,633       13,598       12,279  

Share-based compensation expense

     5,240       6,457       6,667  

Deferred income taxes

     74,977       (8,180 )     (26,862 )

Excess tax benefits from share-based compensation

     (10,399 )     (487 )     (774 )

Other changes

     (1,510 )     (3,498 )     (5,116 )

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

      

Premiums receivable and unearned premiums

     181,344       24,037       (64,281 )

Other receivables, deferred taxes and other assets

     (91,957 )     47,064       (16,665 )

Amounts receivable/payable under government contracts

     (1,122 )     1,213       (71,770 )

Reserves for claims and other settlements

     49,157       (12,672 )     130,298  

Accounts payable and other liabilities

     42,079       72,508       (45,429 )
                        

Net cash provided by (used in) operating activities

     344,027       256,967       (117,333 )
                        

CASH FLOWS FROM INVESTING ACTIVITIES:

      

Sales of investments

     383,857       242,421       341,197  

Maturities of investments

     60,004       65,606       46,820  

Purchases of investments

     (419,172 )     (397,611 )     (377,638 )

Proceeds from sale of property and equipment

     83,870       —         4  

Purchases of property and equipment

     (19,629 )     (17,342 )     (14,765 )

Net cash paid for acquisition of Guardian assets

     (69,780 )     —         —    

Purchases and Sales of restricted investments and other

     (3,970 )     7,127       11,150  
                        

Net cash provided by (used in) investing activities

     15,180       (99,799 )     6,768  
                        

CASH FLOWS FROM FINANCING ACTIVITIES:

      

Proceeds from exercise of stock options and employee stock purchases

     30,652       2,525       5,559  

Repurchases of common stock

     (55,893 )     (27,052 )     (142,978 )

Excess tax benefits from share-based compensation

     10,399       487       774  

Borrowings under financing arrangements

     100,000       175,000       100,000  

Repayment of borrowings under financing arrangements

     (200,000 )     —         —    
                        

Net cash (used in) provided by financing activities

     (114,842 )     150,960       (36,645 )
                        

Net increase (decrease) in cash and cash equivalents

     244,365       308,128       (147,210 )

Cash and cash equivalents, beginning of period

     704,806       698,889       1,007,017  
                        

Cash and cash equivalents, end of period

   $ 949,171     $ 1,007,017     $ 859,807  
                        


Health Net, Inc.

Consolidated Balance Sheet

(Amounts in thousands, except ratio data)

 

     March 31,
2007
    December 31,
2007
    March 31,
2008
 

ASSETS

      

Current Assets

      

Cash and cash equivalents

   $ 949,171     $ 1,007,017     $ 859,807  

Investments - available for sale

     1,393,161       1,557,278       1,547,236  

Premiums receivable, net

     234,795       264,691       335,085  

Amounts receivable under government contracts

     190,259       189,976       263,642  

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

     291,862       266,767       285,545  

Other receivables

     196,029       72,518       90,660  

Deferred taxes

     72,107       132,818       102,868  

Other assets

     175,270       210,039       265,758  
                        

Total current assets

     3,502,654       3,701,104       3,750,601  

Property and equipment, net

     157,464       178,758       184,329  

Goodwill, net

     751,949       751,949       751,949  

Other intangible assets, net

     41,486       109,386       104,348  

Deferred taxes

     90,953       47,765       49,743  

Other noncurrent assets

     176,158       144,093       137,492  
                        

Total Assets

   $ 4,720,664     $ 4,933,055     $ 4,978,462  
                        

LIABILITIES AND STOCKHOLDERS’ EQUITY

      

Current Liabilities

      

Reserves for claims and other settlements

   $ 1,097,953     $ 1,300,432     $ 1,430,730  

Health care and other costs payable under government contracts

     41,952       69,014       70,910  

IBNR health care costs payable under TRICARE North contract

     291,862       266,767       285,545  

Unearned premiums

     402,613       176,981       183,094  

Loans payable and other financing arrangements

     —         35,000       25,356  

Accounts payable and other liabilities

     378,233       463,823       432,304  
                        

Total current liabilities

     2,212,613       2,312,017       2,427,939  

Senior notes payable

     —         398,071       398,122  

Loans payable and other financing arrangements

     400,000       112,363       124,782  

Borrowings under revolving credit facility

     —         —         100,000  

Other noncurrent liabilities

     245,477       235,022       216,042  
                        

Total Liabilities

     2,858,090       3,057,473       3,266,885  
                        

Stockholders’ Equity

      

Common stock and additional paid-in capital

     1,077,210       1,151,395       1,164,688  

Treasury common stock, at cost

     (947,187 )     (1,123,750 )     (1,267,125 )

Retained earnings

     1,743,985       1,849,097       1,813,417  

Accumulated other comprehensive (loss) income

     (11,434 )     (1,160 )     597  
                        

Total Stockholders’ Equity

     1,862,574       1,875,582       1,711,577  
                        

Total Liabilities and Stockholders' Equity

   $ 4,720,664     $ 4,933,055     $ 4,978,462  
                        

Debt-to-Total Capital Ratio

     17.7 %     22.5 %     27.5 %


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:

 

     Q1 2007     Q4 2007     Q1 2008  
     (Dollars in millions)  

Reserve for Claims and Other Settlements

   $ 1,098.0     $ 1,300.4     $ 1,430.7  

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

     (101.1 )     (299.3 )     (286.4 )
                        

Adjusted Reserve for Claims and Other Settlements

     996.9       1,001.1       1,144.3  

(1) Average Reserve for Claims and Other Settlements

     1,073.4       1,306.8       1,365.6  

(2) Average Adjusted Reserve for Claims and Other Settlements

     980.2       1,011.8       1,072.7  

(3) Health Plan Services Cost

     2,341.1       2,409.3       2,788.4  

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

     (720.9 )     (715.2 )     (943.9 )
                        

(4) Adjusted Health Plan Services Cost

     1,620.2       1,694.1       1,844.5  

(5) Number of Days in Period

     90       92       91  

= (1) / (3) * (5) Days Claims Payable

     41.3       49.9       44.6  

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

     54.4       54.9       52.9  


Health Net, Inc.

Reconciliation of Reserves for Claims and Other Settlements

(In millions)

 

     Health Plan Services  
     Q1 2008    Year 2007    Year 2006  

Reserve for claims (a), beginning of period

   $ 838.7    $ 754.2    $ 768.7  

Incurred claims related to:

        

Current Year

     1,597.3      5,790.7      5,222.0  

Prior Years (c)

     7.1      0.6      (77.3 )
                      

Total Incurred (b)

     1,604.4      5,791.3      5,144.7  

Paid claims related to:

        

Current Year

     865.0      4,972.3      4,485.7  

Prior Years

     667.0      734.5      673.5  
                      

Total Paid (b)

     1,532.0      5,706.8      5,159.2  

Reserve for claims (a), end of period

     911.1      838.7      754.2  

Add:

        

Claims Payable (d)

     401.2      365.6      203.9  

Other (e)

     118.4      96.1      90.7  
                      

Reserves for claims and other settlements, end of period

   $ 1,430.7    $ 1,300.4    $ 1,048.8  
                      

 

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