-----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, OzKdH7o2ESqGXrb8epqFFIiqQ5/XVba5UGWwjpb2Vg7zgiFi6GczM7gu3EWmm8HZ Hr/MHH74WQVlQ7ormvbHIg== 0001193125-08-165852.txt : 20080805 0001193125-08-165852.hdr.sgml : 20080805 20080805083623 ACCESSION NUMBER: 0001193125-08-165852 CONFORMED SUBMISSION TYPE: 8-K PUBLIC DOCUMENT COUNT: 3 CONFORMED PERIOD OF REPORT: 20080805 ITEM INFORMATION: Results of Operations and Financial Condition ITEM INFORMATION: Financial Statements and Exhibits FILED AS OF DATE: 20080805 DATE AS OF CHANGE: 20080805 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: 08989749 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): AUGUST 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 August 5, 2008, Health Net, Inc. (the “Company”) issued a press release announcing its earnings for the quarter ended June 30, 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 August 5, 2008 announcing results for the quarter ended June 30, 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: August 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 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

 

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

HEALTH NET REPORTS SECOND QUARTER 2008 EARNINGS

OF $0.71 PER DILUTED SHARE

THE COMPANY RECORDED A $13.0 MILLION, OR $0.03 PER SHARE,

OPERATIONS STRATEGY-RELATED CHARGE IN THE SECOND QUARTER OF 2008

THE COMPANY REDUCES ITS 2008 OUTLOOK

LOS ANGELES, August 5, 2008 – Health Net, Inc. (NYSE: HNT) today announced second quarter 2008 earnings of $76.7 million, or $0.71 per diluted share. Net income for the second quarter of 2007 was $92.0 million, or $0.80 per diluted share.

Included in the results for the second quarter of 2008 is the full effect of a $13.0 million pretax charge relating to the company’s operations strategy that is designed to reduce general and administrative (G&A) expenses.

Adjusted1 earnings per diluted share were $0.74 in the second quarter of 2008.

 

 

1

On a reported GAAP basis, diluted earnings per share were $0.71, pretax margin was 3.1 percent and G&A expense ratio was 9.5 percent for the second quarter of 2008. G&A expense for the second quarter of 2008 includes the operations strategy charge of $13.0 million, or $0.03 per share. Excluding this charge, earnings per share were $0.74, pretax margin was 3.4 percent and G&A expense ratio was 9.1 percent for the second quarter of 2008. Such adjusted numbers are non-GAAP financial measures. Further explanation of these non-GAAP measures and reconciliation to the comparable GAAP measures are included in the attached reconciliation schedule. Other key metrics, including MCR, government contracts cost ratio and selling expense ratio, are not impacted by the charge.


Second Quarter 2008 Highlights

 

  1. Commercial per member per month (PMPM) premium yields increased by 9.0 percent compared to the second quarter of 2007 while commercial health care costs increased by 8.6 percent compared to the second quarter of 2007. Commercial risk membership in the second quarter declined by 57,000 members, or 2.6 percent, to 2.1 million members from the second quarter of 2007, primarily as a result of a further weakening in the economy since the first quarter of 2008 and the company’s continued focus on pricing discipline. Sequentially, commercial risk membership declined by 39,000 members, or 1.8 percent, from the first quarter of 2008.

 

  2. The commercial medical care ratio (MCR) of 84.2 percent improved 30 basis points compared to the second quarter of 2007.

 

  3. The health plan MCR increased by 60 basis points to 85.3 percent compared to the second quarter of 2007 due to higher utilization by new Medicare members added in 2008.

 

 

4.

The adjusted1 G&A ratio was 9.1 percent and improved 50 basis points compared to the second quarter of 2007 as a result of the company’s focus on expense management.

 

  5. Investment income decreased by approximately $7.0 million compared to the second quarter of 2007 and by $14 million compared to the first quarter of 2008. The decrease was primarily due to the change in fair value of a swap contract related to the financing facility that the company secured in late 2007 as well as lower interest rates during the second quarter of 2008.

 

 

6.

Days claims payable increased by 6.1 days compared to the second quarter of 2007 and by 3.2 days compared to the first quarter of 2008. When adjusted for capitation, provider settlements, and Medicare Part D costs, days in claims payable increased by 0.7 days compared to the second quarter of 2007 and by 3.1 days compared to the first quarter of 2008.2

Revised Full-Year 2008 Guidance

The company also announced that it is reducing full-year 2008 guidance to a range of $1.97 to $2.03 per diluted share, which includes charges taken in the first half of 2008 and the

 

 

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.

 

Page 2


remaining $60 million to $70 million in pretax operations strategy charges the company expects to take in the third and fourth quarters.

Excluding these charges, the company currently expects to earn between $2.85 and $2.95 per diluted share in 2008. Previous 2008 guidance was $3.45 to $3.55 per diluted share, excluding the impact of any charges. The revised full-year 2008 guidance is driven by the following factors that are expected to impact the company in the second half of 2008:

 

  1. Lower than expected commercial membership as a result of commercial pricing discipline, coupled with a further weakening in the economy, is expected to have an impact of $15 million to $20 million.

 

  2. An anticipated increase in Medicare health care costs of approximately $37 million due to higher utilization by new Medicare members added in 2008 and reduced Medicare revenue of approximately $8 million as a result of lower per member reimbursement.

 

  3. Higher than anticipated commercial health care costs of approximately $17 million.

 

  4. Higher than expected G&A costs of $6 million and lower than expected investment income of $4 million.

“We believe in the strength of our diversified business portfolio, especially in light of the current economic and regulatory environments. However, based on factors that emerged during the second quarter that will impact the second half of 2008, we are lowering our full-year 2008 outlook,” said Jay Gellert, president and chief executive officer of Health Net.

“First, our focus on maintaining our pricing discipline combined with a further weakening in the economy is causing us to lower our enrollment expectations for the full year,” continued Gellert. “Despite this, we continue to expect to achieve our goal of driving premium revenue increases in the second half of 2008.”

“Also, it is now apparent that Medicare health care costs are running higher than previous expectations. We believe we addressed these issues in our 2009 bid, submitted in early June. As a result, we expect improvements in our Medicare performance across both the Medicare Advantage and Part D businesses in 2009,” said Gellert.

“Although health care costs were relatively stable in the second quarter, we currently expect commercial health care costs to run modestly higher in the second half of 2008,” continued Gellert. “We believe we will maintain a positive spread in commercial premium yields versus health care costs through the balance of 2008.”

 

Page 3


The revised full-year 2008 earnings per diluted share estimates are based on a projected weighted average share count for the full year of 2008 of approximately 105.5 to 107 million, unchanged from prior guidance. Health Net did not repurchase any shares in the second quarter of 2008. The company has $203 million in remaining purchase authority.

A table at the end of this press release outlines the revised full year 2008 guidance.

Third Quarter 2008 Guidance

Including the impact of operations strategy charge, the company expects to earn between $0.68 and $0.71 per diluted share in the third quarter of 2008. Excluding the charges, the company expects to earn between $0.89 and $0.91 per diluted share in the third quarter of 2008.

Revenues and Health Care Costs

Health Net’s total revenues increased 10.9 percent in the second quarter of 2008 to $3.8 billion from $3.5 billion in the second quarter of 2007. Health plan services premium revenues increased 10.8 percent to $3.1 billion in the second quarter of 2008 compared to $2.8 billion in the second quarter of 2007. The company’s Government contracts revenues increased 13.2 percent in the second quarter of 2008 to $694.9 million from $613.9 million in the second quarter of 2007.

The health plan MCR was 85.3 percent in the second quarter of 2008 compared to 84.7 percent in the second quarter of 2007. The commercial MCR was 84.2 percent in the second quarter of 2008 compared to 84.5 percent in the second quarter of 2007.

The Government contracts cost ratio was 94.7 percent in the second quarter of 2008 compared to 92.9 percent in the second quarter of 2007. The year-over-year increase primarily was due to favorable Option Period 3 health care costs that impacted 2007.

“Our Government Contracts division continues to perform as expected,” said Jim Woys, Health Net’s chief operating officer. “We are honored to serve the dynamic needs of the military family – whether through our TRICARE, Veterans Affairs or Military Family Life Counseling programs. We continue to work in a very close and collaborative partnership with our customers, and our collective efforts have broadened access and health care quality for military personnel, their families and Veteran beneficiaries.”

 

Page 4


G&A Expenses

Total G&A expense was $297.5 million in the second quarter of 2008 compared with $270.0 million in the second quarter of 2007. Total adjusted1 G&A expense in the second quarter of 2008 was $284.4 million compared to $270.0 million in the second quarter of 2007. In the first quarter of 2008, G&A expenses of $352.3 million included $35.8 million in litigation and operations strategy charges. Excluding the charges taken in the first and second quarters of 2008, G&A expenses improved by $32.1 million in the second quarter of 2008 compared to the first quarter of 2008.

“The adjusted1 G&A expense ratio in the second quarter improved by 50 basis points from the second quarter of 2007 and 100 basis points from the first quarter of 2008 as we continue to focus on our operations strategy and managing our expenses,” said Joseph C. Capezza, Health Net’s chief financial officer. “For the full year 2008, we expect the G&A ratio, excluding any operations strategy charges, to increase from the second quarter.”

Health Net’s selling expenses of $88.2 million in the second quarter of 2008 increased by $11.4 million compared to the second quarter of 2007.

Membership

Total health plan enrollment as of June 30, 2008 was nearly 3.8 million members. This represents an increase of 60,000 members, or 1.6 percent, compared to June 30, 2007, and a decrease of 88,000 members, or 2.3 percent, compared to March 31, 2008.

Commercial risk enrollment as of June 30, 2008 decreased to approximately 2.1 million, or by 57,000 members, compared to June 30, 2007. Sequentially, commercial risk enrollment decreased by 39,000 members, or 1.8 percent, since March 31, 2008. Administrative Services Only (ASO) membership decreased by 52,000 members, or 54.2 percent, to 44,000 members as of June 30, 2008 compared to June 30, 2007. Sequentially, ASO membership declined by 14,000, or 24.1 percent, from March 31, 2008, consistent with the company’s strategy to de-emphasize this business.

Enrollment in the company’s Medicare Advantage plans grew by 49,000 members, or 20.8 percent, to 285,000 members at the end of the second quarter of 2008 compared to the end of the second quarter of 2007. Sequentially, Medicare Advantage membership grew by 9,000 members, or 3.3 percent, from March 31, 2008. Membership in the company’s Medicare PDP plans was 526,000 at the end of the second quarter of 2008, an increase of 178,000 members, or

 

Page 5


51.1 percent, compared to the end of the second quarter of 2007. Sequentially, PDP membership grew by 4,000 members, or nearly 1.0 percent, from March 31, 2008.

Medicaid enrollment at June 30, 2008 was 781,000 members, a decrease of 58,000 members, or 6.9 percent, from June 30, 2007. Sequentially, Medicaid membership decreased by 48,000 members, or 5.8 percent, from March 31, 2008. The decline in Medicaid membership primarily was due to the company’s exit from the Connecticut Medicaid business in April 2008.

Balance Sheet

The company recorded cash and investments as of June 30, 2008 of approximately $2.3 billion compared with $2.4 billion as of June 30, 2007. The company noted that its investment portfolio is comprised of a diversified mix of high quality, fixed income securities. Mortgage and asset-backed securities represent 41 percent of the portfolio, of which approximately 98 percent are issued by government-sponsored or -owned enterprises. The company does not own any investments that have direct subprime mortgage exposure.

Reserves for claims and other settlements as of June 30, 2008 were approximately $1.4 billion compared with nearly $1.1 billion as of June 30, 2007. Reserves for claims and other settlements decreased by $73.0 million from March 31, 2008 to June 30, 2008.

Days claims payable (DCP), including provider and other claims settlements, capitation payments and Medicare Part D expenses, for the second quarter of 2008 increased by 6.1 days to 47.8 days compared to 41.7 days in the second quarter of 2007, and increased sequentially by 3.2 days compared to the first quarter of 2008.

Excluding provider and other claim settlements, capitation payments and Medicare Part D, DCP in the second quarter of 2008 increased by 0.7 days to 56.0 days compared to the second quarter of 2007, and increased by 3.1 days sequentially.2

The company’s debt-to-total capital ratio was 27.8 percent as of June 30, 2008 compared to 27.5 percent as of March 31, 2008 and 17.0 percent as of June 30, 2007. The debt-to-total capital ratio increased primarily as a result of the result of the company’s draw on its revolving credit facility to fund various legal settlement payments and the purchase of equipment under a lease facility that expired in the second quarter of 2008.

Interest expense increased by $3.5 million in the second quarter of 2008 compared to the second quarter of 2007. The increase is due to the higher draw on the revolving credit facility and an increase in the imputed interest on the company’s financing facility. The imputed interest on the financing facility is offset by other income related to the same facility.

 

Page 6


Cash Flow

Operating cash flow was negative $80.5 million in the second quarter of 2008. This decrease was primarily driven by the following factors:

 

  1. Part D risk adjusters and reinsurance that total $87 million, of which the company received $47 million in July 2008.

 

  2. Litigation settlement and operations strategy payments of $41 million in the quarter.

 

  3. The company’s annual shared risk settlement with California medical groups in the amount of $18 million in the quarter.

“For the full year 2008, we expect operating cash flow of approximately $320 million, excluding litigation and operation strategy payments,” said Capezza. “This will provide sufficient cash to repurchase our annual goal of three to five percent of our outstanding shares.”

Full Year 2008 Guidance Table

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

FY2008 Revised Outlook

 

    

Revised Guidance

  

Comment

Year-end Membership   

Commercial Risk: -6% to -7%

Medicaid: flat

Medicare Advantage: +20% to 25%

PDP: +40% to 45%

  

Previously: -3% to -4%

Unchanged

Unchanged

Unchanged

Consolidated Revenues    $15 to $16 billion    Unchanged
Commercial Yields    8.0%    Unchanged

Commercial

Health Care Cost Trends*

  

8.4%

(Includes 50 bps of prior period development booked in 1Q08)

   Previously: 8.0%

Selling Cost Ratio

Government Contracts Ratio

G&A Expense Ratio*

  

~ 2.8%

~ 94.5%

~ 9.8%

  

Unchanged

Unchanged

Previously: ~10.0%

 

Page 7


FY2008 Revised Outlook (continued)

 

Tax Rate*    ~ 39.5%    Unchanged

Weighted-average

Fully Diluted Shares

Outstanding

   105.5-107 million    Unchanged
EPS*    $2.85 to $2.95    Previously: $3.45 - $3.55

 

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

Conference Call

As previously announced, Health Net will discuss the company’s second quarter 2008 results during a conference call on Tuesday, August 5, 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:

 

877.856.1965 (Domestic)    888.203.1112 (Replay – Domestic)
719.325.4793 (International)    719.457.0820 (Replay – International)

The access code for both the live conference call and the replay is 2150941. A replay of the conference call will be available through August 9, 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, Quarterly Report on Form 10-Q for the quarter ended March 31, 2008, 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 6.7 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

 

Page 8


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 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 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 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]

 

Page 9


Health Net, Inc.

Enrollment Data - By State

(In thousands)

 

                    Change from  
                    March 31, 2008     June 30, 2007  
     June 30,
2008
   March 31,
2008
   June 30,
2007
   Increase/
(Decrease)
    %
Change
    Increase/
(Decrease)
    %
Change
 

California

                 

Large Group

   971    984    1,013    (13 )   (1.3 )%   (42 )   (4.1 )%

Small Group and Individual

   453    468    425    (15 )   (3.2 )%   28     6.6 %
                                       

Commercial Risk

   1,424    1,452    1,438    (28 )   (1.9 )%   (14 )   (1.0 )%

ASO

   5    5    5    0     0.0 %   0     0.0 %
                                       

Total Commercial

   1,429    1,457    1,443    (28 )   (1.9 )%   (14 )   (1.0 )%

Medicare Advantage

   126    123    112    3     2.4 %   14     12.5 %

Medi-Cal

   737    720    708    17     2.4 %   29     4.1 %
                                       

Total California

   2,292    2,300    2,263    (8 )   (0.3 )%   29     1.3 %
                                       

Connecticut

                 

Large Group

   124    127    142    (3 )   (2.4 )%   (18 )   (12.7 )%

Small Group and Individual

   25    25    27    0     0.0 %   (2 )   (7.4 )%
                                       

Commercial Risk

   149    152    169    (3 )   (2.0 )%   (20 )   (11.8 )%

ASO

   25    26    58    (1 )   (3.8 )%   (33 )   (56.9 )%
                                       

Total Commercial

   174    178    227    (4 )   (2.2 )%   (53 )   (23.3 )%

Medicare Advantage

   57    54    43    3     5.6 %   14     32.6 %

Medicaid

   0    65    85    (65 )   (100.0 )%   (85 )   (100.0 )%
                                       

Total Connecticut

   231    297    355    (66 )   (22.2 )%   (124 )   (34.9 )%
                                       

New York

                 

Large Group

   104    105    116    (1 )   (1.0 )%   (12 )   (10.3 )%

Small Group and Individual

   109    113    117    (4 )   (3.5 )%   (8 )   (6.8 )%
                                       

Commercial Risk

   213    218    233    (5 )   (2.3 )%   (20 )   (8.6 )%

ASO

   11    11    15    0     0.0 %   (4 )   (26.7 )%
                                       

Total Commercial

   224    229    248    (5 )   (2.2 )%   (24 )   (9.7 )%

Medicare Advantage

   6    6    9    0     0.0 %   (3 )   (33.3 )%
                                       

Total New York

   230    235    257    (5 )   (2.1 )%   (27 )   (10.5 )%
                                       

New Jersey

                 

Large Group

   22    25    32    (3 )   (12.0 )%   (10 )   (31.3 )%

Small Group and Individual

   56    58    62    (2 )   (3.4 )%   (6 )   (9.7 )%
                                       

Commercial Risk

   78    83    94    (5 )   (6.0 )%   (16 )   (17.0 )%

ASO

   3    16    18    (13 )   (81.3 )%   (15 )   (83.3 )%
                                       

Total Commercial

   81    99    112    (18 )   (18.2 )%   (31 )   (27.7 )%

Medicaid

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

Total New Jersey

   125    143    158    (18 )   (12.6 )%   (33 )   (20.9 )%
                                       

Arizona

                 

Large Group

   84    85    80    (1 )   (1.2 )%   4     5.0 %

Small Group and Individual

   54    54    53    0     0.0 %   1     1.9 %
                                       

Commercial Risk

   138    139    133    (1 )   (0.7 )%   5     3.8 %

Medicare Advantage

   64    62    48    2     3.2 %   16     33.3 %
                                       

Total Arizona

   202    201    181    1     0.5 %   21     11.6 %
                                       

Oregon

                 

Large Group

   103    101    96    2     2.0 %   7     7.3 %

Small Group and Individual

   36    35    35    1     2.9 %   1     2.9 %
                                       

Commercial Risk

   139    136    131    3     2.2 %   8     6.1 %

Medicare Advantage

   22    22    20    0     0.0 %   2     10.0 %
                                       

Total Oregon

   161    158    151    3     1.9 %   10     6.6 %
                                       

Other States

                 

Medicare Advantage

   10    9    4    1     11.1 %   6     150.0 %
                                       

Medicare PDP (stand-alone)

   526    522    348    4     0.8 %   178     51.1 %
                                       

Total Health Plan Enrollment

                 

Large Group

   1,408    1,427    1,479    (19 )   (1.3 )%   (71 )   (4.8 )%

Small Group and Individual

   733    753    719    (20 )   (2.7 )%   14     1.9 %
                                       

Commercial Risk

   2,141    2,180    2,198    (39 )   (1.8 )%   (57 )   (2.6 )%

ASO

   44    58    96    (14 )   (24.1 )%   (52 )   (54.2 )%
                                       

Total Commercial

   2,185    2,238    2,294    (53 )   (2.4 )%   (109 )   (4.8 )%

Medicare Advantage

   285    276    236    9     3.3 %   49     20.8 %

Medicare PDP (stand-alone)

   526    522    348    4     0.8 %   178     51.1 %

Medi-Cal/Medicaid

   781    829    839    (48 )   (5.8 )%   (58 )   (6.9 )%
                                       

Total Health Plans

   3,777    3,865    3,717    (88 )   (2.3 )%   60     1.6 %
                                       

TRICARE - North Contract Eligibles

   2,951    2,895    2,913    56     1.9 %   38     1.3 %
                                       

 

Page 10


Health Net, Inc.

Enrollment Data - Line of Business

(In thousands)

 

                    Change from  
                    March 31, 2008     June 30, 2007  
     June 30,
2008
   March 31,
2008
   June 30,
2007
   Increase/
(Decrease)
    %
Change
    Increase/
(Decrease)
    %
Change
 

Large Group

                 

California

   971    984    1,013    (13 )   (1.3 )%   (42 )   (4.1 )%

Connecticut

   124    127    142    (3 )   (2.4 )%   (18 )   (12.7 )%

New York

   104    105    116    (1 )   (1.0 )%   (12 )   (10.3 )%

New Jersey

   22    25    32    (3 )   (12.0 )%   (10 )   (31.3 )%

Arizona

   84    85    80    (1 )   (1.2 )%   4     5.0 %

Oregon

   103    101    96    2     2.0 %   7     7.3 %
                                       
   1,408    1,427    1,479    (19 )   (1.3 )%   (71 )   (4.8 )%
                                       

Small Group and Individual

                 

California

   453    468    425    (15 )   (3.2 )%   28     6.6 %

Connecticut

   25    25    27    0     0.0 %   (2 )   (7.4 )%

New York

   109    113    117    (4 )   (3.5 )%   (8 )   (6.8 )%

New Jersey

   56    58    62    (2 )   (3.4 )%   (6 )   (9.7 )%

Arizona

   54    54    53    0     0.0 %   1     1.9 %

Oregon

   36    35    35    1     2.9 %   1     2.9 %
                                       
   733    753    719    (20 )   (2.7 )%   14     1.9 %
                                       

Commercial Risk

                 

California

   1,424    1,452    1,438    (28 )   (1.9 )%   (14 )   (1.0 )%

Connecticut

   149    152    169    (3 )   (2.0 )%   (20 )   (11.8 )%

New York

   213    218    233    (5 )   (2.3 )%   (20 )   (8.6 )%

New Jersey

   78    83    94    (5 )   (6.0 )%   (16 )   (17.0 )%

Arizona

   138    139    133    (1 )   (0.7 )%   5     3.8 %

Oregon

   139    136    131    3     2.2 %   8     6.1 %
                                       
   2,141    2,180    2,198    (39 )   (1.8 )%   (57 )   (2.6 )%
                                       

ASO

                 

California

   5    5    5    0     0.0 %   0     0.0 %

Connecticut

   25    26    58    (1 )   (3.8 )%   (33 )   (56.9 )%

New York

   11    11    15    0     0.0 %   (4 )   (26.7 )%

New Jersey

   3    16    18    (13 )   (81.3 )%   (15 )   (83.3 )%
                                       
   44    58    96    (14 )   (24.1 )%   (52 )   (54.2 )%

Total Commercial

                 

California

   1,429    1,457    1,443    (28 )   (1.9 )%   (14 )   (1.0 )%

Connecticut

   174    178    227    (4 )   (2.2 )%   (53 )   (23.3 )%

New York

   224    229    248    (5 )   (2.2 )%   (24 )   (9.7 )%

New Jersey

   81    99    112    (18 )   (18.2 )%   (31 )   (27.7 )%

Arizona

   138    139    133    (1 )   (0.7 )%   5     3.8 %

Oregon

   139    136    131    3     2.2 %   8     6.1 %
                                       
   2,185    2,238    2,294    (53 )   (2.4 )%   (109 )   (4.8 )%

Medicare Advantage

                 

California

   126    123    112    3     2.4 %   14     12.5 %

Connecticut

   57    54    43    3     5.6 %   14     32.6 %

New York

   6    6    9    0     0.0 %   (3 )   (33.3 )%

Arizona

   64    62    48    2     3.2 %   16     33.3 %

Oregon

   22    22    20    0     0.0 %   2     10.0 %

Other States

   10    9    4    1     11.1 %   6     150.0 %
                                       
   285    276    236    9     3.3 %   49     20.8 %

Medi-Cal/Medicaid

                 

California

   737    720    708    17     2.4 %   29     4.1 %

Connecticut

   0    65    85    (65 )   (100.0 )%   (85 )   (100.0 )%

New Jersey

   44    44    46    0     0.0 %   (2 )   (4.3 )%
                                       
   781    829    839    (48 )   (5.8 )%   (58 )   (6.9 )%

Medicare PDP (stand-alone)

   526    522    348    4     0.8 %   178     51.1 %
                                       

Total Health Plan Enrollment

                 

Large Group

   1,408    1,427    1,479    (19 )   (1.3 )%   (71 )   (4.8 )%

Small Group and Individual

   733    753    719    (20 )   (2.7 )%   14     1.9 %
                                       

Commercial Risk

   2,141    2,180    2,198    (39 )   (1.8 )%   (57 )   (2.6 )%

ASO

   44    58    96    (14 )   (24.1 )%   (52 )   (54.2 )%
                                       

Total Commercial

   2,185    2,238    2,294    (53 )   (2.4 )%   (109 )   (4.8 )%

Medicare Advantage

   285    276    236    9     3.3 %   49     20.8 %

Medicare PDP (stand-alone)

   526    522    348    4     0.8 %   178     51.1 %

Medi-Cal/Medicaid

   781    829    839    (48 )   (5.8 )%   (58 )   (6.9 )%
                                       

Total Health Plans

   3,777    3,865    3,717    (88 )   (2.3 )%   60     1.6 %
                                       

TRICARE - North Contract Eligibles

   2,951    2,895    2,913    56     1.9 %   38     1.3 %
                                       

 

Page 11


Health Net, Inc.

Consolidated Statements of Operations

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

 

     Quarter Ended
June 30,
2007
    Quarter Ended
March 31,
2008
    Quarter Ended
June 30,
2008
 

REVENUES:

      

Health plan services premiums

   $ 2,811,186     $ 3,122,988     $ 3,114,168  

Government contracts

     613,865       664,449       694,885  

Net investment income

     27,884       35,371       20,931  

Administrative services fees and other income

     11,243       13,948       11,516  
                        
     3,464,178       3,836,756       3,841,500  
                        
      

EXPENSES:

      

Health plan services

     2,381,279       2,788,403       2,655,066  

Government contracts

     570,518       637,577       658,255  

General and administrative

     270,003       352,278       297,475  

Selling

     76,842       86,592       88,243  

Depreciation and amortization

     9,013       12,279       13,073  

Interest

     7,824       10,657       11,316  
                        
     3,315,479       3,887,786       3,723,428  

Income (loss) from operations before income taxes

     148,699       (51,030 )     118,072  

Income tax provision (benefit)

     56,669       (15,350 )     41,394  
                        

Net income (loss)

   $ 92,030     $ (35,680 )   $ 76,678  
                        

Basic earnings (loss) per share

   $ 0.82     $ (0.33 )   $ 0.71  

Diluted earnings (loss) per share

   $ 0.80     $ (0.33 )   $ 0.71  

Weighted average shares outstanding:

      

Basic

     112,122       109,232       107,308  

Diluted

     114,808       109,232       108,338  

Pretax margin

     4.3 %     -1.3 %     3.1 %

Health plan services MCR

     84.7 %     89.3 %     85.3 %

Government contracts cost ratio

     92.9 %     96.0 %     94.7 %

G&A expense ratio

     9.6 %     11.2 %     9.5 %

Selling costs ratio

     2.7 %     2.8 %     2.8 %

Days claims payable (a)

     41.7       44.6       47.8  

Days claims payable - adjusted (a)

     55.3       52.9       56.0  

Effective tax rate

     38.1 %     30.1 %     35.1 %

Health plan services premiums PMPM

   $ 260.18     $ 277.17     $ 278.25  

Health plan services costs PMPM

   $ 220.39     $ 247.48     $ 237.23  

 

Page 12


Health Net, Inc.

Reconciliation of Non-GAAP Financial Measures

Operating Results Excluding Charge

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

 

Note: This table presents the company’s consolidated operations for the quarter ended June 30, 2008 and the charge recorded in the consolidated statement of operations for quarter ended June 30, 2008. Management believes that the presentation of certain financial information in the attached press release (such as General and administrative expense, Income before income taxes, Income tax provision, Net income, Basic and diluted earnings per share, Pretax margin and G&A expense ratio), excluding the charge that was recorded in the quarter ended June 30, 2008, all of which is non-GAAP financial information, is important to investors as it excludes special 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
June 30,
2008
    Impact of
Charge
    Excluding
Impact of
Charge
 

REVENUES:

      

Health plan services premiums

   $ 3,114,168       $ 3,114,168  

Government contracts

     694,885         694,885  

Net investment income

     20,931         20,931  

Administrative services fees and other income

     11,516         11,516  
                        
     3,841,500       —         3,841,500  
                        

EXPENSES:

      

Health plan services

     2,655,066         2,655,066  

Government contracts

     658,255         658,255  

General and administrative

     297,475       13,037       284,438  

Selling

     88,243         88,243  

Depreciation and amortization

     13,073         13,073  

Interest

     11,316         11,316  
                        
     3,723,428       13,037       3,710,391  

Income (loss) from operations before income taxes

     118,072       (13,037 )     131,109  

Income tax provision (benefit)

     41,394       (9,739 )     51,133  
                        

Net income (loss)

   $ 76,678     $ (3,298 )   $ 79,976  
                        

Basic earnings per share

   $ 0.71       $ 0.75  

Diluted earnings per share

   $ 0.71     $ (0.03 )   $ 0.74  

Weighted average shares outstanding:

      

Basic

     107,308         107,308  

Diluted

     108,338         108,338  

Pretax margin

     3.1 %     -0.3 %     3.4 %

Health plan services MCR

     85.3 %     —         85.3 %

Government contracts cost ratio

     94.7 %     —         94.7 %

G&A expense ratio

     9.5 %     0.4 %     9.1 %

Selling costs ratio

     2.8 %     —         2.8 %

Effective tax rate

     35.1 %     -3.9 %     39.0 %

 

Page 13


Health Net, Inc.

Consolidated Statements of Cash Flows

(Amounts in thousands)

 

     Quarter Ended
June 30,
2007
    Quarter Ended
March 31,
2008
    Quarter Ended
June 30,
2008
 

CASH FLOWS FROM OPERATING ACTIVITIES:

      

Net income (loss)

   $ 92,030     $ (35,680 )   $ 76,678  

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

      

Amortization and depreciation

     9,013       12,279       13,073  

Share-based compensation expense

     6,529       6,667       7,888  

Deferred income taxes

     (7,219 )     (26,862 )     1,975  

Excess tax benefits from share-based compensation

     (3,789 )     (774 )     (6 )

Other changes

     (3,067 )     (5,116 )     5,637  

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

      

Premiums receivable and unearned premiums

     40,925       (64,281 )     (58,723 )

Other receivables, deferred taxes and other assets

     96,616       (16,665 )     35,652  

Amounts receivable/payable under government contracts

     (27,299 )     (71,770 )     8,196  

Reserves for claims and other settlements

     (13,492 )     130,298       (72,974 )

Accounts payable and other liabilities

     (54,591 )     (45,429 )     (97,888 )
                        

Net cash provided by (used in) operating activities

     135,656       (117,333 )     (80,492 )
                        

CASH FLOWS FROM INVESTING ACTIVITIES:

      

Sales of investments

     86,689       341,197       209,569  

Maturities of investments

     46,730       46,820       89,812  

Purchases of investments

     (190,873 )     (377,638 )     (296,988 )

Proceeds from sale of property and equipment

     12,878       4       —    

Purchases of property and equipment

     (13,394 )     (14,765 )     (60,078 )

Net cash paid for acquisition of Guardian assets

     (10,497 )     —         —    

Purchases and Sales of restricted investments and other

     (35,592 )     11,150       1,959  
                        

Net cash (used in) provided by investing activities

     (104,059 )     6,768       (55,726 )
                        

CASH FLOWS FROM FINANCING ACTIVITIES:

      

Proceeds from exercise of stock options and employee stock purchases

     11,949       5,559       842  

Repurchases of common stock

     (13,891 )     (142,978 )     (67 )

Excess tax benefits from share-based compensation

     3,789       774       6  

Borrowings under financing arrangements

     393,535       100,000       45,000  

Repayment of borrowings under financing arrangements

     (400,000 )     —         (8,722 )
                        

Net cash (used in) provided by financing activities

     (4,618 )     (36,645 )     37,059  
                        

Net increase (decrease) in cash and cash equivalents

     26,979       (147,210 )     (99,159 )

Cash and cash equivalents, beginning of period

     949,171       1,007,017       859,807  
                        

Cash and cash equivalents, end of period

   $ 976,150     $ 859,807     $ 760,648  
                        

 

Page 14


Health Net, Inc.

Consolidated Balance Sheet

(Amounts in thousands, except ratio data)

 

     June 30,
2007
    March 31,
2008
    June 30,
2008
 

ASSETS

      

Current Assets

      

Cash and cash equivalents

   $ 976,150     $ 859,807     $ 760,648  

Investments - available for sale

     1,421,537       1,547,236       1,514,421  

Premiums receivable, net

     206,513       335,085       400,918  

Amounts receivable under government contracts

     229,134       263,642       262,877  

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

     271,327       285,545       280,801  

Other receivables

     105,093       90,660       92,310  

Deferred taxes

     69,369       102,868       107,478  

Other assets

     179,722       265,758       223,326  
                        

Total current assets

     3,458,845       3,750,601       3,642,779  

Property and equipment, net

     163,877       184,329       234,423  

Goodwill, net

     751,949       751,949       751,949  

Other intangible assets, net

     119,463       104,348       101,216  

Deferred taxes

     92,127       49,743       55,096  

Other noncurrent assets

     145,703       137,492       135,896  
                        

Total Assets

   $ 4,731,964     $ 4,978,462     $ 4,921,359  
                        
      

LIABILITIES AND STOCKHOLDERS’ EQUITY

      

Current Liabilities

      

Reserves for claims and other settlements

   $ 1,084,461     $ 1,430,730     $ 1,357,756  

Health care and other costs payable under government contracts

     53,528       70,910       78,341  

IBNR health care costs payable under TRICARE North contract

     271,327       285,545       280,801  

Unearned premiums

     415,256       183,094       190,204  

Borrowings under amortizing financing facility

     —         25,356       26,028  

Accounts payable and other liabilities

     315,688       432,304       327,782  
                        

Total current liabilities

     2,140,260       2,427,939       2,260,912  

Senior notes payable

     397,968       398,122       398,173  

Borrowings under amortizing financing facility

     —         124,782       117,984  

Borrowings under revolving credit facility

     —         100,000       145,000  

Other noncurrent liabilities

     243,943       216,042       215,199  
                        

Total Liabilities

     2,782,171       3,266,885       3,137,268  
                        

Stockholders’ Equity

      

Common stock and additional paid-in capital

     1,100,623       1,164,688       1,173,132  

Treasury common stock, at cost

     (966,691 )     (1,267,125 )     (1,267,192 )

Retained earnings

     1,836,015       1,813,417       1,890,095  

Accumulated other comprehensive (loss) income

     (20,154 )     597       (11,944 )
                        

Total Stockholders’ Equity

     1,949,793       1,711,577       1,784,091  
                        

Total Liabilities and Stockholders’ Equity

   $ 4,731,964     $ 4,978,462     $ 4,921,359  
                        

Debt-to-Total Capital Ratio

     17.0 %     27.5 %     27.8 %

 

Page 15


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:

 

     Q2 2007     Q1 2008     Q2 2008  
     (Dollars in millions)  

Reserve for Claims and Other Settlements

   $ 1,084.5     $ 1,430.7     $ 1,357.8  

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

     (98.8 )     (286.4 )     (293.1 )
                        

Adjusted Reserve for Claims and Other Settlements

     985.7       1,144.3       1,064.7  

(1)    Average Reserve for Claims and Other Settlements

     1,091.2       1,365.6       1,394.3  

(2)    Average Adjusted Reserve for Claims and Other Settlements

     991.2       1,072.7       1,104.5  

(3)    Health Plan Services Cost

     2,381.3       2,788.4       2,655.1  

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

     (751.5 )     (943.9 )     (860.8 )
                        

(4)    Adjusted Health Plan Services Cost

     1,629.8       1,844.5       1,794.3  

(5)    Number of Days in Period

     91       91       91  

= (1) / (3) * (5) Days Claims Payable

     41.7       44.6       47.8  

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

     55.3       52.9       56.0  
      

 

Page 16


Health Net, Inc.

Reconciliation of Reserves for Claims and Other Settlements

(In millions)

 

     Health Plan Services  
     YTD 6/2008     Year 2007    Year 2006  

Reserve for claims (a), beginning of period

   $ 838.7     $ 754.2    $ 768.7  

Incurred claims related to:

       

Current Year

     3,155.3       5,790.7      5,222.0  

Prior Years (c)

     (5.5 )     0.6      (77.3 )
                       

Total Incurred (b)

     3,149.8       5,791.3      5,144.7  

Paid claims related to:

       

Current Year

     2,357.7       4,972.3      4,485.7  

Prior Years

     759.9       734.5      673.5  
                       

Total Paid (b)

     3,117.6       5,706.8      5,159.2  

Reserve for claims (a), end of period

     870.9       838.7      754.2  

Add:

       

Claims Payable (d)

     379.8       365.6      203.9  

Other (e)

     107.1       96.1      90.7  
                       

Reserves for claims and other settlements, end of period

   $ 1,357.8     $ 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.

 

Page 17

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