-----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, D84Zj3iDfhwlrg9UoZf7iViiygi12j5Cr6bj66GkV7t8JbAFSM21R6ZPp2nllFj9 29SR+uPGuPPeKg2rtF+y5g== 0001193125-10-020206.txt : 20100203 0001193125-10-020206.hdr.sgml : 20100203 20100203083010 ACCESSION NUMBER: 0001193125-10-020206 CONFORMED SUBMISSION TYPE: 8-K PUBLIC DOCUMENT COUNT: 3 CONFORMED PERIOD OF REPORT: 20100203 ITEM INFORMATION: Results of Operations and Financial Condition ITEM INFORMATION: Financial Statements and Exhibits FILED AS OF DATE: 20100203 DATE AS OF CHANGE: 20100203 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: 10568885 BUSINESS ADDRESS: STREET 1: 21650 OXNARD ST CITY: WOODLAND HILLS STATE: CA ZIP: 91367 BUSINESS PHONE: 8186766000 MAIL ADDRESS: STREET 1: 225 N MAIN ST CITY: PUEBLO STATE: CO ZIP: 81003 FORMER COMPANY: FORMER CONFORMED NAME: FOUNDATION HEALTH SYSTEMS INC DATE OF NAME CHANGE: 19970513 FORMER COMPANY: FORMER CONFORMED NAME: HEALTH SYSTEMS INTERNATIONAL INC DATE OF NAME CHANGE: 19940207 FORMER COMPANY: FORMER CONFORMED NAME: HN MANAGEMENT HOLDINGS INC/DE/ DATE OF NAME CHANGE: 19931213 8-K 1 d8k.htm FORM 8-K Form 8-K

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, D.C. 20549

 

 

FORM 8-K

 

 

CURRENT REPORT

Pursuant to Section 13 or 15(d) of the

Securities Exchange Act of 1934

Date of Report (Date of Earliest Event Reported): February 3, 2010

 

 

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)

Registrant’s telephone number, including area code: (818) 676-6000

Not Applicable

Former Name or Former Address, if Changed Since Last Report

 

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

 

¨ Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

 

¨ Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

 

¨ Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

 

¨ Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

 

 

 


Section 2- Financial Information

Item 2.02 Results of Operations and Financial Condition.

On February 3, 2010, Health Net, Inc. (the “Company”) issued a press release announcing its earnings for the quarter and year ended December 31, 2009. 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. Detailed explanations of the non-GAAP financial information contained in the release and reconciliations to the comparable GAAP information are contained in the financial tables attached to the release. 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.

(d) Exhibits

 

99.1    Press Release dated February 3, 2010 announcing results for the quarter and year ended December 31, 2009 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.

 

    Health Net, Inc.
February 3, 2010     By:   /s/ Angelee F. Bouchard
      Name: Angelee F. Bouchard
      Title: 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      Media Contact
Angie McCabe      Margita Thompson
818.676.8692      818.676.7912
angie.mccabe@healthnet.com      margita.thompson@healthnet.com

HEALTH NET REPORTS ADJUSTED1 FOURTH QUARTER 2009

NET INCOME OF $72.4 MILLION, OR $0.69 PER DILUTED SHARE

ADJUSTED1 NET INCOME FOR THE FULL YEAR 2009 WAS $235.1 MILLION,

OR $2.25 PER DILUTED SHARE

LOS ANGELES, February 3, 2010 – Health Net, Inc. (NYSE: HNT) today announced a fourth quarter 2009 net loss of $45.2 million, or $0.43 per share compared with fourth quarter 2008 net income of $35.5 million, or $0.34 per diluted share. Adjusted1 net income in the fourth quarter of 2009 was $72.4 million, or $0.69 per diluted share, compared with fourth quarter 2008 adjusted1 net income of $63.1 million, or $0.61 per diluted share.

The fourth quarter 2009 results include the effect of two pretax charges:

 

  1. $137.3 million in charges related to the Northeast businesses – $105.9 million for the loss on the sale of the Northeast businesses and $4.3 million in impairments on assets held for sale, both of which are noncash charges, as well as $27.0 million in cash charges, primarily for legal and regulatory costs, and fees and severance related to the Northeast sale; and

 

  2. $15.3 million in cash charges related to the company’s operations strategy and other expenses.

For the full year 2009, Health Net reported a net loss of $49.0 million, or $0.47 per share compared with full year 2008 net income of $95.0 million, or $0.88 per diluted share. Adjusted1 net income for the full year 2009 was $235.1 million, or $2.25 per diluted share compared with adjusted1 net income for the full year 2008 of $199.1 million, or $1.85 per diluted share.

 

1 Adjusted numbers are non-GAAP financial measures. Detailed explanations of the non-GAAP financial measures referred to in the press release and reconciliations to the comparable GAAP measures are included in the attached financial tables.


Fourth Quarter and Full-Year 2009 Key Highlights:

 

  1. The company completed the sale of its Northeast businesses on December 11, 2009, and received $350 million in cash at closing;

 

  2.

The company’s pretax margin on an adjusted1 basis improved 70 basis points to 3.3 percent in the fourth quarter of 2009 compared with the fourth quarter of 2008, and 30 basis points year-over-year;

 

  3. Cost-effective, narrow network commercial products in California grew 14 percent in the fourth quarter of 2009 compared with the fourth quarter of 2008; and

 

  4. The company resumed its share repurchase program in December 2009, and has repurchased more than 2.7 million shares at an average price of $24.74, for a total cost of $67.3 million through January 29, 2010.

“We are pleased with our fourth quarter and full-year 2009 results,” said Jay Gellert, president and chief executive officer of Health Net, Inc. “We completed our strategic review and closed the sale of the Northeast businesses. Also, as expected, our Medicare Advantage and Part D businesses returned to a solid level of performance after a difficult 2008.”

“We believe we are well-positioned to attract customers seeking value in these challenging economic times with our low-cost, narrow network products. We continue to believe that we can achieve our 2010 full-year earnings guidance,” continued Gellert.

“We are very pleased with our operating performance in 2009, especially in light of a challenging environment,” said James Woys, Health Net’s chief operating officer. “For example, commercial health care costs in the fourth quarter were adversely affected by higher utilization related to both the H1N1 flu and COBRA. Excluding these two effects, the commercial medical care ratio in the Western health plans improved both quarter-over-quarter and year-over-year.”

“Our balance sheet is solid, and the cash we received at the close of the Northeast sale gave us ample resources to resume our share repurchase program in December,” said Joseph Capezza, Health Net’s chief financial officer.

CONSOLIDATED RESULTS

Due to the sale of Health Net’s Northeast businesses on December 11, 2009, the company’s consolidated results exclude the results of Northeast businesses after that date through December 31, 2009.

Membership:

Total health plan enrollment in the company’s Western health plans was 3.0 million at December 31, 2009 compared with 3.1 million at December 31, 2008 and 3.0 million at September 30, 2009. The year-over-year decrease in membership is primarily due to higher unemployment as a result of economic pressures.

Total commercial risk enrollment at December 31, 2009 declined by 34,000 members, or 2.3 percent, from September 30, 2009. The Western region health plans produced commercial risk new sales of 35,000 members in the fourth quarter, with more than 9,400 of these new members in California’s low-cost, narrow network products.

 

2


Enrollment in the company’s Medicare Advantage plans at December 31, 2009 increased 2.3 percent to 227,000 members from December 31, 2008. Membership in the company’s Medicare Part D plans decreased by 5.5 percent to 460,000 members at December 31, 2009 compared with December 31, 2008.

Medi-Cal enrollment on December 31, 2009 was 857,000 members, an increase of 92,000 members, or 12.0 percent, from December 31, 2008. Sequentially, Medi-Cal membership increased 1.9 percent, or 16,000 members, from September 30, 2009. Both the year-over-year and the sequential increases were the result of the economic downturn that caused the Medicaid-eligible population to increase.

Revenues:

Health Net’s total revenues in the fourth quarter of 2009 were $3.8 billion. Total revenues in the fourth quarter of 2008 were $3.9 billion. Health plan services revenues were $3.0 billion in the fourth quarter of 2009 and $3.1 billion in the fourth quarter of 2008.

Government contracts revenues were $754.8 million in the fourth quarter of 2009 compared with $751.6 million in the fourth quarter of 2008.

Medical Care Ratios (MCR):

The health plan services MCR in the fourth quarter of 2009 increased 50 basis points to 85.8 percent from 85.3 percent in the fourth quarter of 2008.

The full-year 2009 health plan services MCR was 86.3 percent compared to 86.9 percent for the full year 2008.

The commercial MCR was 86.2 percent in the fourth quarter of 2009 compared with 84.1 percent in the fourth quarter of 2008. The majority of the MCR deterioration was due to higher than expected health care costs in the company’s Northeast businesses.

The commercial MCR in the company’s Western health plans was 86.4 percent in the fourth quarter of 2009 compared with 85.6 percent in the fourth quarter of 2008. For the full year of 2009, the Western health plan commercial MCR was 86.8 percent, while in 2008 it was 86.7 percent. The H1N1 flu and COBRA-related utilization impacted the Western health plan commercial MCR by 95 basis points in the fourth quarter of 2009 and by 55 basis points for the full year 2009.

Health Net’s Medicare Advantage and Part D plans continued to perform consistent with the company’s expectations in the fourth quarter of 2009 and for the full year of 2009.

The Government contracts ratio in the fourth quarter of 2009 was 93.2 percent compared with 95.6 percent in the fourth quarter of 2008 and 94.4 percent in the third quarter of 2009. The Government contracts ratio for the full year of 2009 was 94.6 percent compared with 95.3 percent for the full year of 2008. The improvement in the Government contracts ratio was due to an increase in volume in the company’s Military and Family Life Consultant (MFLC) contract and moderating health care cost trends.

Commercial Premium Yield and Health Care Cost Trends:

Commercial premium yields per member per month (PMPM) increased by 6.1 percent in the fourth quarter of 2009 compared with the fourth quarter of 2008. Total commercial health care costs PMPM increased 8.6 percent in the fourth quarter of 2009 compared with the fourth quarter of 2008.

For the full year 2009, commercial premium yields PMPM increased 7.6 percent. Including the impact of $4.8 million in favorable litigation reserve true-ups recorded in the second and third quarters of 2009, health care costs PMPM increased 7.8 percent. Excluding the impact of the favorable litigation reserve true-up, commercial health care costs PMPM increased by 8.4 percent.

 

3


The commercial premium yield PMPM for the Western health plans increased 8.5 percent in the fourth quarter of 2009 compared with the fourth quarter of 2008. Commercial health care costs PMPM for the Western health plans increased 9.5 percent in the fourth quarter of 2009 compared with the fourth quarter of 2008. For the full year 2009, commercial premium yields PMPM in the Western health plans increased 9.2 percent while commercial health care costs PMPM increased 9.4 percent in the Western health plans and included the negative impact of H1N1 and COBRA-related utilization.

General & Administrative (G&A) Expenses:

G&A expense was $359.0 million in the fourth quarter of 2009 compared with $347.1 million in the fourth quarter of 2008 and $319.5 million in the third quarter of 2009. On an adjusted1 basis, G&A expense was $299.7 million in the fourth quarter of 2009 compared with $293.6 million in the fourth quarter of 2008 and $300.0 million in the third quarter of 2009.

Operating Cash Flow:

Operating cash flow was $153.2 million in the fourth quarter of 2009. For the full year 2009, operating cash flow was $247.5 million. The full year amount was less than the company expected due to the following items:

 

  1. The delay of a $45 million payment from the California Department of Health Services for Medi-Cal. The payment was received in January 2010;

 

  2. A $16 million net increase in the Government contracts receivable due to payment timing issues; and

 

  3. $10 million in legal costs and settlements not included in the company’s cash flow guidance.

Balance Sheet Items:

Due to the sale of the Northeast businesses, the 2009 balance sheet amounts exclude the Northeast. Cash and investments at December 31, 2009 were approximately $2.1 billion compared with $1.8 billion at September 30, 2009 and $2.2 billion at December 31, 2008. Reserves for claims and other settlements as of December 31, 2009 were $951.7 million compared with $951.8 million at September 30, 2009 and $1.3 billion at December 31, 2008.

The company’s debt-to-total capital ratio was 26.2 percent on December 31, 2009 compared with 25.8 percent on September 30, 2009 and 27.9 percent on December 31, 2008.

Days Claims Payable (DCP):

DCP for the fourth quarter of 2009 was 38.6 days compared with 41.0 days in the third quarter of 2009. On a reported basis, days claims payable was calculated using year-end reserves that exclude the Northeast businesses compared to health plan expenses that include expenses related to the Northeast businesses through December 11, 2009. Excluding the fourth quarter Northeast health plan expenses, DCP would have been higher by 1.0 day sequentially.

On an adjusted2 basis, DCP in the fourth quarter of 2009 was 55.7 days compared with 55.4 days in the third quarter of 2009. Adjusted 2 DCP was calculated by excluding the Northeast fourth quarter 2009 health plan expenses, provider and other claims settlements and charges, capitation payments and Medicare and Part D expenses from health plan expenses.

 

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

 

4


2010 Guidance:

 

Metric

  

2010 Guidance

Year-end membership    Health Plan enrollment vs. 2009: flat
Consolidated revenues    $13.0 billion to $13.5 billion
Investment income    ~ $62 million to $68 million
Tax rate(a)    ~ 39%

Weighted-average

diluted shares outstanding

  

103 million to 104 million

(previously 104 million to 105 million)

GAAP EPS

Non-GAAP EPS(a)

  

$1.92 to $2.02 (previously $1.90 to $2.00)

$2.32 to $2.42 (previously $2.30 to $2.40)

 

(a)

Excludes approximately $69 million in pretax charges, of which approximately $53 million are related to the wind-down of the company’s Northeast businesses and approximately $16 million are related to the company’s operations strategy. Health Net currently expects these charges to impact general & administrative expenses.

Conference Call:

As previously announced, Health Net will discuss the company’s fourth quarter and year-end 2009 results during a conference call on Wednesday, February 3, 2010, 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:

 

866.393.1637 (Domestic)      800.642.1687 (Replay – Domestic)
706.643.5711 (International)      706.645.9291 (Replay – International)

An access code is required for both the live conference call and the replay. The access code is 46847009. A replay of the conference call will be available through 12:00 a.m. Eastern time on February 8, 2010. 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, 2008, Quarterly Reports on Form 10-Q for the quarters ended March 31, 2009, June 30, 2009, and September 30, 2009, and other reports filed by the company from time to time with the Securities and Exchange Commission.

 

5


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 6.1 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 6.5 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, 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, 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, costs, fees and expenses related to the post-closing administrative services to be provided under the administrative services agreements entered into in connection with the sale of our Northeast business; potential termination of the administrative services agreements by the service recipients should we breach such agreements or fail to perform all or a material part of the services required thereunder; any liabilities of the Northeast business that were incurred prior to the closing of its sale as well as those liabilities incurred through the winding-up and running-out period of the Northeast business; potential termination of our TRICARE North operations; rising health care costs; a continued decline in the economy; negative prior period claims reserve developments; investment portfolio impairment charges; volatility in the financial markets; trends in medical care ratios; unexpected utilization patterns or unexpectedly severe or widespread illnesses; membership declines; rate cuts affecting our Medicare or Medicaid businesses; litigation costs; regulatory issues; operational issues; health care reform; and general business and market 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, subsequent quarterly reports on Form 10-Q, and the risks discussed in the company’s other filings with the Securities and Exchange Commission. Readers are cautioned not to place undue reliance on these forward-looking statements. The company undertakes no obligation to publicly revise any of its forward-looking statements to reflect events or circumstances that arise after the date of this release.

The financial information presented in this press release is unaudited and is subject to change as a result of subsequent events or adjustments, if any, arising prior to the filing of the company’s Form 10-K for the year ended December 31, 2009.

#        #        #

[Eight pages of tables follow]

 

6


Health Net, Inc.

Enrollment Data - By State

(In thousands)

 

                    Change from  
                    September 30, 2009     December 31, 2008  
     Dec 31,
2009
   Sept 30,
2009
   Dec 31,
2008
   Increase/
(Decrease)
    %
Change
    Increase/
(Decrease)
    %
Change
 

California

                 

Large Group

   870    888    938    (18   (2.0 )%    (68   (7.2 )% 

Small Group and Individual

   357    365    414    (8   (2.2 )%    (57   (13.8 )% 
                                       

Commercial Risk

   1,227    1,253    1,352    (26   (2.1 )%    (125   (9.2 )% 

ASO

   5    5    5    0      0.0   0      0.0
                                       

Total Commercial

   1,232    1,258    1,357    (26   (2.1 )%    (125   (9.2 )% 

Medicare Advantage

   137    136    133    1      0.7   4      3.0

Medi-Cal

   857    841    765    16      1.9   92      12.0
                                       

Total California

   2,226    2,235    2,255    (9   (0.4 )%    (29   (1.3 )% 
                                       

Arizona

                 

Large Group

   59    59    77    0      0.0   (18   (23.4 )% 

Small Group and Individual

   37    38    46    (1   (2.6 )%    (9   (19.6 )% 
                                       

Commercial Risk

   96    97    123    (1   (1.0 )%    (27   (22.0 )% 

Medicare Advantage

   65    65    67    0      0.0   (2   (3.0 )% 
                                       

Total Arizona

   161    162    190    (1   (0.6 )%    (29   (15.3 )% 
                                       

Oregon

                 

Large Group

   72    78    93    (6   (7.7 )%    (21   (22.6 )% 

Small Group and Individual

   46    47    40    (1   (2.1 )%    6      15.0
                                       

Commercial Risk

   118    125    133    (7   (5.6 )%    (15   (11.3 )% 

Medicare Advantage

   25    24    22    1      4.2   3      13.6
                                       

Total Oregon

   143    149    155    (6   (4.0 )%    (12   (7.7 )% 
                                       

Total Health Plan Enrollment

                 

Large Group

   1,001    1,025    1,108    (24   (2.3 )%    (107   (9.7 )% 

Small Group and Individual

   440    450    500    (10   (2.2 )%    (60   (12.0 )% 
                                       

Commercial Risk

   1,441    1,475    1,608    (34   (2.3 )%    (167   (10.4 )% 

ASO

   5    5    5    0      0.0   0      0.0
                                       

Total Commercial

   1,446    1,480    1,613    (34   (2.3 )%    (167   (10.4 )% 

Medicare Advantage

   227    225    222    2      0.9   5      2.3

Medicare PDP (stand-alone)

   460    453    487    7      1.5   (27   (5.5 )% 

Medi-Cal/Medicaid

   857    841    765    16      1.9   92      12.0
                                       
   2,990    2,999    3,087    (9   (0.3 )%    (97   (3.1 )% 

All Other States

   28    599    633    (571   (95.3 )%    (605   (95.6 )% 
                                       
   3,018    3,598    3,720    (580   (16.1 )%    (702   (18.9 )% 
                                       

TRICARE - North Contract Eligibles

   3,067    3,040    3,004    27      0.9   63      2.1
                                       

 

Page 7


Health Net, Inc.

Enrollment Data - Line of Business

(In thousands)

 

                    Change from  
                    September 30, 2009     December 31, 2008  
     Dec 31,
2009
   Sept 30,
2009
   Dec 31,
2008
   Increase/
(Decrease)
    %
Change
    Increase/
(Decrease)
    %
Change
 

Large Group

                 

California

   870    888    938    (18   (2.0 )%    (68   (7.2 )% 

Arizona

   59    59    77    0      0.0   (18   (23.4 )% 

Oregon

   72    78    93    (6   (7.7 )%    (21   (22.6 )% 
                                       
   1,001    1,025    1,108    (24   (2.3 )%    (107   (9.7 )% 
                                       

Small Group and Individual

                 

California

   357    365    414    (8   (2.2 )%    (57   (13.8 )% 

Arizona

   37    38    46    (1   (2.6 )%    (9   (19.6 )% 

Oregon

   46    47    40    (1   (2.1 )%    6      15.0
                                       
   440    450    500    (10   (2.2 )%    (60   (12.0 )% 
                                       

Commercial Risk

                 

California

   1,227    1,253    1,352    (26   (2.1 )%    (125   (9.2 )% 

Arizona

   96    97    123    (1   (1.0 )%    (27   (22.0 )% 

Oregon

   118    125    133    (7   (5.6 )%    (15   (11.3 )% 
                                       
   1,441    1,475    1,608    (34   (2.3 )%    (167   (10.4 )% 
                                       

ASO

   5    5    5    0      0.0   0      0.0

Total Commercial

                 

California

   1,232    1,258    1,357    (26   (2.1 )%    (125   (9.2 )% 

Arizona

   96    97    123    (1   (1.0 )%    (27   (22.0 )% 

Oregon

   118    125    133    (7   (5.6 )%    (15   (11.3 )% 
                                       
   1,446    1,480    1,613    (34   (2.3 )%    (167   (10.4 )% 

Medicare Advantage

                 

California

   137    136    133    1      0.7   4      3.0

Arizona

   65    65    67    0      0.0   (2   (3.0 )% 

Oregon

   25    24    22    1      4.2   3      13.6
                                       
   227    225    222    2      0.9   5      2.3

Medi-Cal/Medicaid

                 

California

   857    841    765    16      1.9   92      12.0

Total Health Plan Enrollment

                 

Large Group

   1,001    1,025    1,108    (24   (2.3 )%    (107   (9.7 )% 

Small Group and Individual

   440    450    500    (10   (2.2 )%    (60   (12.0 )% 
                                       

Commercial Risk

   1,441    1,475    1,608    (34   (2.3 )%    (167   (10.4 )% 

ASO

   5    5    5    0      0.0   0      0.0
                                       

Total Commercial

   1,446    1,480    1,613    (34   (2.3 )%    (167   (10.4 )% 

Medicare Advantage

   227    225    222    2      0.9   5      2.3

Medicare PDP (stand-alone)

   460    453    487    7      1.5   (27   (5.5 )% 

Medi-Cal/Medicaid

   857    841    765    16      1.9   92      12.0
                                       
   2,990    2,999    3,087    (9   (0.3 )%    (97   (3.1 )% 

All Other States

   28    599    633    (571   (95.3 )%    (605   (95.6 )% 
                                       
   3,018    3,598    3,720    (580   (16.1 )%    (702   (18.9 )% 
                                       

TRICARE - North Contract Eligibles

   3,067    3,040    3,004    27      0.9   63      2.1
                                       

 

Page 8


Health Net, Inc.

Consolidated Statements of Operations

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

 

     Quarter Ended
December 31,
2008
    Year Ended
December 31,
2008
    Quarter Ended
September 30,
2009
    Quarter Ended
December 31,
2009
    Year Ended
December 31,
2009
 

REVENUES:

          

Health plan services premiums

   $ 3,082,133        12,392,006      $ 3,166,877      $ 2,981,678      $ 12,440,589   

Government contracts

     751,604        2,835,261        758,507        754,766        3,104,700   

Net investment income

     24,536        91,042        27,691        33,486        105,930   

Administrative services fees and other income

     11,209        48,280        15,578        28,165        62,022   
                                        
     3,869,482        15,366,589        3,968,653        3,798,095        15,713,241   
                                        

EXPENSES:

          

Health plan services

     2,629,398        10,762,657        2,734,984        2,557,149        10,731,951   

Government contracts

     718,893        2,702,573        716,323        703,721        2,936,090   

General and administrative

     347,128        1,291,059        319,451        359,039        1,365,586   

Selling

     92,314        360,381        83,275        84,068        330,112   

Depreciation and amortization

     17,271        59,878        12,689        8,605        53,044   

Interest

     10,523        42,909        10,264        9,538        40,887   

Asset impairments

     —          —          170,570        4,309        174,879   

Loss on sale of businesses

     —          —          —          105,931        105,931   
                                        
     3,815,527        15,219,457        4,047,556        3,832,360        15,738,480   

Income (loss) from operations before income taxes

     53,955        147,132        (78,903     (34,265     (25,239

Income tax provision (benefit)

     18,420        52,129        (12,881     10,892        23,765   
                                        

Net income (loss)

   $ 35,535      $ 95,003      $ (66,022   $ (45,157   $ (49,004
                                        

Basic earnings (loss) per share

   $ 0.34      $ 0.89      $ (0.64   $ (0.43   $ (0.47

Diluted earnings (loss) per share

   $ 0.34      $ 0.88      $ (0.64   $ (0.43   $ (0.47

Weighted average shares outstanding:

          

Basic

     103,694        106,532        103,873        103,902        103,849   

Diluted

     104,063        107,610        103,873        103,902        103,849   

Pretax margin

     1.4     1.0     -2.0     -0.9     -0.2

Health plan services MCR

     85.3     86.9     86.4     85.8     86.3

Government contracts cost ratio

     95.6     95.3     94.4     93.2     94.6

G&A expense ratio

     11.2     10.4     10.0     11.9     10.9

Selling costs ratio

     3.0     2.9     2.6     2.8     2.7

Days claims payable (a)

     47.0        44.9        41.0        38.6        38.9   

Days claims payable - adjusted (a)

     59.9        56.5        55.4        55.7        57.7   

Effective tax rate

     34.1     35.4     16.3     -31.8     -94.2

Health plan services premiums PMPM

   $ 279.47      $ 277.79      $ 296.16      $ 289.15      $ 294.12   

Health plan services costs PMPM

   $ 238.42      $ 241.27      $ 255.77      $ 247.90      $ 253.71   

 

Page 9


Health Net, Inc.

Reconciliation of Non-GAAP Financial Measures

Operating Results Excluding Charges

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

This table presents the company’s consolidated operations for the periods presented below and the charges recorded in the consolidated statement of operations for such periods. Information for the quarter and year-ended December 31, 2009 also includes the financial impact from the December 11, 2009 sale of our Northeast health plans. Management believes that the presentation of certain financial information in the attached press release, excluding the charges that were recorded and excluding the impact from the divestiture of our Northeast health plans, 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. Non-GAAP financial information presented below should be considered in addition to, not as a substitute for, financial information prepared in accordance with GAAP.

 

    Quarter Ended
December 31, 2008
    Year Ended December 31, 2008     Quarter Ended September 30,
2009
 
    As
Reported
    Impact
of
Charge1
    Excluding
Impact of
Charge1
(Non-
GAAP)
    As
Reported
    Impact
of
Charges2
    Excluding
Impact of
Charges2
(Non-
GAAP)
    As
Reported
    Impact
of
Charge3
    Excluding
Impact of
Charge3
(Non-
GAAP)
 

REVENUES:

                 

Health plan services premiums

  $ 3,082,133        $ 3,082,133      $ 12,392,006        $ 12,392,006      $ 3,166,877        $ 3,166,877   

Government contracts

    751,604          751,604        2,835,261          2,835,261        758,507          758,507   

Net investment income

    24,536          24,536        91,042        (14,642     105,684        27,691          27,691   

Administrative services fees and other income

    11,209          11,209        48,280        (3,400     51,680        15,578          15,578   
                                                                       
    3,869,482        —          3,869,482        15,366,589        (18,042     15,384,631        3,968,653        —          3,968,653   
                                                                       

EXPENSES:

                 

Health plan services

    2,629,398        (5,700     2,635,098        10,762,657        37,496        10,725,161        2,734,984        (571     2,735,555   

Government contracts

    718,893          718,893        2,702,573          2,702,573        716,323          716,323   

General and administrative

    347,128        53,535        293,593        1,291,059        119,540        1,171,519        319,451        19,495        299,956   

Selling

    92,314          92,314        360,381          360,381        83,275          83,275   

Depreciation and amortization

    17,271          17,271        59,878          59,878        12,689          12,689   

Interest

    10,523          10,523        42,909          42,909        10,264          10,264   

Asset impairments

    —            —          —            —          170,570        170,570        —     

Loss on sale of businesses

    —            —          —            —          —            —     
                                                                       
    3,815,527        47,835        3,767,692        15,219,457        157,036        15,062,421        4,047,556        189,494        3,858,062   

Income (loss) from operations before income taxes

    53,955        (47,835     101,790        147,132        (175,078     322,210        (78,903     (189,494     110,591   

Income tax provision (benefit)

    18,420        (20,227     38,647        52,129        (70,951     123,080        (12,881     (53,890     41,009   
                                                                       

Net income (loss)

  $ 35,535      $ (27,608   $ 63,143      $ 95,003      $ (104,127   $ 199,130      $ (66,022   $ (135,604   $ 69,582   
                                                                       

Basic earnings (loss) per share

  $ 0.34        $ 0.61      $ 0.89        $ 1.87      $ (0.64     $ 0.67   

Diluted earnings (loss) per share

  $ 0.34        $ 0.61      $ 0.88        $ 1.85      $ (0.64     $ 0.67   

Weighted average shares outstanding:

                 

Basic

    103,694          103,694        106,532          106,532        103,873          103,873   

Diluted

    104,063          104,063        107,610          107,610        103,873          104,432   

Pretax margin

    1.4       2.6     1.0       2.1     -2.0       2.8

Health plan services MCR

    85.3       85.5     86.9       86.5     86.4       86.4

Government contracts cost ratio

    95.6       95.6     95.3       95.3     94.4       94.4

G&A expense ratio

    11.2       9.5     10.4       9.4     10.0       9.4

Selling costs ratio

    3.0       3.0     2.9       2.9     2.6       2.6

Effective tax rate

    34.1       38.0     35.4       38.2     16.3       37.1

 

1 Includes a $5.7 million pretax benefit for a litigation reserve true-up included in health plan services expenses and a $53.5 million pretax charge primarily for severance and other expenses related to the company’s operations strategy and included in G&A.
2 Includes a $175.1 million pretax charge in total of which:

(a) $119.6 million was primarily related to severance and other expenses associated with the company’s operations strategy and included in G&A expenses

(b) $37.5 million was included in health plan services expenses for estimated litigation liability and regulatory actions for the company’s rescission practices in Arizona and California and for the execution of the settlement agreement for the McCoy, et al., lawsuits

(c) $14.6 million investment impairment charge taken in the third quarter of 2008 and included in net investment income

(d) $3.4 million pretax charge related to the estimated loss on the sale of the assets of a subsidiary taken in the first quarter of 2008 and included in other income

3 Includes a $0.6 million pretax benefit for a litigation reserve true-up included in health care costs, a $19.5 million pretax charge primarily for IT systems and other expenses related to the company’s operations strategy and included in G&A expenses and a $170.6 million pretax asset impairment charge for goodwill, intangible and IT-related assets related to the sale of our Northeast health plans.

 

Page 10


Health Net, Inc.

Reconciliation of Non-GAAP Financial Measures

Operating Results Excluding Charges

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

 

    Quarter Ended December 31, 2009     Year Ended December 31, 2009  
    As
Reported
    Impact
of
Charges4
    Divested
Operations5
    Excluding
Impact of
Charges and
Divestiture4,5
(Non-
GAAP)
    As
Reported
    Impact
of
Charge6
    Divested
Operations5
    Excluding
Impact of
Charge and
Divestiture5,6
(Non-
GAAP)
 

REVENUES:

               

Health plan services premiums

  $ 2,981,678        $ 5,483      $ 2,976,195      $ 12,440,589        $ 5,483      $ 12,435,106   

Government contracts

    754,766            754,766        3,104,700            3,104,700   

Net investment income

    33,486          1,126        32,360        105,930          1,126        104,804   

Administrative services fees and other income

    28,165          15,113        13,052        62,022          15,113        46,909   
                                                               
    3,798,095        —          21,722        3,776,373        15,713,241        —          21,722        15,691,519   
                                                               

EXPENSES:

               

Health plan services

    2,557,149          5,508        2,551,641        10,731,951        (4,805     5,508        10,731,248   

Government contracts

    703,721        3,632          700,089        2,936,090        3,632          2,932,458   

General and administrative

    359,039        38,723        20,588        299,728        1,365,586        124,799        20,588        1,220,199   

Selling

    84,068          249        83,819        330,112          249        329,863   

Depreciation and amortization

    8,605          589        8,016        53,044          589        52,455   

Interest

    9,538            9,538        40,887            40,887   

Asset impairments

    4,309        4,309          —          174,879        174,879          —     

Loss on sale of businesses

    105,931        105,931          —          105,931        105,931          —     
                                                               
    3,832,360        152,595        26,934        3,652,831        15,738,480        404,436        26,934        15,307,110   

Income (loss) from operations before income taxes

    (34,265     (152,595     (5,212     123,542        (25,239     (404,436     (5,212     384,409   

Income tax provision (benefit)

    10,892        (38,149     (2,059     51,100        23,765        (123,533     (2,059     149,357   
                                                               

Net income (loss)

  $ (45,157   $ (114,446   $ (3,153   $ 72,442      $ (49,004   $ (280,903   $ (3,153   $ 235,052   
                                                               

Basic earnings (loss) per share

  $ (0.43       $ 0.70      $ (0.47       $ 2.26   

Diluted earnings (loss) per share

  $ (0.43       $ 0.69      $ (0.47       $ 2.25   

Weighted average shares outstanding:

               

Basic

    103,902            103,902        103,849            103,849   

Diluted

    103,902            104,626        103,849            104,412   

Pretax margin

    -0.9         3.3     -0.2         2.4

Health plan services MCR

    85.8         85.7     86.3         86.3

Government contracts cost ratio

    93.2         92.8     94.6         94.5

G&A expense ratio

    11.9         10.0     10.9         9.8

Selling costs ratio

    2.8         2.8     2.7         2.7

Effective tax rate

    -31.8         41.4     -94.2         38.9

 

 

4 Includes a $3.6 million charge for TRICARE contract procurement costs included in government contracts expenses and a $38.7 million operations strategy charge and Northeast divestiture related expenses, each of which are included in G&A expenses, and an asset impairment and loss on the sale of Northeast health plans recorded in 2009.
5 Represents revenues and expenses related to the run-off of the Northeast health plans divested on December 11, 2009.
6 Includes a $4.8 million pretax benefit for a litigation reserve true-up included in health care costs, $3.6 million charge for TRICARE contract procurement costs included in government contracts expenses, and $124.8 million of operations strategy and Northeast sale related expenses included in G&A expenses, and an asset impairment and loss on the sale of Northeast health plans recorded in 2009.

 

Page 11


Health Net, Inc.

Condensed Consolidated Balance Sheets

(Amounts in thousands, except ratio data)

 

     December 31,
2008
    September 30,
2009
    December 31,
2009
 

ASSETS

      

Current Assets

      

Cash and cash equivalents

   $ 668,201      $ 463,311      $ 682,803   

Investments - available for sale

     1,504,658        1,309,864        1,376,142   

Premiums receivable, net

     307,529        307,488        288,719   

Amounts receivable under government contracts

     241,269        224,495        270,810   

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

     302,022        323,207        281,140   

Other receivables

     254,026        183,258        111,608   

Deferred taxes

     87,712        101,043        46,527   

Assets held for sale

     —          848,601        —     

Other assets

     179,649        195,799        187,086   
                        

Total current assets

     3,545,066        3,957,066        3,244,835   

Property and equipment, net

     202,356        136,819        131,480   

Goodwill, net

     751,949        611,886        611,886   

Other intangible assets, net

     91,289        29,478        28,108   

Deferred taxes

     81,771        44,119        89,479   

Investments - available for sale-noncurrent

     —          11,435        20,870   

Other noncurrent assets

     143,919        103,093        155,993   
                        

Total Assets

   $ 4,816,350      $ 4,893,896      $ 4,282,651   
                        

LIABILITIES AND STOCKHOLDERS’ EQUITY

      

Current Liabilities

      

Reserves for claims and other settlements

   $ 1,338,149      $ 951,778      $ 951,655   

Health care and other costs payable under government contracts

     69,876        61,037        90,815   

IBNR health care costs payable under TRICARE North contract

     302,022        323,207        281,140   

Unearned premiums

     180,548        124,828        135,772   

Borrowings under amortizing financing facility

     27,335        119,915        104,007   

Liabilities held for sale

     —          355,530        —     

Accounts payable and other liabilities

     294,840        529,740        366,125   
                        

Total current liabilities

     2,212,770        2,466,035        1,929,514   

Senior notes payable

     398,276        398,429        398,480   

Borrowings under amortizing financing facility

     103,992        —          —     

Borrowings under revolving credit facility

     150,000        100,000        100,000   

Other noncurrent liabilities

     199,186        154,087        158,874   
                        

Total Liabilities

     3,064,224        3,118,551        2,586,868   
                        

Stockholders’ Equity

      

Common stock

     144        144        154   

Additional paid-in capital

     1,182,067        1,184,761        1,190,203   

Treasury common stock, at cost

     (1,367,319     (1,368,854     (1,389,722

Retained earnings

     1,944,100        1,940,253        1,895,096   

Accumulated other comprehensive (loss) income

     (6,866     19,041        52   
                        

Total Stockholders’ Equity

     1,752,126        1,775,345        1,695,783   
                        

Total Liabilities and Stockholders’ Equity

   $ 4,816,350      $ 4,893,896      $ 4,282,651   
                        

Debt-to-Total Capital Ratio

     27.9     25.8     26.2

 

Page 12


Health Net, Inc.

Condensed Consolidated Statements of Cash Flows

(Amounts in thousands)

 

     Fourth Quarter
Ended
December 31,
2008
    Third Quarter
Ended
September 30,
2009
    Fourth Quarter
Ended
December 31,
2009
 

CASH FLOWS FROM OPERATING ACTIVITIES:

      

Net Income (loss)

   $ 35,535      $ (66,022   $ (45,157

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

      

Amortization and depreciation

     17,271        12,689        8,605   

Share-based compensation

     1,294        (5,025     4,914   

Deferred income taxes

     (11,942     (45,976     52,629   

Excess tax benefits from share-based compensation

     —          —          (23

Loss on sale of business

     —          —          105,931   

Asset and investment impairment charges

     27,895        170,570        4,309   

Other changes

     (671     (5,362     (11,688

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

      

Premiums receivable and unearned premiums

     (29,008     48,341        27,352   

Other current assets, receivables and noncurrent assets

     (110,750     (30,470     90,372   

Amounts receivable/payable under government contracts

     7,166        39,123        (16,537

Reserves for claims and other settlements

     (10,532     (48,570     (19,533

Accounts payable and other liabilities

     20,164        85,055        (48,002
                        

Net cash (used in) provided by operating activities

     (53,578     154,353        153,172   
                        

CASH FLOWS FROM INVESTING ACTIVITIES:

      

Sales of investments

     514,047        465,732        680,676   

Maturities of investments

     62,117        37,355        48,194   

Purchases of investments

     (218,258     (520,733     (689,740

Proceeds from sale of property and equipment

     —          12        —     

Purchases of property and equipment

     (12,911     (8,018     (7,461

Net cash impact from sale of businesses

     —          —          (173,422

Sales and purchases of restricted investments and other

     4,220        6,558        (924
                        

Net cash provided by (used in) investing activities

     349,215        (19,094     (142,677
                        

CASH FLOWS FROM FINANCING ACTIVITIES:

      

Proceeds from exercise of stock options and employee stock purchases

     —          485        869   

Repurchases of common stock

     (17     (29     (12,615

Excess tax benefits from share-based compensation

     —          —          23   

Borrowings under financing arrangements

     175,000        —          55,000   

Repayment of borrowings under financing arrangements

     (142,540     —          (72,540
                        

Net cash provided by (used in) financing activities

     32,443        456        (29,263
                        

Net increase (decrease) in cash and cash equivalents

     328,080        135,715        (18,768

Net change in cash and cash equivalents classified as assets held for sale

     —          (238,260     238,260   

Cash and cash equivalents, beginning of period

     340,121        565,856        463,311   
                        

Cash and cash equivalents, end of period

   $ 668,201      $ 463,311      $ 682,803   
                        

 

Page 13


Health Net, Inc.

Notes to Consolidated Financial Statements

Notes:

 

(a) Management believes that days claims payable (adjusting for divested businesses, 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 (adjusting for divested businesses, 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:

 

         Q3 2009     Q4 2009     FY 2009  
         (Dollars in millions)  
 

Reserve for Claims and Other Settlements

   $ 1,195.0      $ 951.7      $ 951.7   
 

Less: Reserve for Claims and Other Settlements for Divested Businesses

     (243.2     —          —     
 

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

     (159.2     (198.0     (198.0
                          
 

Reserve for Claims and Other Settlements - Adjusted

     792.6        753.7        753.7   

(1)

 

Average Reserve for Claims and Other Settlements

     1,219.3        1,073.4        1,144.9   

(2)

 

Average Reserve for Claims and Other Settlements - Adjusted

     788.1        773.2        808.9   

(3)

 

Health Plan Services Cost

     2,735.0        2,557.1        10,732.0   
 

Less: Health Plan Services Cost for Divested Businesses

     (589.9     (460.7     (2,176.6
 

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

     (837.3     (818.4     (3,438.9
                          

(4)

 

Health Plan Services Cost - Adjusted

     1,307.8        1,278.0        5,116.5   

(5)

 

Number of Days in Period

     92        92        365   

= (1) / (3) * (5) Days Claims Payable

     41.0        38.6        38.9   

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

     55.4        55.7        57.7   

 

Page 14


Health Net, Inc.

Reconciliation of Reserves for Claims and Other Settlements

(In millions)

 

     Health Plan Services
     Year 2009     Year 2008     Year 2007

Reserve for claims (a), beginning of period

   $ 957.1      $ 838.7      $ 754.2

Incurred claims related to:

      

Current Year

     6,422.8        6,372.2        5,790.7

Prior Years (c)

     (80.0     (8.3     0.6
                      

Total Incurred (b)

     6,342.8        6,363.9        5,791.3

Paid claims related to:

      

Current Year

     5,572.2        5,443.2        4,972.3

Prior Years

     857.8        802.3        734.5
                      

Total Paid (b)

     6,430.0        6,245.5        5,706.8

Less: Divested businesses

     (177.7     —          —  
                      

Reserve for claims (a), end of period

     692.2        957.1        838.7

Add:

      

Claims Payable (d)

     165.6        284.8        365.6

Other (e)

     93.9        96.2        96.1
                      

Reserves for claims and other settlements, end of period

   $ 951.7      $ 1,338.1      $ 1,300.4
                      

 

(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 15

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