-----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, LXPyQiGPRXl421gAmSja81qc+8dhqJ1Zqu2U3gShOrBCFi7apNFepYZ0UuP1oAbx HNf8/teKJyXUrX9/6D117Q== 0001193125-10-174598.txt : 20100803 0001193125-10-174598.hdr.sgml : 20100803 20100803083050 ACCESSION NUMBER: 0001193125-10-174598 CONFORMED SUBMISSION TYPE: 8-K PUBLIC DOCUMENT COUNT: 3 CONFORMED PERIOD OF REPORT: 20100803 ITEM INFORMATION: Results of Operations and Financial Condition ITEM INFORMATION: Financial Statements and Exhibits FILED AS OF DATE: 20100803 DATE AS OF CHANGE: 20100803 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: 10985825 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 3, 2010

 

 

Health Net, Inc.

(Exact Name of Registrant as Specified in Charter)

 

 

 

Delaware   1-12718   95-4288333

(State or OtherJurisdiction

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 August 3, 2010, Health Net, Inc. (the “Company”) issued a press release announcing its financial results for the quarter ended June 30, 2010. The press release contains the non-GAAP financial measure “adjusted days claims payable (DCP).” Adjusted DCP for the second quarter of 2010 was 53.6 days, adjusted DCP for the first quarter of 2010 was 55.8 days, and adjusted DCP for the second quarter of 2009 was 55.0 days. Adjusted DCP excludes reserves and health plan services expenses for the Company’s divested Northeast businesses, capitation payable, provider and other claim settlements and Medicare Part D. The most directly comparable GAAP financial measure to this non-GAAP financial measure is second quarter of 2010 DCP of 39.3 days, first quarter of 2010 DCP of 40.5 days, and second quarter of 2009 DCP of 41.6 days.

Management believes that adjusted DCP provides useful information to investors because the adjusted DCP calculation excludes amounts related to divested businesses and health care expenses for which no or minimal reserves are maintained. Therefore, management believes that adjusted DCP may present a more accurate reflection of DCP calculated from claims-based reserves than does GAAP DCP, 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. A reconciliation of the non-GAAP financial measure to the most directly comparable GAAP financial measure is attached to the press 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. The information in this Item 2.02 shall not be deemed “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, nor shall it be deemed incorporated by reference in any Company filing under the Securities Act of 1933, except as shall be expressly set forth by specific reference in such filing.

Section 9- Financial Statements and Exhibits

 

Item 9.01 Financial Statements and Exhibits.

 

(d) Exhibits

 

99.1    Press Release dated August 3, 2010 announcing results for the quarter ended June 30, 2010 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.

August 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
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 SECOND QUARTER 2010

GAAP NET INCOME OF $45.1 MILLION, OR $0.45 PER DILUTED SHARE

WESTERN REGION OPERATIONS AND GOVERNMENT CONTRACTS SEGMENTS

PRODUCE COMBINED EARNINGS OF $0.61 PER DILUTED SHARE

LOS ANGELES, August 3, 2010 – Health Net, Inc. (NYSE: HNT) today announced 2010 second quarter GAAP net income of $45.1 million, or $0.45 per diluted share, compared with $40.1 million, or $0.38 per diluted share, for the second quarter of 2009.

The GAAP results include:

 

  1. $24.9 million of expenses, approximately 65 percent of which are related to the company’s corporate overhead cost reduction efforts resulting from the Northeast transaction, approximately 25 percent are related to the company’s operations strategy, and the remainder is related to legal and regulatory expenses.

 

  2. a $3.2 million net benefit comprised of:

 

  a. $9.4 million in pretax losses, of which $6.0 million was noncash, related to the Northeast transaction;

 

  b. $9.0 million in expenses, of which approximately $6.0 million was noncash, to retire the company’s short-term debt; and

 

  c. a $21.6 million noncash benefit to health plan expenses from a litigation reserve true-up that offset the above expenses.

The company’s Western Region Operations and Government Contracts segments produced combined net earnings of $0.61 per diluted share in the second quarter of 2010.

“We are very pleased with our solid second quarter 2010 results which were driven primarily by favorable commercial health care cost trends,” said Jay Gellert, Health Net’s chief executive officer. “We continue to invest to reduce general and administrative expenses in light of health care reform, our lower cost products are growing, and our balance sheet is well-positioned with strong cash and a solid reserve position.”


The company announced that it is raising its full year 2010 guidance for earnings per diluted share to $2.07 to $2.17 on a GAAP basis, and $2.50 to $2.55 for the combined Western Region Operations and Government Contracts segments due to the first half of 2010 results and favorable business trends.

CONSOLIDATED RESULTS

Health Net’s total revenues decreased 14.2 percent in the second quarter of 2010 to $3.4 billion from $4.0 billion in the second quarter of 2009. Health plan services premium revenues decreased by approximately 20.5 percent to $2.5 billion in the second quarter of 2010 compared with $3.2 billion in the second quarter of 2009.

Health plan services expenses decreased to $2.2 billion in the second quarter of 2010 from $2.7 billion in the second quarter of 2009.

Investment income decreased to $16.6 million in the second quarter of 2010 compared with $20.4 million in the second quarter of 2009.

Health Net’s consolidated results for the second quarter of 2009 include the Northeast businesses that were sold in December 2009.

WESTERN REGION OPERATIONS SEGMENT

Health Plan Membership

Total enrollment in the Western Region Operations segment at June 30, 2010 was approximately 3.0 million members, a decrease of approximately 3.9 percent compared with enrollment at June 30, 2009. Total enrollment in the company’s California health plan decreased approximately 2.1 percent from June 30, 2009 to June 30, 2010.

Medicaid enrollment in California at June 30, 2010 was 877,000 members, an increase of 50,000 members, or 6.0 percent, from June 30, 2009.

Western Region commercial enrollment declined by 9.3 percent from June 30, 2009 to 1.4 million members on June 30, 2010.

The enrollment changes noted above are consistent with the overall weak economy in the company’s western markets.

“Despite the economic headwinds for our commercial products, our cost-effective network products grew by 8.7 percent, or approximately 23,000 new members, in the second quarter of 2010 compared with the second quarter of 2009,” said James Woys, Health Net’s chief operating officer.

As of June 30, 2010, these products accounted for 24 percent of the company’s Western Region commercial enrollment compared with 21 percent at June 30, 2009.

Enrollment in the company’s Medicare Advantage plans in the Western Region at June 30, 2010 was 219,000 members, a decrease of approximately 1.8 percent compared with June 30, 2009.

Membership in the company’s Medicare Part D plans was 434,000 at the end of the second quarter of 2010, a 5.2 percent decrease compared with the end of the second quarter of 2009. The company’s Medicare Part D plans are currently offered in 49 states and the District of Columbia and were offered in all 50 states and the District of Columbia in the second quarter of 2009.

 

2


Revenues

Total revenues in the Western Region in the second quarter of 2010 were flat at approximately $2.5 billion compared with the second quarter of 2009.

Investment income in the Western Region was $16.3 million in the second quarter of 2010 compared with $10.6 million in the second quarter of 2009 and $19.6 million in the first quarter of 2010.

Health Plan Services Expenses

Health plan services expenses in the Western Region were approximately $2.2 billion in the second quarter of 2010 compared with $2.1 billion in the second quarter of 2009.

Commercial Premium Yield and Health Care Cost Trends

In the Western Region, commercial premiums per member per month (PMPM) increased by 9.3 percent to $340 in the second quarter of 2010 compared with $311 in the second quarter of 2009.

Commercial health care costs PMPM in the Western Region increased by 9.1 percent to approximately $294 in the second quarter of 2010 compared with $269 in the second quarter of 2009.

“The commercial premium yield PMPM and health care cost increases PMPM in the second quarter of 2010 were driven higher by approximately 60 basis points as a result of certain items booked in the second quarter of 2009, said Woys.

“Due to moderating health care cost trends, we are adjusting our Western Region 2010 PMPM health care cost trend guidance to 60 to 80 basis points less than the 2010 commercial premium yield PMPM guidance of 8.3 percent to 8.8 percent,” added Woys.

Medical Care Ratios (MCR)

The health plan services MCR in the Western Region was 87.1 percent in the second quarter of 2010 compared with 86.5 percent in the second quarter of 2009.

The Western Region commercial MCR was 86.3 percent in the second quarter of 2010 compared with 86.5 percent in the second quarter of 2009.

“The modest improvement in our commercial MCR is further affirmation that our pricing discipline and product and geographic mix shifts are producing consistent margin improvement,” Woys added.

The company expects the full year Western Region commercial MCR in 2010 to show a 70 basis point improvement compared to the full year of 2009.

The Medicare Advantage (MA) MCR in the Western Region was 88.5 percent in the second quarter of 2010 compared with 85.6 percent in the second quarter of 2009 and was consistent with the company’s expectations.

The Medicare Part D MCR was 85.9 percent in the second quarter of 2010 compared with 90.0 percent in the second quarter of 2009. The 410 basis point improvement is consistent with the company’s 2010 bid strategy.

 

3


General & Administrative (G&A) and Selling Expenses

G&A expense in the Western Region was $212.7 million in the second quarter of 2010 compared with $207.8 million in the second quarter of 2009. The G&A expense ratio increased 10 basis points from 8.4 percent in the second quarter of 2009 and decreased 40 basis points sequentially from 8.9 percent in the first quarter of 2010 to 8.5 percent in the second quarter of 2010.

Selling expense in the Western Region was $55.8 million in the second quarter of 2010 compared with $57.9 million in the second quarter of 2009.

GOVERNMENT CONTRACTS SEGMENT

The company’s Government Contracts revenues increased 2.4 percent in the second quarter of 2010 to $851.9 million from $832.1 million in the second quarter of 2009.

The Government Contracts cost ratio was flat at 95.1 percent in the second quarter of 2010 compared with the second quarter of 2009.

“We are pleased that the Department of Defense awarded us the new TRICARE North Region contract that begins April 1, 2011. We are fully engaged in the transition work and look forward to continuing to serve these 3.0 million beneficiaries,” said Woys.

BALANCE SHEET

Health Net’s condensed consolidated balance sheets, attached as an exhibit to this press release, included the Northeast businesses in the second quarter of 2009. As a result of the sale of the Northeast businesses in December 2009, the balance sheets exclude those businesses from the fourth quarter of 2009 and the first and second quarters of 2010.

Cash and investments as of June 30, 2010 were $1.9 billion compared with $2.1 billion as of June 30, 2009.

Reserves for claims and other settlements as of June 30, 2010 were $934.9 million compared with $1.2 billion as of June 30, 2009 and $995.6 million as of March 31, 2010. The year-over-year decline is due to the divestiture of the Northeast businesses. The sequential decline is primarily due to an approximately $30.0 million reduction in claims inventory because of faster claims payment cycles. The faster cycles caused paid claims to be $58.0 million higher in the second quarter of 2010 compared with the first quarter of 2010. In addition, there was a $21.6 million reduction related to litigation reserve true-ups, and a $12.0 million reduction in the shared-risk reserve as payments related to the prior year shared-risk accrual are typically made in the second quarter each year.

“Our claims payment cycles continued to accelerate. Since December 31, 2009, Western Region claims inventory declined by approximately $40 million while the Western Region incurred but not reported (IBNR) reserve increased by more than $16 million,” said Joseph Capezza, Health Net’s chief financial officer.

Days claims payable (DCP) for the second quarter of 2010 was 39.3 days compared with 41.6 days in the second quarter of 2009 and 40.5 days in the first quarter of 2010.

On an adjusted1 basis, DCP in the second quarter of 2010 was 53.6 days compared with 55.0 days in the second quarter of 2009 and 55.8 days in the first quarter of 2010. The sequential decline in adjusted1 DCP was primarily due to the decline in reserves for claims and other settlements discussed above.

 

1 See “Disclosures Regarding Non-GAAP Financial Information” attached to this press release for a reconciliation of this information to the comparable GAAP financial measure.

 

4


The company’s debt-to-total capital ratio was 23.4 percent as of June 30, 2010 compared with 26.2 percent as of December 31, 2009 and 25.2 percent as of June 30, 2009.

Interest expense was $8.8 million in the second quarter of 2010 compared with $11.5 million in the second quarter of 2009. The decline was due to the decrease in the company’s total outstanding debt, including the early retirement of debt in May 2010.

CASH FLOW

Operating cash flow was negative $16.3 million in the second quarter of 2010 due to the increase in premiums receivable and the sequential decline in reserves for claims and other settlements primarily resulting from the higher paid claims as previously noted. The premiums receivable increase was the result of typical seasonal increases in Medicare risk adjuster accruals and also included a $14.0 million increase due to a delayed California Medicaid payment that the company received in early July 2010.

For the first half of 2010, operating cash flow was approximately $111.1 million, or more than 1.4 times net income plus depreciation and amortization.

“We continue to expect that full year cash flow will be $300 million to $325 million, well above net income plus depreciation and amortization,” said Capezza.

NORTHEAST OPERATIONS SEGMENT

Health Net continues to serve the members of the sold Northeast companies under administrative services agreements (ASAs) that the company entered into with UnitedHealthcare and its affiliates on the closing date of the transaction. Health Net will serve these members until they are either transitioned to other UnitedHealthcare products or not renewed. The company expects the ASAs to remain in effect through 2011.

The revenues and expenses associated with the company’s Northeast Operations in the second quarter of 2010 were $82.6 million and $92.0 million, respectively, and they are shown separately in the accompanying segment information table.

SHARE REPURCHASE UPDATE

In the second quarter of 2010, Health Net repurchased 2.9 million shares for approximately $70.1 million at an average price of $24.35 per share. At June 30, 2010, approximately $228.1 million of authorization under the company’s existing $300 million share repurchase program remained.

 

5


2010 GUIDANCE

Health Net is increasing its 2010 annual guidance for GAAP earnings per diluted share to a range of $2.07 to $2.17, or $2.50 to $2.55 per diluted share for the combined Western Region Operations and Government Contracts segments.

 

Metric

  

2010 Guidance

Year-end Membership(a)   

Commercial: -1% to -2%

Medicaid: +5% to +6%

Medicare Advantage: -2% to - -3%

PDP: -6% to -7% (previously +1% to +2%)

Consolidated Revenues    $13.0 to $13.5 billion
Commercial Yields(a)    ~8.3% to 8.8%

Commercial

Health Care Cost Trends(a)

  

~60 to 80 basis points < Premium Yields

(Previously: ~30 to 50 basis points < Premium Yields)

Selling Cost Ratio

Government Contracts Ratio

G&A Expense Ratio

  

~2.4%

~94.5% to 95.0%

~8.8% to 9.0%

Tax Rate(b)    ~39.0%
Weighted-average Fully Diluted Shares Outstanding   

99 million to 100 million

(previously: 101 million to 102 million)

GAAP EPS

Combined Western Region Operations and Government Contracts EPS

  

$2.07 to $2.17 (previously $1.97 to $2.07)

 

$2.50 to $2.55 (previously $2.37 to $2.47)

 

(a) These metrics represent the company’s Western Region Operations.
(b) For the combined Western Region and Government Contracts segments.

 

6


CONFERENCE CALL

As previously announced, Health Net will discuss the company’s second quarter 2010 results during a conference call on Tuesday, August 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)

706.643.5711 (International)

  

800.642.1687 (Replay – Domestic)

706.645.9291 (Replay – International)

The access code for the live conference call and replay is 82574812. A replay of the conference call will be available through August 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, 2009 and Quarterly Report on Form 10-Q for the quarter ended March 31, 2010, 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 6.0 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 5.5 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 website 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, health care reform; 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; rising health care costs; continued recessionary economic conditions or a further decline in the economy; 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 businesses; litigation costs; regulatory issues; operational issues; investment portfolio impairment charges; volatility in the financial markets; 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

 

7


included within the company’s most recent Annual Report on Form 10-K and subsequent Quarterly Reports on Form 10-Q filed with the Securities and Exchange Commission (“SEC”), and the risks discussed in the company’s other filings with the SEC. Readers are cautioned not to place undue reliance on these forward-looking statements. The company undertakes no obligation to publicly revise 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-Q for the period ended June 30, 2010.

Eight pages of tables follow.

# # #

 

8


Health Net, Inc.

Enrollment Data - By State

(In thousands)

 

                    Change from  
                    March 31, 2010     June 30, 2009  
     June 30,
2010
   Mar 31,
2010
   June 30,
2009
   Increase/
(Decrease)
    %
Change
    Increase/
(Decrease)
    %
Change
 

California

                 

Large Group

   836    839    908    (3   (0.4 )%    (72   (7.9 )% 

Small Group and Individual

   355    362    380    (7   (1.9 )%    (25   (6.6 )% 
                                       

Commercial Risk

   1,191    1,201    1,288    (10   (0.8 )%    (97   (7.5 )% 

ASO

   5    5    3    0      0.0   2      66.7
                                       

Total Commercial

   1,196    1,206    1,291    (10   (0.8 )%    (95   (7.4 )% 

Medicare Advantage

   132    130    134    2      1.5   (2   (1.5 )% 

Medi-Cal

   877    873    827    4      0.5   50      6.0
                                       

Total California

   2,205    2,209    2,252    (4   (0.2 )%    (47   (2.1 )% 
                                       

Arizona

                 

Large Group

   53    52    64    1      1.9   (11   (17.2 )% 

Small Group and Individual

   39    38    39    1      2.6   0      0.0
                                       

Commercial Risk

   92    90    103    2      2.2   (11   (10.7 )% 

Medicare Advantage

   49    51    65    (2   (3.9 )%    (16   (24.6 )% 
                                       

Total Arizona

   141    141    168    0      0.0   (27   (16.1 )% 
                                       

Oregon

                 

Large Group

   52    55    86    (3   (5.5 )%    (34   (39.5 )% 

Small Group and Individual

   47    47    47    0      0.0   0      0.0
                                       

Commercial Risk

   99    102    133    (3   (2.9 )%    (34   (25.6 )% 

Medicare Advantage

   38    37    24    1      2.7   14      58.3
                                       

Total Oregon

   137    139    157    (2   (1.4 )%    (20   (12.7 )% 
                                       

Total Health Plan Enrollment

                 

Large Group

   941    946    1,058    (5   (0.5 )%    (117   (11.1 )% 

Small Group and Individual

   441    447    466    (6   (1.3 )%    (25   (5.4 )% 
                                       

Commercial Risk

   1,382    1,393    1,524    (11   (0.8 )%    (142   (9.3 )% 

ASO

   5    5    3    0      0.0   2      66.7
                                       

Total Commercial

   1,387    1,398    1,527    (11   (0.8 )%    (140   (9.2 )% 

Medicare Advantage

   219    218    223    1      0.5   (4   (1.8 )% 

Medicare PDP (stand-alone)

   434    457    458    (23   (5.0 )%    (24   (5.2 )% 

Medi-Cal/Medicaid

   877    873    827    4      0.5   50      6.0
                                       
   2,917    2,946    3,035    (29   (1.0 )%    (118   (3.9 )% 

All Other States

   19    21    584    (2   (9.5 )%    (565   (96.7 )% 
                                       
   2,936    2,967    3,619    (31   (1.0 )%    (683   (18.9 )% 
                                       

TRICARE - North Contract Eligibles

   3,077    3,067    3,040    10      0.3   37      1.2
                                       

 

Page 9


Health Net, Inc.

Enrollment Data - Line of Business

(In thousands)

 

                    Change from  
                    March 31, 2010     June 30, 2009  
     June 30,
2010
   Mar 31,
2010
   June 30,
2009
   Increase/
(Decrease)
    %
Change
    Increase/
(Decrease)
    %
Change
 

Large Group

                 

California

   836    839    908    (3   (0.4 )%    (72   (7.9 )% 

Arizona

   53    52    64    1      1.9   (11   (17.2 )% 

Oregon

   52    55    86    (3   (5.5 )%    (34   (39.5 )% 
                                       
   941    946    1,058    (5   (0.5 )%    (117   (11.1 )% 
                                       

Small Group and Individual

                 

California

   355    362    380    (7   (1.9 )%    (25   (6.6 )% 

Arizona

   39    38    39    1      2.6   0      0.0

Oregon

   47    47    47    0      0.0   0      0.0
                                       
   441    447    466    (6   (1.3 )%    (25   (5.4 )% 
                                       

Commercial Risk

                 

California

   1,191    1,201    1,288    (10   (0.8 )%    (97   (7.5 )% 

Arizona

   92    90    103    2      2.2   (11   (10.7 )% 

Oregon

   99    102    133    (3   (2.9 )%    (34   (25.6 )% 
                                       
   1,382    1,393    1,524    (11   (0.8 )%    (142   (9.3 )% 
                                       

ASO

   5    5    3    0      0.0   2      66.7

Total Commercial

                 

California

   1,196    1,206    1,291    (10   (0.8 )%    (95   (7.4 )% 

Arizona

   92    90    103    2      2.2   (11   (10.7 )% 

Oregon

   99    102    133    (3   (2.9 )%    (34   (25.6 )% 
                                       
   1,387    1,398    1,527    (11   (0.8 )%    (140   (9.2 )% 

Medicare Advantage

                 

California

   132    130    134    2      1.5   (2   (1.5 )% 

Arizona

   49    51    65    (2   (3.9 )%    (16   (24.6 )% 

Oregon

   38    37    24    1      2.7   14      58.3
                                       
   219    218    223    1      0.5   (4   (1.8 )% 

Medi-Cal/Medicaid

                 

California

   877    873    827    4      0.5   50      6.0

Total Health Plan Enrollment

                 

Large Group

   941    946    1,058    (5   (0.5 )%    (117   (11.1 )% 

Small Group and Individual

   441    447    466    (6   (1.3 )%    (25   (5.4 )% 
                                       

Commercial Risk

   1,382    1,393    1,524    (11   (0.8 )%    (142   (9.3 )% 

ASO

   5    5    3    0      0.0   2      66.7
                                       

Total Commercial

   1,387    1,398    1,527    (11   (0.8 )%    (140   (9.2 )% 

Medicare Advantage

   219    218    223    1      0.5   (4   (1.8 )% 

Medicare PDP (stand-alone)

   434    457    458    (23   (5.0 )%    (24   (5.2 )% 

Medi-Cal/Medicaid

   877    873    827    4      0.5   50      6.0
                                       
   2,917    2,946    3,035    (29   (1.0 )%    (118   (3.9 )% 

All Other States

   19    21    584    (2   (9.5 )%    (565   (96.7 )% 
                                       
   2,936    2,967    3,619    (31   (1.0 )%    (683   (18.9 )% 
                                       

TRICARE - North Contract Eligibles

   3,077    3,067    3,040    10      0.3   37      1.2
                                       

 

Page 10


Health Net, Inc.

Consolidated Statements of Operations

(Amounts in thousands, except per share data)

 

     Quarter Ended
June  30,

2010
    Quarter Ended
March 31,
2010
   Quarter Ended
June  30,

2009

REVENUES:

       

Health plan services premiums

   $ 2,507,318      $ 2,527,507    $ 3,152,783

Government contracts

     851,939        809,459      832,088

Net investment income

     16,567        19,922      20,432

Administrative services fees and other income

     7,297        8,856      8,387

Northeast administrative services fees and other

     59,301        50,360      —  
                     
     3,442,422        3,416,104      4,013,690
                     
       

EXPENSES:

       

Health plan services

     2,163,191        2,211,256      2,718,039

Government contracts

     811,386        771,902      791,044

General and administrative

     237,378        247,096      332,188

Selling

     56,574        58,831      81,359

Depreciation and amortization

     8,466        8,663      15,708

Interest

     8,761        9,884      11,518

Northeast administrative services expenses

     71,951        81,878      —  

Adjustment to loss on sale of Northeast subsidiaries

     (8,171     —        —  

Asset impairments

     6,000        —        —  

Early debt extinguishment

     8,992        —        —  
                     
     3,364,528        3,389,510      3,949,856

Income from operations before income taxes

     77,894        26,594      63,834

Income tax provision

     32,828        10,504      23,694
                     

Net income

   $ 45,066      $ 16,090    $ 40,140
                     

Basic earnings per share

   $ 0.46      $ 0.16    $ 0.39

Diluted earnings per share

   $ 0.45      $ 0.16    $ 0.38

Weighted average shares outstanding:

       

Basic

     98,896        101,049      103,854

Diluted

     99,687        102,115      104,323

 

Page 11


Health Net, Inc.

Condensed Consolidated Balance Sheets

(Amounts in thousands, except ratio data)

 

     June 30,
2010
    March 31,
2010
    December 31,
2009
 

ASSETS

      

Current Assets

      

Cash and cash equivalents

   $ 425,663      $ 537,414      $ 682,803   

Investments - available for sale

     1,487,497        1,477,843        1,376,142   

Premiums receivable, net

     351,953        295,514        288,719   

Amounts receivable under government contracts

     277,465        298,827        270,810   

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

     280,151        255,925        281,140   

Other receivables

     101,602        80,260        111,608   

Deferred taxes

     39,217        51,389        46,527   

Other assets

     188,578        205,036        187,086   
                        

Total current assets

     3,152,126        3,202,208        3,244,835   

Property and equipment, net

     119,356        124,235        131,480   

Goodwill, net

     605,886        611,886        611,886   

Other intangible assets, net

     26,111        27,059        28,108   

Deferred taxes

     83,403        83,885        89,479   

Investments - available for sale- noncurrent

     2,985        531        20,870   

Other noncurrent assets

     161,098        164,379        155,993   
                        

Total Assets

   $ 4,150,965      $ 4,214,183      $ 4,282,651   
                        

LIABILITIES AND STOCKHOLDERS’ EQUITY

      

Current Liabilities

      

Reserves for claims and other settlements

   $ 934,879      $ 995,594      $ 951,655   

Health care and other costs payable under government contracts

     91,930        95,194        90,815   

IBNR health care costs payable under TRICARE North contract

     280,151        255,925        281,140   

Unearned premiums

     145,590        152,219        135,772   

Borrowings under amortizing financing facility

     —          105,579        104,007   

Accounts payable and other liabilities

     410,961        412,575        366,125   
                        

Total current liabilities

     1,863,511        2,017,086        1,929,514   

Senior notes payable

     398,583        398,532        398,480   

Borrowings under revolving credit facility

     100,000        —          100,000   

Other noncurrent liabilities

     155,131        159,036        158,874   
                        

Total Liabilities

     2,517,225        2,574,654        2,586,868   
                        

Stockholders’ Equity

      

Common stock

     145        145        154   

Additional paid-in capital

     1,209,130        1,201,904        1,190,203   

Treasury common stock, at cost

     (1,548,166     (1,476,327     (1,389,722

Retained earnings

     1,956,252        1,911,186        1,895,096   

Accumulated other comprehensive (loss) income

     16,379        2,621        52   
                        

Total Stockholders’ Equity

     1,633,740        1,639,529        1,695,783   
                        

Total Liabilities and Stockholders' Equity

   $ 4,150,965      $ 4,214,183      $ 4,282,651   
                        

Debt-to-Total Capital Ratio

     23.4     23.5     26.2

 

Page 12


Health Net, Inc.

Condensed Consolidated Statements of Cash Flows

(Amounts in thousands)

 

     Quarter Ended
June  30,

2010
    Quarter Ended
March 31,
2010
    Quarter Ended
June  30,

2009
 

CASH FLOWS FROM OPERATING ACTIVITIES:

      

Net Income

   $ 45,066      $ 16,090      $ 40,140   

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

      

Amortization and depreciation

     8,466        8,663        15,708   

Share-based compensation

     8,566        14,555        5,987   

Deferred income taxes

     4,016        (638     11,579   

Excess tax benefits from share-based compensation

     —          (473     —     

Net realized (gain) on sale on investments

     (4,028     (6,853     (6,008

Asset impairments

     6,000        —          491   

Other changes

     (15,826     6,058        7,148   

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

      

Premiums receivable and unearned premiums

     (63,068     9,652        (20,673

Other current assets, receivables and noncurrent assets

     (7,167     8,431        29,290   

Amounts receivable/payable under government contracts

     18,098        (23,638     (9,039

Reserves for claims and other settlements

     (60,715     43,939        (85,192

Accounts payable and other liabilities

     44,289        51,661        (43,598
                        

Net cash (used in) provided by operating activities

     (16,303     127,447        (54,167
                        

CASH FLOWS FROM INVESTING ACTIVITIES:

      

Sales of investments

     215,870        444,200        307,407   

Maturities of investments

     72,327        36,631        51,010   

Purchases of investments

     (278,523     (557,102     (455,652

Proceeds from sale of property and equipment

     19        —          (5,081

Purchases of property and equipment

     (5,460     (3,549     —     

Sales and purchases of restricted investments and other

     (3,821     (130     (41
                        

Net cash (used in) provided by investing activities

     412        (79,950     (102,357
                        

CASH FLOWS FROM FINANCING ACTIVITIES:

      

Proceeds from exercise of stock options and employee stock purchases

     196        850        —     

Repurchases of common stock

     (79,285     (94,209     —     

Excess tax benefits from share-based compensation

       473        —     

Borrowings under financing arrangements

     100,000        —          25,000   

Repayment of borrowings under financing arrangements

     (116,771     (100,000     (42,444
                        

Net cash (used in) financing activities

     (95,860     (192,886     (17,444
                        

Net (decrease) in cash and cash equivalents

     (111,751     (145,389     (173,968

Cash and cash equivalents, beginning of period

     537,414        682,803        739,824   
                        

Cash and cash equivalents, end of period

   $ 425,663      $ 537,414      $ 565,856   
                        

 

Page 13


Health Net, Inc.

SEGMENT INFORMATION

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

The following table presents Health Net’s operating segment information.

 

    Quarter Ended June 30, 2010     Quarter Ended March 31, 2010   Quarter Ended June 30, 2009
    Western
Region
Opera-

tions1
    Govern-
ment
Contracts2
    Northeast
Opera-

tions3
    Cor-
porate/
Other4, 5
    Consoli-
dated
    Western
Region
Opera-

tions1
    Govern-
ment
Contracts2
    Northeast
Opera-

tions3
    Cor-
porate/
Other5
    Consoli-
dated
  Western
Region
Opera-

tions1
    Govern-
ment
Contracts2
    Northeast
Opera-

tions3
    Cor-
porate/
Other4, 6
    Consoli-
dated

Health plan services premiums

  $ 2,484,282        $ 23,036        $ 2,507,318      $ 2,502,358        $ 25,149        $ 2,527,507   $ 2,468,879        $ 683,904        $ 3,152,783

Government contracts

      851,939            851,939          809,459            809,459       832,088            832,088

Net investment income

    16,324          243          16,567        19,577        $ 345          19,922     10,642          9,790          20,432

Administrative services fees and other income

    7,275          22          7,297        8,832          24          8,856     6,147          2,240          8,387

Northeast administrative services fees and other

    —            59,301          59,301        —            50,360          50,360             —  
                                                                                                                   

Total revenues

    2,507,881        851,939        82,602        —          3,442,422        2,530,767        809,459        75,878        —          3,416,104     2,485,668        832,088        695,934        —          4,013,690

Health plan services

    2,164,164          20,660        (21,633     2,163,191        2,189,893          21,363          2,211,256     2,135,694          584,402        (2,057     2,718,039

Government contracts

      810,466          920        811,386          771,436          466        771,902       791,044            791,044

G&A excluding insurance, taxes and fees

    194,704          687        23,992        219,383        204,838          9,157        14,062        228,057     196,135          103,516        19,645        319,296

Insurance, taxes and fees

    17,995          —          —          17,995        19,039          —          —          19,039     11,661          1,231        —          12,892
                                                                                                                   

G&A including insurance, taxes and fees

    212,699          687        23,992        237,378        223,877          9,157        14,062        247,096     207,796          104,747        19,645        332,188

Selling

    55,750          824          56,574        57,725          1,106          58,831     57,941          23,418          81,359

Depreciation and amortization

    8,448          18          8,466        8,621          42          8,663     9,526          6,182          15,708

Interest

    8,761              8,761        9,884              9,884     11,154          364          11,518

Early debt extinguishment

          8,992        8,992                       

Asset impairments

        6,000          6,000        —                —               —  

Northeast administrative services expenses

        71,951          71,951        —            81,878          81,878             —  

Adjustment to loss on sale of Northeast health plans

        (8,171       (8,171     —                —               —  
                                                                                                                   

Total expenses

    2,449,822        810,466        91,969        12,271        3,364,528        2,490,000        771,436        113,546        14,528        3,389,510     2,422,111        791,044        719,113        17,588        3,949,856
                                                                                                                   

Income (loss) from operations before income taxes

    58,059        41,473        (9,367     (12,271     77,894        40,767        38,023        (37,668     (14,528     26,594     63,557        41,044        (23,179     (17,588     63,834

Income tax provision (benefit)

    21,967        17,042        (1,343     (4,838     32,828        15,379        15,503        (14,993     (5,385     10,504     23,524        17,047        (9,899     (6,978     23,694
                                                                                                                   

Net income (loss)

  $ 36,092      $ 24,431      $ (8,024   $ (7,433   $ 45,066      $ 25,388      $ 22,520      $ (22,675   $ (9,143   $ 16,090   $ 40,033      $ 23,997      $ (13,280   $ (10,610   $ 40,140
                                                                                                                   

Basic earnings (loss) per share

  $ 0.36      $ 0.25      $ (0.08   $ (0.08   $ 0.46      $ 0.25      $ 0.22      $ (0.22   $ (0.09   $ 0.16   $ 0.39      $ 0.23      $ (0.13   $ (0.10   $ 0.39

Diluted earnings (loss) per share

  $ 0.36      $ 0.25      $ (0.08   $ (0.08   $ 0.45      $ 0.25      $ 0.22      $ (0.22   $ (0.09   $ 0.16   $ 0.38      $ 0.23      $ (0.13   $ (0.10   $ 0.38

Basic weighted average shares outstanding

    98,896        98,896        98,896        98,896        98,896        101,049        101,049        101,049        101,049        101,049     103,854        103,854        103,854        103,854        103,854

Diluted weighted average shares outstanding

    99,687        99,687        98,896        98,896        99,687        102,115        102,115        101,049        101,049        102,115     104,323        104,323        103,854        103,854        104,323

Pretax margin

    2.3     4.9           1.6     4.7           2.6     4.9      

Commercial premium yield

    9.3             8.4             9.5        

Commercial premium PMPM

  $ 340.38              $ 336.44              $ 311.47           

Commercial health care cost trend

    9.1             8.3             10.4        

Commercial health care cost PMPM

  $ 293.81              $ 290.47              $ 269.35           

Commercial MCR

    86.3             86.3             86.5        

Medicare Advantage MCR

    88.5             88.2             85.6        

Medicare Part D MCR

    85.9             96.9             90.0        

Health plan services MCR

    87.1             87.5             86.5        

Government contracts cost ratio

      95.1             95.3             95.1      

G&A expense ratio

    8.5             8.9             8.4        

Selling costs ratio

    2.2             2.3             2.3        

Effective tax rate

    37.8             37.7             37.0        

 

1 Includes the operations of the company’s commercial, Medicare (including Part D) and Medicaid health plans, the operations of the company’s health and life insurance companies in California, Arizona and Oregon and the company’s behavioral health and pharmaceutical services subsidiaries in Arizona, California and Oregon.
2 Includes government-sponsored managed care plans through the TRICARE program and other health care-related Department of Defense and Veterans Affairs government contracts.
3 Includes the operations of the company’s Northeast health plans that were sold on December 11, 2009 and the operations of the company’s health and life insurance companies in Connecticut, New Jersey and New York. Subsequent to the sale, it also includes the operations of the administrative services provided to the buyer.
4 Includes a litigation reserve true-up related to a previously accrued for class action lawsuit.
5 Includes costs related to the company’s operations strategy and corporate overhead cost reduction efforts resulting from the Northeast sale.
6 Includes costs related to the company’s operations strategy.

 

Page 14


Health Net, Inc.

Disclosures Regarding Non-GAAP Financial Information

(Dollars in millions)

Management believes that adjusted days claims payable (adjusted for divested businesses, capitation, provider and other claim settlements and Medicare Part D), a non-GAAP financial measure, provides useful information to investors because the adjusted days claims payable calculation excludes amounts related to divested businesses and health care costs for which no or minimal reserves are maintained. Therefore, management believes that adjusted days claims payable may present a more accurate reflection of days claims payable calculated from claims-based reserves than does GAAP 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 adjusted days claims payable and days claims payable, the most directly comparable GAAP financial measure. You are encouraged to evaluate these adjustments and the reasons we consider them appropriate for supplemental analysis. In evaluating the adjusted amounts, you should be aware that we have incurred expenses that are the same as or similar to some of the adjustments in the current presentation and we may incur them again in the future.

Our presentation of the adjusted amounts should not be construed as an inference that our future results will be unaffected by unusual or non-recurring items.

 

     Q2 2010     Q1 2010     Q2 2009  

Reconciliation of Days Claims Payable:

      

(1)     Reserve for Claims and Other Settlements

   $ 934.9      $ 995.6      $ 1,243.5   

Less: Reserve for Claims and Other Settlements for Divested Businesses

     —          —          (251.7

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

     (155.6     (174.0     (196.9
                        

(2)     Reserve for Claims and Other Settlements - Adjusted

   $ 779.3      $ 821.6      $ 794.9   

(3)     Health Plan Services Cost

   $ 2,163.2      $ 2,211.3      $ 2,718.0   

Less: Health Plan Services Cost for Divested Businesses

     —          —          (563.2

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

     (839.0     (885.2     (838.9
                        

(4)     Health Plan Services Cost - Adjusted

   $ 1,324.2      $ 1,326.1      $ 1,315.9   

(5)     Number of Days in Period

     91        90        91   

= (1) / (3) * (5) Days Claims Payable - (using end of period reserve amount)

     39.3        40.5        41.6   

= (2) / (4) * (5) Days Claims payable - Adjusted (using end of period reserve amount)

     53.6        55.8        55.0   

 

Page 15


Health Net, Inc.

Reconciliation of Reserves for Claims and Other Settlements

(In millions)

 

     Health Plan Services  
     YTD 6/2010     Year 2009     Year 2008  

Reserve for claims (a), beginning of period

   $ 692.2      $ 957.1      $ 838.7   

Incurred claims related to:

      

Current Year

     2,343.4        6,422.8        6,372.2   

Prior Years (c)

     (68.5     (80.0     (8.3
                        

Total Incurred (b)

     2,274.9        6,342.8        6,363.9   

Paid claims related to:

      

Current Year

     1,710.0        5,572.2        5,443.2   

Prior Years

     574.3        857.8        802.3   
                        

Total Paid (b)

     2,284.3        6,430.0        6,245.5   

Less: Divested businesses

     —          (177.7     —     
                        

Reserve for claims (a), end of period

     682.8        692.2        957.1   

Add:

      

Claims Payable (d)

     142.1        165.6        284.8   

Other (e)

     110.0        93.9        96.2   
                        

Reserves for claims and other settlements, end of period

   $ 934.9      $ 951.7      $ 1,338.1   
                        

 

(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 16

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