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 THIRD QUARTER 2010

GAAP NET INCOME OF $62.7 MILLION, OR $0.64 PER DILUTED SHARE

WESTERN REGION OPERATIONS AND GOVERNMENT CONTRACTS SEGMENTS

PRODUCE COMBINED EARNINGS OF $0.74 PER DILUTED SHARE

COMMERCIAL RISK ENROLLMENT GROWS SEQUENTIALLY

LOS ANGELES, November 4, 2010 – Health Net, Inc. (NYSE: HNT) today announced 2010 third quarter GAAP net income of $62.7 million, or $0.64 per diluted share, compared with a GAAP net loss of $66.0 million, or $0.64 per diluted share, for the third quarter of 2009.

The third quarter 2010 GAAP results include $8.6 million in expenses primarily related to severance costs.

The company’s Western Region Operations and Government Contracts segments produced combined net earnings of $0.74 per diluted share in the third quarter of 2010 and $0.75 per diluted share in the third quarter of 2009.

“We are pleased that the third quarter of 2010 produced further evidence of our solid and consistent financial performance,” said Jay Gellert, president and chief executive officer of Health Net, Inc. “Our commercial risk enrollment grew by 3,000 members sequentially, reversing recent trends and demonstrating that our focus on efficient-network products is working.”

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 $2.55 to $2.58 for the combined Western Region Operations and Government Contracts segments.

“Based on our current outlook, we believe that operating income for the full year 2011 will be greater than in 2010,” said Gellert. “In addition, we currently anticipate continued share repurchase activity in 2011.”


 

CONSOLIDATED RESULTS

Health Net’s total revenues decreased 14.5 percent in the third quarter of 2010 to $3.4 billion from $4.0 billion in the third quarter of 2009. Health plan services premium revenues decreased by approximately 22.0 percent to $2.5 billion in the third quarter of 2010 compared with $3.2 billion in the third quarter of 2009. Health plan services expenses decreased to $2.1 billion in the third quarter of 2010 from $2.7 billion in the third quarter of 2009.

Investment income decreased to $19.5 million in the third quarter of 2010 compared with $27.7 million in the third quarter of 2009.

The decreases on these year-over-year comparisons are primarily the result of the company’s sale of its Northeast businesses in December 2009.

WESTERN REGION OPERATIONS SEGMENT

Health Plan Membership

Total enrollment in the Western Region Operations segment at September 30, 2010 was approximately 2.5 million members, a decrease of approximately 1.7 percent compared with enrollment at September 30, 2009. Total enrollment in the company’s California health plan decreased approximately 0.5 percent from September 30, 2009 to September 30, 2010.

Western Region commercial risk enrollment grew by 3,000 members from June 30, 2010 to September 30, 2010.

“In light of the current economic environment, we find this growth in our Western Region commercial risk products very encouraging,” said James Woys, Health Net’s chief operating officer. “Also, our strategy of emphasizing efficient-network products continues to produce share gains in our key markets. These products grew by 11.2 percent, or 30,000 new members, from September 30, 2009 to September 30, 2010.”

As of September 30, 2010, efficient-network products accounted for 22 percent of the company’s Western Region commercial enrollment compared with 19 percent at September 30, 2009.

Commercial enrollment in the Western Region declined by 6.4 percent from September 30, 2009 to approximately 1.4 million members on September 30, 2010. The decline in commercial enrollment is consistent with the overall weak economy in the company’s western markets.

Medicaid enrollment in California at September 30, 2010 was 896,000 members, an increase of 55,000 members, or 6.5 percent, from September 30, 2009.

Enrollment in the company’s Medicare Advantage plans in the Western Region at September 30, 2010 was 221,000 members, a decrease of 1.8 percent compared with September 30, 2009.

Membership in the company’s Medicare Part D plans was 432,000 at the end of the third quarter of 2010, a 7.3 percent decrease compared with the end of the third 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 third quarter of 2009.

Revenues

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

Investment income for the Western Region was $19.2 million in the third quarter of 2010 compared with $21.2 million in the third quarter of 2009 and $16.3 million in the second quarter of 2010.

 

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Health Plan Services Expenses

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

Commercial Premium Yield and Health Care Cost Trends

In the Western Region, commercial premiums per member per month (PMPM) increased by 7.2 percent to approximately $343 in the third quarter of 2010 compared with $320 in the third quarter of 2009.

Commercial health care costs PMPM in the Western Region increased by 5.2 percent to approximately $296 in the third quarter of 2010 compared with approximately $281 in the third quarter of 2009.

“The positive spread between commercial premium yields PMPM and health care costs PMPM and the resulting year-over-year increase in the commercial gross margin PMPM in the Western Region is further affirmation of both our product strategy and pricing discipline,” said Woys.

Medical Care Ratios (MCR)

The health plan services MCR in the Western Region was 86.3 percent in the third quarter of 2010 compared with 86.9 percent in the third quarter of 2009.

The Western Region commercial MCR was 86.3 percent in the third quarter of 2010 compared with 87.9 percent in the third quarter of 2009 and was flat sequentially.

“The year-over-year improvement in our commercial MCR is the result of continued pricing discipline and more moderate health care cost increases,” Woys added.

The Medicare Advantage MCR in the Western Region was 89.4 percent in the third quarter of 2010 compared with 88.4 percent in the third quarter of 2009 and was in-line with company expectations.

The Medicare Part D MCR was 64.6 percent in the third quarter of 2010 compared with 65.9 percent in the third quarter of 2009. The 130 basis point improvement is consistent with the company’s 2010 bid strategy.

General & Administrative (G&A) and Selling Expenses

G&A expense in the Western Region was $214.3 million in the third quarter of 2010 compared with $201.8 million in the third quarter of 2009. The G&A expense ratio increased 60 basis points from 8.1 percent in the third quarter of 2009 and 20 basis points sequentially from 8.5 percent in the second quarter of 2010 to 8.7 percent in the third quarter of 2010.

“The year-over-year increase in the G&A ratio in the Western Region segment was consistent with our expectations,” said Woys. “We continue to expect that the G&A ratio for the full year 2010 will be 8.8 percent to 9.0 percent.”

Selling expense in the Western Region was $58.3 million in the third quarter of 2010 compared with $58.0 million in the third quarter of 2009.

GOVERNMENT CONTRACTS SEGMENT

The company’s Government Contracts revenues increased 13.5 percent in the third quarter of 2010 to $860.7 million from $758.5 million in the third quarter of 2009.

 

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The Government Contracts cost ratio increased slightly from 94.4 percent in the third quarter of 2009 to 94.5 percent in the third quarter of 2010.

BALANCE SHEET

Health Net’s Condensed Consolidated Balance Sheets, attached as an exhibit to this press release, included the Northeast businesses in the third quarter of 2009. The company sold its Northeast businesses in December 2009, and as a result, the balance sheets exclude those businesses in the fourth quarter of 2009 and the first, second and third quarters of 2010.

Cash and investments as of September 30, 2010 were $1.9 billion compared with $1.8 billion as of September 30, 2009.

Reserves for claims and other settlements as of September 30, 2010 were $904.4 million compared with $951.8 million as of September 30, 2009 and $934.9 million as of June 30, 2010. The year-over-year decline is primarily due to a reduction in claims inventory. The sequential decline is primarily due to a $22.0 million payment to providers related to Medicare risk adjusters and a $15.0 million decline in claims inventory.

Days claims payable (DCP) for the third quarter of 2010 was 39.0 days compared with 40.2 days in the third quarter of 2009 and 39.3 days in the second quarter of 2010.

On an adjusted1 basis, DCP in the third quarter of 2010 was 53.6 days compared with 53.7 days in the third quarter of 2009 and 53.6 days in the second quarter of 2010.

The company’s debt-to-total capital ratio was 22.7 percent as of September 30, 2010 compared with 26.2 percent as of December 31, 2009 and 23.4 percent as of June 30, 2010.

Interest expense was $8.2 million in the third quarter of 2010 compared with $10.3 million in the third quarter of 2009. The decline was due to the decrease in the company’s total outstanding debt.

CASH FLOW

Operating cash flow was negative $54.3 million in the third quarter of 2010 due to delays in the receipt of approximately $164 million in Medicaid payments. The company received these payments in October 2010.

“If we had received the Medicaid payments during the third quarter of 2010, operating cash flow would have been approximately $109.7 million, or 1.5 times net income plus depreciation and amortization,” said Joseph Capezza, Health Net’s chief financial officer.

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 third quarter of 2010 were $50.1 million and $57.8 million, respectively, and they are shown separately in the accompanying Segment Information table.

 

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.

 

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SHARE REPURCHASE UPDATE

In the third quarter of 2010, Health Net repurchased 722,900 shares for approximately $19.4 million at an average price of $26.82 per share. At September 30, 2010, approximately $208.7 million of authorization under the company’s existing $300 million share repurchase program remained.

“We are pleased that our strong cash position at the parent has supported our ongoing share repurchase efforts,” said Capezza.

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 $2.55 to $2.58 per diluted share for the combined Western Region Operations and Government Contracts segments.

 

Metric

  

2010 Guidance

Year-end Membership(a)   

Commercial: -3% to -4% (previously -1% to -2%)

Medicaid: +5% to +6%

Medicare Advantage: Flat (previously -2% to -3%)

Total Western Region medical membership: Flat

PDP: -6% to -7%

Consolidated Revenues(b)    $13.0 to $13.5 billion
Commercial Yields(a)    ~8.0% to 8.3% (previously ~8.3% to 8.8%)

Commercial

Health Care Cost Trends(a)

  

~80 to 100 basis points < premium yields

(previously: ~60 to 80 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   

98 million to 100 million

(previously 99 million to 100 million)

GAAP EPS

Combined Western Region Operations and Government Contracts EPS

  

$2.07 to $2.17

 

$2.55 to $2.58 (previously $2.50 to $2.55)

 

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

 

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CONFERENCE CALL

As previously announced, Health Net will discuss the company’s third quarter 2010 results during a conference call on Thursday, November 4, 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 10742408. A replay of the conference call will be available through November 9, 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 Reports on Form 10-Q for the quarters ended March 31, 2010 and June 30, 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 5.4 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, including the ultimate impact of the Patient Protection and Affordable Care Act, which could materially adversely affect the company’s financial condition, results of operations and cash flows through, among other things, reduced revenues, new taxes, expanded liability, and increased costs (including medical, administrative, technology or other costs), or require changes to the ways in which the company does business; rising health care costs; continued slow economic growth or a further decline in the economy; negative prior period claims reserve developments; trends in medical care ratios; membership declines; unexpected utilization patterns or unexpectedly severe or widespread illnesses; rate cuts affecting the company’s Medicare or Medicaid businesses; costs, fees and expenses related to the post-closing administrative services provided under the administrative services agreements entered into in connection with the sale of the company’s Northeast business; potential termination of the administrative services agreements by the service recipients should Health Net 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

 

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running-out period of the Northeast business; litigation costs; regulatory issues with agencies such as the California Department of Managed Health Care, the Centers for Medicare and Medicaid Services and state departments of insurance; 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 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 September 30, 2010.

Eight pages of tables follow.

# # #

 

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Health Net, Inc.

Enrollment Data - By State

(In thousands)

 

                          Change from  
                          June 30, 2010     September 30, 2009  
     Sept 30,
2010
     June 30,
2010
     Sept 30,
2009
     Increase/
(Decrease)
    %
Change
    Increase/
(Decrease)
    %
Change
 

California

                 

Large Group

     844         836         888         8        1.0     (44     (5.0 )% 

Small Group and Individual

     351         355         365         (4     (1.1 )%      (14     (3.8 )% 
                                                           

Commercial Risk

     1,195         1,191         1,253         4        0.3     (58     (4.6 )% 

ASO

     0         5         5         (5     (100.0 )%      (5     (100.0 )% 
                                                           

Total Commercial

     1,195         1,196         1,258         (1     (0.1 )%      (63     (5.0 )% 

Medicare Advantage

     133         132         136         1        0.8     (3     (2.2 )% 

Medi-Cal

     896         877         841         19        2.2     55        6.5
                                                           

Total California

     2,224         2,205         2,235         19        0.9     (11     (0.5 )% 
                                                           

Arizona

                 

Large Group

     53         53         59         0        0.0     (6     (10.2 )% 

Small Group and Individual

     39         39         38         0        0.0     1        2.6
                                                           

Commercial Risk

     92         92         97         0        0.0     (5     (5.2 )% 

Medicare Advantage

     49         49         65         0        0.0     (16     (24.6 )% 
                                                           

Total Arizona

     141         141         162         0        0.0     (21     (13.0 )% 
                                                           

Oregon

                 

Large Group

     52         52         78         0        0.0     (26     (33.3 )% 

Small Group and Individual

     46         47         47         (1     (2.1 )%      (1     (2.1 )% 
                                                           

Commercial Risk

     98         99         125         (1     (1.0 )%      (27     (21.6 )% 

Medicare Advantage

     39         38         24         1        2.6     15        62.5
                                                           

Total Oregon

     137         137         149         0        0.0     (12     (8.1 )% 
                                                           

Total Health Plan Enrollment

                 

Large Group

     949         941         1,025         8        0.9     (76     (7.4 )% 

Small Group and Individual

     436         441         450         (5     (1.1 )%      (14     (3.1 )% 
                                                           

Commercial Risk

     1,385         1,382         1,475         3        0.2     (90     (6.1 )% 

ASO

     0         5         5         (5     (100.0 )%      (5     (100.0 )% 
                                                           

Total Commercial

     1,385         1,387         1,480         (2     (0.1 )%      (95     (6.4 )% 

Medicare Advantage

     221         219         225         2        0.9     (4     (1.8 )% 

Medi-Cal/Medicaid

     896         877         841         19        2.2     55        6.5
                                                           

Total Western Region

     2,502         2,483         2,546         19        0.8     (44     (1.7 )% 

Medicare PDP (stand-alone)

     432         434         466         (2     (0.5 )%      (34     (7.3 )% 

All Other States

     10         19         586         (9     (47.4 )%      (576     (98.3 )% 
                                                           
     2,944         2,936         3,598         8        0.3     (654     (18.2 )% 
                                                           

TRICARE - North Contract Eligibles

     3,077         3,077         3,040         0        0.0     37        1.2
                                                           

 

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Health Net, Inc.

Enrollment Data - Line of Business

(In thousands)

 

                          Change from  
                          June 30, 2010     September 30, 2009  
     Sept  30,
2010
     June  30,
2010
     Sept  30,
2009
     Increase/
(Decrease)
    %
Change
    Increase/
(Decrease)
    %
Change
 

Large Group

                 

California

     844         836         888         8        1.0     (44     (5.0 )% 

Arizona

     53         53         59         0        0.0     (6     (10.2 )% 

Oregon

     52         52         78         0        0.0     (26     (33.3 )% 
                                                           
     949         941         1,025         8        0.9     (76     (7.4 )% 
                                                           

Small Group and Individual

                 

California

     351         355         365         (4     (1.1 )%      (14     (3.8 )% 

Arizona

     39         39         38         0        0.0     1        2.6

Oregon

     46         47         47         (1     (2.1 )%      (1     (2.1 )% 
                                                           
     436         441         450         (5     (1.1 )%      (14     (3.1 )% 
                                                           

Commercial Risk

                 

California

     1,195         1,191         1,253         4        0.3     (58     (4.6 )% 

Arizona

     92         92         97         0        0.0     (5     (5.2 )% 

Oregon

     98         99         125         (1     (1.0 )%      (27     (21.6 )% 
                                                           
     1,385         1,382         1,475         3        0.2     (90     (6.1 )% 
                                                           

ASO

     0         5         5         (5     (100.0 )%      (5     (100.0 )% 

Total Commercial

                 

California

     1,195         1,196         1,258         (1     (0.1 )%      (63     (5.0 )% 

Arizona

     92         92         97         0        0.0     (5     (5.2 )% 

Oregon

     98         99         125         (1     (1.0 )%      (27     (21.6 )% 
                                                           
     1,385         1,387         1,480         (2     (0.1 )%      (95     (6.4 )% 

Medicare Advantage

                 

California

     133         132         136         1        0.8     (3     (2.2 )% 

Arizona

     49         49         65         0        0.0     (16     (24.6 )% 

Oregon

     39         38         24         1        2.6     15        62.5
                                                           
     221         219         225         2        0.9     (4     (1.8 )% 

Medi-Cal/Medicaid

                 

California

     896         877         841         19        2.2     55        6.5

Total Health Plan Enrollment

                 

Large Group

     949         941         1,025         8        0.9     (76     (7.4 )% 

Small Group and Individual

     436         441         450         (5     (1.1 )%      (14     (3.1 )% 
                                                           

Commercial Risk

     1,385         1,382         1,475         3        0.2     (90     (6.1 )% 

ASO

     0         5         5         (5     (100.0 )%      (5     (100.0 )% 
                                                           

Total Commercial

     1,385         1,387         1,480         (2     (0.1 )%      (95     (6.4 )% 

Medicare Advantage

     221         219         225         2        0.9     (4     (1.8 )% 

Medi-Cal/Medicaid

     896         877         841         19        2.2     55        6.5
                                                           

Total Western Region

     2,502         2,483         2,546         19        0.8     (44     (1.7 )% 

Medicare PDP (stand-alone)

     432         434         466         (2     (0.5 )%      (34     (7.3 )% 

All Other States

     10         19         586         (9     (47.4 )%      (576     (98.3 )% 
                                                           
     2,944         2,936         3,598         8        0.3     (654     (18.2 )% 
                                                           

TRICARE - North Contract Eligibles

     3,077         3,077         3,040         0        0.0     37        1.2
                                                           

 

Page 9


 

Health Net, Inc.

Consolidated Statements of Operations

($ in thousands, except per share data)

 

     Quarter Ended
September  30,
2010
    Quarter Ended
June  30,
2010
    Quarter Ended
September  30,
2009
 

REVENUES:

      

Health plan services premiums

   $ 2,470,939      $ 2,507,318      $ 3,166,877   

Government contracts

     860,697        851,939        758,507   

Net investment income

     19,466        16,567        27,691   

Administrative services fees and other income

     5,487        1,837        15,578   

Northeast administrative services fees and other

     36,863        59,301        —     
                        
     3,393,452        3,436,962        3,968,653   
                        
      

EXPENSES:

      

Health plan services

     2,134,701        2,163,191        2,734,984   

Government contracts

     814,385        811,386        716,323   

General and administrative

     225,929        237,378        319,451   

Selling

     59,021        56,574        83,275   

Depreciation and amortization

     8,659        8,466        12,689   

Interest

     8,150        8,761        10,264   

Northeast administrative services expenses

     61,878        71,951        —     

Adjustment to loss on sale of Northeast subsidiaries

     (21,457     (8,171     —     

Asset impairments

     —          6,000        170,570   

Early debt extinguishment

     —          3,532        —     
                        
     3,291,266        3,359,068        4,047,556   

Income (loss) from operations before income taxes

     102,186        77,894        (78,903

Income tax provision (benefit)

     39,503        32,828        (12,881
                        

Net income (loss)

   $ 62,683      $ 45,066      $ (66,022
                        

Basic earnings (loss) per share

   $ 0.64      $ 0.46      $ (0.64

Diluted earnings (loss) per share

   $ 0.64      $ 0.45      $ (0.64

Weighted average shares outstanding:

      

Basic

     97,349        98,896        103,873   

Diluted

     98,304        99,687        103,873   

 

Page 10


 

Health Net, Inc.

Condensed Consolidated Balance Sheets

($ in thousands)

 

     September 30,
2010
    June 30,
2010
    March 31,
2010
 

ASSETS

      

Current Assets

      

Cash and cash equivalents

   $ 446,301      $ 425,663      $ 537,414   

Investments - available for sale

     1,420,124        1,487,497        1,477,843   

Premiums receivable, net

     407,467        351,953        295,514   

Amounts receivable under government contracts

     213,000        277,465        298,827   

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

     348,249        280,151        255,925   

Other receivables

     107,156        101,602        80,260   

Deferred taxes

     63,573        39,217        51,389   

Other assets

     207,545        188,578        205,036   
                        

Total current assets

     3,213,415        3,152,126        3,202,208   

Property and equipment, net

     125,039        119,356        124,235   

Goodwill, net

     605,886        605,886        611,886   

Other intangible assets, net

     25,164        26,111        27,059   

Deferred taxes

     56,987        83,403        83,885   

Investments - available for sale- noncurrent

     —          2,985        531   

Other noncurrent assets

     165,922        161,098        164,379   
                        

Total Assets

   $ 4,192,413      $ 4,150,965      $ 4,214,183   
                        

LIABILITIES AND STOCKHOLDERS’ EQUITY

      

Current Liabilities

      

Reserves for claims and other settlements

   $ 904,377      $ 934,879      $ 995,594   

Health care and other costs payable under government contracts

     58,628        91,930        95,194   

IBNR health care costs payable under TRICARE North contract

     348,249        280,151        255,925   

Unearned premiums

     153,539        145,590        152,219   

Borrowings under amortizing financing facility

     —          —          105,579   

Accounts payable and other liabilities

     379,414        410,961        412,575   
                        

Total current liabilities

     1,844,207        1,863,511        2,017,086   

Senior notes payable

     398,634        398,583        398,532   

Borrowings under revolving credit facility

     100,000        100,000        —     

Other noncurrent liabilities

     156,098        155,131        159,036   
                        

Total Liabilities

     2,498,939        2,517,225        2,574,654   
                        

Stockholders’ Equity

      

Common stock

     145        145        145   

Additional paid-in capital

     1,214,253        1,209,130        1,201,904   

Treasury common stock, at cost

     (1,567,603     (1,548,166     (1,476,327

Retained earnings

     2,018,935        1,956,252        1,911,186   

Accumulated other comprehensive income

     27,744        16,379        2,621   
                        

Total Stockholders’ Equity

     1,693,474        1,633,740        1,639,529   
                        

Total Liabilities and Stockholders’ Equity

   $ 4,192,413      $ 4,150,965      $ 4,214,183   
                        

Debt-to-Total Capital Ratio

     22.7     23.4     23.5

 

Page 11


 

Health Net, Inc.

Condensed Consolidated Statements of Cash Flows

($ in thousands)

 

     Quarter Ended
September  30,
2010
    Quarter Ended
June  30,
2010
    Quarter Ended
September  30,
2009
 

CASH FLOWS FROM OPERATING ACTIVITIES:

      

Net income (loss)

   $ 62,683      $ 45,066      $ (66,022

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

      

Amortization and depreciation

     8,659        8,466        12,689   

Share-based compensation

     4,856        8,566        (5,025

Deferred income taxes

     (4,875     4,016        (45,976

Net realized (gain) on sale on investments

     (7,742     (4,028     (12,312

Loss on sale of Northeast subsidiaries

     —          —          170,570   

Asset impairments

     —          6,000     

Other changes

     (6,554     (15,826     6,950   

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

      

Premiums receivable and unearned premiums

     (47,565     (63,068     48,341   

Other current assets, receivables and noncurrent assets

     (34,674     (7,167     (30,470

Amounts receivable/payable under government contracts

     31,163        18,098        39,123   

Reserves for claims and other settlements

     (30,502     (60,715     (48,570

Accounts payable and other liabilities

     (29,740     44,289        85,055   
                        

Net cash (used in) provided by operating activities

     (54,291     (16,303     154,353   
                        

CASH FLOWS FROM INVESTING ACTIVITIES:

      

Sales of investments

     248,354        215,870        465,732   

Maturities of investments

     47,243        72,327        37,355   

Purchases of investments

     (203,530     (278,523     (520,733

Proceeds from sale of property and equipment

     —          19        12   

Purchases of property and equipment

     (15,989     (5,460     (8,018

Net cash received (paid) for business divestitures

     4,541        (8,415     —     

Sales and purchases of restricted investments and other

     2,567        4,594        6,558   
                        

Net cash provided by (used in) investing activities

     83,186        412        (19,094
                        

CASH FLOWS FROM FINANCING ACTIVITIES:

      

Proceeds from exercise of stock options and employee stock purchases

     568        196        485   

Repurchases of common stock

     (8,825     (79,285     (29

Borrowings under financing arrangements

     —          100,000        —     

Repayment of borrowings under financing arrangements

     —          (116,771     —     
                        

Net cash (used in) provided by financing activities

     (8,257     (95,860     456   
                        

Net increase (decrease) in cash and cash equivalents

     20,638        (111,751     135,715   

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

     —          —          (238,260

Cash and cash equivalents, beginning of period

     425,663        537,414        565,856   
                        

Cash and cash equivalents, end of period

   $ 446,301      $ 425,663      $ 463,311   
                        

 

Page 12


 

Health Net, Inc.

SEGMENT INFORMATION

($ in thousands, except per share and PMPM data)

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

 

    Quarter Ended September 30, 2010     Quarter Ended June 30, 2010     Quarter Ended September 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/
Other4, 5
    Consoli-
dated
    Western
Region
Opera-

tions1
    Govern-
ment
Contracts2
    Northeast
Opera-

tions3
    Cor-
porate/
Other4, 5
    Consoli-
dated
 

Health plan services premiums

  $ 2,457,977        $ 12,962        $ 2,470,939      $ 2,484,282        $ 23,036        $ 2,507,318      $ 2,467,023        $ 699,854        $ 3,166,877   

Government contracts

      860,697            860,697          851,939            851,939          758,507            758,507   

Net investment income

    19,240          226          19,466        16,324        $ 243          16,567        21,182          6,509          27,691   

Administrative services fees and other income

    5,487          0          5,487        7,275          22        (5,460     1,837        13,662          1,916          15,578   

Northeast administrative services fees and other

    —            36,863          36,863        —            59,301          59,301                —     
                                                                                                                       

Total revenues

    2,482,704        860,697        50,051        —          3,393,452        2,507,881        851,939        82,602        (5,460     3,436,962        2,501,867        758,507        708,279        —          3,968,653   

Health plan services

    2,122,005          12,696          2,134,701        2,164,164          20,660        (21,633     2,163,191        2,143,481          592,067        (564     2,734,984   

Government contracts

      813,524          861        814,385          810,466          920        811,386          716,323            716,323   

G&A excluding insurance, taxes and fees

    196,014          3,466        7,771        207,251        194,704          687        23,992        219,383        175,342          97,516        19,495        292,353   

Insurance, taxes and fees

    18,272          406        —          18,678        17,995          —          —          17,995        26,457          641        —          27,098   
                                                                                                                       

G&A including insurance, taxes and fees

    214,286          3,872        7,771        225,929        212,699          687        23,992        237,378        201,799          98,157        19,495        319,451   

Selling

    58,267          754          59,021        55,750          824          56,574        57,966          25,309          83,275   

Depreciation and amortization

    8,585          74          8,659        8,448          18          8,466        9,692          2,997          12,689   

Interest

    8,150              8,150        8,761              8,761        10,069          195          10,264   

Early debt extinguishment

            0              3,532        3,532             

Asset impairments

        0          —              6,000          6,000              170,570        170,570   

Northeast administrative services expenses

        61,878          61,878            71,951          71,951                —     

Adjustment to loss on sale of Northeast health plans

        (21,457       (21,457         (8,171       (8,171             —     
                                                                                                                       

Total expenses

    2,411,293        813,524        57,817        8,632        3,291,266        2,449,822        810,466        91,969        6,811        3,359,068        2,423,007        716,323        718,725        189,501        4,047,556   
                                                                                                                       

Income (loss) from operations before income taxes

    71,411        47,173        (7,766     (8,632     102,186        58,059        41,473        (9,367     (12,271     77,894        78,860        42,184        (10,446     (189,501     (78,903

Income tax provision (benefit)

    26,974        19,332        (3,090     (3,713     39,503        21,967        17,042        (1,343     (4,838     32,828        25,073        17,351        (1,414     (53,891     (12,881
                                                                                                                       

Net income (loss)

  $ 44,437      $ 27,841      $ (4,676   $ (4,919   $ 62,683      $ 36,092      $ 24,431      $ (8,024   $ (7,433   $ 45,066      $ 53,787      $ 24,833      $ (9,032   $ (135,610   $ (66,022
                                                                                                                       

Basic earnings (loss) per share

  $ 0.46      $ 0.29      $ (0.05   $ (0.05   $ 0.64      $ 0.36      $ 0.25      $ (0.08   $ (0.08   $ 0.46      $ 0.52      $ 0.24      $ (0.09   $ (1.31   $ (0.64

Diluted earnings (loss) per share

  $ 0.45      $ 0.29      $ (0.05   $ (0.05   $ 0.64      $ 0.36      $ 0.25      $ (0.08   $ (0.08   $ 0.45      $ 0.52      $ 0.24      $ (0.09   $ (1.31   $ (0.64

Basic weighted average shares outstanding

    97,349        97,349        97,349        97,349        97,349        98,896        98,896        98,896        98,896        98,896        103,873        103,873        103,873        103,873        103,873   

Diluted weighted average shares outstanding

    98,304        98,304        97,349        97,349        98,304        99,687        99,687        98,896        98,896        99,687        104,432        104,432        103,873        103,873        103,873   

Pretax margin

    2.9     5.5           2.3     4.9           3.2     5.6      

Commercial premium yield

    7.2             9.3             9.6        

Commercial premium PMPM

  $ 342.63              $ 340.38              $ 319.71           

Commercial health care cost trend

    5.2             9.1             8.3        

Commercial health care cost PMPM

  $ 295.73              $ 293.81              $ 280.99           

Commercial MCR

    86.3             86.3             87.9        

Medicare Advantage MCR

    89.4             88.5             88.4        

Medicare Part D MCR

    64.6             85.9             65.9        

Medicaid MCR

    87.9             88.5             86.7        

Health plan services MCR

    86.3             87.1             86.9        

Government contracts cost ratio

      94.5             95.1             94.4      

G&A expense ratio

    8.7             8.5             8.1        

Selling costs ratio

    2.4             2.2             2.3        

Effective tax rate

    37.8     41.0           37.8     41.1           31.8     41.1      

 

1 Includes the operations of the company’s commercial, Medicare (including Part D) and Medicaid health plans in California, Arizona and Oregon.
2 Includes the operations of 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 sale of the Northeast health plans.

 

Page 13


 

Health Net, Inc.

Disclosures Regarding Non-GAAP Financial Information

($ 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 includes 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.

 

     Q3 2010     Q2 2010     Q3 2009  

Reconciliation of Days Claims Payable:

      

(1)     Reserve for Claims and Other Settlements

   $ 904.4      $ 934.9      $ 1,194.9   

Less: Reserve for Claims and Other Settlements for Divested Businesses

     —          —          (233.6

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

     (130.0     (155.6     (159.2
                        

(2)     Reserve for Claims and Other Settlements - Adjusted

   $ 774.4      $ 779.3      $ 802.1   

(3)     Health Plan Services Cost

   $ 2,134.7      $ 2,163.2      $ 2,735.0   

Less: Health Plan Services Cost for Divested Businesses

     —          —          (570.1

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

     (804.4     (839.0     (791.3
                        

(4)     Health Plan Services Cost - Adjusted

   $ 1,330.3      $ 1,324.2      $ 1,373.6   

(5)     Number of Days in Period

     92        91        92   

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

     39.0        39.3        40.2   

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

     53.6        53.6        53.7   

 

Page 14


 

Health Net, Inc.

Reconciliation of Reserves for Claims and Other Settlements

($ in millions)

 

     Health Plan Services  
     YTD 9/2010     Year 2009     Year 2008  

Reserve for claims (a), beginning of period

   $ 692.2      $ 957.1      $ 838.7   

Incurred claims related to:

      

Current Year

     3,481.9        6,422.8        6,372.2   

Prior Years (c)

     (63.8     (80.0     (8.3
                        

Total Incurred (b)

     3,418.1        6,342.8        6,363.9   

Paid claims related to:

      

Current Year

     2,837.7        5,572.2        5,443.2   

Prior Years

     600.2        857.8        802.3   
                        

Total Paid (b)

     3,437.9        6,430.0        6,245.5   

Less: Divested businesses

     —          (177.7     —     
                        

Reserve for claims (a), end of period

     672.4        692.2        957.1   

Add:

      

Claims Payable (d)

     141.9        165.6        284.8   

Other (e)

     90.1        93.9        96.2   
                        

Reserves for claims and other settlements, end of period

   $ 904.4      $ 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.

 

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