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 FIRST QUARTER 2011

GAAP NET LOSS OF $108.2 MILLION, OR LOSS OF $1.16 PER SHARE

WESTERN REGION OPERATIONS AND GOVERNMENT CONTRACTS SEGMENTS

GREW COMBINED EARNINGS PER DILUTED SHARE BY 30 PERCENT

TO $0.61 COMPARED WITH THE FIRST QUARTER OF 2010

HEALTH NET RAISES 2011 EARNINGS PER DILUTED SHARE GUIDANCE

FOR THE COMBINED WESTERN REGION OPERATIONS AND

GOVERNMENT CONTRACTS SEGMENTS TO BETWEEN $2.90 AND $3.00

THE COMPANY REPURCHASED 4.9 MILLION SHARES

FROM JANUARY 1 THROUGH APRIL 29, 2011 FOR $149.8 MILLION

LOS ANGELES, May 4, 2011 – Health Net, Inc. (NYSE:HNT) today announced a 2011 first quarter GAAP net loss of $108.2 million, or a loss of $1.16 per share, compared with GAAP net income of $16.1 million, or $0.16 per diluted share, for the first quarter of 2010.

The 2011 first quarter GAAP results include:

 

  1.

a $177.2 million pretax, or $157.9 million after tax, charge related to the AmCareco litigation1; and

 

  2. $11.0 million in pretax expenses related to the company’s administrative cost reduction efforts.


For the first quarter of 2011, the company’s Western Region Operations (Western Region) and Government Contracts segments produced combined earnings of $57.4 million, or $0.61 per diluted share, compared with $47.9 million, or $0.47 per diluted share for the first quarter of 2010.

“We are pleased that diluted earnings per share for our Western Region Operations and Government Contracts segments increased by 30 percent in the first quarter of 2011 compared with the first quarter of 2010,” said Jay Gellert, Health Net’s chief executive officer. “Our results, supported by strong commercial and Government Contracts performance, allowed us to repurchase more than five percent of our outstanding stock from January 1 through April 29, 2011.

“For the first time in several years, we achieved sequential commercial enrollment growth in the first quarter, and at the same time, the first quarter commercial medical care ratio improved year-over-year. Our results lead us to raise our annual earnings per diluted share guidance for the combined Western Region Operations and Government Contracts segments to a range of $2.90 to $3.00,” Gellert added.

CONSOLIDATED RESULTS

Health Net’s total revenues increased 3.2 percent in the first quarter of 2011 to $3.5 billion compared with $3.4 billion in the first quarter of 2010. Health plan services premium revenues increased by 3.4 percent to $2.6 billion in the first quarter of 2011 compared with $2.5 billion in the first quarter of 2010.

Investment income increased to $23.8 million in the first quarter of 2011 compared with $19.9 million in the first quarter of 2010.

WESTERN REGION OPERATIONS SEGMENT

Health Plan Membership

The company’s total health plan enrollment was approximately 2.9 million at March 31, 2011, a decrease of 0.9 percent compared with enrollment at March 31, 2010. Total enrollment in the company’s California health plan increased by 1.5 percent from March 31, 2010 to March 31, 2011.

Western Region commercial enrollment was approximately 1.4 million members at March 31, 2011, a decrease of 0.7 percent compared with enrollment at March 31, 2010, but up 0.4 percent from December 31, 2010.

“Our sequential commercial enrollment growth was driven by the growing popularity of our tailored network products, higher client retention and strong new sales in the first quarter of 2011,” said Jim Woys, Health Net’s chief operating officer.

As of March 31, 2011, tailored network products accounted for 30.0 percent of the company’s Western Region commercial enrollment compared with 20.0 percent at March 31, 2010.

Medicaid enrollment increased 7.8 percent to 941,000 members at March 31, 2011 compared with March 31, 2010.

 

2


Enrollment in Health Net’s Medicare Advantage plans in the Western Region was 209,000 members at March 31, 2011, which represents a 4.1 percent decrease compared with enrollment at March 31, 2010.

Membership in the company’s Medicare Part D plans was 401,000 at March 31, 2011, a 12.3 percent decrease compared with enrollment at March 31, 2010.

Revenues

Total revenues for the Western Region increased 4.2 percent in the first quarter of 2011 to $2.6 billion from $2.5 billion in the first quarter of 2010.

Investment income for the Western Region was $23.8 million in the first quarter of 2011 compared with $19.6 million in the first quarter of 2010 and $15.1 million in the fourth quarter of 2010.

Health Plan Services Expenses

Health plan services expenses in the Western Region increased approximately 4.2 percent to $2.3 billion in the first quarter of 2011 compared with $2.2 billion in the first quarter of 2010.

Commercial Premium Yield and Health Care Cost Trends

In the Western Region, commercial premiums per member per month (PMPM) increased by 5.7 percent to approximately $356 in the first quarter of 2011 compared with approximately $336 in the first quarter of 2010.

Commercial health care costs PMPM in the Western Region increased 5.0 percent to approximately $305 in the first quarter of 2011 compared with approximately $290 in the first quarter of 2010.

“Our first quarter 2011 commercial yields in the Western Region were lower than our initial expectations due to faster than expected growth in tailored network products, more over-age adult dependents enrolled in our products than expected and greater than expected benefit buydowns,” said Woys.

Due to these shifts, the company revised its 2011 guidance for commercial premium yield PMPM to between 6.0 percent and 6.5 percent and health care costs PMPM to be 100 to 120 basis points lower than premium yields.

Medical Care Ratios (MCR)

The health plan services MCR in the Western Region was 87.4 percent in the first quarter of 2011 compared with 87.5 percent in the first quarter of 2010. The Western Region commercial MCR was 85.7 percent in the first quarter of 2011 compared with 86.3 percent in the first quarter of 2010.

“The 60 basis point improvement in our commercial MCR is the result of continued pricing and underwriting discipline combined with moderate utilization and unit cost trends and slower growth in pharmacy costs,” said Joseph Capezza, Health Net’s chief financial officer.

 

3


The Medicare Advantage (MA) MCR in the Western Region was 89.0 percent in the first quarter of 2011 compared with 88.2 percent in the first quarter of 2010. The company’s Medicare Part D (PDP) MCR was 101.1 percent in the first quarter of 2011 compared with 96.9 percent in the first quarter of 2010. The increases in both the MA and PDP MCRs were due to the adverse effect of limited new member growth. The impact of this is more pronounced in the first quarter.

General & Administrative (G&A) and Selling Expenses

G&A expense in the Western Region was approximately $242.0 million in the first quarter of 2011 compared with approximately $223.9 million in the first quarter of 2010. The G&A expense ratio was 9.3 percent in the first quarter of 2011 compared with 8.9 percent in the first quarter of 2010.

“The G&A expense ratio increased 40 basis points quarter-over-quarter due to costs in the first quarter of 2011 associated with CMS compliance remediation as well as costs relating to the previously announced unaccounted-for disk drives in our data center,” said Woys. “For the full year 2011, we continue to expect our G&A ratio to be in the range of 8.7 percent to 8.9 percent.”

Selling expense in the Western Region was $60.6 million in the first quarter of 2011 compared with $57.7 million in the first quarter of 2010 due to strong new sales in the first quarter.

GOVERNMENT CONTRACTS SEGMENT

The company’s Government Contracts revenues increased 8.1 percent in the first quarter of 2011 to $875.1 million compared with $809.5 million in the first quarter of 2010.

The Government Contracts cost ratio decreased to 93.4 percent in the first quarter of 2011 from 95.3 percent in the first quarter of 2010.

“Health care delivery under the company’s new TRICARE North Region contract began April 1, 2011, and the transition to the new contract went smoothly,” said Woys.

BALANCE SHEET

Cash and investments as of March 31, 2011 were approximately $1.8 billion compared with approximately $2.0 billion at March 31, 2010.

Reserves for claims and other settlements as of March 31, 2011 were $889.9 million compared with $995.6 million at March 31, 2010 and $942.0 million at December 31, 2010. The company noted that the sequential decline in reserves is primarily the result of paid claims being approximately $100 million higher in the first quarter of 2011 compared with the fourth quarter of 2010.

Days claims payable (DCP) for the first quarter of 2011 was 35.1 days compared with 40.5 days for the first quarter of 2010 and 41.3 days for the fourth quarter of 2010.

On an adjusted2 basis, DCP for the first quarter of 2011 was 51.8 days compared with 55.8 days for the first quarter of 2010 and 57.3 days for the fourth quarter of 2010.

 

4


The company noted that, as adjusted in the attached reconciliation table2, the reserve for claims and other settlements (a component of DCP) at the end of the first quarter of 2011 was approximately equal to the amounts for the same metric at the end of the second and third quarters of 2010. The sequential decrease in this metric from the fourth quarter of 2010 was due to a reduction in claims inventories in the first quarter of 2011 as a year-end buildup in claims backlog due to holiday closures was paid down in the first quarter of this year. The decrease in this metric from the first quarter of 2010 compared with the first quarter of 2011 reflects faster claims turnaround as a result of more efficient processing due to simplified tailored network product contracts with providers.

The company’s debt-to-total capital ratio was 21.1 percent as of March 31, 2011 compared with 23.5 percent as of March 31, 2010 and 19.0 percent as of December 31, 2010.

Interest expense was $7.6 million in the first quarter of 2011 compared with $9.9 million in the first quarter of 2010. This decline was due to the decrease in the company’s total outstanding debt.

CASH FLOW

Operating cash flow was negative approximately $150 million in the first quarter of 2011 due primarily to the following:

 

  1. A sequential increase in premiums receivable and unearned premiums of approximately $106 million primarily related to Medicaid, MA and PDP.

 

  2. A $35 million increase in the net receivable related to the company’s TRICARE North Region contract.

 

  3. An approximate $52 million sequential decrease in reserves for claims and other settlements.

 

  4. A quarterly payment related to the sale of the company’s Northeast operations of approximately $35 million. This amount was offset by approximately $41 million in membership-related payments that were recorded in “Cash Flow from Investing Activities.”

“By year-end 2011, we expect the Medicaid receivable to decline by approximately $80 million and the TRICARE receivable to decline by approximately $150 million,” added Capezza.

“For 2011, we continue to expect operating cash flow to exceed net income plus depreciation and amortization. We expect that any payments related to the judgment in the AmCareco litigation will be funded through our revolving credit agreement,” said Capezza. “Therefore, excluding any further share repurchases this year, we expect cash at the parent company at December 31, 2011 to be approximately $300 million.”

NORTHEAST OPERATIONS SEGMENT

Health Net continues to serve the members of the Northeast companies previously sold to UnitedHealthcare under administrative services agreements (ASAs) that were entered into 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 the second quarter of 2011. After that time, the company will continue to administer run-out claims pursuant to claims servicing agreements with UnitedHealthcare and its affiliates.

 

5


The revenues associated with the company’s Northeast Operations in the first quarter of 2011 were $14.5 million and expenses were $19.4 million. Each item is shown separately in the Segment Information table accompanying this press release.

SHARE REPURCHASE UPDATE

From January 1 through April 29, 2011, Health Net repurchased 4.9 million shares of its common stock for aggregate consideration of approximately $149.8 million at an average price of $30.49 per share under its $300 million stock repurchase program. The company also announced today in a separate press release that its board of directors has authorized a new $300 million share repurchase program.

2011 GUIDANCE

Following is a table with specific 2011 guidance metrics.

 

Metric

  

2011 Guidance

Year-end Membership(a)   

Commercial: +1% to +2%

Medicaid: +9% to +11% (previously: +6% to +7%)

Medicare Advantage(c): -8% to -10% (previously: -15% to -17%)

Total Western Region Operations medical membership(c):

+3% to +4% (previously: +2% to +3%)

PDP (c): -11% to -13% (previously: -14% to -16%)

Consolidated Revenues(c)    $12.0 billion to $12.5 billion
Commercial Yields(a)    ~6.0% to 6.5% (previously: ~7.8% to 8.3%)
Commercial Health Care Cost Trends(a)   

~100 to 120 basis points < premium yields

(previously: ~ 40 to 60 bps < premium yields)

Selling Cost Ratio(a)

G&A Expense Ratio(a)

  

~ 2.3% to 2.4%

~ 8.7% to 8.9%

Tax Rate(b)    ~39.0% (previously: 39.2%)

 

6


2011 GUIDANCE (continued from previous page)

 

Metric

  

2011 Guidance

Weighted-average Fully Diluted Shares Outstanding

  

92.5 million to 93.5 million

(previously: 96 million to 97 million)

GAAP EPS(c)(d)

   $0.58 to $0.63 (previously: at least $2.05)

Combined Western Region Operations and Government Contracts EPS(c)

   $2.90 to $3.00 (previously: at least $2.75)

 

(a) For the company’s Western Region Operations
(b) For the combined Western Region Operations and Government Contracts segments
(c) Includes the expected impact of the CMS sanctions previously announced on November 19, 2010
(d) Includes the impact of the AmCareco litigation judgment

FOOTNOTES

1 On April 1, 2011, the Louisiana Supreme Court rendered a decision in the AmCareco litigation, which is described in Item 3 of Health Net’s Annual Report on Form 10-K for the year ended December 31, 2010, as updated by Health Net’s Current Report on Form 8-K filed with the Securities and Exchange Commission on April 4, 2011 (the “Form 8-K”). In the Form 8-K, the company noted it was continuing to assess the judgment and its impact on 2011 guidance. The charge recorded in the first quarter of 2011 represents the company’s final assessment of the compensatory and punitive damages and judicial interest to be paid in connection with the judgment as of April 1, 2011. Judicial interest will continue to accrue on the judgment until it is paid. The judgment decreased the company’s net income per diluted share by $1.69 in the first quarter of 2011 and will impact GAAP earnings per diluted share for 2011 by $1.70. The judgment will not affect the company’s earnings per diluted share from its combined Western Region Operations and Government Contracts segments for 2011.

2 See the table “Disclosures Regarding Non-GAAP Financial Information” attached to this press release for a reconciliation of adjusted DCP, a non-GAAP financial measure, to the comparable GAAP financial measure.

CONFERENCE CALL

As previously announced, Health Net will discuss the company’s first quarter 2011 results during a conference call on Wednesday, May 4, 2011, beginning at approximately 11:00 a.m. Eastern time. The conference call should be accessed at least 15 minutes prior to its start with the following numbers:

 

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

The access code for the live conference call and replay is 54183929. A replay of the conference call will be available through May 9, 2011. 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, 2010, and subsequent reports filed by the company from time to time with the Securities and Exchange Commission.

 

7


ABOUT HEALTH NET

Health Net, Inc. is a publicly traded managed care organization that delivers managed health care services through health plans and government-sponsored managed care plans. Its mission is to help people be healthy, secure and comfortable. The company provides health benefits to approximately 6.0 million individuals across the country through group, individual, Medicare (including the Medicare prescription drug benefit commonly referred to as “Part D”), Medicaid, Department of Defense, including TRICARE, and Veterans Affairs programs. Health Net’s behavioral health services subsidiary, Managed Health Network, Inc., provides behavioral health, substance abuse and employee assistance programs to approximately 5.1 million individuals, including Health Net’s own health plan members. 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 Affordable Care Act, which could materially adversely affect Health Net’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 Health Net 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 Health Net’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 Health Net’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 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, including the continued suspension of the marketing of and enrollment into Health Net’s Medicare products for a significant period of time, which could have a material adverse impact on Health Net’s Medicare

 

8


business; operational issues; noncompliance by Health Net or Health Net’s business associates with any privacy laws or any security breach involving the misappropriation, loss or other unauthorized use or disclosure of confidential information; 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 Health Net’s most recent Annual Report on Form 10-K filed with the Securities and Exchange Commission (“SEC”) and the risks discussed in the company’s subsequent 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 quarter ended March 31, 2011.

Eight pages of tables follow.

# # #

 

9


Health Net, Inc.

Enrollment Data—By State

(In thousands)

 

     March 31,
2011
     Dec 31,
2010
     March 31,
2010
     Change from  
              December 31, 2010     March 31, 2010  
              Increase/
(Decrease)
    %
Change
    Increase/
(Decrease)
    %
Change
 

California

                 

Large Group

     836         843         839         (7     (0.8 )%      (3     (0.4 )% 

Small Group and Individual

     338         348         362         (10     (2.9 )%      (24     (6.6 )% 
                                                           

Commercial Risk

     1,174         1,191         1,201         (17     (1.4 )%      (27     (2.2 )% 

ASO

     0         0         5         0        0.0     (5     (100.0 )% 
                                                           

Total Commercial

     1,174         1,191         1,206         (17     (1.4 )%      (32     (2.7 )% 

Medicare Advantage

     127         133         130         (6     (4.5 )%      (3     (2.3 )% 

Medi-Cal

     941         901         873         40        4.4     68        7.8
                                                           

Total California

     2,242         2,225         2,209         17        0.8     33        1.5
                                                           

Arizona

                 

Large Group

     74         56         52         18        32.1     22        42.3

Small Group and Individual

     50         41         38         9        22.0     12        31.6
                                                           

Commercial Risk

     124         97         90         27        27.8     34        37.8

Medicare Advantage

     42         49         51         (7     (14.3 )%      (9     (17.6 )% 
                                                           

Total Arizona

     166         146         141         20        13.7     25        17.7
                                                           

Oregon

                 

Large Group

     49         51         55         (2     (3.9 )%      (6     (10.9 )% 

Small Group and Individual

     41         44         47         (3     (6.8 )%      (6     (12.8 )% 
                                                           

Commercial Risk

     90         95         102         (5     (5.3 )%      (12     (11.8 )% 

Medicare Advantage

     40         40         37         0        0.0     3        8.1
                                                           

Total Oregon

     130         135         139         (5     (3.7 )%      (9     (6.5 )% 
                                                           

Total Health Plan Enrollment

                 

Large Group

     959         950         946         9        0.9     13        1.4

Small Group and Individual

     429         433         447         (4     (0.9 )%      (18     (4.0 )% 
                                                           

Commercial Risk

     1,388         1,383         1,393         5        0.4     (5     (0.4 )% 

ASO

     0         0         5         0        0.0     (5     (100.0 )% 
                                                           

Total Commercial

     1,388         1,383         1,398         5        0.4     (10     (0.7 )% 

Medicare Advantage

     209         222         218         (13     (5.9 )%      (9     (4.1 )% 

Medi-Cal/Medicaid

     941         901         873         40        4.4     68        7.8

Medicare PDP (stand-alone)

     401         427         457         (26     (6.1 )%      (56     (12.3 )% 
                                                           

Western Region Operations

     2,939         2,933         2,946         6        0.2     (7     (0.2 )% 

Northeast Operations

     1         7         21         (6     (85.7 )%      (20     (95.2 )% 
                                                           
     2,940         2,940         2,967         0        0.0     (27     (0.9 )% 
                                                           

TRICARE—North Contract Eligibles

     3,090         3,090         3,067         0        0.0     23        0.7
                                                           

 

Page 10


Health Net, Inc.

Enrollment Data—Line of Business

(In thousands)

 

                          Change from  
                          December 31, 2010     March 31, 2010  
     March 31,
2011
     Dec 31,
2010
     March 31,
2010
     Increase/
(Decrease)
    %
Change
    Increase/
(Decrease)
    %
Change
 

Large Group

                 

California

     836         843         839         (7     (0.8 )%      (3     (0.4 )% 

Arizona

     74         56         52         18        32.1     22        42.3

Oregon

     49         51         55         (2     (3.9 )%      (6     (10.9 )% 
                                                           
     959         950         946         9        0.9     13        1.4
                                                           

Small Group and Individual

                 

California

     338         348         362         (10     (2.9 )%      (24     (6.6 )% 

Arizona

     50         41         38         9        22.0     12        31.6

Oregon

     41         44         47         (3     (6.8 )%      (6     (12.8 )% 
                                                           
     429         433         447         (4     (0.9 )%      (18     (4.0 )% 
                                                           

Commercial Risk

                 

California

     1,174         1,191         1,201         (17     (1.4 )%      (27     (2.2 )% 

Arizona

     124         97         90         27        27.8     34        37.8

Oregon

     90         95         102         (5     (5.3 )%      (12     (11.8 )% 
                                                           
     1,388         1,383         1,393         5        0.4     (5     (0.4 )% 
                                                           

ASO

     0         0         5         0        0.0     (5     (100.0 )% 

Total Commercial

                 

California

     1,174         1,191         1,206         (17     (1.4 )%      (32     (2.7 )% 

Arizona

     124         97         90         27        27.8     34        37.8

Oregon

     90         95         102         (5     (5.3 )%      (12     (11.8 )% 
                                                           
     1,388         1,383         1,398         5        0.4     (10     (0.7 )% 

Medicare Advantage

                 

California

     127         133         130         (6     (4.5 )%      (3     (2.3 )% 

Arizona

     42         49         51         (7     (14.3 )%      (9     (17.6 )% 

Oregon

     40         40         37         0        0.0     3        8.1
                                                           
     209         222         218         (13     (5.9 )%      (9     (4.1 )% 

Medi-Cal/Medicaid

                 

California

     941         901         873         40        4.4     68        7.8

Total Health Plan Enrollment

                 

Large Group

     959         950         946         9        0.9     13        1.4

Small Group and Individual

     429         433         447         (4     (0.9 )%      (18     (4.0 )% 
                                                           

Commercial Risk

     1,388         1,383         1,393         5        0.4     (5     (0.4 )% 

ASO

     0         0         5         0        0.0     (5     (100.0 )% 
                                                           

Total Commercial

     1,388         1,383         1,398         5        0.4     (10     (0.7 )% 

Medicare Advantage

     209         222         218         (13     (5.9 )%      (9     (4.1 )% 

Medi-Cal/Medicaid

     941         901         873         40        4.4     68        7.8

Medicare PDP (stand-alone)

     401         427         457         (26     (6.1 )%      (56     (12.3 )% 
                                                           

Western Region Operations

     2,939         2,933         2,946         6        0.2     (7     (0.2 )% 

Northeast Operations

     1         7         21         (6     (85.7 )%      (20     (95.2 )% 
                                                           
     2,940         2,940         2,967         0        0.0     (27     (0.9 )% 
                                                           

TRICARE—North Contract Eligibles

     3,090         3,090         3,067         0        0.0     23        0.7
                                                           

 

Page 11


Health Net, Inc.

Consolidated Statements of Operations

($ in thousands, except per share data)

 

     Quarter Ended
March 31,
2011
    Quarter Ended
December 31,
2010
    Quarter Ended
March 31,
2010
 

REVENUES:

      

Health plan services premiums

   $ 2,612,384      $ 2,491,124      $ 2,527,507   

Government contracts

     875,127        822,388        809,459   

Net investment income

     23,835        15,226        19,922   

Administrative services fees and other income

     2,721        4,953        8,856   

Northeast administrative services fees and other

     12,449        39,643        50,360   
                        

Total revenues

     3,526,516        3,373,334        3,416,104   
                        

EXPENSES:

      

Health plan services

     2,282,334        2,099,969        2,211,256   

Government contracts

     822,152        770,487        771,902   

General and administrative

     426,361        245,861        247,096   

Selling

     60,691        64,333        58,831   

Depreciation and amortization

     8,828        9,012        8,663   

Interest

     7,620        8,085        9,884   

Northeast administrative services expenses

     52,255        63,727        81,878   

Adjustment to loss on sale of Northeast subsidiaries

     (34,854     (12,331     —     
                        

Total expenses

     3,625,387        3,249,143        3,389,510   

(Loss) income from operations before income taxes

     (98,871     124,191        26,594   

Income tax provision

     9,324        43,787        10,504   
                        

Net (loss) income

   $ (108,195   $ 80,404      $ 16,090   
                        

Basic (loss) earnings per share

   $ (1.16   $ 0.84      $ 0.16   

Diluted (loss) earnings per share

   $ (1.16   $ 0.83      $ 0.16   

Weighted average shares outstanding:

      

Basic

     93,290        95,697        101,049   

Diluted

     93,290        96,885        102,115   

 

Page 12


Health Net, Inc.

Condensed Consolidated Balance Sheets

(Amounts in thousands, except ratio data)

 

     March 31,
2011
    December 31,
2010
    March 31,
2010
 

ASSETS

      

Current Assets

      

Cash and cash equivalents

   $ 142,297      $ 350,138      $ 537,414   

Investments—available for sale

     1,658,788        1,663,218        1,477,843   

Premiums receivable, net

     397,949        298,892        295,514   

Amounts receivable under government contracts

     293,646        266,456        298,827   

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

     292,649        284,247        255,925   

Other receivables

     76,893        136,323        80,260   

Deferred taxes

     25,471        45,769        51,389   

Other assets

     229,568        182,252        205,036   
                        

Total current assets

     3,117,261        3,227,295        3,202,208   

Property and equipment, net

     122,966        123,137        124,235   

Goodwill, net

     605,886        605,886        611,886   

Other intangible assets, net

     23,270        24,217        27,059   

Deferred taxes

     55,957        50,648        83,885   

Investments—available for sale—  noncurrent

     8,870        8,756        531   

Other noncurrent assets

     90,983        91,754        164,379   
                        

Total Assets

   $ 4,025,193      $ 4,131,693      $ 4,214,183   
                        

LIABILITIES AND STOCKHOLDERS' EQUITY

      

Current Liabilities

      

Reserves for claims and other settlements

   $ 889,876      $ 942,024      $ 995,594   

Health care and other costs payable under government contracts

     106,254        113,865        95,194   

IBNR health care costs payable under TRICARE North contract

     292,649        284,247        255,925   

Unearned premiums

     151,963        158,493        152,219   

Borrowings under amortizing financing facility

     —          —          105,579   

Accounts payable and other liabilities

     514,957        402,024        412,575   
                        

Total current liabilities

     1,955,699        1,900,653        2,017,086   

Senior notes payable

     398,736        398,685        398,532   

Other noncurrent liabilities

     184,159        137,939        159,036   
                        

Total Liabilities

     2,538,594        2,437,277        2,574,654   
                        

Stockholders' Equity

      

Common stock

     147        145        145   

Additional paid-in capital

     1,255,246        1,221,301        1,201,904   

Treasury common stock, at cost

     (1,753,760     (1,626,856     (1,476,327

Retained earnings

     1,991,144        2,099,339        1,911,186   

Accumulated other comprehensive (loss) income

     (6,178     487        2,621   
                        

Total Stockholders' Equity

     1,486,599        1,694,416        1,639,529   
                        

Total Liabilities and Stockholders' Equity

   $ 4,025,193      $ 4,131,693      $ 4,214,183   
                        

Debt-to-Total Capital Ratio

     21.1     19.0     23.5

 

Page 13


Health Net, Inc.

Condensed Consolidated Statements of Cash Flows

(Amounts in thousands)

 

     First Quarter
Ended
March 31,
2011
    Fourth Quarter
Ended
December 31,
2010
    First Quarter
Ended
March 31,
2010
 

CASH FLOWS FROM OPERATING ACTIVITIES:

      

Net (loss) income

   $ (108,195   $ 80,404      $ 16,090   

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

      

Amortization and depreciation

     8,828        9,012        8,663   

Share-based compensation expense

     9,428        5,135        14,555   

Deferred income taxes

     19,135        38,661        (638

Excess tax benefits from share-based compensation

     (1,164     (98     (473

Adjustment to loss on sale of business

     (34,854     (12,331     —     

Net realized (gain) on sale on investments

     (12,298     (4,396     (6,853

Other changes

     2,571        (5,091     6,058   

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

      

Premiums receivable and unearned premiums

     (105,587     113,529        9,652   

Other current assets, receivables and noncurrent assets

     11,907        (2,575     8,431   

Amounts receivable/payable under government contracts

     (34,801     1,781        (23,638

Reserves for claims and other settlements

     (52,148     37,647        43,939   

Accounts payable and other liabilities

     147,210        (47,109     51,661   
                        

Net cash (used in) provided by operating activities

     (149,968     214,569        127,447   
                        

CASH FLOWS FROM INVESTING ACTIVITIES:

      

Sales of investments

     398,470        210,533        444,200   

Maturities of investments

     74,407        43,224        36,631   

Purchases of investments

     (468,255     (543,696     (557,102

Purchases of property and equipment

     (10,305     (9,793     (3,549

Purchase price adjustment on sale of Northeast Health Plans

     41,036        80,000        —     

Sales and purchases of restricted investments and other

     (13,764     15,491        (130
                        

Net cash provided by (used in) investing activities

     21,589        (204,241     (79,950
                        

CASH FLOWS FROM FINANCING ACTIVITIES:

      

Proceeds from exercise of stock options and employee stock purchases

     7,990        2,030        850   

Repurchases of common stock

     (113,510     (54,528     (94,209

Excess tax benefits from share-based compensation

     1,164        98        473   

Repayment of borrowings under financing arrangements

     —          (100,000     (100,000

Net increase (decrease) in checks outstanding (net of deposits)

     24,894        45,909        —     
                        

Net cash (used in) financing activities

     (79,462     (106,491     (192,886
                        

Net (decrease) in cash and cash equivalents

     (207,841     (96,163     (145,389

Cash and cash equivalents, beginning of period

     350,138        446,301        682,803   
                        

Cash and cash equivalents, end of period

   $ 142,297      $ 350,138      $ 537,414   
                        

 

Page 14


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 March 31, 2011     Quarter Ended December 31, 2010     Quarter Ended March 31, 2010  
    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/
Other6
    Consoli-
dated
 

Health plan services premiums

  $ 2,610,380        $ 2,004        $ 2,612,384      $ 2,481,121        $ 10,003        $ 2,491,124      $ 2,502,358        $ 25,149        $ 2,527,507   

Government contracts

      875,127            875,127          822,388            822,388          809,459            809,459   

Net investment income

    23,774          61          23,835        15,138          88          15,226        19,577        $ 345          19,922   

Administrative services fees and other income

    2,721              2,721        4,953          —            4,953        8,832          24          8,856   

Northeast administrative services fees and other

        12,449          12,449        —            39,643          39,643        —            50,360          50,360   
                                                                                                                       

Total revenues

    2,636,875        875,127        14,514        —          3,526,516        2,501,212        822,388        49,734        —          3,373,334        2,530,767        809,459        75,878        —          3,416,104   

Health plan services

    2,281,436          898          2,282,334        2,115,099          9,746        (24,876     2,099,969        2,189,893          21,363          2,211,256   

Government contracts

      817,299          4,853        822,152          770,321          166        770,487          771,436          466        771,902   

G&A excluding insurance, taxes and fees

    217,622          873        183,377        401,872        211,894          1,576        13,015        226,485        204,838          9,157        14,062        228,057   

Insurance, taxes and fees

    24,334          155        —          24,489        19,003          373        —          19,376        19,039          —          —          19,039   
                                                                                                                       

G&A including insurance, taxes and fees

    241,956          1,028        183,377        426,361        230,897          1,949        13,015        245,861        223,877          9,157        14,062        247,096   

Selling

    60,587          104          60,691        63,866          467          64,333        57,725          1,106          58,831   

Depreciation and amortization

    8,822          6          8,828        8,980          32          9,012        8,621          42          8,663   

Interest

    7,620          —            7,620        8,085          —            8,085        9,884          —            9,884   

Northeast administrative services expenses

        52,255          52,255            63,727          63,727            81,878          81,878   

Adjustment to loss on sale of Northeast health plans

        (34,854       (34,854         (12,331       (12,331         —            —     
                                                                                                                       

Total expenses

    2,600,421        817,299        19,437        188,230        3,625,387        2,426,927        770,321        63,590        (11,695     3,249,143        2,490,000        771,436        113,546        14,528        3,389,510   
                                                                                                                       

Income (loss) from operations before income taxes

    36,454        57,828        (4,923     (188,230     (98,871     74,285        52,067        (13,856     11,695        124,191        40,767        38,023        (37,668     (14,528     26,594   

Income tax provision (benefit)

    13,476        23,389        (3,998     (23,543     9,324        27,389        21,320        (9,830     4,908        43,787        15,379        15,503        (14,993     (5,385     10,504   
                                                                                                                       

Net income (loss)

  $ 22,978      $ 34,439      $ (925   $ (164,687   $ (108,195   $ 46,896      $ 30,747      $ (4,026   $ 6,787      $ 80,404      $ 25,388      $ 22,520      $ (22,675   $ (9,143   $ 16,090   
                                                                                                                       

Basic earnings (loss) per share

  $ 0.25      $ 0.37      $ (0.01   $ (1.77   $ (1.16   $ 0.49      $ 0.32      $ (0.04   $ 0.07      $ 0.84      $ 0.25      $ 0.22      $ (0.22   $ (0.09   $ 0.16   

Diluted earnings (loss) per share

  $ 0.24      $ 0.37      $ (0.01   $ (1.77   $ (1.16   $ 0.48      $ 0.32      $ (0.04   $ 0.07      $ 0.83      $ 0.25      $ 0.22      $ (0.22   $ (0.09   $ 0.16   

Basic weighted average shares outstanding

    93,290        93,290        93,290        93,290        93,290        95,697        95,697        95,697        95,697        95,697        101,049        101,049        101,049        101,049        101,049   

Diluted weighted average shares outstanding

    94,843        94,843        93,290        93,290        93,290        96,885        96,885        95,697        96,885        96,885        102,115        102,115        101,049        101,049        102,115   

Pretax margin

    1.4     6.6           3.0     6.3           1.6     4.7      

Commercial premium yield

    5.7             6.8             8.4        

Commercial premium PMPM

  $ 355.61              $ 343.85              $ 336.44           

Commercial health care cost trend

    5.0             5.7             8.3        

Commercial health care cost PMPM

  $ 304.86              $ 294.08              $ 290.47           

Commercial MCR

    85.7             85.5             86.3        

Medicare Advantage MCR

    89.0             89.4             88.2        

Medicare Part D MCR

    101.1             53.1             96.9        

Medicaid MCR

    85.0             87.4             87.0        

Health plan services MCR

    87.4             85.2             87.5        

Government contracts cost ratio

      93.4             93.7             95.3      

G&A expense ratio

    9.3             9.3             8.9        

Selling costs ratio

    2.3             2.6             2.3        

Effective tax rate

    37.0     40.4           36.9     40.9           37.7     40.8      

 

1 Includes the operations of the company’s commercial, Medicare (including Part D) and Medicaid health plans in California, Arizona, Oregon and Washington, as well as the operations of the company’s health and life insurance companies, primarily in Arizona, California, Oregon and Washington, and the operations of the company’s behavioral health and pharmaceutical services subsidiaries in several states including 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 businesses that are providing administrative services pursuant to administrative services agreements entered into with UnitedHealthcare and its affiliates, as well as the operations of the company’s health and life insurance companies in Connecticut, New Jersey and New York.
4 Includes a litigation reserve true-up related to a previously accrued for class action lawsuit.
5 Includes expenses primarily related to litigation and the company’s overhead cost reduction efforts.
6 Includes costs related to the company’s operations strategy.

 

Page 15


Health Net, Inc.

Disclosures Regarding Non-GAAP Financial Information

($ in millions)

Set forth below is a reconciliation of adjusted days claims payable (DCP), a non-GAAP financial measure, to the comparable GAAP financial measure, DCP. DCP is calculated by dividing the amount of reserve for claims and other settlements (claims reserve) by health plan services cost (health plan costs) during the quarter and multiplying that amount by the number of days in the quarter. In this press release, management presents an adjusted DCP metric which subtracts capitation payable, provider and other claims settlements and Medicare Part D payables from the claims reserve and health plan costs. Management believes that adjusted DCP provides useful information to investors because the adjusted DCP calculation excludes from both claims reserve and health plan costs amounts related to health care costs 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 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. 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 nonrecurring items.

 

Reconciliation of Days Claims Payable:    Q1 2011     Q4 2010     Q3 2010     Q2 2010     Q1 2010  
          

(1)

  

Reserve for Claims and Other Settlements

   $ 889.9      $ 942.0      $ 904.4      $ 934.9      $ 995.6   
  

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

     (113.0     (108.7     (130.0     (155.6     (174.0
                                           

(2)

  

Reserve for Claims and Other Settlements - Adjusted

   $ 776.9      $ 833.3      $ 774.4      $ 779.3      $ 821.6   

(3)

  

Health Plan Services Cost

   $ 2,282.3      $ 2,100.0      $ 2,134.7      $ 2,163.2      $ 2,211.3   
  

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

     (933.4     (762.6     (804.4     (839.0     (885.2
                                           

(4)

  

Health Plan Services Cost - Adjusted

   $ 1,348.9      $ 1,337.4      $ 1,330.3      $ 1,324.2      $ 1,326.1   

(5)

  

Number of Days in Period

     90        92        92        91        90   

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

     35.1        41.3        39.0        39.3        40.5   

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

     51.8        57.3        53.6        53.6        55.8   

 

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Health Net, Inc.

Reconciliation of Reserves for Claims and Other Settlements

($ in millions)

 

     Health Plan Services  
     Q1 2011     FY 2010     FY 2009  

Reserve for claims (a), beginning of period

   $ 727.5      $ 692.2      $ 957.1   

Incurred claims related to:

      

Current Year

     1,213.8        4,644.2        6,422.8   

Prior Years (c)

     (63.8     (70.0     (80.0
                        

Total Incurred (b)

     1,150.0        4,574.2        6,342.8   

Paid claims related to:

      

Current Year

     663.0        3,929.3        5,572.2   

Prior Years

     541.2        609.6        857.8   
                        

Total Paid (b)

     1,204.2        4,538.9        6,430.0   

Less: Divested businesses

     —          —          (177.7
                        

Reserve for claims (a), end of period

     673.3        727.5        692.2   

Add:

      

Claims Payable (d)

     113.7        123.6        165.6   

Other (e)

     102.9        90.9        93.9   
                        

Reserves for claims and other settlements, end of period

   $ 889.9      $ 942.0      $ 951.7   
                        

 

(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 period-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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