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Health Net Reports Third Quarter 2012 GAAP Net Income Of $18.0 Million, Or $0.22 Per Diluted Share

Stocks in this article: HNT

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 Quarterly Report on Form 10-Q for the quarterly period ended September 30, 2012.

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.
 
                             
Health Net, Inc.
Enrollment Data - By State
(In thousands)
    Change from
June 30, 2012     September 30, 2011
September 30, June 30, September 30, Increase/ % Increase/ %
2012     2012     2011     (Decrease)     Change     (Decrease)     Change
California
Large Group 714 745 837 (31 ) (4.2 )% (123 ) (14.7 )%
Small Group and Individual 307     303     318     4       1.3 %     (11 )     (3.5 )%
Commercial Risk 1,021 1,048 1,155 (27 ) (2.6 )% (134 ) (11.6 )%
Medicare Advantage 143 141 124 2 1.4 % 19 15.3 %
Medi-Cal       1,069     1,060     988     9       0.8 %     81       8.2 %
Total California       2,233     2,249     2,267     (16 )     (0.7 )%     (34 )     (1.5 )%
 
Arizona
Large Group 84 84 76 0 0.0 % 8 10.5 %
Small Group and Individual 59     61     61     (2 )     (3.3 )%     (2 )     (3.3 )%
Commercial Risk 143 145 137 (2 ) (1.4 )% 6 4.4 %
Medicare Advantage       43     43     40     0       0.0 %     3       7.5 %
Total Arizona       186     188     177     (2 )     (1.1 )%     9       5.1 %
 
Oregon
Large Group 30 32 50 (2 ) (6.3 )% (20 ) (40.0 )%
Small Group and Individual 58     56     41     2       3.6 %     17       41.5 %
Commercial Risk 88 88 91 0 0.0 % (3 ) (3.3 )%
Medicare Advantage       45     44     39     1       2.3 %     6       15.4 %
Total Oregon       133     132     130     1       0.8 %     3       2.3 %
 
                                                 
Total Health Plan Enrollment
Large Group 828 861 963 (33 ) (3.8 )% (135 ) (14.0 )%
Small Group and Individual 424     420     420     4       1.0 %     4       1.0 %
Commercial Risk 1,252 1,281 1,383 (29 ) (2.3 )% (131 ) (9.5 )%
Medicare Advantage 231 228 203 3 1.3 % 28 13.8 %
Medi-Cal/Medicaid 1,069     1,060     988     9       0.8 %     81       8.2 %
Western Region Operations 2,552 2,569 2,574 (17 ) (0.7 )% (22 ) (0.9 )%
 
Medicare PDP (stand-alone) 0 0 381 0 0.0 % (381 ) (100.0 )%
                                     
Total       2,552     2,569     2,955     (17 )     (0.7 )%     (403 )     (13.6 )%
 
 
TRICARE - North Contract Eligibles       2,884     2,884     3,010     0       0.0 %     (126 )     (4.2 )%
 
 
                             
Health Net, Inc.
Enrollment Data - Line of Business
(In thousands)
    Change from
June 30, 2012     September 30, 2011
September 30, June 30, September 30, Increase/ % Increase/ %
2012     2012     2011     (Decrease)     Change     (Decrease)     Change
 
Large Group
California 714 745 837 (31 ) (4.2 )% (123 ) (14.7 )%
Arizona 84 84 76 0 0.0 % 8 10.5 %
Oregon 30     32     50     (2 )     (6.3 )%     (20 )     (40.0 )%
828     861     963     (33 )     (3.8 )%     (135 )     (14.0 )%
 
Small Group and Individual
California 307 303 318 4 1.3 % (11 ) (3.5 )%
Arizona 59 61 61 (2 ) (3.3 )% (2 ) (3.3 )%
Oregon 58     56     41     2       3.6 %     17       41.5 %
424     420     420     4       1.0 %     4       1.0 %
 
Commercial Risk
California 1,021 1,048 1,155 (27 ) (2.6 )% (134 ) (11.6 )%
Arizona 143 145 137 (2 ) (1.4 )% 6 4.4 %
Oregon 88     88     91     0       0.0 %     (3 )     (3.3 )%
1,252     1,281     1,383     (29 )     (2.3 )%     (131 )     (9.5 )%
 
Medicare Advantage
California 143 141 124 2 1.4 % 19 15.3 %
Arizona 43 43 40 0 0.0 % 3 7.5 %
Oregon 45     44     39     1       2.3 %     6       15.4 %
231 228 203 3 1.3 % 28 13.8 %
 
Medi-Cal/Medicaid
California 1,069 1,060 988 9 0.8 % 81 8.2 %
 
                                                 
Total Health Plan Enrollment
Large Group 828 861 963 (33 ) (3.8 )% (135 ) (14.0 )%
Small Group and Individual 424     420     420     4       1.0 %     4       1.0 %
Commercial Risk 1,252 1,281 1,383 (29 ) (2.3 )% (131 ) (9.5 )%
Medicare Advantage 231 228 203 3 1.3 % 28 13.8 %
Medi-Cal/Medicaid 1,069     1,060     988     9       0.8 %     81       8.2 %
Western Region Operations 2,552 2,569 2,574 (17 ) (0.7 )% (22 ) (0.9 )%
 
Medicare PDP (stand-alone) 0 0 381 0 0.0 % (381 ) (100.0 )%
                                     
Total       2,552     2,569     2,955     (17 )     (0.7 )%     (403 )     (13.6 )%
 
 
TRICARE - North Contract Eligibles       2,884     2,884     3,010     0       0.0 %     (126 )     (4.2 )%
 
 
                         
Health Net, Inc.
Consolidated Statements of Operations
($ in thousands, except per share data)
     
Quarter Ended Quarter Ended Quarter Ended
September 30. June 30, September 30.
REVENUES: 2012 2012 2011
Health plan services premiums $ 2,578,689 $ 2,618,927 $ 2,487,767
Government contracts 169,811 176,248 175,845
Net investment income 16,355 24,697 15,188
Administrative services fees and other income 1,854 8,662 2,174
Divested operations and services revenue   12,863     12,805   10,976
Total revenues   2,779,572     2,841,339   2,691,950
 
EXPENSES:
Health plan services 2,281,388 2,358,455 2,149,310
Government contracts 151,815 153,406 127,884
General and administrative 222,425 228,756 215,952
Selling 61,053 58,390 57,965
Depreciation and amortization 7,907 7,385 6,937
Interest 8,021 8,246 7,774
Divested operations and services expense 17,587 19,290 32,873
Adjustment to loss on sale of Northeast subsidiaries   -     -   315
Total expenses   2,750,196     2,833,928   2,599,010
Income from continuing operations before income taxes 29,376 7,411 92,940
Income tax provision   8,898     2,241   35,131
Income from continuing operations   20,478     5,170   57,809
 
Discontinued operation:
Income from discontinued operation, net of tax - - 4,003
(Loss) gain on sale of discontinued operation, net of tax   (2,450 )   119,440   -
(Loss) gain on discontinued operation, net of tax   (2,450 )   119,440   4,003
 
Net income $ 18,028   $ 124,610 $ 61,812
 
Net income per share-basic:
Income from continuing operations $ 0.25 $ 0.06 $ 0.66
(Loss) gain on discontinued operation, net of tax   (0.03 )   1.44   0.05
Net income per share-basic $ 0.22   $ 1.50 $ 0.71
 
Net income per share-diluted:
Income from continuing operations $ 0.25 $ 0.06 $ 0.65
(Loss) gain on discontinued operation, net of tax   (0.03 )   1.42   0.05
Net income per share-diluted $ 0.22   $ 1.48 $ 0.70
 
Weighted average shares outstanding:
Basic 81,607 83,255 87,675
Diluted 82,039 84,037 88,874
 
 
                             

Health Net, Inc.

Condensed Consolidated Balance Sheets

(Amounts in thousands, except ratio data)

 
September 30, June 30, September 30,
2012 2012 2011
ASSETS
Current Assets
Cash and cash equivalents $ 312,579 $ 633,144 $ 376,336
Investments - available for sale 1,671,678 1,515,200 1,656,895
Premiums receivable, net 310,804 350,750 276,995
Amounts receivable under government contracts 206,560 247,405 206,113
Other receivables 244,924 220,293 169,438
Deferred taxes 40,647 69,409 54,850
Other assets   151,042     128,340     212,747  
Total current assets 2,938,234 3,164,541 2,953,374
Property and equipment, net 174,932 166,379 125,833
Goodwill 565,886 565,886 605,886
Other intangible assets, net 18,128 18,985 21,556
Deferred taxes 5,737 8,261 51,277
Investments-available for sale-noncurrent - - 2,614
Other noncurrent assets   107,386     109,400     111,238  
Total Assets $ 3,810,303   $ 4,033,452   $ 3,871,778  
 
LIABILITIES AND STOCKHOLDERS' EQUITY
Current Liabilities
Reserves for claims and other settlements $ 1,032,248 $ 1,010,493 $ 873,037
Health care and other costs payable under government contracts 58,410 86,187 47,546
Unearned premiums 128,194 368,699 442,164
Accounts payable and other liabilities   325,636     298,307     308,961  
Total current liabilities 1,544,488 1,763,686 1,671,708
Senior notes payable 399,044 398,992 398,839
Borrowings under revolving credit facility 100,000 90,000 145,000
Other noncurrent liabilities   220,489     241,734     217,827  
Total Liabilities   2,264,021     2,494,412     2,433,374  
 
Stockholders' Equity
Common stock 149 149 147
Additional paid-in capital 1,323,150 1,318,004 1,270,968
Treasury common stock, at cost (2,092,459 ) (2,056,272 ) (1,952,068 )
Retained earnings 2,287,511 2,269,483 2,111,256
Accumulated other comprehensive income   27,931     7,676     8,101  
Total Stockholders' Equity   1,546,282     1,539,040     1,438,404  
Total Liabilities and Stockholders' Equity $ 3,810,303   $ 4,033,452   $ 3,871,778  
 
Debt-to-Total Capital Ratio 24.4 % 24.1 % 27.4 %
 
 
                             

Health Net, Inc.

Condensed Consolidated Statements of Cash Flows

(Amounts in thousands)

 
Quarter Ended Quarter Ended Quarter Ended
September 30, June 30, September 30,
2012 2012 2011
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income $ 18,028 $ 124,610 $ 61,812

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

Amortization and depreciation 7,907 7,385 6,937
Share-based compensation expense 5,346 5,683 6,050
Deferred income taxes 15,430 6,476 (51,206 )
Excess tax benefits from share-based compensation - (163 ) (2 )
Gain on sale of discontinued operation 2,450 (119,440 ) -
Adjustment to loss on sale of business - - 315
Net realized gain on sale on investments (4,272 ) (12,431 ) (5,369 )
Other changes (215 ) 884 4,246
Changes in assets and liabilities:
Premiums receivable and unearned premiums (200,559 ) 115,142 353,123
Other current assets, receivables and noncurrent assets (25,847 ) (26,672 ) (22,535 )
Amounts receivable/payable under government contracts 23,972 (6,029 ) 89,741
Reserves for claims and other settlements 21,755 52,369 (27,687 )
Accounts payable and other liabilities   11,238     (28,048 )   105,283  
Net cash (used in) provided by operating activities   (124,767 )   119,766     520,708  
 
CASH FLOWS FROM INVESTING ACTIVITIES:
Sales of investments 117,584 364,420 434,236
Maturities of investments 28,715 30,142 30,299
Purchases of investments (272,614 ) (459,328 ) (532,032 )
Purchases of property and equipment (17,370 ) (22,287 ) (11,124 )
Net cash received for sale of businesses - 248,238 41,065
Sales and purchases of restricted investments and other   (871 )   4,185     2,620  
Net cash (used in) provided by investing activities   (144,556 )   165,370     (34,936 )
 
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from exercise of stock options and employee stock purchases - 2,174 513
Repurchases of common stock (40,536 ) (9,556 ) (123,551 )
Excess tax benefits from share-based compensation - 163 2
Borrowings under financing arrangements 10,000 - 230,000
Repayment of borrowings under financing arrangements - (22,500 ) (270,000 )
Net (decrease) increase in checks outstanding, net of deposits 34 - (31,960 )
Customer funds administered   (20,740 )   (13,305 )   (80,943 )
Net cash used in financing activities   (51,242 )   (43,024 )   (275,939 )
 
Net (decrease) increase in cash and cash equivalents (320,565 ) 242,112 209,833
Cash and cash equivalents, beginning of period   633,144     391,032     166,503  
Cash and cash equivalents, end of period $ 312,579   $ 633,144   $ 376,336  
 
 
                                 
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, 2012 Quarter Ended June 30, 2012 Quarter Ended September 30, 2011
Divested Divested Divested
Western Region Government Operations Corporate/ Western Region Government Operations Corporate/ Western Region Government Operations Corporate/
Operations 1 Contracts 2 and Services 3

Other 5

Consolidated Operations 1 Contracts 2 and Services 3

Other 4,5

Consolidated Operations 1 Contracts 2 and Services 3

Other 4,5

Consolidated
 
Health plan services premiums $ 2,578,689 $ 2,578,689 $ 2,618,927 $ 2,618,927 $ 2,487,754 $ 13 $ 2,487,767
Government contracts $ 169,811 169,811 $ 176,248 176,248 $ 175,845 175,845
Net investment income 16,355 16,355 24,697 24,697 15,188 15,188
Administrative services fees and other income 1,843 11 1,854 8,662 8,662 2,174 2,174
Divested operations and services revenue     $ 12,863       12,863     $ 12,805       12,805     $ 10,976       10,976
Total revenues 2,596,887 169,811 12,874 - 2,779,572 2,652,286 176,248 12,805 - 2,841,339 2,505,116 175,845 10,989 - 2,691,950
Health plan services 2,281,354 34 2,281,388 2,358,400 14 41 2,358,455 2,149,269 213 (172 ) 2,149,310
Government contracts 148,705 3,110 151,815 152,705 701 153,406 127,707 177 127,884
G&A excluding insurance, taxes and fees 201,845 (332 ) 4,115 205,628 196,907 (353 ) 10,074 206,628 192,151 (558 ) 4,563 196,156
Insurance, taxes and fees   16,555       242       16,797   21,782       346     -     22,128   19,250       546       19,796
G&A including insurance, taxes and fees 218,400 (90 ) 4,115 222,425 218,689 (7 ) 10,074 228,756 211,401 (12 ) 4,563 215,952
Selling 61,053 61,053 58,390 58,390 57,940 25 57,965
Depreciation and amortization 7,907 7,907 7,385 7,385 6,937 6,937
Interest 8,021 8,021 8,246 8,246 7,774 7,774
Divested operations and services expense 17,587 17,587 19,290 19,290 32,873 32,873
Adjustment to loss on sale of Northeast health plans         -           -       315       315
Total expenses   2,576,735     148,705   17,531     7,225     2,750,196   2,651,110     152,705   19,297     10,816     2,833,928   2,433,321     127,707   33,414     4,568     2,599,010
Income (loss) from operations before income taxes 20,152 21,106 (4,657 ) (7,225 ) 29,376 1,176 23,543 (6,492 ) (10,816 ) 7,411 71,795 48,138 (22,425 ) (4,568 ) 92,940
Income tax (benefit) provision   1,640     8,372   (1,946 )   832     8,898   (452 )   9,305   (2,537 )   (4,075 )   2,241   26,143     19,509   (8,608 )   (1,913 )   35,131
Income (loss) from continuing operations $ 18,512   $ 12,734 $ (2,711 ) $ (8,057 ) $ 20,478 $ 1,628   $ 14,238 $ (3,955 ) $ (6,741 ) $ 5,170 $ 45,652   $ 28,629 $ (13,817 ) $ (2,655 ) $ 57,809
 
Basic earnings (loss) per share from continuing operations $ 0.23 $ 0.16 $ (0.03 ) $ (0.10 ) $ 0.25 $ 0.02 $ 0.17 $ (0.05 ) $ (0.08 ) $ 0.06 $ 0.52 $ 0.33 $ (0.16 ) $ (0.03 ) $ 0.66
Diluted earnings (loss) per share from continuing operations $ 0.23 $ 0.15 $ (0.03 ) $ (0.10 ) $ 0.25 $ 0.02 $ 0.17 $ (0.05 ) $ (0.08 ) $ 0.06 $ 0.52 $ 0.32 $ (0.16 ) $ (0.03 ) $ 0.65
 
Basic weighted average shares outstanding 81,607 81,607 81,607 81,607 81,607 83,255 83,255 83,255 83,255 83,255 87,675 87,675 87,675 87,675 87,675
Diluted weighted average shares outstanding 82,039 82,039 81,607 81,607 82,039 84,037 84,037 83,255 83,255 84,037 88,874 88,874 87,675 87,675 88,874
 
 
Pretax margin 0.78 % 0.04 % 2.87 %
Commercial premium yield 4.7 % 4.6 % 5.1 %
Commercial premium PMPM $ 376.89 $ 372.91 $ 359.96
Commercial health care cost trend 7.1 % 8.2 % 3.2 %
Commercial health care cost PMPM $ 326.60 $ 330.71 $ 305.08
Commercial MCR 86.7 % 88.7 % 84.8 %
Medicare Advantage MCR 90.1 % 92.0 % 90.7 %
Medicaid MCR 91.6 % 91.3 % 86.0 %
Health plan services MCR 88.5 % 90.1 % 86.4 %
G&A expense ratio 8.5 % 8.3 % 8.5 %
Selling costs ratio 2.4 % 2.2 % 2.3 %
 
1    

Includes the operations of the company's commercial, Medicare 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 administrative services provided under the T-3 Managed Care Support Contract for the TRICARE North Region and other health care-related Department of Defense and Veterans Affairs government contracts.
 
3 Includes items related to the run-out of the Northeast business sold in 2009 and transition and run-out related expenses related to the Medicare PDP business that was sold on April 1, 2012.
 
4 Includes litigation reserve true-ups related to previous accruals for class action lawsuits and related legal expenses.
 
5 Includes costs related to the company’s G&A cost reduction efforts and/or operations strategy.
 
 
 
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, provider and other claims settlements and Medicare Advantage-Prescription Drug (MAPD) payables/costs from the claims reserve and health plan costs. For the third quarter of 2011, adjusted DCP also subtracts reserve for claims and other settlements related to discontinued operations from the claims reserve.
 
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. In addition, solely with respect to the third quarter of 2011, adjusted DCP excludes from claims reserve the reserves relating to discontinued operations. Therefore, management believes that adjusted DCP may present a more accurate reflection of DCP than does GAAP DCP, which includes such amounts. 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: Q3 2012 Q2 2012 Q3 2011
(1 ) Reserve for Claims and Other Settlements - GAAP $ 1,032.2 $ 1,010.5 $ 873.0
Less: Reserve for Claims and Other Settlements related to discontinued operations   -     -     (30.7 )
Reserve for Claims and Other Settlements excluding discontinued operations $ 1,032.2 $ 1,010.5 $ 842.3
Less: Capitation, Provider and Other Claim Settlements, and MAPD Payables   (126.3 )   (106.5 )   (61.5 )
(2 ) Reserve for Claims and Other Settlements - Adjusted $ 905.9 $ 904.0 $ 780.8
 
(3 ) Health Plan Services Cost - GAAP $ 2,281.4 $ 2,358.5 $ 2,149.3
Less: Capitation, Provider and Other Claim Settlements, and MAPD Costs   (835.9 )   (842.9 )   (759.5 )
(4 ) Health Plan Services Cost - Adjusted $ 1,445.5 $ 1,515.6 $ 1,389.8
 
(5 ) Number of Days in Period 92 91 92
 
= (1) / (3) * (5) Days Claims Payable on GAAP Basis - (using end of period reserve amount) 41.6 39.0 37.4
= (2) / (4) * (5) Days Claims Payable - Adjusted Basis (using end of period reserve amount) 57.7 54.3 51.7
 
 
                         
Health Net, Inc.
Reconciliation of Reserves for Claims and Other Settlements
($ in millions)
 
Health Plan Services

 

YTD 9/2012 FY 2011 FY 2010
 
Reserve for claims (a), beginning of period $ 720.8 $ 727.5 $ 692.2
 
Incurred claims related to:
Current Year 3,723.7 4,733.0 4,644.2
Prior Years (c)   32.8   (96.5 )   (70.0 )
Total Incurred (b) 3,756.5 4,636.5 4,574.2
 
Paid claims related to:
Current Year 2,949.7 4,024.4 3,929.3
Prior Years   727.8   618.8     609.6  
Total Paid (b)   3,677.5   4,643.2     4,538.9  
 
 
Reserve for claims (a), end of period 799.8 720.8 727.5
Add:
Claims Payable (d) 133.7 111.0 123.6
Other (e) 98.7 80.3 90.9
     
 
Reserves for claims and other settlements, end of period $ 1,032.2 $ 912.1   $ 942.0  
 
(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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