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8-K - FORM 8-K - HEALTH NET INCd8k.htm
Jay Gellert
President &
Chief Executive Officer
January 10, 2011
29
th
Annual
J.P. Morgan
Healthcare Conference
Exhibit 99.1


2
Cautionary Statement
Cautionary Statement
All statements in this presentation, 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 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 business; 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 presentation.


3
Emerging Environment
Emerging Environment
Economy is driving change
Federal and state budget pressures
will affect health care
Future implementation of Affordable
Care Act remains to be defined
Diverse book of business with value
differentiation is key


4
HNT: Positioned for the Future
HNT: Positioned for the Future
Value-based products
Adequate coverage an emerging issue
Network and product differentiation key
Diverse book of stable businesses
Important with health care reform
Commercial balanced with multiple
government programs
Expect consistent and predictable financial performance
Can operate with MCR and have targeted G&A
Focus on cost containment


5
Diverse Businesses: Commercial
Diverse Businesses: Commercial
Move to lower price point products
Back to the future: return of HMO products
Efficient networks focused on high quality,
cost-effective providers
Built on medical group model
Sustain broad coverage
Benefit designs that meet customers’
needs
and health care reform requirements
Provider partnerships key
Drive to innovation in product design and
financial structures


6
Diverse Businesses: Medicare
Diverse Businesses: Medicare
Traditional strength: network-model HMO markets
Sustain margins through product design and premiums
Benefit flexibility
Many counties still at zero dollar premium
Revenue opportunities
Ongoing assessment of special needs plans
Provider partnership opportunities


7
Diverse Businesses: Medicaid
Diverse Businesses: Medicaid
Enrollment flexes with employment
Stable financial performance despite
rate pressure
Expansion potential due to health care reform
Low-cost, capitated network presents product
development opportunities


8
Diverse Businesses:
Diverse Businesses:
Government Contracts
Government Contracts
Consistent and predictable TRICARE performance
New contract implementation on schedule for
April 1, 2011 launch
Accounting treatment being evaluated
Reimbursable costs with deployment
MFLC behavioral health program growing
New opportunities
Department of Defense cost pressures
Veterans Affairs health and others


9
Financial Performance
Financial Performance
Stable enrollment
Expanding commercial margins
Managing general and administrative costs
Strong cash position
Share repurchase program


10
2010 Earnings Guidance
2010 Earnings Guidance
Year-end Membership
(a)
Commercial: -3% to -4%
Medicaid: +5% to +6%
Medicare Advantage: Flat
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%
Commercial Health Care Cost Trends
(a)
~ 80 to 100 bps < Premium Yields
Selling Cost Ratio
~ 2.4%
Government Contracts Ratio
~ 94.5% to 95.0%
G&A Expense Ratio
~ 8.8% to 9.0%
Tax Rate
(b)
~ 39.0%
Weighted-average Fully
Diluted Shares Outstanding
98 million –
100 million
GAAP EPS
Combined Western Region Operations
and Government Contracts EPS
$2.07 to $2.17
$2.55 to $2.58
(a)
For the company’s Western Region Operations segment
(b)
For the combined Western Region Operations and Government Contracts segments


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2011 Earnings Guidance
2011 Earnings Guidance
Year-end Membership
(a)
Commercial: +1% to +2%
Medicaid: +6% to +7%
Medicare Advantage
(d)
: -15% to -17%
Total Western Region Operations
medical membership: +2% to +3%
PDP
(d)
: -14% to -16%
Consolidated Revenues
(b)(d)
$12.0 to $12.5 billion
Commercial Yields
(a)
~ 7.8% to 8.3%
Commercial Health Care Cost Trends
(a)
~ 40 to 60 bps < Premium Yields
Selling Cost Ratio
(a)
~ 2.3% to 2.4%
G&A Expense Ratio
(a)
~ 8.7% to 8.9%
Tax Rate
(b)
~ 39.2%
Weighted-average Fully
Diluted Shares Outstanding
(c)
96 million –
97 million
GAAP EPS
(c)(d)
Combined Western Region Operations
and Government Contracts EPS
(c)(d)
At least $2.05
At least $2.75
(a)
For the company’s Western Region Operations segment
(b)
For the combined Western Region Operations and Government Contracts segments
(c)
The company’s guidance does not include the impact of share repurchases other than to counter dilution.
(d)
Includes
the
impact
of
the
CMS
sanctions
previously
announced
on
November
19,
2010


12
HNT: Building Shareholder Value
HNT: Building Shareholder Value
Strategic response to changing environment
Diverse book of stable businesses
Opportunities for growth and further
G&A reductions
Financial flexibility