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8-K - FORM 8-K - COVENTRY HEALTH CARE INCform8k_02082011.htm

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Contact:                 John Stelben
Interim Chief Financial Officer
(301) 581-5729

Drew Asher
SVP, Corporate Finance
(301) 581-5717


Coventry Health Care Reports Fourth Quarter Earnings

BETHESDA, Md. (February 8, 2011) - Coventry Health Care, Inc. (NYSE: CVH) today reported consolidated operating results for the quarter and fiscal year ended December 31, 2010.  Operating revenues totaled $3.0 billion for the quarter with net earnings of $150.3 million, or $1.01 earnings per diluted share (EPS).  These results include a favorable impact from the Medicare Advantage Private Fee-for-Service (MA-PFFS) product of $0.05 EPS.  Excluding the impact of MA-PFFS results(1), core earnings for the quarter were $142.1 million, or $0.96 EPS.

For the year ended December 31, 2010, total operating revenues were $11.6 billion with net earnings of $438.6 million, or $2.97 EPS.  These results include a favorable impact from the MA-PFFS product of $0.45 EPS and an unfavorable impact from the previously announced Louisiana provider class action litigation of $1.18 EPS.  Excluding the impact of MA-PFFS results(1) and the provider class action charge(2), core earnings for the year were $546.4 million, or $3.70 EPS.

“I continue to be pleased with the fundamental performance of our seven core businesses which exceeded our expectations during 2010.  This should position us well as we enter 2011, a year with unique challenges and opportunities as we implement healthcare reform mandates,” said Allen F. Wise, chairman and chief executive officer of Coventry.  “More importantly, I am pleased with the long-term positioning of our core businesses including our health plans and our ability to seize opportunities and grow in 2012 and beyond.”


Fourth Quarter 2010 Consolidated Highlights
·  
Closed the Mercy Health Plan acquisition on October 1, 2010, adding approximately 180,000 members and strengthening our position in the Midwest region
·  
Commercial risk membership of 1,641,000, an increase of 108,000 members sequentially
·  
Sequential membership growth in Medicare Advantage, Medicare Part D, and Medicaid
·  
Excellent liquidity position
o  
Approximately $850 million of deployable free cash at the parent
o  
Debt to Capital of 27.6%




 
 
 

 


Selected Fourth Quarter and Full Year 2010 Highlights

·  
Health Plan Commercial Group Risk.  Reported commercial group risk premium yields rose to $316.34 per member per month (PMPM) in the quarter, an increase of 3.1% from the prior year quarter.  Reported commercial group risk premium yields rose to $314.58 PMPM for the full year, an increase of 4.3% from the prior full year.  The health plan commercial group risk medical loss ratio (MLR) was 81.3% in the quarter, a decrease of 160 basis points (bps) from the prior year quarter.  The health plan commercial group risk MLR was 79.2% for the full year, a decrease of 270 bps from the prior full year.


·  
Medicare Advantage.  As of December 31, 2010, Medicare Advantage Coordinated Care Plan (MA-CCP) membership was 224,000, an increase of 38,000 members from the prior year quarter, largely driven by the acquisition of Mercy Health Plans which closed on October 1, 2010.  The MA-CCP MLR was 84.1% in the quarter and 82.0% for the full year.  During the fourth quarter, the MA-PFFS product line contributed $0.05 EPS largely due to favorable medical cost experience during the claims run-out process.  When combined with the $0.40 EPS contribution reported through the third quarter, the total full year contribution from the MA-PFFS product line was $0.45 EPS. As previously announced, the Company did not renew this product line effective January 1, 2010.


·  
Medicare Part D.  As of December 31, 2010, Medicare Part D membership was 1,628,000, a decrease of 55,000 members from the prior year quarter.  The Medicare Part D MLR was 64.7% in the quarter, an increase of 30 bps from the prior year quarter.   The Medicare Part D MLR was 83.7% for the full year, a decrease of 200 bps from the prior full year.


·  
Medicaid.  As of December 31, 2010, Medicaid membership was 468,000, an increase of 66,000 members from the prior year quarter, largely driven by new markets in Nebraska and Pennsylvania.  The Medicaid MLR was 85.4% in the quarter, a decrease of 40 bps from the prior year quarter.  The Medicaid MLR was 85.7% for the full year, a decrease of 190 bps from the prior full year.






















Page  2
 
 

 


2011 FULL YEAR GUIDANCE
·  
Risk revenue of $10.35 billion to $10.80 billion
·  
Management services revenue of $1.16 billion to $1.19 billion
·  
Consolidated revenue of $11.51 billion to $11.99 billion
·  
Consolidated MLR of 82.0% to 82.8%
·  
Cost of sales expense of $255.0 million to $263.0 million
·  
Selling, general, and administrative expense (SG&A) of $2.00 billion to $2.04 billion
·  
Depreciation and amortization expense of $135.0 million to $141.0 million
·  
Other income of $69.0 million to $74.0 million
·  
Interest expense of $80.0 million to $85.0 million
·  
Tax rate of 36.0% to 37.0%
·  
Diluted share count of 147.0 million to 150.0 million
·  
EPS of $2.50 to $2.70



RECONCILIATION OF 2010 GAAP EPS TO 2010 CORE EPS
                                                  
 2010 GAAP EPS   $ 2.97  
 Remove favorable impact of MA-PFFS(1)   $ (0.45 )
 Remove unfavorable impact of litigation charge(2)   $ 1.18  
 2010 Core EPS   $ 3.70  
 

RECONCILIATION OF 2010 CORE EPS TO 2011 EPS GUIDANCE MIDPOINTS
 
 2010 Core EPS   $ 3.70  
 Increase in commercial group MLR from 79.2% in 2010 to a range of 81% +/- 50 bps in 2011   $ (0.43 )
 Increase in individual MLR from 66% in 2010 to a range of 76% +/- 100 bps in 2011   $ (0.15 )
 Gross margin reduction for loss of approximately 500,000 Medicare Part D members in 2011   $ (0.34 )
 Reset of MA-CCP MLR from 82.0% to 2011 bid levels in the mid 80%’s    $ (0.28 )
 All other, net   $ 0.10  
 Midpoint of 2011 EPS Guidance   $ 2.60  
 


ADDITIONAL SELECTED ASSUMPTIONS FOR 2011 GUIDANCE
·  
Commercial risk membership flat to slightly down
·  
Stable fee based businesses
·  
Medicaid membership growth percentage in the mid single digits
·  
Medicaid MLR in the high 80%’s
·  
Stable Medicare Part D MLR
·  
Guidance does not assume any further impact from capital deployment activities

Page  3
 
 

 


Mr. Allen F. Wise, chairman and chief executive officer of Coventry, will host a conference call at 8:00 a.m. ET on Tuesday, February 8, 2011.  To listen to the call, dial toll-free at (877) 852-6578 or, for international callers, (719) 325-4803. Callers will be asked to identify themselves and their affiliations.  The conference call will also be webcast from Coventry’s Investor Relations site at www.coventryhealthcare.com.  Coventry asks participants on both the call and webcast to review and be familiar with its filings with the Securities and Exchange Commission.  A replay of the call will be available for one week at (888) 203-1112 or, for international callers, (719) 457-0820. The access code is 4643959.

 
This press release contains forward-looking statements made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995.  Forward-looking statements are defined as statements that are not historical facts and include those statements relating to future events or future financial performance, including the guidance herein. Actual performance may be significantly impacted by certain risks and uncertainties including those described in Coventry’s Annual Report on Form 10-K for the year ended December 31, 2009 and Coventry’s subsequent filings with the Securities and Exchange Commission.  Among the factors that may materially affect Coventry’s business, operations or financial condition are the ability to accurately estimate and control future health care costs; the ability to increase premiums to offset increases in the Company’s health care costs; general economic conditions and disruptions in the financial markets; changes in laws or regulations or government investigations; changes in government funding for Medicare and Medicaid; a reduction in the number of members in the Company’s health plans; the Company’s ability to acquire additional managed care businesses and the Company’s ability to successfully integrate acquired businesses into its operations; an ability to attract new members or to increase or maintain premium rates; the non-renewal or termination of the Company’s government contracts, or unsuccessful bids for business with government agencies; failure of the Company’s independent agents and brokers to continue to market its products to employers; a failure to obtain cost-effective agreements with a sufficient number of providers that could result in higher medical costs and a decrease in membership; negative publicity regarding the managed health care industry generally or the Company in particular; a failure to effectively protect, maintain, and develop our information technology systems; periodic reviews, audits and investigations under the Company’s contracts with federal and state government agencies; litigation, including litigation based on new or evolving legal theories; volatility in the Company’s stock price and trading volume; the Company’s indebtedness, which imposes certain restrictions on its business and operations; an inability to generate sufficient cash to service the Company’s indebtedness; the Company’s certificate of incorporation and bylaws and Delaware law, which could delay, discourage or prevent a change in control of the Company that its stockholders may consider favorable; and an impairment of the Company’s intangible assets.  Coventry undertakes no obligation to update or revise any forward-looking statements.
 

Coventry Health Care (www.coventryhealthcare.com) is a diversified national managed healthcare company based in Bethesda, Maryland, operating health plans, insurance companies, network rental and workers’ compensation services companies.  Coventry provides a full range of risk and fee-based managed care products and services to a broad cross section of individuals, employer and government-funded groups, government agencies, and other insurance carriers and administrators.







Page  4
 
 

 

COVENTRY HEALTH CARE, INC.
CONSOLIDATED STATEMENTS OF OPERATIONS
(Amounts in thousands, except per share data)

   
Quarters Ended
   
Years Ended
 
   
December 31,
   
December 31,
 
   
2010
   
2009
   
2010
   
2009
 
Operating revenues:
 
(unaudited)
   
(unaudited)
   
(unaudited)
       
Managed care premiums
  $ 2,730,377     $ 3,121,527     $ 10,414,640     $ 12,717,399  
Management services
    294,639       306,620       1,173,276       1,186,127  
Total operating revenues
    3,025,016       3,428,147       11,587,916       13,903,526  
                                 
Operating expenses:
                               
Medical costs
    2,156,033       2,598,291       8,265,947       10,859,394  
Cost of sales
    64,152       62,548       252,052       240,828  
Selling, general, administrative
    531,442       544,656       1,961,947       2,151,799  
Charge for provider class action
    -       -       278,000       -  
Depreciation and amortization
    36,343       39,246       140,685       149,554  
Total operating expenses
    2,787,970       3,244,741       10,898,631       13,401,575  
                                 
Operating earnings
    237,046       183,406       689,285       501,951  
Operating earnings percentage of total revenues
    7.8 %     5.4 %     5.9 %     3.6 %
                                 
Interest expense
    19,705       20,272       80,418       84,875  
Other income, net
    18,505       17,704       77,667       87,478  
                                 
Earnings before income taxes
    235,846       180,838       686,534       504,554  
                                 
Provision for income taxes
    85,520       71,758       247,918       189,220  
Income from continuing operations
    150,326       109,080       438,616       315,334  
                                 
Discontinued operations:
                               
     Loss from discontinued operations
    -       -       -       (62,278 )
     Provision for income taxes
    -       -       -       10,755  
Loss from discontinued operations
    -       -       -       (73,033 )
                                 
Net earnings
  $ 150,326     $ 109,080     $ 438,616     $ 242,301  
                                 
Net earnings per share:
                               
     Basic earnings per share from continuing operations
  $ 1.02     $ 0.75     $ 3.00     $ 2.15  
     Basic loss per share from discontinued operations
    -       -       -       (0.50 )
     Total basic earnings per share
  $ 1.02     $ 0.75     $ 3.00     $ 1.65  
                                 
     Diluted earnings per share from continuing operations
  $ 1.01     $ 0.74     $ 2.97     $ 2.14  
     Diluted loss per share from discontinued operations
    -       -       -       (0.50 )
     Total diluted earnings per share
  $ 1.01     $ 0.74     $ 2.97     $ 1.64  
                                 
Weighted average shares outstanding, basic
    146,775       145,751       146,169       146,652  
Weighted average shares outstanding, diluted
    148,430       146,885       147,579       147,395  


Page  5
 
 

 

COVENTRY HEALTH CARE, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
(Amounts in thousands)


   
December 31,
   
September 30,
   
December 31,
 
   
2010
   
2010
   
2009
 
   
(unaudited)
   
(unaudited)
       
Assets:
                 
                   
Current assets:
                 
   Cash and cash equivalents
  $ 1,853,988     $ 1,786,587     $ 1,418,554  
   Short-term investments
    16,849       15,093       442,106  
   Accounts receivable, net
    276,694       280,834       258,993  
   Other receivables, net
    515,882       422,878       496,059  
   Other current assets
    371,528       331,875       234,446  
Total current assets
    3,034,941       2,837,267       2,850,158  
                         
Long-term investments
    2,184,606       2,278,844       1,994,987  
Property and equipment, net
    262,282       258,059       271,931  
Goodwill
    2,550,570       2,545,241       2,529,284  
Other intangible assets, net
    431,886       432,991       471,693  
Other long-term assets
    31,300       31,995       48,479  
Total assets
  $ 8,495,585     $ 8,384,397     $ 8,166,532  
                         
                         
                         
Liabilities and Stockholders’ Equity:
                       
                         
Current liabilities:
                       
   Medical liabilities
  $ 1,237,690     $ 1,241,346     $ 1,605,407  
   Accounts payable and accrued liabilities
    942,226       927,127       682,171  
   Deferred revenue
    103,082       120,932       110,855  
Total current liabilities
    2,282,998       2,289,405       2,398,433  
                         
Long-term debt
    1,599,396       1,599,304       1,599,027  
Other long-term liabilities
    414,025       439,299       456,518  
Total liabilities
    4,296,419       4,328,008       4,453,978  
                         
Stockholders’ equity
    4,199,166       4,056,389       3,712,554  
                         
Total liabilities and stockholders’ equity
  $ 8,495,585     $ 8,384,397     $ 8,166,532  


Page  6
 
 

 

COVENTRY HEALTH CARE, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(Amounts in thousands)
(unaudited)

   
Quarter Ended
   
Year Ended
 
   
December 31, 2010
   
December 31, 2010
 
             
Cash flows from operating activities:
           
   Net earnings
  $ 150,326     $ 438,616  
   Adjustments to earnings:
               
      Depreciation and amortization
    36,343       140,685  
      Deferred income tax benefit
    (27,364 )     (130,749 )
      Amortization of stock compensation
    9,387       40,532  
      Charge for provider class action
    -       278,000  
   Changes in assets and liabilities:
               
      Accounts receivable, net
    10,252       (2,389 )
      Medical liabilities
    (36,362 )     (439,265 )
      Accounts payable and other accrued liabilities
    7,914       (46,174 )
      Deferred revenue
    (21,999 )     (15,548 )
   Other operating activities
    (77,471 )     8,544  
   Net cash flows from operating activities
    51,026       272,252  
                 
Cash flows from investing activities:
               
   Capital expenditures, net
    (21,877 )     (63,257 )
   Proceeds from investments, net of purchases
    54,238       315,274  
   Payments for acquisitions, net of cash acquired
    (31,559 )     (102,356 )
   Net cash flows from investing activities
    802       149,661  
                 
Cash flows from financing activities:
               
   Proceeds from issuance of stock
    14,053       15,484  
   Payments for repurchase of stock
    (394 )     (4,888 )
   Excess tax benefit from stock compensation
    1,914       2,925  
   Net cash flows from financing activities
    15,573       13,521  
                 
Net change in cash and cash equivalents for current period
    67,401       435,434  
Cash and cash equivalents at beginning of period
    1,786,587       1,418,554  
Cash and cash equivalents at end of period
  $ 1,853,988     $ 1,853,988  
                 
                 
                 
Cash and Investments:
               
Cash and cash equivalents
  $ 1,853,988     $ 1,853,988  
Short-term investments
    16,849       16,849  
Long-term investments
    2,184,606       2,184,606  
Total cash and investments
  $ 4,055,443     $ 4,055,443  


Page  7
 
 

 

COVENTRY HEALTH CARE, INC.
SELECTED OPERATING STATISTICS
 (Unaudited)

 
Total
2010
    Q4 2010     Q3 2010     Q2 2010     Q1 2010  
Total
2009
 
Membership by Product (000s)
                               
Health Plan Commercial Risk
      1,641     1,533     1,522     1,501     1,418  
Health Plan Commercial ASO
      698     636     657     663     685  
Medicare Advantage CCP
      224     193     192     190     186  
Medicaid Risk
      468     462     413     406     402  
Health Plan Total
      3,031     2,824     2,784     2,760     2,691  
                                   
Medicare Advantage PFFS
      -     -     -     -     329  
Other National Risk
      -     -     -     -     2  
Other National ASO
      459     462     466     482     564  
Total Medical Membership
      3,490     3,286     3,250     3,242     3,586  
                                   
Medicare Part D
      1,628     1,618     1,631     1,600     1,683  
                                   
Total Membership
      5,118     4,904     4,881     4,842     5,269  
                                   
Revenues by Product Type (000s)(3)
                                 
Commercial Risk
$ 5,540,470   $ 1,475,773   $ 1,380,019   $ 1,367,457   $ 1,317,221   $ 5,174,772  
Commercial Management Services
  327,084     81,861     79,869     82,395     82,957     346,042  
Medicare Advantage
  2,114,205     579,329     522,202     505,084     507,592     4,901,918  
Medicaid Risk
  1,133,353     312,359     286,762     268,460     265,771     1,066,231  
Total Health Plan and Medical Services Businesses
  9,115,112     2,449,322     2,268,852     2,223,396     2,173,541     11,488,963  
 
                                   
Medicare Part D
  1,604,198     357,941     348,784     423,664     473,809     1,545,858  
Other Premiums
  100,130     24,770     25,054     25,201     25,105     94,562  
Other Management Services
  856,072     215,279     215,185     217,706     207,904     850,184  
Total Specialized Managed Care Businesses
  2,560,400     597,990     589,023     666,571     706,818     2,490,604  
                                     
Total Premiums
  10,492,356     2,750,172     2,562,821     2,589,866     2,589,498     12,783,341  
Total Management Services
  1,183,156     297,140     295,054     300,101     290,861     1,196,226  
Other/Eliminations
  (87,596 )   (22,296 )   (22,094 )   (21,826 )   (21,381 )   (76,041 )
Total Revenue
$ 11,587,916   $ 3,025,016   $ 2,835,781   $ 2,868,141   $ 2,858,978   $ 13,903,526  
                                     
Consolidated Coventry(3)
                                   
                                     
Operating Income % of Revenues
  5.9 %   7.8 %   10.3 %   0.2 %   5.4 %   3.6 %
                                     
SGA % of Revenues
  16.9 %   17.6 %   17.0 %   15.8 %   17.3 %   15.5 %
                                     
Total Health Plan Medical Liabilities (000s)(4)
      $ 1,021,667   $ 952,810   $ 1,026,355   $ 979,173   $ 900,402  
Health Plan Days in Claims Payable (DCP) (4)
        48.62     51.70     55.47     54.14     49.45  
                                     
Total Debt (millions)
      $ 1,599.4   $ 1,599.3   $ 1,599.2   $ 1,599.1   $ 1,599.0  
Total Capital (millions)
      $ 5,798.6   $ 5,655.7   $ 5,442.7   $ 5,418.2   $ 5,311.6  
Debt to Capital
        27.6 %   28.3 %   29.4 %   29.5 %   30.1 %



 
Page  8
 
 

 

COVENTRY HEALTH CARE, INC.
SELECTED REVENUE AND MEDICAL COST STATISTICS
 (Unaudited)


 
Total
2010
      Q4 2010       Q3 2010       Q2 2010       Q1 2010    
Total
 2009
 
Revenue PMPM
                                         
Health Plan Commercial Group Risk
$ 314.58     $ 316.34     $ 315.82     $ 313.92     $ 312.05     $ 301.63  
Medicare Advantage(5), (6)
$ 876.67     $ 857.39     $ 899.89     $ 867.43     $ 885.26     $ 855.16  
Medicare Part D(7)
$ 87.96     $ 85.74     $ 87.56     $ 90.49     $ 88.05     $ 84.40  
Medicaid
$ 218.98     $ 223.54     $ 215.51     $ 217.77     $ 218.76     $ 229.94  
                                               
                                               
MLR%
                                             
Consolidated Total
  79.4 %     79.0 %     77.2 %     79.1 %     82.3 %     85.4 %
                                               
Health Plan Commercial Group Risk
  79.2 %     81.3 %     76.8 %     78.3 %     80.2 %     81.9 %
Medicare Advantage(6)
  82.0 %     84.1 %     77.0 %     81.2 %     85.7 %     89.9 %
Medicare Part D
  83.7 %     64.7 %     79.0 %     90.7 %     95.3 %     85.7 %
Medicaid
  85.7 %     85.4 %     89.0 %     84.2 %     84.0 %     87.6 %


Explanatory Notes

(1)  
The Company did not renew the MA-PFFS product line effective January 1, 2010 and is in the process of paying claims liabilities related to prior dates of service.  The Company believes that disclosing adjusted earnings, which exclude the 2010 impact of the MA-PFFS results, provides a more meaningful measure of its operating results for comparison to future periods and previously announced guidance.

(2)  
On July 2, 2010, the Company announced that it would incur a non-recurring pre-tax charge to earnings in the second quarter of 2010 in the amount of $278 million, or $1.18 EPS, related to a class action lawsuit filed by providers in Louisiana.  The Company believes that disclosing adjusted earnings, which exclude the impact of this litigation, provides a more meaningful measure of its operating results for comparison to future periods and previously announced guidance.  As previously reported on December 6, 2010, the Company entered into a Memorandum of Understanding with plaintiffs counsel and the provider class setting forth the settlement terms to reduce the amount payable to $150.5 million. On February 2, 2011, the parties executed a definitive settlement agreement, acceptable to the Company, which incorporated the terms and conditions set forth in the Memorandum of Understanding.  Given various contingencies such as court approvals and class acceptance of settlement provisions which must be satisfied before the settlement becomes final, no reduction has been made to the previously recorded amount.  Please refer to the Company’s Form 8-k dated December 10, 2010 for more information.

 (3)
Operating statistics excluding discontinued operations.

 (4) 
“Total Health Plan Medical Liabilities” and “Health Plan Days in Claims Payable” are calculated consistent with prior disclosures to exclude MA-PFFS for all periods presented due to the Company’s non-renewal of this product line effective January 1, 2010.  These statistics exclude the effect of the Preferred Health Systems (“PHS”) acquisition for the first quarter of 2010 due to the timing of closing (February 1, 2010).

(5)  
Revenue PMPM excludes the impact of revenue ceded to external parties.

(6)  
Beginning with Q1 2010, Medicare Advantage revenue and medical cost statistics represent the MA-CCP business only as the Company did not renew the MA-PFFS product line effective January 1, 2010.

(7)  
Revenue PMPM excludes the impact of CMS risk-share premium adjustments and revenue ceded to external parties.



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