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8-K - FORM 8-K - COVENTRY HEALTH CARE INC | form8k_02082011.htm |
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
·
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Closed the Mercy Health Plan acquisition on October 1, 2010, adding approximately 180,000 members and strengthening our position in the Midwest region
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·
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Commercial risk membership of 1,641,000, an increase of 108,000 members sequentially
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·
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Sequential membership growth in Medicare Advantage, Medicare Part D, and Medicaid
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·
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Excellent liquidity position
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o
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Approximately $850 million of deployable free cash at the parent
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o
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Debt to Capital of 27.6%
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Selected Fourth Quarter and Full Year 2010 Highlights
·
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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.
|
·
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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.
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·
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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.
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·
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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.
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Page 2
2011 FULL YEAR GUIDANCE
·
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Risk revenue of $10.35 billion to $10.80 billion
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·
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Management services revenue of $1.16 billion to $1.19 billion
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·
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Consolidated revenue of $11.51 billion to $11.99 billion
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·
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Consolidated MLR of 82.0% to 82.8%
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·
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Cost of sales expense of $255.0 million to $263.0 million
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·
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Selling, general, and administrative expense (SG&A) of $2.00 billion to $2.04 billion
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·
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Depreciation and amortization expense of $135.0 million to $141.0 million
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·
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Other income of $69.0 million to $74.0 million
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·
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Interest expense of $80.0 million to $85.0 million
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·
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Tax rate of 36.0% to 37.0%
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·
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Diluted share count of 147.0 million to 150.0 million
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·
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EPS of $2.50 to $2.70
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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
·
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Commercial risk membership flat to slightly down
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·
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Stable fee based businesses
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Medicaid membership growth percentage in the mid single digits
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Medicaid MLR in the high 80%’s
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Stable Medicare Part D MLR
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·
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Guidance does not assume any further impact from capital deployment activities
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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
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Years Ended
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|||||||||||||||
December 31,
|
December 31,
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|||||||||||||||
2010
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2009
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2010
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2009
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|||||||||||||
Operating revenues:
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(unaudited)
|
(unaudited)
|
(unaudited)
|
|||||||||||||
Managed care premiums
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$ | 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
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3,025,016 | 3,428,147 | 11,587,916 | 13,903,526 | ||||||||||||
Operating expenses:
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Medical costs
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2,156,033 | 2,598,291 | 8,265,947 | 10,859,394 | ||||||||||||
Cost of sales
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64,152 | 62,548 | 252,052 | 240,828 | ||||||||||||
Selling, general, administrative
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531,442 | 544,656 | 1,961,947 | 2,151,799 | ||||||||||||
Charge for provider class action
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- | - | 278,000 | - | ||||||||||||
Depreciation and amortization
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36,343 | 39,246 | 140,685 | 149,554 | ||||||||||||
Total operating expenses
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2,787,970 | 3,244,741 | 10,898,631 | 13,401,575 | ||||||||||||
Operating earnings
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237,046 | 183,406 | 689,285 | 501,951 | ||||||||||||
Operating earnings percentage of total revenues
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7.8 | % | 5.4 | % | 5.9 | % | 3.6 | % | ||||||||
Interest expense
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19,705 | 20,272 | 80,418 | 84,875 | ||||||||||||
Other income, net
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18,505 | 17,704 | 77,667 | 87,478 | ||||||||||||
Earnings before income taxes
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235,846 | 180,838 | 686,534 | 504,554 | ||||||||||||
Provision for income taxes
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85,520 | 71,758 | 247,918 | 189,220 | ||||||||||||
Income from continuing operations
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150,326 | 109,080 | 438,616 | 315,334 | ||||||||||||
Discontinued operations:
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||||||||||||||||
Loss from discontinued operations
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- | - | - | (62,278 | ) | |||||||||||
Provision for income taxes
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- | - | - | 10,755 | ||||||||||||
Loss from discontinued operations
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- | - | - | (73,033 | ) | |||||||||||
Net earnings
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$ | 150,326 | $ | 109,080 | $ | 438,616 | $ | 242,301 | ||||||||
Net earnings per share:
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||||||||||||||||
Basic earnings per share from continuing operations
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$ | 1.02 | $ | 0.75 | $ | 3.00 | $ | 2.15 | ||||||||
Basic loss per share from discontinued operations
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- | - | - | (0.50 | ) | |||||||||||
Total basic earnings per share
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$ | 1.02 | $ | 0.75 | $ | 3.00 | $ | 1.65 | ||||||||
Diluted earnings per share from continuing operations
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$ | 1.01 | $ | 0.74 | $ | 2.97 | $ | 2.14 | ||||||||
Diluted loss per share from discontinued operations
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- | - | - | (0.50 | ) | |||||||||||
Total diluted earnings per share
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$ | 1.01 | $ | 0.74 | $ | 2.97 | $ | 1.64 | ||||||||
Weighted average shares outstanding, basic
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146,775 | 145,751 | 146,169 | 146,652 | ||||||||||||
Weighted average shares outstanding, diluted
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148,430 | 146,885 | 147,579 | 147,395 |
Page 5
COVENTRY HEALTH CARE, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
(Amounts in thousands)
December 31,
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September 30,
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December 31,
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||||||||||
2010
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2010
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2009
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||||||||||
(unaudited)
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(unaudited)
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|||||||||||
Assets:
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||||||||||||
Current assets:
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||||||||||||
Cash and cash equivalents
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$ | 1,853,988 | $ | 1,786,587 | $ | 1,418,554 | ||||||
Short-term investments
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16,849 | 15,093 | 442,106 | |||||||||
Accounts receivable, net
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276,694 | 280,834 | 258,993 | |||||||||
Other receivables, net
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515,882 | 422,878 | 496,059 | |||||||||
Other current assets
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371,528 | 331,875 | 234,446 | |||||||||
Total current assets
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3,034,941 | 2,837,267 | 2,850,158 | |||||||||
Long-term investments
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2,184,606 | 2,278,844 | 1,994,987 | |||||||||
Property and equipment, net
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262,282 | 258,059 | 271,931 | |||||||||
Goodwill
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2,550,570 | 2,545,241 | 2,529,284 | |||||||||
Other intangible assets, net
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431,886 | 432,991 | 471,693 | |||||||||
Other long-term assets
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31,300 | 31,995 | 48,479 | |||||||||
Total assets
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$ | 8,495,585 | $ | 8,384,397 | $ | 8,166,532 | ||||||
Liabilities and Stockholders’ Equity:
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Current liabilities:
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Medical liabilities
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$ | 1,237,690 | $ | 1,241,346 | $ | 1,605,407 | ||||||
Accounts payable and accrued liabilities
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942,226 | 927,127 | 682,171 | |||||||||
Deferred revenue
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103,082 | 120,932 | 110,855 | |||||||||
Total current liabilities
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2,282,998 | 2,289,405 | 2,398,433 | |||||||||
Long-term debt
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1,599,396 | 1,599,304 | 1,599,027 | |||||||||
Other long-term liabilities
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414,025 | 439,299 | 456,518 | |||||||||
Total liabilities
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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
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$ | 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
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Year Ended
|
|||||||
December 31, 2010
|
December 31, 2010
|
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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
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(27,364 | ) | (130,749 | ) | ||||
Amortization of stock compensation
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9,387 | 40,532 | ||||||
Charge for provider class action
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- | 278,000 | ||||||
Changes in assets and liabilities:
|
||||||||
Accounts receivable, net
|
10,252 | (2,389 | ) | |||||
Medical liabilities
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(36,362 | ) | (439,265 | ) | ||||
Accounts payable and other accrued liabilities
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7,914 | (46,174 | ) | |||||
Deferred revenue
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(21,999 | ) | (15,548 | ) | ||||
Other operating activities
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(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
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(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
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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)
|
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Health Plan Commercial Risk
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1,641 | 1,533 | 1,522 | 1,501 | 1,418 | |||||||||||||
Health Plan Commercial ASO
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698 | 636 | 657 | 663 | 685 | |||||||||||||
Medicare Advantage CCP
|
224 | 193 | 192 | 190 | 186 | |||||||||||||
Medicaid Risk
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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
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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)
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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.
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(3)
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Operating statistics excluding discontinued operations.
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(4)
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“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).
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(5)
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Revenue PMPM excludes the impact of revenue ceded to external parties.
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(6)
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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.
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(7)
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Revenue PMPM excludes the impact of CMS risk-share premium adjustments and revenue ceded to external parties.
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