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8-K - FORM 8-K - COVENTRY HEALTH CARE INCform8k_02082012.htm



Coventry Logo
 Contact:    Randy Giles
   Chief Financial Officer
   (301) 581-5687
   
   Drew Asher
   SVP, Corporate Finance
   (301) 581-5717
              

Coventry Health Care Reports Fourth Quarter Earnings

   Announces 2012 EPS Guidance Range of $3.10 - $3.30  

 
BETHESDA, Md. (February 8, 2012) - Coventry Health Care, Inc. (NYSE: CVH) today reported consolidated operating results for the quarter and fiscal year ended December 31, 2011.  Operating revenues totaled $3.1 billion for the quarter with net earnings of $85.7 million, or $0.60 earnings per diluted share (EPS).  These results include a favorable impact from the Medicare Advantage Private Fee-for-Service (MA-PFFS) product of $0.02 EPS.  Excluding the impact of MA-PFFS results(1), core earnings for the quarter were $82.1 million, or $0.58 EPS.

For the year ended December 31, 2011, total operating revenues were $12.2 billion with net earnings of $543.1 million, or $3.70 EPS.  These results include EPS of $0.15 from the MA-PFFS product and EPS of $0.68 related to the definitive settlement agreement associated with the provider class action litigation in Louisiana which was approved by the court during the second quarter.  Excluding the impact of MA-PFFS results(1) and the provider class action litigation adjustment(2), core earnings for the year were $419.5 million, or $2.87 EPS.

“We spent much of 2011 focused on seizing growth opportunities for 2012 and beyond, and I am very pleased with the strong growth in Medicaid and Medicare as we enter the first quarter of 2012, ” said Allen F. Wise, chairman and chief executive officer of Coventry. “As we wrap up 2011, we turn our focus towards 2012 with a forecast of double digit revenue growth coupled with operating earnings and EPS growth.  We are hard at work to deliver on 2012 commitments while laying the foundation to seize opportunities for the future.”

Fourth Quarter and Full Year 2011 Consolidated Highlights
·  
Implemented a Medicaid contract with the Commonwealth of Kentucky effective November 1, 2011
o  
Providing services to approximately 221,000 new members at year-end
·  
Closed the acquisition of Children’s Mercy’s Family Health Partners effective January 1, 2012, adding approximately 210,000 Medicaid members
·  
Successful execution during the 2012 Annual Enrollment Period resulting in enrollment gains of approximately 28,000, or 13%, in Medicare-CCP and just under 300,000, or 25%, in Medicare Part D
·  
Reduced selling, general, and administrative (SG&A) expense as a percentage of revenue from 16.9% in 2010 to 16.5% in 2011
·  
Repurchased 3.2 million shares for $100.0 million during the fourth quarter and 10.7 million shares for $327.7 million for the full year
o  
Increased the share repurchase authorization by 14.4 million shares in the fourth quarter, with authorization remaining at year-end of 16.5 million shares
·  
Approximately $900 million of deployable free cash at the parent at January 31, 2012
·  
Entered into a new $750 million, five-year unsecured revolving credit facility during the second quarter of 2011 which remains undrawn at year-end
 
Page 1 of 9
 

 
 
 
Selected Fourth Quarter and Full Year 2011 Highlights

·  
Commercial Risk(3). As of December 31, 2011, commercial risk membership was 1,635,000, a decrease of 6,000 members from the prior year-end as approximately 18,000 members associated with the State of Illinois account moved to ASO during 2011. The commercial risk medical loss ratio (MLR) was 83.7% in the quarter and 81.6% for the full year.


·   
Medicare Advantage.  As of December 31, 2011, Medicare Advantage Coordinated Care Plan (MA-CCP) membership was 222,000, an increase of 2,000 members from the prior quarter.  The MA-CCP MLR was 82.3% in the quarter, a decrease of 180 bps from the prior year quarter, and 82.9% for the full year.  During the fourth quarter, the run-out of the MA-PFFS product line contributed $0.02 EPS and has now contributed $0.15 EPS for the full year. As previously announced, the Company did not renew this product line effective January 1, 2010.


·   
Medicare Part D.  As of December 31, 2011, Medicare Part D membership was 1,143,000, a decrease of 5,000 members from the prior quarter.  The Medicare Part D MLR was 60.5% in the quarter, a decrease of 420 bps from the prior year quarter.   The Medicare Part D MLR was 81.7% for the full year, a decrease of 200 bps from the prior full year.


·   
Medicaid.  As of December 31, 2011, Medicaid membership was 692,000, an increase of 224,000 members from the prior year-end.  Coventry commenced operations in Kentucky during the fourth quarter which contributed approximately 221,000 new members. The Medicaid MLR was 94.4% in the quarter and 89.4% for the full year.




 
 
 
 
 
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2012 FULL YEAR GUIDANCE
·  
Risk revenue of $12.75 billion to $12.90 billion
·  
Management services revenue of $1.11 billion to $1.15 billion
·  
Consolidated revenue of $13.86 billion to $14.05 billion
·  
Consolidated MLR of 83.1% to 83.9%
·  
Cost of sales expense of $231.0 million to $237.0 million
·  
SG&A expense of $2.13 billion to $2.16 billion
·  
Depreciation and amortization expense of $136.0 million to $140.0 million
·  
Other income of $77.0 million to $83.0 million
·  
Interest expense of $98.0 million to $99.0 million
·  
Tax rate of 36.7% to 37.3%
·  
Diluted share count of 138.0 million to 142.0 million
·  
EPS of $3.10 to $3.30





2011 EPS RECONCILIATION TABLE

   
2011 Actual
Previous Guidance
EPS from core businesses
 
$2.87
$2.82 - $2.87
     Impact from non-recurring MA-PFFS(1)
 
$0.15
$0.13
EPS including MA-PFFS
 
$3.02
$2.95 - $3.00
     Impact from Q2 2011 litigation adjustment(2)
 
$0.68
$0.68
GAAP EPS
 
$3.70
$3.63 - $3.68





Page 3 of 9
 

 
 
Mr. Allen F. Wise, chairman and chief executive officer of Coventry, will host a conference call at 8:30 a.m. ET on Wednesday, February 8, 2012.  To listen to the call, dial toll-free at (888) 312-9865 or, for international callers, (719) 325-2286. 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 4441852.

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, 2010, and Coventry’s subsequent filings with the Securities and Exchange Commission.  Among the risk 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 legal requirements from recently enacted federal or state laws or regulations, court decisions, or government investigations or proceedings; guaranty fund assessments under state insurance guaranty association law; changes in government funding and various other risks associated with our participation in Medicare and Medicaid programs; 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, unsuccessful bids for business with government agencies or renewal of government contracts on less than favorable terms; failure of independent agents and brokers to continue to market the Company’s 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; compromises of the Company’s data security; 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 ability to receive cash from its regulated subsidiaries; 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 of 9
 

 

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

 
Quarters Ended
 
Years Ended
 
December 31,
 
December 31,
 
2011
 
2010
 
2011
 
2010
Operating revenues:
(unaudited)
 
(unaudited)
 
(unaudited)
   
 
Managed care premiums
$ 2,841,976
 
$ 2,730,377
 
$11,014,950
 
$10,414,640
 
Management services
287,180
 
294,639
 
1,171,733
 
1,173,276
Total operating revenues
3,129,156
 
3,025,016
 
12,186,683
 
11,587,916
                 
Operating expenses:
             
 
Medical costs
2,331,881
 
2,156,033
 
9,041,402
 
8,265,947
 
Cost of sales
73,941
 
64,152
 
283,544
 
252,052
 
Selling, general, and administrative
539,717
 
531,442
 
2,016,042
 
1,961,947
 
Provider class action
-
 
-
 
(159,300)
 
278,000
 
Depreciation and amortization
34,674
 
36,343
 
136,865
 
140,685
Total operating expenses
2,980,213
 
2,787,970
 
11,318,553
 
10,898,631
                 
Operating earnings
148,943
 
237,046
 
868,130
 
689,285
Operating earnings percentage of total revenues
4.8%
 
7.8%
 
7.1%
 
5.9%
                 
Interest expense
28,219
 
19,705
 
99,062
 
80,418
Other income, net
22,833
 
18,505
 
89,033
 
77,667
                 
Earnings before income taxes
143,557
 
235,846
 
858,101
 
686,534
                 
Provision for income taxes
57,861
 
85,520
 
314,996
 
247,918
Net earnings
 
$   85,696
 
$  150,326
 
$  543,105
 
$  438,616
                 
Net earnings per share:
               
     Basic earnings per share
 
$        0.61
 
$        1.02
 
$        3.75
 
  $        3.00
     Diluted earnings per share
$        0.60
 
$        1.01
 
$        3.70
 
  $        2.97
                 
Weighted average shares outstanding, basic
141,196
 
146,775
 
144,775
 
146,169
Weighted average shares outstanding, diluted
142,858
 
148,430
 
146,741
 
147,579




Page 5 of 9
 

 
 

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


   
December 31,
   
September 30,
   
December 31,
 
   
2011
   
2011
   
2010
 
   
(unaudited)
   
(unaudited)
       
Assets:
                 
                   
Current assets:
                 
   Cash and cash equivalents
  $ 1,579,003     $ 1,986,323     $ 1,853,988  
   Short-term investments
    116,205       222,631       16,849  
   Accounts receivable, net
    270,263       257,720       276,694  
   Other receivables, net
    717,736       496,631       515,882  
   Other current assets
    286,301       262,903       371,528  
Total current assets
    2,969,508       3,226,208       3,034,941  
                         
Long-term investments
    2,635,309       2,553,792       2,184,606  
Property and equipment, net
    255,485       262,432       262,282  
Goodwill
    2,548,834       2,559,605       2,550,570  
Other intangible assets, net
    367,533       383,582       431,886  
Other long-term assets
    36,863       38,277       31,300  
Total assets
  $ 8,813,532     $ 9,023,896     $ 8,495,585  
                         
                         
                         
Liabilities and Stockholders’ Equity:
                       
                         
Current liabilities:
                       
   Medical liabilities
  $ 1,308,507     $ 1,224,216     $ 1,237,690  
   Accounts payable and accrued liabilities
    695,235       637,245       942,226  
   Deferred revenue
    114,510       398,756       103,082  
   Current portion of long-term debt
    233,903       233,903       -  
Total current liabilities
    2,352,155       2,494,120       2,282,998  
                         
Long-term debt
    1,584,700       1,584,578       1,599,396  
Other long-term liabilities
    365,686       432,603       414,025  
Total liabilities
    4,302,541       4,511,301       4,296,419  
                         
Stockholders’ equity
    4,510,991       4,512,595       4,199,166  
                         
Total liabilities and stockholders’ equity
  $ 8,813,532     $ 9,023,896     $ 8,495,585  


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

   
Quarter Ended
   
Year Ended
 
   
December 31, 2011
   
December 31, 2011
 
             
Cash flows from operating activities:
           
   Net earnings
  $ 85,696     $ 543,105  
   Adjustments to earnings:
               
      Depreciation and amortization
    34,674       136,865  
      Amortization of stock compensation
    10,566       40,530  
      Provider class action – release
    ---       (159,300 )
      Provider class action – deferred tax adjustment
    ---       58,145  
   Changes in assets and liabilities:
               
      Provider class action – settlement
    ---       (150,500 )
      Accounts receivable, net
    (12,543 )     7,287  
      Other receivables
    (218,780 )     (198,479 )
      Medical liabilities
    84,291       68,272  
      Accounts payable and other accrued liabilities
    63,417       68,605  
      Deferred revenue
    (284,246 )     11,510  
   Other operating activities
    (32,656 )     (24,881 )
   Net cash flows from operating activities
    (269,581 )     401,159  
                 
Cash flows from investing activities:
               
   Capital expenditures, net
    (8,190 )     (62,085 )
   Payments for investments, net of sales and maturities
    (1,738 )     (532,305 )
   Payments for acquisitions, net of cash acquired
    (3,500 )     (7,616 )
   Net cash flows from investing activities
    (13,428 )     (602,006 )
                 
Cash flows from financing activities:
               
   Proceeds from issuance of stock
    2,533       44,624  
   Payments for repurchase of stock
    (126,614 )     (336,219 )
   Proceeds from issuance of debt, net
    ---       589,867  
   Repayment of debt
    ---       (380,029 )
   Excess tax benefit from stock compensation
    (230 )     7,619  
   Net cash flows from financing activities
    (124,311 )     (74,138 )
                 
Net change in cash and cash equivalents for current period
    (407,320 )     (274,985 )
Cash and cash equivalents at beginning of period
    1,986,323       1,853,988  
Cash and cash equivalents at end of period
  $ 1,579,003     $ 1,579,003  
                 
                 
                 
Cash and Investments:
               
Cash and cash equivalents
  $ 1,579,003     $ 1,579,003  
Short-term investments
    116,205       116,205  
Long-term investments
    2,635,309       2,635,309  
Total cash and investments
  $ 4,330,517     $ 4,330,517  


Page 7 of 9
 

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

   
Total
2011
      Q4 2011       Q3 2011       Q2 2011       Q1 2011    
Total
2010
 
Membership by Product (000s)
                                           
Commercial Risk
          1,635       1,636       1,648       1,636       1,641  
Health Plan Commercial ASO
          700       710       689       688       698  
Medicare Advantage CCP
          222       220       219       219       224  
Medicaid Risk
          692       467       467       468       468  
Health Plan Total
          3,249       3,033       3,023       3,011       3,031  
                                               
Other National ASO
          373       376       379       383       459  
Total Medical Membership
          3,622       3,409       3,402       3,394       3,490  
                                               
Medicare Part D
          1,143       1,148       1,150       1,159       1,628  
                                               
Total Membership
          4,765       4,557       4,552       4,553       5,118  
                                               
Revenues by Product Type (000s)
                                             
Commercial Risk
  $ 6,009,848     $ 1,510,768     $ 1,497,133     $ 1,510,849     $ 1,491,099     $ 5,540,470  
Commercial Management Services
    302,522       71,049       79,615       74,016       77,842       327,084  
Medicare Advantage
    2,382,330       598,796       591,051       601,240       591,242       2,114,205  
Medicaid Risk
    1,381,706       448,597       316,255       305,788       311,066       1,133,353  
Total Health Plan and Medical Services Businesses
    10,076,406       2,629,210       2,484,054       2,491,893       2,471,249       9,115,112  
 
                                               
Medicare Part D
    1,226,734       280,146       271,947       316,196       358,445       1,604,198  
Other Premiums
    105,597       26,132       26,341       26,709       26,415       100,130  
Other Management Services
    879,707       219,281       218,393       223,892       218,141       856,072  
Total Specialized Managed Care Businesses
    2,212,038       525,559       516,681       566,797       603,001       2,560,400  
                                                 
Total Premiums
    11,106,215       2,864,439       2,702,727       2,760,782       2,778,267       10,492,356  
Total Management Services
    1,182,229       290,330       298,008       297,908       295,983       1,183,156  
Other/Eliminations
    (101,761 )     (25,613 )     (25,192 )     (25,644 )     (25,312 )     (87,596 )
Total Revenue
  $ 12,186,683     $ 3,129,156     $ 2,975,543     $ 3,033,046     $ 3,048,938     $ 11,587,916  
                                                 
Consolidated Coventry
                                               
                                                 
Operating Income % of Revenues
    7.1 %     4.8 %     6.5 %     11.7 %     5.6 %     5.9 %
                                                 
SGA % of Revenues
    16.5 %     17.2 %     16.6 %     16.0 %     16.4 %     16.9 %
                                                 
Total Health Plan Medical Liabilities (000s)(4)
          $ 1,106,174     $ 1,088,989     $ 1,094,021     $ 1,087,137     $ 1,021,667  
Health Plan Days in Claims Payable (DCP) (4)
            50.45       50.52       50.48       50.40       48.62  
                                                 
Total Debt (millions)
          $ 1,818.6     $ 1,818.5     $ 1,818.4     $ 1,599.5     $ 1,599.4  
Total Capital (millions)
          $ 6,329.6     $ 6,331.1     $ 6,313.2     $ 5,869.3     $ 5,798.6  
Debt to Capital
            28.7 %     28.7 %     28.8 %     27.3 %     27.6 %

 
 Page 8 of 9 
 

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


   
Total
2011
      Q4 2011       Q3 2011       Q2 2011       Q1 2011    
Total
 2010
 
Revenue PMPM
                                           
Commercial Risk(3)
  $ 303.69     $ 305.70     $ 303.33     $ 304.19     $ 301.54     $ 298.62  
Medicare Advantage
  $ 895.54     $ 896.77     $ 893.22     $ 909.10     $ 883.09     $ 876.67  
Medicare Part D(5)
  $ 92.41     $ 90.95     $ 94.10     $ 93.72     $ 90.86     $ 87.96  
Medicaid
  $ 228.85     $ 244.71     $ 226.39     $ 218.28     $ 221.16     $ 218.98  
                                                 
                                                 
MLR%
                                               
Consolidated Total
    82.1 %     82.1 %     81.5 %     82.1 %     82.6 %     79.4 %
                                                 
Commercial Risk(3)
    81.6 %     83.7 %     82.1 %     80.7 %     80.0 %     78.4 %
Medicare Advantage
    82.9 %     82.3 %     82.0 %     82.9 %     84.2 %     82.0 %
Medicare Part D
    81.7 %     60.5 %     76.8 %     88.8 %     95.8 %     83.7 %
Medicaid
    89.4 %     94.4 %     88.1 %     86.9 %     86.0 %     85.7 %



(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 2011 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 May 31, 2011, the Company announced that it will record a non-recurring pre-tax adjustment to earnings in the second quarter of 2011 in the amount of $159.3 million, or $0.68 per diluted share related to such litigation.  The Company believes that disclosing adjusted earnings figures 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.

(3)  
"Commercial Risk" includes the results for all commercial risk business including Individual, Small Group, and Large Group members.  Previously, certain metrics reflected the commercial group business only.
 
(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 Kentucky Medicaid business for the fourth quarter of 2011 due to the timing of the contract implementation (November 1, 2011).
 
(5)  
Revenue PMPM excludes the impact of CMS risk-share premium adjustments and revenue ceded to external parties.


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