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Exhibit 99.1
N E W S R E L E A S E                                    
Contact:
Investor Relations Inquiries
 
Edmund E. Kroll
 
Senior Vice President, Finance & Investor Relations
 
(212) 759-0382
 
Media Inquiries
 
Deanne Lane
 
Vice President, Media Affairs
 
(314) 725-4477

FOR IMMEDIATE RELEASE

- CENTENE CORPORATION REPORTS 2012 SECOND QUARTER RESULTS -
-- DILUTED EPS COMPOSED OF $(0.16) LOSS FROM OPERATIONS AND $(0.52) IMPAIRMENT CHARGE --

ST. LOUIS, MISSOURI (July 24, 2012) -- Centene Corporation (NYSE: CNC) today announced its financial results for the quarter ended June 30, 2012.  During the second quarter of 2012, the Company recorded a loss of $(0.68) per diluted share composed of a $(0.16) loss from operations and an impairment loss of $(0.52), compared to net earnings per share of $0.54 in the prior year and $0.45 in the preceding quarter. The losses were the result of three primary factors:
In the Texas health plan, the Company experienced a high level of medical costs related to the March 1, 2012, expansion areas.
In the Kentucky health plan, the Company experienced increased medical costs primarily resulting from the retroactive assignment of members and a high level of non-inpatient claims receipts during the quarter.
In the Celtic subsidiary, the Company experienced a high level of medical costs related to individual health policies. This was primarily associated with recently issued policies related to members converted from another insurer throughout the first quarter of 2012. In addition to the operating loss, the Company also recorded an impairment loss of $28.0 million for the write down of goodwill and intangible assets in the Celtic reporting unit.
Michael F. Neidorff, Centene's Chairman and Chief Executive Officer, stated, “Second quarter results were consistent with the data presented at our June 14, 2012, Investor Day.  We are actively engaged to improve the performance in Kentucky, the Texas expansion areas and the Celtic individual health business.  The balance of our portfolio is performing within normalized ranges. With a return to profitability in June, we expect a profitable third quarter with additional improvement in the fourth quarter.”
Second Quarter Overview    
Quarter-end at-risk managed care membership of 2,397,500, an increase of 817,000 members, or 52% year over year.
Premium and service revenues of $2.1 billion, representing 61% growth year over year.
Health Benefits Ratio of 92.9%, compared to 84.8% in 2011.
General and Administrative expense ratio of 8.2%, compared to 11.2% in 2011.
Diluted net loss per share of $(0.68), including an impairment loss of $(0.52) per diluted share, compared to net earnings per share of $0.54 in the prior year.
Operating cash flow of $22.2 million for the second quarter of 2012.
Other Events
In July 2012, the Company began operating under a new contract with the Washington Health Care Authority to serve Medicaid beneficiaries in the state, initially operating as Coordinated Care. 
In July 2012, the Company's subsidiary, Home State Health Plan, began operating under a new contract with the Office of Administration for Missouri to serve Medicaid beneficiaries in the Eastern, Central, and Western Managed

1



Care Regions of the state.
In June 2012, the Company was notified by the Ohio Department of Job and Family Services that Buckeye Community Health Plan (Buckeye), the Company's Ohio subsidiary, was selected to be awarded a new and expanded contract to serve Medicaid members in Ohio, effective January 2013. Under the new state contract, Buckeye will operate statewide through Ohio's three newly aligned regions (West, Central/Southeast, and Northeast). The award remains subject to ongoing legal proceedings from other managed care organizations that were not awarded a contract.
In June 2012, the Company's Kansas subsidiary, Sunflower State Health Plan, was awarded a statewide contract to serve members in the state's KanCare program, which includes TANF, ABD non-duals, long-term care and CHIP beneficiaries. Operations are expected to commence in the first quarter of 2013.
In May 2012, the Company announced the Governor and Executive Council of New Hampshire had given approval for the Department of Health and Human Services to contract with the Company's subsidiary, Granite State Health Plan, to serve Medicaid beneficiaries in New Hampshire. Operations are currently expected to commence in the first quarter of 2013.
In May 2012, at the Case In Point Platinum Awards, Centene won in three categories: Managed Care: Disease Management / Population Health, Medicaid Case Management, and Woman/Children's Case Management.

The following table sets forth the Company's membership by state for its managed care organizations:
 
June 30,
 
2012
 
2011
Arizona
24,000

 
22,800

Florida
204,100

 
190,600

Georgia
313,300

 
303,100

Illinois
17,800

 
700

Indiana
205,000

 
206,700

Kentucky
143,500

 

Louisiana
168,700

 

Massachusetts
41,400

 
32,900

Mississippi
30,100

 
30,800

Ohio
166,800

 
159,900

South Carolina
87,800

 
82,800

Texas
919,200

 
470,400

Wisconsin
75,800

 
79,800

Total at-risk membership
2,397,500

 
1,580,500

Non-risk membership

 
10,400

Total
2,397,500

 
1,590,900


The following table sets forth the Company's membership by line of business:
 
June 30,
 
2012
 
2011
Medicaid
1,848,500

 
1,172,400
CHIP & Foster Care
222,600

 
211,400
ABD & Medicare
269,900

 
156,300
Hybrid Programs
48,100

 
35,500
Long-term Care
8,400

 
4,900
Total at-risk membership
2,397,500

 
1,580,500
Non-risk membership

 
10,400
Total
2,397,500

 
1,590,900


2



The following table identifies the Company's dual eligible membership by line of business. The membership table above includes these members.
 
June 30,
 
2012
 
2011
ABD
62,000

 
33,000
Long-term Care
7,600

 
4,600
Medicare
3,600

 
3,000
Total
73,200

 
40,600

Statement of Operations: Three Months Ended June 30, 2012
 
For the second quarter of 2012, Premium and Service Revenues increased 61% to $2.1 billion from $1.3 billion in the second quarter of 2011. The increase was primarily driven by the additions between years of the Illinois, Kentucky and Louisiana contracts, Texas and Arizona expansion, pharmacy carve-ins, and membership growth. 

Consolidated HBR of 92.9% for the second quarter of 2012 represents an increase from 84.8% in the comparable period in 2011 and 88.2% from the first quarter of 2012. The increase compared to last year primarily reflects (1) increased medical costs in the March 1, 2012 expansion areas in Texas, (2) increased medical costs resulting from retroactive assignment of members and increased non-inpatient claims in Kentucky, and (3) a high level of medical costs in the individual health business, especially for recently issued polices related to members converted in the first quarter of 2012. Excluding the impact of these items, the second quarter 2012 HBR would have been 88.5%.

Consolidated G&A expense ratio for the second quarter of 2012 was 8.2%, compared to 11.2% in the prior year. The year over year decrease in the G&A expense ratio reflects the leveraging of expenses over higher revenues in 2012 and a reduction in performance based compensation expense in 2012 which lowered the G&A expense ratio by 80 basis points.  The G&A ratio in 2011 reflects a 50 basis point decrease resulting from the recognition of revenue in the second quarter of 2011 from the Mississippi contract for the period January 1, 2011 through March 31, 2011.

Loss from operations was $(46.7) million in the second quarter 2012 compared to earnings of $55.3 million in the second quarter 2011. Net loss attributable to Centene Corporation was $(35.0) million in the second quarter 2012, compared to net earnings of $28.4 million in the second quarter of 2011.

Loss per diluted share was $(0.68) in the second quarter of 2012 compared to earnings of $0.54 in the prior year.

Balance Sheet and Cash Flow

At June 30, 2012, the Company had cash, investments and restricted deposits of $1,238.8 million, including $40.6 million held by its unregulated entities. Medical claims liabilities totaled $859.0 million, representing 41.4 days in claims payable. Total debt was $408.8 million which includes $55 million drawn on the $350 million revolving credit facility at quarter end (subsequently paid off in July 2012). Debt to capitalization was 25.9% at June 30, 2012, excluding the $76.6 million non-recourse mortgage note. Cash flow from operations for the three months ended June 30, 2012 was $22.2 million, and reflects an increase in premium receivable to $221 million due from the State of Georgia at June 30, 2012.

A reconciliation of the Company's change in days in claims payable from the immediately preceding quarter-end is presented below:
Days in claims payable, March 31, 2012
44.7

 
Texas pharmacy carve-in
(2.3
)
 
Full quarter of Texas expansion
(2.4
)
 
Timing of claim payments
1.4

 
Days in claims payable, June 30, 2012
41.4

 
 

The decrease in days in claims payable during the second quarter 2012 is primarily due to the following factors: (1) the carve-in of pharmacy in Texas which pays 70% faster than non-pharmacy claims; (2) the addition of the Texas expansion where the date of service to date of receipt is approximately 50% lower than the consolidated average; and (3) timing of payments at the end of the quarter.

3



Outlook
The table below depicts the Company's annual guidance for 2012 including business expansion costs for the recently announced contract awards in Kansas and New Hampshire.
 
 
Full Year 2012
 
 
 
Low
 
High 
 
Premium and Service Revenues (in millions)
 
$
7,700

 
$
8,100

 
Diluted EPS (Excluding Impairment Loss)
 
$
1.45

 
$
1.65

 
Diluted EPS (Including Impairment Loss)
 
$
0.95

 
$
1.15

 
Consolidated Health Benefits Ratio
 
89.0
%
 
90.0
%
 
General & Administrative expense ratio
 
8.5
%
 
9.0
%
 
Diluted Shares Outstanding (in thousands)
 
53,600

 
53,800

 
 
 
 

 
 

 
The above 2012 guidance for diluted EPS includes the $28.0 million, or $26.7 million after tax, impairment loss related to the individual health business which amounts to $(0.52) per diluted share in the second quarter. The diluted EPS calculation for the three and six months ended June 30, 2012, excludes antidilutive shares; for the full year, it is anticipated that outstanding stock awards will be dilutive and the impact of the shares will be reflected in the diluted EPS calculation, as indicated in the table above.
Conference Call
As previously announced, the Company will host a conference call Tuesday, July 24, 2012, at 8:30 A.M. (Eastern Time) to review the financial results for the second quarter ended June 30, 2012, and to discuss its business outlook.  Michael F. Neidorff and William N. Scheffel will host the conference call.  Investors and other interested parties are invited to listen to the conference call by dialing 1-877-270-2148 in the U.S. and Canada; +1-412-902-6510 from abroad; or via a live, audio webcast on the Company's website at www.centene.com, under the Investors section. A webcast replay will be available for on-demand listening shortly after the completion of the call for the next twelve months or until 11:59 p.m. (Eastern Time) on Tuesday, July 23, 2013, at the aforementioned URL. In addition, a digital audio playback will be available until 9:00 a.m. (Eastern Time) on Wednesday, August 1, 2012, by dialing 1-877-344-7529 in the U.S. and Canada, or +1-412-317-0088 from abroad, and entering access code 10015829.
About Centene Corporation
Centene Corporation, a Fortune 500 company, is a leading multi-line healthcare enterprise that provides programs and related services to the rising number of under-insured and uninsured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and long-term care, in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans). Centene's CeltiCare subsidiary offers states unique, "exchange based" and other cost-effective coverage solutions for low-income populations. The Company operates local health plans and offers a range of health insurance solutions. It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health, life and health management, managed vision, telehealth services, and pharmacy benefits management.
The information provided in this press release contains forward-looking statements that relate to future events and future financial performance of Centene. Subsequent events and developments may cause the Company's estimates to change. The Company disclaims any obligation to update this forward-looking financial information in the future. Readers are cautioned that matters subject to forward-looking statements involve known and unknown risks and uncertainties, including economic, regulatory, competitive and other factors that may cause Centene's or its industry's actual results, levels of activity, performance or achievements to be materially different from any future results, levels of activity, performance or achievements expressed or implied by these forward-looking statements. Actual results may differ from projections or estimates due to a variety of important factors, including Centene's ability to accurately predict and effectively manage health benefits and other operating expenses, competition, membership and revenue projections, timing of regulatory contract approval, changes in healthcare practices, changes in federal or state laws or regulations, changes in expected contract start dates, inflation, provider and state contract changes, new technologies, reduction in provider payments by governmental payors, major epidemics, disasters and numerous other factors affecting the delivery and cost of healthcare, as well as those factors disclosed in the Company's publicly filed documents. The expiration, cancellation or suspension of Centene's Medicaid Managed Care contracts, or the loss of any appeal of or protest to any such expiration, cancellation or suspension, by state governments would also negatively affect Centene.
[Tables Follow]

4




CENTENE CORPORATION AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
(In thousands, except share data)
(Unaudited)

 
June 30,
2012
 
December 31,
2011
ASSETS
 
 
 
Current assets:
 
 
 
Cash and cash equivalents
$
421,894

 
$
573,698

Premium and related receivables
400,194

 
157,450

Short-term investments
152,545

 
130,499

Other current assets
98,805

 
78,363

Total current assets
1,073,438

 
940,010

Long-term investments
630,866

 
506,140

Restricted deposits
33,496

 
26,818

Property, software and equipment, net
379,970

 
349,622

Goodwill
256,288

 
281,981

Intangible assets, net
22,481

 
27,430

Other long-term assets
53,011

 
58,335

Total assets
$
2,449,550

 
$
2,190,336

LIABILITIES AND STOCKHOLDERS’ EQUITY
 

 
 

Current liabilities:
 

 
 

Medical claims liability
$
859,035

 
$
607,985

Accounts payable and accrued expenses
142,766

 
216,504

Unearned revenue
29,133

 
9,890

Current portion of long-term debt
3,302

 
3,234

Total current liabilities
1,034,236

 
837,613

Long-term debt
405,462

 
348,344

Other long-term liabilities
61,865

 
67,960

Total liabilities
1,501,563

 
1,253,917

Commitments and contingencies
 
 
 
Stockholders’ equity:
 

 
 

Common stock, $.001 par value; authorized 100,000,000 shares; 54,320,036 issued and 51,557,064 outstanding at June 30, 2012, and 53,586,726 issued and 50,864,618 outstanding at December 31, 2011
54

 
54

Additional paid-in capital
450,506

 
421,981

Accumulated other comprehensive income:
 
 
 
Unrealized gain on investments, net of tax
5,842

 
5,761

Retained earnings
553,940

 
564,961

Treasury stock, at cost (2,762,972 and 2,722,108 shares, respectively)
(58,914
)
 
(57,123
)
Total Centene stockholders’ equity
951,428

 
935,634

Noncontrolling interest
(3,441
)
 
785

Total stockholders’ equity
947,987

 
936,419

Total liabilities and stockholders’ equity
$
2,449,550

 
$
2,190,336





5



CENTENE CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF OPERATIONS
(In thousands, except share data)
(Unaudited)

 
Three Months Ended June 30,
 
Six Months Ended June 30,
 
2012
 
2011
 
2012
 
2011
Revenues:
 
 
 
 
 
 
 
Premium
$
2,034,558

 
$
1,248,588

 
$
3,669,408

 
$
2,401,365

Service
27,041

 
29,428

 
55,659

 
55,812

Premium and service revenues
2,061,599

 
1,278,016

 
3,725,067

 
2,457,177

Premium tax
49,147

 
36,998

 
97,827

 
74,194

Total revenues
2,110,746

 
1,315,014

 
3,822,894

 
2,531,371

Expenses:
 
 
 
 
 
 
 
Medical costs
1,890,405

 
1,059,120

 
3,333,081

 
2,037,687

Cost of services
21,816

 
20,312

 
45,153

 
40,488

General and administrative expenses
168,062

 
143,045

 
331,249

 
284,133

Premium tax expense
49,176

 
37,234

 
97,926

 
74,663

Impairment loss
28,033

 

 
28,033

 

Total operating expenses
2,157,492

 
1,259,711

 
3,835,442

 
2,436,971

Earnings (loss) from operations
(46,746
)
 
55,303

 
(12,548
)
 
94,400

Other income (expense):
 
 
 
 
 
 
 
Investment and other income
4,045

 
2,933

 
9,336

 
6,682

Debt extinguishment costs

 
(8,488
)
 

 
(8,488
)
Interest expense
(4,739
)
 
(5,256
)
 
(9,538
)
 
(10,951
)
Earnings (loss) from operations, before income tax expense
(47,440
)
 
44,492

 
(12,750
)
 
81,643

Income tax expense (benefit)
(8,608
)
 
16,429

 
3,479

 
30,757

Net earnings (loss)
(38,832
)
 
28,063

 
(16,229
)
 
50,886

Noncontrolling interest
(3,833
)
 
(311
)
 
(5,208
)
 
(1,233
)
Net earnings (loss) attributable to Centene Corporation
$
(34,999
)
 
$
28,374

 
$
(11,021
)
 
$
52,119

 
 
 
 
 
 
 
 
Net earnings (loss) per common share attributable to Centene Corporation:


 


 
 
 
 
Basic earnings (loss) per common share
$
(0.68
)
 
$
0.57

 
$
(0.21
)
 
$
1.04

Diluted earnings (loss) per common share
$
(0.68
)
 
$
0.54

 
$
(0.21
)
 
$
1.00

 
 
 
 
 
 
 
 
Weighted average number of common shares outstanding:
 
 
 
 
 
 
 
Basic
51,515,895

 
50,167,052

 
51,320,784

 
49,959,892

Diluted
51,515,895

 
52,489,414

 
51,320,784

 
52,171,213






6



CENTENE CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
(In thousands)
(Unaudited)

 
Six Months Ended June 30,
 
2012
 
2011
Cash flows from operating activities:
 
 
 
Net earnings (loss)
$
(16,229
)
 
$
50,886

Adjustments to reconcile net earnings (loss) to net cash provided by operating activities
 

 
 

Depreciation and amortization
33,266

 
28,567

Stock compensation expense
11,993

 
8,839

Debt extinguishment costs

 
8,488

Impairment loss
28,033

 

Deferred income taxes
9,364

 
(3,529
)
Changes in assets and liabilities
 

 
 

Premium and related receivables
(232,745
)
 
(16,146
)
Other current assets
(34,105
)
 
(4,001
)
Other assets
1,520

 
(878
)
Medical claims liabilities
251,050

 
24,684

Unearned revenue
19,885

 
(12,465
)
Accounts payable and accrued expenses
(77,010
)
 
(34,739
)
Other operating activities
(4,922
)
 
3,448

Net cash (used in) provided by operating activities
(9,900
)
 
53,154

Cash flows from investing activities:
 

 
 

Capital expenditures
(57,442
)
 
(35,128
)
Purchases of investments
(406,901
)
 
(103,239
)
Sales and maturities of investments
253,719

 
120,448

Investments in acquisitions, net of cash acquired

 
(3,192
)
Net cash used in investing activities
(210,624
)
 
(21,111
)
Cash flows from financing activities:
 

 
 

Proceeds from exercise of stock options
10,320

 
12,264

Proceeds from borrowings
75,000

 
419,183

Payment of long-term debt
(21,601
)
 
(414,695
)
Excess tax benefits from stock compensation
5,810

 
1,369

Common stock repurchases
(1,791
)
 
(1,029
)
Contribution from noncontrolling interest
982

 
244

Debt issue costs

 
(9,095
)
Net cash provided by financing activities
68,720

 
8,241

Net (decrease) increase in cash and cash equivalents
(151,804
)
 
40,284

Cash and cash equivalents, beginning of period
573,698

 
434,166

Cash and cash equivalents, end of period
$
421,894

 
$
474,450

Supplemental disclosures of cash flow information:
 

 
 

Interest paid
$
10,312

 
$
11,822

Income taxes paid
$
32,394

 
$
40,111





7



CENTENE CORPORATION
SUPPLEMENTAL FINANCIAL DATA
 
Q2
 
Q1
 
Q4
 
Q3
 
Q2
 
2012
 
2012
 
2011
 
2011
 
2011
MEMBERSHIP
 
 
 
 
 
 
 
 
 
Managed Care:
 
 
 
 
 
 
 
 
 
Arizona
24,000

 
23,100

 
23,700

 
22,800

 
22,800

Florida
204,100

 
199,500

 
198,300

 
188,600

 
190,600

Georgia
313,300

 
306,000

 
298,200

 
298,000

 
303,100

Illinois
17,800

 
17,400

 
16,300

 
13,600

 
700

Indiana
205,000

 
206,300

 
206,900

 
205,300

 
206,700

Kentucky
143,500

 
145,700

 
180,700

 

 

Louisiana
168,700

 
51,300

 

 

 

Massachusetts
41,400

 
36,000

 
35,700

 
34,700

 
32,900

Mississippi
30,100

 
29,500

 
31,600

 
30,600

 
30,800

Ohio
166,800

 
161,000

 
159,900

 
162,200

 
159,900

South Carolina
87,800

 
86,700

 
82,900

 
86,500

 
82,800

Texas
919,200

 
811,000

 
503,800

 
494,500

 
470,400

Wisconsin
75,800

 
76,000

 
78,000

 
78,900

 
79,800

Total at-risk membership
2,397,500

 
2,149,500

 
1,816,000

 
1,615,700

 
1,580,500

Non-risk membership

 

 
4,900

 
10,600

 
10,400

TOTAL
2,397,500

 
2,149,500

 
1,820,900

 
1,626,300

 
1,590,900

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Medicaid
1,848,500

 
1,634,800

 
1,336,800

 
1,189,900

 
1,172,400

CHIP & Foster Care
222,600

 
218,800

 
213,900

 
210,600

 
211,400

ABD & Medicare
269,900

 
247,400

 
218,000

 
171,700

 
156,300

Hybrid Programs
48,100

 
41,500

 
40,500

 
38,400

 
35,500

Long-term Care
8,400

 
7,000

 
6,800

 
5,100

 
4,900

Total at-risk membership
2,397,500

 
2,149,500

 
1,816,000

 
1,615,700

 
1,580,500

Non-risk membership

 

 
4,900

 
10,600

 
10,400

TOTAL
2,397,500

 
2,149,500

 
1,820,900

 
1,626,300

 
1,590,900

 
 
 
 
 
 
 
 
 
 
Specialty Services(a):
 
 
 
 
 
 
 
 
 
Cenpatico Behavioral Health
 
 
 
 
 
 
 
 
 
Arizona
159,900

 
162,100

 
168,900

 
175,500

 
173,200

Kansas
44,300

 
46,000

 
46,200

 
45,600

 
45,000

TOTAL
204,200

 
208,100

 
215,100

 
221,100

 
218,200

 
 
 
 
 
 
 
 
 
 
(a) Includes external membership only.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
REVENUE PER MEMBER PER MONTH(b)
$
279

 
$
269

 
$
262

 
$
245

 
$
241

 
 
 
 
 
 
 
 
 
 
CLAIMS(b)
 
 
 
 
 
 
 
 
 
Period-end inventory
1,195,000

 
735,000

 
495,500

 
482,900

 
415,700

Average inventory
640,600

 
457,400

 
367,590

 
312,400

 
332,300

Period-end inventory per member
0.50

 
0.34

 
0.27

 
0.30

 
0.26

(b) Revenue per member and claims information are presented for the Managed Care at-risk members.
 
 
 
 
 
 
 
 
 
 
NUMBER OF EMPLOYEES
6,200

 
5,700

 
5,300

 
5,000

 
4,800







8



 
Q2
 
Q1
 
Q4
 
Q3
 
Q2
 
2012
 
2012
 
2011
 
2011
 
2011
 
 
 
 
 
 
 
 
 
 
DAYS IN CLAIMS PAYABLE (c)
41.4

 
44.7

 
45.3

 
43.6

 
43.4

(c) Days in Claims Payable is a calculation of Medical Claims Liabilities at the end of the period divided by average claims expense per calendar day for such period.
 
 
 
 
 
 
 
 
 
 
CASH AND INVESTMENTS (in millions)
 
 
 
 
 
 
 
Regulated
$
1,198.2

 
$
1,166.9

 
$
1,198.9

 
$
1,079.3

 
$
1,061.9

Unregulated
$
40.6

 
$
35.5

 
$
38.2

 
$
35.9

 
$
36.5

TOTAL
$
1,238.8

 
$
1,202.4

 
$
1,237.1

 
$
1,115.2

 
$
1,098.4

 
 
 
 
 
 
 
 
 
 
DEBT TO CAPITALIZATION
30.1
%
 
26.4
%
 
27.3
%
 
28.0
%
 
28.1
%
DEBT TO CAPITALIZATION EXCLUDING NON-RECOURSE DEBT(d)
25.9
%
 
21.8
%
 
22.6
%
 
23.2
%
 
23.0
%
Debt to Capitalization is calculated as follows: total debt divided by (total debt + total equity).
(d) The non-recourse debt represents the Company's mortgage note payable ($76.6 million at June 30, 2012.)
Operating Ratios:
 
Three Months Ended June 30,
 
Six Months Ended
June 30,
 
2012
 
2011
 
2012
 
2011
Health Benefits Ratios:
 
 
 
 
 
 
 
  Medicaid and CHIP
92.3
%
 
81.3
%
 
90.2
%
 
82.7
%
  ABD and Medicare
92.7

 
90.7

 
91.1

 
89.4

  Specialty Services
97.1

 
88.7

 
94.0

 
87.0

  Total
92.9

 
84.8

 
90.8

 
84.9

 
 
 
 
 
 
 
 
Total General & Administrative Expense Ratio
8.2
%
 
11.2
%
 
8.9
%
 
11.6
%
MEDICAL CLAIMS LIABILITY (In thousands)
The changes in medical claims liability are summarized as follows:

Balance, June 30, 2011
 
$
482,913

Incurred related to:
 
 
Current period
 
5,678,719

Prior period
 
(58,579
)
Total incurred
 
5,620,140

Paid related to:
 
 
Current period
 
4,826,839

Prior period
 
417,179

Total paid
 
5,244,018

Balance, June 30, 2012
 
$
859,035


Centene's claims reserving process utilizes a consistent actuarial methodology to estimate Centene's ultimate liability. Any reduction in the “Incurred related to: Prior period” amount may be offset as Centene actuarially determines “Incurred related to: Current period.” As such, only in the absence of a consistent reserving methodology would favorable development of prior period claims liability estimates reduce medical costs. Centene believes it has consistently applied its claims reserving methodology in each of the periods presented.

The amount of the “Incurred related to: Prior period” above represents favorable development and includes the effects of reserving under moderately adverse conditions, new markets where we use a conservative approach in setting reserves during the initial periods of operations, receipts from other third party payors related to coordination of benefits and lower medical utilization and cost trends for dates of service prior to June 30, 2011.

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