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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 2013 THIRD QUARTER EARNINGS OF $0.87 PER DILUTED SHARE -

ST. LOUIS, MISSOURI (October 22, 2013) -- Centene Corporation (NYSE: CNC) today announced its financial results for the quarter ended September 30, 2013
Premium and Service Revenues (in millions)
$
2,734

Consolidated Health Benefits Ratio
87.7
%
General & Administrative expense ratio
9.3
%
Diluted earnings per share (EPS)
$
0.87

Cash flow from operations (in millions)
$
130.7


Michael F. Neidorff, Centene's Chairman and Chief Executive Officer, stated, “The quarter and year to date results reflect the efforts and growing capabilities of all our employees who are committed to delivering high quality and lower cost services.”
Third Quarter Highlights

Quarter-end at-risk managed care membership of 2,612,500, an increase of 109,500 members, or 4% year over year.

Premium and service revenues of $2.7 billion, representing 24% growth year over year.

Health Benefits Ratio of 87.7%, compared to 93.3% in 2012.

General and Administrative expense ratio of 9.3%, compared to 8.2% in 2012.

Operating cash flow of $130.7 million for the third quarter of 2013, or 2.7 times net earnings.

Diluted EPS of $0.87, compared to $0.07 in 2012.

Other Events

In August 2013, our Florida subsidiary, Sunshine State Health Plan, began operating under a contract with the Florida Agency for Health Care Administration to serve members of the Medicaid Managed Care Long Term Care program. Enrollment began in August 2013 and will be implemented by region and continue through March 2014.
In August 2013, Moody's Investor Service affirmed our senior debt rating of Ba2 and raised the outlook of the Company to stable.

1



In September 2013, the Florida Agency for Health Care Administration provided notice of intent to award a contract to our subsidiary, Sunshine State Health Plan, in 9 of 11 regions of the Managed Medical Assistance (MMA) program. The MMA program includes TANF recipients as well as ABD and dual eligible members. The award is subject to challenge and contract readiness periods, with enrollment expected to begin in the second quarter of 2014 and continue through October 2014. In addition, we were recommended as the sole provider under a contract award for the Child Welfare Specialty Plan (Foster Care), expected to commence in the second quarter of 2014.
In September 2013, we were tentatively awarded a contract with the Massachusetts Executive Office of Health and Human Services to participate in the MassHealth CarePlus program in all five regions, with operations expected to begin in January 2014. Under the contract, our subsidiary, CeltiCare, will provide comprehensive healthcare services for eligible non-pregnant Medicaid adults. Services will include medical, behavioral health, dental, vision, pharmacy, therapies and transportation.
In September 2013, we were tentatively awarded a contract in Texas from the Texas Health and Human Services Commission to expand our operations and serve STAR+PLUS members in two Medicaid Rural Service Areas. Upon successful negotiations, execution of a contract and regulatory approval, enrollment is expected to begin in the second half of 2014.
In September 2013, our joint venture subsidiary, Centurion, began operating under a new contract to provide comprehensive healthcare services to individuals incarcerated in Tennessee state correctional facilities.
In September 2013, we received approval from the Centers for Medicare & Medicaid Services (CMS) to operate health insurance exchanges in Arkansas, Florida, Georgia, Indiana, Mississippi, Ohio and Texas. We also received approval from Massachusetts and Washington to participate in their state-based exchanges. Enrollment began in October 2013 and coverage is expected to commence in January 2014.
In September 2013, our Wisconsin subsidiary, Managed Health Services, and South Carolina subsidiary, Absolute Total Care, both earned Commendable ratings from the National Committee for Quality Assurance (NCQA).
In October 2013, our joint venture subsidiary, Centurion, executed an agreement with the Minnesota Department of Corrections to provide managed healthcare services to offenders in the state's correctional facilities. Operations are expected to begin in the first quarter of 2014.
The following table sets forth the Company's membership by state for its managed care organizations:

 
September 30,
 
2013
 
2012
Arizona
23,700

 
23,800

Florida
217,800

 
209,600

Georgia
314,100

 
312,400

Illinois
22,800

 
17,900

Indiana
198,400

 
205,400

Kansas
137,700

 

Kentucky

 
145,400

Louisiana
152,600

 
167,200

Massachusetts
23,200

 
28,000

Mississippi
76,900

 
30,600

Missouri
58,200

 
53,900

Ohio
170,900

 
173,800

South Carolina
89,400

 
89,400

Tennessee
20,400

 

Texas
957,300

 
930,700

Washington
77,100

 
42,000

Wisconsin
72,000

 
72,900

Total
2,612,500

 
2,503,000



2



Membership by line of business:
 
September 30,
 
2013
 
2012
Medicaid
1,953,300

 
1,939,400

CHIP & Foster Care
274,900

 
229,600

ABD & Medicare
302,000

 
289,800

Hybrid Programs
19,600

 
35,700

Long-term Care
31,600

 
8,500

Correctional Services
31,100

 

Total
2,612,500

 
2,503,000


Dual eligible membership (included in tables above):
 
September 30,
 
2013
 
2012
ABD
72,000

 
69,800
Long-term Care
19,600

 
7,800
Medicare
6,100

 
4,000
Total
97,700

 
81,600

Statement of Operations: Three Months Ended September 30, 2013

We have provided additional detail below on our quarterly results to further understand the changes in quarterly earnings per diluted share as compared to the third quarter 2012. During the third quarter 2013, we recorded net earnings of $0.87 per diluted share compared to $0.07 in the corresponding period in 2012 reflecting the following:

 
2013
 
2012
Net earnings per diluted share
$
0.87

 
$
0.07

Loss from Kentucky operations & premium deficiency reserve
0.01

 
1.03

Gains on sales of investments

 
(0.21
)
State tax benefit

 
(0.08
)
Total, excluding above items
$
0.88

 
$
0.81

 
For the third quarter of 2013, Premium and Service Revenues increased 24% to $2.7 billion from $2.2 billion in the third quarter of 2012. The increase was primarily driven as a result of the addition of the Kansas contract on January 1, 2013, increased membership and premium rates in Texas, expansions in Mississippi and Florida and the acquisition of AcariaHealth, partially offset by decreased revenue in Kentucky as a result of our exit.

Consolidated HBR of 87.7% for the third quarter of 2013 represents a decrease from 93.3% in the comparable period in 2012 and a decrease from 88.8% in the second quarter of 2013. Excluding our Kentucky health plan operations, the third quarter 2012 HBR was 88.7%. The HBR improvement compared to both periods reflects the rate increase in Texas as well as a continued level of moderate utilization.

The following table compares the results for new business and existing business for the quarters ended September 30,:
 
2013
 
2012
Premium and Service Revenue
 
 
 
New business
14
%
 
32
%
Existing business
86
%
 
68
%
 

 

HBR
 
 
 
New business
96.5
%
 
106.5
%
Existing business
86.3
%
 
87.0
%

3




Consolidated G&A expense ratio for the third quarter of 2013 was 9.3%, compared to 8.2% in the prior year.  The year over year increase reflects an increase in performance based compensation expense in 2013 and higher start-up costs, partially offset by the leveraging of expenses over higher revenue in 2013.  

Earnings from operations were $82.2 million in the third quarter of 2013 compared to a loss from operations of $(27.6) million in the third quarter of 2012. Net earnings attributable to Centene Corporation were $49.4 million in the third quarter of 2013, compared to $3.8 million in the third quarter of 2012.


Balance Sheet and Cash Flow

At September 30, 2013, the Company had cash, investments and restricted deposits of $1,721.7 million, including $37.6 million held by its unregulated entities. Medical claims liabilities totaled $1,071.7 million, representing 42.9 days in claims payable. Total debt was $521.0 million which includes no borrowings on the $500 million revolving credit facility at quarter end. Debt to capitalization was 27.4% at September 30, 2013, excluding the $73.4 million non-recourse mortgage note. Cash flow from operations for the three months ended September 30, 2013, was $130.7 million.

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, June 30, 2013
43.7

 
Timing of claim payments
(0.8
)
 
Days in claims payable, September 30, 2013
42.9

 
 

Outlook

The table below depicts the Company's annual guidance for 2013.
 
 
Full Year 2013
 
 
 
Low
 
High 
 
Premium and Service Revenues (in millions)
 
$
10,600

 
$
10,800

 
Diluted EPS
 
$
2.77

 
$
2.87

 
Consolidated Health Benefits Ratio
 
88.5
%
 
89.0
%
 
General & Administrative expense ratio
 
8.8
%
 
9.2
%
 
Diluted Shares Outstanding (in thousands)
 
56,000

 
56,500

 
 
 
 

 
 

 

Conference Call

As previously announced, the Company will host a conference call Tuesday, October 22, 2013, at 8:30 A.M. (Eastern Time) to review the financial results for the third quarter ended September 30, 2013, 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, October 21, 2014, at the aforementioned URL. In addition, a digital audio playback will be available until 9:00 a.m. (Eastern Time) on Wednesday, October 30, 2013, by dialing 1-877-344-7529 in the U.S. and Canada, or +1-412-317-0088 from abroad, and entering access code 10033731.

Other Information

The discussion in the third bullet under the heading "Statement of Operations: Three Months Ended September 30, 2013" contains financial information for new and existing businesses. Existing businesses are primarily state markets or significant geographic expansion in an existing state or product that we have managed for four complete quarters. New businesses are primarily new state markets or significant geographic expansion in an existing state or product that conversely, we have not managed for four complete quarters.


4



Non-GAAP Financial Presentation
The Company is providing certain non-GAAP financial measures in this release as the Company believes that these figures are helpful in allowing individuals to more accurately assess the ongoing nature of the Company's operations and measure the Company's performance more consistently. The Company uses the presented non-GAAP financial measures such as internally to allow management to focus on period-to-period changes in the Company's core business operations. Therefore, the Company believes that this information is meaningful in addition to the information contained in the GAAP presentation of financial information. The presentation of this additional non-GAAP financial information is not intended to be considered in isolation or as a substitute for the financial information prepared and presented in accordance with GAAP.

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 (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans). 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, care management software, correctional systems healthcare, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services.

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 and reserves, 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]

5




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

 
September 30,
2013
 
December 31,
2012
ASSETS
 
 
 
Current assets:
 
 
 
Cash and cash equivalents
$
741,281

 
$
843,952

Premium and related receivables
355,947

 
263,452

Short-term investments
122,631

 
139,118

Other current assets
148,576

 
127,080

Total current assets
1,368,435

 
1,373,602

Long-term investments
816,910

 
614,723

Restricted deposits
40,911

 
34,793

Property, software and equipment, net
390,200

 
377,726

Goodwill
347,548

 
256,288

Intangible assets, net
50,541

 
20,268

Other long-term assets
124,492

 
64,282

Total assets
$
3,139,037

 
$
2,741,682

LIABILITIES AND STOCKHOLDERS’ EQUITY
 

 
 

Current liabilities:
 

 
 

Medical claims liability
$
1,071,672

 
$
926,302

Premium deficiency reserve

 
41,475

Accounts payable and accrued expenses
270,381

 
191,343

Unearned revenue
41,873

 
34,597

Current portion of long-term debt
3,046

 
3,373

Total current liabilities
1,386,972

 
1,197,090

Long-term debt
517,931

 
535,481

Other long-term liabilities
49,043

 
55,344

Total liabilities
1,953,946

 
1,787,915

Commitments and contingencies


 


Stockholders’ equity:
 

 
 

Common stock, $.001 par value; authorized 100,000,000 shares; 57,872,798 issued and 54,767,551 outstanding at September 30, 2013, and 55,339,160 issued and 52,329,248 outstanding at December 31, 2012
58

 
55

Additional paid-in capital
578,188

 
450,856

Accumulated other comprehensive income:
 
 
 
Unrealized (loss) gain on investments, net of tax
(1,845
)
 
5,189

Retained earnings
678,679

 
566,820

Treasury stock, at cost (3,105,247 and 3,009,912 shares, respectively)
(75,541
)
 
(69,864
)
Total Centene stockholders’ equity
1,179,539

 
953,056

Noncontrolling interest
5,552

 
711

Total stockholders’ equity
1,185,091

 
953,767

Total liabilities and stockholders’ equity
$
3,139,037

 
$
2,741,682





6




CENTENE CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF OPERATIONS
(In thousands, except share data)
(Unaudited)
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2013
 
2012
 
2013
 
2012
Revenues:
 
 
 
 
 
 
 
Premium
$
2,621,651

 
$
2,184,061

 
$
7,659,418

 
$
5,853,469

Service
112,497

 
28,403

 
251,290

 
84,062

Premium and service revenues
2,734,148

 
2,212,464

 
7,910,708

 
5,937,531

Premium tax
69,504

 
235,657

 
264,781

 
333,484

Total revenues
2,803,652

 
2,448,121

 
8,175,489

 
6,271,015

Expenses:
 
 
 
 
 
 
 
Medical costs
2,298,881

 
2,036,999

 
6,810,892

 
5,370,080

Cost of services
100,479

 
21,744

 
218,844

 
66,897

General and administrative expenses
253,608

 
181,073

 
694,204

 
512,322

Premium tax expense
68,453

 
235,946

 
262,188

 
333,872

Impairment loss

 

 

 
28,033

Total operating expenses
2,721,421

 
2,475,762

 
7,986,128

 
6,311,204

Earnings (loss) from operations
82,231

 
(27,641
)
 
189,361

 
(40,189
)
Other income (expense):
 
 
 
 
 
 
 
Investment and other income
4,946

 
23,244

 
13,703

 
32,580

Interest expense
(6,603
)
 
(4,855
)
 
(20,261
)
 
(14,393
)
Earnings (loss) before income tax expense (benefit)
80,574

 
(9,252
)
 
182,803

 
(22,002
)
Income tax expense (benefit)
31,660

 
(9,547
)
 
71,967

 
(6,068
)
Net earnings (loss)
48,914

 
295

 
110,836

 
(15,934
)
Noncontrolling interest
(459
)
 
(3,524
)
 
(1,023
)
 
(8,732
)
Net earnings (loss) attributable to Centene Corporation
$
49,373

 
$
3,819

 
$
111,859

 
$
(7,202
)
 
 
 
 
 
 
 
 
Net earnings (loss) per common share attributable to Centene Corporation:
Basic earnings (loss) per common share
$
0.90

 
$
0.07

 
$
2.08

 
$
(0.14
)
Diluted earnings (loss) per common share
$
0.87

 
$
0.07

 
$
2.00

 
$
(0.14
)
 
 
 
 
 
 
 
 
Weighted average number of common shares outstanding:
 
 
 
 
Basic
54,679,660

 
51,584,860

 
53,863,779

 
51,393,345

Diluted
56,933,056

 
53,806,197

 
55,956,421

 
51,393,345



7




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

 
Nine Months Ended September 30,
 
2013
 
2012
Cash flows from operating activities:
 
 
 
Net earnings (loss)
$
110,836

 
$
(15,934
)
Adjustments to reconcile net earnings (loss) to net cash provided by operating activities
Depreciation and amortization
50,220

 
49,892

Stock compensation expense
27,252

 
18,417

Impairment loss

 
28,033

Gain on sale of investment in convertible note

 
(17,880
)
Deferred income taxes
1,626

 
(19,318
)
Changes in assets and liabilities
 

 
 

Premium and related receivables
(58,587
)
 
(139,414
)
Other current assets
(19,133
)
 
(23,487
)
Other assets
(65,397
)
 
1,918

Medical claims liabilities
103,895

 
374,046

Unearned revenue
7,976

 
122,077

Accounts payable and accrued expenses
48,840

 
(59,872
)
Other operating activities
4,142

 
(11,196
)
Net cash provided by operating activities
211,670

 
307,282

Cash flows from investing activities:
 

 
 

Capital expenditures
(46,383
)
 
(70,601
)
Purchases of investments
(666,016
)
 
(501,958
)
Sales and maturities of investments
451,034

 
434,009

Investments in acquisitions, net of cash acquired
(62,773
)
 

Net cash used in investing activities
(324,138
)
 
(138,550
)
Cash flows from financing activities:
 

 
 

Proceeds from exercise of stock options
7,674

 
11,686

Proceeds from borrowings
30,000

 
215,000

Payment of long-term debt
(40,842
)
 
(177,422
)
Proceeds from stock offering
15,225

 

Excess tax benefits from stock compensation
1,140

 
6,049

Common stock repurchases
(5,677
)
 
(2,154
)
Contribution from noncontrolling interest
5,864

 
1,032

Debt issue costs
(3,587
)
 

Net cash provided by financing activities
9,797

 
54,191

Net increase (decrease) in cash and cash equivalents
(102,671
)
 
222,923

Cash and cash equivalents, beginning of period
843,952

 
573,698

Cash and cash equivalents, end of period
$
741,281

 
$
796,621

Supplemental disclosures of cash flow information:
 

 
 

Interest paid
$
16,738

 
$
12,127

Income taxes paid
40,921

 
34,001

Equity issued in connection with acquisition
75,425

 


 




8




CENTENE CORPORATION
SUPPLEMENTAL FINANCIAL DATA
 
Q3
 
Q2
 
Q1
 
Q4
 
Q3
 
2013
 
2013
 
2013
 
2012
 
2012
AT-RISK MEMBERSHIP
 
 
 
 
 
 
 
 
 
Managed Care:
 
 
 
 
 
 
 
 
 
Arizona
23,700

 
23,200

 
23,300

 
23,500

 
23,800

Florida
217,800

 
216,200

 
214,600

 
214,000

 
209,600

Georgia
314,100

 
316,600

 
314,000

 
313,700

 
312,400

Illinois
22,800

 
18,000

 
18,000

 
18,000

 
17,900

Indiana
198,400

 
200,000

 
202,400

 
204,000

 
205,400

Kansas
137,700

 
137,500

 
133,700

 

 

Kentucky

 
133,500

 
132,700

 
135,800

 
145,400

Louisiana
152,600

 
153,700

 
162,900

 
165,600

 
167,200

Massachusetts
23,200

 
15,200

 
17,300

 
21,500

 
28,000

Mississippi
76,900

 
77,300

 
77,000

 
77,200

 
30,600

Missouri
58,200

 
58,800

 
57,900

 
59,600

 
53,900

Ohio
170,900

 
156,700

 
157,700

 
157,800

 
173,800

South Carolina
89,400

 
88,800

 
90,100

 
90,100

 
89,400

Tennessee
20,400

 

 

 

 

Texas
957,300

 
960,400

 
948,400

 
949,900

 
930,700

Washington
77,100

 
67,600

 
63,500

 
57,200

 
42,000

Wisconsin
72,000

 
73,400

 
72,600

 
72,400

 
72,900

TOTAL
2,612,500

 
2,696,900

 
2,686,100

 
2,560,300

 
2,503,000

 
 
 
 
 
 
 
 
 
 
Medicaid
1,953,300

 
2,051,700

 
2,049,200

 
1,977,200

 
1,939,400

CHIP & Foster Care
274,900

 
275,900

 
267,900

 
237,700

 
229,600

ABD & Medicare
302,000

 
322,500

 
320,700

 
307,800

 
289,800

Hybrid Programs
19,600

 
22,400

 
24,600

 
29,100

 
35,700

Long-term Care
31,600

 
24,400

 
23,700

 
8,500

 
8,500

Correctional Services
31,100

 

 

 

 

TOTAL
2,612,500

 
2,696,900

 
2,686,100

 
2,560,300

 
2,503,000

 
 
 
 
 
 
 
 
 
 
Specialty Services(a):
 
 
 
 
 
 
 
 
 
Cenpatico Behavioral Health
 
 
 
 
 
 
 
 
 
Arizona
160,700

 
157,100

 
156,200

 
157,900

 
162,000

Kansas

 

 

 
49,800

 
48,500

TOTAL
160,700

 
157,100

 
156,200

 
207,700

 
210,500

 
 
 
 
 
 
 
 
 
 
(a) Includes external membership only.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
REVENUE PER MEMBER PER MONTH(b)
$
327

 
$
305

 
$
304

 
$
292

 
$
283

 
 
 
 
 
 
 
 
 
 
CLAIMS(b)
 
 
 
 
 
 
 
 
 
Period-end inventory
706,100

 
752,800

 
1,020,100

 
641,000

 
826,800

Average inventory
526,000

 
539,800

 
587,800

 
555,200

 
547,400

Period-end inventory per member
0.27

 
0.28

 
0.38

 
0.25

 
0.33

(b) Revenue per member and claims information are presented for the Managed Care at-risk members.
 
 
 
 
 
 
 
 
 
 
NUMBER OF EMPLOYEES
8,200

 
7,900

 
7,100

 
6,800

 
6,400





9



 
Q3
 
Q2
 
Q1
 
Q4
 
Q3
 
2013
 
2013
 
2013
 
2012
 
2012
 
 
 
 
 
 
 
 
 
 
DAYS IN CLAIMS PAYABLE (c)
42.9

 
43.7

 
42.4

 
41.1

 
42.8

(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, excluding the Kentucky premium deficiency reserve liability.
 
 
 
 
 
 
 
 
 
 
CASH AND INVESTMENTS (in millions)
 
 
 
 
 
 
 
Regulated
$
1,684.1

 
$
1,595.4

 
$
1,619.0

 
$
1,595.3

 
$
1,493.8

Unregulated
37.6

 
33.8

 
45.5

 
37.3

 
36.0

TOTAL
$
1,721.7

 
$
1,629.2

 
$
1,664.5

 
$
1,632.6

 
$
1,529.8

 
 
 
 
 
 
 
 
 
 
DEBT TO CAPITALIZATION
30.5
%
 
32.9
%
 
35.2
%
 
36.1
%
 
29.2
%
DEBT TO CAPITALIZATION EXCLUDING NON-RECOURSE DEBT(d)
27.4
%
 
29.8
%
 
31.9
%
 
32.7
%
 
25.0
%
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 ($73.4 million at September 30, 2013).
Operating Ratios:
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2013
 
2012
 
2013
 
2012
Health Benefits Ratios:
 
 
 
 
 
 
 
  Medicaid and CHIP
84.5
%
 
91.4
%
 
88.0
%
 
90.6
%
  ABD and Medicare
92.2

 
97.5

 
90.8

 
93.9

  Specialty Services
86.8

 
87.2

 
84.1

 
91.8

  Total
87.7

 
93.3

 
88.9

 
91.7

 
 
 
 
 
 
 
 
Total General & Administrative Expense Ratio
9.3
%
 
8.2
%
 
8.8
%
 
8.6
%
MEDICAL CLAIMS LIABILITY (In thousands)

The changes in medical claims liability are summarized as follows:

Balance, September 30, 2012
 
$
919,032

Incurred related to:
 
 
Current period
 
8,937,162

Prior period
 
(50,313
)
Total incurred
 
8,886,849

Paid related to:
 
 
Current period
 
7,888,462

Prior period
 
845,747

Total paid
 
8,734,209

Less: Premium Deficiency Reserve
 

Balance, September 30, 2013
 
$
1,071,672


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 September 30, 2012.

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