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8-K - 8-K - MOLINA HEALTHCARE, INC.moh-6302017xq28k.htm

MOH Reports Second Quarter 2017 Results
Page 1
August 2, 2017

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News Release

Contact:
Juan José Orellana
Investor Relations
562-435-3666, ext. 111143


MOLINA HEALTHCARE ANNOUNCES SECOND QUARTER RESULTS AND RESTRUCTURING PLAN

Net loss of $230 million for the quarter, or $4.10 per diluted share.
Restructuring plan now underway is expected to reduce annualized run-rate expenses by $300 million to $400 million upon completion in 2018.
$200 million total reduction to annualized run-rate expenses resulting from staff reductions expected to be achieved by the end of 2017 in time for full realization in 2018.
Annualized salary eliminations of $55 million achieved so far in the third quarter of 2017.
Direct delivery operations will be restructured during the second half of 2017.
2018 Marketplace participation to be terminated in Utah and Wisconsin; additional states in review.
2017 earnings per share guidance withdrawn.

Long Beach, California (August 2, 2017) - Molina Healthcare, Inc. (NYSE: MOH) today reported its financial results for the second quarter of 2017.
“We are disappointed with our bottom-line results for this quarter and have taken aggressive and urgent steps to substantially improve our financial performance going forward,” said Joseph White, chief financial officer and interim president and chief executive officer of Molina Healthcare, Inc. “Following a thorough review of our business operations, we have begun to implement a Company-wide restructuring plan that we expect will reduce annualized run-rate expenses by between $300 million and $400 million by late 2018 when fully implemented, with approximately $200 million of these run-rate reductions expected to be achieved by the end of 2017 and in time for full realization in 2018. In the past, we have been focused on top line growth, often at the expense of bottom line results. While we expect to enjoy continued RFP and organic growth in our Medicaid managed care business, we are now intensively focused on improved operating performance and efficiency as the path to greater profitability and shareholder returns.”

Second Quarter 2017 Compared with Second Quarter 2016
Net loss per diluted share was $4.10 in the second quarter of 2017 compared with net income per diluted share of $0.58 reported for the second quarter of 2016. Loss before income tax benefit for the second quarter of 2017 was $314 million.
Certain significant items increased loss before income tax benefit in the second quarter of 2017 by approximately $330 million. Specifically:
We recorded $72 million in non-cash impairment losses for goodwill and intangibles, primarily relating to our Pathways subsidiary. In the course of developing our restructuring and profitability

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MOH Reports Second Quarter 2017 Results
Page 2
August 2, 2017

improvement plan, we determined that future benefits to be derived from Pathways (including integration with our health plans) will be less than previously anticipated. While such impairment losses have a short-term impact on profitability, there is no impact to our cash flows. Pathways experienced operating losses of $8 million for the quarter ended June 30, 2017 and $12 million for the six months ended June 30, 2017.
Medical care costs related to 2016 service dates were significantly in excess of what the Company usually experiences for out-of-period claims development, particularly at the Florida, Illinois, New Mexico, and Puerto Rico health plans. In total, we experienced out-of-period claims development that was approximately $85 million higher than expected at December 31, 2016.
We recorded $44 million for Marketplace changes in estimates, including risk transfer and cost sharing subsidies, related to 2016 service dates. Liabilities for risk transfer payments and cost sharing subsidies that were estimated at December 31, 2016 were finalized during the second quarter of 2017.
Loss before income tax benefit increased by $78 million as a result of an increase to the premium deficiency reserve established for the Marketplace program. The reserve, which was $22 million at March 31, 2017, increased to $100 million as of June 30, 2017. Based upon revenue and cost trends observed in the second quarter of 2017, we now believe that Marketplace performance in the second half of 2017 will fall substantially short of previous expectations. Marketplace performance has been most disappointing in Florida, Utah, Washington, and Wisconsin.
We recorded $43 million in restructuring and separation costs in the second quarter of 2017 related primarily to contractually required termination benefits paid to our former chief executive officer and chief financial officer. Also included in these costs are consulting fees incurred for the development and implementation of our corporate restructuring initiatives.
In addition to the items noted above, ongoing poor performance at our Florida, Illinois, New Mexico and Puerto Rico health plans in 2017 all contributed to our disappointing financial performance in the second quarter of 2017.

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MOH Reports Second Quarter 2017 Results
Page 3
August 2, 2017

The table below summarizes the impact of these significant items on the Company’s financial performance.
Summary of Significant Items Affecting 2017 Financial Results
 
Three Months Ended
 
Six Months Ended
 
June 30, 2017
 
June 30, 2017
 
(In millions, except per diluted share amounts)
 
Amount
 
Per Diluted Share (1)
 
Amount
 
Per Diluted Share (1)
Impairment losses
$
72

 
$
1.01

 
$
72

 
$
1.02

Losses at behavioral health subsidiary exclusive of impairment
8

 
0.09

 
12

 
0.14

Medical care costs related to prior year service dates that were in excess of historical expectations
85

 
0.95

 
74

 
0.84

Marketplace adjustments related to risk transfer, cost sharing subsidies, and other items for 2016 service dates
44

 
0.49

 
47

 
0.53

Marketplace premium deficiency reserve for 2017 service dates
78

 
0.87

 
70

 
0.79

Restructuring and separation costs
43

 
0.68

 
43

 
0.68

Termination fee received for Terminated Medicare acquisition

 

 
(75
)
 
(0.84
)
 
$
330

 
$
4.09

 
$
243

 
$
3.16

________________________
(1)
Except for certain items that are not deductible for tax purposes, per diluted share amounts are generally calculated at our statutory income tax rate of 37%, which is in excess of the effective tax rate recorded in our consolidated statements of operations.
Income Tax (Benefit) Expense
The effective tax rate benefit for 2017 was less than the statutory tax rate benefit due to the relatively large amount of our reported expenses that are not deductible for tax purposes.
Restructuring and Profit Improvement Plan
As a result of our poor operating performance and catalyzed by our change in management, we accelerated the implementation of a comprehensive restructuring and profitability improvement plan (the Restructuring Plan). Under the Restructuring Plan, we are taking the following actions:
1.
We are streamlining our organizational structure, including the elimination of redundant layers of management, the consolidation of regional support services, and other reductions to our workforce, to improve efficiency as well as the speed and quality of our decision-making.
2.
We are re-designing core operating processes such as provider payment, utilization management, quality monitoring and improvement, and information technology to achieve more effective and cost efficient outcomes.
3.
We are remediating high cost provider contracts and building around high quality, cost-effective networks.
4.
We are restructuring our existing direct delivery operations.
5.
We are reviewing our vendor base to ensure that we are partnering with the lowest-cost, most-effective vendors.
6.
Throughout this process, we are taking precautions to ensure that our actions do not impede our ability to continue to deliver quality health care, retain existing managed care contracts, and to secure new managed care contracts.
In total, we estimate that the Restructuring Plan will reduce annualized run-rate expenses by approximately $300 million to $400 million upon its completion in late 2018. $200 million of these run-rate reductions, which

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MOH Reports Second Quarter 2017 Results
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are a result of staff reductions, will be in place by December 2017, and therefore will fully contribute to our 2018 results. Since the close of the second quarter, we have already achieved $55 million of our annualized run-rate reduction target as a result of staff reductions taken on July 27th. All savings targets discussed in regards to the Restructuring Plan represent annualized run-rate savings that we expect to achieve during the year following the indicated implementation date. One-time costs associated with the Restructuring Plan are expected to exceed the benefits realized in 2017 due to the upfront payment of implementation costs and the delayed benefit of full savings until the beginning of 2018.
We estimate that total pre-tax costs associated with the Restructuring Plan will be approximately $130 million to $150 million for the second half of 2017, with an additional $40 million to be incurred in 2018.
As part of the Restructuring Plan, we are reducing our corporate and health plans workforce by approximately 10%, or 1,500 full-time-equivalent employees. This workforce rightsizing, which represents 7% of the total number of our employees, is expected to be completed by the end of 2017. Affected employees will be offered severance and outplacement assistance.
“This reduction in our workforce is a difficult, but necessary, step as we concentrate our efforts on achieving operational excellence and improved efficiency. By transforming the entire enterprise into a leaner, more streamlined organization, we can enhance our decision-making, improve our operating performance, and grow our margins,” said Mr. White.
Actions Taken to Remediate 2018 Marketplace Performance
In addition to the Restructuring Plan, we are taking these further steps to improve profitability in 2018:
1.
We are exiting the Utah and Wisconsin ACA Marketplaces effective December 31, 2017. For the three months ended June 30, 2017, these two health plans reported a total of $127 million in Marketplace premium revenue (16% of consolidated Marketplace premium revenue), and a combined Marketplace medical care ratio of 128%.
2.
In our remaining Marketplace plans, we are increasing 2018 premiums by 55%. The increase takes into account the absence of cost sharing reduction subsidies. Had we assumed that cost sharing reduction subsidies would be funded for 2018, the premium increase would have been 30%.
3.
We are also reducing the scope of our 2018 participation in the Washington Marketplace.
4.
We continue to closely monitor the current political and programmatic developments pertaining to our 2018 participation in other Marketplace states, and subject to those developments, will withdraw from 2018 participation as may be necessary.
Withdrawing 2017 Outlook
We are withdrawing our previously issued 2017 full-year earnings per diluted share and adjusted earnings per diluted share guidance. Among the reasons for withdrawing guidance are:
Our results for the quarter ended June 30, 2017.
Uncertain medical cost trends in the Florida, Illinois, New Mexico, and Puerto Rico health plans.
Uncertainty around the funding of Marketplace cost sharing subsidies.
Potential variability in the timing of benefits achieved and costs incurred as a result of the Restructuring Plan.
Update on Search for Permanent Chief Executive Officer
Our search for a permanent chief executive officer is well underway and we are encouraged by the response.
Conference Call
Management will host a conference call and webcast to discuss Molina Healthcare’s second quarter results at 5:00 p.m. Eastern time on Wednesday, August 2, 2017. The number to call for the interactive teleconference is (212) 231-2909. A telephonic replay of the conference call will be available from 7:00 p.m. Eastern time on Wednesday, August 2, 2017, through 6:00 p.m. Eastern Time on Thursday, August 3, 2017, by dialing (800) 633-8284 and entering confirmation number 21855049. A live audio broadcast of Molina Healthcare’s

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MOH Reports Second Quarter 2017 Results
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August 2, 2017

conference call will be available on our website, molinahealthcare.com. A 30-day online replay will be available approximately an hour following the conclusion of the live broadcast.
About Molina Healthcare
Molina Healthcare, Inc., a FORTUNE 500 company, provides managed health care services under the Medicaid and Medicare programs and through the state insurance marketplaces. Through our health plans operating in 12 states across the nation and in the Commonwealth of Puerto Rico, Molina currently serves approximately 4.7 million members. Dr. C. David Molina founded our company in 1980 to serve low-income families in Southern California. Today, we continue his mission of providing high quality and cost-effective health care to those who need it most. For more information about Molina Healthcare, please visit our website at molinahealthcare.com.

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MOH Reports Second Quarter 2017 Results
Page 6
August 2, 2017

Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995: This earnings release contains “forward-looking statements” regarding our plans, expectations, and anticipated future events. Actual results could differ materially due to numerous known and unknown risks and uncertainties. Those known risks and uncertainties include, but are not limited to, the following:
the success of the Restructuring Plan, including the timing of the benefits realized;
the numerous political and market-based uncertainties associated with the Affordable Care Act (the “ACA”) or “Obamacare,” including any potential repeal and replacement of the law, amendment of the law, or move to state block grants for Medicaid;
the market dynamics surrounding the ACA Marketplaces, including but not limited to uncertainties associated with risk transfer requirements, the potential for disproportionate enrollment of higher acuity members, the withdrawal of cost sharing subsidies and/or premium tax credits, the adequacy of agreed rates, and potential disruption associated with market withdrawal;
subsequent adjustments to reported premium revenue based upon subsequent developments or new information, including changes to estimated amounts payable or receivable related to Marketplace risk adjustment/risk transfer, risk corridors, and reinsurance;
effective management of our medical costs;
our ability to predict with a reasonable degree of accuracy utilization rates, including utilization rates associated with seasonal flu patterns or other newly emergent diseases;
significant budget pressures on state governments and their potential inability to maintain current rates, to implement expected rate increases, or to maintain existing benefit packages or membership eligibility thresholds or criteria, including the payment of all amounts due to our Illinois health plan following the resolution of the Illinois budget impasse;
the success of our efforts to retain existing government contracts, including those in Florida, Illinois, New Mexico, Puerto Rico, and Texas, and to obtain new government contracts in connection with state requests for proposals (RFPs) in both existing and new states;
any adverse impact resulting from the significant changes to our executive leadership team and the rightsizing of our workforce;
the impact of our decision to exit the Utah and Wisconsin ACA Marketplace markets effective December 31, 2017;
our ability to manage our operations, including maintaining and creating adequate internal systems and controls relating to authorizations, approvals, provider payments, and the overall success of our care management initiatives;
our ability to consummate and realize benefits from acquisitions or divestitures;
our receipt of adequate premium rates to support increasing pharmacy costs, including costs associated with specialty drugs and costs resulting from formulary changes that allow the option of higher-priced non-generic drugs;
our ability to operate profitably in an environment where the trend in premium rate increases lags behind the trend in increasing medical costs;
the interpretation and implementation of federal or state medical cost expenditure floors, administrative cost and profit ceilings, premium stabilization programs, profit sharing arrangements, and risk adjustment provisions;
our estimates of amounts owed for such cost expenditure floors, administrative cost and profit ceilings, premium stabilization programs, profit-sharing arrangements, and risk adjustment provisions;
the Medicaid expansion cost corridors in California, New Mexico, and Washington, and any other retroactive adjustment to revenue where methodologies and procedures are subject to interpretation or dependent upon information about the health status of participants other than Molina members;
the interpretation and implementation of at-risk premium rules and state contract performance requirements regarding the achievement of certain quality measures, and our ability to recognize revenue amounts associated therewith;
cyber-attacks or other privacy or data security incidents resulting in an inadvertent unauthorized disclosure of protected health information;
the success of our health plan in Puerto Rico, including the resolution of the Puerto Rico debt crisis, payment of all amounts due under our Medicaid contract, the effect of the PROMESA law, and our efforts to better manage the health care costs of our Puerto Rico health plan;

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MOH Reports Second Quarter 2017 Results
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August 2, 2017

the success and renewal of our duals demonstration programs in California, Illinois, Michigan, Ohio, South Carolina, and Texas;
the accurate estimation of incurred but not reported or paid medical costs across our health plans;
efforts by states to recoup previously paid and recognized premium amounts;
the continuation and renewal of the government contracts of our health plans, Molina Medicaid Solutions, and Pathways, and the terms under which such contracts are renewed;
complications, member confusion, or enrollment backlogs related to the annual renewal of Medicaid coverage;
government audits and reviews, or potential investigations, and any fine, sanction, enrollment freeze, monitoring program, or premium recovery that may result therefrom, including any potential demand by the state of New Mexico to recover purportedly underpaid premium taxes;
changes with respect to our provider contracts and the loss of providers;
approval by state regulators of dividends and distributions by our health plan subsidiaries;
changes in funding under our contracts as a result of regulatory changes, programmatic adjustments, or other reforms;
high dollar claims related to catastrophic illness;
the favorable resolution of litigation, arbitration, or administrative proceedings;
the relatively small number of states in which we operate health plans;
the availability of adequate financing on acceptable terms to fund and capitalize our expansion and growth, repay our outstanding indebtedness at maturity and meet our liquidity needs, including the interest expense and other costs associated with such financing;
our failure to comply with the financial or other covenants in our credit agreement or the indentures governing our outstanding notes;
the sufficiency of our funds on hand to pay the amounts due upon conversion or maturity of our outstanding notes;
the failure of a state in which we operate to renew its federal Medicaid waiver;
changes generally affecting the managed care or Medicaid management information systems industries;
increases in government surcharges, taxes, and assessments, including but not limited to the deductibility of certain compensation costs;
newly emergent viruses or widespread epidemics, public catastrophes or terrorist attacks, and associated public alarm;
increasing competition and consolidation in the Medicaid industry;
and numerous other risk factors, including those discussed in our periodic reports and filings with the Securities and Exchange Commission. These reports can be accessed under the investor relations tab of our website or on the SEC’s website at sec.gov. Given these risks and uncertainties, we can give no assurances that our forward-looking statements will prove to be accurate, or that any other results or events projected or contemplated by our forward-looking statements will in fact occur, and we caution investors not to place undue reliance on these statements. All forward-looking statements in this release represent our judgment as of August 2, 2017, and we disclaim any obligation to update any forward-looking statements to conform the statement to actual results or changes in our expectations.



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MOH Reports Second Quarter 2017 Results
Page 8
August 2, 2017

MOLINA HEALTHCARE, INC.
UNAUDITED CONSOLIDATED STATEMENTS OF OPERATIONS
 
Three Months Ended June 30,
 
Six Months Ended June 30,
 
2017
 
2016
 
2017
 
2016
 
(Dollar amounts in millions, except per-share amounts)
Revenue:
 
 
 
 
 
 
 
Premium revenue
$
4,740

 
$
4,029

 
$
9,388

 
$
8,024

Service revenue
129

 
135

 
260

 
275

Premium tax revenue
114

 
109

 
225

 
218

Health insurer fee revenue

 
76

 

 
166

Investment income and other revenue
16

 
10

 
30

 
19

Total revenue
4,999

 
4,359

 
9,903

 
8,702

Operating expenses:
 
 
 
 
 
 
 
Medical care costs
4,491

 
3,594

 
8,602

 
7,182

Cost of service revenue
124

 
116

 
246

 
243

General and administrative expenses
405

 
351

 
844

 
691

Premium tax expenses
114

 
109

 
225

 
218

Health insurer fee expenses

 
50

 

 
108

Depreciation and amortization
37

 
34

 
76

 
66

Impairment losses
72

 

 
72

 

Restructuring and separation costs
43

 

 
43

 

Total operating expenses
5,286

 
4,254

 
10,108

 
8,508

Operating (loss) income
(287
)
 
105

 
(205
)
 
194

Other expenses (income), net:
 
 
 
 
 
 
 
Interest expense
27

 
25

 
53

 
50

Other income, net

 

 
(75
)
 

Total other expenses (income), net
27

 
25

 
(22
)
 
50

(Loss) income before income tax (benefit) expense
(314
)
 
80

 
(183
)
 
144

Income tax (benefit) expense
(84
)
 
47

 
(30
)
 
87

Net (loss) income
$
(230
)
 
$
33

 
$
(153
)
 
$
57

 
 
 
 
 
 
 
 
Net (loss) income per diluted share
$
(4.10
)
 
$
0.58

 
$
(2.74
)
 
$
1.01

 
 
 
 
 
 
 
 
Diluted weighted average shares outstanding
56.2

 
55.5

 
56.1

 
56.3

 
 
 
 
 
 
 
 
Operating Statistics:
 
 
 
 
 
 
 
Medical care ratio (1)
94.8
 %
 
89.2
%
 
91.6
 %
 
89.5
%
G&A ratio (2)
8.1
 %
 
8.1
%
 
8.5
 %
 
7.9
%
Premium tax ratio (1)
2.4
 %
 
2.6
%
 
2.3
 %
 
2.6
%
Effective tax rate
26.8
 %
 
59.8
%
 
16.0
 %
 
60.7
%
Net profit margin (2)
(4.6
)%
 
0.7
%
 
(1.5
)%
 
0.7
%
__________________
(1)
Medical care ratio represents medical care costs as a percentage of premium revenue; premium tax ratio represents premium tax expenses as a percentage of premium revenue plus premium tax revenue.
(2)
G&A ratio represents general and administrative expenses as a percentage of total revenue. Net profit margin represents net (loss) income as a percentage of total revenue.

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MOH Reports Second Quarter 2017 Results
Page 9
August 2, 2017

MOLINA HEALTHCARE, INC.
UNAUDITED CONSOLIDATED BALANCE SHEETS
 
June 30,
 
December 31,
 
2017
 
2016
 
(In millions,
except per-share data)
ASSETS
Current assets:
 
 
 
Cash and cash equivalents
$
2,979

 
$
2,819

Investments
2,192

 
1,758

Restricted investments
325

 

Receivables
1,006

 
974

Income taxes refundable
68

 
39

Prepaid expenses and other current assets
159

 
131

Derivative asset
440

 
267

Total current assets
7,169

 
5,988

Property, equipment, and capitalized software, net
449

 
454

Deferred contract costs
93

 
86

Intangible assets, net
112

 
140

Goodwill
559

 
620

Restricted investments
118

 
110

Deferred income taxes
36

 
10

Other assets
47

 
41

 
$
8,583

 
$
7,449

LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
 
 
 
Medical claims and benefits payable
$
2,077

 
$
1,929

Amounts due government agencies
1,844

 
1,202

Accounts payable and accrued liabilities
375

 
385

Deferred revenue
284

 
315

Current portion of long-term debt
773

 
472

Derivative liability
440

 
267

Total current liabilities
5,793

 
4,570

Senior notes
1,017

 
975

Lease financing obligations
198

 
198

Deferred income taxes

 
15

Other long-term liabilities
54

 
42

Total liabilities
7,062

 
5,800

Stockholders’ equity:
 
 
 
Common stock, $0.001 par value; 150 shares authorized; outstanding: 57 shares at June 30, 2017 and December 31, 2016

 

Preferred stock, $0.001 par value; 20 shares authorized, no shares issued and outstanding

 

Additional paid-in capital
865

 
841

Accumulated other comprehensive loss
(1
)
 
(2
)
Retained earnings
657

 
810

Total stockholders’ equity
1,521

 
1,649

 
$
8,583

 
$
7,449


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MOH Reports Second Quarter 2017 Results
Page 10
August 2, 2017

MOLINA HEALTHCARE, INC.
UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
 
Three Months Ended June 30,
 
Six Months Ended June 30,
 
2017
 
2016
 
2017
 
2016
 
(In millions)
Operating activities:
 
 
 
 
 
 
 
Net (loss) income
$
(230
)
 
$
33

 
$
(153
)
 
$
57

Adjustments to reconcile net (loss) income to net cash (used in) provided by operating activities:
 
 
 
 
 
 
 
Depreciation and amortization
47

 
45

 
96

 
89

Impairment losses
72

 

 
72

 

Deferred income taxes
(36
)
 
9

 
(41
)
 
39

Share-based compensation, including accelerated share-based compensation
29

 
9

 
35

 
16

Amortization of convertible senior notes and lease financing obligations
8

 
7

 
16

 
15

Other, net
4

 
5

 
7

 
11

Changes in operating assets and liabilities:
 
 
 
 
 
 
 
Receivables

 
(149
)
 
(32
)
 
(415
)
Prepaid expenses and other assets
(26
)
 
59

 
(38
)
 
(143
)
Medical claims and benefits payable
151

 
(173
)
 
148

 
82

Amounts due government agencies
269

 
328

 
642

 
509

Accounts payable and accrued liabilities
(68
)
 
(58
)
 
(18
)
 
147

Deferred revenue
(178
)
 
10

 
(32
)
 
(119
)
Income taxes
(89
)
 
14

 
(30
)
 
(10
)
Net cash (used in) provided by operating activities
(47
)
 
139

 
672

 
278

Investing activities:
 
 
 
 
 
 
 
Purchases of investments
(903
)
 
(363
)
 
(1,636
)
 
(974
)
Proceeds from sales and maturities of investments
441

 
464

 
874

 
812

Purchases of property, equipment, and capitalized software
(34
)
 
(56
)
 
(60
)
 
(102
)
(Increase) decrease in restricted investments held-to-maturity
(3
)
 
9

 
(10
)
 
5

Net cash paid in business combinations

 
(6
)
 

 
(8
)
Other, net
(7
)
 
(7
)
 
(13
)
 
(6
)
Net cash (used in) provided by investing activities
(506
)
 
41

 
(845
)
 
(273
)
Financing activities:
 
 
 
 
 
 
 
Proceeds from senior notes offerings, net of issuance costs
325

 

 
325

 

Proceeds from employee stock plans
10

 
10

 
11

 
10

Other, net
(1
)
 
(1
)
 
(3
)
 
1

Net cash provided by financing activities
334

 
9

 
333

 
11

Net (decrease) increase in cash and cash equivalents
(219
)
 
189

 
160

 
16

Cash and cash equivalents at beginning of period
3,198

 
2,156

 
2,819

 
2,329

Cash and cash equivalents at end of period
$
2,979

 
$
2,345

 
$
2,979

 
$
2,345


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MOH Reports Second Quarter 2017 Results
Page 11
August 2, 2017

MOLINA HEALTHCARE, INC.
UNAUDITED HEALTH PLANS SEGMENT MEMBERSHIP
 
June 30,
2017
 
December 31, 2016
 
June 30,
2016
Ending Membership by Program:
 
 
 
 
 
Temporary Assistance for Needy Families (TANF) and Children’s Health Insurance Program (CHIP)
2,517,000

 
2,536,000

 
2,500,000

Marketplace
949,000

 
526,000

 
597,000

Medicaid Expansion
678,000

 
673,000

 
654,000

Aged, Blind or Disabled (ABD)
408,000

 
396,000

 
387,000

Medicare-Medicaid Plan (MMP) - Integrated
54,000

 
51,000

 
51,000

Medicare Special Needs Plans
44,000

 
45,000

 
44,000

 
4,650,000

 
4,227,000

 
4,233,000

Ending Membership by Health Plan:
 
 
 
 
 
California
766,000

 
683,000

 
680,000

Florida
672,000

 
553,000

 
565,000

Illinois
163,000

 
195,000

 
201,000

Michigan
414,000

 
391,000

 
393,000

New Mexico
266,000

 
254,000

 
251,000

New York (1)
34,000

 
35,000

 

Ohio
351,000

 
332,000

 
341,000

Puerto Rico
322,000

 
330,000

 
336,000

South Carolina
112,000

 
109,000

 
105,000

Texas
465,000

 
337,000

 
367,000

Utah
167,000

 
146,000

 
151,000

Washington
788,000

 
736,000

 
709,000

Wisconsin
130,000

 
126,000

 
134,000

 
4,650,000

 
4,227,000

 
4,233,000

_______________________
(1)
The New York health plan was acquired on August 1, 2016.






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MOH Reports Second Quarter 2017 Results
Page 12
August 2, 2017

MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA
(In millions, except percentages and per-member per-month amounts)
 
Three Months Ended June 30, 2017
 
Member
Months (1)
 
Premium Revenue
 
Medical Care Costs
 
MCR (2)
 
Medical Margin
 
 
Total
 
PMPM
 
Total
 
PMPM
 
 
TANF and CHIP
7.6

 
$
1,391

 
$
182.47

 
$
1,315

 
$
172.48

 
94.5
%
 
$
76

Medicaid Expansion
2.1

 
786

 
383.07

 
689

 
335.26

 
87.5

 
97

ABD
1.2

 
1,285

 
1,053.89

 
1,245

 
1,020.85

 
96.9

 
40

Total Medicaid
10.9

 
3,462

 
317.79

 
3,249

 
298.10

 
93.8

 
213

MMP
0.1

 
361

 
2,217.44

 
333

 
2,050.20

 
92.5

 
28

Medicare
0.2

 
148

 
1,126.14

 
126

 
963.34

 
85.5

 
22

Total Medicare
0.3

 
509

 
1,730.91

 
459

 
1,565.65

 
90.5

 
50

Excluding Marketplace
11.2

 
3,971

 
354.87

 
3,708

 
331.36

 
93.4

 
263

Marketplace
2.8

 
769

 
267.37

 
783

 
272.37

 
101.9

 
(14
)
 
14.0

 
$
4,740

 
$
336.98

 
$
4,491

 
$
319.29

 
94.8
%
 
$
249


 
Three Months Ended June 30, 2016
 
Member
Months (1)
 
Premium Revenue
 
Medical Care Costs
 
MCR (2)
 
Medical Margin
 
 
Total
 
PMPM
 
Total
 
PMPM
 
 
TANF and CHIP
7.5

 
$
1,302

 
$
173.57

 
$
1,202

 
$
160.26

 
92.3
%
 
$
100

Medicaid Expansion
1.9

 
742

 
378.19

 
634

 
323.56

 
85.6

 
108

ABD
1.2

 
1,168

 
991.38

 
1,038

 
881.80

 
88.9

 
130

Total Medicaid
10.6

 
3,212

 
301.86

 
2,874

 
270.27

 
89.5

 
338

MMP
0.2

 
315

 
2,093.29

 
270

 
1,792.78

 
85.6

 
45

Medicare
0.2

 
129

 
997.44

 
127

 
974.30

 
97.7

 
2

Total Medicare
0.4

 
444

 
1,584.77

 
397

 
1,412.96

 
89.2

 
47

Excluding Marketplace
11.0

 
3,656

 
334.86

 
3,271

 
299.67

 
89.5

 
385

Marketplace
1.8

 
373

 
206.88

 
323

 
178.79

 
86.4

 
50

 
12.8

 
$
4,029

 
$
316.72

 
$
3,594

 
$
282.54

 
89.2
%
 
$
435

______________________
(1)
A member month is defined as the aggregate of each month’s ending membership for the period presented.
(2)
The MCR represents medical costs as a percentage of premium revenue.




-MORE-


MOH Reports Second Quarter 2017 Results
Page 13
August 2, 2017

MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA
(In millions, except percentages and per-member per-month amounts)

 
Six Months Ended June 30, 2017
 
Member
Months (1)
 
Premium Revenue
 
Medical Care Costs
 
MCR (2)
 
Medical Margin
 
 
Total
 
PMPM
 
Total
 
PMPM
 
 
TANF and CHIP
15.3

 
$
2,793

 
$
182.58

 
$
2,619

 
$
171.25

 
93.8
%
 
$
174

Medicaid Expansion
4.1

 
1,603

 
390.88

 
1,378

 
335.88

 
85.9

 
225

ABD
2.4

 
2,481

 
1,030.68

 
2,375

 
986.54

 
95.7

 
106

Total Medicaid
21.8

 
6,877

 
315.39

 
6,372

 
292.22

 
92.7

 
505

MMP
0.3

 
705

 
2,152.75

 
640

 
1,954.15

 
90.8

 
65

Medicare
0.3

 
286

 
1,097.36

 
243

 
933.20

 
85.0

 
43

Total Medicare
0.6

 
991

 
1,685.72

 
883

 
1,502.36

 
89.1

 
108

Excluding Marketplace
22.4

 
7,868

 
351.35

 
7,255

 
323.98

 
92.2

 
613

Marketplace
5.7

 
1,520

 
264.77

 
1,347

 
234.62

 
88.6

 
173

 
28.1

 
$
9,388

 
$
333.68

 
$
8,602

 
$
305.74

 
91.6
%
 
$
786


 
Six Months Ended June 30, 2016
 
Member
Months (1)
 
Premium Revenue
 
Medical Care Costs
 
MCR (2)
 
Medical Margin
 
 
Total
 
PMPM
 
Total
 
PMPM
 
 
TANF and CHIP
14.9

 
$
2,626

 
$
176.00

 
$
2,400

 
$
160.85

 
91.4
%
 
$
226

Medicaid Expansion
3.8

 
1,421

 
371.82

 
1,208

 
316.13

 
85.0

 
213

ABD
2.4

 
2,280

 
976.58

 
2,079

 
890.71

 
91.2

 
201

Total Medicaid
21.1

 
6,327

 
300.19

 
5,687

 
269.86

 
89.9

 
640

MMP
0.3

 
655

 
2,157.55

 
587

 
1,932.73

 
89.6

 
68

Medicare
0.3

 
260

 
1,013.04

 
251

 
977.35

 
96.5

 
9

Total Medicare
0.6

 
915

 
1,633.08

 
838

 
1,494.92

 
91.5

 
77

Excluding Marketplace
21.7

 
7,242

 
334.74

 
6,525

 
301.61

 
90.1

 
717

Marketplace
3.4

 
782

 
228.19

 
657

 
191.62

 
84.0

 
125

 
25.1

 
$
8,024

 
$
320.17

 
$
7,182

 
$
286.57

 
89.5
%
 
$
842

______________________
(1)
A member month is defined as the aggregate of each month’s ending membership for the period presented.
(2)
The MCR represents medical costs as a percentage of premium revenue.


-MORE-


MOH Reports Second Quarter 2017 Results
Page 14
August 2, 2017


MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA—NON-MARKETPLACE
(In millions, except percentages and per-member per-month amounts)
 
Three Months Ended June 30, 2017
 
Member
Months (1)
 
Premium Revenue
 
Medical Care Costs
 
MCR (2)
 
Medical Margin
 
 
Total
 
PMPM
 
Total
 
PMPM
 
 
California
1.9

 
$
598

 
$
318.89

 
$
539

 
$
287.36

 
90.1
%
 
$
59

Florida
1.1

 
380

 
347.20

 
370

 
337.92

 
97.3

 
10

Illinois
0.5

 
149

 
289.51

 
174

 
336.76

 
116.3

 
(25
)
Michigan
1.1

 
390

 
333.26

 
358

 
305.40

 
91.6

 
32

New Mexico
0.8

 
321

 
443.13

 
311

 
428.58

 
96.7

 
10

New York (3)
0.1

 
46

 
457.96

 
45

 
442.16

 
96.5

 
1

Ohio
1.0

 
529

 
536.90

 
489

 
496.41

 
92.5

 
40

Puerto Rico
0.9

 
179

 
184.28

 
189

 
194.42

 
105.5

 
(10
)
South Carolina
0.4

 
111

 
326.57

 
102

 
304.14

 
93.1

 
9

Texas
0.7

 
524

 
752.01

 
473

 
679.43

 
90.3

 
51

Utah
0.3

 
89

 
313.93

 
76

 
267.15

 
85.1

 
13

Washington
2.2

 
618

 
276.90

 
546

 
244.58

 
88.3

 
72

Wisconsin
0.2

 
34

 
170.98

 
26

 
130.54

 
76.3

 
8

Other (4)

 
3

 

 
10

 

 

 
(7
)
 
11.2

 
$
3,971

 
$
354.87

 
$
3,708

 
$
331.36

 
93.4
%
 
$
263

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Three Months Ended June 30, 2016
 
Member
Months (1)
 
Premium Revenue
 
Medical Care Costs
 
MCR (2)
 
Medical Margin
 
Total
 
PMPM
 
Total
 
PMPM
 
 
California
1.9

 
$
519

 
$
281.99

 
$
472

 
$
256.37

 
90.9
%
 
$
47

Florida
1.0

 
314

 
312.23

 
289

 
287.84

 
92.2

 
25

Illinois
0.6

 
154

 
256.17

 
137

 
227.71

 
88.9

 
17

Michigan
1.2

 
366

 
312.88

 
332

 
283.89

 
90.7

 
34

New Mexico
0.7

 
328

 
468.35

 
296

 
422.37

 
90.2

 
32

New York (3)

 

 

 

 

 

 

Ohio
0.9

 
474

 
479.41

 
427

 
431.46

 
90.0

 
47

Puerto Rico
1.0

 
170

 
169.04

 
175

 
173.49

 
102.6

 
(5
)
South Carolina
0.3

 
87

 
277.22

 
71

 
226.27

 
81.6

 
16

Texas
0.8

 
580

 
784.32

 
470

 
633.94

 
80.8

 
110

Utah
0.3

 
86

 
293.39

 
74

 
254.59

 
86.8

 
12

Washington
2.1

 
538

 
263.41

 
484

 
237.43

 
90.1

 
54

Wisconsin
0.2

 
36

 
166.95

 
27

 
120.69

 
72.3

 
9

Other (4)

 
4

 

 
17

 

 

 
(13
)
 
11.0

 
$
3,656

 
$
334.86

 
$
3,271

 
$
299.67

 
89.5
%
 
$
385

__________________
(1)
A member month is defined as the aggregate of each month’s ending membership for the period presented.
(2)
The MCR represents medical costs as a percentage of premium revenue.
(3)
The New York health plan was acquired on August 1, 2016.
(4)
“Other” medical care costs include primarily medically related administrative costs at the parent company, and direct delivery costs.

-MORE-


MOH Reports Second Quarter 2017 Results
Page 15
August 2, 2017


MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA—NON-MARKETPLACE
(In millions, except percentages and per-member per-month amounts)
 
Six Months Ended June 30, 2017
 
Member
Months (1)
 
Premium Revenue
 
Medical Care Costs
 
MCR (2)
 
Medical Margin
 
 
Total
 
PMPM
 
Total
 
PMPM
 
 
California
3.7

 
$
1,170

 
$
313.76

 
$
1,023

 
$
274.42

 
87.5
%
 
$
147

Florida
2.2

 
744

 
343.29

 
722

 
333.23

 
97.1

 
22

Illinois
1.1

 
310

 
282.66

 
354

 
322.63

 
114.1

 
(44
)
Michigan
2.3

 
772

 
330.34

 
690

 
295.02

 
89.3

 
82

New Mexico
1.5

 
629

 
432.98

 
610

 
419.65

 
96.9

 
19

New York (3)
0.2

 
92

 
449.48

 
87

 
425.72

 
94.7

 
5

Ohio
2.0

 
1,049

 
532.35

 
951

 
482.73

 
90.7

 
98

Puerto Rico
1.9

 
362

 
185.40

 
354

 
181.24

 
97.8

 
8

South Carolina
0.7

 
216

 
321.85

 
200

 
298.79

 
92.8

 
16

Texas
1.4

 
1,051

 
751.94

 
962

 
687.96

 
91.5

 
89

Utah
0.6

 
178

 
313.56

 
148

 
260.43

 
83.1

 
30

Washington
4.4

 
1,223

 
275.05

 
1,081

 
243.18

 
88.4

 
142

Wisconsin
0.4

 
67

 
168.16

 
53

 
133.25

 
79.2

 
14

Other (4)

 
5

 

 
20

 

 

 
(15
)
 
22.4

 
$
7,868

 
$
351.35

 
$
7,255

 
$
323.98

 
92.2
%
 
$
613

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Six Months Ended June 30, 2016
 
Member
Months (1)
 
Premium Revenue
 
Medical Care Costs
 
MCR (2)
 
Medical Margin
 
Total
 
PMPM
 
Total
 
PMPM
 
 
California
3.7

 
$
1,028

 
$
281.37

 
$
918

 
$
251.15

 
89.3
%
 
$
110

Florida
2.0

 
639

 
322.01

 
575

 
290.08

 
90.1

 
64

Illinois
1.2

 
303

 
261.43

 
269

 
232.06

 
88.8

 
34

Michigan
2.4

 
751

 
317.13

 
678

 
286.40

 
90.3

 
73

New Mexico
1.4

 
651

 
465.65

 
580

 
414.80

 
89.1

 
71

New York (3)

 

 

 

 

 

 

Ohio
1.9

 
952

 
485.86

 
869

 
443.08

 
91.2

 
83

Puerto Rico
2.0

 
351

 
172.98

 
349

 
171.95

 
99.4

 
2

South Carolina
0.6

 
171

 
276.61

 
138

 
223.58

 
80.8

 
33

Texas
1.5

 
1,116

 
752.54

 
982

 
661.63

 
87.9

 
134

Utah
0.6

 
172

 
295.69

 
150

 
259.29

 
87.7

 
22

Washington
4.0

 
1,030

 
259.79

 
931

 
234.95

 
90.4

 
99

Wisconsin
0.4

 
72

 
164.90

 
52

 
118.37

 
71.8

 
20

Other (4)

 
6

 

 
34

 

 

 
(28
)
 
21.7

 
$
7,242

 
$
334.74

 
$
6,525

 
$
301.61

 
90.1
%
 
$
717

__________________
(1)
A member month is defined as the aggregate of each month’s ending membership for the period presented.
(2)
The MCR represents medical costs as a percentage of premium revenue.
(3)
The New York health plan was acquired on August 1, 2016.
(4)
“Other” medical care costs include primarily medically related administrative costs at the parent company, and direct delivery costs.

-MORE-


MOH Reports Second Quarter 2017 Results
Page 16
August 2, 2017


MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA—MARKETPLACE
(In millions, except percentages and per-member per-month amounts)
 
Three Months Ended June 30, 2017
 
Member
Months (1)
 
Premium Revenue
 
Medical Care Costs
 
MCR (2)
 
Medical Margin
 
 
Total
 
PMPM
 
Total
 
PMPM
 
 
California
0.5

 
$
81

 
$
186.90

 
$
67

 
$
154.23

 
82.5
%
 
$
14

Florida
0.9

 
269

 
284.60

 
317

 
336.78

 
118.3

 
(48
)
Michigan
0.1

 
16

 
204.15

 
10

 
135.89

 
66.6

 
6

New Mexico

 
31

 
367.98

 
23

 
266.91

 
72.5

 
8

Ohio

 
24

 
377.94

 
27

 
404.20

 
106.9

 
(3
)
Texas
0.7

 
177

 
247.49

 
129

 
180.92

 
73.1

 
48

Utah
0.2

 
41

 
186.87

 
53

 
239.50

 
128.2

 
(12
)
Washington
0.2

 
44

 
317.42

 
49

 
359.87

 
113.4

 
(5
)
Wisconsin
0.2

 
86

 
434.01

 
109

 
550.81

 
126.9

 
(23
)
Other (3)

 

 

 
(1
)
 

 

 
1

 
2.8

 
$
769

 
$
267.37

 
$
783

 
$
272.37

 
101.9
%
 
$
(14
)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Three Months Ended June 30, 2016
 
Member
Months (1)
 
Premium Revenue
 
Medical Care Costs
 
MCR (2)
 
Medical Margin
 
Total
 
PMPM
 
Total
 
PMPM
 
 
California
0.1

 
$
35

 
$
159.56

 
$
21

 
$
99.15

 
62.1
%
 
$
14

Florida
0.8

 
150

 
217.96

 
137

 
198.93

 
91.3

 
13

Michigan

 
3

 
235.15

 
2

 
176.34

 
75.0

 
1

New Mexico
0.1

 
14

 
240.40

 
9

 
164.00

 
68.2

 
5

Ohio
0.1

 
9

 
294.90

 
6

 
210.36

 
71.3

 
3

Texas
0.3

 
55

 
146.76

 
29

 
78.56

 
53.5

 
26

Utah
0.2

 
24

 
146.37

 
32

 
195.18

 
133.3

 
(8
)
Washington

 
21

 
291.91

 
16

 
205.59

 
70.4

 
5

Wisconsin
0.2

 
63

 
335.32

 
69

 
369.55

 
110.2

 
(6
)
Other (3)

 
(1
)
 

 
2

 

 

 
(3
)
 
1.8

 
$
373

 
$
206.88

 
$
323

 
$
178.79

 
86.4
%
 
$
50

__________________
(1)
A member month is defined as the aggregate of each month’s ending membership for the period presented.
(2)
The MCR represents medical costs as a percentage of premium revenue.
(3)
“Other” medical care costs include primarily medically related administrative costs at the parent company, and direct delivery costs.

-MORE-


MOH Reports Second Quarter 2017 Results
Page 17
August 2, 2017


MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA—MARKETPLACE
(In millions, except percentages and per-member per-month amounts)
 
Six Months Ended June 30, 2017
 
Member
Months (1)
 
Premium Revenue
 
Medical Care Costs
 
MCR (2)
 
Medical Margin
 
 
Total
 
PMPM
 
Total
 
PMPM
 
 
California
0.9

 
$
153

 
$
185.68

 
$
93

 
$
112.20

 
60.4
%
 
$
60

Florida
1.9

 
561

 
288.81

 
523

 
269.48

 
93.3

 
38

Michigan
0.2

 
27

 
177.12

 
17

 
116.21

 
65.6

 
10

New Mexico
0.1

 
53

 
317.10

 
42

 
249.90

 
78.8

 
11

Ohio
0.1

 
45

 
356.20

 
44

 
339.26

 
95.2

 
1

Texas
1.4

 
334

 
235.07

 
242

 
171.07

 
72.8

 
92

Utah
0.4

 
86

 
194.68

 
104

 
233.85

 
120.1

 
(18
)
Washington
0.3

 
81

 
310.26

 
95

 
362.78

 
116.9

 
(14
)
Wisconsin
0.4

 
180

 
443.86

 
190

 
469.01

 
105.7

 
(10
)
Other (3)

 

 

 
(3
)
 

 

 
3

 
5.7

 
$
1,520

 
$
264.77

 
$
1,347

 
$
234.62

 
88.6
%
 
$
173

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Six Months Ended June 30, 2016
 
Member
Months (1)
 
Premium Revenue
 
Medical Care Costs
 
MCR (2)
 
Medical Margin
 
Total
 
PMPM
 
Total
 
PMPM
 
 
California
0.3

 
$
67

 
$
173.55

 
$
44

 
$
115.80

 
66.7
%
 
$
23

Florida
1.4

 
314

 
230.11

 
264

 
193.24

 
84.0

 
50

Michigan

 
5

 
208.83

 
3

 
141.43

 
67.7

 
2

New Mexico
0.1

 
27

 
251.96

 
21

 
192.53

 
76.4

 
6

Ohio
0.1

 
19

 
330.26

 
13

 
241.55

 
73.1

 
6

Texas
0.7

 
139

 
199.62

 
92

 
132.77

 
66.5

 
47

Utah
0.3

 
52

 
169.84

 
58

 
187.64

 
110.5

 
(6
)
Washington
0.1

 
35

 
267.82

 
27

 
200.50

 
74.9

 
8

Wisconsin
0.4

 
124

 
348.84

 
136

 
382.15

 
109.5

 
(12
)
Other (3)

 

 

 
(1
)
 

 

 
1

 
3.4

 
$
782

 
$
228.19

 
$
657

 
$
191.62

 
84.0
%
 
$
125

__________________
(1)
A member month is defined as the aggregate of each month’s ending membership for the period presented.
(2)
The MCR represents medical costs as a percentage of premium revenue.
(3)
“Other” medical care costs include primarily medically related administrative costs at the parent company, and direct delivery costs.


-MORE-


MOH Reports Second Quarter 2017 Results
Page 18
August 2, 2017


MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA—TOTAL
(In millions, except percentages and per-member per-month amounts)
 
Three Months Ended June 30, 2017
 
Member
Months (1)
 
Premium Revenue
 
Medical Care Costs
 
MCR (2)
 
Medical Margin
 
 
Total
 
PMPM
 
Total
 
PMPM
 
 
California
2.4

 
$
679

 
$
294.09

 
$
606

 
$
262.34

 
89.2
%
 
$
73

Florida
2.0

 
649

 
318.21

 
687

 
337.39

 
106.0

 
(38
)
Illinois
0.5

 
149

 
289.51

 
174

 
336.76

 
116.3

 
(25
)
Michigan
1.2

 
406

 
325.38

 
368

 
295.06

 
90.7

 
38

New Mexico
0.8

 
352

 
435.34

 
334

 
411.83

 
94.6

 
18

New York (3)
0.1

 
46

 
457.96

 
45

 
442.16

 
96.5

 
1

Ohio
1.0

 
553

 
527.14

 
516

 
490.75

 
93.1

 
37

Puerto Rico
0.9

 
179

 
184.28

 
189

 
194.42

 
105.5

 
(10
)
South Carolina
0.4

 
111

 
326.57

 
102

 
304.14

 
93.1

 
9

Texas
1.4

 
701

 
495.93

 
602

 
426.41

 
86.0

 
99

Utah
0.5

 
130

 
258.10

 
129

 
255.00

 
98.8

 
1

Washington
2.4

 
662

 
279.21

 
595

 
251.16

 
90.0

 
67

Wisconsin
0.4

 
120

 
303.59

 
135

 
342.43

 
112.8

 
(15
)
Other (4)

 
3

 

 
9

 

 

 
(6
)
 
14.0

 
$
4,740

 
$
336.98

 
$
4,491

 
$
319.29

 
94.8
%
 
$
249

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Three Months Ended June 30, 2016
 
Member
Months (1)
 
Premium Revenue
 
Medical Care Costs
 
MCR (2)
 
Medical Margin
 
Total
 
PMPM
 
Total
 
PMPM
 
 
California
2.0

 
$
554

 
$
268.95

 
$
493

 
$
239.63

 
89.1
%
 
$
61

Florida
1.8

 
464

 
273.90

 
426

 
251.69

 
91.9

 
38

Illinois
0.6

 
154

 
256.17

 
137

 
227.71

 
88.9

 
17

Michigan
1.2

 
369

 
312.18

 
334

 
282.86

 
90.6

 
35

New Mexico
0.8

 
342

 
451.72

 
305

 
403.52

 
89.3

 
37

New York (3)

 

 

 

 

 

 

Ohio
1.0

 
483

 
473.91

 
433

 
424.87

 
89.7

 
50

Puerto Rico
1.0

 
170

 
169.04

 
175

 
173.49

 
102.6

 
(5
)
South Carolina
0.3

 
87

 
277.22

 
71

 
226.27

 
81.6

 
16

Texas
1.1

 
635

 
571.14

 
499

 
448.23

 
78.5

 
136

Utah
0.5

 
110

 
240.26

 
106

 
233.12

 
97.0

 
4

Washington
2.1

 
559

 
264.40

 
500

 
236.32

 
89.4

 
59

Wisconsin
0.4

 
99

 
244.88

 
96

 
235.88

 
96.3

 
3

Other (4)

 
3

 

 
19

 

 

 
(16
)
 
12.8

 
$
4,029

 
$
316.72

 
$
3,594

 
$
282.54

 
89.2
%
 
$
435

__________________
(1)
A member month is defined as the aggregate of each month’s ending membership for the period presented.
(2)
The MCR represents medical costs as a percentage of premium revenue.
(3)
The New York health plan was acquired on August 1, 2016.
(4)
“Other” medical care costs include primarily medically related administrative costs at the parent company, and direct delivery costs.

-MORE-


MOH Reports Second Quarter 2017 Results
Page 19
August 2, 2017


MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA—TOTAL
(In millions, except percentages and per-member per-month amounts)
 
Six Months Ended June 30, 2017
 
Member
Months (1)
 
Premium Revenue
 
Medical Care Costs
 
MCR (2)
 
Medical Margin
 
 
Total
 
PMPM
 
Total
 
PMPM
 
 
California
4.6

 
$
1,323

 
$
290.56

 
$
1,116

 
$
245.02

 
84.3
%
 
$
207

Florida
4.1

 
1,305

 
317.53

 
1,245

 
303.09

 
95.5

 
60

Illinois
1.1

 
310

 
282.66

 
354

 
322.63

 
114.1

 
(44
)
Michigan
2.5

 
799

 
321.10

 
707

 
284.24

 
88.5

 
92

New Mexico
1.6

 
682

 
421.11

 
652

 
402.27

 
95.5

 
30

New York (3)
0.2

 
92

 
449.48

 
87

 
425.72

 
94.7

 
5

Ohio
2.1

 
1,094

 
521.57

 
995

 
473.95

 
90.9

 
99

Puerto Rico
1.9

 
362

 
185.40

 
354

 
181.24

 
97.8

 
8

South Carolina
0.7

 
216

 
321.85

 
200

 
298.79

 
92.8

 
16

Texas
2.8

 
1,385

 
491.46

 
1,204

 
427.48

 
87.0

 
181

Utah
1.0

 
264

 
261.42

 
252

 
248.77

 
95.2

 
12

Washington
4.7

 
1,304

 
276.99

 
1,176

 
249.79

 
90.2

 
128

Wisconsin
0.8

 
247

 
307.50

 
243

 
302.95

 
98.5

 
4

Other (4)

 
5

 

 
17

 

 

 
(12
)
 
28.1

 
$
9,388

 
$
333.68

 
$
8,602

 
$
305.74

 
91.6
%
 
$
786

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Six Months Ended June 30, 2016
 
Member
Months (1)
 
Premium Revenue
 
Medical Care Costs
 
MCR (2)
 
Medical Margin
 
Total
 
PMPM
 
Total
 
PMPM
 
 
California
4.0

 
$
1,095

 
$
271.14

 
$
962

 
$
238.30

 
87.9
%
 
$
133

Florida
3.4

 
953

 
284.53

 
839

 
250.58

 
88.1

 
114

Illinois
1.2

 
303

 
261.43

 
269

 
232.06

 
88.8

 
34

Michigan
2.4

 
756

 
316.18

 
681

 
285.13

 
90.2

 
75

New Mexico
1.5

 
678

 
450.62

 
601

 
399.17

 
88.6

 
77

New York (3)

 

 

 

 

 

 

Ohio
2.0

 
971

 
481.44

 
882

 
437.35

 
90.8

 
89

Puerto Rico
2.0

 
351

 
172.98

 
349

 
171.95

 
99.4

 
2

South Carolina
0.6

 
171

 
276.61

 
138

 
223.58

 
80.8

 
33

Texas
2.2

 
1,255

 
575.87

 
1,074

 
492.65

 
85.5

 
181

Utah
0.9

 
224

 
252.08

 
208

 
234.46

 
93.0

 
16

Washington
4.1

 
1,065

 
260.05

 
958

 
233.84

 
89.9

 
107

Wisconsin
0.8

 
196

 
247.57

 
188

 
236.92

 
95.7

 
8

Other (4)

 
6

 

 
33

 

 

 
(27
)
 
25.1

 
$
8,024

 
$
320.17

 
$
7,182

 
$
286.57

 
89.5
%
 
$
842

__________________
(1)
A member month is defined as the aggregate of each month’s ending membership for the period presented.
(2)
The MCR represents medical costs as a percentage of premium revenue.
(3)
The New York health plan was acquired on August 1, 2016.
(4)
“Other” medical care costs include primarily medically related administrative costs at the parent company, and direct delivery costs.

-MORE-


MOH Reports Second Quarter 2017 Results
Page 20
August 2, 2017

MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA
(In millions, except percentages and per-member per-month amounts)

The following tables provide the details of our medical care costs for the periods indicated:
 
Three Months Ended June 30,
 
2017
 
2016
 
Amount
 
PMPM
 
% of
Total
 
Amount
 
PMPM
 
% of
Total
Fee for service
$
3,348

 
$
238.04

 
74.5
%
 
$
2,620

 
$
206.01

 
72.9
%
Pharmacy
650

 
46.23

 
14.5

 
529

 
41.59

 
14.7

Capitation
356

 
25.29

 
7.9

 
304

 
23.87

 
8.5

Direct delivery
22

 
1.54

 
0.5

 
18

 
1.39

 
0.5

Other
115

 
8.19

 
2.6

 
123

 
9.68

 
3.4

 
$
4,491

 
$
319.29

 
100.0
%
 
$
3,594

 
$
282.54

 
100.0
%
 
Six Months Ended June 30,
 
2017
 
2016
 
Amount
 
PMPM
 
% of
Total
 
Amount
 
PMPM
 
% of
Total
Fee for service
$
6,434

 
$
228.68

 
74.8
%
 
$
5,357

 
$
213.77

 
74.6
%
Pharmacy
1,266

 
45.00

 
14.7

 
1,054

 
42.05

 
14.7

Capitation
680

 
24.17

 
7.9

 
599

 
23.87

 
8.3

Direct delivery
44

 
1.56

 
0.5

 
34

 
1.36

 
0.5

Other
178

 
6.33

 
2.1

 
138

 
5.52

 
1.9

 
$
8,602

 
$
305.74

 
100.0
%
 
$
7,182

 
$
286.57

 
100.0
%

The following table provides the details of our medical claims and benefits payable as of the dates indicated:
 
June 30,
 
December 31,
 
2017
 
2016
Fee-for-service claims incurred but not paid (IBNP)
$
1,478

 
$
1,352

Pharmacy payable
121

 
112

Capitation payable
45

 
37

Other (1)
433

 
428

 
$
2,077

 
$
1,929

______________________
(1)
“Other” medical claims and benefits payable include amounts payable to certain providers for which we act as an intermediary on behalf of various state agencies without assuming financial risk. Such receipts and payments do not impact our consolidated statements of operations. As of June 30, 2017 and December 31, 2016, we had recorded non-risk provider payables of approximately $111 million and $225 million, respectively.


-MORE-


MOH Reports Second Quarter 2017 Results
Page 21
August 2, 2017

MOLINA HEALTHCARE, INC.
UNAUDITED CHANGE IN MEDICAL CLAIMS AND BENEFITS PAYABLE
(Dollars in millions, except per-member amounts)

Our claims liability includes a provision for adverse claims deviation based on historical experience and other factors including, but not limited to, variations in claims payment patterns, changes in utilization and cost trends, known outbreaks of disease, and large claims. Our reserving methodology is consistently applied across all periods presented. The amounts displayed for “Components of medical care costs related to: Prior period” represent the amount by which our original estimate of claims and benefits payable at the beginning of the period were more than the actual amount of the liability based on information (principally the payment of claims) developed since that liability was first reported. The following table presents the components of the change in medical claims and benefits payable for the periods indicated:

 
Six Months Ended June 30,
 
Year Ended December 31, 2016
 
2017
 
2016
 
Medical claims and benefits payable, beginning balance
$
1,929

 
$
1,685

 
$
1,685

Components of medical care costs related to:
 
 
 
 
 
Current period
8,633

 
7,371

 
14,966

Prior period
(31
)
 
(189
)
 
(192
)
Total medical care costs
8,602

 
7,182

 
14,774

 
 
 
 
 
 
Change in non-risk provider payables
(114
)
 
24

 
58

Payments for medical care costs related to:
 
 
 
 
 
Current period
6,883

 
5,885

 
13,304

Prior period
1,457

 
1,240

 
1,284

Total paid
8,340

 
7,125

 
14,588

Medical claims and benefits payable, ending balance
$
2,077

 
$
1,766

 
$
1,929

 
 
 
 
 
 
Benefit from prior period as a percentage of:
 
 
 
 
 
Balance at beginning of period
1.6
%
 
11.3
%
 
11.4
%
Premium revenue, trailing twelve months
0.2
%
 
1.3
%
 
1.2
%
Medical care costs, trailing twelve months
0.2
%
 
1.4
%
 
1.3
%
 
 
 
 
 
 
Days in claims payable, fee for service (1)
46

 
48

 
47

______________________
(1)
Claims payable includes primarily IBNP. Additionally, it includes certain fee-for-service payables reported in “Other” medical claims and benefits payable amounting to $157 million, $74 million and $94 million, as of June 30, 2017, June 30, 2016, and December 31, 2016, respectively.



-MORE-


MOH Reports Second Quarter 2017 Results
Page 22
August 2, 2017

MOLINA HEALTHCARE, INC.
UNAUDITED NON-GAAP FINANCIAL MEASURES

We use non-GAAP financial measures as supplemental metrics in evaluating our financial performance, making financing and business decisions, and forecasting and planning for future periods. For these reasons, management believes such measures are useful supplemental measures to investors in comparing our performance to the performance of other public companies in the health care industry. These non-GAAP financial measures should be considered as supplements to, and not as substitutes for or superior to, GAAP measures. See further information regarding non-GAAP measures below the tables (in millions, except per diluted share amounts).
 
Three Months Ended June 30,
 
Six Months Ended June 30,
 
2017
 
2016
 
2017
 
2016
 
 
 
 
 
 
 
 
Net (loss) income
$
(230
)
 
$
33

 
$
(153
)
 
$
57

Adjustments:
 
 
 
 
 
 
 
Depreciation, and amortization of intangible assets and capitalized software
44

 
39

 
90

 
76

Interest expense
27

 
25

 
53

 
50

Income tax (benefit) expense
(84
)
 
47

 
(30
)
 
87

EBITDA
$
(243
)
 
$
144

 
$
(40
)
 
$
270


 
Three Months Ended June 30,
 
Six Months Ended June 30,
2017
 
2016
 
2017
 
2016
 
 
 
Amount
 
Per Diluted share
 
Amount
 
Per Diluted share
 
Amount
 
Per Diluted share
 
Amount
 
Per Diluted share
Net (loss) income
$
(230
)
 
$
(4.10
)
 
$
33

 
$
0.58

 
$
(153
)
 
$
(2.74
)
 
$
57

 
$
1.01

Adjustment:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Amortization of intangible assets
8

 
0.14

 
8

 
0.14

 
17

 
0.30

 
15

 
0.27

Income tax effect (1)
(3
)
 
(0.05
)
 
(3
)
 
(0.05
)
 
(6
)
 
(0.11
)
 
(5
)
 
(0.10
)
Amortization of intangible assets, net of tax effect
5

 
0.09

 
5

 
0.09

 
11

 
0.19

 
10

 
0.17

Adjusted net (loss) income
$
(225
)
 
$
(4.01
)
 
$
38

 
$
0.67

 
$
(142
)
 
$
(2.55
)
 
$
67

 
$
1.18

________________________
(1)
Income tax effect of adjustment calculated at the blended federal and state statutory tax rate of 37%.

The following are descriptions of the adjustments made to GAAP measures used to calculate the non-GAAP measures used in this news release:
Earnings before interest, taxes, depreciation and amortization (EBITDA): Net (loss) income (GAAP) less depreciation, and amortization of intangible assets and capitalized software, interest expense and income tax (benefit) expense. We believe that EBITDA is helpful in assessing our ability to meet the cash demands of our operating units.
Adjusted net (loss) income: Net (loss) income (GAAP) less amortization of intangible assets, net of income tax effect calculated at the statutory tax rate of 37%. We believe that adjusted net (loss) income is helpful in assessing our financial performance exclusive of the non-cash impact of the amortization of purchased intangibles.
Adjusted net (loss) income per diluted share: Adjusted net (loss) income divided by weighted average common shares outstanding on a fully diluted basis.

-END-