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Health Net, Inc.
Investor Contact
Angie McCabe, 818-676-8692
angie.mccabe@healthnet.com
or
Media Contact
Margita Thompson, 818-676-7912
margita.thompson@healthnet.com

 


11/03/2009
Health Net Reports Third Quarter 2009 Adjusted(1) Net Income of $69.6 Million, or $0.67 per Diluted Share

The Company Recorded $189.5 Million in Pretax Charges, Including $170.6 Million in Asset Impairments Related to the Pending Sale of Its Northeast Division

Charges Cause GAAP Net Loss of $66.0 Million, or $0.64 Per Share

LOS ANGELES, November 03, 2009 - Health Net, Inc. (NYSE: HNT) today announced a third quarter 2009 GAAP net loss of $66.0 million, or $0.64 per share. GAAP net income in the third quarter of 2008 was $18.5 million, or $0.17 per diluted share.

The third quarter 2009 GAAP results include the effect of two pretax charges:

1. $170.6 million in noncash charges for the impairment of goodwill and other assets related to the pending sale of the company’s Northeast division; and

2. $19.5 million related to the company’s operations strategy that is designed to reduce general and administrative (G&A) expenses.

Both of these charges were offset by a favorable $0.6 million litigation reserve true-up. A reconciliation of non-GAAP financial measures on the income statement is included with this press release.

Excluding the impact of the charges, net income in the third quarter of 2009 was $69.6 million, or $0.67 per diluted share. Net income in the third quarter of 2008 was $37.8 million, or $0.35 per diluted share, excluding the impact of a $17.1 million pretax charge related to the company’s operations strategy and a $14.6 million pretax charge for impairment of the company’s investments.

“We are pleased with our third quarter results. Cash flow was strong, and the balance sheet is solid,” said Jay Gellert, president and chief executive officer of Health Net, Inc. “In addition, while we continue to produce strong new commercial sales in targeted segments and products in our Western health plans, overall commercial enrollment decreased due to in-group losses driven by the economy. Also, our Medicare plans continue to meet expectations, and we are reducing our administrative costs.”

On July 20, 2009, Health Net announced that it had entered into a definitive agreement with UnitedHealthcare for the sale of Health Net’s Northeast health plan subsidiaries and membership renewal rights. The regulatory approval process for the Northeast transaction is proceeding as expected. The transaction is currently expected to close by year-end 2009 or early 2010.

Membership

Total health plan enrollment as of September 30, 2009 was approximately 3.6 million members, a decrease of 144,000 members, or 3.8 percent, compared with September 30, 2008. Sequentially, total health plan enrollment decreased by 21,000 members, or 0.6 percent, from June 30, 2009.

Total commercial risk enrollment decreased by 166,000 members, or 8.0 percent, to approximately 1.9 million members as of September 30, 2009 compared with September 30, 2008. Sequentially, commercial risk enrollment decreased by 49,000 members, or 2.5 percent, from June 30, 2009.

“Our Western health plans produced new commercial sales of 35,000 members in the third quarter, with more than 24,000 of these new members in California’s narrow-network, lower-cost products,” said Jim Woys, Health Net’s chief operating officer. “Overall commercial enrollment declined due to persistent pressures from the economic downturn.”

Enrollment in the company’s Medicare Advantage plans decreased by 7,000 members, or 2.4 percent, to 286,000 members at the end of the third quarter of 2009 compared with the end of the third quarter of 2008. Sequentially, Medicare Advantage membership increased by 2,000 members, or nearly 1.0 percent, from June 30, 2009.

Membership in the company’s Medicare PDP plans was 466,000 at the end of the third quarter of 2009, a decrease of 72,000 members, or 13.4 percent, compared with the end of the third quarter of 2008. Sequentially, PDP membership increased by 8,000 members, or 1.7 percent, from June 30, 2009.

Medicaid enrollment at September 30, 2009 was 894,000 members, an increase of 106,000 members, or 13.5 percent, from September 30, 2008. Sequentially, Medicaid membership increased by 16,000 members, or 1.8 percent, from June 30, 2009. Both the quarter-over-quarter and sequential increases in Medicaid enrollment were the result of the economic downturn that causes the Medicaid-eligible population to increase.

Revenues, Health Care Costs and G&A Expenses

Health Net’s total revenues increased 3.9 percent in the third quarter of 2009 to approximately $4.0 billion from $3.8 billion in the third quarter of 2008. Health plan services premium revenues increased approximately 3.1 percent to nearly $3.2 billion in the third quarter of 2009 compared with approximately $3.1 billion in the third quarter of 2008.

The company’s Government contracts revenues increased 4.7 percent in the third quarter of 2009 to $758.5 million from $724.3 million in the third quarter of 2008. The increase was the result of Option Period 6 pricing for the company’s TRICARE contract and continued growth in the Military and Family Life Consultant (MFLC) contract that is administered by the company’s behavioral health subsidiary, Managed Health Network. Sequentially, revenue decreased 8.8 percent from the second quarter of 2009 primarily as a result of lower estimates of health care costs related to Option Periods 5 and 6 and a change to TRICARE payment policies that align with Medicare payment practices.

The health plan services medical care ratio (MCR) was 86.4 percent in the third quarter of 2009 and 87.5 percent in the third quarter of 2008.

The commercial MCR was 87.0 percent in the third quarter of 2009 compared with 86.7 percent in the third quarter of 2008. Excluding the litigation reserve true-up benefit in the third quarter of 2009, the commercial MCR would have been 40 basis points higher than the commercial MCR in the third quarter of 2008, or 87.1 percent.

Commercial premium yields per member per month (PMPM) increased by 7.6 percent in the third quarter of 2009 compared with the third quarter of 2008. Total commercial health care costs PMPM increased 8.0 percent in the third quarter of 2009 compared with the third quarter of 2008.

“Commercial health care costs in the quarter were adversely affected by higher utilization related to the H1N1 flu virus, COBRA-related utilization and higher-than-expected trends in our Northeast plans,” said Woys. “We are encouraged that the commercial MCR in our Western states improved substantially in the third quarter of 2009 compared to the third quarter of 2008.”

Health Net’s Medicare plans continued to perform consistent with expectations in the third quarter of 2009. The Medicare Advantage and Part D MCRs improved in the third quarter of 2009 compared with the third quarter of 2008.

The Government contracts cost ratio was 94.4 percent in the third quarter of 2009 compared with 95.0 percent in the third quarter of 2008 and 95.1 percent in the second quarter of 2009. “The improvement in the Government contracts cost ratio was due to an increase in MFLC volume and lower health care cost trends in the third quarter,” said Woys. “For 2009, we expect this ratio to be at the low end of our previous guidance of 95.0 percent to 95.5 percent.”

On a GAAP basis, G&A expense was $319.5 million in the third quarter of 2009 compared with $294.2 million in the third quarter of 2008. On an adjusted basis1, G&A expense was approximately $300.0 million in the third quarter of 2009 compared with $277.0 million in the third quarter of 2008. This increase was primarily due to premium taxes and regulatory fees.

On an adjusted1 basis, Health Net’s G&A expense ratio in the third quarter of 2009 increased 40 basis points compared with the third quarter of 2008.

Health Net’s selling expenses of $83.3 million in the third quarter of 2009 decreased by approximately $10.0 million compared with the third quarter of 2008, primarily a result of a decrease in commercial membership during the past 12 months.

Balance Sheet

As a result of the pending sale of the company’s Northeast health plans, assets and liabilities relating to the Northeast business have been reclassified to either “assets held for sale” or “liabilities held for sale” on the company’s consolidated balance sheet. A supplemental balance sheet showing the impact of these reclassifications is included with this press release.

Cash and investments as of September 30, 2009 were approximately $1.8 billion compared with approximately $2.2 billion as of September 30, 2008, and $2.1 billion as of June 30, 2009. Reserves for claims and other settlements as of September 30, 2009 were $951.8 million compared with $1.3 billion as of September 30, 2008. All of these amounts reflect the reclassifications noted above.

Days claims payable (DCP), including provider and other claims settlements and charges, capitation payments and Medicare Part D expenses, for the third quarter of 2009 decreased by 5.3 days to 41.0 days compared with 46.3 days in the third quarter of 2008, and decreased sequentially by 2.1 days compared with the second quarter of 2009.

On an adjusted2 basis, DCP in the third quarter of 2009 decreased by 2.2 days to 50.5 days compared with the third quarter of 2008, and decreased by 3.7 days sequentially. The sequential decline is primarily due to the timing of the company’s check-runs. At September 30, 2009, the amount of claims processed but waiting for the weekly check-run decreased by $48.0 million from June 30, 2009. Reserves for incurred but not reported (IBNR) health care costs were stable in the third quarter of 2009 compared to the second quarter of 2009.

The company’s debt-to-total capital ratio was 25.8 percent as of September 30, 2009 compared with 27.6 percent as of September 30, 2008 and 25.2 percent as of June 30, 2009.

Cash Flow

Operating cash flow was $154.4 million in the third quarter of 2009 and was affected by the company’s receipt of only two of three monthly Medi-Cal payments. The company received the third payment of $64.8 million in early October 2009.

“We received $165.0 million in Medicare risk adjuster payments in the third quarter of 2009 as expected,” said Joseph Capezza, Health Net's chief financial officer. “Therefore, we continue to believe that operating cash flow for the full year of 2009 will be approximately $325 million to $350 million if we receive all 12 monthly Medi-Cal payments in calendar year 2009.”

2009 Guidance

Including the impact of $100 million to $110 million in expected operations strategy-related pretax charges and additional charges related to the pending sale of the Northeast business the company expects to take in 2009, Health Net expects 2009 full-year GAAP earnings per diluted share of $0.51 to $0.56 based on expected diluted weighted average shares of 104 to 105 million shares. The company lowered the top end of its earnings guidance range by $0.05 per diluted share due to anticipated health care cost pressures in the fourth quarter of 2009 from higher utilization due to the H1N1 flu virus and continued expansion of its COBRA membership. Therefore, the company expects full-year 2009 earnings per diluted share of $2.25 to $2.30, excluding the impact of charges.

The company recorded $170.6 million in goodwill and other impairments in the third quarter of 2009 and expects to record additional impairments in the fourth quarter of 2009. The company continues to evaluate the impact of the potential sale of the Northeast business on its 2009 financial results, including potential loss on sale of the Northeast business, tax benefits, severance costs, other transaction-related costs and operating costs that will be incurred during the transition period following the close of the transaction.

The table on the following page updates previously issued full-year 2009 guidance.

     

Metric

 

2009 Guidance

Year-end Membership

 

Commercial Risk: –6% to –7% (previously –3% to –5%)

Medicaid: +10% to +12% (previously +6% to +8%)

Medicare Advantage: –1% to –2%

PDP: –13% to –15% (previously –15% to –20%)

Consolidated Revenues

 

$15.5 billion to $16.0 billion

Commercial Yields

 

~ 8.0% (previously ~ 7.5% – 8.0%)

Commercial

Health Care Cost Trends

 

~ 8.0% (previously ~ 7.0 – 7.5%)

Selling Cost Ratio

Government Contracts Ratio

G&A Expense Ratio(a)

 

~ 2.9%

~ 95.0% to 95.5%

~ 9.6% to 9.8%

Tax Rate(a)

 

38.3% to 38.5% (previously 38.5% to 38.7%)

Weighted-average Fully

Diluted Shares Outstanding

 

 

104 million to 105 million

GAAP EPS(b)

Non-GAAP EPS(a)

 

$0.51 to $0.56 (previously $1.85 to $2.10)

$2.25 to $2.30 (previously $2.25 to $2.35)

 

(a) Excludes the impact of expected operations strategy-related charges of $100 million to $110 million in 2009.

 

(b) The company is currently evaluating the impact of the potential sale of the Northeast business on its 2009 financial results, including potential loss on sale of the Northeast business, tax benefits, severance costs, other transaction-related costs and operating costs that will be incurred during the transition period following the close of the transaction.

 

Conference Call

As previously announced, Health Net will discuss the company’s third quarter 2009 results during a conference call on Tuesday, November 3, 2009, beginning at approximately 11:00 a.m. Eastern time. The conference call should be accessed at least 15 minutes prior to its start with the following numbers:

       

866.393.1637 (Domestic)

        800.642.1687 (Replay – Domestic)
        706.643.5711 (International)         706.645.9291 (Replay – International)

An access code is required for both the live conference call and the replay. The access code is 31753874. A replay of the conference call will be available through 12.00 a.m. Eastern time on November 8, 2009. A live webcast and replay of the conference call also will be available at www.healthnet.com under “Investor Relations.” The conference call webcast is open to all interested parties. Anyone listening to the company’s conference call will be presumed to have read Health Net’s Annual Report on Form 10-K for the year ended December 31, 2008, Quarterly Reports on Form 10-Q for the quarters ended March 31, 2009, and June 30, 2009, and other reports filed by the company from time to time with the Securities and Exchange Commission.

About Health Net

Health Net, Inc. is among the nation’s largest publicly traded managed health care companies. Its mission is to help people be healthy, secure and comfortable. The company’s health plans and government contracts subsidiaries provide health benefits to approximately 6.6 million individuals across the country through group, individual, Medicare, Medicaid and TRICARE and Veterans Affairs programs. Health Net’s behavioral health subsidiary, MHN, provides mental health benefits to approximately 6.5 million individuals in all 50 states. The company’s subsidiaries also offer managed health care products related to prescription drugs, and offer managed health care product coordination for multi-region employers and administrative services for medical groups and self-funded benefits programs.

For more information on Health Net, Inc., please visit the company’s Web site at www.healthnet.com.

Cautionary Statements

All statements in this press release, other than statements of historical information provided herein, may be deemed to be forward-looking statements and as such are subject to a number of risks and uncertainties. These statements are based on management’s analysis, judgment, belief and expectation only as of the date hereof, and are subject to uncertainty and changes in circumstances. Without limiting the foregoing, statements including the words “believes,” “anticipates,” “plans,” “expects,” “may,” “should,” “could,” “estimate,” “intend” and other similar expressions are intended to identify forward-looking statements. Actual results could differ materially due to, among other things, any failure to close the pending sale of our Northeast business; costs, fees and expenses related to the pending sale and proposed post-closing administrative services; potential termination of our TRICARE North operations; rising health care costs; a continued decline in the economy; negative prior period claims reserve developments; investment portfolio impairment charges; volatility in the financial markets; trends in medical care ratios; unexpected utilization patterns or unexpectedly severe or widespread illnesses; membership declines; rate cuts affecting our Medicare or Medicaid businesses; litigation costs; regulatory issues; operational issues; health care reform; and general business and market conditions. Additional factors that could cause actual results to differ materially from those reflected in the forward-looking statements include, but are not limited to, the risks discussed in the “Risk Factors” section included within the company’s most recent Annual Report on Form 10-K, subsequent quarterly reports on Form 10-Q, and the risks discussed in the company’s other filings with the Securities and Exchange Commission. Readers are cautioned not to place undue reliance on these forward-looking statements. The company undertakes no obligation to publicly revise any of its forward-looking statements to reflect events or circumstances that arise after the date of this release.

The financial information presented in this press release is unaudited and is subject to change as a result of subsequent events or adjustments, if any, arising prior to the filing of the company’s Form 10-Q for the period ended September 30, 2009.

Footnotes

1Detailed explanations of the non-GAAP financial measures referred to in this press release and reconciliations to the comparable GAAP measures are included in the attached financial tables.

2See footnote (a) in the Notes to Consolidated Financial Statements in the financial schedules attached to this press release for a reconciliation of this information to the comparable GAAP financial measure.

 
Health Net, Inc.
Enrollment Data - By State
(In thousands)
                    Change from
                    June 30, 2009   September 30, 2008
        Sept 30,   June 30,   Sept 30,   Increase/   %   Increase/   %
        2009   2009   2008   (Decrease)   Change   (Decrease)   Change
California                            
  Large Group   888   908   954   (20 )   (2.2 )%   (66 )   (6.9 )%
  Small Group and Individual   365   380   431   (15 )   (3.9 )%   (66 )   (15.3 )%
  Commercial Risk   1,253   1,288   1,385   (35 )   (2.7 )%   (132 )   (9.5 )%
  ASO   5   3   5   2     66.7 %   0     0.0 %
  Total Commercial   1,258   1,291   1,390   (33 )   (2.6 )%   (132 )   (9.5 )%
  Medicare Advantage   136   134   131   2     1.5 %   5     3.8 %
  Medi-Cal   841   827   742   14     1.7 %   99     13.3 %
    Total California   2,235   2,252   2,263   (17 )   (0.8 )%   (28 )   (1.2 )%
                                 
Connecticut                            
  Large Group   92   92   117   0     0.0 %   (25 )   (21.4 )%
  Small Group and Individual   23   23   26   0     0.0 %   (3 )   (11.5 )%
  Commercial Risk   115   115   143   0     0.0 %   (28 )   (19.6 )%
  ASO   25   26   25   (1 )   (3.8 )%   0     0.0 %
  Total Commercial   140   141   168   (1 )   (0.7 )%   (28 )   (16.7 )%
  Medicare Advantage   53   52   57   1     1.9 %   (4 )   (7.0 )%
    Total Connecticut   193   193   225   0     0.0 %   (32 )   (14.2 )%
                                 
New York                            
  Large Group   97   97   101   0     0.0 %   (4 )   (4.0 )%
  Small Group and Individual   146   145   107   1     0.7 %   39     36.4 %
  Commercial Risk   243   242   208   1     0.4 %   35     16.8 %
  ASO   7   7   11   0     0.0 %   (4 )   (36.4 )%
  Total Commercial   250   249   219   1     0.4 %   31     14.2 %
  Medicare Advantage   2   2   6   0     0.0 %   (4 )   (66.7 )%
    Total New York   252   251   225   1     0.4 %   27     12.0 %
                                 
New Jersey                            
  Large Group   17   19   20   (2 )   (10.5 )%   (3 )   (15.0 )%
  Small Group and Individual   62   61   55   1     1.6 %   7     12.7 %
  Commercial Risk   79   80   75   (1 )   (1.3 )%   4     5.3 %
  ASO   3   2   4   1     50.0 %   (1 )   (25.0 )%
  Total Commercial   82   82   79   0     0.0 %   3     3.8 %
  Medicaid   53   51   46   2     3.9 %   7     15.2 %
    Total New Jersey   135   133   125   2     1.5 %   10     8.0 %
                                 
Arizona                            
  Large Group   59   64   80   (5 )   (7.8 )%   (21 )   (26.3 )%
  Small Group and Individual   38   39   50   (1 )   (2.6 )%   (12 )   (24.0 )%
  Commercial Risk   97   103   130   (6 )   (5.8 )%   (33 )   (25.4 )%
  Medicare Advantage   65   65   67   0     0.0 %   (2 )   (3.0 )%
    Total Arizona   162   168   197   (6 )   (3.6 )%   (35 )   (17.8 )%
                                 
Oregon                            
  Large Group   78   86   99   (8 )   (9.3 )%   (21 )   (21.2 )%
  Small Group and Individual   47   47   38   0     0.0 %   9     23.7 %
  Commercial Risk   125   133   137   (8 )   (6.0 )%   (12 )   (8.8 )%
  Medicare Advantage   24   24   22   0     0.0 %   2     9.1 %
    Total Oregon   149   157   159   (8 )   (5.1 )%   (10 )   (6.3 )%
                                 
Other States                            
  Medicare Advantage   6   7   10   (1 )   (14.3 )%   (4 )   (40.0 )%
                                 
Medicare PDP (stand-alone)   466   458   538   8     1.7 %   (72 )   (13.4 )%
                                 
                                 
Total Health Plan Enrollment                            
  Large Group   1,231   1,266   1,371   (35 )   (2.8 )%   (140 )   (10.2 )%
  Small Group and Individual   681   695   707   (14 )   (2.0 )%   (26 )   (3.7 )%
  Commercial Risk   1,912   1,961   2,078   (49 )   (2.5 )%   (166 )   (8.0 )%
  ASO   40   38   45   2     5.3 %   (5 )   (11.1 )%
  Total Commercial   1,952   1,999   2,123   (47 )   (2.4 )%   (171 )   (8.1 )%
  Medicare Advantage   286   284   293   2     0.7 %   (7 )   (2.4 )%
  Medicare PDP (stand-alone)   466   458   538   8     1.7 %   (72 )   (13.4 )%
  Medi-Cal/Medicaid   894   878   788   16     1.8 %   106     13.5 %
    Total Health Plans   3,598   3,619   3,742   (21 )   (0.6 )%   (144 )   (3.8 )%
                                 
                                 
TRICARE - North Contract Eligibles   3,040   3,040   2,951   0     0.0 %   89     3.0 %
                                     
Health Net, Inc.
Enrollment Data - Line of Business
(In thousands)
                    Change from
                    June 30, 2009   September 30, 2008
        Sept 30,   June 30,   Sept 30,   Increase/   %   Increase/   %
        2009   2009   2008   (Decrease)   Change   (Decrease)   Change
                                 
Large Group                            
  California   888   908   954   (20 )   (2.2 )%   (66 )   (6.9 )%
  Connecticut   92   92   117   0     0.0 %   (25 )   (21.4 )%
  New York   97   97   101   0     0.0 %   (4 )   (4.0 )%
  New Jersey   17   19   20   (2 )   (10.5 )%   (3 )   (15.0 )%
  Arizona   59   64   80   (5 )   (7.8 )%   (21 )   (26.3 )%
  Oregon   78   86   99   (8 )   (9.3 )%   (21 )   (21.2 )%
        1,231   1,266   1,371   (35 )   (2.8 )%   (140 )   (10.2 )%
                                 
Small Group and Individual                            
  California   365   380   431   (15 )   (3.9 )%   (66 )   (15.3 )%
  Connecticut   23   23   26   0     0.0 %   (3 )   (11.5 )%
  New York   146   145   107   1     0.7 %   39     36.4 %
  New Jersey   62   61   55   1     1.6 %   7     12.7 %
  Arizona   38   39   50   (1 )   (2.6 )%   (12 )   (24.0 )%
  Oregon   47   47   38   0     0.0 %   9     23.7 %
        681   695   707   (14 )   (2.0 )%   (26 )   (3.7 )%
                                 
Commercial Risk                            
  California   1,253   1,288   1,385   (35 )   (2.7 )%   (132 )   (9.5 )%
  Connecticut   115   115   143   0     0.0 %   (28 )   (19.6 )%
  New York   243   242   208   1     0.4 %   35     16.8 %
  New Jersey   79   80   75   (1 )   (1.3 )%   4     5.3 %
  Arizona   97   103   130   (6 )   (5.8 )%   (33 )   (25.4 )%
  Oregon   125   133   137   (8 )   (6.0 )%   (12 )   (8.8 )%
        1,912   1,961   2,078   (49 )   (2.5 )%   (166 )   (8.0 )%
                                 
ASO                              
  California   5   3   5   2     66.7 %   0     0.0 %
  Connecticut   25   26   25   (1 )   (3.8 )%   0     0.0 %
  New York   7   7   11   0     0.0 %   (4 )   (36.4 )%
  New Jersey   3   2   4   1     50.0 %   (1 )   (25.0 )%
        40   38   45   2     5.3 %   (5 )   (11.1 )%
                                 
Total Commercial                            
  California   1,258   1,291   1,390   (33 )   (2.6 )%   (132 )   (9.5 )%
  Connecticut   140   141   168   (1 )   (0.7 )%   (28 )   (16.7 )%
  New York   250   249   219   1     0.4 %   31     14.2 %
  New Jersey   82   82   79   0     0.0 %   3     3.8 %
  Arizona   97   103   130   (6 )   (5.8 )%   (33 )   (25.4 )%
  Oregon   125   133   137   (8 )   (6.0 )%   (12 )   (8.8 )%
        1,952   1,999   2,123   (47 )   (2.4 )%   (171 )   (8.1 )%
                                 
Medicare Advantage                            
  California   136   134   131   2     1.5 %   5     3.8 %
  Connecticut   53   52   57   1     1.9 %   (4 )   (7.0 )%
  New York   2   2   6   0     0.0 %   (4 )   (66.7 )%
  Arizona   65   65   67   0     0.0 %   (2 )   (3.0 )%
  Oregon   24   24   22   0     0.0 %   2     9.1 %
  Other States   6   7   10   (1 )   (14.3 )%   (4 )   (40.0 )%
        286   284   293   2     0.7 %   (7 )   (2.4 )%
                                 
Medi-Cal/Medicaid                            
  California   841   827   742   14     1.7 %   99     13.3 %
  New Jersey   53   51   46   2     3.9 %   7     15.2 %
        894   878   788   16     1.8 %   106     13.5 %
                                 
Medicare PDP (stand-alone)   466   458   538   8     1.7 %   (72 )   (13.4 )%
                                 
                                 
Total Health Plan Enrollment                            
  Large Group   1,231   1,266   1,371   (35 )   (2.8 )%   (140 )   (10.2 )%
  Small Group and Individual   681   695   707   (14 )   (2.0 )%   (26 )   (3.7 )%
  Commercial Risk   1,912   1,961   2,078   (49 )   (2.5 )%   (166 )   (8.0 )%
  ASO   40   38   45   2     5.3 %   (5 )   (11.1 )%
  Total Commercial   1,952   1,999   2,123   (47 )   (2.4 )%   (171 )   (8.1 )%
  Medicare Advantage   286   284   293   2     0.7 %   (7 )   (2.4 )%
  Medicare PDP (stand-alone)   466   458   538   8     1.7 %   (72 )   (13.4 )%
  Medi-Cal/Medicaid   894   878   788   16     1.8 %   106     13.5 %
    Total Health Plans   3,598   3,619   3,742   (21 )   (0.6 )%   (144 )   (3.8 )%
                                 
                                 
TRICARE - North Contract Eligibles   3,040   3,040   2,951   0     0.0 %   89     3.0 %
                                     
Health Net, Inc.
Consolidated Statements of Operations
(Amounts in thousands, except per share, PMPM and ratio data)
                     
                     
            Quarter Ended   Quarter Ended   Quarter Ended
            September 30,   June 30,   September 30,
REVENUES:     2008   2009   2009
  Health plan services premiums   $ 3,072,717     $ 3,152,783     $ 3,166,877  
  Government contracts     724,323       832,088       758,507  
  Net investment income     10,204       20,432       27,691  
  Administrative services fees and other income     11,607       8,387       15,578  
              3,818,851       4,013,690       3,968,653  
                     
EXPENSES:              
  Health plan services     2,689,790       2,718,039       2,734,984  
  Government contracts     687,848       791,044       716,323  
  General and administrative     294,178       332,188       319,451  
  Selling     93,232       81,359       83,275  
  Depreciation and amortization     17,255       15,708       12,689  
  Interest     10,413       11,518       10,264  
  Impairments on assets held for sale     -       -       170,570  
              3,792,716       3,949,856       4,047,556  
Income from operations before income taxes     26,135       63,834       (78,903 )
Income tax provision     7,665       23,694       (12,881 )
Net income   $ 18,470     $ 40,140     $ (66,022 )
                     
Basic earnings per share   $ 0.17     $ 0.39     $ (0.64 )
Diluted earnings per share   $ 0.17     $ 0.38     $ (0.64 )
                     
Weighted average shares outstanding:            
  Basic     105,915       103,854       103,873  
  Diluted     106,869       104,323       103,873  
                     
Pretax margin     0.7 %     1.6 %     -2.0 %
Health plan services MCR     87.5 %     86.2 %     86.4 %
Government contracts cost ratio     95.0 %     95.1 %     94.4 %
G&A expense ratio     9.5 %     10.5 %     10.0 %
Selling costs ratio     3.0 %     2.6 %     2.6 %
Days claims payable (a)     46.3       43.1       41.0  
Days claims payable - adjusted (a)     52.7       54.2       50.5  
Effective tax rate     29.3 %     37.1 %     16.3 %
Health plan services premiums PMPM   $ 276.29     $ 295.11     $ 296.16  
Health plan services costs PMPM   $ 241.86     $ 254.41     $ 255.77  
                         
Health Net, Inc.
Reconciliation of Non-GAAP Financial Measures
Operating Results Excluding Charges
(Amounts in thousands, except per share, PMPM and ratio data)
         

Note: This table presents the company's consolidated operations for the periods presented below and the charges recorded in the consolidated statement of operations. Management believes that the presentation of certain financial information in the attached press release (such as Net investment income, Health plan services expense, General and administrative expense, Income before income taxes, Income tax provision, Net income, Basic and diluted earnings per share, Pretax margin, MCR, G&A expense ratio, and effective tax rate), excluding the charges that were recorded, all of which are non-GAAP financial information, are important to investors as they exclude special items that are not indicative of our core operating results. Non-GAAP financial information presented below should be considered in addition to, not as a substitute for, financial information prepared in accordance with GAAP.

                                                 
                                                 
            Quarter Ended September 30, 2008   Quarter Ended June 30, 2009   Quarter Ended September 30, 2009
                        Excluding           Excluding           Excluding
                  Impact of     Impact of       Impact of   Impact of       Impact of   Impact of
            As Reported     Charge1     Charge1   As Reported   Charge2   Charge2   As Reported   Charge3   Charge3
                        (Non-GAAP)           (Non-GAAP)           (Non-GAAP)
REVENUES:                                        
  Health plan services premiums   $ 3,072,717             $ 3,072,717     $ 3,152,783         $ 3,152,783     $ 3,166,877         $ 3,166,877  
  Government contracts     724,323               724,323       832,088           832,088       758,507           758,507  
  Net investment income     10,204         (14,642 )       24,846       20,432           20,432       27,691           27,691  
  Administrative services fees and other income     11,607               11,607       8,387           8,387       15,578           15,578  
              3,818,851  

 

    (14,642 )

 

    3,833,493       4,013,690       -       4,013,690       3,968,653       -       3,968,653  
                                                 
EXPENSES:                                        
  Health plan services     2,689,790               2,689,790       2,718,039       (2,056 )     2,720,095       2,734,984       (571 )     2,735,555  
  Government contracts     687,848               687,848       791,044           791,044       716,323           716,323  
  General and administrative     294,178         17,145         277,033       332,188       19,646       312,542       319,451       19,495       299,956  
  Selling     93,232               93,232       81,359           81,359       83,275           83,275  
  Depreciation and amortization     17,255               17,255       15,708           15,708       12,689           12,689  
  Interest     10,413               10,413       11,518           11,518       10,264           10,264  
  Impairments on assets held for sale     -               -       -           -       170,570       170,570       -  
              3,792,716         17,145         3,775,571       3,949,856       17,590       3,932,266       4,047,556       189,494       3,858,062  
Income (loss) from operations before income taxes     26,135  

 

    (31,787 )

 

    57,922       63,834       (17,590 )     81,424       (78,903 )     (189,494 )     110,591  
Income tax provision (benefit)     7,665         (12,498 )       20,163       23,694       (6,977 )     30,671       (12,881 )     (53,890 )     41,009  
Net income (loss)   $ 18,470       $ (19,289 )     $ 37,759     $ 40,140     $ (10,613 )   $ 50,753     $ (66,022 )   $ (135,604 )   $ 69,582  
                                                 
Basic earnings (loss) per share   $ 0.17       $ (0.19 )     $ 0.36     $ 0.39     $ (0.10 )   $ 0.49     $ (0.64 )   $ (1.31 )   $ 0.67  
Diluted earnings (loss) per share   $ 0.17       $ (0.18 )     $ 0.35     $ 0.38     $ (0.11 )   $ 0.49     $ (0.64 )   $ (1.31 )   $ 0.67  
                                                 
Weighted average shares outstanding:                                        
  Basic     105,915               105,915       103,854           103,854       103,873           103,873  
  Diluted     106,869               106,869       104,323           104,323       103,873           104,432  
                                                 
Pretax margin     0.7 %       -0.8 %       1.5 %     1.6 %     -0.4 %     2.0 %     -2.0 %     -4.8 %     2.8 %
Health plan services MCR     87.5 %       0.0 %       87.5 %     86.2 %     -0.1 %     86.3 %     86.4 %     0.0 %     86.4 %
Government contracts cost ratio     95.0 %       -         95.0 %     95.1 %     -       95.1 %     94.4 %     -       94.4 %
G&A expense ratio     9.5 %       0.5 %       9.0 %     10.5 %     0.6 %     9.9 %     10.0 %     0.6 %     9.4 %
Selling costs ratio     3.0 %       -         3.0 %     2.6 %     -       2.6 %     2.6 %     -       2.6 %
Effective tax rate     29.3 %       -5.5 %       34.8 %     37.1 %     -0.6 %     37.7 %     16.3 %     -20.8 %     37.1 %
                                                 
                                                 

1 Includes a $14.6 million pretax realized losses from other-than-temporary impairments of investment securities included in net investment income and a $17.1 million pretax charge primarily for severance and other expenses related to the company's operations strategy and included in G&A expenses.

 

2 Includes a $2.1 million pretax benefit for a litigation reserve true-up included in health plan services expenses and a $19.7 million pretax charge primarily for severance and other expenses related to the company's operations strategy and included in G&A expenses.

     

 

           

3 Includes $0.6 million litigation reserve true-up included in health care costs, a $19.5 million pretax charge primarily for IT systems and other expenses related to the company's operations strategy and included in G&A expenses and a $170.6 million pretax asset impairments for goodwill, intangible and IT-related assets related to the pending sale of our Northeast health plans.

     

 

                   
Health Net, Inc.
Consolidated Balance Sheet
(Amounts in thousands, except ratio data)
                       
                       
              September 30,   June 30,   Sept 30,
              2008   2009   2009
ASSETS            
Current Assets            
  Cash and cash equivalents   $ 340,121     $ 565,856     $ 463,311  
  Investments - available for sale     1,838,951       1,477,651       1,309,864  
  Premiums receivable, net     295,854       414,199       307,488  
  Amounts receivable under government contracts     235,064       279,290       224,495  
 

Incurred but not reported (IBNR) health care costs receivable under TRICARE North contract

    307,970       334,104       323,207  
  Other receivables     107,032       181,563       183,258  
  Deferred taxes     111,266       77,600       101,043  
  Assets held for sale     -       -       848,601  
  Other assets     238,615       207,383       195,799  
Total current assets     3,474,873       3,537,646       3,957,066  
Property and equipment, net     228,256       169,925       136,819  
Goodwill, net     751,949       751,949       611,886  
Other intangible assets, net     96,122       82,698       29,478  
Deferred taxes     58,555       67,247       44,119  
Investments - available for sale-noncurrent     -       60,047       11,435  
Other noncurrent assets     132,427       133,501       103,093  
Total Assets   $ 4,742,182     $ 4,803,013     $ 4,893,896  
                       
LIABILITIES AND STOCKHOLDERS' EQUITY            
Current Liabilities            
  Reserves for claims and other settlements   $ 1,348,681     $ 1,243,517     $ 951,778  
  Health care and other costs payable under government contracts     56,505       76,709       61,037  
  IBNR health care costs payable under TRICARE North contract     307,970       334,104       323,207  
  Unearned premiums     197,881       184,881       124,828  
  Borrowings under amortizing financing facility     26,693       117,999       119,915  
  Liabilities held for sale     -       -       355,530  
  Accounts payable and other liabilities     285,016       352,890       529,740  
Total current liabilities     2,222,746       2,310,100       2,466,035  
Senior notes payable     398,224       398,378       398,429  
Borrowings under amortizing financing facility     119,900       -       -  
Borrowings under revolving credit facility     100,000       100,000       100,000  
Other noncurrent liabilities     206,187       167,993       154,087  
Total Liabilities     3,047,057       2,976,471       3,118,551  
                       
Stockholders' Equity            
  Common stock and additional paid-in capital     1,181,481       1,191,021       1,184,905  
  Treasury common stock, at cost     (1,367,302 )     (1,368,825 )     (1,368,854 )
  Retained earnings     1,908,565       2,006,275       1,940,253  
  Accumulated other comprehensive loss     (27,619 )     (1,929 )     19,041  
Total Stockholders' Equity     1,695,125       1,826,542       1,775,345  
Total Liabilities and Stockholders' Equity   $ 4,742,182     $ 4,803,013     $ 4,893,896  
                       
Debt-to-Total Capital Ratio     27.6 %     25.2 %     25.8 %
                         
Health Net, Inc.
Supplemental Consolidated Balance Sheet
As of September 30, 2009
(Amounts in thousands, except ratio data)
                       
Note:

Set forth below is a supplemental consolidated balance sheet as of September 30, 2009, which breaks out certain assets and liabilities being held for sale, a portion of which is non-GAAP financial information. Management believes that the presentation of this non-GAAP financial information presented below is important to investors as it shows the assets and liabilities and the related amounts that will no longer be included in our consolidated balance sheet following closing of the pending sale of our Northeast health plans to UnitedHealth Group. Non-GAAP financial information presented below should be considered in addition to, not as a substitute for, financial information prepared in accordance with GAAP.

                       
              Including        
              Assets/Liabilities        
              Held for Sale   Assets/Liabilities    
              (Non-GAAP)   Held for Sale   As Reported
ASSETS            
Current Assets            
  Cash and cash equivalents   $ 701,571     $ 238,260     $ 463,311  
  Investments - available for sale     1,663,264       353,400       1,309,864  
  Premiums receivable, net     350,390       42,902       307,488  
  Amounts receivable under government contracts     224,495           224,495  
 

Incurred but not reported (IBNR) health care costs receivable under TRICARE North contract

    323,207           323,207  
  Other receivables     211,840       28,582       183,258  
  Deferred taxes     114,897       13,854       101,043  
  Assets held for sale     -       (848,601 )     848,601  
  Other assets     222,496       26,697       195,799  
Total current assets     3,812,160       (144,906 )     3,957,066  
Property and equipment, net