(Source: Business Wire)

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 $69.6million, 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 2.4percent, 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 $4.0billion 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 $3.1billion 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 2.1days compared with the second quarter of 2009.
On an adjusted2 basis, DCP in the third quarter of 2009
decreased by 2.2 days to 50.5days 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.
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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)
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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 6.6million
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.