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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
   
Form 10-K
(Mark One)
xANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
FOR THE FISCAL YEAR ENDED DECEMBER 31, 20142015
or
¨TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
Commission File Number 1-31719  
   
MOLINA HEALTHCARE, INC.
(Exact name of registrant as specified in its charter)
 
   

Delaware 13-4204626
(State or other jurisdiction of (I.R.S. Employer
incorporation or organization) Identification No.)
200 Oceangate, Suite 100, Long Beach, California 90802
(Address of principal executive offices)
(562) 435-3666
(Registrant’s telephone number, including area code)
Securities registered pursuant to Section 12(b) of the Act:
 
Title of Class Name of Each Exchange on Which Registered
Common Stock, $0.001 Par Value New York Stock Exchange
Securities registered pursuant to Section 12(g) of the Act:
None
 
   
 
Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act.    ý  Yes    ¨  No
Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act.    
¨  Yes     ý  No
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    ý  Yes    ¨  No
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).     ý  Yes    ¨  No
Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K is not contained herein, and will not be contained, to the best of registrant’s knowledge, in definitive proxy or information statements incorporated by reference in Part III of this Form 10-K or any amendment to this Form 10-K.  ý
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See the definitions of "large accelerated filer," "accelerated filer" and "smaller reporting company" in Rule 12b-2 of the Exchange Act. (Check one):
 
Large accelerated filerý Accelerated filer¨
Non-accelerated filer¨(Do not check if a smaller reporting company)Smaller reporting company¨
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    ¨  Yes    ý  No
The aggregate market value of Common Stock held by non-affiliates of the registrant as of June 30, 20142015, the last business day of our most recently completed second fiscal quarter, was approximately $1,338.4$2,823.5 million (based upon the closing price for shares of the registrant’s Common Stock as reported by the New York Stock Exchange, Inc. on June 30, 20142015).
As of February 20, 2015,23, 2016, approximately 49,873,00056,199,000 shares of the registrant’s Common Stock, $0.001 par value per share, were outstanding.
 
   
 
DOCUMENTS INCORPORATED BY REFERENCE
Portions of the registrant’s Proxy Statement for the 20152016 Annual Meeting of Stockholders to be held on May 6,April 27, 20152016, are incorporated by reference into Part III of this Form 10-K.




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Molina Healthcare, Inc.
Form 10-K
For the Year Ended December 31, 20142015
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This Annual Report on Form 10-K ("Form 10-K") contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 that involve risks and uncertainties. Many of the forward-looking statements are located under the headings "Business," and "Management's Discussion and Analysis of Financial Condition and Results of Operations." Forward-looking statements provide current expectations of future events based on certain assumptions and include any statement that does not directly relate to any historical or current fact. Forward-looking statements can also be identified by words such as "future," "anticipates," "believes," "estimates," "expects," "intends," "plans," "predicts," "will," "would," "could," "can," "may," and similar terms. Forward-looking statements are not guarantees of future performance and the Company's actual results may differ significantly from the results discussed in the forward-looking statements. Factors that might cause such differences include, but are not limited to, those discussed in Part I, Item 1A of this Form 10-K under the heading "Risk Factors." Each of the terms "Company," "Molina Healthcare," "we," "our," and "us," as used herein refers collectively to Molina Healthcare, Inc. and its wholly owned subsidiaries, unless otherwise stated. The Company assumes no obligation to revise or update any forward-looking statements for any reason, except as required by law.

PART I
Item 1: Business
OVERVIEW
Our Vision and Mission
Molina Healthcare, Inc. provides quality health care to those receiving government assistance. We offeroffers cost-effective Medicaid-related solutions to meet the health care needs of low-income families and individuals, and to assist stategovernment agencies in their administration of the Medicaid program.program.We envision a future where everyone receives quality health care, and our mission is to provide quality health care to people receiving government assistance. To execute on our vision and mission, we dedicate ourselves to the following core values:
AsCaring - We care about those we serve and advocate on their behalf.
Enthusiasm - We enthusiastically address problems and seek creative solutions.
Respect - We respect each other and value ethical business practices.
Focus - We focus on our mission.
Thrift - We are careful with scarce resources.
Accountability - We are personally accountable for our actions and collaborate to get results.
Feedback - We strive to improve the organization and achieve meaningful change through feedback and coaching.
Our Strategy
The primary objectives of our strategy over the past 35 years have been to grow and diversify our revenue; sustain our mission by being profitable; and to always remain focused on providing access to high quality healthcare for our members.
According to the U.S. Department of Health and Human Services (HHS), by late 2015 nearly 18 million people nationally gained health insurance by signing up for Medicaid or the Health Insurance Marketplace (Marketplace), since several of the Affordable Care Act's coverage provisions took effect. The uninsured rate has fallen from a high of 18% to nearly 11%; the lowest uninsured rate in 50 years according to an ongoing study by the Centers for Disease Control and Prevention. We have participated in this trend by enrolling approximately 1.6 million members since January 2014, including more than a half million Medicaid expansion members and 205,000 low-income Marketplace members. In total, as of December 31, 2014,2015, our health plans served over 2.63.5 million members eligible for Medicaid, Medicare, and other government-sponsored health care programs for low-income families and individuals.


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Beyond growing the number of members we serve, we believe our most important contribution lies in our commitment to provide access to quality health care for our members. To that end, we have set about expanding and deepening the care capabilities that we provide, focusing on quality outcomes, care integration, and measurable results. For example, the National Committee for Quality Assurance (NCQA) has accredited nine of our 12 Medicaid managed care plans. Our newer Illinois and South Carolina health plans are preparing for NCQA accreditation review in 2016. Our Puerto Rico health plan, which began serving members in 2015, will seek NCQA accreditation as soon as it is eligible to do so. We believe that these objective measures of the quality of the services we provide are increasingly important to state Medicaid agencies.
In addition, as states continue to seek cost-effective strategies to manage the care of individuals with more complex healthcare and behavioral needs, we believe that the movement toward the integration of behavioral health and medical care will continue.
Our growth strategy has four components:
Growth and retention in our existing markets;
Expansion into new geographies;
Transitioning members and benefits from fee for service to managed care; and
Developing and acquiring new products and capabilities.
Significant accomplishments in support of our strategic growth initiatives during 2015 and early 2016 included:
Growth and retention in our existing markets.
We retained and grew existing business with our re-procurement wins in Michigan and Washington. Our new contract in Michigan expanded our service area across all of the Lower Peninsula, spanning an additional 18 counties. The Washington win, along with the acquisition described below, strengthens our position in the southwestern region of that state.
Our Florida and Michigan health plans acquired Medicaid contracts which added approximately 192,000 new members in 2015.
We have announced and/or closed on Medicaid contract acquisitions in Illinois, Michigan and Washington that we expect to add approximately 257,000 new members in the first quarter of 2016.
Our Marketplace enrollment grew from approximately 15,000 members in 2014, to over 200,000 members as of December 31, 2015.
Molina Medicaid Solutions entered into a 10-year contract with the state of New Jersey to design and operate that state's new Medicaid management information system (MMIS).
Expansion into new geographies. Our Puerto Rico health plan began serving its first members in April 2015. As of December 31, 2015, our Puerto Rico plan enrollment amounted to approximately 348,000 members.
Transitioning members and benefits from fee for service to managed care. In 2015, we saw strong growth in our Medicare-Medicaid Plan (MMP) and Aged, Blind or Disabled (ABD) programs. While smaller programs in total membership, they translate to strong revenue growth because these members bring much higher premiums when

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compared with our other members, including those in the Temporary Assistance for Needy Families, Medicaid expansion and Marketplace programs.
Developing and acquiring new products and capabilities. We acquired Pathways Health and Community Support LLC (Pathways), formerly known as Providence Human Services, LLC, a division of The Providence Service Corporation. Pathways is one of the largest national providers of accessible, outcome-based behavioral/mental health and social services with operations in 23 states and the District of Columbia. We believe this acquisition will complement our Health Plans segment services with behavioral health and other services that focus on social determinants of health, as we increasingly arrange for healthcare services for members with complex needs.
Finally, to support our future growth initiatives, in 2015 we raised approximately $1.1 billion under debt and equity financing transactions, and supplemented our financing resources under a new unsecured $250 million revolving credit facility.
Our Strengths
From a strategic perspective, we believe our organizational structure allows us to participate in an expanding sector of the economy and continue our mission to provide quality health care to people receiving government assistance. Our approach to our business is based on the following strengths:
Flexible Health Services Portfolio. We offer a comprehensive suite of Medicaid services, ranging from quality care, disease management, cost management, and direct delivery of health care services, to state-level Medicaid management information systems (MMIS) administration through our Molina Medicaid Solutions segment. Our health plan care delivery systems are diverse and readily adaptable to different markets and changing conditions. We arrange health care services with a variety of providers, including independent physicians and medical groups, hospitals, ancillary providers, and our own clinics. Our systems support multiple types of contract models. Our provider networks are well-suited, based on medical specialty, member proximity, and cultural sensitivity, to provide services to our members. We believe that our Molina Medicaid Solutions platform, which is based on commercial off-the-shelf technology, has the flexibility to meet a wide variety of state Medicaid administrative needs in a timely and cost-effective manner.
Focus on People Receiving Government Assistance. Our experience over more than 35 years has allowed us to develop strong relationships with the constituents we serve, establish significant expertise as a government contractor, and develop sophisticated disease management, care coordination and health education programs that address the particular health care needs of our members. We also benefit from a thorough understanding of the cultural and linguistic needs of Medicaid populations.
Scalable Administrative Infrastructure. Our operations share common systems platforms, which allow for economies of scale and common experience in meeting the needs of state Medicaid programs. We have centralized and standardized various functions and practices to increase administrative efficiency. In addition, we have designed our administrative and operational infrastructure to be scalable for cost-effective expansion into new and existing markets.
Consistent Medicaid National Brand. Since the founding of our company in 1980 to serve the Medicaid population in southern California through a small network of primary care clinics, we have increased our Health Plans membership to 3.5 million members as of December 31, 2015, added Molina Medicaid Solutions, and introduced new capabilities with the acquisition of Pathways.
Seasoned Management Team. Dr. C. David Molina founded our company in 1980 as a provider organization serving the Medicaid population in Southern California. Today, we remain a provider-focused company led by his son, Dr. J. Mario Molina.
Significant Accomplishments in 2014
Our missionMolina, whose tenure with Molina is to provide quality health care to those receiving government assistance. Our goal is to achieve this mission while improving our financial strength. Our significant operational, financial and strategic accomplishments supporting this goal during 2014 included:
Expanding existing markets. Our Health Plans segment enrollment has grown approximately 36% since December 31, 2013, primarily a result of:
Our 2014 growth initiatives associated with the Affordable Care Act (ACA). Since the inception of these programs in January 2014 through the end of fiscal 2014, we have added approximately 385,000 Medicaid expansion members, 18,000 integrated Medicare-Medicaid Plan (MMP) members, and 15,000 Marketplace members;
The inception and growth of operations at our newer health plans in South Carolina and Illinois, adding over 200,000 members in the aggregate in fiscal 2014; and
Acquisition of two Medicaid contracts in Florida, which added approximately 73,000 new members in fiscal 2014.
Entering new strategic markets. In 2014, we were awarded a managed care contract in the Commonwealth of Puerto Rico that is expected to enroll its first members April 1, 2015. Total enrollment is expected to be approximately 350,000 new members, with anticipated annualized revenue of $750 million.
Funding future growth. Debt financing transactions generated net cash of approximately $123 million; such transactions both extended the maturity date and lowered the rateover 19 years. The rest of our convertible senior notes previously due in 2014.
Our Structure
We report our financial performance based on two reportable segments: the Health Plans segment and thenamed executive officers have been with Molina Medicaid Solutions segment. We derive our revenues primarilyfor periods ranging from health insurance premiums and service revenues. Refer10 years to Part II, Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, Note 2, "Significant Accounting Policies," and Note 21, "Segment Information," for revenue information by state health plan, and segment revenue, profit and total asset information, respectively.

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The Health Plans segment consists of operational health plans in 11 states and our direct delivery business. The health plans are operated by our respective wholly owned subsidiaries in those states, each of which is licensed as a health maintenance organization (HMO). Our direct delivery business consists primarily of the management of a hospital in southern California under a management services agreement, and the operation of primary care clinics in several states in which we operate health plans. Our Health Plans segment operates in a highly regulated environment, with stringent minimum capitalization requirements that limit the ability of our health plan subsidiaries to pay dividends to us.
Our Molina Medicaid Solutions segment provides design, development, implementation (DDI), and business process outsourcing (BPO) solutions to state governments for their Medicaid management information systems (MMIS). MMIS is a core tool used to support the administration of state Medicaid and other health care entitlement programs. Molina Medicaid Solutions currently holds MMIS contracts with the states of Idaho, Louisiana, Maine, New Jersey, and West Virginia; the U.S. Virgin Islands; and a contract to provide pharmacy rebate administration services for the Florida Medicaid program. We added the Molina Medicaid Solutions segment to our business in 2010 to expand our product offerings to include support of state Medicaid agency administrative needs, reduce the variability in our earnings resulting from fluctuations in medical care costs, improve our operating profit margin percentages, and improve our cash flow by adding a business for which there are no restrictions on dividend payments.
Our reliance on operations in a limited number of states could cause our revenue and profitability to change suddenly and unexpectedly. Additionally, our inability to continue to operate in any of the states in which we currently operate, or a significant change in the nature of our existing operations, could adversely affect our business, financial condition, cash flows, or results of operations.
Health Care Reform
The ACA has made broad-based changes to the U.S. health care system that have significantly affected the U.S. economy and our business. We expect the ACA to continue to significantly impact our business operations and financial results, including our medical care ratios.
Key components of the legislation will continue to be phased in over the next several years, with the most significant changes having occurred at the start of 2014, including the implementation of the Medicaid expansion (in electing states) and Marketplace programs, Medicare and Marketplace minimum medical loss ratios (MLRs), and new industry-wide fees, assessments, and taxes. We have dedicated material resources and have incurred material expenses in implementing and complying with the ACA, and we will continue to do so. As a result of the novelty and extremely broad scale of all of the programmatic changes effected by the ACA, many of the business and market impacts of the ACA will not be known for several20 years. Further, given the inherent difficulty of foreseeing how individuals will respond to the choices afforded to them by the ACA, we cannot predict the full effect the ACA will have on us.
Our Strategic Growth Initiatives
Our mission is to provide quality health care to those receiving government assistance. This mission drives our strategic growth and growth-related initiatives as follows:
Enter New Programs Within Existing Markets
Medicaid Expansion. In the states that have elected to participate, the ACA provides for the expansion of the Medicaid program to offer eligibility to nearly all low-income people under age 65 with incomes at or below 138% of the federal poverty line. Medicaid expansion membership phased in beginning January 1, 2014. Since that date, our health plans in California, Illinois, Michigan, New Mexico, Ohio, and Washington have begun participating in Medicaid expansion. At December 31, 2014, our membership included approximately 385,000 Medicaid expansion members, or 15% of total membership.
Health Insurance Marketplace. The ACA authorized the creation of Marketplace insurance exchanges, allowing individuals and small groups to purchase health insurance that is federally subsidized, effective January 1, 2014. We participate in the Marketplace in all of the states in which we operate, except Illinois and South Carolina. At December 31, 2014, we had approximately 15,000 Marketplace members.
Medicare-Medicaid Plans. Policymakers at the federal and state levels are increasingly focused on the design and implementation of programs that improve the coordination of care for those who qualify to receive both Medicare and Medicaid services (the "dual eligible"), and to deliver services to the dual eligible in a more financially efficient manner. As a result of these efforts, 15 states have undertaken demonstration programs to integrate Medicare and Medicaid services for dual-eligible individuals. The health plans participating in such demonstrations are referred to as Medicare-Medicaid Plans (MMPs). Our MMPs in California, Illinois, and Ohio offered coverage beginning in 2014, and we expect to begin offering MMP coverage in South Carolina and Texas in the first quarter of 2015, and in Michigan in the second quarter of 2015.

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Direct Delivery. Growth and aging of the U.S. population foreshadows an increasing shortage of physicians over the next 15 years. Health care reform is expected to worsen this shortage. We believe the shortage will be felt most acutely among already under-served populations, such as the financially vulnerable families and individuals we serve. While we have no plans to become an organization that fully integrates primary care delivery with our health plans, by leveraging our direct delivery capability on a selective basis we can improve access for our plan members in areas that are most under-served by primary care providers. We operate primary care clinics in the states of California, Florida, New Mexico, Utah, Virginia and Washington. In addition, we perform certain medical and administrative management services for a hospital in Long Beach, California, including the assumption of financial benefit and risk for a number of acute care beds at the hospital. We believe that this arrangement improves hospital access forextensive experience allows senior management to take a longer-term view of our members in the Long Beach, California area, and enhances our overall direct delivery strategy. We may incur lossesoperations, while we seek to modify various business operations and patient behaviors under the management services agreement.maintaining consistency.
Enter New Strategic Markets
We plan to continue to enter new markets through both acquisitions and by building our own start-up operations. We intend to focus our expansion in markets with competitive provider communities, supportive regulatory environments, significant size, and, where practicable, mandated Medicaid managed care enrollment. As described above, in December 2014 we entered into a Medicaid contract with the Puerto Rico Health Insurance Administration. The operational start date for the program is expected to be April 1, 2015.
Deliver Administrative Value to Medicaid AgenciesUnique Culture.
As Medicaid expenditures increase, we believe that an increasing number of states’ and other Medicaid agencies will demand comprehensive solutions that improve both quality and cost-effectiveness. We intend to use our MMIS solution to provide state Medicaid agencies with a flexible and robust solution to their administrative needs. We believe that we are unique culturally because of our MMIS platform, together withemployees' dedication to our extensive experience in health care managementcore values and health plan operations, enables usour mission. Many of our employees seek to offer state work here—and other Medicaid agenciescontinue to work here—because of our shared belief that we envision a comprehensive suite of Medicaid-related solutions that meets their needs forfuture where everyone receives quality and for the cost-effective operation of their Medicaid programs.healthcare.
Leverage Operational Efficiencies
We intend to leverage the operational efficiencies created by our centralized administrative infrastructure and flexible information systems to earn higher margins on future revenues. We believe our administrative infrastructure has significant expansion capacity, allowing us to integrate new members from expansion within existing markets and enter new markets at lower incremental cost. For example, our general and administrative expenses as a percentage of revenue (the general and administrative expense ratio) declined to 7.9% for the year ended December 31, 2014, compared with 10.1% for the year ended December 31, 2013.

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OUR INDUSTRY
Medicaid
Medicaid was established in 1965 under the U.S. Social Security Act to provide health care and long-term care services and support to low-income Americans. Although jointly funded by federal and state governments, Medicaid is a state-operated and state-implemented program. Subject to federal laws and regulations, states have significant flexibility to structure their own programs in terms of eligibility, benefits, delivery of services, and provider payments. As a result, there are 56 separate Medicaid programs—one for each U.S. state, each U.S. territory, and the District of Columbia.

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The federal government guarantees matching funds to states for qualifying Medicaid expenditures based on each state’s federal medical assistance percentage (FMAP). A state’s FMAP is calculated annually and varies inversely with average personal income in the state. The average FMAP across all statesjurisdictions is currently about 57%59%, and ranges from a federally established FMAP floor of 50% to as high as 74%.
The most common state-administered Medicaid program is the Temporary Assistance for Needy Families program (TANF), which covers primarily low-income mothers and children. In states that have elected to participate, Medicaid expansion provides eligibility to nearly all low-income people under age 65 with incomes at or below 138% of the federal poverty line. Another common state-administered Medicaid program is for aged, blind or disabled (ABD)ABD Medicaid beneficiaries, which covers low-income persons with chronic physical disabilities or behavioral health impairments. ABD beneficiaries represent a growing portion of all Medicaid recipients, and typically use more services because of their critical health issues. Additionally, the Children's Health Insurance Program (CHIP) is a joint federal and state matching program that provides health care coverage to children whose families earn too much to qualify for Medicaid coverage. States have the option of administering CHIP through their Medicaid programs. As of December 31, 2014, approximately 70% of our members were TANF beneficiaries, 15% were Medicaid expansion beneficiaries, 12% were ABD beneficiaries, 2% were Medicare beneficiaries, and 1% were integrated MMP and Marketplace beneficiaries combined. For the year ended December 31, 2014, approximately 54% of our premium revenue was from TANF and Medicaid expansion membership combined; 36% was from ABD membership, 7% was from Medicare membership, 2% was from MMP integrated membership, and 1% was from Marketplace membership.
Every state Medicaid program must balance many potentially competing demands, including the need for quality care, adequate provider access, and cost-effectiveness. To improve quality and provide more uniform and cost-effective care, many states have implemented Medicaid managed care programs. These programs seek to improve access to coordinated health care services, including preventive care, and to control health care costs. Under Medicaid managed care programs, a health plan receives capitation payments from the state. The health plan, in turn, arranges for the provision of health care services by contracting with a network of medical providers. The health plan implements care management and care coordination programs that seek to improve both care access and care quality, while controlling costs more effectively.
While many states have embraced Medicaid managed care programs, others continue to operate traditional fee-for-service programs to serve all or part of their Medicaid populations. Under fee-for-service Medicaid programs, health care services are made available to beneficiaries as they seek that care, without the benefit of a coordinated effort to maintain and improve their health. As a consequence, treatment is often postponed until medical conditions become more severe, leading to higher costs and more unfavorable outcomes. Additionally, providers paid on a fee-for-service basis are compensated based upon services they perform, rather than health outcomes, and therefore lack incentives to coordinate preventive care, monitor utilization, and control costs.
Medicare
Medicare is a federal program that provides eligible persons age 65 and over and some disabled persons with a variety of hospital, medical insurance, and prescription drug benefits. Medicare is funded by Congress, and administered by the Centers for Medicare and Medicaid Services (CMS). Medicare beneficiaries may enroll in a Medicare Advantage plan, under which managed care plans contract with CMS to provide benefits that are comparable to original Medicare. Such benefits are provided in exchange for a fixed per-member per-month (PMPM) premium payment that varies based on the county in which a member resides, the demographics of the member, and the member’s health condition.
Since 2006, Medicare beneficiaries have had the option of selecting a new prescription drug benefit from an existing Medicare Advantage plan. The drug benefit, available to beneficiaries for a monthly premium, is subject to certain cost sharing depending upon the specific benefit design of the selected plan.
Medicaid Management Information Systems
Because Medicaid is a state-administered program, every state must have mechanisms, policies, and procedures in place to perform a large number of crucial functions, including the determination of eligibility and the reimbursement of medical providers for services provided. This requirement exists regardless of whether a state has adopted a fee-for-service or a

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managed care delivery model. MMIS are used by states to support these administrative activities. Although a small number of states build and operate their own MMIS, a far more typical practice is for states to sub-contract the design, development, implementation, and operation of their MMIS to private parties. Through our Molina Medicaid Solutions segment, we actively participate in this market.

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Competition
The Medicaid managed care industry is fragmented, and the competitive landscape is subject to ongoing changes as a result of health care reform, business consolidations and new strategic alliances. We compete with a large number of national, regional, and local Medicaid service providers, principally on the basis of size, location, quality of provider network, quality of service, and reputation. Our primary competitors in the Medicaid managed care industry include Centene Corporation, WellCare Health Plans, Inc., UnitedHealth Group Incorporated, Anthem, Inc., and Aetna Inc. Competition can vary considerably from state to state. Below is a general description of our principal competitors for state contracts, members, and providers: 
Multi-Product Managed Care Organizations - National and regional managed care organizations that have Medicaid members in addition to numerous commercial health plan and Medicare members.
Medicaid HMOs - National and regional managed care organizations that focus principally on providing health care services to Medicaid beneficiaries, many of which operate in only one city or state.
Prepaid Health Plans - Health plans that provide less comprehensive services on an at-risk basis or that provide benefit packages on a non-risk basis.
Primary Care Case Management Programs - Programs established by the states through contracts with primary care providers to provide primary care services to Medicaid beneficiaries, as well as to provide limited oversight of other services.
We will continue to face varying levels of competition. Health care reform proposals may cause organizations to enter or exit the market for government sponsored health programs. However, the licensing requirements and bidding and contracting procedures in some states may present partial barriers to entry into our industry.
We compete for government contracts, renewals of those government contracts, members, and providers. State agencies consider many factors in awarding contracts to health plans. Among such factors are the health plan’s provider network, medical management, degree of member satisfaction, timeliness of claims payment, and financial resources. Potential members typically choose a health plan based on a specific provider being a part of the network, the quality of care and services available, accessibility of services, and reputation or name recognition of the health plan. We believe factors that providers consider in deciding whether to contract with a health plan include potential member volume, payment methods, timeliness and accuracy of claims payment, and administrative service capabilities.
Molina Medicaid Solutions competes with large MMIS vendors, such as HP Enterprise Services, (formerly known as EDS), ACS (owned by Xerox Corporation), Computer Services Corporation, and CNSI.

BUSINESS OPERATIONS
Our Structure
We currently manage our operations through three reportable segments: the Health Plans segment, the Molina Medicaid Solutions segment, and Other, which includes our recent Pathways acquisition described above. We regularly evaluate the appropriateness of our reportable segments, particularly in light of organizational changes, acquisition activity and changing laws and regulations. Therefore, these reportable segments may change in the future.
We derive our revenues primarily from health insurance premiums. Refer to Part II, Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, Note 2, "Significant Accounting Policies," and Note 20, "Segment Information," for revenue information by state health plan, and segment revenue, profit and total asset information, respectively.
Health Plans. The Health Plans segment consists of operational health plans in 11 states and the Commonwealth of Puerto Rico, and our direct delivery business. The health plans are operated by our respective wholly owned subsidiaries in those states, each of which is licensed as a health maintenance organization (HMO). Our direct delivery business consists primarily of the operation of primary care clinics in several states in which we operate health plans. Our Health Plans segment operates in a highly regulated environment, with stringent minimum capitalization requirements that limit the ability of our health plan subsidiaries to pay dividends to us. As of December 31, 2015, the components of our membership by program, are indicated in the following chart.

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BUSINESS OPERATIONS
Our Strengths
From a strategic perspective, we believe our two business segments allow us to participate in an expanding sector of the economy and continue our mission to provide quality health services to financially vulnerable families and individuals covered by government programs. Our approach to our business is based on the following strengths:
ComprehensiveMolina Medicaid ServicesSolutions.. We offer a complete suite of Medicaid services, ranging from quality care, disease management, cost management, and direct delivery of health care services, to state-level MMIS administration through our The Molina Medicaid Solutions segment. We have the ability to draw upon our experiencesegment provides design, development, implementation (DDI), and expertise in each of these areas to enhance the quality of the services we offer in the others. We also believe that we may have opportunities to marketbusiness process outsourcing (BPO) solutions to state governments for their Medicaid agencies various cost containmentmanagement information systems. MMIS is a core tool used to support the administration of state Medicaid and quality practices used by our health plans, such as care management and care coordination, for incorporation into their own fee-for-service Medicaid programs.
Flexible Service Delivery Systems. Our health plan care delivery systems are diverse and readily adaptable to different markets and changing conditions. We arrangeother health care services with a variety of providers, including independent physicians and medical groups, hospitals, ancillary providers, and our own clinics. Our systems support multiple types of contract models. Our provider networks are well-suited, based on medical specialty, member proximity, and cultural sensitivity, to provide services to our members. We believe that ourentitlement programs. Molina Medicaid Solutions platform, which is based on commercial off-the-shelf technology, hascurrently holds MMIS contracts with the flexibilitystates of Idaho, Louisiana, Maine, New Jersey, and West Virginia; the U.S. Virgin Islands; and a contract to meet a wide variety ofprovide pharmacy rebate administration services for the Florida Medicaid program. The Molina Medicaid Solutions segment supports state Medicaid agency administrative needs, reduces the variability in our earnings resulting from fluctuations in medical care costs, improves our operating profit margin percentages, and improves our cash flow by adding a business for which there are no restrictions on dividend payments.
Other. Our Other segment includes other businesses, such as our Pathways behavioral health and social services provider, that do not meet the quantitative thresholds for a reportable segment as defined by U.S. generally accepted accounting principles (GAAP), as well as corporate amounts not allocated to other reportable segments.
Our reliance on operations in a timelylimited number of states could cause our revenue and cost-effective manner.
Proven Expansionprofitability to change suddenly and Acquisition Capability. We have successfully replicatedunexpectedly. Additionally, our inability to continue to operate in any of the business model of our Health Plans segment through the acquisition of health plans, the start-up development of new operations, and the transition of members from other health plans. The initial acquisitions of our New Mexico, South Carolina and Wisconsin health plans have demonstrated our ability to expand into new states. The establishment of our health plans in Florida, Illinois, Ohio, Texas and Utah reflects our ability to replicate our business model on a start-up basis in new states, while significant contract acquisitions in California, Michigan, New Mexico and Washington have demonstrated our ability to expand our operations within states in which we were already operating.
Administrative Efficiency. Operationally, our two business segments sharecurrently operate, or a common systems platform, which allows for economies of scale and common experiencesignificant change in meeting the needs of state Medicaid programs. We have centralized and standardized various functions and practices to increase administrative efficiency. The steps we have taken include centralizing claims processing and information services onto a single platform and standardization of medical management programs, pharmacy benefits management contracts, and health education programs. In addition, we have designed our administrative and operational infrastructure to be scalable for cost-effective expansion into new and existing markets.
Recognition for Quality of Care. The National Committee for Quality Assurance (NCQA) has accredited ninenature of our 11 Medicaid managed care plans. We believe that these objective measuresexisting operations, could adversely affect our business, financial condition, cash flows, or results of the quality of the services that we provide will become increasingly important to state Medicaid agencies.
Experience and Expertise. Since the founding of our company in 1980 to serve the Medicaid population in southern California through a small network of primary care clinics, we have increased our membership to 2.6 million members as of December 31, 2014, expanded our Health Plans segment to 11 states, and added our Molina Medicaid Solutions segment. Our experience over more than 30 years has allowed us to develop strong relationships with the constituents we serve, establish significant expertise as a government contractor, and develop sophisticated disease management, care coordination and health education programs that address the particular health care needs of our members. We also benefit from a thorough understanding of the cultural and linguistic needs of Medicaid populations.operations.
Pricing
Medicaid. Under our Medicaid contracts, state government agencies pay our health plans fixed PMPM rates that vary by state, line of business and demographics; and we arrange, pay for and manage health care services provided to Medicaid beneficiaries. Therefore, our health plans are at risk for the medical costs associated with their members’ health care. The rates we receive are subject to change by each state and, in some instances, provide for adjustments for health risk factors. CMS requires these rates to be actuarially sound. Payments to us under each of our Medicaid contracts are subject to the annual appropriation process in the applicable state.
Medicare. Under Medicare Advantage, managed care plans contract with CMS to provide benefits in exchange for a fixed PMPM premium payment that varies based on the county in which a member resides, and adjusted for demographic and health risk factors. CMS also considers inflation, changes in utilization patterns and average per capita fee-for-service Medicare costs in the calculation of the fixed PMPM premium payment.
Amounts payable to us under the Medicare Advantage contracts are subject to annual revision by CMS, and we elect to participate in each Medicare service area or region on an annual basis. Medicare Advantage premiums paid to us are subject to

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federal government reviews and audits which can result, and have resulted, in retroactive and prospective premium adjustments. Compared with our Medicaid plans, Medicare Advantage contracts generate higher average PMPM revenues and health care costs.
Marketplace. For our Marketplace plans, we develop premium rates during early spring of any giveneach year to take effect onfor policies effective January 1st of the following year. We develop our premium rates based on our estimates of projected member utilization, medical unit costs, member risk acuity, and administrative costs, with the intent of realizing a target pretax percentage profit margin. In setting premium rates for our Marketplace plans, we also take into account the competitive environment on a region–by–region basis. Our

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actuaries certify the actuarial soundness of Marketplace premiums in the rate filings submitted to the various state and federal authorities for approval.
Medical Management
Our experience in medical management extends back to our roots as a provider organization. Primary care physicians are the focal point of the delivery of health care to our members, providing routine and preventive care, coordinating referrals to specialists, and assessing the need for hospital care. This model has proved to be an effective method for coordinating medical care for our members. The underlying challenge we face is to coordinate health care so that our members receive timely and appropriate care from the right provider at the appropriate cost. In support of this goal, and to ensure medical management consistency among our various state health plans, we continuously refine and upgrade our medical management efforts at both the corporate and subsidiary levels.
We seek to ensure quality care for our members on a cost-effective basis through the use of certain key medical management and cost control tools. These tools include utilization management, case and health management, and provider network and contract management.
Utilization Management. We continuously review utilization patterns with the intent to optimize quality of care and ensure that only appropriate services are rendered in the most cost-effective manner. Utilization management, along with our other tools of medical management and cost control, is supported by a centralized corporate medical informatics function which utilizes third-party software and data warehousing tools to convert data into actionable information. We use predictive modeling that supports a proactive case and health management approach both for us and our affiliated physicians.
Case and Health Management. We seek to encourage quality, cost-effective care through a variety of case and health management programs, including disease management programs, educational programs, and pharmacy management programs such as the following:
Disease Management Programs. We develop specialized disease management programs that address the particular health care needs of our members. "motherhood matters!sm" is a comprehensive program designed to improve pregnancy outcomes and enhance member satisfaction. "breathe with ease!" is a multi-disciplinary disease management program that provides health education resources and case management services to assist physicians caring for asthmatic members between the ages of three and 15. "Healthy Living with Diabetes" is a diabetes disease management program. "Heart Healthy Living" is a cardiovascular disease management program for members who have suffered from congestive heart failure, angina, heart attack, or high blood pressure.
Educational Programs. Educational programs are an important aspect of our approach to health care delivery. These programs are designed to increase awareness of various diseases, conditions, and methods of prevention in a manner that supports our providers while meeting the unique needs of our members. For example, we provide our members with information to guide them through various episodes of care. This information, which is available in several languages, is designed to educate members on the use of primary care physicians, emergency rooms, and nurse call centers.
Pharmacy Management Programs. Our pharmacy management programs focus on physician education regarding appropriate medication utilization and encouraging the use of generic medications. Our pharmacists and medical directors work with our pharmacy benefits manager to maintain a formulary that promotes both improved patient care and generic drug use. We employ full-time pharmacists and pharmacy technicians who work with physicians to educate them on the uses of specific drugs, the implementation of best practices, and the importance of cost-effective care.
Provider Network and Contract Management. The quality, depth, and scope of our provider network are essential if we are to ensure quality, cost-effective care for our members. In partnering with quality, cost-effective providers, we utilize clinical and financial information derived by our medical informatics function, as well as the experience we have gained in serving Medicaid members, to gain insight into the needs of both our members and our providers. As we grow in size, we seek to strengthen our ties with high-quality, cost-effective providers by offering them greater patient volume.

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Provider Networks
We arrange health care services for our members through contracts with providers that include independent physicians and groups, hospitals, ancillary providers, and our own clinics. Our network of providers includes primary care physicians, specialists and hospitals. Our strategy is to contract with providers in those geographic areas and medical specialties necessary to meet the needs of our members. We also strive to ensure that our providers have the appropriate cultural and linguistic experience and skills.
Physicians. We contract with both primary care physicians and specialists, many of whom are organized into medical groups or independent practice associations (IPAs). Primary care physicians provide office-based primary care services. Primary care

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physicians may be paid under capitation or fee-for-service contracts and may receive additional compensation by providing certain preventive services. Our specialists care for patients for a specific episode or condition, usually upon referral from a primary care physician, and are usually compensated on a fee-for-service basis. When we contract with groups of physicians on a capitated basis, we monitor their solvency.
Hospitals. We generally contract with hospitals that have significant experience dealing with the medical needs of the Medicaid population. We reimburse hospitals under a variety of payment methods, including fee-for-service, per diems, diagnostic-related groups (DRGs) capitation, and case rates.
Direct Delivery. The clinics we operate are located in neighborhoods where our members live, and provide us a first-hand opportunity to understand the special needs of our members. The clinics we operate and the clinics and hospital services we manage, assist us in developing and implementing community education, disease management, and other programs. Direct clinic management experience also enables us to better understand the needs of our contracted providers.
Reinsurance
Our health plans currently have reinsurance agreements with an unaffiliated insurer to cover certain claims. We enter into these contracts to reduce the risk of catastrophic losses which in turn reduce our capital and surplus requirements. We frequently evaluate reinsurance opportunities and review our reinsurance and risk management strategies on a regular basis.
Management Information Systems
All of our health plan information technology systems operate on a single platform. This approach avoids the costs associated with maintaining multiple systems, improves productivity, and enables medical directors to compare costs, identify trends, and exchange best practices among our plans. Our single platform also facilitates our compliance with current and future regulatory requirements.
The software we use is based on client-server technology and is scalable. We believe the software is flexible, easy to use, and allows us to accommodate anticipated enrollment growth and new contracts. The open architecture of the system gives us the ability to transfer data from other systems without the need to write a significant amount of computer code, thereby facilitating the integration of new plans and acquisitions.
We have designed our corporate website with a focus on ease of use and visual appeal. Our website has a secure ePortal which allows providers, members, and trading partners to access individualized data. The ePortal allows the following self-services:
Provider Self Services - Providers have the ability to access information regarding their members and claims. Key functionalities include "Check Member Eligibility," "View Claim," and "View/Submit Authorizations."
Member Self Services - Members can access information regarding their personal data, and can perform the following key functionalities: "View Benefits," "Request New ID Card," "Print Temporary ID Card," and "Request Change of Address/PCP."
File Exchange Services - Various trading partners, such as service partners, providers, vendors, management companies, and individual IPAs, are able to exchange data files (such as those that may be required by federal health care privacy regulations, or any other proprietary format) with us using the file exchange functionality.
Best Practices. We continuously seek to promote best practices. Our approach to quality is broad, encompassing traditional medical management and the improvement of our internal operations. We have staff assigned full-time to the development and implementation of a uniform, efficient, and quality-based medical care delivery model for our health plans. These employees coordinate and implement company-wide programs and strategic initiatives such as preparation of the Healthcare Effectiveness Data and Information Set (HEDIS), and accreditation by the NCQA. We use measures established by the NCQA in credentialing the physicians in our network. We routinely use peer review to assess the quality of care rendered by providers.
Claims Processing. All of our health plans operate on a single managed care platform for claims processing (the QNXT system).

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Centralized Management Services. We provide certain centralized medical and administrative services to our health plans pursuant to administrative services agreements, including medical affairs and quality management, health education, credentialing, management, financial, legal, information systems, and human resources services. Fees for such services are based on the fair market value of services rendered and are recorded as operating revenue.rendered. Payment is subordinated to the health plan’s ability to comply with minimum capital and other restrictive financial requirements of the states in which they operate.
Compliance. Our health plans have established high standards of ethical conduct. Our compliance programs are modeled after the compliance guidance statements published by the Office of the Inspector General of the U.S. Department of Health and Human Services (HHS).HHS. Our uniform approach to compliance makes it easier for our health plans to share information and practices and reduces the potential for compliance errors and any associated liability.

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Disaster Recovery. We have established a disaster recovery and business resumption plan, with back-up operating sites, to be deployed in the case of a major disruptive event.

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CONTRACTING AND REGULATORY COMPLIANCE
Government Contracts
Medicaid. In all the states in which we operate health plans, we enter into a contract with the state’s Medicaid agency to offer managed care benefits to Medicaid-eligible individuals. Some states award contracts to any applicant demonstrating that it meets the state’s requirements, while other states engage in a competitive bidding process. In all cases, we must demonstrate to the satisfaction of the state Medicaid program that we are able to meet the state’s operational and financial requirements. These requirements are in addition to those required for a license and are targeted to the specific needs of the Medicaid population; for example:
We must measure provider access and availability in terms of the time needed to reach the doctor’s office using public transportation;
Our quality improvement programs must emphasize member education and outreach and include measures designed to promote utilization of preventive services;
We must have linkages with schools, city or county health departments, and other community-based providers of health care, to demonstrate our ability to coordinate all of the sources from which our members may receive care;
We must be able to meet the needs of the disabled and others with special needs;
Our providers and member service representatives must be able to communicate with members who do not speak English or who are deaf; and
Our member handbook, newsletters, and other communications must be written at the prescribed reading level, and must be available in languages other than English.
To operate a health plan in a given state, we must apply for and obtain a certificate of authority or license from that state. We are regulated by the state agency with responsibility for the oversight of HMOs which, in most cases, is the state department of insurance. In California, however, the agency with responsibility for the oversight of HMOs is the Department of Managed Health Care. Licensing requirements are the same for us as they are for health plans serving commercial or Medicare members. For example, we must demonstrate that:
Our provider network is adequate;
Our quality and utilization management processes comply with state requirements;
We have adequate procedures in place for responding to member and provider complaints and grievances;
We can meet requirements for the timely processing of provider claims;
We can collect and analyze the information needed to manage our quality improvement activities;
We have the financial resources necessary to pay our anticipated medical care expenses and the infrastructure needed to account for our costs;
We have the systems required to process enrollment information, to report on care and services provided, and to process claims for payment in a timely fashion; and
We have the financial resources needed to protect the state, our providers, and our members against the insolvency of one of our health plans.
Our state contracts determine the type and scope of health care services that we arrange for our members. Generally, our contracts require us to arrange for preventive care, office visits, inpatient and outpatient hospital and medical services, and pharmacy benefits. The contracts also detail the requirements for operating in the Medicaid sector, including provisions relating to: eligibility; enrollment and dis-enrollment processes; covered benefits; eligible providers; subcontractors; record-keeping and record retention; periodic financial and informational reporting; quality assurance; marketing; financial standards; timeliness of claims payments; health education, wellness and prevention programs; safeguarding of member information; fraud and abuse detection and reporting; grievance procedures; and organization and administrative systems. A health plan’s compliance with these requirements is subject to monitoring by state regulators. A health plan is subject to periodic comprehensive quality assurance evaluation by a third-party reviewing organization and generally by the insurance department of the jurisdiction that licenses the health plan.

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The contractual relationship with the state is generally for a period of three to four years and is renewable on an annual or biennial basis at the discretion of the state. In general, either the state Medicaid agency or the health plan may terminate the state contract with or without cause upon 30 days to nine months’ prior written notice.

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Most of these contracts contain renewal options that are exercisable by the state. Our health plan subsidiaries have generally been successful in obtaining the renewal of their contracts in each state prior to the actual expiration of their contracts. Our state contracts are generally at greatest risk of loss when a state issues a new request for proposals (RFP), subject to competitive bidding by other health plans. If one of our health plans is not a successful responsive bidder to a state RFP, its contract may be subject to non-renewal. For instance, in early 2012 our Missouri health plan was notified that it was not awarded a new contract under that state’s RFP, and therefore its contract expired in that year.
Medicare. Under annually renewable contracts with CMS, our state health plans offer Medicare Advantage special needs plans which include a mandatory Part D prescription drug benefit. Molina Medicare Options Plus, our trade name for these plans, serves beneficiaries who are dually eligible for both Medicare and Medicaid, such as low-income seniors and people with disabilities. We believe offering these Medicare plans is consistent with our historical mission of serving low-income and medically under-served families and individuals. We employ sales personnel, and engage independent brokers, agents and consultants to enroll new Molina Medicare Options Plus members. None of our health plans operates a Medicare Advantage private fee-for-service plan.
Total enrollment in our Medicare Advantage plans as of December 31, 2014 was approximately 49,000 members. For the year ended December 31, 2014, Medicare premium revenues in the aggregate represented approximately 7% of our total premium revenues.
Federal regulations place prohibitions and limitations on certain sales and marketing activities of Medicare Advantage plans. Among other things, Medicare Advantage plans are not permitted to make unsolicited outbound calls to potential members or engage in other forms of unsolicited contact, establish appointments without documented consent from potential members, or conduct sales events in certain provider-based settings. Additionally, there are certain restrictions on agent and broker compensation.
Molina Medicaid Solutions. We continually monitor the status of various states’states' legacy MMIS capabilities and contracts to determine whether Molina Medicaid Solutions’ value proposition and core strengths will address a state’s MMIS goals. Once an RFP with a Medicaid agency is won, our Molina Medicaid Solutions contracts may extend over a number of years, particularly in circumstances where we deliver extensive and complex DDI services, such as the initial design, development and implementation of a complete MMIS. For example, the initial termsterm of our most recently implemented Molina Medicaid Solutions contracts (in Idaho and Maine) were each sevencontract in New Jersey is 10 years in total, consisting of two2.5 years allocated for the delivery of DDI services, followed by five7.5 years for the performance of BPO services. In most of these engagements option years are offered which span 2-3 years. The terms of some of our other established Molina Medicaid Solutions contracts - contracts—which primarily involve the delivery of BPO services with only minimal DDI activity (consisting of system enhancements) - are shorter in duration than our Idaho and Mainemore recent contracts.
The federal government typically reimburses the states for 90% of the costs incurred in the design, development, and implementation of an MMIS and for 75% of the costs incurred in operating a certified MMIS. Federal certification increases the share of the claims processing costs the federal government will pay for monthly operations. With an uncertified system, the federal government contributes approximately 50% of claims processing costs, with the state paying the other half. With a certified system, the federal government pays 75% of costs, reducing the state’s share.
Other. Substantially all of Pathways' revenue is derived from contracts with state or local government agencies and government intermediaries, the majority of which are negotiated fee-for-service arrangements. A significant number of these contracts allow the payer to terminate the contract immediately for cause, such as for our failure to meet our contract obligations. Additionally, these contracts typically permit the payer to terminate the contract at any time prior to its stated expiration date without cause, at will and without penalty to the payer, either upon the expiration of a short notice period, typically 30 days, or immediately, in the event federal or state appropriations supporting the programs serviced by the contract are reduced or eliminated.
Regulatory Compliance
Our health plans are highly regulated by both state and federal government agencies. Regulation of managed care products and health care services varies from jurisdiction to jurisdiction, and changes in applicable laws and rules occur frequently. Regulatory agencies generally have discretion to issue regulations and interpret and enforce laws and rules. Such agencies have become increasingly active in recent years in their review and scrutiny of health insurers and managed care organizations, including those operating in the Medicaid and Medicare programs.
Health Insurer Fee (HIF). One notable provision of the ACA is an excise tax or annual fee that applies to most health plans, including commercial health plans and Medicaid managed care plans like Molina Healthcare. While characterized as a "fee" in the text of the ACA, the intent of Congress was to impose a broad-based health insurance industry excise tax, with the understanding that the tax could be passed on to consumers, most likely through higher commercial insurance premiums.
However, because Medicaid is a government funded program, Medicaid health plans have no alternative but to look to their respective state partners for payment to offset the impact of this tax. Additionally, when states reimburse us for the amount of the HIF, that reimbursement is itself subject to income tax, the HIF, and applicable state premium taxes. Because the HIF is not deductible for income tax purposes, our net income is reduced by the full amount of the assessment. We expect our 2015 HIF assessment related to our Medicaid business to be approximately $143 million, with an expected tax effect from the reimbursement of the assessment of approximately $88 million. Therefore, the total reimbursement needed as a result of the Medicaid-related HIF is approximately $231 million.

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For further discussion of the risks and uncertainties relating to this excise tax, refer to Part II, Item 7 of this Form 10-K, Management’s Discussion and Analysis of Financial Condition and Results of Operations, under the subheading "Liquidity and Capital Resources—Financial Condition."
States’ Risk-Based Capital Requirements. Our health plans are required to file quarterly and annual reports of their operating results with the appropriate state regulatory agencies. These reports are accessible for public viewing. Each health plan undergoes periodic examinations and reviews by the state in which it operates. The health plans generally must obtain approval from the state before declaring dividends in excess of certain thresholds. Each health plan must maintain its net worth at an amount determined by statute or regulation. The minimum statutory net worth requirements differ by state, and are generally based on statutory minimum risk-based capital (RBC) requirements. The RBC requirements are based on guidelines established

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by the National Association of Insurance Commissioners (NAIC) and are administered by the states. All of our state health plans are subject to RBC requirements, except California and Florida. Any acquisition of another plan’s members or its state contracts must also be approved by the state, and our ability to invest in certain financial securities may be prescribed by statute. For further information regarding RBC requirements, refer to Part II, Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, in Note 20,19, "Commitments and Contingencies."
In addition, we are also regulated by each state’s department of health services or the equivalent agency charged with oversight of Medicaid and CHIP. These agencies typically require demonstration of the same capabilities mentioned above and perform periodic audits of performance, usually annually.
HIPAA. In 1996, Congress enacted the Health Insurance Portability and Accountability Act (HIPAA). All health plans are subject to HIPAA, including ours. HIPAA generally requires health plans to:
Establish the capability to receive and transmit electronically certain administrative health care transactions, like claims payments, in a standardized format;
Afford privacy to patient health information; and
Protect the privacy of patient health information through physical and electronic security measures.
Health care reform created additional tools for fraud prevention, including increased oversight of providers and suppliers participating or enrolling in Medicaid, CHIP, and Medicare. Those enhancements included mandatory licensure for all providers, and site visits, fingerprinting, and criminal background checks for higher risk providers.
The Health Information Technology for Economic and Clinical Health Act (HITECH Act), a part of the American Recovery and Reinvestment Act of 2009, or ARRA, modified certain provisions of HIPAA by, among other things, extending the privacy and security provisions to business associates, mandating new regulations around electronic medical records, expanding enforcement mechanisms, allowing the state Attorneys General to bring enforcement actions, and increasing penalties for violations. As required by ARRA, the Secretary of HHS has promulgated regulations implementing various provisions of the HITECH Act. The Final Omnibus Rule promulgated by HHS in January 2013, included the Final Breach Notification Rule as well as provisions that apply the HIPAA regulatory scheme to business associates. We anticipate that HHS will promulgate additional rules under the HITECH Act to implement provisions of the statute which were not addressed in the Final Omnibus Rule. The various requirements of the HITECH Act and the Final Omnibus Rule have different compliance dates, and in some cases, the applicable compliance date may depend on the publication of additional rules or guidance by HHS. With respect to those requirements whose compliance dates have passed, we believe that we are in compliance with such provisions. With respect to additional requirements that may be issued in the future by HHS, it is our intention to implement any such new requirements on or before the applicable compliance dates.
Fraud and Abuse Laws. Our operations are subject to various state and federal health care laws commonly referred to as "fraud and abuse" laws. Fraud and abuse prohibitions encompass a wide range of activities, including kickbacks for referral of members, billing for unnecessary medical services, improper marketing, and violations of patient privacy rights. These fraud and abuse laws include the federal False Claims Act which prohibits the knowing filing of a false claim or the knowing use of false statements to obtain payment from the federal government. Many states have false claim act statutes that closely resemble the federal False Claims Act. If an entity is determined to have violated the federal False Claims Act, it must pay three times the actual damages sustained by the government, plus mandatory civil penalties up to fifty thousand dollars for each separate false claim. Suits filed under the Federal False Claims Act, known as "qui tam" actions, can be brought by any individual on behalf of the government and such individuals (known as "relators" or, more commonly, as "whistleblowers") may share in any amounts paid by the entity to the government in fines or settlement. Qui tam actions have increased significantly in recent years, causing greater numbers of health care companies to have to defend a false claim action, pay fines or be excluded from the Medicaid, Medicare or other state or Federal health care programs as a result of an investigation arising out of such action. In addition, the Deficit Reduction Act of 2005 (DRA) encourages states to enact state-versions of the federal False Claims Act that establish liability to the state for false and fraudulent Medicaid claims and that provide for, among other things, claims to be filed by qui tam relators.

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Companies involved in public health care programs such as Medicaid are often the subject of fraud and abuse investigations. The regulations and contractual requirements applicable to participants in these public sector programs are complex and subject to change. Violations of certain fraud and abuse laws applicable to us could result in civil monetary penalties, criminal fines and imprisonment, and/or exclusion from participation in Medicaid, Medicare, other federal health care programs and federally funded state health programs.
Federal and state governments have made investigating and prosecuting health care fraud and abuse a priority. Although we believe that our compliance efforts are adequate, we will continue to devote significant resources to support our compliance efforts.

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Federal and State Self-Referral Prohibitions. We may be subject to federal and state statutes banning payments for referrals of patients and referrals by physicians to healthcare providers with whom the physicians have a financial relationship. Section 1877 of the Social Security Act, also known as the "Stark Law," prohibits physicians from making a "referral" for "designated health services" for Medicare (and in many cases Medicaid) patients from entities or facilities in which such physicians directly or indirectly hold a "financial relationship." A financial relationship can take the form of a direct or indirect ownership, investment or compensation arrangement. A referral includes the request by a physician for, or ordering of, or the certifying or re-certifying the need for, any designated health services.
Certain services that we provide may be identified as "designated health services" for purposes of the Stark Law. We cannot provide assurance that future regulatory changes will not result in other services we provide becoming subject to the Stark Law’s ownership, investment or compensation prohibitions in the future.
Many states, including some states where we do business, have adopted similar or broader prohibitions against payments that are intended to induce referrals of clients. Moreover, many states where we operate have laws similar to the Stark Law prohibiting physician self-referrals. We contract with a significant number of human services providers and practitioners, including therapists, physicians and psychiatrists, and arrange for these individuals or entities to provide services to our clients. While we believe that these contracts are in compliance with the Stark Law, no assurance can be made that such contracts will not be considered in violation of the Stark Law.
For-profit ownership. Certain of the agencies for which we provide services restrict our ability to contract directly as a for-profit organization. Instead, these agencies contract directly with a not-for-profit organization and in certain cases we negotiate to provide administrative and management services to the not-for-profit providers. The extent to which other agencies impose such requirements may affect our ability to continue to provide the full range of services that we provide or limit the organizations with which we can contract directly to provide services.
Corporate practice of medicine and fee splitting. Some states in which we operate prohibit general business entities, such as us, from "practicing medicine," which definition varies from state to state and can include employing physicians, professional therapists and other mental health professionals, as well as engaging in fee-splitting arrangements with these health care providers. Among other things, we currently contract with professional therapists to provide intensive home based counseling and with nurse practitioners to perform comprehensive health assessments. We believe that we have structured our operations appropriately, however, we could be alleged or found to be in violation of some or all of these laws. If a state determines that some portion of our business violates these laws, it may seek to have us discontinue those portions or subject us to penalties, fines, certain license requirements or other measures. Any determination that we have acted improperly in this regard may result in liability to us. In addition, agreements between the corporation and the professional may be considered void and unenforceable.
Professional licensure and other requirements. Many of our employees are subject to federal and state laws and regulations governing the ethics and practice of their professions. In addition, professionals who are eligible to participate in Medicare and Medicaid as individual providers must not have been excluded from participation in government programs at any time. Our ability to provide services depends upon the ability of our personnel to meet individual licensure and other requirements.

OTHER INFORMATION
Intellectual Property
We have registered and maintain various service marks, trademarks and trade names that we use in our businesses, including marks and names incorporating the "Molina" or "Molina Healthcare" phrase, and from time to time we apply for additional registrations of such marks. We utilize these and other marks and names in connection with the marketing and identification of products and services. We believe such marks and names are valuable and material to our marketing efforts.
Employees
As of December 31, 2014,2015, we had approximately 10,50021,000 employees. Our employee base is multicultural and reflects the diverse membership we serve. We believe we have good relations with our employees. None of our employees is represented by a union.
Available Information
We are organized asMolina Healthcare, Inc. is a C corporation under Delaware law.law incorporated in 2002. Our principal executive offices are located at 200 Oceangate, Suite 100, Long Beach, California 90802, and our telephone number is (562) 435-3666.
You can access our website at www.molinahealthcare.com to learn more about our Company. From that site, you can download and print copies of our Annual Reports on Form 10-K, Quarterly Reports on Form 10-Q, and Current Reports on Form 8-K, along with amendments to those reports. You can also download our Corporate Governance Guidelines, Board of Directors

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committee charters, and Code of Business Conduct and Ethics. We make periodic reports and amendments available, free of charge, as soon as reasonably practicable after we file or furnish these reports to the SEC. We will also provide a copy of any of our corporate governance policies published on our website free of charge, upon request. To request a copy of any of these documents, please submit your request to: Molina Healthcare, Inc., 200 Oceangate, Suite 100, Long Beach, California 90802, Attn: Investor Relations. Information on or linked to our website is neither part of nor incorporated by reference into this Annual Report on Form 10-K or any other SEC filings.
Executive Officers of the Registrant
The following sets forth certain information regarding our executive officers, including the business experience of each executive officer during the past five years:
NameAgePosition
J. Mario Molina, M.D.5657President and Chief Executive Officer
John C. Molina, J.D.5051Chief Financial Officer
Terry P. Bayer6465Chief Operating Officer
Joseph W. White5657Chief Accounting Officer
Jeff D. Barlow5253Chief Legal Officer and Corporate Secretary

Dr. Molina has served as President and Chief Executive Officer since succeeding his father and company founder, Dr. C. David Molina, in 1996. He has also served as Chairman of the Board of Directors since 1996. Dr. Molina is the brother of John C. Molina.
Mr. Molina has served as Chief Financial Officer since 1995. He also has served as a member of the Board of Directors since 1994. Mr. Molina is the brother of Dr. J. Mario Molina.
Ms. Bayer has served as Chief Operating Officer since 2005.
Mr. White has served as Chief Accounting Officer since 2007.
Mr. Barlow has served as Chief Legal Officer and Corporate Secretary since 2010. From 2004 to 2010, Mr. Barlow served as Vice President, Assistant Secretary, and Assistant General Counsel of Molina Healthcare.


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Item 1A:  Risk Factors
RISK FACTORS
Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995
This Annual Report on Form 10-K and the documents we incorporate by reference in this report contain forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended (the "Securities Act"), and Section 21E of the Securities Exchange Act of 1934, as amended (the "Exchange Act"). Other than statements of historical fact, all statements that we include in this report and in the documents we incorporate by reference may be deemed to be forward-looking statements for purposes of the Securities Act and the Exchange Act. Such forward-looking statements may be identified by words such as "anticipates," "believes," "could," "estimates," "expects," "guidance," "intends," "may," "outlook," "plans," "projects," "seeks," "will," or similar words or expressions.
Investing in our securities involves a high degree of risk. Before making an investment decision, you should carefully read and consider the following risk factors, as well as the other information we include or incorporate by reference in this report and the information in the other reports we file with the U.S. Securities Exchange Commission, or SEC. Such risk factors should be considered not only with regard to the information contained in this annual report, but also with regard to the information and statements in the other periodic or current reports we file with the SEC, as well as our press releases, presentations to securities analysts or investors, or other communications made by or with the approval of one of our executive officers. No assurance can be given that we will actually achieve the results contemplated or disclosed in our forward-looking statements. Such statements may turn out to be wrong due to the inherent uncertainties associated with future events. Accordingly, you should not place undue reliance on our forward-looking statements, which reflect management’s analyses, judgments, beliefs, or expectations only as of the date they are made.
If any of the events described in the following risk factors actually occur, our business, results of operations, financial condition, cash flows, or prospects could be materially adversely affected. The risks and uncertainties described below are those that we currently believe may materially affect us. Additional risks and uncertainties not currently known to us or that we currently deem immaterial may also affect our business and operations. As such, you should not consider this list to be a complete statement of all potential risks or uncertainties. Except to the extent otherwise required by federal securities laws, we do not undertake to address or update forward-looking statements in future filings or communications regarding our business or operating results, and do not undertake to address how any of these factors may have caused results to differ from discussions or information contained in previous filings or communications.
Risks Related to Our Health Plans Segment
Numerous risks associated with the Affordable Care Act and its implementation, and changes to health care regulatory laws, could have a material adverse effect on our business, financial condition, cash flows, or results of operations.
In March 2010, President Obama signed both the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act (collectively, the Affordable Care Act, or ACA). The ACA enactsenacted comprehensive changes to the United StatesU.S. health care system, elements of which will behave been phased in at various stages over the nextpast several years. However, theThe most significant changes effected by the ACA were implemented as of January 1, 2014. There are a multitude of risks associated with the scope of change in the health care system represented by the ACA, including, but not limited to, the following:
Risks associated with the health care federal excise tax. One notable provision of the ACA is an excise tax or annual fee that applies to most health plans, including commercial health plans and Medicaid managed care plans like Molina Healthcare. While characterized as a "fee" in the text of the ACA, the intent of Congress was to impose a broad-based health insurance industry excise tax, with the understanding that the tax could be passed on to consumers, most likely through higher commercial insurance premiums. However, because Medicaid is a government funded program, Medicaid health plans have no alternative but to look to their respective state partners for payment to offset the impact of this tax. Additionally, when states reimburse us for the amount of the HIF, that reimbursement is itself subject to income tax, the HIF, and applicable state premium taxes. Because the HIF is not deductible for income tax purposes, our net income is reduced by the full amount of the assessment. The state of California has not formally committed to reimburse us for either the HIF itself, or the related tax effects. The states of Michigan and Utah have reimbursed us for the HIF, but have not formally committed to reimbursement for the related tax effect. The total amount of HIF revenue for which agreements were not secured (and revenue was not recognized) amounted to approximately $20 million for fiscal 2014. We expect to collect and recognize this revenue related to 2014 in 2015. We further expect to recognize revenue in 2015 sufficient to reimburse us for the full amount of the HIF we will pay (along with related tax effects) in September of 2015. We expect our 2015 HIF assessment related to our Medicaid business to be approximately $143 million, with an expected tax effect from the reimbursement of the assessment of approximately $88 million. Therefore, the total reimbursement needed as a result of the Medicaid-related HIF is approximately $231

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million. The failure of our state partners to reimburse us in full for the HIF and its related tax effects could have a material adverse effect on our business, financial condition, cash flows or results of operations.
Risks associated with the duals expansion. Nine million low-income elderly and disabled people are covered under both the Medicare and Medicaid programs. These beneficiaries are more likely than other Medicare beneficiaries to be frail, live with multiple chronic conditions, and have functional and cognitive impairments. Medicare is their primary source of health insurance coverage, as it is for the nearly 50 million elderly and under-65 disabled beneficiaries in 2012. Medicaid supplements Medicare by paying for services not covered by Medicare, such as dental care and long-term care services and support, and by helping to cover Medicare’s premiums and cost-sharing requirements. Together, these two programs help to shield very low-income Medicare beneficiaries from potentially unaffordable out-of-pocket medical and long-term care costs. Policymakers at the federal and state levels are increasingly focused on the design and implementation of programs that improve the coordination ofTo coordinate care for those who qualify to receive both Medicare and Medicaid services (the "dual eligible"), and to deliver services to the dual eligiblethese individuals in a more financially efficient manner. As a result of these efforts, 15manner, some states have undertaken demonstration programs to integrate Medicare and Medicaid services for dual-eligibledual eligible individuals. The health plans participating in such demonstrations are referred to as Medicare-Medicaid Plans (MMPs). We operate MMPs in six states. Our MMPs in California, Illinois, and Ohio offered coverage beginning in 2014, and we expect to begin offering MMP coverage2014; our MMPs in South Carolina and Texas offered coverage beginning in the first quarter of 2015,2015; and our MMP in Michigan offered coverage beginning in the second quarter of 2015. At December 31, 2015, our membership included approximately 51,000 integrated MMP members.
There are numerous risks associated with the initial implementation of a new program, with a health plan’s expansion into a new service area, and with the provision of medical services to a new population which has not previously been

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in managed care. One such risk is the development of actuarially sound rates. Because there is limited historical information on which to develop rates, certain assumptions are required to be made which may subsequently prove to have been inaccurate. Rates of utilization could be significantly higher than had been projected, or the assumptions of policymakers about the amount of savings that could be achieved through the use of utilization management in managed care could be flawed. Moreover, because of our lack of actuarial experience for that program, region, or population, our reserve levels may be set at an inadequate level. For instance, these problems arose at our Texas health plan in the second quarter of 2012, leading to extremely elevated medical care costs and substantial losses at the health plan. All of these risks are present in the implementation of the duals demonstration programs. In the event these risks materialize at one or more of our health plans, the negative results of the health plan or plans could adversely affect our business, financial condition, cash flows, or results of operations.
Risks associated with Medicaid expansion. In the states that have elected to participate, the ACA provides for the expansion of the Medicaid program to offer eligibility to nearly all low-income people under age 65 with incomes at or below 138% of the federal poverty line. Medicaid expansion membership phased in beginning January 1, 2014. Since that date, our health plans in California, Illinois, Michigan, New Mexico, Ohio, and Washington have begun participatingparticipated in Medicaid expansion. At December 31, 2014,2015, our membership included approximately 385,000557,000 Medicaid expansion members, or 15%16% of total membership. The new enrollees in our health plans represent a population that is different from the population of Medicaid enrollees we have historically managed. All of the risk factors described above with regard to the duals demonstration programs apply equally to Medicaid expansion.
Risks associated with health insurance marketplaces. The ACA authorized the creation of Marketplace insurance exchanges, allowing individuals and small groups to purchase health insurance that is federally subsidized, effective January 1, 2014. We participate in the Marketplace in all of the states in which we operate, except Illinois, Puerto Rico and South Carolina. At December 31, 2014, we had2015, our membership included approximately 15,000205,000 Marketplace members, and that enrollment is expected to grow appreciablywith approximately 133,000, or 65%, of those members in 2015, particularly at our Florida health plan.Florida. All of the risk factors described above with regard to the duals demonstration programs apply equally to our participation in the insurance marketplaces.
Risks associated with the King v. Burwell case. There is a case currently pending before the United States Supreme Court to be argued on March 4, 2015, challenging whether the IRS may permissibly promulgate regulations to extend tax-credit subsidies to coverage purchased through exchanges established by the federal government under Section 1321 of the ACA. In the event the Supreme Court rules against Health and Human Services Secretary Burwell, no federal subsidies would be allowed to be paid to those individuals purchasing health insurance through the federally facilitated exchanges, of which there are currently 36. This would undermine the functioning of those exchanges, and cause major disruption under the entire ACA throughout the nation.
Risk associated with implementing regulations. There are many parts of the ACA that require further guidance in the form of regulations. Due to the breadth and complexity of the ACA, the lack of implementing regulations and interpretive guidance, and the phased nature of the ACA’s implementation, the overall impact of the ACA on our business and on the health industry in general over the coming years is difficult to predict and not yet fully known, and implementing regulations could contain provisions that have a material adverse effect on our business, financial condition, cash flows, or results of operations.

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The health care regulatory law landscape is constantly changing. For example, on May 26, 2015, CMS posted a new proposed rule to the Federal Register regarding Medicaid programs and CHIP, Medicaid managed care, CHIP delivered in managed care, Medicaid and CHIP comprehensive quality strategies, and revisions related to third party liability that, if implemented, would, among other things, impose a medical loss ratio of 85% for Medicaid and CHIP programs, establish a Medicaid managed care quality rating system like the five-star system for Medicare Advantage plans, and expand health plans’ responsibilities in program integrity efforts. It is difficult to predict what final rules may be adopted and implemented by CMS, and if the final rule would result in any material adverse effect on our business, financial condition, cash flows, or results of operations.

Our profitability depends on our ability to accurately predict and effectively manage our medical care costs.
Our profitability depends to a significant degree on our ability to accurately predict and effectively manage our medical care costs. Historically, our medical care cost ratio, meaning our medical care costs as a percentage of our premium revenue net of premium tax, has fluctuated substantially, and has also varied across our state health plans. Because the premium payments we receive are generally fixed in advance and we operate with a narrow profit margin, relatively small changes in our medical care cost ratio can create significant changes in our overall financial results. For example, if our overall medical care ratio, continuing operations of 89.1%, for the year ended December 31, 2014 of 89.5%2015 had been one percentage point higher, or 90.5%90.1%, our net income from continuing operations for the year ended December 31, 20142015 would have been approximately $0.12$1.08 per diluted share rather than our actual income from continuing operations of $1.30$2.58 per diluted share, a decrease of approximately 91%58%.
Factors that may affect our medical care costs include the level of utilization of health care services, unexpected patterns in the annual flu season, increases in hospital costs, an increased incidence or acuity of high dollar claims related to catastrophic illnesses or medical conditions for which we do not have adequate reinsurance coverage, increased maternity costs, payment rates that are not actuarially sound, changes in state eligibility certification methodologies, relatively low levels of hospital and specialty provider competition in certain geographic areas, increases in the cost of pharmaceutical products and services, changes in health care regulations and practices, epidemics, new medical technologies, and other various external factors. Many of these factors are beyond our control and could reduce our ability to accurately predict and effectively manage the costs of

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providing health care services. The inability to forecast and manage our medical care costs or to establish and maintain a satisfactory medical care cost ratio, either with respect to a particular state health plan or across the consolidated entity, could have a material adverse effect on our business, financial condition, cash flows, or results of operations.
State and federal budget deficits may result in Medicaid, CHIP, or Medicare funding cuts which could reduce our revenues and profit margins.
Nearly all of our premium revenues come from the joint federal and state funding of the Medicaid and CHIP programs. Due to high unemployment levels, Medicaid enrollment levels and Medicaid costs remain elevated at the same time that state budgets are suffering from significant fiscal strain. Because Medicaid is one of the largest expenditures in every state budget, and one of the fastest-growing, it is a prime target for cost-containment efforts. The states in which we operate our health plans regularly face significant budgetary pressures. These budgetary pressures may result in unexpected Medicaid, CHIP, or Medicare rate cuts which could reduce our revenues and profit margins. Moreover, some federal deficit reduction or entitlement reform proposals would fundamentally change the structure and financing of the Medicaid program. A number of these proposals include both tax increases and spending reductions in discretionary programs and mandatory programs, such as Social Security, Medicare, and Medicaid.
We are unable to determine how any future Congressionalcongressional spending cuts will affect Medicare and Medicaid reimbursement. There likely will continue to be legislative and regulatory proposals at the federal and state levels directed at containing or lowering the cost of health care that, if adopted, could have a material adverse effect on our business, financial condition, cash flows, or results of operations.
The Commonwealth of Puerto Rico may become unable to pay the premiums of our Puerto Rico health plan.
The government of Puerto Rico currently faces major fiscal and liquidity challenges. The government recently warned that it may lack sufficient resources to fund all necessary governmental programs and services as well as meet debt service obligations for fiscal year 2016. The extreme financial difficulties faced by the Commonwealth may make it impossible for ASES, the Puerto Rico Medicaid agency, to pay our Puerto Rico health plan under the terms of the parties’ Medicaid contract. As of December 31, 2015, our Puerto Rico health plan served approximately 348,000 members, and had recognized premium revenue of approximately $192 million in the fourth quarter of 2015, or approximately $64 million per month. It is the practice of the Commonwealth to pay us for eligible members only after those members have been assigned to us, and our plan has sent electronic confirmation of the receipt of eligibility. Particularly in the early stages of our contract with Puerto Rico, the plan's confirmation of eligibility of certain members was not accepted by the Commonwealth as a result of various technical issues. The plan has continued to pay for medical services for all members in question, but the Commonwealth is withholding payment of approximately $12 million of premium revenue related to those members. We believe we have a valid claim to all of the premiums withheld and we are in discussions with the Commonwealth regarding this matter. A default by ASES on its payment obligations under our Medicaid contract, or a determination by ASES to terminate our contract based on insufficient funds available, could result in our having paid, or in our having to pay, provider claims in amounts for which we are not paid reimbursement, and could make it unfeasible for the Puerto Rico health plan to continue to operate. A default by ASES or termination of our Puerto Rico Medicaid contract could have a material adverse effect on our business, financial condition, cash flows, or results of operations.
A failure to accurately estimate incurred but not reported medical care costs may negatively impact our results of operations.
Because of the time lag between when medical services are actually rendered by our providers and when we receive, process, and pay a claim for those medical services, we must continually estimate our medical claims liability at particular points in time, and establish claims reserves related to such estimates. Our estimated reserves for such "incurred but not paid" (IBNP) medical care costs are based on numerous assumptions. We estimate our medical claims liabilities using actuarial methods based on historical data adjusted for claims receipt and payment experience (and variations in that experience), changes in membership, provider billing practices, health care service utilization trends, cost trends, product mix, seasonality, prior authorization of medical services, benefit changes, known outbreaks of disease or increased incidence of illness such as influenza, provider contract changes, changes to Medicaid fee schedules, and the incidence of high dollar or catastrophic claims. Our ability to accurately estimate claims for our newer lines of business or populations, such as with respect to duals, Medicaid expansion members, or aged, blind or disabled Medicaid members, is impacted by the more limited experience we have had with those populations.
The IBNP estimation methods we use and the resulting reserves that we establish are reviewed and updated, and adjustments, if deemed necessary, are reflected in the current period. Given the numerous uncertainties inherent in such estimates, our actual claims liabilities for a particular quarter or other period could differ significantly from the amounts estimated and reserved for that quarter or period. Our actual claims liabilities have varied and will continue to vary from our estimates, particularly in times of significant changes in utilization, medical cost trends, and populations and markets served.

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If our actual liability for claims payments is higher than estimated, our earnings per share in any particular quarter or annual period could be negatively affected. Our estimates of IBNP may be inadequate in the future, which would negatively affect our

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results of operations for the relevant time period. Furthermore, if we are unable to accurately estimate IBNP, our ability to take timely corrective actions may be limited, further exacerbating the extent of the negative impact on our results.
An increased incidence of fluLarge-scale medical emergencies in one or more of the states in which we operate aour health planplans could significantly increase utilization rates and medical costs.
Our resultsLarge-scale medical emergencies can take many forms and be significantly impacted byassociated with widespread illness or medical conditions. For example, natural disasters, such as a severe flu seasonmajor earthquake in Los Angeles or Cascadia, or a major hurricane in Florida or South Carolina, could have a significant impact on the states inhealth of a large number of our covered members. Other conditions that could impact our members include an influenza epidemic, or newly emergent mosquito-borne illnesses, such as the Zika virus, the West Nile virus, or the Chikungunya virus, conditions for which we operated ourvaccines may not exist, are not effective, or have not been widely administered. In addition, federal and state law enforcement officials have issued warnings about potential terrorist activity involving biological or other weapons of mass destruction. All of these conditions, and others, could have a significant impact on the health plans.of the population of wide-spread areas. We seek to set our IBNP reserves appropriately to account for seasonalanticipatable spikes in utilization, such as for the incidence of the flu.flu season. However, if one of our health plan states were to experience a large-scale natural disaster, a viral epidemic or pandemic, a significant terrorism attack, or some other large-scale event affecting the actual utilization rateshealth of a large number of our members, are higher than we had anticipated, our covered medical expenses in that state would rise, which could have a material adverse effect on our business, cash flows, financial condition, and results of operations, or, in the relevant periodsevent of extreme circumstances, could be materially and adversely affected.threaten our viability.
If the responsive bids of our health plans for new or renewed Medicaid contracts are not successful, or if our government contracts are terminated or are not renewed, our premium revenues could be materially reduced and our operating results could be negatively impacted.
Our government contracts may be subject to periodic competitive bidding. In such process, our health plans may face competition as other plans, many with greater financial resources and greater name recognition, attempt to enter our markets through the competitive bidding process. In the event the responsive bid of one or more of our health plans is not successful, we will lose our Medicaid contract in the applicable state or states, and our premium revenues could be materially reduced as a result. If we are unable to renew, successfully re-bid, or compete for any of our government contracts, or if any of our contracts are terminated or renewed on less favorable terms, our business, financial condition, cash flows, or results of operations could be adversely affected. Alternatively, even if our responsive bids are successful, the bids may be based upon assumptions regarding enrollment, utilization, medical costs, or other factors which could result in the Medicaid contract being less profitable than we had expected.
In addition, all of our contracts may be terminated for cause if we breach a material provision of the contract or violate relevant laws or regulations. Our contracts with the states are also subject to cancellation by the state in the event of the unavailability of state or federal funding. In some jurisdictions, such cancellation may be immediate and in other jurisdictions a notice period is required. Further, most of our contracts are terminable without cause.
Our government contracts generally run for periods of three to four years, and may be successively extended by amendment for additional periods if the relevant state agency so elects. Our current contracts expire on various dates over the next several years. Although our health plans have generally been successful in obtaining the renewal and/or extension of their state contracts, there can be no guarantee that any of our state government contracts will be renewed or extended, as shown by the loss of our Missouri contract in 2012 in connection with an unsuccessful RFP bid. During 2015, our Michigan Medicaid contract will be subject to a new RFP. We expect the Michigan RFP to be released on May 1, 2015, and for the new contract to become effective on October 1, 2015. If we are unable to renew, successfully re-bid, or compete for any of our government contracts, including our Michigan contract, or if any of our contracts are terminated or renewed on less favorable terms, our business, financial condition, cash flows, or results of operations could be adversely affected.
If we sustain a cyberattackcyber-attack or suffer privacy or data security breaches that disrupt our operations or result in the dissemination of sensitive personal or confidential information, we could suffer increased costs, exposure to significant liability, reputational harm, loss of business, and other serious negative consequences.
As part of our normal operations, we routinely collect, process, store, and transmit large amounts of data in our operations, including sensitive personal information as well as proprietary or confidential information relating to our business or third parties. We may be subject to breaches of the information technology systems we use. Experienced computer programmers and hackers may be able to penetrate our layered security controls and misappropriate or compromise sensitive personal information or proprietary or confidential information, vandalize our systems, create system disruptions, or cause shutdowns. They also may be able to develop and deploy viruses, worms, and other malicious software programs that attack our systems or otherwise exploit any security vulnerabilities. Our systems are also susceptible to human error. Because the techniques used to circumvent security systems can be highly sophisticated and change frequently, often are not recognized until launched against a target, and may originate from less regulated and remote areas around the world, we may be unable to proactively address these techniques or to implement adequate preventive measures. Our facilities may also be vulnerable to security incidents or security attacks;attacks, acts of vandalism or theft;theft, misplaced or lost data;data, human errors;errors, acts of malicious insiders, or other similar events that could negatively affect our systems and our and our members’ data. The cost to eliminate or address the foregoing security threats and vulnerabilities before or after a cyber-incident could be significant. While we currently expend significant resources and have implemented solutions, processes and procedures to protect against cyber-attacks and security breaches, we may need to expend significant additional resources in the future to continue to protect against potential security breaches or to address problems caused by such attacks or any breach of our systems. Our remediation efforts may not be successful and could result in interruptions, delays, or cessation of service, and loss of members, vendors, and state contracts. In addition, breaches of our security measures and the unauthorized dissemination of sensitive personal information or proprietary information or confidential information about our members could expose our members to the risk of financial or medical identity theft, or expose us or other third parties to a risk of loss or misuse of this information, result in litigation and potential liability for us, damage our reputation, or otherwise have a material adverse effect on our business, financial condition, cash flows, or results of operations.


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The exorbitant cost of specialty drugs and new generic drugs could have a material adverse effect on the level of our medical costs and our results of operations.
In 2014, Gilead’s pricing of the hepatitis C drug, Sovaldi, at $84,000 per standard course of therapy received major attention as a health care policy and public policy matter. Because of the relatively high incidence of hepatitis C throughout the nation, particularly in the Medicaid population, the pricing of specialty drugs for the treatment of hepatitis C represents a major public health and public financing problem. In the case of Sovaldi, because of its advent on the health care market in early 2014, the cost of the drug was generally not factored into our 2014 capitation rates, thus threatening to undermine the actuarial soundness of those rates. New high priced specialty drugs and generic drugs are expected to enter the health care market in 2015. In addition, evolving regulations and state and federal mandates regarding coverage may impact the ability of our health plans to continue to receive existing price discounts on pharmaceutical products for our members. Other factors affecting our pharmaceutical costs include, but are not limited to, geographic variation in utilization of new and existing pharmaceuticals, and changes in discounts. We will seek to work with state Medicaid agencies to ensure that we receive appropriate and actuarially sound reimbursement for all new drug therapies and pharmaceuticals. In the event we are required to bear the high costs of new specialty drugs or generic drugs without an appropriate rate adjustment or other reimbursement mechanism, or if new regulations or mandates affect our pharmaceutical costs, our business, financial condition, cash flows, or results of operations could be adversely affected.
States may not adequately compensate us for the value of drug rebates that were previously earned by us but that are now collectible by the states.
The ACA includes certain provisions that change the way drug rebates are handled for drug claims filled by Medicaid managed care plans. Retroactive to March 23, 2010, state Medicaid programs are now required to collect federal rebates on all Medicaid-covered outpatient drugs dispensed or administered to Medicaid managed care enrollees (excluding certain drugs that are already discounted), and pharmaceutical manufacturers are required to pay specified rebates directly to the state Medicaid programs for those claims. This has impacted the level of rebates received by managed care plans from the manufacturers for Medicaid managed care enrollees. Many manufacturers have renegotiated or discontinued their rebate contracts with Medicaid managed care plans and pharmacy benefits managers to offset these new rebates paid directly to state Medicaid programs. As a result, the drug rebate amounts paid to managed care plans like ours continue to remain at levels that are much lower than prior to ACA implementation. There are provisions in the ACA that require rates paid to Medicaid managed care plans to be actuarially sound in regard to drug rebates. Although we will be pursuing rate increases with state agencies to make us whole for the rebate amounts lost, there can be no assurances that the premium increases we may receive, if any, will be adequate to offset the amount of the lost rebates. If such premium increases prove to be inadequate, our business, financial condition, cash flows, or results of operations could be adversely affected.
We derive our premium revenues from a relatively small number of state health plans.
We currently derive our premium revenues from 11 state health plans, and commenced operations with our Puerto Rico health plan expected to commence operations in April 2015. If we are unable to continue to operate in any of those 11 states,jurisdictions, or if our current operations in any portion of the statesjurisdictions we are in are significantly curtailed, our revenues could decrease materially. Our reliance on operations in a limited number of statesjurisdictions could cause our revenue and profitability to change suddenly and unexpectedly, depending on an abrupt loss of membership, significant rate reductions, a loss of a material contract, legislative actions, changes in Medicaid eligibility methodologies, catastrophic claims, an epidemic, an unexpected increase in utilization, general economic conditions, and similar factors in those states.jurisdictions. Our inability to continue to operate in any of the statesjurisdictions in which we currently operate, or a significant change in the nature of our existing operations, could adversely affect our business, financial condition, cash flows, or results of operations.
There are performance risks and other risks associated with certain provisions in the state Medicaid contracts of severalA large portion of our health plans.premium revenues are subject to risks related to medical cost expenditure floors and corridors, administrative cost and profit ceilings, premium stabilization programs, and cost-plus and performance-based reimbursement programs.
The state contractsA substantial portion of our California, Illinois, New Mexico, Ohio, Texas, Washington,premium revenue is subject to contract provisions pertaining to medical cost floors and Wisconsin health planscorridors, administrative cost and profit ceilings, cost-plus reimbursement, premium stabilization programs, and profit-sharing arrangements. Many of these contract provisions are complex, or are poorly or ambiguously drafted, and thus are potentially subject to differing interpretations by ourselves and the relevant government agency with whom we contract. In the event the applicable government agency disagrees with our interpretation or implementation of a particular contract provisions at issue, we could be required to adjust the amount of our obligations under these provisions and/or make a payment or payments to the government agency. Any interpretation of these contract provisions at variance with our interpretation and implementation of the provision, or that is inconsistent with our revenue recognition accounting treatment, could have a material adverse effect on our business, financial condition, cash flows, or results of operations.
In addition, many of our contracts also contain provisions pertaining to at-risk premiums that require us to meet certain quality performance measures to earn all of our contract revenues in those states.revenues. In the event we are unsuccessful in achieving the stated performance

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measure, the health planwe will be unable to recognize the revenue associated with that measure. Any failure of our health plans to satisfy one of these performance measure provisions could have a material adverse effect on our business, financial condition, cash flows or results of operations. In addition, the state contracts of our California, Florida, Illinois, Michigan, New Mexico, Ohio, Texas, and Washington health plans contain provisions pertaining to medical cost floors and corridors, administrative cost and profit ceilings, and profit-sharing arrangements. Our Medicare and Marketplace business is also subject to medical cost floor requirements enacted by the Federal government. These provisions are subject to interpretation and application by our health plans. In the event the applicable state government agency disagrees with our health plan’s interpretation or application of the sometimes complicated contract provisions at issue, the health plan could be required to adjust the amount of its obligations under these provisions and/or make a payment or payments to the state. Any interpretation or application of these provisions at

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variance with our health plan’s interpretation or inconsistent with our revenue recognition accounting treatment could have a material adverse effect on our business, financial condition, cash flows or results of operations.
Failure to attain profitability in any new start-up operations, including in our new Puerto Rico health plan, could negatively affect our results of operations.
Start-up costs associated with a new business can be substantial. For example, to obtain a certificate of authority to operate as a health maintenance organization in most jurisdictions, we must first establish a provider network, have infrastructure and required systems in place, and demonstrate our ability to obtain a state contract and process claims. Often, we are also required to contribute significant capital to fund mandated net worth requirements, performance bonds or escrows, or contingency guaranties. If we are unsuccessful in obtaining the certificate of authority, winning the bid to provide services, or attracting members in sufficient numbers to cover our costs, any new business of ours would fail. We also could be required by the state or commonwealth to continue to provide services for some period of time without sufficient revenue to cover our ongoing costs or to recover our significant start-up costs.
Even if we are successful in establishing a profitable health plan in a new state or commonwealth, increasing membership, revenues, and medical costs will trigger increased mandated net worth requirements which could substantially exceed the net income generated by the health plan. Rapid growth in an existing state or commonwealth will also result in increased net worth requirements. In such circumstances, we may not be able to fund on a timely basis or at all the increased net worth requirements with our available cash resources. All of these risks will pertain to our new start-up Puerto Rico health plan, which is expected to commence operations in April 2015. The expenses associated with starting up a health plan in a new state or commonwealth, or expanding a health plan in an existing state or commonwealth could have a material adverse effect on our business, financial condition, cash flows, or results of operations.
Receipt of inadequate or significantly delayed premiums could negatively affect our business, financial condition, cash flows, or results of operations.
Our premium revenues consist of fixed monthly payments per member, and supplemental payments for other services such as maternity deliveries. These premiums are fixed by contract, and we are obligated during the contract periods to provide health care services as established by the state governments. We use a large portion of our revenues to pay the costs of health care services delivered to our members. If premiums do not increase when expenses related to medical services rise, our medical margins will be compressed, and our earnings will be negatively affected. A state could increase hospital or other provider rates without making a commensurate increase in the rates paid to us, or could lower our rates without making a commensurate reduction in the rates paid to hospitals or other providers. In addition, if the actuarial assumptions made by a state in implementing a rate or benefit change are incorrect or are at variance with the particular utilization patterns of the members of one of our health plans, our medical margins could be reduced. Any of these rate adjustments in one or more of the states in which we operate could have a material adverse effect our business, financial condition, cash flows, or results of operations.
Furthermore, a state undergoing a budget crisis may significantly delay the premiums paid to one of our health plans. Any significant delay in the monthly payment of premiums to any of our health plans could have a material adverse effect on our business, financial condition, cash flows, or results of operations.
Centene’s acquisition of Health Net could affect the Los Angeles county subcontract of our California health plan.
Our California health plan operates in Los Angeles County, California as a subcontractor to Health Net, which holds a direct Medi-Cal contract with the state of California. Health Net has entered into a merger agreement with Centene Corporation, with the merger expected to close in early 2016. We currently do not expect there to be any material change to our Los Angeles county subcontract in connection with Centene’s acquisition of Health Net. However, if Centene seeks to modify our subcontract or otherwise refuses to perform under the contract, our business, financial condition, cash flows, or results of operations may be adversely affected.
Reductions in Medicare payments could reduce our earnings potential for our Medicare Advantage plans and our duals demonstration programs.
The Sequestration Transparency Act of 2012 included a 2% reduction of payments from CMS to our Medicare Advantage plans beginning April 1, 2013. Medicare Advantage plans will continue to be affected until Congress lifts the sequestration mandated under the Sequestration Transparency Act of 2012. The impact of sequestration cuts on our Medicare Advantage revenues is partially mitigated by reductions in provider reimbursements paid to those providers with rates indexed to the Medicare fee-for-service reimbursement rates. Such reduction in our Medicare payments may have an adverse effect on our earnings potential for our Medicare Advantage plans and our duals demonstration programs. In addition, reductions to provider reimbursement rates associated with sequestration may adversely impact our relations with the impacted providers.
Difficulties in executing our acquisition strategy could adversely affect our business.
The acquisitions of other health plans and the assignment and assumption of Medicaid contract rights of other health plans have accounted for a significant amount of our growth over the last several years. Although we cannot predict with certainty our rate of growth as the result of acquisitions, we believe that additional acquisitions of all sizes will be important to our future growth

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strategy. Many of the other potential purchasers of these assets—particularly operators of large commercial health plans—have significantly greater financial resources than we do. Also, many of the sellers may insist on selling assets that we do not want, such as commercial lines of business, or may insist on transferring their liabilities to us as part of the sale of their companies or assets. Even if we identify suitable targets, we may be unable to complete acquisitions on terms favorable to us, or at all, or obtain the necessary financing for these acquisitions. For these reasons, among others, we cannot provide assurance that we will be able to complete favorable acquisitions, especially in light of the volatility in the capital markets over the past several years, or that we will not complete acquisitions that turn out to be unfavorable. Further, to the extent we complete an acquisition, we

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may be unable to realize the anticipated benefits from such acquisition because of operational factors or difficulty in integrating the acquisition with our existing business. This may include problems involving the integration of:
additional employees who are not familiar with our operations or our corporate culture,
new provider networks which may operate on terms different from our existing networks,
additional members who may decide to transfer to other health care providers or health plans,
disparate information, claims processing, and record-keeping systems,
internal controls and accounting policies, including those which require the exercise of judgment and complex estimation processes, such as estimates of claims incurred but not reported, accounting for goodwill, intangible assets, stock-based compensation, and income tax matters, and
new regulatory schemes, relationships, practices, and compliance requirements.
Also, we are generally required to obtain regulatory approval from one or more state agencies when making acquisitions of health plans. In the case of an acquisition of a business located in a state in which we do not already operate, we would be required to obtain the necessary licenses to operate in that state. In addition, although we may already operate in a state in which we acquire a new business, we would be required to obtain regulatory approval if, as a result of the acquisition, we will operate in an area of that state in which we did not operate previously. Furthermore, we may be required to renegotiate contracts with the network providers of the acquired business. We may be unable to obtain the necessary governmental approvals, comply with these regulatory requirements or renegotiate the necessary provider contracts in a timely manner, if at all.
In addition, we may be unable to successfully identify, consummate, and integrate future acquisitions, including integrating the acquired businesses on our information technology platform, or to implement our operations strategy in order to operate acquired businesses profitably. Furthermore, we may incur significant transaction expenses in connection with a potential acquisition which may or may not be consummated. These expenses could impact our selling, general and administrative expense ratio.
For all of the above reasons, we may not be able to consummate our proposed acquisitions as announced from time to time to sustain our pattern of growth or to realize benefits from completed acquisitions.
We face periodic routine and non-routine reviews, audits, and investigations by government agencies, and these reviews and audits could have adverse findings, which could negatively impact our business.
We are subject to various routine and non-routine governmental reviews, audits, and investigations. Violation of the laws, regulations, or contract provisions governing our operations, or changes in interpretations of those laws and regulations, could result in the imposition of civil or criminal penalties, the cancellation of our contracts to provide managed care services, the suspension or revocation of our licenses, the exclusion from participation in government sponsored health programs, or the revision and recoupment of past payments made based on audit findings. If we are unable to correct any noted deficiencies, or become subject to material fines or other sanctions, we could suffer a substantial reduction in profitability, and could also lose one or more of our government contracts and as a result lose significant numbers of members and amounts of revenue. In addition, government receivables are subject to government audit and negotiation, and government contracts are vulnerable to disagreements with the government. The final amounts we ultimately receive under government contracts may be different from the amounts we initially recognize in our financial statements.
We rely on the accuracy of eligibility lists provided by state governments. Inaccuracies in those lists would negatively affect our results of operations.
Premium payments to our health plan segment are based upon eligibility lists produced by state governments. From time to time, states require us to reimburse them for premiums paid to us based on an eligibility list that a state later discovers contains individuals who are not in fact eligible for a government sponsored program or are eligible for a different premium category or a different program. Alternatively, a state could fail to pay us for members for whom we are entitled to payment. Our results of operations would be adversely affected as a result of such reimbursement to the state if we make or have made related payments to providers and are unable to recoup such payments from the providers.

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We are subject to extensive fraud and abuse laws whichthat may give rise to lawsuits and claims against us, the outcome of which may have a material adverse effect on our business, financial condition, cash flows, or results of operations.
Because we receive payments from federal and state governmental agencies, we are subject to various laws commonly referred to as "fraud and abuse" laws, including federal and state anti-kickback statutes, prohibited referrals, and the federal False Claims Act, which permit agencies and enforcement authorities to institute a suit against us for violations and, in some cases, to seek treble damages, criminal and civil fines, penalties, and assessments. Violations of these laws can also result in exclusion, debarment, temporary or permanent suspension from participation in government health care programs, or the institution of corporate integrity agreements. Liability under such federal and state statutes and regulations may arise if we know, or it is found that we should have known, that information

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we provide to form the basis for a claim for government payment is false or fraudulent, and some courts have permitted False Claims Act suits to proceed if the claimant was out of compliance with program requirements. Fraud, waste and abuse prohibitions encompass a wide range of operating activities, including kickbacks or other inducements for referral of members or for the coverage of products (such as prescription drugs) by a plan, billing for unnecessary medical services by a provider, improper marketing, and the violation of patient privacy rights. Companies involved in public health care programs such as Medicaid and Medicare are required to maintain compliance programs to detect and deter fraud, waste and abuse, and are often the subject of fraud, waste and abuse investigations and audits. The regulations and contractual requirements applicable to participants in these public-sector programs are complex and subject to change. The federal government has taken the position that claims presented in violation of the federal anti-kickback statute may be considered a violation of the federal False Claims Act. In addition, under the federal civil monetary penalty statute, the U.S. Department of Health and Human Services (HHS), Office of Inspector General has the authority to impose civil penalties against any person who, among other things, knowingly presents, or causes to be presented, certain false or otherwise improper claims. Qui tam actions under federal and state law can be brought by any individual on behalf of the government. Qui tam actions have increased significantly in recent years, causing greater numbers of health care companies to have to defend a false claim action, pay fines, or be excluded from the Medicare, Medicaid, or other state or federal health care programs as a result of an investigation arising out of such action. We are currently defending twoone qui tam actionsaction where both the federal and state governmentsgovernment has declined to intervene: (i) USA and StateUnited States of FloridaAmerica, ex rel Charles Wilhelm v. Molina Healthcare and Molina Healthcare of Florida; and (ii) USA ex relrel., Anita Silingo v. Mobile Medical Examination Service, Molina HealthcareServices, Inc.,et al. Other qui tam actions may have been filed against us of California, et al. We believewhich we have meritorious defenses to both matters, and intend to defend both matters vigorously.are presently unaware, or other qui tam actions may be filed against us in the future. In the event we are subject to liability under these or other qui tam actions, our business, financial condition, cash flows, or results of operations could be adversely affected.
Our business could be adversely impacted by adoption of the new ICD-10 standardized coding set for diagnoses.
The U.S. Department of Health and Human Services, or HHS has released rules pursuant to the Health Insurance Portability and Accountability Act, or HIPAA, which mandate the use of standard formats in electronic health care transactions. HHS also has published rules requiring the use of standardized code sets and unique identifiers for providers. These new standardized code sets, known as ICD-10, will require substantial investments from health care organizations, including us. CMS has now scheduled implementationWe implemented ICD-10 effective as of ICD-10 by October 1, 2015. Use of the ICD-10 code sets will require significant administrative changes and may result in errors and otherwise negatively impact our service levels. In addition, we may experience complications related to supporting customers that are not fully compliant with the revised requirements as of the applicable compliance date. Furthermore, if physicians fail to provide appropriate codes for services provided as a result of the new coding set, we may not be reimbursed, or adequately reimbursed, for such services.
If we are unable to deliver quality care, maintain good relations with the physicians, hospitals, and other providers with whom we contract, or if we are unable to enter into cost-effective contracts with such providers, our profitability could be adversely affected.
We contract with physicians, hospitals, and other providers as a means to ensure access to health care services for our members, to manage health care costs and utilization, and to better monitor the quality of care being delivered. We compete with other health plans to contract with these providers. We believe providers select plans in which they participate based on criteria including reimbursement rates, timeliness and accuracy of claims payment, potential to deliver new patient volume and/or retain existing patients, effectiveness of resolution of calls and complaints, and other factors. We cannot be sure that we will be able to successfully attract and retain providers to maintain a competitive network in the geographic areas we serve. In addition, in any particular market, providers could refuse to contract with us, demand higher payments, or take other actions which could result in higher health care costs, disruption to provider access for current members, a decline in our growth rate, or difficulty in meeting regulatory or accreditation requirements.
The Medicaid program generally pays doctors and hospitals at levels well below those of Medicare and private insurance. Large numbers of doctors, therefore, do not accept Medicaid patients. In the face of fiscal pressures, some states may reduce rates paid to providers, which may further discourage participation in the Medicaid program.
In some markets, certain providers, particularly hospitals, physician/hospital organizations, and some specialists, may have significant market positions or even monopolies. If these providers refuse to contract with us or utilize their market position to negotiate favorable contracts which are disadvantageous to us, our profitability in those areas could be adversely affected.

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Some providers that render services to our members are not contracted with our health plans. In those cases, there is no pre-established understanding between the provider and our health plan about the amount of compensation that is due to the provider. In some states, the amount of compensation is defined by law or regulation, but in most instances it is either not defined or it is established by a standard that is not clearly translatable into dollar terms. In such instances, providers may believe they are underpaid for their services and may either litigate or arbitrate their dispute with our health plan. The uncertainty of the amount to pay and the possibility of subsequent adjustment of the payment could adversely affect our business, financial condition, results of operations, and cash flows.
The insolvency of a delegated provider could obligate us to pay its referral claims, which could have an adverse effect on our business, cash flows, or results of operations.
Circumstances may arise where providers to whom we have delegated risk, due to insolvency or other circumstances, are unable to pay claims they have incurred with third parties in connection with referral services provided to our members. The inability of delegated providers to pay referral claims presents us with both immediate financial risk and potential disruption to member care. Depending on states’ laws, we may be held liable for such unpaid referral claims even though the delegated provider has contractually assumed such risk. Additionally, competitive pressures may force us to pay such claims even when we have no legal obligation to do so or we have already paid claims to a delegated provider and payments cannot be recouped when the delegated provider becomes insolvent. To reduce the risk that delegated providers are unable to pay referral claims,

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we monitor the operational and financial performance of such providers. We also maintain contingency plans that include transferring members to other providers in response to potential network instability. In certain instances, we have required providers to place funds on deposit with us as protection against their potential insolvency. These funds are frequently in the form of segregated funds received from the provider and held by us or placed in a third-party financial institution. These funds may be used to pay claims that are the financial responsibility of the provider in the event the provider is unable to meet these obligations. However, there can be no assurances that these precautionary steps will fully protect us against the insolvency of a delegated provider. Liabilities incurred or losses suffered as a result of provider insolvency could have an adverse effect on our business, financial condition, cash flows, or results of operations.
Regulatory actions and negative publicity regarding Medicaid managed care and Medicare Advantage may lead to programmatic changes and intensified regulatory scrutiny and regulatory burdens.
Several of our health care competitors have recently been involved in governmental investigations and regulatory actions which have resulted in significant volatility in the price of their stock. In addition, there has been negative publicity and proposed programmatic changes regarding Medicare Advantage private fee-for-service plans, a part of the Medicare Advantage program in which we do not participate. These actions and the resulting negative publicity could become associated with or imputed to us, regardless of our actual regulatory compliance or programmatic participation. Such an association, as well as any perception of a recurring pattern of abuse among the health plan participants in government programs and the diminished reputation of the managed care sector as a whole, could result in public distrust, political pressure for changes in the programs in which we do not participate, intensified scrutiny by regulators, additional regulatory requirements and burdens, increased stock volatility due to speculative trading, and heightened barriers to new managed care markets and contracts, all of which could have a material adverse effect on our business, financial condition, cash flows, or results of operations.
If a state fails to renew its federal waiver application for mandated Medicaid enrollment into managed care or such application is denied, our membership in that state will likely decrease.
States may only mandate Medicaid enrollment into managed care under federal waivers or demonstrations. Waivers and programs under demonstrations are approved for two- to five-year periods and can be renewed on an ongoing basis if the state applies and the waiver request is approved or renewed by CMS. We have no control over this renewal process. If a state does not renew its mandated program or the federal government denies the state’s application for renewal, our business would suffer as a result of a likely decrease in membership.
If state regulators do not approve payments of dividends and distributions by our subsidiaries, it may negatively affect our business strategy.
We are a corporate parent holding company and hold most of our assets at, and conduct most of our operations through, direct subsidiaries. As a holding company, our results of operations depend on the results of operations of our subsidiaries. Moreover, we are dependent on dividends or other intercompany transfers of funds from our subsidiaries to meet our debt service and other obligations. The ability of our subsidiaries to pay dividends or make other payments or advances to us will depend on their operating results and will be subject to applicable laws and restrictions contained in agreements governing the debt of such subsidiaries. In addition, our health plan subsidiaries are subject to laws and regulations that limit the amount of dividends and distributions that they can pay to us without prior approval of, or notification to, state regulators. In California, our health plan may dividend, without notice to or approval of the California Department of Managed Health Care, amounts by which its tangible net equity exceeds 130% of the tangible net equity requirement. Our other health plans must give thirty days’ advance notice and the opportunity to disapprove "extraordinary" dividends to the respective state departments of insurance for amounts

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over the lesser of (a) ten percent of surplus or net worth at the prior year end or (b) the net income for the prior year. The discretion of the state regulators, if any, in approving or disapproving a dividend is not clearly defined. Health plans that declare non-extraordinary dividends must usually provide notice to the regulators ten or fifteen days in advance of the intended distribution date of the non-extraordinary dividend. For the years ended December 31, 2013 and 2012, weWe received $125 million in dividends from our regulated health plan subsidiaries amounting to $24.4 million and $101.8 million, respectively.during 2015. We did not receive any dividends from our regulated health plan subsidiaries during 2014, because significant growth across all of our health plans necessitated that the year ended December 31, 2014.plans retain their cash to meet increasing net worth requirements. The aggregate additional amounts our health plan subsidiaries could have paid us at December 31, 2014, 20132015 and 2012,2014, without approval of the regulatory authorities, were approximately $96 million, $54$121 million and $24$96 million, respectively. If the regulators were to deny or significantly restrict our subsidiaries’ requests to pay dividends to us, the funds available to our company as a whole would be limited, which could harm our ability to implement our business strategy. For example, we could be hindered in our ability to make debt service payments under our convertiblethe senior notes or anythe revolving credit facility.
Unforeseen changes in pharmaceutical regulations or market conditions may impact our revenues and adversely affect our results of operations.
A significant category of our health care costs relate to pharmaceutical products and services. Evolving regulations and state and federal mandates regarding coverage may impact the ability of our health plans to continue to receive existing price discounts on pharmaceutical products for our members. Other factors affecting our pharmaceutical costs include, but are not limited to, the price of pharmaceuticals, geographic variation in utilization of new and existing pharmaceuticals, and changes in discounts. The unpredictable nature of these factors may have a material adverse effect on our business, financial condition, cash flows, or results of operations.
Our use and disclosure of individually identifiable information, including health information, is subject to federal and state privacy and security regulations, and our failure to comply with those regulations or to adequately secure the information we hold could result in significant liability or reputational harm.
State and federal laws and regulations, including HIPAA and the Gramm-Leach-Bliley Act, govern the collection, dissemination, use, privacy, confidentiality, security, availability, and integrity of individually identifiable information, including protected health information, or PHI. HIPAA establishes basic national privacy and security standards for protection of PHI by covered entities, including health plans such as ours. HIPAA requires covered entities like us to develop and maintain policies and procedures for PHI that is used or disclosed, and to adopt administrative, physical, and technical safeguards to protect PHI. HIPAA also implemented the use of standard transaction code sets and standard identifiers that covered entities must use when submitting or receiving certain electronic health care transactions, including activities associated with the billing and collection of health care claims.
Mandatory penalties for HIPAA violations range from $100 to $50,000 per violation, and up to $1.5 million per violation of the same standard per calendar year. A single breach incident can result in violations of multiple standards, resulting in possible penalties potentially in excess of $1.5 million. If a person knowingly or intentionally obtains or discloses PHI in violation of HIPAA requirements, criminal penalties may also be imposed. HIPAA authorizes state attorneys general to file suit under HIPAA on behalf of state residents. Courts can award damages, costs, and attorneys’ fees related to violations of HIPAA in such cases. While HIPAA does not create a private right of action allowing individuals to sue us in civil court for HIPAA violations, its standards have been used as the basis for a duty of care in state civil suits such as those for negligence or recklessness in the misuse or breach of PHI.
In addition, HIPAA mandates that the Secretary of HHS conduct periodic compliance audits of HIPAA covered entities for compliance with the HIPAA Privacy and Security Standards. Investigations of violations that indicate willful neglect, for which penalties are now mandatory, are statutorily required. It also tasks HHS with establishing a methodology whereby harmed individuals who were the victims of breaches of unsecured PHI may receive a percentage of the civil monetary penalty fine paid by the violator.
HIPAA further requires covered entities to notify affected individuals “without unreasonable delay and in no case later than 60 calendar days after discovery of the breach” if their unsecured PHI is subject to an unauthorized access, use, or disclosure. If a breach affects 500 patients or more, it must be reported to HHS and local media without unreasonable delay, and HHS will post the name of the breaching entity on its public website. If a breach affects fewer than 500 individuals, the covered entity must log it and notify HHS at least annually. We have experienced HIPAA breaches in the past, including breaches affecting over 500 individuals.
New health information standards, whether implemented pursuant to HIPAA, congressional action, or otherwise, could have a significant effect on the manner in which we must handle health care related data, and the cost of complying with standards could be significant. If we do not comply with existing or new laws and regulations related to PHI, we could be subject to criminal or civil sanctions. Any security breach involving the misappropriation, loss, or other unauthorized disclosure or use of confidential member information, whether by us or a third party, such as our vendors, could subject us to civil and criminal

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penalties, divert management’s time and energy, and have a material adverse effect on our business, financial condition, cash flows, or results of operations.

Risks Related to the Operation of Our Molina Medicaid Solutions Segment
We may be unable to retain or renew the state government contracts of the Molina Medicaid Solutions segment on terms consistent with our expectations or at all.
Molina Medicaid Solutions currently has management contractsprovides business processing and information technology development and administrative services to Medicaid agencies in only six states.Idaho, Louisiana, Maine, New Jersey, West Virginia, and the U.S. Virgin Islands, and drug rebate administration services in Florida. If we are unable to continue to operate in any of those six states,jurisdiction, or if our current operations in any of those six statesjurisdictions are significantly curtailed, the revenues and cash flows of Molina Medicaid Solutions could decrease materially, and as a result our profitability would be negatively impacted.
If the responsive bids to RFPs of Molina Medicaid Solutions are not successful, our revenues could be materially reduced and our operating results could be negatively impacted.
The government contracts of Molina Medicaid Solutions may be subject to periodic competitive bidding. In such process, Molina Medicaid Solutions may face competition as other service providers, some with much greater financial resources and greater name recognition, attempt to enter our markets through the competitive bidding process. For instance, in 2012, the government contract of Molina Medicaid Solutions in Louisiana was subject to competitive bidding, and we were unsuccessful in being awarded a new contract. Molina Medicaid Solutions also anticipates bidding in other states which have issued RFPs for procurement of a new MMIS. In the event our responsive bids in other states are not successful, we will be unable to grow in a manner consistent with our projections. Even if our responsive bids are successful, the bids may be based upon assumptions or other factors which could result in the contract being less profitable than we had expected or had been the case prior to competitive re-bidding.
Because of the complexity and duration of the services and systems required to be delivered under the government contracts of Molina Medicaid Solutions, there are substantial risks associated with full performance under the contracts.
The state contracts of Molina Medicaid Solutions typically require significant investment in the early stages that is expected to be recovered through billings over the life of the contracts. These contracts involve the construction of new computer systems and communications networks and the development and deployment of complex technologies. Substantial performance risk exists under each contract. Some or all elements of service delivery under these contracts are dependent upon successful completion of the design, development, construction, and implementation phases. Any increased or unexpected costs or delays in connection with the performance of these contracts, including delays caused by factors outside our control, could make these contracts less profitable or unprofitable, which could have an adverse effect on our business, financial condition, cash flows, or results of operations.
If we fail to comply with our state government contracts or government contracting regulations, our business could be adversely affected.
Molina Medicaid Solutions’ contracts with state government customers may include unique and specialized performance requirements. In particular, contracts with state government customers are subject to various procurement regulations, contract provisions, and other requirements relating to their formation, administration, and performance. Any failure to comply with the specific provisions in our customer contracts or any violation of government contracting regulations could result in the imposition of various civil and criminal penalties, which may include termination of the contracts, forfeiture of profits, suspension of payments, imposition of fines, and suspension from future government contracting. Further, any negative publicity related to our state government contracts or any proceedings surrounding them may damage our business by affecting our ability to compete for new contracts. The termination of a state government contract, our suspension from government work, or any negative impact on our ability to compete for new contracts, could have a material adverse effect on our business, financial condition, cash flows, or results of operations.
System security risks and systems integration issues that disrupt our internal operations or information technology services provided to customers could adversely affect our financial results and damage our reputation.
Computer programmers and hackers may be able to penetrate our network security and misappropriate our confidential information or that of third parties, create system disruptions, or cause shutdowns. Computer programmers and hackers also may be able to develop and deploy viruses, worms, and other malicious software programs that attack our products or otherwise exploit any security vulnerabilities of our products. In addition, sophisticated hardware and operating system software and applications that we produce or procure from third parties may contain defects in design or manufacture, including "bugs" and other problems that could unexpectedly interfere with the operation of the system. The costs to us to eliminate or alleviate security problems, bugs, viruses, worms, malicious software programs and security vulnerabilities could be significant, and the efforts to address these problems could result in interruptions, delays, cessation of service, and loss of existing or potential government customers.

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Molina Medicaid Solutions routinely processes, stores, and transmits large amounts of data for our clients, including sensitive and personally identifiable information. Breaches of our security measures could expose us, our customers, or the individuals affected to a risk of loss or misuse of this information, resulting in litigation and potential liability for us and damage to our

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brand and reputation. Accordingly, we could lose existing or potential government customers for outsourcing services or other information technology solutions or incur significant expenses in connection with our customers’ system failures or any actual or perceived security vulnerabilities in our products. In addition, the cost and operational consequences of implementing further data protection measures could be significant.
Portions of our information technology infrastructure also may experience interruptions, delays, or cessations of service or produce errors in connection with systems integration or migration work that takes place from time to time. We may not be successful in implementing new systems and transitioning data, which could cause business disruptions and be more expensive, time consuming, disruptive, and resource-intensive. Such disruptions could adversely impact our ability to fulfill orders and interrupt other processes. Delayed sales, lower margins, or lost government customers resulting from these disruptions could adversely affect our financial results, reputation, and stock price.
In the course of providing services to customers, Molina Medicaid Solutions may inadvertently infringe on the intellectual property rights of others and be exposed to claims for damages.
The solutions we provide to our state government customers may inadvertently infringe on the intellectual property rights of third parties resulting in claims for damages against us. The expense and time of defending against these claims may have a material and adverse impact on our profitability. Additionally, the publicity we may receive as a result of infringing intellectual property rights may damage our reputation and adversely impact our ability to develop new MMIS business or retain existing MMIS business.
Inherent in the government contracting process are various risks which may materially and adversely affect our business and profitability.
We are subject to the risks inherent in the government contracting process. These risks include government audits of billable contract costs and reimbursable expenses and compliance with government reporting requirements. In the event we are found to be out of compliance with government contracting requirements, our reputation may be adversely impacted and our relationship with the government agencies we work with may be damaged, resulting in a material and adverse effect on our profitability.
Our performance onof contracts, including those onwith respect to which we have partnered with third parties, may be adversely affected if we or the third parties fail to deliver on commitments.
In some instances, our contracts require that we partner with other parties, including software and hardware vendors, to provide the complex solutions required by our state government customers. Our ability to deliver the solutions and provide the services required by our customers is dependent on our and our partners’ ability to meet our customers’ delivery schedules. If we or our partners fail to deliver services or products on time, our ability to complete the contract may be adversely affected, which may have a material and adverse impact on our revenues and profitability.
Our business may be adversely affected by the transition from traditional fee-for-service to Medicaid managed care.
In order to save on costs, a number of state Medicaid programs are expected to pursue the transition from a fee-for-service focus of their Medicaid programs to a Medicaid managed care focus. A shift in Medicaid payment models from fee-for-service to managed care will require a concomitant shift in the focus of MMIS. In connection with such a transition, MMIS must also make a transition from a system built around claims adjudication to one that performs analytics and can be used to manage Medicaid population health outcomes. In the event Molina Medicaid Solutions is unable to accomplish this transition, our business, financial condition, cash flows, or results of operations may be adversely affected.

Risks Related to our General Business Operations
Ineffective management of our growth may negatively affect our business, financial condition, or results of operations.
We expect to continue to grow our membership and to expand into other markets through acquisitions and other opportunities. Continued rapid growth could place a significant strain on our management and on our other resources. Our ability to manage our growth may depend on our ability to strengthen our management team and attract, train, and retain skilled employees, and our ability to implement and improve operational, financial, and management information systems on a timely basis. If we are unable to manage our growth effectively, our business, financial condition, cash flows, or results of operations could be materially and adversely affected. In addition, due to the initial substantial costs related to acquisitions, rapid growth could adversely affect our short-term profitability and liquidity.

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Any changes to the laws and regulations governing our business, or the interpretation and enforcement of those laws or regulations, could cause us to modify our operations and could negatively impact our operating results.
Our business is extensively regulated by the federal government and the states in which we operate. The laws and regulations governing our operations are generally intended to benefit and protect health plan members and providers rather than managed care organizations. The government agencies administering these laws and regulations have broad latitude in interpreting and applying them. These laws and regulations, along with the terms of our government contracts, regulate how we do business, what services we offer, and how we interact with members and the public. For instance, some states mandate minimum medical expense levels as a percentage of premium revenues. These laws and regulations, and their interpretations, are subject to frequent change. The interpretation of certain contract provisions by our governmental regulators may also change. Changes in existing laws or regulations, or their interpretations, or the enactment of new laws or regulations, could reduce our profitability by imposing additional capital requirements, increasing our liability, increasing our administrative and other costs, increasing mandated benefits, forcing us to restructure our relationships with providers, or requiring us to implement additional or

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different programs and systems. Changes in the interpretation of our contracts could also reduce our profitability if we have detrimentally relied on a prior interpretation.
Our business depends on our information and medical management systems, and our inability to effectively integrate, manage, and keep secure our information and medical management systems could disrupt our operations.
Our business is dependent on effective and secure information systems that assist us in, among other things, processing provider claims, monitoring utilization and other cost factors, supporting our medical management techniques, and providing data to our regulators. Our providers also depend upon our information systems for membership verifications, claims status, and other information. If we experience a reduction in the performance, reliability, or availability of our information and medical management systems, our operations, ability to pay claims, and ability to produce timely and accurate reports could be adversely affected. In addition, if the licensor or vendor of any software which is integral to our operations were to become insolvent or otherwise fail to support the software sufficiently, our operations could be negatively affected.
Our information systems and applications require continual maintenance, upgrading, and enhancement to meet our operational needs. Moreover, our acquisition activity requires transitions to or from, and the integration of, various information systems. If we experience difficulties with the transition to or from information systems or are unable to properly implement, maintain, upgrade or expand our system, we could suffer from, among other things, operational disruptions, loss of members, difficulty in attracting new members, regulatory problems, and increases in administrative expenses.
Our business requires the secure transmission of confidential information over public networks. Advances in computer capabilities, new discoveries in the field of cryptography, or other events or developments could result in compromises or breaches of our security systems and member data stored in our information systems. Anyone who circumvents our security measures could misappropriate our confidential information or cause interruptions in services or operations. The internet is a public network, and data is sent over this network from many sources. In the past, computer viruses or software programs that disable or impair computers have been distributed and have rapidly spread over the internet. Computer viruses could be introduced into our systems, or those of our providers or regulators, which could disrupt our operations, or make our systems inaccessible to our members, providers, or regulators. We may be required to expend significant capital and other resources to protect against the threat of security breaches or to alleviate problems caused by breaches. Because of the confidential health information we store and transmit, security breaches could expose us to a risk of regulatory action, litigation, possible liability, and loss. Our security measures may be inadequate to prevent security breaches, and our business operations would be negatively impacted by cancellation of contracts and loss of members if security breaches are not prevented.
Because our corporate headquarters are located in Southern California, our business operations may be significantly disrupted as a result of a major earthquake.
Our corporate headquarters is located in Long Beach, California. In addition, the claims of our health plans are also processed in Long Beach. Southern California is exposed to a statistically greater risk of a major earthquake than most other parts of the United States. If a major earthquake were to strike the Los Angeles area, our corporate functions and claims processing could be significantly impaired for a substantial period of time. Although we have established a disaster recovery and business resumption plan with back-up operating sites to be deployed in the case of such a major disruptive event, there can be no assurances that the disaster recovery plan will be successful or that the business operations of all our health plans, including those that are remote from any such event, would not be substantially impacted by a major Southern California earthquake.
We face claims related to litigation which could result in substantial monetary damages.
We are subject to a variety of legal actions, including medical malpractice actions, provider disputes, employment related disputes, health care regulatory law-based litigation, and breach of contract actions. In the event we incur liability materially in excess of the amount for which we have insurance coverage, our profitability would suffer. In addition, our providers involved in medical care decisions are exposed to the risk of medical malpractice claims. As an employer of physicians and ancillary

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medical personnel and as an operator of primary care clinics, our plans are subject to liability for negligent acts, omissions, or injuries occurring at one of our clinics or caused by one of our employees. We maintain medical malpractice insurance for our clinics in an amount which we believe to be reasonable in light of our experience to date. However, given the significant amount of some medical malpractice awards and settlements, this insurance may not be sufficient or available at a reasonable cost to protect us from damage awards or other liabilities. Even if any claims brought against us are unsuccessful or without merit, we may have to defend ourselves against such claims. The defense of any such actions may be time-consuming and costly, and may distract our management’s attention. As a result, we may incur significant expenses and may be unable to effectively operate our business.
Furthermore, claimants often sue managed care organizations for improper denials of or delays in care, and in some instances improper authorizations of care. Claims of this nature could result in substantial damage awards against us and our providers that could exceed the limits of any applicable medical malpractice insurance coverage. Successful malpractice or tort claims asserted against us, our providers, or our employees could adversely affect our business, financial condition, cash flows, or results of operations.

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We cannot predict the outcome of any lawsuit with certainty. While we currently have insurance coverage for some of the potential liabilities relating to litigation, other such liabilities may not be covered by insurance, the insurers could dispute coverage, or the amount of insurance could be insufficient to cover the damages awarded. In addition, insurance coverage for all or certain types of liability may become unavailable or prohibitively expensive in the future or the deductible on any such insurance coverage could be set at a level which would result in us effectively self-insuring cases against us.
Although we establish reserves for litigation as we believe appropriate, we cannot assure you that our recorded reserves will be adequate to cover such costs. Therefore, the litigation to which we are subject could have a material adverse effect on our business, financial condition, results of operations, and cash flows, and could prompt us to change our operating procedures.
We are subject to competition which negatively impacts our ability to increase penetration in the markets we serve.
We operate in a highly competitive environment and in an industry that is subject to ongoing changes from business consolidations, new strategic alliances, and aggressive marketing practices by other managed care organizations. We compete for members principally on the basis of size, location, and quality of provider network, benefits supplied, quality of service, and reputation. A number of these competitive elements are partially dependent upon and can be positively affected by the financial resources available to a health plan. Many other organizations with which we compete, including large commercial plans, have substantially greater financial and other resources than we do. For these reasons, we may be unable to grow our membership, or may lose members to other health plans.
Failure to maintain effective internal controls over financial reporting could have a material adverse effect on our business, operating results, and stock price.
The Sarbanes-Oxley Act of 2002 requires, among other things, that we maintain effective internal control over financial reporting. In particular, we must perform system and process evaluation and testing of our internal controls over financial reporting to allow management to report on, and our independent registered public accounting firm to attest to, our internal controls over financial reporting as required by Section 404 of the Sarbanes-Oxley Act of 2002. Our future testing, or the subsequent testing by our independent registered public accounting firm, may reveal deficiencies in our internal controls over financial reporting that are deemed to be material weaknesses. Our compliance with Section 404 will continue to require that we incur substantial accounting expense and expend significant management time and effort. Moreover, if we are not able to continue to comply with the requirements of Section 404 in a timely manner, or if we or our independent registered public accounting firm identify deficiencies in our internal control over financial reporting that are deemed to be material weaknesses, the market price of our stock could decline and we could be subject to sanctions or investigations by the NYSE,New York Stock Exchange, SEC, or other regulatory authorities which would require additional financial and management resources.
Changes in accounting may affect our results of operations.
U.S. generally accepted accounting principles (GAAP) and related implementation guidelines and interpretations can be highly complex and involve subjective judgments. Changes in these rules or their interpretation, or the adoption of new pronouncements could significantly affect our stated results of operations.
The value of our investments is influenced by varying economic and market conditions, and a decrease in value could have an adverse effect on our results of operations, liquidity, and financial condition.
Our investments consist solely of investment-grade debt securities. The unrestricted portion of this portfolio is designated as available-for-sale. Our non-current restricted investments are designated as held-to-maturity. Available-for-sale investments are carried at fair value, and the unrealized gains or losses are included in accumulated other comprehensive income or loss as a separate component of stockholders’ equity, unless the decline in value is deemed to be other-than-temporary and we do not have the intent and ability to hold such securities until their full cost can be recovered. For our available-for-sale investments

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and held-to-maturity investments, if a decline in value is deemed to be other-than-temporary and we do not have the intent and ability to hold such security until its full cost can be recovered, the security is deemed to be other-than-temporarily impaired and it is written down to fair value and the loss is recorded as an expense.
In accordance with applicable accounting standards, we review our investment securities to determine if declines in fair value below cost are other-than-temporary. This review is subjective and requires a high degree of judgment. We conduct this review on a quarterly basis, using both quantitative and qualitative factors, to determine whether a decline in value is other-than-temporary. Such factors considered include the length of time and the extent to which market value has been less than cost, the financial condition and near term prospects of the issuer, recommendations of investment advisors, and forecasts of economic, market or industry trends. This review process also entails an evaluation of our ability and intent to hold individual securities until they mature or full cost can be recovered.
The current economic environment and recent volatility of the securities markets increase the difficulty of assessing investment impairment and the same influences tend to increase the risk of potential impairment of these assets. Over time, the economic and market environment may provide additional insight regarding the fair value of certain securities, which could change our

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judgment regarding impairment. This could result in realized losses relating to other-than-temporary declines to be recorded as an expense. Given the current market conditions and the significant judgments involved, there is continuing risk that declines in fair value may occur and material other-than-temporary impairments may result in realized losses in future periods which could have a material adverse effect on our business, financial condition, cash flows, or results of operations.
Unanticipated changes in our tax rates or exposure to additional income tax liabilities could affect our profitability.
We are subject to income taxes in the United States. Our effective tax rate could be adversely affected by changes in the mix of earnings in states with different statutory tax rates, changes in the valuation of deferred tax assets and liabilities, changes in U.S. tax laws and regulations, and changes in our interpretations of tax laws, including pending tax law changes, such as the health care federal excise tax discussed above. In addition, we are subject to the routine examination of our income tax returns by the Internal Revenue Service and other local and state tax authorities. We regularly assess the likelihood of outcomes resulting from these examinations to determine the adequacy of our estimated income tax liabilities. Adverse outcomes from tax examinations could have a material adverse effect on our provision for income taxes, estimated income tax liabilities, or results of operations.
We are dependent on our executive officers and other key employees.
Our operations are highly dependent on the efforts of our executive officers. The loss of their leadership, knowledge, and experience could negatively impact our operations. Replacing many of our executive officers might be difficult or take an extended period of time because a limited number of individuals in the managed care industry have the breadth and depth of skills and experience necessary to operate and expand successfully a business such as ours. Our success is also dependent on our ability to hire and retain qualified management, technical, and medical personnel. It is critical that we recruit, manage, enable, and retain talent to successfully execute our strategic objections which requires aligned policies, a positive work environment, and a robust succession and talent development process. Further, particularly in light of the changing healthcarehealth care environment, we must focus on building employee capabilities to help ensure that we can meet upcoming challenges and opportunities. If we are unsuccessful in recruiting, retaining, managing, and enabling such personnel and are unable to meet upcoming challenges and opportunities, our operations could be negatively impacted.
We are subject to risks associated with outsourcing services and functions to third parties.
We contract with independent third party vendors and service providers who provide services to us and our subsidiaries or to whom we delegate selected functions. Our arrangements with third party vendors and service providers may make our operations vulnerable if those third parties fail to satisfy their obligations to us, including their obligations to maintain and protect the security and confidentiality of our information and data. In addition, we may have disagreements with third party vendors and service providers regarding relative responsibilities for any such failures under applicable business associate agreements or other applicable outsourcing agreements. Further, we may not be adequately indemnified against all possible losses through the terms and conditions of our contracts with third party vendors and service providers. Our outsourcing arrangements could be adversely impacted by changes in vendors’ or service providers’ operations or financial condition or other matters outside of our control. If we fail to adequately monitor and regulate the performance of our third party vendors and service providers, we could be subject to additional risk. Violations of, or noncompliance with, laws and/or regulations governing our business or noncompliance with contract terms by third party vendors and service providers could increase our exposure to liability to our members, providers, or other third parties, or sanctions and/or fines from the regulators that oversee our business. In turn, this could increase the costs associated with the operation of our business or have an adverse impact on our business and reputation. Moreover, if these vendor and service provider relationships were terminated for any reason, we may not be able to find alternative partners in a timely manner or on acceptable financial terms, and may incur significant costs in connection with any such vendor or service provider transition. As a result, we may not be able to meet the full demands of our customers and, in turn, our business, financial condition, or results of operations may be harmed. In addition, we may not

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fully realize the anticipated economic and other benefits from our outsourcing projects or other relationships we enter into with third party vendors and service providers, as a result of regulatory restrictions on outsourcing, unanticipated delays in transitioning our operations to the third party, vendor or service provider noncompliance with contract terms or violations of laws and/or regulations, or otherwise. This could result in substantial costs or other operational or financial problems that could adversely impact our business, financial condition, cash flows, or results of operations.
An impairment charge with respect to our recorded goodwill, or our finite-lived intangible assets, could have a material impact on our financial results.
As of December 31, 2014, the balance of2015, goodwill was $272.0$519 million, and the balance of intangible assets, net, was $89.3were $122 million. Intangible assets are amortized generally on a straight-line basis over their estimated useful lives.
Goodwill represents the amount of the purchase price in excess of the fair values assigned to the underlying identifiable net assets of acquired businesses. Goodwill is not amortized, but is subject to an annual impairment test. Tests are performed more frequently if events occur or circumstances change that would more likely than not reduce the fair value of a reporting unit

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below its carrying amount. Our intangible assets are subject to impairment tests when events or circumstances indicate that a finite-lived intangible asset’s (or asset group’s) carrying value may not be recoverable.
The determination of the value of goodwill, and intangible assets, net, requires us to make estimates and assumptions about estimated asset lives, future business trends, and growth. Such evaluation is significantly impacted by estimates and assumptions of future revenues, costs and expenses, and other factors. If an event or events occur that would cause us to revise our estimates and assumptions used in analyzing the value of our goodwill, and intangible assets, net, such revision could result in a non-cash impairment charge that could have a material impact on our financial results.
We are subject to the risks of owning and leasing real property.
We are a tenant under numerous leases in multiple states, including a 25-year lease of an approximately 460,000 square foot office building housing our principal executive offices in Long Beach, California. We also own a 186,000 square-foot office building in Troy, Michigan, a 26,700 square-foot data center in Albuquerque, New Mexico, and a 24,000 square-foot community clinic in Pomona, California.California, and 40 properties in Pennsylvania, which are primarily residential housing facilities. Accordingly, we are subject to all of the risks generally associated with leasing and owning real estate, which include, but are not limited to: the possibility of environmental contamination, the costs associated with fixing any environmental problems and the risk of damages resulting from such contamination; adverse changes in the value of the property due to interest rate changes, changes in the neighborhood in which the property is located, or other factors; ongoing maintenance expenses and costs of improvements; the possible need for structural improvements in order to comply with changes in zoning, seismic, disability act, or other requirements; inability to renew or enter into leases for space not utilized by us on commercially acceptable terms or at all; and possible disputes with neighboring owners or other individuals and entities.
Our substantial indebtedness could adversely affect our ability to raise additional capital to fund our operations, limit our ability to react to changes in the economy or our industry, expose us to interest rate risk to the extent of any variable rate debt, and prevent us from meeting our our outstanding indebtedness.
We have a significant amount of indebtedness. As of December 31, 2015, our total indebtedness was approximately $1,609 million, including lease financing obligations. As of December 31, 2015, we also had $244 million available for borrowing under our revolving credit facility. Our substantial indebtedness could have significant consequences, including:
increasing our vulnerability to adverse economic, industry, or competitive developments;
requiring a substantial portion of our cash flows from operations to be dedicated to the payment of principal and interest on our indebtedness, therefore reducing our ability to use our cash flows to fund operations, make capital expenditures, and pursue future business opportunities;
exposing us to the risk of increased interest rates to the extent of any future borrowings, including borrowings under the revolving credit facility, at variable rates of interest;
making it more difficult for us to satisfy our obligations with respect to our indebtedness, including the revolving credit facility and our outstanding senior notes, and any failure to comply with the obligations of any of our debt instruments, including restrictive covenants and borrowing conditions, could result in an event of default under the indenture governing our outstanding senior notes and the agreements governing such other indebtedness;
restricting us from making strategic acquisitions or causing us to make non-strategic divestitures;
limiting our ability to obtain additional financing for working capital, capital expenditures, product and service development, debt service requirements, acquisitions, and general corporate or other purposes; and

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limiting our flexibility in planning for, or reacting to, changes in our business or market conditions and placing us at a competitive disadvantage compared to our competitors who are less highly leveraged and who, therefore, may be able to take advantage of opportunities that our substantial indebtedness may prevent us from exploiting.
Despite our high indebtedness level, we and our subsidiaries are able to incur substantial additional amounts of debt, including secured debt, which could further exacerbate the risks associated with our substantial indebtedness.
We and our subsidiaries may be able to incur substantial additional indebtedness in the future. Although the indentures governing our outstanding senior notes and the credit agreement governing the revolving credit facility contain restrictions on the incurrence of additional indebtedness, these restrictions are subject to a number of significant qualifications and exceptions, and under certain circumstances, the amount of indebtedness that could be incurred in compliance with these restrictions could be substantial. As of December 31, 2015, we had approximately $244 million available for additional borrowing under our revolving credit facility. In addition, the indentures governing our outstanding senior notes and the credit agreement governing our revolving credit facility do not prevent us from incurring obligations that do not constitute prohibited indebtedness thereunder. If new debt is added to our and our subsidiaries’ existing debt levels, the related risks that we now face would increase.
The terms of our debt impose, and will impose, restrictions on us that may affect our ability to successfully operate our business and our ability to make payments on our outstanding senior notes.
The indentures governing our outstanding senior notes and the credit agreement governing the revolving credit facility contain various covenants that could materially and adversely affect our ability to finance our future operations or capital needs and to engage in other business activities that may be in our best interest. These covenants limit our ability to, among other things:
incur additional indebtedness or issue certain preferred equity;
pay dividends on, repurchase, or make distributions in respect of our capital stock, prepay, redeem, or repurchase certain debt or make other restricted payments;
make certain investments;
create certain liens;
sell assets, including capital stock of restricted subsidiaries;
enter into agreements restricting our restricted subsidiaries’ ability to pay dividends to us;
consolidate, merge, sell, or otherwise dispose of all or substantially all of our assets;
enter into certain transactions with our affiliates; and
designate our restricted subsidiaries as unrestricted subsidiaries.
All of these covenants may restrict our ability to expand or to pursue our business strategies. Our ability to comply with these covenants may be affected by events beyond our control, such as prevailing economic conditions and changes in regulations, and if such events occur, we cannot be sure that we will be able to comply. A breach of these covenants could result in a default under the indentures for our outstanding senior notes and/or the credit agreement governing the revolving credit facility including, as a result of cross default provisions and, in the case of the revolving credit facility permit the lenders to cease making loans to us. If there were an event of default under the indentures governing our outstanding senior notes and/or the credit agreement governing the revolving credit facility, holders of such defaulted debt could cause all amounts borrowed under these instruments to be due and payable immediately. Our assets or cash flow may not be sufficient to repay borrowings under our outstanding debt instruments in the event of a default thereunder.
In addition, the restrictive covenants in the credit agreement governing the revolving credit facility require us to maintain specified financial ratios and satisfy other financial condition tests. Our ability to meet those financial ratios and tests will depend on our ongoing financial and operating performance, which, in turn, will be subject to economic conditions and to financial, market, and competitive factors, many of which are beyond our control.
If our operating performance declines, we may be required to obtain waivers from the lenders under the revolving credit facility, from the holders of our outstanding senior notes or from the holders of other obligations, to avoid defaults thereunder. If we are not able to obtain such waivers, our creditors could exercise their rights upon default, and we could be forced into bankruptcy or liquidation.

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We may not have the funds necessary to pay the amounts due upon conversion or required repurchase of our outstanding notes, and our indebtedness may contain limitations on our ability to pay the amounts due upon conversion or required repurchase.
In February 2013, we issued $550.0 million aggregate principal amount of 1.125% cash convertible senior notes due January 15, 2020, unless earlier repurchased or converted. We refer to these notes as our 1.125% Notes. In September 2014, we issued $301.6 million aggregate principal amount of 1.625% convertible senior notes due August 14, 2044, unless earlier repurchased, redeemed, or converted. We refer to these notes as our 1.625% Notes. As of December 31, 2015, the aggregate outstanding principal amount of our 1.125% Notes and our 1.625% Notes was $550 million and $302 million, respectively. Both our 1.125% Notes and our 1.625% Notes are convertible into cash prior to their respective maturity dates under certain circumstances, one of which relates to the closing price of our common stock over a specified period. We refer to this conversion trigger as the stock price trigger. The 1.125% Notes met the stock price trigger in the quarter ended December 31, 2015, and are convertible to cash through at least March 31, 2016. Because the 1.125% Notes may be converted into cash within 12 months, the $448 million carrying amount is reported in current portion of long-term debt as of December 31, 2015. In addition, holders of our 1.625% Notes may convert their notes into cash during any calendar quarter (and only during such calendar quarter) if the last reported sales price of our common stock for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on the last trading day of the immediately preceding calendar quarter is greater than or equal to $75.51 per share. The last reported sale price of our common stock as reported on the New York Stock Exchange on February 23, 2016 was $62.28 per share. As of December 31, 2015, our 1.625% Notes were not convertible. If conversion requests are received, the settlement of the notes must be paid primarily in cash pursuant to the terms of the relevant indentures.
For economic reasons related to the trading market for our 1.125% Notes, we believe that the amount of the notes that may be converted over the next twelve months, if any, will not be significant. However, if the trading market for our 1.125% Notes becomes closed or restricted due to market turmoil or other reasons such that the notes cannot be traded, or if the trading price of our 1.125% Notes, which normally trade at a marginal premium to the underlying composite stock-and-interest economic value, no longer includes that marginal premium, holders of our 1.125% Notes may elect to convert the notes to cash. As of December 31, 2015, we had sufficient available cash, combined with borrowing capacity available under our revolving credit facility, to fund such conversions.
In addition, in the event of a change in control or the termination in trading of our stock, each holder of our 1.125% Notes and our 1.625% Notes would have the right to require us to purchase some or all of their notes at a purchase price in cash equal to 100% of the principal amount of the notes, plus any accrued and unpaid interest.
In the event of conversions or required repurchases, we may not have enough available cash or be able to obtain financing at the time we are required to comply with our conversion or repurchase obligations. In addition, our ability to comply with these obligations may be limited by law, by regulatory authority, or by agreements governing our future indebtedness. The indentures for the 1.125% Notes and the 1.625% Notes provide that it would be an event of default if we do not make the cash payments due upon conversion or required repurchase of the notes. The occurrence of an event of default under one or both of these indentures may also constitute an event of default under our revolving credit facility and under our other indebtedness we may have outstanding at such time. Any such default could have a material adverse effect on our business, financial condition, cash flows, or results of operations.
Variable rate indebtedness subjects us to interest rate risk, which could cause our debt service obligations to increase significantly.
Our borrowings under the revolving credit facility are at variable rates of interest and expose us to interest rate risk. If interest rates increase, our debt service obligations on the variable rate indebtedness could increase even though the amount borrowed remained the same, and our net income could decrease. The applicable margin with respect to the loan under the revolving credit facility is a percentage per annum equal to a reference rate plus the applicable margin. In order to manage our exposure to interest rate risk, in the future we may enter into derivative financial instruments, typically interest rate swaps and caps, involving the exchange of floating for fixed rate interest payments. If we are unable to enter into interest rate swaps, it may adversely affect our cash flow and may impact our ability to make required principal and interest payments on our indebtedness.
We may not be able to generate sufficient cash to service all of our indebtedness and may be forced to take other actions to satisfy our obligations under our indebtedness, which may not be successful.
Our ability to make scheduled payments on or to refinance our debt obligations depends on our financial condition and operating performance, which is subject to prevailing economic and competitive conditions and to certain financial, business, and other factors beyond our control. We may not be able to maintain a level of cash flows from operating activities sufficient to permit us to pay the principal, and interest on our indebtedness.

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If our cash flows and capital resources are insufficient to fund our debt service obligations, we may be forced to reduce or delay investments and capital expenditures, or to sell assets, seek additional capital, or restructure or refinance our indebtedness. Our ability to restructure or refinance our debt will depend on the condition of the capital markets and our financial condition at such time. Any refinancing of our debt could be at higher interest rates and may require us to comply with more onerous covenants, which could further restrict our business operations. The terms of existing or future debt instruments, including the revolving credit facility, and the indentures governing our outstanding senior notes, may restrict us from adopting some of these alternatives. In addition, any failure to make payments of interest and principal on our outstanding indebtedness on a timely basis would likely result in a reduction of our credit rating, which would harm our ability to incur additional indebtedness. These alternative measures may not be successful and may not permit us to meet our scheduled debt service obligations.
A lowering or withdrawal of the ratings assigned to our debt securities by rating agencies may increase our future borrowing costs and reduce our access to capital.
Our debt currently has a non-investment grade rating, and there can be no assurance that any rating assigned by the rating agencies to our debt or our corporate rating will remain for any given period of time or that a rating will not be lowered or withdrawn entirely by a rating agency if, in that rating agency’s judgment, future circumstances relating to the basis of the rating, such as adverse changes, so warrant. A lowering or withdrawal of the ratings assigned to our debt securities by rating agencies would likely increase our future borrowing costs and reduce our access to capital, which could have a materially adverse impact on our financial condition and results of operations.

Risks Related to Our Common Stock
Delaware law and our charter documents may impede or discourage a takeover, which could cause the market price of our common stock to decline.
We are a Delaware corporation, and the anti-takeover provisions of Delaware law impose various impediments to the ability of a third party to acquire control of us, even if a change in control would be beneficial to our existing stockholders. In addition, our board of directors or a committee thereof has the power, without stockholder approval, to designate the terms of one or more series of preferred stock and issue shares of preferred stock. The ability of our board of directors or a committee thereof to create and issue a new series of preferred stock and certain provisions of Delaware law and our certificate of incorporation and bylaws could impede a merger, takeover or other business combination involving us or discourage a potential acquirer from making a tender offer for our common stock, which, under certain circumstances, could reduce the market price of our common stock and the value of our convertible senior notes.
Members of the Molina family own a significant amount of our capital stock, decreasing the influence of other stockholders on stockholder decisions.
Members of the Molina family, either directly or as trustees or beneficiaries of Molina family trusts, in the aggregate owned or were entitled to receive upon certain events approximately 32%26% of our capital stock as of December 31, 2014.2015. Our president and chief executive officer, as well as our chief financial officer, are members of the Molina family, and they are also on our board of directors. Because of the amount of their shareholdings, Molina family members, if they were to act as a group with the trustees of their family trusts, have the ability to significantly influence all matters submitted to stockholders for approval, including the election of directors, amendments to our charter, and any merger, consolidation, or sale of our company. A significant concentration of share ownership can also adversely affect the trading price for our common stock because investors often discount the value of stock in companies that have controlling stockholders. Furthermore, the concentration of share ownership in the Molina family could delay or prevent a merger or consolidation, takeover, or other business combination that could be favorable to our stockholders. Finally, the interests and objectives of the Molina family may be different from those of our company or our other stockholders, and they may vote their common stock in a manner that is contrary to the vote of our other stockholders.

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Future sales of our common stock or equity-linked securities in the public market could adversely affect the trading price of our common stock and our ability to raise funds in new stock offerings.
We may issue equity securities in the future, or securities that are convertible into or exchangeable for, or that represent the right to receive, shares of our common stock. Sales of a substantial number of shares of our common stock or other equity securities, including sales of shares in connection with any future acquisitions, could be substantially dilutive to our stockholders. These sales may have a harmful effect on prevailing market prices for our common stock and our ability to raise additional capital in the financial markets at a time and price favorable to us. Moreover, to the extent that we issue restricted stock units, stock appreciation rights, options, or warrants to purchase our common stock in the future and those stock appreciation rights, options, or warrants are exercised or as the restricted stock units vest, our stockholders may experience further dilution. Holders of our shares of common stock have no preemptive rights that entitle holders to purchase a pro rata share of any offering of shares of any class or series and, therefore, such sales or offerings could result in increased dilution to

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our stockholders. Our certificate of incorporation provides that we have authority to issue 150,000,000 shares of common stock and 20,000,000 shares of preferred stock. As of December 31, 2014,2015, approximately 49,727,00056,000,000 shares of common stock and no shares of preferred or other capital stock were issued and outstanding.
It may be difficult for a third party to acquire us, which could inhibit stockholders from realizing a premium on their stock price.
We are subject to the Delaware anti-takeover laws regulating corporate takeovers. These provisions may prohibit stockholders owning 15% or more of our outstanding voting stock from merging or combining with us. In addition, any change in control of our state health plans would require the approval of the applicable insurance regulator in each state in which we operate.
Our certificate of incorporation and bylaws also contain provisions that could have the effect of delaying, deferring, or preventing a change in control of our company that stockholders may consider favorable or beneficial. These provisions could discourage proxy contests and make it more difficult for our stockholders to elect directors and take other corporate actions. These provisions could also limit the price that investors might be willing to pay in the future for shares of our common stock. These provisions include:
a staggered board of directors, so that it would take three successive annual meetings to replace all directors,
prohibition of stockholder action by written consent, and
advance notice requirements for the submission by stockholders of nominations for election to the board of directors and for proposing matters that can be acted upon by stockholders at a meeting.
In addition, changes of control are often subject to state regulatory notification, and in some cases, prior approval.

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Item 1B: Unresolved Staff Comments
None.
Item 2: Properties
As of December 31, 2014,2015, the Health Plans segment leasesleased a total of 7084 facilities, and the Molina Medicaid Solutions segment leasesleased a total of 12 facilities and the Other segment leased a total of 215 facilities. We own a 186,000 square-foot office building in Troy, Michigan a 26,700 square-foot data center in Albuquerque, New Mexico, and a 24,000 square-foot mixed use (office and clinic) facility in Pomona, California under our Health Plans segment. We own a 26,700 square-foot data center in Albuquerque, New Mexico and 40 properties in Pennsylvania, which are primarily residential housing facilities, under our Other segment. While we believe our current and anticipated facilities will be adequate to meet our operational needs for the foreseeable future, we are continuing to periodically evaluate our employee and operations growth prospects to determine if additional space is required, and where it would be best located.
Item 3:  Legal Proceedings
The health care and business process outsourcing industries are subject to numerous laws and regulations of federal, state, and local governments. Compliance with these laws and regulations can be subject to government review and interpretation, as well as regulatory actions unknown and unasserted at this time. Penalties associated with violations of these laws and regulations include significant fines and penalties, exclusion from participating in publicly funded programs, and the repayment of previously billed and collected revenues.
We are involved in legal actions in the ordinary course of business, some of which seek monetary damages, including claims for punitive damages, which are not covered by insurance. We have accrued liabilities for certain matters for which we deem the loss to be both probable and estimable. Although we believe that our estimates of such losses are reasonable, these estimates could change as a result of further developments of these matters. The outcome of legal actions is inherently uncertain and such pending matters for which accruals have not been established have not progressed sufficiently through discovery and/or development of important factual information and legal issues to enable us to estimate a range of possible loss, if any. While it is not possible to accurately predict or determine the eventual outcomes of these items, an adverse determination in one or more of these pending matters could have a material adverse effect on our consolidated financial position, results of operations, or cash flows.
State of Louisiana v. Molina Medicaid Solutions et al. On June 26, 2014, the state of Louisiana filed a Petition for Damages against Molina Medicaid Solutions, Molina Healthcare, Inc., Unisys Corporation, and Paramax Systems Corporation, a subsidiary of Unisys, in the Parish of Baton Rouge, 19th Judicial District, versus number 631612. The Petition alleges that between 1989 and 2012, the defendants utilized an incorrect reimbursement formula for the payment of pharmaceutical claims. The petitioner seeks actual damages to be proved at trial, plus interest. We believe we have several meritorious defenses to the claims of the state, and any liability for the alleged claims is not currently probable or reasonably estimable.

USA and State
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United States of America, ex rel., Anita Silingo v. Mobile Medical Examination Services, Inc., et al. On or around October 14, 2014, Molina Healthcare of California, Molina Healthcare of California Partner Plan, Inc., Mobile Medical Examination Services, Inc. (MedXM), and other health plan defendants were served with a Complaint previously filed under seal in the Central District Court of California by relator,Relator, Anita Silingo, Case No. SACV13-1348-FMO(SHx). The Complaint alleges that MedXM improperly modified medical records and otherwise took inappropriate steps to increase members’ risk adjustment scores, and that the defendants, including Molina Healthcare of California and Molina Healthcare of California Partner Plan, Inc., purportedly turned a “blind eye” to these unlawful practices. The relator seeks treble damages in the amount of $3 billion, plus interest and penalties. The Department of Justice has declined to intervene. The District Court dismissed this action as to Molina without leave to amend as to some allegations and with leave to amend as to other allegations. On October 22, 2015, the Relator filed a third amended complaint. We believe that we have several meritorious defenses to the claims of the relator,Relator, and any liability for the alleged claims is not currently probable or reasonably estimable.
Item 4:  Mine Safety Disclosures
None.

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PART II
Item 5:  Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities
Our common stock is listed on the New York Stock Exchange under the trading symbol "MOH." As of February 20, 2015,23, 2016, there were approximately 120 holders of record of our common stock. The high and low intra-day sales prices of our common stock for specified periods are set forth below:
Date RangeHigh Low
High Low
2015   
First Quarter$67.58
 $49.37
Second Quarter$73.98
 $57.35
Third Quarter$82.37
 $65.72
Fourth Quarter$70.82
 $55.49
2014      
First Quarter$39.21
 $32.41
$39.21
 $32.41
Second Quarter$46.17
 $32.86
$46.17
 $32.86
Third Quarter$48.03
 $39.23
$48.03
 $39.23
Fourth Quarter$54.57
 $40.79
$54.57
 $40.79
2013   
First Quarter$33.85
 $25.70
Second Quarter$38.74
 $30.26
Third Quarter$40.90
 $33.31
Fourth Quarter$37.39
 $31.10
Dividends
To date we have not paid cash dividends on our common stock. We currently intend to retain any future earnings to fund our projected business growth. However, we intend to periodically evaluate our cash position to determine whether to pay a cash dividend in the future.
Our ability to pay dividends is partially dependent on, among other things, our receipt of cash dividends from our regulated subsidiaries. The ability of our regulated subsidiaries to pay dividends to us is limited by the state departments of insurance in the states in which we operate or may operate, as well as requirements of the government-sponsored health programs in which we participate. Additionally, the indentures governing our outstanding senior notes and the credit agreement governing the revolving credit facility contain various covenants that limit our ability to pay dividends on our common stock.
Any future determination to pay dividends will be at the discretion of our Boardboard of directors and will depend upon, among other factors, our results of operations, financial condition, capital requirements and contractual and regulatory restrictions. For more information regarding restrictions on the ability of our regulated subsidiaries to pay dividends to us, please see Item 7 of this Form 10-K, Management’s Discussion and Analysis of Financial Condition and Results of Operations, in "Liquidity and Capital Resources," under the subheading "Regulatory Capital and Dividend Restrictions."
Unregistered Issuances of Equity Securities
None.
Stock Repurchase Programs
Securities Repurchases and Repurchase Programs. Effective as of February 25,December 16, 2015, our board of directors authorized the repurchase of up to $50 million in aggregate of our common stock. Stock repurchases under this program may be made through open-market and/stock or privately negotiated transactions at times and in such amounts as management deems appropriate. The timing and actual number of shares repurchased will depend on a variety of factors including price, corporate and regulatory requirements and market conditions.senior notes. This newly authorized repurchase program extends through December 31, 2015.2016.


3235


Purchases of common stock made by or on behalf of the Company during the quarter ended December 31, 2014,2015, including shares withheld by the Company to satisfy our employees’ income tax obligations, are set forth below:
Total Number
of Shares
Purchased (1)
 
Average Price
Paid per Share (1)
 
Total Number of
Shares Purchased as
Part of Publicly
Announced Plans or
Programs (2)
 Approximate Dollar Value of Shares That May Yet Be Purchased Under the Plans or Programs (2)
Total Number
of Shares
Purchased (1)
 
Average Price
Paid per Share (1)
 
Total Number of
Shares Purchased as
Part of Publicly
Announced Plans or
Programs (2)
 Approximate Dollar Value of Shares That May Yet Be Purchased Under the Plans or Programs (2)
October 1 — October 311,052
 $41.66
 
 $47,338,505
94
 $66.79
 
 $50,000,000
November 1 — November 301,781
 $48.64
 
 $47,338,505
576
 $62.00
 
 $50,000,000
December 1 — December 311,523
 $49.96
 
 $47,338,505
104,222
 $59.15
 
 $50,000,000
4,356
 $47.42
 
  104,892
 $59.17
 
  

(1)During the quarter we withheld 4,356104,892 shares of common stock under our 2002 Equity Incentive Plan and 2011 Equity Incentive Plan to settle our employees' income tax obligations.
(2)Effective as of September 30, 2013,February 25, 2015, our board of directors authorized the repurchase of up to $50 million in aggregate of our common stock. This repurchase program expired December 31, 2014.2015.

33


STOCK PERFORMANCE GRAPH
The following graph and related discussion are being furnished solely to accompany this Annual Report on Form 10-K pursuant to Item 201(e) of Regulation S-K and shall not be deemed to be "soliciting materials" or to be "filed" with the SEC (other than as provided in Item 201) nor shall this information be incorporated by reference into any future filing under the Securities Act or the Exchange Act, whether made before or after the date hereof and irrespective of any general incorporation language contained therein, except to the extent that the Company specifically incorporates it by reference into a filing.
The following line graph compares the percentage change in the cumulative total return on our common stock against the cumulative total return of the Standard & Poor's Corporation Composite 500 Index (S&P 500) and a peer group index for the five-year period from December 31, 20092010 to December 31, 2014.2015. The comparison assumes $100 was invested on December 31, 2009,2010, in the Company’s common stock and in each of the foregoing indices and assumes reinvestment of dividends. The stock performance shown on the graph below represents historical stock performance and is not necessarily indicative of future stock price performance.
The old peer group index, used in last year's Annual Report on Form 10-K and also set forth below, consists of Centene Corporation (CNC), Community Health Systems, Inc. (CYH), Coventry Health Care, Inc. (CVH), Health Management Associates, Inc. (HMA), Health Net, Inc. (HNT), Laboratory Corporation of America Holdings (LH), Lifepoint Hospitals, Inc. (LPNT), Magellan Health Services, Inc. (MGLN), Select Medical Holdings Corporation (SEM), Team Health Holdings, Inc. (TMH), Triple-S Management Corporation (GTS), Universal American Corporation (UAM), and WellCare Health Plans, Inc. (WCG).
The new peer group index consists of Brookdale Senior Living, Inc. (BKD), Catamaran Corporation (CTRX), Centene Corporation (CNC), Community Health Systems, Inc. (CYH), DaVita HealthCare Partners, Inc. (DVA), Health Net, Inc. (HNT), Kindred Healthcare, Inc. (KND), Laboratory Corporation of America Holdings (LH), Life Point Hospitals, Inc. (LPNT), Magellan Health, Inc. (MGLN), Omnicare, Inc. (OCR), Quest Diagnostics, Inc. (DGX), Select Medical Holdings Corporation (SEM), Team Health Holdings, Inc. (TMH), Tenet Healthcare Corporation (THC), Universal American Corporation (UAM), Universal Health Services, Inc. (UHS) and WellCare Health Plans, Inc. (WCG).

36



December 31,December 31,
Name200920102011201220132014201020112012201320142015
Molina Healthcare, Inc.$100.00
$121.78
$146.46
$177.48
$227.92
$351.09
$100.00
$120.27
$145.75
$187.16
$288.31
$323.86
S&P 500100.00
115.06
117.49
136.30
180.44
205.14
100.00
102.11
118.45
156.82
178.29
180.75
Old Peer Group100.00
112.08
135.26
142.21
177.30
236.56
New Peer Group100.00
111.51
124.46
147.53
178.64
225.58
Peer Group100.00
110.25
131.73
155.98
197.59
189.81

3437


Item 6.  Selected Financial Data
SELECTED FINANCIAL DATA
We derived the following selected consolidated financial data (other than the data under the caption "Operating Statistics, Continuing Operations") for the five years ended December 31, 20142015 from our audited consolidated financial statements. You should read the data in conjunction with our consolidated financial statements, related notes and other financial information included herein. All dollar amounts are presented in thousands,millions, except per-share data. The data under the caption "Operating Statistics, Continuing Operations" has not been audited.
Year Ended December 31,Year Ended December 31,
2014 2013 2012 2011 2010 (1)2015 (1) 2014 2013 2012 2011
Statements of Income Data:                  
Revenue:                  
Premium revenue$9,022,511
 $6,179,170
 $5,544,121
 $4,211,493
 $3,632,142
$13,241
 $9,023
 $6,179
 $5,544
 $4,212
Service revenue (1)210,051
 204,535
 187,710
 160,447
 89,809
253
 210
 205
 188
 160
Premium tax revenue294,388
 172,017
 158,991
 154,589
 139,775
397
 294
 172
 159
 155
Health insurer fee revenue119,484
 
 
 
 
264
 120
 
 
 
Investment income8,093
 6,890
 5,075
 5,446
 6,198
18
 8
 7
 5
 5
Other revenue12,074
 26,322
 18,312
 8,288
 7,140
5
 12
 26
 18
 8
Total revenue9,666,601
 6,588,934
 5,914,209
 4,540,263
 3,875,064
14,178
 9,667
 6,589
 5,914
 4,540
Operating expenses:                  
Medical care costs8,076,331
 5,380,124
 4,991,188
 3,664,161
 3,190,566
11,794
 8,076
 5,380
 4,991
 3,664
Cost of service revenue (1)156,764
 161,494
 141,208
 143,987
 78,647
193
 157
 161
 141
 144
General and administrative expenses764,693
 665,996
 518,615
 393,452
 326,193
1,146
 765
 666
 519
 393
Premium tax expenses294,388
 172,017
 158,991
 154,589
 139,775
397
 294
 172
 159
 155
Health insurer fee expenses88,591
 
 
 
 
157
 89
 
 
 
Depreciation and amortization92,917
 72,743
 63,114
 48,253
 43,246
104
 93
 73
 63
 48
Total operating expenses9,473,684
 6,452,374
 5,873,116
 4,404,442
 3,778,427
13,791
 9,474
 6,452
 5,873
 4,404
Operating income192,917
 136,560
 41,093
 135,821
 96,637
387
 193
 137
 41
 136
Other expenses, net:                  
Interest expense56,811
 52,071
 16,769
 15,519
 15,509
66
 57
 52
 17
 16
Other expense, net802
 3,343
 945
 
 
Other (income) expense, net(1) 1
 4
 1
 
Total other expenses, net57,613
 55,414
 17,714
 15,519
 15,509
65
 58
 56
 18
 16
Income from continuing operations before income taxes135,304
 81,146
 23,379
 120,302
 81,128
322
 135
 81
 23
 120
Income tax expense72,726
 36,316
 10,513
 42,914
 30,511
179
 73
 36
 10
 43
Income from continuing operations62,578
 44,830
 12,866
 77,388
 50,617
143
 62
 45
 13
 77
(Loss) income from discontinued operations, net of tax (benefit) expense (2)(355) 8,099
 (3,076) (56,570) 4,353
Income (loss) from discontinued operations, net of tax expense (benefit) (2)

 
 8
 (3) (56)
Net income$62,223
 $52,929
 $9,790
 $20,818
 $54,970
$143
 $62
 $53
 $10
 $21
                  
Basic net income per share:(3)                  
Income from continuing operations$1.34
 $0.98
 $0.28
 $1.69
 $1.23
$2.75
 $1.34
 $0.98
 $0.28
 $1.69
(Loss) income from discontinued operations(0.01) 0.18
 (0.07) (1.24) 0.11

 (0.01) 0.18
 (0.07) (1.24)
Basic net income per share$1.33
 $1.16
 $0.21
 $0.45
 $1.34
$2.75
 $1.33
 $1.16
 $0.21
 $0.45
Diluted net income per share:(3)                  
Income from continuing operations$1.30
 $0.96
 $0.27
 $1.67
 $1.22
$2.58
 $1.30
 $0.96
 $0.27
 $1.67
(Loss) income from discontinued operations(0.01) 0.17
 (0.06) (1.22) 0.10

 (0.01) 0.17
 (0.06) (1.22)
Diluted net income per share$1.29
 $1.13
 $0.21
 $0.45
 $1.32
$2.58
 $1.29
 $1.13
 $0.21
 $0.45
                  
Weighted average shares outstanding:                  
Basic46,935,000
 45,717,000
 46,380,000
 45,756,000
 41,174,000
52
 47
 46
 46
 46
Diluted48,340,000
 46,862,000
 46,999,000
 46,425,000
 41,631,000
56
 48
 47
 47
 46
Operating Statistics, Continuing Operations:(3)                  
Medical care ratio (3)(4)89.5% 87.1% 90.0% 87.0% 87.8%89.1% 89.5% 87.1% 90.0% 87.0%
General and administrative expense ratio (4)(5)7.9% 10.1% 8.8% 8.7% 8.4%8.1% 7.9% 10.1% 8.8% 8.7%
Premium tax ratio (5)3.2% 2.7% 2.8% 3.5% 3.7%
Net profit margin(5)
1.0% 0.6% 0.7% 0.2% 1.7%
Members (6)2,623,000
 1,931,000
 1,797,000
 1,618,000
 1,532,000
3,533,000
 2,623,000
 1,931,000
 1,797,000
 1,618,000

3538



Year Ended December 31,December 31,
2014 2013 2012 2011 20102015 2014 2013 2012 2011
Balance Sheet Data:                  
Cash and cash equivalents$1,539,063
 $935,895
 $795,770
 $493,827
 $455,886
$2,329
 $1,539
 $936
 $796
 $494
Total assets(7)4,477,215
 3,002,937
 1,934,822
 1,652,146
 1,509,214
6,576
 4,435
 2,988
 1,901
 1,631
Long-term debt, including current maturities (7)905,389
 784,862
 262,939
 218,126
 164,014
Long-term debt, including current maturities (7) (8)
1,609
 887
 770
 261
 216
Total liabilities(7)3,466,773
 2,110,000
 1,152,508
 897,073
 790,157
5,019
 3,425
 2,095
 1,119
 876
Stockholders’ equity1,010,442
 892,937
 782,314
 755,073
 719,057
1,557
 1,010
 893
 782
 755

(1)Service revenue and cost of service revenue representinclude revenue and costs generated by our Molina Medicaid Solutions segment. Because wePathways subsidiary, which was acquired this business on MayNovember 1, 2010, results for the year ended December 31, 2010 include eight months of results for this segment.2015.
(2)As previously reported, in February 2012 the Division of Purchasing of the Missouri Office of Administration notified our Missouri health plan that it was not awarded a contract under the Missouri HealthNet Managed Care Request for Proposal; therefore, the Missouri health plan’s existing contract with the state expired without renewal on June 30, 2012. In connection with this notification, the Missouri health plan recorded a non-cash impairment charge of $64.6 million in the fourth quarter of 2011. Results relating to the Missouri health plan have been reported as discontinued operations for all periods presented. (Loss) incomeIncome (loss) from discontinued operations is presented net of income tax (benefit) expense of $(203)(benefit), $(9,912)which was insignificant in 2015 and 2014, and $(10), $(1,238)and $(1), $922, and $4,011,$1, in 2013, 2012 and 2011, respectively.
(3)Source data for calculations in thousands.
(4)Medical care ratio represents medical care costs as a percentage of premium revenue. The medical care ratio is a key operating indicator used to measure our performance in delivering efficient and cost effective health care services. Changes in the medical care ratio from period to period result from changes in Medicaid funding by the states, utilization of medical services, our ability to effectively manage costs, contract changes, and changes in accounting estimates related to incurred but not paid claims. See Item 7 in this Form 10-K, "Management’s Discussion and Analysis of Financial Condition and Results of Operations," for further discussion.
(4)(5)General and administrative expense ratio represents such expensesComputed as a percentage of total revenue.
(5)Premium tax ratio represents such expenses as a percentage of premium revenue plus premium tax revenue.
(6)Number of members at end of period.
(7)We have reclassified certain amounts in prior periods to conform to the 2015 presentation. Specifically, deferred issuance costs relating to our senior notes are now reported as a direct deduction of the applicable debt liabilities. Additionally, aggregate deferred income taxes are now reported as non-current. Both reclassifications are a result of recently adopted accounting pronouncements. See Item 8 in this Form 10-K, "Financial Statements and Supplementary Data," for further discussion.
(8)Includes convertible senior notes, lease financing obligations, and other long-term debt.


3639


Item 7.  Management’s Discussion and Analysis of Financial Condition and Results of Operations
The following discussion of our financial condition and results of operations should be read in conjunction with Items 6 and 8 of this Form 10-K, Selected Financial Data, and Financial Statements and Supplementary Data, respectively. This discussion contains forward-looking statements that involve known and unknown risks and uncertainties, including those set forth in Part I, Item 1A of this Form 10-K, Risk Factors.

Overview
Molina Healthcare, Inc. provides quality health care to thosepeople receiving government assistance. We offer cost-effective Medicaid-related solutions to meet the health care needs of low-income families and individuals, and to assist stategovernment agencies in their administration of the Medicaid program. We reporthave three reportable segments. These segments include our financial performance based on two reportable segments: the Health Plans segment and the Molina Medicaid Solutions segments, which comprise the vast majority of our operations, and our Other segment. As of December 31, 2015, we changed our reporting structure as a result of the Pathways acquisition in November 2015, which is reported in Other.
Our Health Plans segment consists of health plans in 11 states and the Commonwealth of Puerto Rico, and includes our direct delivery business. As of December 31, 2014,2015, these health plans served over 2.63.5 million members eligible for Medicaid, Medicare, and other government-sponsored health care programs for low-income families and individuals. Additionally, we serve a small number of Health Insurance Marketplace members, manymost of whom are eligible forreceive government premium subsidies. The health plans are operated by our respective wholly owned subsidiaries in those states, each of which is licensed as a health maintenance organization (HMO). Our direct delivery business consists primarily of the management of a hospital in southern California under a management services agreement, and the operation of primary care clinics in several states in which we operate.
Our Molina Medicaid Solutions segment provides business processing and information technology development and administrative services to Medicaid agencies in Idaho, Louisiana, Maine, New Jersey, West Virginia, and the U.S. Virgin Islands, and drug rebate administration services in Florida.
We previously reportedOur Other segment includes other businesses, such as our Pathways behavioral health and social services provider, that do not meet the quantitative thresholds for a reportable segment as defined by U.S. generally accepted accounting principles (GAAP), as well as corporate amounts not allocated to other reportable segments.
Refer to Part II, Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, Note 2, "Significant Accounting Policies," for a comprehensive description of our Health Plans and Molina Medicaid Solutions revenues and costs, and how we recognize them.We report revenue and costs attributable to Pathways as service revenue and cost of service revenue, respectively.
Beginning in 2013, after our Medicaid managed care contract with the state of Missouri expired, without renewal in 2012, and effective June 2013 the transition obligations associated with that contract terminated. Therefore, beginning in the second quarter of 2013, we have reported the results relating to the Missouri health plan as discontinued operations for all periods presented. The following discussion and analysis, with the exception of cash flow information, is presented in the context of continuing operations unless otherwise noted.
Fiscal Year 20142015 Financial Highlights
NetEarnings per diluted share nearly doubled in 2015 when compared with 2014, while net income from continuing operationsmore than doubled. Substantial increases in revenue, along with improved operating efficiency, were responsible for our improved performance. Our after-tax margin increased to $62.6 million1.0% in 2014,2015 from $44.8 million0.6% in 2013 due to increases in enrollment and revenue, and improved administrative cost efficiency; which offset higher medical costs and higher tax rates.2014.
Strong enrollment growth across all of our programs, combined with an 18%a 5% increase in premium revenue per member, generated almost $3over $4 billion, or 46%47%, more premium revenue in 20142015 compared with 2013.2014.
Medical care costs as a percentage of premium revenue (the "medical care ratio") decreased to 89.1% in 2015, from 89.5% in 2014.
General and administrative expenses as a percentage of revenue declined(the "general and administrative expense ratio") increased slightly to 8.1% in 2015, versus 7.9% in 2014, versus 10.1% in 2013.
Medical care costsprimarily as a percentageresult of premium revenue increaseddramatic growth in our Marketplace membership. Excluding Marketplace broker and exchange fees from both years, the general and administrative expense ratio decreased to 89.5%7.5% in 2014,2015 from 87.1%7.9% in 2013.2014.
Debt and equity financing transactions generated net cash of $122.6 million; such transactions both extended the maturity date and lowered the rate of our convertible senior notes previously due in 2014.
$1,062 million.
Health Care Reform
We believe that the government-sponsored initiatives, including the Affordable Care Act (ACA), will continue to provide us with significant opportunities for membership growth in our existing markets and in new programs in the future as follows:
Medicaid Expansion. In the states that have elected to participate, the ACA provides for the expansion of the Medicaid program to offer eligibility to nearly all low-income people under age 65 with incomes at or below 138% of the federal poverty line. Medicaid expansion membership phased in beginning January 1, 2014. Since that date, our health plans in California, Illinois, Michigan, New Mexico, Ohio, and Washington have begun participating in Medicaid expansion. At December 31, 2014 our membership included approximately 385,000 Medicaid expansion members, or 15% of total membership.
Marketplace. The ACA authorized the creation of Marketplace insurance exchanges, allowing individuals and small groups to purchase health insurance that is federally subsidized, effective January 1, 2014. We participate in the Marketplace in all of the states in which we operate, except Illinois and South Carolina. At December 31, 2014, we had approximately 15,000 Marketplace members, and that enrollment is expected to grow appreciably in 2015, particularly at our Florida health plan.


3740


Market Updates—Health Plans
Medicare-Medicaid Plans. Policymakers at the federal and state levels are increasingly focused on the design and implementation of programs that improve the coordination ofTo coordinate care for those who qualify to receive both Medicare and Medicaid services (the "dual eligible"), and to deliver services to the dual eligiblethese individuals in a more financially efficient manner. As a result of these efforts, 15manner, some states have undertaken demonstration programs to integrate Medicare and Medicaid services for dual-eligibledual eligible individuals. The health plans participating in such demonstrations are referred to as Medicare-Medicaid Plans (MMPs). We operate MMPs in six states. Our MMPs in California, Illinois, and Ohio offered coverage beginning in 2014, and we expect to begin offering MMP coverage2014; our MMPs in South Carolina and Texas offered coverage beginning in the first quarter of 2015,2015; and our MMP in Michigan offered coverage beginning in the second quarter of 2015.
Health Insurer Fee. The ACA imposes an annual fee, or excise tax, on health insurers for each calendar year beginning on or after January 1, 2014. A health insurer’s liability for the payment of the fee (the health insurer fee, or HIF) is established upon first writing business in 2014 or any subsequent year. In other words, an active health insurer becomes liable for the fee on January 1st of any given year. The amount of the HIF for the insurer is based upon the insurer’s share of the industry's net premiums written during the preceding calendar year. The HIF must be paid by the insurer by September 30th of the year in which the insurer becomes liable for the HIF. During the third quarter of 2014 we paid At December 31, 2015, our 2014 HIF assessment, which amounted to $88.6 million. This expense was recognized on a straight-line basis in 2014; and is non-deductible for income tax purposes.
We believe that state Medicaid agencies are required to reimburse us for the HIF imposed on our Medicaid premiums, as well as for the negative financial impact associated with the absence of tax deductibility for the HIF. Although all of our state Medicaid partners have agreed informally to reimbursement of the HIF and the costs of its related tax effects, we have not secured binding commitments to that effect from California, Michigan and Utah. Our 2014 results were adversely affected by our inability to recognize as revenue reimbursement (including reimbursement for tax effects) for the full impact of the HIF from those states. The state of California has not formally committed to reimburse us for either the HIF itself, or the related tax effects. The states of Michigan and Utah have reimbursed us for the HIF, but have not formally committed to reimbursement for the related tax effect. The total amount of HIF revenue for which agreements were not secured (and revenue was not recognized) amounted tomembership included approximately $20 million for fiscal 2014. We expect to collect and recognize this revenue related to 2014 in 2015. We further expect to recognize revenue in 2015 sufficient to reimburse us for the full amount of the HIF we will pay (along with related tax effects) in September of 2015. We expect our 2015 HIF assessment related to our Medicaid business to be approximately $143 million, with an expected tax effect from the reimbursement of the assessment of approximately $88 million. Therefore, the total reimbursement needed as a result of the Medicaid-related HIF is approximately $231 million.
For further discussion of the risks and uncertainties relating to the HIF, refer to the subheading below, "Liquidity and Capital Resources—Financial Condition."
Market Updates—Health Plans Segment51,000 integrated MMP members.
Florida. During 2014,On November 1, 2015, our Florida health plan acquired twoclosed on its acquisition of the Medicaid contracts, addingand certain assets related to operation of the Medicaid business, of Integral Health Plan, Inc.
On August 1, 2015, our Florida health plan closed on its acquisition of the Medicaid contracts, and certain assets related to the operation of the Medicaid business, of Preferred Medical Plan, Inc.
Illinois. On January 1, 2016, our Illinois health plan closed on its acquisition of the Medicaid membership, and certain assets related to the Medicaid business of, Accountable Care Chicago, LLC, also known as MyCare Chicago. We assumed approximately 73,000 members.58,000 Medicaid members in this acquisition.
On January 1, 2016, our Illinois health plan closed on its acquisition of the Medicaid membership, and certain assets related to the Medicaid business, of Loyola Physician Partners, LLC. We assumed approximately 21,000 Medicaid members in this acquisition.
On November 30, 2015, we announced that our Illinois health plan entered into an agreement to assume the membership and certain Medicaid assets of Better Health Network, LLC (Better Health). As of November 30, 2015, Better Health served approximately 40,000 members in the Medicaid Family Health program in Cook County. Subject to regulatory approvals and the satisfaction of other closing conditions, we expect the transaction to close during the first half of 2016.
Michigan. On January 1, 2016, our Michigan health plan closed on its acquisition of the Medicaid and MIChild membership, and certain Medicaid and MIChild assets, of HAP Midwest Health Plan, Inc. We assumed approximately 81,000 Medicaid and MIChild members in this acquisition.
In October 2015, the Michigan Department of Health and Human Services announced that Molina Healthcare of Michigan was recommended to serve the state's Medicaid members under Michigan's Comprehensive Health Plan, which commenced on January 1, 2016. The new contract has a five-year term with three one-year extensions, and covers Regions 2 through 6, and 8 through 10 of the state, representing an expansion into 18 additional counties compared with the previous Michigan Medicaid contract.
On September 1, 2015, our Michigan health plan closed on its acquisition of the Medicaid and MIChild contracts, and certain provider agreements, of HealthPlus of Michigan and its subsidiary, HealthPlus Partners, Inc.
Puerto Rico. In 2014, we were awarded a managed care contract in the Commonwealth ofEffective April 1, 2015, our Puerto Rico that is expected to enrollhealth plan served its first members April 1, 2015. Total enrollment is expected to be approximately 350,000 new members, with anticipated annualized revenuemembers. As of $750 million.
South Carolina. Our South Carolina health plan began serving members under the state of South Carolina’s new full-risk Medicaid managed care program effective January 1, 2014.
Market Update—Molina Medicaid Solutions Segment
In 2011, Molina Medicaid Solutions received notice from the state of Louisiana that the state intended to award the contract for a replacement Medicaid management information system (MMIS) to a different vendor, CNSI. However, in March 2013, the state of Louisiana canceled its contract award to CNSI. The state had informed us that we will continue to perform under our current contract until a successor is named. On December 18, 2014, Molina Medicaid Solutions received notice from the state of Louisiana that they have extended our contract through December 31, 2015. We recognized2015, our Puerto Rico plan enrollment amounted to approximately $41 million of service revenue under this contract in 2014.348,000 members.
Composition of Revenue and Membership
Health Plans Segment
Our Health Plans segment derives its revenue, in the form of premiums, chiefly from Medicaid contracts with the states in which our health plans operate; and, to a lesser degree, from Medicare contracts entered into with the Centers for Medicare and Medicaid Services (CMS), a federal government agency.
Our health plans’ state Medicaid contracts generally have terms of three to four years. These contracts typically contain renewal options exercisable by the state Medicaid agency, and allow either the state or the health plan to terminate the contract with or

3841


without cause. OurWashington. In November 2015, our Washington health plan subsidiaries have generally been successfulwas selected by the Washington State Health Care Authority (HCA) to negotiate and enter into managed care contracts for the Southwest region of the state's Apple Health Fully Integrated Managed Care Program. The start date is scheduled for April 1, 2016.
On January 1, 2016, our Washington health plan closed on its acquisition of the Medicaid membership and certain Medicaid assets of Columbia United Providers, Inc. We assumed approximately 57,000 Medicaid members in retaining their contracts, but such contracts are subjectthis acquisition.
Market Update—Molina Medicaid Solutions
New Jersey. On April 9, 2015, the state of New Jersey announced its selection of Molina Medicaid Solutions to riskdesign and operate that state's new Medicaid management information system (MMIS). The new contract was effective May 1, 2015, and has a term of loss when10 years with three one-year renewal options. Molina Medicaid Solutions was the state's incumbent MMIS provider, and was awarded the new contract as a result of Molina Medicaid Solutions' submission in response to the state issues a newof New Jersey's request for proposals (RFP) open to competitive bidding by other health plans. Ifproposals.
Market Update—Other
Pathways. On November 1, 2015, we acquired all of the outstanding ownership interests in Pathways Health and Community Support LLC (Pathways), formerly known as Providence Human Services, LLC. Pathways is one of ourthe largest national providers of accessible, outcome-based behavioral/mental health plans is not a successful responsive bidder to a state RFP, its contract may be subject to non-renewal. The state Medicaid programsand social services with operations in 23 states and the federal Medicare program periodically adjust premium rates.District of Columbia.
In addition to contract renewal,

42


Financial Performance Summary
The following table summarizes our state Medicaid contracts may be periodically amended to include or exclude certain health benefits (such as pharmacy services, behavioral health services, or long-term care services); populations such asfinancial and operating performance from continuing operations for the aged, blind or disabled (ABD); and regions or service areas.
Premium revenue is fixed in advance of the periods covered and, except as described in Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, Note 2 "Significant Accounting Policies," is not generally subject to significant accounting estimates. For the yearyears ended December 31, 2015, 2014, we received more than 95% of our premium revenue as a fixed amount per member per month (PMPM), pursuant to our Medicaid, Medicare and Marketplace contracts, including agreements with other managed care organizations for which we operate as a subcontractor. These premium revenues2013. All dollar amounts are recognizedpresented in the month that members are entitled to receive health care services. Revenue not received on a fixed PMPM basis is recognized as earned.
The amount of the premiums paid to us may vary substantially between states and among various government programs. The following table sets forth the ranges of premiums paid to our state health plans by program, on a per-member per-month basis for the year ended December 31, 2014. The "Consolidated" column represents the weighted-average amounts for our total membership by program.millions, except per-share data.
 Ending PMPM Premiums
 Membership Low High Consolidated
Temporary Assistance for Needy Families (TANF), CHIP (1)1,831,000
 $130.00
 $280.00
 $180.00
Medicaid Expansion385,000
 340.00
 520.00
 420.00
Aged, Blind or Disabled (ABD)325,000
 320.00
 1,580.00
 900.00
Medicare Special Needs Plans (Medicare)49,000
 970.00
 1,480.00
 1,180.00
Medicare-Medicaid Plan (MMP) – Integrated (2)18,000
 1,510.00
 3,240.00
 1,970.00
Marketplace15,000
 190.00
 560.00
 320.00
 Year Ended   Year Ended  
 December 31, % Change December 31, % Change
 2015 2014  2014 2013 
Revenue:           
Premium revenue$13,241
 $9,023
 46.7 % $9,023
 $6,179
 46.0 %
Service revenue253
 210
 20.5
 210
 205
 2.4
Premium tax revenue397
 294
 35.0
 294
 172
 70.9
Health insurer fee revenue264
 120
 120.0
 120
 
 
Investment income18
 8
 125.0
 8
 7
 14.3
Other revenue5
 12
 (58.3) 12
 26
 (53.8)
Total revenue14,178
 9,667
 46.7
 9,667
 6,589
 46.7
Operating expenses:           
Medical care costs11,794
 8,076
 46.0
 8,076
 5,380
 50.1
Cost of service revenue193
 157
 22.9
 157
 161
 (2.5)
General and administrative expenses1,146
 765
 49.8
 765
 666
 14.9
Premium tax expenses397
 294
 35.0
 294
 172
 70.9
Health insurer fee expenses157
 89
 76.4
 89
 
 
Depreciation and amortization104
 93
 11.8
 93
 73
 27.4
Total operating expenses13,791
 9,474
 45.6
 9,474
 6,452
 46.8
Operating income387
 193
 100.5
 193
 137
 40.9
Other expenses, net:           
Interest expense66
 57
 15.8
 57
 52
 9.6
Other (income) expense, net(1) 1
 (200.0) 1
 4
 (75.0)
Total other expenses, net65
 58
 12.1
 58
 56
 3.6
Income from continuing operations before income tax expense322
 135
 138.5
 135
 81
 66.7
Income tax expense179
 73
 145.2
 73
 36
 102.8
Income from continuing operations$143
 $62
 130.6 % $62
 $45
 37.8 %
            
Diluted net income per share, continuing operations (1)$2.58
 $1.30
 98.5 % $1.30
 $0.96
 35.4 %
            
Diluted weighted average shares outstanding56
 48
 16.7 % 48
 47
 2.1 %
            
Non-GAAP Measures: (2)           
Adjusted net income per share, continuing operations (1)(3)$3.11
 $1.93
 61.1 % $1.93
 $1.55
 24.5 %
            
EBITDA$508
 $305
 66.6 % $305
 $225
 35.6 %
            
Operating Statistics: (1)           
Medical care ratio (4)89.1% 89.5%   89.5% 87.1%  
Service revenue ratio (5)76.4% 74.6%   74.6% 79.0%  
General and administrative expense ratio (6)8.1% 7.9%   7.9% 10.1%  
Premium tax ratio (4)2.9% 3.2%   3.2% 2.7%  
Effective tax rate55.5% 53.8%   53.8% 44.8%  
Net profit margin (6)1.0% 0.6%   0.6% 0.7%  

____________
(1)CHIP standsSource data for Children's Health Insurance Program.calculations of per-share amounts and ratios in thousands.
(2)MMP members who receive both MedicaidSee reconciliation of non-GAAP financial measures to U.S. GAAP below.
(3)Effective January 1, 2016, we will no longer exclude amortization of convertible notes and Medicare coveragelease financing obligations from Molina Healthcare.our presentation of adjusted net income and adjusted net income per share. We made this change because various capital transactions that we completed in 2015 reduced our relative reliance on convertible notes and lease financing as sources of capital. We believe that this change will enhance the comparability of these non-GAAP measures with the corresponding non-GAAP measures used by our competitors.
(4)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.
(5)Service revenue ratio represents cost of service revenue as a percentage of service revenue.
(6)Computed as a percentage of total revenue.

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The following tables set forth our Health Plans segment membership as of the dates indicated:
As of December 31,As of December 31,
2014 2013 20122015 2014 2013
Ending Membership by Health Plan:          
California531,000
 368,000
 336,000
620,000
 531,000
 368,000
Florida164,000
 89,000
 73,000
440,000
 164,000
 89,000
Illinois100,000
 4,000
 
98,000
 100,000
 4,000
Michigan242,000
 213,000
 220,000
328,000
 242,000
 213,000
New Mexico212,000
 168,000
 91,000
231,000
 212,000
 168,000
Ohio347,000
 255,000
 244,000
327,000
 347,000
 255,000
South Carolina (1)118,000
 
 
Puerto Rico (1)348,000
 
 
South Carolina (2)99,000
 118,000
 
Texas245,000
 252,000
 282,000
260,000
 245,000
 252,000
Utah83,000
 86,000
 87,000
102,000
 83,000
 86,000
Washington497,000
 403,000
 418,000
582,000
 497,000
 403,000
Wisconsin84,000
 93,000
 46,000
98,000
 84,000
 93,000
2,623,000
 1,931,000
 1,797,000
3,533,000
 2,623,000
 1,931,000
Ending Membership by Program:          
TANF/CHIP1,831,000
 1,624,000
 1,517,000
Medicaid Expansion (2)385,000
 
 
ABD325,000
 268,000
 244,000
Medicare49,000
 39,000
 36,000
MMP - Integrated18,000
 
 
Marketplace (2)15,000
 
 
Temporary Assistance for Needy Families (TANF), CHIP (3)2,312,000
 1,809,000
 1,603,000
Medicaid Expansion (4)557,000
 385,000
 
Aged, Blind or Disabled (ABD)366,000
 347,000
 289,000
Marketplace (4)205,000
 15,000
 
Medicare-Medicaid Plan (MMP) – Integrated (5)51,000
 18,000
 
Medicare Special Needs Plans (Medicare)42,000
 49,000
 39,000
2,623,000
 1,931,000
 1,797,000
3,533,000
 2,623,000
 1,931,000

(1)Our Puerto Rico health plan began serving members effective April 1, 2015.
(2)Our South Carolina health plan began serving members under the state of South Carolina’s new full-risk Medicaid managed care program effective January 1, 2014.
(2)(3)CHIP stands for Children's Health Insurance Program.
(4)Medicaid expansion membership phased in, and the Marketplace became available for consumers to access coverage, beginning January 1, 2014.
Molina Medicaid Solutions Segment
The payments received by our Molina Medicaid Solutions segment under its state contracts are based on the performance of multiple services. The first of these is the design, development and implementation (DDI) of a Medicaid management information system (MMIS). An additional service, following completion of DDI, is the operation of the MMIS under a business process outsourcing (BPO) arrangement. When providing BPO services (which include claims payment and eligibility processing) we also provide the state with other services including both hosting and support, and maintenance. Because we have determined the services provided under our Molina Medicaid Solutions contracts represent a single unit of accounting, we recognize revenue associated with such contracts on a straight-line basis over the contract term during which BPO, hosting, and support and maintenance services are delivered. There may be certain contractual provisions containing contingencies, however that require us to delay recognition of all or part of our service revenue until such contingencies have been removed. For further information regarding revenue recognition for the Molina Medicaid Solutions segment, refer to Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, in Note 2, "Significant Accounting Policies."
Composition of Expenses
Health Plans Segment
Operating expenses for the Health Plans segment include expenses related to the provision of medical care services (including long-term services and supports, or LTSS), general and administrative expenses, premium tax and health insurer fee expenses. Our results of operations are impacted by our ability to effectively manage expenses related to medical care services and to accurately estimate medical costs incurred. Expenses related to medical care services are captured in the following categories:
Fee-for-service expenses: Nearly all hospital services and the majority of our primary care and physician specialist services and LTSS costs are paid on a fee-for-service basis. Under fee-for-service arrangements, we retain the financial responsibility for medical care provided and incur costs based on actual utilization of services. Such expenses are

40


recorded in the period in which the related services are dispensed. The costs of drugs administered in a physician or hospital setting that are not billed through our pharmacy benefit manager are included in fee-for-service costs.
Pharmacy expenses: All drug, injectibles, and immunization costs paid through our pharmacy benefit manager are classified as pharmacy expenses. As noted above, drugs and injectibles not paid through our pharmacy benefit manager are included in fee-for-service costs, except in those limited instances where we capitate drug and injectible costs.
Capitation expenses: Many of our primary care physicians and a small portion of our specialists and hospitals are paid on a capitated basis. Under capitation arrangements, we pay a fixed amount PMPM to the provider without regard to the frequency, extent, or nature of the medical services actually furnished. Under capitated arrangements, we remain liable for the provision of certain health care services. Capitation payments are fixed in advance of the periods covered and are not subject to significant accounting estimates. These payments are expensed in the period the providers are obligated to provide services. The financial risk for pharmacy services for a small portion of our membership is delegated to capitated providers.
Direct delivery expenses: All costs associated with our direct delivery of medical care are separately identified.
Other medical expenses: All medically related administrative costs, certain provider incentive costs, reinsurance costs and other health care expenses are classified as other medical expenses. Medically related administrative costs include, for example, expenses relating to health education, quality assurance, case management, care coordination, disease management, and 24-hour on-call nurses. Salary and benefit costs are a substantial portion of these expenses. For the years ended December 31, 2014, 2013, and 2012, medically related administrative costs were $262.6 million, $153.0 million, and $125.2 million, respectively.
Our medical care costs include amounts that have been paid by us through the reporting date as well as estimated liabilities for medical care costs incurred but not paid by us as of the reporting date. See "Critical Accounting Estimates" below, and Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, in Note 11, "Medical Claims and Benefits Payable," for further information on how we estimate such liabilities.
Molina Medicaid Solutions Segment
Cost of service revenue consists primarily of the costs incurred to provide BPO and technology outsourcing services under our MMIS contracts. General and administrative costs consist primarily of indirect administrative costs and business development costs. In some circumstances we may defer recognition of incremental direct costs (such as direct labor, hardware, and software) associated with a contract if revenue recognition is also deferred. Such deferred contract costs are amortized on a straight-line basis over the contract term, consistent with the revenue recognition period.
(5)MMP members who receive both Medicaid and Medicare coverage from Molina Healthcare.


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Financial Performance Summary, Continuing Operations
The following table and narrative briefly summarize our financial and operating performance from continuing operations for the years ended December 31, 2014, 2013, and 2012. All ratios, with the exception of the medical care ratio and the premium tax ratio, are computed as a percentage of total revenue. The medical care ratio is computed as a percentage of premium revenue, and the premium tax ratio is computed as a percentage of premium revenue plus premium tax revenue, because direct relationships exist between premium revenue earned, and the cost of health care and premium taxes.
 Year Ended December 31,
 2014 2013 2012
 (Dollar amounts in thousands, except per-share data)
Net income per diluted share$1.30
 $0.96
 $0.27
Adjusted net income per diluted share$3.43
 $3.13
 $1.72
Premium revenue$9,022,511
 $6,179,170
 $5,544,121
Service revenue$210,051
 $204,535
 $187,710
Operating income$192,917
 $136,560
 $41,093
Net income$62,578
 $44,830
 $12,866
      
Total ending membership2,623,000
 1,931,000
 1,797,000
      
Premium revenue93.3% 93.8% 93.7%
Service revenue2.2
 3.1
 3.2
Premium tax revenue3.1
 2.6
 2.7
Health insurer fee revenue1.2
 
 
Investment income0.1
 0.1
 0.1
Other revenue0.1
 0.4
 0.3
Total revenue100.0% 100.0% 100.0%
      
Medical care ratio89.5% 87.1% 90.0%
General and administrative expense ratio7.9% 10.1% 8.8%
Premium tax ratio3.2% 2.7% 2.8%
Operating income2.0% 2.1% 0.7%
Net income0.6% 0.7% 0.2%
Effective tax rate53.8% 44.8% 45.0%
Non-GAAP Financial Measures
We use the following 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 and the performance of other companies in the health care industry. These non-GAAP financial measures should be considered as supplements to, and not substitutes for or superior to, GAAP measures (GAAP stands for U.S. generally accepted accounting principles).measures.
The first of these non-GAAP measures is earnings before interest, taxes, depreciation and amortization, or EBITDA. The following table reconciles net income, which we believe to be the most comparable GAAP measure, to EBITDA.
 Year Ended December 31,
 2014 2013 2012
 (In thousands)
Net income$62,223
 $52,929
 $9,790
Adjustments:     
Depreciation, and amortization of intangible assets and capitalized software113,715
 93,866
 78,764
Interest expense56,811
 52,071
 16,769
Income tax expense72,523
 26,404
 9,275
EBITDA$305,272
 $225,270
 $114,598
The increases in EBITDA for both 2015 over 2014, and 2014 over 2013, were due primarily to increased net income and income taxes. The increases for both of these items are described below in Results of Operations, in the components of net income.

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 Year Ended December 31,
 2015 2014 2013
 (In millions)
Net income$143
 $62
 $53
Adjustments:     
Depreciation, and amortization of intangible assets and capitalized software120
 114
 94
Interest expense66
 57
 52
Income tax expense179
 72
 26
EBITDA$508
 $305
 $225
The second of these non-GAAP measures is adjusted net income and adjusted net income per diluted share, continuing operations. The following tables reconcile net income and net income per diluted share from continuing operations, which we believe to be the most comparable GAAP measures, to adjusted net income and adjusted net income per diluted share, continuing operations. The increases in adjusted net income and adjusted net income per diluted share for both 2015 over 2014, and 2014 over 2013, were due primarily to increased net income. Such increases are described below in Results of Operations, in the components of net income.
Year Ended December 31,Year Ended December 31,
2014 2013 20122015 2014 2013
(In thousands, except diluted per-share amounts)(In millions, except diluted per-share amounts)
Net income, continuing operations$62,578
 $1.30
 $44,830
 $0.96
 $12,866
 $0.27
$143
 $2.58
 $62
 $1.30
 $45
 $0.96
Adjustments, net of tax:                      
Depreciation, and amortization of capitalized software58,770
 1.21
 46,018
 0.98
 35,267
 0.75
Amortization of convertible senior notes and lease financing obligations17,249
 0.36
 14,377
 0.31
 3,714
 0.08
19
 0.33
 17
 0.36
 14
 0.31
Share-based compensation14,288
 0.29
 24,501
 0.52
 14,556
 0.31
Amortization of intangible assets12,870
 0.27
 13,117
 0.28
 13,592
 0.29
11
 0.20
 13
 0.27
 13
 0.28
Change in fair value of derivatives(10) 
 3,580
 0.08
 817
 0.02
Adjusted net income per diluted share, continuing operations$165,745
 $3.43
 $146,423
 $3.13
 $80,812
 $1.72
Adjusted net income per diluted share, continuing operations (1)(2)$173
 $3.11
 $92
 $1.93
 $72
 $1.55
________________________

(1)Beginning in the first quarter of 2015, we revised the calculation of adjusted net income, continuing operations. We no longer subtract "depreciation, and amortization of capitalized software" and "share-based compensation" from net income, continuing operations to arrive at adjusted net income, continuing operations. We have made this change to better reflect how we evaluate financial performance, make financing and business decisions, and forecast and plans for future periods. All periods presented conform to this presentation.
(2)Effective January 1, 2016, we will no longer exclude amortization of convertible notes and lease financing obligations from our presentation of adjusted net income and adjusted net income per share. We made this change because various capital transactions that we completed in 2015 reduced our relative reliance on convertible notes and lease financing as sources of capital. We believe that this change will enhance the comparability of these non-GAAP measures with the corresponding non-GAAP measures used by our competitors.
Results of Operations, Continuing Operations
Year EndedAs described above, as of December 31, 2014 Compared with2015, we changed our reporting structure as a result of the Year Ended December 31, 2013Pathways acquisition in November 2015. The following table presents gross margin as the appropriate earnings measure for our reportable segments, based on how our chief operating decision maker currently reviews results, assesses performance, and allocates resources.
Gross margin for our Health Plans segment is referred to as "Medical margin," and for our Molina Medicaid Solutions and Other segments, as "Service margin." Medical margin represents the actual dollars earned by the Health Plans segment after medical costs are deducted from premium revenue. The medical care ratio represents the amount of medical care costs as a percentage of premium revenue. One of the key metrics used to assess the performance of the Health Plans segment is the medical care ratio; therefore, the underlying medical margin is the most important measure of earnings reviewed by the chief operating decision maker. The service margin is equal to service revenue minus cost of service revenue.


45


 Year Ended December 31,
 2015 2014 2013
 (In millions)
Health Plans:     
Premium revenue$13,241
 $9,023
 $6,179
Less: medical care costs11,794
 8,076
 5,380
Medical margin$1,447
 $947
 $799
      
Molina Medicaid Solutions:     
Service revenue$195
 $210
 $205
Less: cost of service revenue140
 157
 161
Service margin$55
 $53
 $44
      
Other:     
Service revenue$58
 $
 $
Less: cost of service revenue53
 
 
Service margin$5
 $
 $
Health Plans Segment
Premium RevenueRevenue. Our Health Plans segment derives its revenue, in the form of premiums, chiefly from Medicaid contracts with the states in which our health plans operate, and, to a lesser degree, from Medicare contracts entered into with the Centers for Medicare and Medicaid Services (CMS), a federal government agency.
A2015 Compared with 2014
In 2015, a 42% increase in membership and a 5% increase in revenue PMPM resulted in increased premium revenue of 47%, or over $4.2 billion, when compared with 2014.
Enrollment growth was primarily due to increased Medicaid expansion, Marketplace and integrated Medicare-Medicaid Plan (MMP) enrollment, and the start-up of the Puerto Rico health plan in April 2015.
2014 Compared with 2013
In 2014, premium revenue increased 46% over 2013, due to a 28% increase in membership, and an 18% increase in revenue PMPM in 2014 resulted in an increase in premium revenue of 46%, or over $2.8 billion, when compared with 2013. Medicare premium revenue was approximately $627 million in the year ended December 31, 2014, compared with approximately $526 million in the year ended December 31, 2013.PMPM.
Enrollment growth was primarily due to Medicaid expansion program membership added as a result of the Affordable Care Act, and membership added at our South Carolina and Illinois health plans. Higher PMPM premium revenue was primarily the result of the inclusion of long-term services and supports (LTSS) benefits in various Medicaid managed care programs in California, Florida, Illinois, New Mexico, and Ohio.
Premiums by Program. The amount of the premiums paid to us may vary substantially between states and among various government programs. The following table sets forth the ranges of premiums paid to our state health plans by program, on a per-member per-month basis for the year ended December 31, 2015. The "Consolidated" column represents the weighted-average amounts for our total membership by program.
 PMPM Premiums
 Low High Consolidated
TANF, CHIP$120.00
 $280.00
 $180.00
Medicaid Expansion310.00
 500.00
 410.00
ABD470.00
 1,470.00
 970.00
Marketplace180.00
 400.00
 250.00
MMP – Integrated1,170.00
 3,220.00
 2,030.00
Medicare900.00
 1,110.00
 1,040.00

46


Medical Care CostsCosts. Our medical care costs include amounts that have been paid by us through the reporting date as well as estimated liabilities for medical care costs incurred but not paid by us as of the reporting date. See "Critical Accounting Estimates" below, and Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, Note 11, "Medical Claims and Benefits Payable," for further information on how we estimate such liabilities.
2015 Compared with 2014
Our medical margin increased nearly 53% in 2015 over 2014, and our consolidated medical care ratio decreased to 89.1% in 2015 from 89.5% in 2014.
2014 Compared with 2013
Although medical margin (defined as the excess of premium revenue over medical care costs) increased nearly 20% in 2014 over 2013;2013, our consolidated medical care ratio (defined as medical care costs as a percentage of premium revenue) increased to 89.5% in 2014 from 87.1% in 2013.
The medical care ratio increased substantially in 2014 as a result of three developments:
Much of our revenue growth has come from participation in Medicaid programs covering LTSS. Percentage profit margins for LTSS benefits are generally lower than percentage profit margins for acute medical benefits.
Increases to our base premiums in recent years have not kept pace with medical cost trends.
Lack of coordination in the design of profit caps and medical cost floors in some of our state Medicaid contracts is resulting in counterproductive outcomes. In some instances, givebacks due to profitable performance in one productprogram cannot be offset against losses in other products.programs.
Medical care ratiosCare Costs by program for 2014 were as follows: TANF and CHIP - 89.3%; Medicaid expansion - 79.4%;
ABD - 92.3%; Medicare - 95.8%; MMP integrated - 92.1%; and Marketplace - 83.7%.

43


Category.The following table provides the details of consolidated medical care costs by category for the periods indicated (dollars in thousandsmillions except PMPM amounts):
Year Ended December 31,Year Ended December 31,
2014 20132015 2014 2013
Amount PMPM 
% of
Total
 Amount PMPM 
% of
Total
Amount PMPM 
% of
Total
 Amount PMPM 
% of
Total
 Amount PMPM 
% of
Total
Fee for service$5,672,483
 $202.87
 70.2% $3,611,529
 $160.43
 67.1%$8,572
 $218.35
 72.7% $5,673
 $202.87
 70.2% $3,612
 $160.43
 67.1%
Pharmacy1,273,329
 45.54
 15.8
 935,204
 41.54
 17.4
1,610
 41.01
 13.7
 1,273
 45.54
 15.8
 935
 41.54
 17.4
Capitation748,388
 26.77
 9.3
 603,938
 26.83
 11.2
982
 25.02
 8.3
 748
 26.77
 9.3
 604
 26.83
 11.2
Direct delivery96,196
 3.44
 1.2
 48,288
 2.14
 0.9
128
 3.26
 1.1
 96
 3.44
 1.2
 48
 2.14
 0.9
Other285,935
 10.22
 3.5
 181,165
 8.05
 3.4
502
 12.79
 4.2
 286
 10.22
 3.5
 181
 8.05
 3.4
$8,076,331
 $288.84
 100.0% $5,380,124
 $238.99
 100.0%$11,794
 $300.43
 100.0% $8,076
 $288.84
 100.0% $5,380
 $238.99
 100.0%

Financial Performance by Program. The following table presents the components of premium revenue and medical care costs by program.
 Year Ended December 31, 2015 (1)
 
Member
Months(2)
 Premium Revenue Medical Care Costs 
MCR(3)
 Medical Margin
  Total PMPM Total PMPM  
TANF and CHIP25.5
 $4,483
 $175.64
 $4,122
 $161.50
 92.0% $361
Medicaid Expansion5.9
 2,389
 408.51
 1,931
 330.18
 80.8
 458
ABD4.3
 4,124
 966.83
 3,784
 887.27
 91.8
 340
Marketplace2.6
 652
 251.96
 481
 185.85
 73.8
 171
MMP0.5
 1,063
 2,034.51
 974
 1,863.93
 91.6
 89
Medicare0.5
 530
 1,038.15
 502
 982.50
 94.6
 28
 39.3
 $13,241
 $337.28
 $11,794
 $300.43
 89.1% $1,447
_______________________
(1)Year ended December 31, 2014 and 2013 data not presented due to lack of comparability.
(2)A member month is defined as the aggregate of each month's ending membership for the period presented.
(3)"MCR" represents medical costs as a percentage of premium revenue.

47


Financial Performance by State Health Plan. The following tables summarize member months, premium revenue, medical care costs, medical care ratio, and medical margin by state health plan for the periods indicated (PMPM amounts are in whole dollars; member months and other dollar amounts are in millions):
 Year Ended December 31, 2015
 
Member
Months
 Premium Revenue Medical Care Costs MCR Medical Margin
  Total PMPM Total PMPM  
California7.1
 $2,200
 $310.89
 $1,926
 $272.22
 87.6% $274
Florida4.1
 1,199
 289.85
 1,081
 261.49
 90.2
 118
Illinois1.2
 397
 328.93
 367
 303.72
 92.3
 30
Michigan3.4
 1,067
 317.15
 903
 268.27
 84.6
 164
New Mexico2.8
 1,237
 446.27
 1,106
 398.98
 89.4
 131
Ohio4.1
 2,034
 499.34
 1,718
 421.61
 84.4
 316
Puerto Rico (1)
3.2
 567
 178.31
 505
 158.80
 89.1
 62
South Carolina (1)
1.3
 348
 267.25
 278
 213.30
 79.8
 70
Texas3.1
 1,961
 621.37
 1,809
 573.32
 92.3
 152
Utah1.2
 331
 286.22
 300
 259.32
 90.6
 31
Washington6.6
 1,602
 242.36
 1,470
 222.36
 91.7
 132
Wisconsin1.2
 261
 213.48
 215
 176.01
 82.4
 46
Other (2)

 37
 
 116
 
 
 (79)
 39.3
 $13,241
 $337.28
 $11,794
 $300.43
 89.1% $1,447
 Year Ended December 31, 2014
 
Member
Months
 Premium Revenue Medical Care Costs MCR Medical Margin
  Total PMPM Total PMPM  
California5.6
 $1,523
 $270.51
 $1,269
 $225.37
 83.3% $254
Florida1.1
 439
 397.79
 419
 379.95
 95.5
 20
Illinois0.3
 153
 498.48
 141
 456.88
 91.7
 12
Michigan2.8
 781
 278.68
 661
 235.81
 84.6
 120
New Mexico2.5
 1,076
 435.17
 996
 402.92
 92.6
 80
Ohio3.7
 1,553
 425.47
 1,335
 365.87
 86.0
 218
Puerto Rico (1)

 
 
 
 
 
 
South Carolina (1)
1.5
 381
 260.72
 323
 220.89
 84.7
 58
Texas3.0
 1,318
 442.32
 1,197
 401.81
 90.8
 121
Utah1.0
 310
 310.64
 285
 286.43
 92.2
 25
Washington5.5
 1,305
 236.27
 1,219
 220.75
 93.4
 86
Wisconsin1.0
 156
 150.87
 136
 130.91
 86.8
 20
Other (2)

 28
 
 95
 
 
 (67)
 28.0
 $9,023
 $322.68
 $8,076
 $288.84
 89.5% $947

48


 Year Ended December 31, 2013
 
Member
Months
 Premium Revenue Medical Care Costs MCR Medical Margin
  Total PMPM Total PMPM  
California4.2
 $750
 $177.10
 $667
 $157.46
 88.9% $83
Florida1.0
 265
 272.23
 231
 237.57
 87.3
 34
Illinois
 8
 1,201.34
 8
 1,164.10
 96.9
 
Michigan2.6
 676
 261.91
 571
 221.09
 84.4
 105
New Mexico1.5
 447
 299.36
 384
 257.62
 86.1
 63
Ohio3.0
 1,099
 365.44
 925
 307.53
 84.2
 174
Puerto Rico (1)

 
 
 
 
 
 
South Carolina (1)

 
 
 
 
 
 
Texas3.2
 1,291
 406.27
 1,115
 350.84
 86.4
 176
Utah1.0
 311
 299.05
 259
 249.51
 83.4
 52
Washington4.9
 1,168
 236.47
 1,028
 208.10
 88.0
 140
Wisconsin1.1
 143
 135.40
 114
 107.91
 79.7
 29
Other (2)

 21
 
 78
 
 
 (57)
 22.5
 $6,179
 $274.48
 $5,380
 $238.99
 87.1% $799


(1)Our Puerto Rico health plan began serving members effective April 1, 2015. Our South Carolina health plan began serving members under the state of South Carolina’s new full-risk Medicaid managed care program effective January 1, 2014.
(2)"Other" medical care costs include primarily medically related administrative costs of the parent company, and direct delivery costs.
Individual Health Plan Analysis
2015 Compared with 2014
California. Premium revenue grew $677 million, or 44%, in 2015 compared with 2014, the result of higher membership. Overall, enrollment on a member-month basis increased 31% in 2015 compared with 2014. Increased premium revenue was also driven by a 15% increase in premium revenue PMPM, which was the result of the higher relative premium revenue PMPM among those programs experiencing enrollment growth (Medicaid expansion and MMP); and the addition of long-term care benefits to some of the California health plan's Medicaid membership. The medical care ratio increased to 87.6% in 2015, from 83.3% in 2014. During 2014, the plan benefited from the recognition of approximately $23 million in premium revenue and medical margin that related to 2013, as a result of certain programmatic changes implemented by the state of California. Absent this benefit, the medical care ratio of the California plan would have been 84.6% in 2014.
Florida. Premium revenue grew to $1,199 million in 2015, from $439 million in 2014, due to increased Marketplace membership. The medical care ratio decreased to 90.2% in 2015, from 95.5% in 2014, due to the lower medical care ratio of the Marketplace membership more than offsetting an increase in the medical care ratio for the Medicaid program.
Illinois. Premium revenue grew to $397 million in 2015, from $153 million in 2014, due to significant membership growth in late 2014. The medical care ratio increased to 92.3% in 2015, from 91.7% in 2014.
Michigan. Premium revenue grew $286 million, or 37%, in 2015 compared with 2014, due to increased Medicaid expansion membership and the startup of the MMP program. The medical care ratio of 84.6% for 2015 was unchanged from 2014.
New Mexico. Premium revenue grew $161 million, or 15%, in 2015 compared with 2014, due to substantial increases in membership in all Medicaid programs. The medical care ratio decreased to 89.4% in 2015, from 92.6% in 2014, due to improved profitability for the ABD and Medicaid expansion programs.
Ohio. Premium revenue grew $481 million, or 31%, in 2015 compared with 2014, due to growth in membership within the Medicaid expansion, and MMP programs. The medical care ratio decreased to 84.4% in 2015, from 86.0% in 2014, due to lower medical care ratios in these newer programs, as well as ABD.
Puerto Rico. The Puerto Rico health plan began serving members on April 1, 2015, and finished the year with a medical care ratio of 89.1%. See further discussion below, under Financial Condition, regarding the Commonwealth of Puerto Rico.

49


South Carolina. The medical care ratio decreased to 79.8% in 2015, from 84.7% in 2014. We believe that medical care ratios below 80% are not sustainable over time, and that the performance of the South Carolina health plan in 2014 is more representative of its likely long-term performance than are its financial results for 2015.
Texas. Premium revenue grew $643 million, or 49%, in 2015 compared with 2014, primarily due to the addition of ABD members receiving nursing facility benefits effective March 1, 2015, and the start-up of the Texas MMP program on that date. The medical care ratio increased to 92.3% in 2015, from 90.8% in 2014, primarily as a result of lower percentage margins on premiums to support nursing home services. As previously disclosed, we are unable to recognize certain quality related revenue in Texas because we do not have historical information, clear definitions, and clarity around minimum standards.
Utah. The medical care ratio of the Utah health plan decreased to 90.6% in 2015, from 92.2% in 2014, primarily due to improved financial performance of the plan's Medicare program.
Washington. Premium revenue grew $297 million, or 23%, in 2015 when compared with 2014, primarily due to growth in Medicaid expansion membership. The medical care ratio decreased to 91.7% in 2015, from 93.4% in 2014, as a lower medical care ratio for the ABD program more than offset a higher medical care ratio in the TANF and Medicaid expansion programs.
Wisconsin. Premium revenue grew $105 million, or 67%, in 2015 compared with 2014 as a result of increased Marketplace enrollment. The medical care ratio decreased to 82.4% in 2015, from 86.8% in 2014, primarily as a result of improvement in the financial performance of the Wisconsin health plan's Medicaid program.
2014 Compared with 2013
California. The medical care ratio for the California health plan decreased significantly to 83.3% in 2014 from 88.9% in 2013. Additionally, medical margin improved $171.0$171 million when compared with 2013. This improvement was the result of higher enrollment, primarily due to the addition of approximately 107,000 Medicaid expansion members; and premium increases effective October 1, 2013 (2.5%), and July 1, 2014 (5.5%). During 2014, the California health plan benefited from the recognition of approximately $23 million in premium revenue and medical margin that related to 2013 as a result of certain programmatic changes implemented by the state of California. In 2013, the California health plan recognized approximately $32 million of premium revenue related to 2012 and earlier years as a result of retroactive rate increases from the state of California. The California health plan served its first MMP members in 2014.
Florida.Due to the re-procurement undertaken by the Florida Agency for Health Care Administration as part of its Managed Medical Assistance program starting in 2014, the Florida health plan transitioned many of its members to other health plans in the second quarter of 2014, and then added approximately 105,000 members in the second half of 2014, both from the addition of new service areas and through acquisitions. Although revenue increased approximately 66% at the Florida health plan for the year ended December 31, 2014, when compared with 2013, profitability fell in 2014. Medical margin declined $14.1 million, and the medical care ratio increased to 95.5% from 87.3% in 2013. The higher medical care costs were the result of 1) the assumption of risk for LTSS benefits for certain members effective December 2013 (as noted above percentage profit margins for LTSS benefits are generally less than those for other benefits); and 2) our inability to recognize revenue related to a rate increase effective September 1, 2014, as a result of those rates not being finalized prior to year end.
Illinois. The medical care ratio for the Illinois health plan decreased to 91.7% in 2014, from 96.9% in 2013. The plan experienced significant growth in 2014; enrollment increased approximately 96,000 members overall, with 78,000 members added in the fourth quarter alone. This growth occurred primarily within the traditional TANF program, and to a lesser degree within the Medicaid expansion program. The Illinois health plan served its first MMP members in 2014.
Michigan.The medical care ratio of the Michigan health plan was consistent year over year, at 84.6% in 2014, compared with 84.4% in 2013.
New Mexico. Premium revenue at the New Mexico health plan increased 141% for 2014 compared with 2013, primarily as a result of the addition of Medicaid behavioral health and LTSS benefits effective January 1, 2014, and the addition of approximately 54,000 Medicaid expansion members during the course of 2014. The medical care ratio of the New Mexico health plan increased to 92.6% in 2014, from 86.1% in 2013. The higher medical care ratio was the result ofof: 1) the assumption of risk for LTSS benefits effective January 1, 2014; and 2) premium rates effective January 1, 2014 that did not keep pace with the increase in medical costs in 2014. The New Mexico health plan received a blended rate increase of approximately 3% effective January 1, 2015. For the portion of New Mexico health plan’s membership that is eligible for LTSS benefits, the rate increase effective January 1, 2015 was 8%.
Ohio. The medical care ratio of the Ohio health plan increased to 86.0% in 2014, from 84.2% in 2013, primarily due to the increase in Medicaid expansion enrollment (which is incurring a medical care ratio slightly in excess of the plan's traditional experience), and the initiation of the Ohio MMP.
South Carolina. Our TheSouth Carolina health plan commenced operations effectivebegan serving members on January 1, 2014, and finished the year with a medical care ratio of 84.7%.
Texas. Financial performance at the Texas health plan declined in 2014, when compared with 2013. The medical care ratio of the Texas health plan increased to 90.8% in 2014, from 86.4% in 2013. Our inability to recognize a portion of the Texas healthplan's quality

4450


plan's quality revenue reduced income before taxes by approximately $26 million, or $0.33 per diluted share, for the year ended December 31, 2014. Approximately $20 million of this amount is related to measures for which we lack sufficient information to calculate our compliance. Should such information become available in the future, we may be able to recognize all or a portion of such revenue. Removing quality revenue and profit-sharing adjustments would have resulted in a medical care ratio at the Texas health plan of approximately 88% in 2014 and 86% in 2013.
Utah. The medical care ratio of the Utah health plan increased to 92.2% in 2014, from 83.4% in 2013, due to deteriorating margins for both Medicaid and Medicare products.
Washington. Financial performance at the Washington health plan declined in 2014, when compared with 2013. The2013.The medical care ratio of the Washington health plan increased to 93.4% in 2014, compared with 88.0% in 2013, primarily due to the high cost of medical services relative to revenue for members served under the state's program for ABD members; and to the $11.2 million net settlement with the Washington Health Care Authority, as described in Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, in Note 20, "Commitments and Contingencies."members. The Washington health plan added approximately 102,000 Medicaid expansion members in 2014. The Washington health plan received a blended rate increase of approximately 3% effective January 1, 2015. For the Washington health plan’s ABD membership, the rate increase effective January 1, 2015 was 11%.
Wisconsin. The medical care ratio of the Wisconsin health plan increased to 86.8% in 2014, compared with 79.7% in 2013.
Operating Data
The following tables summarize member months, premium revenue, medical care costs, medical care ratio, and medical margin by health plan for the periods indicated (PMPM amounts are in whole dollars; member months and other dollar amounts are in thousands):
 Year Ended December 31, 2014
 
Member
Months (1)
 Premium Revenue Medical Care Costs MCR (2) Medical Margin
  Total PMPM Total PMPM  
California5,630
 $1,523,084
 $270.51
 $1,268,937
 $225.37
 83.3% $254,147
Florida1,104
 439,107
 397.79
 419,422
 379.95
 95.5
 19,685
Illinois307
 153,271
 498.48
 140,480
 456.88
 91.7
 12,791
Michigan2,802
 780,896
 278.68
 660,790
 235.81
 84.6
 120,106
New Mexico2,471
 1,075,330
 435.17
 995,626
 402.92
 92.6
 79,704
Ohio3,650
 1,552,949
 425.47
 1,335,436
 365.87
 86.0
 217,513
South Carolina1,463
 381,317
 260.72
 323,061
 220.89
 84.7
 58,256
Texas2,980
 1,318,192
 442.32
 1,197,465
 401.81
 90.8
 120,727
Utah996
 309,411
 310.64
 285,303
 286.43
 92.2
 24,108
Washington5,522
 1,304,605
 236.27
 1,218,886
 220.75
 93.4
 85,719
Wisconsin1,036
 156,229
 150.87
 135,557
 130.91
 86.8
 20,672
Other (3)

 28,120
 
 95,368
 
 
 (67,248)
 27,961
 $9,022,511
 $322.68
 $8,076,331
 $288.84
 89.5% $946,180

45


 Year Ended December 31, 2013
 
Member
Months (1)
 Premium Revenue Medical Care Costs MCR (2) Medical Margin
  Total PMPM Total PMPM  
California4,233
 $749,755
 $177.10
 $666,592
 $157.46
 88.9% $83,163
Florida973
 264,998
 272.23
 231,261
 237.57
 87.3
 33,737
Illinois7
 8,121
 1,201.34
 7,869
 1,164.10
 96.9
 252
Michigan2,581
 676,000
 261.91
 570,644
 221.09
 84.4
 105,356
New Mexico1,492
 446,758
 299.36
 384,466
 257.62
 86.1
 62,292
Ohio3,007
 1,098,795
 365.44
 924,675
 307.53
 84.2
 174,120
South Carolina
 
 
 
 
 
 
Texas3,178
 1,291,001
 406.27
 1,114,852
 350.84
 86.4
 176,149
Utah1,040
 310,895
 299.05
 259,397
 249.51
 83.4
 51,498
Washington4,941
 1,168,405
 236.47
 1,028,210
 208.10
 88.0
 140,195
Wisconsin1,060
 143,465
 135.40
 114,340
 107.91
 79.7
 29,125
Other (3)

 20,977
 
 77,818
 
 
 (56,841)
 22,512
 $6,179,170
 $274.48
 $5,380,124
 $238.99
 87.1% $799,046

(1)A member month is defined as the aggregate of each month’s ending membership for the period presented.
(2)"MCR" represents medical costs as a percentage of premium revenue.
(3)"Other" medical care costs include primarily medically related administrative costs of the parent company, and direct delivery costs.
Molina Medicaid Solutions Segment
Performance2015 Compared with 2014
Service revenue declined $15 million in 2015 compared with 2014, primarily due to an extension of the Molina Medicaid Solutions segmentIdaho contract under which we are now amortizing certain deferred revenues over a longer term. Service margin was as follows:consistent between 2015 and 2014, with 2015 showing a $2 million increase.
2014 Compared with 2013
 Year Ended December 31,
 2014 2013
 (In thousands)
Service revenue before amortization$212,965
 $207,449
Amortization recorded as reduction of service revenue(2,914) (2,914)
Service revenue210,051
 204,535
Cost of service revenue156,764
 161,494
General and administrative costs7,105
 5,285
Amortization of customer relationship intangibles3,355
 5,127
Operating income$42,827
 $32,629
Operating income for our Molina Medicaid Solutions segmentService margin improved $10.2$9 million for the year ended December 31, 2014, compared with 2013. This improvement was2013, primarily the result of increased revenues due to higher Medicaid transaction volumes and lower cost of services overall,overall.
Other Segment
Our Other segment includes other businesses, such as existing contract operations gained efficiencies.our Pathways behavioral health and social services provider, that do not meet the quantitative thresholds for a reportable segment as defined by U.S. generally accepted accounting principles (GAAP), as well as corporate amounts not allocated to other reportable segments. The Other segment service margin for the year ended December 31, 2015, was insignificant.
Consolidated Expenses
General and Administrative ExpensesExpenses. General and administrative expenses increased slightly to 8.1% of revenue in 2015, from 7.9% in 2014, primarily the result of dramatic growth in our Marketplace membership. Excluding Marketplace broker and exchange fees from both years, the general and administrative expense ratio decreased to 7.5% in 2015 from 7.9% in 2014.
General and administrative expenses decreased to 7.9% of revenue in 2014, from 10.1% in 2013. The significant decline in the ratio of general and administrative expenses relative to total revenue was primarily the result of improved leverage of fixed administrative expenses over higher total revenue.

46


Premium Tax Expense
PremiumExpense. The premium tax ratio (premium tax expense as a percentage of premium revenue plus premium tax revenue) decreased to 2.9% in 2015, from 3.2% in 2014. This decrease was primarily due to the current year increase in MMP revenues, which are not subject to premium taxes.
The premium tax ratio increased to 3.2% in 2014, compared withfrom 2.7% in 2013. In June 2014, the state of Michigan instituted a 6% use tax on medical premiums. That state has agreed to fund this tax through rate increases; as a result, we recorded approximately $30 million in additional premium revenue in 2014, as well as corresponding premium tax expense.
Health Insurer Fee (HIF) Revenue and ExpensesExpenses. For our Medicaid program, actuarial standards require that we be reimbursed by state Medicaid agencies for both the expense associated with the HIF and the absence of tax deductibility for that expense. During 2015, we secured full reimbursement for our expenses under the HIF (including the absence of tax deductibility) and as a result HIF revenue, as a percentage of premium revenue, increased to 2.0% in 2015, from 1.3% in 2014. During 2015, we recognized approximately $20 million of HIF premium revenue meant to reimburse us for the cost of HIF expense recognized in 2014. Health insurer fee expenses, as a percentage of premium revenue, were 1.2% in 2015, compared with 1.0% in 2014.
In addition, both HIF revenue and expenses increased over the prior year proportionally to the increase in the total HIF tax base, which is assessed to all insurers. This base increased to $11.3 billion in 2015, from $8.0 billion in 2014. Refer to "Liquidity and Capital Resources—Financial Condition" below, for a comprehensivefurther discussion of the HIF.

51


Depreciation and Amortization
Amortization.The following table presents all depreciation and amortization recorded in our consolidated statements of income, regardless of whether the item appears as depreciation and amortization, a reduction of revenue, or as cost of service revenue. 
Year Ended December 31,Year Ended December 31,
2014 20132015 2014
Amount 
% of Total
Revenue
 Amount 
% of Total
Revenue
Amount 
% of Total
Revenue
 Amount 
% of Total
Revenue
(Dollar amounts in thousands)(Dollar amounts in millions)
Depreciation, and amortization of capitalized software, continuing operations$75,402
 0.8% $54,837
 0.8%$87
 0.6% $75
 0.8%
Amortization of intangible assets, continuing operations17,515
 0.2
 17,906
 0.3
17
 0.1
 18
 0.2
Depreciation and amortization, continuing operations92,917
 1.0
 72,743
 1.1
104
 0.7
 93
 1.0
Depreciation and amortization, discontinued operations
 
 2
 
Amortization recorded as reduction of service revenue2,914
 
 2,914
 
1
 
 3
 
Amortization of capitalized software recorded as cost of service revenue38,573
 0.4
 18,207
 0.3
21
 0.1
 38
 0.4
Depreciation and amortization reported in statement of cash flows$134,404
 1.4% $93,866
 1.4%$126
 0.8% $134
 1.4%
 Year Ended December 31,
 2014 2013
 Amount 
% of Total
Revenue
 Amount 
% of Total
Revenue
 (Dollar amounts in millions)
Depreciation, and amortization of capitalized software, continuing operations$75
 0.8% $55
 0.8%
Amortization of intangible assets, continuing operations18
 0.2
 18
 0.3
Depreciation and amortization, continuing operations93
 1.0
 73
 1.1
Amortization recorded as reduction of service revenue3
 
 3
 
Amortization of capitalized software recorded as cost of service revenue38
 0.4
 18
 0.3
Depreciation and amortization reported in statement of cash flows$134
 1.4% $94
 1.4%
Interest ExpenseExpense. Interest expense increased to $66 million for the year ended December 31, 2015, compared with $57 million for the year ended December 31, 2014. The increase was due primarily to our issuance of $700 million aggregate principal amount of senior notes (5.375% Notes) due November 15, 2022, in the fourth quarter of 2015. For further details regarding this transaction, please refer to Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, in Note 12, "Debt."
Interest expense increased to $56.8$57 million for the year ended December 31, 2014, compared with $52.1$52 million for the year ended December 31, 2013. The increase was due primarily to our 3.75% Notes exchange transaction and related issuance of 1.625% Notes in the third quarter of 2014, and lease financing transactions executed in 2013. For further details regarding these transactions, please refer to Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, in Note 12, "Long-Term Debt."Debt."
Interest expense includes non-cash interest expense relating to the amortization of the discount on our long-term debt obligations, which amounted to $27.4$30 million, $27 million and $22.8$23 million for the years ended December 31, 2015, 2014, and 2013, respectively.
Other Expenses, NetWe expect interest expense to continue to increase in the future due to interest on the 5.375% Notes which were issued in November 2015.
Other expenses, net decreased to $0.8 millionIncome Taxes. The provision for the year endedDecember 31, 2014, from $3.3 millionincome taxes in continuing operations is recorded at an effective rate of 55.5% for the year ended December 31, 2013. Other expenses, net include2015, compared with 53.8% for the year ended December 31, 2014. The effective tax rate for 2015 is higher than 2014 primarily gains or losses associated with changesas a result of certain discrete tax benefits recorded in the fair value of our derivative financial instruments. In the second quarter of 2013 we recorded a one-time non-cash charge of $3.9 million related to the change2014 that were not recurring in fair value of warrants issued in connection with the 1.125% Notes, with no comparable activity in 2014.2015.
Income Taxes
The provision for income taxes in continuing operations iswas recorded at an effective rate of 53.8% for the year ended December 31, 2014, compared with 44.8% for the year ended December 31, 2013. The increase is primarily due to the nondeductible health insurer fee in 2014 that did not exist in 2013.


4752


Results of Operations, Continuing Operations
Year Ended December 31, 2013 Compared with the Year Ended December 31, 2012
Premium Revenue
Premium revenue in 2013 increased 11% over 2012, due to a 6% increase in member months, and a 5% increase in revenue PMPM. Medicare premium revenue was $526 million for the year ended December 31, 2013, compared with $468 million for the year ended December 31, 2012.
Medical Care Costs
The following table provides the details of consolidated medical care costs for the periods indicated (dollars in thousands except PMPM amounts):
 Year Ended December 31,
 2013 2012
 Amount PMPM % of
Total
 Amount PMPM 
% of
Total
Fee for service$3,611,529
 $160.43
 67.1% $3,423,751
 $161.67
 68.6%
Pharmacy935,204
 41.54
 17.4
 835,830
 39.47
 16.7
Capitation603,938
 26.83
 11.2
 552,136
 26.07
 11.1
Direct delivery48,288
 2.14
 0.9
 33,920
 1.60
 0.7
Other181,165
 8.05
 3.4
 145,551
 6.87
 2.9
 $5,380,124
 $238.99
 100.0% $4,991,188
 $235.68
 100.0%
Excluding our Illinois health plan, which was not operational until 2013, eight of our nine health plans reported higher medical margins in 2013 than in 2012. The consolidated medical margin increased by approximately 45% year over year. Our consolidated medical care ratio decreased to 87.1% for the year ended December 31, 2013, compared with 90.0% for the year ended December 31, 2012.
Individual Health Plan Analysis
California. Financial performance improved at the California health plan in 2013, when compared with 2012, primarily due to the receipt of premium rate increases for both TANF and ABD membership; and lower inpatient facility costs for the TANF membership. Approximately $32 million of premium revenue received and recognized in 2013 related to 2012 and earlier years. The medical care ratio at the California health plan decreased to 88.9% in 2013 from 91.1% in 2012.
Florida. The medical care ratio of the Florida health plan increased to 87.3% in 2013, from 85.3% in 2012, due to higher fee-for-service costs that more than offset lower pharmacy costs.
Illinois. The medical care ratio for the Illinois health plan was 96.9% in 2013. The Illinois health plan served its first member effective September 2013.
Michigan. Financial performance improved at the Michigan health plan in 2013, when compared with 2012. The medical care ratio of the Michigan health plan decreased to 84.4% in 2013, from 88.3% in 2012, primarily due to lower fee-for-service and pharmacy costs for both the ABD and the TANF membership.
New Mexico. Financial performance improved at the New Mexico health plan in 2013, when compared with 2012. The medical care ratio of the New Mexico health plan decreased to 86.1% in 2013, from 87.0% in 2012, primarily as a result of higher Medicaid premium rates PMPM effective January 1, 2013, and stable medical costs PMPM. The New Mexico health plan added approximately 80,000 new members in 2013, as a result of its acquisition of Lovelace Community Health Plan's contract for the New Mexico Medicaid Salud! Program effective August 1, 2013.
Ohio. Financial performance improved at the Ohio health plan in 2013, when compared with 2012. The medical care ratio of the Ohio health plan decreased to 84.2% in 2013, from 88.6% in 2012, primarily due to lower fee-for-service and pharmacy costs for both the ABD and the TANF membership. Financial performance deteriorated in the second half of 2013 due to both premium decreases, and increases to fee schedules effective July 1, 2013, that combined to reduce medical margin approximately 3% for the second half of 2013. We also experienced an additional 1.5% decrease in premium rates in Ohio effective July 1, 2013, due to a re-basing of revenue risk adjusters.
Texas. Financial performance improved at the Texas health plan in 2013, when compared with 2012. The medical care ratio of the Texas health plan decreased to 86.4% in 2013, from 93.7% in 2012, primarily due to rate increases received on September 1, 2013 and 2012, respectively.

48


Utah. Financial performance deteriorated at the Utah health plan in 2013, when compared with 2012. Reductions to the medical portion of the Medicaid premium, and the addition of the pharmacy benefit to our Medicaid premium, both effective January 1, 2013, more than offset stable medical costs. The medical care ratio of the Utah health plan increased to 83.4% in 2013, from 82.3% in 2012.
Washington. The medical care ratio of the Washington health plan increased to 88.0% in 2013, compared with 86.8% in 2012, due to the addition of ABD members effective July 1, 2012 and lower TANF premium rates. The higher premium revenue PMPM associated with the ABD membership, however, offset the increased medical care ratio, so that medical margin increased to $140.2 million in 2013, from $129.0 million in 2012.
Wisconsin. Financial performance improved at the Wisconsin health plan in 2013, when compared with 2012. The medical care ratio of the Wisconsin health plan decreased to 79.7% in 2013, compared with 96.2% in 2012, due to both higher revenue PMPM and lower fee-for-service physician, specialty and outpatient costs PMPM. Additionally, the health plan gained approximately 50,000 members in the first half of 2013 due to another health plan's exit from the market.
Health Plans Segment Operating Data
The following table summarizes member months, premium revenue, medical care costs, medical care ratio, and medical margin by health plan for the periods indicated (PMPM amounts are in whole dollars; member months and other dollar amounts are in thousands):
 Year Ended December 31, 2013
 
Member
Months (2)
 Premium Revenue (1) Medical Care Costs (1) MCR (3) Medical Margin
  Total PMPM Total PMPM  
California4,233
 $749,755
 $177.10
 $666,592
 $157.46
 88.9% $83,163
Florida973
 264,998
 272.23
 231,261
 237.57
 87.3
 33,737
Illinois7
 8,121
 1,201.34
 7,869
 1,164.10
 96.9
 252
Michigan2,581
 676,000
 261.91
 570,644
 221.09
 84.4
 105,356
New Mexico1,492
 446,758
 299.36
 384,466
 257.62
 86.1
 62,292
Ohio3,007
 1,098,795
 365.44
 924,675
 307.53
 84.2
 174,120
Texas3,178
 1,291,001
 406.27
 1,114,852
 350.84
 86.4
 176,149
Utah1,040
 310,895
 299.05
 259,397
 249.51
 83.4
 51,498
Washington4,941
 1,168,405
 236.47
 1,028,210
 208.10
 88.0
 140,195
Wisconsin1,060
 143,465
 135.40
 114,340
 107.91
 79.7
 29,125
Other(4)

 20,977
 
 77,818
 
 
 (56,841)
 22,512
 $6,179,170
 $274.48
 $5,380,124
 $238.99
 87.1% $799,046
 Year Ended December 31, 2012
 
Member
Months (2)
 Premium Revenue (1) Medical Care Costs (1) MCR (3) Medical Margin
  Total PMPM Total PMPM  
California4,177
 $665,600
 $159.36
 $606,494
 $145.20
 91.1% $59,106
Florida850
 228,832
 269.36
 195,226
 229.80
 85.3
 33,606
Illinois
 
 
 
 
 
 
Michigan2,639
 646,551
 244.97
 570,636
 216.20
 88.3
 75,915
New Mexico1,069
 321,853
 301.08
 280,108
 262.03
 87.0
 41,745
Ohio3,065
 1,095,137
 357.36
 970,504
 316.69
 88.6
 124,633
Texas3,245
 1,233,621
 380.18
 1,155,433
 356.08
 93.7
 78,188
Utah1,026
 298,392
 290.78
 245,671
 239.41
 82.3
 52,721
Washington4,600
 974,712
 211.91
 845,733
 183.87
 86.8
 128,979
Wisconsin508
 70,678
 139.25
 67,968
 133.91
 96.2
 2,710
Other(4)

 8,745
 
 53,415
 
 
 (44,670)
 21,179
 $5,544,121
 $261.79
 $4,991,188
 $235.68
 90.0% $552,933


49


(1)Premium revenue for our former Missouri health plan was $0.2 million and $114.4 million for the years ended December 31, 2013 and 2012, respectively. Medical care costs for the plan were $1.5 million and $105.6 million for the years ended December 31, 2013 and 2012, respectively. These amounts are excluded from the tables above because the results of this health plan are classified as discontinued operations.
(2)A member month is defined as the aggregate of each month’s ending membership for the period presented.
(3)"MCR" represents medical costs as a percentage of premium revenue.
(4)"Other" medical care costs include primarily medically related administrative costs of the parent company, and direct delivery costs.
Molina Medicaid Solutions Segment
Performance of the Molina Medicaid Solutions segment was as follows:
 Year Ended December 31,
 2013 2012
 (In thousands)
Service revenue before amortization$207,449
 $189,281
Amortization recorded as reduction of service revenue(2,914) (1,571)
Service revenue204,535
 187,710
Cost of service revenue161,494
 141,208
General and administrative costs5,285
 17,648
Amortization of customer relationship intangibles5,127
 5,127
Operating income$32,629
 $23,727
Operating income for our Molina Medicaid Solutions segment increased $8.9 million for the year ended December 31, 2013, compared with 2012. The increase in operating income was primarily the result of additional sales in existing markets, and the favorable resolution of certain contingencies related to the Maine contract.
Consolidated Expenses
General and Administrative Expenses
General and administrative expenses increased to 10.1% of revenue in 2013, from 8.8% in 2012, primarily due to higher costs incurred as we prepared for significant membership growth anticipated in 2014. Increased administrative expenses related to anticipated membership growth represented approximately 2% of premium revenue, or $135 million during 2013.
Premium Tax Expense
Premium tax expense was consistent year over year.
Depreciation and Amortization
The following table presents all depreciation and amortization recorded in our consolidated statements of income, regardless of whether the item appears as depreciation and amortization, a reduction of service revenue, or as cost of service revenue.
 Year Ended December 31,
 2013 2012
 Amount 
% of Total
Revenue
 Amount 
% of Total
Revenue
 (Dollar amounts in thousands)
Depreciation, and amortization of capitalized software, continuing operations$54,837
 0.8% $42,938
 0.7%
Amortization of intangible assets, continuing operations17,906
 0.3
 20,176
 0.3
Depreciation and amortization, continuing operations72,743
 1.1
 63,114
 1.0
Depreciation and amortization, discontinued operations2
 
 590
 
Amortization recorded as reduction of service revenue2,914
 
 1,571
 
Amortization of capitalized software recorded as cost of service revenue18,207
 0.3
 13,489
 0.2
 $93,866
 1.4% $78,764
 1.2%

50


Interest Expense
Interest expense was $52.1 million for the year ended December 31, 2013, compared with $16.8 million for the year ended December 31, 2012. Interest expense includes non-cash interest expense relating to the amortization of the discount on our long-term debt obligations, which amounted to $22.8 million and $5.9 million for the years ended December 31, 2013 and 2012, respectively. The increase in interest expense for the year ended December 31, 2013, was primarily due to our issuance of $550.0 million aggregate principal amount 1.125% cash convertible senior notes due 2020 (the 1.125% Notes) in the first quarter of 2013. Interest expense in 2013 also included the immediate recognition of approximately $6 million in debt issuance costs associated with this transaction. The remaining fees associated with that issuance, amounting to approximately $12 million, are being amortized over the life of the 1.125% Notes. For the year ended December 31, 2013, interest expense also includes amounts relating to lease financing transactions executed in the second quarter of 2013.
Other Expenses, Net
Other expenses, net increased to $3.3 million for the year endedDecember 31, 2013, from $0.9 million for the year ended December 31, 2012. Other expenses, net include primarily gains or losses associated with changes in the fair value of our derivative financial instruments. In the second quarter of 2013 we recorded a one-time non-cash charge of $3.9 million related to the change in fair value of warrants issued in connection with the 1.125% Notes. We settled the interest rate swap in the second quarter of 2013, which resulted in a gain of $0.4 million, partially offsetting the $3.9 million charge described above. Other expenses, net was $0.9 million for the year ended December 31, 2012, primarily due to the change in fair value of the interest rate swap.
Income Taxes
The provision for income taxes in continuing operations is recorded at an effective rate of 44.8% for the year ended December 31, 2013, compared with 45.0% for the year ended December 31, 2012.
Liquidity and Capital Resources
Introduction
We manage our cash, investments, and capital structure to meet the short- and long-term obligations of our business while maintaining liquidity and financial flexibility. We forecast, analyze, and monitor our cash flows to enable prudent investment management and financing within the confines of our financial strategy.
Our regulated subsidiaries generate significant cash flows from premium revenue. Such cash flows are our primary source of liquidity. Thus, any future decline in our profitability may have a negative impact on our liquidity. We generally receive premium revenue a short time before we pay for the related health care services. A majority of the assets held by our regulated subsidiaries are in the form of cash, cash equivalents, and investments. After considering expected cash flows from operating activities, we generally invest cash of regulated subsidiaries that exceeds our expected short-term obligations in longer term, investment-grade, and marketable debt securities to improve our overall investment return. These investments are made pursuant to board approved investment policies which conform to applicable state laws and regulations.
Our investment policies are designed to provide liquidity, preserve capital, and maximize total return on invested assets, all in a manner consistent with state requirements that prescribe the types of instruments in which our subsidiaries may invest. These investment policies require that our investments have final maturities of 10 years or less (excluding auction rate securities and variable rate securities, for which interest rates are periodically reset) and that the average maturity be three years or less. Professional portfolio managers operating under documented guidelines manage our investments.investments and a portion of our cash equivalents. Our portfolio managers must obtain our prior approval before selling investments where the loss position of those investments exceeds certain levels. As of December 31, 2014,2015, a substantial portion of our cash was invested in a portfolio of highly liquid money market securities, and our investments consisted solelyprimarily of investment-grade debt securities. All of our investments are classified as current assets, except for our restricted investments, and our investments in auction rate securities, which are classified as non-current assets. Our restricted investments are invested principally in certificates of deposit and U.S. treasury securities.
Investment income increased to $8.1$18 million for the year ended December 31, 2014,2015, compared with $6.9$8 million for the year ended December 31, 2013,2014, primarily due to the increase in invested assets. Our annualized portfolio yields for the year ended December 31, 2015 was 0.5%, and for both years ended December 31, 2014 and 2013, werewas 0.4% and for 2012 was 0.5%.
Investments and restricted investments are subject to interest rate risk and will decrease in value if market rates increase. We have the ability to hold our restricted investments until maturity. Declines in interest rates over time will reduce our investment income.
Cash in excess of the capital needs of our regulated health plans is generally paid to our non-regulatedunregulated parent company in the form of dividends, when and as permitted by applicable regulations, for general corporate use. We received $125 million in dividends from our regulated health plan subsidiaries, and $17 million in dividends from our unregulated subsidiaries during 2015. We did not receive any dividends from our regulated health plan subsidiaries during the year ended December 31, 2014, because significant growth across all of our health plans necessitated that the plans retain their capital for operations.cash to meet increasing net worth requirements. See further discussion in Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, Note 20,19, "Commitments and Contingencies," under the subheading

51


"Regulatory "Regulatory Capital and Dividend Restrictions," and Note 23,22, "Condensed Financial Information of Registrant," under "Note C - Dividends and Capital Contributions."
Liquidity
A condensed schedule of cash flows to facilitate our discussion of liquidity follows:
 Year Ended December 31,
 2014 2013 Change
 (In thousands)
Net cash provided by operating activities$1,060,257
 $190,083
 $870,174
Net cash used in investing activities(535,729) (543,311) 7,582
Net cash provided by financing activities78,640
 493,353
 (414,713)
Net increase in cash and cash equivalents$603,168
 $140,125
 $463,043
Year Ended December 31,Year Ended December 31,
2013 2012 Change2015 2014 2013 2014 to 2015 Change 2013 to 2014 Change
(In thousands)(In millions)
Net cash provided by operating activities$190,083
 $347,784
 $(157,701)$1,125
 $1,060
 $190
 $65
 $870
Net cash used in investing activities(543,311) (93,584) (449,727)(1,420) (536) (543) (884) 7
Net cash provided by financing activities493,353
 47,743
 445,610
1,085
 79
 493
 1,006
 (414)
Net increase in cash and cash equivalents$140,125
 $301,943
 $(161,818)$790
 $603
 $140
 $187
 $463
Operating Activities. Cash provided by operating activities was $1,060.3$1,125 million in 2015 compared with $1,060 million in 2014, compared with $190.1 million in 2013, an increase of $870.2$65 million. This increase was due primarily to increased net income of $81 million, and collection of premiums receivable at our California health plan in the following:first quarter of 2015. These sources of cash were partially offset by:
$441.8A decrease in amounts due to government agencies of $268 million, primarily due to a fourth quarter 2015 Medicaid expansion-related payment to the state of Washington's Medicaid authority of $247 million. Changes in this account

53


relate primarily to Health Plans segment programs that contain medical cost floors or medical cost corridors. Under such programs, a portion of certain Medicaid, Medicare, and Marketplace premiums received by our health plans may be returned if certain minimum amounts are not spent on defined medical care costs; and
The change in medical claims and benefits payable, which resulted in the use of $49 million, primarily because membership and related medical costs grew at a higher rate in 2014 than in 2015, resulting in a lower year-over-year change in 2015.
In 2014, cash provided by operating activities was $1,060 million compared with $190 million for 2013, an increase of $870 million. This increase was primarily due to a $442 million increase in amounts due to government agencies due tobecause of a significant increase in amounts accrued for medical cost floor contract provisions, primarily associated with our Medicaid expansion membership; and
$355.5 million increase inmembership. In addition, medical claims and benefits payable increased $356 million due to significant membership growth in 2014.
In 2013, cash provided by operating activities was $190.1 million compared with $347.8 million for 2012, a decrease of $157.7 million. In 2013, deferred revenue was a use of cash from operations amounting to $19.6 million, compared with a source of cash amounting to $90.9 million in 2012. This was primarily due to an advance premium payment received by our Washington health plan in December 2012, with no comparable advance premium receipts in December 2013.
Investing Activities. Cash used in investing activities decreasedincreased to $535.7$1,420 million in 2015, compared with $536 million in 2014, compared with $543.3 millionan increase of $884 million. This increase was due in 2013. This $7.6 million decline in cash used was primarily duepart to lowerhigher purchases of investments, net of sales and maturities, compared with 2013.amounting to $477 million, a result of cash generated from 2015 financing activities, described below.
In addition, cash paid for business acquisitions increased $406 million. As described below, therein Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, Note 1 ,"Basis of Presentation," we closed several business acquisitions in 2015. Additionally, we announced several Health Plans acquisitions in 2015 that did not close until January 1, 2016. Because the closing dates for these acquisitions fell on January 1, 2016, a holiday, approximately $101 million was greater investment activityrecorded to prepaid expenses and other assets as of December 31, 2015, for purchase price amounts funded in 2013 associated with significant debt financing transactions.December 2015. Such amounts are reported in investing activities in the accompanying consolidated statements of cash flows.
In 2013,2014, cash used in investing activities was $543.3$536 million, comparedcomparable with $93.6$543 million in 2012. This $449.7 million increase was primarily due to greater purchases of investments in 2013, as a result of the cash generated in financing activities, described below. In addition to increased purchases of investments, we paid $61.5 million in connection with business combinations in 2013, with no comparable activity in 2012.2013.
Financing Activities. Cash provided by financing activities was $78.6$1,085 million in 2015, primarily due to net proceeds from our fiscal 2015 offerings of 5.375% Notes, amounting to $689 million, and common stock, amounting to $373 million. In 2014, compared with $493.4 million in 2013, a decrease of $414.7 million. Cashcash provided by financing activities in 2014was $79 million, which included primarily $122.6$123 million net proceeds from our fiscal 2014 offering of 1.625% Notes, partially offset by $50.3$50 million paid in the settlement ofto settle contingent consideration liabilities associated with our 2013 business combinations. Cash provided by financing activities in 2014 was significantly outpaced by debt financing activities in 2013, as described below.
acquisitions. In 2013, cash provided by financing activities was $493.4 million compared with $47.7 million in 2012, an increase of $445.6 million. The increase in cash provided by financing activities was primarily due to 2013 activity including $538.0 million innet proceeds received from our offering of 1.125% Notes $158.7offering and lease financing transactions provided $623 million, received from sale-leaseback transactions, and $75.1 million from the sale of warrants,which was partially offset by $149.3 million paid for the purchased call option relating to 1.125% Notes, $52.7 million paid for repurchases of our common stock, $47.5$53 million used to repay our term loan,purchase treasury stock and $40.0$88 million used to repay our credit facility. Our credit facility was terminated in early 2013 when the balance was repaid.debt.

52


Financial Condition
We believe that our cash resources and internally generated funds will be sufficient to support our operations, regulatory requirements, and capital expenditures for at least the next 12 months.
On a consolidated basis, at December 31, 2014,2015, our working capital was $1,070.6$1,484 million compared with $745.7$1,028 million at December 31, 2013.2014. At December 31, 2014,2015, our cash and investments amounted to $2,665.9$4,241 million, compared with $1,712.9$2,666 million of cash and investments at December 31, 2013.2014.
Regulatory Capital. Our health plans, which are operated by our respective wholly owned subsidiaries in those states, are subject to state laws and regulations that, among other things, require the maintenance of minimum levels of statutory capital, as defined by each state. Regulators in some states may also attempt to enforce capital requirements upon us that require the retention of net worth in excess of amounts formally required by statute or regulation. Such statutes, regulations and informal capital requirements also restrict the timing, payment, and amount of dividends and other distributions that may be paid to us as the sole stockholder. To the extent our subsidiaries must comply with these regulations, they may not have the financial flexibility to transfer funds to us.
Based upon current statutes and regulations, the net assets in these subsidiaries (after intercompany eliminations) which may not be transferable to us in the form of loans, advances, or cash dividends was approximately $1,229 million at December 31, 2015, and $859 million at December 31, 2014. Because of the statutory restrictions that inhibit the ability of our health plans to transfer net assets to us, the amount of retained earnings readily available to pay dividends to our stockholders is generally limited to cash, cash equivalents and investments held by the parent company – Molina Healthcare, Inc. Such cash, cash equivalents and investments amounted to $612 million and $203 million as of December 31, 2015, and 2014, respectively.
Debt Ratings. Our 5.375% Notes are rated "BB" by Standard & Poor's, and "Ba3" by Moody's Investor Service, Inc. A significant downgrade in our ratings could adversely affect our borrowing capacity and costs.
Health Insurer Fee. One notable provision ofEffective January 1, 2014, the ACA is an excise tax or annual fee that applies torequires most health plans including commercial health plans and Medicaid managed care plans like Molina Healthcare. While characterized asto pay a "fee" in the text of the ACA, the intent of Congress was to impose a broad-based health insurance industry excisefee based on premium revenue (the Health Insurer Fee, or HIF). The HIF is not tax with the understandingdeductible. Actuarial standards require that the tax could be passed on to consumers, most likely through higher commercial insurance premiums.
However, because Medicaid is a government funded program, Medicaid health plans have no alternative but to look to their respective state partners for payment to offset the impact of this tax. Additionally, when states reimburse us for the amount of the HIF that reimbursement is itself subjectwe incur related to Medicaid revenue, in addition to paying us a "tax gross up" to compensate us for incremental income tax, the HIF, and applicable state premium taxes. Becausetaxes we pay because the HIF is not deductible for income tax purposes, our net income is reduced by thedeductible. During 2015, we secured full amount of the assessment. We expect our 2015 HIF assessment related to our Medicaid business to be approximately $143 million, with an expected tax effect from the reimbursement of the assessment of approximately $88 million. Therefore, the total reimbursement needed as a result of the Medicaid-related HIF is approximately $231 million.
Our 2014 HIF assessment amounted to $88.6 million, which was paid in September 2014. As indicated in the table below, it was necessary for the states to pay us an incremental amount of approximately $131 million during 2014 to account for the HIF and the absence of its deductibility.
The state of California has not formally committed to reimburse us for either the HIF itself, or the related tax effects. The states of Michigan and Utah have reimbursed us for the HIF, but have not formally committed to reimbursement for our expenses under the related tax effect. The total amountHIF.

54

Table of HIF revenue for which agreements were not secured (and revenue was not recognized) amounted to approximately $20 million for fiscal 2014. We expect to collect and recognize this revenue related to 2014 in 2015. We further expect to recognize revenue in 2015 sufficient to reimburse us for the full amount of the HIF we will pay (along with related tax effects) in September of 2015.Contents

We continue to work with our state partners to obtain reimbursement for the full economic impact of the excise tax. The failure of our state partners to reimburse us in full for the HIF and its related tax effects could have a material adverse effect on our business, financial condition, cash flows or results of operations.
The following table provides the details of our HIF revenue reimbursement by health plan to date in 20142015 (in thousands)millions):
HIF Reimbursement Recognized Required HIF Reimbursement through Dec. 31, 2014
HIF Reimbursement Revenue, Gross(1)
Three Months Ended Year Ended Dec. 31, 2014 Year Ended December 31, 2015
March 31, 2014 June 30, 2014 Sept. 30, 2014 Dec. 31, 2014 Recognized Necessary for Full Reimbursement
Gross (1)Q1 2015  Q2 2015 Q3 2015 Q4 2015 Total 
2015 HIF: 
California$
 $
 $
 $
 $
 $11,616
$
 $17
 $6
 $8
 $31
 $31
Florida1,416
 1,473
 1,487
 1,459
 5,835
 5,835
2
 2
 2
 2
 8
 8
Illinois40
 42
 40
 40
 162
 162
1
 1
 1
 1
 4
 4
Michigan
 
 8,011
 2,663
 10,674
 17,471

 
 21
 7
 28
 28
New Mexico
 
 
 11,322
 11,322
 11,322
7
 8
 8
 7
 30
 30
Ohio7,791
 8,117
 6,912
 7,606
 30,426
 30,426
12
 12
 12
 12
 48
 48
South Carolina3
 3
 3
 3
 12
 12
Texas
 
 
 18,518
 18,518
 18,518
6
 6
 6
 5
 23
 23
Utah
 
 3,000
 1,049
 4,049
 5,332

 
 4
 2
 6
 6
Washington6,229
 6,489
 6,217
 6,311
 25,246
 25,246
11
 11
 6
 9
 37
 37
Wisconsin1,080
 1,126
 1,372
 1,193
 4,771
 4,771
1
 1
 1
 2
 5
 5
Medicaid16,556
 17,247
 27,039
 50,161
 111,003
 130,699
Subtotal, Medicaid43
 61
 70
 58
 232
 232
Marketplace
 
 1
 1
 2
 2
Medicare2,892
 3,199
 3,068
 3,053
 12,212
 12,212
6
 4
 4
 5
 19
 19
49
 65
 75
 64
 253
 $253
2014 HIF:           
California
 12
 
 
 12
  
Michigan
 
 7
 
 7
  
Utah
 
 1
 
 1
  
$49
 $77
 $83
 $64
 $273
  
$19,448
 $20,446
 $30,107
 $53,214
 $123,215
 $142,911
           
Recognized in:                      
Health insurer fee revenue$18,696
 $19,662
 $29,427
 $51,699
 $119,484
  $48
 $74
 $81
 $61
 $264
  
Premium tax revenue752
 784
 680
 1,515
 3,731
  1
 3
 2
 3
 9
  
$19,448
 $20,446
 $30,107
 $53,214
 $123,215
  $49
 $77
 $83
 $64
 $273
  

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_____________
(1)Amounts in the table include our estimate of the full economic impact of the excise tax including premium tax and the income tax effect.
Future Sources and Uses of Liquidity
Shelf Registration Statement. We have a shelf registration statement on file with the Securities and Exchange Commission to register an unlimited amount of any combination of debt or equity securities in one or more offerings. Specific information regarding the terms and securities being offered will be provided at the time of an offering. Proceeds from future offerings are expected to be used for general corporate purposes, including, but not limited to, the repayment of debt, investments in or extensions of credit to our subsidiaries and the financing of possible acquisitions or business expansion.
Credit Facility. In June 2015, weentered into an unsecured $250 million revolving credit facility (Credit Facility). Borrowings under the Credit Facility bear interest based, at our election, on a base rate or an adjusted London Interbank Offered Rate (LIBOR), plus in each case the applicable margin. The Credit Facility has a term of five years and all amounts outstanding will be due and payable on June 12, 2020. Subject to obtaining commitments from existing or new lenders and satisfaction of other specified conditions, we may increase the Credit Facility to up to $350 million. Our ability to borrow under the Credit Facility is subject to compliance with certain covenants. As of December 31, 2015, outstanding letters of credit amounting to $6 million reduced the borrowing capacity to $244 million, and no amounts were outstanding under the Credit Facility.

55

Regulatory Capital and Dividend Restrictions
For a comprehensive discussionTable of our regulatory capital requirements and dividend restrictions, refer toContents

Announced Acquisitions. As described in Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, in Note 20 "Commitments1, "Basis of Presentation," we announced several Health Plans acquisitions in 2015 that did not close until January 1, 2016. Because the closing dates for these acquisitions fell on January 1, 2016, a holiday, approximately $101 million was recorded to prepaid expenses and Contingencies."
Future Sources and Usesother assets as of LiquidityDecember 31, 2015, for purchase price amounts funded in December 2015. Such amounts are reported in investing activities in the accompanying consolidated statements of cash flows. The total aggregate purchase price for these acquisitions amounted to approximately $115 million.
For a comprehensive discussionConvertible Senior Notes. In February 2013, we issued $550 million aggregate principal amount of our debt instruments, including our1.125% cash convertible senior notes transactions in 2014 and 2013,due January 15, 2020, unless earlier repurchased or converted. We refer to Item 8these notes as our 1.125% Notes. In September 2014, we issued $302 million aggregate principal amount of this Form 10-K, Notes1.625% convertible senior notes due August 14, 2044, unless earlier repurchased, redeemed, or converted. We refer to Consolidated Financial Statements, in Note 12 "Long-Term Debt."
For a discussionthese notes as our 1.625% Notes. As of December 31, 2015, the aggregate outstanding principal amount of our shelf registration statement,1.125% Notes and our securities repurchase programs through December 31, 2014, refer1.625% Notes was $550 million and $302 million, respectively. Both our 1.125% Notes and our 1.625% Notes are convertible into cash prior to Item 8their respective maturity dates under certain circumstances, one of this Form 10-K, Noteswhich relates to Consolidated Financial Statements, in Note 15, "Stockholders' Equity."
Effective as of February 25, 2015, our board of directors authorized the repurchase of up to $50 million in aggregateclosing price of our common stock. Stock repurchases understock over a specified period. We refer to this programconversion trigger as the stock price trigger. The 1.125% Notes met the stock price trigger in the quarter ended December 31, 2015, and are convertible to cash through at least March 31, 2016. Because the 1.125% Notes may be made through open-market and/or privately negotiated transactions at times andconverted into cash within 12 months, the $448 million carrying amount is reported in such amountscurrent portion of long-term debt as management deems appropriate. The timing and actual number of shares repurchased will depend on a variety of factors including price, corporate and regulatory requirements and market conditions. This newly authorized repurchase program extends through December 31, 2015. In addition, holders of our 1.625% Notes may convert their notes into cash during any calendar quarter (and only during such calendar quarter) if the last reported sales price of our common stock for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on the last trading day of the immediately preceding calendar quarter is greater than or equal to $75.51 per share. The last reported sale price of our common stock as reported on the New York Stock Exchange on February 23, 2016 was $62.28 per share. As of December 31, 2015, our 1.625% Notes were not convertible. If conversion requests are received, the settlement of the notes must be paid primarily in cash pursuant to the terms of the relevant indentures.
For economic reasons related to the trading market for our 1.125% Notes, we believe that the amount of the notes that may be converted over the next twelve months, if any, will not be significant. However, if the trading market for our 1.125% Notes becomes closed or restricted due to market turmoil or other reasons such that the notes cannot be traded, or if the trading price of our 1.125% Notes, which normally trade at a marginal premium to the underlying composite stock-and-interest economic value, no longer includes that marginal premium, holders of our 1.125% Notes may elect to convert the notes to cash. As of December 31, 2015, we had sufficient available cash, combined with borrowing capacity available under our Credit Facility, to fund such conversions.
States' Budgets. From time to time the states in which our health plans operate may delay premium payments. For example, the state of Illinois is currently operating without a budget for its fiscal year ending June 30, 2016. As of December 31, 2015, our Illinois health plan served approximately 98,000 members, and recognized premium revenue of approximately $397 million for the year ended December 31, 2015. As of February 23, 2016, Illinois is current with its premium payments.
In another example, the Commonwealth of Puerto Rico has reported that it may lack sufficient resources to fund all necessary governmental programs including health care-related programs, as well as meet its debt obligations for its fiscal year ending June 30, 2016. Our Puerto Rico health plan became operational on April 1, 2015. As of December 31, 2015, the plan served approximately 348,000 members and recognized premium revenue of approximately $192 million in the fourth quarter of 2015, or approximately $64 million per month. As of February 23, 2016, the Commonwealth continues to pay us weekly for current membership.
It is the practice of the Commonwealth to pay us for eligible members only after those members have been assigned to us, and our plan has sent electronic confirmation of the receipt of eligibility. Particularly in the early stages of our contract with Puerto Rico, the plan's confirmation of eligibility of certain members was not accepted by the Commonwealth as a result of various technical issues. The plan has continued to pay for medical services for all members in question, but the Commonwealth is withholding payment of approximately $12 million of premium revenue related to those members. We believe we have a valid claim to all of the premiums withheld and we are in discussions with the Commonwealth regarding this matter.
It has been our practice in the past, and will remain so in the future, to continue to serve our members and pay health care providers for services rendered in circumstances where state (or Commonwealth) governments are temporarily unable to pay us, so long as we continue to believe that such state (or Commonwealth) governments will ultimately pay us.



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Critical Accounting Estimates
When we prepare our consolidated financial statements, we use estimates and assumptions that may affect reported amounts and disclosures. Actual results could differ from these estimates. Our most significant accounting estimates relate to:
Health Plans segment medical claims and benefits payable (see discussion below).
Health Plans segment contractual provisions that may adjust or limit revenue or profit. For a comprehensive discussion of this topic, including amounts recorded in our consolidated financial statements, refer to Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, in Note 2, "Significant Accounting Policies."
Health Plans segment quality incentives. For a comprehensive discussion of this topic, including amounts recorded in our consolidated financial statements, refer to Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, in Note 2, "Significant Accounting Policies."
Molina Medicaid Solutions segment revenue and cost recognition. For a comprehensive discussion of this topic, refer to Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, in Note 2, "Significant Accounting Policies."
Medical Claims and Benefits Payable — Health Plans Segment
The following table provides the details of our medical claims and benefits payable as of the dates indicated:
December 31,December 31,
2014 2013 20122015 2014 2013
(In thousands)(In millions)
Fee-for-service claims incurred but not paid (IBNP)$870,429
 $424,173
 $377,614
$1,191
 $871
 $424
Pharmacy payable71,412
 45,037
 38,992
88
 71
 45
Capitation payable28,150
 20,267
 49,066
140
 28
 20
Other (1)230,531
 180,310
 28,858
266
 231
 181
$1,200,522
 $669,787
 $494,530
$1,685
 $1,201
 $670

(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 income. As of December 31, 2015, 2014 and 2013, we recorded non-risk provider payables relating to such intermediary arrangements of approximately $119.3$167 million, $119 million and $151.3$151 million, respectively.
The determination of our liability for medical claims and medical benefits payable is particularly important to the determination of our financial position and results of operations in any given period. Such determination of our liability requires the application of a significant degree of judgment by our management.
As a result, the determination of our liability for medical claims and medical benefits payable is subject to an inherent degree of uncertainty. Our medical care costs include amounts that have been paid by us through the reporting date, as well as estimated

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liabilities for medical care costs incurred but not paid by us as of the reporting date. Such medical care cost liabilities include, among other items, unpaid fee-for-service claims, capitation payments owed providers, unpaid pharmacy invoices, and various medically related administrative costs that have been incurred but not paid. We use judgment to determine the appropriate assumptions for determining the required estimates.
The most important element in estimating our medical care costs is our estimate for fee-for-service claims which have been incurred but not paid by us. These fee-for-service costs that have been incurred but have not been paid at the reporting date are collectively referred to as medical costs that are incurred but not paid (IBNP). Our IBNP, as reported on our balance sheet, represents our best estimate of the total amount of claims we will ultimately pay with respect to claims that we have incurred as of the balance sheet date. We estimate our IBNP monthly using actuarial methods based on a number of factors. As indicated in the table above, our estimated IBNP liability represented $870.4$1,191 million of our total medical claims and benefits payable of $1,200.5$1,685 million as of December 31, 2014. Excluding amounts that we anticipate paying on behalf of certain capitated providers in Ohio (which we will subsequently withhold from those providers' monthly capitation payments), our IBNP liability at December 31, 2014, was $861.8 million.2015.
The factors we consider when estimating our IBNP include, without limitation, claims receipt and payment experience (and variations in that experience), changes in membership, provider billing practices, health care service utilization trends, cost trends, product mix, seasonality, prior authorization of medical services, benefit changes, known outbreaks of disease or increased incidence of illness such as influenza, provider contract changes, changes to Medicaid fee schedules, and the incidence of high dollar or catastrophic claims. Our assessment of these factors is then translated into an estimate of our IBNP liability at the relevant measuring point through the calculation of a base estimate of IBNP, a further provision for adverse

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claims deviation, and an estimate of the administrative costs of settling all claims incurred through the reporting date. The base estimate of IBNP is derived through application of claims payment completion factors and trended PMPM cost estimates.
For the fifth month of service prior to the reporting date and earlier, we estimate our outstanding claims liability based on actual claims paid, adjusted for estimated completion factors. Completion factors seek to measure the cumulative percentage of claims expense that will have been paid for a given month of service as of the reporting date, based on historical payment patterns.
The following table reflects the hypothetical change in our estimate of claims liability as of December 31, 20142015 that would have resulted had we changed our completion factors for the fifth through the twelfth months preceding December 31, 2014,2015, by the percentages indicated. A reduction in the completion factor results in an increase in medical claims liabilities. Dollar amounts are in thousands.millions.
Increase (Decrease) in Estimated Completion Factors
Increase (Decrease) in
Medical Claims and
Benefits Payable
Increase (Decrease) in
Medical Claims and
Benefits Payable
(6)%$223,129
$348
(4)%148,753
232
(2)%74,376
116
2%(74,376)(116)
4%(148,753)(232)
6%(223,129)(348)
For the four months of service immediately prior to the reporting date, actual claims paid are not a reliable measure of our ultimate liability, given the inherent delay between the patient/physician encounter and the actual submission of a claim for payment. For these months of service, we estimate our claims liability based on trended PMPM cost estimates. These estimates are designed to reflect recent trends in payments and expense, utilization patterns, authorized services, and other relevant factors. The following table reflects the hypothetical change in our estimate of claims liability as of December 31, 20142015 that would have resulted had we altered our trend factors by the percentages indicated. An increase in the PMPM costs results in an increase in medical claims liabilities. Dollar amounts are in thousands.millions.

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(Decrease) Increase in Trended Per member Per Month Cost Estimates
(Decrease) Increase in
Medical Claims and
Benefits Payable
(Decrease) Increase in
Medical Claims and
Benefits Payable
(6)%$(135,631)$(202)
(4)%(90,421)(135)
(2)%(45,210)(67)
2%45,210
67
4%90,421
135
6%135,631
202
The following per-share amounts are based on a combined federal and state statutory tax rate of 37%, and 48.356 million diluted shares outstanding for the year ended December 31, 2014.2015. Assuming a hypothetical 1% change in completion factors from those used in our calculation of IBNP at December 31, 2014,2015, net income for the year ended December 31, 20142015 would increase or decrease by approximately $23$37 million, or $0.48$0.66 per diluted share. Assuming a hypothetical 1% change in PMPM cost estimates from those used in our calculation of IBNP at December 31, 2014,2015, net income for the year ended December 31, 20142015 would increase or decrease by approximately $14$21 million, or $0.29$0.38 per diluted share. The corresponding figures for a 5% change in completion factors and PMPM cost estimates would be $117$183 million, or $2.42$3.29 per diluted share, and $71$106 million, or $1.47$1.91 per diluted share, respectively.
It is important to note that any change in the estimate of either completion factors or trended PMPM costs would usually be accompanied by a change in the estimate of the other component, and that a change in one component would almost always compound rather than offset the resulting distortion to net income. When completion factors are overestimated, trended PMPM costs tend to be underestimated. Both circumstances will create an overstatement of net income. Likewise, when completion factors are underestimated, trended PMPM costs tend to be overestimated, creating an understatement of net income. In other words, errors in estimates involving both completion factors and trended PMPM costs will usually act to drive estimates of claims liabilities and medical care costs in the same direction. If completion factors were overestimated by 1%, resulting in an overstatement of net income by approximately $23$37 million, it is likely that trended PMPM costs would be underestimated, resulting in an additional overstatement of net income.

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After we have established our base IBNP reserve through the application of completion factors and trended PMPM cost estimates, we then compute an additional liability, once again using actuarial techniques, to account for adverse deviation in our claims payments which the base actuarial model is not intended to and does not account for. We refer to this additional liability as the provision for adverse claims deviation. The provision for adverse claims deviation is a component of our overall determination of the adequacy of our IBNP. It is intended to capture the potential inadequacy of our IBNP estimate as a result of our inability to adequately assess the impact of factors such as changes in the speed of claims receipt and payment, the relative magnitude or severity of claims, known outbreaks of disease such as influenza, our entry into new geographical markets, our provision of services to new populations such as the aged, blind or disabled, (ABD), changes to state-controlled fee schedules upon which a large proportion of our provider payments are based, modifications and upgrades to our claims processing systems and practices, and increasing medical costs. Because of the complexity of our business, the number of states in which we operate, and the need to account for different health care benefit packages among those states, we make an overall assessment of IBNP after considering the base actuarial model reserves and the provision for adverse claims deviation.
We also include in our IBNP liability an estimate of the administrative costs of settling all claims incurred through the reporting date.
The development of IBNP is a continuous process that we monitor and refine on a monthly basis as additional claims payment information becomes available. As additional information becomes known to us, we adjust our actuarial model accordingly.
On a monthly basis, we review and update our estimated IBNP and the methods used to determine that liability. Any adjustments, if appropriate, are reflected in the period known. While we believe our current estimates are adequate, we have in the past been required to increase significantly our claims reserves for periods previously reported, and may be required to do so again in the future. Any significant increases to prior period claims reserves would materially decrease reported earnings for the period in which the adjustment is made.
In our judgment, the estimates for completion factors will likely prove to be more accurate than trended PMPM cost estimates because estimated completion factors are subject to fewer variables in their determination. Specifically, completion factors are developed over long periods of time, and are most likely to be affected by changes in claims receipt and payment experience and by provider billing practices. Trended PMPM cost estimates, while affected by the same factors, will also be influenced by health care service utilization trends, cost trends, product mix, seasonality, prior authorization of medical services, benefit changes, outbreaks of disease or increased incidence of illness, provider contract changes, changes to Medicaid fee schedules, and the incidence of high dollar or catastrophic claims. As discussed above, however, errors in estimates involving trended

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PMPM costs will almost always be accompanied by errors in estimates involving completion factors, and vice versa. In such circumstances, errors in estimation involving both completion factors and trended PMPM costs will act to drive estimates of claims liabilities (and therefore medical care costs) in the same direction.
Refer to Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, in Note 11, "Medical Claims and Benefits Payable," for additional information regarding the specific factors used to determine our changes in estimates of IBNP for all periods presented in the accompanying consolidated financial statements.  

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The following table presents the components of the change in our medical claims and benefits payable from continuing and discontinued operations combined for the periods indicated. The amounts presented for "Components of medical care costs related to: Prior periods" represent the amount by which our original estimate of medical 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.
Year ended December 31,Year ended December 31,
2014 2013 20122015 2014 2013
(Dollars in thousands, except
per-member amounts)
(Dollars in millions, except
per-member amounts)
Balances at beginning of period$669,787
 $494,530
 $402,476
$1,201
 $670
 $495
Components of medical care costs related to:          
Current period8,122,885
 5,434,443
 5,136,055
11,935
 8,123
 5,434
Prior periods(1)(45,979) (52,779) (39,295)(141) (46) (53)
Total medical care costs8,076,906
 5,381,664
 5,096,760
11,794
 8,077
 5,381
          
Change in non-risk provider payables(31,973) 111,267
 (7,004)48
 (32) 111
          
Payments for medical care costs related to:          
Current period7,064,427
 4,932,195
 4,689,395
10,448
 7,064
 4,932
Prior periods449,771
 385,479
 308,307
910
 450
 385
Total paid7,514,198
 5,317,674
 4,997,702
11,358
 7,514
 5,317
Balances at end of period$1,200,522
 $669,787
 $494,530
$1,685
 $1,201
 $670
          
Benefit from prior periods as a percentage of:          
Balance at beginning of period6.9% 10.7% 9.8%11.8% 6.9% 10.7%
Premium revenue0.5% 0.9% 0.7%1.1% 0.5% 0.9%
Medical care costs0.6% 1.0% 0.8%1.2% 0.6% 1.0%
          
Claims Data:          
Days in claims payable, fee for service49
 43
 40
48
 49
 43
Number of members at end of period2,623,000
 1,931,000
 1,797,000
3,533,000
 2,623,000
 1,931,000
Number of claims in inventory at end of period307,700
 145,800
 122,700
380,800
 307,700
 145,800
Billed charges of claims in inventory at end of period$718,500
 $276,500
 $255,200
$816
 $719
 $277
Claims in inventory per member at end of period0.12
 0.08
 0.07
0.11
 0.12
 0.08
Billed charges of claims in inventory per member end of period$273.92
 $143.19
 $142.01
$230.91
 $273.92
 $143.19
Number of claims received during the period27,597,000
 21,317,500
 20,842,400
40,173,300
 27,597,000
 21,317,500
Billed charges of claims received during the period$30,315,600
 $21,414,600
 $19,429,300
$46,211
 $30,316
 $21,415

Commitments and Contingencies
We are not a party to off-balance sheet financing arrangements, except for operating leases which are disclosed in Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, in Note 2019 ,"Commitments and Contingencies."

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Contractual Obligations
In the table below, we present our contractual obligations as of December 31, 2014.(1)2015. Some of the amounts we have included in this table are based on management’s estimates and assumptions about these obligations, including their duration, the possibility of renewal, anticipated actions by third parties, and other factors. Because these estimates and assumptions are necessarily subjective, the contractual obligations we will actually pay in future periods may vary from those reflected in the table. Amounts are
Additionally, we have a variety of other contractual agreements related to acquiring services used in thousands.our operations. However, we believe these other agreements do not contain material noncancelable commitments. 

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Total (1)
 2016 2017-2018 2019-2020 2021 and Beyond
Total 2015 2016-2017 2018-2019 2020 and Beyond(In millions)
Medical claims and benefits payable$1,200,522
 $1,200,522
 $
 $
 $
$1,685
 $1,685
 $
 $
 $
Principal amount of convertible senior notes (2)851,551
 
 
 
 851,551
Principal amount of senior notes (2)1,552
 
 
 550
 1,002
Amounts due government agencies527,193
 527,193
 
 
 
729
 729
 
 
 
Interest on long-term debt424
 49
 97
 91
 187
Lease financing obligations380,956
 11,397
 23,830
 25,282
 320,447
403
 15
 32
 33
 323
Interest on long-term debt176,405
 11,088
 22,176
 22,175
 120,966
Operating leases122,035
 29,142
 44,591
 33,073
 15,229
232
 49
 88
 56
 39
Lease financing obligations - related party102,394
 5,346
 11,243
 12,021
 73,784
Purchase commitments26,029
 14,232
 11,797
 
 
15
 11
 4
 
 
$3,387,085
 $1,798,920
 $113,637
 $92,551
 $1,381,977
$5,040
 $2,538
 $221
 $730
 $1,551

(1)As of December 31, 2014,2015, we have recorded approximately $2.6$9 million of unrecognized tax benefits. The table does not contain this amount because we cannot reasonably estimate when or if such amount may be settled. For further information, refer to Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, in Note 14, "Income Taxes."
(2)Represents the principal amounts due on our 5.375% Senior Notes due 2022, 1.125% Cash Convertible Senior Notes due 2020, and our 1.625% Convertible Senior Notes due 2044 (1.625% Notes). The 1.625% Notes have a contractual maturity date in 2044; however, on specified dates beginning in 2018, holders of the 1.625% Notes may require us to repurchase some or all of the 1.625% Notes, as described in Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, in Note 12, "Long-Term Debt."Debt."
Item 7A.  Quantitative and Qualitative Disclosures About Market Risk
Quantitative and Qualitative Disclosures About Market Risk
Refer to Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, in Note 2, "Significant Accounting Policies," Note 5, "Fair Value Measurements," and Note 6, "Investments."
Inflation
We use various strategies to mitigate the negative effects of health care cost inflation. Specifically, our health plans try to control medical and hospital costs through contracts with independent providers of health care services. Through these contracted providers, our health plans emphasize preventive health care and appropriate use of specialty and hospital services. There can be no assurance, however, that our strategies to mitigate health care cost inflation will be successful. Competitive pressures, new health care and pharmaceutical product introductions, demands from health care providers and customers, applicable regulations, or other factors may affect our ability to control health care costs.
Compliance Costs
Our health plans are regulated by both state and federal government agencies. Regulation of managed care products and health care services is an evolving area of law that varies from jurisdiction to jurisdiction. Regulatory agencies generally have discretion to issue regulations and interpret and enforce laws and rules. Changes in applicable laws and rules occur frequently. Compliance with such laws and rules may lead to additional costs related to the implementation of additional systems, procedures and programs that we have not yet identified.

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Item 8.  Financial Statements and Supplementary Data
INDEX TO FINANCIAL STATEMENTS
 
 Page
MOLINA HEALTHCARE, INC. 


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REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
The Board of Directors and Stockholders
of Molina Healthcare, Inc.
We have audited the accompanying consolidated balance sheets of Molina Healthcare, Inc. (the Company) as of December 31, 20142015 and 20132014, and the related consolidated statements of income, comprehensive income, stockholders’ equity and cash flows for each of the three years in the period ended December 31, 20142015. These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on these financial statements based on our audits.
We conducted our audits in accordance with the standards of the Public Company Accounting Oversight Board (United States). Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion.
In our opinion, the financial statements referred to above present fairly, in all material respects, the consolidated financial position of Molina Healthcare, Inc. at December 31, 20142015 and 20132014, and the consolidated results of its operations and its cash flows for each of the three years in the period ended December 31, 20142015, in conformity with U.S. generally accepted accounting principles.
We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States), Molina Healthcare, Inc.’s internal control over financial reporting as of December 31, 20142015, based on criteria established in Internal Control — Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission (2013 framework) and our report dated February 26, 20152016 expressed an unqualified opinion thereon.
/s/ ERNST & YOUNG LLP
Los Angeles, California
February 26, 20152016


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MOLINA HEALTHCARE, INC.
CONSOLIDATED BALANCE SHEETS
December 31,December 31,
2014 20132015 2014
(Amounts in thousands,
except per-share data)
(Amounts in millions,
except per-share data)
ASSETS
Current assets:      
Cash and cash equivalents$1,539,063
 $935,895
$2,329
 $1,539
Investments1,019,462
 703,052
1,801
 1,019
Receivables596,456
 298,935
597
 596
Income tax refundable
 32,742
Deferred income taxes39,532
 26,556
Income taxes refundable13
 
Prepaid expenses and other current assets50,884
 42,484
192
 49
Derivative asset374
 
Total current assets3,245,397
 2,039,664
5,306
 3,203
Property, equipment, and capitalized software, net340,778
 292,083
393
 341
Deferred contract costs53,675
 45,675
81
 54
Intangible assets, net89,273
 98,871
122
 89
Goodwill271,964
 230,738
519
 272
Restricted investments102,479
 63,093
109
 102
Derivative asset329,323
 186,351

 329
Deferred income taxes18
 15
Other assets44,326
 46,462
28
 30
$4,477,215
 $3,002,937
$6,576
 $4,435
      
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:      
Medical claims and benefits payable$1,200,522
 $669,787
$1,685
 $1,201
Amounts due government agencies729
 527
Accounts payable and accrued liabilities241,654
 263,043
362
 242
Amounts due government agencies527,193
 56,922
Deferred revenue196,076
 122,216
223
 196
Income taxes payable8,987
 

 9
Current maturities of long-term debt341
 182,008
449
 
Derivative liability374
 
Total current liabilities2,174,773
 1,293,976
3,822
 2,175
Convertible senior notes704,097
 416,368
Senior notes962
 690
Lease financing obligations160,710
 159,394
198
 157
Lease financing obligations - related party40,241
 27,092

 40
Deferred income taxes24,271
 580
Derivative liability329,194
 186,239

 329
Other long-term liabilities33,487
 26,351
37
 34
Total liabilities3,466,773
 2,110,000
5,019
 3,425
Stockholders’ equity:      
Common stock, $0.001 par value; 150,000 shares authorized; outstanding: 49,727 shares at December 31, 2014 and 45,871 shares at December 31, 201350
 46
Preferred stock, $0.001 par value; 20,000 shares authorized, no shares issued and outstanding
 
Common stock, $0.001 par value; 150 shares authorized; outstanding: 56 shares at December 31, 2015 and 50 shares at December 31, 2014
 
Preferred stock, $0.001 par value; 20 shares authorized, no shares issued and outstanding
 
Additional paid-in capital396,059
 340,848
803
 396
Accumulated other comprehensive loss(1,019) (1,086)(4) (1)
Retained earnings615,352
 553,129
758
 615
Total stockholders’ equity1,010,442
 892,937
1,557
 1,010
$4,477,215
 $3,002,937
$6,576
 $4,435
 

See accompanying notes.

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MOLINA HEALTHCARE, INC.
CONSOLIDATED STATEMENTS OF INCOME
 
Year Ended December 31,Year Ended December 31,
2014 2013 20122015 2014 2013
(In thousands, except per-share data)(In millions, except per-share data)
Revenue:          
Premium revenue$9,022,511
 $6,179,170
 $5,544,121
$13,241
 $9,023
 $6,179
Service revenue210,051
 204,535
 187,710
253
 210
 205
Premium tax revenue294,388
 172,017
 158,991
397
 294
 172
Health insurer fee revenue119,484
 
 
264
 120
 
Investment income8,093
 6,890
 5,075
18
 8
 7
Other revenue12,074
 26,322
 18,312
5
 12
 26
Total revenue9,666,601
 6,588,934
 5,914,209
14,178
 9,667
 6,589
Operating expenses:          
Medical care costs8,076,331
 5,380,124
 4,991,188
11,794
 8,076
 5,380
Cost of service revenue156,764
 161,494
 141,208
193
 157
 161
General and administrative expenses764,693
 665,996
 518,615
1,146
 765
 666
Premium tax expenses294,388
 172,017
 158,991
397
 294
 172
Health insurer fee expenses88,591
 
 
157
 89
 
Depreciation and amortization92,917
 72,743
 63,114
104
 93
 73
Total operating expenses9,473,684
 6,452,374
 5,873,116
13,791
 9,474
 6,452
Operating income192,917
 136,560
 41,093
387
 193
 137
Other expenses, net:          
Interest expense56,811
 52,071
 16,769
66
 57
 52
Other expense, net802
 3,343
 945
Other (income) expense, net(1) 1
 4
Total other expenses, net57,613
 55,414
 17,714
65
 58
 56
Income from continuing operations before income tax expense135,304
 81,146
 23,379
322
 135
 81
Income tax expense72,726
 36,316
 10,513
179
 73
 36
Income from continuing operations62,578
 44,830
 12,866
143
 62
 45
(Loss) income from discontinued operations, net of tax (benefit) expense of $(203), $(9,912), and $(1,238), respectively(355) 8,099
 (3,076)
Income from discontinued operations, net of tax expense (benefit) of $0, $0, and $(10), respectively
 
 8
Net income$62,223
 $52,929
 $9,790
$143
 $62
 $53
          
          
Basic net income per share:          
Income from continuing operations$1.34
 $0.98
 $0.28
$2.75
 $1.34
 $0.98
(Loss) income from discontinued operations(0.01) 0.18
 (0.07)
 (0.01) 0.18
Basic net income per share$1.33
 $1.16
 $0.21
$2.75
 $1.33
 $1.16
Diluted net income per share:          
Income from continuing operations$1.30
 $0.96
 $0.27
$2.58
 $1.30
 $0.96
(Loss) income from discontinued operations(0.01) 0.17
 (0.06)
 (0.01) 0.17
Diluted net income per share$1.29
 $1.13
 $0.21
$2.58
 $1.29
 $1.13
Weighted average shares outstanding:          
Basic46,935
 45,717
 46,380
52
 47
 46
Diluted48,340
 46,862
 46,999
56
 48
 47
 
See accompanying notes.

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MOLINA HEALTHCARE, INC.
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
Year Ended December 31,Year Ended December 31,
2014 2013 20122015 2014 2013
(In thousands)(In millions)
Net income$62,223
 $52,929
 $9,790
$143
 $62
 $53
Other comprehensive income (loss):          
Unrealized investment gain (loss)108
 (1,015) 1,529
Effect of income tax expense (benefit)41
 (386) 581
Other comprehensive income (loss), net of tax67
 (629) 948
Unrealized investment loss(5) 
 (1)
Effect of income tax benefit2
 
 
Other comprehensive loss, net of tax(3) 
 (1)
Comprehensive income$62,290
 $52,300
 $10,738
$140
 $62
 $52

See accompanying notes.










































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MOLINA HEALTHCARE, INC.
CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY
 
Common Stock 
Additional
Paid-in
Capital
 
Accumulated
Other
Comprehensive
Loss
 
Retained
Earnings
 
Treasury
Stock
  Common Stock 
Additional
Paid-in
Capital
 
Accumulated
Other
Comprehensive
Loss
 
Retained
Earnings
 
Treasury
Stock
  
Outstanding Amount TotalOutstanding Amount Total
(In thousands)(In millions)
Balance at January 1, 201245,815
 $46
 $266,022
 $(1,405) $490,410
 $
 $755,073
Net income
 
 
 
 9,790
 
 9,790
Other comprehensive income, net
 
 
 948
 
 
 948
Purchase of treasury stock(111) 
 
 
 
 (3,000) (3,000)
Share-based compensation1,058
 1
 16,361
 
 
 
 16,362
Tax benefit from share-based compensation
 
 3,141
 
 
 
 3,141
Balance at December 31, 201246,762
 47
 285,524
 (457) 500,200
 (3,000) 782,314
Balance at January 1, 201347
 $
 $285
 $
 $500
 $(3) $782
Net income
 
 
 
 52,929
 
 52,929

 
 
 
 53
 
 53
Other comprehensive loss, net
 
 
 (629) 
 
 (629)
 
 
 (1) 
 
 (1)
Purchase of treasury stock(1,710) (2) 
 
 
 (52,660) (52,662)(2) 
 
 
 
 (53) (53)
Retirement of treasury stock
 
 (55,660) 
 
 55,660
 

 
 (56) 
 
 56
 
Issuance of warrants
 
 78,997
 
 
 
 78,997

 
 79
 
 
 
 79
Share-based compensation819
 1
 30,385
 
 
 
 30,386
1
 
 31
 
 
 
 31
Tax benefit from share-based compensation
 
 1,602
 
 
 
 1,602

 
 2
 
 
 
 2
Balance at December 31, 201345,871
 46
 340,848
 (1,086) 553,129
 
 892,937
46
 
 341
 (1) 553
 
 893
Net income
 
 
 
 62,223
 
 62,223

 
 
 
 62
 
 62
Other comprehensive income, net
 
 
 67
 
 
 67
Convertible senior notes transactions, including issuance costs1,787
 2
 21,961
 
 
 
 21,963
2
 
 22
 
 
 
 22
Share-based compensation2,069
 2
 30,261
 
 
 
 30,263
2
 
 30
 
 
 
 30
Tax benefit from share-based compensation
 
 2,989
 
 
 
 2,989

 
 3
 
 
 
 3
Balance at December 31, 201449,727
 $50
 $396,059
 $(1,019) $615,352
 $
 $1,010,442
50
 
 396
 (1) 615
 
 1,010
Net income
 
 
 
 143
 
 143
Other comprehensive loss, net
 
 
 (3) 
 
 (3)
Common stock offering, including issuance costs6
 
 373
 
 
 
 373
Share-based compensation
 
 26
 
 
 
 26
Tax benefit from share-based compensation
 
 8
 
 
 
 8
Balance at December 31, 201556
 $
 $803
 $(4) $758
 $
 $1,557

See accompanying notes.

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MOLINA HEALTHCARE, INC.
CONSOLIDATED STATEMENTS OF CASH FLOWS
Year Ended December 31,Year Ended December 31,
2014 2013 20122015 2014 2013
(In thousands)(In millions)
Operating activities:          
Net income$62,223
 $52,929
 $9,790
$143
 $62
 $53
Adjustments to reconcile net income to net cash provided by operating activities:          
Depreciation and amortization134,404
 93,866
 78,764
126
 134
 94
Deferred income taxes(2,352) (31,047) (9,887)(7) (2) (32)
Share-based compensation21,727
 28,694
 20,018
23
 22
 29
Amortization of convertible senior notes and lease financing obligations27,379
 22,820
 5,942
30
 27
 23
Gain on sale of subsidiary
 
 (1,747)
Other, net6,222
 17,729
 11,224
19
 7
 18
Changes in operating assets and liabilities:     
Changes in operating assets and liabilities, net of effects from acquisitions:     
Receivables(297,521) (149,253) 18,216
56
 (298) (149)
Prepaid expenses and other current assets(19,517) (23,064) (8,958)(35) (20) (23)
Medical claims and benefits payable530,735
 175,257
 92,054
482
 531
 175
Amounts due government agencies202
 470
 28
Accounts payable and accrued liabilities11,097
 32,550
 8,078
84
 11
 33
Amounts due government agencies470,271
 28,446
 15,267
Deferred revenue73,860
 (19,582) 90,851
24
 74
 (20)
Income taxes41,729
 (39,262) 18,172
(22) 42
 (39)
Net cash provided by operating activities1,060,257
 190,083
 347,784
1,125
 1,060
 190
Investing activities:          
Purchases of investments(953,355) (770,083) (306,437)(1,923) (953) (770)
Proceeds from sales and maturities of investments632,800
 399,595
 298,006
1,126
 633
 400
Purchases of equipment(114,934) (98,049) (78,145)(132) (115) (98)
Increase in restricted investments(6) (34) (19)
Net cash paid in business combinations(44,133) (61,521) 
(450) (44) (62)
Increase in restricted investments(33,661) (18,992) (2,647)
Proceeds from sale of subsidiary, net of cash surrendered
 
 9,162
Other, net(22,446) 5,739
 (13,523)(35) (23) 6
Net cash used in investing activities(535,729) (543,311) (93,584)(1,420) (536) (543)
Financing activities:          
Proceeds from issuance of convertible senior notes, net of financing costs paid122,625
 537,973
 
Proceeds from senior notes offerings, net of issuance costs689
 123
 538
Proceeds from common stock offering, net of issuance costs373
 
 
Proceeds from sale-leaseback transactions
 158,694
 

 
 159
Purchase of call option
 (149,331) 

 
 (149)
Proceeds from issuance of warrants
 75,074
 

 
 75
Contingent consideration liabilities settled(50,349) 
 

 (50) 
Treasury stock purchases
 (52,662) (3,000)
 
 (53)
Principal payments on term loan
 (47,471) (1,129)
 
 (48)
Repayment of amount borrowed under credit facility
 (40,000) (20,000)
 
 (40)
Proceeds from employee stock plans14,040
 9,402
 8,205
18
 14
 9
Principal payments on convertible senior notes(10,449) 
 

 (10) 
Amount borrowed under credit facility
 
 60,000
Other, net2,773
 1,674
 3,667
5
 2
 2
Net cash provided by financing activities78,640
 493,353
 47,743
1,085
 79
 493
Net increase in cash and cash equivalents603,168
 140,125
 301,943
790
 603
 140
Cash and cash equivalents at beginning of period935,895
 795,770
 493,827
1,539
 936
 796
Cash and cash equivalents at end of period$1,539,063
 $935,895
 $795,770
$2,329
 $1,539
 $936

See accompanying notes.


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MOLINA HEALTHCARE, INC.
CONSOLIDATED STATEMENTS OF CASH FLOWS
(continued)
 
Year Ended December 31,Year Ended December 31,
2014 2013 20122015 2014 2013
(Amounts in thousands)(Amounts in millions)
(Unaudited) 
Supplemental cash flow information:          
          
Cash paid (received) during the period for:     
Cash paid during the period for:     
Income taxes$30,413
 $95,240
 $(4,634)$197
 $30
 $95
Interest$29,178
 $34,881
 $10,099
$38
 $29
 $35
          
Schedule of non-cash investing and financing activities:          
3.75% Notes exchanged for 1.625% Notes$176,551
 $
 $
Senior notes exchange transaction$
 $177
 $
Retirement of treasury stock$
 $55,660
 $
$
 $
 $56
Increase in non-cash lease financing obligation - related party$13,841
 $27,211
 $
$
 $14
 $27
Common stock used for stock-based compensation$(8,802) $(7,711) $(11,862)$(15) $(9) $(8)
          
Details of business combinations:          
Fair value of assets acquired$(52,057) $(121,801) $
$(389) $(52) $(122)
Fair value of liabilities assumed41
 
 
Fair value of contingent consideration liabilities incurred
 59,948
 

 
 60
Payable to seller7,924
 
 

 8
 
Escrow deposit
 332
 
Amounts advanced for acquisitions(102) 
 
Net cash paid in business combinations$(44,133) $(61,521) $
$(450) $(44) $(62)
          
Details of change in fair value of derivatives, net:          
Gain on 1.125% Call Option$142,972
 $37,020
 $
Gain on 1.125% Notes Call Option$45
 $143
 $37
Loss on 1.125% Notes Conversion Option(142,955) (36,908) 
(45) (143) (37)
Loss on 1.125% Warrants
 (3,923) 

 
 (4)
Gain (loss) on interest rate swap
 433
 (1,307)
Change in fair value of derivatives, net$17
 $(3,378) $(1,307)$
 $
 $(4)
     
Details of sale of subsidiary:     
Decrease in carrying value of assets$
 $
 $30,942
Decrease in carrying value of liabilities
 
 (23,527)
Gain on sale
 
 1,747
Proceeds from sale of subsidiary, net of cash surrendered$
 $
 $9,162

See accompanying notes.


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MOLINA HEALTHCARE, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
1. Basis of Presentation
Organization and Operations
Molina Healthcare, Inc. provides quality health care to thosepeople receiving government assistance. We offer cost-effective Medicaid-related solutions to meet the health care needs of low-income families and individuals, and to assist stategovernment agencies in their administration of the Medicaid program. We reporthave three reportable segments. These segments include our financial performance based on two reportable segments: the Health Plans segment and the Molina Medicaid Solutions segments, which comprise the vast majority of our operations, and our Other segment. As of December 31, 2015, we changed our reporting structure as a result of the Pathways acquisition in November 2015, which is reported in Other. See Note 20, "Segment Information," for further details.
Our Health Plans segment consists of health plans in 11 states and the Commonwealth of Puerto Rico, and includes our direct delivery business. As of December 31, 2014,2015, these health plans served over 2.63.5 million members eligible for Medicaid, Medicare, and other government-sponsored health care programs for low-income families and individuals. Additionally, we serve a small number of Health Insurance Marketplace members, manymost of whom are eligible forreceive government premium subsidies. The health plans are operated by our respective wholly owned subsidiaries in those states, each of which is licensed as a health maintenance organization (HMO). Our direct delivery business consists primarily of the management of a hospital in southern California under a management services agreement, and the operation of primary care clinics in several states in which we operate.
Our health plans’ state Medicaid contracts generally have terms of three to four years. These contracts typically contain renewal options exercisable by the state Medicaid agency, and allow either the state or the health plan to terminate the contract with or without cause. Our health plan subsidiaries have generally been successful in retaining their contracts, but such contracts are subject to risk of loss when a state issues a new request for proposals (RFP) open to competitive bidding by other health plans. If one of our health plans is not a successful responsive bidder to a state RFP, its contract may be subject to non-renewal.
In addition to contract renewal, our state Medicaid contracts may be periodically amended to include or exclude certain health benefits (such as pharmacy services, behavioral health services, or long-term care services); populations such as the aged, blind or disabled (ABD); and regions or service areas.
Our Molina Medicaid Solutions segment provides business processing and information technology development and administrative services to Medicaid agencies in Idaho, Louisiana, Maine, New Jersey, West Virginia, and the U.S. Virgin Islands, and drug rebate administration services in Florida.
Our Other segment includes other businesses, such as our Pathways behavioral health and social services provider, that do not meet the quantitative thresholds for a reportable segment as defined by U.S. generally accepted accounting principles (GAAP), as well as corporate amounts not allocated to other reportable segments.
Market Updates—Health Plans SegmentUpdate—Other
Florida.Pathways. During 2014, our FloridaOn November 1, 2015, we acquired all of the outstanding ownership interests in Pathways Health and Community Support LLC (Pathways), formerly known as Providence Human Services, LLC. Pathways is one of the largest national providers of accessible, outcome-based behavioral/mental health plan acquired two Medicaid contracts, adding approximately 73,000 members.and social services with operations in 23 states and the District of Columbia. See Note 4, "Business Combinations," for further information.
Market Updates—Health Plans
Medicare-Medicaid Plans. To coordinate care for those who qualify to receive both Medicare and Medicaid services (the "dual eligible"), and to deliver services to these individuals in a more financially efficient manner, some states have undertaken demonstration programs to integrate Medicare and Medicaid services for dual eligible individuals. The health plans participating in such demonstrations are referred to as Medicare-Medicaid Plans (MMPs). We operate MMPs in six states. Our MMPs in California, Illinois, and Ohio offered coverage beginning in 2014; our MMPs in South Carolina and Texas offered coverage beginning in the first quarter of 2015; and our MMP in Michigan offered coverage beginning in the second quarter of 2015. At December 31, 2015, our membership included approximately 51,000 integrated MMP members.
Florida. On November 1, 2015, our Florida health plan closed on its acquisition of the Medicaid contracts, and certain assets related to operation of the Medicaid business, of Integral Health Plan, Inc. See Note 4, "Business Combinations," for further information.
On August 1, 2015, our Florida health plan closed on its acquisition of the Medicaid contracts, and certain assets related to the operation of the Medicaid business, of Preferred Medical Plan, Inc. See Note 4, "Business Combinations," for further information.

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Illinois. On January 1, 2016, our Illinois health plan closed on its acquisition of the Medicaid membership, and certain assets related to the Medicaid business of, Accountable Care Chicago, LLC, also known as MyCare Chicago. We assumed approximately 58,000 Medicaid members in this acquisition.
On January 1, 2016, our Illinois health plan closed on its acquisition of the Medicaid membership, and certain assets related to the Medicaid business, of Loyola Physician Partners, LLC. We assumed approximately 21,000 Medicaid members in this acquisition.
On November 30, 2015, we announced that our Illinois health plan entered into an agreement to assume the membership and certain Medicaid assets of Better Health Network, LLC (Better Health). As of November 30, 2015, Better Health served approximately 40,000 members in the Medicaid Family Health program in Cook County. Subject to regulatory approvals and the satisfaction of other closing conditions, we expect the transaction to close during the first half of 2016.
Michigan. On January 1, 2016, our Michigan health plan closed on its acquisition of the Medicaid and MIChild membership, and certain Medicaid and MIChild assets, of HAP Midwest Health Plan, Inc. We assumed approximately 81,000 Medicaid and MIChild members in this acquisition.
In October 2015, the Michigan Department of Health and Human Services announced that Molina Healthcare of Michigan was recommended to serve the state's Medicaid members under Michigan's Comprehensive Health Plan, which commenced on January 1, 2016. The new contract has a five-year term with three one-year extensions, and covers Regions 2 through 6, and 8 through 10 of the state, representing an expansion into 18 additional counties compared with the previous Michigan Medicaid contract.
On September 1, 2015, our Michigan health plan closed on its acquisition of the Medicaid and MIChild contracts, and certain provider agreements, of HealthPlus of Michigan and its subsidiary, HealthPlus Partners, Inc. See Note 4, "Business Combinations," for further information.
Puerto Rico. Effective April 1, 2015, our Puerto Rico health plan served its first members. As of December 31, 2015, our Puerto Rico plan enrollment amounted to approximately 348,000 members.
Washington.In 2014, we were awarded aNovember 2015, our Washington health plan was selected by the Washington State Health Care Authority (HCA) to negotiate and enter into managed care contracts for the Southwest region of the state's Apple Health Fully Integrated Managed Care Program. Molina Healthcare of Washington was selected by HCA pursuant to the request for proposal HCA issued in August 2015. The start date for the new contract in the Commonwealth of Puerto Rico that is expected to enroll its first membersscheduled for April 1, 2015.2016.
South Carolina. Our South CarolinaOn January 1, 2016, our Washington health plan began servingclosed on its acquisition of the Medicaid membership and certain Medicaid assets of Columbia United Providers, Inc. We assumed approximately 57,000 Medicaid members under the state of South Carolina’s new full-risk Medicaid managed care program effective January 1, 2014.in this acquisition.
Market Update—Molina Medicaid Solutions Segment
In 2011,New Jersey. On April 9, 2015, the state of New Jersey announced its selection of Molina Medicaid Solutions received notice from the state of Louisianato design and operate that the state intended to award the contract for a replacementstate's new Medicaid management information system (MMIS). The new contract was effective May 1, 2015, and has a term of 10 years with three one-year renewal options. Molina Medicaid Solutions was the state's incumbent MMIS provider, and was awarded the new contract as a result of Molina Medicaid Solutions' submission in response to a different vendor, CNSI. However, in March 2013, the state of Louisiana canceled its contract award to CNSI. The state had informed us that we will continue to perform under our current contract until a successor is named. On December 18, 2014, Molina Medicaid Solutions received notice from the state of Louisiana that they have extended our contract through December 31, 2015. We recognized approximately $41 million of service revenue under this contract in 2014.New Jersey's request for proposals.
Consolidation
The consolidated financial statements include the accounts of Molina Healthcare, Inc., its subsidiaries, and variable interest entities in which Molina Healthcare, Inc. is considered to be the primary beneficiary. See Note 19,18, "Variable Interest Entities (VIEs)," for more information regarding these variable interest entities. In the opinion of management, all adjustments considered necessary for a fair presentation of the results as of the date and for the periods presented have been included; such adjustments consist of normal recurring adjustments. All significant inter-company balances and transactions have been eliminated in consolidation. Financial information related to subsidiaries acquired during any year is included only for periods subsequent to their acquisition.
Presentation and Reclassifications
We previously reported thatBeginning in 2013, after our Medicaid managed care contract with the state of Missouri expired, without renewal in 2012, and effective June 2013 the transition obligations associated with that contract terminated. Therefore, beginning in the second quarter of 2013, we have reported the results relating to the Missouri health plan as discontinued operations for all periods presented. Additionally, we abandoned our equity interests in the Missouri health plan during the second quarter of 2013, resulting in the

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recognition of a tax benefit of $9.5$10 million, which is also included in discontinued operations in the consolidated statements of income. The Missouri health plan's premium revenues were insignificant in 2014 and 2013, and amounted to $114.4 million for the year ended December 31, 2012.all periods presented.

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We have reclassified certain amounts in the 20132014 consolidated balance sheet and 2013 and 2012 statements of cash flows to conform to the 20142015 presentation includingrelating to the presentation of amounts due government agencies asdeferred taxes and debt issuance costs. Both reclassifications are a separate line item in the consolidated balance sheets and statementsresult of cash flows.recently adopted accounting pronouncements. See Note 2, "Significant Accounting Policies," for further information.
Use of Estimates
The preparation of consolidated financial statements in conformity with U.S. generally accepted accounting principles requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the financial statements.liabilities. Estimates also affect the reported amounts of revenues and expenses during the reporting period. Actual results could differ from these estimates. Principal areas requiring the use of estimates include:
The determination of medical claims and benefits payable of our Health Plans segment;
Health plan contractual provisions that may limit revenue recognition based upon the costs incurred or the profits realized under a specific contract;
Health plan quality incentives that allow us to recognize incremental revenue if certain quality standards are met;
The determination of medical claimsMolina Medicaid Solutions segment revenue and benefits payable of our Health Plans segment;
The valuation of certain investments;cost recognition;
Settlements under risk or savings sharing programs;
The assessment of deferred contract costs, deferred revenue, long-lived and intangible assets, and goodwill for impairment;
The determination of professional and general liability claims, and reserves for potential absorption of claims unpaid by insolvent providers;
The determination of reserves for the outcome of litigation;
The determination of valuation allowances for deferred tax assets; and
The determination of unrecognized tax benefits.
2. Significant Accounting Policies
Cash and Cash Equivalents
Cash and cash equivalents consist of cash and short-term, highly liquid investments that are both readily convertible into known amounts of cash and have a maturity of three months or less on the date of purchase.
Investments
Our investments are principally held in debt securities, which are grouped into two separate categories for accounting and reporting purposes: available-for-sale securities, and held-to-maturity securities. Available-for-sale securities are recorded at fair value and unrealized gains and losses, if any, are recorded in stockholders’ equity as other comprehensive income, net of applicable income taxes. Held-to-maturity securities are recorded at amortized cost, which approximates fair value, and unrealized holding gains or losses are not generally recognized. Realized gains and losses and unrealized losses judged to be other than temporary with respect to available-for-sale and held-to-maturity securities are included in the determination of net income. The cost of securities sold is determined using the specific-identification method, on an amortized cost basis.method.
Our investment policy requires that all of our investments have final maturities of 10 years or less (excluding auction rate and variable rate securities where interest rates may be periodically reset), and that the average maturity be three years or less. Investments and restricted investments are subject to interest rate risk and will decrease in value if market rates increase. Declines in interest rates over time will reduce our investment income.
In general, our available-for-sale securities are classified as current assets without regard to the securities’ contractual maturity dates because they may be readily liquidated. Our auction rate securities are classified as non-current assets and reported in other assets. We monitor our investments for other-than-temporary impairment. For comprehensive discussions of the fair value and classification of our current and non-current investments, including auction rate securities, see Note 5, "Fair Value Measurements," Note 6, "Investments," and Note 10, "Restricted Investments."

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Receivables
Receivables are readily determinable and because our creditors are primarily state governments, our allowance for doubtful accounts is immaterial. Any amounts determined to be uncollectible are charged to expense when such determination is made. See Note 7, "Receivables."

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Property, Equipment, and Capitalized Software
Property and equipment are stated at historical cost. Replacements and major improvements are capitalized, and repairs and maintenance are charged to expense as incurred. Furniture and equipment are generally depreciated using the straight-line method over estimated useful lives ranging from three to seven years. Software developed for internal use is capitalized. Software is generally amortized over its estimated useful life of three years. Leasehold improvements are amortized over the term of the lease, or over their useful lives from five to 10 years, whichever is shorter. Buildings are depreciated over their estimated useful lives of 31.5 to 40 years. See Note 8, "Property, Equipment, and Capitalized Software."
As discussed below, the costs associated with certain of our Molina Medicaid Solutions segment equipment and software are capitalized and recorded as deferred contract costs. Such costs are amortized on a straight-line basis over the shorter of the useful life or the contract period.
Depreciation and Amortization
Depreciation and amortization related to our Health Plans segment is all recorded in "Depreciation and Amortization"amortization" in the consolidated statements of income. Depreciation and amortization related to our Molina Medicaid Solutions segment is recorded within three different headings in the consolidated statements of income as follows:
Amortization of purchased intangibles relating to customer relationships is reported as amortization within the heading "Depreciation and amortization;"
Amortization of purchased intangibles relating to contract backlog is recorded as a reduction of "Service revenue;" and
Amortization of capitalized software is recorded within the heading "Cost of service revenue."
The following table presents all depreciation and amortization recorded in our consolidated statements of income, regardless of whether the item appears as depreciation and amortization, a reduction of revenue, or as cost of service revenue.
Year Ended December 31,Year Ended December 31,
2014 2013 20122015 2014 2013
(In thousands)(In millions)
Depreciation, and amortization of capitalized software, continuing operations$75,402
 $54,837
 $42,938
$87
 $75
 $55
Amortization of intangible assets, continuing operations17,515
 17,906
 20,176
17
 18
 18
Depreciation and amortization, continuing operations92,917
 72,743
 63,114
104
 93
 73
Depreciation and amortization, discontinued operations
 2
 590
Amortization recorded as reduction of service revenue2,914
 2,914
 1,571
1
 3
 3
Amortization of capitalized software recorded as cost of service revenue38,573
 18,207
 13,489
21
 38
 18
Depreciation and amortization reported in the statement of cash flows$134,404
 $93,866
 $78,764
$126
 $134
 $94
Long-Lived Assets, including Intangible Assets
Long-lived assets compriseconsist primarily of property, equipment, capitalized software and intangible assets. Finite-lived, separately-identifiableseparately-identified intangible assets are acquired in business combinations and are assets that represent future expected benefits but lack physical substance (such as purchased contract rights and provider contracts). Intangible assets are initially recorded at their fair valuesvalue and are then amortized on a straight-line basis over their expected useful lives, generally between threetwo and 15 years.
Identifiable intangible assets associated with Molina Medicaid Solutions are classified as either contract backlog or customer relationships as follows:
The contract backlog intangible asset comprises all contractual cash flows anticipated to be received during the remaining contracted period for each specific contract relating to work that was performed prior to acquisition. Because each acquired contract constitutes a single revenue stream, amortization of the contract backlog intangible is recorded to contra-service revenue so that amortization is matched to any revenues associated with contract performance that occurred prior to the acquisition date. The contract backlog intangible asset is amortized on a

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straight-line basis for each specific contract over periods generally ranging from one to six years. The contract backlog intangible assets will be fully amortized in 2015.
The customer relationship intangible asset comprises all contractual cash flows that are anticipated to be received during the option periods of each specific contract as well as anticipated renewals of those contracts. The customer relationship intangible is amortized on a straight-line basis for each specific contract over periods generally ranging from four to nine years.
Our intangible assets are subject to impairment tests when events or circumstances indicate that a finite-lived intangible asset’s (or asset group’s) carrying value may not be recoverable. Consideration is given to a number of potential impairment indicators. For example, our health plan subsidiaries have generally been successful in obtaining the renewal by amendment of their contracts in each state prior to the actual expiration of their contracts. However, there can be no assurance that these contracts will continue to be renewed.
Following the identification of any potential impairment indicators, to determine whether an impairment exists, we would compare the carrying amount of a finite-lived intangible asset with the undiscounted cash flows that are expected to result from the use of the asset or related group of assets. If it is determined that the carrying amount of the asset is not recoverable, the amount by which the carrying value exceeds the estimated fair value is recorded as an impairment.
No significant impairment charges relating to long-lived assets, including intangible assets, were recorded in the years ended December 31, 2015, 2014, 2013, and 2012.2013.

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Goodwill
Goodwill represents the amount of the purchase price in excess of the fair values assigned to the underlying identifiable net assets of acquired businesses. Goodwill is not amortized, but is subject to an annual impairment test. Tests are performed more frequently if events occur or circumstances change that would more likely than not reduce the fair value of a reporting unit below its carrying amount.
To determine whether goodwill is impaired, we measure the fair values of our reporting units and compare them to the carrying values of the respective units, including goodwill. If the fair value is less than the carrying value of the reporting unit, then the implied value of goodwill would be calculated and compared towith the carrying amount of goodwill to determine whether goodwill is impaired.
We estimate the fair values of our reporting units using discounted cash flows. To determine fair values, we must make assumptions about a wide variety of internal and external factors. Significant assumptions used in the impairment analysis include financial projections of free cash flow (including significant assumptions about operations, capital requirements and income taxes), long-term growth rates for determining terminal value, and discount rates.
No impairment charges relating to goodwill were recorded in the years ended December 31, 2015, 2014, 2013, and 2012.2013.
Business Combinations
Accounting for acquisitions requires us to recognize separately from goodwill the assets acquired and the liabilities assumed at their acquisition date fair values. Goodwill as of the acquisition date is measured as the excess of consideration transferred over the net of the acquisition date fair values of the assets acquired and the liabilities assumed. While we use our best estimates and assumptions to accurately value assets acquired and liabilities assumed at the acquisition date, our estimates are inherently uncertain and subject to refinement. As a result, during the measurement period, which may be up to one year from the acquisition date, we record adjustments to the assets acquired and liabilities assumed with the corresponding offset to goodwill. Upon the conclusion of the measurement period or final determination of the values of assets acquired or liabilities assumed, whichever comes first, any subsequent adjustments are recorded to our consolidated statements of income. Refer to Note 4, "Business Combinations," for further details regarding our 2015 acquisitions.
Restricted Investments
Restricted investments, which consist of certificates of deposit and U.S. treasury securities, are designated as held-to-maturity and are carried at amortized cost, which approximates marketfair value. The use of these funds is limited to specific purposes as required by each state,regulation in the various states in which we operate, or as protection against the insolvency of capitated providers. We have the ability to hold our restricted investments until maturity and, as a result, we would not expect the value of these investments to decline significantly due to a sudden change in market interest rates. See Note 10, "Restricted Investments."
Other Assets
Other assets primarily includes deferred financing costs associated with our convertible senior notes and lease financing obligations, and certain investments held in connection with our employee deferred compensation program. The deferred financing costs are being amortized on a straight-line basis over the terms of the convertible senior notes and lease financing obligations.

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Delegated Provider Insolvency
Circumstances may arise where providers to whom we have delegated risk are unable to pay claims they have incurred with third parties in connection with referral services (including hospital inpatient services) provided to our members. The inability of delegated providers to pay referral claims presents us with both immediate financial risk and potential disruption to member care. Depending on states’ laws, we may be held liable for such unpaid referral claims even though the delegated provider has contractually assumed such risk. Additionally, competitive pressures may force us to pay such claims even when we have no legal obligation to do so. To reduce the risk that delegated providers are unable to pay referral claims, we monitor the operational and financial performance of such providers. We also maintain contingency plans that include transferring members to other providers in response to potential network instability.
In certain instances, we have required providers to place funds on deposit with us as protection against their potential insolvency. These reserves are frequently in the form of segregated funds received from the provider and held by us or placed in a third-party financial institution. These funds may be used to pay claims that are the financial responsibility of the provider in the event the provider is unable to meet these obligations. Additionally, we have recorded liabilities for estimated losses arising from provider instability or insolvency in excess of provider funds on deposit with us. Such liabilities were not material at December 31, 20142015 and 2013.2014.
Premium Revenue - Health Plans
Premium revenue is fixed in advance of the periods covered and, except as described below, is not generally subject to significant accounting estimates. For the year ended December 31, 2014, we received more than 95% of our premium revenue as a fixed amount per member per month (PMPM), pursuant togenerated primarily from our Medicaid, Medicare and Marketplace contracts, including agreements with other managed care organizations for which we operate as a subcontractor. Premium revenue is generally received based on per member per month (PMPM) rates established in advance of the periods covered. These premium revenues are recognized in the month that members are entitled to receive health care services. Revenue not received on a fixed PMPM basis is recognized as earned.services, and premiums collected in advance are deferred. The state Medicaid programs and the federal Medicare program periodically adjust premium. Additionally, many of our contracts contain provisions that may adjust or limit revenue or profit, as described below. Consequently, we recognize premium rates.revenue as it is

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earned under such provisions.
The following table summarizes premium revenue from continuing operations for the periods indicated:
Year Ended December 31,Year Ended December 31,
2014 2013 20122015 2014 2013
Amount % of Total Amount % of Total Amount % of TotalAmount % of Total Amount % of Total Amount % of Total
(Dollars in thousands)(Dollars in millions)
California$1,523,084
 16.9% $749,755
 12.1% $665,600
 12.0%$2,200
 16.6% $1,523
 16.9% $750
 12.1%
Florida439,107
 4.9
 264,998
 4.3
 228,832
 4.1
1,199
 9.0
 439
 4.9
 265
 4.3
Illinois153,271
 1.7
 8,121
 0.1
 
 
397
 3.0
 153
 1.7
 8
 0.1
Michigan780,896
 8.7
 676,000
 11.0
 646,551
 11.7
1,067
 8.1
 781
 8.7
 676
 11.0
New Mexico1,075,330
 11.9
 446,758
 7.2
 321,853
 5.8
1,237
 9.3
 1,076
 11.9
 447
 7.2
Ohio1,552,949
 17.2
 1,098,795
 17.8
 1,095,137
 19.7
2,034
 15.4
 1,553
 17.2
 1,099
 17.8
Puerto Rico567
 4.3
 
 
 
 
South Carolina381,317
 4.2
 
 
 
 
348
 2.6
 381
 4.2
 
 
Texas1,318,192
 14.6
 1,291,001
 20.9
 1,233,621
 22.2
1,961
 14.8
 1,318
 14.6
 1,291
 20.9
Utah309,411
 3.4
 310,895
 5.0
 298,392
 5.4
331
 2.5
 310
 3.4
 311
 5.0
Washington1,304,605
 14.5
 1,168,405
 18.9
 974,712
 17.6
1,602
 12.1
 1,305
 14.5
 1,168
 18.9
Wisconsin156,229
 1.7
 143,465
 2.3
 70,678
 1.3
261
 2.0
 156
 1.7
 143
 2.3
Direct delivery28,120
 0.3
 20,977
 0.4
 8,745
 0.2
37
 0.3
 28
 0.3
 21
 0.4
$9,022,511
 100.0% $6,179,170
 100.0% $5,544,121
 100.0%$13,241
 100.0% $9,023
 100.0% $6,179
 100.0%
Certain components of premium revenue are subject to accounting estimates and fall into the following categories:
Contractual Provisions That May Adjust or Limit Revenue or Profit
Medicaid
Health Plan Medical Cost Floors (Minimums), Medical Cost Corridors, and Administrative Cost Ceilings (Maximums): A portion of certain Medicaid, Medicare, and Marketplace premiums received by our health plans may be returned if certain minimum amounts are not spent on defined medical care costs. In the aggregate, we recorded a liability under the terms of such contract provisions of $392.4$224 million and $1.4$392 million at December 31, 2014,2015 and December 31, 2013,2014, respectively, to amounts due government agencies. SuchApproximately $208 million of the liability amounts could be subjectaccrued at December 31, 2015 relates to future changesour participation in estimate. The increase is primarily driven by contractual provisions relating to the Medicaid expansion program, which began to phase in during January 2014. Beginning in 2014,programs.
In certain circumstances, the health plans may receive additional premiums if amounts spent on medical care costs exceed a defined

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maximum threshold. Separately, in certain states we may be levied with non-monetary sanctions if certain minimum amounts are not spent on defined medical care costs, or if administrative costs exceed certain amounts.We had $3 million recorded at December 31, 2015 relating to such provisions. No such receivables were recorded at December 31, 2014.
Health Plan Profit Sharing and Profit Ceiling: Our contracts with certain states contain profit-sharing or profit ceiling provisions under which we refund amounts to the states if our health plans generate profit above a certain specified percentage, in some cases in accordance with a tiered rebate schedule. In some cases, we are limited in the amount of administrative costs that we may deduct in calculating the refund, if any. As a result of profits in excess of the amount we are allowed to fully retain, we recorded a liability of $0.5 million and $2.5$10 million at December 31, 2014 and2015. The amount recorded at December 31, 2013, respectively.2014 was insignificant.
Retroactive Premium Adjustments: In New Mexico, when members are retroactively enrolled into our health plan we earn revenue only to the extent of the actual medical costs incurred by us for services provided during those retroactive periods, plus a small percentage of that medical cost for administration and profit. This cost plus arrangement for members retroactively enrolled in our health plan first became effective July 1, 2014 (retroactive to January 1, 2014). We are paid normal monthly capitation rates for the retroactive eligibility periods, and the difference between those capitation rates and the amounts due us on a cost plus basis are periodically settled with the state. To date, no such settlement has been made with the state. Our New Mexico contract is not specific as to the definition of retroactive membership, and the amount we owe the state (or that the state owes us) for the difference between capitation received and amounts due us under the cost plus arrangement varies widely depending upon the definition of retroactive membership. 
In August 2015 the state provided us with a request for payment under the terms of this contract provision for the period January 1, 2014 through December 31, 2014. That request was based upon definitions of retroactive membership that were at odds with our interpretations of that term. The New Mexico health plan reduced revenue by approximately $24 million in 2015

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as a result of aligning more closely our definition of retroactive membership with the state's definition. Using the state's definition of retroactive membership, however, we estimate that the state will ultimately seek repayment of an amount that ranges from $15 million to $20 million higher than what we have accrued. We do not believe that any reasonable definition of retroactive membership supports the state's position, and expect to resolve this matter with payment of the amount we have accrued at December 31, 2015. We are currently engaged in discussions with the state regarding the appropriate amount, if any, owed to the state under this contract term.
Medicare Revenue
Risk Adjustment: Based on member encounter data that we submit to the Centers for Medicare and Medicaid Services (CMS), our Medicare premiums are subject to retroactive adjustment for bothincrease or decrease based upon member risk scores and member pharmacy cost experiencemedical conditions for up to two years after the original year of service. This adjustment takes into account the acuity of each member’s medical needs relative to what was anticipated when premiums were originally set for that member. In the event that a member requires less acute medical care than was anticipated by the original premium amount, CMS may recover premium from us. In the event that a member requires more acute medical care than was anticipated by the original premium amount, CMS may pay us additional retroactive premium. A similar retroactive reconciliation is undertaken by CMS for our Medicare members’ pharmacy utilization. We estimate the amount of Medicare revenue that will ultimately be realized for the periods presented based on our knowledge of our members’ health care utilization patterns and CMS practices. Based on our knowledge of member health care utilization patterns and expenses, we have recorded a net payable of $4 million and a net receivable of $7.6 million and $20.8$8 million for anticipated Medicare risk adjustment premiums at December 31, 20142015 and December 31, 2013,2014, respectively.
Marketplace
Premium Stabilization Programs: The Affordable Care Act (ACA) established Marketplace premium stabilization programs effective January 1, 2014. These programs, commonly referred to as the "3R's," include a permanent risk adjustment program, a transitional reinsurance program, and a temporary risk corridor program.
Permanent risk adjustment program: Under this permanent program, our health plans' risk scores are compared to the overall average risk score for the relevant state and market pool. Generally, our health plans will pay into the pool if their risk scores are below the average risk score, and will receive funds from the pool if their risk scores are above the average risk score. We estimate our ultimate premium based on insurance policy year-to-date experience, and recognize estimated premiums relating to the risk adjustment program as an adjustment to premium revenue in our consolidated statements of income.
Transitional reinsurance program: This program is designed to provide reimbursement to insurers for high cost members. Our health plans pay an annual contribution on a per-member basis, and are eligible for recoveries if claims for individual members exceed a specified threshold, up to a maximum amount. This three-year program will end on December 31, 2016. We recognize the assessments to fund the transitional reinsurance program as a reduction to premium revenue in our consolidated statements of income. We recognize recoveries under the reinsurance program as a reduction to medical care costs in our consolidated statements of income.
Temporary risk corridor program: This program is intended to limit gains and losses of insurers by comparing allowable costs to a target amount as defined by the U.S. Department of Health and Human Services (HHS). Variances from the target amount exceeding certain thresholds may result in amounts due to or receivables due from HHS. This three-year program will end on December 31, 2016. Due to uncertainties as to the amount of federal funding available to support the risk corridor program, we do not recognize amounts receivable under this program. All liabilities are recognized as incurred. We estimate our ultimate premium based on insurance policy year-to-date experience, and recognize estimated premiums relating to the risk corridor program as an adjustment to premium revenue in our consolidated statements of income.
Additionally, the ACA established a minimum annual medical loss ratio (Minimum MLR) of 80% for the Marketplace. The medical loss ratio represents medical costs as a percentage of premium revenue. What constitutes medical costs and premium revenue are specifically defined by federal regulations. If the Minimum MLR is not met, we may be required to pay rebates to our Marketplace policyholders. Each of the 3R programs is taken into consideration when computing the Minimum MLR. We recognize estimated rebates under the Minimum MLR as an adjustment to premium revenue in our consolidated statements of income.
We record receivables or payables related to the 3R programs and the Minimum MLR when the amounts are reasonably estimable as described above, and, for receivables, collection is reasonably assured.

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Our receivables (payables) for each of these programs, as of the dates indicated, were as follows (in millions):
 December 31, 2015 December 31, 2014
Risk adjustment$(214) $(5)
Reinsurance36
 5
Risk corridor(10) 
Minimum MLR(3) 
Quality Incentives
At several of our California, Illinois, New Mexico, Ohio, Texas, Washington and Wisconsin health plans, revenue ranging from approximately 1% to 4% of certain health plan premiums is earned if certain performance measures are met.
The following table quantifies the quality incentive premium revenue recognized for the periods presented, including the amounts earned in the period presented and prior periods. Although the reasonably possible effects of a change in estimate related to quality incentive premium revenue as of December 31, 20142015 are not known, we have no reason to believe that the adjustments to prior years noted below are not indicative of the potential future changes in our estimates as of December 31, 2014.2015.
 Year Ended December 31,
 2014 2013 2012
 (In thousands)
Maximum available quality incentive premium - current period$90,327
 $63,311
 $74,564
      
Amount of quality incentive premium revenue recognized in current period:     
Earned current period$40,396
 $45,803
 $62,489
Earned prior periods3,950
 9,056
 2,202
Total$44,346
 $54,859
 $64,691
      
Total premium revenue recognized for state health plans with quality incentive premiums$7,083,660
 $2,980,019
 $2,721,289
California Health Plan Rate Settlement Agreement
In the fourth quarter of 2013, our California health plan entered into a settlement agreement with the California Department of Health Care Services (DHCS). The agreement settled rate disputes initiated by our California health plan dating back to 2003 with respect to its participation in Medi-Cal (California’s Medicaid program). Under the terms of the agreement, a settlement account (the Account) applicable to the California health plan’s managed care contracts has been established.
Effective January 1, 2014, the Account was established with an initial balance of zero, and will be settled after December 31, 2017. DHCS will make an interim partial settlement payment to us if it terminates early, without replacement, any of our managed care contracts. The Account will be adjusted annually to reflect a calendar year deficit or surplus, which is determined by comparing the California health plan’s pre-tax margin and a target margin established in the settlement agreement. Upon expiration of the settlement agreement, if the Account is in a deficit position, then DHCS will pay the amount of the deficit to us, subject to an alternative minimum payment amount. If the Account is in a surplus position, then no amount is owed to either party. The maximum amount that DHCS would pay to us under the terms of the settlement agreement is $40.0 million.

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We estimate and recognize the retrospective adjustments to premium revenue based on our experience to date under the California health plan's managed care contracts. As of December 31, 2014, the California health plan's pre-tax margin exceeded the target margin, resulting in a surplus position. Consequently, a retrospective premium adjustment was not required for the year ended December 31, 2014.
 Year Ended December 31,
 2015 2014 2013
 (In millions)
Maximum available quality incentive premium - current period$118
 $90
 $63
      
Amount of quality incentive premium revenue recognized in current period:     
Earned current period$66
 $40
 $46
Earned prior periods13
 4
 9
Total$79
 $44
 $55
      
Total premium revenue recognized for state health plans with quality incentive premiums$11,107
 $7,084
 $2,980
Medical Care Costs - Health Plans
Expenses related to medical care services are captured in the following categories:
Fee-for-service expenses: Nearly all hospital services and the majority of our primary care and physician specialist services and LTSS costs are paid on a fee-for-service basis. Under fee-for-service arrangements, we retain the financial responsibility for medical care provided and incur costs based on actual utilization of services. Such expenses are recorded in the period in which the related services are dispensed. The costs of drugs administered in a physician or hospital setting that are not billed through our pharmacy benefit manager are included in fee-for-service costs.
Pharmacy expenses: All drug, injectibles, and immunization costs paid through our pharmacy benefit manager are classified as pharmacy expenses. As noted above, drugs and injectibles not paid through our pharmacy benefit manager are included in fee-for-service costs, except in those limited instances where we capitate drug and injectible costs.
Capitation expenses: Many of our primary care physicians and a small portion of our specialists and hospitals are paid on a capitated basis. Under capitation arrangements, we pay a fixed amount PMPM to the provider without regard to the frequency, extent, or nature of the medical services actually furnished. Under capitated arrangements, we remain liable for the provision of certain health care services. Capitation payments are fixed in advance of the periods covered and are not subject to significant accounting estimates. These payments are expensed in the period the providers are obligated to provide services. The financial risk for pharmacy services for a small portion of our membership is delegated to capitated providers.
Direct delivery expenses: All costs associated with our direct delivery of medical care are separately identified.
Other medical expenses: All medically related administrative costs, certain provider incentive costs, reinsurance costs and other health care expenses are classified as other medical expenses. Medically related administrative costs include, for example, expenses relating to health education, quality assurance, case management, care coordination, disease management,

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and 24-hour on-call nurses. Salary and benefit costs are a substantial portion of these expenses. For the years ended December 31, 2015, 2014, 2013, and 2012,2013, medically related administrative costs were $262.6$398 million, $153.0$263 million, and $125.2$153 million, respectively.
The following table provides the details of our consolidated medical care costs from continuing operations for the periods indicated (dollars in thousands,millions, except PMPM amounts): 
 Year Ended December 31,
 2014 2013 2012
 Amount PMPM 
% of
Total
 Amount PMPM 
% of
Total
 Amount PMPM 
% of
Total
Fee-for-service$5,672,483
 $202.87
 70.2% $3,611,529
 $160.43
 67.1% $3,423,751
 $161.67
 68.6%
Pharmacy1,273,329
 45.54
 15.8
 935,204
 41.54
 17.4
 835,830
 39.47
 16.7
Capitation748,388
 26.77
 9.3
 603,938
 26.83
 11.2
 552,136
 26.07
 11.1
Direct delivery96,196
 3.44
 1.2
 48,288
 2.14
 0.9
 33,920
 1.60
 0.7
Other285,935
 10.22
 3.5
 181,165
 8.05
 3.4
 145,551
 6.87
 2.9
Total$8,076,331
 $288.84
 100.0% $5,380,124
 $238.99
 100.0% $4,991,188
 $235.68
 100.0%
The Missouri health plan's medical care costs, which are not included in the table above, amounted to $0.6 million, $1.5 million, and $105.6 million for the years ended December 31, 2014, 2013, and 2012, respectively.
 Year Ended December 31,
 2015 2014 2013
 Amount PMPM 
% of
Total
 Amount PMPM 
% of
Total
 Amount PMPM 
% of
Total
Fee-for-service$8,572
 $218.35
 72.7% $5,673
 $202.87
 70.2% $3,612
 $160.43
 67.1%
Pharmacy1,610
 41.01
 13.7
 1,273
 45.54
 15.8
 935
 41.54
 17.4
Capitation982
 25.02
 8.3
 748
 26.77
 9.3
 604
 26.83
 11.2
Direct delivery128
 3.26
 1.1
 96
 3.44
 1.2
 48
 2.14
 0.9
Other502
 12.79
 4.2
 286
 10.22
 3.5
 181
 8.05
 3.4
Total$11,794
 $300.43
 100.0% $8,076
 $288.84
 100.0% $5,380
 $238.99
 100.0%
Our medical care costs include amounts that have been paid by us through the reporting date, as well as estimated liabilities for medical care costs incurred but not paid by us as of the reporting date. Such medical care cost liabilities include, among other items, unpaid fee-for-service claims, capitation payments owed providers, unpaid pharmacy invoices, and various medically related administrative costs that have been incurred but not paid. We use judgment to determine the appropriate assumptions for determining the required estimates.
The most important element in estimating our medical care costs is our estimate for fee-for-service claims which have been incurred but not paid by us. These fee-for-service costs that have been incurred but have not been paid at the reporting date are collectively referred to as medical costs that are incurred but not paid (IBNP). Our IBNP claims reserve, as reported in our

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balance sheet, represents our best estimate of the total amount of claims we will ultimately pay with respect to claims that we have incurred as of the balance sheet date. We estimate our IBNP monthly using actuarial methods based on a number of factors. For further information, see Note 11, "Medical Claims and Benefits Payable."
We report reinsurance premiums as medical care costs,a reduction to premium revenue, while related reinsurance recoveries are reported as deductions froma reduction to medical care costs. We limit our risk of catastrophic losses by maintaining high deductible reinsurance coverage. Such reinsurance coverage does not relieve us of our primary obligation to our policyholders. We do not consider this coverage to be material because the cost is not significant and the likelihood that coverage will apply is low.
Taxes Based on Premiums
Health Insurer Fee. The federal government under the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively, the Affordable Care Act, or ACA)ACA imposes an annual fee, or excise tax, on health insurers for each calendar year. The health insurer fee (HIF)HIF is based on a company's share of the industry's net premiums written during the preceding calendar year, and is non-deductible for income tax purposes. We recognize expense for the HIF over the year on a straight-line basis. Because we primarily serve individuals in government-sponsored programs, we must secure additional reimbursement from our state partners for this added cost. We recognize the related revenue when we have obtained a contractual commitment or payment from a state to reimburse us for the HIF; such HIF revenue is recognized ratably throughout the year.
Premium and Use Tax. Certain of our health plans are assessed a tax based on premium revenue collected. The premium revenues we receive from these states include the premium tax assessment. We have reported these taxes on a gross basis, as premium tax revenue and as premium tax expense in the consolidated statements of income.
Premium Deficiency Reserves on Loss Contracts
We assess the profitability of our contracts for providing medical care services to our members and identify those contracts where current operating results or forecasts indicate probable future losses. Anticipated future premiums are compared to anticipated medical care costs, including the cost of processing claims. If the anticipated future costs exceed the premiums, a loss contract accrual is recognized. No such accrual was recorded as of December 31, 2014,2015 or 2013.2014.

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Service Revenue and Cost of Service Revenue — Molina Medicaid Solutions Segment
The payments received by our Molina Medicaid Solutions segment under its state contracts are based on the performance of multiple services. The first of these is the design, development and implementation (DDI) of a Medicaid management information system (MMIS). An additional service, following completion of DDI, is the operation of the MMIS under a business process outsourcing (BPO) arrangement. When providing BPO services (which include claims payment and eligibility processing) we also provide the state with other services including both hosting and support, and maintenance. Because we have determined the services provided under our Molina Medicaid Solutions contracts represent a single unit of accounting, we recognize revenue associated with such contracts on a straight-line basis over the contract term during which BPO, hosting, and support and maintenance services are delivered. There may be certain contractual provisions containing contingencies, however that require us to delay recognition of all or part of our service revenue until such contingencies have been removed.
We have evaluated our Molina Medicaid Solutions contracts to determine if such arrangements include a software element. Based on this evaluation, we have concluded that these arrangements do not include a software element, and are therefore multiple-element service arrangements.
Additionally, we evaluate each required deliverable under our multiple-element service arrangements to determine whether it qualifies as a separate unit of accounting. Such evaluation is generally based on whether the deliverable has standalone value to the customer. If the deliverable has standalone value, the arrangement’s consideration that is fixed or determinable is then allocated to each separate unit of accounting based on the relative selling price of each deliverable. In general, the consideration allocated to each unit of accounting is recognized as the related goods or services are delivered, limited to the consideration that is not contingent.
We have concluded that the various service elements in our Molina Medicaid Solutions contracts represent a single unit of accounting due to the fact that DDI, which is the only service performed in advance of the other services (all other services are performed over an identical period), does not have standalone value because our DDI services are not sold separately by any vendor and the customer could not resell our DDI services. Further, we have no objective and reliable evidence of fair value for any of the individual elements in these contracts, and at no point in the contract will we have objective and reliable evidence of fair value for the undelivered elements in the contracts. We lack objective and reliable evidence of the fair value of the individual elements of our Molina Medicaid Solutions contracts for the following reasons:
Each contract calls for the provision of its own specific set of services. While all contracts support the system of record for state MMIS, the actual services we provide vary significantly between contracts; and

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The nature of the MMIS installed varies significantly between our older contracts (proprietary mainframe systems) and our new contracts (commercial off-the-shelf technology solutions).
Because we have determined the services provided under our Molina Medicaid Solutions contracts represent a single unit of accounting, and because we are unable to determine a pattern of performance of services during the contract period, we recognize all revenue (both the DDI and BPO elements) associated with such contracts on a straight-line basis over the period during which BPO, hosting, and support and maintenance services are delivered. Therefore, absent any contingencies as discussed in the following paragraph, or contract extensions, we would recognize all revenue associated with those contracts over the initial contract period. When a contract is extended, we generally consider the extension to be a continuation of the single unit of accounting; therefore, the deferred revenue as of the extension date is recognized prospectively over the new remaining term of the contract. In cases where there is no DDI element associated with our contracts, BPO revenue is recognized on a monthly basis as specified in the applicable contract or contract extension.
Provisions specific to each contract may, however, lead us to modify this general principle. In those circumstances, the right of the state to refuse acceptance of services, as well as the related obligation to compensate us, may require us to delay recognition of all or part of our revenue until that contingency (the right of the state to refuse acceptance) has been removed. In those circumstances, we defer recognition of any contingent revenue (whether DDI, BPO services, hosting, and support and maintenance services) until the contingency has been removed. These types of contingency features are present in our Maine and Idaho contracts, for example. In those states, we deferred recognition of revenue until the contingencies were removed.
Costs associated with our Molina Medicaid Solutions contracts include software related costs and other costs. With respect to software related costs, we apply the guidance for internal-use software and capitalize external direct costs of materials and services consumed in developing or obtaining the software, and payroll and payroll-related costs associated with employees who are directly associated with and who devote time to the computer software project. With respect to all other direct costs, such costs are expensed as incurred, unless corresponding revenue is being deferred. If revenue is being deferred, direct costs relating to delivered service elements are deferred as well and are recognized on a straight-line basis over the period of revenue recognition, in a manner consistent with our recognition of revenue that has been deferred. Such direct costs can include:
Transaction processing costs;
Employee costs incurred in performing transaction services;
Vendor costs incurred in performing transaction services;
Costs incurred in performing required monitoring of and reporting on contract performance;

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Costs incurred in maintaining and processing member and provider eligibility; and
Costs incurred in communicating with members and providers.
The recoverability of deferred contract costs associated with a particular contract is analyzed on a periodic basis using the undiscounted estimated cash flows of the whole contract over its remaining contract term. If such undiscounted cash flows are insufficient to recover the long-lived assets and deferred contract costs, the deferred contract costs are written down by the amount of the cash flow deficiency. If a cash flow deficiency remains after reducing the balance of the deferred contract costs to zero, any remaining long-lived assets are evaluated for impairment. Any such impairment recognized would equal the amount by which the carrying value of the long-lived assets exceeds the fair value of those assets.
Income Taxes
The provision for income taxes is determined using an estimated annual effective tax rate, which is generally greater than the U.S. federal statutory rate primarily because of state and Puerto Rico taxes, nondeductible HIF expenses under the Affordable Care Act Health Insurer Fee (HIF), nondeductible compensation and other general and administrative expenses. The effective tax rate may be subject to fluctuations during the year, particularly as a result of the mathematical impact of the level of pretax earnings, and also as new information is obtained. Such information may affect the assumptions used to estimate the annual effective tax rate, including factors such as the mix of pretax earnings in the various tax jurisdictions in which we operate, valuation allowances against deferred tax assets, the recognition or the reversal of the recognition of tax benefits related to uncertain tax positions, and changes in or the interpretation of tax laws in jurisdictions where we conduct business. We recognize deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of our assets and liabilities, along with net operating loss and tax credit carryovers. For further discussion and disclosure, see Note 14, "Income Taxes."
Concentrations of Credit Risk
Financial instruments that potentially subject us to concentrations of credit risk consist primarily of cash and cash equivalents, investments, receivables, and restricted investments. We invest a substantial portion of our cash in the PFM Funds Prime Series — Institutional Class, and the PFM Funds Government Series. These funds represent a portfolio of highly liquid money market securities that are managed by PFM Asset Management LLC (PFM), a Virginia business trust registered as an open-end

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management investment fund. As of December 31, 2014,2015 and 2013,2014, our investments with PFM amounted to approximately $321$605 million and $374$321 million, respectively. Our investments and a portion of our cash equivalents are managed by professional portfolio managers operating under documented investment guidelines. No investment that is in aOur portfolio managers must obtain our prior approval before selling investments where the loss position can be sold by our managers without our prior approval.of those investments exceeds certain levels. Our investments consist solelyprimarily of investment gradeinvestment-grade debt securities with a maximum maturity of 10 years and an average duration of three years or less. Restricted investments are invested principally in certificates of deposit and U.S. treasury securities. Concentration of credit risk with respect to accounts receivable is limited due tobecause our payors consistingconsist principally of the governments of each state in which our health plan subsidiaries operate.
Risks and Uncertainties
Our profitability depends in large part on our ability to accurately predict and effectively manage medical care costs. We continually review our medical costs in light of our underlying claims experience and revised actuarial data. However, several factors could adversely affect medical care costs. These factors, which include changes in health care practices, inflation, new technologies, major epidemics, natural disasters, and malpractice litigation, are beyond our control and may have an adverse effect on our ability to accurately predict and effectively control medical care costs. Costs in excess of those anticipated could have a material adverse effect on our financial condition, results of operations, or cash flows.
We operate health plans in 11 states, primarily as a direct contractor with the states (or Commonwealth), and in Los Angeles County, California, as a subcontractor to another health plan holding a direct contract with the state. We are therefore dependent upon a small number of contracts to support our revenue. The loss of any one of those contracts could have a material adverse effect on our financial position, results of operations, or cash flows. Our ability to arrange for the provision of medical services to our members is dependent upon our ability to develop and maintain adequate provider networks. Our inability to develop or maintain such networks might, in certain circumstances, have a material adverse effect on our financial position, results of operations, or cash flows.
Recent Accounting Pronouncements Not Yet Adopted
Health Insurer Fee.Leases. In the first quarter of 2014, we adopted the guidance ofFebruary 2016, the Financial Accounting Standards Board (FASB) related to accounting for the fees to be paid by health insurers to the federal government under the ACA, specifically the HIF. The HIF is imposed beginning in 2014, is based on a company's share of the industry's net premiums written during the preceding calendar year, and is payable on September 30 of each year. Effective January 1, 2014, we recorded our estimate of the 2014 liability to accounts payable and accrued liabilities. During the third quarter of 2014 we paid our 2014 HIF assessment, which amounted to $88.6 million.
Revenue Recognition. In May 2014, the FASB issued Accounting Standards Update (ASU) ASU 2016-02, Leases. ASU 2016-02 amends the existing accounting standards for lease accounting, including requiring lessees to recognize most leases on their balance sheets and making targeted changes to lessor accounting. The ASU is effective for us beginning in the first quarter of 2019, and requires a modified retrospective transition approach. Early adoption is permitted; we are currently evaluating the potential effects of the adoption to our financial statements.

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Financial Instruments. In January 2016, the FASB issued ASU 2016-01, Recognition and Measurement of Financial Assets and Financial Liabilities, which will require public business entities to use the exit price notion when measuring the fair value of financial instruments for disclosure purposes. Also, entities will have to assess the realizability of a deferred tax asset related to an available for sale debt security in combination with the entity’s other deferred tax assets. Effective for us in the first quarter of 2018, ASU 2016-01 is applied prospectively with a cumulative-effect adjustment to beginning retained earnings as of the beginning of the first reporting period in which the guidance is adopted. Early adoption is permitted in regards to certain provisions of the standard; we are evaluating the potential effects of the adoption to our financial statements.
Revenue Recognition. In July 2015, the FASB affirmed its proposal to defer the effective date of ASU 2014-09, - Revenue from Contracts with Customers, for all entities by one year. As a result, public business entities will apply the new revenue standard to annual reporting periods beginning after December 15, 2017, and for interim reporting periods within annual reporting periods beginning after December 15, 2017. We intend to adopt this standard on January 1, 2018. We are currently evaluating our plan for adoption and its impact to our revenue recognition policies, procedures and control framework, and the resulting impact to our consolidated financial position, results of operations and cash flows.
Short-Duration Contracts. In May 2015, the FASB issued ASU 2015-09, Disclosures about Short-Duration Contracts, which will supersede nearly all existing revenue recognition guidance under U.S. generally accepted accounting principles (GAAP). The core principal ofrequire additional disclosure on the liability for unpaid claims and claim adjustment expenses. We intend to adopt this ASU is that an entity should recognize revenue when it transfers promised goods or services to customers in an amount that reflectsstandard effective for our annual report for the consideration to which the entity expects to be entitled in exchangeyear ending December 31, 2016, and for those goods or services. This ASU alsointerim periods thereafter. It requires additional disclosure aboutonly and will not have a significant impact to our consolidated financial statements.
Software Licenses. In April 2015, the nature, amount, timing and uncertaintyFASB issued ASU 2015-05, Customer's Accounting for Fees Paid in a Cloud Computing Arrangement, which will require customers to determine whether a cloud computing arrangement includes the license of revenue and cash flows arising from customer contracts, including significant judgments and changes in judgments and assets recognized from costs incurredsoftware by applying the same guidance cloud service providers use to obtain or fulfill a contract.make this determination. The ASU also eliminates the existing requirement for customers to account for software licenses they acquire by analogizing to the guidance on leases. This ASU will be effective for us in the first quarter of 2017; early adoption is not permitted. The ASU allows for either full retrospective or modified retrospective adoption. We are evaluating the transition method that will be elected and the potential effects of the adoption of this ASU on our financial statements.
Discontinued Operations. In April 2014, the FASB issued ASU 2014-08 - Reporting Discontinued Operations and Disclosures of Disposal of Components of an Entity, which raises the threshold for disposals to qualify as discontinued operations by focusing on strategic shifts that have or will have a major effect on an entity’s operations and financial results. This ASU will be effective for us in the first quarter of 2015,2016, and is applied prospectively. Early adoption is permitted but only for disposals (or classifications as held for sale) that have not been reported in financial statements previously issuedeither prospectively or available for issue.retrospectively. We are evaluating the potential effects of the adoption of the ASU onto our financial statements.
Other recent accounting pronouncements issued by the FASB (including its Emerging Issues Task Force), the American Institute of Certified Public Accountants, (AICPA), and the Securities and Exchange Commission (SEC),SEC did not have, or are not believed by management to have, a material impact on our present or future consolidated financial statements.
Recent Accounting Pronouncements Adopted
Income Taxes. In the fourth quarter of 2015, we early adopted ASU 2015-17, Balance Sheet Classification of Deferred Taxes, which requires deferred tax assets and liabilities to be classified as non-current, in a classified statement of financial position. We have applied the guidance retrospectively to all periods presented. Such retrospective adoption had an insignificant impact to our consolidated balance sheets, and had no impact to our consolidated statements of income, stockholders’ equity, and cash flows.
Business Combinations. In the fourth quarter of 2015, we early adopted ASU 2015-16, Simplifying the Accounting for Measurement-Period Adjustments, which requires acquirers to recognize adjustments to provisional amounts identified during the measurement period (a reasonable time period after the acquisition date) in the reporting period in which such adjustment amounts are determined. For the year ended December 31, 2015, there was no impact to our consolidated financial statements.
Debt Issuance Costs. In the fourth quarter of 2015, we early adopted ASU 2015-03, Simplifying the Presentation of Debt Issuance Costs, which requires that debt issuance costs related to a recognized debt liability be presented in the balance sheet as a direct deduction from the carrying amount of such debt liability, consistent with debt discounts. In a subsequent Staff Announcement, the SEC announced that it would not object to the deferral and presentation of debt issuance costs relating to line-of-credit arrangements as an asset. We have applied the guidance retrospectively to all periods presented. Such retrospective adoption had an insignificant impact to our consolidated balance sheets, and had no impact to our consolidated statements of income, stockholders’ equity, and cash flows.

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3. Net Income per Share
The following table sets forth the calculation of the denominators used to compute basic and diluted net income per share:
December 31,December 31,
2014 2013 20122015 2014 2013
(In thousands)(In millions)
Shares outstanding at the beginning of the period45,871
 46,762
 45,815
49
 46
 47
Weighted-average number of shares:          
Issued:     
Common stock offering3
 
 
Convertible senior notes
 1
 
Repurchased
 (1,445) (2)
 
 (1)
Issued, 3.75% Notes and 3.75% Exchange (1)566
 
 
Issued, share-based compensation498
 400
 567
Denominator for basic net income per share46,935
 45,717
 46,380
52
 47
 46
Effect of dilutive securities:          
Share-based compensation498
 643
 619
1
 
 1
3.75% Notes and 3.75% Exchange (1)907
 502
 
Convertible senior notes (1)1
 1
 
1.125% Warrants (1)2
 
 
Denominator for diluted net income per share48,340
 46,862
 46,999
56
 48
 47
          
Potentially dilutive common shares excluded from calculations (2):          
Stock options
 51
 87
1.125% Warrants13,490
 11,975
 

 13
 12
Restricted shares
 
 304
_______________________________ 
(1)For more information regarding the convertible senior notes, including the 1.625% Notes, 3.75% ExchangeNotes, and 3.75% Notes,Exchange, refer to Note 12, "Long-Term Debt."Debt." For more information regarding the 1.125% Warrants, refer to Note 13, "Derivatives."
(2)PotentiallyThe dilutive effect of all potentially dilutive common shares is calculated using the treasury-stock method. Certain potentially dilutive common shares issuable pursuant to certain of our employee stock options, 1.125% Warrants (defined in Note 13, "Derivative Financial Instruments"), and 1.625% Notes (defined in Note 12, "Long-Term Debt") wereare not included in the computation of diluted net income per share because to do so would have beenbe anti-dilutive. For the years ended December 31, 2014 and 2013, the 1.125% Warrants were excluded from diluted shares outstanding because the exercise price exceeded the average market price of our common stock.
4. Business Combinations
During 2015, we closed on business combinations in both the Health Plans Segmentand Other segments. For all of these transactions we applied the acquisition method of accounting, where the total purchase price was allocated, or preliminarily allocated, to tangible and intangible assets acquired, and liabilities assumed based on their respective fair values. For Health Plans acquisitions, in general, only intangible assets are acquired. All of the 2015 acquisitions were funded using available cash.
Health Plans
Consistent with our strategy to grow in our existing markets, we closed the following Health Plans acquisitions in 2015:
Florida. In December 2014,On November 1, 2015, our Florida health plan acquiredclosed on its acquisition of the Medicaid contracts, and certain assets relatingrelated to operation of the Medicaid business, of First Coast Advantage, LLC (FCA). As partIntegral Health Plan, Inc. The final purchase price was $67 million, and the Florida health plan added approximately 101,000 members in the Northwest and Southwest regions of Florida as a result of this transaction. On the closing date, we withheld 10%, or approximately $7 million, of the transaction,purchase price to establish an indemnification amount held as security for the seller's indemnification obligations under the purchase agreement. We have recorded the indemnification amount to restricted assets, which will be settled in November 2016. If we assumed FCA'sdo not have any claims against the seller on or before the settlement date, we will pay the full withhold amount to the seller. As of December 31, 2015, we had not made any claims against the withhold amount.
On August 1, 2015, our Florida health plan closed on its acquisition of the Medicaid contractcontracts, and certain provider agreements for Region 4assets related to the operation of the Statewide Medicaid Managed Care Managedbusiness, of Preferred Medical Assistance Program inPlan, Inc. The final purchase price was $8 million, and the state of Florida. The Florida health plan's membership increased byplan added approximately 62,00023,000 members as a result of this transaction. We estimate that

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Michigan. On September 1, 2015, our Michigan health plan closed on its acquisition of the finalMedicaid and MIChild contracts, and certain provider agreements, of HealthPlus of Michigan and its subsidiary, HealthPlus Partners, Inc. The purchase price for this acquisition, to be settled inwas $47 million, and the first quarter of 2015, will be approximately $44.6 million.
In August 2014, our FloridaMichigan health plan acquired certain assets relating to the Medicaid business of Healthy Palm Beaches, Inc. The final purchase price for this acquisition was $7.5 million. The Florida health plan's membership increased byadded approximately 11,00068,000 members as a result of this transaction.
In connection with these transactions,For the Health Plans acquisitions closed in 2015, we recorded goodwill amounting to $41.2$90 million in the aggregate, which relates to future economic benefits arising from expected synergies to be achieved. Such synergies include use of our existing infrastructure to support the added membership. The amount recorded as goodwill represents intangible assets that do not qualify for separate recognition as identifiable intangible assets. Goodwill is not amortized, but is subject to an annual impairment test. The entire amount recorded as goodwill is deductible for income tax purposes. We also recordedRefer to the table below for a summary of the intangible assets identified, and their economic lives.
Announced Acquisitions. As described in Note 1, "Basis of Presentation," we announced several Health Plans acquisitions in 2015 that did not close until January 1, 2016. Because the closing dates for these acquisitions fell on January 1, 2016, a holiday, approximately $101 million was recorded to prepaid expenses and other assets as of December 31, 2015, for purchase price amounts funded in December 2015. Such amounts are reported in investing activities in the following major classes: contract rights and licenses amounting to $5.8 million, and provider networks amounting to $5.0 million. Contract rights and licenses are amortized over a periodaccompanying consolidated statements of five years, and provider networks are amortized over a period of 10 years.cash flows. The weighted-average amortization period, in thetotal aggregate is 7.3 years.
South Carolina.In July 2013, we entered into an agreement with Community Health Solutions of America, Inc. (CHS) to acquire certain assets, including rights to convert certain of CHS' Medicaid members covered by South Carolina's full-risk Medicaid managed care program. The conversion conditions under the agreement were satisfied by January 1, 2014, and on that date such Medicaid members were converted to the managed care program and enrolled with our South Carolina health plan. The total purchase price for the converted Medicaid membershipthese acquisitions amounted to $57.2approximately $115 million, which will be allocated among goodwill and intangible assets. The initial accounting for these transactions is incomplete.
Transaction costs associated with the Health Plans acquisitions were insignificant.
Other
Pathways. Consistent with our strategy to acquire and develop new products and capabilities, on November 1, 2015, we acquired all of which $49.7 millionthe outstanding ownership interests in Pathways Health and Community Support LLC (Pathways), formerly known as Providence Human Services, LLC. Pathways is one of the largest national providers of accessible, outcome-based behavioral/mental health and social services with operations in 23 states and the District of Columbia.
The following table summarizes the preliminary values of the assets acquired and liabilities assumed at the date of acquisition.
 November 1, 2015
 (In millions)
Assets: 
Cash and cash equivalents$20
Receivables52
Prepaid expenses and other current assets4
Property and equipment14
Intangible assets19
Goodwill155
Other assets1
Liabilities: 
Medical claims and benefits payable(2)
Accounts payable and accrued liabilities(23)
Deferred revenue(2)
Other long-term liabilities(7)
Total purchase price$231
As of December 31, 2015, the purchase price allocation for the acquisition was preliminary and subject to completion. Adjustments to the current fair value estimates in the above table may occur as the process conducted for various valuations and assessments is finalized, including tax assets and liabilities. Goodwill is calculated as the excess of the consideration transferred over the net assets recognized and represents the estimated future economic benefits arising from other assets acquired that could not be individually identified and separately recognized, including expected medical cost synergies to be achieved, and the workforce acquired. Such synergies include the achievement of better outcomes for our members through more effective care coordination and integration, and our retention of the net profit margin captured by the mental health provider. The workforce acquired is a significant component of goodwill because it represents primarily the patient-facing employees, now employed by us, who provide the behavioral/mental health and social services. Approximately 10% of the goodwill recorded at December 31, 2015, is deductible for income tax purposes. This percentage may increase if certain tax elections are completed in 2016.

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paid in the first halfThe gross contractual amount of 2014, and $7.5 million was paid when the agreement was executed in 2013. The total amount paid included indemnification withhold funds transferred to restricted investments amounting to $5.7 million, which were released to CHS in January 2015.
Because the number of Medicaid members we would ultimately convert was unknown as ofreceivables, at the acquisition date, in 2013, we recorded a contingent consideration liability for such members to be settled when the final purchase price was known in the second quarter of 2014. In addition, we recorded a contingent consideration liability for dual-eligible members we expect to enroll in our Medicare-Medicaid Plan (MMP) implementation in South Carolina in 2015. The contingent consideration liability is remeasured to fair value at each quarter until the contingency is resolved with fair value adjustments, if any, recorded to operations. As of December 31, 2014, the fair value of the remaining contingent consideration liability for the MMP implementation amounted to $0.5approximately $61 million. The aggregate contingent consideration liability fair value adjustments for the South Carolina transaction resulted in a gain of $5.2 million in the year ended December 31, 2014.
New Mexico. In August 2013, our New Mexico health plan acquired Lovelace Community Health Plan's contract for the state of New Mexico's Medicaid program. In addition to Lovelace's Medicaid members, we also added membership previously covered under New Mexico's State Coverage Insurance (SCI) program with Lovelace. Effective January 1, 2014, these SCI members were either enrolled in New Mexico's Medicaid program, or eligible to enroll in New Mexico's Marketplace. Because the number of SCI members we would ultimately retain was unknown as ofAt the acquisition date, in 2013, we recorded a contingent consideration liability for such membersthe best estimate of contractual cash flows not expected to be settled whencollected was approximately $9 million.
In connection with this acquisition, we incurred approximately $3 million in transaction costs, which are recorded in general and administrative expenses.
The following table presents the final purchase price was knownintangible assets identified, by segment. The weighted-average amortization period for the Health Plans identified intangible assets, in the second quarter of 2014.aggregate, is 6.4 years. The aggregate contingent consideration liability fair value adjustmentsweighted-average amortization period for the New Mexico transaction resulted in a gain of $1.5 millionOther identified intangible assets, in the year ended December 31, 2014.aggregate, is 4.2 years.
 Fair Value Life (years)
 (In millions)
Intangible asset type   
Health Plans:   
Contract rights - member list$23
 5
Provider network9
 10
Other:   
Contract licenses5
 2
Contract rights - member list14
 5
 $51
  
5. Fair Value Measurements
Our consolidated balance sheets include the following financial instruments: cash and cash equivalents, investments, receivables, other assets, trade accounts payable, medical claims and benefits payable, amounts due government agencies, long-term debt, and other liabilities. We consider the carrying amounts of cash and cash equivalents receivables,and other current assets and current liabilities (excluding contingent consideration)(not including derivatives and current portion of long-term debt) to approximate their fair values because of the relatively short period of time between the origination of these instruments and their expected realization or payment. For our financial instruments measured at fair value on a recurring basis, we prioritize the inputs used in measuring fair value according to a three-tier fair value hierarchy as follows:
Level 1 — Observable Inputs
Level 1 financial instruments recorded at fair value consist of investments including government-sponsored enterprise securities (GSEs) and U.S. treasury notes that are classified as current investments in the accompanying consolidated balance sheets. These financial instruments are actively traded and therefore the fair value for these securities is based on quoted market prices on one or more securities exchanges.
Level 2 — Directly or Indirectly Observable Inputs
Level 2 financial instruments recorded at fair value consist of investments including corporate debt securities, municipal securities, and certificates of deposit that are classified as current investments in the accompanying consolidated balance sheets. Such investments are traded frequently though not necessarily daily. Fair value for these investments is determined using a market approach based on quoted prices for similar securities in active markets or quoted prices for identical securities in inactive markets.
Level 3 — Unobservable Inputs
Level 3 financial instruments are valued using unobservable inputs that represent management's best estimate of what market participants would use in pricing the financial instrument at the measurement date. Our Level 3 financial instruments include the following:
Derivative financial instruments. Derivative financial instruments include the 1.125% Call Option derivative asset and the 1.125% Notes Conversion Option derivative liability. These derivatives are not actively traded and are valued based on an option pricing model that uses observable and unobservable market data for inputs. Significant market data inputs used to determine fair value as of December 31, 20142015 included the price of our common stock, price,the time to maturity of the derivative instruments, the risk-free interest rate, and the implied volatility of our common stock. As described further in Note 13, "Derivative Financial Instruments,"Derivatives," the 1.125% Call Option asset and the 1.125% Notes Conversion Option liability were designed such that changes in their fair values would offset, with minimal impact to the consolidated statements of income. Therefore, the sensitivity of changes in the unobservable inputs to the option pricing model for such instruments is mitigated.
Contingent consideration liability. Such liability relates to our South Carolina health plan acquisition described The changes in Note 4, "Business Combinations," and is recorded in accounts payable and accrued liabilities. We applied a cash flow analysis to determine the fair value of this liability. Significant unobservable inputs primarily related to the purchase price estimateLevel 3 instruments for the projected membership.
Auction rate securities. Auction rate securities are designated as available-for-sale and are reported at fair value in other assets. To estimate the fair value of these securities we use valuation data from our primary pricing source, a third party who providesyear ended December 31, 2015 were insignificant.

7884


a marketplace for illiquid assets with over 10,000 participants. This valuation data is basedOur financial instruments measured at fair value on a range of prices that represent indicative bids from potential buyers. To validate the reasonableness of the data, we compare these valuations to data from other third-party pricing sources, which also provide a range of prices representing indicative bids from potential buyers. We have concluded that these estimates, given the lack of market available pricing, provide a reasonablerecurring basis for determining the fair value of the auction rate securities as ofat December 31, 2014.2015, were as follows:
 Total Level 1 Level 2 Level 3
 (In millions)
Corporate debt securities$1,184
 $
 $1,184
 $
Government-sponsored enterprise securities (GSEs)211
 211
 
 
Municipal securities185
 
 185
 
Certificates of deposit80
 
 80
 
U.S. treasury notes78
 78
 
 
Asset-backed securities63
 
 63
 
Subtotal - current investments1,801
 289
 1,512
 
1.125% Call Option derivative asset374
 
 
 374
Total assets measured at fair value on a recurring basis$2,175
 $289
 $1,512
 $374
        
1.125% Conversion Option derivative liability$374
 $
 $
 $374
Total liabilities measured at fair value on a recurring basis$374
 $
 $
 $374
Our financial instruments measured at fair value on a recurring basis at December 31, 2014, were as follows:
 Total Level 1 Level 2 Level 3
 (In thousands)
Corporate debt securities$641,729
 $
 $641,729
 $
Municipal securities127,045
 
 127,045
 
GSEs122,269
 122,269
 
 
U.S. treasury notes59,543
 59,543
 
 
Certificates of deposit68,876
 
 68,876
 
Auction rate securities4,847
 
 
 4,847
1.125% Call Option derivative asset329,323
 
 
 329,323
Total assets measured at fair value on a recurring basis$1,353,632
 $181,812
 $837,650
 $334,170
        
1.125% Notes Conversion Option derivative liability$329,194
 $
 $
 $329,194
Contingent consideration liability500
 
 
 500
Total liabilities measured at fair value on a recurring basis$329,694
 $
 $
 $329,694
Our financial instruments measured at fair value on a recurring basis at December 31, 2013, were as follows:
 Total Level 1 Level 2 Level 3
 (In thousands)
Corporate debt securities$449,772
 $
 $449,772
 $
Municipal securities113,330
 
 113,330
 
GSEs68,817
 68,817
 
 
U.S. treasury notes37,376
 37,376
 
 
Certificates of deposit33,757
 
 33,757
 
Auction rate securities10,898
 
 
 10,898
1.125% Call Option derivative asset186,351
 
 
 186,351
Total assets measured at fair value on a recurring basis$900,301
 $106,193
 $596,859
 $197,249
        
1.125% Notes Conversion Option derivative liability$186,239
 $
 $
 $186,239
Contingent consideration liabilities57,548
 
 
 57,548
Total liabilities measured at fair value on a recurring basis$243,787
 $
 $
 $243,787


79


The following table presents activity relating to our assets (liabilities) measured at fair value on a recurring basis using significant unobservable inputs (Level 3):
 Changes in Level 3 Instruments
 Auction Rate Securities Derivatives, Net Contingent Consideration Liabilities
 (In thousands)
Balance at December 31, 2013$10,898
 $112
 $(57,548)
Total gains for the period recognized in:     
General and administrative expenses
 
 6,699
Other expense, net
 17
 
Other comprehensive income249
 
 
Settlements(6,300) 
 50,349
Balance at December 31, 2014$4,847
 $129
 $(500)
 Total Level 1 Level 2 Level 3
 (In millions)
Corporate debt securities$641
 $
 $641
 $
GSEs122
 122
 
 
Municipal securities127
 
 127
 
Certificates of deposit69
 
 69
 
U.S. treasury notes60
 60
 
 
Subtotal - current investments1,019
 182
 837
 
1.125% Call Option derivative asset329
 
 
 329
Total assets measured at fair value on a recurring basis$1,348
 $182
 $837
 $329
        
1.125% Conversion Option derivative liability$329
 $
 $
 $329
Total liabilities measured at fair value on a recurring basis$329
 $
 $
 $329
Fair Value Measurements - Disclosure Only
The carrying amounts and estimated fair values of our convertible senior notes, which are classified as Level 2 financial instruments, are indicated in the following table. Fair value for these securities is determined using a market approach based on quoted prices for similar securities in active markets or quoted prices for identical securities in inactive markets. As described in Note 2, "Significant Accounting Policies," the carrying amount of debt has been reduced by deferred issuance costs for all periods presented.
 December 31, 2014
 Carrying Total      
 Amount Fair Value Level 1 Level 2 Level 3
 (In thousands)
1.125% Notes$435,330
 $767,377
 $
 $767,377
 $
1.625% Notes268,767
 337,292
 
 337,292
 
 $704,097
 $1,104,669
 $
 $1,104,669
 $
  
 December 31, 2013
 Carrying Total      
 Amount Fair Value Level 1 Level 2 Level 3
 (In thousands)
1.125% Notes$416,368
 $572,627
 $
 $572,627
 $
3.75% Notes181,872
 219,491
 
 219,491
 
 $598,240
 $792,118
 $
 $792,118
 $
 December 31, 2015 December 31, 2014
 Carrying Total Fair Value Carrying Total Fair Value
 Amount  Amount 
 (In millions)
5.375% Notes$689
 $700
 $
 $
1.125% Convertible Notes448
 865
 426
 767
1.625% Convertible Notes273
 365
 264
 337
 $1,410
 $1,930
 $690
 $1,104

85


6. Investments
The following tables summarize our investments as of the dates indicated:
December 31, 2014December 31, 2015
Amortized 
Gross
Unrealized
 EstimatedAmortized 
Gross
Unrealized
 Estimated
Cost Gains Losses Fair ValueCost Gains Losses Fair Value
(In thousands)(In millions)
Corporate debt securities$642,910
 $201
 $1,382
 $641,729
$1,189
 $
 $5
 $1,184
GSEs212
 
 1
 211
Municipal securities127,185
 129
 269
 127,045
186
 
 1
 185
GSEs122,317
 34
 82
 122,269
Certificates of deposit80
 
 
 80
U.S. treasury notes59,546
 30
 33
 59,543
78
 
 
 78
Certificates of deposit68,893
 1
 18
 68,876
Subtotal - current investments1,020,851
 395
 1,784
 1,019,462
Auction rate securities5,100
 
 253
 4,847
Asset-backed securities63
 
 
 63
$1,025,951
 $395
 $2,037
 $1,024,309
$1,808
 $
 $7
 $1,801

80


December 31, 2013December 31, 2014
Amortized 
Gross
Unrealized
 EstimatedAmortized 
Gross
Unrealized
 Estimated
Cost Gains Losses Fair ValueCost Gains Losses Fair Value
(In thousands)(In millions)
Corporate debt securities$450,162
 $442
 $832
 $449,772
$643
 $
 $2
 $641
GSEs122
 
 
 122
Municipal securities114,126
 119
 915
 113,330
127
 
 
 127
GSEs68,898
 6
 87
 68,817
Certificates of deposit69
 
 
 69
U.S. treasury notes37,360
 44
 28
 37,376
60
 
 
 60
Certificates of deposit33,756
 2
 1
 33,757
Subtotal - current investments704,302
 613
 1,863
 703,052
Auction rate securities11,400
 
 502
 10,898
$715,702
 $613
 $2,365
 $713,950
$1,021
 $
 $2
 $1,019
The contractual maturities of our investments as of December 31, 20142015 are summarized below:
 
Amortized
Cost
 
Estimated
Fair Value
 (In thousands)
Due in one year or less$448,880
 $448,732
Due one year through five years571,971
 570,730
Due after ten years5,100
 4,847
 $1,025,951
 $1,024,309
 
Amortized
Cost
 
Estimated
Fair Value
 (In millions)
Due in one year or less$830
 $829
Due after one year through five years967
 962
Due after five years through ten years11
 10
 $1,808
 $1,801
Gross realized gains and losses from sales of available-for-sale securities are calculated under the specific identification method and are included in investment income. Gross realized investment gains and losses for the yearyears ended December 31, 2015, 2014 2013, and 20122013 were insignificant.
For investments other than our auction rate securities, discussed below, weWe have determined that unrealized gains and losses at December 31, 2014,2015 and 2013,2014 are temporary in nature, because the change in market value for these securities has resulted from fluctuating interest rates, rather than a deterioration of the credit worthiness of the issuers. So long as we hold these securities to maturity, we are unlikely to experience gains or losses. In the event that we dispose of these securities before maturity, we expect that realized gains or losses, if any, will be immaterial.
The following table segregates those available-for-sale investments that have been in a continuous loss position for less than 12 months, and those that have been in a loss position for 12 months or more as of December 31, 2014.
 
In a Continuous Loss Position
for Less than 12 Months
 
In a Continuous Loss Position
for 12 Months or More
 
Estimated
Fair
Value
 
Unrealized
Losses
 Total Number of Positions 
Estimated
Fair
Value
 
Unrealized
Losses
 Total Number of Positions
 (Dollars in thousands)
Corporate debt securities$379,034
 $1,151
 265
 $28,668
 $231
 10
Municipal securities53,626
 168
 64
 11,075
 101
 13
GSEs75,025
 69
 22
 2,986
 13
 3
U.S. treasury notes19,199
 33
 13
 
 
 
Certificates of deposit12,591
 18
 52
 
 
 
Auction rate securities
 
 
 4,847
 253
 6
 $539,475
 $1,439
 416
 $47,576
 $598
 32

8186


The following table segregates those available-for-sale investments that have been in a continuous loss position for less than 12 months, and those that have been in a loss position for 12 months or more as of December 31, 2013.2015.
In a Continuous Loss Position
for Less than 12 Months
 
In a Continuous Loss Position
for 12 Months or More
In a Continuous Loss Position
for Less than 12 Months
 
In a Continuous Loss Position
for 12 Months or More
Estimated
Fair
Value
 
Unrealized
Losses
 Total Number of Positions 
Estimated
Fair
Value
 
Unrealized
Losses
 Total Number of Positions
Estimated
Fair
Value
 
Unrealized
Losses
 Total Number of Positions 
Estimated
Fair
Value
 
Unrealized
Losses
 Total Number of Positions
(Dollars in thousands)(Dollars in millions)
Corporate debt securities$210,057
 $802
 91
 $2,540
 $30
 3
$825
 $4
 588
 $119
 $1
 87
GSEs182
 1
 77
 
 
 
Municipal securities30,715
 398
 49
 31,091
 517
 39
128
 1
 181
 5
 
 12
GSEs53,308
 87
 21
 
 
 
Certificates of deposit53
 
 218
 
 
 
U.S. treasury notes12,037
 28
 11
 
 
 
53
 
 32
 
 
 
Certificates of deposit414
 1
 2
 
 
 
Auction rate securities
 
 
 10,898
 502
 15
Asset-backed securities55
 
 47
 
 
 
$306,531
 $1,316
 174
 $44,529
 $1,049
 57
$1,296
 $6
 1,143
 $124
 $1
 99
Auction Rate Securities. Due to eventsThe following table segregates those available-for-sale investments that have been in the credit markets, the auction rate securities held by us experienced failed auctions beginninga continuous loss position for less than 12 months, and those that have been in the first quartera loss position for 12 months or more as of 2008, and such auctions have not resumed. Therefore, quoted prices in active markets have not been available since early 2008. Our investments in auction rate securities are collateralized by student loan portfolios guaranteed by the U.S. government, and the range of maturities for such securities is from 16 years to 32 years. Considering the insignificance of these securities when compared with our liquid assets and other sources of liquidity, we have no current intention of selling these securities nor do we expect to be required to sell these securities before a recovery in their cost basis. For this reason, and because the decline in the fair value of the auction rate securities was not due to the credit quality of the issuers, we do not consider the auction rate securities to be other-than-temporarily impaired at December 31, 2014. At the time of the first failed auctions during first quarter 2008, we held a total of $82.1 million in auction rate securities at par value; since that time, we have settled $77.0 million of these instruments at par value.
For the years ended December 31, 2014, 2013 and 2012, we recorded unrealized gains of $0.2 million, $0.7 million and $1.6 million, respectively, to accumulated other comprehensive income for the changes in their fair value. Any future fluctuation in fair value related to these instruments that we deem to be temporary, including any recoveries of previous write-downs, would be recorded to accumulated other comprehensive income. If we determine that any future impairment is other-than-temporary, we will record a charge to earnings as appropriate.
 
In a Continuous Loss Position
for Less than 12 Months
 
In a Continuous Loss Position
for 12 Months or More
 
Estimated
Fair
Value
 
Unrealized
Losses
 Total Number of Positions 
Estimated
Fair
Value
 
Unrealized
Losses
 Total Number of Positions
 (Dollars in millions)
Corporate debt securities$379
 $1
 265
 $29
 $1
 10
GSEs75
 
 22
 3
 
 3
Municipal securities54
 
 64
 11
 
 13
Certificates of deposit13
 
 52
 
 
 
U.S. treasury notes19
 
 13
 
 
 
 $540
 $1
 416
 $43
 $1
 26


8287


7. Receivables
Receivables consist primarily of amounts due from the various states in which we operate,government Medicaid agencies, which may be subject to potential retroactive adjustments. Because all of our receivable amounts are readily determinable and substantially all of our creditors are state governments,governmental authorities, our allowance for doubtful accounts is immaterial. Accounts receivable increased as of December 31, 2014, primarily due to significant enrollment growth in 2014.The information below is presented by segment.
December 31,December 31,
2014 20132015 2014
(In thousands)(In millions)
California$310,938
 $148,654
$104
 $311
Florida2,141
 2,901
22
 2
Illinois31,594
 5,773
35
 32
Michigan19,880
 15,253
39
 20
New Mexico49,609
 17,056
51
 50
Ohio45,187
 43,969
66
 45
Puerto Rico33
 
South Carolina4,134
 
6
 4
Texas29,348
 9,736
56
 29
Utah6,389
 10,953
18
 6
Washington42,848
 13,455
53
 43
Wisconsin8,102
 8,087
22
 8
Direct delivery and other11,295
 2,463
6
 11
Total Health Plans segment561,465
 278,300
511
 561
Molina Medicaid Solutions segment34,991
 20,635
37
 35
Other segment49
 
$596,456
 $298,935
$597
 $596
8. Property, Equipment, and Capitalized Software
A summary of property, equipment, and capitalized software is as follows:
December 31,December 31,
2014 20132015 2014
(In thousands)(In millions)
Land$15,514
 $15,764
$16
 $15
Building and improvements195,405
 165,670
153
 195
Furniture and equipment140,691
 131,478
250
 141
Capitalized software266,782
 187,105
336
 267
618,392
 500,017
755
 618
Less: accumulated depreciation and amortization on building and improvements, furniture and equipment(129,161) (103,918)(167) (129)
Less: accumulated amortization for capitalized software(148,453) (104,016)(195) (148)
(277,614) (207,934)(362) (277)
Property, equipment, and capitalized software, net$340,778
 $292,083
$393
 $341
Depreciation recognized for building and improvements, and furniture and equipment was $34.6$49 million, $26.6$35 million, and $20.5$27 million for the years ended December 31, 2015, 2014 2013 and 2012,2013, respectively. Amortization of capitalized software was $58.7$52 million, $46.4$59 million, and $36.2$46 million for the years ended December 31, 2015, 2014 2013 and 2012,2013, respectively.
Molina Center. We acquired the Molina Center in December 2011. Subsequently, in June 2013 we entered into a sale-leaseback transaction for the sale and contemporaneous leaseback of the Molina Center. Due to our continuing involvement with the leased property, the sale did not qualify for sale-leaseback accounting treatmentsales recognition and we remain the "accounting owner" of the property. See Note 12, "Long-Term Debt."Debt."

8388


Future minimum rental income on noncancelable leases from third party tenants of the Molina Center is sublease rental income, and is reported in other revenue in our consolidated statements of income. The future minimum rental income is as follows:
 (In thousands)
2015$4,313
20164,035
20174,256
20184,116
20191,557
Thereafter2,164
Total minimum future rentals$20,441
 2016 2017 2018 2019 2020 Thereafter Total
 (In millions)
Future minimum rentals$4
 4
 4
 2
 2
 1
 $17

9. Goodwill and Intangible Assets
The following table provides the details of identified intangible assets, by major class, for the periods indicated:
Cost 
Accumulated
Amortization
 
Net
Balance
Cost 
Accumulated
Amortization
 
Net
Balance
(In thousands)(In millions)
Intangible assets:          
Contract rights and licenses$182,228
 $105,613
 $76,615
$224
 $120
 $104
Customer relationships24,550
 22,154
 2,396
25
 23
 2
Contract backlog23,600
 22,540
 1,060
24
 24
 
Provider networks18,401
 9,199
 9,202
27
 11
 16
Balance at December 31, 2014$248,779
 $159,506
 $89,273
Balance at December 31, 2015$300
 $178
 $122
Intangible assets:          
Contract rights and licenses$176,428
 $92,789
 $83,639
$182
 $105
 $77
Customer relationships24,550
 18,801
 5,749
25
 23
 2
Contract backlog23,600
 19,624
 3,976
24
 23
 1
Provider networks13,370
 7,863
 5,507
18
 9
 9
Balance at December 31, 2013$237,948
 $139,077
 $98,871
Balance at December 31, 2014$249
 $160
 $89
Based on the balances of our identifiable intangible assets as of December 31, 2014,2015, we estimate that our intangible asset amortization will be $16.3 million in 2015, $14.4$25 million in 2016, $14.1$25 million in 2017, $13.8$22 million in 2018, and $9.2$18 million in 2019.2019, and $13 million in 2020. For a presentation of our goodwill and intangible assets by reportable segment, refer to Note 21,20, "Segment Information."
The following table presents the balances of goodwill as of December 31, 20142015 and 2013:2014:
December 31, 2014 Acquisitions by Segment December 31, 2015
December 31, 2013 Acquisitions December 31, 2014 Health Plans Other 
(In thousands)(In millions)
Goodwill, gross$289,268
 $41,226
 $330,494
$330
 $90
 $157
 $577
Accumulated impairment losses(58,530) 
 (58,530)(58) 
 
 (58)
Goodwill, net$230,738
 $41,226
 $271,964
$272
 $90
 $157
 $519
The changechanges in the carrying amountamounts of goodwill and intangible assets, at cost, in 2014 was2015 were due to the acquisitions described in Note 4, "Business Combinations."

8489


10. Restricted Investments
Pursuant to the regulations governing our Health Plans segment subsidiaries, we maintain statutory deposits and deposits required by stategovernment authorities in certificates of deposit and U.S. treasury securities. We also maintain restricted investments as protection against the insolvency of certain capitated providers. Additionally, inIn connection with a Molina Medicaid Solutions segment state contract, we maintainmaintained restricted investments as collateral for a letter of credit.credit as of December 31, 2014. The following table presents the balances of restricted investments:
December 31,December 31,
2014 20132015 2014
(In thousands)(In millions)
California$373
 $373
Florida28,649
 9,242
$34
 $29
Illinois311
 310
Michigan1,014
 1,014
1
 1
New Mexico35,135
 24,622
43
 35
Ohio12,719
 9,080
12
 13
Puerto Rico10
 5
South Carolina6,040
 310

 6
Texas3,500
 3,500
4
 3
Utah3,601
 3,301
4
 4
Washington151
 151
Wisconsin1
 
Other5,985
 886

 1
Total Health Plans segment97,478
 52,789
109
 97
Molina Medicaid Solutions segment5,001
 10,304

 5
$102,479
 $63,093
$109
 $102
The contractual maturities of our held-to-maturity restricted investments as of December 31, 20142015 are summarized below.
Amortized
Cost
 
Estimated
Fair Value
Amortized
Cost
 
Estimated
Fair Value
(In thousands)(In millions)
Due in one year or less$101,017
 $101,022
$100
 $100
Due one year through five years1,462
 1,462
9
 9
$102,479
 $102,484
$109
 $109
11. Medical Claims and Benefits Payable
The following table provides the details of our medical claims and benefits payable (including amounts payable for the provision of long-term services and supports, or LTSS) as of the dates indicated.
December 31,December 31,
2014 2013 20122015 2014 2013
(In thousands)(In millions)
Fee-for-service claims incurred but not paid (IBNP)$870,429
 $424,173
 $377,614
$1,191
 $871
 $424
Pharmacy payable71,412
 45,037
 38,992
88
 71
 45
Capitation payable28,150
 20,267
 49,066
140
 28
 20
Other230,531
 180,310
 28,858
266
 231
 181
$1,200,522
 $669,787
 $494,530
$1,685
 $1,201
 $670

85


"Other" medical claims and benefits payable include amounts payable to certain providers for which we act as an intermediary on behalf of various stategovernment agencies without assuming financial risk. Such receipts and payments do not impact our consolidated statements of income. Such non-riskNon-risk provider payables amounted to $119.3$167 million, $119 million and $151.3$151 million, as of December 31, 2015, 2014 and 2013, respectively.
The following table presents the components of the change in our medical claims and benefits payable from continuing and discontinued operations combined for the periods indicated. The amounts presented for "Components of medical care costs

90


related to: Prior periods" represent the amount by which our original estimate of medical 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.
Year Ended December 31,Year Ended December 31,
2014 2013 20122015 2014 2013
(Dollars in thousands)(Dollars in millions)
Balances at beginning of period$669,787
 $494,530
 $402,476
$1,201
 $670
 $495
Components of medical care costs related to:          
Current period8,122,885
 5,434,443
 5,136,055
11,935
 8,123
 5,434
Prior periods(45,979) (52,779) (39,295)(141) (46) (53)
Total medical care costs8,076,906
 5,381,664
 5,096,760
11,794
 8,077
 5,381
          
Change in non-risk provider payables(31,973) 111,267
 (7,004)48
 (32) 111
          
Payments for medical care costs related to:          
Current period7,064,427
 4,932,195
 4,689,395
10,448
 7,064
 4,932
Prior periods449,771
 385,479
 308,307
910
 450
 385
Total paid7,514,198
 5,317,674
 4,997,702
11,358
 7,514
 5,317
Balances at end of period$1,200,522
 $669,787
 $494,530
$1,685
 $1,201
 $670

That portion of our total medical claims and benefits payable liability that is most subject to variability in the estimate is fee-for-service claims incurred but not paid (IBNP). Our IBNP, as included in medical claims and benefits payable, represents our best estimate of the total amount of claims we will ultimately pay with respect to claims that we have incurred as of the balance sheet date. We estimate our IBNP monthly using actuarial methods based on a number of factors.
Assuming that our initial estimate of IBNP is accurate, we believe that amounts ultimately paid out would generally be between 8% and 10% less than the IBNP liability recorded at the end of the period as a result of the inclusion in that liability of the provision for adverse claims deviation and the accrued cost of settling those claims. Because the amount of our initial liability is merely an estimate (and therefore not perfectly accurate), we will always experience variability in that estimate as new information becomes available with the passage of time. Therefore, there can be no assurance that amounts ultimately paid out will fall within the range of 8% to 10% lower than the liability that was initially recorded. Furthermore, because our initial estimate of IBNP is derived from many factors, some of which are qualitative in nature rather than quantitative, we are seldom able to assign specific values to the reasons for a change in estimate—we only know when the circumstances for any one or more factors are out of the ordinary.
The use of a consistent methodology in estimating our liability for medical claims and medical benefits payable minimizes the degree to which the under– or overestimation of that liability at the close of one period may affect consolidated results of operations in subsequent periods. In particular, the use of a consistent methodology should result in the replenishment of reserves during any given period in a manner that generally offsets the benefit of favorable prior period development in that period. Facts and circumstances unique to the estimation process at any single date, however, may still lead to a material impact on consolidated results of operations in subsequent periods. Any absence of adverse claims development (as well as the expensing through general and administrative expense of the costs to settle claims held at the start of the period) will lead to the recognition of a benefit from prior period claims development in the period subsequent to the date of the original estimate.
As indicated above, the amounts ultimately paid out on our medical claims and benefits payable liabilities in fiscal years 2015, 2014, 2013, and 20122013 were less than what we had expected when we had established those liabilities. The differences between our original estimates and the amounts ultimately paid out (or now expected to be ultimately paid out) for the most part related to IBNP. While many related factors working in conjunction with one another determine the accuracy of our estimates, we are seldom able to quantify the impact that any single factor has on a change in estimate. In addition, given the variability inherent in the reserving process, we will only be able to identify specific factors if they represent a significant departure from expectations. As a result, we do not expect to be able to fully quantify the impact of individual factors on changes in estimates.

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20142015
We believe that the most significant factors that will determine the accuracy of our IBNP estimates at December 31, 20142015 are:
The addition since JanuaryA new version of diagnosis codes was required for all claims with dates of service October 1, 2014,2015 and later. As a result, payment was delayed for a significant number of 385,000claims due to the use of diagnosis codes that were no longer valid. Due to the resulting variability in the ratio of paid to billed amounts, the reserves are subject to more than the usual amount of uncertainty.

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At our Illinois, Puerto Rico and Wisconsin health plans, we overpaid certain provider and outpatient facility claims due to a system configuration error. For this reason, the reserves are subject to more than the usual amount of uncertainty.
Our Michigan health plan added approximately 68,000 new members under Medicaid expansionan acquisition in sixthe third quarter of our health plans.2015. Because these new members are transitioning into managed care, andmay have different demographicsutilization patterns than those of our legacy membership,members, the reserves are subject to more than the usual amount of uncertainty.
Our Puerto Rico health plan started operations on April 1, 2015. Because we have little insight into their utilization of medical services. Additionally,lack sufficient historical claims data, our reserves as of December 31, 2014, we have relatively little medical2015 are based on a combination of claims payment history related to Medicaid expansion membership in Illinois, Michiganexperience and Ohio because such members were enrolled in these states laterthe expected claims in the year. Accordingly, our estimates ofpricing assumptions. For this reason, the claims liability for this populationreserves are subject to a higher degree of uncertainty.
The addition of approximately 6,000 to 8,000 members per month on a retroactive basis duringmore than the last several months of 2014 at our New Mexico health plan. Because we have no claims payment history for these members, our estimates of the claims liability for this population are subject to a higher degree of uncertainty. However, for these members, the state will reimburse the health plan for claims with dates of services during the retroactive period on a cost-plus basis (claims paid plus an administration fee).
The addition of new membership to our MMP and aged, blind or disabled (ABD) programs at several of our health plans whose benefits include a substantialusual amount of managed LTSS benefits. Because these are newer members with substantially different benefits than our legacy members, our estimates of the claims liability for this population are subject to a higher degree of uncertainty.
We recognized favorable prior period claims development in the amount of $46.0$141 million for the year ended December 31, 2015. This amount represents our estimate as of December 31, 2015, of the extent to which our initial estimate of medical claims and benefits payable at December 31, 2014 was more than the amount that will ultimately be paid out in satisfaction of that liability. We believe the overestimation was due primarily to the following factors:
At our Ohio and California health plans, approximately 61,000 and 100,000 members, respectively, were enrolled in the new Medicaid expansion program during 2014. Also in Ohio, approximately 17,000 members were enrolled in the new MMP program in 2014. Because we lacked sufficient historical claims data, we initially estimated the reserves for these new members based upon a number of factors that included pricing assumptions provided by the state; our expectations regarding pent up demand; our beliefs about the speed at which new members would utilize health care services; and other factors. Our actual costs were ultimately less than expected.
At our New Mexico health plan, the state implemented a retroactive increase to the provider fee schedules in mid-2014. As a result, many claims that were previously settled were reopened, and subject to, additional payment. Because our reserving methodology is most accurate when claims payment patterns are consistent and predictable, the payment of additional amounts on claims that in some cases had been settled more than six months before added a substantial degree of complexity to our liability estimation process. Due to the difficulties in addressing that added complexity, liabilities recorded as of December 31, 2014, were in excess of amounts ultimately paid.
At our Washington health plan, in 2015 we collected amounts related to certain claims paid in 2013. Such collections were not anticipated in our reserves as of December 31, 2014.
2014
We recognized favorable prior period claims development in the amount of $46 million for the year ended December 31, 2014. This amount representsrepresented our estimate as of December 31, 2014, of the extent to which our initial estimate of medical claims and benefits payable at December 31, 2013 was more than the amount that willwas ultimately be paid out in satisfaction of that liability. We believe the overestimation was due primarily to the following factors:
At our Ohio health plan, we entered new regions in the state, and a new product, ABD Kids, in July 2013. SinceBecause we did not have enoughlacked sufficient historical claims data, to use the pattern of paid and incurred claims, we initially estimated the reserves for these new members based upon a number of factors that included pricing assumptions provided by applying an estimated medicalthe state; our expectations regarding pent up demand; our beliefs about the speed at which new members would utilize health care ratio (MCR). This resulted in an overstatement of our reserve liability as of December 31, 2013.

services; and other factors. Our actual costs were ultimately less than expected.
At our Michigan health plan, we overestimated the impact of certain unpaid potentially high-dollar claims. In addition, we overestimated the impact of the flu season on the outpatient claims for November and December 2013, which caused an overestimation in our outpatient reserve liability as of December 31, 2013.
2013
We recognized favorable prior period claims development in the amount of $52.8$53 million for the year ended December 31, 2013. This amount representsrepresented our estimate as of December 31, 2013, of the extent to which our initial estimate of medical claims and benefits payable at December 31, 2012 was more than the amount that was ultimately paid out in satisfaction of that liability. We believe the overestimation was due primarily to the following factors:
At our Washington health plan certain high-cost newborns, as well as other high-cost disabled members, were covered by the health plan effective July 1, 2012. AtBecause we lacked sufficient historical claims data, we initially estimated the endreserves for these new members based upon a number of 2012, we had limited claims history with which to estimate the claims liability of these members, and overstated the liability for such members.factors. Our actual costs were ultimately less than expected.
At our New Mexico health plan, we overestimated the impact of certain high-dollar outstanding claim payments as of December 31, 2012.

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At our Ohio health plan, we overestimated the impact of several potential high-dollar claims relating to our ABD members.
2012
Prior period claims development of our estimate as of December 31, 2011 through December 31, 2012 was favorable by $39.3 million.     

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12. Long-Term Debt
As of December 31, 2014,2015, contractual maturities of long-term debt for the years ending December 31 are as follows (in thousands)millions):
 Total 2015 2016 2017 2018 2019 Thereafter
1.125% Notes$550,000
 $
 $
 $
 $
 $
 $550,000
1.625% Notes (1)301,551
 
 
 
 
 
 301,551
 $851,551
 $
 $
 $
 $
 $
 $851,551
 Total 2016 2017 2018 2019 2020 Thereafter
5.375% Notes$700
 $
 $
 $
 $
 $
 $700
1.125% Convertible Notes550
 
 
 
 
 550
 
1.625% Convertible Notes (1)302
 
 
 
 
 
 302
Other1
 1
 
 
 
 
 
 $1,553
 $1
 $
 $
 $
 $550
 $1,002
(1)The 1.625% Notes have a contractual maturity date in 2044; however, on specified dates beginning in 2018 as described below, holders of the 1.625% Notes may require us to repurchase some or all of the 1.625% Notes, or we may redeem any or all of the 1.625% Notes.
Substantially all of our debt is held at the parent, which is reported in the Other segment. The principal amounts, unamortized discount (net of premium related to 1.625% Notes), unamortized issuance costs, and net carrying amounts of debt were as follows:
 Principal Balance Unamortized Discount Unamortized Issuance Costs Net Carrying Amount
 (In millions)
December 31, 2015:       
5.375% Notes$700
 $
 $11
 $689
1.125% Convertible Notes550
 95
 7
 448
1.625% Convertible Notes302
 25
 4
 273
Other1
 
 
 1
 $1,553
 $120
 $22
 $1,411
December 31, 2014:       
1.125% Convertible Notes$550
 $115
 $9
 $426
1.625% Convertible Notes302
 33
 5
 264
 $852
 $148
 $14
 $690
 Years Ended December 31,
 2015 2014 2013
 (In millions)
Interest cost recognized for the period relating to:     
Contractual interest coupon rate$17
 $13
 $13
Amortization of the discount29
 26
 22
 $46
 $39
 $35
5.375% Senior Notes due 2022. On November 10, 2015, we completed the private offering of $700 million aggregate principal amount of senior notes (5.375% Notes) due November 15, 2022, unless earlier redeemed. Interest is payable semiannually in arrears on May 15 and November 15, beginning on May 15, 2016. The 5.375% Notes are not convertible into our common stock or any other securities.
The 5.375% Notes are guaranteed by certain of our wholly owned subsidiaries. The 5.375% Notes and the guarantees are effectively subordinated to all existing and future secured debt of us and our guarantors to the extent of the assets securing such debt. In addition, the 5.375% Notes and the guarantees are structurally subordinated to all indebtedness and other liabilities and preferred stock of our subsidiaries that do not guarantee the 5.375% Notes.
We may redeem some or all of the 5.375% Notes at any time, and prior to August 15, 2022, at a price equal to 100% of the principal amount redeemed plus accrued and unpaid interest thereon, plus a "make-whole" premium. Thereafter, we may redeem some or all of the 5.375% Notes at a price equal to 100% of the principal amount redeemed plus accrued and unpaid

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interest thereon. The 5.375% Notes contain customary non-financial covenants and change of control provisions.
In connection with the issuance and sale of the 5.375% Notes, we entered into a registration rights agreement. Under this agreement, we will use commercially reasonable efforts to register substantially identical notes (the Exchange Notes) with the SEC in 2016. We will then offer such freely tradable Exchange Notes in exchange for the 5.375% Notes. We will pay additional interest on the 5.375% Notes if the Exchange Notes offering is not completed timely.
Credit Facility. In June 2015, weentered into an unsecured $250 million revolving credit facility (Credit Facility). The Credit Facility has a term of five years and all amounts outstanding will be due and payable on June 12, 2020. Subject to obtaining commitments from existing or new lenders and satisfaction of other specified conditions, we may increase the Credit Facility to up to $350 million. As of December 31, 2015, outstanding letters of credit amounting to $6 million reduced the borrowing capacity to $244 million, and no amounts were outstanding under the Credit Facility.
Borrowings under the Credit Facility bear interest based, at our election, on a base rate or an adjusted London Interbank Offered Rate (LIBOR), plus in each case the applicable margin. In addition to interest payable on the principal amount of indebtedness outstanding from time to time under the Credit Facility, we are required to pay a quarterly commitment fee.
Although the Credit Facility is not secured by any of our assets, certain of our wholly owned subsidiaries have jointly and severally guaranteed our obligations under the Credit Facility.
The Credit Facility contains customary non-financial and financial covenants, including a minimum fixed charge coverage ratio, a maximum debt-to-EBITDA ratio and minimum statutory net worth. At December 31, 2015, we were in compliance with all financial covenants under the Credit Facility.
1.125% Cash Convertible Senior Notes due 2020. In February 2013, we issued $550.0$550 million aggregate principal amount of 1.125% cash convertible senior notes (the 1.125%(1.125% Notes) due January 15, 2020, unless earlier repurchased or converted. Interest on the 1.125% Notes is payable semiannually in arrears on January 15 and July 15 at a rate of 1.125% per annum.15.
The 1.125% Notes are senior unsecured obligations and rank senior in right of payment to any of our indebtedness that is expressly subordinated in right of payment to the 1.125% Notes; equal in right of payment to any of our unsecured indebtedness that is not subordinated; effectively junior in right of payment to any of our secured indebtedness to the extent of the value of the assets securing such indebtedness; and structurally junior to all indebtedness and other liabilities of our subsidiaries.
The 1.125% Notes are convertible only into cash, and not into shares of our common stock or any other securities. The initial conversion rate for the 1.125% Notes is 24.5277 shares of our common stock per $1,000 principal amount of the 1.125% Notes. This represents an initial conversion price of approximately $40.77 per share of our common stock. TheUpon conversion, rate is subjectin lieu of receiving shares of our common stock, a holder will receive an amount in cash, per $1,000 principal amount of 1.125% Notes, equal to adjustmentthe settlement amount, determined in some events but willthe manner set forth in the indenture. We may not be adjusted for any accrued and unpaid interest.redeem the 1.125% Notes prior to the maturity date. Holders may convert their 1.125% Notes only under the following circumstances:
during any calendar quarter commencing after the calendar quarter ending on June 30, 2013 (and only during such calendar quarter), if the last reported sale price of the common stock for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on the last trading day of the immediately preceding calendar quarter is greater than or equal to 130% of the conversion price on each applicable trading day;
during the five business day period immediately after any five consecutive trading day period (the measurement period) in which the trading price per $1,000 principal amount of 1.125% Notes for each trading day of the measurement period was less than 98% of the product of the last reported sale price of our common stock and the conversion rate on each such trading day;
upon the occurrence of specified corporate events; or
at any time on or after July 15, 2019 until the close of business on the second scheduled trading day immediately preceding the maturity date. Upon conversion, in lieu of receiving shares of our common stock, a holder will receive an amount in cash, per $1,000 principal amount of
The 1.125% Notes equal tomet the settlement amount, determinedstock price trigger in the manner set forth in the indenture. We may not redeemquarter ended December 31, 2015, and are convertible into cash through at least March 31, 2016. Because the 1.125% Notes priormay be converted to cash within 12 months, the maturity date.
As$448 million carrying amount is reported in current portion of long-term debt as of December 31, 2014, the 1.125% Notes were not convertible.2015.
The 1.125% Notes contain an embedded cash conversion option (the 1.125% Notes Conversion Option), which was separated from the 1.125% Notes and accounted for separately as a derivative liability, with changes in fair value reported in our consolidated statements of income until the 1.125% Notes Conversion Option transaction settles or expires. The initial fair value liability of the 1.125% Notes Conversion Option simultaneously reduced the carrying value of the 1.125% Notes (effectively an original issuance discount).

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This discount is amortized to the 1.125% Notes' principal amount through the recognition of non-cash interest expense over the expected life of the debt. This has resulted in our recognition of interest expense on the 1.125% Notes at an effective rate approximating what we would have incurred had nonconvertible debt with otherwise similar terms been issued, orof approximately 6%. As of December 31, 2014, we expect2015, the 1.125% Notes to be outstanding until their maturity date, forhave a remaining amortization period of 5.04.0 years. The 1.125% Notes' if-converted value exceeded their principal amount by approximately $332 million and $93 million as of December 31, 2014,2015 and did not exceed their principal amount as of December 31, 2013.
3.75% Exchange. In August 2014, we entered into separate, privately negotiated, exchange agreements (the 3.75% Exchange) with certain holders of our outstanding 3.75% convertible senior notes due 2014 (the 3.75% Notes). In this transaction, we

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exchanged $176.6 million aggregate principal amount of the 3.75% Notes for $176.6 million principal amount of 1.625% convertible senior notes due 2044 (see further discussion below), approximately 1.7 million shares of our common stock, and payment of accrued interest on the exchanged 3.75% Notes. We did not receive any proceeds related to the 3.75% Exchange.respectively.
1.625% Convertible Senior Notes due 2044. In September 2014, we issued $125.0$125 million principal amount of 1.625% convertible senior notes (the 1.625%(1.625% Notes) due August 15, 2044, unless earlier repurchased, redeemed or converted. Combined with the 1.625% Notes issued in connection with the 3.75% Exchange described above,below, the aggregate principal amount issued under the 1.625% Notes was $301.6$302 million.
Interest on the 1.625% Notes is payable semiannually in arrears on February 15 and August 15, at a rate of 1.625% per annum, beginning on February 15, 2015.15. In addition, beginning with the semiannual interest period commencing immediately following the interest payment date on August 15, 2018, contingent interest will accrue on the 1.625% Notes during any semiannual interest period in which certain conditions or events occur, or under certain events of default. For example, additional interest of 0.25% per year will be payable on the 1.625% Notes for any semiannual interest period for which the principal amount of 1.625% Notes outstanding is less than $100 million.
The proceeds from the issuance of the 1.625% Notes amounted to $122.6 million, including a premium of $0.6 million, and net of deferred issuance costs paid for both the 3.75% Exchange and the additional $125.0 million principal amount issued. In connection with aggregate principal amount of the 1.625% Notes, we have recorded total deferred issuance costs of approximately $6 million, which will be amortized over the expected term of the debt, as discussed further below.
The 1.625% Notes are senior unsecured obligations and rank senior in right of payment to any of our indebtedness that is expressly subordinated in right of payment to the 1.625% Notes; equal in right of payment to any of our unsecured indebtedness that is not subordinated; effectively junior in right of payment to any of our secured indebtedness to the extent of the value of the assets securing such indebtedness; and structurally junior to all indebtedness and other liabilities of our subsidiaries.
The initial conversion rate for the 1.625% Notes is 17.2157 shares of our common stock per $1,000 principal amount of the 1.625% Notes. This represents an initial conversion price of approximately $58.09 per share of our common stock. Upon conversion, we will pay cash and, if applicable, deliver shares of our common stock to the converting holder in an amount per $1,000 principal amount of 1.625% Notes equal to the settlement amount (as defined in the related indenture).
Holders may convert their 1.625% Notes only under the following circumstances:
during any calendar quarter commencing after the calendar quarter ending on September 30, 2014 (and only during such calendar quarter), if the last reported sale price of the common stock for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on the last trading day of the immediately preceding calendar quarter is greater than or equal to 130% of the conversion price on each applicable trading day;
during the five business day period after any five consecutive trading day period (the measurement period) in which the trading price per $1,000 principal amount of 1.625% Notes for each trading day of the measurement period was less than 98% of the product of the last reported sale price of our common stock and the conversion rate on each such trading day;
upon the occurrence of specified corporate events;
if we call any 1.625% Notes for redemption, at any time until the close of business on the business day immediately preceding the redemption date;
during the period from, and including, May 15, 2018 to the close of business on the business day immediately preceding August 19, 2018; or
at any time on or after February 15, 2044 until the close of business on the second scheduled trading day immediately preceding the maturity date, holders may convert their 1.625% Notes, in integral multiples of $1,000 principal amount, at the option of the holder regardless of the foregoing circumstances.
As of December 31, 2014,2015, the 1.625% Notes were not convertible.
We may not redeem the 1.625% Notes prior to August 19, 2018. On or after August 19, 2018, we may redeem for cash all or part of the 1.625% Notes, except for the 1.625% Notes we are required to repurchase in connection with a fundamental change or on any specified repurchase date. The redemption price for the 1.625% Notes will equal 100% of the principal amount of the 1.625% Notes being redeemed, plus accrued and unpaid interest. In addition, holders of the 1.625% Notes may require us to repurchase some or all of the 1.625% Notes for cash on August 19, 2018, August 19, 2024, August 19, 2029, August 19, 2034 and August 19, 2039, in each case, at a specified price equal to 100% of the principal amount of the 1.625% Notes to be repurchased, plus accrued and unpaid interest.

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Because the 1.625% Notes are net share settled and have cash settlement features, we have allocated the principal amount between a liability component and an equity component. The reduced carrying value on the 1.625% Notes resulted in a debt discount that is amortized back to the 1.625% Notes' principal amount through the recognition of non-cash interest expense over the expected life of the debt. The expected life of the debt is approximately four years, beginning on the issuance date and

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ending on the first date we may redeem the notes in August 2018. As of December 31, 2014, we expect2015, the 1.625% Notes to be outstanding until August 2018, forhave a remaining amortization period of 3.62.6 years. This has resulted in our recognition of interest expense on the 1.625% Notes at an effective rate approximating what we would have incurred had nonconvertible debt with otherwise similar terms been issued, or approximately 5%. The outstanding 1.625% Notes’ if-converted value exceeded their principal amount by approximately $10 million as of December 31, 2015, and did not exceed their principal amount as of December 31, 2014. At December 31, 2015 and December 31, 2014, the equity component of the 1.625% Notes, including the impact of deferred taxes, was $22.9$23 million.
3.75% Convertible SeniorExchange. In August 2014, we entered into separate, privately negotiated, exchange agreements (the 3.75% Exchange) with certain holders of our outstanding 3.75% convertible senior notes due 2014 (the 3.75% Notes). In this transaction, we exchanged $177 million aggregate principal amount of the 3.75% Notes for $177 million principal amount of 1.625% convertible senior notes due 2014.2044, approximately 2 million shares of our common stock, and payment of accrued interest on the exchanged 3.75% Notes; additionally, we issued approximately 81,000 shares of common stock for services rendered in connection with the 3.75% Exchange. We did not receive any proceeds from the 3.75% Exchange.
3.75% Notes. As described above, we entered into the 3.75% Exchange transaction in August 2014, under which we exchanged $176.6$177 million of the outstanding principal amount of the 3.75% Notes for the 1.625% Notes. The remaining $10.4$10 million principleprincipal amount was repaid in full in October 2014. In addition to the repayment of the outstanding principle balance, in early October 2014 we issued approximately 0.1 million shares to settle the 3.75% Notes' conversion feature.
The principal amounts, unamortized discount (net of premium related to 1.625% Notes), and net carrying amounts of the convertible senior notes were as follows:
 Principal Balance Unamortized Discount Net Carrying Amount
 (In thousands)
December 31, 2014:     
1.125% Notes$550,000
 $114,670
 $435,330
1.625% Notes301,551
 32,784
 268,767
 $851,551
 $147,454
 $704,097
December 31, 2013:     
1.125% Notes$550,000
 $133,632
 $416,368
3.75% Notes187,000
 5,128
 181,872
 $737,000
 $138,760
 $598,240
 Years Ended December 31,
 2014 2013 2012
 (In thousands)
Interest cost recognized for the period relating to the:     
Contractual interest coupon rate$12,504
 $12,427
 $7,012
Amortization of the discount26,064
 22,103
 5,942
 $38,568
 $34,530
 $12,954
Lease Financing Obligations. In 2013, we entered into a sale-leaseback transaction for the sale and contemporaneous leaseback of the Molina Center located in Long Beach, California, and our Ohio health plan office building located in Columbus, Ohio. Due to our continuing involvement with these leased properties, the sale did not qualify for sale-leaseback accounting treatmentsales recognition and we remain the "accounting owner" of the properties. These assets continue to be included in our consolidated balance sheets, and also continue to be depreciated and amortized over their remaining useful lives. The lease financing obligation is amortized over the 25-year lease term such that there will be no gain or loss recorded if the lease is not extended at the end of its term. Rent will increase 3% per year through the initial term. Payments under the lease adjust the lease financing obligation, and the imputed interest is recorded to interest expense in our consolidated statements of income. Such interest amounted to $12.5 million and $6.8$13 million for the yearboth years ended December 31, 20142015 and 2013, respectively.2014.
As described and defined in further detail in Note 18,17, "Related Party Transactions," we entered into a lease for office space in February 2013 consisting of two office buildings. We have concluded that we are the accounting owner of the buildings due to our continuing involvement with the properties. We have recorded $38.4$36 million to property, equipment and capitalized software, net, in the accompanying consolidated balance sheet as of December 31, 2014,2015, which represents the total cost incurred by the Landlord for the construction of the buildings, net of accumulated depreciation. As of December 31, 2015 and December 31, 2014, the aggregate amount recorded to lease financing obligations, including the current portion, amounted to $40.6 million.$40 million and $41 million, respectively. Payments under the lease adjust the lease financing obligation, and the imputed interest is recorded to interest expense in our consolidated statements of income. Such interest expense was $4 million and $3 million for the yearsyear ended December 31, 2014,2015 and 2013, was $3.2 million and $1.3

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million,2014, respectively. In addition to the capitalization of the costs incurred by the Landlord, we impute and record rent expense relating to the ground leases for the property sites. Such rent expense is computed based on the fair value of the land and our incremental borrowing rate, amounting to $1.1and was $1 million for the yearboth years ended December 31, 2014,2015 and insignificant for the year ended December 31, 2013.2014. For information regarding the future minimum lease obligation, refer to Note 20,19, "Commitments and Contingencies."
13. Derivative Financial InstrumentsDerivatives
The following table summarizes the fair values and the presentation of our derivative financial instruments (defined and discussed individually below) in the consolidated balance sheets:
 December 31, December 31,
Balance Sheet Location 2014 2013Balance Sheet Location 2015 2014
 (In thousands) (In millions)
Derivative asset:        
1.125% Call OptionNon-current assets: Derivative asset $329,323
 $186,351
Current assets: Derivative asset $374
 $
    Non-current assets: Derivative asset $
 $329
    
Derivative liability:        
1.125% Notes Conversion OptionNon-current liabilities: Derivative liability $329,194
 $186,239
1.125% Conversion OptionCurrent liabilities: Derivative liability $374
 $
Non-current liabilities: Derivative liability $
 $329
Our derivative financial instruments do not qualify for hedge treatment, therefore the change in fair value of these instruments is recognized immediately in our consolidated statements of income, and reported in other expense, net. Gains and losses for our derivative financial instruments are presented individually in the consolidated statements of cash flows, supplemental cash flow information.

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1.125% Notes Call Spread Overlay. Concurrent with the issuance of the 1.125% Notes in 2013, as described in Note 12, "Long-Term Debt," we entered into privately negotiated hedge transactions (collectively, the 1.125% Call Option) and warrant transactions (collectively, the 1.125% Warrants), with certain of the initial purchasers of the 1.125% Notes (the Counterparties). We refer to these transactions collectively as the Call Spread Overlay. Under the Call Spread Overlay, the cost of the 1.125% Call Option we purchased to cover the cash outlay upon conversion of the 1.125% Notes was reduced by proceeds from the sale of the 1.125% Warrants. Assuming full performance by the Counterparties (and 1.125% Warrants strike prices in excess of the conversion price of the 1.125% Notes), these transactions are intended to offset cash payments in excess of the principal amount of the notes due upon any conversion of the 1.125% Notes.
1.125% Call Option. The 1.125% Call Option, which is indexed to our common stock, is a derivative asset that requires mark-to-market accounting treatment due to cash settlement features until the 1.125% Call Option settles or expires. For further discussion of the inputs used to determine the fair value of the 1.125% Call Option, refer to Note 5, "Fair Value Measurements."
1.125% Notes Conversion Option. The embedded cash conversion option within the 1.125% Notes is accounted for separately as a derivative liability, with changes in fair value reported in our consolidated statements of income until the cash conversion option settles or expires. For further discussion of the inputs used to determine the fair value of the 1.125% Notes Conversion Option, refer to Note 5, "Fair Value Measurements."
Interest Rate Swap. In 2012, we entered intoAs of December 31, 2015, the 1.125% Call Option and the 1.125% Conversion Option were classified as a $42.5 million notional amount interest rate swap, which was intended to reduce our exposure to fluctuationscurrent asset and current liability, respectively, because the 1.125% Notes may be converted within 12 months of December 31, 2015, as described in the contractual variable interest rates under our term loan agreement that was repaid in June 2013. In June 2013, we settled the interest rate swap for $0.9 million.Note 12, "Debt."

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14. Income Taxes
The provision for income taxes for continuing operations consisted of the following:
Year Ended December 31,Year Ended December 31,
2014 2013 20122015 2014 2013
(In thousands)(In millions)
Current:          
Federal$72,040
 $66,883
 $23,019
$172
 $72
 $67
State3,038
 581
 1,254
8
 3
 
Foreign6
 
 
Total current75,078
 67,464
 24,273
186
 75
 67
Deferred:          
Federal(72) (25,498) (9,205)(10) 
 (25)
State(2,280) (5,650) (4,555)4
 (2) (6)
Foreign(1) 
 
Total deferred(2,352) (31,148) (13,760)(7) (2) (31)
$72,726
 $36,316
 $10,513
$179
 $73
 $36
A reconciliation of the U.S. federal statutory income tax rate to the combined effective income tax rate for continuing operations is as follows:
Year Ended December 31,Year Ended December 31,
2014 2013 20122015 2014 2013
Statutory federal tax rate35.0 % 35.0 % 35.0 %35.0 % 35.0 % 35.0 %
State income taxes, net of federal benefit0.4
 (0.5) (9.2)2.4
 0.4
 (0.5)
Change in unrecognized tax benefits(0.1) (3.7) 0.7
0.9
 (0.1) (3.7)
Nondeductible health insurer fee (HIF)22.9
 
 
17.0
 22.9
 
Nondeductible compensation(4.1) 9.6
 6.2
0.6
 (4.1) 9.6
Nondeductible lobbying(0.3) 1.6
 4.2
Nondeductible fair value of 1.125% Warrants
 2.4
 

 
 2.4
Change in fair value of contingent consideration liabilities
 (0.3) 4.8
Other
 0.7
 3.3
(0.4) (0.3) 2.0
Effective tax rate53.8 % 44.8 % 45.0 %55.5 % 53.8 % 44.8 %
Our effective tax rate is based on expected income, statutory tax rates, and tax planning opportunities available to us in the various jurisdictions in which we operate. Significant management estimates and judgments are required in determining our

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effective tax rate. We are routinely under audit by federal, state, or local authorities regarding the timing and amount of deductions, nexus of income among various tax jurisdictions, and compliance with federal, state, foreign, and local tax laws.
During 2014, the Internal Revenue Service (IRS) issued final regulations related to compensation deduction limitations applicable to certain health insurance issuers. Pursuant to these final regulations, we reversed amounts treated as nondeductible in 2013 and recognized a tax benefit during 2014.
During 2015, 2014, 2013, and 2012,2013, excess tax benefits from share-based compensation amounted to $3.0$8 million, $1.6$3 million, and $3.1$2 million, respectively. These amounts were recorded as a decrease to income taxes payable and an increase to additional paid-in capital.

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Deferred tax assets and liabilities are classified as current or non-current according to the classification of the related asset or liability.non-current. Significant components of our deferred tax assets and liabilities as of December 31, 20142015 and 20132014 were as follows:
December 31,December 31,
2014 20132015 2014
(In thousands)(In millions)
Accrued expenses$13,323
 $19,545
$37
 $13
Reserve liabilities2,487
 1,712
14
 4
State taxes(134) (1,323)
Other accrued medical costs3,800
 2,540
5
 4
Net operating losses27
 27
7
 3
Unrealized losses444
 380
2
 1
Unearned premiums21,749
 10,543
21
 22
Lease financing obligation35
 34
Deferred compensation8
 10
Tax credit carryover8
 8
Valuation allowance(9) (6)
Total deferred income tax assets, net of valuation allowance128
 93
Prepaid expenses(5,920) (5,354)(9) (6)
Depreciation and amortization(83) (57)
Basis in debt(210) (2,162)(18) (15)
Deferred compensation5,252
 2,087
Other, net(244) (928)
Valuation allowance(1,042) (511)
Deferred tax asset, net of valuation allowance — current39,532
 26,556
Reserve liabilities2,017
 1,909
State tax credit carryover8,157
 7,027
Net operating losses3,138
 2,326
Unrealized losses181
 286
Depreciation and amortization(57,068) (40,433)
Deferred compensation4,405
 3,404
Lease financing obligation34,084
 27,543
Basis in debt(14,724) 466
Other, net(96) (24)
Valuation allowance(4,365) (3,084)
Deferred tax liability, net of valuation allowance — long term(24,271) (580)
Net deferred income tax asset$15,261
 $25,976
Total deferred income tax liabilities(110) (78)
Net deferred income tax asset - long term$18
 $15
At December 31, 2014,2015, we had federal and state net operating loss carryforwards of $0.2$180 million, and $84.0 million, respectively. The federal net operating loss begins expiring in 2018, and state net operating losseswhich begin expiring in 2015. The utilization of the net operating losses is subject to certain limitations under federal law.2016.
At December 31, 2014,2015, we had California enterprise zone tax credit carryovers of $12.5$11 million, which will begin to expire in 2024, and foreign tax credit carryovers of $1 million, which expire in 2024.2025.
We evaluate the need for a valuation allowance taking into consideration the ability to carry back and carry forward tax credits and losses, available tax planning strategies and future income, including reversal of temporary differences. We have determined that as of December 31, 2014, $5.42015, $9 million of deferred tax assets did not satisfy the recognition criteria due to uncertainty regarding the realization of some of our state tax operating loss and foreign tax credit carryforwards. Therefore, we increased our valuation allowance by $1.8$3 million, from $3.6$6 million at December 31, 2013,2014, to $5.4$9 million as of December 31, 2014.2015.
We recognize tax benefits only if the tax position is more likely than not to be sustained. We are subject to income taxes in the U.S.United States, Puerto Rico, and numerous state jurisdictions. Significant judgment is required in evaluating our tax positions and determining our provision for income taxes. During the ordinary course of business, there are many transactions and calculations for which the ultimate tax determination is uncertain. We establish reserves for tax-related uncertainties based on estimates of whether, and the extent to which, additional taxes will be due. These reserves are established when we believe that certain positions might be challenged despite our belief that our tax return positions are fully supportable. We adjust these reserves in light of changing facts and circumstances, such as the outcome of tax audits. The provision for income taxes includes the impact of reserve provisions and changes to reserves that are considered appropriate.

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The roll forward of our unrecognized tax benefits is as follows:
Year Ended December 31,Year Ended December 31,
2014 2013 20122015 2014 2013
(In thousands)(In millions)
Gross unrecognized tax benefits at beginning of period$(8,030) $(10,622) $(10,712)$(3) $(8) $(11)
Increases in tax positions for current year(1) 
 
Increases in tax positions for prior years
 
 (441)(5) (1) (2)
Decreases in tax positions for prior years
 3,615
 320

 
 5
Increases in tax positions for current year(777) (2,084) 
Decreases in tax positions for current year
 886
 
Settlements5,960
 
 

 6
 
Lapse in statute of limitations253
 175
 211
Gross unrecognized tax benefits at end of period$(2,594) $(8,030) $(10,622)$(9) $(3) $(8)
The total amount of unrecognized tax benefits at December 31, 2015, 2014 2013 and 20122013 that, if recognized, would affect the effective tax rates is $1.6$7 million, $5.7$2 million and $7.4$6 million, respectively. We expect that during the next 12 months it is reasonably possible that unrecognized tax benefit liabilities may decrease by as much as $0.1$1 million due to the normal expiration of statutes of limitation.
Our continuing practice is to recognize interest and/or penalties related to unrecognized tax benefits in income tax expense. Amounts accrued for the payment of interest and penalties as of December 31, 2014,2015, and 20132014 were insignificant.
We are under examination by the IRS for calendar year 2011 and may be subject to examination for calendar years 2012 through 2014. We are under examination, or may be subject to examination, in Puerto Rico and certain state and local jurisdictions, with the major state jurisdictions being California, Utah, and Michigan, for the years 2010 through 2014.
15. Stockholders' Equity
Stockholders' equity increased $117.5$547 million during the year ended December 31, 2014.2015. The increase was primarily due to the common stock offering described below, net income of $62.2$143 million, $22.0 million related to 1.625% Notes and 3.75% Exchange, $33.2$34 million related to share-based compensation transactions, and $0.1 million related to other comprehensive income.transactions.
3.75% Exchange and 3.75% Notes.Common Stock Offering. As described in Note 12, "Long-Term Debt,"In June 2015, we issued approximately 1.8 million shares in connection with the 3.75% Exchange, and the 3.75% Notes settlement in 2014; additionally, we issued approximately 81,000completed an underwritten public offering of 5,750,000 shares of our common stock, for services renderedincluding the over-allotment option. Net of issuance costs, proceeds from the offering amounted to $373 million, or $64.90 per share, resulting in connection withan increase to additional paid-in capital. We are using the 3.75% Exchange.proceeds to finance working capital needs, acquisitions, capital expenditures, and other general corporate activities.
1.125% Warrants. In connection with the 1.125% Notes Call Spread Overlay transaction described in Note 13, "Derivative Financial Instruments,"Derivatives," in 2013, we issued 13,490,236 warrants with a strike price of $53.8475 per share. The number of warrants and the strike price are subject to adjustment under certain circumstances. If the market value per share of our common stock exceeds the strike price of the 1.125% Warrants on any trading day during the 160 trading day measurement period (beginning on April 15, 2020) under the 1.125% Warrants, we will be obligated to issue to the Counterparties a number of shares equal in value to the product of the amount by which such market value exceeds such strike price and 1/160th of the aggregate number of shares of our common stock underlying the 1.125% Warrants, subject to a share delivery cap. The 1.125% Warrants could separately have a dilutive effect to the extent that the market value per share of our common stock (as measured under the terms of the warrant transactions) exceeds the applicable strike price of the 1.125% Warrants. Refer to Note 3, "Net Income per Share," for dilution information for the periods presented. We will not receive any additional proceeds if the 1.125% Warrants are exercised.
Securities Repurchases. In connection with the issuance and settlement of the 1.125% Notes, we used a portion of the net proceeds from the offering to repurchase $50 million of our common stock in negotiated transactions with institutional investors in the offering, concurrently with the pricing of the offering. In February 2013, we repurchased a total of 1,624,959 shares at $30.77 per share, which was our closing stock price on that date.
Securities Repurchase Programs. Effective as of December 16, 2015, our board of directors authorized the repurchase of up to $50 million in aggregate of our common stock or senior notes. This newly authorized repurchase program extends through December 31, 2016.
In February 25, 2015, our board of directors authorized the repurchase of up to $50 million in aggregate of our common stock. Stock repurchasesWe did not repurchase any shares under this program, may be made through open-market and/or privately negotiated transactions at times and in such amounts as management deems appropriate. The timing and actual number of shares repurchased will depend on a variety of factors including price, corporate and regulatory requirements and market conditions. This newly authorized repurchase program extends throughwhich expired December 31, 2015.
Effective as of September 30, 2013, our board of directors authorized the repurchase of up to $50 million in aggregate of our common stock. Under this program, we purchased approximately 85,000 shares of our common stock for $2.7 million (average cost of $31.28 per share) during November 2013. This repurchase program expired December 31, 2014.

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Shelf Registration Statement.In May 2012, we filed an automatic shelf registration statement on Form S-3 with the SEC covering the issuance of an indeterminate number of our securities, including common stock, warrants, or debt securities. We may publicly offer securities from time to time at prices and terms to be determined at the time of the offering.
Stock Incentive Plans. In connection with the stock plans described in Note 17, "Share-Based Compensation," we issued approximately 840,000, and 820,000 shares of common stock, net of shares used to settle employees’ income tax obligations, for the years ended December 31, 2014 and 2013, respectively.
16. Employee Benefits
We sponsor a defined contribution 401(k) plan that covers substantially all full-time salaried and hourly employees of our company and its subsidiaries. Eligible employees are permitted to contribute up to the maximum amount allowed by law. We match up to the first 4% of compensation contributed by employees. Expense recognized in connection with our contributions to the 401(k) plan totaled $21.2 million, $12.8 million and $10.7 million in the years ended December 31, 2014, 2013, and 2012, respectively.
We also have a nonqualified deferred compensation plan for certain key employees. Under this plan, eligible participants may defer up to 100% of their base salary and 100% of their bonus to provide tax-deferred growth for retirement. The funds deferred are invested in corporate-owned life insurance, under a rabbi trust.
17. Share-Based Compensation
At December 31, 2014,2015, we had employee equity incentives outstanding under two plans: (1) the 2011 Equity Incentive Plan (2011 Plan); and (2) the 2002 Equity Incentive Plan (from which equity incentives are no longer awarded).
The 2011 Plan provides for the award of stock options, restricted shares and units, performance shares and units, stock options and stock bonuses to the company’s officers, employees, directors, consultants, advisers, and other service providers. The 2011 Plan allowsprovides for the issuance of up to 4.5 million shares of common stock.
In March 2014, our named executive officers were granted a total of 356,292 restricted shares with service, market, and performance conditions. In the event the vesting conditions are not achieved, the awards shall lapse. As of December 31, 2014, we expect the performance conditions to be met in full.
Restricted share awards are granted with a fair value equal to the market price of our common stock on the date of grant, and generally vest in equal annual installments over periods up to four years from the date of grant. Stock option awards have an

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exercise price equal to the fair market value of our common stock on the date of grant, generally vest in equal annual installments over periods up to four years from the date of grant, and have a maximum term of ten years from the date of grant.
In connection with our stock plans, we issued approximately 830,000 shares of common stock, net of shares used to settle employees’ income tax obligations, in the year ended December 31, 2015.
The following table illustrates the components of our share-based compensation expense that are reported in general and administrative expenses in the consolidated statements of income:
 Year Ended December 31,
 2015 2014 2013
 (In millions)
 
Pretax
Charges
 
Net-of-Tax
Amount
 
Pretax
Charges
 
Net-of-Tax
Amount
 
Pretax
Charges
 
Net-of-Tax
Amount
Restricted stock and performance awards$19
 $13
 $19
 $12
 $26
 $23
Employee stock purchase plan and stock options4
 3
 3
 2
 3
 2
 $23
 $16
 $22
 $14
 $29
 $25
As of December 31, 2015, there was $25 million of total unrecognized compensation expense related to unvested restricted share awards, including those with performance conditions, which we expect to recognize over a remaining weighted-average period of 1.6 years. This unrecognized compensation cost assumes an estimated forfeiture rate of 6.5% for non-executive employees as of December 31, 2015. As of December 31, 2015, the unrecognized compensation expense related to unvested stock options was insignificant.
Restricted stock. Restricted and performance stock activity for the year ended December 31, 2015 is summarized below:
 Shares 
Weighted
Average
Grant Date
Fair Value
Unvested balance as of December 31, 20141,282,072
 $33.55
Granted - restricted shares273,710
 64.56
Granted - performance shares162,827
 63.90
Vested - restricted shares(371,489) 34.58
Vested - performance shares(264,604) 30.80
Forfeited(47,759) 37.51
Unvested balance as of December 31, 20151,034,757
 46.68
The total fair value of restricted and performance share awards granted during the years ended December 31, 2015, 2014, and 2013 was $28 million, $25 million, and $33 million, respectively. The total fair value of restricted share awards, including those with performance or market conditions which vested during the years ended December 31, 2015, 2014, and 2013 was $39 million, $24 million, and $22 million, respectively.
In 2015, our named executive officers were granted approximately 163,000 restricted shares with performance and market conditions. The grant date fair value for the awards with market conditions were determined based on a Monte Carlo Simulation which projected Total Stockholder Return (TSR) over the performance period using correlations and volatilities of our ISS peer groups. The weighted-average grant date fair value per share of the 2015 performance awards based on three-year TSR was $49.43, determined using additional inputs as follows: risk-free interest rate of 0.8%, dividend yield of 0%, and expected life of 2.8 years.
As of December 31, 2015, there were approximately 377,000 unvested restricted shares outstanding which contained one or more performance measures. In the event the vesting conditions are not achieved, the awards will lapse. Based on our assessment as of December 31, 2015, we expect the performance conditions relating to approximately 199,000 of these outstanding restricted share awards to be met in full.
In 2015, we reversed approximately $3 million in share-based compensation expense recognized from grant date through March 31, 2015, related to 178,000 of the awards granted in 2014, due to management's determination in the second quarter of 2015 that the achievement of the underlying performance conditions was not probable.

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In December 2015, approximately 229,000 restricted stock awards with performance conditions, granted in 2013, vested due to achievement of the total revenue metric as defined in the terms of the grant.
Employee Stock Purchase Plan.Under our employee stock purchase plan (ESPP), eligible employees may purchase common shares at 85% of the lower of the fair market value of our common stock on either the first or last trading day of each six-month offering period. Each participant is limited to a maximum purchase of $25,000 (as measured by the fair value of the stock acquired) per year through payroll deductions. We estimate the fair value of the stock issued using the Black-Scholes option pricing model. For the years ended December 31, 2015, 2014, and 2013, 2012, the inputs to this model were as follows: risk-free interest rates ranging fromof approximately 0.1% to 0.2%; expected volatilities ranging from approximately 30% to 50%, dividend yields of 0%, and an average expected life of 0.5 years. We issued approximately 301,900, 327,200 299,600 and 277,400299,600 shares of our common stock under the ESPP during the years ended December 31, 2015, 2014, 2013, and 2012,2013, respectively. The 2011 ESPP allowsprovides for the issuance of up to three million shares of common stock.
The following table illustrates the components of our share-based compensation expense that are reportedStock Options. No stock options were granted in general2015 and administrative expenses in the consolidated statements of income:
 Year Ended December 31,
 2014 2013 2012
 (In thousands)
 
Pretax
Charges
 
Net-of-Tax
Amount
 
Pretax
Charges
 
Net-of-Tax
Amount
 
Pretax
Charges
 
Net-of-Tax
Amount
Restricted stock and performance awards$18,535
 $11,936
 $26,116
 $22,489
 $18,106
 $12,943
Employee stock purchase plan and stock options3,192
 2,352
 2,578
 2,012
 1,912
 1,613
 $21,727
 $14,288
 $28,694
 $24,501
 $20,018
 $14,556
As of December 31, 2014, there was $24.5 million of total unrecognized compensation expense related to unvested restricted share awards, including those with performance conditions, which we expect to recognize over a remaining weighted-average period of 1.7 years. This unrecognized compensation cost assumes an estimated forfeiture rate of 4.0% as of December 31,

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2014. Alsoand stock options outstanding as of December 31, 2014, there was $0.3 million of unrecognized compensation expense related to unvested stock options, which we expect to recognize over a weighted-average period of 1.0 year.
Restricted and performance stock activity for the year ended December 31, 2014 is summarized below:
 Shares 
Weighted
Average
Grant Date
Fair Value
Unvested balance as of December 31, 20131,299,852
 $29.03
Granted - restricted stock420,352
 38.06
Granted - performance stock249,402
 34.61
Vested - restricted stock(423,970) 26.70
Vested - performance stock(199,948) 30.18
Forfeited(63,616) 31.31
Unvested balance as of December 31, 20141,282,072
 33.55
The total fair value of restricted and performance awards granted during the year ended December 31, 2014, 2013, and 2012 was $25.4 million, $33.3 million, and $16.2 million, respectively. The total fair value of restricted awards, including those with performance and market conditions which vested during the year ended December 31, 2014, 2013, and 2012 was $23.7 million, $22.3 million, and $25.4 million, respectively.
The weighted-average grant date fair value per share of the performance awards with vesting conditions based on one-year Total Stockholder Return (TSR) was $27.25. We estimated the fair value on the grant date using a Monte Carlo Simulation to project TSR over the performance period using correlations and volatilities of the ISS peer group. Additional inputs included a risk-free interest rate of 0.1%, dividend yield of 0%, and an expected life of 0.8 years. The weighted-average grant date fair value per share of the performance awards with vesting conditions based on three-year TSR, as described above, was $26.60. Additional inputs included a risk-free interest rate of 0.5%, dividend yield of 0%, and an expected life of 2.8 years.
The total fair value of restricted stock units granted during the year ended December 31, 2012 was $0.3 million with a weighted average grant date fair value of $35.01. These restricted stock units vested during 2013. No restricted stock units2015 were granted in 2014 and 2013 and there were no outstanding restricted stock units as of December 31, 2014.
Stock option activity for the year ended December 31, 2014 is summarized below:
 Shares 
Weighted
Average
Exercise Price
 
Aggregate
Intrinsic
Value
 
Weighted
Average
Remaining
Contractual
term
     (In thousands) (Years)
Stock options outstanding as of December 31, 2013379,221
 $24.14
    
Exercised(122,523) 24.93
    
Stock options outstanding as of December 31, 2014256,698
 23.77
 $7,640
 3.3
Stock options exercisable and expected to vest as of December 31, 2014256,698
 23.77
 $7,640
 3.3
Exercisable as of December 31, 2014221,698
 22.26
 $6,932
 2.5
insignificant. The weighted-average grant date fair value per share of the stock options awarded to the new members of our board of directors during 2013 was $14.67. The weighted-average grant date fair value per share of the stock option awarded to the director appointed during 2012 was $13.97. We estimateestimated the fair value of each stock option award on the grant date using the Black-Scholes option pricing model. To determinemodel, with the fair value of these stock options we appliedfollowing inputs: risk-free interest ratesrate of 1.1% to 1.4%, expected volatilitiesvolatility of 41.3% to 43.0%, dividend yieldsyield of 0%, and expected liveslife of 6 years to 7 years. No stock options were granted in 2014.

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The total intrinsic value of options exercised during the yearyears ended December 31, 2015, 2014, and 2013 and 2012 was $2.1$6 million, $1.2$2 million, and $2.0$1 million, respectively. The following is a summary of information about stock options outstanding and exercisable at December 31, 2014:
 Options Outstanding Options Exercisable
Range of Exercise Prices
Number
Outstanding
 
Weighted-
Average
Remaining
Contractual
Life (Years)
 
Weighted-
Average
Exercise
Price
 
Number
Exercisable
 
Weighted-
Average
Exercise
Price
$19.1146,148
 1.1 $19.11
 46,148
 $19.11
$20.88139,500
 2.2 20.88
 139,500
 20.88
$22.86 – $34.8271,050
 6.9 32.46
 36,050
 31.66
 256,698
     221,698
  
18.16. Employee Benefits
We sponsor defined contribution 401(k) plans that cover substantially all full-time salaried and hourly employees of our company and its subsidiaries. Eligible employees are permitted to contribute up to the maximum amount allowed by law. We match up to the first 4% of compensation contributed by employees. Expense recognized in connection with our contributions to the 401(k) plans totaled $27 million, $21 million and $13 million in the years ended December 31, 2015, 2014, and 2013, respectively.
We also have a nonqualified deferred compensation plan for certain key employees. Under this plan, eligible participants may defer up to 100% of their base salary and 100% of their bonus to provide tax-deferred growth for retirement. The funds deferred are invested in corporate-owned life insurance, under a rabbi trust.
17. Related Party Transactions
In February 2013,Prior to December 22, 2015, we were the Parent (as defined in Note 23, "Condensed Financial Information of Registrant,") entered intolessee under a lease with 6th6th & Pine Development, LLC (the Landlord) for two office buildings, referred to as Building A and Building B, in Long Beach, California. The lease term for Building A commenced in June 2013, and the lease term for Building B commenced in July 2014.
buildings. The principal members of the Landlord arewere John C. Molina, our chief financial officer and a director of the Company,Molina Healthcare, Inc., and his wife. In addition, in connection with the development of the buildings being leased, John C. Molina has pledged sharescertain of his common stock holdings in the Company that he holds.Molina Healthcare, Inc. Dr. J. Mario Molina, our chief executive officer, president and chairman of the board of directors, holds a partial interest in such shares as trust beneficiary.
Effective October 31, 2014, On December 22, 2015, the Parent entered intoLandlord assigned the First Amendmentlease to Office Building Lease (the Amended Lease) withan unrelated third party. There were no significant changes to the Landlord. The Amended Lease reducedlease other than the annual rent escalator underassignment to the original lease from 3.75% per year to 3.4% per year. The Amended Lease also extended the initial base termnew owner. As a result of the original lease by five years such that the Amended Lease will now expire onassignment, as of December 31, 2029, unless extended or earlier terminated. The Amended Lease also converted2015, amounts previously reported as lease financing obligations - related party were reported in lease financing obligations on the original lease from a full service gross lease to a triple-net lease. For information regarding the future minimum lease payments, refer to Note 20, "Commitments and Contingencies."accompanying consolidated balance sheets. For information regarding the lease financing obligation associated with this lease, refer to Note 12, "Long-Term Debt."Debt."
Our California health plan has entered into a provider agreement with Pacific Healthcare IPA (Pacific), which is 50% owned by the brother-in-law of Dr. J. Mario Molina and John C. Molina. Under the terms of this provider agreement, the California health plan paid Pacific approximately $1 million in each of 2015 and 2014 for medical care provided to health plan members. Payments in 2013 were insignificant.
Refer to Note 19,18, "Variable Interest Entities (VIEs)," for a discussion of the Joseph M. Molina, M.D. Professional Corporations.

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19.18. Variable Interest Entities (VIEs)
Joseph M. Molina M.D., Professional Corporations
The Joseph M. Molina, M.D. Professional Corporations (JMMPC) were created in 2012 to further advance our direct delivery business. JMMPC's soleprimary shareholder is Dr. J. Mario Molina, our chief executive officer, president, and chairman of the board of directors. Dr. Molina is paid no salary and receives no dividends in connection with his work for, or ownership of, JMMPC. JMMPC provides primary care medical services through its employed physicians and other medical professionals. Beginning in the fourth quarter of 2014, JMMPC also provided certain specialty referral services to our California health plan members through a contracted provider network. Substantially all of the individuals served by JMMPC are members of our health plans. JMMPC does not have agreements to provide professional medical services with any other entities.
Our wholly owned subsidiary, Molina Medical Management, Inc. (MMM), has entered into services agreements with JMMPC to provide clinic facilities, clinic administrative support staff, patient scheduling services and medical supplies to JMMPC. The services agreements were designed such that JMMPC will operate at break even, ensuring the availability of quality care and access for our health plan members. The services agreements provide that the administrative fees charged to JMMPC by MMM are reviewed annually to assure the achievement of this goal.
Separately, our California, Florida, New Mexico, Utah and Washington health plans have entered into primary care services agreements with JMMPC. These agreements direct our health plans to perform a monthly reconciliation, to either fund JMMPC's operating deficits, or receive JMMPC's operating surpluses, such that JMMPC will derive no profit or loss. Because the MMM services agreements described above mitigate the likelihood of significant operating deficits or surpluses, such monthly reconciliation amounts are generally insignificant.
We have determined that JMMPC is a variable interest entity (VIE),VIE, and that we are its primary beneficiary. We have reached this conclusion under the power and benefits criterion model according to GAAP. Specifically, we have the power to direct the activities that most significantly affect JMMPC's economic performance, and the obligation to absorb losses or right to receive

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benefits that are potentially significant to the VIE, under the agreements described above. Because we are its primary beneficiary, we have consolidated JMMPC. JMMPC's assets may be used to settle only JMMPC's obligations, and JMMPC's creditors have no recourse to the general credit of Molina Healthcare, Inc. As of December 31, 2015, JMMPC had total assets of $17 million, and total liabilities of $17 million. As of December 31, 2014, JMMPC had total assets of $31.1$31 million, and total liabilities of $30.8 million. As of December 31, 2013, JMMPC had total assets of $6.9 million, and total liabilities of $6.6$31 million.
Our maximum exposure to loss as a result of our involvement with JMMPC is generally limited to the amounts needed to fund JMMPC's ongoing payroll, and employee benefits. Additionally, in connection with specialty referral services provided beginning in 2014, our exposure to loss includesbenefits and medical care costs associated with such services.JMMPC's specialty referral activities. We believe that such loss exposures will be immaterial to our consolidated operating results and cash flows for the foreseeable future.
New Markets Tax Credit
In 2011, our New Mexico data center subsidiary entered into a financing transaction with Wells Fargo Community Investment Holdings, LLC (Wells Fargo), its wholly owned subsidiary New Mexico Healthcare Data Center Investment Fund, LLC (Investment Fund), and certain of Wells Fargo's affiliated Community Development Entities (CDEs), in connection with our participation in the federal government's New Markets Tax Credit Program (NMTC). The NMTC was established by Congress in 2000 to facilitate new or increased investments in businesses and real estate projects in low-income communities. The NMTC attracts investment capital to low-income communities by permitting investors to receive a tax credit against their federal income tax return in exchange for equity investments in specialized financial institutions, called CDEs, which provide financing to qualified active businesses operating in low-income communities. The credit amounts to 39% of the original investment amount and is claimed over a period of seven years (five percent for each of the first three years, and six percent for each of the remaining four years). The investment in the CDE cannot be redeemed before the end of the seven-year period.
In the fourth quarter of 2011, as a result of a series of simultaneous financing transactions, Wells Fargo contributed capital of $5.9$6 million to the Investment Fund, and Molina Healthcare, Inc. loaned the principal amount of $15.5$16 million to the Investment Fund. The Investment Fund then contributed the proceeds to certain CDEs, which, in turn, loaned the proceeds of $20.9$21 million to our New Mexico data center subsidiary. Wells Fargo will be entitled to claim the NMTC while we effectively received net loan proceeds equal to Wells Fargo's contribution to the Investment Fund, or approximately $5.9$6 million. Additionally, financing costs incurred in structuring the arrangement amounting to $1.2$1 million were deferred and will be recognized as expense over the term of the loans. This transaction also includes a put/call feature that becomes enforceable at the end of the seven-year compliance period. Wells Fargo may exercise its put option or we can exercise the call, both of which will serve to transfer the debt obligation to us. Incremental costs to maintain the structure during the compliance period will be recognized as incurred.
We have determined that the financing arrangement with Investment Fund and CDEs is a VIE, and that we are the primary beneficiary of the VIE. We reached this conclusion based on the following:

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The ongoing activities of the VIE—collecting and remitting interest and fees and NMTC compliance—were all considered in the initial design and are not expected to significantly affect economic performance throughout the life of the VIE;
Contractual arrangements obligate us to comply with NMTC rules and regulations and provide various other guarantees to Investment Fund and CDEs;
Wells Fargo lacks a material interest in the underling economics of the project; and
We are obligated to absorb losses of the VIE.
Because we are the primary beneficiary of the VIE, we have included it in our consolidated financial statements. Wells Fargo's contribution of $5.9$6 million is included in cash at December 31, 20142015 and December 31, 20132014 and the offsetting Wells Fargo's interest in the financing arrangement is included in other liabilities in the accompanying consolidated balance sheets.
As described above, this transaction also includes a put/call provision whereby we may be obligated or entitled to repurchase Wells Fargo's interest in the Investment Fund. The value attributed to the put/call is nominal. The NMTC is subject to 100% recapture for a period of seven years as provided in the Internal Revenue Code and applicable U.S. Treasury regulations. We are required to be in compliance with various regulations and contractual provisions that apply to the NMTC arrangement. Non-compliance with applicable requirements could result in Wells Fargo's projected tax benefits not being realized and, therefore, require us to indemnify Wells Fargo for any loss or recapture of NMTCs related to the financing until such time as the recapture provisions have expired under the applicable statute of limitations. We do not anticipate any credit recaptures will be required in connection with this arrangement.

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20.19. Commitments and Contingencies
Certain Leasing Transactions. As described in Note 12, "Long-Term Debt,"Debt," we entered into certain leasing transactions that have been classified as lease financing obligations. Such leases have initial terms that range from 16.5 years to 25 years. Additionally, the leases provide for renewal options ranging from 10 years to 25 years in aggregate.
Operating Leases. We lease administrative and clinic facilities and certain equipment under non-cancelable operating leases expiring at various dates through 2023.2025. Facility lease terms generally range from five to 10 years with one to two renewal options for extended terms. In most cases, we are required to make additional payments under facility operating leases for taxes, insurance and other operating expenses incurred during the lease period. Certain of our leases contain rent escalation clauses or lease incentives, including rent abatements and tenant improvement allowances. Rent escalation clauses and lease incentives are taken into account in determining total rent expense to be recognized during the lease term.
Future minimum lease payments by year and in the aggregate under all operating leases and lease financing obligations consist of the following approximate amounts:
Lease Financing Obligations Lease Financing Obligations - Related Party Operating Leases TotalLease Financing Obligations Operating Leases Total
(In thousands)(In millions)
2015$11,397
 $5,346
 $29,142
 $45,885
201611,739
 5,528
 22,989
 40,256
$15
 $49
 $64
201712,091
 5,715
 21,602
 39,408
16
 47
 63
201812,454
 5,910
 20,296
 38,660
16
 41
 57
201912,828
 6,111
 12,777
 31,716
16
 32
 48
202017
 24
 41
Thereafter320,447
 73,784
 15,229
 409,460
323
 39
 362
$380,956
 $102,394
 $122,035
 $605,385
$403
 $232
 $635
Rental expense related to operating leases amounted to $32.4$44 million, $24.5$32 million, and $20.5$25 million for the years ended December 31, 2015, 2014, 2013, and 2012,2013, respectively. The amounts reported in "Lease Financing Obligations," and "Lease Financing Obligations - Related Party,"Obligations" above represent our contractual lease commitments for the properties described in Note 12, "Long-Term Debt""Debt" under the subheading "Lease Financing Obligations." Payments under these leases adjust the lease financing obligation, and the imputed interest is recorded to interest expense in our consolidated statements of income.

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Employment Agreements. In 2002 we entered into employment agreements with our Chief Executive Officer and Chief Financial Officer, which were amended and restated in 2009. These employment agreements had initial terms of one to three years and are subject to automatic one-year extensions thereafter. Should the executives be terminated without cause or resign for good reason before a change of control, as defined, we will pay one year’s base salary and termination bonus, as defined, in addition to full vesting of stock-based awards,equity compensation, and a cash payment for health and welfare benefits.
In 2013 we entered into employment agreements with our Chief Operating Officer, Chief Accounting Officer, and Chief Legal Officer. These agreements continue until terminated by us, or the executive resigns. If the executive’s employment is terminated by us without cause or the executive resigns for good reason, the executive will be entitled to receive one year’s base salary and termination bonus, as defined, full vesting of all time-based equity compensation, and a cash payment for health and welfare benefits.
Payment of the executives’ severance benefits described above is contingent upon the executive’s signing a release agreement waiving claims against us. If the executives are terminated for cause, no further payments are due under the contracts.
Legal Proceedings. The health care and business process outsourcing industries are subject to numerous laws and regulations of federal, state, and local governments. Compliance with these laws and regulations can be subject to government review and interpretation, as well as regulatory actions unknown and unasserted at this time. Penalties associated with violations of these laws and regulations include significant fines and penalties, exclusion from participating in publicly funded programs, and the repayment of previously billed and collected revenues.
We are involved in legal actions in the ordinary course of business, some of which seek monetary damages, including claims for punitive damages, which are not covered by insurance. We have accrued liabilities for certain matters for which we deem the loss to be both probable and estimable. Although we believe that our estimates of such losses are reasonable, these estimates could change as a result of further developments of these matters. The outcome of legal actions is inherently uncertain and such pending matters for which accruals have not been established have not progressed sufficiently through

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discovery and/or development of important factual information and legal issues to enable us to estimate a range of possible loss, if any. While it is not possible to accurately predict or determine the eventual outcomes of these items, an adverse determination in one or more of these pending matters could have a material adverse effect on our consolidated financial position, results of operations, or cash flows.
Washington Health Plan. In September 2014, our Washington health plan paid $19.2 million to the Washington Health Care Authority (HCA) to settle two outstanding overpayment matters. The matters related to demands for recoupment of claims for psychotropic drugs and claims for health plan members under the Washington Community Options Program Entry System (COPES). Additionally, in September 2014 HCA paid our Washington health plan $8.0 million to settle certain matters brought by the Washington health plan related to auto-assignment provisions in the parties' contract. The net effect of these settlements resulted in a premium revenue reduction of $11.2 million in the third quarter of 2014, and resolved all pending disputes between the parties.
State of Louisiana. On June 26, 2014, the state of Louisiana filed a Petition for Damages against Molina Medicaid Solutions, Molina Healthcare, Inc., Unisys Corporation, and Paramax Systems Corporation, a subsidiary of Unisys, in the Parish of Baton Rouge, 19th Judicial District, versus number 631612. The Petition alleges that between 1989 and 2012, the defendants utilized an incorrect reimbursement formula for the payment of pharmaceutical claims. We believe we have several meritorious defenses to the claims of the state, and any liability for the alleged claims is not currently probable or reasonably estimable.
USA and State of Florida ex rel. Charles Wilhelm. On July 24, 2014, Molina Healthcare, Inc. and Molina Healthcare of Florida, Inc. were served with a Complaint filed under seal on December 5, 2012 in District Court for the Southern District of Florida by relator, Charles C. Wilhelm, M.D., Case No. 12-24298. The Complaint alleges that, in late 2008 and early 2009, in connection with the acquisition of Florida NetPass by which Molina Healthcare entered into the state of Florida, the defendants failed to adequately staff the plan and provide other services, resulting in a disproportionate number of sicker beneficiaries of Florida NetPass moving back into the Florida fee-for-service Medicaid program. This alleged conduct purportedly resulted in a violation of the federal False Claims Act. Both the United States of America and the state of Florida have declined to intervene. We believe we have several meritorious defenses to the claims of the relator, and any liability for the alleged claims is not currently probable or reasonably estimable.
United States of America, ex rel., Anita Silingo v. Mobile Medical Examination Services, Inc., et al. On or around October 14, 2014, Molina Healthcare of California, Molina Healthcare of California Partner Plan, Inc., Mobile Medical Examination Services, Inc. (MedXM), and other health plan defendants were served with a Complaint previously filed under seal in the Central District Court of California by relator,Relator, Anita Silingo, Case No. SACV13-1348-FMO(SHx). The Complaint alleges that MedXM improperly modified medical records and otherwise took inappropriate steps to increase members’ risk adjustment scores, and that the defendants, including Molina Healthcare of California and Molina Healthcare of California Partner Plan, Inc., purportedly turned a “blind eye” to these unlawful practices. The Department of Justice has declined to intervene. The District Court dismissed this action as to Molina without leave to amend as to some allegations and with leave to amend as to other allegations. On October 22, 2015, the Relator filed a third amended complaint. We believe that we have several meritorious defenses to the claims of the relator,Relator, and any liability for the alleged claims is not currently probable or reasonably estimable.
Hospital Management Contract. During the fourth quarter of 2015, we recorded a contract settlement charge of approximately $15 million as a result of our termination of a hospital management agreement.
Professional Liability Insurance. We carry medical professional liability insurance for health care services rendered in the primary care and hospital institutions that we manage. In addition, we also carry errors and omissions insurance for all Molina entities.
Provider Claims. Many of our medical contracts are complex in nature and may be subject to differing interpretations regarding amounts due for the provision of various services. Such differing interpretations have led certain medical providers to pursue us for additional compensation. The claims made by providers in such circumstances often involve issues of contract compliance, interpretation, payment methodology, and intent. These claims often extend to services provided by the providers over a number of years.
Various providers have contacted us seeking additional compensation for claims that we believe to have been settled. These matters, when finally concluded and determined, will not, in our opinion, have a material adverse effect on our business, consolidated financial position, results of operations, or cash flows.

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States' Budgets. From time to time the states in which our health plans operate may delay premium payments. For example, the state of Illinois is currently operating without a budget for its fiscal year ending June 30, 2016. As of December 31, 2015, our Illinois health plan served approximately 98,000 members, and recognized premium revenue of approximately $397 million for the year ended December 31, 2015. As of February 23, 2016, Illinois is current with its premium payments.
In another example, the Commonwealth of Puerto Rico has reported that it may lack sufficient resources to fund all necessary governmental programs including health care-related programs, as well as meet its debt obligations for its fiscal year ending June 30, 2016. Our Puerto Rico health plan became operational on April 1, 2015. As of December 31, 2015, the plan served approximately 348,000 members and recognized premium revenue of approximately $192 million in the fourth quarter of 2015, or approximately $64 million per month. As of February 23, 2016, the Commonwealth continues to pay us weekly for current membership.
It is the practice of the Commonwealth to pay us for eligible members only after those members have been assigned to us, and our plan has sent electronic confirmation of the receipt of eligibility. Particularly in the early stages of our contract with Puerto Rico, the plan's confirmation of eligibility of certain members was not accepted by the Commonwealth as a result of various technical issues. The plan has continued to pay for medical services for all members in question, but the Commonwealth is withholding payment of approximately $12 million of premium revenue related to those members. We believe we have a valid claim to all of the premiums withheld and we are in discussions with the Commonwealth regarding this matter.
It has been our practice in the past, and will remain so in the future, to continue to serve our members and pay health care providers for services rendered in circumstances where state (or Commonwealth) governments are temporarily unable to pay us, so long as we continue to believe that such state (or Commonwealth) governments will ultimately pay us.
Regulatory Capital and Dividend Restrictions. Our health plans, which are operated by our respective wholly owned subsidiaries in those states, are subject to state laws and regulations that, among other things, require the maintenance of minimum levels of statutory capital, as defined by each state. Regulators in some states may also attempt to enforce capital requirements upon us that require the retention of net worth in excess of amounts formally required by statute or regulation. Such statutes, regulations and informal capital requirements also restrict the timing, payment, and amount of dividends and other distributions that may be paid to us as the sole stockholder. To the extent our subsidiaries must comply with these regulations, they may not have the financial flexibility to transfer funds to us. Based upon current statutes and regulations, the net assets in these subsidiaries (after intercompany eliminations) which may not be transferable to us in the form of loans, advances, or cash dividends was approximately $1,229 million at December 31, 2015, and $859 million at December 31, 2014, and $608 million at December 31, 2013.2014. Because of the statutory restrictions that inhibit the ability of our health plans to transfer net assets to us, the amount of retained

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earnings readily available to pay dividends to our stockholders is generally limited to cash, cash equivalents and investments held by the parent company – Molina Healthcare, Inc. Such cash, cash equivalents and investments amounted to $202.6$612 million and $365.2$203 million as of December 31, 2015, and 2014, and 2013, respectively.
The National Association of Insurance Commissioners (NAIC), adopted rules effective December 31, 1998, which, if implemented by the states, set minimum capitalization requirements for insurance companies, HMOs, and other entities bearing risk for health care coverage. The requirements take the form of risk-based capital (RBC), rules. Illinois, Michigan, New Mexico, Ohio, South Carolina, Texas, Utah, Washington, and Wisconsin have adopted these rules which may vary from state to state. All of the states in which our health plans operate, except California and Florida, have adopted these rules. California and Florida have not adopted NAIC risk-based capital requirements for HMOs, and have not formally given notice of their intention to do so. Such requirements, if adopted by California and Florida, may increase the minimum capital required for those states.
As of December 31, 2014,2015, our health plans had aggregate statutory capital and surplus of approximately $955$1,350 million compared with the required minimum aggregate statutory capital and surplus of approximately $541$776 million. All of our health plans were in compliance with the minimum capital requirements at December 31, 2014, with the exception of our Florida health plan, which was funded in February 2015 to meet the minimum capital requirement.2015. We have the ability and commitment to provide additional capital to each of our health plans when necessary to ensure that statutory capital and surplus continue to meet regulatory requirements.
21.20. Segment Information
We reporthave three reportable segments. These segments include our financial performance based on two reportable segments: the Health Plans segment and the Molina Medicaid Solutions segments, which comprise the vast majority of our operations, and our Other segment. As of December 31, 2015, we changed our reporting structure as a result of the Pathways acquisition in November 2015, which is reported in Other.
Our reportable segments are consistent with how we currently manage the business and view the markets we serve. OurThe Health Plans segment consists of our state health plans and our direct delivery business. Our state health plans represent operating segments that have been aggregated for reporting purposes because they share similar economic characteristics.
Our The Molina Medicaid Solutions segment provides MMIS design, development, implementation; business process outsourcing solutions; hosting services; and information technology support services to state Medicaid agencies. Our Other segment includes other businesses, such as our Pathways behavioral health and social services provider, that do not meet the quantitative thresholds for a

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reportable segment as defined by U.S. generally accepted accounting principles (GAAP), as well as corporate amounts not allocated to other reportable segments.
The following table presents gross margin as the appropriate earnings measure for our reportable segments, based on how our chief operating decision maker currently reviews results, assesses performance, and allocates resources.
Gross margin for our Health Plans segment is referred to as "Medical margin," and for our Molina Medicaid Solutions and Other segments, as "Service margin." Medical margin represents the actual dollars earned by the Health Plans segment after medical costs are deducted from premium revenue. The medical care ratio represents the amount of medical care costs as a percentage of premium revenue. One of the key metrics used to assess the performance of the Health Plans segment is the medical care ratio; therefore, the underlying medical margin is the most important measure of earnings reviewed by the chief operating decision maker. The service margin is equal to service revenue minus cost of service revenue. We rely on an internal management reporting process that providespreviously reported our segment informationresults to the operating income level, for purposeswhere we reported the cost of making financial decisions and allocating resources. all centralized services within our most significant segment, the Health Plans segment.
The accounting policies of the segments are the same as those described in Note 2, "Significant Accounting Policies." For presentation purposes, the cost of centralized services is reported within the Health Plans segment.
 Year Ended December 31,
 2014 2013 2012
 (In thousands)
Revenue, continuing operations:     
Health Plans segment:     
Premium revenue$9,022,511
 $6,179,170
 $5,544,121
Premium tax revenue294,388
 172,017
 158,991
Health insurer fee revenue119,484
 
 
Investment income8,093
 6,890
 5,075
Other revenue12,074
 26,322
 18,312
Molina Medicaid Solutions segment:     
Service revenue210,051
 204,535
 187,710
 $9,666,601
 $6,588,934
 $5,914,209
      
Depreciation and amortization reported in the consolidated statements of cash flows:     
Health Plans segment$89,438
 $67,446
 $58,577
Molina Medicaid Solutions segment44,966
 26,420
 20,187
 $134,404
 $93,866
 $78,764
Income from continuing operations before income tax expense:     
Health Plans segment$150,090
 $103,931
 $17,366
Molina Medicaid Solutions segment42,827
 32,629
 23,727
Operating income, continuing operations192,917
 136,560
 41,093
Other expenses, net57,613
 55,414
 17,714
 $135,304
 $81,146
 $23,379
  Health Plans Molina Medicaid Solutions Other Consolidated
     
  (In millions)
2015        
Total revenue (1) $13,917
 $195
 $66
 $14,178
Gross margin 1,447
 55
 5
 1,507
Depreciation and amortization (2) 95
 25
 6
 126
Goodwill, and intangible assets, net 393
 73
 175
 641
Total assets 4,707
 213
 1,656
 6,576
         
2014        
Total revenue (1) 9,449
 210
 8
 9,667
Gross margin 947
 53
 
 1,000
Depreciation and amortization (2) 83
 46
 5
 134
Goodwill, and intangible assets, net 286
 75
 
 361
Total assets 3,355
 185
 895
 4,435
         
2013        
Total revenue (1) 6,376
 205
 8
 6,589
Gross margin 799
 44
 
 843
Depreciation and amortization (2) 60
 28
 6
 94
Goodwill, and intangible assets, net 249
 81
 
 330
Total assets 1,921
 176
 891
 2,988
______________________
(1)Total revenues consists primarily of premium revenue for the Health Plans segment, and service revenue for the Molina Medicaid Solutions and Other segments.
(2)Depreciation and amortization reported in accompanying consolidated statements of cash flows.
 As of December 31,
 2014 2013 2012
 (In thousands)
Goodwill and intangible assets, net:     
Health Plans segment$286,459
 $248,562
 $139,710
Molina Medicaid Solutions segment74,778
 81,047
 89,089
 $361,237
 $329,609
 $228,799
Total assets:     
Health Plans segment$4,270,870
 $2,809,439
 $1,702,212
Molina Medicaid Solutions segment206,345
 193,498
 232,610
 $4,477,215
 $3,002,937
 $1,934,822
Goodwill and intangible assets increased in the Health Plans segment due to the acquisitions described in Note 4, "Business Combinations."

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22.The following table reconciles gross margin by segment to consolidated income from continuing operations before income tax expense:
 Year Ended December 31,
 2015 2014 2013
 (In millions)
Gross margin:     
Health Plans$1,447
 $947
 $799
Molina Medicaid Solutions55
 53
 44
Other5
 
 
Other operating revenues (1)684
 434
 205
Other operating expenses (2)1,804
 1,241
 911
Operating income387
 193
 137
Other expenses, net65
 58
 56
Income from continuing operations before income tax expense$322
 $135
 $81
______________________
(1)Other operating revenues include premium tax revenue, health insurer fee revenue, investment income and other revenue.
(2)Other operating expenses include general and administrative expenses, premium tax expenses, health insurer fee expenses and depreciation and amortization.

21. Quarterly Results of Operations (Unaudited)
The following table summarizes quarterly unaudited results of operations for the years ended December 31, 20142015 and 2013. As described in Note 1, "Basis of Presentation," the results of the Missouri health plan are reported as discontinued operations for all periods presented. For further information relating to our segment reporting, refer to Note 21, "Segment Information."2014.
For The Quarter EndedFor The Quarter Ended
March 31,
2014
 June 30,
2014
 September 30, 2014 December 31,
2014
March 31,
2015
 June 30,
2015
 September 30, 2015 December 31,
2015
(In thousands, except per-share data)(In millions, except per-share data)
Premium revenue$1,940,337
 $2,167,142
 $2,316,759
 $2,598,273
$2,971
 $3,304
 $3,377
 $3,589
Service revenue53,630
 50,232
 52,557
 53,632
52
 47
 47
 107
Operating income, Health Plans segment14,019
 21,986
 29,874
 84,211
Operating income, Molina Medicaid Solutions segment10,248
 10,441
 9,905
 12,233
       
Operating income82
 116
 113
 76
Income from continuing operations$4,834
 $7,741
 $16,070
 $33,933
28
 39
 46
 30
(Loss) income from discontinued operations(336) 70
 52
 (141)
Net income$4,498
 $7,811
 $16,122
 $33,792
28
 39
 46
 30
       
Net income per share (1):              
Basic$0.10
 $0.17
 $0.34
 $0.70
$0.58
 $0.78
 $0.84
 $0.54
Diluted$0.09
 $0.16
 $0.33
 $0.69
$0.56
 $0.72
 $0.77
 $0.52
 For The Quarter Ended
 March 31,
2013
 June 30,
2013 (2)
 September 30, 2013 December 31,
2013
 (In thousands, except per-share data)
Premium revenue$1,497,433
 $1,501,729
 $1,584,656
 $1,595,352
Service revenue49,756
 49,672
 51,100
 54,007
Operating income (loss), Health Plans segment61,520
 40,151
 16,929
 (14,669)
Operating income, Molina Medicaid Solutions segment6,353
 6,295
 7,997
 11,984
        
Income (loss) from continuing operations$30,522
 $15,796
 $7,553
 $(9,041)
(Loss) income from discontinued operations(607) 8,775
 16
 (85)
Net income (loss)$29,915
 $24,571
 $7,569
 $(9,126)
        
Net income (loss) per share (1):       
Basic$0.65
 $0.54
 $0.17
 $(0.20)
Diluted$0.64
 $0.53
 $0.16
 $(0.20)
 For The Quarter Ended
 March 31,
2014
 June 30,
2014
 September 30, 2014 December 31,
2014
 (In millions, except per-share data)
Premium revenue$1,940
 $2,167
 $2,317
 $2,599
Service revenue54
 50
 52
 54
Operating income24
 32
 40
 97
Income from continuing operations4
 8
 16
 34
Net income4
 8
 16
 34
Net income per share (1):       
Basic$0.10
 $0.17
 $0.34
 $0.70
Diluted$0.09
 $0.16
 $0.33
 $0.69


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(1)PotentiallyThe dilutive effect of all potentially dilutive common shares is calculated using the treasury-stock method. Certain potentially dilutive common shares issuable pursuant to our 1.125% Warrants and 1.625% Notes wereare not included in the computation of diluted net income per share because to do so would have beenbe anti-dilutive. Potentially dilutiveFor the year ended December 31, 2014, the 1.125% Warrants were excluded from diluted shares issuable pursuant tooutstanding because the exercise price exceeded the average market price of our 3.75% Notes were not included in the computation of diluted net income per share for the quarter ended March 31, 2013, because to do so would have been anti-dilutive.common stock.
(2)We abandoned our equity interests in the Missouri health plan during the second quarter of 2013, resulting in the recognition of a tax benefit of $9.5 million, which is reported in (loss) income from discontinued operations.


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23.22. Condensed Financial Information of Registrant
Following are our parent company onlyThe condensed balance sheets as of December 31, 2015 and 2014, and 2013, and ourthe related condensed statements of income, condensed statements of comprehensive income and condensed statements of cash flows for each of the three years in the period ended December 31, 2014.2015 for our parent company Molina Healthcare, Inc. (the Registrant), are presented below.
Condensed Balance Sheets
December 31,December 31,
2014 20132015 2014
(Amounts in thousands, except per-share data)(Amounts in millions, except per-share data)
ASSETS
Current assets: 
   
  
Cash and cash equivalents$74,696
 $99,698
$360
 $75
Investments126,439
 262,665
252
 126
Income tax refundable13,413
 8,403
Deferred income taxes8,546
 10,073
Income taxes refundable7
 13
Due from affiliates17,567
 35,928
86
 18
Prepaid expenses and other current assets36,143
 28,387
46
 33
Derivative asset374
 
Total current assets276,804
 445,154
1,125
 265
Property, equipment, and capitalized software, net265,110
 225,522
267
 265
Goodwill and intangible assets, net64,972
 68,902
61
 65
Investments in subsidiaries1,376,613
 992,998
2,205
 1,377
Deferred income taxes2,824
 17,245
23
 11
Derivative asset329,323
 186,351

 329
Advances to related parties and other assets57,263
 52,615
36
 43
$2,372,909
 $1,988,787
$3,717
 $2,355
      
LIABILITIES AND STOCKHOLDERS' EQUITY
Liabilities:   
Current liabilities:   
Accounts payable and accrued liabilities$106,212
 $109,388
$157
 $107
Long-term debt865,148
 757,770
Current portion of long-term debt449
 
Derivative liability374
 
Total current liabilities980
 107
Senior notes962
 690
Lease financing obligations198
 157
Lease financing obligations - related party40,241
 27,092

 40
Derivative liability329,194
 186,239

 329
Other long-term liabilities21,672
 15,361
20
 22
Total liabilities1,362,467
 1,095,850
2,160
 1,345
Stockholders' equity:      
Common stock, $0.001 par value; 150,000 shares authorized; outstanding:  

49,727 shares at December 31, 2014 and 45,871 shares at December 31, 201350
 46
Preferred stock, $0.001 par value; 20,000 shares authorized, no shares issued and outstanding
 
Common stock, $0.001 par value; 150 shares authorized; outstanding:  

56 shares at December 31, 2015 and 50 shares at December 31, 2014
 
Preferred stock, $0.001 par value; 20 shares authorized, no shares issued and outstanding
 
Additional paid-in capital396,059
 340,848
803
 396
Accumulated other comprehensive loss(1,019) (1,086)(4) (1)
Retained earnings615,352
 553,129
758
 615
Total stockholders' equity1,010,442
 892,937
1,557
 1,010
$2,372,909
 $1,988,787
$3,717
 $2,355

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Condensed Statements of Income
Year Ended December 31,Year Ended December 31,
2014 2013 20122015 2014 2013
(In thousands)(In millions)
Revenue:          
Management fees and other operating revenue$703,710
 $599,049
 $406,981
$928
 $704
 $599
Investment income2,218
 2,768
 550
3
 2
 3
Total revenue705,928
 601,817
 407,531
931
 706
 602
Expenses:     
     
Medical care costs46,437
 37,862
 33,102
55
 46
 38
General and administrative expenses582,587
 503,781
 367,606
797
 583
 504
Depreciation and amortization72,995
 51,562
 38,794
82
 73
 51
Total operating expenses702,019
 593,205
 439,502
934
 702
 593
Operating income (loss)3,909
 8,612
 (31,971)
Operating (loss) income(3) 4
 9
Interest expense56,728
 50,508
 14,469
66
 57
 51
Other expense844
 3,811
 

 1
 4
Loss before income taxes and equity in net income of subsidiaries(53,663) (45,707) (46,440)(69) (54) (46)
Income tax benefit(26,776) (15,455) (15,779)(21) (27) (16)
Net loss before equity in net income of subsidiaries(26,887) (30,252) (30,661)(48) (27) (30)
Equity in net income of subsidiaries89,110
 83,181
 40,451
191
 89
 83
Net income$62,223
 $52,929
 $9,790
$143
 $62
 $53

Condensed Statements of Comprehensive Income
Year Ended December 31,Year Ended December 31,
2014 2013 20122015 2014 2013
(In thousands)(In millions)
Net income$62,223
 $52,929
 $9,790
$143
 $62
 $53
Other comprehensive income (loss):          
Unrealized investment gain (loss)108
 (1,015) 1,529
Effect of income tax expense (benefit)41
 (386) 581
Other comprehensive income (loss), net of tax67
 (629) 948
Unrealized investment loss(5) 
 (1)
Effect of income tax benefit2
 
 
Other comprehensive loss, net of tax(3) 
 (1)
Comprehensive income$62,290
 $52,300
 $10,738
$140
 $62
 $52

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Condensed Statements of Cash Flows
Year Ended December 31,Year Ended December 31,
2014 2013 20122015 2014 2013
(In thousands)(In millions)
Operating activities:          
Net cash provided by operating activities$73,674
 $62,602
 $20,611
$113
 $74
 $63
Investing activities:     
     
Capital contributions to subsidiaries(292,232) (166,112) (100,221)(770) (292) (166)
Dividends received from subsidiaries
 24,429
 101,800
142
 
 24
Purchases of investments(128,996) (362,927) (1,905)(244) (129) (363)
Proceeds from sales and maturities of investments263,479
 97,713
 4,067
118
 263
 98
Proceeds from sale of subsidiary, net of cash surrendered
 
 9,162
Purchases of equipment(93,610) (76,873) (61,813)(91) (94) (77)
Change in amounts due to/from affiliates16,054
 (5,888) 5,187
(68) 16
 (6)
Other, net7,640
 (6,175) (1,342)
 8
 (6)
Net cash used in investing activities(227,665) (495,833) (45,065)(913) (228) (496)
Financing activities:     
     
Proceeds from issuance of convertible senior notes, net of financing costs paid122,625
 537,973
 
Proceeds from senior notes offerings, net of issuance costs689
 123
 538
Proceeds from common stock offering, net of issuance costs373
 
 
Proceeds from sale-leaseback transactions
 158,694
 

 
 159
Purchase of call option
 (149,331) 

 
 (149)
Proceeds from issuance of warrants
 75,074
 

 
 75
Treasury stock repurchases
 (52,662) (3,000)
 
 (53)
Principal payment on term loan of subsidiary
 (46,963) 

 
 (47)
Repayment of amount borrowed under credit facility
 (40,000) (20,000)
 
 (40)
Proceeds from employee stock plans14,040
 9,402
 8,205
18
 14
 9
Principal payments on convertible senior notes(10,449) 
 

 (11) 
Amount borrowed under credit facility
 
 60,000
Other, net2,773
 1,674
 3,667
5
 3
 2
Net cash provided by financing activities128,989
 493,861
 48,872
1,085
 129
 494
Net (decrease) increase in cash and cash equivalents(25,002) 60,630
 24,418
Net increase (decrease) in cash and cash equivalents285
 (25) 61
Cash and cash equivalents at beginning of year99,698
 39,068
 14,650
75
 100
 39
Cash and cash equivalents at end of year$74,696
 $99,698
 $39,068
$360
 $75
 $100
Notes to Condensed Financial Information of Registrant
Note A - Basis of Presentation
Molina Healthcare, Inc. (theThe Registrant or the Parent), was incorporated on July 24,in 2002. Prior to that date, Molina Healthcare of California (formerly known as Molina Medical Centers) operated as a California health plan and as the parent company for Molina Healthcare of Utah, Inc., Molina Healthcare of Michigan, Inc., and Molina Healthcare of Washington, Inc.three other state health plans. In June 2003, the employees and operations of the corporate entity were transferred from Molina Healthcare of California to the Registrant.
The Registrant's investment in subsidiaries is stated at cost plus equity in undistributed earnings of subsidiaries since the date of acquisition. The accompanying condensed financial information of the Registrant should be read in conjunction with the consolidated financial statements and accompanying notes.
Note B - Transactions with Subsidiaries
The Registrant provides certain centralized medical and administrative services to its subsidiaries pursuant to administrative services agreements, including medical affairs and quality management, health education, credentialing, management,

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financial, legal, information systems and human resources services. Fees are based on the fair market value of services rendered and are recorded as operating revenue. Payment is subordinated to the subsidiaries' ability to comply with minimum capital and other restrictive financial requirements of the states in which they operate. Charges in 2015, 2014, 2013, and 20122013 for these services amounted to $691.6$914 million, $592.1$692 million, and $406.4$592 million, respectively, and are included in operating revenue.

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During 2013, the Registrant used a portion of the proceeds from the sale of the Molina Center, described in Note 12, "Long-Term Debt,"Debt," to repay the remaining principal balance of the related term loan, on behalf of a subsidiary of the Registrant.
The Registrant and its subsidiaries are included in the consolidated federal and state income tax returns filed by the Registrant. Income taxes are allocated to each subsidiary in accordance with an intercompany tax allocation agreement. The agreement allocates income taxes in an amount generally equivalent to the amount which would be expensed by the subsidiary if it filed a separate tax return. Net operating loss benefits are paid to the subsidiary by the Registrant to the extent such losses are utilized in the consolidated tax returns.
Note C - Dividends and Capital Contributions
During 2013 and 2012,When the Registrant receivedreceives dividends from its subsidiaries. Suchsubsidiaries, such amounts have beenare recorded as a reduction to the investments in the respective subsidiaries.
During 2014, 2013, and 2012,For all periods presented, the Registrant made capital contributions to certain subsidiaries primarily to comply with minimum net worth requirements and to fund contract acquisitions. Such amounts have been recorded as an increase in investment in the respective subsidiaries, net of insignificant returns of capital.
Note D - Related Party Transactions
The Registrant's related party transactions are described in Note 18,17, "Related Party Transactions."

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Item 9.  Changes in and Disagreements with Accountants on Accounting and Financial Disclosures
None.
Item 9A.  Controls and Procedures
Disclosure Controls and Procedures: Our management is responsible for establishing and maintaining effective internal control over financial reporting as defined in Rules 13a-15(f) and 15d-15(f) under the Securities Exchange Act of 1934 (the "Exchange Act"). Our internal control over financial reporting is designed to provide reasonable assurance to our management and board of directors regarding the preparation and fair presentation of published financial statements. We maintain controls and procedures designed to ensure that we are able to collect the information we are required to disclose in the reports we file with the Securities and Exchange Commission, and to process, summarize and disclose this information within the time periods specified in the rules of the Securities and Exchange Commission.
Evaluation of Disclosure Controls and Procedures: Our management, with the participation of our Chief Executive Officer and our Chief Financial Officer, has conducted an evaluation of the design and operation of our "disclosure controls and procedures" (as defined in Rules 13a-15(e) and 15d-15(e)) under the Exchange Act. Based on this evaluation, our Chief Executive Officer and our Chief Financial Officer have concluded that our disclosure controls and procedures are effective as of the end of the period covered by this report to ensure that information required to be disclosed in the reports that we file or submit under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the Securities and Exchange Commission’s rules and forms.
Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Therefore, even those systems determined to be effective can provide only reasonable assurance with respect to financial statement preparation and presentation.
Management’s Report on Internal Control over Financial Reporting: Management of the Company is responsible for establishing and maintaining adequate internal control over financial reporting, as such term is defined in Rule 13a-15(f) under the Exchange Act. The Company’s internal control over financial reporting is designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles in the United States. However, all internal control systems, no matter how well designed, have inherent limitations. Therefore, even those systems determined to be effective can provide only reasonable assurance with respect to financial statement preparation and reporting.
Management assessed the effectiveness of the Company’s internal control over financial reporting as of December 31, 20142015. In making this assessment, management used the criteria set forth by the Committee of Sponsoring Organizations of the Treadway Commission (COSO) in Internal Control-Integrated Framework (2013 framework).
Our management's evaluation did not include an assessment of the effectiveness of internal control over financial reporting at Pathways Health and Community Support LLC (Pathways), which was acquired on November 1, 2015. The total assets and net assets of Pathways included in our consolidated balance sheets at December 31, 2015, were $276 million and $231 million, respectively. Total revenue and net loss of Pathways included in our consolidated results of operations for the year ended December 31, 2015, were $57 million and $4 million, respectively. Our management has not had sufficient time to make an assessment of this subsidiary's internal control over financial reporting.
Based on our assessment, management believes that the Company maintained effective internal control over financial reporting as of December 31, 20142015, based on thosethe 2013 framework criteria.
Ernst & Young, LLP, the independent registered public accounting firm who audited the Company’s Consolidated Financial Statements included in this Form 10-K, has issued a report on the Company’s internal control over financial reporting, which is included herein.
Changes in Internal Control over Financial Reporting. There were no changes in the Company’s internal control over financial reporting (as defined in Rule 13a-15(f) of the Exchange Act) during the quarter ended December 31, 20142015, that have materially affected, or are reasonably likely to materially affect, the Company’s internal control over financial reporting.
Item 9B.  Other Information
None.


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REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
The Board of Directors and Stockholders
of Molina Healthcare, Inc.
We have audited Molina Healthcare, Inc.’s (the "Company’s") internal control over financial reporting as of December 31, 20142015, based on criteria established in Internal Control — Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission (2013 framework) (the COSO criteria). The Company’s management is responsible for maintaining effective internal control over financial reporting, and for its assessment of the effectiveness of internal control over financial reporting included in the accompanying Management’s Report on Internal Control over Financial Reporting. Our responsibility is to express an opinion on the Company’s internal control over financial reporting based on our audit.
We conducted our audit in accordance with the standards of the Public Company Accounting Oversight Board (United States). Those standards require that we plan and perform the audit to obtain reasonable assurance about whether effective internal control over financial reporting was maintained in all material respects. Our audit included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness exists, testing and evaluating the design and operating effectiveness of internal control based on the assessed risk, and performing such other procedures as we considered necessary in the circumstances. We believe that our audit provides a reasonable basis for our opinion.
A company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company’s internal control over financial reporting includes those policies and procedures that (1) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; (2) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management and directors of the company; and (3) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the financial statements.
Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.
As indicated in the accompanying Management’s Report on Internal Control over Financial Reporting, management’s assessment of and conclusion on the effectiveness of internal control over financial reporting did not include the internal controls of Pathways Health and Community Support LLC (Pathways), which is included in the 2015 consolidated financial statements of Molina Healthcare, Inc. and constituted $276 million and $231 million of total and net assets, respectively, as of December 31, 2015, and $57 million and $4 million of revenues and net loss, respectively, for the year then ended. Our audit of internal control over financial reporting of Molina Healthcare, Inc. also did not include an evaluation of the internal control over financial reporting of Pathways.
In our opinion, Molina Healthcare, Inc. maintained, in all material respects, effective internal control over financial reporting as of December 31, 20142015, based on the COSO criteria.
We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States), the consolidated balance sheets of Molina Healthcare, Inc. as of December 31, 20142015 and 20132014, and the related consolidated statements of income, comprehensive income, stockholders’ equity, and cash flows for each of the three years in the period ended December 31, 20142015 and our report dated February 26, 20152016 expressed an unqualified opinion thereon.
 
 /s/ ERNST & YOUNG LLP
Los Angeles, California
February 26, 20152016


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PART III
Item 10.  Directors, Executive Officers, and Corporate Governance
Pursuant to General Instruction G(3) to Form 10-K and Instruction 3 to Item 401(b) of Regulation S-K, information regarding our executive officers is provided in Item 1 of Part I of this Annual Report on Form 10-K under the caption "Executive Officers of the Registrant," and will also appear in our definitive proxy statement for our 20152016 Annual Meeting of Stockholders. The remaining information required by Items 401, 405, 406 and 407(c)(3), (d)(4) and (d)(5) of Regulation S-K will be included under the headings "Election of Directors," "Corporate Governance," and "Section 16(a) Beneficial Ownership Reporting Compliance" in our definitive proxy statement for our 20152016 Annual Meeting of Stockholders, and such required information is incorporated herein by reference.
Item 11. Executive Compensation
The information required by Items 402, 407(e)(4), and (e)(5) of Regulation S-K will be included under the headings "Executive Compensation" and "Compensation Committee Interlocks and Insider Participation" in our definitive proxy statement for our 20152016 Annual Meeting of Stockholders, and such required information is incorporated herein by reference.
Item 12.  Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
Securities Authorized for Issuance Under Equity Compensation Plans (as of December 31, 20142015)
 
Plan Category
Number of Securities to be
Issued Upon Exercise of Outstanding Options, Warrants and Rights
(a)
 
Weighted  Average
Exercise Price of
Outstanding  Options,
Warrants and Rights
(b)
 
Number of  Securities
Remaining Available  for Future Issuance
Under Equity Compensation
Plans (Excluding Securities
Reflected in Column (a))
(c)
 
Number of Securities to be
Issued Upon Exercise of Outstanding Options, Warrants and Rights
(a)
 
Weighted  Average
Exercise Price of
Outstanding  Options,
Warrants and Rights
(b)
 
Number of  Securities
Remaining Available  for Future Issuance
Under Equity Compensation
Plans (Excluding Securities
Reflected in Column (a))
(c)
 
Equity compensation plans approved by security holders256,698
(1)$23.77
 4,529,223
(2)121,711
(1)$25.40
 4,058,668
(2)

(1)Options to purchase shares of our common stock issued under the 2002 Equity Incentive Plan and 2011 Equity Incentive Plan. Further grants under the 2002 Equity Incentive Plan have been suspended.
(2)Includes shares remaining available to issue under the 2011 Equity Incentive Plan, and the 2011 Employee Stock Purchase Plan.
The remaining information required by Item 403 of Regulation S-K will be included under the heading "Security Ownership of Certain Beneficial Owners and Management" in our definitive proxy statement for our 20152016 Annual Meeting of Stockholders, and such required information is incorporated herein by reference.
Item 13.  Certain Relationships and Related Transactions, and Director Independence
The information required by Items 404 and 407(a) of Regulation S-K will be included under the headings "Related Party Transactions," "Corporate Governance," and "Director Independence" in our definitive proxy statement for our 20152016 Annual Meeting of Stockholders, and such required information is incorporated herein by reference.
Additionally, refer to Part II, Item 8 of this Form 10-K, Notes to Consolidated Financial Statements, in Note 1817, "Related Party Transactions," and Note 1918, "Variable Interest Entities (VIEs)," under the subheading "Joseph M. Molina M.D., Professional Corporations."
Item 14.  Principal Accountant Fees and Services
The information required by Item 9(e) of Schedule 14A will be included under the heading "Disclosure of Auditor Fees" in our definitive proxy statement for our 20152016 Annual Meeting of Stockholders, and such required information is incorporated herein by reference.


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PART IV
Item 15. Exhibits and Financial Statement Schedules
(a)The consolidated financial statements and exhibits listed below are filed as part of this report.
(1)The financial statements included in Item 8 of this Form 10-K, Financial Statements and Supplementary Data, above are filed as part of this annual report.
(2)Financial Statement Schedules
None of the schedules apply, or the information required is included in the Notes to the Consolidated Financial Statements.
(3)Exhibits
Reference is made to the accompanying Index to Exhibits.



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SIGNATURES
Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, as amended, the undersigned registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized, on the 26th day of February, 2015.2016.
 
 MOLINA HEALTHCARE, INC.
    
 By: /s/ Joseph M. Molina
   Joseph M. Molina, M.D. (Dr. J. Mario Molina)
   
Chief Executive Officer
(Principal Executive Officer)
Pursuant to the requirements of the Securities Exchange Act of 1934, as amended, this report has been signed below by the following persons on behalf of the registrant and in the capacities and on the dates indicated.


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Signature Title Date
     
/s/ Joseph M. Molina Chairman of the Board, Chief Executive Officer, and President February 26, 20152016
Joseph M. Molina, M.D. (Principal Executive Officer)  
     
/s/ John C. Molina Director, Chief Financial Officer, and Treasurer February 26, 20152016
John C. Molina, J.D. (Principal Financial Officer)  
     
/s/ Joseph W. White Chief Accounting Officer February 26, 20152016
Joseph W. White (Principal Accounting Officer)  
     
/s/ Garrey E. Carruthers Director February 26, 20152016
Garrey E. Carruthers, Ph.D.    
     
/s/ Daniel Cooperman Director February 26, 20152016
Daniel Cooperman    
     
/s/ Charles Z. Fedak Director February 26, 20152016
Charles Z. Fedak    
     
/s/ Steven G. James Director February 26, 20152016
Steven G. James    
     
/s/ Frank E. Murray Director February 26, 20152016
Frank E. Murray, M.D.    
     
/s/ Steven J. Orlando Director February 26, 20152016
Steven J. Orlando    
     
/s/ Ronna E. Romney Director February 26, 20152016
Ronna E. Romney    
     
/s/ John P. Szabo, Jr.Richard M. Schapiro Director February 26, 20152016
John P. Szabo, Jr.Richard M. Schapiro    
     
/s/ Dale B. Wolf Director February 26, 20152016
Dale B. Wolf    
     

                                                                                                                                                         

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INDEX TO EXHIBITS
The following exhibits, which are furnished with this annual report or incorporated herein by reference, are filed as part of this annual report.
The agreements included or incorporated by reference as exhibits to this Annual Report on Form 10-K may contain representations and warranties by each of the parties to the applicable agreement. These representations and warranties were made solely for the benefit of the other parties to the applicable agreement and (i) were not intended to be treated as categorical statements of fact, but rather as a way of allocating the risk to one of the parties if those statements prove to be inaccurate; (ii) may have been qualified in such agreement by disclosures that were made to the other party in connection with the negotiation of the applicable agreement; (iii) may apply contract standards of "materiality" that are different from "materiality" under the applicable securities laws; and (iv) were made only as of the date of the applicable agreement or such other date or dates as may be specified in the agreement. The Company acknowledges that, notwithstanding the inclusion of the foregoing cautionary statements, it is responsible for considering whether additional specific disclosures of material information regarding material contractual provisions are required to make the statements in this Annual Report on Form 10-K not misleading.
Number Description Method of Filing
1.12.1 Membership Interest Purchase Agreement, dated as of February 11, 2013,September 3, 2015, by and among The Providence Service Corporation, Ross Innovative Employment Solutions Corp., and Molina Healthcare, Inc. and J.P. Morgan Securities LLC and Merrill Lynch, Pierce, Fenner & Smith Incorporated, as Representatives of the Initial PurchasersFiled as Exhibit 1.1 to registrant's Form 8-K filed February 15, 2013.
2.1Asset Purchase Agreement between Molina Healthcare, Inc. and Unisys Corporation dated as of January 18, 2010 Filed as Exhibit 2.1 to registrant's Form 8-K filed January 19, 2010.September 8, 2015.
2.2Amendment to Membership Interest Purchase Agreement, dated as of October 30, 2015, by and among The Providence Service Corporation, Ross Innovative Employment Solutions Corp., and Molina Pathways, LLC, as assignee of all rights and obligations of Molina Healthcare, Inc.Filed herewith.
3.1 Certificate of Incorporation Filed as Exhibit 3.2 to registrant's Registration Statement on Form S-1 filed December 30, 2002.
3.2 Certificate of Amendment to Certificate of Incorporation Filed as Exhibit 3.1 to registrant’s Form 8-K filed July 24, 2013.
3.3 Third Amended and Restated Bylaws of Molina Healthcare, Inc. Filed as Exhibit 3.1 to registrant's Form 10-Q filed July 30, 2014.
4.1 Indenture, dated as of February 15, 2013, by and between Molina Healthcare, Inc. and U.S. Bank, National Association Filed as Exhibit 4.1 to registrant's Form 8-K filed February 15, 2013.
4.2 Form of 1.125% Cash Convertible Senior Note due 2020 Included in Exhibit 4.1 to registrant's Form 8-K filed February 15, 2013.
4.3 Indenture, dated as of September 5, 2014, by and between Molina Healthcare, Inc. and U.S. Bank National Association Filed as Exhibit 4.1 to registrant’s Form 8-K filed September 8, 2014.
4.4 Form of 1.625% Convertible Senior Note due 2044 Included in Exhibit 4.1 to registrant’s Form 8-K filed September 8, 2014.
4.5 
Form of 1.625% Convertible Senior Notes Due 2044
Note Purchase Agreement, dated as of September 11, 2014, by and between Molina Healthcare, Inc. and certain institutional investors
 Filed as Exhibit 10.1 to registrant’s Form 8-K filed September 12, 2014.
4.6 First Supplemental Indenture, dated as of September 16, 2014, by and between Molina Healthcare, Inc. and the U.S. Bank National Association 
Filed as Exhibit 4.1 to registrant’s Form 8-K filed
September 17, 2014.
4.7 Form of 1.625% Convertible Senior Note due 2044 Included in Exhibit 4.1 to registrant’s Form 8-K filed September 17, 2014.
4.8Indenture dated November 10, 2015, by and among Molina Healthcare, Inc., the guarantor parties thereto and U.S. Bank National Association, as Trustee.Filed as Exhibit 4.1 to registrant's Form 8-K filed November 10, 2015.
4.9Form of 5.375% Senior Notes due 2022.Filed as Exhibit 4.1 to registrant's Form 8-K filed November 10, 2015.
4.10Form of Guarantee pursuant to Indenture dated November 10, 2015, by and among Molina Healthcare, Inc., the guarantor parties thereto and U.S. Bank National Association, as Trustee.Filed as Exhibit 4.1 to registrant's Form 8-K filed November 10, 2015.

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NumberDescriptionMethod of Filing
4.11Registration Rights Agreement dated November 10, 2015, by and among Molina Healthcare, Inc., the guarantor parties thereto and SunTrust Robinson Humphrey, Inc., as representative of the Initial Purchasers (as defined therein).Filed as Exhibit 4.1 to registrant's Form 8-K filed November 10, 2015.
4.12First Supplemental Indenture, dated February 18, 2016, by and among Molina Healthcare, Inc., the guarantor parties thereto and U.S. Bank National Association, as trustee.Filed as Exhibit 4.1 to registrant’s Form 8-K filed February 18, 2016.
*10.1 2002 Equity Incentive Plan Filed as Exhibit 10.13 to registrant's Form S-1 filed December 30, 2002.
*10.2 Molina Healthcare, Inc. Amended and Restated Deferred Compensation Plan (2013) Filed as Exhibit 10.5 to registrant’s Form 10-K filed February 26, 2014.
*10.3 
Amendment No. 1 to the Molina Healthcare, Inc.
Amended and Restated Deferred Compensation
Plan (2013)
 Filed as Exhibit 10.6 to registrant’s Form 10-K filed February 26, 2014.
*10.4 
Amendment No. 2 to the Molina Healthcare, Inc.
Amended and Restated Deferred Compensation Plan (2013)
 Filed herewith.as Exhibit 10.4 to registrant's Form 10-K filed February 26, 2015.
*10.5 2011 Equity Incentive Plan Filed as Exhibit 10.8 to registrant’s Form 10-K filed February 26, 2014.

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NumberDescriptionMethod of Filing
*10.6 2011 Employee Stock Purchase Plan Filed herewith.as Exhibit 10.6 to registrant's Form 10-K filed February 26, 2015.
*10.7 Form of Restricted Stock Award Agreement (Executive Officer) under Molina Healthcare, Inc. Equity Incentive Plan Filed as Exhibit 10.1 to registrant's Form 10-Q filed August 9, 2005.
*10.8 Form of Restricted Stock Award Agreement (Outside Director) under Molina Healthcare, Inc. Equity Incentive Plan Filed as Exhibit 10.1 to registrant's Form 10-Q filed August 9, 2005.
*10.9 Form of Restricted Stock Award Agreement (Employee) under Molina Healthcare, Inc. Equity Incentive Plan Filed as Exhibit 10.1 to registrant's Form 10-Q filed August 9, 2005.
*10.10 Form of Stock Option Agreement under Equity Incentive Plan Filed as Exhibit 10.3 to registrant's Form 10-K filed March 14, 2007.
*10.11 Amended and Restated Employment Agreement with J. Mario Molina, M.D. dated as of December 31, 2009 Filed as Exhibit 10.1 to registrant's Form 8-K filed January 7, 2010.
*10.12 Amended and Restated Employment Agreement with John C. Molina dated as of December 31, 2009 Filed as Exhibit 10.2 to registrant's Form 8-K filed January 7, 2010.
*10.13 Employment Agreement with Terry Bayer dated June 14, 2013 Filed as Exhibit 10.1 to registrant’s Form 8-K filed June 14, 2013.
*10.14 Employment Agreement with Joseph White dated June 14, 2013 Filed as Exhibit 10.2 to registrant’s Form 8-K filed June 14, 2013.
*10.15 Employment Agreement with Jeff Barlow, dated June 14, 2013 Filed as Exhibit 10.3 to registrant’s Form 8-K filed June 14, 2013.
*10.16 Amended and Restated Change in Control Agreement with Terry Bayer, dated as of December 31, 2009 Filed as Exhibit 10.4 to registrant's Form 8-K filed January 7, 2010.
*10.17 Amended and Restated Change in Control Agreement with Joseph W. White, dated as of December 31, 2009 Filed as Exhibit 10.6 to registrant's Form 8-K filed January 7, 2010.
*10.18 Change in Control Agreement with Jeff D. Barlow, dated as of September 18, 2012 Filed as Exhibit 10.16 to registrant’s Form 10-K filed February 28, 2013.
10.19 Form of Indemnification Agreement Filed as Exhibit 10.14 to registrant's Form 10-K filed March 14, 2007.
10.20 Base Call Option Transaction Confirmation, dated as of February 11, 2013, between Molina Healthcare, Inc. and JPMorgan Chase Bank, National Association, London Branch Filed as Exhibit 10.1 to registrant's Form 8-K filed February 15, 2013.
10.21 Base Call Option Transaction Confirmation, dated as of February 11, 2013, between Molina Healthcare, Inc. and Bank of America, N.A. Filed as Exhibit 10.2 to registrant's Form 8-K filed February 15, 2013.
10.22 Base Warrants Confirmation, dated as of February 11, 2013, between Molina Healthcare, Inc. and JPMorgan Chase Bank, National Association, London Branch Filed as Exhibit 10.3 to registrant's Form 8-K filed February 15, 2013.

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NumberDescriptionMethod of Filing
10.23 Base Warrants Confirmation, dated as of February 11, 2013, between Molina Healthcare, Inc. and Bank of America, N.A. Filed as Exhibit 10.4 to registrant's Form 8-K filed February 15, 2013.
10.24 Amendment to Base Call Option Transaction Confirmation, dated as of February 13, 2013, between Molina Healthcare, Inc. and JPMorgan Chase Bank, National Association, London Branch Filed as Exhibit 10.5 to registrant's Form 8-K filed February 15, 2013.
10.25 Amendment to Base Call Option Transaction Confirmation, dated as of February 13, 2013, between Molina Healthcare, Inc. and Bank of America, N.A. Filed as Exhibit 10.6 to registrant's Form 8-K filed February 15, 2013.
10.26 Additional Base Warrants Confirmation, dated as of February 13, 2013, between Molina Healthcare, Inc. and JPMorgan Chase Bank, National Association, London Branch Filed as Exhibit 10.7 to registrant's Form 8-K filed February 15, 2013.
10.27 Additional Base Warrants Confirmation, dated as of February 13, 2013, between Molina Healthcare, Inc. and Bank of America, N.A. Filed as Exhibit 10.8 to registrant's Form 8-K filed February 15, 2013.

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NumberDescriptionMethod of Filing
10.28 Amended and Restated Base Warrants Confirmation, dated as of April 22, 2013, between Molina Healthcare, Inc. and JPMorgan Chase Bank, National Association, London Branch Filed as Exhibit 10.1 to registrant's Form 10-Q filed May 3, 2013.
10.29 Amended and Restated Base Warrants Confirmation, dated as of April 22, 2013, between Molina Healthcare, Inc. and Bank of America, N.A. Filed as Exhibit 10.2 to registrant's Form 10-Q filed May 3, 2013.
10.30 Additional Amended and Restated Base Warrants Confirmation, dated as of April 22, 2013, between Molina Healthcare, Inc. and JPMorgan Chase Bank, National Association, London Branch Filed as Exhibit 10.3 to registrant's Form 10-Q filed May 3, 2013.
10.31 Additional Amended and Restated Base Warrants Confirmation, dated as of April 22, 2013, between Molina Healthcare, Inc. and Bank of America, N.A. Filed as Exhibit 10.4 to registrant's Form 10-Q filed May 3, 2013.
10.32 Lease Agreement, dated as of February 27, 2013, by and between 6th & Pine Development, LLC and Molina Healthcare, Inc. Filed as Exhibit 10.32 to registrant’s Form 10-K filed February 28, 2013.
10.33 
First Amendment to Office Building Lease, effective as of
October 31, 2014, by and between 6th & Pine Development,
LLC and Molina Healthcare, Inc.
 Filed as Exhibit 10.1 to registrant’s Form 8-K filed November 5, 2014.
10.34 Second Amendment to Office Building Lease, effective as of November 2, 2015, by and between 6th & Pine Development, LLC and Molina Healthcare, Inc.Filed as Exhibit 10.1 to registrant's Form 8-K filed November 6, 2015.
10.35Settlement Agreement entered into on October 30, 2013, by and between the Department of Health Care Services and Molina Healthcare of California and Molina Healthcare of California Partner Plan, Inc. Filed as Exhibit 10.1 to registrant's Form 10-Q filed October 30, 2013.
10.3510.36 Agreement of Purchase and Sale, dated as of June 12, 2013, by and between Molina Healthcare, Inc. and Molina Center, LLC, and AG Net Lease Acquisition Corp. Filed as Exhibit 10.1 to registrant's Form 10-Q filed July 25, 2013.
10.3610.37 Lease Agreement, dated as of June 13, 2013, by and between AGNL Clinic, L.P., and Molina Healthcare, Inc. Filed as Exhibit 10.2 to registrant's Form 10-Q filed July 25, 2013.
10.3710.38 Form of Exchange Agreement, dated August 11, 2014, by and between Molina Healthcare, Inc. and certain beneficial owners of Molina Healthcare, Inc.’s 3.75% Convertible Senior Notes due 2014 Filed as Exhibit 10.1 to registrant’s Form 8-K filed August 12, 2014.
10.39Credit Agreement, dated as of June 12, 2015, by and among Molina Healthcare, Inc., Molina Information Systems, LLC, Molina Medical Management, Inc., certain lenders named on the signature pages thereto and SunTrust Bank, as Administrative Agent, Swingline Lender and Issuing BankFiled as Exhibit 10.1 to registrant's Form 8-K filed June 16, 2015.
10.40Guarantor Joinder Agreement, dated February 18, 2016, by and among the guarantor parties thereto and SunTrust Bank, as Administrative Agent.Filed as Exhibit 10.1 to registrant’s Form 8-K filed February 18, 2016.

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NumberDescriptionMethod of Filing
10.41Purchase Agreement, dated as of February 11, 2013, among Molina Healthcare, Inc. and J.P. Morgan Securities LLC and Merrill Lynch, Pierce, Fenner & Smith Incorporated, as Representatives of the Initial PurchasersFiled as Exhibit 1.1 to registrant's Form 8-K filed February 15, 2013.
10.42Capitated Medical Group/IPA Provider Services Agreement, effective May 1, 2013, by and between Molina Healthcare of California and Pacific Healthcare IPA.Filed herewith.
10.43Regulatory Amendment for the Capitated Financial Alignment Demonstration Product to Molina Healthcare of California Group/IPA Provider Services Agreement(s), effective September 26, 2014, by and between Molina Healthcare of California and Pacific Healthcare IPA Associates, Inc.Filed herewith.
10.44Capitated Financial Alignment Demonstration Amendment to Molina Healthcare of California Group/IPA Provider Services Agreement, effective as of July 1, 2014, by and between Molina Healthcare of  California and Pacific Healthcare IPA Associates, Inc.Filed herewith.
12.1 Computation of Ratio of Earnings to Fixed Charges Filed herewith.
21.1 List of subsidiaries Filed herewith.
23.1 Consent of Independent Registered Public Accounting Firm Filed herewith.
31.1 Section 302 Certification of Chief Executive Officer Filed herewith.
31.2 Section 302 Certification of Chief Financial Officer Filed herewith.
32.1 Certificate of Chief Executive Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002 Filed herewith.
32.2 Certificate of Chief Financial Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002 Filed herewith.
101.INS XBRL Taxonomy Instance Document Filed herewith.
101.SCH XBRL Taxonomy Extension Schema Document Filed herewith.
101.CAL XBRL Taxonomy Extension Calculation Linkbase Document Filed herewith.
101.DEF XBRL Taxonomy Extension Definition Linkbase Document Filed herewith.
101.LAB XBRL Taxonomy Extension Label Linkbase Document Filed herewith.
101.PRE XBRL Taxonomy Extension Presentation Linkbase Document Filed herewith.
*Management contract or compensatory plan or arrangement required to be filed (and/or incorporated by reference) as an exhibit to this Annual Report on Form 10-K pursuant to Item 15(b) of Form 10-K.



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