CONTACTS: | | |
Investor relations: | | Media relations: |
Gregg Haddad 813-206-3916 gregg.haddad@wellcare.com | | Amy Knapp 813-290-6208 amy.knapp@wellcare.com |
WELLCARE REPORTS THIRD QUARTER 2010 RESULTS
Tampa, Florida (November 4, 2010) — WellCare Health Plans, Inc. (NYSE: WCG) today reported results for the three and nine months ended September 30, 2010. As determined under generally accepted accounting principles (“GAAP”), the Company reported net income for the third quarter of 2010 of $42.9 million, or $1.00 per diluted share, compared with net income of $28.7 million, or $0.68 per diluted share, for the prior year period.
Adjusted net income for the third quarter of 2010 was $37.9 million, or $0.89 per diluted share, as compared with $34.7 million, or $0.82 per diluted share, for the same period in 2009. Adjusted net income excludes a benefit, net of certain expenses and before income taxes, of $7 million, which results from matters related to previously disclosed government investigations and related litigation. Additional information on this benefit is provided later in this news release.
“We are pleased with our financial and operating results for the third quarter, which were driven by our progress in improving health care quality and access, ensuring a competitive cost structure, and re-establishing prudent, profitable growth,” said Alec Cunningham, WellCare’s chief executive officer. “We will sustain our focus on these objectives in 2011 to continue to strengthen our performance in meeting the needs of our members, government customers, and business partners.”
In addition to results determined under GAAP, net income and certain other operating results described in this news release are reported after adjustment for certain selling, general, and administrative (“SG&A”) expenses, primarily related to previously disclosed government investigations and related litigation that management believes are not indicative of long-term business operations. Please refer to the schedules in this news release that provide supplemental information reconciling results determined under GAAP to adjusted results.
Highlights of Operations for the Third Quarter
Adjusted net income for the third quarter of 2010 was favorable in comparison to the third quarter of 2009 primarily due to the performance of the Medicare prescription drug plan (“PDP”) and Medicaid segments, as well as lower SG&A expense. These improvements were offset in part by the loss of gross margin from the December 31, 2009, withdrawal of our Medicare Advantage private fee-for-service (“PFFS”) plans, and from reduced membership in our Medicare Advantage coordinated care plans (“CCPs”) due mainly to the impact of the previously disclosed 2009 CMS marketing sanction.
WCG Reports Third Quarter 2010 Results
Page 2
November 4, 2010
Membership as of September 30, 2010, decreased to 2.2 million compared with 2.3 million members as of September 30, 2009. Medicaid segment membership increased by 6,000 year-over-year to 1.3 million as of September 30, 2010, principally due to growth in the Georgia Medicaid program. Medicare Advantage membership decreased year-over-year by 124,000 members. The withdrawal from PFFS plans reduced membership by 101,000 year-over-year. Medicare Advantage CCP membership decreased 23,000, and PDP membership decreased 12,000 year-over-year, principally due to the impact of the 2009 CMS marketing sanction.
Premium revenue for the third quarter 2010 decreased 17% year-over-year to $1.4 billion. The decrease is attributable to the withdrawal of PFFS plans and to the impact of the 2009 CMS marketing sanction on Medicare Advantage CCP premium revenue, offset in part by growth in revenue for the Medicaid and PDP segments.
Medical benefits expense was $1.1 billion, a decrease of 19% from the third quarter of 2009. The medical benefits ratio (“MBR”) was 82.8% in the third quarter of 2010, compared with 85.2% in the third quarter of 2009. Excluding the impact of premium taxes, the third quarter 2010 MBR was 83.9%, a decrease of 270 basis points from 86.6% in the third quarter of 2009. The decrease was driven by the improved performance of the Company’s PDPs and Medicaid plans, as well as the withdrawal from PFFS plans.
SG&A expense as determined under GAAP was $162 million in the third quarter of 2010, compared with $196 million for the same period in 2009. Adjusted SG&A was $169 million in 2010, a decrease of 9% from $186 million in the same period last year. Adjusted SG&A expense excludes a net benefit of $7 million resulting from directors and officers (“D&O”) liability insurance recoveries of $25 million, offset in part by $18 million in government investigations and related litigation expense. The year-over-year decrease in adjusted SG&A expense resulted principally from the reduction in the Georgia Medicaid program premium tax rate, the withdrawal from PFFS plans, and from gains in operating efficiency. Adjusted SG&A expense was 12.2% of total revenues in the t hird quarter of 2010, compared with 11.2% of total revenues in the same period in 2009, due primarily to a lower revenue base in 2010 resulting from the withdrawal of the Company’s PFFS plans and the impact of the 2009 CMS marketing sanction.
Cash Flow and Financial Condition Highlights
Net cash used in operating activities as determined under GAAP was $72 million, compared with net cash provided by operating activities of $70 million for the nine month periods ended September 30, 2010 and 2009, respectively. Net cash used in operating activities, modified for the timing of receipts from and payments to the Company’s government clients, was $28 million for the nine months ended September 30, 2010, compared with net cash provided by operating activities of $142 million for the nine months ended September 30, 2009.
As of September 30, 2010, unregulated cash and short-term investments were approximately $201 million. Unregulated cash and short-term investments were approximately $160 million as of June 30, 2010, $120 million on December 31, 2009, and $93 million on September 30, 2009.
WCG Reports Third Quarter 2010 Results
Page 3
November 4, 2010
Days in claims payable were 56 days as of September 30, 2010, compared with 54 days as of June 30, 2010, and 56 days as of September 30, 2009. Excluding the impact of Medicare Advantage PFFS plans, days in claims payable were 55 days as of September 30, 2010, 51 days as of June 30, 2010, and 52 days as of September 30, 2009.
Financial Outlook
WellCare is updating its financial outlook for the year ended December 31, 2010. Adjusted net income per diluted share now is expected to be between approximately $2.30 and $2.35, an increase from the previous guidance for adjusted net income per diluted share of between approximately $2.05 and $2.20. The following elements of WellCare’s financial outlook also have changed.
| · | Premium revenue is expected to be between approximately $5.40 and $5.45 billion, an increase from the previous guidance of $5.30 to $5.40 billion. |
| · | The 2010 Medicaid segment MBR is anticipated to be above the 2009 MBR. The previous guidance was for the 2010 Medicaid segment MBR to be below the 2009 MBR. Excluding the impact of premium taxes, the 2010 Medicaid segment MBR is expected to decrease relative to the 2009 MBR. |
| · | The adjusted administrative expense ratio is expected to be in the mid-12% range, down from the high 12% range as described in the previous guidance. |
The following elements of WellCare’s financial outlook are unchanged from the Company’s previous guidance.
| · | The 2010 Medicare Advantage segment MBR will decrease relative to the 2009 MBR. |
| · | The 2010 PDP segment MBR will decrease from the 2009 MBR. |
Webcast
A discussion of WellCare’s third quarter 2010 results will be webcast live on Thursday, November 4, 2010, beginning at 8:30 a.m. Eastern Time. A replay will be available beginning approximately one hour following the conclusion of the live broadcast and will be available for 30 days. The webcast is available via the Company’s web site at www.wellcare.com and at www.earnings.com.
About WellCare Health Plans, Inc.
WellCare Health Plans, Inc. provides managed care services targeted to government-sponsored health care programs, focusing on Medicaid and Medicare. Headquartered in Tampa, Florida, WellCare offers a variety of health plans for families, children, and the aged, blind, and disabled, as well as prescription drug plans. The Company served approximately 2.2 million members nationwide as of September 30, 2010. For more information about WellCare, please visit the Company’s website at www.wellcare.com.
WCG Reports Third Quarter 2010 Results
Page 4
November 4, 2010
Cautionary Statement Regarding Forward-Looking Statements
This news release contains “forward-looking” statements that are made pursuant to the Safe Harbor provisions of the Private Securities Litigation Reform Act of 1995. Statements that are predictive in nature, that depend upon or refer to future events or conditions, or that include words such as “expects,” “anticipates,” “intends,” “plans,” “believes,” “estimates,” and similar expressions are forward-looking statements. Our financial outlook contains forward-looking statements. Forward-looking statements involve known and unknown risks and uncertainties that may cause WellCare’s actual future results to differ materially from those projected or contemplated in the forward-looking statements. These risks a nd uncertainties include, but are not limited to, WellCare’s current financial outlook for 2010 and progress on top priorities such as improving health care quality and access, ensuring a competitive cost position, and reestablishing prudent, profitable growth.
Additional information concerning these and other important risks and uncertainties can be found under the captions “Cautionary Statement Regarding Forward-Looking Statements” and “Risk Factors” in the Company’s Annual Report on Form 10-K for the year ended December 31, 2009, and other filings by WellCare with the U.S. Securities and Exchange Commission, which contain discussions of WellCare’s business and the various factors that may affect it. WellCare undertakes no duty to update these forward-looking statements to reflect any future events, developments, or otherwise.
WCG Reports Third Quarter 2010 Results
Page 5
November 4, 2010
WELLCARE HEALTH PLANS, INC.
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
(Unaudited; dollars in thousands except per share data)
| | Three Months Ended September 30, | | | Nine Months Ended September 30, | |
| | | | | | | | | | | | |
Revenues: | | | | | | | | | | | | |
Premium | | $ | 1,385,874 | | | $ | 1,666,031 | | | $ | 4,077,269 | | | $ | 5,245,809 | |
Investment and other income | | | 2,299 | | | | 1,614 | | | | 7,506 | | | | 8,375 | |
Total revenues | | | 1,388,173 | | | | 1,667,645 | | | | 4,084,775 | | | | 5,254,184 | |
| | | | | | | | | | | | | | | | |
Expenses: | | | | | | | | | | | | | | | | |
Medical benefits | | | 1,147,107 | | | | 1,420,193 | | | | 3,435,870 | | | | 4,477,210 | |
Selling, general and administrative | | | 161,662 | | | | 195,665 | | | | 739,769 | | | | 682,488 | |
Depreciation and amortization | | | 6,123 | | | | 5,851 | | | | 17,770 | | | | 17,547 | |
Interest | | | 117 | | | | 4 | | | | 160 | | | | 3,087 | |
Total expenses | | | 1,315,009 | | | | 1,621,713 | | | | 4,193,569 | | | | 5,180,332 | |
| | | | | | | | | | | | | | | | |
Income (loss) before income taxes | | | 73,164 | | | | 45,932 | | | | (108,794 | ) | | | 73,852 | |
Income tax expense (benefit) | | | 30,248 | | | | 17,272 | | | | (29,257 | ) | | | 45,120 | |
Net income (loss) | | $ | 42,916 | | | $ | 28,660 | | | $ | (79,537 | ) | | $ | 28,732 | |
| | | | | | | | | | | | | | | | |
Net income (loss) per common share: | | | | | | | | | | | | | | | | |
Basic | | $ | 1.01 | | | $ | 0.68 | | | $ | (1.88 | ) | | $ | 0.69 | |
Diluted | | $ | 1.00 | | | $ | 0.68 | | | $ | (1.88 | ) | | $ | 0.68 | |
| | | | | | | | | | | | | | | | |
Weighted average common shares outstanding: | | | | | | | | | | | | | | | | |
Basic | | | 42,411,455 | | | | 41,849,749 | | | | 42,313,973 | | | | 41,771,713 | |
Diluted | | | 42,740,369 | | | | 42,280,035 | | | | 42,313,973 | | | | 42,007,302 | |
WCG Reports Third Quarter 2010 Results
Page 6
November 4, 2010
WELLCARE HEALTH PLANS, INC. CONDENSED CONSOLIDATED BALANCE SHEETS
(Dollars in thousands)
| | | | | | |
| | (Unaudited) | | | | |
ASSETS | |
Current Assets: | | | | | | |
Cash and cash equivalents | | $ | 1,091,015 | | | $ | 1,158,131 | |
Investments | | | 72,709 | | | | 62,722 | |
Premium and other receivables, net | | | 309,998 | | | | 285,808 | |
Funds receivable for the benefit of members | | | 55,262 | | | | 77,851 | |
Prepaid expenses and other current assets, net | | | 121,106 | | | | 104,079 | |
Deferred income tax asset | | | 56,638 | | | | 28,874 | |
Total current assets | | | 1,706,728 | | | | 1,717,465 | |
Property, equipment and capitalized software, net | | | 68,534 | | | | 61,785 | |
Goodwill | | | 111,131 | | | | 111,131 | |
Other intangible assets, net | | | 11,811 | | | | 12,961 | |
Long-term investments | | | 46,838 | | | | 51,710 | |
Restricted investments | | | 124,694 | | | | 130,550 | |
Deferred income tax asset | | | 69,277 | | | | 29,654 | |
Other assets | | | 4,118 | | | | 3,191 | |
Total Assets | | $ | 2,143,131 | | | $ | 2,118,447 | |
| |
LIABILITIES AND STOCKHOLDERS’ EQUITY | |
Current Liabilities: | | | | | | | | |
Medical benefits payable | | $ | 703,664 | | | $ | 802,515 | |
Unearned premiums | | | 65,992 | | | | 90,496 | |
Accounts payable | | | 8,869 | | | | 5,270 | |
Other accrued expenses and liabilities | | | 150,834 | | | | 220,562 | |
Current portion of amounts accrued related to investigation resolution | | | 117,601 | | | | 18,192 | |
Other payables to government partners | | | 42,447 | | | | 38,147 | |
Income taxes payable | | | 18,362 | | | | 4,888 | |
Total current liabilities | | | 1,107,769 | | | | 1,180,070 | |
Amounts accrued related to investigation resolution | | | 213,649 | | | | 40,205 | |
Other liabilities | | | 19,677 | | | | 17,272 | |
Total liabilities | | | 1,341,095 | | | | 1,237,547 | |
Commitments and contingencies | | | – | | | | – | |
Stockholders’ Equity: | | | | | | | | |
Preferred stock, $0.01 par value (20,000,000 authorized, no shares issued or outstanding) | | | – | | | | – | |
Common stock, $0.01 par value (100,000,000 authorized, 42,538,975 and 42,361,207 shares issued and outstanding at September 30, 2010 and December 31, 2009, respectively) | | | 425 | | | | 424 | |
Paid-in capital | | | 424,529 | | | | 425,083 | |
Retained earnings | | | 378,975 | | | | 458,512 | |
Accumulated other comprehensive loss | | | (1,893 | ) | | | (3,119 | ) |
Total stockholders’ equity | | | 802,036 | | | | 880,900 | |
Total Liabilities and Stockholders’ Equity | | $ | 2,143,131 | | | $ | 2,118,447 | |
WCG Reports Third Quarter 2010 Results
Page 7
November 4, 2010
WELLCARE HEALTH PLANS, INC. CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(Unaudited; dollars in thousands)
| | Nine Months Ended September 30, | |
| | | | | | |
Cash provided by (used in) operating activities: | | | | | | |
Net (loss) income | | $ | (79,537 | ) | | $ | 28,732 | |
Adjustments to reconcile net (loss) income to net cash (used in) provided by operating activities: | | | | | | | | |
Depreciation and amortization | | | 17,770 | | | | 17,547 | |
Equity-based compensation expense | | | 8,655 | | | | 29,776 | |
Deferred taxes, net | | | (67,386 | ) | | | 8,526 | |
Changes in operating accounts: | | | | | | | | |
Premium and other receivables, net | | | (24,190 | ) | | | 10,111 | |
Other receivables from government partners, net | | | – | | | | (40,073 | ) |
Prepaid expenses and other current assets, net | | | (17,027 | ) | | | 15,301 | |
Medical benefits payable | | | (98,851 | ) | | | 91,708 | |
Unearned premiums | | | (24,504 | ) | | | (60,489 | ) |
Accounts payable and other accrued expenses | | | (43,635 | ) | | | (64,465 | ) |
Other payables to government partners | | | 4,300 | | | | 18,397 | |
Amounts accrued related to investigation resolution | | | 249,915 | | | | 30,249 | |
Income taxes, net | | | 7,594 | | | | (5,450 | ) |
Other, net | | | (5,088 | ) | | | (10,328 | ) |
Net cash (used in) provided by operating activities | | | (71,984 | ) | | | 69,542 | |
Cash provided by (used in) investing activities: | | | | | | | | |
Purchases of investments | | | (117,903 | ) | | | (19,295 | ) |
Proceeds from sales and maturities of investments | | | 114,726 | | | | 34,012 | |
Purchases of restricted investments | | | (18,386 | ) | | | (64,039 | ) |
Proceeds from maturities of restricted investments | | | 24,298 | | | | 131,707 | |
Additions to property, equipment and capitalized software, net | | | (16,192 | ) | | | (9,908 | ) |
Net cash (used in) provided by investing activities | | | (13,457 | ) | | | 72,477 | |
Cash provided by (used in) financing activities: | | | | | | | | |
Proceeds from option exercises and other | | | 1,091 | | | | 418 | |
Purchase of treasury stock | | | (4,420 | ) | | | – | |
Payments on debt | | | – | | | | (152,800 | ) |
Payments on capital leases | | | (935 | ) | | | – | |
Funds received (used) for the benefit of members | | | 22,589 | | | | (341 | ) |
Net cash provided by (used in) financing activities | | | 18,325 | | | | (152,723 | ) |
Cash and cash equivalents: | | | | | | | | |
Decrease during the period | | | (67,116 | ) | | | (10,704 | ) |
Balance at beginning of year | | | 1,158,131 | | | | 1,181,922 | |
Balance at end of period | | $ | 1,091,015 | | | $ | 1,171,218 | |
| | | | | | | | |
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION: | | | | | | | | |
Cash paid for taxes | | $ | 35,686 | | | $ | 58,489 | |
Cash paid for interest | | $ | 183 | | | $ | 2,642 | |
Equipment acquired through capital leases | | $ | 8,868 | | | $ | 559 | |
WCG Reports Third Quarter 2010 Results
Page 8
November 4, 2010
WELLCARE HEALTH PLANS, INC.
MEMBERSHIP STATISTICS
| | | |
| | | | | | |
Membership by Program | | | | | | |
Medicaid Membership | | | | | | |
TANF | | | 1,073,000 | | | | 1,072,000 | |
S-CHIP | | | 168,000 | | | | 158,000 | |
SSI and ABD | | | 77,000 | | | | 78,000 | |
FHP | | | 10,000 | | | | 14,000 | |
Total Medicaid Membership | | | 1,328,000 | | | | 1,322,000 | |
| | | | | | | | |
Medicare Membership | | | | | | | | |
Medicare Advantage | | | 116,000 | | | | 240,000 | |
Prescription Drug Plan (stand-alone) | | | 756,000 | | | | 768,000 | |
Total Medicare Membership | | | 872,000 | | | | 1,008,000 | |
Total Membership | | | 2,200,000 | | | | 2,330,000 | |
| | | | | | | | |
Medicaid Membership by State | | | | | | | | |
Florida | | | 418,000 | | | | 412,000 | |
Georgia | | | 548,000 | | | | 527,000 | |
Other states | | | 362,000 | | | | 383,000 | |
Total Medicaid Membership | | | 1,328,000 | | | | 1,322,000 | |
WCG Reports Third Quarter 2010 Results
Page 9
November 4, 2010
WELLCARE HEALTH PLANS, INC.
SEGMENT INFORMATION
(Unaudited; dollars in thousands)
| | Three Months Ended September 30, | | | Nine Months Ended September 30, | |
| | | | | | | | | | | | |
Premium revenue: | | | | | | | | | | | | |
Medicaid: | | | | | | | | | | | | |
Florida | | $ | 223,409 | | | $ | 220,409 | | | $ | 669,654 | | | $ | 720,662 | |
Georgia | | | 359,744 | | | | 345,640 | | | | 1,013,471 | | | | 999,487 | |
Other states | | | 271,740 | | | | 248,062 | | | | 781,499 | | | | 716,899 | |
Total Medicaid | | | 854,893 | | | | 814,111 | | | | 2,464,624 | | | | 2,437,048 | |
| | | | | | | | | | | | | | | | |
Medicare: | | | | | | | | | | | | | | | | |
Medicare Advantage plans | | | 331,338 | | | | 660,009 | | | | 1,012,366 | | | | 2,142,921 | |
Prescription Drug plans | | | 199,643 | | | | 191,911 | | | | 600,279 | | | | 665,840 | |
Total Medicare | | | 530,981 | | | | 851,920 | | | | 1,612,645 | | | | 2,808,761 | |
Total Premium Revenue | | $ | 1,385,874 | | | $ | 1,666,031 | | | $ | 4,077,269 | | | $ | 5,245,809 | |
WCG Reports Third Quarter 2010 Results
Page 10
November 4, 2010
WELLCARE HEALTH PLANS, INC. UNAUDITED SUPPLEMENTAL INFORMATION
Reconciliation of GAAP Statements of Operations to Adjusted Statements of Operations
(Dollars in thousands except per-share data)
The Company reports adjusted operating results on a non-GAAP basis to exclude certain expenses that management believes are not indicative of longer-term business trends and operations. Following are statements of operations and related measures for the third quarters ended September 30, 2010 and 2009, as determined under GAAP, reconciled to the adjusted statements of operations and related measures for each of the same periods.
| Three Months Ended September 30, 2010 | | Three Months Ended September 30, 2009 |
| | | | | | | |
Revenues: | | | | | | | | | |
Premium | $ 1,385,874 | $ – | | $ 1,385,874 | | $ 1,666,031 | $ – | | $ 1,666,031 |
Investment and other income | | | | | | | | | |
Total revenues | | | | | | | | | |
| | | | | | | | | |
Expenses: | | | | | | | | | |
Medical benefits | 1,147,107 | – | | 1,147,107 | | 1,420,193 | – | | 1,420,193 |
Selling, general, and administrative | 161,662 | 7,342 | (a) (b) (c) | 169,004 | | 195,665 | (9,463) | (a) (b) | 186,202 |
Depreciation and amortization | 6,123 | – | | 6,123 | | 5,851 | – | | 5,851 |
Interest | | | | | | | | | |
Total expenses | | | | | | | | | |
| | | | | | | | | |
Income before income taxes | 73,164 | (7,342) | | 65,822 | | 45,932 | 9,463 | | 55,395 |
Income tax expense | | | | | | | | | |
Net income | | | | | | | | | |
| | | | | | | | | |
Weighted average shares: | | | | | | | | | |
Basic | 42,411,455 | – | | 42,411,455 | | 41,849,749 | – | | 41,849,749 |
Diluted | 42,740,369 | – | | 42,740,369 | | 42,280,035 | – | | 42,280,035 |
| | | | | | | | | |
Net income per share: | | | | | | | | | |
Basic | $ 1.01 | $ (0.12) | | $ 0.89 | | $ 0.68 | $ 0.15 | | $ 0.83 |
Diluted | $ 1.00 | $ (0.11) | | $ 0.89 | | $ 0.68 | $ 0.14 | | $ 0.82 |
| | | | | | | | | |
Medical benefits ratio: | | | | | | | | | |
Medicaid | 86.9% % | | | 86.9% | | 87.2% | | | 87.2% |
Medicare Advantage | 78.7% | | | 78.7% | | 83.4% | | | 83.4% |
Prescription Drug Plans | 71.7% | | | 71.7% | | 83.2% | | | 83.2% |
Aggregate | 82.8% % | | | 82.8% | | 85.2% | | | 85.2% |
| | | | | | | | | |
Administrative expense ratio | 11.6% % | 0.6% | (a) (b) (c) | 12.2% | | 11.7% | -0.5% | (a) (b) | 11.2% |
| | | | | | | | | |
Days in claims payable | 56 | | | 56 | | 56 | | | 56 |
(a) | Investigation-related legal, accounting, employee retention, and other costs: Administrative expenses associated with the government and Company investigations, net of D&O insurance recoveries, amounted to a credit of $10.5 million and expense of $9.0 million, in the quarters ended September 30, 2010 and 2009, respectively. |
(b) | Liability for investigation resolution: Based on the status of the government investigations, the Company recorded expense of $2.3 million and $0.5 million, respectively, in the quarters ended September 30, 2010 and 2009. |
(c) | Liability for securities class action litigation resolution: The Company recorded expense of $0.8 million in the three months ended September 30, 2010, as its estimate for the resolution of putative securities class action litigation. |
WCG Reports Third Quarter 2010 Results
Page 11
November 4, 2010
| WELLCARE HEALTH PLANS, INC. UNAUDITED SUPPLEMENTAL INFORMATION |
Reconciliation of GAAP Statements of Operations to Adjusted Statements of Operations
(Dollars in thousands except per-share data)
| Nine Months Ended September 30, 2010 | | Nine Months Ended September 30, 2009 |
| | | | | | | |
| | | | | | | | | |
Revenues: | | | | | | | | | |
Premium | $ 4,077,269 | $ – | | $ 4,077,269 | | $ 5,245,809 | $ – | | $ 5,245,809 |
Investment and other income | | | | | | | | | |
Total revenues | | | | | | | | | |
| | | | | | | | | |
Expenses: | | | | | | | | | |
Medical benefits | 3,435,870 | – | | 3,435,870 | | 4,477,210 | – | | 4,477,210 |
Selling, general, and administrative | 739,769 | (250,381) | (a)(b) (c) | 489,388 | | 682,488 | (93,146) | (a)(b) | 589,342 |
Depreciation and amortization | 17,770 | – | | 17,770 | | 17,547 | – | | 17,547 |
Interest | | | | | | | | | |
Total expenses | | | | | | | | | |
| | | | | | | | | |
(Loss) income before income taxes | (108,794) | 250,381 | | 141,587 | | 73,852 | 93,146 | | 166,998 |
Income tax (benefit) expense | | | | | | | | | |
Net (loss) income | | | | | | | | | |
| | | | | | | | | |
Weighted average shares: | | | | | | | | | |
Basic | 42,313,973 | – | | 42,313,973 | | 41,771,713 | – | | 41,771,713 |
Diluted | 42,313,973 | 424,564 | | 42,738,537 | | 42,007,302 | – | | 42,007,302 |
| | | | | | | | | |
Net (loss) income per share: | | | | | | | | | |
Basic | $ (1.88) | $ 3.86 | | $ 1.98 | | $ 0.69 | $ 1.87 | | $ 2.56 |
Diluted | $ (1.88) | $ 3.84 | | $ 1.96 | | $ 0.68 | $ 1.86 | | $ 2.54 |
| | | | | | | | | |
Medical benefits ratio: | | | | | | | | | |
Medicaid | 86.6% | | | 86.6% | | 85.8% | | | 85.8% |
Medicare Advantage | 78.6% | | | 78.6% | | 82.2% | | | 82.2% |
Prescription Drug Plans | 84.4% | | | 84.4% | | 93.6% | | | 93.6% |
Aggregate | 84.3% | | | 84.3% | | 85.3% | | | 85.3% |
| | | | | | | | | |
Administrative expense ratio | 18.1% | -6.1% | (a)(b) (c) | 12.0% | | 13.0% | -1.8% | (a) (b) | 11.2% |
(a) | Investigation-related legal, accounting, employee retention, and other costs: Administrative expenses associated with the government and Company investigations, net of D&O insurance recoveries, amounted to a credit of $1.1 million and expense of $32.9 million, in the nine months ended September 30, 2010 and 2009, respectively. |
(b) | Liability for investigation resolution: Based on the status of the government investigations, the Company recorded expense of $56.7 million and $60.2 million, respectively, in the nine months ended September 30, 2010 and 2009. |
(c) | Liability for securities class action litigation resolution: The Company recorded expense of $194.8 million in the nine months ended September 30, 2010, as its estimate for the resolution of putative securities class action litigation. |
WCG Reports Third Quarter 2010 Results
Page 12
November 4, 2010
WELLCARE HEALTH PLANS, INC.
UNAUDITED SUPPLEMENTAL INFORMATION
Reconciliation of Medical Benefits Ratios and Administrative Expense Ratio
to Medical Benefits Ratios and Administrative Expense Ratio Modified
to Exclude Premium Taxes and Certain Specified Expenses
The Company reports MBRs and administrative expense ratios on a non-GAAP basis that excludes premium taxes paid primarily on Medicaid managed care premium revenue, as well as certain investigation and litigation-related administrative expenses, net of D&O insurance recoveries. The Company believes that MBRs and administrative expense ratios excluding premium taxes are useful measures for investors, as premium taxes are recorded as both revenue of and expense to the Company, and therefore do not affect the Company’s operating results. In addition, certain investigation and litigation-related administrative expenses, net of D&O insurance recoveries, are excluded from the administrative expense ratio, as management believes these expenses are not indicative of longer-term business trends and operations.
| | GAAP | | | Adjustments (see pages 10 and 11) | | | Adjusted | | | Premium Tax Impact | | | Excluding Premium Taxes | |
| | Three Months Ended September 30, 2010 | |
Medical benefits ratio: | | | | | | | | | | | | | | | |
Medicaid | | | 86.9 | % | | | | | | 86.9 | % | | | 2.0 | % | | | 88.9 | % |
Medicare Advantage | | | 78.7 | % | | | | | | 78.7 | % | | | | | | | 78.7 | % |
PDP | | | 71.7 | % | | | | | | 71.7 | % | | | | | | | 71.7 | % |
Aggregate | | | 82.8 | % | | | | | | 82.8 | % | | | 1.1 | % | | | 83.9 | % |
| | | | | | | | | | | | | | | | | | | |
Administrative expense ratio | | | 11.6 | % | | | 0.6 | % | | | 12.2 | % | | | -1.2 | % | | | 11.0 | % |
| | | | | | | | | | | | | | | | | | | | |
| | Three Months Ended September 30, 2009 | |
Medical benefits ratio: | | | | | | | | | | | | | | | | | | | | |
Medicaid | | | 87.2 | % | | | | | | | 87.2 | % | | | 3.0 | % | | | 90.2 | % |
Medicare Advantage | | | 83.4 | % | | | | | | | 83.4 | % | | | | | | | 83.4 | % |
PDP | | | 83.2 | % | | | | | | | 83.2 | % | | | | | | | 83.2 | % |
Aggregate | | | 85.2 | % | | | | | | | 85.2 | % | | | 1.4 | % | | | 86.6 | % |
| | | | | | | | | | | | | | | | | | | | |
Administrative expense ratio | | | 11.7 | % | | | -0.5 | % | | | 11.2 | % | | | -1.5 | % | | | 9.7 | % |
| | | | | | | | | | | | | | | | | | | | |
| | GAAP | | | Adjustments (see pages 10 and 11) | | | Adjusted | | | Premium Tax Impact | | | Excluding Premium Taxes | |
| | Nine Months Ended September 30, 2010 | |
Medical benefits ratio: | | | | | | | | | | | | | | | | | | | | |
Medicaid | | | 86.6 | % | | | | | | | 86.6 | % | | | 1.3 | % | | | 87.9 | % |
Medicare Advantage | | | 78.6 | % | | | | | | | 78.6 | % | | | | | | | 78.6 | % |
PDP | | | 84.4 | % | | | | | | | 84.4 | % | | | | | | | 84.4 | % |
Aggregate | | | 84.3 | % | | | | | | | 84.3 | % | | | 0.8 | % | | | 85.1 | % |
| | | | | | | | | | | | | | | | | | | | |
Administrative expense ratio | | | 18.1 | % | | | -6.1 | % | | | 12.0 | % | | | -0.8 | % | | | 11.2 | % |
| | | | | | | | | | | | | | | | | | | | |
| | Nine Months Ended September 30, 2009 | |
Medical benefits ratio: | | | | | | | | | | | | | | | | | | | | |
Medicaid | | | 85.8 | % | | | | | | | 85.8 | % | | | 3.0 | % | | | 88.8 | % |
Medicare Advantage | | | 82.2 | % | | | | | | | 82.2 | % | | | | | | | 82.2 | % |
PDP | | | 93.6 | % | | | | | | | 93.6 | % | | | | | | | 93.6 | % |
Aggregate | | | 85.3 | % | | | | | | | 85.3 | % | | | 1.4 | % | | | 86.7 | % |
| | | | | | | | | | | | | | | | | | | | |
Administrative expense ratio | | | 13.0 | % | | | -1.8 | % | | | 11.2 | % | | | -1.4 | % | | | 9.8 | % |
Premium taxes were $19.0 million and $26.8 million, respectively, for the three months ended September 30, 2010 and 2009. Premium taxes were $38.1 million and $80.1 million, respectively, for the nine months ended September 30, 2010 and 2009.
WCG Reports Third Quarter 2010 Results
Page 13
November 4, 2010
WELLCARE HEALTH PLANS, INC.
UNAUDITED SUPPLEMENTAL INFORMATION
Reconciliation of GAAP Net Cash (Used in) Provided by Operating Activities
to Net Cash (Used in) Provided by Operating Activities Modified
for the Timing of Receipts from and Payments to Government Clients
(Dollars in thousands)
The Company reports cash (used in) provided by operating activities on a non-GAAP basis to exclude the changes in unearned premiums, premiums and other receivables, and other receivables from and payables to government customers. The Company believes that cash flow excluding these changes is a useful measure for investors, as the excluded changes are a function of the timing of cash receipts from and payments to federal and state government agencies at the end of a period.
| | Nine Months Ended September 30, | |
| | 2010 | | | 2009 | |
Net cash (used in) provided by operating activities, as reported under GAAP | | $ | (71,984 | ) | | $ | 69,542 | |
Modifications to eliminate changes in: | | | | | | | | |
Premium and other receivables, net | | | 24,190 | | | | (10,111 | ) |
Other receivables from government partners, net | | | – | | | | 40,073 | |
Unearned premiums | | | 24,504 | | | | 60,489 | |
Other payables to government partners | | | (4,300 | ) | | | (18,397 | ) |
Net cash (used in) provided by operating activities, modified for the timing of receipts from and payments to government clients | | $ | (27,590 | ) | | $ | 141,596 | |
Reconciliation of GAAP Days in Claims Payable to Days in Claims Payable Modified
to Eliminate the Impact of Medicare Advantage Private Fee-for-Service Plans
The Company reports days in claims payable on a non-GAAP basis to exclude the impact of Medicare Advantage PFFS plans. The Company believes that days in claims payable excluding the impact of PFFS plans is a useful measure for investors, because the Company withdrew these plans on December 31, 2009, and, as a result, the impact of the plans on historical operations is not necessarily indicative of the Company’s future long-term business operations. Days in claims payable is equal to the medical benefits payable at the end of a quarter divided by average medical benefits expense per calendar day for the quarter.
| | | |
| | | | | | | | | | | | | | | |
Days in claims payable, as reported under GAAP | | | 56 | | | | 53 | | | | 55 | | | | 54 | | | | 56 | |
Modification to eliminate impact of PFFS plans | | | (4 | ) | | | (4 | ) | | | (5 | ) | | | (3 | ) | | | (1 | ) |
Days in claims payable, modified to eliminate the impact of PFFS plans | | | 52 | | | | 49 | | | | 50 | | | | 51 | | | | 55 | |
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