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8-K Filing
Humana (HUM) 8-KHumana Reports Third Quarter Financial Results
Filed: 1 Nov 10, 12:00am
Exhibit 99
Humana Reports Third Quarter Financial Results
LOUISVILLE, Ky.--(BUSINESS WIRE)--November 1, 2010--Humana Inc. (NYSE: HUM) today reported diluted earnings per common share (EPS) for the quarter ended September 30, 2010 (3Q10) of $2.32, ahead of management’s guidance of $1.65 to $1.75. The company earned $1.78 per share for the quarter ended September 30, 2009 (3Q09). Results for 3Q10 reflect improved performance in the company’s operations, the beneficial effect of $0.21 per share in higher-than-expected favorable medical claims development related to prior years(a) and $0.10 per share in higher-than-expected favorable medical claims development related to the first half of 2010(a).
For the nine months ended September 30, 2010 (YTD10) the company reported $5.84 in EPS compared to $4.67 in EPS for the nine months ended September 30, 2009 (YTD09). Results for YTD10 reflect improved performance in the company’s operations and the beneficial effect of $0.72 per share in higher-than-expected favorable medical claims development related to prior years(a), partially offset by $0.55 per share in expenses from the write-down of certain deferred acquisition costs in the second quarter 2010.
“Our third-quarter results showed strong operating performance in both our Government and Commercial segments,” said Michael B. McCallister, Humana's chairman of the board and chief executive officer. “With the success of our one-to-one retail approach to membership growth solidly aligned with the continued expansion of Medicare and potential retail opportunities in the individual market, Humana faces the post-reform future with confidence.”
The company now anticipates EPS of approximately $6.40 to $6.50 for the year ending December 31, 2010 (FY10) reflecting the improved operating performance and the expectation of a TRICARE contract extension, as discussed below.
Humana plans to issue its 2011 earnings guidance in conjunction with its biennial investor meeting scheduled for November 18, 2010. That meeting will be available to the media and general public via a live web cast.
TRICARE Update
As previously disclosed by the company, on October 5, 2010, Humana Military Healthcare Services, Inc. (HMHS), a wholly-owned subsidiary of the company, was notified by the United States Department of Defense TRICARE Management Activity (TMA) that the TMA intends to negotiate with HMHS for an extension of HMHS’s administration of the TRICARE program South Region contract for an additional option period from April 1, 2011 through March 31, 2012.
Discussions are still at a preliminary stage, but Humana no longer anticipates incurring the previously expected expenses of between $0.19 and $0.28 per diluted common share during FY10 related to the previously anticipated loss of the TRICARE contract on March 31, 2011. Such expenses may, however, be incurred in future periods, depending on the ultimate disposition of future contract awards, as discussed in the company’s Securities and Exchange Commission filings.
Consolidated Highlights
Revenues – 3Q10 consolidated revenues rose 9 percent to $8.42 billion from $7.72 billion in 3Q09, with total premium and administrative services fees also up 9 percent compared to the prior year’s quarter. The year-over-year increase in premiums and administrative services fees primarily reflects a 17 percent increase in average membership for the company’s Medicare Advantage plans and continued pricing discipline across all of the company’s lines of business, partially offset by lower average stand-alone Prescription Drug Plan (PDP) and commercial fully-insured group medical membership.
Consolidated revenues for YTD10 rose 9 percent to $25.52 billion from $23.33 billion for YTD09 with total premiums and administrative services fees up 9 percent compared to the prior year’s period, also driven primarily by the same factors as the third quarter year-over-year increase.
Benefit expenses – The 3Q10 consolidated benefit ratio (benefit expenses as a percent of premium revenues) of 81.6 percent decreased 50 basis points from 82.1 percent for the prior year’s quarter and included a 100 basis point beneficial effect of higher-than-expected favorable prior-period medical claims development in 3Q10 (a). The Commercial Segment benefit ratio for 3Q10 improved 350 basis points while that for the Government Segment increased 30 basis points year over year. The primary drivers of these changes are detailed in the segment discussions below.
The consolidated benefit ratio for YTD10 of 82.3 percent was 80 basis points lower than the YTD09 consolidated benefit ratio of 83.1 percent due primarily to an 80 basis point beneficial effect of higher-than-expected favorable prior-year medical claims development YTD10 (a). The lower consolidated benefit ratio versus the prior year’s period included a 390 basis point improvement in the benefit ratio for the Commercial Segment and a 20 basis point improvement for the Government Segment. These changes were primarily driven by the same factors impacting the third quarter year-over-year comparisons.
Selling, general, & administrative (SG&A) expenses – The 3Q10 consolidated SG&A expense ratio (SG&A expenses as a percent of premiums, administrative services fees and other revenue) of 12.9 percent decreased 80 basis points from the 3Q09 ratio of 13.7 percent reflecting both scale efficiencies associated with higher average Medicare Advantage membership and the company’s continued focus on administrative cost reductions.
The YTD10 consolidated SG&A expense ratio of 13.3 percent decreased 20 basis points from the YTD09 ratio of 13.5 percent primarily reflecting the same factors impacting the third quarter year-over-year comparison, partially offset by the impact of the write-down of certain deferred acquisition costs in the second quarter of 2010.
Government Segment Results
Pretax results:
Enrollment:
Premiums and administrative services fees:
Benefit Expenses:
SG&A Expenses:
Commercial Segment Results
Pretax results:
Enrollment:
Premiums and administrative services fees:
Benefit Expenses:
SG&A Expenses:
Balance Sheet
Cash Flows from Operations
Cash flows provided by operations for 3Q10 of $1.21 billion compared to cash flows provided by operations of $940.1 million in 3Q09 with the increase primarily due to higher net income and changes in working capital balances year over year.
Share Repurchase Program
In December 2009, the company’s Board of Directors renewed its authorization for the use of up to $250 million for the repurchase of Humana common shares. During 3Q10, the company repurchased 968,000 of its outstanding shares at an average price per share of $51.66. As of November 1, 2010, the company had approximately $150 million remaining on the December 2009 authorization, which is effective until December 31, 2011.
Footnotes
(a) | Actuarial standards require the use of assumptions based on moderately adverse experience, which generally results in favorable reserve development, or reserves that are considered redundant. When the Company recognizes a release of the redundancy, it discloses the amount that is not in the ordinary course of business. | |
(b) | The Commercial Segment provides a full range of insured specialty products including dental, vision and other supplemental products. Members included in these products may not be unique to each product since members have the ability to enroll in multiple products. Other supplemental benefits include life, disability, and fixed benefit products including cancer and critical illness policies. | |
Conference Call & Virtual Slide Presentation
Humana will host a conference call, as well as a virtual slide presentation, at 9:00 a.m. eastern time today to discuss its financial results for the quarter and the company’s expectations for future earnings. A live virtual presentation (audio with slides) may be accessed via Humana’s Investor Relations page at www.humana.com. The company suggests web participants sign on approximately 15 minutes in advance of the call. The company also suggests web participants visit the site well in advance of the call to run a system test and to download any free software needed to view the presentation.
All parties interested in the audio-only portion of the conference call are invited to dial 888-625-7430. No password is required. The company suggests participants dial in approximately ten minutes in advance of the call. For those unable to participate in the live event, the virtual presentation archive may be accessed via the Historical Webcasts & Presentations section of the Investor Relations page at www.humana.com.
Cautionary Statement
This news release includes forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. When used in investor presentations, press releases, Securities and Exchange Commission (SEC) filings, and in oral statements made by or with the approval of one of Humana’s executive officers, the words or phrases like “expects,” “anticipates,” “intends,” “likely will result,” “estimates,” “projects” or variations of such words and similar expressions are intended to identify such forward-looking statements. These forward-looking statements are not guarantees of future performance and are subject to risks, uncertainties, and assumptions, including, among other things, information set forth in the “Risk Factors” section of the company’s SEC filings, a summary of which includes but is not limited to the following:
In making forward-looking statements, Humana is not undertaking to address or update them in future filings or communications regarding its business or results. In light of these risks, uncertainties, and assumptions, the forward-looking events discussed herein may or may not occur. There also may be other risks that the company is unable to predict at this time. Any of these risks and uncertainties may cause actual results to differ materially from the results discussed in the forward-looking statements.
Humana advises investors to read the following documents as filed by the company with the SEC for further discussion both of the risks it faces and its historical performance:
About Humana
Humana Inc., headquartered in Louisville, Kentucky, is one of the nation’s largest publicly traded health and supplemental benefits companies, with approximately 10.1 million medical members and 7.0 million specialty members. Humana is a full-service benefits solutions company, offering a wide array of health, pharmacy and supplemental benefit plans for employer groups, government programs and individuals.
Over its 49-year history, Humana has consistently seized opportunities to meet changing customer needs. Today, the company is a leader in consumer engagement, providing guidance that leads to lower costs and a better health plan experience throughout its diversified customer portfolio.
More information regarding Humana is available to investors via the Investor Relations page of the company’s web site at www.humana.com, including copies of:
Humana Inc. – Earnings Guidance Points as of November 1, 2010 | ||||||
(in accordance with Generally Accepted Accounting Principles (GAAP)) | For the year ending December 31, 2010 (FY10) | Comments | ||||
Diluted earnings per common share (EPS) | FY10: approximately $6.40 to $6.50 | EPS estimates exclude the impact of potential future share repurchases
FY10 EPS includes $0.72 per share beneficial effect from higher-than-expected favorable prior-year medical claims reserve development and $0.55 per share in expenses associated with the write-down of certain deferred acquisition costs | ||||
Revenues | Consolidated revenues: $33.5 billion to $34.0 billion | |||||
Premiums and ASO fees: | ||||||
Medicare Advantage: approximately $19.3 billion | ||||||
Medicare stand-alone PDPs: approximately $2.4 billion | ||||||
Military Services: $3.5 billion to $3.6 billion | ||||||
Commercial Segment: approximately $7.3 billion | ||||||
Consolidated investment income: $330 million to $340 million | ||||||
Consolidated other revenue: $290 million to $310 million | ||||||
Ending medical membership | Medicare Advantage: up approximately 255,000 to 260,000 from prior year | Medicare Advantage includes ASO and fully-insured group and individual Medicare members | ||||
| ||||||
Medicare stand-alone PDPs: down 175,000 to 180,000 from prior year | ||||||
Military services: no material change from prior year | ||||||
Medicaid: up approximately 150,000 from prior year | Includes additional Puerto Rico contract effective 10/1/10 | |||||
Commercial fully-insured: down 210,000 to 215,000 from prior year |
| |||||
Commercial ASO: down 115,000 to 125,000 from prior year | ||||||
Benefit ratios and benefit expense trend components | Government Segment benefit ratio in the range of 84.0% to 84.5% | Government Segment benefit ratio is Medicare, Medicaid, and Military Services combined and includes an 60 basis point benefit from higher-than-expected favorable prior-period medical claims development | ||||
Medicare benefit ratio in the range of 83.0% to 83.5% | Medicare benefit ratio is Medicare Advantage and Stand-Alone PDP combined and includes a 70 basis point benefit from higher-than-expected favorable prior-period medical claims development | |||||
Commercial Segment benefit ratio in the range of 77% to 78% | Commercial Segment benefit ratio is Medical and Specialty combined and includes an 60 basis point benefit from higher-than-expected favorable prior-period medical claims development | |||||
Commercial group fully-insured secular benefit expense trend components: inpatient hospital utilization – flat to down; inpatient and outpatient hospital rates (base rate plus severity adjustments) – low-to-mid single digits; outpatient hospital utilization – low single digits; physician – essentially flat; pharmacy – low to mid single digits | Commercial group fully-insured secular trends of 4% to 5% represent the underlying percentage change in total medical expenses which excludes the impact of benefit changes and business, product, and demographic mix. | |||||
Selling, general & administrative expense ratio | 13.5% to 14.0% | Ratio computed as SG&A expenses as a percent of premiums, administrative services fees, and other revenue
Includes 40 basis point negative impact from write-down of certain deferred acquisition costs (DAC) in the second quarter 2010 | ||||
Depreciation & amortization | $250 million to $260 million | |||||
Interest expense | $105 million to $110 million | |||||
Government Segment pretax operating results | Medicare pretax operating margin: approximately 6.5%
Military services: pretax operating earnings of approximately $110 million | Medicare margin includes Medicare Advantage and stand-alone PDP combined | ||||
Commercial Segment pretax earnings | $165 million to $170 million | Commercial Segment results include the impact of investment income and interest expense, approximately $42.1 million in beneficial effect of higher-than-expected favorable prior-year medical claims development and $147.5 million of DAC impairment expenses, as discussed above | ||||
Cash flows from operations | $2.1 billion to $2.3 billion | |||||
Capital expenditures | Approximately $205 million | |||||
Effective tax rate | Approximately 37% | |||||
Shares used in computing full-year EPS | Approximately 170 million | Excludes impact of potential future share repurchases |
Humana Inc. Statistical Schedules And Supplementary Information 3Q10 Earnings Release |
S-1 |
Humana Inc. | |||||
Statistical Schedules and Supplementary Information | |||||
3Q10 Earnings Release | |||||
Contents | |||||
Page | Description | ||||
S-3-4 | Consolidated Statements of Income | ||||
S-5 | Consolidated Balance Sheets | ||||
S-6-7 | Consolidated Statements of Cash Flows | ||||
S-8 | Key Income Statement Ratios and Segment Operating Results | ||||
S-9 | Membership Detail | ||||
S-10-11 | Premiums and Administrative Services Fees Detail | ||||
S-12 | Percentage of Ending Membership under Capitation Arrangements | ||||
S-13 | Investments | ||||
S-14-16 | Benefits Payable | ||||
S-17 | Footnotes | ||||
S-2 | |||||
Humana Inc. | ||||||||||||||
Consolidated Statements of Income | ||||||||||||||
In thousands, except per common share results | ||||||||||||||
Three Months Ended September 30, | ||||||||||||||
Dollar | Percentage | |||||||||||||
2010 | 2009 | Change | Change | |||||||||||
Revenues: | ||||||||||||||
Premiums | $8,134,645 | $7,444,122 | $690,523 | 9.3 | % | |||||||||
Administrative services fees | 121,815 | 133,732 | (11,917 | ) | -8.9 | % | ||||||||
Investment income | 87,250 | 74,861 | 12,389 | 16.5 | % | |||||||||
Other revenue | 80,938 | 64,104 | 16,834 | 26.3 | % | |||||||||
Total revenues | 8,424,648 | 7,716,819 | 707,829 | 9.2 | % | |||||||||
Operating expenses: | ||||||||||||||
Benefits | 6,637,470 | 6,111,351 | 526,119 | 8.6 | % | |||||||||
Selling, general and administrative | 1,074,188 | 1,047,773 | 26,415 | 2.5 | % | |||||||||
Depreciation | 54,115 | 52,897 | 1,218 | 2.3 | % | |||||||||
Other intangible amortization | 10,442 | 9,191 | 1,251 | 13.6 | % | |||||||||
Total operating expenses | 7,776,215 | 7,221,212 | 555,003 | 7.7 | % | |||||||||
Income from operations | 648,433 | 495,607 | 152,826 | 30.8 | % | |||||||||
Interest expense | 26,143 | 26,259 | (116 | ) | -0.4 | % | ||||||||
Income before income taxes | 622,290 | 469,348 | 152,942 | 32.6 | % | |||||||||
Provision for income taxes | 229,069 | 167,829 | 61,240 | 36.5 | % | |||||||||
Net income | $393,221 | $301,519 | $91,702 | 30.4 | % | |||||||||
Basic earnings per common share | $2.35 | $1.80 | $0.55 | 30.6 | % | |||||||||
Diluted earnings per common share | $2.32 | $1.78 | $0.54 | 30.3 | % | |||||||||
Shares used in computing basic earnings per common share | 167,574 | 167,404 | ||||||||||||
Shares used in computing diluted earnings per common share | 169,582 | 169,246 | ||||||||||||
S-3 | ||||||||||||||
Humana Inc. | ||||||||||||||
Consolidated Statements of Income | ||||||||||||||
In thousands, except per common share results | ||||||||||||||
Nine Months Ended September 30, | ||||||||||||||
Dollar | Percentage | |||||||||||||
2010 | 2009 | Change | Change | |||||||||||
Revenues: | ||||||||||||||
Premiums | $24,673,259 | $22,557,943 | $2,115,316 | 9.4 | % | |||||||||
Administrative services fees | 374,441 | 368,308 | 6,133 | 1.7 | % | |||||||||
Investment income | 252,495 | 219,745 | 32,750 | 14.9 | % | |||||||||
Other revenue | 217,768 | 181,373 | 36,395 | 20.1 | % | |||||||||
Total revenues | 25,517,963 | 23,327,369 | 2,190,594 | 9.4 | % | |||||||||
Operating expenses: | ||||||||||||||
Benefits | 20,304,590 | 18,748,206 | 1,556,384 | 8.3 | % | |||||||||
Selling, general and administrative | 3,363,021 | 3,115,918 | 247,103 | 7.9 | % | |||||||||
Depreciation | 168,030 | 152,250 | 15,780 | 10.4 | % | |||||||||
Other intangible amortization | 28,573 | 28,330 | 243 | 0.9 | % | |||||||||
Total operating expenses | 23,864,214 | 22,044,704 | 1,819,510 | 8.3 | % | |||||||||
Income from operations | 1,653,749 | 1,282,665 | 371,084 | 28.9 | % | |||||||||
Interest expense | 78,679 | 79,605 | (926 | ) | -1.2 | % | ||||||||
Income before income taxes | 1,575,070 | 1,203,060 | 372,010 | 30.9 | % | |||||||||
Provision for income taxes | 583,005 | 414,044 | 168,961 | 40.8 | % | |||||||||
Net income | $992,065 | $789,016 | $203,049 | 25.7 | % | |||||||||
Basic earnings per common share | $5.90 | $4.72 | $1.18 | 25.0 | % | |||||||||
Diluted earnings per common share | $5.84 | $4.67 | $1.17 | 25.1 | % | |||||||||
Shares used in computing basic earnings per common share | 168,082 | 167,250 | ||||||||||||
Shares used in computing diluted earnings per common share | 169,964 | 168,858 | ||||||||||||
S-4 | ||||||||||||||
Humana Inc. | |||||||||||||||||||
Consolidated Balance Sheets | |||||||||||||||||||
Dollars in thousands, except share amounts | |||||||||||||||||||
| |||||||||||||||||||
September 30, | June 30, | December 31, | Sequential Change | ||||||||||||||||
2010 | 2010 | 2009 | Dollar | Percent | |||||||||||||||
Assets | |||||||||||||||||||
Current assets: | |||||||||||||||||||
Cash and cash equivalents | $2,922,852 | $1,998,982 | $1,613,588 | ||||||||||||||||
Investment securities | 7,142,395 | 6,882,063 | 6,190,062 | ||||||||||||||||
Receivables, net: | |||||||||||||||||||
Premiums | 794,197 | 1,310,269 | 811,800 | ||||||||||||||||
Administrative services fees | 13,831 | 14,833 | 11,820 | ||||||||||||||||
Securities lending invested collateral | 31,921 | 45,234 | 119,586 | ||||||||||||||||
Other | 479,417 | 535,708 | 505,960 | ||||||||||||||||
Total current assets | 11,384,613 | 10,787,089 | 9,252,816 | $597,524 | 5.5 | % | |||||||||||||
Property and equipment, net | 670,277 | 660,223 | 679,142 | ||||||||||||||||
Long-term investment securities | 1,477,147 | 1,405,734 | 1,307,088 | ||||||||||||||||
Goodwill | 1,997,277 | 1,994,593 | 1,992,924 | ||||||||||||||||
Other | 861,038 | 842,931 | 921,524 | ||||||||||||||||
Total assets | $16,390,352 | $15,690,570 | $14,153,494 | $699,782 | 4.5 | % | |||||||||||||
Liabilities and Stockholders' Equity | |||||||||||||||||||
Current liabilities: | |||||||||||||||||||
Benefits payable | $3,726,911 | $3,829,723 | $3,222,574 | ||||||||||||||||
Trade accounts payable and accrued expenses | 2,041,101 | 1,666,386 | 1,307,710 | ||||||||||||||||
Book overdraft | 241,229 | 239,916 | 374,464 | ||||||||||||||||
Securities lending payable | 38,106 | 51,618 | 126,427 | ||||||||||||||||
Unearned revenues | 213,778 | 209,346 | 228,817 | ||||||||||||||||
Total current liabilities | 6,261,125 | 5,996,989 | 5,259,992 | $264,136 | 4.4 | % | |||||||||||||
Long-term debt | 1,671,222 | 1,673,565 | 1,678,166 | ||||||||||||||||
Future policy benefits payable | 1,279,168 | 1,227,348 | 1,193,047 | ||||||||||||||||
Other long-term liabilities | 239,868 | 313,843 | 246,286 | ||||||||||||||||
Total liabilities | 9,451,383 | 9,211,745 | 8,377,491 | $239,638 | 2.6 | % | |||||||||||||
Commitments and contingencies | |||||||||||||||||||
Stockholders' equity: | |||||||||||||||||||
Preferred stock, $1 par; 10,000,000 shares authorized, none issued | - | - | - | ||||||||||||||||
Common stock, $0.16 2/3 par; 300,000,000 shares authorized; 190,107,065 issued at September 30, 2010 | 31,685 | 31,674 | 31,634 | ||||||||||||||||
Capital in excess of par value | 1,720,651 | 1,704,035 | 1,658,521 | ||||||||||||||||
Retained earnings | 5,421,676 | 5,028,455 | 4,429,611 | ||||||||||||||||
Accumulated other comprehensive income | 259,025 | 158,428 | 42,135 | ||||||||||||||||
Treasury stock, at cost, 21,788,518 shares at September 30, 2010 | (494,068 | ) | (443,767 | ) | (385,898 | ) | |||||||||||||
Total stockholders' equity | 6,938,969 | 6,478,825 | 5,776,003 | $460,144 | 7.1 | % | |||||||||||||
Total liabilities and stockholders' equity | $16,390,352 | $15,690,570 | $14,153,494 | $699,782 | 4.5 | % | |||||||||||||
Debt-to-total capitalization ratio | 19.4 | % | 20.5 | % | 22.5 | % | |||||||||||||
S-5 | |||||||||||||||||||
Humana Inc. | ||||||||||||||||
Consolidated Statements of Cash Flows | ||||||||||||||||
Dollars in thousands | ||||||||||||||||
| ||||||||||||||||
Three Months Ended September 30, | ||||||||||||||||
Dollar | Percentage | |||||||||||||||
2010 | 2009 | Change | Change | |||||||||||||
Cash flows from operating activities | ||||||||||||||||
Net income | $393,221 | $301,519 | ||||||||||||||
Adjustments to reconcile net income to net cash provided by operating activities: | ||||||||||||||||
Depreciation and amortization | 64,557 | 62,088 | ||||||||||||||
Net realized capital gains | (4,310 | ) | (4,184 | ) | ||||||||||||
Stock-based compensation | 12,477 | 15,796 | ||||||||||||||
(Benefit from) provision for deferred income taxes | (34,656 | ) | 12,072 | |||||||||||||
Changes in operating assets and liabilities excluding the effects of acquisitions: | ||||||||||||||||
Receivables | 517,074 | 500,386 | ||||||||||||||
Other assets | 46,045 | 30,545 | ||||||||||||||
Benefits payable | (102,812 | ) | (45,716 | ) | ||||||||||||
Other liabilities | 301,608 | 87,766 | ||||||||||||||
Unearned revenues | 4,398 | (25,066 | ) | |||||||||||||
Other | 11,607 | 4,905 | ||||||||||||||
Net cash provided by operating activities | 1,209,209 | 940,111 | $269,098 | 28.6 | % | |||||||||||
Cash flows from investing activities | ||||||||||||||||
Acquisitions, net of cash acquired | (8,451 | ) | (69 | ) | ||||||||||||
Purchases of property and equipment | (61,005 | ) | (39,533 | ) | ||||||||||||
Purchases of investment securities | (823,184 | ) | (2,451,044 | ) | ||||||||||||
Proceeds from maturities of investment securities | 478,569 | 197,796 | ||||||||||||||
Proceeds from sales of investment securities | 207,630 | 1,152,495 | ||||||||||||||
Change in securities lending collateral | 13,512 | 115,234 | ||||||||||||||
Net cash used in investing activities | (192,929 | ) | (1,025,121 | ) | $832,192 | 81.2 | % | |||||||||
Cash flows from financing activities | ||||||||||||||||
Receipts from CMS contract deposits | 439,622 | 499,987 | ||||||||||||||
Withdrawals from CMS contract deposits | (473,679 | ) | (481,123 | ) | ||||||||||||
Change in book overdraft | 1,313 | 45,531 | ||||||||||||||
Change in securities lending payable | (13,512 | ) | (115,234 | ) | ||||||||||||
Common stock repurchases | (50,301 | ) | (2,271 | ) | ||||||||||||
Excess tax benefit from stock-based compensation | 142 | 1,473 | ||||||||||||||
Proceeds from stock option exercises and other | 4,005 | 3,544 | ||||||||||||||
Net cash used in financing activities | (92,410 | ) | (48,093 | ) | ($44,317 | ) | -92.1 | % | ||||||||
Increase (decrease) in cash and cash equivalents | 923,870 | (133,103 | ) | |||||||||||||
Cash and cash equivalents at beginning of period | 1,998,982 | 1,585,109 | ||||||||||||||
Cash and cash equivalents at end of period | $2,922,852 | $1,452,006 | ||||||||||||||
S-6 | ||||||||||||||||
Humana Inc. | |||||||||||||||
Consolidated Statements of Cash Flows | |||||||||||||||
Dollars in thousands | |||||||||||||||
| |||||||||||||||
Nine Months Ended September 30, | |||||||||||||||
Dollar | Percentage | ||||||||||||||
2010 | 2009 | Change | Change | ||||||||||||
Cash flows from operating activities | |||||||||||||||
Net income | $992,065 | $789,016 | |||||||||||||
Adjustments to reconcile net income to net cash provided by operating activities: | |||||||||||||||
Depreciation and amortization | 196,603 | 180,580 | |||||||||||||
Net realized capital gain | (12,286 | ) | (13,734 | ) | |||||||||||
Stock-based compensation | 52,104 | 48,818 | |||||||||||||
Benefit from deferred income taxes | (115,923 | ) | (22,753 | ) | |||||||||||
Changes in operating assets and liabilities excluding the effects of acquisitions: | |||||||||||||||
Receivables | 15,592 | 6,247 | |||||||||||||
Other assets | 119,728 | 11,718 | |||||||||||||
Benefits payable | 504,337 | 159,902 | |||||||||||||
Other liabilities | 520,771 | (10,681 | ) | ||||||||||||
Unearned revenues | (15,073 | ) | (18,309 | ) | |||||||||||
Other | 31,253 | 16,687 | |||||||||||||
Net cash provided by operating activities | 2,289,171 | 1,147,491 | $1,141,680 | 99.5 | % | ||||||||||
Cash flows from investing activities | |||||||||||||||
Acquisitions, net of cash acquired | (10,120 | ) | (12,436 | ) | |||||||||||
Purchases of property and equipment | (152,432 | ) | (122,135 | ) | |||||||||||
Purchases of investment securities | (3,582,352 | ) | (5,290,819 | ) | |||||||||||
Proceeds from maturities of investment securities | 1,492,601 | 802,331 | |||||||||||||
Proceeds from sales of investment securities | 1,298,912 | 2,903,936 | |||||||||||||
Change in securities lending collateral | 88,321 | 248,925 | |||||||||||||
Net cash used in investing activities | (865,070 | ) | (1,470,198 | ) | $605,128 | 41.2 | % | ||||||||
Cash flows from financing activities | |||||||||||||||
Receipts from CMS contract deposits | 1,319,874 | 1,534,629 | |||||||||||||
Withdrawals from CMS contract deposits | (1,117,655 | ) | (1,204,536 | ) | |||||||||||
Repayments under credit agreement | - | (250,000 | ) | ||||||||||||
Change in book overdraft | (133,235 | ) | (25,158 | ) | |||||||||||
Change in securities lending payable | (88,321 | ) | (248,925 | ) | |||||||||||
Common stock repurchases | (108,170 | ) | (8,270 | ) | |||||||||||
Excess tax benefit from stock-based compensation | 1,406 | 1,717 | |||||||||||||
Proceeds from stock option exercises and other | 11,264 | 4,833 | |||||||||||||
Net cash used in financing activities | (114,837 | ) | (195,710 | ) | $80,873 | 41.3 | % | ||||||||
Increase (decrease) in cash and cash equivalents | 1,309,264 | (518,417 | ) | ||||||||||||
Cash and cash equivalents at beginning of period | 1,613,588 | 1,970,423 | |||||||||||||
Cash and cash equivalents at end of period | $2,922,852 | $1,452,006 | |||||||||||||
S-7 | |||||||||||||||
Humana Inc. | ||||||||||||||||||||||||||||||||
Key Income Statement Ratios and Segment Operating Results | ||||||||||||||||||||||||||||||||
Dollars in thousands | ||||||||||||||||||||||||||||||||
Three Months Ended September 30, | Nine Months Ended September 30, | |||||||||||||||||||||||||||||||
Percentage | Percentage | |||||||||||||||||||||||||||||||
2010 | 2009 | Difference | Change | 2010 | 2009 | Difference | Change | |||||||||||||||||||||||||
Benefit ratio | ||||||||||||||||||||||||||||||||
Government Segment | 82.2 | % | 81.9 | % | 0.3 | % | 84.1 | % | 84.3 | % | -0.2 | % | ||||||||||||||||||||
Commercial Segment | 79.2 | % | 82.7 | % | -3.5 | % | 75.5 | % | 79.4 | % | -3.9 | % | ||||||||||||||||||||
Consolidated | 81.6 | % | 82.1 | % | -0.5 | % | 82.3 | % | 83.1 | % | -0.8 | % | ||||||||||||||||||||
Selling, general, and administrative expense ratio (A) | ||||||||||||||||||||||||||||||||
Government Segment | 9.5 | % | 10.2 | % | -0.7 | % | 9.3 | % | 10.0 | % | -0.7 | % | ||||||||||||||||||||
Commercial Segment | 24.4 | % | 24.0 | % | 0.4 | % | 27.1 | % | 23.9 | % | 3.2 | % | ||||||||||||||||||||
Consolidated | 12.9 | % | 13.7 | % | -0.8 | % | 13.3 | % | 13.5 | % | -0.2 | % | ||||||||||||||||||||
Investment income | ||||||||||||||||||||||||||||||||
Government Segment | $56,857 | $44,936 | $11,921 | 26.5 | % | $164,545 | $132,894 | $31,651 | 23.8 | % | ||||||||||||||||||||||
Commercial Segment | 30,393 | 29,925 | 468 | 1.6 | % | 87,950 | 86,851 | 1,099 | 1.3 | % | ||||||||||||||||||||||
Consolidated | $87,250 | $74,861 | $12,389 | 16.5 | % | $252,495 | $219,745 | $32,750 | 14.9 | % | ||||||||||||||||||||||
Interest expense | ||||||||||||||||||||||||||||||||
Government Segment | $19,899 | $17,447 | $2,452 | 14.1 | % | $59,266 | $50,160 | $9,106 | 18.2 | % | ||||||||||||||||||||||
Commercial Segment | 6,244 | 8,812 | (2,568 | ) | -29.1 | % | 19,413 | 29,445 | (10,032 | ) | -34.1 | % | ||||||||||||||||||||
Consolidated | $26,143 | $26,259 | ($116 | ) | -0.4 | % | $78,679 | $79,605 | ($926 | ) | -1.2 | % | ||||||||||||||||||||
Detail of pretax income (loss) | ||||||||||||||||||||||||||||||||
Government Segment | $554,147 | $474,501 | $79,646 | 16.8 | % | $1,361,689 | $1,045,277 | $316,412 | 30.3 | % | ||||||||||||||||||||||
Commercial Segment | 68,143 | (5,153 | ) | 73,296 | 1422.4 | % | 213,381 | 157,783 | 55,598 | 35.2 | % | |||||||||||||||||||||
Consolidated | $622,290 | $469,348 | $152,942 | 32.6 | % | $1,575,070 | $1,203,060 | $372,010 | 30.9 | % | ||||||||||||||||||||||
Detail of pretax margins | ||||||||||||||||||||||||||||||||
Government Segment | 8.5 | % | 8.2 | % | 0.3 | % | 6.9 | % | 6.0 | % | 0.9 | % | ||||||||||||||||||||
Commercial Segment | 3.6 | % | -0.3 | % | 3.9 | % | 3.7 | % | 2.7 | % | 1.0 | % | ||||||||||||||||||||
Consolidated | 7.4 | % | 6.1 | % | 1.3 | % | 6.2 | % | 5.2 | % | 1.0 | % | ||||||||||||||||||||
S-8 | ||||||||||||||||||||||||||||||||
Humana Inc. | ||||||||||||||||||||||||||||
Membership Detail | ||||||||||||||||||||||||||||
In thousands | ||||||||||||||||||||||||||||
| ||||||||||||||||||||||||||||
Ending | Average | Ending | Year-over-year Change | Ending | Sequential Change | |||||||||||||||||||||||
September 30, 2010 | 3Q10 | September 30, 2009 | Amount | Percent | June 30, 2010 | Amount | Percent | |||||||||||||||||||||
Medical Membership: | ||||||||||||||||||||||||||||
Government Segment: | ||||||||||||||||||||||||||||
Medicare Advantage - HMO | 636.1 | 636.0 | 591.0 | 45.1 | 7.6 | % | 634.8 | 1.3 | 0.2 | % | ||||||||||||||||||
Medicare Advantage - PPO | 645.7 | 644.6 | 348.0 | 297.7 | 85.5 | % | 618.3 | 27.4 | 4.4 | % | ||||||||||||||||||
Medicare Advantage - PFFS | 454.6 | 456.2 | 575.8 | (121.2 | ) | -21.0 | % | 479.3 | (24.7 | ) | -5.2 | % | ||||||||||||||||
Total MA fully-insured | 1,736.4 | 1,736.8 | 1,514.8 | 221.6 | 14.6 | % | 1,732.4 | 4.0 | 0.2 | % | ||||||||||||||||||
ASO | 28.4 | 28.5 | - | 28.4 | 28.7 | (0.3 | ) | -1.0 | % | |||||||||||||||||||
Total Medicare Advantage | 1,764.8 | 1,765.3 | 1,514.8 | 250.0 | 16.5 | % | 1,761.1 | 3.7 | 0.2 | % | ||||||||||||||||||
Medicare stand-alone PDPs | 1,785.6 | 1,789.5 | 1,960.4 | (174.8 | ) | -8.9 | % | 1,793.4 | (7.8 | ) | -0.4 | % | ||||||||||||||||
Total Medicare | 3,550.4 | 3,554.8 | 3,475.2 | 75.2 | 2.2 | % | 3,554.5 | (4.1 | ) | -0.1 | % | |||||||||||||||||
Military services insured | 1,762.6 | 1,759.9 | 1,754.3 | 8.3 | 0.5 | % | 1,759.8 | 2.8 | 0.2 | % | ||||||||||||||||||
Military services ASO | 1,268.5 | 1,270.5 | 1,260.8 | 7.7 | 0.6 | % | 1,270.9 | (2.4 | ) | -0.2 | % | |||||||||||||||||
Total military services | 3,031.1 | 3,030.4 | 3,015.1 | 16.0 | 0.5 | % | 3,030.7 | 0.4 | 0.0 | % | ||||||||||||||||||
Medicaid | 408.0 | 405.1 | 399.8 | 8.2 | 2.1 | % | 404.0 | 4.0 | 1.0 | % | ||||||||||||||||||
Total Government Segment | 6,989.5 | 6,990.3 | 6,890.1 | 99.4 | 1.4 | % | 6,989.2 | 0.3 | 0.0 | % | ||||||||||||||||||
Commercial Segment: | ||||||||||||||||||||||||||||
Fully-insured medical: | ||||||||||||||||||||||||||||
Group | 1,257.9 | 1,267.3 | 1,474.1 | (216.2 | ) | -14.7 | % | 1,295.4 | (37.5 | ) | -2.9 | % | ||||||||||||||||
Individual | 374.9 | 373.9 | 358.8 | 16.1 | 4.5 | % | 371.5 | 3.4 | 0.9 | % | ||||||||||||||||||
Medicare supplement | 37.8 | 37.2 | 27.8 | 10.0 | 36.0 | % | 35.6 | 2.2 | 6.2 | % | ||||||||||||||||||
Total fully-insured medical | 1,670.6 | 1,678.4 | 1,860.7 | (190.1 | ) | -10.2 | % | 1,702.5 | (31.9 | ) | -1.9 | % | ||||||||||||||||
ASO | 1,460.3 | 1,471.2 | 1,566.2 | (105.9 | ) | -6.8 | % | 1,582.6 | (122.3 | ) | -7.7 | % | ||||||||||||||||
Total Commercial Segment | 3,130.9 | 3,149.6 | 3,426.9 | (296.0 | ) | -8.6 | % | 3,285.1 | (154.2 | ) | -4.7 | % | ||||||||||||||||
Total medical membership | 10,120.4 | 10,139.9 | 10,317.0 | (196.6 | ) | -1.9 | % | 10,274.3 | (153.9 | ) | -1.5 | % | ||||||||||||||||
Specialty Membership | ||||||||||||||||||||||||||||
Dental - fully-insured | 2,605.8 | 2,599.8 | 2,650.9 | (45.1 | ) | -1.7 | % | 2,677.5 | (71.7 | ) | -2.7 | % | ||||||||||||||||
Dental - ASO | 1,236.5 | 1,225.1 | 1,197.4 | 39.1 | 3.3 | % | 1,211.6 | 24.9 | 2.1 | % | ||||||||||||||||||
Total dental | 3,842.3 | 3,824.9 | 3,848.3 | (6.0 | ) | -0.2 | % | 3,889.1 | (46.8 | ) | -1.2 | % | ||||||||||||||||
Vision | 2,208.4 | 2,196.3 | 2,337.3 | (128.9 | ) | -5.5 | % | 2,442.1 | (233.7 | ) | -9.6 | % | ||||||||||||||||
Other supplemental benefits (B) | 988.1 | 984.1 | 888.1 | 100.0 | 11.3 | % | 965.8 | 22.3 | 2.3 | % | ||||||||||||||||||
Total specialty membership | 7,038.8 | 7,005.3 | 7,073.7 | (34.9 | ) | -0.5 | % | 7,297.0 | (258.2 | ) | -3.5 | % | ||||||||||||||||
S-9 | ||||||||||||||||||||||||||||
Humana Inc. | ||||||||||||||||||||
Premiums and Administrative Services Fees Detail | ||||||||||||||||||||
Dollars in thousands, except per member per month | ||||||||||||||||||||
Per Member per Month (C) | ||||||||||||||||||||
Three Months Ended September 30, | Three Months Ended September 30, | |||||||||||||||||||
Dollar | Percentage | |||||||||||||||||||
2010 | 2009 | Change | Change | 2010 | 2009 | |||||||||||||||
Premium revenues | ||||||||||||||||||||
Government Segment: | ||||||||||||||||||||
Medicare Advantage | $4,798,910 | $4,135,198 | $663,712 | 16.1 | % | $921 | $912 | |||||||||||||
Medicare stand-alone PDPs | 579,583 | 578,142 | 1,441 | 0.2 | % | $108 | $98 | |||||||||||||
Total Medicare | 5,378,493 | 4,713,340 | 665,153 | 14.1 | % | |||||||||||||||
Military services insured (D) | 873,588 | 796,126 | 77,462 | 9.7 | % | $165 | $151 | |||||||||||||
Medicaid insured | 168,847 | 162,896 | 5,951 | 3.7 | % | $139 | $137 | |||||||||||||
Total Government Segment premiums | 6,420,928 | 5,672,362 | 748,566 | 13.2 | % | |||||||||||||||
Commercial Segment: | ||||||||||||||||||||
Fully-insured medical | 1,465,448 | 1,540,442 | (74,994 | ) | -4.9 | % | $291 | $276 | ||||||||||||
Specialty | 248,269 | 231,318 | 16,951 | 7.3 | % | $13 | $12 | |||||||||||||
Total Commercial Segment premiums | 1,713,717 | 1,771,760 | (58,043 | ) | -3.3 | % | ||||||||||||||
Total premium revenues | $8,134,645 | $7,444,122 | $690,523 | 9.3 | % | |||||||||||||||
Administrative services fees | ||||||||||||||||||||
Military services ASO (D) | $22,169 | $22,690 | ($521 | ) | -2.3 | % | $6 | $6 | ||||||||||||
Other government ASO (E) | 4,779 | 15,257 | (10,478 | ) | -68.7 | % | ||||||||||||||
Commercial Segment | 94,867 | 95,785 | (918 | ) | -1.0 | % | $12 | $12 | ||||||||||||
Total administrative services fees | $121,815 | $133,732 | ($11,917 | ) | -8.9 | % | ||||||||||||||
S-10 | ||||||||||||||||||||
Humana Inc. | ||||||||||||||||||||
Premiums and Administrative Services Fees Detail | ||||||||||||||||||||
Dollars in thousands, except per member per month | ||||||||||||||||||||
Per Member per Month (C) | ||||||||||||||||||||
Nine Months Ended September 30, | Nine Months Ended September 30, | |||||||||||||||||||
Dollar | Percentage | |||||||||||||||||||
2010 | 2009 | Change | Change | 2010 | 2009 | |||||||||||||||
Premium revenues | ||||||||||||||||||||
Government Segment: | ||||||||||||||||||||
Medicare Advantage | $14,501,099 | $12,340,786 | $2,160,313 | 17.5 | % | $934 | $922 | |||||||||||||
Medicare stand-alone PDPs | 1,858,830 | 1,812,638 | 46,192 | 2.5 | % | $113 | $99 | |||||||||||||
Total Medicare | 16,359,929 | 14,153,424 | 2,206,505 | 15.6 | % | |||||||||||||||
Military services insured (D) | 2,603,950 | 2,591,605 | 12,345 | 0.5 | % | $165 | $165 | |||||||||||||
Medicaid insured | 501,605 | 480,085 | 21,520 | 4.5 | % | $139 | $136 | |||||||||||||
Total Government Segment premiums | 19,465,484 | 17,225,114 | 2,240,370 | 13.0 | % | |||||||||||||||
Commercial Segment: | ||||||||||||||||||||
Fully-insured medical | 4,456,286 | 4,643,204 | (186,918 | ) | -4.0 | % | $288 | $274 | ||||||||||||
Specialty | 751,489 | 689,625 | 61,864 | 9.0 | % | $12 | $12 | |||||||||||||
Total Commercial Segment premiums | 5,207,775 | 5,332,829 | (125,054 | ) | -2.3 | % | ||||||||||||||
Total premium revenues | $24,673,259 | $22,557,943 | $2,115,316 | 9.4 | % | |||||||||||||||
Administrative services fees | ||||||||||||||||||||
Military services ASO (D) | $67,010 | $63,140 | $3,870 | 6.1 | % | $6 | $6 | |||||||||||||
Other government ASO (E) | 14,717 | 18,295 | (3,578 | ) | -19.6 | % | ||||||||||||||
Commercial Segment | 292,714 | 286,873 | 5,841 | 2.0 | % | $12 | $12 | |||||||||||||
Total administrative services fees | $374,441 | $368,308 | $6,133 | 1.7 | % | |||||||||||||||
S-11 | ||||||||||||||||||||
Humana Inc. | ||||||||||||||||||||||||||||||||||||
Percentage of Ending Membership under Capitation Arrangements | ||||||||||||||||||||||||||||||||||||
Government Segment | Commercial Segment | |||||||||||||||||||||||||||||||||||
September 30, 2010 | Medicare Advantage | Medicare stand-alone PDPs | Military Services | Medicaid | Total Govt. Segment | Fully-insured | ASO | Total Comm. Segment | Total Medical Membership | |||||||||||||||||||||||||||
Capitated HMO hospital system based (F) | 0.8 | % | - | - | - | 0.2 | % | 1.3 | % | - | 0.7 | % | 0.4 | % | ||||||||||||||||||||||
Capitated HMO physician group based (F) | 2.5 | % | - | - | 28.0 | % | 2.3 | % | 1.6 | % | - | 0.8 | % | 1.8 | % | |||||||||||||||||||||
Risk-sharing (G) | 18.3 | % | - | - | 67.8 | % | 8.6 | % | 1.4 | % | - | 0.8 | % | 6.2 | % | |||||||||||||||||||||
All other membership | 78.4 | % | 100.0 | % | 100.0 | % | 4.2 | % | 88.9 | % | 95.7 | % | 100.0 | % | 97.7 | % | 91.6 | % | ||||||||||||||||||
Total medical membership | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | ||||||||||||||||||
September 30, 2009 | ||||||||||||||||||||||||||||||||||||
Capitated HMO hospital system based (F) | 1.9 | % | - | - | - | 0.4 | % | 1.2 | % | - | 0.7 | % | 0.5 | % | ||||||||||||||||||||||
Capitated HMO physician group based (F) | 3.2 | % | - | - | 29.3 | % | 2.4 | % | 1.5 | % | - | 0.8 | % | 1.9 | % | |||||||||||||||||||||
Risk-sharing (G) | 18.8 | % | - | - | 69.9 | % | 8.2 | % | 1.0 | % | - | 0.6 | % | 5.7 | % | |||||||||||||||||||||
All other membership | 76.1 | % | 100.0 | % | 100.0 | % | 0.8 | % | 89.0 | % | 96.3 | % | 100.0 | % | 97.9 | % | 91.9 | % | ||||||||||||||||||
Total medical membership | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | 100.0 | % | ||||||||||||||||||
S-12 | ||||||||||||||||||||||||||||||||||||
Humana Inc. | Fair value | ||||||||
Investments | |||||||||
Dollars in thousands | |||||||||
9/30/2010 | 6/30/2010 | 12/31/2009 | |||||||
Investment Portfolio: | |||||||||
Cash & cash equivalents | $2,922,852 | $1,998,982 | $1,613,588 | ||||||
Investment securities | 7,142,395 | 6,882,063 | 6,190,062 | ||||||
Long-term investment securities | 1,477,147 | 1,405,734 | 1,307,088 | ||||||
Total investment portfolio | $11,542,394 | $10,286,779 | $9,110,738 | ||||||
Duration (H) | 3.27 | 3.36 | 3.78 | ||||||
Average Credit Rating | AA | AA | AA+ | ||||||
Securities Lending Invested Collateral Portfolio: | |||||||||
Cash & cash equivalents | $6,396 | $12,527 | $53,569 | ||||||
Corporate floating rate | - | - | 32,375 | ||||||
Asset-backed securities | 25,525 | 32,707 | 33,642 | ||||||
$31,921 | $45,234 | $119,586 | |||||||
Average Credit Rating | AAA | AAA | AAA- | ||||||
Investment Portfolio Detail: | |||||||||
Cash and cash equivalents | $2,922,852 | $1,998,982 | $1,613,588 | ||||||
U.S. Government and agency obligations | |||||||||
U.S. Treasury and agency obligations | 745,680 | 905,531 | 1,009,352 | ||||||
U.S. Government residential mortgage-backed | 1,889,185 | 1,916,433 | 1,662,246 | ||||||
U.S. Government commercial mortgage-backed | 31,065 | 30,037 | 26,417 | ||||||
Total U.S. Government and agency obligations | 2,665,930 | 2,852,001 | 2,698,015 | ||||||
Tax-exempt municipal securities | |||||||||
Pre-refunded | 340,903 | 341,435 | 346,937 | ||||||
Insured | 636,887 | 583,805 | 587,203 | ||||||
Other | 1,382,742 | 1,187,734 | 1,221,087 | ||||||
Auction rate securities | 51,369 | 51,473 | 68,814 | ||||||
Total tax-exempt municipal securities | 2,411,901 | 2,164,447 | 2,224,041 | ||||||
Residential mortgage-backed | |||||||||
Prime residential mortgages | 70,094 | 70,897 | 89,956 | ||||||
Alt-A residential mortgages | 2,324 | 2,419 | 3,856 | ||||||
Sub-prime residential mortgages | 1,333 | 1,420 | 1,600 | ||||||
Total residential mortgage-backed | 73,751 | 74,736 | 95,412 | ||||||
Commercial mortgage-backed | 291,581 | 287,310 | 279,626 | ||||||
Asset-backed securities | 176,425 | 227,900 | 107,188 | ||||||
Corporate securities | |||||||||
Financial services | 904,426 | 828,813 | 775,990 | ||||||
Other | 2,090,361 | 1,847,590 | 1,303,578 | ||||||
Total corporate securities | 2,994,787 | 2,676,403 | 2,079,568 | ||||||
Redeemable preferred stocks | 5,167 | 5,000 | 13,300 | ||||||
Total investment portfolio | $11,542,394 | $10,286,779 | $9,110,738 | ||||||
S-13 | |||||||||
Humana Inc. | ||||||||||||
Detail of Benefits Payable Balance and Year-to-Date Changes | ||||||||||||
Dollars in thousands | ||||||||||||
September 30, | June 30, | December 31, | ||||||||||
2010 | 2010 | 2009 | ||||||||||
Detail of benefits payable | ||||||||||||
IBNR and other benefits payable (I) | $2,711,282 | $2,869,801 | $2,377,324 | |||||||||
Unprocessed claim inventories (J) | 428,900 | 433,800 | 323,000 | |||||||||
Processed claim inventories (K) | 155,193 | 109,348 | 48,358 | |||||||||
Payable to pharmacy benefit administrator (L) | 116,070 | 115,043 | 194,697 | |||||||||
Benefits payable, excluding military services | 3,411,445 | 3,527,992 | 2,943,379 | |||||||||
Military services benefits payable (M) | 315,466 | 301,731 | 279,195 | |||||||||
Total Benefits Payable | $3,726,911 | $3,829,723 | $3,222,574 | |||||||||
Nine Months Ended | Nine Months Ended | Year Ended | ||||||||||
September 30, 2010 | September 30, 2009 | December 31, 2009 | ||||||||||
Year-to-date changes in benefits payable, excluding military services (N) | ||||||||||||
Balances at January 1 | $2,943,379 | $2,898,782 | $2,898,782 | |||||||||
Incurred related to: | ||||||||||||
Current year | 18,307,363 | 16,639,799 | 21,934,973 | |||||||||
Prior years (O) | (401,250 | ) | (221,887 | ) | (252,756 | ) | ||||||
Total incurred | 17,906,113 | 16,417,912 | 21,682,217 | |||||||||
Paid related to: | ||||||||||||
Current year | (15,306,536 | ) | (14,707,443 | ) | (19,572,740 | ) | ||||||
Prior years | (2,131,511 | ) | (1,554,643 | ) | (2,064,880 | ) | ||||||
Total paid | (17,438,047 | ) | (16,262,086 | ) | (21,637,620 | ) | ||||||
Balances at end of period | $3,411,445 | $3,054,608 | $2,943,379 | |||||||||
Nine Months Ended | Nine Months Ended | Year Ended | ||||||||||
September 30, 2010 | September 30, 2009 | December 31, 2009 | ||||||||||
Summary of Consolidated Benefit Expense: | ||||||||||||
Total benefit expense incurred, per above | $17,906,113 | $16,417,912 | $21,682,217 | |||||||||
Military services benefit expense | 2,307,618 | 2,279,918 | 3,019,655 | |||||||||
Future policy benefit expense (P) | 90,859 | 50,376 | 73,130 | |||||||||
Consolidated Benefit Expense | $20,304,590 | $18,748,206 | $24,775,002 | |||||||||
S-14 | ||||||||||||
Humana Inc. | ||||||||||||||
Benefits Payable Statistics (Q) | ||||||||||||||
Receipt Cycle Time (R) | ||||||||||||||
2010 | 2009 | Change | Percentage Change | |||||||||||
1st Quarter Average | 13.8 | 14.8 | (1.0 | ) | -6.8 | % | ||||||||
2nd Quarter Average | 13.9 | 14.0 | (0.1 | ) | -0.7 | % | ||||||||
3rd Quarter Average | 13.9 | 13.7 | 0.2 | 1.5 | % | |||||||||
4th Quarter Average | - | 13.6 | n/a | n/a | ||||||||||
Full Year Average | 13.9 | 14.0 | (0.1 | ) | -0.7 | % | ||||||||
Unprocessed Claims Inventories | ||||||||||||||
Date | Estimated Valuation (000s) | Claim Item Counts | Number of Days on Hand | |||||||||||
9/30/2008 | $293,600 | 946,500 | 6.0 | |||||||||||
12/31/2008 | $247,200 | 745,500 | 4.3 | |||||||||||
3/31/2009 | $258,800 | 740,600 | 4.2 | |||||||||||
6/30/2009 | $258,000 | 709,900 | 4.0 | |||||||||||
9/30/2009 | $317,100 | 856,500 | 4.9 | |||||||||||
12/31/2009 | $323,000 | 775,500 | 4.3 | |||||||||||
3/31/2010 | $426,200 | 1,091,700 | 5.6 | |||||||||||
6/30/2010 | $433,800 | 1,009,200 | 4.9 | |||||||||||
9/30/2010 | $428,900 | 1,064,200 | 5.2 | |||||||||||
S-15 | ||||||||||||||
Humana Inc. | |||||||||||||||||||||||
Benefits Payable Statistics (Continued) (Q) | |||||||||||||||||||||||
Days in Claims Payable (S) | |||||||||||||||||||||||
Quarter Ended | Days in Claims Payable (DCP) | Change Last 4 Quarters | Percentage Change | DCP Excluding Capitation | Change Last 4 Quarters | Percentage Change | |||||||||||||||||
9/30/2008 | 58.1 | (3.7 | ) | -6.0 | % | 65.1 | (5.1 | ) | -7.3 | % | |||||||||||||
12/31/2008 | 59.4 | (0.8 | ) | -1.3 | % | 66.5 | (1.8 | ) | -2.6 | % | |||||||||||||
3/31/2009 | 54.6 | (2.3 | ) | -4.0 | % | 60.9 | (2.4 | ) | -3.8 | % | |||||||||||||
6/30/2009 | 56.1 | (1.1 | ) | -1.9 | % | 61.5 | (1.8 | ) | -2.8 | % | |||||||||||||
9/30/2009 | 56.2 | (1.9 | ) | -3.3 | % | 62.7 | (2.4 | ) | -3.7 | % | |||||||||||||
12/31/2009 | 55.4 | (4.0 | ) | -6.7 | % | 62.1 | (4.4 | ) | -6.6 | % | |||||||||||||
3/31/2010 | 57.0 | 2.4 | 4.4 | % | 64.3 | 3.4 | 5.6 | % | |||||||||||||||
6/30/2010 | 57.1 | 1.0 | 1.8 | % | 64.5 | 3.0 | 4.9 | % | |||||||||||||||
9/30/2010 | 57.9 | 1.7 | 3.0 | % | 64.5 | 1.8 | 2.9 | % | |||||||||||||||
Year-to-Date Change in Days in Claims Payable (T) | |||||||||||||||||||||||
2010 | 2009 | ||||||||||||||||||||||
DCP - beginning of period | 55.4 | 59.4 | |||||||||||||||||||||
Components of change in DCP: | |||||||||||||||||||||||
Change in unprocessed claims inventories | 1.8 | 0.6 | |||||||||||||||||||||
Change in processed claims inventories | 1.8 | (1.5 | ) | ||||||||||||||||||||
Change in pharmacy payment cutoff | (1.3 | ) | (1.3 | ) | |||||||||||||||||||
Impact of Cariten acquisition in 4Q08 | - | (0.9 | ) | ||||||||||||||||||||
All other | 0.2 | (0.1 | ) | ||||||||||||||||||||
DCP - end of period | 57.9 | 56.2 | |||||||||||||||||||||
S-16 | |||||||||||||||||||||||
Humana Inc. Footnotes to Statistical Schedules and Supplementary Information 3Q10 Earnings Release | ||
(A) | The selling, general and administrative (SG&A) expense ratio is defined as SG&A expenses as a percent of premiums, administrative services fees and other revenue. | |
(B) | Other supplemental benefits include life, disability, and fixed benefit products including cancer and critical illness policies. | |
(C) | Computed based on average membership for the period (i.e., monthly ending membership during the period divided by the number of months in the period). | |
(D) | Military services revenues are generally not contracted on a per-member basis. | |
(E) | Includes administrative services fees associated with Medicare and Medicaid, operations in the United Kingdom, and, for 2009, fees associated with Green Ribbon Health. | |
(F) | In a limited number of circumstances, the company contracts with hospitals and physicians to accept financial risk for a defined set of HMO membership. In transferring this risk, the company prepays these providers a monthly fixed-fee per member to coordinate substantially all of the medical care for their capitated HMO membership, including some health benefit administrative functions and claims processing. For these capitated HMO arrangements, the company generally agrees to reimbursement rates that target a benefit expense ratio. Providers participating in hospital-based capitated HMO arrangements generally receive a monthly payment for all of the services within their system for their HMO membership. Providers participating in physician-based capitated HMO arrangements generally have subcontracted specialist physicians and are responsible for reimbursing such physicians and hospitals for services rendered to their HMO membership. | |
(G) | In some circumstances, the company contracts with physicians under risk-sharing arrangements whereby physicians have assumed some level of risk for all or a portion of the benefit expenses of their HMO membership. Although these arrangements do include capitation payments for services rendered, the company processes substantially all of the claims under these arrangements. | |
(H) | Duration is the time-weighted average of the present value of the bond portfolio cash flows. | |
(I) | IBNR represents an estimate of benefit expenses payable for claims incurred but not reported (IBNR) at the balance sheet date. The level of IBNR is primarily impacted by membership levels, benefit claim trends and the receipt cycle time, which represents the length of time between when a claim is initially incurred and when the claim form is received (i.e. a shorter time span results in lower reserves for claims IBNR). Other benefits payable includes amounts payable to providers under capitation arrangements. | |
(J) | Unprocessed claim inventories represent the estimated valuation of claims received but not yet fully processed. | |
(K) | Processed claim inventories represent the estimated valuation of processed claims that are in the post-claim-adjudication process, which consists of administrative functions such as audit and check batching and handling. | |
(L) | The balance due to the company's pharmacy benefit administrator fluctuates as a result of the number of business days in the last payment cycle of the month. Payment cycles are every 10 days (10th & 20th of month) and the last day of the month. | |
(M) | Military services benefits payable primarily consist of IBNR and to a lesser extent risk share payables to the Department of Defense and liabilities to subcontractors. | |
(N) | The table excludes activity associated with military services benefits payable, because the federal government bears a substantial portion of the risk associated with financing the cost of health benefits. More specifically, the risk-sharing provisions of the military services contracts with the federal government and with subcontractors effectively limit profits and losses when actual claim experience varies from the targeted claim amount negotiated annually. As a result of these contract provisions, the impact of changes in estimates for prior year military services benefits payable are substantially offset by the associated changes in estimates of revenue from health care services reimbursements. As such, any impact on the company's results of operations is reduced substantially, whether positive or negative. | |
(O) | Amounts incurred related to prior years vary from previously estimated liabilities as the claims ultimately are settled. Negative amounts reported for incurred related to prior years result from claims being ultimately settled for amounts less than originally estimated (favorable development). There were no changes in the approach used to determine the company's estimate of claim reserves during the quarter. | |
(P) | Future policy benefit expense has a related liability classified as a long-term liability on the balance sheet. | |
(Q) | Benefits reserves statistics represents fully-insured medical claims data and excludes military services claims data and specialty benefits. | |
(R) | The receipt cycle time measures the average length of time between when a claim was initially incurred and when the claim form was received. Receipt cycle time data for the company's largest claim processing platforms represent approximately 96% of the company's fully-insured claims volume. Pharmacy and specialty claims, including dental, vision and other supplemental benefits, are excluded from this measurement. | |
(S) | A common metric for monitoring benefits payable levels relative to the benefit expense is days in claims payable, or DCP, which represents the benefits payable at the end of the period divided by average benefit expenses per day in the quarterly period. Since the company has some providers under capitation payment arrangements (which do not require a benefits payable IBNR reserve), the company has also summarized this metric excluding capitation expense. In addition, this calculation excludes the impact of the company's military services and stand-alone PDP business. | |
(T) | DCP fluctuates due to a number of issues, the more significant of which are detailed in this rollforward. Growth in certain product lines can also impact DCP for the quarter since a provision for claims would not have been recorded for members that had not yet enrolled earlier in the quarter, yet those members would have a provision and corresponding reserve recorded upon enrollment later in the quarter. This analysis excludes the impact of military services and Medicare stand-alone PDPs upon DCP. | |
S-17 |
CONTACT:
Humana Inc.
Investor Relations
Regina Nethery, 502-580-3644
Rnethery@humana.com
or
Corporate Communications
Tom Noland, 502-580-3674
Tnoland@humana.com