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UNITED STATES

SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549


FORM 10-Q


     
(Mark One)
   
x
  QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES
EXCHANGE ACT OF 1934
 
For the Quarterly Period Ended June 30, 2003
 
OR
o
  TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from                to 

Commission File Number 000-21949


PACIFICARE HEALTH SYSTEMS, INC.

(Exact Name of Registrant as Specified in its Charter)
     
Delaware   95-4591529
(State or Other Jurisdiction of
Incorporation or Organization)
  (IRS Employer
Identification Number)


5995 Plaza Drive, Cypress, California 90630-5028

(Address of Principal Executive Offices, Including Zip Code)

(Registrant’s Telephone Number, Including Area Code) (714) 952-1121

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.

Yes x     No o

Indicate by check mark whether the registrant is an accelerated filer (as defined in Rule 12b-2 of the Exchange Act)     Yes x     No o

There were approximately 37,558,000 shares of common stock outstanding on July 31, 2003.




TABLE OF CONTENTS

PART I. FINANCIAL INFORMATION
Item 1: Financial Statements
CONDENSED CONSOLIDATED BALANCE SHEETS
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
Item 2: Management’s Discussion and Analysis of Financial Condition and Results of Operations
Item 3: Quantitative and Qualitative Disclosures About Market Risk
Item 4: Controls and Procedures
PART II: OTHER INFORMATION
Item 1: Legal Proceedings
Item 2: Changes In Securities/Recent Sales of Unregistered Securities
Item 3: Defaults Upon Senior Securities
Item 4: Submission of Matters to a Vote of Security Holders
Item 5: Other Information
Item 6: Exhibits and Reports on Form 8-K
SIGNATURES
EXHIBIT INDEX
EXHIBIT 3.03
EXHIBIT 10.13
EXHIBIT 10.15
EXHIBIT 10.17
EXHIBIT 10.29
EXHIBIT 10.33
EXHIBIT 10.36
EXHIBIT 15
EXHIBIT 20
EXHIBIT 31.1
EXHIBIT 31.2
EXHIBIT 32.1
EXHIBIT 32.2


Table of Contents

PACIFICARE HEALTH SYSTEMS, INC.

FORM 10-Q

INDEX
             
Page

PART I. FINANCIAL INFORMATION
Item 1.
  Financial Statements        
    Condensed Consolidated Balance Sheets as of June 30, 2003 and December 31, 2002     1  
    Condensed Consolidated Statements of Operations for the three months ended June 30, 2003 and 2002     2  
    Condensed Consolidated Statements of Operations for the six months ended June 30, 2003 and 2002     3  
    Condensed Consolidated Statements of Cash Flows for the six months ended June 30, 2003 and 2002     4  
    Notes to Condensed Consolidated Financial Statements     6  
Item 2.
  Management’s Discussion and Analysis of Financial Condition and Results of Operations     24  
Item 3.
  Quantitative and Qualitative Disclosures About Market Risk     45  
Item 4.
  Controls and Procedures     45  
PART II. OTHER INFORMATION
Item 1.
  Legal Proceedings     46  
Item 2.
  Changes in Securities/ Recent Sales of Unregistered Securities     46  
Item 3.
  Defaults Upon Senior Securities     46  
Item 4.
  Submission of Matters to a Vote of Security Holders     46  
Item 5.
  Other Information     47  
Item 6.
  Exhibits and Reports on Form 8-K     47  
Signatures     51  
Exhibits     52  

i


Table of Contents

PART I. FINANCIAL INFORMATION

 
Item 1: Financial Statements

PACIFICARE HEALTH SYSTEMS, INC.

 
CONDENSED CONSOLIDATED BALANCE SHEETS
(Amounts in thousands, except per-share data)
                     
June 30, December 31,
2003 2002


(unaudited)
ASSETS
Current assets:
               
 
Cash and equivalents
  $ 652,627     $ 951,689  
 
Marketable securities
    1,309,150       1,195,517  
 
Receivables, net
    308,634       289,735  
 
Prepaid expenses and other current assets
    52,784       46,970  
 
Restricted cash collateral for FHP senior notes
    43,250       43,346  
 
Deferred income taxes
    87,958       100,758  
     
     
 
   
Total current assets
    2,454,403       2,628,015  
     
     
 
Property, plant and equipment at cost, net
    159,418       161,685  
Marketable securities-restricted
    167,848       186,189  
Goodwill, net
    983,104       983,104  
Intangible assets, net
    231,969       243,016  
Other assets
    75,439       49,124  
     
     
 
    $ 4,072,181     $ 4,251,133  
     
     
 
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
               
 
Medical claims and benefits payable
  $ 1,059,900     $ 1,044,500  
 
Accounts payable and accrued liabilities
    466,215       440,403  
 
Unearned premium revenue
    73,352       477,791  
 
Current portion of long-term debt
    48,355       107,235  
     
     
 
   
Total current liabilities
    1,647,822       2,069,929  
     
     
 
Long-term debt
    653,188       596,794  
Convertible subordinated debentures
    135,000       135,000  
Deferred income taxes
    101,479       103,790  
Other liabilities
    23,276       17,315  
Stockholders’ equity:
               
 
Common stock, $0.01 par value; 200,000 shares authorized; issued 49,161 in 2003 and 47,709 shares in 2002.
    492       477  
 
Unearned compensation
    (19,556 )     (2,000 )
 
Additional paid-in capital
    1,608,156       1,560,785  
 
Accumulated other comprehensive income
    28,795       21,730  
 
Retained earnings
    494,137       350,369  
 
Treasury stock, at cost; 11,657 shares in 2003 and 11,704 shares in 2002
    (600,608 )     (603,056 )
     
     
 
   
Total stockholders’ equity
    1,511,416       1,328,305  
     
     
 
    $ 4,072,181     $ 4,251,133  
     
     
 

See accompanying notes.

1


Table of Contents

PACIFICARE HEALTH SYSTEMS, INC.

 
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
(unaudited)
(Amounts in thousands, except per-share data)
                     
Three Months Ended
June 30,

2003 2002


Revenue:
               
 
Commercial
  $ 1,237,190     $ 1,188,230  
 
Senior
    1,355,621       1,477,720  
 
Specialty and other
    119,592       100,547  
 
Net investment income
    17,831       2,863  
     
     
 
   
Total operating revenue
    2,730,234       2,769,360  
     
     
 
Expenses:
               
Health care services and other:
               
 
Commercial
    1,046,962       1,047,428  
 
Senior
    1,135,320       1,296,222  
 
Specialty and other
    64,214       40,668  
     
     
 
   
Total health care services and other
    2,246,496       2,384,318  
     
     
 
Selling, general and administrative expenses
    345,612       315,426  
Impairment, disposition, restructuring, Office of Personnel Management and other charges (credits), net
          18,336  
     
     
 
Operating income
    138,126       51,280  
Interest expense
    (20,410 )     (18,955 )
     
     
 
Income before income taxes
    117,716       32,325  
Provision for income taxes
    44,718       12,058  
     
     
 
Net income
  $ 72,998     $ 20,267  
     
     
 
Basic earnings per share
  $ 2.00     $ 0.58  
     
     
 
Diluted earnings per share
  $ 1.92     $ 0.56  
     
     
 

See accompanying notes.

2


Table of Contents

PACIFICARE HEALTH SYSTEMS, INC.

 
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
(unaudited)
(Amounts in thousands, except per-share data)
                     
Six Months Ended
June 30,

2003 2002


Revenue:
               
 
Commercial
  $ 2,469,306     $ 2,382,386  
 
Senior
    2,725,369       3,025,775  
 
Specialty and other
    236,335       202,966  
 
Net investment income
    38,819       21,684  
     
     
 
   
Total operating revenue
    5,469,829       5,632,811  
     
     
 
Expenses:
               
Health care services and other:
               
 
Commercial
    2,099,635       2,096,261  
 
Senior
    2,296,876       2,686,048  
 
Specialty and other
    125,748       86,042  
     
     
 
   
Total health care services and other
    4,522,259       4,868,351  
     
     
 
Selling, general and administrative expenses
    676,843       630,643  
Impairment, disposition, restructuring, Office of Personnel Management and other charges (credits), net
          5,485  
     
     
 
Operating income
    270,727       128,332  
Interest expense
    (39,960 )     (35,146 )
     
     
 
Income before income taxes
    230,767       93,186  
Provision for income taxes
    86,999       34,759  
     
     
 
Income before cumulative effect of a change in accounting principle
    143,768       58,427  
Cumulative effect of a change in accounting principle
          (897,000 )
     
     
 
Net income (loss)
  $ 143,768     $ (838,573 )
     
     
 
Basic earnings (loss) per share:
               
 
Income before cumulative effect of a change in accounting principle
  $ 3.97     $ 1.68  
 
Cumulative effect of a change in accounting principle
          (25.75 )
     
     
 
 
Basic earnings (loss) per share
  $ 3.97     $ (24.07 )
     
     
 
Diluted earnings (loss) per share:
               
 
Income before cumulative effect of a change in accounting principle
  $ 3.83     $ 1.68  
 
Cumulative effect of a change in accounting principle
          (25.75 )
     
     
 
 
Diluted earnings (loss) per share
  $ 3.83     $ (24.07 )
     
     
 

See accompanying notes.

3


Table of Contents

PACIFICARE HEALTH SYSTEMS, INC.

 
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(unaudited)
(Amounts in thousands)
                         
Six Months Ended
June 30,

2003 2002


Operating activities:
               
 
Net income (loss)
  $ 143,768     $ (838,573 )
 
Adjustments to reconcile net income (loss) to net cash flows used in operating activities:
               
   
Depreciation and amortization
    22,697       25,323  
   
Amortization of intangible assets
    11,047       11,219  
   
Stock based compensation expense
    8,249       289  
   
Deferred income taxes
    6,295       19,383  
   
Amortization of capitalized loan fees
    5,096       5,810  
   
Tax benefit realized for stock option exercises
    4,663       164  
   
Provision for doubtful accounts
    2,777       19,223  
   
Amortization of notes receivable from sale of fixed assets
    (2,764 )     (1,502 )
   
Loss (gain) on disposal of property, plant and equipment
    2,680       (2,886 )
   
Employee benefit plan contributions in treasury stock
    1,363       6,581  
   
Amortization of discount on 10 3/4% senior notes
    218       48  
   
Cumulative effect of a change in accounting principle
          897,000  
   
Marketable and other securities impairment for other than temporary declines in value
          12,543  
   
Impairment, disposition, restructuring, Office of Personnel Management and other credits, net
          5,485  
   
Changes in assets and liabilities:
               
     
Receivables, net
    (18,912 )     36,949  
     
Prepaid expenses and other assets
    (30,180 )     (7,940 )
     
Medical claims and benefits payable
    15,400       (49,400 )
     
Accounts payable and accrued liabilities:
               
       
Payments for Office of Personnel Management settlement, net of amounts received
    (10,000 )     (53,875 )
       
Other changes in accounts payable and accrued liabilities
    46,611       5,186  
     
Unearned premium revenue
    (404,439 )     (487,858 )
     
     
 
       
Net cash flows used in operating activities
    (195,431 )     (396,831 )
     
     
 
Investing activities:
               
 
Purchase of marketable securities-restricted
    (102,374 )     (81,164 )
 
Purchase of property, plant and equipment
    (23,101 )     (33,195 )
 
Sale (purchase) of marketable securities, net
    18,341       (4,809 )
 
Proceeds from the sale of property, plant and equipment
    21       12,408  
     
     
 
       
Net cash flows used in investing activities
    (107,113 )     (106,760 )
     
     
 

Table continued on next page.

See accompanying notes.

4


Table of Contents

PACIFICARE HEALTH SYSTEMS, INC.

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Continued)

(unaudited)
(Amounts in thousands)
                       
Six Months Ended
June 30,

2003 2002


Financing activities:
               
 
Principal payments on senior credit facility
  $ (150,547 )   $ (461,578 )
 
Proceeds from senior credit facility
    150,000        
 
Proceeds from issuance of common stock
    13,165       395  
 
Loan fees
    (6,949 )     (32,539 )
 
Payments on software financing agreement