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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 10-Q

     
(Mark One)

þ
  QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended March 31, 2005

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: 001-32209

WELLCARE HEALTH PLANS, INC.

(Exact name of registrant as specified in its charter)
     
Delaware   47-0937650
(State or other jurisdiction of   (I.R.S. Employer
incorporation or organization)   Identification No.)
     
8725 Henderson Road, Renaissance One
Tampa, Florida

(Address of principal executive offices)
 
33634
(Zip Code)

(813) 290-6200
(Registrant’s telephone number, including area code)

     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 þ           No o

     Indicate by check mark whether the registrant is an accelerated filer (as defined in Rule 12b-2 of the Exchange Act).

Yes o            No þ

     As of May 6, 2005, there were 38,774,192 shares of the registrant’s common stock, par value $.01 per share, outstanding.

 
 

 


WELLCARE HEALTH PLANS, INC.

TABLE OF CONTENTS

             
Part I – FINANCIAL INFORMATION     1  
 
           
  Financial Statements        
 
           
 
  Condensed Consolidated Balance Sheets at March 31, 2005 and December 31, 2004     1  
 
  Condensed Consolidated Statements of Income for the three months ended March 31, 2005 and 2004     2  
 
  Condensed Consolidated Statements of Cash Flows for the three months ended March 31, 2005 and 2004     3  
 
  Notes to Condensed Consolidated Financial Statements     4  
 
           
  Management’s Discussion and Analysis of Financial Condition and Results of Operations     10  
 
           
  Quantitative and Qualitative Disclosures About Market Risk     17  
 
           
  Controls and Procedures     18  
 
           
Part II – OTHER INFORMATION     18  
 
           
  Legal Proceedings     18  
 
           
  Unregistered Sales of Equity Securities and Use of Proceeds     19  
 
           
  Defaults Upon Senior Securities     19  
 
           
  Submission of Matters to a Vote of Security Holders     19  
 
           
  Other Information     19  
 
           
  Exhibits     20  
 
           
        22  
 
 
 EX-31.1: SECTION 302 CERTIFICATION OF PRESIDENT AND CFO
 EX-31.2: SECTION 302 CERTIFICATION OF CFO
 EX-32.1: SECTION 906 CERTIFICATION OF PRESIDENT AND CEO
 EX-32.2: SECTION 906 CERTIFICATION OF CFO

-i-


Table of Contents

Part I– FINANCIAL INFORMATION

Item 1: Financial Statements

WELLCARE HEALTH PLANS, INC.

CONDENSED CONSOLIDATED BALANCE SHEETS

(Unaudited, in thousands, except share data)

                 
    March 31,     December 31,  
    2005     2004  
Assets
               
Current Assets:
               
Cash and cash equivalents
  $ 340,745     $ 397,627  
Investments
    173,746       75,515  
Premiums and other receivables, net
    44,534       52,170  
Prepaid expenses and other current assets
    5,512       6,119  
Income taxes receivable
          1,615  
Deferred income taxes
    18,123       15,362  
 
           
Total current assets
    582,660       548,408  
Property and equipment, net
    13,943       12,587  
Goodwill
    180,848       180,848  
Other intangibles, net
    24,140       25,441  
Restricted investment assets
    31,502       31,473  
Other assets
    256       279  
 
           
Total Assets
  $ 833,349     $ 799,036  
 
           
Liabilities and Stockholders’ Equity
               
Current Liabilities:
               
Medical benefits payable
  $ 206,931     $ 190,595  
Unearned premiums
    64,453       63,449  
Accounts payable and accrued expenses
    34,474       35,520  
Income taxes payable
    5,631        
Current portion of long-term debt
    1,600       1,600  
 
           
Total current liabilities
    313,089       291,164  
Notes payable to related party
    25,000       25,000  
Long-term debt
    156,541       156,901  
Deferred income taxes
    15,588       14,818  
Other liabilities
    2,743       2,522  
 
           
Total liabilities
    512,961       490,405  
 
           
Commitments and Contingencies (see Note 4)
               
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, 38,768,293 and 38,590,655 shares issued and outstanding)
    388       386  
Paid-in capital
    231,912       230,804  
Retained earnings
    88,084       77,444  
Accumulated other comprehensive income (expense)
    4       (3 )
 
           
Total stockholders’ equity
    320,388       308,631  
 
           
Total Liabilities and Stockholders’ Equity
  $ 833,349     $ 799,036  
 
           

See notes to condensed consolidated financial statements.

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WELLCARE HEALTH PLANS, INC.

CONDENSED CONSOLIDATED STATEMENTS OF INCOME

(Unaudited, in thousands, except per share and unit data)

                 
    Three Months  
    Ended March 31,  
    2005     2004  
Revenues:
               
Premium
  $ 415,866     $ 301,250  
Investment and other income
    3,015       586  
 
           
Total revenues
    418,881       301,836  
 
           
Expenses:
               
Medical benefits
    344,926       251,435  
Selling, general and administrative
    51,248       36,791  
Depreciation and amortization
    2,042       1,659  
Interest
    3,205       2,265  
 
           
Total expenses
    401,421       292,150  
 
           
Income before income taxes
    17,460       9,686  
Income tax expense
    6,820       3,864  
 
           
Net income
  $ 10,640       5,822  
 
             
 
               
Class A common unit yield
            (1,571 )
 
             
Net income attributable to common units
          $ 4,251  
 
             
 
               
Net income per share (see Note 1):
               
Net income per share — basic
  $ 0.29          
Net income per share — diluted
  $ 0.27          
 
               
Net income attributable per common unit (see Note 1):
               
Net income attributable per common unit - basic
          $ 0.15  
Net income attributable per common unit - diluted
          $ 0.13  
 
               
Pro forma net income per common share (see Note 1) (unaudited):
               
Pro forma net income per common share - basic (unaudited)
          $ 0.19  
Pro forma net income per common share - diluted (unuadited)
          $ 0.16  

See notes to condensed consolidated financial statements.

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WELLCARE HEALTH PLANS, INC.

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(Unaudited, in thousands)

                 
    Three Months  
    Ended March 31,  
    2005     2004  
Cash from operating activities:
               
Net income
  $ 10,640     $ 5,822  
Adjustments to reconcile net income to net cash provided by operating activities:
               
Depreciation and amortization expense
    2,042       1,659  
Realized gains on investments
    7        
Equity-based compensation expense
    719       260  
Accreted interest
    40       277  
Deferred taxes, net
    (1,991 )     (909 )
Provision for doubtful receivables
          1,416  
Changes in operating accounts, net of effect of acquisition:
               
Premiums and other receivables
    7,636       (5,347 )
Prepaid expenses and other current assets
    590       (769 )
Medical benefits payable
    16,336       106  
Unearned premiums
    1,004       (24,215 )
Accounts payable and accrued expenses
    (1,169 )     (4,675 )
Accrued interest
    257       (1,514 )
Taxes payable
    7,246       3,732  
Other liabilities
    (53 )      
 
           
Net cash provided by (used in) operations
    43,304       (24,157 )
 
           
Cash from investing activities:
               
Proceeds from sale and maturities of investments, net
    25,174       48  
Purchases of investments
    (123,405 )     (5,201 )
Purchases and dispositions of restricted investments
    (29 )     (4,847 )
Additions to property and equipment, net
    (2,098 )     (774 )
 
           
Net cash used in investing activities
    (100,358 )     (10,774 )
 
           
 
               
Cash from financing activities:
               
Proceeds from options
    572        
Payments on debt
    (400 )     (3,591 )
 
           
Net cash provided by (used in) financing activities
    172       (3,591 )
 
           
Cash and cash equivalents:
               
Decrease during period
    (56,882 )     (38,522 )
Balance at beginning of period
    397,627       237,321  
 
           
Balance at end of period
  $ 340,745     $ 198,799  
 
           
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION —
               
Cash paid for taxes
  $ 1,571     $ 1,040  
 
           
Cash paid for interest
  $ 2,643     $ 2,002  
 
           

See notes to condensed consolidated financial statements.

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WELLCARE HEALTH PLANS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

(In thousands, except member, share and unit data)

1.   ORGANIZATION, BASIS OF PRESENTATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

     WellCare Health Plans, Inc., a Delaware corporation (the “Company”), provides managed care services targeted exclusively to government-sponsored healthcare programs, focusing on Medicaid and Medicare. Through its health plans, the Company offers a diverse array of products, primarily Medicaid and related state programs, such as the State Children’s Health Insurance Program (“S-CHIP”), and Medicare programs, serving approximately 765,000 members as of March 31, 2005. Through its health maintenance organization (“HMO”) subsidiaries, the Company operates in the states of Florida, Illinois, Indiana, New York, Connecticut, Louisiana and Georgia.

History

     WellCare Holdings, LLC (“Holdings”), a Delaware limited liability corporation, was formed in May 2002 for the purpose of acquiring various subsidiaries that operate health plans focused on government programs in various states. Holdings began operating in August 2002 in conjunction with the acquisition of its indirect operating subsidiaries and did not have any activity from May 2002 through July 2002. The Company, formerly known as WellCare Group, Inc., became the successor to Holdings following a reorganization (the “Reorganization”) that took place immediately prior to the closing of the Company’s initial public offering in July 2004. The Reorganization was effected through a merger of Holdings with and into the Company, a wholly-owned subsidiary of Holdings. The Company issued an aggregate of 29,735,757 shares of the Company’s common stock in exchange for all of the outstanding membership interests in Holdings, plus accrued yields, pursuant to the merger. Upon consummation of the merger, the Company changed its name to WellCare Health Plans, Inc.

     In July 2004, the Company completed its initial public offering, at a price of $17 per share. The offering resulted in net proceeds to the Company of approximately $112.3 million.

     In December 2004, the Company completed a follow-on public offering of common stock whereby 6,000,000 shares were sold by selling stockholders and 1,500,000 shares were sold by the Company. The Company received net proceeds of $44.9 million from this offering.

Basis of Presentation

     The accompanying unaudited condensed consolidated interim financial statements should be read in conjunction with the consolidated and combined financial statements and notes thereto for the fiscal year ended December 31, 2004 included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission (the “SEC”) on February 15, 2005 (the “2004 Form 10-K”). In the opinion of the Company’s management, the interim financial statements reflect all normal recurring adjustments which the Company considers necessary for the fair presentation of the financial position and results of operations and cash flows for the interim periods presented. The interim financial statements included herein have been prepared in accordance with accounting principles generally accepted in the United States of America and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, certain information and footnote disclosures normally included in financial statements prepared in accordance with accounting principles generally accepted in the United States of America have been condensed or omitted. Results for the interim periods presented are not necessarily indicative of results that may be expected for the entire year or any other interim period.

     Certain 2004 amounts in the consolidated financial statements have been reclassified to conform to the 2005 presentation. These reclassifications have no effect on net income, total assets, liabilities or stockholders’ equity as previously reported.

Earnings Per Common Share

     Basic net income per common share is computed by dividing the net income for the period by the weighted average number of shares of common stock outstanding during the period. Diluted net income per common share is computed by dividing the net income for the period by the weighted average number of shares of common stock outstanding during the period, plus other potentially dilutive securities.

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WELLCARE HEALTH PLANS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS – (Continued)

(In thousands, except member, share and unit data)

Earnings Attributable Per Common Unit

     Basic net income attributable per unit is computed by dividing the net income less the Class A common unit yield for the period by the weighted average number of units outstanding during the period, less units outstanding. Diluted net income attributable per unit is computed by dividing the net income for the period less the Class A common unit yield by the weighted average number of units outstanding during the period, plus, other potentially dilutive securities, including the unvested units.

     Holdings’ historic capital structure is not indicative of the Company’s current structure due to the automatic conversion of all units of Holdings into common stock of the Company immediately prior to the closing of the Company’s initial public offering. Accordingly, historic basic and diluted net income attributable per common unit should not be used as an indicator of the future earnings per common share. The pro forma information in the condensed consolidated statements of income assumes conversion of all outstanding units of Holdings into shares of the Company’s common stock resulting from the completion of the initial public offering as if it had occurred at the beginning of all periods presented. Pro forma net income per share is computed using the weighted average number of common shares outstanding, including the pro forma effects of automatic conversion of all outstanding common units into shares of the Company’s common stock effective immediately prior to the closing of the Company’s initial public offering on July 7, 2004.

     The components of total shares outstanding at March 31, 2005 and December 31, 2004, are as follows:

                 
    March 31,     December 31,  
    2005     2004  
Common Shares Outstanding
    34,789,662       34,681,436  
Vested restricted shares
    2,665,598       2,432,280  
Unvested restricted shares
    1,313,033       1,476,939  
Options outstanding
    2,363,882       2,415,075  
 
           
Total Shares outstanding including options
    41,132,175       41,005,730  
 
           

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WELLCARE HEALTH PLANS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS – (Continued)

(In thousands, except member, share and unit data)

     The following table illustrates the effect on net income and net income attributable per common unit as if the fair value based method had been applied to all awards:

                 
    Three Months Ended  
    March 31,  
    2005     2004  
    (unaudited)  
Net income, as reported
  $ 10,640     $ 5,822  
Reconciling items (net of tax effects):
               
Add: equity-based employee compensation expense determined under the intrinsic-value based method for all awards
    438       154  
Deduct: equity-based employee compensation expense determined under the fair-value based method for all awards
    (2,093 )     (487 )
 
           
Net adjustment
    (1,655 )     (333 )
 
           
Net income, as adjusted
  $ 8,985       5,489  
 
             
Class A common unit yield
            (1,571 )
 
             
 
               
Adjusted net income attributable to common units
          $ 3,918  
 
             
Net income per common share:
               
Basic-as reported
  $ 0.29          
Basic-as adjusted
  $ 0.24          
Diluted-as reported
  $ 0.27          
Diluted-as adjusted
  $ 0.23          
Net income attributable per common unit:
               
Basic-as reported
          $ 0.15  
Basic-as adjusted
          $ 0.14  
Diluted-as reported
          $ 0.13  
Diluted-as adjusted
          $ 0.12  

     The Company has equity-based compensation plans for the benefit of its eligible associates, consultants and directors. The Company accounts for equity-based compensation under Accounting Principles Board Opinion No. 25, “Accounting for Stock Issued to Employees.” The Company has adopted the disclosure-only provisions of Statement of Financial Accounting Standards (“SFAS”) No. 123, “Accounting for Stock-Based Compensation,” and SFAS No. 148, “Accounting for Stock-Based Compensation – Transition and Disclosure.”

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WELLCARE HEALTH PLANS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS – (Continued)

(In thousands, except member, share and unit data)

     The following table presents the calculation of net income per common share – basic and diluted and net income attributable per common unit – basic and diluted:

                 
    Three Months Ended  
    March 31,  
    2005     2004  
    (unaudited)  
Numerator:
               
Net income — basic and diluted
  $ 10,640     $ 5,822  
 
             
Class A common unit yield
            (1,571 )
 
             
Net income attributable to common unit
          $ 4,251  
 
             
Denominator
               
Weighted average common shares outstanding - basic
    37,250,621          
Adjustment for unvested restricted common shares
    1,394,423          
Dilutive effect of stock options (as determined by the treasury stock method)
    832,044          
 
             
Weighted average common shares outstanding - diluted
    39,477,088          
 
             
 
               
Weighted average units outstanding — basic
            27,613,922  
Adjustment for unvested outstanding Class C common units and equity options issued
            4,606,674  
 
             
Weighted average units outstanding — diluted
            32,220,596  
 
             
 
               
Pro forma weighted average shares outstanding - basic
            22,454,244  
 
             
 
               
Pro forma weighted average shares outstanding - diluted
            26,200,158  
 
             
 
               
Net income per common share:
               
Net income per common share — basic
  $ 0.29          
Net income per common share — diluted
  $ 0.27          
Net income attributable per common unit:
               
Net income attributable per common unit - basic
          $ 0.15  
Net income attributable per common unit - diluted
          $ 0.13  
Pro forma net income per common share:
               
Pro forma net income per common share - basic
          $ 0.19  
Pro forma net income per common share - diluted
          $ 0.16  

2.   BUSINESS ACQUISITION

     In June 2004, the Company acquired Harmony Health Systems, Inc. and its subsidiaries, (collectively, “Harmony”) pursuant to the terms of a merger agreement entered into in March 2004, for $50,296, including acquisition costs of $1,609. The results of Harmony’s operations have been included in the condensed consolidated financial statements since the acquisition date.

     The following unaudited pro forma summary information presents the consolidated income statement information for the three-month period ended March 31, 2004 as if the acquisition had been consummated on January 1, 2004, and does not purport to be indicative of what would have occurred had the acquisition been completed at that date or the results that may occur in the future.

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WELLCARE HEALTH PLANS, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS – (Continued)

(In thousands, except member, share and unit data)

         
    Three Months  
    Ended  
    March 31,  
    2004  
Premium Revenue
  $ 332,935  
 
     
Net Income
  $ 6,161  
 
     
Net income per share - basic
       
Net income per share - diluted
       
Net income attributable per common unit - basic
  $ 0.17  
 
     
Net income attributable per common unit - diluted
  $ 0.16  
 
     

3.   SEGMENT REPORTING

     The Company has two reportable segments: Medicaid and Medicare. The segments were determined based upon the type of governmental administration, regulation and funding of the health plans. Segment performance is evaluated based upon earnings from operations without corporate allocations. Accounting policies of the segments are consistent with those applied at the December 31, 2004 year end.

     The Medicaid segment includes operations to provide healthcare services to recipients that are eligible for state supported programs including Medicaid and family and children’s health programs. The Medicare segment includes operations to provide healthcare services to recipients who are eligible for the federally supported Medicare program. The Company no longer operates a commercial line of business.

     Asset, liability and equity amounts by segment have not been disclosed, as they are not reported by segment internally by the Company.

                 
    Three Months  
    Ended March 31,  
    2005     2004  
Premium revenue:
               
Medicaid
  $ 309,210     $ 216,120  
Medicare
    106,656       84,560  
Corporate and other
          570  
 
           
Total
    415,866       301,250  
Medical benefits expense:
               
Medicaid
    257,996       183,062  
Medicare
    86,930       67,969  
Corporate and other
          404  
 
           
Total
    344,926       251,435  
Gross profit:
               
Medicaid
    51,214       33,058  
Medicare
    19,726       16,591  
Corporate and other
          166  
 
           
Total
  $ 70,940     $ 49,815  
 
           

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WELLCARE HEALTH PLANS, INC.
(SUCCESSOR TO WELLCARE HOLDINGS, LLC)

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS – (Concluded)

(In thousands, except members, share and unit data)

4.   COMMITMENTS AND CONTINGENCIES

     The Company is a party to legal proceedings in the ordinary course of business. The Company does not believe these proceedings, individually or in the aggregate, will have a material adverse effect on its financial position, results of operations or cash flows. The Company believes that it has obtained adequate insurance or rights to indemnification or, where appropriate, has established adequate reserves in connection with these legal proceedings.

5.   INCOME TAXES

     The Company uses the asset and liability method of accounting for income taxes. At March 31, 2005, net deferred tax assets were approximately $2,535. In assessing the realizability of deferred tax assets, management considers the scheduled reversal of deferred tax liabilities, projected future taxable income, and tax planning strategies. The Company expects the deferred tax assets to be realized through the generation of future taxable income and the reversal of existing taxable temporary differences.

6.   CREDIT AGREEMENT

     In May 2004, the Company and certain subsidiaries entered into a credit agreement (the “Credit Agreement”) and obtained two new credit facilities, consisting of a senior secured term loan facility in the amount of $160,000 and a revolving credit facility in the amount of $50,000, of which $10,000 is available for short-term borrowings on a swingline basis. Interest is payable quarterly, currently at the six month LIBOR rate option of 6.49%. The term loan matures in May 2009, and the revolving credit facility will mature in May 2008. The revolving credit facility has not been utilized.

     The Credit Agreement contains various restrictive covenants which limit, among other things, the Company’s ability to incur indebtedness and liens and to enter into business combination transactions. In addition, the Company must maintain certain fixed charge and leverage ratios. The Company believes that it is in compliance with all the financial and non-financial covenants at March 31, 2005.

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Item 2: Management’s Discussion and Analysis of Financial Condition and Results of Operations.

Forward-Looking Statements

     The following discussion of our financial condition and results of operations should be read in conjunction with the accompanying unaudited condensed consolidated interim financial statements and the notes to those statements appearing elsewhere in this report and our audited consolidated and combined financial statements and the notes thereto for the year ended December 31, 2004, appearing in the 2004 Form 10-K.

     This Quarterly Report on Form 10-Q 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 “may,” “will,” “should,” “expects,” “anticipates,” “intends,” “plans,” “believes,” “estimates,” “predicts,” “potential,” “continues” and similar expressions are forward-looking statements.

     Forward-looking statements involve known and unknown risks and uncertainties that may cause our actual future results to differ materially from those projected or contemplated in the forward-looking statements. These risks and uncertainties include, but are not limited to:

  •   the potential expiration, cancellation or suspension of our state and federal contracts;
 
  •   our ability to accurately predict and effectively manage health benefits and other operating expenses;
 
  •   our ability to accurately estimate incurred but not reported medical costs;
 
  •   risks associated with future changes in healthcare laws;
 
  •   potential reductions in funding for government healthcare programs;
 
  •   risks associated with our acquisition strategy;
 
  •   risks associated with our efforts to expand into additional states and counties;