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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, 2004

 

OR

 

¨ 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 001-31700

 


 

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

(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  ¨

 

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

 

There were approximately 86,024,000 shares of common stock outstanding on July 30, 2004.

 



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, 2004 and December 31, 2003    1
     Condensed Consolidated Statements of Income for the three months ended June 30, 2004 and 2003    2
     Condensed Consolidated Statements of Income for the six months ended June 30, 2004 and 2003    3
     Condensed Consolidated Statements of Cash Flows for the six months ended June 30, 2004 and 2003    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    46
     PART II. OTHER INFORMATION     

Item 1.

   Legal Proceedings    47

Item 2.

   Changes in Securities, Use of Proceeds and Issuer Purchases of Equity Securities    47

Item 3.

   Defaults Upon Senior Securities    47

Item 4.

   Submission of Matters to a Vote of Security Holders    47

Item 5.

   Other Information    47

Item 6.

   Exhibits and Reports on Form 8-K    48

Signatures

   49

Exhibit Index

   50

 

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,

2004


   

December 31,

2003


 
     (unaudited)        

ASSETS

                

Current assets:

                

Cash and equivalents

   $ 879,792     $ 1,198,422  

Marketable securities

     1,436,613       1,359,720  

Receivables, net

     313,770       265,943  

Prepaid expenses and other current assets

     59,226       57,299  

Deferred income taxes

     128,795       149,817  
    


 


Total current assets

     2,818,196       3,031,201  
    


 


Property, plant and equipment, net

     151,534       149,407  

Marketable securities-restricted

     139,683       166,546  

Goodwill

     983,104       983,104  

Intangible assets, net

     211,215       221,108  

Other assets

     67,299       67,938  
    


 


     $ 4,371,031     $ 4,619,304  
    


 


LIABILITIES AND STOCKHOLDERS’ EQUITY

                

Current liabilities:

                

Medical claims and benefits payable

   $ 1,080,700     $ 1,027,500  

Accounts payable and accrued liabilities

     444,397       490,810  

Unearned premium revenue

     90,873       496,480  

Current portion of long-term debt

     6,142       7,496  
    


 


Total current liabilities

     1,622,112       2,022,286  
    


 


Long-term debt

     474,195       477,700  

Convertible subordinated debentures

     135,000       135,000  

Deferred income taxes

     105,072       104,777  

Other liabilities

     33,481       28,004  

Stockholders’ equity:

                

Common stock, $0.01 par value; 200,000 shares authorized; issued and outstanding 85,418 shares in 2004 and 84,854 shares in 2003

     854       848  

Unearned compensation

     (37,204 )     (16,843 )

Additional paid-in capital

     1,527,196       1,458,310  

Accumulated other comprehensive income (loss)

     (2,573 )     18,815  

Retained earnings

     512,898       390,407  
    


 


Total stockholders’ equity

     2,001,171       1,851,537  
    


 


     $ 4,371,031     $ 4,619,304  
    


 


 

All applicable share and per share amounts reflect the retroactive effects of the two-for-one common stock split in the form of a stock dividend that was effective January 20, 2004.

 

See accompanying notes.

 

1


Table of Contents

PACIFICARE HEALTH SYSTEMS, INC.

CONDENSED CONSOLIDATED STATEMENTS OF INCOME

(unaudited)

(Amounts in thousands, except per share data)

 

    

Three Months Ended

June 30,


 
     2004

    2003

 

Revenue:

                

Commercial

   $ 1,413,587     $ 1,237,190  

Senior

     1,441,187       1,355,621  

Specialty and other

     170,845       119,592  

Net investment income

     21,829       17,831  
    


 


Total operating revenue

     3,047,448       2,730,234  
    


 


Expenses:

                

Health care services and other:

                

Commercial

     1,198,216       1,046,962  

Senior

     1,248,111       1,135,320  

Specialty and other

     93,420       64,214  
    


 


Total health care services and other

     2,539,747       2,246,496  
    


 


Selling, general and administrative expenses

     372,423       345,612  
    


 


Operating income

     135,278       138,126  

Interest expense

     (10,853 )     (20,410 )
    


 


Income before income taxes

     124,425       117,716  

Provision for income taxes

     48,401       44,718  
    


 


Net income

   $ 76,024     $ 72,998  
    


 


Basic earnings per share

   $ .90     $ 1.00  
    


 


Diluted earnings per share

   $ .80     $ .96  
    


 


 

All applicable share and per share amounts reflect the retroactive effects of the two-for-one common stock split in the form of a stock dividend that was effective January 20, 2004.

 

See accompanying notes.

 

2


Table of Contents

PACIFICARE HEALTH SYSTEMS, INC.

CONDENSED CONSOLIDATED STATEMENTS OF INCOME

(unaudited)

(Amounts in thousands, except per share data)

 

    

Six Months Ended

June 30,


 
     2004

    2003

 

Revenue:

                

Commercial

   $ 2,799,905     $ 2,469,306  

Senior

     2,851,300       2,725,369  

Specialty and other

     320,692       236,335  

Net investment income

     39,674       38,819  
    


 


Total operating revenue

     6,011,571       5,469,829  
    


 


Expenses:

                

Health care services and other:

                

Commercial

     2,366,779       2,099,635  

Senior

     2,473,072       2,296,876  

Specialty and other

     174,492       125,748  
    


 


Total health care services and other

     5,014,343       4,522,259  
    


 


Selling, general and administrative expenses

     741,475       676,843  
    


 


Operating income

     255,753       270,727  

Interest expense

     (21,670 )     (39,960 )
    


 


Income before income taxes

     234,083       230,767  

Provision for income taxes

     91,058       86,999  
    


 


Net income

   $ 143,025     $ 143,768  
    


 


Basic earnings per share

   $ 1.69     $ 1.98  
    


 


Diluted earnings per share

   $ 1.51     $ 1.91  
    


 


 

All applicable share and per share amounts reflect the retroactive effects of the two-for-one common stock split in the form of a stock dividend that was effective January 20, 2004.

 

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,


 
     2004

    2003

 

Operating activities:

                

Net income

   $ 143,025     $ 143,768  

Adjustments to reconcile net income to net cash flows used in operating activities:

                

Deferred income taxes

     34,021       6,295  

Depreciation and amortization

     24,721       22,697  

Stock-based compensation expense

     20,377       8,249  

Tax benefit realized upon exercise of stock-based compensation

     13,364       4,663  

Amortization of intangible assets

     9,893       11,047  

Amortization of notes receivable from sale of fixed assets

     (2,751 )     (2,764 )

Amortization of capitalized loan fees

     2,155       5,096  

(Recovery) provision for doubtful accounts

     (1,176 )     2,777  

Loss on disposal of property, plant and equipment

     424       2,680  

Amortization of discount on 10 3/4% senior notes

     142       218  

Employer benefit plan contributions in treasury stock

     —         1,363  

Changes in assets and liabilities:

                

Receivables, net

     (51,200 )     (18,867 )

Prepaid expenses and other assets

     (10,843 )     (30,225 )

Medical claims and benefits payable

     53,200       15,400  

Accounts payable and accrued liabilities:

                

Payments for Office of Personnel Management settlement, net of amounts received

     —         (10,000 )

Accrued taxes

     (8,046 )     24,153  

Other changes in accounts payable and accrued liabilities

     (21,768 )     22,388  

Unearned premium revenue

     (398,307 )     (404,369 )
    


 


Net cash flows used in operating activities

     (192,769 )     (195,431 )
    


 


Investing activities:

                

Purchase of marketable securities, net

     (110,985 )     (102,374 )

Purchase of property, plant and equipment

     (27,272 )     (23,101 )

Sale of marketable securities-restricted, net

     26,863       18,341  

Proceeds from the sale of property, plant and equipment

     —         21  
    


 


Net cash flows used in investing activities