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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 September 30, 2004

 

OR

 

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

 

For the transition period from              to             

 

Commission file number 001-31513

 


 

WELLCHOICE, INC.

(Exact name of registrant as specified in its charter)

 


 

DELAWARE   71-0901607

(State or Other Jurisdiction of

Incorporation or Organization)

 

(I.R.S. Employer

Identification Number)

11 WEST 42ND STREET

NEW YORK, NEW YORK

  10036
(Address of Principal Executive Offices)   (Zip Code)

 

Registrant’s telephone number, including area code: (212) 476-7800

 

Not Applicable

(Former Name, Former Address and Former Fiscal Year, if Changed Since Last Report)

 


 

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  ¨

 

Indicate the number of shares outstanding of each of the issuer’s classes of common stock, as of the latest practicable date. 84,005,079 shares of common stock, $0.01 par value, and one share of Class B common stock, $0.01 par value per share, as of October 25, 2004.

 



Table of Contents

WellChoice, Inc and Subsidiaries

INDEX TO FORM 10-Q

 

          Page

PART I            FINANCIAL INFORMATION    3
Item 1.    Financial Statements    3
     Consolidated Balance Sheets at September 30, 2004 (Unaudited) and December 31, 2003    3
     Consolidated Statements of Income for the Three Months and Nine Months Ended September 30, 2004 and 2003 (Unaudited)    5
     Consolidated Statements of Cash Flows for the Nine Months Ended September 30, 2004 and 2003 (Unaudited)    6
     Notes to Consolidated Financial Statements (Unaudited)    7
     Report of Independent Registered Public Accounting Firm    24
Item 2.    Management’s Discussion and Analysis of Financial Condition and Results of Operations    25
Item 3.    Quantitative and Qualitative Disclosures About Market Risk    48
Item 4.    Controls and Procedures    49
PART II             OTHER INFORMATION    50
Item 1.    Legal Proceedings    50
Item 6.    Exhibits and Reports on Form 8-K    53
SIGNATURES    54
INDEX TO EXHIBITS    55


Table of Contents

WellChoice, Inc. and Subsidiaries

 

Consolidated Balance Sheets

 

     September 30,
2004


   December 31,
2003


     (Unaudited)     
     (In thousands)

Assets

             

Investments:

             

Fixed maturities, at fair value (amortized cost: $1,289,232 and $1,036,747)

   $ 1,287,092    $ 1,037,255

Marketable equity securities, at fair value (cost: $46,971 and $52,890)

     48,538      60,414

Short-term investments

     177,968      232,474

Other long-term equity investments

     32,903      31,686
    

  

Total investments

     1,546,501      1,361,829

Cash and cash equivalents

     696,936      697,518
    

  

Total investments and cash and cash equivalents

     2,243,437      2,059,347

Receivables:

             

Billed premiums, net

     106,459      92,399

Accrued premiums

     315,501      285,773

Other amounts due from customers, net

     104,520      107,062

Notes receivable, net

     12,160      12,410

Advances to hospitals, net

     4,455      10,788

Accrued investment income

     11,273      9,613

Miscellaneous, net

     65,464      51,333
    

  

Total receivables

     619,832      569,378

Property, equipment and information systems, net of accumulated depreciation

     106,577      113,526

Prepaid pension expense

     63,945      53,515

Deferred taxes, net

     170,402      216,534

Other

     34,496      30,693
    

  

Total assets

   $ 3,238,689    $ 3,042,993
    

  

 

See notes to consolidated financial statements.

 

3


Table of Contents

WellChoice, Inc. and Subsidiaries

 

Consolidated Balance Sheets

 

     September 30,
2004


    December 31,
2003


 
     (Unaudited)        
     (In thousands, except share and
per share data)
 

Liabilities and stockholders’ equity

                

Liabilities:

                

Unpaid claims and claims adjustment expense

   $ 681,603     $ 609,491  

Unearned premium income

     98,344       134,174  

Managed cash overdrafts

     174,214       197,995  

Accounts payable and accrued expenses

     73,726       104,526  

Advance deposits

     157,038       113,843  

Group and other contract liabilities

     101,756       112,204  

Postretirement benefits other than pensions

     146,027       142,743  

Obligations under capital lease

     45,144       48,345  

Other

     140,978       147,315  
    


 


Total liabilities

     1,618,830       1,610,636  

Stockholders’ equity:

                

Common stock, $0.01 par value, 225,000,000 shares authorized; shares issued and outstanding 2004—84,005,079; 2003—83,676,446

     840       837  

Class B common stock, $0.01 per share value, one share authorized; one share issued and outstanding

     —         —    

Preferred stock, $0.01 per share value, 25,000,000 shares authorized; none issued and outstanding

     —         —    

Additional paid-in capital

     1,273,553       1,262,222  

Retained earnings

     349,096       162,584  

Unearned restricted stock compensation

     (12,565 )     (6,027 )

Accumulated other comprehensive income

     8,935       12,741  
    


 


Total stockholders’ equity

     1,619,859       1,432,357  
    


 


Total liabilities and stockholders’ equity

   $ 3,238,689     $ 3,042,993  
    


 


 

See notes to consolidated financial statements.

 

4


Table of Contents

WellChoice, Inc. and Subsidiaries

 

Consolidated Statements of Income

 

    

Three months ended

September 30,


   

Nine months ended

September 30,


     2004

   2003

    2004

   2003

     (Unaudited)     (Unaudited)
     (In thousands, except share and per share data)

Revenue:

                            

Premiums earned

   $ 1,305,897    $ 1,209,296     $ 3,915,074    $ 3,622,884

Administrative service fees

     128,339      113,825       373,505      336,312

Investment income, net

     15,859      14,067       43,264      38,984

Net realized investment gains

     861      2,650       7,550      6,956

Other income (expense), net

     43      (499 )     219      792
    

  


 

  

Total revenue

     1,450,999      1,339,339       4,339,612      4,005,928

Expenses:

                            

Cost of benefits provided

     1,122,593      1,020,356       3,371,702      3,089,381

Administrative expenses

     228,590      231,522       676,740      660,667
    

  


 

  

Total expenses

     1,351,183      1,251,878       4,048,442      3,750,048
    

  


 

  

Income from continuing operations before income taxes

     99,816      87,461       291,170      255,880

Income tax expense

     37,921      35,403       104,658      107,306
    

  


 

  

Net income

   $ 61,895    $ 52,058     $ 186,512    $ 148,574
    

  


 

  

Basic earnings per common share

   $ 0.74    $ 0.62     $ 2.23    $ 1.78

Diluted earnings per common share

     0.74      0.62       2.23      1.78

Shares used to compute basic earnings per common share based on weighted average shares outstanding

     83,559,141      83,490,478       83,514,673      83,490,478

Shares used to compute diluted earnings per common share based on weighted average shares outstanding

     83,908,346      83,490,478       83,832,419      83,490,478

 

See notes to consolidated financial statements.

 

5


Table of Contents

WellChoice, Inc. and Subsidiaries

 

Consolidated Statements of Cash Flows

 

    

Nine months ended

September 30,


 
     2004

    2003

 
     (Unaudited)  
     (In thousands)  

Cash flows from operating activities

                

Net income

   $ 186,512     $ 148,574  

Adjustments to reconcile net income to net cash provided by operating activities:

                

Depreciation and amortization

     29,138       28,238  

Net realized (gain) on sales of investments

     (7,550 )     (6,956 )

(Credit) provision for doubtful accounts

     (3,923 )     361  

Accretion of discount, net

     1,596       4,418  

Equity in earnings of other long-term equity investments

     (2,369 )     (2,247 )

Deferred income tax expense

     47,816       41,169  

Other

     (10,429 )     (4,383 )

Changes in assets and liabilities:

                

Billed and accrued premiums receivables

     (42,561 )     (11,689 )

Other customer receivable

     2,006       297  

Long-term notes receivable

     250       (214 )

Advances to hospitals

     6,866       (10,777 )

Accrued investment income

     (1,661 )     836  

Miscellaneous receivables

     (11,201 )     (18,537 )

Other assets

     (3,802 )     (4,883 )

Unpaid claims and claims adjustment expenses

     72,112       46,517  

Unearned premium income

     (35,830 )     (28,917 )

Managed cash overdrafts

     (23,782 )     (12,029 )

Accounts payable and accrued expenses

     (23,057 )     (5,927 )

Advance deposits

     43,195       (15,304 )

Group and other contract liabilities

     (10,448 )     45,063  

Postretirement benefits other than pensions

     3,285       905  

Other liabilities

     (2,139 )     33,478  
    


 


Net cash provided by operating activities

     214,024       227,993  
    


 


Cash flows from investment activities

                

Purchases of property, equipment and information systems

     (25,152 )     (42,394 )

Proceeds from sale of property, equity and information systems

     16       1,096  

Purchases of available for sale investments

     (1,086,744 )     (1,062,021 )

Proceeds from sales and maturities of available for sale investments

     900,475       1,179,418  
    


 


Net cash (used in) provided by investing activities

     (211,405 )     76,099  
    


 


Cash flows from financing activities

                

(Decrease) increase in capital lease obligations

     (3,201 )     1,588  
    


 


Net cash (used in) provided by financing activities

     (3,201 )     1,588  
    


 


Net change in cash and cash equivalents

     (582 )     305,680  

Cash and cash equivalents at beginning of period

     697,518       487,431  
    


 


Cash and cash equivalents at end of period

   $ 696,936     $ 793,111  
    


 


Supplemental disclosure