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8-K - FORM 8-K - HEALTH NET INCd8k.htm
Health Net, Inc.
Health Net, Inc.
2010 Investor Day
2010 Investor Day
February 11, 2010
Exhibit 99.1


2
Cautionary Statement
All statements in this presentation, other than statements of historical information provided herein,
including but not limited to the guidance for future periods included herein and the assumptions and
underlying such projections, may be deemed to be forward-looking statements and as such are subject
to a number of risks and uncertainties. These statements are based on management’s analysis,
judgment, belief and expectation only as of the date hereof, and are subject to uncertainty and changes
in circumstances. Without limiting the foregoing, the guidance as to expected future period results and
statements including the words “believes,” “anticipates,” “plans,” “expects,” “may,” “should,” “could,”
“estimate,” “intend” and other similar expressions are intended to identify forward-looking statements.
Actual results could differ materially due to, among other things, costs, fees and expenses related to the
post-closing administrative services to be provided under the administrative services agreements
entered into in connection with the sale of our Northeast business; potential termination of the
administrative services agreements by the service recipients should we breach such agreements or fail
to perform all or a material part of the services required thereunder; any liabilities of the Northeast
business that were incurred prior to the closing of its sale as well as those liabilities incurred through the
winding-up and running-out period of the Northeast business; potential termination of our TRICARE
North operations; rising health care costs; a continued decline in the economy; negative prior period
claims reserve developments; investment portfolio impairment charges; volatility in the financial
markets; trends in medical care ratios; unexpected utilization patterns or unexpectedly severe or
widespread illnesses; membership declines; rate cuts affecting our Medicare or Medicaid businesses;
litigation costs; regulatory issues; operational issues; health care reform; and general business and
market conditions. 
Additional factors that could cause actual results to differ materially from those reflected in the forward-
looking statements include, but are not limited to, the risks discussed in the “Risk Factors” section
included within the company's most recent Annual Report on Form 10-K, subsequent quarterly reports
on Form 10-Q, and the risks discussed in the company’s other filings with the Securities and Exchange
Commission. Readers are cautioned not to place undue reliance on these forward-looking statements.
The company undertakes no obligation to publicly revise its guidance, the assessment of the underlying
assumptions or any of its forward-looking statements to reflect events or circumstances that arise after
the date of this presentation.


3
Non-GAAP Measures
These presentations include quarterly and full-year
income statement measurements that are not calculated
and presented in accordance with Generally Accepted
Accounting Principles. Audience participants should refer
to the reconciliation table included in the Appendix to the
presentations, which is available on the company’s Web
site at www.healthnet.com, and reconciles certain non-
GAAP financial information to GAAP financial information.


Health Net, Inc.
Health Net, Inc.
2010 Investor Day
2010 Investor Day
Overview
Overview
Jay Gellert
President and Chief Executive Officer
4


5
2009 Summary
Improve Medicare performance
Solidify commercial base
Close Northeast transaction
Strengthen balance sheet
Strong TRICARE performance
Position for the future


6
Our Positioning
Commercial product approach
Diverse portfolio, consistent performance
DoD
/ VA franchise
Simplified administration and medical management
Available cash


7
Aligned with Environment
New face of consumer
Ongoing affordability pressures
Not overinvested in high risk areas
Leverage with economic recovery
Opportunities from reform


8
To Do Today
Comfortable with 2010
Approach that leads into 2011
Administrative savings line of sight
Can handle TRICARE transition
Have cash, will use it wisely
Longer term margin expansion opportunities
Well-positioned for the future


9
2010 Earnings Guidance
2010 Earnings Guidance
Year-end Membership
Commercial: -1% to -2%
Medicaid: +5% to +6%
Medicare Advantage: -2% to -3%
PDP: +1% to +2%
Consolidated Revenues
$13 billion to $13.5 billion
Commercial Premium Yields
(b)
~ 8.3% to 8.8%
(Western Region 2009: ~$316 PMPM)
Commercial Health Care Cost Trends
(b)
~ 20-40 bps < Premium Yields
(Western Region 2009: ~$274 PMPM)
Selling Cost Ratio
~ 2.4%
Gov’t
Contracts Ratio
~ 94.5% to 95%
G&A Expense Ratio
~ 8.8% to 9%
Tax Rate
~ 39%
Weighted-average Fully
Diluted Shares Outstanding
103 million –
104 million
GAAP EPS
Non-GAAP EPS
(a)
$1.92 to $2.02
$2.32 to $2.42
(a)
Excludes approximately $69 million in pretax charges. These charges include approximately $53 million related to the wind-down of the company’s Northeast
businesses and approximately $16 million related to the company’s operations strategy.
(b)
Commercial premium yields and commercial health care cost comparisons are on a same-store basis for the company’s Western health plans only for both
2009 and 2010.


Earnings
Earnings
Guidance
Guidance
Bridge
Bridge
2009-2010
2009-2010
(a)
(a)
Expect pretax margin to improve by
~60 basis points
G&A ratio to improve by 70 to 90 basis points
Health plan MCR to rise by ~20 basis points
Selling costs improve by ~30 basis points
Government contracts cost ratio flat
Net non-operating gains lower by
~30 basis points
10
(a)
Excludes the impact of charges taken during 2009 and charges expected during 2010.  Also excludes revenues and expenses associated with the run-out of the Northeast
business. This information is non-GAAP financial information.  A reconciliation of non-GAAP financial measures is attached as an Appendix to this presentation.


11
Our Goal
Simple
Transparent
Aligned
Tailwinds over headwinds
Flexible


Operations Review
Operations Review
Jim Woys
Executive Vice President and
Chief Operating Officer
12


13
2010 and Long-Term Focus
2010 and Long-Term Focus
Expand Western commercial revenues
and margins
Sustain Medicare membership and margins
“Stay the course”
in Medi-Cal
Maintain and then grow Government contracts
Manage health care costs in a capitated
group setting
Reduce administrative expenses to drive
margin expansion
13


Commercial Business
Commercial Business
Steven Sell
President, Western Region Health Plan
President, Health Net of California
14


Commercial Plan: Build on Strength
Commercial Plan: Build on Strength
Strong California HMO position
Gaining market share
Strategically changing the mix 
Geographies, small and mid-market and
low cost products
Positioned for changes in the market
Build on provider relationships
Multiple networks using capitated
group model
Allows wide range of price points
Goal: steady margin improvement
15


16
The New and Improved HMO
The New and Improved HMO
HMO strong in California
HDHP growth has changed little since 2007
CA Commercial Market Share by Product Type
Sources: California Health Care Foundation (CHCF)/NORC California Employer Health Benefits Survey: 2007-2009,
2005-2006, 2004, Kaiser/HRET CHCF Survey: 2001-2003, 2001-2009


2009 Health Plan Market Share in CA
(Commercial HMO/POS)
Network HMO
2009 Health Plan Market Share in Inland
Empire, Los Angeles, and Orange County
(Commercial HMO/POS)
Network HMO
17
Health Net Strong in Commercial HMO
Health Net Strong in Commercial HMO
Note: Commercial HMO/POS excludes self-funded membership.
Source: HealthLeaders, Managed Market Surveyor data, January 2009


The New and Improved HMO
The New and Improved HMO
Integrated provider groups provide cost stability
and predictability
Low
cost
products
meet
“value
shopper”
needs
Comprehensive benefits at competitive price points
Prices for high deductible, consumer-directed
products rising substantially
Up to 40 percent
18


Group Networks: Our Sweet Spot
Group Networks: Our Sweet Spot
A staple of Western
markets
Health Net is the lead
network model HMO
player
*
More penetrated
landscape in Southern
California
Health Net’s best
geography
The most cost-effective
delivery system
Reduces risk
19
* Based on membership


The Value of the Group Model
The Value of the Group Model
More predictable costs and pricing
Integrates care and avoids duplicative or
unnecessary procedures
Care starts at low cost setting, “steps-up”
only as necessary
Collaborate on cost and quality initiatives
20


Economy Driving to Affordable Products
Economy Driving to Affordable Products
Affordability issues –
need for lower cost products
Small and mid-market
Two approaches to lower cost products:
Narrow network products are growing
Consumer-driven, high deductible products not
producing promised savings
Competitive prices
Capitated
HMO is 30 percent less compared with
PPO in Southern California
21


Strength: Narrow Network Products
Strength: Narrow Network Products
22
Steady growth in all narrow network products
Success with a growing Latino population
Growing interest in substantive coverage in lieu of broad access
Health Net Narrow Network Products Membership
200,000
210,000
220,000
230,000
240,000
250,000
260,000
270,000
280,000
Q1'08
Q2'08
Q3'08
Q4'08
Q1'09
Q2'09
Q3'09
Q4'09
Total Narrow
Network
Products


31%
36%
38%
69%
64%
62%
0%
20%
40%
60%
80%
100%
Q1-2007
Q1-2008
Q1-2009
Small Group Network Model HMO Market Share
Health Net has continued to gain market share in small
groups in network model HMO from 1Q07 to 1Q09
(1)
Strength: Small Group Segment
Strength: Small Group Segment
HNT small group membership increased 7 percent
Total membership for the other four largest network model
HMO plans dropped 7 percent
(1) Source:  Data from DMHC and excludes Kaiser and all PPO data. Percent share reflects percent share of top statewide competitors.
23


Expanding Gross Margin
Expanding Gross Margin
24
Disciplined pricing –
20 to 40 basis points
MCR improvement
Segment shift to small and mid-markets
Mix shift to narrow network products
Geographic shift to profitable regions


Winning Strategy for Today’s Market
Winning Strategy for Today’s Market
Strong California HMO position
Built on strong provider group relationships
Change the mix to small and mid-group, lower
costs and key geographies
Sustained disciplined pricing
25
Result: steady margin improvement


Medicare &
Medicare &
State Programs
State Programs
Scott Kelly
Chief Government Programs Officer
26


Medicare Positioning
Medicare Positioning
Focus on network model markets in
Western region
Established and accepting of MA since before BBA
Best “age-in”
opportunities
Build on strength of capitated
networks
in California
Balance cost, revenue and benefits/premiums
to maintain margins in challenging
reimbursement environment
27


Medicare
Medicare
28


Medicare Advantage 2009
Medicare Advantage 2009
Met goals in 2009
Emphasized margin with reasonable growth
Risk mitigation
Improvement driven by targeted benefit and
premium changes
Improved risk adjuster data collection
Stable enrollment
Exited Private Fee-for-Service
29


Medicare Advantage: 2010 Expectations
Medicare Advantage: 2010 Expectations
30
Early enrollment results positive
MCR expected to improve
Premium and benefit design
Exit Private Fee-for-Service
Margins consistent with long-term targets


Medicare Part D
Medicare Part D
31
Solid franchise
2009 enrollment slightly better than expected
Returned to solid margins
2010 enrollment expected to increase
1 to 2 percent
2010 margins consistent with long-term targets


State Programs: Medi-Cal
State Programs: Medi-Cal
Highest ranking HMO plan in California by
U.S. News and World Report
702,000 members at year-end 2009, an
increase of 12.5 percent year-over-year
2010 outlook
Expect 5 to 6 percent membership growth
Continued rate pressure
Continued provider partnership attention
Maintain stable financial performance
Key strategic position for health care reform
32


Medi-Cal
Medi-Cal
33


State Programs: Healthy Families
State Programs: Healthy Families
153,000 members at year-end 2009, an
increase of 10.3 percent year-over-year
2010 program outlook
Expect 5 to 6 percent membership gains
Continued rate pressure
Margin stability
34


Key Takeaways
Key Takeaways
Strong 2009 Medicare results lead to solid
2010 outlook based on benefits, premiums
and enrollment
Medicare margin stability in long-standing MA
network-model markets
Predictable cost structure
Maintain Medi-Cal stability and position in
advance of health care reform
Support commercial and Medicare low-cost
products, e.g. Salud
con Health Net
35


Government Segment
Government Segment
Federal Services / MHN
Federal Services / MHN
Steve Tough
President, 
Government Programs Division
36


37
2009 Review and 2010 Outlook
2009 Government contracts ratio of 94.6 percent
Better than planned due to lower health care cost
trends and DoD behavioral health growth
2010 Expectations
Current TRICARE contract and terms to continue
through March of 2011
Revenue growth of approximately 10 percent
consistent with health care cost inflation and
continued behavioral health growth
Government contracts ratio of 94.5 to 95.0 percent


38
Status of TRICARE Award Protest
GAO sustained Health Net’s protest
Appearance of “conflict of interest”
Evaluation of provider discounts
GAO concluded errors could have impacted the
DoD
agreed
to
consider
“conflict”
issue first
Awaiting next steps from DoD
relative standing of the proposals


39
MFLC: DoD
Behavioral Health Program
Substantial year-over-year revenue growth, with
2009 revenues of more than $200 million
More than 1,500 consultants at approximately
300 locations worldwide seeing over 1 million
encounters per month
Expect to achieve 2010 growth
Increasing demand for services (including base non-
medical counseling and personal financial counseling)
Prepared to respond quickly to emergent events


40
MFLC Program Revenue
MFLC Program Revenue
40
$0
$50
$100
$150
$200
$250
2004
2005
2006
2007
2008
2009


41
Future Opportunities
Department of Veterans Affairs
Department of Defense
MFLC expansion
Other government and commercial entities
Customized Behavioral Health & EAP for targeted
market segments, including:
Colleges and universities / student health
Federal agencies
Correctional health


Health Care Cost
Health Care Cost
Management
Management
John Sivori
Health Care Services Officer
42


Health Care Cost Management
2009 commercial trends higher than
initial expectations
H1N1 and COBRA
Significant progress in network contracting
Better management of trend is key element
of long-term margin expansion
Longer term opportunities with established
capitated
provider relationships
More stable cost environment
Unique medical management
Low-cost product flexibility
43


2010 Expectations
Expect commercial costs to be 20 to 40 basis
points better than premium yields
Stable physician (~6 percent) and inpatient
(~10 percent) trends
Moderating outpatient trends (~12 percent)
Lower Rx trends compared with 2009
(~10 percent)
Assuming abatement in flu
COBRA impact included in assumptions
Effective medical management in capitated
group setting is key to long-term success
44


Medical Management
in a Capitated
Group Setting
Focus on provider groups that optimize cost
effectiveness and quality
Understand local delivery system issues
Influence with physician community
Support for complex management
Offer tools and resources to providers for
improved performance
Targeted Efficiency Program using aligned
incentives to reward effective management
45


Execution on the Basics
Care management
Active evidence-based interventions
Integrated with delegated providers and vendors
Complex case management
Enroll the sickest and most complicated patients
Monitor key measures
Inpatient days per thousand
ER visits per thousand
Re-admits
46


Provider Contracting Update
Completed more than 80 percent of 2010
contracts on dollar-spend basis
90 percent completed in California
Expand cost-effective narrow network
solutions with key provider groups (Salud,
Silver, Bronze)
Enhance partnerships with key
hospital systems
Renew physician awareness of shared
risk benefits
47


Pharmacy Cost Management
Utilization trends moderating
Unit costs an area of focus
2009 impact from H1N1 flu
Captive PBM allows aggressive
formulary management
Integrated specialty management
Success with generics
48


Pharmacy Performance
Industry-leading generic fill rate
(72 percent in 2009 in Western health plans)
Continued improvement in generic fill rate
Key driver of overall trend management to
near single digits for the last eight years
49


Key Takeaways
Leveraging existing provider relationships to
deliver products and a cost structure that
meets customer needs
Delegated model recognized as vehicle for
cost containment
Focused on improved execution of the basics
in 2010
50


Operational Efficiency
Operational Efficiency
Jim Woys
Executive Vice President and
Chief Operating Officer
51


52
Operations Strategy Rationale
Operations Strategy Rationale
2007: cost structure inefficient and expensive
2009: repositioned G&A –
efficient and cost-
effective
Improved operating performance
The majority of key metrics in claims, call center
and enrollment have shown year-over-year
improvement
Long-term sustainable savings


53
Operations Strategy Results
Operations Strategy Results
A “high return”
investment
Achieved more than $125 million in run-rate G&A
savings since 2007
Operations strategy nearly complete
Application and infrastructure outsourcing and
systems efficiencies: $53 million in run-rate savings
Business process outsourcing and vendor
management: $37 million in run-rate savings
Other restructuring and efficiency initiatives:
$35 million in run-rate savings
Headcount reduced by approximately 1,300
Further run-rate savings of $15 million from 
additional overhead reductions
53


54
Operations Strategy Investments
Operations Strategy Investments
Necessary charges of $191 million pretax
to-date, with further charges of $16 million
pretax in 2010 as headcount continues to decline
$43 million for noncash asset write-downs
$88 million for severance due to headcount reductions
$60 million for facilities, system consolidation
and consulting
Without investments, 2009 G&A would have been
$105 million higher
Assuming 3 percent annual inflation


55
Ongoing savings exceed investments
Operations Strategy Results
Operations Strategy Results
Total charges = $207 million pretax
Positive return realized in second half of 2010
Operations Strategy Savings vs. Charges
$'s in millions
-$150
-$100
-$50
$0
$50
$100
$150
$200
2008
2009
2010
2011
2012
Savings
Charge


56
Overhead Reductions
Overhead Reductions
Further administrative cost savings
necessary with Northeast sale
Expect to achieve savings by reducing
corporate overhead
Eliminate $80 million to $100 million in
run-rate G&A expenses by year-end 2011
New G&A base will be scalable as
growth resumes
56


57
2010 and Long-Term Focus
2010 and Long-Term Focus
Expand Western commercial revenues
and margins
Sustain Medicare membership and margins
“Stay the course”
in Medi-Cal
Maintain and then grow Government contracts
Manage health care costs in a capitated
group setting
Reduce administrative expenses to drive
margin expansion
57


Financial Review
Financial Review
Joseph C. Capezza
Executive Vice President
and Chief Financial Officer
58


59
On the Right Track
On the Right Track
Completed Northeast transaction
Met 2009 expectations
Fixed Medicare
Contributed $100 million to subsidiaries in
December
2009
RBC
more
than
400
percent
Strong cash at parent
$450 million at
year-end 2009
Expect 2010 cash flow of $300 million to
$325 million


Northeast Transaction Cash
Northeast Transaction Cash
2009
$377 million
2010
$  23 million
2011
$  90 million to $210 million
Total
$490 to $610 million
60


Retained regulatory capital
~$  90 million
Debt repayment
~$140 million
Share repurchase
~$  90 million*
Severance, capital expenditures and
other expenses
~$  80 million
TOTAL
~$400 million
61
*  Assumes share repurchases equal to current authorization of approximately $103 million.
2010 Cash Uses
2010 Cash Uses


Capital Summary
Capital Summary
Parent cash
12/31/10
~$350 million
Revolver capacity
12/31/10
~$485 million
Additional Northeast payments
~$90 million to $210 million
Total debt
12/31/10
~$475 million
62


63
2010 Earnings Guidance
2010 Earnings Guidance
Year-end Membership
Commercial: -1% to -2%
Medicaid: +5% to +6%
Medicare Advantage: -2% to -3%
PDP: +1% to +2%
Consolidated Revenues
$13 billion to $13.5 billion
Commercial Premium Yields
~ 8.3% to 8.8%
Commercial Health Care Cost Trends
~ 20-40 bps < Premium Yields
Selling Cost Ratio
~ 2.4%
Gov’t Contracts Ratio
~ 94.5% to 95%
G&A Expense Ratio
~ 8.8% to 9%
Tax Rate
~ 39%
Weighted-average Fully
Diluted Shares Outstanding
103 million –
104 million
GAAP EPS
Non-GAAP EPS*
$1.92 to $2.02
$2.32 to $2.42
(a)
Excludes approximately $69 million in pretax charges. These charges include approximately $53 million related to the wind-down of the company’s Northeast
businesses and approximately $16 million related to the company’s operations strategy.
(b)
Commercial premium yields and commercial health care cost comparisons are on a same-store basis for the company’s Western health plans only for both
2009 and 2010.


Health Net, Inc.
Health Net, Inc.
2010 Investor Day
2010 Investor Day
Appendix
Appendix
February 11, 2010
64


Health Net, Inc.

Reconciliation of Non-GAAP Financial Measures

Operating Results Excluding Charges

(Amounts in thousands, except per share, PMPM and ratio data)

This table presents the company’s consolidated operations for the periods presented below and the charges recorded in the consolidated statement of operations for such periods. Information for the quarter and year-ended December 31, 2009 also includes the financial impact from the December 11, 2009 sale of our Northeast health plans. Management believes that the presentation of certain financial information in the attached press release, excluding the charges that were recorded and excluding the impact from the divestiture of our Northeast health plans, all of which is non-GAAP financial information, is important to investors as it excludes special items that are not indicative of our core operating results. Non-GAAP financial information presented below should be considered in addition to, not as a substitute for, financial information prepared in accordance with GAAP.

 

    Quarter Ended
December 31, 2008
    Year Ended December 31, 2008     Quarter Ended September 30,
2009
 
    As
Reported
    Impact
of
Charge1
    Excluding
Impact of
Charge1
(Non-
GAAP)
    As
Reported
    Impact
of
Charges2
    Excluding
Impact of
Charges2
(Non-
GAAP)
    As
Reported
    Impact
of
Charge3
    Excluding
Impact of
Charge3
(Non-
GAAP)
 

REVENUES:

                 

Health plan services premiums

  $ 3,082,133        $ 3,082,133      $ 12,392,006        $ 12,392,006      $ 3,166,877        $ 3,166,877   

Government contracts

    751,604          751,604        2,835,261          2,835,261        758,507          758,507   

Net investment income

    24,536          24,536        91,042        (14,642     105,684        27,691          27,691   

Administrative services fees and other income

    11,209          11,209        48,280        (3,400     51,680        15,578          15,578   
                                                                       
    3,869,482        —          3,869,482        15,366,589        (18,042     15,384,631        3,968,653        —          3,968,653   
                                                                       

EXPENSES:

                 

Health plan services

    2,629,398        (5,700     2,635,098        10,762,657        37,496        10,725,161        2,734,984        (571     2,735,555   

Government contracts

    718,893          718,893        2,702,573          2,702,573        716,323          716,323   

General and administrative

    347,128        53,535        293,593        1,291,059        119,540        1,171,519        319,451        19,495        299,956   

Selling

    92,314          92,314        360,381          360,381        83,275          83,275   

Depreciation and amortization

    17,271          17,271        59,878          59,878        12,689          12,689   

Interest

    10,523          10,523        42,909          42,909        10,264          10,264   

Asset impairments

    —            —          —            —          170,570        170,570        —     

Loss on sale of businesses

    —            —          —            —          —            —     
                                                                       
    3,815,527        47,835        3,767,692        15,219,457        157,036        15,062,421        4,047,556        189,494        3,858,062   

Income (loss) from operations before income taxes

    53,955        (47,835     101,790        147,132        (175,078     322,210        (78,903     (189,494     110,591   

Income tax provision (benefit)

    18,420        (20,227     38,647        52,129        (70,951     123,080        (12,881     (53,890     41,009   
                                                                       

Net income (loss)

  $ 35,535      $ (27,608   $ 63,143      $ 95,003      $ (104,127   $ 199,130      $ (66,022   $ (135,604   $ 69,582   
                                                                       

Basic earnings (loss) per share

  $ 0.34        $ 0.61      $ 0.89        $ 1.87      $ (0.64     $ 0.67   

Diluted earnings (loss) per share

  $ 0.34        $ 0.61      $ 0.88        $ 1.85      $ (0.64     $ 0.67   

Weighted average shares outstanding:

                 

Basic

    103,694          103,694        106,532          106,532        103,873          103,873   

Diluted

    104,063          104,063        107,610          107,610        103,873          104,432   

Pretax margin

    1.4       2.6     1.0       2.1     -2.0       2.8

Health plan services MCR

    85.3       85.5     86.9       86.5     86.4       86.4

Government contracts cost ratio

    95.6       95.6     95.3       95.3     94.4       94.4

G&A expense ratio

    11.2       9.5     10.4       9.4     10.0       9.4

Selling costs ratio

    3.0       3.0     2.9       2.9     2.6       2.6

Effective tax rate

    34.1       38.0     35.4       38.2     16.3       37.1

 

1 Includes a $5.7 million pretax benefit for a litigation reserve true-up included in health plan services expenses and a $53.5 million pretax charge primarily for severance and other expenses related to the company’s operations strategy and included in G&A.
2 Includes a $175.1 million pretax charge in total of which:

(a) $119.6 million was primarily related to severance and other expenses associated with the company’s operations strategy and included in G&A expenses

(b) $37.5 million was included in health plan services expenses for estimated litigation liability and regulatory actions for the company’s rescission practices in Arizona and California and for the execution of the settlement agreement for the McCoy, et al., lawsuits

(c) $14.6 million investment impairment charge taken in the third quarter of 2008 and included in net investment income

(d) $3.4 million pretax charge related to the estimated loss on the sale of the assets of a subsidiary taken in the first quarter of 2008 and included in other income

3 Includes a $0.6 million pretax benefit for a litigation reserve true-up included in health care costs, a $19.5 million pretax charge primarily for IT systems and other expenses related to the company’s operations strategy and included in G&A expenses and a $170.6 million pretax asset impairment charge for goodwill, intangible and IT-related assets related to the sale of our Northeast health plans.

 

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Health Net, Inc.

Reconciliation of Non-GAAP Financial Measures

Operating Results Excluding Charges

(Amounts in thousands, except per share, PMPM and ratio data)

 

    Quarter Ended December 31, 2009     Year Ended December 31, 2009  
    As
Reported
    Impact
of
Charges4
    Divested
Operations5
    Excluding
Impact of
Charges and
Divestiture4,5
(Non-
GAAP)
    As
Reported
    Impact
of
Charge6
    Divested
Operations5
    Excluding
Impact of
Charge and
Divestiture5,6
(Non-
GAAP)
 

REVENUES:

               

Health plan services premiums

  $ 2,981,678        $ 5,483      $ 2,976,195      $ 12,440,589        $ 5,483      $ 12,435,106   

Government contracts

    754,766            754,766        3,104,700            3,104,700   

Net investment income

    33,486          1,126        32,360        105,930          1,126        104,804   

Administrative services fees and other income

    28,165          15,113        13,052        62,022          15,113        46,909   
                                                               
    3,798,095        —          21,722        3,776,373        15,713,241        —          21,722        15,691,519   
                                                               

EXPENSES:

               

Health plan services

    2,557,149          5,508        2,551,641        10,731,951        (4,805     5,508        10,731,248   

Government contracts

    707,353        3,632          703,721        2,939,722        3,632          2,936,090   

General and administrative

    355,407        38,723        20,588        296,096        1,361,956        124,799        20,588        1,216,569   

Selling

    84,068          249        83,819        330,112          249        329,863   

Depreciation and amortization

    8,605          589        8,016        53,042          589        52,453   

Interest

    9,538            9,538        40,887            40,887   

Asset impairments

    4,309        4,309          —          174,879        174,879          —     

Loss on sale of businesses

    105,931        105,931          —          105,931        105,931          —     
                                                               
    3,832,360        152,595        26,934        3,652,831        15,738,480        404,436        26,934        15,307,110   

Income (loss) from operations before income taxes

    (34,265     (152,595     (5,212     123,542        (25,239     (404,436     (5,212     384,409   

Income tax provision (benefit)

    10,892        (38,149     (2,059     51,100        23,765        (123,533     (2,059     149,357   
                                                               

Net income (loss)

  $ (45,157   $ (114,446   $ (3,153   $ 72,442      $ (49,004   $ (280,903   $ (3,153   $ 235,052   
                                                               

Basic earnings (loss) per share

  $ (0.43       $ 0.70      $ (0.47       $ 2.26   

Diluted earnings (loss) per share

  $ (0.43       $ 0.69      $ (0.47       $ 2.25   

Weighted average shares outstanding:

               

Basic

    103,902            103,902        103,849            103,849   

Diluted

    103,902            104,626        103,849            104,412   

Pretax margin

    -0.9         3.3     -0.2         2.4

Health plan services MCR

    85.8         85.7     86.3         86.3

Government contracts cost ratio

    93.2         92.8     94.6         94.5

G&A expense ratio

    11.9         10.0     10.9         9.8

Selling costs ratio

    2.8         2.8     2.7         2.7

Effective tax rate

    -31.8         41.4     -94.2         38.9

 

4 Includes a $3.6 million charge for TRICARE contract procurement costs included in government contracts expenses and a $38.7 million operations strategy charge and Northeast divestiture related expenses, each of which are included in G&A expenses, and an asset impairment and loss on the sale of Northeast health plans recorded in 2009.
5 Represents revenues and expenses related to the run-off of the Northeast health plans divested on December 11, 2009.
6 Includes a $4.8 million pretax benefit for a litigation reserve true-up included in health care costs, $3.6 million charge for TRICARE contract procurement costs included in government contracts expenses, and $124.8 million of operations strategy and Northeast sale related expenses included in G&A expenses, and an asset impairment and loss on the sale of Northeast health plans recorded in 2009.

 

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