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8-K - HUMANA INC. 8-K - HUMANA INC | a50357693.htm |
Exhibit 99
Humana Reports Second Quarter 2012 Financial Results
- 2Q12 EPS of $2.16 included $0.18 in expenses associated with litigation settlement
- Full-year EPS now anticipated to be $6.90 to $7.10, down from previous estimate of $7.38 to $7.58
- Company to host conference call at 5:00 p.m. today
LOUISVILLE, Ky.--(BUSINESS WIRE)--July 30, 2012--Humana Inc. (NYSE: HUM) today reported diluted earnings per common share (EPS) for the quarter ended June 30, 2012 (2Q12) of $2.16, compared to $2.71 per share for the quarter ended June 30, 2011 (2Q11). For the six months ended June 30, 2012 (1H12) the company reported $3.65 in EPS compared to $4.57 for the six months ended June 30, 2011 (1H11).
Results for 2Q12 and 1H12 included $0.18 per share in expenses related to the previously-disclosed settlement of a litigation matter. Prior-year favorable medical claims reserve development for 2Q12 of $0.15 per share compared to $0.12 per share in 2Q11. Results for 1H12 and 1H11 included $0.18 per share and $0.44 per share, respectively, of prior-year favorable medical claims reserve development.
The company lowered EPS guidance for the year ending December 31, 2012 (FY12) to a range of $6.90 to $7.10 versus its previous estimate of $7.38 to $7.58. This reduction in FY12 EPS guidance primarily reflects higher-than-previously expected individual Medicare Advantage benefit ratios associated with new members and increased utilization for both new and existing members.
"Our company’s strategy is sound, though we are disappointed by the need to lower our full-year earnings guidance," said Michael B. McCallister, Humana’s Chairman of the Board and Chief Executive Officer. “We believe the steps we are taking to address certain short-term operational challenges will put us back on the path for sustainable earnings growth moving forward."
Consolidated Highlights
Revenues – 2Q12 consolidated revenues were $9.70 billion, an increase of $415 million, or 4 percent from $9.28 billion in 2Q11, with total premiums and services revenue of $9.60 billion up $407 million, or 4 percent compared to $9.19 billion in the prior year’s quarter. The increase in consolidated revenues was primarily due to related increases in the Retail and Employer Group segments driven by increases in average membership of the company’s individual and group Medicare Advantage plans. These increases were partially offset by the company’s new South Region TRICARE contract being accounted for as self-funded versus fully-insured for the previous contract. This new contract became effective on April 1, 2012.
1H12 consolidated revenues rose $1.44 billion, or 8 percent to $19.92 billion from $18.48 billion in 1H11 with total premiums and services revenue of $19.73 billion also up 8 percent, increasing $1.43 billion compared to $18.30 billion in the prior year’s period, driven primarily by the same factors as the second quarter year-over-year increase.
Benefit expenses – The 2Q12 consolidated benefit ratio (benefit expenses as a percent of premiums) of 83.5 percent increased 140 basis points from 82.1 percent for the prior year’s quarter due primarily to higher year-over-year benefit ratios for the Retail and Employer Group segments. The consolidated benefit ratio for 1H12 of 84.5 percent increased by 150 basis points from the 1H11 consolidated benefit ratio of 83.0 percent primarily due to the same factors impacting the 2Q12 year-over-year comparison.
Operating costs – The consolidated operating cost ratio (operating costs as a percent of total revenues less investment income) of 14.4 percent increased 140 basis points for 2Q12 compared to 13.0 percent in 2Q11. The increased year-over-year ratio primarily reflects the impact of the accounting for the company’s new South Region TRICARE contract discussed above.
The 1H12 consolidated operating cost ratio of 14.0 percent increased 60 basis points from 13.4 percent for 1H11 primarily due to the same factor impacting the second quarter year-over-year comparison.
Retail Segment Highlights
Pretax results:
- Retail Segment pretax income of $367 million in 2Q12 decreased $136 million from $503 million in 2Q11. For 1H12, pretax earnings for the Retail Segment of $482 million decreased by $238 million versus 1H11 pretax earnings for the segment of $720 million. These decreases were primarily driven by year-over-year increases in both the segment’s benefit ratio and its operating cost ratio during 2Q12 and 1H12.
Enrollment:
- Individual Medicare Advantage membership was 1,895,800 at June 30, 2012, an increase of 293,300 members, or 18 percent, from 1,602,500 at June 30, 2011. Individual Medicare Advantage membership has increased 255,500 or 16 percent from 1,640,300 at December 31, 2011.
- The company acquired 12,100 members with the acquisition of MD Care effective December 30, 2011 and 62,600 members from the acquisition of Arcadian Management Services, Inc. (Arcadian) effective March 31, 2012. As previously announced, the company expects to divest approximately 12,600 members acquired with Arcadian effective January 1, 2013 in accordance with the company’s previously disclosed agreement with the United States Department of Justice.
- Membership in the company’s individual stand-alone Prescription Drug Plans (PDPs) of 2,896,800 at June 30, 2012 was up 488,100, or 20 percent compared to 2,408,700 at June 30, 2011 and up 356,400, or 14 percent, from 2,540,400 at December 31, 2011. These increases resulted primarily from growth in the company’s Humana-Walmart plan offering.
- HumanaOne® medical membership increased to 443,800 at June 30, 2012, an increase of 40,100 or 10 percent, from 403,700 at June 30, 2011 and an increase of 10,200, or 2 percent, from 433,600 at December 31, 2011.
- Membership in individual specialty products(a) of 906,200 at June 30, 2012 increased 225,700, or 33 percent, from 680,500 at June 30, 2011 and increased 123,700, or 16 percent from 782,500 at December 31, 2011. Both the sequential and year-over-year increases were primarily driven by increased sales in dental offerings.
Premiums and services revenue:
- 2Q12 premiums and services revenue for the Retail Segment totaled $6.28 billion, an increase of $882 million, or 16 percent from $5.40 billion in 2Q11. The increase was primarily the result of year-over-year membership growth for individual Medicare Advantage plans.
Benefit expenses:
- The 2Q12 benefit ratio for the Retail Segment was 84.1 percent, an increase of 270 basis points from 81.4 percent in 2Q11. The increase was primarily driven by the planned increase associated with positioning for Health Care Reform funding changes and minimum medical loss ratio requirements, a higher-than-previously expected Medicare Advantage benefit ratio associated with new members and increased utilization for both new and existing members as well as a year-over-year increase in clinicians and other health care quality expenditures given the continued growth in membership.
- Retail Segment prior-year favorable medical claims reserve development for 2Q12 of $24 million compared to $32 million in 2Q11 lowered the related benefit ratio by 40 basis points in 2Q12 and 60 basis points in 2Q11.
Operating costs:
- The Retail Segment’s operating cost ratio of 10.0 percent in 2Q12 increased 90 basis points from 9.1 percent in 2Q11 reflecting higher year-over-year clinical, provider and technological infrastructure spending.
Employer Group Segment Highlights
Pretax results:
- Employer Group Segment pretax income of $114 million in 2Q12 increased $6 million compared to $108 million in 2Q11 as the benefit of a lower operating cost ratio during 2Q12 more than offset the year-over-year impact of a higher benefit ratio. For 1H12, pretax earnings for the Employer Group Segment of $235 million decreased by $12 million versus 1H11 pretax earnings for the segment of $247 million primarily reflecting a year-over-year increase in this segment’s benefit ratio partially offset by a lower operating cost ratio compared to 1H11.
Enrollment:
- Group Medicare Advantage membership was 388,400 at June 30, 2012, an increase of 78,700 members, or 25 percent, from 309,700 at June 30, 2011, and an increase of 70,200, or 22 percent, from 318,200 at December 31, 2011. These increases primarily reflect the addition of a large group retiree account that became effective January 1, 2012.
- Group fully-insured commercial medical membership of 1,196,900 at June 30, 2012, increased 10,700, or 1 percent from 1,186,200 at June 30, 2011 and 16,700, or 1 percent from 1,180,200 at December 31, 2011. Second quarter year-over-year and year-to-date changes primarily reflected growth in small group membership being partially offset by declines in large group business.
- Group ASO commercial medical membership declined to 1,228,800 at June 30, 2012, a decrease of 84,800, or 6 percent, from 1,313,600 at June 30, 2011 and a decrease of 63,500, or 5 percent, from 1,292,300 at December 31, 2011. These declines reflected a continuation of pricing discipline in a highly competitive environment for self-funded accounts.
- Membership in Employer Group specialty products(a) of 6,957,800 at June 30, 2012 increased 288,200, or 4 percent, from 6,669,600 at June 30, 2011 and increased 425,200, or 7 percent from 6,532,600 at December 31, 2011 primarily due to increased cross-sales of such products and growth in stand-alone specialty product sales.
Premiums and services revenue:
- 2Q12 premiums and services revenue for the Employer Group Segment totaled $2.62 billion, an increase of $309 million, or 13 percent from $2.31 billion in 2Q11 due primarily to the result of increased group Medicare Advantage membership year over year.
Benefit expenses:
- The 2Q12 benefit ratio for the Employer Group Segment was 82.2 percent, an increase of 100 basis points from 81.2 percent in 2Q11 primarily due to higher average group Medicare membership year over year. Group Medicare benefit ratios generally carry a higher benefit ratio than commercial group medical products.
- Employer Group Segment prior-year favorable medical claims reserve development for 2Q12 of $12 million compared to unfavorable development of $8 million in 2Q11. As a result, this segment’s benefit ratio was lowered by 50 basis points in 2Q12 and increased by 40 basis points in 2Q11.
Operating costs:
- The Employer Group Segment’s operating cost ratio of 15.9 percent in 2Q12 decreased 90 basis points from 16.8 percent in 2Q11 reflecting increased year-over-year membership in the company’s group Medicare Advantage products which generally carry a lower operating cost ratio than the company’s fully-insured commercial group products, as well as savings associated with operating cost reduction initiatives.
Health and Well-Being Services Segment Highlights
Pretax results:
- Health and Well-Being Services Segment pretax income of $131 million in 2Q12 rose $43 million compared to $88 million in 2Q11 reflecting growth in the company’s pharmacy solutions business, including higher utilization of the company’s RightSourceRx® mail-order pharmacy by the company’s members. For 1H12, pretax earnings for the Health and Well-Being Services Segment of $263 million increased by $78 million versus 1H11 pretax earnings for the segment of $185 million.
Script volume:
- Script volumes for the Retail and Employer Group Segments’ membership increased to approximately 59 million in 2Q12, up 8 million, or 15 percent, versus 2Q11 scripts of approximately 51 million. The year-over-year increase primarily reflects growth associated with higher average medical membership for 2Q12 than in 2Q11.
Services revenue:
- Services revenue of $3.22 billion in 2Q12 for the Health and Well-Being Services Segment increased $484 million, or 18 percent from $2.73 billion in 2Q11. This increase was primarily driven by growth in the company’s Medicare Advantage membership, who use the company’s pharmacy benefit management services under its health plan offerings, as well as increased utilization of RightSourceRx mail-order pharmacy by the company’s membership across all product lines.
Operating costs:
- The Health and Well-Being Services Segment’s operating cost ratio of 95.2 percent in 2Q12 decreased 80 basis points from 96.0 percent in 2Q11 reflecting better administrative cost leverage and improved wholesale drug costs associated with higher script volumes in the company’s RightSourceRx mail-order pharmacy.
Other Businesses Highlights
- On April 1, 2012, the company’s new South Region TRICARE contract became effective with the Department of Defense (DoD). The company’s new contract is structured similar to self-funded products versus a fully-insured structure for the company’s previous South Region TRICARE contract with the DoD. This change resulted in significant volatility in year-over-year comparisons for the company’s Other Businesses.
- During 2Q12, the company incurred benefit expenses of approximately $46 million, or $0.18 per share, related to the resolution of certain previously-disclosed litigation involving Humana Military Healthcare Services, Inc.
Balance Sheet
- At June 30, 2012, the company’s cash, cash equivalents, and investment securities of $13.53 billion, increased $285 million, or 2 percent from $13.25 billion at March 31, 2012.
- Parent company cash and investments of $1.28 billion at June 30, 2012 increased $1.06 billion from $225 million at March 31, 2012, primarily reflecting dividends to the parent company from the operating subsidiaries. These dividends were partially offset by share repurchases and the payment of a cash dividend to stockholders during the second quarter.
- Days in claims payable were 51.0 at June 30, 2012, up 0.9 days from 50.1 at March 31, 2012.
- Debt-to-total capitalization at June 30, 2012 was 16.1 percent, down 30 basis points compared to 16.4 percent at March 31, 2012 primarily driven by higher capitalization associated with second quarter earnings.
Cash Flows from Operations
Cash flows provided by operations for 2Q12 totaled $706 million compared to cash flows provided by operations of $161 million in 2Q11. For the first half of 2012, cash flows provided by operations totaled $3.05 billion versus $957 million in cash flows from operations during the first half of 2011. The company also evaluates operating cash flows on a non-GAAP(b) basis:
Net cash provided by operating activities
(in millions) |
2Q12 | 2Q11 | 1H12 | 1H11 | ||||||||||
GAAP | $ | 706 | $ | 161 | $ | 3,052 | $ | 957 | ||||||
CMS Medicare premium payment timing (c) | (118 | ) |
- |
(2,133 | ) |
- |
||||||||
Non-GAAP (b) | $ | 588 | $ | 161 | $ | 919 | $ | 957 | ||||||
The year over year decrease in the non-GAAP(b) cash flows from operations is due to the effect on cash flows of changes in working capital accounts.
Share Repurchase Program and Cash Dividend
- During 2Q12, the company repurchased 1,579,000 of its outstanding shares at an average price per share of $79.94 in connection with a share repurchase authorization for up to $1 billion approved by the company’s Board of Directors in April 2012. As of June 30, 2012, $874 million of the April 2012 share repurchase authorization was remaining, with an expiration date of June 30, 2014.
- A cash dividend payment of approximately $42 million, or $0.26 per share, for stockholders of record as of June 29, 2012, was paid on July 27, 2012 as approved by the company’s Board of Directors in accordance with its quarterly cash dividend policy.
Footnotes
(a) |
The company provides a full range of insured specialty products including dental, vision and other supplemental products. Members included in these products may not be unique to each product since members have the ability to enroll in multiple products. Other supplemental benefits include life, disability, and fixed benefit products including cancer and critical illness policies. |
(b) |
The Company has included certain financial measures that are not in accordance with Generally Accepted Accounting Principles (GAAP) in its summary of financial results within this earnings press release. The company believes that these non-GAAP measures, when presented in conjunction with comparable GAAP measures, are useful to both management and its investors in analyzing the company's ongoing business and operating performance. Internally, management uses these non-GAAP financial measures as indicators of business performance, as well as for operational planning and decision making purposes. Non-GAAP financial measures should be considered in addition to, but not as a substitute for, or superior to, financial measures prepared in accordance with GAAP. |
(c) |
Generally, when the first day of a month falls on a weekend or holiday, with the exception of January 1 (New Year’s Day), the company receives this payment at the end of the previous month. Therefore 1Q12 included four monthly Medicare payments compared to only three monthly Medicare payments in 1Q11. While 2Q12 included three monthly payments as did 2Q11 the three payments in 2Q12 were related to May, June and July versus April, May, and June in 2Q11. |
Conference Call & Virtual Slide Presentation
Humana will host a conference call, as well as a virtual slide presentation, at 5:00 p.m. eastern time today to discuss its financial results for the quarter and the company’s expectations for future earnings. A live virtual presentation (audio with slides) may be accessed via Humana’s Investor Relations page at www.humana.com. The company suggests web participants sign on at least 15 minutes in advance of the call. The company also suggests web participants visit the site well in advance of the call to run a system test and to download any free software needed to view the presentation.
All parties interested in the audio-only portion of the conference call are invited to dial 888-625-7430. No password is required. The company suggests participants dial in at least ten minutes in advance of the call. For those unable to participate in the live event, the virtual presentation archive may be accessed via the Historical Webcasts & Presentations section of the Investor Relations page at www.humana.com.
Cautionary Statement
This news release includes forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. When used in investor presentations, press releases, Securities and Exchange Commission (SEC) filings, and in oral statements made by or with the approval of one of Humana’s executive officers, the words or phrases like “expects,” “anticipates,” “intends,” “likely will result,” “estimates,” “projects” or variations of such words and similar expressions are intended to identify such forward-looking statements. These forward-looking statements are not guarantees of future performance and are subject to risks, uncertainties, and assumptions, including, among other things, information set forth in the “Risk Factors” section of the company’s SEC filings, a summary of which includes but is not limited to the following:
- If Humana does not design and price its products properly and competitively, if the premiums Humana charges are insufficient to cover the cost of health care services delivered to its members, or if its estimates of benefit expenses are inadequate, Humana’s profitability could be materially adversely affected. Humana estimates the costs of its benefit expense payments, and designs and prices its products accordingly, using actuarial methods and assumptions based upon, among other relevant factors, claim payment patterns, medical cost inflation, and historical developments such as claim inventory levels and claim receipt patterns. These estimates, however, involve extensive judgment, and have considerable inherent variability that is extremely sensitive to payment patterns and medical cost trends.
- If Humana fails to effectively implement its operational and strategic initiatives, including its Medicare initiatives, the company’s business may be materially adversely affected, which is of particular importance given the concentration of the company’s revenues in the Medicare business.
- If Humana fails to properly maintain the integrity of its data, to strategically implement new information systems, to protect Humana’s proprietary rights to its systems, or to defend against cyber-security attacks, the company’s business may be materially adversely affected.
- Humana’s business may be materially adversely impacted by CMS’s adoption of a new coding set for diagnoses.
- Humana is involved in various legal actions and governmental and internal investigations, including without limitation, an ongoing internal investigation and litigation and government requests for information related to certain aspects of its Florida subsidiary operations, any of which, if resolved unfavorably to the company, could result in substantial monetary damages. Increased litigation and negative publicity could increase the company’s cost of doing business.
- As a government contractor, Humana is exposed to risks that may materially adversely affect its business or its willingness or ability to participate in government health care programs.
- Recently enacted health insurance reform, including The Patient Protection and Affordable Care Act and The Health Care and Education Reconciliation Act of 2010, could have a material adverse effect on Humana’s results of operations, including restricting revenue, enrollment and premium growth in certain products and market segments, restricting the company’s ability to expand into new markets, increasing the company's medical and operating costs by, among other things, requiring a minimum benefit ratio on insured products (and particularly how the ratio may apply to Medicare plans, including aggregation, credibility thresholds, and its possible application to prescription drug plans), lowering the company’s Medicare payment rates and increasing the company’s expenses associated with a non-deductible federal premium tax and other assessments; financial position, including the company's ability to maintain the value of its goodwill; and cash flows. In addition, if the new non-deductible federal premium tax and other assessments, including a three-year commercial reinsurance fee, were imposed as enacted, and if Humana is unable to adjust its business model to address these new taxes and assessments, such as through the reduction of the company’s operating costs, there can be no assurance that the non-deductible federal premium tax and other assessments would not have a material adverse effect on the company’s results of operations, financial position, and cash flows.
- Humana’s business activities are subject to substantial government regulation. New laws or regulations, or changes in existing laws or regulations or their manner of application could increase the company’s cost of doing business and may adversely affect the company’s business, profitability and cash flows.
- Any failure to manage administrative costs could hamper Humana’s profitability.
- Any failure by Humana to manage acquisitions and other significant transactions successfully may have a material adverse effect on its results of operations, financial position, and cash flows.
- If Humana fails to develop and maintain satisfactory relationships with the providers of care to its members, the company’s business may be adversely affected.
- Humana’s pharmacy business is highly competitive and subjects it to regulations in addition to those the company faces with its core health benefits businesses.
- Changes in the prescription drug industry pricing benchmarks may adversely affect Humana’s financial performance.
- If Humana does not continue to earn and retain purchase discounts and volume rebates from pharmaceutical manufacturers at current levels, Humana’s gross margins may decline.
- Humana’s ability to obtain funds from its subsidiaries is restricted by state insurance regulations.
- Downgrades in Humana’s debt ratings, should they occur, may adversely affect its business, results of operations, and financial condition.
- Changes in economic conditions could adversely affect Humana’s business and results of operations.
- The securities and credit markets may experience volatility and disruption, which may adversely affect Humana’s business.
- Given the current economic climate, Humana’s stock and the stock of other companies in the insurance industry may be increasingly subject to stock price and trading volume volatility.
In making forward-looking statements, Humana is not undertaking to address or update them in future filings or communications regarding its business or results. In light of these risks, uncertainties, and assumptions, the forward-looking events discussed herein may or may not occur. There also may be other risks that the company is unable to predict at this time. Any of these risks and uncertainties may cause actual results to differ materially from the results discussed in the forward-looking statements.
Humana advises investors to read the following documents as filed by the company with the SEC for further discussion both of the risks it faces and its historical performance:
- Form 10-K for the year ended December 31, 2011;
- Form 10-Q for the quarter ending March 31, 2012;
- Form 8-Ks filed during 2012.
About Humana
Humana Inc., headquartered in Louisville, Kentucky, is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.
More information regarding Humana is available to investors via the Investor Relations page of the company’s web site at www.humana.com, including copies of:
- Annual reports to stockholders;
- Securities and Exchange Commission filings;
- Most recent investor conference presentations;
- Quarterly earnings news releases;
- Replays of most recent earnings release conference calls;
- Calendar of events (including upcoming earnings conference call dates and times, as well as planned interaction with research analysts and institutional investors);
- Corporate Governance information
Humana Inc. – Earnings Guidance Points as of July 30, 2012
(in accordance with | For the year ending December 31, 2012 | Comments |
Generally Accepted | ||
Accounting Principles) | ||
Diluted earnings | Full year 2012: $6.90 to $7.10 | Projections exclude the impact of future share |
per common share (EPS) | Third quarter 2012: $2.00 to $2.10 | repurchases |
Projections anticipate weighted average | ||
shares outstanding of 165 million | ||
Revenues | Consolidated revenues: $39.0 billion to $39.5 billion | Includes expected investment income in the |
range of $375 million to $395 million | ||
Total revenues: | Segment-level revenues include intersegment | |
Retail Segment: $24.5 billion to $25.0 billion | amounts that eliminate in consolidation | |
Employer Group Segment: $10.5 billion to $11.0 billion | ||
Health and Well-Being Services Segment: $13.1 billion to $13.3 billion | ||
Other Businesses: $2.50 billion to $2.75 billion | ||
Ending medical | Retail Segment: | |
membership versus | Medicare Advantage: Up 270,000 to 280,000 | |
prior year end | Medicare stand-alone PDPs: Up 420,000 to 520,000 | |
HumanaOne: Up 25,000 to 35,000 |
||
Medicare Supplement: Up 30,000 to 40,000 | ||
Employer Group Segment: | ||
Medicare Advantage: Up approximately 80,000 | ||
Commercial Fully Insured: Up 35,000 to 45,000 | ||
Commercial ASO: Down 50,000 to 60,000 | ||
Benefit ratios | Retail Segment: 84.2% to 85.2% | Benefit expenses as a percent of premiums |
Employer Group Segment: 84.0% to 85.0% | ||
Operating cost ratios | Consolidated: 14.75% to 15.25% | Consolidated operating costs as a percent of |
Health & Well-Being Services Segment: 95.25% to 95.75% | total revenues excluding investment income | |
Consolidated depreciation | $330 million to $345 million | Approximately $40 million is expected to be |
and amortization (cash | included in benefits expense on the income | |
flows) | statement | |
Consolidated interest | Approximately $105 million | |
expense | ||
Detailed pretax results | Retail Segment: | Segment-level pretax results and margins |
$1.0 billion to $1.1 billion; 4.2% to 4.4% pretax margin | include the impact of net investment income | |
Employer Group Segment: | ||
$205 million to $215 million; Approximately 2% pretax margin | ||
Health and Well-Being Services Segment: | ||
$505 million to $515 million; 3.75% to 4.25% pretax margin | ||
Effective Tax Rate | Approximately 36.7% | |
Cash flows from | $1.6 billion to $1.8 billion | |
operations | ||
Capital expenditures | Approximately $375 million |
Humana Inc. |
Statistical Schedules |
And |
Supplementary Information |
2Q12 Earnings Release |
S-1 |
|
Humana Inc. | |
Statistical Schedules and Supplementary Information | |
2Q12 Earnings Release | |
Contents | |
Page |
Description |
S-3-4 | Consolidated Statements of Income |
S-5-6 | Quarterly Segment Financial Information |
S-7-8 | YTD Segment Financial Information |
S-9 | Consolidated Balance Sheets |
S-10-11 | Consolidated Statements of Cash Flows |
S-12 | Key Income Statement Ratios and Segment Operating Results |
S-13 | Pharmacy Statistics |
S-14 | Membership Detail |
S-15-16 | Premiums and Services Revenue Detail |
S-17 | Medicare Summary |
S-18 | Investments |
S-19-21 | Benefits Payable |
S-22 | Footnotes |
S-2 |
Humana Inc. | |||||||||||||
Consolidated Statements of Income | |||||||||||||
In millions, except per common share results | |||||||||||||
Three Months Ended June 30, | |||||||||||||
Dollar | Percentage | ||||||||||||
2012 | 2011 | Change | Change | ||||||||||
Revenues: | |||||||||||||
Premiums | $ | 9,166 | $ | 8,849 | $ | 317 | 3.6 | % | |||||
Services | 434 | 344 | 90 | 26.2 | % | ||||||||
Investment income | 99 | 91 | 8 | 8.8 | % | ||||||||
Total revenues | 9,699 | 9,284 | 415 | 4.5 | % | ||||||||
Operating expenses: | |||||||||||||
Benefits | 7,652 | 7,269 | 383 | 5.3 | % | ||||||||
Operating costs | 1,384 | 1,193 | 191 | 16.0 | % | ||||||||
Depreciation and amortization | 73 | 68 | 5 | 7.4 | % | ||||||||
Total operating expenses | 9,109 | 8,530 | 579 | 6.8 | % | ||||||||
Income from operations | 590 | 754 | (164 | ) | -21.8 | % | |||||||
Interest expense | 26 | 28 | (2 | ) | -7.1 | % | |||||||
Income before income taxes | 564 | 726 | (162 | ) | -22.3 | % | |||||||
Provision for income taxes | 208 | 266 | (58 | ) | -21.8 | % | |||||||
Net income | $ | 356 | $ | 460 | $ | (104 | ) | -22.6 | % | ||||
Basic earnings per common share | $ | 2.19 | $ | 2.76 | $ | (0.57 | ) | -20.7 | % | ||||
Diluted earnings per common share | $ | 2.16 | $ | 2.71 | $ | (0.55 | ) | -20.3 | % | ||||
Shares used in computing basic earnings per common share (000's) | 162,816 | 167,021 | |||||||||||
Shares used in computing diluted earnings per common share (000's) | 164,639 | 169,560 | |||||||||||
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S-3 |
Humana Inc. | |||||||||||||
Consolidated Statements of Income | |||||||||||||
In millions, except per common share results | |||||||||||||
Six Months Ended June 30, | |||||||||||||
Dollar | Percentage | ||||||||||||
2012 | 2011 | Change | Change | ||||||||||
Revenues: | |||||||||||||
Premiums | $ | 18,941 | $ | 17,616 | $ | 1,325 | 7.5 | % | |||||
Services | 784 | 679 | 105 | 15.5 | % | ||||||||
Investment income | 193 | 180 | 13 | 7.2 | % | ||||||||
Total revenues | 19,918 | 18,475 | 1,443 | 7.8 | % | ||||||||
Operating expenses: | |||||||||||||
Benefits | 16,002 | 14,614 | 1,388 | 9.5 | % | ||||||||
Operating costs | 2,767 | 2,449 | 318 | 13.0 | % | ||||||||
Depreciation and amortization | 143 | 134 | 9 | 6.7 | % | ||||||||
Total operating expenses | 18,912 | 17,197 | 1,715 | 10.0 | % | ||||||||
Income from operations | 1,006 | 1,278 | (272 | ) | -21.3 | % | |||||||
Interest expense | 52 | 55 | (3 | ) | -5.5 | % | |||||||
Income before income taxes | 954 | 1,223 | (269 | ) | -22.0 | % | |||||||
Provision for income taxes | 350 | 448 | (98 | ) | -21.9 | % | |||||||
Net income | $ | 604 | $ | 775 | $ | (171 | ) | -22.1 | % | ||||
Basic earnings per common share | $ | 3.70 | $ | 4.64 | $ | (0.94 | ) | -20.3 | % | ||||
Diluted earnings per common share | $ | 3.65 | $ | 4.57 | $ | (0.92 | ) | -20.1 | % | ||||
Shares used in computing basic earnings per common share (000's) | 163,267 | 167,146 | |||||||||||
Shares used in computing diluted earnings per common share (000's) | 165,363 | 169,547 | |||||||||||
S-4 |
Humana Inc. | ||||||||||||||||||||||||
2Q12 Segment Financial Information | ||||||||||||||||||||||||
In millions | ||||||||||||||||||||||||
Health and | ||||||||||||||||||||||||
Employer | Well-Being | Other | Eliminations/ | |||||||||||||||||||||
|
Retail |
Group | Services | Businesses | Corporate | Consolidated | ||||||||||||||||||
Revenues - external customers | ||||||||||||||||||||||||
Premiums: | ||||||||||||||||||||||||
Medicare Advantage | $ | 5,308 | $ | 1,011 | $ | - | $ | - | $ | - | $ | 6,319 | ||||||||||||
Medicare stand-alone PDP | 672 | 2 | - | 73 | - | 747 | ||||||||||||||||||
Total Medicare | 5,980 | 1,013 | - | 73 | - | 7,066 | ||||||||||||||||||
Fully-insured | 250 | 1,247 | - | - | - | 1,497 | ||||||||||||||||||
Specialty | 42 | 262 | - | - | - | 304 | ||||||||||||||||||
Military services | - | - | - | 44 | - | 44 | ||||||||||||||||||
Medicaid and other (A) | - | - | - | 255 | - | 255 | ||||||||||||||||||
Total premiums | 6,272 | 2,522 | - | 372 | - | 9,166 | ||||||||||||||||||
Services revenue: | ||||||||||||||||||||||||
Provider | - | - | 245 | - | - | 245 | ||||||||||||||||||
ASO and other (B) | 5 | 89 | - | 91 | - | 185 | ||||||||||||||||||
Pharmacy | - | - | 4 | - | - | 4 | ||||||||||||||||||
Total services revenue | 5 | 89 | 249 | 91 | - | 434 | ||||||||||||||||||
Total revenues - external customers | 6,277 | 2,611 | 249 | 463 | - | 9,600 | ||||||||||||||||||
Intersegment revenues | ||||||||||||||||||||||||
Services | 1 | 4 | 2,377 | - | (2,382 | ) | - | |||||||||||||||||
Products | - | - | 591 | - | (591 | ) | - | |||||||||||||||||
Total intersegment revenues | 1 | 4 | 2,968 | - | (2,973 | ) | - | |||||||||||||||||
Investment income | 20 | 10 | - | 15 | 54 | 99 | ||||||||||||||||||
Total revenues | 6,298 | 2,625 | 3,217 | 478 | (2,919 | ) | 9,699 | |||||||||||||||||
Operating expenses: | ||||||||||||||||||||||||
Benefits | 5,273 | 2,074 | - | 406 | (101 | ) | 7,652 | |||||||||||||||||
Operating costs | 625 | 417 | 3,064 | 123 | (2,845 | ) | 1,384 | |||||||||||||||||
Depreciation and amortization | 33 | 20 | 22 | 4 | (6 | ) | 73 | |||||||||||||||||
Total operating expenses | 5,931 | 2,511 | 3,086 | 533 | (2,952 | ) | 9,109 | |||||||||||||||||
Income from operations | 367 | 114 | 131 | (55 | ) | 33 | 590 | |||||||||||||||||
Interest expense | - | - | - | - | 26 | 26 | ||||||||||||||||||
Income (loss) before income taxes | $ | 367 | $ | 114 | $ | 131 | $ | (55 | ) | $ | 7 | $ | 564 | |||||||||||
Benefit ratio | 84.1 | % | 82.2 | % | 109.1 | % | 83.5 | % | ||||||||||||||||
Operating cost ratio (C) | 10.0 | % | 15.9 | % | 95.2 | % | 26.6 | % | 14.4 | % | ||||||||||||||
S-5 |
Humana Inc. | ||||||||||||||||||||||||
2Q11 Segment Financial Information | ||||||||||||||||||||||||
In millions | ||||||||||||||||||||||||
Health and | ||||||||||||||||||||||||
Employer | Well-Being | Other | Eliminations/ | |||||||||||||||||||||
Retail | Group | Services | Businesses | Corporate | Consolidated | |||||||||||||||||||
Revenues - external customers | ||||||||||||||||||||||||
Premiums: | ||||||||||||||||||||||||
Medicare Advantage | $ | 4,555 | $ | 764 | $ | - | $ | - | $ | - | $ | 5,319 | ||||||||||||
Medicare stand-alone PDP | 601 | 2 | - | 77 | - | 680 | ||||||||||||||||||
Total Medicare | 5,156 | 766 | - | 77 | - | 5,999 | ||||||||||||||||||
Fully-insured | 206 | 1,217 | - | - | - | 1,423 | ||||||||||||||||||
Specialty | 30 | 233 | - | - | - | 263 | ||||||||||||||||||
Military services | - | - | - | 935 | - | 935 | ||||||||||||||||||
Medicaid and other (A) | - | - | - | 229 | - | 229 | ||||||||||||||||||
Total premiums | 5,392 | 2,216 | - | 1,241 | - | 8,849 | ||||||||||||||||||
Services revenue: | ||||||||||||||||||||||||
Provider | - | - | 222 | - | - | 222 | ||||||||||||||||||
ASO and other (B) | 4 | 87 | - | 28 | - | 119 | ||||||||||||||||||
Pharmacy | - | - | 3 | - | - | 3 | ||||||||||||||||||
Total services revenue | 4 | 87 | 225 | 28 | - | 344 | ||||||||||||||||||
Total revenues - external customers | 5,396 | 2,303 | 225 | 1,269 | - | 9,193 | ||||||||||||||||||
Intersegment revenues | ||||||||||||||||||||||||
Services | - | 3 | 2,074 | - | (2,077 | ) | - | |||||||||||||||||
Products | - | - | 434 | - | (434 | ) | - | |||||||||||||||||
Total intersegment revenues | - | 3 | 2,508 | - | (2,511 | ) | - | |||||||||||||||||
Investment income | 19 | 12 | - | 13 | 47 | 91 | ||||||||||||||||||
Total revenues | 5,415 | 2,318 | 2,733 | 1,282 | (2,464 | ) | 9,284 | |||||||||||||||||
Operating expenses: | ||||||||||||||||||||||||
Benefits | 4,390 | 1,800 | - | 1,149 | (70 | ) | 7,269 | |||||||||||||||||
Operating costs | 490 | 387 | 2,625 | 111 | (2,420 | ) | 1,193 | |||||||||||||||||
Depreciation and amortization | 32 | 23 | 20 | 3 | (10 | ) | 68 | |||||||||||||||||
Total operating expenses | 4,912 | 2,210 | 2,645 | 1,263 | (2,500 | ) | 8,530 | |||||||||||||||||
Income from operations | 503 | 108 | 88 | 19 | 36 | 754 | ||||||||||||||||||
Interest expense | - | - | - | - | 28 | 28 | ||||||||||||||||||
Income before income taxes | $ | 503 | $ | 108 | $ | 88 | $ | 19 | $ | 8 | $ | 726 | ||||||||||||
Benefit ratio | 81.4 | % | 81.2 | % | 92.6 | % | 82.1 | % | ||||||||||||||||
Operating cost ratio (C) | 9.1 | % | 16.8 | % | 96.0 | % | 8.7 | % | 13.0 | % | ||||||||||||||
S-6 |
Humana Inc. | ||||||||||||||||||||||||
YTD12 Segment Financial Information | ||||||||||||||||||||||||
In millions | ||||||||||||||||||||||||
Health and | ||||||||||||||||||||||||
Employer | Well-Being | Other | Eliminations/ | |||||||||||||||||||||
Retail | Group | Services | Businesses | Corporate | Consolidated | |||||||||||||||||||
Revenues - external customers | ||||||||||||||||||||||||
Premiums: | ||||||||||||||||||||||||
Medicare Advantage | $ | 10,401 | $ | 2,036 | $ | - | $ | - | $ | - | $ | 12,437 | ||||||||||||
Medicare stand-alone PDP | 1,332 | 4 | - | 139 | - | 1,475 | ||||||||||||||||||
Total Medicare | 11,733 | 2,040 | - | 139 | - | 13,912 | ||||||||||||||||||
Fully-insured | 494 | 2,489 | - | - | - | 2,983 | ||||||||||||||||||
Specialty | 80 | 522 | - | - | - | 602 | ||||||||||||||||||
Military services | - | - | - | 937 | - | 937 | ||||||||||||||||||
Medicaid and other (A) | - | - | - | 507 | - | 507 | ||||||||||||||||||
Total premiums | 12,307 | 5,051 | - | 1,583 | - | 18,941 | ||||||||||||||||||
Services revenue: | ||||||||||||||||||||||||
Provider | - | - | 478 | - | - | 478 | ||||||||||||||||||
ASO and other (B) | 11 | 178 | - | 109 | - | 298 | ||||||||||||||||||
Pharmacy | - | - | 8 | - | - | 8 | ||||||||||||||||||
Total services revenue | 11 | 178 | 486 | 109 | - | 784 | ||||||||||||||||||
Total revenues - external customers | 12,318 | 5,229 | 486 | 1,692 | - | 19,725 | ||||||||||||||||||
Intersegment revenues | ||||||||||||||||||||||||
Services | 1 | 8 | 4,863 | - | (4,872 | ) | - | |||||||||||||||||
Products | - | - | 1,175 | - | (1,175 | ) | - | |||||||||||||||||
Total intersegment revenues | 1 | 8 | 6,038 | - | (6,047 | ) | - | |||||||||||||||||
Investment income | 39 | 20 | - | 29 | 105 | 193 | ||||||||||||||||||
Total revenues | 12,358 | 5,257 | 6,524 | 1,721 | (5,942 | ) | 19,918 | |||||||||||||||||
Operating expenses: | ||||||||||||||||||||||||
Benefits | 10,560 | 4,138 | - | 1,512 | (208 | ) | 16,002 | |||||||||||||||||
Operating costs | 1,253 | 844 | 6,218 | 239 | (5,787 | ) | 2,767 | |||||||||||||||||
Depreciation and amortization | 63 | 40 | 43 | 8 | (11 | ) | 143 | |||||||||||||||||
Total operating expenses | 11,876 | 5,022 | 6,261 | 1,759 | (6,006 | ) | 18,912 | |||||||||||||||||
Income from operations | 482 | 235 | 263 | (38 | ) | 64 | 1,006 | |||||||||||||||||
Interest expense | - | - | - | - | 52 | 52 | ||||||||||||||||||
Income (loss) before income taxes | $ | 482 | $ | 235 | $ | 263 | $ | (38 | ) | $ | 12 | $ | 954 | |||||||||||
Benefit ratio | 85.8 | % | 81.9 | % | 95.5 | % | 84.5 | % | ||||||||||||||||
Operating cost ratio (C) | 10.2 | % | 16.1 | % | 95.3 | % | 14.1 | % | 14.0 | % | ||||||||||||||
S-7 |
Humana Inc. | ||||||||||||||||||||||||
YTD11 Segment Financial Information | ||||||||||||||||||||||||
In millions | ||||||||||||||||||||||||
Health and | ||||||||||||||||||||||||
Employer | Well-Being | Other | Eliminations/ | |||||||||||||||||||||
Retail | Group | Services | Businesses | Corporate | Consolidated | |||||||||||||||||||
Revenues - external customers | ||||||||||||||||||||||||
Premiums: | ||||||||||||||||||||||||
Medicare Advantage | $ | 9,080 | $ | 1,560 | $ | - | $ | - | $ | - | $ | 10,640 | ||||||||||||
Medicare stand-alone PDP | 1,158 | 4 | - | 153 | - | 1,315 | ||||||||||||||||||
Total Medicare | 10,238 | 1,564 | - | 153 | - | 11,955 | ||||||||||||||||||
Fully-insured | 407 | 2,416 | - | - | - | 2,823 | ||||||||||||||||||
Specialty | 56 | 463 | - | - | - | 519 | ||||||||||||||||||
Military services | - | - | - | 1,858 | - | 1,858 | ||||||||||||||||||
Medicaid and other (A) | - | - | - | 461 | - | 461 | ||||||||||||||||||
Total premiums | 10,701 | 4,443 | - | 2,472 | - | 17,616 | ||||||||||||||||||
Services revenue: | ||||||||||||||||||||||||
Provider | - | - | 437 | - | - | 437 | ||||||||||||||||||
ASO and other (B) | 7 | 180 | - | 50 | - | 237 | ||||||||||||||||||
Pharmacy | - | - | 5 | - | - | 5 | ||||||||||||||||||
Total services revenue | 7 | 180 | 442 | 50 | - | 679 | ||||||||||||||||||
Total revenues - external customers | 10,708 | 4,623 | 442 | 2,522 | - | 18,295 | ||||||||||||||||||
Intersegment revenues | ||||||||||||||||||||||||
Services | - | 6 | 4,195 | - | (4,201 | ) | - | |||||||||||||||||
Products | - | - | 869 | - | (869 | ) | - | |||||||||||||||||
Total intersegment revenues | - | 6 | 5,064 | - | (5,070 | ) | - | |||||||||||||||||
Investment income | 38 | 24 | - | 25 | 93 | 180 | ||||||||||||||||||
Total revenues | 10,746 | 4,653 | 5,506 | 2,547 | (4,977 | ) | 18,475 | |||||||||||||||||
Operating expenses: | ||||||||||||||||||||||||
Benefits | 8,944 | 3,552 | - | 2,258 | (140 | ) | 14,614 | |||||||||||||||||
Operating costs | 1,023 | 811 | 5,281 | 230 | (4,896 | ) | 2,449 | |||||||||||||||||
Depreciation and amortization | 59 | 43 | 40 | 5 | (13 | ) | 134 | |||||||||||||||||
Total operating expenses | 10,026 | 4,406 | 5,321 | 2,493 | (5,049 | ) | 17,197 | |||||||||||||||||
Income from operations | 720 | 247 | 185 | 54 | 72 | 1,278 | ||||||||||||||||||
Interest expense | - | - | - | - | 55 | 55 | ||||||||||||||||||
Income before income taxes | $ | 720 | $ | 247 | $ | 185 | $ | 54 | $ | 17 | $ | 1,223 | ||||||||||||
Benefit ratio | 83.6 | % | 79.9 | % | 91.3 | % | 83.0 | % | ||||||||||||||||
Operating cost ratio (C) | 9.6 | % | 17.5 | % | 95.9 | % | 9.1 | % | 13.4 | % | ||||||||||||||
S-8 |
Humana Inc. | ||||||||||||||
Consolidated Balance Sheets | ||||||||||||||
Dollars in millions, except share amounts | ||||||||||||||
June 30, | December 31, | Sequential Change | ||||||||||||
2012 | 2011 | Dollar | Percent | |||||||||||
Assets | ||||||||||||||
Current assets: | ||||||||||||||
Cash and cash equivalents | $ | 3,869 | $ | 1,377 | ||||||||||
Investment securities | 7,882 | 7,743 | ||||||||||||
Receivables, net | 898 | 1,034 | ||||||||||||
Other | 1,422 | 1,027 | ||||||||||||
Total current assets | 14,071 | 11,181 | $ | 2,890 | 25.8 | % | ||||||||
Property and equipment, net | 976 | 912 | ||||||||||||
Long-term investment securities | 1,783 | 1,710 | ||||||||||||
Goodwill | 2,792 | 2,740 | ||||||||||||
Other | 1,233 | 1,165 | ||||||||||||
Total assets | 20,855 | 17,708 | $ | 3,147 | 17.8 | % | ||||||||
Liabilities and Stockholders' Equity | ||||||||||||||
Current liabilities: | ||||||||||||||
Benefits payable | 3,994 | 3,754 | ||||||||||||
Trade accounts payable and accrued expenses | 2,081 | 1,783 | ||||||||||||
Book overdraft | 260 | 306 | ||||||||||||
Unearned revenues | 2,341 | 213 | ||||||||||||
Total current liabilities | 8,676 | 6,056 | $ | 2,620 | 43.3 | % | ||||||||
Long-term debt | 1,618 | 1,659 | ||||||||||||
Future policy benefits payable | 1,785 | 1,663 | ||||||||||||
Other long-term liabilities | 321 | 267 | ||||||||||||
Total liabilities | 12,400 | 9,645 | $ | 2,755 | 28.6 | % | ||||||||
Commitments and contingencies | ||||||||||||||
Stockholders' equity: | ||||||||||||||
Preferred stock, $1 par; 10,000,000 shares authorized, none issued | - | - | ||||||||||||
Common stock, $0.16 2/3 par; 300,000,000 shares authorized; 194,250,130 issued at June 30, 2012 |
32 | 32 | ||||||||||||
Capital in excess of par value | 2,063 | 1,938 | ||||||||||||
Retained earnings | 7,346 | 6,825 | ||||||||||||
Accumulated other comprehensive income | 327 | 303 | ||||||||||||
Treasury stock, at cost, 32,537,691 shares at June 30, 2012 | (1,313 | ) | (1,035 | ) | ||||||||||
Total stockholders' equity | 8,455 | 8,063 | $ | 392 | 4.9 | % | ||||||||
Total liabilities and stockholders' equity | $ | 20,855 | $ | 17,708 | $ | 3,147 | 17.8 | % | ||||||
Debt-to-total capitalization ratio | 16.1 | % | 17.1 | % | ||||||||||
S-9 |
Humana Inc. | |||||||||||||||
Consolidated Statements of Cash Flows | |||||||||||||||
Dollars in millions | |||||||||||||||
Three Months Ended June 30, | |||||||||||||||
Dollar | Percentage | ||||||||||||||
2012 | 2011 | Change | Change | ||||||||||||
Cash flows from operating activities | |||||||||||||||
Net income | $ | 356 | $ | 460 | |||||||||||
Adjustments to reconcile net income to net cash provided by operating activities: |
|||||||||||||||
Depreciation and amortization | 82 | 75 | |||||||||||||
Net realized capital gains | (10 | ) | (1 | ) | |||||||||||
Stock-based compensation | 14 | 11 | |||||||||||||
(Benefit from) provision for deferred income taxes | - | (6 | ) | ||||||||||||
Changes in operating assets and liabilities excluding the effects of acquisitions: |
|||||||||||||||
Receivables | 432 | (327 | ) | ||||||||||||
Other assets | (112 | ) | (64 | ) | |||||||||||
Benefits payable | (114 | ) | 13 | ||||||||||||
Other liabilities | (1 | ) | (2 | ) | |||||||||||
Unearned revenues | 43 | (14 | ) | ||||||||||||
Other | 16 | 16 | |||||||||||||
Net cash provided by operating activities | 706 | 161 | $ | 545 | 338.5 | % | |||||||||
Cash flows from investing activities | |||||||||||||||
Acquisitions, net of cash acquired | (20 | ) | (6 | ) | |||||||||||
Purchases of property and equipment | (99 | ) | (58 | ) | |||||||||||
Purchases of investment securities | (650 | ) | (715 | ) | |||||||||||
Proceeds from maturities of investment securities | 333 | 333 | |||||||||||||
Proceeds from sales of investment securities | 287 | 278 | |||||||||||||
Net cash used in investing activities | (149 | ) | (168 | ) | $ | 19 | 11.3 | % | |||||||
Cash flows from financing activities | |||||||||||||||
Receipts (withdrawals) from contract deposits, net | (146 | ) | 5 | ||||||||||||
Change in book overdraft | (34 | ) | (35 | ) | |||||||||||
Common stock repurchases | (127 | ) | (212 | ) | |||||||||||
Excess tax benefit from stock-based compensation | 1 | 6 | |||||||||||||
Dividends paid | (41 | ) | - | ||||||||||||
Proceeds from stock option exercises and other | 3 | 55 | |||||||||||||
Net cash used in financing activities | (344 | ) | (181 | ) | ($163 | ) | -90.1 | % | |||||||
Increase (decrease) in cash and cash equivalents | 213 | (188 | ) | ||||||||||||
Cash and cash equivalents at beginning of period | 3,656 | 1,756 | |||||||||||||
Cash and cash equivalents at end of period | $ | 3,869 | $ | 1,568 | |||||||||||
S-10 |
Humana Inc. | |||||||||||||||
Consolidated Statements of Cash Flows | |||||||||||||||
Dollars in millions | |||||||||||||||
Six Months Ended June 30, | |||||||||||||||
Dollar | Percentage | ||||||||||||||
2012 | 2011 | Change | Change | ||||||||||||
Cash flows from operating activities | |||||||||||||||
Net income | $ | 604 | $ | 775 | |||||||||||
Adjustments to reconcile net income to net cash provided by operating activities: |
|||||||||||||||
Depreciation and amortization | 160 | 151 | |||||||||||||
Net realized capital gains | (14 | ) | (5 | ) | |||||||||||
Stock-based compensation | 54 | 41 | |||||||||||||
(Benefit from) provision for deferred income taxes | (9 | ) | 21 | ||||||||||||
Changes in operating assets and liabilities excluding | |||||||||||||||
the effects of acquisitions: | |||||||||||||||
Receivables | 177 | (587 | ) | ||||||||||||
Other assets | (250 | ) | (175 | ) | |||||||||||
Benefits payable | 170 | 484 | |||||||||||||
Other liabilities | 51 | 202 | |||||||||||||
Unearned revenues | 2,077 | 20 | |||||||||||||
Other | 32 | 30 | |||||||||||||
Net cash provided by operating activities | 3,052 | 957 | $ | 2,095 | 218.9 | % | |||||||||
Cash flows from investing activities | |||||||||||||||
Acquisitions, net of cash acquired | (76 | ) | (11 | ) | |||||||||||
Purchases of property and equipment | (185 | ) | (129 | ) | |||||||||||
Purchases of investment securities | (1,364 | ) | (1,902 | ) | |||||||||||
Proceeds from maturities of investment securities | 757 | 751 | |||||||||||||
Proceeds from sales of investment securities | 529 | 432 | |||||||||||||
Net cash used in investing activities | (339 | ) | (859 | ) | $ | 520 | 60.5 | % | |||||||
Cash flows from financing activities | |||||||||||||||
Receipts (withdrawals) from contract deposits, net | 152 | 188 | |||||||||||||
Repayment of long-term debt | (36 | ) | - | ||||||||||||
Change in book overdraft | (46 | ) | (192 | ) | |||||||||||
Common stock repurchases | (278 | ) | (301 | ) | |||||||||||
Excess tax benefit from stock-based compensation | 21 | 11 | |||||||||||||
Dividends paid | (82 | ) | - | ||||||||||||
Proceeds from stock option exercises and other | 48 | 91 | |||||||||||||
Net cash used in financing activities | (221 | ) | (203 | ) | ($18 | ) | -8.9 | % | |||||||
Increase (decrease) in cash and cash equivalents | 2,492 | (105 | ) | ||||||||||||
Cash and cash equivalents at beginning of period | 1,377 | 1,673 | |||||||||||||
Cash and cash equivalents at end of period | $ | 3,869 | $ | 1,568 | |||||||||||
S-11 |
Humana Inc. | |||||||||||||||||||||||||
Key Income Statement Ratios and Segment Operating Results | |||||||||||||||||||||||||
Dollars in millions | |||||||||||||||||||||||||
Three Months Ended June 30, | Six Months Ended June 30, | ||||||||||||||||||||||||
Percentage | Percentage | ||||||||||||||||||||||||
2012 | 2011 | Difference | Change | 2012 | 2011 | Difference | Change | ||||||||||||||||||
Benefit ratio | |||||||||||||||||||||||||
Retail | 84.1 | % | 81.4 | % | 2.7 | % | 85.8 | % | 83.6 | % | 2.2 | % | |||||||||||||
Employer Group | 82.2 | % | 81.2 | % | 1.0 | % | 81.9 | % | 79.9 | % | 2.0 | % | |||||||||||||
Other Businesses | 109.1 | % | 92.6 | % | 16.5 | % | 95.5 | % | 91.3 | % | 4.2 | % | |||||||||||||
Consolidated | 83.5 | % | 82.1 | % | 1.4 | % | 84.5 | % | 83.0 | % | 1.5 | % | |||||||||||||
Operating cost ratio (C) | |||||||||||||||||||||||||
Retail | 10.0 | % | 9.1 | % | 0.9 | % | 10.2 | % | 9.6 | % | 0.6 | % | |||||||||||||
Employer Group | 15.9 | % | 16.8 | % | -0.9 | % | 16.1 | % | 17.5 | % | -1.4 | % | |||||||||||||
Health and Well-Being Services | 95.2 | % | 96.0 | % | -0.8 | % | 95.3 | % | 95.9 | % | -0.6 | % | |||||||||||||
Other Businesses | 26.6 | % | 8.7 | % | 17.9 | % | 14.1 | % | 9.1 | % | 5.0 | % | |||||||||||||
Consolidated | 14.4 | % | 13.0 | % | 1.4 | % | 14.0 | % | 13.4 | % | 0.6 | % | |||||||||||||
Detail of pretax income (loss) | |||||||||||||||||||||||||
Retail | $367 | $503 | ($136 | ) | -27.0 | % | $482 | $720 | ($238 | ) | -33.1 | % | |||||||||||||
Employer Group | $114 | $108 | $6 | 5.6 | % | $235 | $247 | ($12 | ) | -4.9 | % | ||||||||||||||
Health and Well-Being Services | $131 | $88 | $43 | 48.9 | % | $263 | $185 | $78 | 42.2 | % | |||||||||||||||
Other Businesses | ($55 | ) | $19 | ($74 | ) | -389.5 | % | ($38 | ) | $54 | ($92 | ) | -170.4 | % | |||||||||||
Consolidated | $564 | $726 | ($162 | ) | -22.3 | % | $954 | $1,223 | ($269 | ) | -22.0 | % | |||||||||||||
S-12 |
Humana Inc. | |||||||||||||||||||||||||
Pharmacy Metrics | |||||||||||||||||||||||||
Script volume in thousands | |||||||||||||||||||||||||
Three Months Ended June 30, | Six Months Ended June 30, | ||||||||||||||||||||||||
2012 | 2011 | Difference | 2012 | 2011 | Difference | ||||||||||||||||||||
Generic Dispense Rate | |||||||||||||||||||||||||
Retail | |||||||||||||||||||||||||
Mail-Order | 89.0 | % | 86.8 | % | 2.2 | % | 88.3 | % | 86.1 | % | 2.2 | % | |||||||||||||
90-Day Retail | 86.6 | % | 83.2 | % | 3.4 | % | 86.2 | % | 83.0 | % | 3.2 | % | |||||||||||||
All Other | 80.7 | % | 77.7 | % | 3.0 | % | 79.8 | % | 77.3 | % | 2.5 | % | |||||||||||||
Total | 84.1 | % | 80.8 | % | 3.3 | % | 83.3 | % | 80.4 | % | 2.9 | % | |||||||||||||
Employer Group | |||||||||||||||||||||||||
Mail-order | 74.5 | % | 67.5 | % | 7.0 | % | 73.3 | % | 67.2 | % | 6.1 | % | |||||||||||||
90-Day Retail | 81.8 | % | 76.1 | % | 5.7 | % | 81.2 | % | 76.0 | % | 5.2 | % | |||||||||||||
All Other | 73.1 | % | 69.4 | % | 3.7 | % | 72.5 | % | 69.3 | % | 3.2 | % | |||||||||||||
Total Employer Group | 75.5 | % | 70.7 | % | 4.8 | % | 74.8 | % | 70.4 | % | 4.4 | % | |||||||||||||
Percentage | Percentage | ||||||||||||||||||||||||
Difference | Change | Difference | Change | ||||||||||||||||||||||
Script volume | |||||||||||||||||||||||||
Retail | |||||||||||||||||||||||||
Mail-order | 12,388 | 9,095 | 3,293 | 36.2 | % | 24,428 | 17,746 | 6,682 | 37.7 | % | |||||||||||||||
90-Day Retail | 12,823 | 10,654 | 2,169 | 20.4 | % | 25,132 | 20,528 | 4,604 | 22.4 | % | |||||||||||||||
All Other | 27,341 | 25,223 | 2,118 | 8.4 | % | 55,040 | 50,408 | 4,632 | 9.2 | % | |||||||||||||||
Total Retail | 52,552 | 44,972 | 7,580 | 16.9 | % | 104,600 | 88,682 | 15,918 | 17.9 | % | |||||||||||||||
Employer Group | |||||||||||||||||||||||||
Mail-order | 1,012 | 969 | 43 | 4.4 | % | 1,995 | 1,927 | 68 | 3.5 | % | |||||||||||||||
90-Day Retail | 1,565 | 1,443 | 122 | 8.5 | % | 3,047 | 2,740 | 307 | 11.2 | % | |||||||||||||||
All Other | 3,752 | 3,892 | (140 | ) | -3.6 | % | 7,555 | 7,817 | (262 | ) | -3.4 | % | |||||||||||||
Total Employer Group | 6,329 | 6,304 | 25 | 0.4 | % | 12,597 | 12,484 | 113 | 0.9 | % | |||||||||||||||
Total Retail and Employer Group | 58,881 | 51,276 | 7,605 | 14.8 | % | 117,197 | 101,166 | 16,031 | 15.8 | % | |||||||||||||||
S-13 |
Humana Inc. | ||||||||||||||||||||||
Membership Detail | ||||||||||||||||||||||
In thousands | ||||||||||||||||||||||
Ending |
Average |
Ending |
Year-over-year Change |
Ending December 31, 2011 |
Sequential Change | |||||||||||||||||
Amount | Percent | Amount | Percent | |||||||||||||||||||
Medical Membership: | ||||||||||||||||||||||
Retail | ||||||||||||||||||||||
Medicare Advantage | 1,895.8 | 1,891.3 | 1,602.5 | 293.3 | 18.3 | % | 1,640.3 | 255.5 | 15.6 | % | ||||||||||||
Medicare stand-alone PDPs | 2,896.8 | 2,884.5 | 2,408.7 | 488.1 | 20.3 | % | 2,540.4 | 356.4 | 14.0 | % | ||||||||||||
Individual commercial | 443.8 | 442.8 | 403.7 | 40.1 | 9.9 | % | 433.6 | 10.2 | 2.4 | % | ||||||||||||
Medicare Supplement | 70.5 | 69.3 | 52.9 | 17.6 | 33.3 | % | 59.6 | 10.9 | 18.3 | % | ||||||||||||
Total Retail | 5,306.9 | 5,287.9 | 4,467.8 | 839.1 | 18.8 | % | 4,673.9 | 633.0 | 13.5 | % | ||||||||||||
Employer Group | ||||||||||||||||||||||
Medicare Advantage | 360.5 | 359.4 | 282.0 | 78.5 | 27.8 | % | 290.6 | 69.9 | 24.1 | % | ||||||||||||
Medicare Advantage ASO | 27.9 | 27.9 | 27.7 | 0.2 | 0.7 | % | 27.6 | 0.3 | 1.1 | % | ||||||||||||
Medicare stand-alone PDPs | 4.4 | 4.4 | 4.1 | 0.3 | 7.3 | % | 4.2 | 0.2 | 4.8 | % | ||||||||||||
Fully-insured medical commercial | 1,196.9 | 1,191.2 | 1,186.2 | 10.7 | 0.9 | % | 1,180.2 | 16.7 | 1.4 | % | ||||||||||||
ASO commercial | 1,228.8 | 1,231.6 | 1,313.6 | (84.8 | ) | -6.5 | % | 1,292.3 | (63.5 | ) | -4.9 | % | ||||||||||
Total Employer Group | 2,818.5 | 2,814.5 | 2,813.6 | 4.9 | 0.2 | % | 2,794.9 | 23.6 | 0.8 | % | ||||||||||||
Other Businesses | ||||||||||||||||||||||
Military Services | 3,133.5 | 3,102.4 | 3,015.2 | 118.3 | 3.9 | % | 3,028.1 | 105.4 | 3.5 | % | ||||||||||||
Medicaid and other | 607.1 | 606.4 | 619.2 | (12.1 | ) | -2.0 | % | 614.2 | (7.1 | ) | -1.2 | % | ||||||||||
LI-NET (D) | 73.3 | 72.8 | 87.0 | (13.7 | ) | -15.7 | % | 73.5 | (0.2 | ) | -0.3 | % | ||||||||||
Total Other Businesses | 3,813.9 | 3,781.6 | 3,721.4 | 92.5 | 2.5 | % | 3,715.8 | 98.1 | 2.6 | % | ||||||||||||
Total Medical Membership | 11,939.3 | 11,884.0 | 11,002.8 | 936.5 | 8.5 | % | 11,184.6 | 754.7 | 6.7 | % | ||||||||||||
Specialty Membership: | ||||||||||||||||||||||
Retail | ||||||||||||||||||||||
Dental - fully-insured | 662.7 | 650.3 | 512.5 | 150.2 | 29.3 | % | 579.6 | 83.1 | 14.3 | % | ||||||||||||
Vision | 103.8 | 99.8 | 70.8 | 33.0 | 46.6 | % | 83.8 | 20.0 | 23.9 | % | ||||||||||||
Other supplemental benefits (E) | 139.7 | 137.6 | 97.2 | 42.5 | 43.7 | % | 119.1 | 20.6 | 17.3 | % | ||||||||||||
Total Retail | 906.2 | 887.7 | 680.5 | 225.7 | 33.2 | % | 782.5 | 123.7 | 15.8 | % | ||||||||||||
Employer Group | ||||||||||||||||||||||
Dental - fully-insured | 2,416.4 | 2,407.5 | 2,250.3 | 166.1 | 7.4 | % | 2,283.9 | 132.5 | 5.8 | % | ||||||||||||
Dental - ASO | 849.4 | 851.3 | 1,220.7 | (371.3 | ) | -30.4 | % | 869.9 | (20.5 | ) | -2.4 | % | ||||||||||
Vision | 2,456.3 | 2,442.0 | 2,227.0 | 229.3 | 10.3 | % | 2,329.6 | 126.7 | 5.4 | % | ||||||||||||
Other supplemental benefits (E) | 1,235.7 | 1,223.3 | 971.6 | 264.1 | 27.2 | % | 1,049.2 | 186.5 | 17.8 | % | ||||||||||||
Total Employer Group | 6,957.8 | 6,924.1 | 6,669.6 | 288.2 | 4.3 | % | 6,532.6 | 425.2 | 6.5 | % | ||||||||||||
Total Specialty Membership | 7,864.0 | 7,811.8 | 7,350.1 | 513.9 | 7.0 | % | 7,315.1 | 548.9 | 7.5 | % | ||||||||||||
S-14 |
Humana Inc. | |||||||||||||||||
Premiums and Services Revenue Detail | |||||||||||||||||
Dollars in millions, except per member per month | |||||||||||||||||
Per Member per Month (F) | |||||||||||||||||
Three Months Ended June 30, | Three Months Ended June 30, | ||||||||||||||||
Dollar | Percentage | ||||||||||||||||
2012 | 2011 | Change | Change | 2012 | 2011 | ||||||||||||
Premiums and Services Revenue | |||||||||||||||||
Retail: | |||||||||||||||||
Medicare Advantage | $ | 5,308 | $ | 4,555 | $ | 753 | 16.5 | % | $936 | $949 | |||||||
Medicare stand-alone PDPs | 672 | 601 | 71 | 11.8 | % | $78 | $84 | ||||||||||
Individual commercial | 215 | 181 | 34 | 18.8 | % | $162 | $152 | ||||||||||
Medicare Supplemental | 35 | 25 | 10 | 40.0 | % | $168 | $161 | ||||||||||
Specialty | 42 | 30 | 12 | 40.0 | % | $16 | $15 | ||||||||||
ASO & other services (B) | 6 | 4 | 2 | 50.0 | % | ||||||||||||
Total Retail | 6,278 | 5,396 | 882 | 16.3 | % | ||||||||||||
Employer Group: | |||||||||||||||||
Medicare Advantage | 1,011 | 764 | 247 | 32.3 | % | $938 | $905 | ||||||||||
Medicare stand-alone PDPs | 2 | 2 | - | 0.0 | % | ||||||||||||
Fully-insured medical commercial | 1,247 | 1,217 | 30 | 2.5 | % | $349 | $342 | ||||||||||
Specialty | 262 | 233 | 29 | 12.4 | % | $14 | $14 | ||||||||||
ASO & other services (B) | 93 | 90 | 3 | 3.3 | % | ||||||||||||
Total Employer Group | 2,615 | 2,306 | 309 | 13.4 | % | ||||||||||||
Health and Well-Being Services: | |||||||||||||||||
Pharmacy solutions | 2,833 | 2,406 | 427 | 17.7 | % | ||||||||||||
Primary care services | 292 | 265 | 27 | 10.2 | % | ||||||||||||
Home care services | 42 | 18 | 24 | 133.3 | % | ||||||||||||
Integrated wellness services | 50 | 44 | 6 | 13.6 | % | ||||||||||||
Total Health and Well-Being Services | 3,217 | 2,733 | 484 | 17.7 | % | ||||||||||||
Other Businesses: | |||||||||||||||||
Military services (G) | 130 | 959 | (829 | ) | -86.4 | % | $8 | $179 | |||||||||
LI-NET (D) | 73 | 77 | (4 | ) | -5.2 | % | $334 | $278 | |||||||||
Medicaid and other (H) | 260 | 233 | 27 | 11.6 | % | $140 | $123 | ||||||||||
Total Other Businesses | 463 | 1,269 | (806 | ) | -63.5 | % | |||||||||||
|
|
|
|
||||||||||||||
S-15 |
Humana Inc. | |||||||||||||||||
Premiums and Services Revenue Detail | |||||||||||||||||
Dollars in millions, except per member per month | |||||||||||||||||
Per Member per Month (F) | |||||||||||||||||
Six Months Ended June 30, | Six Months Ended June 30, | ||||||||||||||||
Dollar | Percentage | ||||||||||||||||
2012 | 2011 | Change | Change | 2012 | 2011 | ||||||||||||
Premiums and Services Revenue | |||||||||||||||||
Retail: | |||||||||||||||||
Medicare Advantage | $ | 10,401 | $ | 9,080 | $ | 1,321 | 14.5 | % | $930 | $948 | |||||||
Medicare stand-alone PDPs | 1,332 | 1,158 | 174 | 15.0 | % | $77 | $82 | ||||||||||
Individual commercial | 426 | 358 | 68 | 19.0 | % | $161 | $154 | ||||||||||
Medicare Supplemental | 68 | 49 | 19 | 38.8 | % | $167 | $162 | ||||||||||
Specialty | 80 | 56 | 24 | 42.9 | % | $16 | $15 | ||||||||||
ASO & other services (B) | 12 | 7 | 5 | 71.4 | % | ||||||||||||
Total Retail | 12,319 | 10,708 | 1,611 | 15.0 | % | ||||||||||||
Employer Group: | |||||||||||||||||
Medicare Advantage | 2,036 | 1,560 | 476 | 30.5 | % | $947 | $926 | ||||||||||
Medicare stand-alone PDPs | 4 | 4 | - | 0.0 | % | ||||||||||||
Fully-insured medical commercial | 2,489 | 2,416 | 73 | 3.0 | % | $349 | $341 | ||||||||||
Specialty | 522 | 463 | 59 | 12.7 | % | $14 | $14 | ||||||||||
ASO & other services (B) | 186 | 186 | - | 0.0 | % | ||||||||||||
Total Employer Group | 5,237 | 4,629 | 608 | 13.1 | % | ||||||||||||
Health and Well-Being Services: | |||||||||||||||||
Pharmacy solutions | 5,766 | 4,863 | 903 | 18.6 | % | ||||||||||||
Primary care services | 573 | 520 | 53 | 10.2 | % | ||||||||||||
Home care services | 78 | 34 | 44 | 129.4 | % | ||||||||||||
Integrated wellness services | 107 | 89 | 18 | 20.2 | % | ||||||||||||
Total Health and Well-Being Services | 6,524 | 5,506 | 1,018 | 18.5 | % | ||||||||||||
Other Businesses: | |||||||||||||||||
Military services (G) | 1,036 | 1,901 | (865 | ) | -45.5 | % | $90 | $177 | |||||||||
LI-NET (D) | 139 | 153 | (14 | ) | -9.2 | % | $313 | $265 | |||||||||
Medicaid and other (H) | 517 | 468 | 49 | 10.5 | % | $140 | $124 | ||||||||||
Total Other Businesses | 1,692 | 2,522 | (830 | ) | -32.9 | % | |||||||||||
S-16 |
Humana Inc. | ||||||||||||||||||||
Medicare Summary | ||||||||||||||||||||
Premiums in millions | ||||||||||||||||||||
Membership in thousands | ||||||||||||||||||||
Per Member per Month (F) | ||||||||||||||||||||
Three Months Ended June 30, | Year-over-year Change | Three Months Ended June 30, | ||||||||||||||||||
2012 | 2011 | Amount | Percent | 2012 | 2011 | |||||||||||||||
Premiums | ||||||||||||||||||||
Medicare Advantage | $ | 6,319 | $ | 5,319 | $ | 1,000 | 18.8 | % | $936 |
$942 |
||||||||||
Medicare stand-alone PDPs | 747 | 680 | 67 | 9.9 | % | $84 |
$91 |
|||||||||||||
Total Medicare | $ | 7,066 | $ | 5,999 | $ | 1,067 | 17.8 | % | ||||||||||||
Per Member per Month (F) | ||||||||||||||||||||
Six Months Ended June 30, | Year-over-year Change | Six Months Ended June 30, | ||||||||||||||||||
2012 | 2011 | Amount | Percent | 2012 | 2011 | |||||||||||||||
Premiums | ||||||||||||||||||||
Medicare Advantage | $ | 12,437 | $ | 10,640 | $ | 1,797 | 16.9 | % | $932 | $945 | ||||||||||
Medicare stand-alone PDPs | 1,475 | 1,315 | 160 | 12.2 | % | $84 | $89 | |||||||||||||
Total Medicare | $ | 13,912 | $ | 11,955 | $ | 1,957 | 16.4 | % | ||||||||||||
Ending | Ending | Year-over-year Change | ||||||||||||||||||
June 30, 2012 | June 30, 2011 | Amount | Percent | |||||||||||||||||
Fully-Insured Membership | ||||||||||||||||||||
Medicare Advantage | 2,256.3 | 1,884.5 | 371.8 | 19.7 | % | |||||||||||||||
Medicare stand-alone PDPs | 2,974.5 | 2,499.8 | 474.7 | 19.0 | % | |||||||||||||||
Total Medicare | 5,230.8 | 4,384.3 | 846.5 | 19.3 | % | |||||||||||||||
S-17 |
Humana Inc. | Fair value | ||||||||
Investments | |||||||||
Dollars in millions | |||||||||
6/30/2012 | 3/31/2012 | 12/31/2011 | |||||||
Investment Portfolio: | |||||||||
Cash & cash equivalents | $3,869 | $3,656 | $1,377 | ||||||
Investment securities | 7,882 | 7,889 | 7,743 | ||||||
Long-term investments | 1,783 | 1,704 | 1,710 | ||||||
Total investment portfolio | $13,534 | $13,249 | $10,830 | ||||||
Duration (I) | 3.24 | 3.33 | 3.94 | ||||||
Average Credit Rating | AA- | AA- | AA- | ||||||
Investment Portfolio Detail: | |||||||||
Cash and cash equivalents | $3,869 | $3,656 | $1,377 | ||||||
U.S. Government and agency obligations | |||||||||
U.S. Treasury and agency obligations | 553 | 550 | 725 | ||||||
U.S. Government residential mortgage-backed | 1,921 | 1,725 | 1,751 | ||||||
U.S. Government commercial mortgage-backed | 34 | 33 | 33 | ||||||
Total U.S. Government and agency obligations | 2,508 | 2,308 | 2,509 | ||||||
Tax-exempt municipal securities | |||||||||
Pre-refunded | 294 | 304 | 332 | ||||||
Insured | 631 | 645 | 634 | ||||||
Other | 1,946 | 1,928 | 1,874 | ||||||
Auction rate securities | 15 | 15 | 16 | ||||||
Total tax-exempt municipal securities | 2,886 | 2,892 | 2,856 | ||||||
Residential mortgage-backed | |||||||||
Prime residential mortgages | 36 | 38 | 41 | ||||||
Alt-A residential mortgages | 1 | 2 | 2 | ||||||
Sub-prime residential mortgages | 1 | 1 | 1 | ||||||
Total residential mortgage-backed | 38 | 41 | 44 | ||||||
Commercial mortgage-backed | 448 | 437 | 381 | ||||||
Asset-backed securities | 44 | 74 | 83 | ||||||
Corporate securities | |||||||||
Financial services | 818 | 867 | 692 | ||||||
Other | 2,923 | 2,974 | 2,888 | ||||||
Total corporate securities | 3,741 | 3,841 | 3,580 | ||||||
Redeemable preferred stocks | - | - | - | ||||||
Total investment portfolio | $13,534 | $13,249 | $10,830 | ||||||
S-18 |
|||||||||
Humana Inc. | ||||||||||||
Detail of Benefits Payable Balance and Year-to-Date Changes | ||||||||||||
Dollars in millions | ||||||||||||
June 30, | June 30, | December 31, | ||||||||||
2012 | 2011 | 2011 | ||||||||||
Detail of benefits payable | ||||||||||||
IBNR and other benefits payable (J) | $3,085 | $2,795 | $2,759 | |||||||||
Unprocessed claim inventories (K) | 310 | 410 | 280 | |||||||||
Processed claim inventories (L) | 359 | 274 | 209 | |||||||||
Payable to pharmacy benefit administrator (M) | 163 | 142 | 167 | |||||||||
Benefits payable, excluding military services | 3,917 | 3,621 | 3,415 | |||||||||
Military services benefits payable (N) | 77 | 332 | 339 | |||||||||
Total Benefits Payable | $3,994 | $3,953 | $3,754 | |||||||||
Six Months Ended | Six Months Ended | Year Ended | ||||||||||
June 30, 2012 | June 30, 2011 | December 31, 2011 | ||||||||||
Year-to-date changes in benefits payable, excluding military services (O) |
||||||||||||
Balances at January 1 | $3,415 | $3,214 | $3,214 | |||||||||
Acquisitions | 70 | 29 | ||||||||||
Incurred related to: | ||||||||||||
Current year | 15,169 | 13,158 | 25,821 | |||||||||
Prior years (P) | (181 | ) | (284 | ) | (372 | ) | ||||||
Total incurred | 14,988 | 12,874 | 25,449 | |||||||||
Paid related to: | ||||||||||||
Current year | (11,805 | ) | (10,083 | ) | (22,729 | ) | ||||||
Prior years | (2,751 | ) | (2,384 | ) | (2,548 | ) | ||||||
Total paid | (14,556 | ) | (12,467 | ) | (25,277 | ) | ||||||
Balances at end of period | $3,917 | $3,621 | $3,415 | |||||||||
Six Months Ended | Six Months Ended | Year Ended | ||||||||||
June 30, 2012 | June 30, 2011 | December 31, 2011 | ||||||||||
Summary of Consolidated Benefit Expense: | ||||||||||||
Total benefit expense incurred, per above | $14,988 | $12,874 | $25,449 | |||||||||
Military services benefit expense | 890 | 1,671 | 3,247 | |||||||||
Future policy benefit expense (Q) | 124 | 69 | 127 | |||||||||
Consolidated Benefit Expense | $16,002 | $14,614 | $28,823 | |||||||||
S-19 |
||||||||||||
Humana Inc. | ||||||||||||||
Benefits Payable Statistics (R) | ||||||||||||||
Receipt Cycle Time (S) | ||||||||||||||
2012 | 2011 | Change |
Percentage |
|||||||||||
1st Quarter Average | 13.0 | 13.8 | (0.8 | ) | -5.8 | % | ||||||||
2nd Quarter Average | 13.7 | 13.8 | (0.1 | ) | -0.7 | % | ||||||||
3rd Quarter Average | 13.6 | n/a | n/a | |||||||||||
4th Quarter Average | 14.0 | n/a | n/a | |||||||||||
Full Year Average | 13.4 | 13.8 | (0.4 | ) | -2.9 | % | ||||||||
Unprocessed Claims Inventories | ||||||||||||||
Date |
Estimated Valuation |
Claim Item |
Number of Days |
|||||||||||
6/30/2010 | $434 | 1,009 | 4.9 | |||||||||||
9/30/2010 | $429 | 1,064 | 5.2 | |||||||||||
12/31/2010 | $374 | 981 | 5.0 | |||||||||||
3/31/2011 | $482 | 1,197 | 6.0 | |||||||||||
6/30/2011 | $410 | 1,093 | 5.1 | |||||||||||
9/30/2011 | $419 | 1,272 | 5.7 | |||||||||||
12/31/2011 | $280 | 599 | 2.8 | |||||||||||
3/31/2012 | $376 | 1,028 | 4.2 | |||||||||||
6/30/2012 | $310 | 1,077 | 4.2 | |||||||||||
S-20 |
||||||||||||||
Humana Inc. | ||||||||||||||||
Benefits Payable Statistics (Continued) (R) | ||||||||||||||||
Days in Claims Payable (T) | ||||||||||||||||
Quarter Ended |
Days in Claims |
Change Last 4 |
Percentage |
|||||||||||||
6/30/2010 | 57.0 | 0.9 | 1.6 | % | ||||||||||||
9/30/2010 | 57.8 | 1.6 | 2.8 | % | ||||||||||||
12/31/2010 | 53.5 | (1.9 | ) | -3.4 | % | |||||||||||
3/31/2011 | 55.5 | 1.3 | 2.4 | % | ||||||||||||
6/30/2011 | 56.0 | (1.0 | ) | -1.8 | % | |||||||||||
9/30/2011 | 54.2 | (3.6 | ) | -6.2 | % | |||||||||||
12/31/2011 | 52.5 | (1.0 | ) | -1.9 | % | |||||||||||
3/31/2012 | 50.1 | (5.4 | ) | -9.7 | % | |||||||||||
6/30/2012 | 51.0 | (5.0 | ) | -8.9 | % | |||||||||||
Year-to-Date Change in Days in Claims Payable (U) | ||||||||||||||||
2012 | 2011 | |||||||||||||||
DCP - beginning of period | 52.5 | 53.5 | ||||||||||||||
Components of change in DCP: | ||||||||||||||||
Change in unprocessed claims inventories | 0.1 | (2.3 | ) | |||||||||||||
Change in processed claims inventories | 1.9 | 1.4 | ||||||||||||||
Change in pharmacy payment cutoff | (0.2 | ) | 0.6 | |||||||||||||
Change in capitation/provider settlements | (3.0 | ) | (0.7 | ) | ||||||||||||
All other | (0.3 | ) | ||||||||||||||
DCP - end of period | 51.0 | 52.5 | ||||||||||||||
S-21 |
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Humana Inc.
Footnotes to Statistical Schedules and Supplementary Information 2Q12 Earnings Release |
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(A) |
The Medicaid and other category includes the company’s Medicaid business as well as the closed block of long-term care. |
(B) |
The ASO and other category is primarily comprised of ASO fees and other ancillary services fees. |
(C) |
The operating cost ratio is defined as operating costs as a percent of total revenues excluding investment income. |
(D) |
LI-NET is the CMS Limited Income Newly Eligible Transition program, operated by Humana, to provide Part D prescription drug coverage for all uncovered Full Duals and SSI-only |
beneficiaries on a retroactive basis and all uncovered LIS eligible beneficiaries on a current basis. |
|
(E) |
Other supplemental benefits include life, disability, and fixed benefit products including cancer and critical illness policies. |
(F) |
Computed based on average membership for the period (i.e., monthly ending membership during the period divided by the number of months in the period). |
(G) |
Military services revenues are generally not contracted on a per-member basis. |
(H) |
Includes premiums associated with Medicaid and the closed block of long-term care as well as services revenue. |
(I) |
Duration is the time-weighted average of the present value of the fixed income portfolio cash flows. |
(J) |
IBNR represents an estimate of benefit expenses payable for claims incurred but not reported (IBNR) at the balance sheet date. The level of IBNR is primarily impacted by membership |
levels, benefit claim trends and the receipt cycle time, which represents the length of time between when a claim is initially incurred and when the claim form is received (i.e. a shorter time |
|
span results in lower reserves for claims IBNR). Other benefits payable includes amounts payable to providers under capitation arrangements. |
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(K) |
Unprocessed claim inventories represent the estimated valuation of claims received but not yet fully processed. |
(L) |
Processed claim inventories represent the estimated valuation of processed claims that are in the post-claim-adjudication process, which consists of administrative functions such as audit |
and check batching and handling. |
|
(M) |
The balance due to the company's pharmacy benefit administrator fluctuates as a result of the number of business days in the last payment cycle of the month. Payment cycles are every 8 |
days (8th, 16th, and 24th of month) and the last day of the month. |
|
(N) |
Military services benefits payable primarily consist of IBNR and to a lesser extent risk share payables to the Department of Defense and liabilities to subcontractors. |
(O) |
The table excludes activity associated with military services benefits payable because the federal government bears a substantial portion of the risk associated with financing the cost of |
health benefits. More specifically, the risk-sharing provisions of the military services contracts with the federal government and with subcontractors effectively limit profits and losses when |
|
actual claim experience varies from the targeted claim amount negotiated annually. As a result of these contract provisions, the impact of changes in estimates for prior year military |
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services benefits payable are substantially offset by the associated changes in estimates of revenue from health care services reimbursements. As such, any impact on the company's |
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results of operations is reduced substantially, whether positive or negative. |
|
(P) |
Amounts incurred related to prior years vary from previously estimated liabilities as the claims ultimately are settled. Negative amounts reported for incurred related to prior years result from |
claims being ultimately settled for amounts less than originally estimated (favorable development). There were no changes in the approach used to determine the company's estimate of |
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claim reserves during the quarter. |
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(Q) |
Future policy benefit expense has a related liability classified as a long-term liability on the balance sheet. |
(R) |
Benefits reserves statistics represents fully-insured medical claims data and excludes military services claims data and specialty benefits. |
(S) |
The receipt cycle time measures the average length of time between when a claim was initially incurred and when the claim form was received. Receipt cycle time data for the company's |
largest claim processing platforms represent approximately 95% of the company's fully-insured medical claims volume. Pharmacy and specialty claims, including dental, vision and other |
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supplemental benefits, are excluded from this measurement. |
|
(T) |
A common metric for monitoring benefits payable levels relative to the benefit expense is days in claims payable, or DCP, which represents the benefits payable at the end of the period |
divided by average benefit expenses per day in the quarterly period. |
|
(U) |
DCP fluctuates due to a number of issues, the more significant of which are detailed in this rollforward. Growth in certain product lines can also impact DCP for the quarter since a provision |
for claims would not have been recorded for members that had not yet enrolled earlier in the quarter, yet those members would have a provision and corresponding reserve recorded upon |
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enrollment later in the quarter. This analysis excludes the impact of military services and Medicare stand-alone PDPs upon DCP. |
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S-22 |
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CONTACT:
Humana Investor Relations
Regina Nethery, 502-580-3644
Rnethery@humana.com
or
Humana
Corporate Communications
Tom Noland, 502-580-3674
Tnoland@humana.com