[August 02, 2017] |
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Humana Reports Second Quarter 2017 Financial Results; Raises Full Year 2017 Guidance; Provides Update on Bonus Year 2018 Star Ratings
Humana Inc. (NYSE: HUM) today reported diluted earnings per common share
(EPS) for the quarter ended June 30, 2017 (2Q17) versus the quarter
ended June 30, 2016 (2Q16) and for the six months ended June 30, 2017
(1H 2017) versus for the six months ended June 30, 2016 (1H 2016) as
follows:
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Consolidated pretax income
In millions
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2Q17 (a)
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2Q16 (b)
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1H 2017 (c)
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1H 2016 (d)
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Generally Accepted Accounting Principles (GAAP)
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$1,042
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$636
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$2,731
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$1,136
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Net (gain) expenses associated with the terminated merger agreement
(for 1H 2017, primarily the break-up fee)
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-
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27
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(947
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)
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61
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Amortization associated with identifiable intangibles
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18
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20
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36
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41
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Guaranty fund assessment expense to support the policyholder
obligations of Penn Treaty (an unaffiliated long-term care insurance
company)
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-
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-
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54
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-
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Operating (income) losses associated with the Individual Commercial
business
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(118
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)
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225
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(181
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)
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237
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Adjusted (non-GAAP) - 2Q16 and 1H 2016 as recast
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$942
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$908
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$1,693
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$1,475
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Diluted earnings per common share (EPS)
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2Q17 (a)
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2Q16 (b)
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1H 2017 (c)
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1H 2016 (d)
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GAAP
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$4.46
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$2.06
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$11.98
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$3.75
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Net (gain) expenses associated with the terminated merger agreement
(for 1H 2017, primarily the break-up fee)
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-
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0.16
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(4.31
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)
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0.37
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Amortization associated with identifiable intangibles
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0.08
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0.08
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0.16
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0.17
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Beneficial effect of lower effective tax rate in light of pricing
and benefit design assumptions associated with the 2017 temporary
suspension of the non-deductible health insurance industry fee;
excludes Individual Commercial business impact
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(0.54
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)
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-
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(1.06
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)
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-
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Guaranty fund assessment expense to support the policyholder
obligations of Penn Treaty (an unaffiliated long-term care insurance
company)
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-
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-
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0.23
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Operating (income) losses associated with the Individual Commercial
business
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(0.51
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)
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0.99
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(0.77
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1.08
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Adjusted (non-GAAP) - 2Q16 and 1H 2016 as recast
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$3.49
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$3.29
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$6.23
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$5.37
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The company has included financial measures throughout this
earnings release that are not in accordance with GAAP. Management
believes that these measures, when presented in conjunction with the
comparable GAAP measures, are useful to both management and its
investors in analyzing the company's ongoing business and operating
performance. Consequently, management uses these non-GAAP financial
measures as indicators of the company's 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. All financial measures in this press release are
in accordance with GAAP unless otherwise indicated.
"With the completion of our first full quarter since the deal break,
Humana's strong 2Q17 results and increase in full-year guidance
demonstrate the strength of our integrated care delivery strategy," said
Bruce D. Broussard, Humana's President and Chief Executive Officer.
"It's our talented team that's made this possible. Throughout the
lengthy deal period, our associates never wavered in their focus and
commitment to our members, provider partners and shareholders. It's
because of this that we continue to make strides in advancing our
strategy while delivering strong operating performance."
The GAAP consolidated pretax income for 2Q17 of $1.04 billion rose $406
million, or 64 percent, compared to GAAP consolidated pretax income of
$636 million in 2Q16 primarily due to year-over-year improvement in
earnings for the company's individual Medicare Advantage and Individual
Commercial businesses, partially offset by lower pretax earnings in the
Group and Specialty and Healthcare Services segments.
The Adjusted consolidated pretax income for 2Q17 of $942 million rose
$34 million, or 4 percent, versus $908 million in 2Q16 primarily
reflecting the same factors impacting the GAAP comparison, while
excluding the impact of the items detailed in the consolidated pretax
income table above.
GAAP consolidated pretax income for 1H 2017 of $2.73 billion increased
$1.60 billion, or 140 percent, from $1.14 billion in 1H 2016. The
increase primarily reflects the net gain associated with the terminated
merger agreement, mainly the break-up fee recognized in the first
quarter of 2017, along with the factors impacting the second quarter
comparison.
The Adjusted consolidated pretax income for 1H 2017 of $1.69 billion
increased $218 million, or 15 percent, versus $1.48 billion in 1H 2016
primarily reflecting the same factors impacting the GAAP comparison,
while excluding the impact of items noted in the table above.
Further discussions of each segment's financial results are included in
the segment highlights below.
The year-over-year changes in GAAP EPS for 2Q17 and 1H 2017 reflected
the same factors impacting the GAAP consolidated pretax income
comparisons year over year as well as the beneficial effect of the lower
effective tax rate in light of pricing and benefit design assumptions
associated with the temporary suspension of the health insurance
industry fee in 2017. The year-over-year increases in Adjusted EPS for
2Q17 and 1H 2017 reflected the same factors impacting the Adjusted
consolidated pretax income comparisons year over year. In addition, the
second quarter and year-to-date comparisons of both GAAP and Adjusted
EPS are favorably impacted by a lower number of shares used to compute
EPS, primarily reflecting share repurchases in the first quarter of
2017, including the previously disclosed accelerated stock repurchase
(ASR) program.
"We are pleased that our individual Medicare Advantage business is
significantly outperforming our previous expectations, reflecting our
focus on operational excellence and the solid execution of our
strategy," said Brian A. Kane, Senior Vice President and Chief Financial
Officer. "We were therefore able to invest this outperformance in 2018
benefit designs, resulting in stable and competitive benefits for 2018
despite certain headwinds, in particular the return of the health
insurance industry fee."
2017 Earnings Guidance
Humana today raised its GAAP and Adjusted EPS guidance for the year
ending December 31, 2017 (FY17). FY17 GAAP EPS was increased to
approximately $17.83 from the previous guidance of at least $16.91,
while Adjusted EPS was increased to approximately $11.50 from the
previous guidance of at least $11.10. The increases in FY17 guidance for
both GAAP and Adjusted EPS were primarily driven by the strong results
in the Retail segment, largely attributable to the company's individual
Medicare Advantage business, partially offset by lower than expected
Healthcare Services segment pretax income due to lower than anticipated
pharmacy utilization and the continued optimization of our chronic care
management programs. The individual Medicare Advantage business is
exceeding its operational targets, experiencing lower than anticipated
utilization, higher than expected revenue on a per member basis and
favorable medical fee-for-service claims reserve development (Prior
Period Development).
A reconciliation of GAAP to Adjusted EPS for the company's FY17
projections as well as comparable numbers for the year ended December
31, 2016 (FY16) is shown below:
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Diluted earnings per common share
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FY17 Guidance (e)
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FY16 (f)
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GAAP
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~$17.83
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$4.07
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Net (gain) expenses associated with the terminated merger agreement
(for FY17, primarily the break-up fee)
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(4.36)
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0.64
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Amortization of identifiable intangibles
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0.31
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0.32
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Beneficial effect of lower effective tax rate in light of pricing
and benefit design assumptions associated with the 2017 temporary
suspension of the non-deductible health insurance industry fee;
excludes Individual Commercial business impact
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(2.15)
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-
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Reserve strengthening for the company's non-strategic closed block
of long-term care insurance business (g)
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-
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2.11
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Guaranty fund assessment expense to support the policyholder
obligations of Penn Treaty (an unaffiliated long-term care insurance
company)
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0.24
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-
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Operating results associated with the Individual Commercial business
given the company's exit on January 1, 2018 as previously disclosed
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(0.37)
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3.78
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Adjusted (non-GAAP) - FY17 projected; FY16 as recast
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~ $11.50
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$10.92
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Star Quality Ratings
The company now expects 74 percent of its June 30, 2017 Medicare
Advantage membership to be in 4-Star plans or higher for bonus year
2018. As previously disclosed, in October 2016, the Centers for Medicare
and Medicaid Services (CMS) published its Star quality ratings (Star
ratings) showing that the percentage of the company's July 31, 2016
Medicare Advantage membership in 4-Star plans or higher declined to
approximately 37 percent for bonus year 2018 compared to approximately
78 percent of the company's July 31, 2015 membership for bonus year
2017. While Star ratings are based on a number of plan performance
measures that are evaluated each year, the projected Star ratings for
the company's plans for the 2018 bonus year included certain reductions
that were primarily attributable to the 2015 comprehensive program audit
by CMS. The company filed a reconsideration request with CMS, which was
denied. The company subsequently decided not to appeal that denial
further, and worked through existing CMS processes to rationalize
contract structures, resulting in final Star ratings for bonus year 2018
that reflect its commitment to quality products and services for its
members. The company remains committed to its partnership with CMS and
to delivering quality products and services to its members.
Detailed press release
Humana's full earnings press release including the statistical pages has
been posted to the company's Investor Relations site and may be accessed
at http://phx.corporate-ir.net/phoenix.zhtml?c=92913&p=irol-IRHome
or via a current report on Form 8-K filed by the company with the
Securities and Exchange Commission this morning (available at www.sec.gov
or on the company's website).
Conference Call
Humana will host a conference call at 9:00 a.m. eastern time today to
discuss its financial results for the quarter and the company's
expectations for future earnings.
All parties interested in the audio only portion of the company's 2Q17
earnings conference call are invited to dial 888-625-7430. No password
is required. A webcast of the 2Q17 earnings call may also be accessed
via Humana's Investor Relations page at humana.com.
The company suggests participants for both the conference call and those
listening via the web dial in or sign on at least 15 minutes in advance
of the call.
For those unable to participate in the live event, the archive will be
available in the Historical Webcasts and Presentations section of the
Investor Relations page at humana.com,
approximately two hours following the live webcast. Telephone replays
will also be available approximately two hours following the live event
until midnight eastern time on October 2, 2017 and can be accessed by
dialing 855-859-2056 and providing the conference ID #89803304.
Footnotes
(a) 2Q17 Adjusted results exclude the following:
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Amortization expense for identifiable intangibles of approximately $18
million pretax, or $0.08 per diluted common share; GAAP measures
affected in this release include consolidated pretax, EPS, and segment
pretax results (for each segment's amount of such amortization).
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The one-year beneficial effect of a lower effective tax rate of
approximately $0.54 per diluted common share in light of pricing and
benefit design assumptions associated with the 2017 temporary
suspension of the non-deductible health insurance industry fee;
excludes Individual Commercial business impact. GAAP measures affected
in this release include consolidated EPS.
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Operating earnings of approximately $118 million pretax, or $0.51 per
diluted common share, for the company's Individual Commercial business
given the company's planned exit on January 1, 2018, as previously
disclosed. GAAP measures affected in this release include consolidated
pretax income, EPS, consolidated revenues, consolidated benefit ratio
and consolidated operating cost ratio.
(b) 2Q16 Adjusted results (recast) exclude the
following:
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Transaction and integration costs of $27 million pretax, or $0.16 per
diluted common share, associated with the then-pending merger
agreement; GAAP measures affected in this release include consolidated
pretax income and EPS.
-
Amortization expense for identifiable intangibles of approximately $20
million, or $0.08 per diluted common share; GAAP measures affected in
this release include consolidated pretax, EPS, and segment pretax
results (for each segment's amount of such amortization).
-
Operating losses of $225 million pretax, or $0.99 per diluted common
share, for the company's Individual Commercial business given the
company's planned exit on January 1, 2018, as previously disclosed.
GAAP measures affected in this release include consolidated pretax
income, EPS, consolidated revenues, consolidated benefit ratio and
consolidated operating cost ratio.
(c) 1H 2017 Adjusted results exclude the following:
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Net gain from the termination of the merger agreement of approximately
$947 million pretax, or $4.31 per diluted common share; includes the
net break-up fee and transaction costs net of the tax benefit
associated with certain expenses which were previously non-deductible;
GAAP measures affected in this release include consolidated pretax
income and EPS.
-
Amortization expense for identifiable intangibles of approximately $36
million pretax, or $0.16 per diluted common share; GAAP measures
affected in this release include consolidated pretax, EPS, and segment
pretax results (for each segment's amount of such amortization).
-
The one-year beneficial effect of a lower effective tax rate of
approximately $1.06 per diluted common share in light of pricing and
benefit design assumptions associated with the 2017 temporary
suspension of the non-deductible health insurance industry fee;
excludes Individual Commercial business impact. GAAP measures affected
in this release include consolidated EPS.
-
Guaranty fund assessment expense of approximately $54 million pretax,
or $0.23 per diluted common share, to support the policyholder
obligations of Penn Treaty (an unaffiliated long-term care insurance
company); GAAP measures affected in this release include consolidated
pretax income, EPS, and consolidated operating costs ratio. Under
state guaranty assessment laws, the company may be assessed (up to
prescribed limits) for certain obligations to the policyholders and
claimants of insolvent insurance companies that write the same line or
lines of business as the company. On March 1, 2017, a court ordered
the liquidation of Penn Treaty which triggered assessments from the
state guaranty associations.
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Operating earnings of approximately $181 million pretax, or $0.77 per
diluted common share, for the company's Individual Commercial business
given the company's planned exit on January 1, 2018, as previously
disclosed. GAAP measures affected in this release include consolidated
pretax income, EPS, consolidated revenues, consolidated benefit ratio
and consolidated operating cost ratio.
(d) 1H 2016 Adjusted results (recast) exclude the
following:
-
Transaction and integration costs of $61 million pretax, or $0.37 per
diluted common share, associated with the then-pending merger
agreement; GAAP measures affected in this release include consolidated
pretax income and EPS.
-
Amortization expense for identifiable intangibles of approximately $41
million, or $0.17 per diluted common share; GAAP measures affected in
this release include consolidated pretax, EPS, and segment pretax
results (for each segment's amount of such amortization).
-
Operating losses of $237 million pretax, or $1.08 per diluted common
share, for the company's Individual Commercial business given the
company's planned exit on January 1, 2018, as previously disclosed.
GAAP measures affected in this release include consolidated pretax
income, EPS, consolidated revenues, consolidated benefit ratio and
consolidated operating cost ratio.
(e) FY17 Adjusted EPS projections exclude the
following:
-
Net gain from the termination of the merger agreement of approximately
$947 million pretax, or $4.36 per diluted common share; includes the
net break-up fee and transaction costs net of the tax benefit
associated with certain expenses which were previously non-deductible.
-
Amortization expense for identifiable intangibles of approximately $71
million pretax, or $0.31 per diluted common share.
-
The one-year beneficial effect of a lower effective tax rate of
approximately $2.15 per diluted common share in light of pricing and
benefit design assumptions associated with the 2017 temporary
suspension of the non-deductible health insurance industry fee;
excludes Individual Commercial business impact.
-
Guaranty fund assessment expense of approximately $54 million pretax,
or $0.24 per diluted common share, to support the policyholder
obligations of Penn Treaty (an unaffiliated long-term care insurance
company).
-
Operating results of approximately $85 million pretax, or $0.37 per
diluted common share, for the company's Individual Commercial business
given the company's planned exit on January 1, 2018, as previously
disclosed.
(f) FY16 Adjusted EPS (recast) exclude the
following:
-
Transaction and integration costs of $104 million pretax, or $0.64 per
diluted common share, associated with the then-pending merger
agreement.
-
Amortization expense for identifiable intangibles of approximately $77
million pretax, or $0.32 per diluted common share.
-
Pretax expenses of $505 million, or $2.11 per diluted common share, of
reserve strengthening related to the company's non-strategic closed
block of long-term care insurance business. See related footnote (g).
-
Operating losses of $869 million pretax, or $3.78 per diluted common
share, for the company's Individual Commercial business given the
company's planned exit on January 1, 2018, as previously disclosed.
Includes the write-off of receivables associated with the risk
corridor premium stabilization program. See related footnote (h).
(g) As noted above, in addition to previously-disclosed adjustments, EPS
for FY16 included a strengthening of reserves for the company's
non-strategic closed block of long-term care business. In connection
with its acquisition of KMG America in 2007, the company acquired a
non-strategic closed block of long-term care insurance policies. These
policies were sold between 1995 and 2005, of which approximately 30,800
remained in force as of December 31, 2016. During the fourth quarter of
2016, the company recorded a reserve strengthening for this closed block
of policies as it determined the present value of future premiums,
together with its existing reserves were not adequate to provide for
future policy benefits. This adjustment primarily was driven by emerging
experience indicating longer claims duration, a prolonged lower interest
rate environment and an increase in policyholder life expectancies.
(h) On November 10, 2016, the U.S. Court of Federal Claims ruled in
favor of the government in one of a series of cases filed by insurers
against the Department of Health and Human Services (HHS) to collect
risk corridor payments, rejecting all of the insurer's statutory,
contract and Constitutional claims for payment. Prior to this decision,
the company had maintained the receivable in previous periods in
reliance upon the interpretation previously promulgated by HHS that the
risk corridor receivables were obligations of the U.S. government. Given
this court decision, however, the company's conclusion with respect to
the ultimate collectability of the receivable shifted, and accounting
rules required that the receivable be written off. Land of Lincoln
Mutual Health Insurance Company v. United States; United States Court of
Federal Claims No. 16-744C.
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 (News - Alert)) filings, and in oral statements made by or with the
approval of one of Humana's executive officers, the words or phrases
like "expects," "believes," "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 receives are insufficient to
cover the cost of healthcare services delivered to its members, if the
company is unable to implement clinical initiatives to provide a
better healthcare experience for its members, lower costs and
appropriately document the risk profile of its members, or if its
estimates of benefits expense 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. The company continually reviews estimates
of future payments relating to benefit expenses for services incurred
in the current and prior periods and makes necessary adjustments to
its reserves, including premium deficiency reserves, where
appropriate. These estimates, however, involve extensive judgment, and
have considerable inherent variability because they are extremely
sensitive to changes in claim payment patterns and medical cost
trends, so any reserves the company may establish, including premium
deficiency reserves, may be insufficient.
-
If Humana fails to effectively implement its operational and strategic
initiatives, particularly its Medicare initiatives, state-based
contract strategy, and its participation in the new health insurance
exchanges, the company's business may be materially adversely
affected, which is of particular importance given the concentration of
the company's revenues in these products. In addition, there can be no
assurances that the company will be successful in maintaining or
improving its Star ratings in future years.
-
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 is involved in various legal actions, or disputes that could
lead to legal actions (such as, among other things, provider contract
disputes relating to rate adjustments resulting from the Balanced
Budget and Emergency Deficit Control Act of 1985, as amended, commonly
referred to as "sequestration"; other provider contract disputes; and
qui tam litigation brought by individuals on behalf of the government)
and governmental and internal investigations, any of which, if
resolved unfavorably to the company, could result in substantial
monetary damages or changes in its business practices. Increased
litigation and negative publicity could also 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 healthcare programs including, among
other things, loss of material government contracts, governmental
audits and investigations, potential inadequacy of government
determined payment rates, potential restrictions on profitability,
including by comparison of profitability of the company's Medicare
Advantage business to non-Medicare Advantage business, or other
changes in the governmental programs in which Humana participates.
-
The Healthcare Reform Law, including The Patient Protection and
Affordable Care Act and The Healthcare 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, lowering the company's
Medicare payment rates and increasing the company's expenses
associated with a non-deductible health insurance industry fee and
other assessments; the company's financial position, including the
company's ability to maintain the value of its goodwill; and the
company's cash flows. Additionally, potential legislative changes,
including activities to repeal or replace, in whole or in part, the
Health Care Reform Law, creates uncertainty for Humana's business, and
when, or in what form, such legislative changes may occur cannot be
predicted with certainty.
-
Humana's continued participation in the federal and state health
insurance exchanges, which entail uncertainties associated with mix,
volume of business and the operation of premium stabilization programs
that are subject to federal administrative action, could adversely
affect 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.
-
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 certain of its licensed
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.
-
The securities and credit markets may experience volatility and
disruption, which may adversely affect Humana's business.
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, 2016;
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Form 10-Q for the quarter ended March 31, 2017; and
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Form 8-Ks filed during 2017.
About Humana
Humana Inc. is committed to helping our millions of medical and
specialty members achieve their best health. Our successful history in
care delivery and health plan administration is helping us create a new
kind of integrated care with the power to improve health and well-being
and lower costs. Our efforts are leading to a better quality of life for
people with Medicare, families, individuals, military service personnel,
and communities at large.
To accomplish that, we support physicians and other health care
professionals as they work to deliver the right care in the right place
for their patients, our members. Our range of clinical capabilities,
resources and tools - such as in-home care, behavioral health, pharmacy
services, data analytics and wellness solutions - combine to produce a
simplified experience that makes health care easier to navigate and more
effective.
More information regarding Humana is available to investors via the
Investor Relations page of the company's website at humana.com,
including copies of:
-
Annual reports to stockholders;
-
Securities and Exchange Commission filings;
-
Most recent investor conference presentations;
-
Quarterly earnings news releases and conference calls;
-
Calendar of events; and
-
Corporate Governance information.
View source version on businesswire.com: http://www.businesswire.com/news/home/20170802005336/en/
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