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FORM 10-Q
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ý
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QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15 (d) OF THE
SECURITIES EXCHANGE ACT OF 1934
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¨
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TRANSITION REPORT PURSUANT TO SECTION 13 OR 15 (d) OF THE
SECURITIES EXCHANGE ACT OF 1934
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HUMANA INC.
(Exact name of registrant as specified in its charter)
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Delaware
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61-0647538
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(State or other jurisdiction of
incorporation or organization)
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(I.R.S. Employer
Identification Number)
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Large accelerated filer
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ý
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Accelerated filer
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¨
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Non-accelerated filer
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¨
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Smaller reporting company
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¨
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Class of Common Stock
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Outstanding at
March 31, 2016 |
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$0.16 2/3 par value
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149,036,654 shares
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Page
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Part I: Financial Information
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Item 1.
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Financial Statements (Unaudited)
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Item 2.
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||
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Item 3.
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||
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Item 4.
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||
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Item 1.
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||
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Item 1A.
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||
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Item 2.
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||
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Item 3.
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||
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Item 4.
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||
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Item 5.
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||
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Item 6.
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||
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Certifications
|
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|
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March 31,
2016 |
|
December 31,
2015 |
||||
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(in millions, except share amounts)
|
||||||
|
A
SSETS
|
|
|
|
||||
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Current assets:
|
|
|
|
||||
|
Cash and cash equivalents
|
$
|
2,801
|
|
|
$
|
2,571
|
|
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Investment securities
|
7,738
|
|
|
7,267
|
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||
|
Receivables, less allowance for doubtful accounts of $115 in 2016
and $101 in 2015: |
1,737
|
|
|
1,161
|
|
||
|
Other current assets
|
5,568
|
|
|
4,712
|
|
||
|
Total current assets
|
17,844
|
|
|
15,711
|
|
||
|
Property and equipment, net
|
1,420
|
|
|
1,384
|
|
||
|
Long-term investment securities
|
1,940
|
|
|
1,843
|
|
||
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Goodwill
|
3,265
|
|
|
3,265
|
|
||
|
Other long-term assets
|
2,465
|
|
|
2,475
|
|
||
|
Total assets
|
$
|
26,934
|
|
|
$
|
24,678
|
|
|
L
IABILITIES
AND
S
TOCKHOLDERS
’ E
QUITY
|
|
|
|
||||
|
Current liabilities:
|
|
|
|
||||
|
Benefits payable
|
$
|
5,114
|
|
|
$
|
4,976
|
|
|
Trade accounts payable and accrued expenses
|
4,074
|
|
|
2,212
|
|
||
|
Book overdraft
|
257
|
|
|
301
|
|
||
|
Unearned revenues
|
360
|
|
|
364
|
|
||
|
Short-term borrowings
|
300
|
|
|
299
|
|
||
|
Total current liabilities
|
10,105
|
|
|
8,152
|
|
||
|
Long-term debt
|
3,793
|
|
|
3,794
|
|
||
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Future policy benefits payable
|
2,233
|
|
|
2,151
|
|
||
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Other long-term liabilities
|
278
|
|
|
235
|
|
||
|
Total liabilities
|
16,409
|
|
|
14,332
|
|
||
|
Commitments and contingencies
|
|
|
|
||||
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Stockholders’ equity:
|
|
|
|
||||
|
Preferred stock, $1 par; 10,000,000 shares authorized; none issued
|
—
|
|
|
—
|
|
||
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Common stock, $0.16 2/3 par; 300,000,000 shares authorized;
198,393,793 shares issued at March 31, 2016 and 198,372,059 shares issued at December 31, 2015 |
33
|
|
|
33
|
|
||
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Capital in excess of par value
|
2,498
|
|
|
2,530
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|
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Retained earnings
|
11,205
|
|
|
11,017
|
|
||
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Accumulated other comprehensive income
|
76
|
|
|
58
|
|
||
|
Treasury stock, at cost, 49,357,139 shares at March 31, 2016 and
50,084,043 shares at December 31, 2015 |
(3,287
|
)
|
|
(3,292
|
)
|
||
|
Total stockholders’ equity
|
10,525
|
|
|
10,346
|
|
||
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Total liabilities and stockholders’ equity
|
$
|
26,934
|
|
|
$
|
24,678
|
|
|
|
Three Months Ended
March 31, |
||||||
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2016
|
|
2015
|
||||
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|
(in millions, except per share results)
|
||||||
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Revenues:
|
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|
|
||||
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Premiums
|
$
|
13,440
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|
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$
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13,248
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|
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Services
|
260
|
|
|
490
|
|
||
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Investment income
|
100
|
|
|
95
|
|
||
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Total revenues
|
13,800
|
|
|
13,833
|
|
||
|
Operating expenses:
|
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|
||||
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Benefits
|
11,397
|
|
|
11,005
|
|
||
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Operating costs
|
1,768
|
|
|
1,945
|
|
||
|
Depreciation and amortization
|
88
|
|
|
93
|
|
||
|
Total operating expenses
|
13,253
|
|
|
13,043
|
|
||
|
Income from operations
|
547
|
|
|
790
|
|
||
|
Interest expense
|
47
|
|
|
46
|
|
||
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Income before income taxes
|
500
|
|
|
744
|
|
||
|
Provision for income taxes
|
266
|
|
|
314
|
|
||
|
Net income
|
$
|
234
|
|
|
$
|
430
|
|
|
Basic earnings per common share
|
$
|
1.57
|
|
|
$
|
2.86
|
|
|
Diluted earnings per common share
|
$
|
1.56
|
|
|
$
|
2.82
|
|
|
Dividends declared per common share
|
$
|
0.29
|
|
|
$
|
0.28
|
|
|
|
Three Months Ended
March 31, |
||||||
|
|
2016
|
|
2015
|
||||
|
|
(in millions)
|
||||||
|
Net income
|
$
|
234
|
|
|
$
|
430
|
|
|
Other comprehensive income:
|
|
|
|
||||
|
Change in gross unrealized investment
gains/losses |
48
|
|
|
14
|
|
||
|
Effect of income taxes
|
(17
|
)
|
|
(5
|
)
|
||
|
Total change in unrealized
investment gains/losses, net of tax |
31
|
|
|
9
|
|
||
|
Reclassification adjustment for net
realized gains included in investment income |
(20
|
)
|
|
(9
|
)
|
||
|
Effect of income taxes
|
7
|
|
|
4
|
|
||
|
Total reclassification adjustment, net
of tax |
(13
|
)
|
|
(5
|
)
|
||
|
Other comprehensive income, net
of tax |
18
|
|
|
4
|
|
||
|
Comprehensive income
|
$
|
252
|
|
|
$
|
434
|
|
|
|
For the three months ended
March 31, |
||||||
|
|
2016
|
|
2015
|
||||
|
|
(in millions)
|
||||||
|
Cash flows from operating activities
|
|
|
|
||||
|
Net income
|
$
|
234
|
|
|
$
|
430
|
|
|
Adjustments to reconcile net income to net cash provided by
operating activities: |
|
|
|
||||
|
Net realized capital gains
|
(20
|
)
|
|
(9
|
)
|
||
|
Stock-based compensation
|
23
|
|
|
44
|
|
||
|
Depreciation
|
94
|
|
|
88
|
|
||
|
Other intangible amortization
|
21
|
|
|
26
|
|
||
|
Provision (benefit) for deferred income taxes
|
15
|
|
|
(58
|
)
|
||
|
Changes in operating assets and liabilities, net of effect of
businesses acquired and dispositions: |
|
|
|
||||
|
Receivables
|
(576
|
)
|
|
(644
|
)
|
||
|
Other assets
|
(685
|
)
|
|
(1,145
|
)
|
||
|
Benefits payable
|
138
|
|
|
289
|
|
||
|
Other liabilities
|
1,210
|
|
|
1,051
|
|
||
|
Unearned revenues
|
(4
|
)
|
|
17
|
|
||
|
Other, net
|
32
|
|
|
18
|
|
||
|
Net cash provided by operating activities
|
482
|
|
|
107
|
|
||
|
Cash flows from investing activities
|
|
|
|
||||
|
Purchases of property and equipment
|
(125
|
)
|
|
(123
|
)
|
||
|
Purchases of investment securities
|
(1,430
|
)
|
|
(829
|
)
|
||
|
Maturities of investment securities
|
213
|
|
|
330
|
|
||
|
Proceeds from sales of investment securities
|
914
|
|
|
528
|
|
||
|
Net cash used in investing activities
|
(428
|
)
|
|
(94
|
)
|
||
|
Cash flows from financing activities
|
|
|
|
||||
|
Receipts (withdrawals) from contract deposits, net
|
318
|
|
|
123
|
|
||
|
Change in book overdraft
|
(44
|
)
|
|
(46
|
)
|
||
|
Common stock repurchases
|
(71
|
)
|
|
(66
|
)
|
||
|
Dividends paid
|
(47
|
)
|
|
(44
|
)
|
||
|
Excess tax benefit from stock-based compensation
|
20
|
|
|
13
|
|
||
|
Proceeds from stock option exercises and other
|
—
|
|
|
18
|
|
||
|
Net cash provided by (used in) financing activities
|
176
|
|
|
(2
|
)
|
||
|
Increase in cash and cash equivalents
|
230
|
|
|
11
|
|
||
|
Cash and cash equivalents at beginning of period
|
2,571
|
|
|
1,935
|
|
||
|
Cash and cash equivalents at end of period
|
$
|
2,801
|
|
|
$
|
1,946
|
|
|
Supplemental cash flow disclosures:
|
|
|
|
||||
|
Interest payments
|
$
|
10
|
|
|
$
|
9
|
|
|
Income tax payments, net
|
$
|
5
|
|
|
$
|
26
|
|
|
|
Amortized
Cost
|
|
Gross
Unrealized
Gains
|
|
Gross
Unrealized
Losses
|
|
Fair
Value
|
||||||||
|
|
(in millions)
|
||||||||||||||
|
March 31, 2016
|
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and other U.S. government
corporations and agencies: |
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and agency obligations
|
$
|
451
|
|
|
$
|
2
|
|
|
$
|
—
|
|
|
$
|
453
|
|
|
Mortgage-backed securities
|
2,015
|
|
|
20
|
|
|
(1
|
)
|
|
2,034
|
|
||||
|
Tax-exempt municipal securities
|
2,967
|
|
|
74
|
|
|
(3
|
)
|
|
3,038
|
|
||||
|
Mortgage-backed securities:
|
|
|
|
|
|
|
|
||||||||
|
Residential
|
11
|
|
|
—
|
|
|
—
|
|
|
11
|
|
||||
|
Commercial
|
885
|
|
|
7
|
|
|
(33
|
)
|
|
859
|
|
||||
|
Asset-backed securities
|
252
|
|
|
1
|
|
|
—
|
|
|
253
|
|
||||
|
Corporate debt securities
|
2,870
|
|
|
187
|
|
|
(27
|
)
|
|
3,030
|
|
||||
|
Total debt securities
|
$
|
9,451
|
|
|
$
|
291
|
|
|
$
|
(64
|
)
|
|
$
|
9,678
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
December 31, 2015
|
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and other U.S. government
corporations and agencies: |
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and agency obligations
|
$
|
331
|
|
|
$
|
2
|
|
|
$
|
(1
|
)
|
|
$
|
332
|
|
|
Mortgage-backed securities
|
1,902
|
|
|
12
|
|
|
(23
|
)
|
|
1,891
|
|
||||
|
Tax-exempt municipal securities
|
2,611
|
|
|
61
|
|
|
(4
|
)
|
|
2,668
|
|
||||
|
Mortgage-backed securities:
|
|
|
|
|
|
|
|
||||||||
|
Residential
|
13
|
|
|
—
|
|
|
—
|
|
|
13
|
|
||||
|
Commercial
|
1,024
|
|
|
2
|
|
|
(41
|
)
|
|
985
|
|
||||
|
Asset-backed securities
|
264
|
|
|
1
|
|
|
(2
|
)
|
|
263
|
|
||||
|
Corporate debt securities
|
2,873
|
|
|
140
|
|
|
(55
|
)
|
|
2,958
|
|
||||
|
Total debt securities
|
$
|
9,018
|
|
|
$
|
218
|
|
|
$
|
(126
|
)
|
|
$
|
9,110
|
|
|
|
Less than 12 months
|
|
12 months or more
|
|
Total
|
||||||||||||||||||
|
|
Fair
Value |
|
Gross
Unrealized Losses |
|
Fair
Value |
|
Gross
Unrealized Losses |
|
Fair
Value |
|
Gross
Unrealized Losses |
||||||||||||
|
|
(in millions)
|
||||||||||||||||||||||
|
March 31, 2016
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
U.S. Treasury and other U.S.
government corporations and agencies: |
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
U.S. Treasury and agency
obligations |
$
|
76
|
|
|
$
|
—
|
|
|
$
|
4
|
|
|
$
|
—
|
|
|
$
|
80
|
|
|
$
|
—
|
|
|
Mortgage-backed
securities |
177
|
|
|
—
|
|
|
126
|
|
|
(1
|
)
|
|
303
|
|
|
(1
|
)
|
||||||
|
Tax-exempt municipal
securities |
597
|
|
|
(2
|
)
|
|
42
|
|
|
(1
|
)
|
|
639
|
|
|
(3
|
)
|
||||||
|
Mortgage-backed securities:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Residential
|
2
|
|
|
—
|
|
|
3
|
|
|
—
|
|
|
5
|
|
|
—
|
|
||||||
|
Commercial
|
276
|
|
|
(6
|
)
|
|
249
|
|
|
(27
|
)
|
|
525
|
|
|
(33
|
)
|
||||||
|
Asset-backed securities
|
146
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
146
|
|
|
—
|
|
||||||
|
Corporate debt securities
|
374
|
|
|
(16
|
)
|
|
97
|
|
|
(11
|
)
|
|
471
|
|
|
(27
|
)
|
||||||
|
Total debt securities
|
$
|
1,648
|
|
|
$
|
(24
|
)
|
|
$
|
521
|
|
|
$
|
(40
|
)
|
|
$
|
2,169
|
|
|
$
|
(64
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
December 31, 2015
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
U.S. Treasury and other U.S.
government corporations and agencies: |
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
U.S. Treasury and agency
obligations |
$
|
195
|
|
|
$
|
(1
|
)
|
|
$
|
14
|
|
|
$
|
—
|
|
|
$
|
209
|
|
|
$
|
(1
|
)
|
|
Mortgage-backed
securities |
1,484
|
|
|
(20
|
)
|
|
86
|
|
|
(3
|
)
|
|
1,570
|
|
|
(23
|
)
|
||||||
|
Tax-exempt municipal
securities |
843
|
|
|
(3
|
)
|
|
52
|
|
|
(1
|
)
|
|
895
|
|
|
(4
|
)
|
||||||
|
Mortgage-backed securities:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Residential
|
2
|
|
|
—
|
|
|
4
|
|
|
—
|
|
|
6
|
|
|
—
|
|
||||||
|
Commercial
|
626
|
|
|
(13
|
)
|
|
265
|
|
|
(28
|
)
|
|
891
|
|
|
(41
|
)
|
||||||
|
Asset-backed securities
|
258
|
|
|
(2
|
)
|
|
—
|
|
|
—
|
|
|
258
|
|
|
(2
|
)
|
||||||
|
Corporate debt securities
|
918
|
|
|
(45
|
)
|
|
63
|
|
|
(10
|
)
|
|
981
|
|
|
(55
|
)
|
||||||
|
Total debt securities
|
$
|
4,326
|
|
|
$
|
(84
|
)
|
|
$
|
484
|
|
|
$
|
(42
|
)
|
|
$
|
4,810
|
|
|
$
|
(126
|
)
|
|
|
Three Months Ended
March 31, |
||||||
|
|
2016
|
|
2015
|
||||
|
|
(in millions)
|
||||||
|
Gross realized gains
|
$
|
31
|
|
|
$
|
17
|
|
|
Gross realized losses
|
(11
|
)
|
|
(8
|
)
|
||
|
Net realized capital gains
|
$
|
20
|
|
|
$
|
9
|
|
|
|
Amortized
Cost |
|
Fair
Value |
||||
|
|
(in millions)
|
||||||
|
Due within one year
|
$
|
420
|
|
|
$
|
419
|
|
|
Due after one year through five years
|
1,961
|
|
|
2,006
|
|
||
|
Due after five years through ten years
|
1,432
|
|
|
1,473
|
|
||
|
Due after ten years
|
2,475
|
|
|
2,623
|
|
||
|
Mortgage and asset-backed securities
|
3,163
|
|
|
3,157
|
|
||
|
Total debt securities
|
$
|
9,451
|
|
|
$
|
9,678
|
|
|
|
Fair Value Measurements Using
|
||||||||||||||
|
|
Fair
Value |
|
Quoted Prices
in Active Markets (Level 1) |
|
Other
Observable Inputs (Level 2) |
|
Unobservable
Inputs (Level 3) |
||||||||
|
|
(in millions)
|
||||||||||||||
|
March 31, 2016
|
|
|
|
|
|
|
|
||||||||
|
Cash equivalents
|
$
|
2,669
|
|
|
$
|
2,669
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
Debt securities:
|
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and other U.S. government
corporations and agencies: |
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and agency obligations
|
453
|
|
|
—
|
|
|
453
|
|
|
—
|
|
||||
|
Mortgage-backed securities
|
2,034
|
|
|
—
|
|
|
2,034
|
|
|
—
|
|
||||
|
Tax-exempt municipal securities
|
3,038
|
|
|
—
|
|
|
3,035
|
|
|
3
|
|
||||
|
Mortgage-backed securities:
|
|
|
|
|
|
|
|
||||||||
|
Residential
|
11
|
|
|
—
|
|
|
11
|
|
|
—
|
|
||||
|
Commercial
|
859
|
|
|
—
|
|
|
859
|
|
|
—
|
|
||||
|
Asset-backed securities
|
253
|
|
|
—
|
|
|
252
|
|
|
1
|
|
||||
|
Corporate debt securities
|
3,030
|
|
|
—
|
|
|
3,025
|
|
|
5
|
|
||||
|
Total debt securities
|
9,678
|
|
|
—
|
|
|
9,669
|
|
|
9
|
|
||||
|
Total invested assets
|
$
|
12,347
|
|
|
$
|
2,669
|
|
|
$
|
9,669
|
|
|
$
|
9
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
December 31, 2015
|
|
|
|
|
|
|
|
||||||||
|
Cash equivalents
|
$
|
2,229
|
|
|
$
|
2,229
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
Debt securities:
|
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and other U.S. government
corporations and agencies: |
|
|
|
|
|
|
|
||||||||
|
U.S. Treasury and agency obligations
|
332
|
|
|
—
|
|
|
332
|
|
|
—
|
|
||||
|
Mortgage-backed securities
|
1,891
|
|
|
—
|
|
|
1,891
|
|
|
—
|
|
||||
|
Tax-exempt municipal securities
|
2,668
|
|
|
—
|
|
|
2,663
|
|
|
5
|
|
||||
|
Mortgage-backed securities:
|
|
|
|
|
|
|
|
||||||||
|
Residential
|
13
|
|
|
—
|
|
|
13
|
|
|
—
|
|
||||
|
Commercial
|
985
|
|
|
—
|
|
|
985
|
|
|
—
|
|
||||
|
Asset-backed securities
|
263
|
|
|
—
|
|
|
263
|
|
|
—
|
|
||||
|
Corporate debt securities
|
2,958
|
|
|
—
|
|
|
2,952
|
|
|
6
|
|
||||
|
Total debt securities
|
9,110
|
|
|
—
|
|
|
9,099
|
|
|
11
|
|
||||
|
Total invested assets
|
$
|
11,339
|
|
|
$
|
2,229
|
|
|
$
|
9,099
|
|
|
$
|
11
|
|
|
|
For the three months ended March 31,
|
||||||||||||||||||||||
|
|
2016
|
|
2015
|
||||||||||||||||||||
|
|
Private
Placements |
|
Auction
Rate Securities |
|
Total
|
|
Private
Placements |
|
Auction
Rate Securities |
|
Total
|
||||||||||||
|
|
(in millions)
|
||||||||||||||||||||||
|
Beginning balance at January 1
|
$
|
6
|
|
|
$
|
5
|
|
|
$
|
11
|
|
|
$
|
24
|
|
|
$
|
8
|
|
|
$
|
32
|
|
|
Total gains or losses:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Realized in earnings
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||
|
Unrealized in other
comprehensive income |
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||
|
Purchases
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||
|
Sales
|
—
|
|
|
—
|
|
|
—
|
|
|
(18
|
)
|
|
(2
|
)
|
|
(20
|
)
|
||||||
|
Settlements
|
—
|
|
|
(2
|
)
|
|
(2
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||
|
Balance at March 31
|
$
|
6
|
|
|
$
|
3
|
|
|
$
|
9
|
|
|
$
|
6
|
|
|
$
|
6
|
|
|
$
|
12
|
|
|
|
March 31, 2016
|
|
December 31, 2015
|
||||||||||||
|
Risk
Corridor Settlement |
|
CMS
Subsidies/ Discounts |
|
Risk
Corridor Settlement |
|
CMS
Subsidies/ Discounts |
|||||||||
|
|
(in millions)
|
||||||||||||||
|
Other current assets
|
$
|
33
|
|
|
$
|
2,408
|
|
|
$
|
25
|
|
|
$
|
2,082
|
|
|
Trade accounts payable and accrued expenses
|
(44
|
)
|
|
(704
|
)
|
|
(47
|
)
|
|
(63
|
)
|
||||
|
Net current (liability) asset
|
(11
|
)
|
|
1,704
|
|
|
(22
|
)
|
|
2,019
|
|
||||
|
Other long-term assets
|
49
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
Other long-term liabilities
|
(29
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
Net long-term asset
|
20
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
Total net asset (liability)
|
$
|
9
|
|
|
$
|
1,704
|
|
|
$
|
(22
|
)
|
|
$
|
2,019
|
|
|
|
Premium Deficiency Reserve
|
||
|
|
(in millions)
|
||
|
Balance at January 1, 2016
|
$
|
176
|
|
|
Current period results applied to the PDR liability
|
13
|
|
|
|
Balance at March 31, 2016
|
$
|
189
|
|
|
|
March 31, 2016
|
|
December 31, 2015
|
||||||||||||||||||||||||
|
|
Risk Adjustment
Settlement |
|
Reinsurance
Recoverables |
|
Risk
Corridor Settlement |
|
Risk Adjustment
Settlement |
|
Reinsurance
Recoverables |
|
Risk
Corridor Settlement |
||||||||||||||||
|
|
(in millions)
|
||||||||||||||||||||||||||
|
Prior Coverage Years
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||||
|
Premiums receivable
|
$
|
136
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
126
|
|
|
$
|
—
|
|
|
$
|
—
|
|
||||
|
Other current assets
|
—
|
|
|
402
|
|
|
—
|
|
|
—
|
|
|
610
|
|
|
—
|
|
||||||||||
|
Trade accounts payable and
accrued expenses |
(258
|
)
|
|
—
|
|
|
—
|
|
|
(223
|
)
|
|
—
|
|
|
—
|
|
||||||||||
|
Net current (liability) asset
|
(122
|
)
|
|
402
|
|
|
—
|
|
|
(97
|
)
|
|
610
|
|
|
—
|
|
||||||||||
|
Other long-term assets
|
—
|
|
|
—
|
|
|
369
|
|
|
10
|
|
|
—
|
|
|
459
|
|
||||||||||
|
Other long-term liabilities
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||||||
|
Net long-term asset
|
—
|
|
|
—
|
|
|
369
|
|
|
10
|
|
|
—
|
|
|
459
|
|
||||||||||
|
Total prior coverage years' net
(liability) asset |
(122
|
)
|
|
402
|
|
|
369
|
|
|
(87
|
)
|
|
610
|
|
|
459
|
|
||||||||||
|
Current Coverage Year
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Other long-term assets
|
—
|
|
|
25
|
|
|
97
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||||||
|
Other long-term liabilities
|
(12
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||||||
|
Net long-term (liability) asset
|
(12
|
)
|
|
25
|
|
|
97
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||||||
|
Total 2016 coverage year net
(liability) asset |
(12
|
)
|
|
25
|
|
|
97
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||||||
|
Total net (liability) asset
|
$
|
(134
|
)
|
|
$
|
427
|
|
|
$
|
466
|
|
|
$
|
(87
|
)
|
|
$
|
610
|
|
|
$
|
459
|
|
||||
|
|
Retail
|
|
Group
|
|
Healthcare
Services |
|
Total
|
||||||||
|
|
(in millions)
|
||||||||||||||
|
Balance at March 31, 2016
|
$
|
1,069
|
|
|
$
|
385
|
|
|
$
|
1,811
|
|
|
$
|
3,265
|
|
|
|
|
|
March 31, 2016
|
|
December 31, 2015
|
||||||||||||||||||||
|
|
Weighted
Average Life |
|
Cost
|
|
Accumulated
Amortization |
|
Net
|
|
Cost
|
|
Accumulated
Amortization |
|
Net
|
||||||||||||
|
|
|
|
($ in millions)
|
||||||||||||||||||||||
|
Other intangible assets:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Customer contracts/
relationships |
9.8 yrs
|
|
$
|
566
|
|
|
$
|
307
|
|
|
$
|
259
|
|
|
$
|
566
|
|
|
$
|
292
|
|
|
$
|
274
|
|
|
Trade names and
technology |
8.3 yrs
|
|
104
|
|
|
58
|
|
|
46
|
|
|
104
|
|
|
54
|
|
|
50
|
|
||||||
|
Provider contracts
|
14.6 yrs
|
|
51
|
|
|
25
|
|
|
26
|
|
|
51
|
|
|
24
|
|
|
27
|
|
||||||
|
Noncompetes and
other |
8.2 yrs
|
|
32
|
|
|
27
|
|
|
5
|
|
|
32
|
|
|
26
|
|
|
6
|
|
||||||
|
Total other intangible
assets |
9.8 yrs
|
|
$
|
753
|
|
|
$
|
417
|
|
|
$
|
336
|
|
|
$
|
753
|
|
|
$
|
396
|
|
|
$
|
357
|
|
|
|
(in millions)
|
||
|
For the years ending December 31,:
|
|
||
|
2016
|
$
|
78
|
|
|
2017
|
71
|
|
|
|
2018
|
62
|
|
|
|
2019
|
51
|
|
|
|
2020
|
47
|
|
|
|
2021
|
13
|
|
|
|
|
Three months ended March 31,
|
||||||
|
|
2016
|
|
2015
|
||||
|
|
(dollars in millions, except per common share results; number of shares in thousands)
|
||||||
|
Net income available for common stockholders
|
$
|
234
|
|
|
$
|
430
|
|
|
Weighted average outstanding shares of common stock
used to compute basic earnings per common share |
149,161
|
|
|
150,490
|
|
||
|
Dilutive effect of:
|
|
|
|
||||
|
Employee stock options
|
169
|
|
|
218
|
|
||
|
Restricted stock
|
1,224
|
|
|
1,641
|
|
||
|
Shares used to compute diluted earnings per common share
|
150,554
|
|
|
152,349
|
|
||
|
Basic earnings per common share
|
$
|
1.57
|
|
|
$
|
2.86
|
|
|
Diluted earnings per common share
|
$
|
1.56
|
|
|
$
|
2.82
|
|
|
Number of antidilutive stock options and restricted stock
excluded from computation |
1,273
|
|
|
718
|
|
||
|
Record
Date |
|
Payment
Date |
|
Amount
per Share |
|
Total
Amount |
||||
|
|
|
|
|
|
|
(in millions)
|
||||
|
2015 payments
|
|
|
|
|
|
|
||||
|
12/31/2014
|
|
1/30/2015
|
|
$
|
0.28
|
|
|
$
|
42
|
|
|
3/31/2015
|
|
4/24/2015
|
|
$
|
0.28
|
|
|
$
|
42
|
|
|
6/30/2015
|
|
7/31/2015
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
9/30/2015
|
|
10/30/2015
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
2016 payments
|
|
|
|
|
|
|
||||
|
12/30/2015
|
|
1/29/2016
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
3/31/2016
|
|
4/29/2016
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
|
March 31, 2016
|
|
December 31, 2015
|
||||
|
|
(in millions)
|
||||||
|
Senior notes:
|
|
|
|
||||
|
$500 million, 7.20% due June 15, 2018
|
$
|
501
|
|
|
$
|
502
|
|
|
$300 million, 6.30% due August 1, 2018
|
307
|
|
|
307
|
|
||
|
$400 million, 2.625% due October 1, 2019
|
398
|
|
|
398
|
|
||
|
$600 million, 3.15% due December 1, 2022
|
595
|
|
|
595
|
|
||
|
$600 million, 3.85% due October 1, 2024
|
595
|
|
|
595
|
|
||
|
$250 million, 8.15% due June 15, 2038
|
263
|
|
|
263
|
|
||
|
$400 million, 4.625% due December 1, 2042
|
396
|
|
|
396
|
|
||
|
$750 million, 4.95% due October 1, 2044
|
738
|
|
|
738
|
|
||
|
Total long-term debt
|
$
|
3,793
|
|
|
$
|
3,794
|
|
|
|
Retail
|
|
Group
|
|
Healthcare
Services |
|
Other
Businesses |
|
Eliminations/
Corporate |
|
Consolidated
|
||||||||||||
|
|
(in millions)
|
||||||||||||||||||||||
|
Three months ended March 31, 2016
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||
|
Revenues - external customers
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Premiums:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Individual Medicare Advantage
|
$
|
8,027
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
8,027
|
|
|
Group Medicare Advantage
|
1,077
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
1,077
|
|
||||||
|
Medicare stand-alone PDP
|
1,039
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
1,039
|
|
||||||
|
Total Medicare
|
10,143
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
10,143
|
|
||||||
|
Fully-insured
|
997
|
|
|
1,337
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
2,334
|
|
||||||
|
Specialty
|
65
|
|
|
253
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
318
|
|
||||||
|
Medicaid and other
|
630
|
|
|
5
|
|
|
—
|
|
|
10
|
|
|
—
|
|
|
645
|
|
||||||
|
Total premiums
|
11,835
|
|
|
1,595
|
|
|
—
|
|
|
10
|
|
|
—
|
|
|
13,440
|
|
||||||
|
Services revenue:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Provider
|
—
|
|
|
13
|
|
|
58
|
|
|
—
|
|
|
—
|
|
|
71
|
|
||||||
|
ASO and other
|
2
|
|
|
177
|
|
|
—
|
|
|
3
|
|
|
—
|
|
|
182
|
|
||||||
|
Pharmacy
|
—
|
|
|
—
|
|
|
7
|
|
|
—
|
|
|
—
|
|
|
7
|
|
||||||
|
Total services revenue
|
2
|
|
|
190
|
|
|
65
|
|
|
3
|
|
|
—
|
|
|
260
|
|
||||||
|
Total revenues - external customers
|
11,837
|
|
|
1,785
|
|
|
65
|
|
|
13
|
|
|
—
|
|
|
13,700
|
|
||||||
|
Intersegment revenues
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Services
|
—
|
|
|
21
|
|
|
4,754
|
|
|
—
|
|
|
(4,775
|
)
|
|
—
|
|
||||||
|
Products
|
—
|
|
|
—
|
|
|
1,360
|
|
|
—
|
|
|
(1,360
|
)
|
|
—
|
|
||||||
|
Total intersegment revenues
|
—
|
|
|
21
|
|
|
6,114
|
|
|
—
|
|
|
(6,135
|
)
|
|
—
|
|
||||||
|
Investment income
|
27
|
|
|
5
|
|
|
7
|
|
|
15
|
|
|
46
|
|
|
100
|
|
||||||
|
Total revenues
|
11,864
|
|
|
1,811
|
|
|
6,186
|
|
|
28
|
|
|
(6,089
|
)
|
|
13,800
|
|
||||||
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Benefits
|
10,378
|
|
|
1,193
|
|
|
—
|
|
|
25
|
|
|
(199
|
)
|
|
11,397
|
|
||||||
|
Operating costs
|
1,276
|
|
|
436
|
|
|
5,913
|
|
|
4
|
|
|
(5,861
|
)
|
|
1,768
|
|
||||||
|
Depreciation and amortization
|
56
|
|
|
24
|
|
|
32
|
|
|
—
|
|
|
(24
|
)
|
|
88
|
|
||||||
|
Total operating expenses
|
11,710
|
|
|
1,653
|
|
|
5,945
|
|
|
29
|
|
|
(6,084
|
)
|
|
13,253
|
|
||||||
|
Income (loss) from operations
|
154
|
|
|
158
|
|
|
241
|
|
|
(1
|
)
|
|
(5
|
)
|
|
547
|
|
||||||
|
Interest expense
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
47
|
|
|
47
|
|
||||||
|
Income (loss) before income taxes
|
$
|
154
|
|
|
$
|
158
|
|
|
$
|
241
|
|
|
$
|
(1
|
)
|
|
$
|
(52
|
)
|
|
$
|
500
|
|
|
|
Retail
|
|
Group
|
|
Healthcare
Services |
|
Other
Businesses |
|
Eliminations/
Corporate |
|
Consolidated
|
||||||||||||
|
|
(in millions)
|
||||||||||||||||||||||
|
Three months ended March 31, 2015
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||
|
Revenues - external customers
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Premiums:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Individual Medicare Advantage
|
$
|
7,433
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
7,433
|
|
|
Group Medicare Advantage
|
1,394
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
1,394
|
|
||||||
|
Medicare stand-alone PDP
|
1,003
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
1,003
|
|
||||||
|
Total Medicare
|
9,830
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
9,830
|
|
||||||
|
Fully-insured
|
1,094
|
|
|
1,384
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
2,478
|
|
||||||
|
Specialty
|
63
|
|
|
270
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
333
|
|
||||||
|
Medicaid and other
|
591
|
|
|
6
|
|
|
—
|
|
|
10
|
|
|
—
|
|
|
607
|
|
||||||
|
Total premiums
|
11,578
|
|
|
1,660
|
|
|
—
|
|
|
10
|
|
|
—
|
|
|
13,248
|
|
||||||
|
Services revenue:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Provider
|
—
|
|
|
9
|
|
|
308
|
|
|
—
|
|
|
—
|
|
|
317
|
|
||||||
|
ASO and other
|
4
|
|
|
160
|
|
|
—
|
|
|
2
|
|
|
—
|
|
|
166
|
|
||||||
|
Pharmacy
|
—
|
|
|
—
|
|
|
7
|
|
|
—
|
|
|
—
|
|
|
7
|
|
||||||
|
Total services revenue
|
4
|
|
|
169
|
|
|
315
|
|
|
2
|
|
|
—
|
|
|
490
|
|
||||||
|
Total revenues - external customers
|
11,582
|
|
|
1,829
|
|
|
315
|
|
|
12
|
|
|
—
|
|
|
13,738
|
|
||||||
|
Intersegment revenues
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Services
|
—
|
|
|
22
|
|
|
4,367
|
|
|
—
|
|
|
(4,389
|
)
|
|
—
|
|
||||||
|
Products
|
—
|
|
|
—
|
|
|
1,150
|
|
|
—
|
|
|
(1,150
|
)
|
|
—
|
|
||||||
|
Total intersegment revenues
|
—
|
|
|
22
|
|
|
5,517
|
|
|
—
|
|
|
(5,539
|
)
|
|
—
|
|
||||||
|
Investment income
|
27
|
|
|
5
|
|
|
—
|
|
|
15
|
|
|
48
|
|
|
95
|
|
||||||
|
Total revenues
|
11,609
|
|
|
1,856
|
|
|
5,832
|
|
|
27
|
|
|
(5,491
|
)
|
|
13,833
|
|
||||||
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
Benefits
|
9,936
|
|
|
1,226
|
|
|
—
|
|
|
23
|
|
|
(180
|
)
|
|
11,005
|
|
||||||
|
Operating costs
|
1,254
|
|
|
453
|
|
|
5,560
|
|
|
3
|
|
|
(5,325
|
)
|
|
1,945
|
|
||||||
|
Depreciation and amortization
|
44
|
|
|
23
|
|
|
42
|
|
|
—
|
|
|
(16
|
)
|
|
93
|
|
||||||
|
Total operating expenses
|
11,234
|
|
|
1,702
|
|
|
5,602
|
|
|
26
|
|
|
(5,521
|
)
|
|
13,043
|
|
||||||
|
Income from operations
|
375
|
|
|
154
|
|
|
230
|
|
|
1
|
|
|
30
|
|
|
790
|
|
||||||
|
Interest expense
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
46
|
|
|
46
|
|
||||||
|
Income (loss) before income taxes
|
$
|
375
|
|
|
$
|
154
|
|
|
$
|
230
|
|
|
$
|
1
|
|
|
$
|
(16
|
)
|
|
$
|
744
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
•
|
Our 2016 results through
March 31, 2016
reflect the continued implementation of our strategy to offer our members affordable health care combined with a positive consumer experience in growing markets. At the core of this strategy is our integrated care delivery model, which unites quality care, high member engagement, and sophisticated data analytics. Our approach to primary, physician-directed care for our members aims to provide quality care that is consistent, integrated, cost-effective, and member-focused, provided by both employed physicians and physicians with network contract arrangements. The model is designed to improve health outcomes and affordability for individuals and for the health system as a whole, while offering our members a simple, seamless healthcare experience. We believe this strategy is positioning us for long-term growth in both membership and earnings. We offer providers a continuum of opportunities to increase the integration of care and offer assistance to providers in transitioning from a fee-for-service to a value-based arrangement. These include performance bonuses, shared savings and shared risk relationships. At
March 31, 2016
, approximately
1,715,100
members, or
61.1%
, of our individual Medicare Advantage members were in value-based relationships under our integrated care delivery model, as compared to
1,633,100
members, or
59.3%
, at
December 31, 2015
and
1,456,800
members, or
54.2%
, at
March 31, 2015
.
|
|
•
|
During the
three months ended March 31, 2016
we recorded transaction and integration costs in connection with the Merger of approximately
$34 million
, or
$0.21
per diluted common share. Certain costs associated with the transaction are not deductible for tax purposes.
|
|
•
|
Our pretax results for the
three months ended March 31, 2016
as compared to the
three months ended March 31, 2015
reflect a year-over-year decline in the Retail segment pretax results, partially offset by a slight year-over-year improvement in the Healthcare Services and Group segment pretax results as discussed in the detailed segment results discussion that follows.
|
|
•
|
Year-over year comparisons of results are impacted by the June 1, 2015
sale of our wholly owned subsidiary, Concentra Inc., or Concentra, to MJ Acquisition Corporation, a joint venture between Select Medical Holdings Corporation and Welsh, Carson, Anderson & Stowe XII, L.P., a private equity fund, for approximately
$1,055 million
in cash, excluding approximately
$22 million
of transaction costs.
In connection with the sale, we recognized a pretax gain, net of transaction costs, of
$270 million
, or
$1.57
per diluted common share in
2015
, including a
$0.35
tax benefit recognized during
three months ended March 31, 2015
.
|
|
•
|
Year-over-year comparisons of the benefit ratio in the first quarter are impacted by the unfavorable seasonal affect of one extra business day's claims from leap year in the 2016 quarter and the recognition of a premium deficiency reserve for our individual commercial medical business as discussed in the detailed segment results discussion that follows.
|
|
•
|
Year-over-year comparisons of diluted earnings per common share are favorably impacted by a lower number of shares used to compute diluted earnings per common share reflecting the impact of share repurchases in the first half of 2015.
|
|
•
|
During the
three months ended March 31, 2016
, operating cash flow provided by operations was
$482 million
as compared to
$107 million
for the
three months ended March 31, 2015
. The increase in our operating cash flows for the
three months ended March 31, 2016
primarily was due to the favorable timing of working capital items partially offset by lower earnings year-over-year. Significant year-over-year changes in working capital items primarily included the early receipt of certain commercial reinsurance recoveries from HHS for the 2015 coverage year in the first quarter of 2016 as discussed below, the timing of payroll cycles resulting in one less payroll cycle in the first quarter of 2016 than in the first quarter of 2015, and lower management incentive payments in the first quarter of 2016 associated with prior year performance than those paid in the first quarter of 2015. In 2015, commercial reinsurance recoveries associated with the 2014 coverage year primarily were collected in the third quarter of 2015. In the first quarter of 2016, HHS provided issuers with a portion of the estimated full year payment for the 2015 coverage year, with the remainder expected to be paid in the third and fourth quarters of 2016.
|
|
•
|
In
2016
, we expect to pay the federal government an estimated
$908 million
for the annual non-deductible health insurance industry fee compared to our payment of
$867 million
in 2015. This fee is not deductible for tax purposes, which significantly increased our effective income tax rate beginning in 2014. The health insurance industry fee is further described below under the section titled “Health Care Reform.” The Consolidated Appropriations Act, 2016, enacted on December 18, 2015, included a one-time one year suspension in 2017 of the health insurer fee. This will significantly reduce our operating costs and effective tax rate in 2017.
|
|
•
|
During the
three months ended March 31, 2016
, we paid dividends to stockholders of
$47 million
.
|
|
•
|
On April 4, 2016, CMS announced final 2017 Medicare benchmark payment rates and related technical factors impacting the bid benchmark premiums, which we refer to as the Final Rate Notice. We believe the Final Rate Notice, together with the impact of payment cuts associated with the Health Care Reform Law, quality bonuses, risk coding modifications, Star ratings for 2017, and other funding formula changes, indicate 2017 Medicare Advantage funding decreases for us of approximately 1.3% on average. Although the overall rate adjustment is negative, geographic-specific impacts may vary significantly from this average. The beneficial effect of the temporary suspension of the health insurer fee for 2017 discussed above is not reflected in our estimate for our 2017 rate changes. We believe our 2017 Medicare Advantage plan filings, including the applicable level of rate changes will remain competitive compared to both the combination of original Medicare with a
|
|
•
|
For the
three months ended March 31, 2016
, our Retail segment pretax income
decrease
d by
$221 million
, or
58.9%
, as compared to the
three months ended March 31, 2015
as higher premiums were more than offset by an increase in the segment's benefit ratio as discussed in the detailed segment results of operations discussion that follows.
|
|
•
|
Operating results for our individual commercial medical business compliant with the Health Care Reform Law have been challenged primarily due to unanticipated modifications in the program subsequent to the passing of the Health Care Reform Law, resulting in higher covered population morbidity and the ensuing enrollment and claims issues causing volatility in claims experience. The benefit ratios reported for the full year 2015 associated with many of our individual commercial medical products, in particular Health Care Reform Law compliant offerings, significantly exceeded prior expectations, driven primarily by the on-going impact of the transitional policies, special enrollment period exemptions associated with the program, and government-mandated product designs that attracted higher-utilizing members.
|
|
•
|
Individual Medicare Advantage membership of
2,807,200
at
March 31, 2016
increased
53,800
, or
2.0%
, from
2,753,400
at
December 31, 2015
and
increased
121,300
members, or
4.5%
, from
2,685,900
at
March 31, 2015
reflecting net membership additions, particularly for our Health Maintenance Organization, or HMO, offerings for the 2016 plan year.
|
|
•
|
Group Medicare Advantage membership of
349,200
at
March 31, 2016
decreased
134,900
members, or
27.9%
, from
484,100
at
December 31, 2015
and
decreased
121,700
members, or
25.8%
, from
470,900
at
March 31, 2015
. These declines primarily reflect
the loss of a large account that moved to a private exchange offering on January 1, 2016.
|
|
•
|
Medicare stand-alone PDP membership of
4,834,100
at
March 31, 2016
increased
276,200
members, or
6.1%
, from
4,557,900
at
December 31, 2015
and
increased
452,700
members, or
10.3%
, from
4,381,400
at
March 31,
|
|
•
|
Our state-based Medicaid membership of
388,400
as of
March 31, 2016
increased
14,700
members, or
3.9%
, from
373,700
at
December 31, 2015
and
increased
49,400
members, or
14.6%
, from
339,000
at
March 31, 2015
, in each case primarily due to
the addition of members under our Florida Medicaid contracts in the second half of 2015.
|
|
•
|
Individual commercial medical membership of
1,085,500
at
March 31, 2016
increased
27,800
members, or
2.6%
, from
1,057,700
at
December 31, 2015
and
decreased
172,600
members, or
13.7%
, from
1,258,100
at
March 31, 2015
. The increase from December 31, 2015 primarily reflects an increase in Medicare Supplement membership partially offset by the loss of members subscribing to plans that are not compliant with the Health Care Reform Law as well as loss of members in plans that are compliant with the Health Care Reform Law due to plan discontinuances in the first quarter of 2016. The decrease from
March 31, 2015
primarily reflects
the loss of members in plans compliant with the Health Care Reform Law, including the loss of approximately 150,000 members due to termination by CMS for lack of eligibility documentation as well as the loss of members due to the non-payment of premiums during the last three quarters of 2015, and the loss of members subscribing to plans that are not compliant with the Health Care Reform Law.
At
March 31, 2016
, individual commercial medical membership in plans compliant with the Health Care Reform Law, both on-exchange and off-exchange, was
763,000
members, an
increase
of
5,100
members, or
0.7%
, from
December 31, 2015
and a
decrease
of
181,100
members, or
19.2%
, from
March 31, 2015
.
|
|
•
|
For the
three months ended March 31, 2016
, our Group segment pretax income of
$158 million
increased
$4 million
from the
three months ended March 31, 2015
as discussed in the results of operations discussion that follows.
|
|
•
|
As noted previously, year-over-year comparisons of results of operations are impacted by the completion of the sale of Concentra on June 1, 2015.
|
|
•
|
As discussed in the detailed Healthcare Services segment results of operations discussion that follows, our Healthcare Services segment pretax income increased
$11 million
, or
4.8%
, for the
three months ended March 31, 2016
as compared to the
three months ended March 31, 2015
. This increase was primarily due to
revenue growth from our pharmacy solutions business, including mail order, and home based services business as they serve our growing individual Medicare membership
.
These items were substantially offset by decreased profitability in our provider services business primarily reflecting significantly lower Medicare rates year-over-year
.
|
|
•
|
Programs to enhance the quality of care for members are key elements of our integrated care delivery model. We have accelerated our process for identifying and reaching out to members in need of clinical intervention. Medicare Advantage membership with complex chronic conditions in the Humana Chronic Care Program rose to approximately
572,300
at
March 31, 2016
, an increase of
23.6%
from approximately
463,000
Medicare Advantage members at
March 31, 2015
, reflecting enhanced predictive modeling capabilities and focus on proactive clinical outreach and member engagement, but was down
3.0%
from
590,300
at
December 31, 2015
primarily due to the loss of engaged members associated with the group Medicare account that termed on January 1, 2016 as discussed previously. We believe these initiatives lead to better health outcomes for our members and lower health care costs.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||
|
|
For the three months ended
March 31, |
|
Change
|
|||||||||||
|
|
2016
|
|
2015
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(dollars in millions, except per common share results)
|
|
|
|||||||||||
|
Revenues:
|
|
|
|
|
|
|
|
|||||||
|
Premiums:
|
|
|
|
|
|
|
|
|||||||
|
Retail
|
$
|
11,835
|
|
|
$
|
11,578
|
|
|
$
|
257
|
|
|
2.2
|
%
|
|
Group
|
1,595
|
|
|
1,660
|
|
|
(65
|
)
|
|
(3.9
|
)%
|
|||
|
Other Businesses
|
10
|
|
|
10
|
|
|
—
|
|
|
—
|
%
|
|||
|
Total premiums
|
13,440
|
|
|
13,248
|
|
|
192
|
|
|
1.4
|
%
|
|||
|
Services:
|
|
|
|
|
|
|
|
|||||||
|
Retail
|
2
|
|
|
4
|
|
|
(2
|
)
|
|
(50.0
|
)%
|
|||
|
Group
|
190
|
|
|
169
|
|
|
21
|
|
|
12.4
|
%
|
|||
|
Healthcare Services
|
65
|
|
|
315
|
|
|
(250
|
)
|
|
(79.4
|
)%
|
|||
|
Other Businesses
|
3
|
|
|
2
|
|
|
1
|
|
|
50.0
|
%
|
|||
|
Total services
|
260
|
|
|
490
|
|
|
(230
|
)
|
|
(46.9
|
)%
|
|||
|
Investment income
|
100
|
|
|
95
|
|
|
5
|
|
|
5.3
|
%
|
|||
|
Total revenues
|
13,800
|
|
|
13,833
|
|
|
(33
|
)
|
|
(0.2
|
)%
|
|||
|
Operating expenses:
|
|
|
|
|
|
|
|
|||||||
|
Benefits
|
11,397
|
|
|
11,005
|
|
|
392
|
|
|
3.6
|
%
|
|||
|
Operating costs
|
1,768
|
|
|
1,945
|
|
|
(177
|
)
|
|
(9.1
|
)%
|
|||
|
Depreciation and amortization
|
88
|
|
|
93
|
|
|
(5
|
)
|
|
(5.4
|
)%
|
|||
|
Total operating expenses
|
13,253
|
|
|
13,043
|
|
|
210
|
|
|
1.6
|
%
|
|||
|
Income from operations
|
547
|
|
|
790
|
|
|
(243
|
)
|
|
(30.8
|
)%
|
|||
|
Interest expense
|
47
|
|
|
46
|
|
|
1
|
|
|
2.2
|
%
|
|||
|
Income before income taxes
|
500
|
|
|
744
|
|
|
(244
|
)
|
|
(32.8
|
)%
|
|||
|
Provision for income taxes
|
266
|
|
|
314
|
|
|
(48
|
)
|
|
(15.3
|
)%
|
|||
|
Net income
|
$
|
234
|
|
|
$
|
430
|
|
|
$
|
(196
|
)
|
|
(45.6
|
)%
|
|
Diluted earnings per common share
|
$
|
1.56
|
|
|
$
|
2.82
|
|
|
$
|
(1.26
|
)
|
|
(44.7
|
)%
|
|
Benefit ratio
(a)
|
84.8
|
%
|
|
83.1
|
%
|
|
|
|
1.7
|
%
|
||||
|
Operating cost ratio
(b)
|
12.9
|
%
|
|
14.2
|
%
|
|
|
|
(1.3
|
)%
|
||||
|
Effective tax rate
|
53.2
|
%
|
|
42.2
|
%
|
|
|
|
11.0
|
%
|
||||
|
(a)
|
Represents total benefits expense as a percentage of premiums revenue.
|
|
(b)
|
Represents total operating costs, excluding depreciation and amortization, as a percentage of total revenues less investment income.
|
|
|
March 31,
|
|
Change
|
||||||||
|
|
2016
|
|
2015
|
|
Members
|
|
Percentage
|
||||
|
Membership:
|
|
|
|
|
|
|
|
||||
|
Medical membership:
|
|
|
|
|
|
|
|
||||
|
Individual Medicare Advantage
|
2,807,200
|
|
|
2,685,900
|
|
|
121,300
|
|
|
4.5
|
%
|
|
Group Medicare Advantage
|
349,200
|
|
|
470,900
|
|
|
(121,700
|
)
|
|
(25.8
|
)%
|
|
Medicare stand-alone PDP
|
4,834,100
|
|
|
4,381,400
|
|
|
452,700
|
|
|
10.3
|
%
|
|
Total Retail Medicare
|
7,990,500
|
|
|
7,538,200
|
|
|
452,300
|
|
|
6.0
|
%
|
|
Individual commercial (a)
|
1,085,500
|
|
|
1,258,100
|
|
|
(172,600
|
)
|
|
(13.7
|
)%
|
|
State-based Medicaid
|
388,400
|
|
|
339,000
|
|
|
49,400
|
|
|
14.6
|
%
|
|
Total Retail medical members
|
9,464,400
|
|
|
9,135,300
|
|
|
329,100
|
|
|
3.6
|
%
|
|
Individual specialty membership (b)
|
1,143,200
|
|
|
1,173,300
|
|
|
(30,100
|
)
|
|
(2.6
|
)%
|
|
(a)
|
Individual commercial medical membership includes Medicare Supplement members.
|
|
(b)
|
Specialty products include dental, vision, and other supplemental health and financial protection products. Members included in these products may not be unique to each product since members have the ability to enroll in multiple products.
|
|
|
For the three months ended
March 31, |
|
Change
|
|||||||||||
|
|
2016
|
|
2015
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(in millions)
|
|
|
|||||||||||
|
Premiums and Services Revenue:
|
|
|
|
|
|
|
|
|||||||
|
Premiums:
|
|
|
|
|
|
|
|
|||||||
|
Individual Medicare Advantage
|
$
|
8,027
|
|
|
$
|
7,433
|
|
|
$
|
594
|
|
|
8.0
|
%
|
|
Group Medicare Advantage
|
1,077
|
|
|
1,394
|
|
|
(317
|
)
|
|
(22.7
|
)%
|
|||
|
Medicare stand-alone PDP
|
1,039
|
|
|
1,003
|
|
|
36
|
|
|
3.6
|
%
|
|||
|
Total Retail Medicare
|
10,143
|
|
|
9,830
|
|
|
313
|
|
|
3.2
|
%
|
|||
|
Individual commercial
|
997
|
|
|
1,094
|
|
|
(97
|
)
|
|
(8.9
|
)%
|
|||
|
State-based Medicaid
|
630
|
|
|
591
|
|
|
39
|
|
|
6.6
|
%
|
|||
|
Individual specialty
|
65
|
|
|
63
|
|
|
2
|
|
|
3.2
|
%
|
|||
|
Total premiums
|
11,835
|
|
|
11,578
|
|
|
257
|
|
|
2.2
|
%
|
|||
|
Services
|
2
|
|
|
4
|
|
|
(2
|
)
|
|
(50.0
|
)%
|
|||
|
Total premiums and services revenue
|
$
|
11,837
|
|
|
$
|
11,582
|
|
|
$
|
255
|
|
|
2.2
|
%
|
|
Income before income taxes
|
$
|
154
|
|
|
$
|
375
|
|
|
$
|
(221
|
)
|
|
(58.9
|
)%
|
|
Benefit ratio
|
87.7
|
%
|
|
85.8
|
%
|
|
|
|
1.9
|
%
|
||||
|
Operating cost ratio
|
10.8
|
%
|
|
10.8
|
%
|
|
|
|
—
|
%
|
||||
|
•
|
Retail segment pretax income was
$154 million
in the
2016 quarter
, a
decrease
of
$221 million
, or
58.9%
, compared to
$375 million
in the
2015 quarter
, as higher premiums were more than offset by an increase in the benefit ratio in the
2016 quarter
as discussed below.
|
|
•
|
Individual Medicare Advantage membership
increased
121,300
members, or
4.5%
, from
March 31, 2015
to
March 31, 2016
reflecting net membership additions, particularly for our HMO offerings, for the 2016 plan year.
|
|
•
|
Group Medicare Advantage membership
decreased
121,700
, or
25.8%
, from
March 31, 2015
to
March 31, 2016
reflecting
the loss of a large account that moved to a private exchange offering on January 1, 2016.
|
|
•
|
Medicare stand-alone PDP membership
increased
452,700
members, or
10.3%
, from
March 31, 2015
to
March 31, 2016
reflecting net membership additions, primarily for our Humana-Walmart plan offering, for the 2016 plan year
.
|
|
•
|
Individual commercial medical membership
decreased
172,600
members, or
13.7%
, from
March 31, 2015
to
March 31, 2016
primarily reflecting
the loss of members in plans compliant with the Health Care Reform Law, including the loss of approximately 150,000 members due to termination by CMS for lack of eligibility documentation as well as the loss of members due to the non-payment of premiums during the last three quarters of 2015, and the loss of members subscribing to plans that are not compliant with the Health Care Reform Law.
|
|
•
|
State-based Medicaid membership
increased
49,400
members, or
14.6%
, from
March 31, 2015
to
March 31, 2016
, primarily driven by
the addition of members under our Florida Medicaid contracts in the second half of 2015.
|
|
•
|
Individual specialty membership
decreased
30,100
members, or
2.6%
, from
March 31, 2015
to
March 31, 2016
.
|
|
•
|
Retail segment premiums increased
$257 million
, or
2.2%
, from the
2015 quarter
to the
2016 quarter
, primarily due to individual Medicare Advantage membership growth and increased per member premiums partially offset by declines in group Medicare Advantage and individual commercial medical membership. Average individual Medicare Advantage membership increased
4.7%
for the
2016 quarter
as compared to the
2015 quarter
.
|
|
•
|
The Retail segment benefit ratio
increased
190
basis points from
85.8%
in the
2015 quarter
to
87.7%
in the
2016 quarter
. This increase primarily was due to the unfavorable seasonal impact of an extra business day's claims from leap year in the 2016 quarter and a lower benefit in the 2016 quarter of the seasonal pattern of earnings associated with the individual business. The year-over-year lower seasonal pattern of earnings associated with the individual business includes lower future policy benefit reserve releases as individual commercial medical members transitioned to plans compliant with the Health Care Reform Law, the impact of a change in estimate for the net 3Rs receivables, and the unfavorable seasonal impact of the recognition of a premium deficiency reserve in the fourth quarter of 2015 for our individual commercial medical business compliant with the Health Care Reform law for the 2016 coverage year. These unfavorable items were partially offset by favorable year-over-year comparisons of prior-period medical claims reserve development. As previously disclosed, in the fourth quarter of 2015 we recorded a premium deficiency reserve associated with our 2016 individual commercial medical offerings compliant with the Health Care Reform Law. Historically, this business has reported profit in the first quarter of the year due to benefit designs. Because we continue to anticipate a loss associated with this business for the full year 2016, the seasonal earnings generated in the 2016 quarter were offset by an increase in the premium deficiency reserve, as expected, resulting in a higher benefit ratio year-over-year.
|
|
•
|
The Retail segment’s benefits expense for the
2016 quarter
included the beneficial effect of
$298 million
in favorable prior-period medical claims reserve development versus
$188 million
in the
2015 quarter
primarily due to the timing of Medicare financial claim recoveries and favorable year-over-year comparisons for our individual commercial and state-based contracts businesses. Prior-period medical claims reserve development decreased the Retail segment benefit ratio by approximately
250
basis points in the
2016 quarter
versus approximately
160
basis points in the
2015 quarter
.
|
|
•
|
The Retail segment operating cost ratio of
10.8%
for the
2016 quarter
remained unchanged year-over-year as administrative cost efficiencies associated with medical membership growth in the segment were offset by the loss of a large group Medicare Advantage account which carried a lower operating cost ratio than our individual Medicare Advantage business. The non-deductible health insurance industry fee impacted the operating cost ratio by
170
basis points in each of the
2016 quarter
and
2015 quarter
.
|
|
|
March 31,
|
|
Change
|
||||||||
|
|
2016
|
|
2015
|
|
Members
|
|
Percentage
|
||||
|
Membership:
|
|
|
|
|
|
|
|
||||
|
Medical membership:
|
|
|
|
|
|
|
|
||||
|
Fully-insured commercial group
|
1,136,400
|
|
|
1,189,600
|
|
|
(53,200
|
)
|
|
(4.5
|
)%
|
|
ASO
|
579,400
|
|
|
736,800
|
|
|
(157,400
|
)
|
|
(21.4
|
)%
|
|
Military services
|
3,076,800
|
|
|
3,085,600
|
|
|
(8,800
|
)
|
|
(0.3
|
)%
|
|
Total group medical members
|
4,792,600
|
|
|
5,012,000
|
|
|
(219,400
|
)
|
|
(4.4
|
)%
|
|
Group specialty membership (a)
|
5,901,900
|
|
|
6,251,200
|
|
|
(349,300
|
)
|
|
(5.6
|
)%
|
|
(a)
|
Specialty products include dental, vision, and voluntary benefit products. Members included in these products may not be unique to each product since members have the ability to enroll in multiple products.
|
|
|
For the three months ended
March 31, |
|
Change
|
|||||||||||
|
|
2016
|
|
2015
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(in millions)
|
|
|
|||||||||||
|
Premiums and Services Revenue:
|
|
|
|
|
|
|
|
|||||||
|
Premiums:
|
|
|
|
|
|
|
|
|||||||
|
Fully-insured commercial group
|
$
|
1,337
|
|
|
$
|
1,384
|
|
|
$
|
(47
|
)
|
|
(3.4
|
)%
|
|
Group specialty
|
253
|
|
|
270
|
|
|
(17
|
)
|
|
(6.3
|
)%
|
|||
|
Military services
|
5
|
|
|
6
|
|
|
(1
|
)
|
|
(16.7
|
)%
|
|||
|
Total premiums
|
1,595
|
|
|
1,660
|
|
|
(65
|
)
|
|
(3.9
|
)%
|
|||
|
Services
|
190
|
|
|
169
|
|
|
21
|
|
|
12.4
|
%
|
|||
|
Total premiums and services revenue
|
$
|
1,785
|
|
|
$
|
1,829
|
|
|
$
|
(44
|
)
|
|
(2.4
|
)%
|
|
Income before income taxes
|
$
|
158
|
|
|
$
|
154
|
|
|
$
|
4
|
|
|
2.6
|
%
|
|
Benefit ratio
|
74.8
|
%
|
|
73.9
|
%
|
|
|
|
0.9
|
%
|
||||
|
Operating cost ratio
|
24.1
|
%
|
|
24.5
|
%
|
|
|
|
(0.4
|
)%
|
||||
|
•
|
Group segment pretax income
increased
$4 million
to
$158 million
for the
2016 quarter
from the
2015 quarter
, primarily reflecting
improvement in the operating cost ratio partially offset by an increase in the benefit ratio
as discussed below.
|
|
•
|
Fully-insured commercial group medical membership
decreased
53,200
members, or
4.5%
, from
March 31, 2015
to
March 31, 2016
reflecting lower membership in both large and small group accounts.
|
|
•
|
Group ASO commercial medical membership
decreased
157,400
members, or
21.4%
, from
March 31, 2015
to
March 31, 2016
primarily due to the loss of certain large group accounts as a result of continued discipline in pricing of services for self-funded accounts amid a highly competitive environment.
|
|
•
|
Group specialty membership
decreased
349,300
members, or
5.6%
, from
March 31, 2015
to
March 31, 2016
primarily due to the loss of several large stand-alone dental and vision accounts as well as the loss of certain fully-insured group medical accounts that also had specialty coverage.
|
|
•
|
Group segment premiums
decreased
$65 million
, or
3.9%
from the
2015 quarter
to
$1.6 billion
for the
2016 quarter
primarily due to a net decline in fully-insured commercial medical membership partially offset by an increase in fully-insured commercial medical per member premiums.
|
|
•
|
Group segment services revenue
increased
$21 million
, or
12.4%
, to
$190 million
for the
2016 quarter
from the
2015 quarter
primarily due to an increase in incentives earned under our TRICARE South Region contract.
|
|
•
|
The Group segment benefit ratio
increased
90
basis points from
73.9%
in the
2015 quarter
to
74.8%
in the
2016 quarter
, primarily due to unfavorable medical claims reserve development in the last three quarters of 2015 related to claims incurred in the first quarter of 2015 (including changes in estimate for risk adjustment accruals) and the unfavorable seasonal impact of an extra business day's claims from leap year in the 2016 quarter, partially offset by the beneficial effect of higher favorable prior-period claims reserve development year-over-year.
|
|
•
|
The Group segment’s benefits expense included the beneficial effect of favorable prior-period medical claims reserve development of
$41 million
in the
2016 quarter
versus
$5 million
in the
2015 quarter
. This favorable prior-period medical claims reserve development decreased the Group segment benefit ratio by approximately
260
basis points in the
2016 quarter
and
30
basis points in the
2015 quarter
. The year-over-year increase in favorable prior-period medical claims reserve development primarily was due to higher financial claim recoveries.
|
|
•
|
The Group segment operating cost ratio of
24.1%
for the
2016 quarter
decreased
40
basis points from
24.5%
for the
2015 quarter
primarily due to a decline in our group ASO commercial medical membership which carries a higher operating cost ratio than our fully-insured commercial medical membership, as well as operating cost efficiencies associated with the fully-insured commercial medical business. The non-deductible health insurance industry fee impacted the operating cost ratio by
140
basis points in both the
2016 quarter
and the
2015 quarter
.
|
|
|
For the three months ended March 31,
|
|
Change
|
|||||||||||
|
|
2016
|
|
2015
|
|
Dollars
|
|
Percentage
|
|||||||
|
|
(in millions)
|
|
|
|||||||||||
|
Revenues:
|
|
|
|
|
|
|
|
|||||||
|
Services:
|
|
|
|
|
|
|
|
|||||||
|
Provider services
|
$
|
20
|
|
|
$
|
279
|
|
|
$
|
(259
|
)
|
|
(92.8
|
)%
|
|
Home based services
|
38
|
|
|
29
|
|
|
9
|
|
|
31.0
|
%
|
|||
|
Pharmacy solutions
|
7
|
|
|
7
|
|
|
0
|
|
|
—
|
%
|
|||
|
Total services revenues
|
65
|
|
|
315
|
|
|
(250
|
)
|
|
(79.4
|
)%
|
|||
|
Intersegment revenues:
|
|
|
|
|
|
|
|
|||||||
|
Pharmacy solutions
|
5,407
|
|
|
4,960
|
|
|
447
|
|
|
9.0
|
%
|
|||
|
Provider services
|
418
|
|
|
318
|
|
|
100
|
|
|
31.4
|
%
|
|||
|
Home based services
|
243
|
|
|
190
|
|
|
53
|
|
|
27.9
|
%
|
|||
|
Clinical programs
|
46
|
|
|
49
|
|
|
(3
|
)
|
|
(6.1
|
)%
|
|||
|
Total intersegment revenues
|
6,114
|
|
|
5,517
|
|
|
597
|
|
|
10.8
|
%
|
|||
|
Total services and intersegment revenues
|
$
|
6,179
|
|
|
$
|
5,832
|
|
|
$
|
347
|
|
|
5.9
|
%
|
|
Income before income taxes
|
$
|
241
|
|
|
$
|
230
|
|
|
$
|
11
|
|
|
4.8
|
%
|
|
Operating cost ratio
|
95.7
|
%
|
|
95.3
|
%
|
|
|
|
0.4
|
%
|
||||
|
•
|
Healthcare Services segment pretax income of
$241 million
for the
2016 quarter
increased
$11 million
, or
4.8%
, from the
2015 quarter
primarily due to
revenue growth from our pharmacy solutions business, including mail order, and home based services business as they serve our growing individual Medicare membership
. These items were substantially offset by decreased profitability in our provider services business discussed further below.
|
|
•
|
Humana Pharmacy Solutions
®
script volumes for Retail and Group segment membership increased to approximately
104 million
in the
2016 quarter
, up
8.6%
versus scripts of approximately
96 million
in the
2015 quarter
. This increase primarily reflects growth associated with higher average medical membership for the
2016 quarter
than in the
2015 quarter
.
|
|
•
|
Services revenues
decreased
$250 million
, or
79.4%
, from the
2015 quarter
to
$65 million
for the
2016 quarter
primarily due to the completion of the sale of Concentra on June 1, 2015.
|
|
•
|
Intersegment revenues
increased
$597 million
, or
10.8%
, from the
2015 quarter
to
$6.1 billion
for the
2016 quarter
primarily due to growth in our individual Medicare Advantage and Medicare stand-alone PDP membership as well as increased engagement of members in clinical programs which collectively resulted in higher utilization of services across the segment.
|
|
•
|
The Healthcare Services segment operating cost ratio of
95.7%
for the
2016 quarter
increased
40
basis points from the
2015 quarter
primarily due to decreased profitability in our provider services business reflecting significantly lower Medicare rates year-over-year associated with CMS' risk coding recalibration for 2016 in geographies where provider assets are located.
|
|
|
2016
|
|
2015
|
||||
|
|
(in millions)
|
||||||
|
Net cash provided by operating activities
|
$
|
482
|
|
|
$
|
107
|
|
|
Net cash used in investing activities
|
(428
|
)
|
|
(94
|
)
|
||
|
Net cash provided by (used in) financing activities
|
176
|
|
|
(2
|
)
|
||
|
Increase in cash and cash equivalents
|
$
|
230
|
|
|
$
|
11
|
|
|
|
March 31, 2016
|
|
December 31, 2015
|
|
2016
Quarter Change |
|
2015
Quarter Change |
||||||||
|
|
(in millions)
|
||||||||||||||
|
IBNR (1)
|
$
|
3,623
|
|
|
$
|
3,730
|
|
|
$
|
(107
|
)
|
|
$
|
144
|
|
|
Reported claims in process (2)
|
730
|
|
|
600
|
|
|
130
|
|
|
78
|
|
||||
|
Premium deficiency reserve (3)
|
189
|
|
|
176
|
|
|
13
|
|
|
—
|
|
||||
|
Other benefits payable (4)
|
$
|
572
|
|
|
$
|
470
|
|
|
102
|
|
|
67
|
|
||
|
Total benefits payable
|
$
|
5,114
|
|
|
$
|
4,976
|
|
|
$
|
138
|
|
|
$
|
289
|
|
|
(1)
|
IBNR represents an estimate of benefits payable for claims incurred but not reported (IBNR) at the balance sheet date and includes unprocessed claim inventories. The level of IBNR is primarily impacted by membership levels, medical 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 and processed (i.e. a shorter time span results in a lower IBNR).
|
|
(2)
|
Reported claims in process represents 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, as well as amounts owed to our pharmacy benefit administrator which fluctuate due to bi-weekly payments and the month-end cutoff.
|
|
(3)
|
Premium deficiency reserve recorded in the fourth quarter of 2015 and the first quarter of 2016 for our individual commercial medical business compliant with the Health Care Reform Law associated with the 2016 coverage year.
|
|
(4)
|
Other benefits payable primarily include amounts owed to providers under capitated and risk sharing arrangements.
|
|
|
March 31, 2016
|
|
December 31, 2015
|
|
2016
Quarter Change |
|
2015
Quarter Change |
||||||||
|
|
(in millions)
|
||||||||||||||
|
Medicare
|
$
|
1,357
|
|
|
$
|
765
|
|
|
$
|
592
|
|
|
$
|
542
|
|
|
Commercial and other
|
407
|
|
|
420
|
|
|
(13
|
)
|
|
141
|
|
||||
|
Military services
|
88
|
|
|
77
|
|
|
11
|
|
|
(34
|
)
|
||||
|
Allowance for doubtful accounts
|
(115
|
)
|
|
(101
|
)
|
|
(14
|
)
|
|
(12
|
)
|
||||
|
Total net receivables
|
$
|
1,737
|
|
|
$
|
1,161
|
|
|
576
|
|
|
637
|
|
||
|
Reconciliation to cash flow statement:
|
|
|
|
|
|
|
|
||||||||
|
Change in receivables held-for-sale and
disposition of receivables from sale of business |
|
|
|
|
—
|
|
|
7
|
|
||||||
|
Change in receivables per cash flow
statement resulting in cash from operations |
|
|
|
|
$
|
576
|
|
|
$
|
644
|
|
||||
|
Record
Date |
|
Payment
Date |
|
Amount
per Share |
|
Total
Amount |
||||
|
|
|
|
|
|
|
(in millions)
|
||||
|
2015 payments
|
|
|
|
|
|
|
||||
|
12/31/2014
|
|
1/30/2015
|
|
$
|
0.28
|
|
|
$
|
42
|
|
|
3/31/2015
|
|
4/24/2015
|
|
$
|
0.28
|
|
|
$
|
42
|
|
|
6/30/2015
|
|
7/31/2015
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
9/30/2015
|
|
10/30/2015
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
2016 payments
|
|
|
|
|
|
|
||||
|
12/30/2015
|
|
1/29/2016
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
3/31/2016
|
|
4/29/2016
|
|
$
|
0.29
|
|
|
$
|
43
|
|
|
Item 2:
|
Unregistered Sales of Equity Securities and Use of Proceeds
|
|
(a)
|
None.
|
|
(b)
|
N/A
|
|
(c)
|
The following table provides information about our purchases of equity securities that are registered by us pursuant to Section 12 of the Securities Exchange Act of 1934, as amended, during the
three months ended March 31, 2016
:
|
|
Period
|
Total Number
of Shares Purchased (1)(2) |
|
Average
Price Paid per Share |
|
Total Number of
Shares Purchased as Part of Publicly Announced Plans or Programs (1)(2) |
|
Dollar Value of
Shares that May Yet Be Purchased Under the Plans or Programs (1) |
||||||
|
January 2016
|
—
|
|
|
$
|
—
|
|
|
—
|
|
|
$
|
—
|
|
|
February 2016
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||
|
March 2016
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||
|
Total
|
—
|
|
|
$
|
—
|
|
|
—
|
|
|
|
||
|
(1)
|
In September 2014, the Board of Directors replaced a previous share repurchase authorization of up to $1 billion with a current authorization for repurchases of up to $2 billion of our common shares exclusive of shares repurchased in connection with employee stock plans, expiring on December 31, 2016.
Pursuant to the Merger Agreement
, after July 2, 2015, we are prohibited from repurchasing any of our outstanding securities without the prior written consent of Aetna, other than repurchases of shares of our common stock in connection with the exercise of outstanding stock options or the vesting or settlement of outstanding restricted stock awards. Accordingly, as announced on July 3, 2015, we have suspended our share repurchase program.
Our remaining repurchase authorization was
$1.04 billion
as of July 3, 2015.
|
|
(2)
|
Excludes
0.43 million
shares repurchased in connection with employee stock plans.
|
|
Item 3:
|
Defaults Upon Senior Securities
|
|
Item 4:
|
Mine Safety Disclosures
|
|
Item 5:
|
Other Information
|
|
Item 6:
|
Exhibits
|
|
3(i)
|
Restated Certificate of Incorporation of Humana Inc. filed with the Secretary of State of Delaware on November 9, 1989, as restated to incorporate the amendment of January 9, 1992, and the correction of March 23, 1992 (incorporated herein by reference to Exhibit 4(i) to Humana Inc.’s Post-Effective Amendment No. 1 to the Registration Statement on Form S-8 (Reg. No. 33-49305) filed February 2, 1994).
|
|
3(ii)
|
By-Laws of Humana Inc., as amended on January 4, 2007 (incorporated herein by reference to Exhibit 3 to Humana Inc.’s Annual Report on Form 10-K for the year ended December 31, 2006).
|
|
12
|
Computation of ratio of earnings to fixed charges.
|
|
31.1
|
Principal Executive Officer certification pursuant to Section 302 of Sarbanes–Oxley Act of 2002.
|
|
31.2
|
Principal Financial Officer certification pursuant to Section 302 of Sarbanes–Oxley Act of 2002.
|
|
32
|
Principal Executive Officer and Principal Financial Officer certification pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
|
|
101
|
The following materials from Humana Inc.'s Quarterly Report of Form 10-Q formatted in XBRL (Extensible Business Reporting Language): (i) the Condensed Consolidated Balance Sheets at
March 31, 2016
and
December 31, 2015
; (ii) the Condensed Consolidated Statements of Income for the
three
months ended
March 31, 2016
and
2015
; (iii) the Condensed Consolidated Statements of Comprehensive Income for the
three
months ended
March 31, 2016
and
2015
; (iv) the Condensed Consolidated Statements of Cash Flows for the
three
months ended
March 31, 2016
and
2015
; and (v) Notes to Condensed Consolidated Financial Statements.
|
|
|
|
HUMANA INC.
|
|
|
|
|
(Registrant)
|
|
|
|
|
|
|
|
Date:
|
May 4, 2016
|
By:
|
/s/ CYNTHIA H. ZIPPERLE
|
|
|
|
|
Cynthia H. Zipperle
|
|
|
|
|
Vice President, Chief Accounting Officer and Controller (Principal Accounting Officer)
|
|
|
|
|
|
No information found
* THE VALUE IS THE MARKET VALUE AS OF THE LAST DAY OF THE QUARTER FOR WHICH THE 13F WAS FILED.
| FUND | NUMBER OF SHARES | VALUE ($) | PUT OR CALL |
|---|
| DIRECTORS | AGE | BIO | OTHER DIRECTOR MEMBERSHIPS |
|---|
No information found
No Customers Found
Suppliers
| Supplier name | Ticker |
|---|---|
| Amgen Inc. | AMGN |
| Bristol-Myers Squibb Company | BMY |
| Abbott Laboratories | ABT |
| AbbVie Inc. | ABBV |
| Johnson & Johnson | JNJ |
| Eli Lilly and Company | LLY |
| Merck & Co., Inc. | MRK |
| Pfizer Inc. | PFE |
Price
Yield
| Owner | Position | Direct Shares | Indirect Shares |
|---|