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FORM 10-Q
|
ý
|
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15 (d) OF THE
SECURITIES EXCHANGE ACT OF 1934
|
¨
|
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15 (d) OF THE
SECURITIES EXCHANGE ACT OF 1934
|
HUMANA INC.
(Exact name of registrant as specified in its charter)
|
|
Delaware
|
|
61-0647538
|
(State or other jurisdiction of
incorporation or organization)
|
|
(I.R.S. Employer
Identification Number)
|
|
Large accelerated filer
|
ý
|
|
Accelerated filer
|
¨
|
|
|
|
|
|
Non-accelerated filer
|
¨
|
|
Smaller reporting company
|
¨
|
|
|
|
|
|
Emerging growth company
|
¨
|
|
|
|
Class of Common Stock
|
Outstanding at
March 31, 2017 |
$0.16 2/3 par value
|
144,314,925 shares
|
|
|
Page
|
Part I: Financial Information
|
|
|
Item 1.
|
Financial Statements (Unaudited)
|
|
|
|
|
|
||
|
|
|
|
||
|
|
|
|
||
|
|
|
|
||
|
|
|
|
||
|
|
|
Item 2.
|
||
|
|
|
Item 3.
|
||
|
|
|
Item 4.
|
||
|
|
|
|
||
|
|
|
Item 1.
|
||
|
|
|
Item 1A.
|
||
|
|
|
Item 2.
|
||
|
|
|
Item 3.
|
||
|
|
|
Item 4.
|
||
|
|
|
Item 5.
|
||
|
|
|
Item 6.
|
||
|
|
|
|
||
|
|
|
|
Certifications
|
|
|
March 31,
2017 |
|
December 31,
2016 |
||||
|
(in millions, except share amounts)
|
||||||
A
SSETS
|
|
|
|
||||
Current assets:
|
|
|
|
||||
Cash and cash equivalents
|
$
|
8,425
|
|
|
$
|
3,877
|
|
Investment securities
|
8,205
|
|
|
7,595
|
|
||
Receivables, less allowance for doubtful accounts of $113 in 2017
and $118 in 2016: |
1,838
|
|
|
1,280
|
|
||
Other current assets
|
3,849
|
|
|
3,438
|
|
||
Total current assets
|
22,317
|
|
|
16,190
|
|
||
Property and equipment, net
|
1,525
|
|
|
1,505
|
|
||
Long-term investment securities
|
2,424
|
|
|
2,203
|
|
||
Goodwill
|
3,279
|
|
|
3,272
|
|
||
Other long-term assets
|
2,167
|
|
|
2,226
|
|
||
Total assets
|
$
|
31,712
|
|
|
$
|
25,396
|
|
L
IABILITIES
AND
S
TOCKHOLDERS
’ E
QUITY
|
|
|
|
||||
Current liabilities:
|
|
|
|
||||
Benefits payable
|
$
|
4,761
|
|
|
$
|
4,563
|
|
Trade accounts payable and accrued expenses
|
4,675
|
|
|
2,467
|
|
||
Book overdraft
|
178
|
|
|
212
|
|
||
Unearned revenues
|
3,420
|
|
|
280
|
|
||
Short-term borrowings
|
470
|
|
|
300
|
|
||
Total current liabilities
|
13,504
|
|
|
7,822
|
|
||
Long-term debt
|
4,780
|
|
|
3,792
|
|
||
Future policy benefits payable
|
2,827
|
|
|
2,834
|
|
||
Other long-term liabilities
|
367
|
|
|
263
|
|
||
Total liabilities
|
21,478
|
|
|
14,711
|
|
||
Commitments and contingencies
|
|
|
|
||||
Stockholders’ equity:
|
|
|
|
||||
Preferred stock, $1 par; 10,000,000 shares authorized; none issued
|
—
|
|
|
—
|
|
||
Common stock, $0.16 2/3 par; 300,000,000 shares authorized;
198,565,891 shares issued at March 31, 2017 and 198,495,007 shares issued at December 31, 2016 |
33
|
|
|
33
|
|
||
Capital in excess of par value
|
2,246
|
|
|
2,562
|
|
||
Retained earnings
|
12,509
|
|
|
11,454
|
|
||
Accumulated other comprehensive loss
|
(58
|
)
|
|
(66
|
)
|
||
Treasury stock, at cost, 54,250,966 shares at March 31, 2017 and
49,189,811 shares at December 31, 2016 |
(4,496
|
)
|
|
(3,298
|
)
|
||
Total stockholders’ equity
|
10,234
|
|
|
10,685
|
|
||
Total liabilities and stockholders’ equity
|
$
|
31,712
|
|
|
$
|
25,396
|
|
|
Three months ended
March 31, |
||||||
|
2017
|
|
2016
|
||||
|
(in millions, except per share results)
|
||||||
Revenues:
|
|
|
|
||||
Premiums
|
$
|
13,398
|
|
|
$
|
13,440
|
|
Services
|
253
|
|
|
260
|
|
||
Investment income
|
111
|
|
|
100
|
|
||
Total revenues
|
13,762
|
|
|
13,800
|
|
||
Operating expenses:
|
|
|
|
||||
Benefits
|
11,326
|
|
|
11,397
|
|
||
Operating costs
|
1,553
|
|
|
1,734
|
|
||
Merger termination fee and related costs, net
|
(947
|
)
|
|
34
|
|
||
Depreciation and amortization
|
92
|
|
|
88
|
|
||
Total operating expenses
|
12,024
|
|
|
13,253
|
|
||
Income from operations
|
1,738
|
|
|
547
|
|
||
Interest expense
|
49
|
|
|
47
|
|
||
Income before income taxes
|
1,689
|
|
|
500
|
|
||
Provision for income taxes
|
574
|
|
|
246
|
|
||
Net income
|
$
|
1,115
|
|
|
$
|
254
|
|
Basic earnings per common share
|
$
|
7.54
|
|
|
$
|
1.70
|
|
Diluted earnings per common share
|
$
|
7.49
|
|
|
$
|
1.68
|
|
Dividends declared per common share
|
$
|
0.40
|
|
|
$
|
0.29
|
|
|
Three months ended
March 31, |
||||||
|
2017
|
|
2016
|
||||
|
(in millions)
|
||||||
Net income
|
$
|
1,115
|
|
|
$
|
254
|
|
Other comprehensive income:
|
|
|
|
||||
Change in gross unrealized investment
gains/losses |
38
|
|
|
48
|
|
||
Effect of income taxes
|
(14
|
)
|
|
(17
|
)
|
||
Total change in unrealized
investment gains/losses, net of tax |
24
|
|
|
31
|
|
||
Reclassification adjustment for net
realized gains included in investment income |
(26
|
)
|
|
(20
|
)
|
||
Effect of income taxes
|
10
|
|
|
7
|
|
||
Total reclassification adjustment, net
of tax |
(16
|
)
|
|
(13
|
)
|
||
Other comprehensive income, net
of tax |
8
|
|
|
18
|
|
||
Comprehensive income
|
$
|
1,123
|
|
|
$
|
272
|
|
|
For the three months ended
March 31, |
||||||
|
2017
|
|
2016
|
||||
|
(in millions)
|
||||||
Cash flows from operating activities
|
|
|
|
||||
Net income
|
$
|
1,115
|
|
|
$
|
254
|
|
Adjustments to reconcile net income to net cash provided by
operating activities: |
|
|
|
||||
Net realized capital gains
|
(26
|
)
|
|
(20
|
)
|
||
Stock-based compensation
|
26
|
|
|
23
|
|
||
Depreciation
|
100
|
|
|
94
|
|
||
Other intangible amortization
|
18
|
|
|
21
|
|
||
Provision for deferred income taxes
|
29
|
|
|
15
|
|
||
Changes in operating assets and liabilities, net of effect of
businesses acquired and dispositions: |
|
|
|
||||
Receivables
|
(558
|
)
|
|
(576
|
)
|
||
Other assets
|
(415
|
)
|
|
(685
|
)
|
||
Benefits payable
|
198
|
|
|
138
|
|
||
Other liabilities
|
542
|
|
|
1,210
|
|
||
Unearned revenues
|
3,140
|
|
|
(4
|
)
|
||
Other, net
|
36
|
|
|
32
|
|
||
Net cash provided by operating activities
|
4,205
|
|
|
502
|
|
||
Cash flows from investing activities
|
|
|
|
||||
Acquisitions, net of cash acquired
|
(7
|
)
|
|
—
|
|
||
Purchases of property and equipment
|
(122
|
)
|
|
(125
|
)
|
||
Purchases of investment securities
|
(1,876
|
)
|
|
(1,430
|
)
|
||
Maturities of investment securities
|
284
|
|
|
213
|
|
||
Proceeds from sales of investment securities
|
795
|
|
|
914
|
|
||
Net cash used in investing activities
|
(926
|
)
|
|
(428
|
)
|
||
Cash flows from financing activities
|
|
|
|
||||
Receipts from contract deposits, net
|
1,730
|
|
|
318
|
|
||
Proceeds from issuance of senior notes, net
|
991
|
|
|
—
|
|
||
Proceeds from issuance of commercial paper, net
|
169
|
|
|
—
|
|
||
Change in book overdraft
|
(34
|
)
|
|
(44
|
)
|
||
Common stock repurchases
|
(1,574
|
)
|
|
(71
|
)
|
||
Dividends paid
|
(47
|
)
|
|
(47
|
)
|
||
Proceeds from stock option exercises and other
|
34
|
|
|
—
|
|
||
Net cash provided by financing activities
|
1,269
|
|
|
156
|
|
||
Increase in cash and cash equivalents
|
4,548
|
|
|
230
|
|
||
Cash and cash equivalents at beginning of period
|
3,877
|
|
|
2,571
|
|
||
Cash and cash equivalents at end of period
|
$
|
8,425
|
|
|
$
|
2,801
|
|
Supplemental cash flow disclosures:
|
|
|
|
||||
Interest payments
|
$
|
10
|
|
|
$
|
10
|
|
Income tax (refunds) payments, net
|
$
|
(4
|
)
|
|
$
|
5
|
|
|
Amortized
Cost
|
|
Gross
Unrealized
Gains
|
|
Gross
Unrealized
Losses
|
|
Fair
Value
|
||||||||
|
(in millions)
|
||||||||||||||
March 31, 2017
|
|
|
|
|
|
|
|
||||||||
U.S. Treasury and other U.S. government
corporations and agencies: |
|
|
|
|
|
|
|
||||||||
U.S. Treasury and agency obligations
|
$
|
833
|
|
|
$
|
—
|
|
|
$
|
(12
|
)
|
|
$
|
821
|
|
Mortgage-backed securities
|
1,645
|
|
|
4
|
|
|
(31
|
)
|
|
1,618
|
|
||||
Tax-exempt municipal securities
|
3,408
|
|
|
9
|
|
|
(48
|
)
|
|
3,369
|
|
||||
Mortgage-backed securities:
|
|
|
|
|
|
|
|
||||||||
Residential
|
8
|
|
|
—
|
|
|
—
|
|
|
8
|
|
||||
Commercial
|
412
|
|
|
1
|
|
|
(4
|
)
|
|
409
|
|
||||
Asset-backed securities
|
132
|
|
|
—
|
|
|
—
|
|
|
132
|
|
||||
Corporate debt securities
|
4,198
|
|
|
144
|
|
|
(70
|
)
|
|
4,272
|
|
||||
Total debt securities
|
$
|
10,636
|
|
|
$
|
158
|
|
|
$
|
(165
|
)
|
|
$
|
10,629
|
|
|
|
|
|
|
|
|
|
||||||||
December 31, 2016
|
|
|
|
|
|
|
|
||||||||
U.S. Treasury and other U.S. government
corporations and agencies: |
|
|
|
|
|
|
|
||||||||
U.S. Treasury and agency obligations
|
$
|
800
|
|
|
$
|
1
|
|
|
$
|
(15
|
)
|
|
$
|
786
|
|
Mortgage-backed securities
|
1,662
|
|
|
6
|
|
|
(31
|
)
|
|
1,637
|
|
||||
Tax-exempt municipal securities
|
3,358
|
|
|
15
|
|
|
(68
|
)
|
|
3,305
|
|
||||
Mortgage-backed securities:
|
|
|
|
|
|
|
|
||||||||
Residential
|
9
|
|
|
—
|
|
|
—
|
|
|
9
|
|
||||
Commercial
|
307
|
|
|
1
|
|
|
(4
|
)
|
|
304
|
|
||||
Asset-backed securities
|
160
|
|
|
—
|
|
|
—
|
|
|
160
|
|
||||
Corporate debt securities
|
3,530
|
|
|
145
|
|
|
(78
|
)
|
|
3,597
|
|
||||
Total debt securities
|
$
|
9,826
|
|
|
$
|
168
|
|
|
$
|
(196
|
)
|
|
$
|
9,798
|
|
|
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, 2017
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
U.S. Treasury and other U.S.
government corporations and agencies: |
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
U.S. Treasury and agency
obligations |
$
|
705
|
|
|
$
|
(12
|
)
|
|
$
|
3
|
|
|
$
|
—
|
|
|
$
|
708
|
|
|
$
|
(12
|
)
|
Mortgage-backed
securities |
1,565
|
|
|
(31
|
)
|
|
3
|
|
|
—
|
|
|
1,568
|
|
|
(31
|
)
|
||||||
Tax-exempt municipal
securities |
2,493
|
|
|
(47
|
)
|
|
25
|
|
|
(1
|
)
|
|
2,518
|
|
|
(48
|
)
|
||||||
Mortgage-backed securities:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
Residential
|
—
|
|
|
—
|
|
|
4
|
|
|
—
|
|
|
4
|
|
|
—
|
|
||||||
Commercial
|
190
|
|
|
(3
|
)
|
|
8
|
|
|
(1
|
)
|
|
198
|
|
|
(4
|
)
|
||||||
Asset-backed securities
|
65
|
|
|
—
|
|
|
52
|
|
|
—
|
|
|
117
|
|
|
—
|
|
||||||
Corporate debt securities
|
1,710
|
|
|
(65
|
)
|
|
70
|
|
|
(5
|
)
|
|
1,780
|
|
|
(70
|
)
|
||||||
Total debt securities
|
$
|
6,728
|
|
|
$
|
(158
|
)
|
|
$
|
165
|
|
|
$
|
(7
|
)
|
|
$
|
6,893
|
|
|
$
|
(165
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
December 31, 2016
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
U.S. Treasury and other U.S.
government corporations and agencies: |
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
U.S. Treasury and agency
obligations |
$
|
697
|
|
|
$
|
(15
|
)
|
|
$
|
3
|
|
|
$
|
—
|
|
|
$
|
700
|
|
|
$
|
(15
|
)
|
Mortgage-backed
securities |
1,528
|
|
|
(31
|
)
|
|
3
|
|
|
—
|
|
|
1,531
|
|
|
(31
|
)
|
||||||
Tax-exempt municipal
securities |
2,756
|
|
|
(67
|
)
|
|
43
|
|
|
(1
|
)
|
|
2,799
|
|
|
(68
|
)
|
||||||
Mortgage-backed securities:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
Residential
|
—
|
|
|
—
|
|
|
4
|
|
|
—
|
|
|
4
|
|
|
—
|
|
||||||
Commercial
|
182
|
|
|
(3
|
)
|
|
24
|
|
|
(1
|
)
|
|
206
|
|
|
(4
|
)
|
||||||
Asset-backed securities
|
51
|
|
|
—
|
|
|
63
|
|
|
—
|
|
|
114
|
|
|
—
|
|
||||||
Corporate debt securities
|
1,544
|
|
|
(71
|
)
|
|
69
|
|
|
(7
|
)
|
|
1,613
|
|
|
(78
|
)
|
||||||
Total debt securities
|
$
|
6,758
|
|
|
$
|
(187
|
)
|
|
$
|
209
|
|
|
$
|
(9
|
)
|
|
$
|
6,967
|
|
|
$
|
(196
|
)
|
|
Three months ended
March 31, |
||||||
|
2017
|
|
2016
|
||||
|
(in millions)
|
||||||
Gross realized gains
|
$
|
27
|
|
|
$
|
31
|
|
Gross realized losses
|
(1
|
)
|
|
(11
|
)
|
||
Net realized capital gains
|
$
|
26
|
|
|
$
|
20
|
|
|
Amortized
Cost |
|
Fair
Value |
||||
|
(in millions)
|
||||||
Due within one year
|
$
|
561
|
|
|
$
|
562
|
|
Due after one year through five years
|
2,764
|
|
|
2,770
|
|
||
Due after five years through ten years
|
2,188
|
|
|
2,153
|
|
||
Due after ten years
|
2,926
|
|
|
2,977
|
|
||
Mortgage and asset-backed securities
|
2,197
|
|
|
2,167
|
|
||
Total debt securities
|
$
|
10,636
|
|
|
$
|
10,629
|
|
|
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, 2017
|
|
|
|
|
|
|
|
||||||||
Cash equivalents
|
$
|
8,034
|
|
|
$
|
8,034
|
|
|
$
|
—
|
|
|
$
|
—
|
|
Debt securities:
|
|
|
|
|
|
|
|
||||||||
U.S. Treasury and other U.S. government
corporations and agencies: |
|
|
|
|
|
|
|
||||||||
U.S. Treasury and agency obligations
|
821
|
|
|
—
|
|
|
821
|
|
|
—
|
|
||||
Mortgage-backed securities
|
1,618
|
|
|
—
|
|
|
1,618
|
|
|
—
|
|
||||
Tax-exempt municipal securities
|
3,369
|
|
|
—
|
|
|
3,366
|
|
|
3
|
|
||||
Mortgage-backed securities:
|
|
|
|
|
|
|
|
||||||||
Residential
|
8
|
|
|
—
|
|
|
8
|
|
|
—
|
|
||||
Commercial
|
409
|
|
|
—
|
|
|
409
|
|
|
—
|
|
||||
Asset-backed securities
|
132
|
|
|
—
|
|
|
132
|
|
|
—
|
|
||||
Corporate debt securities
|
4,272
|
|
|
—
|
|
|
4,268
|
|
|
4
|
|
||||
Total debt securities
|
10,629
|
|
|
—
|
|
|
10,622
|
|
|
7
|
|
||||
Total invested assets
|
$
|
18,663
|
|
|
$
|
8,034
|
|
|
$
|
10,622
|
|
|
$
|
7
|
|
|
|
|
|
|
|
|
|
||||||||
December 31, 2016
|
|
|
|
|
|
|
|
||||||||
Cash equivalents
|
$
|
3,654
|
|
|
$
|
3,654
|
|
|
$
|
—
|
|
|
$
|
—
|
|
Debt securities:
|
|
|
|
|
|
|
|
||||||||
U.S. Treasury and other U.S. government
corporations and agencies: |
|
|
|
|
|
|
|
||||||||
U.S. Treasury and agency obligations
|
786
|
|
|
—
|
|
|
786
|
|
|
—
|
|
||||
Mortgage-backed securities
|
1,637
|
|
|
—
|
|
|
1,637
|
|
|
—
|
|
||||
Tax-exempt municipal securities
|
3,305
|
|
|
—
|
|
|
3,302
|
|
|
3
|
|
||||
Mortgage-backed securities:
|
|
|
|
|
|
|
|
||||||||
Residential
|
9
|
|
|
—
|
|
|
9
|
|
|
—
|
|
||||
Commercial
|
304
|
|
|
—
|
|
|
304
|
|
|
—
|
|
||||
Asset-backed securities
|
160
|
|
|
—
|
|
|
160
|
|
|
—
|
|
||||
Corporate debt securities
|
3,597
|
|
|
—
|
|
|
3,593
|
|
|
4
|
|
||||
Total debt securities
|
9,798
|
|
|
—
|
|
|
9,791
|
|
|
7
|
|
||||
Total invested assets
|
$
|
13,452
|
|
|
$
|
3,654
|
|
|
$
|
9,791
|
|
|
$
|
7
|
|
|
For the three months ended March 31,
|
||||||||||||||||||||||
|
2017
|
|
2016
|
||||||||||||||||||||
|
Private
Placements |
|
Auction
Rate Securities |
|
Total
|
|
Private
Placements |
|
Auction
Rate Securities |
|
Total
|
||||||||||||
|
(in millions)
|
||||||||||||||||||||||
Beginning balance at January 1
|
$
|
4
|
|
|
$
|
3
|
|
|
$
|
7
|
|
|
$
|
6
|
|
|
$
|
5
|
|
|
$
|
11
|
|
Settlements
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(2
|
)
|
|
(2
|
)
|
||||||
Balance at March 31
|
$
|
4
|
|
|
$
|
3
|
|
|
$
|
7
|
|
|
$
|
6
|
|
|
$
|
3
|
|
|
$
|
9
|
|
|
March 31, 2017
|
|
December 31, 2016
|
||||||||||||
Risk
Corridor Settlement |
|
CMS
Subsidies/ Discounts |
|
Risk
Corridor Settlement |
|
CMS
Subsidies/ Discounts |
|||||||||
|
(in millions)
|
||||||||||||||
Other current assets
|
$
|
8
|
|
|
$
|
1,044
|
|
|
$
|
8
|
|
|
$
|
1,001
|
|
Trade accounts payable and accrued expenses
|
(126
|
)
|
|
(1,895
|
)
|
|
(158
|
)
|
|
(128
|
)
|
||||
Net current (liability) asset
|
(118
|
)
|
|
(851
|
)
|
|
(150
|
)
|
|
873
|
|
||||
Other long-term assets
|
12
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
Other long-term liabilities
|
(74
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
Net long-term liability
|
(62
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
Total net (liability) asset
|
$
|
(180
|
)
|
|
$
|
(851
|
)
|
|
$
|
(150
|
)
|
|
$
|
873
|
|
|
March 31, 2017
|
|
December 31, 2016
|
||||||||||||||||
|
Risk Adjustment
Settlement |
|
Reinsurance
Recoverables |
|
Risk Adjustment
Settlement |
|
Reinsurance
Recoverables |
||||||||||||
|
(in millions)
|
||||||||||||||||||
Prior Coverage Years
|
|
|
|
|
|
|
|
||||||||||||
Premiums receivable
|
$
|
320
|
|
|
$
|
—
|
|
|
$
|
307
|
|
|
$
|
—
|
|
||||
Other current assets
|
—
|
|
|
207
|
|
|
—
|
|
|
260
|
|
||||||||
Trade accounts payable and
accrued expenses |
(124
|
)
|
|
—
|
|
|
(117
|
)
|
|
—
|
|
||||||||
Net current asset
|
196
|
|
|
207
|
|
|
190
|
|
|
260
|
|
||||||||
Other long-term assets
|
—
|
|
|
—
|
|
|
6
|
|
|
—
|
|
||||||||
Total prior coverage years' net
asset |
196
|
|
|
207
|
|
|
196
|
|
|
260
|
|
||||||||
Current Coverage Year
|
|
|
|
|
|
|
|
||||||||||||
Other long-term assets
|
17
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||||
Other long-term liabilities
|
(26
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||||
Total 2017 coverage year net
liability |
(9
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||||
Total net asset
|
$
|
187
|
|
|
$
|
207
|
|
|
$
|
196
|
|
|
$
|
260
|
|
|
Retail
|
|
Group and Specialty
|
|
Healthcare
Services |
|
Total
|
||||||||
|
(in millions)
|
||||||||||||||
Balance at January 1, 2017
|
$
|
1,059
|
|
|
$
|
261
|
|
|
$
|
1,952
|
|
|
$
|
3,272
|
|
Acquisitions
|
—
|
|
|
—
|
|
|
7
|
|
|
7
|
|
||||
Balance at March 31, 2017
|
$
|
1,059
|
|
|
$
|
261
|
|
|
$
|
1,959
|
|
|
$
|
3,279
|
|
|
|
|
March 31, 2017
|
|
December 31, 2016
|
||||||||||||||||||||
|
Weighted
Average Life |
|
Cost
|
|
Accumulated
Amortization |
|
Net
|
|
Cost
|
|
Accumulated
Amortization |
|
Net
|
||||||||||||
|
|
|
($ in millions)
|
||||||||||||||||||||||
Other intangible assets:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
Customer contracts/
relationships |
9.8 years
|
|
$
|
566
|
|
|
$
|
360
|
|
|
$
|
206
|
|
|
$
|
566
|
|
|
$
|
347
|
|
|
$
|
219
|
|
Trade names and
technology |
8.2 years
|
|
104
|
|
|
72
|
|
|
32
|
|
|
104
|
|
|
69
|
|
|
35
|
|
||||||
Provider contracts
|
14.1 years
|
|
51
|
|
|
30
|
|
|
21
|
|
|
51
|
|
|
29
|
|
|
22
|
|
||||||
Noncompetes and
other |
8.2 years
|
|
32
|
|
|
29
|
|
|
3
|
|
|
32
|
|
|
28
|
|
|
4
|
|
||||||
Total other intangible
assets |
9.8 years
|
|
$
|
753
|
|
|
$
|
491
|
|
|
$
|
262
|
|
|
$
|
753
|
|
|
$
|
473
|
|
|
$
|
280
|
|
|
(in millions)
|
||
For the years ending December 31,:
|
|
||
2017
|
$
|
71
|
|
2018
|
63
|
|
|
2019
|
52
|
|
|
2020
|
48
|
|
|
2021
|
14
|
|
|
2022
|
11
|
|
|
|
For the three months ended March 31,
|
||||||
|
|
2017
|
|
2016
|
||||
|
|
(in millions)
|
||||||
Balances at January 1
|
|
$
|
4,563
|
|
|
$
|
4,976
|
|
Less: Premium deficiency reserve
|
|
—
|
|
|
(176
|
)
|
||
Less: Reinsurance recoverables
|
|
(76
|
)
|
|
(85
|
)
|
||
Balances at January 1, net
|
|
4,487
|
|
|
4,715
|
|
||
Incurred related to:
|
|
|
|
|
||||
Current year
|
|
11,580
|
|
|
11,751
|
|
||
Prior years
|
|
(231
|
)
|
|
(340
|
)
|
||
Total incurred
|
|
11,349
|
|
|
11,411
|
|
||
Paid related to:
|
|
|
|
|
||||
Current year
|
|
(7,695
|
)
|
|
(7,692
|
)
|
||
Prior years
|
|
(3,451
|
)
|
|
(3,576
|
)
|
||
Total paid
|
|
(11,146
|
)
|
|
(11,268
|
)
|
||
Premium deficiency reserve
|
|
—
|
|
|
189
|
|
||
Reinsurance recoverable
|
|
71
|
|
|
67
|
|
||
Ending Balance
|
|
$
|
4,761
|
|
|
$
|
5,114
|
|
|
|
March 31, 2017
|
|
March 31, 2016
|
||||
|
|
(in millions)
|
||||||
Premium deficiency reserve - Individual Commercial
|
|
$
|
—
|
|
|
$
|
13
|
|
Military services
|
|
—
|
|
|
3
|
|
||
Future policy benefits:
|
|
|
|
|
||||
Individual Commercial
|
|
(33
|
)
|
|
(40
|
)
|
||
Other Businesses
|
|
10
|
|
|
10
|
|
||
Total future policy benefits
|
|
(23
|
)
|
|
(30
|
)
|
||
Total
|
|
$
|
(23
|
)
|
|
$
|
(14
|
)
|
|
|
For the three months ended March 31,
|
||||||
|
|
2017
|
|
2016
|
||||
|
|
(in millions)
|
||||||
Balances at January 1
|
|
$
|
3,507
|
|
|
$
|
3,600
|
|
Less: Reinsurance recoverables
|
|
(76
|
)
|
|
(85
|
)
|
||
Balances at January 1, net
|
|
3,431
|
|
|
3,515
|
|
||
Incurred related to:
|
|
|
|
|
||||
Current year
|
|
10,255
|
|
|
9,851
|
|
||
Prior years
|
|
(204
|
)
|
|
(218
|
)
|
||
Total incurred
|
|
10,051
|
|
|
9,633
|
|
||
Paid related to:
|
|
|
|
|
||||
Current year
|
|
(7,014
|
)
|
|
(6,706
|
)
|
||
Prior years
|
|
(2,572
|
)
|
|
(2,685
|
)
|
||
Total paid
|
|
(9,586
|
)
|
|
(9,391
|
)
|
||
Reinsurance recoverable
|
|
71
|
|
|
67
|
|
||
Ending Balance
|
|
$
|
3,967
|
|
|
$
|
3,824
|
|
|
|
For the three months ended March 31,
|
||||||
|
|
2017
|
|
2016
|
||||
|
|
(in millions)
|
||||||
Balances at January 1
|
|
$
|
578
|
|
|
$
|
616
|
|
Incurred related to:
|
|
|
|
|
||||
Current year
|
|
1,306
|
|
|
1,260
|
|
||
Prior years
|
|
(20
|
)
|
|
(41
|
)
|
||
Total incurred
|
|
1,286
|
|
|
1,219
|
|
||
Paid related to:
|
|
|
|
|
||||
Current year
|
|
(824
|
)
|
|
(728
|
)
|
||
Prior years
|
|
(493
|
)
|
|
(502
|
)
|
||
Total paid
|
|
(1,317
|
)
|
|
(1,230
|
)
|
||
Ending Balance
|
|
$
|
547
|
|
|
$
|
605
|
|
|
|
For the three months ended March 31,
|
||||||
|
|
2017
|
|
2016
|
||||
|
|
(in millions)
|
||||||
Balances at January 1
|
|
$
|
454
|
|
|
$
|
740
|
|
Less: Premium deficiency reserve
|
|
—
|
|
|
(176
|
)
|
||
Balances at January 1, net
|
|
454
|
|
|
564
|
|
||
Incurred related to:
|
|
|
|
|
||||
Current year
|
|
185
|
|
|
826
|
|
||
Prior years
|
|
(6
|
)
|
|
(80
|
)
|
||
Total incurred
|
|
179
|
|
|
746
|
|
||
Paid related to:
|
|
|
|
|
||||
Current year
|
|
(49
|
)
|
|
(465
|
)
|
||
Prior years
|
|
(363
|
)
|
|
(370
|
)
|
||
Total paid
|
|
(412
|
)
|
|
(835
|
)
|
||
Premium deficiency reserve
|
|
—
|
|
|
189
|
|
||
Ending Balance
|
|
$
|
221
|
|
|
$
|
664
|
|
Reconciliation of the Disclosure of Incurred and Paid Claims Development to Benefits Payable, net of reinsurance
|
||||
|
March 31,
|
|||
|
2017
|
|||
Net outstanding liabilities
|
|
|||
Retail
|
$
|
3,896
|
|
|
Group and Specialty
|
547
|
|
||
Individual Commercial
|
221
|
|
||
Other Businesses
|
26
|
|
||
Benefits payable, net of reinsurance
|
4,690
|
|
||
|
|
|||
Reinsurance recoverable on unpaid claims
|
|
|||
Retail
|
71
|
|
||
Total reinsurance recoverable on unpaid claims
|
71
|
|
||
|
|
|||
Total benefits payable, gross
|
$
|
4,761
|
|
|
Three months ended March 31,
|
||||||
|
2017
|
|
2016
|
||||
|
(dollars in millions, except per common share results; number of shares in thousands)
|
||||||
Net income available for common stockholders
|
$
|
1,115
|
|
|
$
|
254
|
|
Weighted average outstanding shares of common stock
used to compute basic earnings per common share |
147,824
|
|
|
149,161
|
|
||
Dilutive effect of:
|
|
|
|
||||
Employee stock options
|
199
|
|
|
218
|
|
||
Restricted stock
|
849
|
|
|
1,517
|
|
||
Shares used to compute diluted earnings per common share
|
148,872
|
|
|
150,896
|
|
||
Basic earnings per common share
|
$
|
7.54
|
|
|
$
|
1.70
|
|
Diluted earnings per common share
|
$
|
7.49
|
|
|
$
|
1.68
|
|
Number of antidilutive stock options and restricted stock
excluded from computation |
938
|
|
|
1,285
|
|
Record
Date |
|
Payment
Date |
|
Amount
per Share |
|
Total
Amount |
||||
|
|
|
|
|
|
(in millions)
|
||||
2016 payments
|
|
|
|
|
|
|
||||
12/30/2015
|
|
1/29/2016
|
|
$
|
0.29
|
|
|
$
|
43
|
|
3/31/2016
|
|
4/29/2016
|
|
$
|
0.29
|
|
|
$
|
43
|
|
6/30/2016
|
|
7/29/2016
|
|
$
|
0.29
|
|
|
$
|
43
|
|
10/13/2016
|
|
10/28/2016
|
|
$
|
0.29
|
|
|
$
|
43
|
|
2017 payments
|
|
|
|
|
|
|
||||
1/12/2017
|
|
1/27/2017
|
|
$
|
0.29
|
|
|
$
|
43
|
|
3/31/2017
|
|
4/28/2017
|
|
$
|
0.40
|
|
|
$
|
58
|
|
|
March 31, 2017
|
|
December 31, 2016
|
||||
|
(in millions)
|
||||||
Senior notes:
|
|
|
|
||||
$500 million, 7.20% due June 15, 2018
|
$
|
501
|
|
|
$
|
501
|
|
$300 million, 6.30% due August 1, 2018
|
304
|
|
|
304
|
|
||
$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
|
|
||
$600 million, 3.95% due March 15, 2027
|
594
|
|
|
—
|
|
||
$250 million, 8.15% due June 15, 2038
|
263
|
|
|
264
|
|
||
$400 million, 4.625% due December 1, 2042
|
396
|
|
|
396
|
|
||
$750 million, 4.95% due October 1, 2044
|
739
|
|
|
739
|
|
||
$400 million, 4.80% due March 15, 2047
|
395
|
|
|
—
|
|
||
Total long-term debt
|
$
|
4,780
|
|
|
$
|
3,792
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
Retail
|
|
Group and Specialty
|
|
Healthcare
Services |
|
Individual Commercial
|
|
Other
Businesses |
|
Eliminations/
Corporate |
|
Consolidated
|
||||||||||||||
|
(in millions)
|
||||||||||||||||||||||||||
Three months ended March 31, 2017
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||
Revenues - external customers
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||
Premiums:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
Individual Medicare Advantage
|
$
|
8,376
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
8,376
|
|
Group Medicare Advantage
|
1,318
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
1,318
|
|
|||||||
Medicare stand-alone PDP
|
941
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
941
|
|
|||||||
Total Medicare
|
10,635
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
10,635
|
|
|||||||
Fully-insured
|
118
|
|
|
1,378
|
|
|
—
|
|
|
283
|
|
|
—
|
|
|
—
|
|
|
1,779
|
|
|||||||
Specialty
|
—
|
|
|
322
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
322
|
|
|||||||
Medicaid and other
|
653
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
9
|
|
|
—
|
|
|
662
|
|
|||||||
Total premiums
|
11,406
|
|
|
1,700
|
|
|
—
|
|
|
283
|
|
|
9
|
|
|
—
|
|
|
13,398
|
|
|||||||
Services revenue:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
Provider
|
—
|
|
|
—
|
|
|
70
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
70
|
|
|||||||
ASO and other
|
2
|
|
|
161
|
|
|
—
|
|
|
—
|
|
|
2
|
|
|
—
|
|
|
165
|
|
|||||||
Pharmacy
|
—
|
|
|
—
|
|
|
18
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
18
|
|
|||||||
Total services revenue
|
2
|
|
|
161
|
|
|
88
|
|
|
—
|
|
|
2
|
|
|
—
|
|
|
253
|
|
|||||||
Total revenues - external customers
|
11,408
|
|
|
1,861
|
|
|
88
|
|
|
283
|
|
|
11
|
|
|
—
|
|
|
13,651
|
|
|||||||
Intersegment revenues
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
Services
|
—
|
|
|
5
|
|
|
4,310
|
|
|
—
|
|
|
—
|
|
|
(4,315
|
)
|
|
—
|
|
|||||||
Products
|
—
|
|
|
—
|
|
|
1,552
|
|
|
—
|
|
|
—
|
|
|
(1,552
|
)
|
|
—
|
|
|||||||
Total intersegment revenues
|
—
|
|
|
5
|
|
|
5,862
|
|
|
—
|
|
|
—
|
|
|
(5,867
|
)
|
|
—
|
|
|||||||
Investment income
|
25
|
|
|
11
|
|
|
8
|
|
|
1
|
|
|
21
|
|
|
45
|
|
|
111
|
|
|||||||
Total revenues
|
11,433
|
|
|
1,877
|
|
|
5,958
|
|
|
284
|
|
|
32
|
|
|
(5,822
|
)
|
|
13,762
|
|
|||||||
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
Benefits
|
10,051
|
|
|
1,286
|
|
|
—
|
|
|
156
|
|
|
29
|
|
|
(196
|
)
|
|
11,326
|
|
|||||||
Operating costs
|
954
|
|
|
399
|
|
|
5,680
|
|
|
62
|
|
|
4
|
|
|
(5,546
|
)
|
|
1,553
|
|
|||||||
Merger termination fee and related costs, net
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(947
|
)
|
|
(947
|
)
|
|||||||
Depreciation and amortization
|
58
|
|
|
21
|
|
|
34
|
|
|
3
|
|
|
—
|
|
|
(24
|
)
|
|
92
|
|
|||||||
Total operating expenses
|
11,063
|
|
|
1,706
|
|
|
5,714
|
|
|
221
|
|
|
33
|
|
|
(6,713
|
)
|
|
12,024
|
|
|||||||
Income (loss) from operations
|
370
|
|
|
171
|
|
|
244
|
|
|
63
|
|
|
(1
|
)
|
|
891
|
|
|
1,738
|
|
|||||||
Interest expense
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
49
|
|
|
49
|
|
|||||||
Income (loss) before income taxes
|
$
|
370
|
|
|
$
|
171
|
|
|
$
|
244
|
|
|
$
|
63
|
|
|
$
|
(1
|
)
|
|
$
|
842
|
|
|
$
|
1,689
|
|
|
Retail
|
|
Group and Specialty
|
|
Healthcare
Services |
|
Individual Commercial
|
|
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
|
104
|
|
|
1,337
|
|
|
—
|
|
|
893
|
|
|
—
|
|
|
—
|
|
|
2,334
|
|
|||||||
Specialty
|
—
|
|
|
318
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
318
|
|
|||||||
Medicaid and other
|
630
|
|
|
5
|
|
|
—
|
|
|
—
|
|
|
10
|
|
|
—
|
|
|
645
|
|
|||||||
Total premiums
|
10,877
|
|
|
1,660
|
|
|
—
|
|
|
893
|
|
|
10
|
|
|
—
|
|
|
13,440
|
|
|||||||
Services revenue:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
Provider
|
—
|
|
|
—
|
|
|
71
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
71
|
|
|||||||
ASO and other
|
1
|
|
|
177
|
|
|
1
|
|
|
—
|
|
|
3
|
|
|
—
|
|
|
182
|
|
|||||||
Pharmacy
|
—
|
|
|
—
|
|
|
7
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
7
|
|
|||||||
Total services revenue
|
1
|
|
|
177
|
|
|
79
|
|
|
—
|
|
|
3
|
|
|
—
|
|
|
260
|
|
|||||||
Total revenues - external customers
|
10,878
|
|
|
1,837
|
|
|
79
|
|
|
893
|
|
|
13
|
|
|
—
|
|
|
13,700
|
|
|||||||
Intersegment revenues
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
Services
|
—
|
|
|
6
|
|
|
4,784
|
|
|
—
|
|
|
—
|
|
|
(4,790
|
)
|
|
—
|
|
|||||||
Products
|
—
|
|
|
—
|
|
|
1,360
|
|
|
—
|
|
|
—
|
|
|
(1,360
|
)
|
|
—
|
|
|||||||
Total intersegment revenues
|
—
|
|
|
6
|
|
|
6,144
|
|
|
—
|
|
|
—
|
|
|
(6,150
|
)
|
|
—
|
|
|||||||
Investment income
|
24
|
|
|
6
|
|
|
7
|
|
|
2
|
|
|
15
|
|
|
46
|
|
|
100
|
|
|||||||
Total revenues
|
10,902
|
|
|
1,849
|
|
|
6,230
|
|
|
895
|
|
|
28
|
|
|
(6,104
|
)
|
|
13,800
|
|
|||||||
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
Benefits
|
9,633
|
|
|
1,222
|
|
|
—
|
|
|
729
|
|
|
25
|
|
|
(212
|
)
|
|
11,397
|
|
|||||||
Operating costs
|
1,082
|
|
|
434
|
|
|
5,942
|
|
|
169
|
|
|
4
|
|
|
(5,897
|
)
|
|
1,734
|
|
|||||||
Merger termination fee and related costs, net
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
34
|
|
|
34
|
|
|||||||
Depreciation and amortization
|
46
|
|
|
21
|
|
|
36
|
|
|
9
|
|
|
—
|
|
|
(24
|
)
|
|
88
|
|
|||||||
Total operating expenses
|
10,761
|
|
|
1,677
|
|
|
5,978
|
|
|
907
|
|
|
29
|
|
|
(6,099
|
)
|
|
13,253
|
|
|||||||
Income (loss) from operations
|
141
|
|
|
172
|
|
|
252
|
|
|
(12
|
)
|
|
(1
|
)
|
|
(5
|
)
|
|
547
|
|
|||||||
Interest expense
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
47
|
|
|
47
|
|
|||||||
Income (loss) before income taxes
|
$
|
141
|
|
|
$
|
172
|
|
|
$
|
252
|
|
|
$
|
(12
|
)
|
|
$
|
(1
|
)
|
|
$
|
(52
|
)
|
|
$
|
500
|
|
•
|
Our consolidated pretax results for the three months ended March 31, 2017 as compared to the three months ended March 31, 2016, were primarily impacted by the net gain associated with the terminated Merger Agreement, mainly the break-up fee, and higher Retail segment earnings year-over-year.
|
•
|
Year-over-year comparisons of diluted earnings per common share reflect the same factors impacting our 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 2017 temporary suspension of the health insurance industry fee. In addition the year-over-year comparisons were favorably impacted by lower number of shares, primarily reflecting share repurchases.
|
•
|
Our
2017
results through
March 31, 2017
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, 2017
, approximately
1,827,600
members, or
64.4%
, of our individual Medicare Advantage members were in value-based relationships under our integrated care delivery model, as compared to
1,816,300
members, or
64.0%
, at
December 31, 2016
and
1,715,100
members, or
61.1%
, at
March 31, 2016
.
|
•
|
We recorded
a net gain associated with the terminated Merger Agreement
,
consisting primarily of the break-up
fee, of approximately
$947 million
, or
$4.26
per diluted common share during the
three months ended March 31, 2017
. We recorded transaction costs in connection with the Merger of approximately
$34 million
, or
$0.21
per diluted common share during the
three months ended March 31, 2016
. Certain costs associated with the Merger were previously not deductible for tax purposes, but became deductible, and were recorded as such in the three months ended March 31, 2017 as a result of the termination of the Merger Agreement.
|
•
|
The annual health insurance industry fee has been suspended for calendar year 2017, but is scheduled to resume in calendar year 2018. Operating cost associated with the health insurer fee attributable to the three months ended March 31, 2016 was
$227 million
. This fee is not deductible for tax purposes, which significantly increases our effective income tax rate. The one-year suspension in 2017 of the health insurer fee has significantly reduced our operating costs and effective tax rate during the
three months ended March 31, 2017
.
|
•
|
On February 14, 2017, we announced we are exiting our individual commercial medical business January 1, 2018. As discussed previously, we have worked over the past several years to address market and programmatic challenges in order to keep coverage options available wherever we could offer a viable product. This has included pursuing business changes, such as modifying networks, restructuring product offerings, reducing the company’s geographic footprint and increasing premiums. All of these actions were taken with the expectation that our individual commercial medical business would stabilize to the point where we could continue to participate in the program. However, based on our analysis of data associated with our healthcare exchange membership following the 2017 open enrollment period, we saw further signs of an unbalanced risk pool. Therefore, we decided that we cannot continue to offer this coverage and plan to exit this business commencing January 1, 2018.
The 2017 quarter includes pretax income from our individual commercial business of
$63 million
, or
$0.27
per diluted common share.
|
•
|
On March 1, 2017, a court ordered the liquidation of Penn Treaty (an unaffiliated long-term care insurance company) which triggered assessments from state guaranty associations that resulted in our recording a
$54 million
, or
$0.23
per diluted common share
estimate in operating costs in the three months ended March 31, 2017.
|
•
|
During the
three months ended March 31, 2017
, operating cash flow provided by operations was
$4.2 billion
as compared to
$502 million
for the
three months ended March 31, 2016
. Our operating cash flows for the
three months ended March 31, 2017
were significantly impacted by the early receipt of the Medicare premium remittance for April 2017 of $3.1 billion in March 2017 because the payment date of April 1, 2017 fell on a weekend.
Our operating cash flows were also significantly impacted by the
$1 billion
receipt of the Merger termination fee.
Excluding the timing of the Medicare premium remittance and the Merger termination fee, our operating cash flows were negatively impacted by the timing of working capital items partially offset by higher earnings.
See further discussion under the section titled "Liquidity" in this report.
|
•
|
On April 3, 2017 CMS issued its announcement of 2018 Medicare Advantage Capitation Rates and Medicare Advantage and Part D payment policies and Final Call Letter, which we refer to collectively as the Final Rate Notice. We expect the Final Rate Notice to result in a 0.45% rate increase for Humana versus CMS’ estimate for the sector of 0.85% increase on a comparable basis. The rate increase excludes the impact of Star quality bonus ratings, the impact of encounter data weighting in risk score calculations and estimates of changes in revenue associated with increased accuracy of risk coding. The primary difference between the estimates is the impact of fee-for-service county rebasing/re-pricing by CMS.
|
•
|
The achievement of Star Ratings of four or higher qualifies Medicare Advantage plans for premium bonuses. Star Ratings for the 2018 bonus year issued by CMS in October 2016 indicated that the percentage of our July 31, 2016 Medicare Advantage membership in 4-Star plans or higher declined to approximately 37% from approximately 78% of our July 31, 2015 Medicare Advantage membership. The decline in membership in 4- Star rated plans does not take into account certain operational actions discussed below that we have taken and intend to take over the coming months to mitigate any potential negative impact of these published ratings on Star bonus revenues for 2018.
|
•
|
On March 2, 2017, we received notice that the Defense Health Agency, or DHA, had exercised its option to extend the TRICARE South Region contract
through March 31, 2018.
On July 21, 2016, we were notified by the DHA that we were awarded the contract for the new TRICARE East Region, which is a consolidation of the former North and South Regions, with delivery of health care services expected to commence on October 1, 2017. On March 30, 2017, we received notice that the DHA is moving the date upon which delivery of health care services is expected to commence under the new TRICARE East Region contract from October 1, 2017, to January 1, 2018.
The next generation East Region and West Region contract awards are currently subject to protests by an unsuccessful bidder in the U.S. Court of Federal Claims and before the DHA.
|
•
|
At
March 31, 2017
, approximately 51,300 primary care providers were in value-based (shared risk and path to risk) relationships, an increase of 7% from 47,800 at March 31, 2016 and an increase of 2% from 50,400 at December 31, 2016. At March 31, 2017, 64% of our individual Medicare Advantage members were in value-based relationships compared to 61% at March 31, 2016 and 64% at December 31, 2016.
|
•
|
Medicare Advantage and dual demonstration program membership enrolled in a Humana chronic condition management program rose to 1,035,300 at March 31, 2017, an increase of 11% from 931,500 at March 31, 2016, but declined 6% from 1,099,200 at December 31, 2016. We have undergone an optimization process that ensures the appropriate level of member interaction with clinicians to drive quality outcomes leading to reduced segment earnings but higher returns on investment.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||
|
For the three months ended
March 31, |
|
Change
|
|||||||||||
|
2017
|
|
2016
|
|
Dollars
|
|
Percentage
|
|||||||
|
(dollars in millions, except per common share results)
|
|
|
|||||||||||
Revenues:
|
|
|
|
|
|
|
|
|||||||
Premiums:
|
|
|
|
|
|
|
|
|||||||
Retail
|
$
|
11,406
|
|
|
$
|
10,877
|
|
|
$
|
529
|
|
|
4.9
|
%
|
Group and Specialty
|
1,700
|
|
|
1,660
|
|
|
40
|
|
|
2.4
|
%
|
|||
Individual Commercial
|
283
|
|
|
893
|
|
|
(610
|
)
|
|
(68.3
|
)%
|
|||
Other Businesses
|
9
|
|
|
10
|
|
|
(1
|
)
|
|
(10.0
|
)%
|
|||
Total premiums
|
13,398
|
|
|
13,440
|
|
|
(42
|
)
|
|
(0.3
|
)%
|
|||
Services:
|
|
|
|
|
|
|
|
|||||||
Retail
|
2
|
|
|
1
|
|
|
1
|
|
|
100.0
|
%
|
|||
Group and Specialty
|
161
|
|
|
177
|
|
|
(16
|
)
|
|
(9.0
|
)%
|
|||
Healthcare Services
|
88
|
|
|
79
|
|
|
9
|
|
|
11.4
|
%
|
|||
Other Businesses
|
2
|
|
|
3
|
|
|
(1
|
)
|
|
(33.3
|
)%
|
|||
Total services
|
253
|
|
|
260
|
|
|
(7
|
)
|
|
(2.7
|
)%
|
|||
Investment income
|
111
|
|
|
100
|
|
|
11
|
|
|
11.0
|
%
|
|||
Total revenues
|
13,762
|
|
|
13,800
|
|
|
(38
|
)
|
|
(0.3
|
)%
|
|||
Operating expenses:
|
|
|
|
|
|
|
|
|||||||
Benefits
|
11,326
|
|
|
11,397
|
|
|
(71
|
)
|
|
(0.6
|
)%
|
|||
Operating costs
|
1,553
|
|
|
1,734
|
|
|
(181
|
)
|
|
(10.4
|
)%
|
|||
Merger termination fee and related costs
|
(947
|
)
|
|
34
|
|
|
(981
|
)
|
|
(2,885.3
|
)%
|
|||
Depreciation and amortization
|
92
|
|
|
88
|
|
|
4
|
|
|
4.5
|
%
|
|||
Total operating expenses
|
12,024
|
|
|
13,253
|
|
|
(1,229
|
)
|
|
(9.3
|
)%
|
|||
Income from operations
|
1,738
|
|
|
547
|
|
|
1,191
|
|
|
217.7
|
%
|
|||
Interest expense
|
49
|
|
|
47
|
|
|
2
|
|
|
4.3
|
%
|
|||
Income before income taxes
|
1,689
|
|
|
500
|
|
|
1,189
|
|
|
237.8
|
%
|
|||
Provision for income taxes
|
574
|
|
|
246
|
|
|
328
|
|
|
133.3
|
%
|
|||
Net income
|
$
|
1,115
|
|
|
$
|
254
|
|
|
$
|
861
|
|
|
339.0
|
%
|
Diluted earnings per common share
|
$
|
7.49
|
|
|
$
|
1.68
|
|
|
$
|
5.81
|
|
|
345.8
|
%
|
Benefit ratio
(a)
|
84.5
|
%
|
|
84.8
|
%
|
|
|
|
(0.3
|
)%
|
||||
Operating cost ratio
(b)
|
11.4
|
%
|
|
12.7
|
%
|
|
|
|
(1.3
|
)%
|
||||
Effective tax rate
|
34.0
|
%
|
|
49.2
|
%
|
|
|
|
(15.2
|
)%
|
(a)
|
Represents total benefits expense as a percentage of premiums revenue.
|
(b)
|
Represents total operating costs, excluding
Merger termination fee and related costs, net,
and depreciation and amortization, as a percentage of total revenues less investment income.
|
|
March 31,
|
|
Change
|
||||||||
|
2017
|
|
2016
|
|
Members
|
|
Percentage
|
||||
Membership:
|
|
|
|
|
|
|
|
||||
Medical membership:
|
|
|
|
|
|
|
|
||||
Individual Medicare Advantage
|
2,839,700
|
|
|
2,807,200
|
|
|
32,500
|
|
|
1.2
|
%
|
Group Medicare Advantage
|
431,100
|
|
|
349,200
|
|
|
81,900
|
|
|
23.5
|
%
|
Medicare stand-alone PDP
|
5,199,400
|
|
|
4,834,100
|
|
|
365,300
|
|
|
7.6
|
%
|
Total Retail Medicare
|
8,470,200
|
|
|
7,990,500
|
|
|
479,700
|
|
|
6.0
|
%
|
State-based Medicaid
|
380,400
|
|
|
388,400
|
|
|
(8,000
|
)
|
|
(2.1
|
)%
|
Medicare Supplement
|
231,400
|
|
|
209,800
|
|
|
21,600
|
|
|
10.3
|
%
|
Total Retail medical members
|
9,082,000
|
|
|
8,588,700
|
|
|
493,300
|
|
|
5.7
|
%
|
|
|
|
|
|
|
|
|
|
For the three months ended
March 31, |
|
Change
|
|||||||||||
|
2017
|
|
2016
|
|
Dollars
|
|
Percentage
|
|||||||
|
(in millions)
|
|
|
|||||||||||
Premiums and Services Revenue:
|
|
|
|
|
|
|
|
|||||||
Premiums:
|
|
|
|
|
|
|
|
|||||||
Individual Medicare Advantage
|
$
|
8,376
|
|
|
$
|
8,027
|
|
|
$
|
349
|
|
|
4.3
|
%
|
Group Medicare Advantage
|
1,318
|
|
|
1,077
|
|
|
241
|
|
|
22.4
|
%
|
|||
Medicare stand-alone PDP
|
941
|
|
|
1,039
|
|
|
(98
|
)
|
|
(9.4
|
)%
|
|||
Total Retail Medicare
|
10,635
|
|
|
10,143
|
|
|
492
|
|
|
4.9
|
%
|
|||
State-based Medicaid
|
653
|
|
|
630
|
|
|
23
|
|
|
3.7
|
%
|
|||
Medicare Supplement
|
118
|
|
|
104
|
|
|
14
|
|
|
13.5
|
%
|
|||
Total premiums
|
11,406
|
|
|
10,877
|
|
|
529
|
|
|
4.9
|
%
|
|||
Services
|
2
|
|
|
1
|
|
|
1
|
|
|
100.0
|
%
|
|||
Total premiums and services revenue
|
$
|
11,408
|
|
|
$
|
10,878
|
|
|
$
|
530
|
|
|
4.9
|
%
|
Income before income taxes
|
$
|
370
|
|
|
$
|
141
|
|
|
$
|
229
|
|
|
162.4
|
%
|
Benefit ratio
|
88.1
|
%
|
|
88.6
|
%
|
|
|
|
(0.5
|
)%
|
||||
Operating cost ratio
|
8.4
|
%
|
|
9.9
|
%
|
|
|
|
(1.5
|
)%
|
•
|
Retail segment pretax income was
$370 million
in the
2017 quarter
, an
increase
of
$229 million
, or
162.4%
, compared to
$141 million
in the
2016 quarter
, primarily driven by lower benefit and operating cost ratios.
|
•
|
Individual Medicare Advantage membership
increased
32,500
members, or
1.2%
, from
March 31, 2016
to
March 31, 2017
reflecting net membership additions for Medicare beneficiaries including the effect of market and product exits in 2017. We decided certain markets and/or products were not meeting long term strategic and financial objectives. Additionally, membership was muted due to competitive actions including the uncertainty associated with the then-pending Merger transaction.
|
•
|
Group Medicare Advantage membership
increased
81,900
, or
23.5%
, from
March 31, 2016
to
March 31, 2017
reflecting the addition of a large account in January 2017.
|
•
|
Medicare stand-alone PDP membership
increased
365,300
members, or
7.6%
, from
March 31, 2016
to
March 31, 2017
reflecting net membership additions, primarily for our Humana-Walmart plan offering, for the 2017 plan year
.
|
•
|
State-based Medicaid membership
decreased
8,000
members, or
2.1%
, from
March 31, 2016
to
March 31, 2017
, primarily driven by lower membership associated with our Florida contracts resulting from network realignments.
|
•
|
Retail segment premiums increased
$529 million
, or
4.9%
, from the
2016 quarter
to the
2017 quarter
primarily due to group and individual Medicare Advantage membership growth and increased per-member premiums for the individual Medicare Advantage and state-based contract businesses. Average group and individual Medicare Advantage membership increased
3.8%
for the
2017 quarter
. Average membership is calculated by summing the ending membership for each month in a period and dividing the result by the number of months in a period. Premiums revenue reflects changes in membership and average per-member premiums. Items impacting average per-member premiums include changes in premium rates as well as changes in the
|
•
|
The Retail segment benefit ratio
decreased
50
basis points from
88.6%
in the
2016 quarter
to
88.1%
in the
2017 quarter
, primarily due to the planned exits from certain Medicare Advantage markets that carried a higher benefit ratio than other markets as well as the seasonal impact of leap day in the
2016 quarter
versus none in the
2017 quarter
. These favorable items were partially offset by lower prior period development, margin compression associated with the competitive environment in the group Medicare Advantage business, and the impact of the temporary suspension of the health insurance industry fee for calendar year 2017 which was contemplated in the pricing and benefit design of our products.
|
•
|
The Retail segment’s benefits expense for the
2017 quarter
included
$204 million
in favorable prior-period medical claims reserve development versus
$218 million
in favorable prior-prior period medical claims reserve development in the
2016 quarter
. The decline in prior period development is due to unfavorable year-over-year comparisons for our Medicare business. Prior-period medical claims reserve development decreased the Retail segment benefit ratio by approximately
180
basis points in the
2017 quarter
versus approximately
200
basis points in the
2016 quarter
.
|
•
|
The Retail segment operating cost ratio of
8.4%
for the
2017 quarter
decreased
150
basis points from
9.9%
for the
2016 quarter
due to the temporary suspension of the health insurance industry fee for calendar year 2017. The non-deductible health insurance industry fee impacted the operating cost ratio by
170
basis points in the
2016 quarter
.
|
|
March 31,
|
|
Change
|
||||||||
|
2017
|
|
2016
|
|
Members
|
|
Percentage
|
||||
Membership:
|
|
|
|
|
|
|
|
||||
Medical membership:
|
|
|
|
|
|
|
|
||||
Fully-insured commercial group
|
1,119,400
|
|
|
1,136,400
|
|
|
(17,000
|
)
|
|
(1.5
|
)%
|
ASO
|
447,000
|
|
|
579,400
|
|
|
(132,400
|
)
|
|
(22.9
|
)%
|
Military services
|
3,082,800
|
|
|
3,076,800
|
|
|
6,000
|
|
|
0.2
|
%
|
Total group and specialty medical members
|
4,649,200
|
|
|
4,792,600
|
|
|
(143,400
|
)
|
|
(3.0
|
)%
|
Specialty membership (a)
|
6,921,800
|
|
|
7,045,100
|
|
|
(123,300
|
)
|
|
(1.8
|
)%
|
(a)
|
Specialty products include dental, vision, voluntary benefit products 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
|
|||||||||||
|
2017
|
|
2016
|
|
Dollars
|
|
Percentage
|
|||||||
|
(in millions)
|
|
|
|||||||||||
Premiums and Services Revenue:
|
|
|
|
|
|
|
|
|||||||
Premiums:
|
|
|
|
|
|
|
|
|||||||
Fully-insured commercial group
|
$
|
1,378
|
|
|
$
|
1,337
|
|
|
$
|
41
|
|
|
3.1
|
%
|
Group specialty
|
322
|
|
|
318
|
|
|
4
|
|
|
1.3
|
%
|
|||
Military services
|
—
|
|
|
5
|
|
|
(5
|
)
|
|
(100.0
|
)%
|
|||
Total premiums
|
1,700
|
|
|
1,660
|
|
|
40
|
|
|
2.4
|
%
|
|||
Services
|
161
|
|
|
177
|
|
|
(16
|
)
|
|
(9.0
|
)%
|
|||
Total premiums and services revenue
|
$
|
1,861
|
|
|
$
|
1,837
|
|
|
$
|
24
|
|
|
1.3
|
%
|
Income before income taxes
|
$
|
171
|
|
|
$
|
172
|
|
|
$
|
(1
|
)
|
|
(0.6
|
)%
|
Benefit ratio
|
75.6
|
%
|
|
73.6
|
%
|
|
|
|
2.0
|
%
|
||||
Operating cost ratio
|
21.4
|
%
|
|
23.5
|
%
|
|
|
|
(2.1
|
)%
|
•
|
Group and Specialty segment pretax income was
$171 million
in the
2017 quarter
, a decrease of
$1 million
or
0.6%
, from
$172 million
in the
2016 quarter
. The decline was primarily due to an increase in the benefit ratio, largely offset by the improvement in the operating cost ratio.
|
•
|
Fully-insured commercial group medical membership
decreased
17,000
members, or
1.5%
, from
March 31, 2016
to
March 31, 2017
reflecting lower membership in small group accounts due in part to certain small group accounts moving from fully insured to ASO products.
|
•
|
Group ASO commercial medical membership
decreased
132,400
members, or
22.9%
, from
March 31, 2016
to
March 31, 2017
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, partially offset by certain small group accounts moving from fully-insured to ASO products.
|
•
|
Specialty membership
decreased
123,300
members, or
1.8%
, from
March 31, 2016
to
March 31, 2017
primarily due to the loss of certain group fully-insured commercial medical and ASO accounts that also had specialty coverage.
|
•
|
Group and Specialty segment premiums
increased
$40 million
, or
2.4%
from the
2016 quarter
to
$1.7 billion
for the
2017 quarter
primarily due to an increase in fully-insured commercial medical per-member premiums, partially offset by a decline in average fully-insured commercial medical membership.
|
•
|
Group and Specialty segment services revenue
decreased
$16 million
, or
9.0%
, from the
2016 quarter
to
$161 million
for the
2017 quarter
primarily due to a decline in revenue in our group ASO commercial medical business mainly due to membership declines.
|
•
|
The Group and Specialty segment benefit ratio
increased
200
basis points from
73.6%
in the
2016 quarter
to
75.6%
in the
2017 quarter
primarily due to the impact of lower favorable prior-period medical claims reserve
|
•
|
The Group and Specialty segment’s benefits expense included
$20 million
in favorable prior-period medical claims reserve development in the
2017 quarter
and
$41 million
in the
2016 quarter
. This favorable prior-period medical claims reserve development decreased the Group and Specialty segment benefit ratio by approximately
120
basis points in the
2017 quarter
and
250
basis points in the
2016 quarter
.
|
•
|
The Group and Specialty segment operating cost ratio of
21.4%
for the
2017 quarter
decreased
210
basis points from
23.5%
for the
2016 quarter
primarily due to the temporary suspension of the health insurance industry fee for calendar year 2017 and operating cost efficiencies. The non-deductible health insurance industry fee impacted the operating cost ratio by
150
basis points in the
2016 quarter
.
|
|
|
|
|
|
|
|
|
|
For the three months ended
March 31, |
|
Change
|
|||||||||||
|
2017
|
|
2016
|
|
Dollars
|
|
Percentage
|
|||||||
|
(in millions)
|
|
|
|||||||||||
Revenues:
|
|
|
|
|
|
|
|
|||||||
Services:
|
|
|
|
|
|
|
|
|||||||
Clinical care services
|
$
|
50
|
|
|
$
|
52
|
|
|
$
|
(2
|
)
|
|
(3.8
|
)%
|
Provider services
|
20
|
|
|
20
|
|
|
0
|
|
|
—
|
%
|
|||
Pharmacy solutions
|
18
|
|
|
7
|
|
|
11
|
|
|
157.1
|
%
|
|||
Total services revenues
|
88
|
|
|
79
|
|
|
9
|
|
|
11.4
|
%
|
|||
Intersegment revenues:
|
|
|
|
|
|
|
|
|
||||||
Pharmacy solutions
|
5,141
|
|
|
5,407
|
|
|
(266
|
)
|
|
(4.9
|
)%
|
|||
Provider services
|
418
|
|
|
418
|
|
|
—
|
|
|
—
|
%
|
|||
Clinical care services
|
303
|
|
|
319
|
|
|
(16
|
)
|
|
(5.0
|
)%
|
|||
Total intersegment revenues
|
5,862
|
|
|
6,144
|
|
|
(282
|
)
|
|
(4.6
|
)%
|
|||
Total services and intersegment revenues
|
$
|
5,950
|
|
|
$
|
6,223
|
|
|
$
|
(273
|
)
|
|
(4.4
|
)%
|
Income before income taxes
|
$
|
244
|
|
|
$
|
252
|
|
|
$
|
(8
|
)
|
|
(3.2
|
)%
|
Operating cost ratio
|
95.5
|
%
|
|
95.5
|
%
|
|
|
|
—
|
%
|
•
|
Healthcare Services segment pretax income of
$244 million
for the
2017 quarter
decreased slightly by
$8 million
, or
3.2%
from
$252 million
in the
2016 quarter
reflecting the impact of the optimization process associated with our chronic condition management programs. The reduction in pharmacy solutions intersegment revenues was offset by a similar reduction in operating costs associated with the pharmacy solutions business.
|
•
|
Humana Pharmacy Solutions
®
script volumes for Retail, Group and Specialty, and Individual Commercial segment membership increased to approximately
107 million
in the
2017 quarter
, up
2.9%
, versus scripts of approximately
104 million
in the
2016 quarter
primarily reflecting growth associated with higher average Retail segment Medicare membership for the
2017 quarter
compared to the
2016 quarter
.
|
•
|
Services revenues
increased
$9 million
, or
11.4%
, from the
2016 quarter
to
$88 million
for the
2017 quarter
primarily due to service revenue growth from our pharmacy solutions business.
|
•
|
Intersegment revenues
decreased
$282 million
, or
4.6%
, from the
2016 quarter
to
$5.9 billion
for the
2017 quarter
primarily due to our pharmacy solutions business as well as the impact of the optimization process associated with our chronic conditions management programs discussed previously. Our pharmacy solutions business revenues were impacted by improvements in net pharmacy costs driven by our pharmacy benefit manager and an increase in the generic dispensing rate. These items were partially offset by higher year-over-year script volume from growth in our Medicare Advantage and stand-alone PDP membership. Our generic dispensing rate improved to 91.1% during the
2017 quarter
compared to 90.1% during the
2016 quarter
. The higher generic dispensing rate reduced revenues (and operating costs) for our pharmacy solutions business as generic drugs are generally priced lower than branded drugs.
|
•
|
The Healthcare Services segment operating cost ratio was unchanged from the
2016 quarter
to the
2017 quarter
.
|
•
|
As announced on February 14, 2017, we are exiting our individual commercial medical business January 1, 2018.
|
•
|
Individual Commercial segment pretax income of
$63 million
for the 2017 quarter
increased
$75 million
from the 2016 quarter, reflecting the exit of certain markets in 2017, per-member premium increases, and the effect of the 2016 premium deficiency reserve recognized in the fourth quarter of 2015.
|
•
|
Individual commercial medical membership
decreased
674,700
members, or
77.0%
, from March 31, 2016 to March 31, 2017 reflecting the decline in the number of counties we offered on-exchange coverage and the discontinuance of all off-exchange products.
|
•
|
The benefit ratio for the Individual Commercial segment was
55.1%
for the 2017 quarter, a significant decrease from
81.6%
for the 2016 quarter. The year-over-year decrease primarily resulted from planned exits from certain markets that carried a higher benefit ratio than other markets, per-member premium increases, and the effect of the 2016 premium deficiency reserve recognized in the fourth quarter of 2015.
|
•
|
The operating cost ratio for the Individual Commercial segment was
21.9%
in the 2017 quarter, an increase of
300
basis points from
18.9%
in the 2016 quarter, primarily due to reduced leverage from market exits in 2017 partially offset by the temporary suspension of the health insurance industry fee for calendar year 2017.
|
|
2017
|
|
2016
|
||||
|
(in millions)
|
||||||
Net cash provided by operating activities
|
$
|
4,205
|
|
|
$
|
502
|
|
Net cash used in investing activities
|
(926
|
)
|
|
(428
|
)
|
||
Net cash provided by financing activities
|
1,269
|
|
|
156
|
|
||
Increase in cash and cash equivalents
|
$
|
4,548
|
|
|
$
|
230
|
|
|
March 31, 2017
|
|
December 31, 2016
|
|
2017
Quarter Change |
|
2016
Quarter Change |
||||||||
|
(in millions)
|
||||||||||||||
IBNR (1)
|
$
|
3,397
|
|
|
$
|
3,422
|
|
|
$
|
(25
|
)
|
|
$
|
(107
|
)
|
Reported claims in process (2)
|
588
|
|
|
654
|
|
|
(66
|
)
|
|
130
|
|
||||
Premium deficiency reserve (3)
|
—
|
|
|
—
|
|
|
—
|
|
|
13
|
|
||||
Other benefits payable (4)
|
776
|
|
|
487
|
|
|
289
|
|
|
102
|
|
||||
Total benefits payable
|
$
|
4,761
|
|
|
$
|
4,563
|
|
|
$
|
198
|
|
|
$
|
138
|
|
(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 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, 2017
|
|
December 31, 2016
|
|
2017
Quarter Change |
|
2016
Quarter Change |
||||||||
|
(in millions)
|
||||||||||||||
Medicare
|
$
|
1,254
|
|
|
$
|
787
|
|
|
$
|
467
|
|
|
$
|
592
|
|
Commercial and other
|
643
|
|
|
579
|
|
|
64
|
|
|
(13
|
)
|
||||
Military services
|
54
|
|
|
32
|
|
|
22
|
|
|
11
|
|
||||
Allowance for doubtful accounts
|
(113
|
)
|
|
(118
|
)
|
|
5
|
|
|
(14
|
)
|
||||
Total net receivables
|
$
|
1,838
|
|
|
$
|
1,280
|
|
|
$
|
558
|
|
|
$
|
576
|
|
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, 2017
:
|
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 2017
|
—
|
|
|
$
|
—
|
|
|
—
|
|
|
$
|
2,250,000,000
|
|
February 2017
|
5,833,738
|
|
|
205.70
|
|
|
5,833,738
|
|
|
1,050,000,093
|
|
||
March 2017
|
—
|
|
|
—
|
|
|
—
|
|
|
1,050,000,093
|
|
||
Total
|
5,833,738
|
|
|
$
|
205.70
|
|
|
5,833,738
|
|
|
|
(1)
|
On February 14, 2017, we announced that the Board had approved a new authorization for share repurchases of up to
$2.25 billion
of our common stock exclusive of shares repurchased in connection with employee stock plans, expiring on December 31, 2017. Under this new authorization, we entered into a
$1.5 billion
accelerated share repurchase program in the first quarter of 2017, $300 million of which reflects the value of stock held back pending final settlement.
|
(2)
|
Excludes
0.35 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
|
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).
|
4.1
|
Tenth Supplemental Indenture, dated March 16, 2017, between the Company and The Bank of New York Mellon Trust Company, N.A., as trustee (incorporated herein by reference to Exhibit 4.2 to the Current Report on Form 8-K filed by Humana Inc. on March 16, 2017).
|
4.2
|
Eleventh Supplemental Indenture, dated March 16, 2017, between the Company and The Bank of New York Mellon Trust Company, N.A., as trustee (incorporated herein by reference to Exhibit 4.4 to the Current Report on Form 8-K filed by Humana Inc. on March 16, 2017).
|
4.3
|
Form of 3.950% Senior Notes due 2027 (incorporated herein by reference to Exhibit 4.3 to the Current Report on Form 8-K filed by Humana Inc. on March 16, 2017).
|
4.4
|
Form of 4.800% Senior Notes due 2047 (incorporated herein by reference to Exhibit 4.5 to the Current Report on Form 8-K filed by Humana Inc. on March 16, 2017).
|
10.1
|
Termination letter dated as of February 14, 2017, by and between Humana Inc., Aetna Inc., Echo Merger Sub, LLC and Echo Merger Sub, Inc. (incorporated herein by reference to Exhibit 10.1 to the Current Report on Form 8-K filed by Humana Inc. on February 14, 2017).
|
10.2
|
Master Confirmation, by and between Humana Inc. and Goldman, Sachs & Co., dated February 27, 2017 (incorporated herein by reference to Exhibit 10 to the Current Report on Form 8-K filed by Humana Inc. on February 27, 2017).
|
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 on Form 10-Q formatted in XBRL (Extensible Business Reporting Language): (i) the Condensed Consolidated Balance Sheets at
March 31, 2017
and
December 31, 2016
; (ii) the Condensed Consolidated Statements of Income for the
three
months ended
March 31, 2017
and
2016
; (iii) the Condensed Consolidated Statements of Comprehensive Income for the
three
months ended
March 31, 2017
and
2016
; (iv) the Condensed Consolidated Statements of Cash Flows for the
three
months ended
March 31, 2017
and
2016
; and (v) Notes to Condensed Consolidated Financial Statements.
|
|
|
HUMANA INC.
|
|
|
|
(Registrant)
|
|
|
|
|
|
Date:
|
May 3, 2017
|
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 |
---|---|---|---|
Wayne A. I. Frederick, M.D. was initially elected to the Board in February 2020. He is the President Emeritus of Howard University, having previously served as the 17th President from July 2014 -September 2023, and is the distinguished Charles R. Drew Professor of Surgery at the Howard University College of Medicine. He is also a practicing cancer surgeon at Howard University Hospital. Prior to that Dr. Frederick served as Howard University’s Interim President (elected October 2013) after serving as Provost and Chief Academic Officer for more than a year. | |||
Raquel C. Bono, M.D. was initially elected to the Board in September 2020. Dr. Bono is a Principal at RCB Consulting having held this position since October 2019, and serves as CEO and Chief of Surgical Innovation at Medical iSight, having held this position since 2023. Dr. Bono was formerly Chief Health Officer at Viking Cruises from November 2020 until her retirement in December 2023. Prior to Viking Cruises, Dr. Bono, a board-certified trauma surgeon and retired Vice Admiral, U.S. Navy Medical Corps, served as the Chief Executive Officer and Director for the Defense Health Agency (DHA). In this capacity, Dr. Bono led a joint, integrated combat support agency that enables all branches of the U.S. military medical services to provide health care services to combatant commands in times of both peace and war. Dr. Bono integrated an unprecedented $50 billion worldwide health care enterprise for the Army, Navy, Air Force, and Marine Corps, composed of 50 hospitals and 300 clinics that provide care to 9.5 million military personnel, oversaw the Department of Defense deployment of the electronic health record, and facilitated the collaboration between the largest federated health systems of the Department of Defense and Department of Veterans Affairs (VA). An American College of Surgeons (ACS) Fellow since 1991, Dr. Bono served on the ACS Board of Governors and the Governors Health Policy and Advocacy Workgroup. She has been honored with the Defense Distinguished Service Medal, three Defense Superior Service Medals, four Legion of Merit Medals, two Meritorious Service Medals, and two Navy and Marine Corps Commendation medals. | |||
Marcy S. Klevorn was initially elected to the Board in February 2021. Ms. Klevorn was formerly the Chief Transformation Officer of Ford Motor Company from May 2019 until her retirement in October 2019. In this role, she accelerated the company’s transformation by helping to refine its corporate governance systems, facilitate faster adoption of agile teams across the business and ensure process improvements across the enterprise. She also facilitated strategic partnerships with key technology partners and supported the company’s diversity efforts. Having joined Ford Motor Company in 1983, Ms. Klevorn served in key executive and leadership roles within the company’s information technology organization including Director of the Office of the Chief Information Officer and Group Vice President of Information Technology. Ms. Klevorn also served as Executive Vice President and President of Ford Smart Mobility LLC, a division of Ford Motor Company, where she oversaw certain acquisitions and other investments and helped to accelerate the company’s plans to design, build, grow and invest in emerging mobility services and global data insight and analytics. | |||
Kurt J. Hilzinger was initially elected to the Board in July 2003 and was elected Chairman of the Board effective January 1, 2014. Mr. Hilzinger served as Lead Director from August 2010 until his appointment as Chairman. Mr. Hilzinger is a Partner at Court Square Capital Partners (Court Square), an independent private equity firm, having held this position since November 2007. At Court Square, Mr. Hilzinger focuses principally on investments in the healthcare industry. | |||
Karen W. Katz, M.B.A. was initially elected to the Board in September 2019. She was most recently interim CEO of Intermix, LLC from June 2022 to December 2022. Prior to Intermix, Ms. Katz served as the President and CEO of Neiman Marcus Group LTD LLC from 2010 to February 2018. Neiman Marcus Group is an international multibrand omni-channel retailer whose portfolio of brands includes Neiman Marcus, Bergdorf Goodman and MyTheresa. Having joined Neiman Marcus in 1985, Ms. Katz served in key executive and leadership roles in the company’s merchant, stores and eCommerce organizations as Executive Vice President—Stores, a member of the Office of the Chairman of Neiman Marcus Group, and President, Neiman Marcus Online, and President and CEO, Neiman Marcus Stores. | |||
Jorge S. Mesquita was initially elected to the Board in February 2021. Mr. Mesquita was formerly Chief Executive Officer of BlueTriton Brands, from July 2021 until March 2022. In this role Mr. Mesquita led the company’s initiatives to expand market leadership, advance commitment to sustainability and environmental stewardship and to realize the potential of the company’s portfolio of water brands. | |||
John W. Garratt was initially elected to the Board in February 2020. He was formerly the President and Chief Financial Officer of Dollar General Corporation, having held this position from September 2022 to June 2023. Mr. Garratt joined Dollar General in October 2014 as Senior Vice President, Finance & Strategy and subsequently served as Interim Chief Financial Officer from July 2015 to December 2015 and most recently served as Executive Vice President and Chief Financial Officer from December 2015 to September 1, 2022. Prior to joining Dollar General, Mr. Garratt held various positions of increasing responsibility with Yum! Brands, Inc., one of the world’s largest restaurant companies, between May 2004 and October 2014, holding leadership positions in corporate strategy and financial planning. Mr. Garratt served as Vice President, Finance and Division Controller for the KFC division and earlier for the Pizza Hut division and for Yum Restaurants International between October 2013 and October 2014. Mr. Garratt also served as the Senior Director, Yum Corporate Strategy, from March 2010 to October 2013, reporting directly to the corporate Chief Financial Officer and leading corporate strategy as well as driving key cross-divisional initiatives. Mr. Garratt served in various other financial positions at Yum from May 2004 to March 2010. Prior to his career at Yum! Brands, Mr. Garratt served as Plant Controller for Alcoa Inc. between April 2002 and May 2004, and held various financial management positions at General Electric from March 1999 to April 2002. He began his career in May 1990 at Alcoa, where he served for approximately nine years. | |||
James A. Rechtin Director, President and Chief Executive Officer, and Stockholder March 7, 2025 | |||
Gordon Smith was initially elected to the Board in October 2024. Mr. Smith was formerly the Co-President and Co-Chief Operating Officer of JPMorgan Chase & Co. (JPMorgan), having held these positions from 2018 until retiring in January of 2022. In this role, Mr. Smith served as a member of the firm’s Operating Committee and helped oversee all aspects of the company’s business and operations. Mr. Smith’s career at JPMorgan began in 2007 and spanned 15 years, where he previously served as Chief Executive Officer of Consumer & Community Banking (2012-2021), and prior to that held various roles of increasing responsibility, including as CEO of Chase Card Services, Auto Finance and Student Lending (2011-2012), and CEO of Chase Card Services (2007-2011). Prior to his time at JPMorgan, Mr. Smith spent more than 25 years at American Express, where he led and managed several businesses, including the Global Commercial Card Business. Mr. Smith is also an operating advisor to Clayton Dubilier & Rice. | |||
The Board believes that Mr. D’Amelio’s skills, global experience and proven leadership in both financial and operational roles contribute greatly to the Board’s composition. As a senior executive at various global companies undergoing the kind of rapid and complex changes that the Company has undertaken in response to the rapidly changing markets and regulatory environment, Mr. D’Amelio has extensive knowledge of the capital markets as well as broad experience working with the investment community, regulatory bodies and rating agencies. | |||
David T. Feinberg, M.D. was initially elected to the Board in March 2022. Dr. Feinberg is Chairman of Oracle Health, where he is committed to making healthcare more accessible, affordable, and equitable. His work advances thought leadership and strategy related to unleashing the healing power of data through an open and connected healthcare ecosystem. Previously, Dr. Feinberg served as President and Chief Executive Officer and member of the Board of Directors of Cerner Corporation (Cerner), which is now Oracle Health. In that role Dr. Feinberg focused on delivering tools and technology to help caregivers optimize the health of their patients and communities. |
Name and Principal Position |
Year |
Salary ($) |
Bonus ($) |
Stock Awards ($) |
Option Awards ($) |
Non-Equity Incentive Plan
Compensation
|
Change in Pension Value and Nonqualified Deferred Compensation Earnings ($) |
All Other Compensation ($) |
Total ($) |
||||||||||||||||||||||||||||||||||||
James A. Rechtin
|
2024 | 1,105,769 | — | 7,317,483 | 4,495,979 | 1,943,477 | — | 716,768 | 15,579,476 | ||||||||||||||||||||||||||||||||||||
Bruce D. Broussard
|
2024 | 1,344,231 | — | 8,000,037 | 0 | 2,491,803 | — | 221,093 | 12,057,164 | ||||||||||||||||||||||||||||||||||||
2023 | 1,469,893 | — | 10,898,833 | 3,492,874 | — | — | 465,784 | 16,327,384 | |||||||||||||||||||||||||||||||||||||
2022 | 1,349,465 | — | 9,638,547 | 2,785,410 | 3,072,394 | — | 353,028 | 17,198,844 | |||||||||||||||||||||||||||||||||||||
Susan M. Diamond
|
2024 | 846,192 | — | 6,733,897 | 948,087 | 911,377 | — | 177,961 | 9,617,514 | ||||||||||||||||||||||||||||||||||||
2023 | 790,000 | — | 2,802,776 | 898,145 | — | — | 239,812 | 4,730,733 | |||||||||||||||||||||||||||||||||||||
2022 | 750,000 | — | 2,258,317 | 652,754 | 975,750 | — | 174,177 | 4,810,998 | |||||||||||||||||||||||||||||||||||||
David E. Dintenfass
|
2024 | 605,769 | 5,684,000 | 6,084,670 | 4,877,489 | 601,407 | — | 208,222 | 18,061,557 | ||||||||||||||||||||||||||||||||||||
Sanjay K. Shetty, M.D.
|
2024 | 694,808 | 550,000 | 3,798,420 | 623,769 | 661,107 | — | 107,159 | 6,435,263 | ||||||||||||||||||||||||||||||||||||
2023 | 493,269 | 1,400,000 | 1,401,072 | 449,844 | — | — | 837,756 | 4,581,941 | |||||||||||||||||||||||||||||||||||||
George Renaudin II
|
2024 | 717,885 | — | 3,906,380 | 661,165 | 756,626 | — | 110,025 | 6,152,081 | ||||||||||||||||||||||||||||||||||||
2023 | 655,000 | — | 1,712,892 | 548,910 | — | — | 135,676 | 3,052,478 |
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 |
---|---|---|---|
BROUSSARD BRUCE D | - | 85,130 | 25,000 |
Mellet Celeste | - | 29,676 | 0 |
Diamond Susan M | - | 19,960 | 2,179 |
HILZINGER KURT J | - | 19,448 | 0 |
Ventura Joseph C | - | 17,267 | 264 |
Renaudin George II | - | 15,702 | 512 |
Fleming William Kevin | - | 11,723 | 121 |
Shetty Sanjay K | - | 7,317 | 0 |
Mehta Japan | - | 5,046 | 0 |
Huval Timothy S. | - | 4,368 | 0 |
Wheatley Timothy Alan | - | 3,983 | 1,025 |
Schick Susan D. | - | 3,687 | 0 |
Diamond Susan M | - | 3,131 | 2,145 |
Renaudin George II | - | 1,547 | 482 |
Smith Gordon | - | 765 | 0 |
Feinberg David T | - | 441 | 0 |
SMITH BRAD D | - | 386 | 0 |
JONES DAVID A JR/KY | - | 380 | 32,440 |
Felter John-Paul W. | - | 145 | 0 |
OBRIEN JAMES J /KY | - | 0 | 1,794 |
Mesquita Jorge S. | - | 0 | 3,361 |
Rechtin James A. | - | 0 | 30,474 |
DAMELIO FRANK A | - | 0 | 20,634 |
McDonald William J. | - | 0 | 2,276 |