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x
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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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Delaware
|
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13-4204626
|
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(State or other jurisdiction of
incorporation or organization)
|
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(I.R.S. Employer
Identification No.)
|
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|
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200 Oceangate, Suite 100
Long Beach, California
|
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90802
|
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(Address of principal executive offices)
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(Zip Code)
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|
|
|
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Large accelerated filer
|
x
|
Accelerated filer
|
¨
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|
|
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Non-accelerated filer
|
¨
(Do not check if a smaller reporting company)
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Smaller reporting company
|
¨
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|
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|
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June 30,
2013 |
|
December 31,
2012 |
||||
|
|
(Amounts in thousands,
except per-share data)
|
||||||
|
|
(Unaudited)
|
|
|
||||
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ASSETS
|
|
|
|
||||
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Current assets:
|
|
|
|
||||
|
Cash and cash equivalents
|
$
|
742,670
|
|
|
$
|
795,770
|
|
|
Investments
|
718,544
|
|
|
342,845
|
|
||
|
Receivables
|
213,776
|
|
|
149,682
|
|
||
|
Deferred income taxes
|
21,995
|
|
|
32,443
|
|
||
|
Prepaid expenses and other current assets
|
47,817
|
|
|
28,386
|
|
||
|
Total current assets
|
1,744,802
|
|
|
1,349,126
|
|
||
|
Property, equipment, and capitalized software, net
|
249,298
|
|
|
221,443
|
|
||
|
Deferred contract costs
|
51,319
|
|
|
58,313
|
|
||
|
Intangible assets, net
|
68,987
|
|
|
77,711
|
|
||
|
Goodwill and indefinite-lived intangible assets
|
153,152
|
|
|
151,088
|
|
||
|
Derivative asset
|
207,123
|
|
|
—
|
|
||
|
Restricted investments
|
56,935
|
|
|
44,101
|
|
||
|
Auction rate securities
|
12,527
|
|
|
13,419
|
|
||
|
Other assets
|
35,773
|
|
|
19,621
|
|
||
|
|
$
|
2,579,916
|
|
|
$
|
1,934,822
|
|
|
LIABILITIES AND STOCKHOLDERS’ EQUITY
|
|
|
|
||||
|
Current liabilities:
|
|
|
|
||||
|
Medical claims and benefits payable
|
$
|
465,487
|
|
|
$
|
494,530
|
|
|
Accounts payable and accrued liabilities
|
180,227
|
|
|
184,034
|
|
||
|
Deferred revenue
|
45,949
|
|
|
141,798
|
|
||
|
Income taxes payable
|
15,496
|
|
|
6,520
|
|
||
|
Current maturities of long-term debt
|
—
|
|
|
1,155
|
|
||
|
Total current liabilities
|
707,159
|
|
|
828,037
|
|
||
|
Convertible senior notes
|
585,825
|
|
|
175,468
|
|
||
|
Lease financing obligations
|
175,666
|
|
|
—
|
|
||
|
Other long-term debt
|
—
|
|
|
86,316
|
|
||
|
Derivative liabilities
|
207,017
|
|
|
1,307
|
|
||
|
Deferred income taxes
|
3,919
|
|
|
37,900
|
|
||
|
Other long-term liabilities
|
23,943
|
|
|
23,480
|
|
||
|
Total liabilities
|
1,703,529
|
|
|
1,152,508
|
|
||
|
Stockholders’ equity:
|
|
|
|
||||
|
Common stock, $0.001 par value; 150,000 shares authorized; outstanding: 45,683 shares at June 30, 2013 and 46,762 shares at December 31, 2012
|
46
|
|
|
47
|
|
||
|
Preferred stock, $0.001 par value; 20,000 shares authorized, no shares issued and outstanding
|
—
|
|
|
—
|
|
||
|
Additional paid-in capital
|
324,360
|
|
|
285,524
|
|
||
|
Accumulated other comprehensive loss
|
(2,705
|
)
|
|
(457
|
)
|
||
|
Treasury stock, at cost; 111 shares at December 31, 2012
|
—
|
|
|
(3,000
|
)
|
||
|
Retained earnings
|
554,686
|
|
|
500,200
|
|
||
|
Total stockholders’ equity
|
876,387
|
|
|
782,314
|
|
||
|
|
$
|
2,579,916
|
|
|
$
|
1,934,822
|
|
|
|
Three Months Ended
|
|
Six Months Ended
|
||||||||||||
|
|
June 30,
|
|
June 30,
|
||||||||||||
|
|
2013
|
|
2012
|
|
2013
|
|
2012
|
||||||||
|
|
(Amounts in thousands, except
net income (loss) per share)
(Unaudited)
|
||||||||||||||
|
Revenue:
|
|
|
|
|
|
|
|
||||||||
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Premium revenue
|
$
|
1,548,612
|
|
|
$
|
1,432,403
|
|
|
$
|
3,083,045
|
|
|
$
|
2,701,196
|
|
|
Service revenue
|
49,672
|
|
|
41,724
|
|
|
99,428
|
|
|
83,929
|
|
||||
|
Investment income
|
1,628
|
|
|
1,059
|
|
|
3,144
|
|
|
2,738
|
|
||||
|
Rental and other income
|
5,922
|
|
|
3,977
|
|
|
10,616
|
|
|
8,236
|
|
||||
|
Total revenue
|
1,605,834
|
|
|
1,479,163
|
|
|
3,196,233
|
|
|
2,796,099
|
|
||||
|
Expenses:
|
|
|
|
|
|
|
|
||||||||
|
Medical care costs
|
1,294,706
|
|
|
1,317,597
|
|
|
2,582,621
|
|
|
2,395,464
|
|
||||
|
Cost of service revenue
|
39,305
|
|
|
30,613
|
|
|
79,075
|
|
|
61,107
|
|
||||
|
General and administrative expenses
|
161,479
|
|
|
125,819
|
|
|
302,757
|
|
|
241,048
|
|
||||
|
Premium tax expenses
|
46,883
|
|
|
38,354
|
|
|
83,883
|
|
|
80,540
|
|
||||
|
Depreciation and amortization
|
17,015
|
|
|
16,210
|
|
|
33,578
|
|
|
31,058
|
|
||||
|
Total expenses
|
1,559,388
|
|
|
1,528,593
|
|
|
3,081,914
|
|
|
2,809,217
|
|
||||
|
Operating income (loss)
|
46,446
|
|
|
(49,430
|
)
|
|
114,319
|
|
|
(13,118
|
)
|
||||
|
Other expenses:
|
|
|
|
|
|
|
|
||||||||
|
Interest expense
|
11,667
|
|
|
3,808
|
|
|
24,704
|
|
|
8,106
|
|
||||
|
Other expense
|
3,502
|
|
|
1,086
|
|
|
3,371
|
|
|
1,086
|
|
||||
|
Total other expenses
|
15,169
|
|
|
4,894
|
|
|
28,075
|
|
|
9,192
|
|
||||
|
Income (loss) from continuing operations before income tax expense
|
31,277
|
|
|
(54,324
|
)
|
|
86,244
|
|
|
(22,310
|
)
|
||||
|
Income tax expense (benefit)
|
15,481
|
|
|
(21,267
|
)
|
|
39,926
|
|
|
(9,147
|
)
|
||||
|
Income (loss) from continuing operations
|
15,796
|
|
|
(33,057
|
)
|
|
46,318
|
|
|
(13,163
|
)
|
||||
|
Income (loss) from discontinued operations, net of tax benefit of $9,968, $4,502, $10,143, and $5,589, respectively
|
8,775
|
|
|
(4,249
|
)
|
|
8,168
|
|
|
(6,054
|
)
|
||||
|
Net income (loss)
|
$
|
24,571
|
|
|
$
|
(37,306
|
)
|
|
$
|
54,486
|
|
|
$
|
(19,217
|
)
|
|
|
|
|
|
|
|
|
|
||||||||
|
Basic income (loss) per share
|
|
|
|
|
|
|
|
||||||||
|
Income (loss) from continuing operations
|
$
|
0.35
|
|
|
$
|
(0.71
|
)
|
|
$
|
1.01
|
|
|
$
|
(0.29
|
)
|
|
Income (loss) from discontinued operations
|
0.19
|
|
|
(0.09
|
)
|
|
0.18
|
|
|
(0.13
|
)
|
||||
|
Basic net income (loss) per share
|
$
|
0.54
|
|
|
$
|
(0.80
|
)
|
|
$
|
1.19
|
|
|
$
|
(0.42
|
)
|
|
Diluted income (loss) per share
|
|
|
|
|
|
|
|
||||||||
|
Income (loss) from continuing operations
|
$
|
0.34
|
|
|
$
|
(0.71
|
)
|
|
$
|
1.00
|
|
|
$
|
(0.29
|
)
|
|
Income (loss) from discontinued operations
|
0.19
|
|
|
(0.09
|
)
|
|
0.17
|
|
|
(0.13
|
)
|
||||
|
Diluted net income (loss) per share
|
$
|
0.53
|
|
|
$
|
(0.80
|
)
|
|
$
|
1.17
|
|
|
$
|
(0.42
|
)
|
|
|
|
|
|
|
|
|
|
||||||||
|
Weighted average shares outstanding:
|
|
|
|
|
|
|
|
||||||||
|
Basic
|
45,446
|
|
|
46,355
|
|
|
45,712
|
|
|
46,176
|
|
||||
|
Diluted
|
46,507
|
|
|
46,355
|
|
|
46,506
|
|
|
46,176
|
|
||||
|
|
Three Months Ended
|
|
Six Months Ended
|
||||||||||||
|
|
June 30,
|
|
June 30,
|
||||||||||||
|
|
2013
|
|
2012
|
|
2013
|
|
2012
|
||||||||
|
|
(Amounts in thousands)
(Unaudited)
|
||||||||||||||
|
Net income (loss)
|
$
|
24,571
|
|
|
$
|
(37,306
|
)
|
|
$
|
54,486
|
|
|
$
|
(19,217
|
)
|
|
Other comprehensive (loss) income:
|
|
|
|
|
|
|
|
||||||||
|
Gross unrealized investment (loss) gain
|
(4,045
|
)
|
|
523
|
|
|
(3,626
|
)
|
|
1,001
|
|
||||
|
Effect of income taxes
|
(1,537
|
)
|
|
199
|
|
|
(1,378
|
)
|
|
381
|
|
||||
|
Other comprehensive (loss) income, net of tax
|
(2,508
|
)
|
|
324
|
|
|
(2,248
|
)
|
|
620
|
|
||||
|
Comprehensive income (loss)
|
$
|
22,063
|
|
|
$
|
(36,982
|
)
|
|
$
|
52,238
|
|
|
$
|
(18,597
|
)
|
|
|
Six Months Ended
|
||||||
|
|
June 30,
|
||||||
|
|
2013
|
|
2012
|
||||
|
|
(Amounts in thousands)
(Unaudited)
|
||||||
|
Operating activities:
|
|
|
|
||||
|
Net income (loss)
|
$
|
54,486
|
|
|
$
|
(19,217
|
)
|
|
Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities:
|
|
|
|
||||
|
Depreciation and amortization
|
43,907
|
|
|
38,010
|
|
||
|
Deferred income taxes
|
(22,155
|
)
|
|
(1,264
|
)
|
||
|
Stock-based compensation
|
12,150
|
|
|
9,812
|
|
||
|
Gain on sale of subsidiary
|
—
|
|
|
(1,747
|
)
|
||
|
Amortization of convertible senior notes
|
9,688
|
|
|
2,915
|
|
||
|
Change in fair value of derivatives
|
3,384
|
|
|
1,086
|
|
||
|
Amortization of premium/discount on investments
|
4,298
|
|
|
3,615
|
|
||
|
Amortization of deferred financing costs
|
2,366
|
|
|
515
|
|
||
|
Tax deficiency from employee stock compensation
|
(38
|
)
|
|
(50
|
)
|
||
|
Changes in operating assets and liabilities:
|
|
|
|
||||
|
Receivables
|
(64,094
|
)
|
|
6,891
|
|
||
|
Prepaid expenses and other current assets
|
(22,856
|
)
|
|
(10,352
|
)
|
||
|
Medical claims and benefits payable
|
(29,043
|
)
|
|
123,062
|
|
||
|
Accounts payable and accrued liabilities
|
(16,968
|
)
|
|
(22,982
|
)
|
||
|
Deferred revenue
|
(95,849
|
)
|
|
125,426
|
|
||
|
Income taxes
|
8,976
|
|
|
(19,737
|
)
|
||
|
Net cash (used in) provided by operating activities
|
(111,748
|
)
|
|
235,983
|
|
||
|
Investing activities:
|
|
|
|
||||
|
Purchases of equipment
|
(35,229
|
)
|
|
(33,301
|
)
|
||
|
Purchases of investments
|
(532,151
|
)
|
|
(144,348
|
)
|
||
|
Sales and maturities of investments
|
149,420
|
|
|
136,772
|
|
||
|
Proceeds from sale of subsidiary, net of cash surrendered
|
—
|
|
|
9,162
|
|
||
|
Change in deferred contract costs
|
6,994
|
|
|
(23,055
|
)
|
||
|
Increase in restricted investments
|
(12,834
|
)
|
|
(2,154
|
)
|
||
|
Change in other non-current assets and liabilities
|
(8,012
|
)
|
|
(4,383
|
)
|
||
|
Net cash used in investing activities
|
(431,812
|
)
|
|
(61,307
|
)
|
||
|
Financing activities:
|
|
|
|
||||
|
Proceeds from issuance of 1.125% Notes, net of deferred issuance costs
|
537,973
|
|
|
—
|
|
||
|
Proceeds from sale-leaseback transactions
|
158,694
|
|
|
—
|
|
||
|
Purchase of 1.125% Notes call option
|
(149,331
|
)
|
|
—
|
|
||
|
Proceeds from issuance of warrants
|
75,074
|
|
|
—
|
|
||
|
Treasury stock purchases
|
(50,000
|
)
|
|
—
|
|
||
|
Repayment of amounts borrowed under credit facility
|
(40,000
|
)
|
|
(10,000
|
)
|
||
|
Amount borrowed under credit facility
|
—
|
|
|
60,000
|
|
||
|
Principal payments on term loan
|
(47,471
|
)
|
|
(573
|
)
|
||
|
Settlement of interest rate swap
|
(875
|
)
|
|
—
|
|
||
|
Proceeds from employee stock plans
|
4,852
|
|
|
5,485
|
|
||
|
Excess tax benefits from employee stock compensation
|
1,544
|
|
|
3,677
|
|
||
|
Net cash provided by financing activities
|
490,460
|
|
|
58,589
|
|
||
|
Net (decrease) increase in cash and cash equivalents
|
(53,100
|
)
|
|
233,265
|
|
||
|
Cash and cash equivalents at beginning of period
|
795,770
|
|
|
493,827
|
|
||
|
Cash and cash equivalents at end of period
|
$
|
742,670
|
|
|
$
|
727,092
|
|
|
|
Six Months Ended
|
||||||
|
|
June 30,
|
||||||
|
|
2013
|
|
2012
|
||||
|
|
(Amounts in thousands)
|
||||||
|
|
(Unaudited)
|
||||||
|
Supplemental cash flow information:
|
|
|
|
||||
|
Cash paid during the period for:
|
|
|
|
||||
|
Income taxes
|
$
|
41,407
|
|
|
$
|
1,074
|
|
|
Interest
|
$
|
21,933
|
|
|
$
|
4,719
|
|
|
Schedule of non-cash investing and financing activities:
|
|
|
|
||||
|
Retirement of treasury stock
|
$
|
53,000
|
|
|
$
|
—
|
|
|
Common stock used for stock-based compensation
|
$
|
5,669
|
|
|
$
|
9,390
|
|
|
Details of change in fair value of derivatives:
|
|
|
|
||||
|
Gain on 1.125% Call Option
|
$
|
57,792
|
|
|
$
|
—
|
|
|
Loss on embedded cash conversion option
|
(57,686
|
)
|
|
—
|
|
||
|
Loss on 1.125% Warrants
|
(3,923
|
)
|
|
—
|
|
||
|
Gain (loss) on interest rate swap
|
433
|
|
|
(1,086
|
)
|
||
|
Change in fair value of derivatives
|
$
|
(3,384
|
)
|
|
$
|
(1,086
|
)
|
|
Details of sale of subsidiary:
|
|
|
|
||||
|
Decrease in carrying value of assets
|
$
|
—
|
|
|
$
|
30,942
|
|
|
Decrease in carrying value of liabilities
|
—
|
|
|
(23,527
|
)
|
||
|
Gain on sale
|
—
|
|
|
1,747
|
|
||
|
Proceeds from sale of subsidiary, net of cash surrendered
|
$
|
—
|
|
|
$
|
9,162
|
|
|
|
Three Months Ended June 30, 2013
|
||||||||||||||||||
|
|
Maximum
Available Quality
Incentive
Premium -
Current Year
|
|
Amount of
Current Year
Quality Incentive
Premium Revenue
Recognized
|
|
Amount of
Quality Incentive
Premium Revenue
Recognized from
Prior Year
|
|
Total Quality
Incentive
Premium Revenue
Recognized
|
|
Total Revenue
Recognized
|
||||||||||
|
|
(In thousands)
|
||||||||||||||||||
|
New Mexico
|
$
|
588
|
|
|
$
|
535
|
|
|
$
|
49
|
|
|
$
|
584
|
|
|
$
|
86,527
|
|
|
Ohio
|
2,964
|
|
|
1,087
|
|
|
553
|
|
|
1,640
|
|
|
292,706
|
|
|||||
|
Texas
|
15,675
|
|
|
15,675
|
|
|
2,752
|
|
|
18,427
|
|
|
324,600
|
|
|||||
|
Wisconsin
|
1,269
|
|
|
—
|
|
|
495
|
|
|
495
|
|
|
37,740
|
|
|||||
|
|
$
|
20,496
|
|
|
$
|
17,297
|
|
|
$
|
3,849
|
|
|
$
|
21,146
|
|
|
$
|
741,573
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||
|
|
Three Months Ended June 30, 2012
|
||||||||||||||||||
|
|
Maximum
Available Quality
Incentive
Premium -
Current Year
|
|
Amount of
Current Year
Quality Incentive
Premium Revenue
Recognized
|
|
Amount of
Quality Incentive
Premium Revenue
Recognized from
Prior Year
|
|
Total Quality
Incentive
Premium Revenue
Recognized
|
|
Total Revenue
Recognized
|
||||||||||
|
|
(In thousands)
|
||||||||||||||||||
|
New Mexico
|
$
|
561
|
|
|
$
|
482
|
|
|
$
|
630
|
|
|
$
|
1,112
|
|
|
$
|
82,706
|
|
|
Ohio
|
2,720
|
|
|
2,720
|
|
|
—
|
|
|
2,720
|
|
|
297,069
|
|
|||||
|
Texas
|
18,252
|
|
|
14,284
|
|
|
—
|
|
|
14,284
|
|
|
359,486
|
|
|||||
|
Wisconsin
|
449
|
|
|
—
|
|
|
246
|
|
|
246
|
|
|
18,788
|
|
|||||
|
|
$
|
21,982
|
|
|
$
|
17,486
|
|
|
$
|
876
|
|
|
$
|
18,362
|
|
|
$
|
758,049
|
|
|
|
Six Months Ended June 30, 2013
|
||||||||||||||||||
|
|
Maximum
Available Quality
Incentive
Premium -
Current Year
|
|
Amount of
Current Year
Quality Incentive
Premium Revenue
Recognized
|
|
Amount of
Quality Incentive
Premium Revenue
Recognized from
Prior Year
|
|
Total Quality
Incentive
Premium Revenue
Recognized
|
|
Total Revenue
Recognized
|
||||||||||
|
|
(In thousands)
|
||||||||||||||||||
|
New Mexico
|
$
|
1,173
|
|
|
$
|
867
|
|
|
$
|
157
|
|
|
$
|
1,024
|
|
|
$
|
172,325
|
|
|
Ohio
|
5,969
|
|
|
2,139
|
|
|
553
|
|
|
2,692
|
|
|
584,224
|
|
|||||
|
Texas
|
31,939
|
|
|
29,187
|
|
|
8,747
|
|
|
37,934
|
|
|
659,896
|
|
|||||
|
Wisconsin
|
2,030
|
|
|
—
|
|
|
1,104
|
|
|
1,104
|
|
|
64,864
|
|
|||||
|
|
$
|
41,111
|
|
|
$
|
32,193
|
|
|
$
|
10,561
|
|
|
$
|
42,754
|
|
|
$
|
1,481,309
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||
|
|
Six Months Ended June 30, 2012
|
||||||||||||||||||
|
|
Maximum
Available Quality
Incentive
Premium -
Current Year
|
|
Amount of
Current Year
Quality Incentive
Premium Revenue
Recognized
|
|
Amount of
Quality Incentive
Premium Revenue
Recognized from
Prior Year
|
|
Total Quality
Incentive
Premium Revenue
Recognized
|
|
Total Revenue
Recognized
|
||||||||||
|
|
(In thousands)
|
||||||||||||||||||
|
New Mexico
|
$
|
1,116
|
|
|
$
|
818
|
|
|
$
|
658
|
|
|
$
|
1,476
|
|
|
$
|
163,932
|
|
|
Ohio
|
5,398
|
|
|
5,398
|
|
|
966
|
|
|
6,364
|
|
|
590,594
|
|
|||||
|
Texas
|
24,002
|
|
|
20,034
|
|
|
—
|
|
|
20,034
|
|
|
557,722
|
|
|||||
|
Wisconsin
|
865
|
|
|
—
|
|
|
246
|
|
|
246
|
|
|
35,930
|
|
|||||
|
|
$
|
31,381
|
|
|
$
|
26,250
|
|
|
$
|
1,870
|
|
|
$
|
28,120
|
|
|
$
|
1,348,178
|
|
|
•
|
Each contract calls for the provision of its own specific set of services. While all contracts support the system of record for state MMIS, the actual services we provide vary significantly between contracts; and
|
|
•
|
The nature of the MMIS installed varies significantly between our older contracts (proprietary mainframe systems) and our new contracts (commercial off-the-shelf technology solutions).
|
|
|
Three Months Ended June 30,
|
|
Six Months Ended June 30,
|
||||||||
|
|
2013
|
|
2012
|
|
2013
|
|
2012
|
||||
|
|
(In thousands)
|
||||||||||
|
Shares outstanding at the beginning of the period
|
45,415
|
|
|
46,347
|
|
|
46,762
|
|
|
45,815
|
|
|
Weighted-average number of shares repurchased
|
—
|
|
|
—
|
|
|
(1,248
|
)
|
|
—
|
|
|
Weighted-average number of shares issued
|
31
|
|
|
8
|
|
|
198
|
|
|
361
|
|
|
Denominator for basic net income per share
|
45,446
|
|
|
46,355
|
|
|
45,712
|
|
|
46,176
|
|
|
Dilutive effect of employee stock options and stock grants (1)
|
378
|
|
|
—
|
|
|
488
|
|
|
—
|
|
|
Dilutive effect of convertible senior notes
|
683
|
|
|
—
|
|
|
306
|
|
|
—
|
|
|
Denominator for diluted net income per share (2)
|
46,507
|
|
|
46,355
|
|
|
46,506
|
|
|
46,176
|
|
|
(1)
|
Unvested restricted shares are included in the calculation of diluted income per share when their grant date fair values are below the average fair value of the common shares for each of the periods presented. Options to purchase common shares are included in the calculation of diluted income per share when their exercise prices are below the average fair value of the common shares for each of the periods presented. For the three and six months ended
June 30, 2013
there were no anti-dilutive weighted restricted shares. For the three and six months ended
June 30, 2013
there were approximately
60,000
and
42,800
anti-dilutive weighted options, respectively. Potentially dilutive unvested restricted shares and stock options were not included in the computation of diluted loss per share for the three and six months ended
June 30, 2012
, because to do so would have been anti-dilutive.
|
|
(2)
|
Potentially dilutive shares issuable pursuant to our 1.125% Warrants (defined in Note 10, "Long-Term Debt") were not included in the computation of diluted income per share for the three and six month period ended
June 30, 2013
, because to do so would have been anti-dilutive. Potentially dilutive shares issuable pursuant to our 3.75% Notes (defined in Note 10, "Long-Term Debt") were not included in the computation of diluted loss per share for the three and six month period ended
June 30, 2012
, because to do so would have been anti-dilutive.
|
|
|
Three Months Ended June 30,
|
|
Six Months Ended June 30,
|
||||||||||||
|
|
2013
|
|
2012
|
|
2013
|
|
2012
|
||||||||
|
|
(In thousands)
|
||||||||||||||
|
Restricted stock and performance awards
|
$
|
7,111
|
|
|
$
|
4,452
|
|
|
$
|
10,959
|
|
|
$
|
8,850
|
|
|
Employee stock purchase plan and stock options
|
618
|
|
|
694
|
|
|
1,191
|
|
|
962
|
|
||||
|
|
$
|
7,729
|
|
|
$
|
5,146
|
|
|
$
|
12,150
|
|
|
$
|
9,812
|
|
|
|
Shares
|
|
Weighted
Average
Grant Date
Fair Value
|
|||
|
Unvested balance as of December 31, 2012
|
986,577
|
|
|
$
|
23.74
|
|
|
Granted
|
1,038,880
|
|
|
31.53
|
|
|
|
Vested
|
(495,221
|
)
|
|
23.64
|
|
|
|
Forfeited
|
(21,751
|
)
|
|
26.63
|
|
|
|
Unvested balance as of June 30, 2013
|
1,508,485
|
|
|
29.10
|
|
|
|
|
Options
|
|
Weighted
Average
Exercise
Price
|
|
Aggregate
Intrinsic
Value
|
|
Weighted
Average
Remaining
Contractual
term
|
|||||
|
|
|
|
|
|
(In thousands)
|
|
(Years)
|
|||||
|
Outstanding as of December 31, 2012
|
414,061
|
|
|
$
|
22.39
|
|
|
|
|
|
||
|
Granted
|
45,000
|
|
|
33.02
|
|
|
|
|
|
|||
|
Exercised
|
(54,500
|
)
|
|
17.93
|
|
|
|
|
|
|
||
|
Forfeited
|
(300
|
)
|
|
17.63
|
|
|
|
|
|
|||
|
Outstanding as of June 30, 2013
|
404,261
|
|
|
24.18
|
|
|
$
|
5,255
|
|
|
3.8
|
|
|
Stock options exercisable and expected to vest as of June 30, 2013
|
404,261
|
|
|
24.18
|
|
|
$
|
5,255
|
|
|
3.8
|
|
|
Exercisable as of June 30, 2013
|
349,261
|
|
|
22.74
|
|
|
$
|
5,045
|
|
|
2.9
|
|
|
•
|
Level 1 — Observable inputs such as quoted prices in active markets:
Our Level 1 financial instruments recorded at fair value consist of investments including government-sponsored enterprise securities (GSEs) and U.S. treasury notes that are classified as current investments in the accompanying consolidated balance sheets. These financial instruments are actively traded and therefore the fair value for these securities is based on quoted market prices on one or more securities exchanges.
|
|
•
|
Level 2 — Inputs other than quoted prices in active markets that are either directly or indirectly observable:
Our Level 2 financial instruments recorded at fair value consist of investments including corporate debt securities, municipal securities, and certificates of deposit that are classified as current investments in the accompanying consolidated balance sheets. Our investments classified as Level 2 are traded frequently though not necessarily daily. Fair value for these investments is determined using a market approach based on quoted prices for similar securities in active markets or quoted prices for identical securities in inactive markets.
|
|
•
|
Level 3 — Unobservable inputs in which little or no market data exists, therefore requiring an entity to develop its own assumptions:
Our Level 3 financial instruments recorded at fair value include non-current auction rate securities that are designated as available-for-sale, and are reported at fair value of
$12.5 million
(par value of
$13.4 million
) as of
June 30, 2013
. To estimate the fair value of these securities we use valuation data from our primary pricing source, a third party who provides a marketplace for illiquid assets with over 10,000 participants including global financial institutions, hedge funds, private equity funds, mutual funds, corporations and other institutional investors. This valuation data is based on a range of prices that represent indicative bids from potential buyers. To validate the reasonableness of the data, we compare these valuations to data from two other third-party pricing sources, which also provide a range of prices representing indicative bids from potential buyers. We have concluded that these estimates, given the lack of market available pricing, provide a reasonable basis for determining the fair value of the auction rate securities as of
June 30, 2013
.
|
|
|
Total
|
|
Level 1
|
|
Level 2
|
|
Level 3
|
||||||||
|
|
(In thousands)
|
||||||||||||||
|
Corporate debt securities
|
$
|
463,723
|
|
|
$
|
—
|
|
|
$
|
463,723
|
|
|
$
|
—
|
|
|
GSEs
|
84,101
|
|
|
84,101
|
|
|
—
|
|
|
—
|
|
||||
|
Municipal securities
|
105,936
|
|
|
—
|
|
|
105,936
|
|
|
—
|
|
||||
|
U.S. treasury notes
|
26,495
|
|
|
26,495
|
|
|
—
|
|
|
—
|
|
||||
|
Certificates of deposit
|
38,289
|
|
|
—
|
|
|
38,289
|
|
|
—
|
|
||||
|
Auction rate securities
|
12,527
|
|
|
—
|
|
|
—
|
|
|
12,527
|
|
||||
|
1.125% Call Option derivative asset
|
207,123
|
|
|
—
|
|
|
—
|
|
|
207,123
|
|
||||
|
Total assets measured at fair value on a recurring basis
|
$
|
938,194
|
|
|
$
|
110,596
|
|
|
$
|
607,948
|
|
|
$
|
219,650
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
Embedded cash conversion option derivative liability
|
$
|
207,017
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
207,017
|
|
|
|
Total
|
|
Level 1
|
|
Level 2
|
|
Level 3
|
||||||||
|
|
(In thousands)
|
||||||||||||||
|
Corporate debt securities
|
$
|
191,008
|
|
|
$
|
—
|
|
|
$
|
191,008
|
|
|
$
|
—
|
|
|
GSEs
|
29,525
|
|
|
29,525
|
|
|
—
|
|
|
—
|
|
||||
|
Municipal securities
|
75,848
|
|
|
—
|
|
|
75,848
|
|
|
—
|
|
||||
|
U.S. treasury notes
|
35,740
|
|
|
35,740
|
|
|
—
|
|
|
—
|
|
||||
|
Certificates of deposit
|
10,724
|
|
|
—
|
|
|
10,724
|
|
|
—
|
|
||||
|
Auction rate securities
|
13,419
|
|
|
—
|
|
|
—
|
|
|
13,419
|
|
||||
|
Total assets measured at fair value on a recurring basis
|
$
|
356,264
|
|
|
$
|
65,265
|
|
|
$
|
277,580
|
|
|
$
|
13,419
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
Interest rate swap derivative liability
|
$
|
1,307
|
|
|
$
|
—
|
|
|
$
|
1,307
|
|
|
$
|
—
|
|
|
|
Changes in Level 3 Instruments for the Six Months Ended June 30, 2013
|
||||||||||
|
|
Total
|
|
Auction Rate Securities
|
|
Derivatives, Net
|
||||||
|
|
|
|
(In thousands)
|
|
|
||||||
|
Balance at December 31, 2012
|
$
|
13,419
|
|
|
$
|
13,419
|
|
|
$
|
—
|
|
|
Net unrealized gains included in other comprehensive income
|
358
|
|
|
358
|
|
|
—
|
|
|||
|
Net unrealized gains (losses) included in other expense
|
(3,817
|
)
|
|
—
|
|
|
(3,817
|
)
|
|||
|
Issuances
|
(75,074
|
)
|
|
—
|
|
|
(75,074
|
)
|
|||
|
Settlements and derivative redesignation
|
77,747
|
|
|
(1,250
|
)
|
|
78,997
|
|
|||
|
Balance at June 30, 2013
|
$
|
12,633
|
|
|
$
|
12,527
|
|
|
$
|
106
|
|
|
The amount of total unrealized gains for the period included in other comprehensive income attributable to the change in accumulated other comprehensive losses relating to assets still held at June 30, 2013
|
$
|
290
|
|
|
$
|
290
|
|
|
$
|
—
|
|
|
|
Changes in Level 3 Instruments for the Year Ended December 31, 2012
|
||||||||||
|
|
Total
|
|
Auction Rate Securities
|
|
Derivatives, Net
|
||||||
|
|
(In thousands)
|
||||||||||
|
Balance at December 31, 2011
|
$
|
16,134
|
|
|
$
|
16,134
|
|
|
$
|
—
|
|
|
Net unrealized gains included in other comprehensive income
|
1,635
|
|
|
1,635
|
|
|
—
|
|
|||
|
Settlements
|
(4,350
|
)
|
|
(4,350
|
)
|
|
—
|
|
|||
|
Balance at December 31, 2012
|
$
|
13,419
|
|
|
$
|
13,419
|
|
|
$
|
—
|
|
|
The amount of total unrealized gains for the period included in other comprehensive income attributable to the change in accumulated other comprehensive losses relating to assets still held at December 31, 2012
|
$
|
1,059
|
|
|
$
|
1,059
|
|
|
$
|
—
|
|
|
|
June 30, 2013
|
||||||||||||||||||
|
|
Carrying
Value
|
|
Total
Fair Value
|
|
Level 1
|
|
Level 2
|
|
Level 3
|
||||||||||
|
|
(In thousands)
|
||||||||||||||||||
|
1.125% Notes
|
$
|
407,215
|
|
|
$
|
608,416
|
|
|
$
|
—
|
|
|
$
|
608,416
|
|
|
$
|
—
|
|
|
3.75% Notes
|
178,610
|
|
|
242,466
|
|
|
—
|
|
|
242,466
|
|
|
—
|
|
|||||
|
Lease financing obligations
|
175,666
|
|
|
175,666
|
|
|
—
|
|
|
—
|
|
|
175,666
|
|
|||||
|
|
$
|
761,491
|
|
|
$
|
1,026,548
|
|
|
$
|
—
|
|
|
$
|
850,882
|
|
|
$
|
175,666
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||
|
|
December 31, 2012
|
||||||||||||||||||
|
|
Carrying
|
|
Total
|
|
|
|
|
|
|
||||||||||
|
|
Value
|
|
Fair Value
|
|
Level 1
|
|
Level 2
|
|
Level 3
|
||||||||||
|
|
(In thousands)
|
||||||||||||||||||
|
3.75% Notes
|
$
|
175,468
|
|
|
$
|
208,460
|
|
|
$
|
—
|
|
|
$
|
208,460
|
|
|
$
|
—
|
|
|
Term loan
|
47,471
|
|
|
47,471
|
|
|
—
|
|
|
—
|
|
|
47,471
|
|
|||||
|
Credit facility
|
40,000
|
|
|
40,000
|
|
|
—
|
|
|
—
|
|
|
40,000
|
|
|||||
|
|
$
|
262,939
|
|
|
$
|
295,931
|
|
|
$
|
—
|
|
|
$
|
208,460
|
|
|
$
|
87,471
|
|
|
|
June 30, 2013
|
||||||||||||||
|
|
Amortized
|
|
Gross
Unrealized
|
|
Estimated
Fair
|
||||||||||
|
|
Cost
|
|
Gains
|
|
Losses
|
|
Value
|
||||||||
|
|
(In thousands)
|
||||||||||||||
|
Corporate debt securities
|
$
|
465,943
|
|
|
$
|
215
|
|
|
$
|
2,436
|
|
|
$
|
463,722
|
|
|
GSEs
|
84,310
|
|
|
9
|
|
|
218
|
|
|
84,101
|
|
||||
|
Municipal securities
|
106,933
|
|
|
103
|
|
|
1,100
|
|
|
105,936
|
|
||||
|
U.S. treasury notes
|
26,557
|
|
|
11
|
|
|
72
|
|
|
26,496
|
|
||||
|
Certificates of deposit
|
38,291
|
|
|
3
|
|
|
5
|
|
|
38,289
|
|
||||
|
Subtotal - current investments
|
722,034
|
|
|
341
|
|
|
3,831
|
|
|
718,544
|
|
||||
|
Auction rate securities
|
13,400
|
|
|
—
|
|
|
873
|
|
|
12,527
|
|
||||
|
|
$
|
735,434
|
|
|
$
|
341
|
|
|
$
|
4,704
|
|
|
$
|
731,071
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
|
December 31, 2012
|
||||||||||||||
|
|
Amortized
|
|
Gross
Unrealized
|
|
Estimated
Fair
|
||||||||||
|
|
Cost
|
|
Gains
|
|
Losses
|
|
Value
|
||||||||
|
|
(In thousands)
|
||||||||||||||
|
Corporate debt securities
|
$
|
190,545
|
|
|
$
|
528
|
|
|
$
|
65
|
|
|
$
|
191,008
|
|
|
GSEs
|
29,481
|
|
|
45
|
|
|
1
|
|
|
29,525
|
|
||||
|
Municipal securities
|
75,909
|
|
|
185
|
|
|
246
|
|
|
75,848
|
|
||||
|
U.S. treasury notes
|
35,700
|
|
|
42
|
|
|
2
|
|
|
35,740
|
|
||||
|
Certificates of deposit
|
10,715
|
|
|
9
|
|
|
—
|
|
|
10,724
|
|
||||
|
Subtotal - current investments
|
342,350
|
|
|
809
|
|
|
314
|
|
|
342,845
|
|
||||
|
Auction rate securities
|
14,650
|
|
|
—
|
|
|
1,231
|
|
|
13,419
|
|
||||
|
|
$
|
357,000
|
|
|
$
|
809
|
|
|
$
|
1,545
|
|
|
$
|
356,264
|
|
|
|
Cost
|
|
Estimated
Fair Value
|
||||
|
|
(In thousands)
|
||||||
|
Due in one year or less
|
$
|
348,784
|
|
|
$
|
348,700
|
|
|
Due one year through five years
|
373,250
|
|
|
369,844
|
|
||
|
Due after ten years
|
13,400
|
|
|
12,527
|
|
||
|
|
$
|
735,434
|
|
|
$
|
731,071
|
|
|
|
In a Continuous Loss Position
for Less than 12 Months
|
|
In a Continuous Loss Position
for 12 Months or More
|
||||||||||||||||||
|
|
Estimated
Fair
Value
|
|
Unrealized
Losses
|
|
Total
Number of
Securities
|
|
Estimated
Fair
Value
|
|
Unrealized
Losses
|
|
Total
Number of
Securities
|
||||||||||
|
|
(Dollars in thousands)
|
||||||||||||||||||||
|
Corporate debt securities
|
$
|
349,918
|
|
|
$
|
2,436
|
|
|
158
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
—
|
|
|
Municipal securities
|
82,592
|
|
|
1,100
|
|
|
100
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
GSEs
|
70,453
|
|
|
218
|
|
|
27
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
U.S. treasury notes
|
20,720
|
|
|
72
|
|
|
17
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
Certificates of deposit
|
4,743
|
|
|
5
|
|
|
19
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
Auction rate securities
|
—
|
|
|
—
|
|
|
—
|
|
|
12,527
|
|
|
873
|
|
|
18
|
|
||||
|
|
$
|
528,426
|
|
|
$
|
3,831
|
|
|
321
|
|
|
$
|
12,527
|
|
|
$
|
873
|
|
|
18
|
|
|
|
In a Continuous Loss Position
for Less than 12 Months
|
|
In a Continuous Loss Position
for 12 Months or More
|
||||||||||||||||||
|
|
Estimated
Fair
Value
|
|
Unrealized
Losses
|
|
Total
Number of
Securities
|
|
Estimated
Fair
Value
|
|
Unrealized
Losses
|
|
Total
Number of
Securities
|
||||||||||
|
|
(Dollars in thousands)
|
||||||||||||||||||||
|
Corporate debt securities
|
$
|
44,457
|
|
|
$
|
65
|
|
|
23
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
—
|
|
|
Municipal securities
|
35,223
|
|
|
246
|
|
|
43
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
GSEs
|
5,004
|
|
|
1
|
|
|
1
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
U.S. treasury notes
|
4,511
|
|
|
2
|
|
|
5
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
Auction rate securities
|
—
|
|
|
—
|
|
|
—
|
|
|
13,419
|
|
|
1,231
|
|
|
21
|
|
||||
|
|
$
|
89,195
|
|
|
$
|
314
|
|
|
72
|
|
|
$
|
13,419
|
|
|
$
|
1,231
|
|
|
21
|
|
|
|
June 30,
2013 |
|
December 31,
2012 |
||||
|
|
(In thousands)
|
||||||
|
Health Plans segment:
|
|
|
|
||||
|
California
|
$
|
94,479
|
|
|
$
|
28,553
|
|
|
Florida
|
1,277
|
|
|
953
|
|
||
|
Michigan
|
11,087
|
|
|
12,873
|
|
||
|
New Mexico
|
11,720
|
|
|
9,059
|
|
||
|
Ohio
|
37,103
|
|
|
40,980
|
|
||
|
Texas
|
4,647
|
|
|
7,459
|
|
||
|
Utah
|
4,507
|
|
|
3,359
|
|
||
|
Washington
|
15,292
|
|
|
17,587
|
|
||
|
Wisconsin
|
16,332
|
|
|
4,098
|
|
||
|
Other
|
852
|
|
|
2,177
|
|
||
|
Total Health Plans segment
|
197,296
|
|
|
127,098
|
|
||
|
Molina Medicaid Solutions segment
|
16,480
|
|
|
22,584
|
|
||
|
|
$
|
213,776
|
|
|
$
|
149,682
|
|
|
|
June 30,
2013 |
|
December 31,
2012 |
||||
|
|
(In thousands)
|
||||||
|
California
|
$
|
373
|
|
|
$
|
373
|
|
|
Florida
|
8,492
|
|
|
5,738
|
|
||
|
Michigan
|
1,014
|
|
|
1,014
|
|
||
|
New Mexico
|
15,917
|
|
|
15,915
|
|
||
|
Ohio
|
9,081
|
|
|
9,082
|
|
||
|
Texas
|
3,500
|
|
|
3,503
|
|
||
|
Utah
|
3,314
|
|
|
3,126
|
|
||
|
Washington
|
151
|
|
|
151
|
|
||
|
Other
|
4,792
|
|
|
5,199
|
|
||
|
Total Health Plans segment
|
46,634
|
|
|
44,101
|
|
||
|
Molina Medicaid Solutions segment
|
10,301
|
|
|
—
|
|
||
|
|
$
|
56,935
|
|
|
$
|
44,101
|
|
|
|
Amortized
Cost
|
|
Estimated
Fair Value
|
||||
|
|
(In thousands)
|
||||||
|
Due in one year or less
|
$
|
52,694
|
|
|
$
|
52,697
|
|
|
Due one year through five years
|
4,241
|
|
|
4,238
|
|
||
|
|
$
|
56,935
|
|
|
$
|
56,935
|
|
|
|
Six Months Ended
|
|
Three Months Ended
|
|
Year Ended
|
||||||
|
|
June 30, 2013
|
|
June 30, 2013
|
|
Dec. 31, 2012
|
||||||
|
|
(Dollars in thousands)
|
||||||||||
|
Balances at beginning of period
|
$
|
494,530
|
|
|
$
|
491,145
|
|
|
$
|
402,476
|
|
|
Components of medical care costs related to:
|
|
|
|
|
|
||||||
|
Current period
|
2,647,083
|
|
|
1,345,592
|
|
|
5,136,055
|
|
|||
|
Prior periods
|
(62,757
|
)
|
|
(50,020
|
)
|
|
(39,295
|
)
|
|||
|
Total medical care costs
|
2,584,326
|
|
|
1,295,572
|
|
|
5,096,760
|
|
|||
|
Payments for medical care costs related to:
|
|
|
|
|
|
||||||
|
Current period
|
2,206,474
|
|
|
940,186
|
|
|
4,649,363
|
|
|||
|
Prior periods
|
406,895
|
|
|
381,044
|
|
|
355,343
|
|
|||
|
Total paid
|
2,613,369
|
|
|
1,321,230
|
|
|
5,004,706
|
|
|||
|
Balances at end of period
|
$
|
465,487
|
|
|
$
|
465,487
|
|
|
$
|
494,530
|
|
|
Benefit from prior period as a percentage of:
|
|
|
|
|
|
||||||
|
Balance at beginning of period
|
12.7
|
%
|
|
10.2
|
%
|
|
9.8
|
%
|
|||
|
Premium revenue, trailing twelve months
|
1.0
|
%
|
|
0.8
|
%
|
|
0.7
|
%
|
|||
|
Medical care costs, trailing twelve months
|
1.2
|
%
|
|
1.0
|
%
|
|
0.8
|
%
|
|||
|
•
|
At our Texas health plan, STAR+PLUS (the state’s program for ABD members) membership declined during mid– to late– 2012. This caused a reduction in costs per member that we did not fully recognize in our December 31, 2012 reserve estimates.
|
|
•
|
At our Washington health plan, prior to July 2012, certain high-cost newborns that were approved for supplemental security income (SSI) coverage by the state were retroactively dis-enrolled from our Healthy Options (TANF) coverage, and the health plan was reimbursed for the claims paid on behalf of these members. Starting July 1, 2012, these newborns, as well as other high-cost disabled members, are now covered by the health plan under the Healthy Options Blind and Disabled (HOBD) program. At the end of 2012, we had limited claims history with which to estimate the claims liability of the HOBD members, and as a result the liability for these high-cost members was overstated.
|
|
•
|
For our New Mexico health plan, we overestimated the impact of certain high-dollar outstanding claim payments as of December 31, 2012.
|
|
•
|
At our Washington health plan, we had limited claims history with which to estimate the incurred claims for members enrolled in the HOBD program. Because claims on this group of members were being paid at a rate faster than expected, the reserves for unpaid claims were overstated.
|
|
•
|
At our Ohio and New Mexico health plans, we overestimated the impact of several potential high-dollar claims on critically ill members.
|
|
•
|
At our Washington health plan, we underestimated the amount of recoveries we would collect for certain high-cost newborn claims, resulting in an overestimation of reserves at year end.
|
|
•
|
At our Texas health plan, we overestimated the cost of new members in STAR+PLUS, in the Dallas region.
|
|
•
|
The overestimation of our liability for medical claims and benefits payable was partially offset by an underestimation of that liability at our Missouri health plan, as a result of the costs associated with an unusually large number of premature infants during the fourth quarter of 2011.
|
|
•
|
In our Texas health plan, we have noted an unusually large number of claims with incurred dates older than 10 months. This has caused some distortion in the claims lag pattern that we use to estimate the incurred claims.
|
|
•
|
Our Wisconsin health plan is experiencing significant membership increases, and approximately doubled in size during the first four months of 2013. This new membership is transitioning to our health plan from a terminated health plan. We enrolled approximately
50,000
new members in February, March and April 2013.
We have computed a separate reserve analysis for these members and have noted that paid claims thus far are less than what we would expect for newly transitioned members. It has been our experience that when members move to new health plans, there is a delay in the submission of claims for payment. Therefore, we have increased the reserves for this membership, in anticipation of higher claims costs eventually being reported for these members.
|
|
•
|
In our Michigan health plan, there were a large number of claim recoveries recorded in June 2013 due to overpayments that resulted from a system configuration issue. These recoveries impacted the completion factors used to estimate incurred claims. While we have attempted to remove this distortion from the claims data to develop a more accurate reserve estimate, this type of correction in claims data adds a degree of uncertainty for the Michigan reserves as of June 30, 2013.
|
|
|
Total
|
|
2013
|
|
2014
|
|
2015
|
|
2016
|
|
2017
|
|
Thereafter
|
||||||||||||||
|
1.125% Notes
|
$
|
550,000
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
550,000
|
|
|
3.75% Notes
|
187,000
|
|
|
—
|
|
|
187,000
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|||||||
|
|
$
|
737,000
|
|
|
$
|
—
|
|
|
$
|
187,000
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
550,000
|
|
|
|
Principal Balance
|
|
Unamortized Discount
|
|
Net Carrying Amount
|
||||||
|
|
(In thousands)
|
||||||||||
|
June 30, 2013:
|
|
|
|
|
|
||||||
|
1.125% Notes
|
$
|
550,000
|
|
|
$
|
142,785
|
|
|
$
|
407,215
|
|
|
3.75% Notes
|
187,000
|
|
|
8,390
|
|
|
178,610
|
|
|||
|
|
$
|
737,000
|
|
|
$
|
151,175
|
|
|
$
|
585,825
|
|
|
December 31, 2012:
|
|
|
|
|
|
||||||
|
3.75% Notes
|
$
|
187,000
|
|
|
$
|
11,532
|
|
|
$
|
175,468
|
|
|
|
Three Months Ended June 30,
|
|
Six Months Ended June 30,
|
||||||||||||
|
|
2013
|
|
2012
|
|
2013
|
|
2012
|
||||||||
|
|
(In thousands)
|
||||||||||||||
|
Interest cost recognized for the period relating to the:
|
|
|
|
|
|
|
|
||||||||
|
Contractual interest coupon rate
|
$
|
3,300
|
|
|
$
|
1,753
|
|
|
$
|
5,827
|
|
|
$
|
3,506
|
|
|
Amortization of the discount
|
5,965
|
|
|
1,472
|
|
|
9,688
|
|
|
2,915
|
|
||||
|
Total interest cost recognized
|
$
|
9,265
|
|
|
$
|
3,225
|
|
|
$
|
15,515
|
|
|
$
|
6,421
|
|
|
|
Balance Sheet Location
|
|
June 30, 2013
|
||
|
|
|
|
(In thousands)
|
||
|
Derivative asset:
|
|
|
|
||
|
1.125% Call Option
|
Non-current assets: Derivative asset
|
|
$
|
207,123
|
|
|
|
|
|
|
|
|
|
Derivative liability:
|
|
|
|
||
|
Embedded cash conversion option
|
Non-current liabilities: Derivative liability
|
|
$
|
207,017
|
|
|
|
Three Months Ended June 30,
|
|
Six Months Ended June 30,
|
||||||||||||
|
|
2013
|
|
2012
|
|
2013
|
|
2012
|
||||||||
|
|
(In thousands)
|
||||||||||||||
|
Derivative gains (losses):
|
|
|
|
|
|
|
|
||||||||
|
1.125% Call Option
|
$
|
59,738
|
|
|
$
|
—
|
|
|
$
|
57,792
|
|
|
$
|
—
|
|
|
Embedded cash conversion option
|
(59,708
|
)
|
|
—
|
|
|
(57,686
|
)
|
|
—
|
|
||||
|
1.125% Warrants
|
(3,923
|
)
|
|
—
|
|
|
(3,923
|
)
|
|
—
|
|
||||
|
Interest rate swap
|
390
|
|
|
(1,086
|
)
|
|
433
|
|
|
(1,086
|
)
|
||||
|
|
$
|
(3,503
|
)
|
|
$
|
(1,086
|
)
|
|
$
|
(3,384
|
)
|
|
$
|
(1,086
|
)
|
|
|
Three Months Ended June 30,
|
|
Six Months Ended June 30,
|
||||||||||||
|
|
2013
|
|
2012
|
|
2013
|
|
2012
|
||||||||
|
|
(In thousands)
|
||||||||||||||
|
Revenue from continuing operations:
|
|
|
|
|
|
|
|
||||||||
|
Health Plans:
|
|
|
|
|
|
|
|
||||||||
|
Premium revenue
|
$
|
1,548,612
|
|
|
$
|
1,432,403
|
|
|
$
|
3,083,045
|
|
|
$
|
2,701,196
|
|
|
Investment income
|
1,628
|
|
|
1,059
|
|
|
3,144
|
|
|
2,738
|
|
||||
|
Rental and other income
|
5,922
|
|
|
3,977
|
|
|
10,616
|
|
|
8,236
|
|
||||
|
Molina Medicaid Solutions:
|
|
|
|
|
|
|
|
||||||||
|
Service revenue
|
49,672
|
|
|
41,724
|
|
|
99,428
|
|
|
83,929
|
|
||||
|
|
$
|
1,605,834
|
|
|
$
|
1,479,163
|
|
|
$
|
3,196,233
|
|
|
$
|
2,796,099
|
|
|
Depreciation and amortization reported in the consolidated statements of cash flows:
|
|
|
|
|
|
|
|
||||||||
|
Health Plans
|
$
|
15,685
|
|
|
$
|
15,104
|
|
|
$
|
30,922
|
|
|
$
|
28,847
|
|
|
Molina Medicaid Solutions
|
6,423
|
|
|
4,567
|
|
|
12,985
|
|
|
9,163
|
|
||||
|
|
$
|
22,108
|
|
|
$
|
19,671
|
|
|
$
|
43,907
|
|
|
$
|
38,010
|
|
|
Operating income (loss) from continuing operations:
|
|
|
|
|
|
|
|
||||||||
|
Health Plans
|
$
|
40,151
|
|
|
$
|
(56,072
|
)
|
|
$
|
101,671
|
|
|
$
|
(28,169
|
)
|
|
Molina Medicaid Solutions
|
6,295
|
|
|
6,642
|
|
|
12,648
|
|
|
15,051
|
|
||||
|
Total operating income (loss) from continuing operations
|
46,446
|
|
|
(49,430
|
)
|
|
114,319
|
|
|
(13,118
|
)
|
||||
|
Interest expense
|
(11,667
|
)
|
|
(3,808
|
)
|
|
(24,704
|
)
|
|
(8,106
|
)
|
||||
|
Other expense
|
(3,502
|
)
|
|
(1,086
|
)
|
|
(3,371
|
)
|
|
(1,086
|
)
|
||||
|
Income (loss) from continuing operations before
|
|
|
|
|
|
|
|
||||||||
|
income taxes
|
$
|
31,277
|
|
|
$
|
(54,324
|
)
|
|
$
|
86,244
|
|
|
$
|
(22,310
|
)
|
|
|
June 30,
2013 |
|
December 31,
2012 |
||||
|
|
(In thousands)
|
||||||
|
Goodwill and intangible assets, net:
|
|
|
|
||||
|
Health Plans
|
$
|
137,071
|
|
|
$
|
139,710
|
|
|
Molina Medicaid Solutions
|
85,068
|
|
|
89,089
|
|
||
|
|
$
|
222,139
|
|
|
$
|
228,799
|
|
|
Total assets:
|
|
|
|
||||
|
Health Plans
|
$
|
2,376,308
|
|
|
$
|
1,702,212
|
|
|
Molina Medicaid Solutions
|
203,608
|
|
|
232,610
|
|
||
|
|
$
|
2,579,916
|
|
|
$
|
1,934,822
|
|
|
|
(In thousands)
|
||
|
2014
|
$
|
14,395
|
|
|
2015
|
18,277
|
|
|
|
2016
|
18,877
|
|
|
|
2017
|
19,496
|
|
|
|
2018
|
20,137
|
|
|
|
Thereafter
|
385,813
|
|
|
|
Total minimum lease payments
|
$
|
476,995
|
|
|
•
|
The ongoing activities of the VIE-collecting and remitting interest and fees and NMTC compliance-were all considered in the initial design and are not expected to significantly affect economic performance throughout the life of the VIE;
|
|
•
|
Contractual arrangements obligate us to comply with NMTC rules and regulations and provide various other guarantees to Investment Fund and CDEs;
|
|
•
|
Wells Fargo lacks a material interest in the underling economics of the project; and
|
|
•
|
We are obligated to absorb losses of the VIE.
|
|
•
|
uncertainties associated with the implementation of the Affordable Care Act, including the impact of the health insurance industry excise tax, the expansion of Medicaid eligibility in participating states to previously uninsured populations unfamiliar with managed care, the implementation of state insurance exchanges currently expected to become operational by October 1, 2013, the effect of various implementing regulations, and uncertainties regarding the impact of other federal or state health care and insurance reform measures, including the duals demonstration programs in California, Ohio, Michigan, and Texas;
|
|
•
|
the success of our medical cost containment initiatives in Texas, and other risks associated with the expansion of our Texas health plan's service areas in 2012;
|
|
•
|
significant budget pressures on state governments and their potential inability to maintain current rates, to implement expected rate increases, or to maintain existing benefit packages or membership eligibility thresholds or criteria;
|
|
•
|
management of our medical costs, including seasonal flu patterns and rates of utilization that are consistent with our expectations and our accruals for incurred but not reported medical costs;
|
|
•
|
the success of our efforts to retain existing government contracts and to obtain new government contracts in connection with state requests for proposals (RFPs) in both existing and new states, and our ability to increase our revenues consistent with our expectations;
|
|
•
|
accurate estimation of incurred but not reported medical costs across our health plans;
|
|
•
|
risks associated with the continued growth in new Medicaid and Medicare enrollees, and the development of actuarially sound rates with respect to such new enrollees, including duals;
|
|
•
|
retroactive adjustments to premium revenue or accounting estimates which require adjustment based upon subsequent developments, including Medicaid pharmaceutical rebates;
|
|
•
|
continuation and renewal of the government contracts of both our health plans and Molina Medicaid Solutions and the terms under which such contracts are renewed;
|
|
•
|
government audits and reviews, and any enrollment freeze or monitoring program that may result therefrom;
|
|
•
|
changes with respect to our provider contracts and the loss of providers;
|
|
•
|
the establishment of a federal or state medical cost expenditure floor as a percentage of the premiums we receive, and the interpretation and implementation of medical cost expenditure floors, administrative cost and profit ceilings, and profit sharing arrangements;
|
|
•
|
interpretation and implementation of at-risk premium rules regarding the achievement of certain quality measures;
|
|
•
|
approval by state regulators of dividends and distributions by our health plan subsidiaries;
|
|
•
|
changes in funding under our contracts as a result of regulatory changes, programmatic adjustments, or other reforms;
|
|
•
|
high dollar claims related to catastrophic illness;
|
|
•
|
the favorable resolution of litigation, arbitration, or administrative proceedings, including our pending litigation against the state of California related to rates paid to our California plan in earlier years that were not actuarially sound;
|
|
•
|
restrictions and covenants in any future credit facility;
|
|
•
|
the relatively small number of states in which we operate health plans;
|
|
•
|
the availability of adequate financing to fund and capitalize our expansion and growth activities and to meet our liquidity needs, including the interest expense and other costs associated with such financing;
|
|
•
|
a state's failure to renew its federal Medicaid waiver;
|
|
•
|
inadvertent unauthorized disclosure of protected health information;
|
|
•
|
changes generally affecting the managed care or Medicaid management information systems industries;
|
|
•
|
increases in government surcharges, taxes, and assessments;
|
|
•
|
changes in general economic conditions, including unemployment rates; and
|
|
•
|
increasing consolidation in the Medicaid industry.
|
|
|
June 30,
2013 |
|
March 31,
2013 |
|
December 31,
2012 |
|
June 30,
2012 |
||||
|
Total Ending Membership by Health Plan:
|
|
|
|
|
|
|
|
||||
|
California
|
355,000
|
|
|
332,000
|
|
|
336,000
|
|
|
350,000
|
|
|
Florida
|
81,000
|
|
|
75,000
|
|
|
73,000
|
|
|
70,000
|
|
|
Michigan
|
215,000
|
|
|
217,000
|
|
|
220,000
|
|
|
220,000
|
|
|
New Mexico
|
92,000
|
|
|
91,000
|
|
|
91,000
|
|
|
89,000
|
|
|
Ohio
|
240,000
|
|
|
242,000
|
|
|
244,000
|
|
|
260,000
|
|
|
Texas
|
266,000
|
|
|
274,000
|
|
|
282,000
|
|
|
301,000
|
|
|
Utah
|
87,000
|
|
|
87,000
|
|
|
87,000
|
|
|
86,000
|
|
|
Washington
|
413,000
|
|
|
416,000
|
|
|
418,000
|
|
|
356,000
|
|
|
Wisconsin
|
98,000
|
|
|
86,000
|
|
|
46,000
|
|
|
42,000
|
|
|
Total
|
1,847,000
|
|
|
1,820,000
|
|
|
1,797,000
|
|
|
1,774,000
|
|
|
Total Ending Membership for our Medicare Advantage Plans:
|
|
|
|
|
|
|
|
||||
|
California
|
8,100
|
|
|
7,700
|
|
|
7,700
|
|
|
7,000
|
|
|
Florida
|
600
|
|
|
600
|
|
|
900
|
|
|
900
|
|
|
Michigan
|
9,500
|
|
|
9,200
|
|
|
9,700
|
|
|
8,900
|
|
|
New Mexico
|
900
|
|
|
900
|
|
|
900
|
|
|
900
|
|
|
Ohio
|
400
|
|
|
300
|
|
|
300
|
|
|
200
|
|
|
Texas
|
2,300
|
|
|
1,900
|
|
|
1,500
|
|
|
800
|
|
|
Utah
|
7,800
|
|
|
7,600
|
|
|
8,200
|
|
|
8,300
|
|
|
Washington
|
6,600
|
|
|
6,100
|
|
|
6,500
|
|
|
5,700
|
|
|
Total
|
36,200
|
|
|
34,300
|
|
|
35,700
|
|
|
32,700
|
|
|
Total Ending Membership for our Aged, Blind or Disabled Population:
|
|
|
|
|
|
|
|
||||
|
California
|
45,400
|
|
|
44,600
|
|
|
44,700
|
|
|
41,100
|
|
|
Florida
|
11,200
|
|
|
10,400
|
|
|
10,300
|
|
|
10,400
|
|
|
Michigan
|
45,000
|
|
|
44,000
|
|
|
41,900
|
|
|
40,000
|
|
|
New Mexico
|
6,000
|
|
|
5,800
|
|
|
5,700
|
|
|
5,600
|
|
|
Ohio
|
28,000
|
|
|
28,200
|
|
|
28,200
|
|
|
29,600
|
|
|
Texas
|
92,000
|
|
|
94,200
|
|
|
95,900
|
|
|
111,000
|
|
|
Utah
|
9,400
|
|
|
9,200
|
|
|
9,000
|
|
|
8,800
|
|
|
Washington
|
31,700
|
|
|
31,300
|
|
|
30,000
|
|
|
4,400
|
|
|
Wisconsin
|
1,600
|
|
|
1,600
|
|
|
1,700
|
|
|
1,700
|
|
|
Total
|
270,300
|
|
|
269,300
|
|
|
267,400
|
|
|
252,600
|
|
|
•
|
Fee-for-service
— Expenses paid for specific encounters or episodes of care according to a fee schedule or other basis established by the state or by contract with the provider.
|
|
•
|
Capitation
— Expenses for PMPM payments to the provider without regard to the frequency, extent, or nature of the medical services actually furnished.
|
|
•
|
Pharmacy
— Expenses for all drug, injectible, and immunization costs paid through our pharmacy benefit manager.
|
|
•
|
Other
— Expenses for medically related administrative costs of approximately $68.4 million, and $62.6 million, for the
six months ended
June 30, 2013
and
2012
, respectively, as well as certain provider incentive costs, reinsurance, costs to operate our medical clinics, and other medical expenses.
|
|
|
Three Months Ended June 30,
|
|
Six Months Ended June 30,
|
||||||||||||
|
|
2013
|
|
2012
|
|
2013
|
|
2012
|
||||||||
|
|
(Dollar amounts in thousands, except per share data)
|
||||||||||||||
|
Net income (loss) per diluted share
|
$
|
0.34
|
|
|
$
|
(0.71
|
)
|
|
$
|
1.00
|
|
|
$
|
(0.29
|
)
|
|
Premium revenue
|
$
|
1,548,612
|
|
|
$
|
1,432,403
|
|
|
$
|
3,083,045
|
|
|
$
|
2,701,196
|
|
|
Service revenue
|
$
|
49,672
|
|
|
$
|
41,724
|
|
|
$
|
99,428
|
|
|
$
|
83,929
|
|
|
Operating income (loss)
|
$
|
46,446
|
|
|
$
|
(49,430
|
)
|
|
$
|
114,319
|
|
|
$
|
(13,118
|
)
|
|
Net income (loss)
|
$
|
15,796
|
|
|
$
|
(33,057
|
)
|
|
$
|
46,318
|
|
|
$
|
(13,163
|
)
|
|
Total ending membership
|
1,847,000
|
|
|
1,774,000
|
|
|
1,847,000
|
|
|
1,774,000
|
|
||||
|
Premium revenue
|
96.4
|
%
|
|
96.8
|
%
|
|
96.5
|
%
|
|
96.6
|
%
|
||||
|
Service revenue
|
3.1
|
%
|
|
2.8
|
%
|
|
3.1
|
%
|
|
3.0
|
%
|
||||
|
Investment income
|
0.1
|
%
|
|
0.1
|
%
|
|
0.1
|
%
|
|
0.1
|
%
|
||||
|
Rental and other income
|
0.4
|
%
|
|
0.3
|
%
|
|
0.3
|
%
|
|
0.3
|
%
|
||||
|
Total revenue
|
100.0
|
%
|
|
100.0
|
%
|
|
100.0
|
%
|
|
100.0
|
%
|
||||
|
|
|
|
|
|
|
|
|
||||||||
|
Medical care ratio
|
86.2
|
%
|
|
94.5
|
%
|
|
86.1
|
%
|
|
91.4
|
%
|
||||
|
General and administrative expense ratio
|
10.1
|
%
|
|
8.5
|
%
|
|
9.5
|
%
|
|
8.6
|
%
|
||||
|
Premium tax ratio
|
3.0
|
%
|
|
2.7
|
%
|
|
2.7
|
%
|
|
3.0
|
%
|
||||
|
Operating income (loss)
|
2.9
|
%
|
|
(3.3
|
)%
|
|
3.6
|
%
|
|
(0.5
|
)%
|
||||
|
Net income (loss)
|
1.0
|
%
|
|
(2.2
|
)%
|
|
1.4
|
%
|
|
(0.5
|
)%
|
||||
|
Effective tax rate
|
49.5
|
%
|
|
(39.1
|
)%
|
|
46.3
|
%
|
|
(41.0
|
)%
|
||||
|
|
Three months ended June 30,
|
|
Six months ended June 30,
|
||||||||||||
|
2013
|
|
2012
|
|
2013
|
|
2012
|
|||||||||
|
|
(In thousands)
|
||||||||||||||
|
Net income (loss)
|
$
|
24,571
|
|
|
$
|
(37,306
|
)
|
|
$
|
54,486
|
|
|
$
|
(19,217
|
)
|
|
Add back:
|
|
|
|
|
|
|
|
||||||||
|
Depreciation and amortization reported in the consolidated statements of cash flows
|
22,108
|
|
|
19,671
|
|
|
43,907
|
|
|
38,010
|
|
||||
|
Interest expense
|
11,667
|
|
|
3,808
|
|
|
24,704
|
|
|
8,106
|
|
||||
|
Income tax expense (benefit)
|
5,513
|
|
|
(25,769
|
)
|
|
29,783
|
|
|
(14,736
|
)
|
||||
|
EBITDA
|
$
|
63,859
|
|
|
$
|
(39,596
|
)
|
|
$
|
152,880
|
|
|
$
|
12,163
|
|
|
|
Three Months Ended June 30,
|
||||||||||||||||||||
|
|
2013
|
|
2012
|
||||||||||||||||||
|
|
Amount
|
|
PMPM
|
|
% of
Total
|
|
Amount
|
|
PMPM
|
|
% of
Total
|
||||||||||
|
Fee for service
|
$
|
879,865
|
|
|
$
|
158.96
|
|
|
68.0
|
%
|
|
$
|
925,039
|
|
|
$
|
174.04
|
|
|
70.2
|
%
|
|
Pharmacy
|
222,992
|
|
|
40.29
|
|
|
17.2
|
|
|
212,944
|
|
|
40.06
|
|
|
16.2
|
|
||||
|
Capitation
|
138,409
|
|
|
25.00
|
|
|
10.7
|
|
|
136,376
|
|
|
25.66
|
|
|
10.3
|
|
||||
|
Other
|
53,440
|
|
|
9.66
|
|
|
4.1
|
|
|
43,238
|
|
|
8.14
|
|
|
3.3
|
|
||||
|
Total
|
$
|
1,294,706
|
|
|
$
|
233.91
|
|
|
100.0
|
%
|
|
$
|
1,317,597
|
|
|
$
|
247.90
|
|
|
100.0
|
%
|
|
|
Three Months Ended June 30, 2013
|
||||||||||||||||||||||||||||
|
|
Member
Months (1)
|
|
Premium Revenue
|
|
Medical Care Costs
|
|
Premium Tax
Expense
|
|
MCR (2)
|
|
Medical Margin
|
||||||||||||||||||
|
|
|
Total
|
|
PMPM
|
|
Total
|
|
PMPM
|
|
|
|
||||||||||||||||||
|
California
|
1,055
|
|
|
$
|
191,059
|
|
|
$
|
181.19
|
|
|
$
|
170,777
|
|
|
$
|
161.96
|
|
|
$
|
10,132
|
|
|
94.4
|
%
|
|
$
|
10,150
|
|
|
Florida
|
238
|
|
|
61,838
|
|
|
260.61
|
|
|
51,915
|
|
|
218.80
|
|
|
1
|
|
|
84.0
|
|
|
9,922
|
|
||||||
|
Michigan
|
648
|
|
|
168,446
|
|
|
259.88
|
|
|
141,859
|
|
|
218.86
|
|
|
961
|
|
|
84.7
|
|
|
25,626
|
|
||||||
|
New Mexico
|
275
|
|
|
86,527
|
|
|
314.76
|
|
|
68,253
|
|
|
248.28
|
|
|
2,078
|
|
|
80.8
|
|
|
16,196
|
|
||||||
|
Ohio
|
722
|
|
|
292,706
|
|
|
405.05
|
|
|
215,664
|
|
|
298.44
|
|
|
22,599
|
|
|
79.8
|
|
|
54,443
|
|
||||||
|
Texas
|
805
|
|
|
324,600
|
|
|
403.06
|
|
|
275,959
|
|
|
342.66
|
|
|
5,645
|
|
|
86.5
|
|
|
42,996
|
|
||||||
|
Utah
|
261
|
|
|
77,511
|
|
|
296.69
|
|
|
61,677
|
|
|
236.08
|
|
|
—
|
|
|
79.6
|
|
|
15,834
|
|
||||||
|
Washington
|
1,238
|
|
|
305,000
|
|
|
246.30
|
|
|
263,512
|
|
|
212.80
|
|
|
5,467
|
|
|
88.0
|
|
|
36,021
|
|
||||||
|
Wisconsin
|
293
|
|
|
37,740
|
|
|
128.79
|
|
|
31,185
|
|
|
106.43
|
|
|
—
|
|
|
82.6
|
|
|
6,555
|
|
||||||
|
Other
(3)
|
—
|
|
|
3,185
|
|
|
—
|
|
|
13,905
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(10,720
|
)
|
||||||
|
|
5,535
|
|
|
$
|
1,548,612
|
|
|
$
|
279.77
|
|
|
$
|
1,294,706
|
|
|
$
|
233.91
|
|
|
$
|
46,883
|
|
|
86.2
|
%
|
|
$
|
207,023
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
|
Three Months Ended June 30, 2012
|
||||||||||||||||||||||||||||
|
|
Member
Months (1)
|
|
Premium Revenue
|
|
Medical Care Costs
|
|
Premium Tax
Expense
|
|
MCR (2)
|
|
Medical Margin
|
||||||||||||||||||
|
|
|
Total
|
|
PMPM
|
|
Total
|
|
PMPM
|
|
|
|
||||||||||||||||||
|
California
|
1,056
|
|
|
$
|
167,644
|
|
|
$
|
158.77
|
|
|
$
|
149,239
|
|
|
$
|
141.34
|
|
|
$
|
2,683
|
|
|
90.5
|
%
|
|
$
|
15,722
|
|
|
Florida
|
210
|
|
|
57,303
|
|
|
273.00
|
|
|
48,442
|
|
|
230.79
|
|
|
(21
|
)
|
|
84.5
|
|
|
8,882
|
|
||||||
|
Michigan
|
662
|
|
|
162,758
|
|
|
245.89
|
|
|
141,682
|
|
|
214.04
|
|
|
31
|
|
|
87.1
|
|
|
21,045
|
|
||||||
|
New Mexico
|
266
|
|
|
82,706
|
|
|
310.94
|
|
|
67,836
|
|
|
255.03
|
|
|
2,257
|
|
|
84.3
|
|
|
12,613
|
|
||||||
|
Ohio
|
762
|
|
|
297,069
|
|
|
389.85
|
|
|
245,284
|
|
|
321.89
|
|
|
23,011
|
|
|
89.5
|
|
|
28,774
|
|
||||||
|
Texas
|
907
|
|
|
359,486
|
|
|
396.63
|
|
|
393,237
|
|
|
433.87
|
|
|
6,670
|
|
|
111.5
|
|
|
(40,421
|
)
|
||||||
|
Utah
|
259
|
|
|
76,911
|
|
|
297.00
|
|
|
63,419
|
|
|
244.90
|
|
|
—
|
|
|
82.5
|
|
|
13,492
|
|
||||||
|
Washington
|
1,068
|
|
|
207,376
|
|
|
194.14
|
|
|
174,045
|
|
|
162.93
|
|
|
3,701
|
|
|
85.5
|
|
|
29,630
|
|
||||||
|
Wisconsin
|
125
|
|
|
18,788
|
|
|
150.12
|
|
|
22,758
|
|
|
181.84
|
|
|
—
|
|
|
121.1
|
|
|
(3,970
|
)
|
||||||
|
Other
(3)
|
—
|
|
|
2,362
|
|
|
—
|
|
|
11,655
|
|
|
—
|
|
|
22
|
|
|
—
|
|
|
(9,315
|
)
|
||||||
|
|
5,315
|
|
|
$
|
1,432,403
|
|
|
$
|
269.53
|
|
|
$
|
1,317,597
|
|
|
$
|
247.90
|
|
|
$
|
38,354
|
|
|
94.5
|
%
|
|
$
|
76,452
|
|
|
(1)
|
A member month is defined as the aggregate of each month’s ending membership for the period presented.
|
|
(2)
|
The MCR represents medical costs as a percentage of premium revenues, where premium revenue is reduced by premium tax expense.
|
|
(3)
|
“Other” medical care costs also include medically related administrative costs at the parent company.
|
|
|
Three Months Ended June 30,
|
||||||
|
|
2013
|
|
2012
|
||||
|
|
(In thousands)
|
||||||
|
Service revenue before amortization
|
$
|
50,400
|
|
|
$
|
41,877
|
|
|
Amortization recorded as reduction of service revenue
|
(728
|
)
|
|
(153
|
)
|
||
|
Service revenue
|
49,672
|
|
|
41,724
|
|
||
|
Cost of service revenue
|
39,305
|
|
|
30,613
|
|
||
|
General and administrative costs
|
2,790
|
|
|
3,187
|
|
||
|
Amortization of customer relationship intangibles recorded as amortization
|
1,282
|
|
|
1,282
|
|
||
|
Operating income
|
$
|
6,295
|
|
|
$
|
6,642
|
|
|
|
Six Months Ended June 30,
|
||||||||||||||||||||
|
|
2013
|
|
2012
|
||||||||||||||||||
|
|
Amount
|
|
PMPM
|
|
% of
Total
|
|
Amount
|
|
PMPM
|
|
% of
Total
|
||||||||||
|
Fee for service
|
$
|
1,746,620
|
|
|
$
|
159.48
|
|
|
67.6
|
%
|
|
$
|
1,653,024
|
|
|
$
|
160.57
|
|
|
69.0
|
%
|
|
Pharmacy
|
454,830
|
|
|
41.53
|
|
|
17.6
|
|
|
386,181
|
|
|
37.51
|
|
|
16.1
|
|
||||
|
Capitation
|
278,733
|
|
|
25.45
|
|
|
10.8
|
|
|
269,968
|
|
|
26.22
|
|
|
11.3
|
|
||||
|
Other
|
102,438
|
|
|
9.35
|
|
|
4.0
|
|
|
86,291
|
|
|
8.38
|
|
|
3.6
|
|
||||
|
Total
|
$
|
2,582,621
|
|
|
$
|
235.81
|
|
|
100.0
|
%
|
|
$
|
2,395,464
|
|
|
$
|
232.68
|
|
|
100.0
|
%
|
|
|
Six Months Ended June 30, 2013
|
||||||||||||||||||||||||||||
|
|
Member
Months (1)
|
|
Premium Revenue
|
|
Medical Care Costs
|
|
Premium Tax
Expense
|
|
MCR (2)
|
|
Medical Margin
|
||||||||||||||||||
|
|
|
Total
|
|
PMPM
|
|
Total
|
|
PMPM
|
|
|
|
||||||||||||||||||
|
California
|
2,056
|
|
|
$
|
378,939
|
|
|
$
|
184.33
|
|
|
$
|
330,540
|
|
|
$
|
160.79
|
|
|
$
|
10,224
|
|
|
89.6
|
%
|
|
$
|
38,175
|
|
|
Florida
|
461
|
|
|
120,005
|
|
|
260.39
|
|
|
101,319
|
|
|
219.84
|
|
|
4
|
|
|
84.4
|
|
|
18,682
|
|
||||||
|
Michigan
|
1,300
|
|
|
336,122
|
|
|
258.56
|
|
|
288,607
|
|
|
222.01
|
|
|
2,080
|
|
|
86.4
|
|
|
45,435
|
|
||||||
|
New Mexico
|
549
|
|
|
172,325
|
|
|
314.15
|
|
|
140,402
|
|
|
255.95
|
|
|
3,876
|
|
|
83.3
|
|
|
28,047
|
|
||||||
|
Ohio
|
1,448
|
|
|
584,224
|
|
|
403.39
|
|
|
443,118
|
|
|
305.96
|
|
|
45,309
|
|
|
82.2
|
|
|
95,797
|
|
||||||
|
Texas
|
1,637
|
|
|
659,896
|
|
|
403.02
|
|
|
542,408
|
|
|
331.27
|
|
|
11,490
|
|
|
83.7
|
|
|
105,998
|
|
||||||
|
Utah
|
520
|
|
|
152,467
|
|
|
293.16
|
|
|
126,706
|
|
|
243.63
|
|
|
—
|
|
|
83.1
|
|
|
25,761
|
|
||||||
|
Washington
|
2,488
|
|
|
608,719
|
|
|
244.67
|
|
|
524,909
|
|
|
210.98
|
|
|
10,900
|
|
|
87.8
|
|
|
72,910
|
|
||||||
|
Wisconsin
|
493
|
|
|
64,864
|
|
|
131.53
|
|
|
54,849
|
|
|
111.22
|
|
|
—
|
|
|
84.6
|
|
|
10,015
|
|
||||||
|
Other
(3)
|
—
|
|
|
5,484
|
|
|
—
|
|
|
29,763
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(24,279
|
)
|
||||||
|
|
10,952
|
|
|
$
|
3,083,045
|
|
|
$
|
281.51
|
|
|
$
|
2,582,621
|
|
|
$
|
235.81
|
|
|
$
|
83,883
|
|
|
86.1
|
%
|
|
$
|
416,541
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
|
Six Months Ended June 30, 2012
|
||||||||||||||||||||||||||||
|
|
Member
Months (1)
|
|
Premium Revenue
|
|
Medical Care Costs
|
|
Premium Tax
Expense
|
|
MCR (2)
|
|
Medical Margin
|
||||||||||||||||||
|
|
|
Total
|
|
PMPM
|
|
Total
|
|
PMPM
|
|
|
|
||||||||||||||||||
|
California
|
2,115
|
|
|
$
|
329,329
|
|
|
$
|
155.70
|
|
|
$
|
290,588
|
|
|
$
|
137.39
|
|
|
$
|
4,992
|
|
|
89.6
|
%
|
|
$
|
33,749
|
|
|
Florida
|
418
|
|
|
113,493
|
|
|
271.44
|
|
|
98,011
|
|
|
234.41
|
|
|
(14
|
)
|
|
86.3
|
|
|
15,496
|
|
||||||
|
Michigan
|
1,327
|
|
|
330,664
|
|
|
249.20
|
|
|
275,893
|
|
|
207.92
|
|
|
8,071
|
|
|
85.5
|
|
|
46,700
|
|
||||||
|
New Mexico
|
532
|
|
|
163,932
|
|
|
308.29
|
|
|
134,947
|
|
|
253.78
|
|
|
4,210
|
|
|
84.5
|
|
|
24,775
|
|
||||||
|
Ohio
|
1,508
|
|
|
590,594
|
|
|
391.77
|
|
|
481,985
|
|
|
319.72
|
|
|
45,864
|
|
|
88.5
|
|
|
62,745
|
|
||||||
|
Texas
|
1,499
|
|
|
557,722
|
|
|
372.11
|
|
|
573,326
|
|
|
382.53
|
|
|
9,867
|
|
|
104.6
|
|
|
(25,471
|
)
|
||||||
|
Utah
|
511
|
|
|
152,049
|
|
|
297.29
|
|
|
121,300
|
|
|
237.17
|
|
|
—
|
|
|
79.8
|
|
|
30,749
|
|
||||||
|
Washington
|
2,135
|
|
|
422,986
|
|
|
198.11
|
|
|
355,470
|
|
|
166.49
|
|
|
7,517
|
|
|
85.6
|
|
|
59,999
|
|
||||||
|
Wisconsin
|
250
|
|
|
35,930
|
|
|
143.54
|
|
|
39,644
|
|
|
158.31
|
|
|
—
|
|
|
110.3
|
|
|
(3,714
|
)
|
||||||
|
Other
(3)
|
—
|
|
|
4,497
|
|
|
—
|
|
|
24,300
|
|
|
—
|
|
|
33
|
|
|
—
|
|
|
(19,836
|
)
|
||||||
|
|
10,295
|
|
|
$
|
2,701,196
|
|
|
$
|
262.38
|
|
|
$
|
2,395,464
|
|
|
$
|
232.68
|
|
|
$
|
80,540
|
|
|
91.4
|
%
|
|
$
|
225,192
|
|
|
(1)
|
A member month is defined as the aggregate of each month’s ending membership for the period presented.
|
|
(2)
|
The MCR represents medical costs as a percentage of premium revenues, where premium revenue is reduced by premium tax expense.
|
|
(3)
|
“Other” medical care costs also include medically related administrative costs at the parent company.
|
|
|
Six Months Ended June 30,
|
||||||
|
|
2013
|
|
2012
|
||||
|
|
(In thousands)
|
||||||
|
Service revenue before amortization
|
$
|
100,885
|
|
|
$
|
84,235
|
|
|
Amortization recorded as reduction of service revenue
|
(1,457
|
)
|
|
(306
|
)
|
||
|
Service revenue
|
99,428
|
|
|
83,929
|
|
||
|
Cost of service revenue
|
79,075
|
|
|
61,107
|
|
||
|
General and administrative costs
|
5,141
|
|
|
5,207
|
|
||
|
Amortization of customer relationship intangibles recorded as amortization
|
2,564
|
|
|
2,564
|
|
||
|
Operating income
|
$
|
12,648
|
|
|
$
|
15,051
|
|
|
•
|
Amortization of purchased intangibles relating to customer relationships is reported as amortization within the heading “Depreciation and amortization;”
|
|
•
|
Amortization of purchased intangibles relating to contract backlog is recorded as a reduction of “Service revenue;” and
|
|
•
|
Amortization of capitalized software is recorded within the heading “Cost of service revenue.”
|
|
|
Three Months Ended June 30,
|
||||||||||||
|
|
2013
|
|
2012
|
||||||||||
|
|
Amount
|
|
% of Total
Revenue
|
|
Amount
|
|
% of Total
Revenue
|
||||||
|
|
(Dollar amounts in thousands)
|
||||||||||||
|
Depreciation and amortization of capitalized software, continuing operations
|
$
|
12,896
|
|
|
0.8
|
%
|
|
$
|
10,674
|
|
|
0.7
|
%
|
|
Amortization of intangible assets, continuing operations
|
4,119
|
|
|
0.3
|
|
|
5,536
|
|
|
0.4
|
|
||
|
Depreciation and amortization, continuing operations
|
17,015
|
|
|
1.1
|
|
|
16,210
|
|
|
1.1
|
|
||
|
Depreciation and amortization, discontinued operations
|
—
|
|
|
—
|
|
|
177
|
|
|
—
|
|
||
|
Amortization recorded as reduction of service revenue
|
728
|
|
|
—
|
|
|
153
|
|
|
—
|
|
||
|
Amortization of capitalized software recorded as cost of service revenue
|
4,365
|
|
|
0.3
|
|
|
3,131
|
|
|
0.2
|
|
||
|
|
$
|
22,108
|
|
|
1.4
|
%
|
|
$
|
19,671
|
|
|
1.3
|
%
|
|
|
Six Months Ended June 30,
|
||||||||||||
|
|
2013
|
|
2012
|
||||||||||
|
|
Amount
|
|
% of Total
Revenue |
|
Amount
|
|
% of Total
Revenue |
||||||
|
|
(Dollar amounts in thousands)
|
||||||||||||
|
Depreciation and amortization of capitalized software, continuing operations
|
$
|
25,341
|
|
|
0.8
|
%
|
|
$
|
19,969
|
|
|
0.7
|
%
|
|
Amortization of intangible assets, continuing operations
|
8,237
|
|
|
0.3
|
|
|
11,089
|
|
|
0.4
|
|
||
|
Depreciation and amortization, continuing operations
|
33,578
|
|
|
1.1
|
|
|
31,058
|
|
|
1.1
|
|
||
|
Depreciation and amortization, discontinued operations
|
2
|
|
|
—
|
|
|
354
|
|
|
—
|
|
||
|
Amortization recorded as reduction of service revenue
|
1,457
|
|
|
—
|
|
|
306
|
|
|
—
|
|
||
|
Amortization of capitalized software recorded as cost of service revenue
|
8,870
|
|
|
0.3
|
|
|
6,292
|
|
|
0.2
|
|
||
|
|
$
|
43,907
|
|
|
1.4
|
%
|
|
$
|
38,010
|
|
|
1.3
|
%
|
|
|
Total
|
|
2013
|
|
2014
|
|
2015
|
|
2016
|
|
2017
|
|
Thereafter
|
||||||||||||||
|
1.125% Notes
|
$
|
550,000
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
550,000
|
|
|
3.75% Notes
|
187,000
|
|
|
—
|
|
|
187,000
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|||||||
|
|
$
|
737,000
|
|
|
$
|
—
|
|
|
$
|
187,000
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
550,000
|
|
|
•
|
Health plan contractual provisions that may limit revenue based upon the costs incurred or the profits realized under a specific contract;
|
|
•
|
Health plan quality incentives that allow us to recognize incremental revenue if certain quality standards are met;
|
|
•
|
The recognition of revenue and costs associated with contracts held by our Molina Medicaid Solutions segment; and
|
|
•
|
The determination of medical claims and benefits payable.
|
|
|
Three Months Ended June 30, 2013
|
||||||||||||||||||
|
|
Maximum
Available Quality
Incentive
Premium -
Current Year
|
|
Amount of
Current Year
Quality Incentive
Premium Revenue
Recognized
|
|
Amount of
Quality Incentive
Premium Revenue
Recognized from
Prior Year
|
|
Total Quality
Incentive
Premium Revenue
Recognized
|
|
Total Revenue
Recognized
|
||||||||||
|
|
(In thousands)
|
||||||||||||||||||
|
New Mexico
|
$
|
588
|
|
|
$
|
535
|
|
|
$
|
49
|
|
|
$
|
584
|
|
|
$
|
86,527
|
|
|
Ohio
|
2,964
|
|
|
1,087
|
|
|
553
|
|
|
1,640
|
|
|
292,706
|
|
|||||
|
Texas
|
15,675
|
|
|
15,675
|
|
|
2,752
|
|
|
18,427
|
|
|
324,600
|
|
|||||
|
Wisconsin
|
1,269
|
|
|
—
|
|
|
495
|
|
|
495
|
|
|
37,740
|
|
|||||
|
|
$
|
20,496
|
|
|
$
|
17,297
|
|
|
$
|
3,849
|
|
|
$
|
21,146
|
|
|
$
|
741,573
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||
|
|
Three Months Ended June 30, 2012
|
||||||||||||||||||
|
|
Maximum
Available Quality
Incentive
Premium -
Current Year
|
|
Amount of
Current Year
Quality Incentive
Premium Revenue
Recognized
|
|
Amount of
Quality Incentive
Premium Revenue
Recognized from
Prior Year
|
|
Total Quality
Incentive
Premium Revenue
Recognized
|
|
Total Revenue
Recognized
|
||||||||||
|
|
(In thousands)
|
||||||||||||||||||
|
New Mexico
|
$
|
561
|
|
|
$
|
482
|
|
|
$
|
630
|
|
|
$
|
1,112
|
|
|
$
|
82,706
|
|
|
Ohio
|
2,720
|
|
|
2,720
|
|
|
—
|
|
|
2,720
|
|
|
297,069
|
|
|||||
|
Texas
|
18,252
|
|
|
14,284
|
|
|
—
|
|
|
14,284
|
|
|
359,486
|
|
|||||
|
Wisconsin
|
449
|
|
|
—
|
|
|
246
|
|
|
246
|
|
|
18,788
|
|
|||||
|
|
$
|
21,982
|
|
|
$
|
17,486
|
|
|
$
|
876
|
|
|
$
|
18,362
|
|
|
$
|
758,049
|
|
|
|
Six Months Ended June 30, 2013
|
||||||||||||||||||
|
|
Maximum
Available Quality
Incentive
Premium -
Current Year
|
|
Amount of
Current Year
Quality Incentive
Premium Revenue
Recognized
|
|
Amount of
Quality Incentive
Premium Revenue
Recognized from
Prior Year
|
|
Total Quality
Incentive
Premium Revenue
Recognized
|
|
Total Revenue
Recognized
|
||||||||||
|
|
(In thousands)
|
||||||||||||||||||
|
New Mexico
|
$
|
1,173
|
|
|
$
|
867
|
|
|
$
|
157
|
|
|
$
|
1,024
|
|
|
$
|
172,325
|
|
|
Ohio
|
5,969
|
|
|
2,139
|
|
|
553
|
|
|
2,692
|
|
|
584,224
|
|
|||||
|
Texas
|
31,939
|
|
|
29,187
|
|
|
8,747
|
|
|
37,934
|
|
|
659,896
|
|
|||||
|
Wisconsin
|
2,030
|
|
|
—
|
|
|
1,104
|
|
|
1,104
|
|
|
64,864
|
|
|||||
|
|
$
|
41,111
|
|
|
$
|
32,193
|
|
|
$
|
10,561
|
|
|
$
|
42,754
|
|
|
$
|
1,481,309
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||
|
|
Six Months Ended June 30, 2012
|
||||||||||||||||||
|
|
Maximum
Available Quality
Incentive
Premium -
Current Year
|
|
Amount of
Current Year
Quality Incentive
Premium Revenue
Recognized
|
|
Amount of
Quality Incentive
Premium Revenue
Recognized from
Prior Year
|
|
Total Quality
Incentive
Premium Revenue
Recognized
|
|
Total Revenue
Recognized
|
||||||||||
|
|
(In thousands)
|
||||||||||||||||||
|
New Mexico
|
$
|
1,116
|
|
|
$
|
818
|
|
|
$
|
658
|
|
|
$
|
1,476
|
|
|
$
|
163,932
|
|
|
Ohio
|
5,398
|
|
|
5,398
|
|
|
966
|
|
|
6,364
|
|
|
590,594
|
|
|||||
|
Texas
|
24,002
|
|
|
20,034
|
|
|
—
|
|
|
20,034
|
|
|
557,722
|
|
|||||
|
Wisconsin
|
865
|
|
|
—
|
|
|
246
|
|
|
246
|
|
|
35,930
|
|
|||||
|
|
$
|
31,381
|
|
|
$
|
26,250
|
|
|
$
|
1,870
|
|
|
$
|
28,120
|
|
|
$
|
1,348,178
|
|
|
•
|
Each contract calls for the provision of its own specific set of services. While all contracts support the system of record for state MMIS, the actual services we provide vary significantly between contracts; and
|
|
•
|
The nature of the MMIS installed varies significantly between our older contracts (proprietary mainframe systems) and our new contracts (commercial off-the-shelf technology solutions).
|
|
•
|
Transaction processing costs
|
|
•
|
Employee costs incurred in performing transaction services
|
|
•
|
Vendor costs incurred in performing transaction services
|
|
•
|
Costs incurred in performing required monitoring of and reporting on contract performance
|
|
•
|
Costs incurred in maintaining and processing member and provider eligibility
|
|
•
|
Costs incurred in communicating with members and providers
|
|
|
June 30,
2013 |
|
December 31,
2012 |
|
June 30,
2012 |
||||||
|
|
(In thousands)
|
||||||||||
|
Fee-for-service claims incurred but not paid (IBNP)
|
$
|
360,153
|
|
|
$
|
377,614
|
|
|
$
|
378,782
|
|
|
Capitation payable
|
47,474
|
|
|
49,066
|
|
|
79,739
|
|
|||
|
Pharmacy
|
37,241
|
|
|
38,992
|
|
|
34,848
|
|
|||
|
Other
|
20,619
|
|
|
28,858
|
|
|
32,169
|
|
|||
|
|
$
|
465,487
|
|
|
$
|
494,530
|
|
|
$
|
525,538
|
|
|
Increase (Decrease) in Estimated Completion Factors
|
Increase (Decrease) in
Medical Claims and
Benefits Payable
|
||
|
(6)%
|
$
|
154,224
|
|
|
(4)%
|
102,816
|
|
|
|
(2)%
|
51,408
|
|
|
|
2%
|
(51,408
|
)
|
|
|
4%
|
(102,816
|
)
|
|
|
6%
|
(154,224
|
)
|
|
|
(Decrease) Increase in Trended Per member Per Month Cost Estimates
|
(Decrease) Increase in
Medical Claims and
Benefits Payable
|
||
|
(6)%
|
$
|
(77,698
|
)
|
|
(4)%
|
(51,799
|
)
|
|
|
(2)%
|
(25,899
|
)
|
|
|
2%
|
25,899
|
|
|
|
4%
|
51,799
|
|
|
|
6%
|
77,698
|
|
|
|
•
|
At our Texas health plan, STAR+PLUS (the state’s program for ABD members) membership declined during mid– to late– 2012. This caused a reduction in costs per member that we did not fully recognize in our December 31, 2012 reserve estimates.
|
|
•
|
At our Washington health plan, prior to July 2012, certain high-cost newborns that were approved for supplemental security income (SSI) coverage by the state were retroactively dis-enrolled from our Healthy Options (TANF) coverage, and the health plan was reimbursed for the claims paid on behalf of these members. Starting July 1, 2012, these newborns, as well as other high-cost disabled members, are now covered by the health plan under the Healthy Options Blind and Disabled (HOBD) program. At the end of 2012, we had limited claims history with which to estimate the claims liability of the HOBD members, and as a result the liability for these high-cost members was overstated.
|
|
•
|
For our New Mexico health plan, we overestimated the impact of certain high-dollar outstanding claim payments as of December 31, 2012.
|
|
•
|
At our Washington health plan, we had limited claims history with which to estimate the incurred claims for members enrolled in the HOBD program. Because claims on this group of members were being paid at a rate faster than expected, the reserves for unpaid claims were overstated.
|
|
•
|
At our Ohio and New Mexico health plans, we overestimated the impact of several potential high-dollar claims on critically ill members.
|
|
•
|
At our Washington health plan, we underestimated the amount of recoveries we would collect for certain high-cost newborn claims, resulting in an overestimation of reserves at year end.
|
|
•
|
At our Texas health plan, we overestimated the cost of new members in STAR+PLUS, in the Dallas region.
|
|
•
|
The overestimation of our liability for medical claims and benefits payable was partially offset by an underestimation of that liability at our Missouri health plan, as a result of the costs associated with an unusually large number of premature infants during the fourth quarter of 2011.
|
|
•
|
In our Texas health plan, we have noted an unusually large number of claims with incurred dates older than 10 months. This has caused some distortion in the claims lag pattern that we use to estimate the incurred claims.
|
|
•
|
Our Wisconsin health plan is experiencing significant membership increases, and approximately doubled in size during the first four months of 2013. This new membership is transitioning to our health plan from a terminated health plan. We enrolled approximately
50,000
new members in February, March and April 2013.
We have computed a separate reserve analysis for these members and have noted that paid claims thus far are less than what we would expect for newly transitioned members. It has been our experience that when members move to new health plans, there is a delay in the submission of claims for payment. Therefore, we have increased the reserves for this membership, in anticipation of higher claims costs eventually being reported for these members.
|
|
•
|
In our Michigan health plan, there were a large number of claim recoveries recorded in June 2013 due to overpayments that resulted from a system configuration issue. These recoveries impacted the completion factors used to estimate incurred claims. While we have attempted to remove this distortion from the claims data to develop a more accurate reserve estimate, this type of correction in claims data adds a degree of uncertainty for the Michigan reserves as of June 30, 2013.
|
|
|
Six Months Ended June 30,
|
|
Three Months Ended June 30,
|
|
Year Ended December 31, 2012
|
||||||||||||||
|
|
2013
|
|
2012
|
|
2013
|
|
2012
|
|
|||||||||||
|
|
(Dollars in thousands, except per-member amounts)
|
||||||||||||||||||
|
Balances at beginning of period
|
$
|
494,530
|
|
|
$
|
402,476
|
|
|
$
|
491,145
|
|
|
$
|
455,833
|
|
|
$
|
402,476
|
|
|
Components of medical care costs related to:
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Current period
|
2,647,083
|
|
|
2,544,922
|
|
|
1,345,592
|
|
|
1,377,084
|
|
|
5,136,055
|
|
|||||
|
Prior periods
|
(62,757
|
)
|
|
(36,357
|
)
|
|
(50,020
|
)
|
|
493
|
|
|
(39,295
|
)
|
|||||
|
Total medical care costs
|
2,584,326
|
|
|
2,508,565
|
|
|
1,295,572
|
|
|
1,377,577
|
|
|
5,096,760
|
|
|||||
|
Payments for medical care costs related to:
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Current period
|
2,206,474
|
|
|
2,033,611
|
|
|
940,186
|
|
|
891,573
|
|
|
4,649,363
|
|
|||||
|
Prior periods
|
406,895
|
|
|
351,892
|
|
|
381,044
|
|
|
416,299
|
|
|
355,343
|
|
|||||
|
Total paid
|
2,613,369
|
|
|
2,385,503
|
|
|
1,321,230
|
|
|
1,307,872
|
|
|
5,004,706
|
|
|||||
|
Balances at end of period
|
$
|
465,487
|
|
|
$
|
525,538
|
|
|
$
|
465,487
|
|
|
$
|
525,538
|
|
|
$
|
494,530
|
|
|
Benefit from prior period as a percentage of:
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Balance at beginning of period
|
12.7
|
%
|
|
9.0
|
%
|
|
10.2
|
%
|
|
(0.1
|
)%
|
|
9.8
|
%
|
|||||
|
Premium revenue, trailing twelve months
|
1.0
|
%
|
|
0.7
|
%
|
|
0.8
|
%
|
|
—
|
%
|
|
0.7
|
%
|
|||||
|
Medical care costs, trailing twelve months
|
1.2
|
%
|
|
0.8
|
%
|
|
1.0
|
%
|
|
—
|
%
|
|
0.8
|
%
|
|||||
|
Claims Data:
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Days in claims payable, fee for service
|
38
|
|
|
44
|
|
|
38
|
|
|
44
|
|
|
40
|
|
|||||
|
Number of members at end of period
|
1,847,000
|
|
|
1,853,000
|
|
|
1,847,000
|
|
|
1,853,000
|
|
|
1,797,000
|
|
|||||
|
Number of claims in inventory at end of period
|
109,900
|
|
|
209,200
|
|
|
109,900
|
|
|
209,200
|
|
|
122,700
|
|
|||||
|
Billed charges of claims in inventory at end of period
|
$
|
200,400
|
|
|
$
|
324,500
|
|
|
$
|
200,400
|
|
|
$
|
324,500
|
|
|
$
|
255,200
|
|
|
Claims in inventory per member at end of period
|
0.06
|
|
|
0.11
|
|
|
0.06
|
|
|
0.11
|
|
|
0.07
|
|
|||||
|
Billed charges of claims in inventory per member at end of period
|
$
|
108.50
|
|
|
$
|
175.12
|
|
|
$
|
108.50
|
|
|
$
|
175.12
|
|
|
$
|
142.01
|
|
|
Number of claims received during the period
|
10,524,500
|
|
|
10,375,700
|
|
|
5,253,500
|
|
|
5,520,100
|
|
|
20,842,400
|
|
|||||
|
Billed charges of claims received during the period
|
$
|
10,477,900
|
|
|
$
|
9,388,700
|
|
|
$
|
5,307,200
|
|
|
$
|
5,051,800
|
|
|
$
|
19,429,300
|
|
|
Item 3.
|
Quantitative and Qualitative Disclosures About Market Risk
|
|
Item 4.
|
Controls and Procedures
|
|
|
Total Number
of
Shares
Purchased (a)
|
|
Average Price Paid
per Share
|
|
Total Number of Shares
Purchased as Part of
Publicly Announced Plans
or Programs
|
|
Maximum Number (or
Approximate Dollar Value)
of Shares that May Yet Be
Purchased Under the Plans
or Programs
|
||||||
|
April 1 - April 30
|
590
|
|
|
$
|
30.76
|
|
|
—
|
|
|
$
|
75,000,000
|
|
|
May 1 - May 31
|
541
|
|
|
$
|
33.15
|
|
|
—
|
|
|
$
|
75,000,000
|
|
|
June 1 - June 30
|
26,550
|
|
|
$
|
37.26
|
|
|
—
|
|
|
$
|
75,000,000
|
|
|
Total
|
27,681
|
|
|
$
|
37.04
|
|
|
—
|
|
|
|
||
|
(a)
|
During the
three months ended June 30, 2013
, we withheld 27,681 shares of common stock under our 2002 Equity Incentive Plan and 2011 Equity Incentive Plan to settle our employees’ income tax obligations.
|
|
Exhibit No.
|
|
Title
|
|
|
|
|
|
3.1
|
|
Certificate of Amendment to Certificate of Incorporation.
|
|
3.2
|
|
Second Amendment and Restated Bylaws - Filed as Exhibit 3.1 to registrant's Form 8-K filed July 24, 2013.
|
|
10.1
|
|
Agreement of Purchase and Sale, dated as of June 12, 2013, by and between Molina Healthcare, Inc. and Molina Center, LLC, and AG Net Lease Acquisition Corp.
|
|
10.2
|
|
Lease Agreement, dated as of June 13, 2013, by and between AGNL Clinic, L.P., and Molina Healthcare, Inc.
|
|
10.3
|
|
Employment Agreement with Terry Bayer dated June 14, 2013 - Filed as Exhibit 10.1 to registrant's Form 8-K filed June 14, 2013.
|
|
10.4
|
|
Employment Agreement with Joseph White dated June 14, 2013 - Filed as Exhibit 10.2 to registrant's Form 8-K filed June 14, 2013.
|
|
10.5
|
|
Employment Agreement with Jeff Barlow dated June 14, 2013 - Filed as Exhibit 10.3 to registrant's Form 8-K filed June 14, 2013.
|
|
31.1
|
|
Certification of Chief Executive Officer pursuant to Rules 13a-14(a)/15d-14(a) under the Securities Exchange Act of 1934, as amended.
|
|
31.2
|
|
Certification of Chief Financial Officer pursuant to Rules 13a-14(a)/15d-14(a) under the Securities Exchange Act of 1934, as amended.
|
|
32.1
|
|
Certification of Chief Executive Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
|
|
32.2
|
|
Certification of Chief Financial Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
|
|
101.INS (1)
|
|
XBRL Taxonomy Instance Document.
|
|
101.SCH (1)
|
|
XBRL Taxonomy Extension Schema Document.
|
|
101.CAL (1)
|
|
XBRL Taxonomy Extension Calculation Linkbase Document.
|
|
101.DEF (1)
|
|
XBRL Taxonomy Extension Definition Linkbase Document.
|
|
101.LAB (1)
|
|
XBRL Taxonomy Extension Label Linkbase Document.
|
|
101.PRE (1)
|
|
XBRL Taxonomy Extension Presentation Linkbase Document.
|
|
(1)
|
Pursuant to Rule 406T of Regulation S-T, XBRL (eXtensible Business Reporting Language) information is furnished and not filed or a part of a registration statement or prospectus for purposes of Sections 11 or 12 of the Securities Act of 1933, as amended, is deemed not filed for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, and otherwise is not subject to liability under these sections.
|
|
|
|
|
MOLINA HEALTHCARE, INC.
|
|
|
|
|
(Registrant)
|
|
|
|
|
|
|
Dated:
|
July 25, 2013
|
|
/s/ JOSEPH M. MOLINA, M.D.
|
|
|
|
|
Joseph M. Molina, M.D.
|
|
|
|
|
Chairman of the Board,
|
|
|
|
|
Chief Executive Officer and President
|
|
|
|
|
(Principal Executive Officer)
|
|
|
|
|
|
|
Dated:
|
July 25, 2013
|
|
/s/ JOHN C. MOLINA, J.D.
|
|
|
|
|
John C. Molina, J.D.
|
|
|
|
|
Chief Financial Officer and Treasurer
|
|
|
|
|
(Principal Financial Officer)
|
|
Exhibit No.
|
|
Title
|
|
|
|
|
|
3.1
|
|
Certificate of Amendment to Certificate of Incorporation.
|
|
|
|
|
|
3.2
|
|
Second Amendment and Restated Bylaws - Filed as Exhibit 3.1 to registrant's Form 8-K filed July 24, 2013.
|
|
|
|
|
|
10.1
|
|
Agreement of Purchase and Sale, dated as of June 12, 2013, by and between Molina Healthcare, Inc. and Molina Center, LLC, and AG Net Lease Acquisition Corp.
|
|
|
|
|
|
10.2
|
|
Lease Agreement, dated as of June 13, 2013, by and between AGNL Clinic, L.P., and Molina Healthcare, Inc.
|
|
|
|
|
|
10.3
|
|
Employment Agreement with Terry Bayer dated June 14, 2013 - Filed as Exhibit 10.1 to registrant's Form 8-K filed June 14, 2013.
|
|
|
|
|
|
10.4
|
|
Employment Agreement with Joseph White dated June 14, 2013 - Filed as Exhibit 10.2 to registrant's Form 8-K filed June 14, 2013.
|
|
|
|
|
|
10.5
|
|
Employment Agreement with Jeff Barlow dated June 14, 2013 - Filed as Exhibit 10.3 to registrant's Form 8-K filed June 14, 2013.
|
|
|
|
|
|
31.1
|
|
Certification of Chief Executive Officer pursuant to Rules 13a-14(a)/15d-14(a) under the Securities Exchange Act of 1934, as amended.
|
|
|
|
|
|
31.2
|
|
Certification of Chief Financial Officer pursuant to Rules 13a-14(a)/15d-14(a) under the Securities Exchange Act of 1934, as amended.
|
|
|
|
|
|
32.1
|
|
Certification of Chief Executive Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
|
|
|
|
|
|
32.2
|
|
Certification of Chief Financial Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
|
|
|
|
|
|
101.INS (1)
|
|
XBRL Taxonomy Instance Document.
|
|
|
|
|
|
101.SCH (1)
|
|
XBRL Taxonomy Extension Schema Document.
|
|
|
|
|
|
101.CAL (1)
|
|
XBRL Taxonomy Extension Calculation Linkbase Document.
|
|
|
|
|
|
101.DEF (1)
|
|
XBRL Taxonomy Extension Definition Linkbase Document.
|
|
|
|
|
|
101.LAB (1)
|
|
XBRL Taxonomy Extension Label Linkbase Document.
|
|
|
|
|
|
101.PRE (1)
|
|
XBRL Taxonomy Extension Presentation Linkbase Document.
|
|
(1)
|
Pursuant to Rule 406T of Regulation S-T, XBRL (eXtensible Business Reporting Language) information is furnished and not filed or a part of a registration statement or prospectus for purposes of Sections 11 or 12 of the Securities Act of 1933, as amended, is deemed not filed for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, and otherwise is not subject to liability under these sections.
|
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
No Suppliers Found
Price
Yield
| Owner | Position | Direct Shares | Indirect Shares |
|---|