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ý
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QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
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¨
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TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
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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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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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Large accelerated filer
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ý
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Accelerated filer
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¨
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Non-accelerated filer
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¨
(Do not check if a smaller reporting company)
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Smaller reporting company
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¨
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Emerging growth company
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¨
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ITEM NUMBER
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Page
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PART I - Financial Information
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1.
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2.
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3.
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Quantitative and Qualitative Disclosures About Market Risk
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41
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4.
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Part II
- Other Information
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1.
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1A.
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2.
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3.
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Defaults Upon Senior Securities
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Not Applicable.
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4.
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Mine Safety Disclosures
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Not Applicable.
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5.
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Other Information
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Not Applicable.
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6.
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Three Months Ended March 31,
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||||||
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2017
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2016
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||||
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(In millions, except per-share data)
(Unaudited)
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||||||
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Revenue:
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||||
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Premium revenue
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$
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4,648
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$
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3,995
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Service revenue
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131
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140
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||
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Premium tax revenue
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111
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109
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||
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Health insurer fee revenue
|
—
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90
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||
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Investment income and other revenue
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14
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9
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Total revenue
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4,904
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|
|
4,343
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Operating expenses:
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||||
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Medical care costs
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4,111
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3,588
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||
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Cost of service revenue
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122
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|
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127
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|
||
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General and administrative expenses
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439
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340
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|
||
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Premium tax expenses
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111
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109
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|
||
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Health insurer fee expenses
|
—
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58
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|
||
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Depreciation and amortization
|
39
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32
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|
||
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Total operating expenses
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4,822
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|
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4,254
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||
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Operating income
|
82
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|
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89
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|
||
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Other (income) expenses, net:
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||||
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Interest expense
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26
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25
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Other income, net
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(75
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)
|
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—
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Total other (income) expenses, net
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(49
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)
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25
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Income before income tax expense
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131
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64
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Income tax expense
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54
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40
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Net income
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$
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77
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$
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24
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Net income per share:
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Basic
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$
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1.38
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$
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0.44
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Diluted
|
$
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1.37
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$
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0.43
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Three Months Ended March 31,
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||||||
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2017
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2016
|
||||
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(Amounts in millions)
(Unaudited)
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||||||
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Net income
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$
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77
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$
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24
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Other comprehensive income:
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Unrealized investment gain
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1
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9
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Less: effect of income taxes
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—
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3
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|
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Other comprehensive income, net of tax
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1
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6
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Comprehensive income
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$
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78
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$
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30
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March 31,
2017 |
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December 31,
2016 |
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(Amounts in millions,
except per-share data)
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||||||
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(Unaudited)
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ASSETS
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|||||||
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Current assets:
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Cash and cash equivalents
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$
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3,198
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$
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2,819
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Investments
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2,056
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1,758
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Receivables
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1,006
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974
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Income taxes refundable
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—
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39
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|
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Prepaid expenses and other current assets
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142
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131
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|
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Derivative asset
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—
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267
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Total current assets
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6,402
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5,988
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Property, equipment, and capitalized software, net
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447
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454
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Deferred contract costs
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89
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86
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Intangible assets, net
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131
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140
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Goodwill
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620
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620
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Restricted investments
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115
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|
110
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|
||
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Deferred income taxes
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10
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|
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10
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|
||
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Derivative asset
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181
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|
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—
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Other assets
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43
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|
|
41
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|
||
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$
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8,038
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$
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7,449
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||||
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LIABILITIES AND STOCKHOLDERS’ EQUITY
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|||||||
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Current liabilities:
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|
||||
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Medical claims and benefits payable
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$
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1,926
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$
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1,929
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Amounts due government agencies
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1,575
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|
|
1,202
|
|
||
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Accounts payable and accrued liabilities
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438
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|
|
385
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|
||
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Deferred revenue
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461
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|
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315
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|
||
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Income taxes payable
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21
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|
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—
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||
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Current portion of long-term debt
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1
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472
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|
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Derivative liability
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—
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267
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|
||
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Total current liabilities
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4,422
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4,570
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|
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Senior notes
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1,455
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975
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|
||
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Lease financing obligations
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198
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|
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198
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|
||
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Deferred income taxes
|
11
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|
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15
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|
||
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Derivative liability
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181
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|
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—
|
|
||
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Other long-term liabilities
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44
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|
|
42
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|
||
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Total liabilities
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6,311
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|
5,800
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|
||
|
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|
||||
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Stockholders’ equity:
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|
||||
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Common stock, $0.001 par value; 150 shares authorized; outstanding: 57 shares at March 31, 2017 and December 31, 2016
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—
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—
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Preferred stock, $0.001 par value; 20 shares authorized, no shares issued and outstanding
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—
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|
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—
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|
||
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Additional paid-in capital
|
841
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|
|
841
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|
||
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Accumulated other comprehensive loss
|
(1
|
)
|
|
(2
|
)
|
||
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Retained earnings
|
887
|
|
|
810
|
|
||
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Total stockholders’ equity
|
1,727
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|
|
1,649
|
|
||
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|
$
|
8,038
|
|
|
$
|
7,449
|
|
|
|
Three Months Ended March 31,
|
||||||
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2017
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2016
|
||||
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|
(Amounts in millions)
(Unaudited) |
||||||
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Operating activities:
|
|
|
|
||||
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Net income
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$
|
77
|
|
|
$
|
24
|
|
|
Adjustments to reconcile net income to net cash provided by operating activities:
|
|
|
|
||||
|
Depreciation and amortization
|
49
|
|
|
44
|
|
||
|
Deferred income taxes
|
(5
|
)
|
|
30
|
|
||
|
Share-based compensation
|
6
|
|
|
7
|
|
||
|
Amortization of convertible senior notes and lease financing obligations
|
8
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|
|
8
|
|
||
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Other, net
|
3
|
|
|
6
|
|
||
|
Changes in operating assets and liabilities:
|
|
|
|
||||
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Receivables
|
(32
|
)
|
|
(266
|
)
|
||
|
Prepaid expenses and other assets
|
(12
|
)
|
|
(202
|
)
|
||
|
Medical claims and benefits payable
|
(3
|
)
|
|
255
|
|
||
|
Amounts due government agencies
|
373
|
|
|
181
|
|
||
|
Accounts payable and accrued liabilities
|
50
|
|
|
205
|
|
||
|
Deferred revenue
|
146
|
|
|
(129
|
)
|
||
|
Income taxes
|
59
|
|
|
(24
|
)
|
||
|
Net cash provided by operating activities
|
719
|
|
|
139
|
|
||
|
Investing activities:
|
|
|
|
||||
|
Purchases of investments
|
(733
|
)
|
|
(611
|
)
|
||
|
Proceeds from sales and maturities of investments
|
433
|
|
|
348
|
|
||
|
Purchases of property, equipment and capitalized software
|
(26
|
)
|
|
(46
|
)
|
||
|
Increase in restricted investments
|
(7
|
)
|
|
(4
|
)
|
||
|
Net cash paid in business combinations
|
—
|
|
|
(2
|
)
|
||
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Other, net
|
(6
|
)
|
|
1
|
|
||
|
Net cash used in investing activities
|
(339
|
)
|
|
(314
|
)
|
||
|
Financing activities:
|
|
|
|
||||
|
Proceeds from employee stock plans
|
1
|
|
|
—
|
|
||
|
Other, net
|
(2
|
)
|
|
2
|
|
||
|
Net cash (used in) provided by financing activities
|
(1
|
)
|
|
2
|
|
||
|
Net increase (decrease) in cash and cash equivalents
|
379
|
|
|
(173
|
)
|
||
|
Cash and cash equivalents at beginning of period
|
2,819
|
|
|
2,329
|
|
||
|
Cash and cash equivalents at end of period
|
$
|
3,198
|
|
|
$
|
2,156
|
|
|
|
Three Months Ended March 31,
|
||||||
|
|
2017
|
|
2016
|
||||
|
|
(Amounts in millions)
(Unaudited) |
||||||
|
Supplemental cash flow information:
|
|
|
|
||||
|
|
|
|
|
||||
|
Schedule of non-cash investing and financing activities:
|
|
|
|
||||
|
Common stock used for share-based compensation
|
$
|
(6
|
)
|
|
$
|
(7
|
)
|
|
|
|
|
|
||||
|
Details of change in fair value of derivatives, net:
|
|
|
|
||||
|
(Loss) gain on 1.125% Call Option
|
$
|
(86
|
)
|
|
$
|
3
|
|
|
Gain (loss) on 1.125% Conversion Option
|
86
|
|
|
(3
|
)
|
||
|
Change in fair value of derivatives, net
|
$
|
—
|
|
|
$
|
—
|
|
|
|
|
|
|
||||
|
Details of business combinations:
|
|
|
|
||||
|
Fair value of assets acquired
|
$
|
—
|
|
|
$
|
(134
|
)
|
|
Purchase price amounts accrued/received
|
—
|
|
|
30
|
|
||
|
Reversal of amounts advanced to sellers in prior year
|
—
|
|
|
102
|
|
||
|
Net cash paid in business combinations
|
$
|
—
|
|
|
$
|
(2
|
)
|
|
|
March 31, 2017
|
|
December 31,
2016 |
||||||||||||
|
|
Current Benefit Year
|
|
Prior Benefit Years
|
|
Total
|
|
|||||||||
|
|
|
|
|
|
|
|
|
||||||||
|
|
(In millions)
|
||||||||||||||
|
Risk adjustment
|
$
|
(247
|
)
|
|
$
|
(522
|
)
|
|
$
|
(769
|
)
|
|
$
|
(522
|
)
|
|
Reinsurance
|
—
|
|
|
58
|
|
|
58
|
|
|
55
|
|
||||
|
Risk corridor
|
—
|
|
|
(5
|
)
|
|
(5
|
)
|
|
(1
|
)
|
||||
|
Minimum MLR
|
(37
|
)
|
|
(3
|
)
|
|
(40
|
)
|
|
(1
|
)
|
||||
|
•
|
Risk adjustment: Under this permanent program, our health plans’ composite risk scores are compared with the overall average risk score for the relevant state and market pool. Generally, our health plans will make a risk transfer payment into the pool if their composite risk scores are below the average risk score, and will receive a risk transfer payment from the pool if their composite risk scores are above the average risk score. We estimate our ultimate premium based on insurance policy year-to-date experience, and recognize estimated premiums relating to the risk adjustment program as an adjustment to premium revenue in our consolidated statements of income.
|
|
•
|
Reinsurance: This program was designed to provide reimbursement to insurers for high cost members and ended December 31, 2016; we expect to settle the outstanding receivable balance in 2017.
|
|
•
|
Risk corridor: This program was intended to limit gains and losses of insurers by comparing allowable costs to a target amount as defined by CMS, and ended December 31, 2016; we expect to settle the outstanding payable balance in 2017.
|
|
|
Three Months Ended March 31,
|
||||||
|
|
2017
|
|
2016
|
||||
|
|
(In millions)
|
||||||
|
Maximum available quality incentive premium - current period
|
$
|
38
|
|
|
$
|
40
|
|
|
Amount of quality incentive premium revenue recognized in current period:
|
|
|
|
||||
|
Earned current period
|
$
|
19
|
|
|
$
|
18
|
|
|
Earned prior periods
|
5
|
|
|
5
|
|
||
|
Total
|
$
|
24
|
|
|
$
|
23
|
|
|
|
|
|
|
||||
|
Quality incentive premium revenue recognized as a percentage of total premium revenue
|
0.5
|
%
|
|
0.6
|
%
|
||
|
|
Three Months Ended March 31,
|
||||||
|
|
2017
|
|
2016
|
||||
|
|
(In millions, except net income per share)
|
||||||
|
Numerator:
|
|
|
|
||||
|
Net income
|
$
|
77
|
|
|
$
|
24
|
|
|
Denominator:
|
|
|
|
||||
|
Denominator for basic net income per share
|
56
|
|
|
55
|
|
||
|
Effect of dilutive securities:
|
|
|
|
||||
|
Share-based compensation
|
—
|
|
|
1
|
|
||
|
1.125% Warrants
(1)
|
—
|
|
|
1
|
|
||
|
Denominator for diluted net income per share
|
56
|
|
|
57
|
|
||
|
|
|
|
|
||||
|
Net income per share:
(2)
|
|
|
|
||||
|
Basic
|
$
|
1.38
|
|
|
$
|
0.44
|
|
|
Diluted
|
$
|
1.37
|
|
|
$
|
0.43
|
|
|
(1)
|
For more information regarding the
1.125%
Warrants, refer to Note
9
, “
Stockholders' Equity
.”
|
|
(2)
|
Source data for calculations in thousands.
|
|
|
Total
|
|
Level 1
|
|
Level 2
|
|
Level 3
|
||||||||
|
|
(In millions)
|
||||||||||||||
|
Corporate debt securities
|
$
|
1,353
|
|
|
$
|
—
|
|
|
$
|
1,353
|
|
|
$
|
—
|
|
|
Government-sponsored enterprise securities (GSEs)
|
209
|
|
|
209
|
|
|
—
|
|
|
—
|
|
||||
|
U.S. treasury notes
|
193
|
|
|
193
|
|
|
—
|
|
|
—
|
|
||||
|
Municipal securities
|
152
|
|
|
—
|
|
|
152
|
|
|
—
|
|
||||
|
Asset-backed securities
|
110
|
|
|
—
|
|
|
110
|
|
|
—
|
|
||||
|
Certificates of deposit
|
39
|
|
|
—
|
|
|
39
|
|
|
—
|
|
||||
|
Subtotal - current investments
|
2,056
|
|
|
402
|
|
|
1,654
|
|
|
—
|
|
||||
|
1.125% Call Option derivative asset
|
181
|
|
|
—
|
|
|
—
|
|
|
181
|
|
||||
|
Total assets measured at fair value on a recurring basis
|
$
|
2,237
|
|
|
$
|
402
|
|
|
$
|
1,654
|
|
|
$
|
181
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
1.125% Conversion Option derivative liability
|
$
|
181
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
181
|
|
|
Total liabilities measured at fair value on a recurring basis
|
$
|
181
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
181
|
|
|
|
Total
|
|
Level 1
|
|
Level 2
|
|
Level 3
|
||||||||
|
|
(In millions)
|
||||||||||||||
|
Corporate debt securities
|
$
|
1,179
|
|
|
$
|
—
|
|
|
$
|
1,179
|
|
|
$
|
—
|
|
|
GSEs
|
231
|
|
|
231
|
|
|
—
|
|
|
—
|
|
||||
|
U.S. treasury notes
|
84
|
|
|
84
|
|
|
—
|
|
|
—
|
|
||||
|
Municipal securities
|
142
|
|
|
—
|
|
|
142
|
|
|
—
|
|
||||
|
Asset-backed securities
|
69
|
|
|
—
|
|
|
69
|
|
|
—
|
|
||||
|
Certificates of deposit
|
53
|
|
|
—
|
|
|
53
|
|
|
—
|
|
||||
|
Subtotal - current investments
|
1,758
|
|
|
315
|
|
|
1,443
|
|
|
—
|
|
||||
|
1.125% Call Option derivative asset
|
267
|
|
|
—
|
|
|
—
|
|
|
267
|
|
||||
|
Total assets measured at fair value on a recurring basis
|
$
|
2,025
|
|
|
$
|
315
|
|
|
$
|
1,443
|
|
|
$
|
267
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
1.125% Conversion Option derivative liability
|
$
|
267
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
267
|
|
|
Total liabilities measured at fair value on a recurring basis
|
$
|
267
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
267
|
|
|
|
March 31, 2017
|
|
December 31, 2016
|
||||||||||||
|
|
Carrying
Value
|
|
Fair Value
|
|
Carrying
Value
|
|
Fair Value
|
||||||||
|
|
(In millions)
|
||||||||||||||
|
5.375% Notes
|
$
|
691
|
|
|
$
|
726
|
|
|
$
|
691
|
|
|
$
|
714
|
|
|
1.125% Convertible Notes
|
477
|
|
|
705
|
|
|
471
|
|
|
792
|
|
||||
|
1.625% Convertible Notes
|
287
|
|
|
321
|
|
|
284
|
|
|
344
|
|
||||
|
|
$
|
1,455
|
|
|
$
|
1,752
|
|
|
$
|
1,446
|
|
|
$
|
1,850
|
|
|
|
March 31, 2017
|
||||||||||||||
|
|
Amortized
|
|
Gross
Unrealized
|
|
Estimated
Fair
|
||||||||||
|
|
Cost
|
|
Gains
|
|
Losses
|
|
Value
|
||||||||
|
|
(In millions)
|
||||||||||||||
|
Corporate debt securities
|
$
|
1,354
|
|
|
$
|
1
|
|
|
$
|
2
|
|
|
$
|
1,353
|
|
|
GSEs
|
210
|
|
|
—
|
|
|
1
|
|
|
209
|
|
||||
|
U.S. treasury notes
|
193
|
|
|
—
|
|
|
—
|
|
|
193
|
|
||||
|
Municipal securities
|
153
|
|
|
—
|
|
|
1
|
|
|
152
|
|
||||
|
Asset-backed securities
|
110
|
|
|
—
|
|
|
—
|
|
|
110
|
|
||||
|
Certificates of deposit
|
39
|
|
|
—
|
|
|
—
|
|
|
39
|
|
||||
|
|
$
|
2,059
|
|
|
$
|
1
|
|
|
$
|
4
|
|
|
$
|
2,056
|
|
|
|
December 31, 2016
|
||||||||||||||
|
|
Amortized
|
|
Gross
Unrealized
|
|
Estimated
Fair
|
||||||||||
|
|
Cost
|
|
Gains
|
|
Losses
|
|
Value
|
||||||||
|
|
(In millions)
|
||||||||||||||
|
Corporate debt securities
|
$
|
1,180
|
|
|
$
|
1
|
|
|
$
|
2
|
|
|
$
|
1,179
|
|
|
GSEs
|
232
|
|
|
—
|
|
|
1
|
|
|
231
|
|
||||
|
U.S. treasury notes
|
84
|
|
|
—
|
|
|
—
|
|
|
84
|
|
||||
|
Municipal securities
|
143
|
|
|
—
|
|
|
1
|
|
|
142
|
|
||||
|
Asset-backed securities
|
69
|
|
|
—
|
|
|
—
|
|
|
69
|
|
||||
|
Certificates of deposit
|
53
|
|
|
—
|
|
|
—
|
|
|
53
|
|
||||
|
|
$
|
1,761
|
|
|
$
|
1
|
|
|
$
|
4
|
|
|
$
|
1,758
|
|
|
|
Amortized Cost
|
|
Estimated
Fair Value
|
||||
|
|
(In millions)
|
||||||
|
Due in one year or less
|
$
|
1,151
|
|
|
$
|
1,151
|
|
|
Due after one year through five years
|
872
|
|
|
870
|
|
||
|
Due after five years through ten years
|
36
|
|
|
35
|
|
||
|
|
$
|
2,059
|
|
|
$
|
2,056
|
|
|
|
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
Positions
|
|
Estimated
Fair
Value
|
|
Unrealized
Losses
|
|
Total
Number of
Positions
|
||||||||||
|
|
(Dollars in millions)
|
||||||||||||||||||||
|
Corporate debt securities
|
$
|
570
|
|
|
$
|
2
|
|
|
341
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
—
|
|
|
GSEs
|
200
|
|
|
1
|
|
|
83
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
Municipal securities
|
84
|
|
|
1
|
|
|
101
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
|
$
|
854
|
|
|
$
|
4
|
|
|
525
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
—
|
|
|
|
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
Positions
|
|
Estimated
Fair
Value
|
|
Unrealized
Losses
|
|
Total
Number of
Positions
|
||||||||||
|
|
(Dollars in millions)
|
||||||||||||||||||||
|
Corporate debt securities
|
$
|
542
|
|
|
$
|
2
|
|
|
378
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
—
|
|
|
GSEs
|
198
|
|
|
1
|
|
|
73
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
Municipal securities
|
101
|
|
|
1
|
|
|
129
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||
|
|
$
|
841
|
|
|
$
|
4
|
|
|
580
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
—
|
|
|
|
Amortized
Cost
|
|
Estimated
Fair Value
|
||||
|
|
(In millions)
|
||||||
|
Due in one year or less
|
$
|
97
|
|
|
$
|
97
|
|
|
Due after one year through five years
|
18
|
|
|
18
|
|
||
|
|
$
|
115
|
|
|
$
|
115
|
|
|
|
March 31,
2017 |
|
December 31,
2016 |
||||
|
|
(In millions)
|
||||||
|
Fee-for-service claims incurred but not paid (IBNP)
|
$
|
1,425
|
|
|
$
|
1,352
|
|
|
Pharmacy payable
|
133
|
|
|
112
|
|
||
|
Capitation payable
|
36
|
|
|
37
|
|
||
|
Other
|
332
|
|
|
428
|
|
||
|
|
$
|
1,926
|
|
|
$
|
1,929
|
|
|
|
Three Months Ended March 31,
|
||||||
|
|
2017
|
|
2016
|
||||
|
|
(Dollars in millions)
|
||||||
|
Medical claims and benefits payable, beginning balance
|
$
|
1,929
|
|
|
$
|
1,685
|
|
|
Components of medical care costs related to:
|
|
|
|
||||
|
Current period
|
4,253
|
|
|
3,755
|
|
||
|
Prior periods
|
(142
|
)
|
|
(167
|
)
|
||
|
Total medical care costs
|
4,111
|
|
|
3,588
|
|
||
|
|
|
|
|
||||
|
Change in non-risk provider payables
|
(96
|
)
|
|
24
|
|
||
|
|
|
|
|
||||
|
Payments for medical care costs related to:
|
|
|
|
||||
|
Current period
|
2,683
|
|
|
2,241
|
|
||
|
Prior periods
|
1,335
|
|
|
1,116
|
|
||
|
Total paid
|
4,018
|
|
|
3,357
|
|
||
|
Medical claims and benefits payable, ending balance
|
$
|
1,926
|
|
|
$
|
1,940
|
|
|
Benefit from prior period as a percentage of:
|
|
|
|
||||
|
Balance at beginning of period
|
7.4
|
%
|
|
10.0
|
%
|
||
|
Premium revenue, trailing twelve months
|
0.8
|
%
|
|
1.2
|
%
|
||
|
Medical care costs, trailing twelve months
|
0.9
|
%
|
|
1.3
|
%
|
||
|
•
|
In the first quarter of 2017, our Marketplace enrollment across all health plans increased over
500,000
members. Due to limited insight into the cost patterns associated with this large number of new Marketplace members, our liability estimates for these members are subject to more than the usual amount of uncertainty.
|
|
•
|
At our Florida health plan, claims receipts increased significantly over the last few months due to an increase in the receipt of secondary claims, many of which are not our liability. These claims, known as COBA (coordination of benefits agreement) claims, will either be denied or will have very small paid amounts. For this reason, claims denial rates, amounts paid per claim and other claims indicators will be impacted, making our liability estimates subject to more than the usual amount of uncertainty.
|
|
•
|
At our Illinois health plan, we paid a large number of claims in the first quarter of 2017 that had previously been denied and disputed by providers. This has created some distortion in the payment patterns, making our liability estimates subject to more than the usual amount of uncertainty.
|
|
•
|
At our Puerto Rico health plan, we increased the outpatient claims liability at December 31, 2016 due to a significant increase in pharmacy utilization, which typically indicates that outpatient costs will also be increasing. However, our actual outpatient costs were ultimately lower than our estimates
.
|
|
•
|
At our California health plan, we increased our claims liability at December 31, 2016 to reflect delays in the processing of paper claims. Subsequent adjudication of those claims has demonstrated that our actual additional claim costs were less than the additional amount we added to the December 31, 2016 liability estimate
.
|
|
•
|
At our Texas health plan, higher than expected claims recoveries caused our actual costs to be less than expected.
|
|
|
March 31,
2017 |
|
December 31,
2016 |
||||
|
Current portion of long-term debt:
|
|
|
|
||||
|
1.125% Convertible Notes, net of unamortized discount
|
$
|
—
|
|
|
$
|
477
|
|
|
Lease financing obligations
|
1
|
|
|
1
|
|
||
|
Debt issuance costs
|
—
|
|
|
(6
|
)
|
||
|
|
1
|
|
|
472
|
|
||
|
Senior notes:
|
|
|
|
||||
|
5.375% Notes
|
700
|
|
|
700
|
|
||
|
1.125% Convertible Notes, net of unamortized discount
|
482
|
|
|
—
|
|
||
|
1.625% Convertible Notes, net of unamortized premium and discount
|
289
|
|
|
286
|
|
||
|
Debt issuance costs
|
(16
|
)
|
|
(11
|
)
|
||
|
|
1,455
|
|
|
975
|
|
||
|
Lease financing obligations
|
198
|
|
|
198
|
|
||
|
|
$
|
1,654
|
|
|
$
|
1,645
|
|
|
|
Balance Sheet Location
|
|
March 31,
2017 |
|
December 31,
2016 |
||||
|
|
|
|
(In millions)
|
||||||
|
Derivative asset:
|
|
|
|
|
|
||||
|
1.125% Call Option
|
Current assets: Derivative asset
|
|
$
|
—
|
|
|
$
|
267
|
|
|
|
Non-current assets: Derivative asset
|
|
$
|
181
|
|
|
$
|
—
|
|
|
Derivative liability:
|
|
|
|
|
|
||||
|
1.125% Conversion Option
|
Current liabilities: Derivative liability
|
|
$
|
—
|
|
|
$
|
267
|
|
|
|
Non-current liabilities: Derivative liability
|
|
$
|
181
|
|
|
$
|
—
|
|
|
|
Restricted Shares
|
|
Performance Shares
|
|
Total
|
|
Weighted
Average
Grant Date
Fair Value
|
|||||
|
Unvested balance as of December 31, 2016
|
577,244
|
|
|
345,656
|
|
|
922,900
|
|
|
$
|
58.15
|
|
|
Granted
|
351,214
|
|
|
—
|
|
|
351,214
|
|
|
49.51
|
|
|
|
Vested
|
(208,425
|
)
|
|
(107,320
|
)
|
|
(315,745
|
)
|
|
51.88
|
|
|
|
Forfeited
|
(5,061
|
)
|
|
—
|
|
|
(5,061
|
)
|
|
63.71
|
|
|
|
Unvested balance as of March 31, 2017
|
714,972
|
|
|
238,336
|
|
|
953,308
|
|
|
57.02
|
|
|
|
|
|
Health Plans
|
|
Molina Medicaid Solutions
|
|
Other
|
|
Consolidated
|
||||||||
|
|
|
|
|
|
||||||||||||
|
|
|
(In millions)
|
||||||||||||||
|
Three Months Ended March 31, 2017
|
|
|
|
|
|
|
|
|
||||||||
|
Total revenue
(1)
|
|
$
|
4,771
|
|
|
$
|
46
|
|
|
$
|
87
|
|
|
$
|
4,904
|
|
|
Gross margin
|
|
537
|
|
|
4
|
|
|
5
|
|
|
546
|
|
||||
|
|
|
|
|
|
|
|
|
|
||||||||
|
Three Months Ended March 31, 2016
|
|
|
|
|
|
|
|
|
||||||||
|
Total revenue
(1)
|
|
4,201
|
|
|
52
|
|
|
90
|
|
|
4,343
|
|
||||
|
Gross margin
|
|
407
|
|
|
6
|
|
|
7
|
|
|
420
|
|
||||
|
|
|
|
|
|
|
|
|
|
||||||||
|
Total Assets
|
|
|
|
|
|
|
|
|
||||||||
|
March 31, 2017
|
|
6,586
|
|
|
279
|
|
|
1,173
|
|
|
8,038
|
|
||||
|
December 31, 2016
|
|
5,897
|
|
|
267
|
|
|
1,285
|
|
|
7,449
|
|
||||
|
(1)
|
Total revenue consists primarily of premium revenue, premium tax revenue and health insurer fee revenue for the Health Plans segment, and service revenue for the Molina Medicaid Solutions and Other segments. Inter-segment revenue is insignificant.
|
|
|
Three Months Ended March 31,
|
||||||
|
|
2017
|
|
2016
|
||||
|
|
(In millions)
|
||||||
|
Gross margin:
|
|
|
|
||||
|
Health Plans
|
$
|
537
|
|
|
$
|
407
|
|
|
Molina Medicaid Solutions
|
4
|
|
|
6
|
|
||
|
Other
|
5
|
|
|
7
|
|
||
|
Total gross margin
|
546
|
|
|
420
|
|
||
|
Add: other operating revenues
(1)
|
125
|
|
|
208
|
|
||
|
Less: other operating expenses
(2)
|
(589
|
)
|
|
(539
|
)
|
||
|
Operating income
|
82
|
|
|
89
|
|
||
|
Other (income) expenses, net
|
(49
|
)
|
|
25
|
|
||
|
Income before income tax expense
|
$
|
131
|
|
|
$
|
64
|
|
|
(1)
|
Other operating revenues include premium tax revenue, health insurer fee revenue, investment income and other revenue.
|
|
(2)
|
Other operating expenses include general and administrative expenses, premium tax expenses, health insurer fee expenses and depreciation and amortization.
|
|
|
Three Months Ended March 31, 2017
|
||||||||||||||||||
|
|
Parent Guarantor
|
|
Other Guarantors
|
|
Non-Guarantors
|
|
Eliminations
|
|
Consolidated
|
||||||||||
|
|
(In millions)
|
||||||||||||||||||
|
Revenue:
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Total revenue
|
$
|
341
|
|
|
$
|
48
|
|
|
$
|
4,857
|
|
|
$
|
(342
|
)
|
|
$
|
4,904
|
|
|
Expenses:
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Medical care costs
|
4
|
|
|
—
|
|
|
4,107
|
|
|
—
|
|
|
4,111
|
|
|||||
|
Cost of service revenue
|
—
|
|
|
42
|
|
|
80
|
|
|
—
|
|
|
122
|
|
|||||
|
General and administrative expenses
|
297
|
|
|
7
|
|
|
477
|
|
|
(342
|
)
|
|
439
|
|
|||||
|
Premium tax expenses
|
—
|
|
|
—
|
|
|
111
|
|
|
—
|
|
|
111
|
|
|||||
|
Depreciation and amortization
|
27
|
|
|
—
|
|
|
12
|
|
|
—
|
|
|
39
|
|
|||||
|
Total operating expenses
|
328
|
|
|
49
|
|
|
4,787
|
|
|
(342
|
)
|
|
4,822
|
|
|||||
|
Operating income (loss)
|
13
|
|
|
(1
|
)
|
|
70
|
|
|
—
|
|
|
82
|
|
|||||
|
Interest expense
|
26
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
26
|
|
|||||
|
Other income, net
|
(75
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(75
|
)
|
|||||
|
Income (loss) before income taxes
|
62
|
|
|
(1
|
)
|
|
70
|
|
|
—
|
|
|
131
|
|
|||||
|
Income tax expense
|
31
|
|
|
—
|
|
|
23
|
|
|
—
|
|
|
54
|
|
|||||
|
Net income (loss) before equity in earnings of subsidiaries
|
31
|
|
|
(1
|
)
|
|
47
|
|
|
—
|
|
|
77
|
|
|||||
|
Equity in net earnings of subsidiaries
|
46
|
|
|
(2
|
)
|
|
—
|
|
|
(44
|
)
|
|
—
|
|
|||||
|
Net income (loss)
|
$
|
77
|
|
|
$
|
(3
|
)
|
|
$
|
47
|
|
|
$
|
(44
|
)
|
|
$
|
77
|
|
|
|
Three Months Ended March 31, 2016
|
||||||||||||||||||
|
|
Parent Guarantor
|
|
Other Guarantors
|
|
Non-Guarantors
|
|
Eliminations
|
|
Consolidated
|
||||||||||
|
|
(In millions)
|
||||||||||||||||||
|
Revenue:
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Total revenue
|
$
|
251
|
|
|
$
|
52
|
|
|
$
|
4,290
|
|
|
$
|
(250
|
)
|
|
$
|
4,343
|
|
|
Expenses:
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Medical care costs
|
12
|
|
|
—
|
|
|
3,576
|
|
|
—
|
|
|
3,588
|
|
|||||
|
Cost of service revenue
|
—
|
|
|
65
|
|
|
62
|
|
|
—
|
|
|
127
|
|
|||||
|
General and administrative expenses
|
217
|
|
|
(15
|
)
|
|
388
|
|
|
(250
|
)
|
|
340
|
|
|||||
|
Premium tax expenses
|
—
|
|
|
—
|
|
|
109
|
|
|
—
|
|
|
109
|
|
|||||
|
Health insurer fee expenses
|
—
|
|
|
—
|
|
|
58
|
|
|
—
|
|
|
58
|
|
|||||
|
Depreciation and amortization
|
22
|
|
|
2
|
|
|
8
|
|
|
—
|
|
|
32
|
|
|||||
|
Total operating expenses
|
251
|
|
|
52
|
|
|
4,201
|
|
|
(250
|
)
|
|
4,254
|
|
|||||
|
Operating income
|
—
|
|
|
—
|
|
|
89
|
|
|
—
|
|
|
89
|
|
|||||
|
Interest expense
|
25
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
25
|
|
|||||
|
(Loss) income before income taxes
|
(25
|
)
|
|
—
|
|
|
89
|
|
|
—
|
|
|
64
|
|
|||||
|
Income tax (benefit) expense
|
(16
|
)
|
|
—
|
|
|
56
|
|
|
—
|
|
|
40
|
|
|||||
|
Net (loss) income before equity in earnings of subsidiaries
|
(9
|
)
|
|
—
|
|
|
33
|
|
|
—
|
|
|
24
|
|
|||||
|
Equity in net earnings of subsidiaries
|
33
|
|
|
2
|
|
|
—
|
|
|
(35
|
)
|
|
—
|
|
|||||
|
Net income
|
$
|
24
|
|
|
$
|
2
|
|
|
$
|
33
|
|
|
$
|
(35
|
)
|
|
$
|
24
|
|
|
|
Three Months Ended March 31, 2017
|
||||||||||||||||||
|
|
Parent Guarantor
|
|
Other Guarantors
|
|
Non-Guarantors
|
|
Eliminations
|
|
Consolidated
|
||||||||||
|
|
|
|
|
|
|
|
|
|
|
||||||||||
|
|
(In millions)
|
||||||||||||||||||
|
Net income (loss)
|
$
|
77
|
|
|
$
|
(3
|
)
|
|
$
|
47
|
|
|
$
|
(44
|
)
|
|
$
|
77
|
|
|
Other comprehensive income, net of tax
|
1
|
|
|
—
|
|
|
1
|
|
|
(1
|
)
|
|
1
|
|
|||||
|
Comprehensive income (loss)
|
$
|
78
|
|
|
$
|
(3
|
)
|
|
$
|
48
|
|
|
$
|
(45
|
)
|
|
$
|
78
|
|
|
|
Three Months Ended March 31, 2016
|
||||||||||||||||||
|
|
Parent Guarantor
|
|
Other Guarantors
|
|
Non-Guarantors
|
|
Eliminations
|
|
Consolidated
|
||||||||||
|
|
|
|
|
|
|
|
|
|
|
||||||||||
|
|
(In millions)
|
||||||||||||||||||
|
Net income
|
$
|
24
|
|
|
$
|
2
|
|
|
$
|
33
|
|
|
$
|
(35
|
)
|
|
$
|
24
|
|
|
Other comprehensive income, net of tax
|
6
|
|
|
—
|
|
|
5
|
|
|
(5
|
)
|
|
6
|
|
|||||
|
Comprehensive income
|
$
|
30
|
|
|
$
|
2
|
|
|
$
|
38
|
|
|
$
|
(40
|
)
|
|
$
|
30
|
|
|
|
March 31, 2017
|
||||||||||||||||||
|
|
Parent Guarantor
|
|
Other Guarantors
|
|
Non-Guarantors
|
|
Eliminations
|
|
Consolidated
|
||||||||||
|
|
(In millions)
|
||||||||||||||||||
|
ASSETS
|
|||||||||||||||||||
|
Current assets:
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Cash and cash equivalents
|
$
|
187
|
|
|
$
|
19
|
|
|
$
|
2,992
|
|
|
$
|
—
|
|
|
$
|
3,198
|
|
|
Investments
|
86
|
|
|
—
|
|
|
1,970
|
|
|
—
|
|
|
2,056
|
|
|||||
|
Receivables
|
2
|
|
|
41
|
|
|
963
|
|
|
—
|
|
|
1,006
|
|
|||||
|
Due from (to) affiliates
|
155
|
|
|
(7
|
)
|
|
(148
|
)
|
|
—
|
|
|
—
|
|
|||||
|
Prepaid expenses and other current assets
|
53
|
|
|
22
|
|
|
67
|
|
|
—
|
|
|
142
|
|
|||||
|
Total current assets
|
483
|
|
|
75
|
|
|
5,844
|
|
|
—
|
|
|
6,402
|
|
|||||
|
Property, equipment, and capitalized software, net
|
294
|
|
|
47
|
|
|
106
|
|
|
—
|
|
|
447
|
|
|||||
|
Deferred contract costs
|
—
|
|
|
89
|
|
|
—
|
|
|
—
|
|
|
89
|
|
|||||
|
Goodwill and intangible assets, net
|
56
|
|
|
72
|
|
|
623
|
|
|
—
|
|
|
751
|
|
|||||
|
Restricted investments
|
—
|
|
|
—
|
|
|
115
|
|
|
—
|
|
|
115
|
|
|||||
|
Investment in subsidiaries, net
|
2,722
|
|
|
244
|
|
|
—
|
|
|
(2,966
|
)
|
|
—
|
|
|||||
|
Deferred income taxes
|
10
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
10
|
|
|||||
|
Derivative asset
|
181
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
181
|
|
|||||
|
Other assets
|
50
|
|
|
3
|
|
|
6
|
|
|
(16
|
)
|
|
43
|
|
|||||
|
|
$
|
3,796
|
|
|
$
|
530
|
|
|
$
|
6,694
|
|
|
$
|
(2,982
|
)
|
|
$
|
8,038
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||
|
LIABILITIES AND STOCKHOLDERS’ EQUITY
|
|||||||||||||||||||
|
Current liabilities:
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Medical claims and benefits payable
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
1,926
|
|
|
$
|
—
|
|
|
$
|
1,926
|
|
|
Amounts due government agencies
|
—
|
|
|
—
|
|
|
1,575
|
|
|
—
|
|
|
1,575
|
|
|||||
|
Accounts payable and accrued liabilities
|
187
|
|
|
39
|
|
|
212
|
|
|
—
|
|
|
438
|
|
|||||
|
Deferred revenue
|
—
|
|
|
48
|
|
|
413
|
|
|
—
|
|
|
461
|
|
|||||
|
Income taxes payable
|
17
|
|
|
(7
|
)
|
|
11
|
|
|
—
|
|
|
21
|
|
|||||
|
Current portion of long-term debt
|
1
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
1
|
|
|||||
|
Total current liabilities
|
205
|
|
|
80
|
|
|
4,137
|
|
|
—
|
|
|
4,422
|
|
|||||
|
Long-term debt
|
1,653
|
|
|
—
|
|
|
16
|
|
|
(16
|
)
|
|
1,653
|
|
|||||
|
Deferred income taxes
|
8
|
|
|
42
|
|
|
(39
|
)
|
|
—
|
|
|
11
|
|
|||||
|
Derivative liability
|
181
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
181
|
|
|||||
|
Other long-term liabilities
|
22
|
|
|
1
|
|
|
21
|
|
|
—
|
|
|
44
|
|
|||||
|
Total liabilities
|
2,069
|
|
|
123
|
|
|
4,135
|
|
|
(16
|
)
|
|
6,311
|
|
|||||
|
Total stockholders’ equity
|
1,727
|
|
|
407
|
|
|
2,559
|
|
|
(2,966
|
)
|
|
1,727
|
|
|||||
|
|
$
|
3,796
|
|
|
$
|
530
|
|
|
$
|
6,694
|
|
|
$
|
(2,982
|
)
|
|
$
|
8,038
|
|
|
|
December 31, 2016
|
||||||||||||||||||
|
|
Parent Guarantor
|
|
Other Guarantors
|
|
Non-Guarantors
|
|
Eliminations
|
|
Consolidated
|
||||||||||
|
|
(In millions)
|
||||||||||||||||||
|
ASSETS
|
|||||||||||||||||||
|
Current assets:
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Cash and cash equivalents
|
$
|
86
|
|
|
$
|
6
|
|
|
$
|
2,727
|
|
|
$
|
—
|
|
|
$
|
2,819
|
|
|
Investments
|
178
|
|
|
—
|
|
|
1,580
|
|
|
—
|
|
|
1,758
|
|
|||||
|
Receivables
|
2
|
|
|
34
|
|
|
938
|
|
|
—
|
|
|
974
|
|
|||||
|
Income tax refundable
|
17
|
|
|
4
|
|
|
18
|
|
|
—
|
|
|
39
|
|
|||||
|
Due from (to) affiliates
|
104
|
|
|
(5
|
)
|
|
(99
|
)
|
|
—
|
|
|
—
|
|
|||||
|
Prepaid expenses and other current assets
|
58
|
|
|
30
|
|
|
43
|
|
|
—
|
|
|
131
|
|
|||||
|
Derivative asset
|
267
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
267
|
|
|||||
|
Total current assets
|
712
|
|
|
69
|
|
|
5,207
|
|
|
—
|
|
|
5,988
|
|
|||||
|
Property, equipment, and capitalized software, net
|
301
|
|
|
46
|
|
|
107
|
|
|
—
|
|
|
454
|
|
|||||
|
Deferred contract costs
|
—
|
|
|
86
|
|
|
—
|
|
|
—
|
|
|
86
|
|
|||||
|
Goodwill and intangible assets, net
|
58
|
|
|
73
|
|
|
629
|
|
|
—
|
|
|
760
|
|
|||||
|
Restricted investments
|
—
|
|
|
—
|
|
|
110
|
|
|
—
|
|
|
110
|
|
|||||
|
Investment in subsidiaries, net
|
2,609
|
|
|
246
|
|
|
—
|
|
|
(2,855
|
)
|
|
—
|
|
|||||
|
Deferred income taxes
|
10
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
10
|
|
|||||
|
Other assets
|
48
|
|
|
3
|
|
|
6
|
|
|
(16
|
)
|
|
41
|
|
|||||
|
|
$
|
3,738
|
|
|
$
|
523
|
|
|
$
|
6,059
|
|
|
$
|
(2,871
|
)
|
|
$
|
7,449
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||
|
LIABILITIES AND STOCKHOLDERS’ EQUITY
|
|||||||||||||||||||
|
Current liabilities:
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Medical claims and benefits payable
|
$
|
1
|
|
|
$
|
—
|
|
|
$
|
1,928
|
|
|
$
|
—
|
|
|
$
|
1,929
|
|
|
Amounts due government agencies
|
—
|
|
|
—
|
|
|
1,202
|
|
|
—
|
|
|
1,202
|
|
|||||
|
Accounts payable and accrued liabilities
|
146
|
|
|
34
|
|
|
205
|
|
|
—
|
|
|
385
|
|
|||||
|
Deferred revenue
|
—
|
|
|
40
|
|
|
275
|
|
|
—
|
|
|
315
|
|
|||||
|
Current portion of long-term debt
|
472
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
472
|
|
|||||
|
Derivative liability
|
267
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
267
|
|
|||||
|
Total current liabilities
|
886
|
|
|
74
|
|
|
3,610
|
|
|
—
|
|
|
4,570
|
|
|||||
|
Long-term debt
|
1,173
|
|
|
—
|
|
|
16
|
|
|
(16
|
)
|
|
1,173
|
|
|||||
|
Deferred income taxes
|
11
|
|
|
39
|
|
|
(35
|
)
|
|
—
|
|
|
15
|
|
|||||
|
Other long-term liabilities
|
19
|
|
|
1
|
|
|
22
|
|
|
—
|
|
|
42
|
|
|||||
|
Total liabilities
|
2,089
|
|
|
114
|
|
|
3,613
|
|
|
(16
|
)
|
|
5,800
|
|
|||||
|
Total stockholders’ equity
|
1,649
|
|
|
409
|
|
|
2,446
|
|
|
(2,855
|
)
|
|
1,649
|
|
|||||
|
|
$
|
3,738
|
|
|
$
|
523
|
|
|
$
|
6,059
|
|
|
$
|
(2,871
|
)
|
|
$
|
7,449
|
|
|
|
Three Months Ended March 31, 2017
|
||||||||||||||||||
|
|
Parent Guarantor
|
|
Other Guarantors
|
|
Non-Guarantors
|
|
Eliminations
|
|
Consolidated
|
||||||||||
|
|
(In millions)
|
||||||||||||||||||
|
Operating activities:
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Net cash provided by operating activities
|
$
|
144
|
|
|
$
|
21
|
|
|
$
|
554
|
|
|
$
|
—
|
|
|
$
|
719
|
|
|
Investing activities:
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Purchases of investments
|
—
|
|
|
—
|
|
|
(733
|
)
|
|
—
|
|
|
(733
|
)
|
|||||
|
Proceeds from sales and maturities of investments
|
92
|
|
|
—
|
|
|
341
|
|
|
—
|
|
|
433
|
|
|||||
|
Purchases of property, equipment and capitalized software
|
(18
|
)
|
|
(5
|
)
|
|
(3
|
)
|
|
—
|
|
|
(26
|
)
|
|||||
|
Increase in restricted investments
|
—
|
|
|
—
|
|
|
(7
|
)
|
|
—
|
|
|
(7
|
)
|
|||||
|
Capital contributions to/from subsidiaries
|
(106
|
)
|
|
1
|
|
|
105
|
|
|
—
|
|
|
—
|
|
|||||
|
Dividends to/from subsidiaries
|
50
|
|
|
—
|
|
|
(50
|
)
|
|
—
|
|
|
—
|
|
|||||
|
Change in amounts due to/from affiliates
|
(60
|
)
|
|
2
|
|
|
58
|
|
|
—
|
|
|
—
|
|
|||||
|
Other, net
|
—
|
|
|
(6
|
)
|
|
—
|
|
|
—
|
|
|
(6
|
)
|
|||||
|
Net cash used in investing activities
|
(42
|
)
|
|
(8
|
)
|
|
(289
|
)
|
|
—
|
|
|
(339
|
)
|
|||||
|
Financing activities:
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Proceeds from employee stock plans
|
1
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
1
|
|
|||||
|
Other, net
|
(2
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(2
|
)
|
|||||
|
Net cash used in financing activities
|
(1
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(1
|
)
|
|||||
|
Net increase in cash and cash equivalents
|
101
|
|
|
13
|
|
|
265
|
|
|
—
|
|
|
379
|
|
|||||
|
Cash and cash equivalents at beginning of period
|
86
|
|
|
6
|
|
|
2,727
|
|
|
—
|
|
|
2,819
|
|
|||||
|
Cash and cash equivalents at end of period
|
$
|
187
|
|
|
$
|
19
|
|
|
$
|
2,992
|
|
|
$
|
—
|
|
|
$
|
3,198
|
|
|
|
Three Months Ended March 31, 2016
|
||||||||||||||||||
|
|
Parent Guarantor
|
|
Other Guarantors
|
|
Non-Guarantors
|
|
Eliminations
|
|
Consolidated
|
||||||||||
|
|
(In millions)
|
||||||||||||||||||
|
Operating activities:
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Net cash (used in) provided by operating activities
|
$
|
(38
|
)
|
|
$
|
23
|
|
|
$
|
154
|
|
|
$
|
—
|
|
|
$
|
139
|
|
|
Investing activities:
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Purchases of investments
|
(35
|
)
|
|
—
|
|
|
(576
|
)
|
|
—
|
|
|
(611
|
)
|
|||||
|
Proceeds from sales and maturities of investments
|
10
|
|
|
—
|
|
|
338
|
|
|
—
|
|
|
348
|
|
|||||
|
Purchases of property, equipment and capitalized software
|
(28
|
)
|
|
(14
|
)
|
|
(4
|
)
|
|
—
|
|
|
(46
|
)
|
|||||
|
Increase in restricted investments
|
—
|
|
|
—
|
|
|
(4
|
)
|
|
—
|
|
|
(4
|
)
|
|||||
|
Net cash paid in business combinations
|
—
|
|
|
(1
|
)
|
|
(1
|
)
|
|
—
|
|
|
(2
|
)
|
|||||
|
Capital contributions to/from subsidiaries
|
(36
|
)
|
|
2
|
|
|
34
|
|
|
—
|
|
|
—
|
|
|||||
|
Change in amounts due to/from affiliates
|
23
|
|
|
(5
|
)
|
|
(18
|
)
|
|
—
|
|
|
—
|
|
|||||
|
Other, net
|
6
|
|
|
(5
|
)
|
|
—
|
|
|
—
|
|
|
1
|
|
|||||
|
Net cash used in investing activities
|
(60
|
)
|
|
(23
|
)
|
|
(231
|
)
|
|
—
|
|
|
(314
|
)
|
|||||
|
Financing activities:
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Other, net
|
2
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
2
|
|
|||||
|
Net cash provided by financing activities
|
2
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
2
|
|
|||||
|
Net decrease in cash and cash equivalents
|
(96
|
)
|
|
—
|
|
|
(77
|
)
|
|
—
|
|
|
(173
|
)
|
|||||
|
Cash and cash equivalents at beginning of period
|
360
|
|
|
13
|
|
|
1,956
|
|
|
—
|
|
|
2,329
|
|
|||||
|
Cash and cash equivalents at end of period
|
$
|
264
|
|
|
$
|
13
|
|
|
$
|
1,879
|
|
|
$
|
—
|
|
|
$
|
2,156
|
|
|
•
|
the success of our profit improvement and cost-cutting initiatives;
|
|
•
|
the numerous political and market-based uncertainties associated with the Affordable Care Act (the “ACA”) or “Obamacare,” including any potential repeal and replacement of the law, amendment of the law, or move to state block grants for Medicaid;
|
|
•
|
the market dynamics surrounding the ACA Marketplaces, including but not limited to uncertainties associated with risk transfer requirements, the potential for disproportionate enrollment of higher acuity members, the withdrawal of cost sharing subsidies and/or premium tax credits, the adequacy of agreed rates, and potential disruption associated with market withdrawal;
|
|
•
|
subsequent adjustments to reported premium revenue based upon subsequent developments or new information, including changes to estimated amounts payable or receivable related to Marketplace risk adjustment/risk transfer, risk corridors, and reinsurance;
|
|
•
|
management of our medical costs, including our ability to reduce over time the high medical costs commonly associated with new patient populations;
|
|
•
|
our ability to predict with a reasonable degree of accuracy utilization rates, including utilization rates in new plans, geographies, and programs where we have less experience with patient and provider populations, and also including utilization rates associated with seasonal flu patterns or other newly emergent diseases;
|
|
•
|
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, including the resolution of the Illinois budget impasse and continued payment of all amounts due to our Illinois health plan;
|
|
•
|
the success of our efforts to retain existing government contracts, including those in Illinois, Washington, Florida, Texas, and New Mexico, and to obtain new government contracts in connection with state requests for proposals (RFPs) in both existing and new states;
|
|
•
|
the impact of the recent changes to our executive leadership team;
|
|
•
|
our ability to manage growth, including maintaining and creating adequate internal systems and controls relating to authorizations, approvals, provider payments, and the overall success of our care management initiatives;
|
|
•
|
our ability to consummate and realize benefits from acquisitions, and to integrate acquisitions;
|
|
•
|
our receipt of adequate premium rates to support increasing pharmacy costs, including costs associated with specialty drugs and costs resulting from formulary changes that allow the option of higher-priced non-generic drugs;
|
|
•
|
our ability to operate profitably in an environment where the trend in premium rate increases lags behind the trend in increasing medical costs;
|
|
•
|
the interpretation and implementation of federal or state medical cost expenditure floors, administrative cost and profit ceilings, premium stabilization programs, profit sharing arrangements, and risk adjustment provisions;
|
|
•
|
our estimates of amounts owed for such cost expenditure floors, administrative cost and profit ceilings, premium stabilization programs, profit-sharing arrangements, and risk adjustment provisions;
|
|
•
|
the Medicaid expansion cost corridors in California, New Mexico and Washington, and any other retroactive adjustment to revenue where methodologies and procedures are subject to interpretation or dependent upon information about the health status of participants other than Molina members;
|
|
•
|
the interpretation and implementation of at-risk premium rules and state contract performance requirements regarding the achievement of certain quality measures, and our ability to recognize revenue amounts associated therewith;
|
|
•
|
cyber-attacks or other privacy or data security incidents resulting in an inadvertent unauthorized disclosure of protected health information;
|
|
•
|
the success of our health plan in Puerto Rico, including the resolution of the Puerto Rico debt crisis, any impact of Puerto Rico’s filing for bankruptcy protection under the PROMESA law, payment of all amounts due under our Medicaid contract, the effect of the PROMESA law, and our efforts to better manage the health care costs of our Puerto Rico health plan;
|
|
•
|
the success and renewal of our duals demonstration programs in California, Illinois, Michigan, Ohio, South Carolina, and Texas;
|
|
•
|
the accurate estimation of incurred but not reported or paid medical costs across our health plans;
|
|
•
|
efforts by states to recoup previously paid and recognized premium amounts;
|
|
•
|
the continuation and renewal of the government contracts of our health plans, Molina Medicaid Solutions, and Pathways, and the terms under which such contracts are renewed;
|
|
•
|
complications, member confusion, or enrollment backlogs related to the annual renewal of Medicaid coverage;
|
|
•
|
government audits and reviews, or potential investigations, and any fine, sanction, enrollment freeze, monitoring program, or premium recovery that may result therefrom;
|
|
•
|
changes with respect to our provider contracts and the loss of providers;
|
|
•
|
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;
|
|
•
|
the relatively small number of states in which we operate health plans;
|
|
•
|
the availability of adequate financing on acceptable terms to fund and capitalize our expansion and growth, repay our outstanding indebtedness at maturity and meet our liquidity needs, including the interest expense and other costs associated with such financing;
|
|
•
|
our failure to comply with the financial or other covenants in our credit agreement or the indentures governing our outstanding notes;
|
|
•
|
the sufficiency of our funds on hand to pay the amounts due upon conversion or maturity of our outstanding notes;
|
|
•
|
the failure of a state in which we operate to renew its federal Medicaid waiver;
|
|
•
|
changes generally affecting the managed care or Medicaid management information systems industries;
|
|
•
|
increases in government surcharges, taxes, and assessments, including but not limited to the deductibility of certain compensation costs;
|
|
•
|
newly emergent viruses or widespread epidemics, public catastrophes or terrorist attacks, and associated public alarm; and
|
|
•
|
increasing competition and consolidation in the Medicaid industry.
|
|
|
Three Months Ended March 31,
|
||||||
|
|
2017
|
|
2016
|
||||
|
|
(Dollar amounts in millions, except per-share amounts)
|
||||||
|
Net income
|
$
|
77
|
|
|
$
|
24
|
|
|
Net income per diluted share
|
$
|
1.37
|
|
|
$
|
0.43
|
|
|
MCR
(1)
|
88.4
|
%
|
|
89.8
|
%
|
||
|
G&A ratio
(2)
|
8.9
|
%
|
|
7.8
|
%
|
||
|
Premium tax ratio
(1)
|
2.3
|
%
|
|
2.6
|
%
|
||
|
Effective tax rate
|
41.6
|
%
|
|
61.7
|
%
|
||
|
Net profit margin
(2)
|
1.6
|
%
|
|
0.6
|
%
|
||
|
Net profit margin excluding acquisition termination fee
(2)
|
0.6
|
%
|
|
0.6
|
%
|
||
|
EBITDA*
|
$
|
203
|
|
|
$
|
126
|
|
|
Adjusted net income*
|
$
|
83
|
|
|
$
|
29
|
|
|
Adjusted net income per diluted share*
|
$
|
1.47
|
|
|
$
|
0.51
|
|
|
(1)
|
MCR represents medical care costs as a percentage of premium revenue; premium tax ratio represents premium tax expenses as a percentage of premium revenue plus premium tax revenue.
|
|
(2)
|
G&A ratio represents general and administrative expenses as a percentage of total revenue. Net profit margin represents net income as a percentage of total revenue. Net profit margin excluding acquisition termination fee represents net income excluding the acquisition termination fee (net of income taxes at our blended federal and state statutory tax rate of 37%), as a percentage of total revenue.
|
|
•
|
As previously reported, we received a payment of
$75 million
relating to the termination of a proposed Medicare acquisition, which was recorded as other income in the first quarter of 2017.
|
|
•
|
The performance of our Marketplace program was consistent with management’s expectations.
See below for further discussion regarding Marketplace premium deficiency reserves.
|
|
•
|
The performance of our combined Medicaid and Medicare programs was consistent with management’s expectations, with the exception of the unfavorable prior-period development of medical claims liabilities in Illinois discussed below.
|
|
•
|
The G&A ratio was
8.9%
in the first quarter
of
2017
, compared with
7.8%
in the first quarter of
2016
.
|
|
•
|
The effective tax rate in the first quarter of 2017, while consistent with our previously announced full year 2017 Outlook, dropped substantially from prior year levels due primarily to the 2017 HIF moratorium.
|
|
|
|
|
|
|
|
Premium Revenue
|
|
|
|
|
|||
|
|
|
|
|
Membership as of
|
|
Three Months Ended
|
|
Anticipated
|
|||||
|
State Health Plan
|
|
Medicaid Program(s)
|
|
March 31, 2017
|
|
March 31, 2017
|
|
Award Date
|
|
Effective Date
|
|||
|
Florida
|
|
All
|
|
358,000
|
|
|
$
|
356
|
|
|
Q1 2018
|
|
1/1/2019
|
|
Illinois
|
|
All
|
|
189,000
|
|
|
92
|
|
|
Q3 2017
|
|
1/1/2018
|
|
|
New Mexico
|
|
All
|
|
236,000
|
|
|
297
|
|
|
Q1 2018
|
|
1/1/2019
|
|
|
Puerto Rico
|
|
All
|
|
326,000
|
|
|
183
|
|
|
Unknown
|
|
7/1/2018
|
|
|
Texas
|
|
ABD
|
|
86,000
|
|
|
347
|
|
|
Q4 2017
|
|
1/1/2019
|
|
|
Texas
|
|
CHIP
|
|
26,000
|
|
|
10
|
|
|
Q4 2017
|
|
9/1/2018
|
|
|
Washington
|
|
All - North Central Region
|
|
40,000
|
|
|
24
|
|
|
Q2 2017
|
|
1/1/2018
|
|
|
|
Three Months Ended March 31,
|
||||||
|
|
2017
|
|
2016
|
||||
|
|
(In millions)
|
||||||
|
Segment gross margin:
|
|
|
|
||||
|
Health Plans medical margin
(1)
|
$
|
537
|
|
|
$
|
407
|
|
|
Molina Medicaid Solutions service margin
(2)
|
4
|
|
|
6
|
|
||
|
Other
(2)
|
5
|
|
|
7
|
|
||
|
Total segment gross margin
|
546
|
|
|
420
|
|
||
|
Other operating revenues
(3)
|
125
|
|
|
208
|
|
||
|
Other operating expenses
(4)
|
(589
|
)
|
|
(539
|
)
|
||
|
Operating income
|
82
|
|
|
89
|
|
||
|
Other (income) expenses, net
|
(49
|
)
|
|
25
|
|
||
|
Income before income tax expense
|
131
|
|
|
64
|
|
||
|
Income tax expense
|
54
|
|
|
40
|
|
||
|
Net income
|
$
|
77
|
|
|
$
|
24
|
|
|
(1)
|
Represents premium revenue minus medical care costs.
|
|
(2)
|
Represents service revenue minus cost of service revenue.
|
|
(3)
|
Other operating revenues include premium tax revenue, health insurer fee revenue, investment income and other revenue.
|
|
(4)
|
Other operating expenses include general and administrative expenses, premium tax expenses, health insurer fee expenses and depreciation and amortization.
|
|
|
March 31,
2017 |
|
December 31,
2016 |
|
March 31,
2016 |
|||
|
Ending Membership by Program:
|
|
|
|
|
|
|||
|
Temporary Assistance for Needy Families (TANF) and Children’s Health Insurance Program (CHIP)
|
2,548,000
|
|
|
2,536,000
|
|
|
2,485,000
|
|
|
Marketplace
|
1,035,000
|
|
|
526,000
|
|
|
630,000
|
|
|
Medicaid Expansion
|
684,000
|
|
|
673,000
|
|
|
632,000
|
|
|
Aged, Blind or Disabled (ABD)
|
401,000
|
|
|
396,000
|
|
|
380,000
|
|
|
Medicare-Medicaid Plan (MMP) – Integrated
(1)
|
55,000
|
|
|
51,000
|
|
|
50,000
|
|
|
Medicare Special Needs Plans (Medicare)
|
43,000
|
|
|
45,000
|
|
|
43,000
|
|
|
|
4,766,000
|
|
|
4,227,000
|
|
|
4,220,000
|
|
|
Ending Membership by Health Plan:
|
|
|
|
|
|
|||
|
California
|
765,000
|
|
|
683,000
|
|
|
676,000
|
|
|
Florida
|
711,000
|
|
|
553,000
|
|
|
576,000
|
|
|
Illinois
|
194,000
|
|
|
195,000
|
|
|
206,000
|
|
|
Michigan
|
417,000
|
|
|
391,000
|
|
|
399,000
|
|
|
New Mexico
|
270,000
|
|
|
254,000
|
|
|
246,000
|
|
|
New York
(2)
|
34,000
|
|
|
35,000
|
|
|
—
|
|
|
Ohio
|
351,000
|
|
|
332,000
|
|
|
336,000
|
|
|
Puerto Rico
|
326,000
|
|
|
330,000
|
|
|
339,000
|
|
|
South Carolina
|
111,000
|
|
|
109,000
|
|
|
102,000
|
|
|
Texas
|
493,000
|
|
|
337,000
|
|
|
380,000
|
|
|
Utah
|
172,000
|
|
|
146,000
|
|
|
151,000
|
|
|
Washington
|
785,000
|
|
|
736,000
|
|
|
672,000
|
|
|
Wisconsin
|
137,000
|
|
|
126,000
|
|
|
137,000
|
|
|
|
4,766,000
|
|
|
4,227,000
|
|
|
4,220,000
|
|
|
(1)
|
MMP members receive both Medicaid and Medicare coverage from Molina Healthcare.
|
|
(2)
|
The New York health plan was acquired on August 1, 2016.
|
|
|
PMPM Premiums
|
||||||||||
|
|
Low
|
|
High
|
|
Consolidated
|
||||||
|
TANF and CHIP
|
$
|
120.00
|
|
|
$
|
320.00
|
|
|
$
|
180.00
|
|
|
Marketplace
|
150.00
|
|
|
450.00
|
|
|
260.00
|
|
|||
|
Medicaid Expansion
|
310.00
|
|
|
520.00
|
|
|
400.00
|
|
|||
|
ABD
|
360.00
|
|
|
1,510.00
|
|
|
1,010.00
|
|
|||
|
MMP – Integrated
|
1,100.00
|
|
|
3,240.00
|
|
|
2,090.00
|
|
|||
|
Medicare
|
840.00
|
|
|
1,200.00
|
|
|
1,070.00
|
|
|||
|
|
Three Months Ended March 31, 2017
|
||||||||||||||||||||||||
|
|
Member
Months
(1)
|
|
Premium Revenue
|
|
Medical Care Costs
|
|
MCR
(2)
|
|
Medical Margin
|
||||||||||||||||
|
|
|
Total
|
|
PMPM
|
|
Total
|
|
PMPM
|
|
|
|||||||||||||||
|
TANF and CHIP
|
7.7
|
|
|
$
|
1,402
|
|
|
$
|
182.69
|
|
|
$
|
1,304
|
|
|
$
|
170.02
|
|
|
93.1
|
%
|
|
$
|
98
|
|
|
Medicaid Expansion
|
2.0
|
|
|
817
|
|
|
398.70
|
|
|
689
|
|
|
336.51
|
|
|
84.4
|
|
|
128
|
|
|||||
|
ABD
|
1.2
|
|
|
1,196
|
|
|
1,006.84
|
|
|
1,130
|
|
|
951.32
|
|
|
94.5
|
|
|
66
|
|
|||||
|
Total Medicaid
|
10.9
|
|
|
3,415
|
|
|
312.98
|
|
|
3,123
|
|
|
286.35
|
|
|
91.5
|
|
|
292
|
|
|||||
|
MMP
|
0.2
|
|
|
344
|
|
|
2,088.96
|
|
|
307
|
|
|
1,859.41
|
|
|
89.0
|
|
|
37
|
|
|||||
|
Medicare
|
0.1
|
|
|
138
|
|
|
1,068.20
|
|
|
117
|
|
|
902.67
|
|
|
84.5
|
|
|
21
|
|
|||||
|
Total Medicare
|
0.3
|
|
|
482
|
|
|
1,640.63
|
|
|
424
|
|
|
1,439.20
|
|
|
87.7
|
|
|
58
|
|
|||||
|
Excluding Marketplace
|
11.2
|
|
|
3,897
|
|
|
347.84
|
|
|
3,547
|
|
|
316.62
|
|
|
91.0
|
|
|
350
|
|
|||||
|
Marketplace
|
2.9
|
|
|
751
|
|
|
262.16
|
|
|
564
|
|
|
196.72
|
|
|
75.0
|
|
|
187
|
|
|||||
|
|
14.1
|
|
|
$
|
4,648
|
|
|
$
|
330.39
|
|
|
$
|
4,111
|
|
|
$
|
292.20
|
|
|
88.4
|
%
|
|
$
|
537
|
|
|
|
Three Months Ended March 31, 2016
|
||||||||||||||||||||||||
|
|
Member
Months
(1)
|
|
Premium Revenue
|
|
Medical Care Costs
|
|
MCR
(2)
|
|
Medical Margin
|
||||||||||||||||
|
|
|
Total
|
|
PMPM
|
|
Total
|
|
PMPM
|
|
|
|||||||||||||||
|
TANF and CHIP
|
7.4
|
|
|
$
|
1,324
|
|
|
$
|
178.47
|
|
|
$
|
1,198
|
|
|
$
|
161.46
|
|
|
90.5
|
%
|
|
$
|
126
|
|
|
Medicaid Expansion
|
1.9
|
|
|
679
|
|
|
365.11
|
|
|
574
|
|
|
308.30
|
|
|
84.4
|
|
|
105
|
|
|||||
|
ABD
|
1.2
|
|
|
1,112
|
|
|
961.49
|
|
|
1,041
|
|
|
899.79
|
|
|
93.6
|
|
|
71
|
|
|||||
|
Total Medicaid
|
10.5
|
|
|
3,115
|
|
|
298.51
|
|
|
2,813
|
|
|
269.42
|
|
|
90.3
|
|
|
302
|
|
|||||
|
MMP
|
0.1
|
|
|
340
|
|
|
2,220.68
|
|
|
317
|
|
|
2,070.23
|
|
|
93.2
|
|
|
23
|
|
|||||
|
Medicare
|
0.1
|
|
|
131
|
|
|
1,029.10
|
|
|
124
|
|
|
980.49
|
|
|
95.3
|
|
|
7
|
|
|||||
|
Total Medicare
|
0.2
|
|
|
471
|
|
|
1,681.57
|
|
|
441
|
|
|
1,577.21
|
|
|
93.8
|
|
|
30
|
|
|||||
|
Excluding Marketplace
|
10.7
|
|
|
3,586
|
|
|
334.62
|
|
|
3,254
|
|
|
303.59
|
|
|
90.7
|
|
|
332
|
|
|||||
|
Marketplace
|
1.6
|
|
|
409
|
|
|
251.85
|
|
|
334
|
|
|
205.86
|
|
|
81.7
|
|
|
75
|
|
|||||
|
|
12.3
|
|
|
$
|
3,995
|
|
|
$
|
323.73
|
|
|
$
|
3,588
|
|
|
$
|
290.74
|
|
|
89.8
|
%
|
|
$
|
407
|
|
|
(1)
|
A member month is defined as the aggregate of each month’s ending membership for the period presented.
|
|
(2)
|
“MCR” represents medical costs as a percentage of premium revenue.
|
|
|
Three Months Ended March 31, 2017
|
||||||||||||||||||||||||
|
|
Member
Months
|
|
Premium Revenue
|
|
Medical Care Costs
|
|
MCR
|
|
Medical Margin
|
||||||||||||||||
|
|
|
Total
|
|
PMPM
|
|
Total
|
|
PMPM
|
|
|
|||||||||||||||
|
California
|
2.2
|
|
|
$
|
644
|
|
|
$
|
286.92
|
|
|
$
|
510
|
|
|
$
|
227.19
|
|
|
79.2
|
%
|
|
$
|
134
|
|
|
Florida
|
2.1
|
|
|
656
|
|
|
316.86
|
|
|
558
|
|
|
269.33
|
|
|
85.0
|
|
|
98
|
|
|||||
|
Illinois
|
0.6
|
|
|
161
|
|
|
276.58
|
|
|
180
|
|
|
310.08
|
|
|
112.1
|
|
|
(19
|
)
|
|||||
|
Michigan
|
1.3
|
|
|
393
|
|
|
316.80
|
|
|
339
|
|
|
273.36
|
|
|
86.3
|
|
|
54
|
|
|||||
|
New Mexico
|
0.8
|
|
|
330
|
|
|
406.90
|
|
|
318
|
|
|
392.72
|
|
|
96.5
|
|
|
12
|
|
|||||
|
New York
(1)
|
0.1
|
|
|
46
|
|
|
441.19
|
|
|
42
|
|
|
409.63
|
|
|
92.8
|
|
|
4
|
|
|||||
|
Ohio
|
1.1
|
|
|
541
|
|
|
516.00
|
|
|
479
|
|
|
457.14
|
|
|
88.6
|
|
|
62
|
|
|||||
|
Puerto Rico
|
1.0
|
|
|
183
|
|
|
186.51
|
|
|
165
|
|
|
168.18
|
|
|
90.2
|
|
|
18
|
|
|||||
|
South Carolina
|
0.3
|
|
|
105
|
|
|
317.07
|
|
|
98
|
|
|
293.34
|
|
|
92.5
|
|
|
7
|
|
|||||
|
Texas
|
1.4
|
|
|
684
|
|
|
486.96
|
|
|
602
|
|
|
428.55
|
|
|
88.0
|
|
|
82
|
|
|||||
|
Utah
|
0.5
|
|
|
134
|
|
|
264.73
|
|
|
123
|
|
|
242.57
|
|
|
91.6
|
|
|
11
|
|
|||||
|
Washington
|
2.3
|
|
|
642
|
|
|
274.74
|
|
|
581
|
|
|
248.40
|
|
|
90.4
|
|
|
61
|
|
|||||
|
Wisconsin
|
0.4
|
|
|
127
|
|
|
311.30
|
|
|
108
|
|
|
264.53
|
|
|
85.0
|
|
|
19
|
|
|||||
|
Other
(2)
|
—
|
|
|
2
|
|
|
—
|
|
|
8
|
|
|
—
|
|
|
—
|
|
|
(6
|
)
|
|||||
|
|
14.1
|
|
|
$
|
4,648
|
|
|
$
|
330.39
|
|
|
$
|
4,111
|
|
|
$
|
292.20
|
|
|
88.4
|
%
|
|
$
|
537
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
|
Three Months Ended March 31, 2016
|
||||||||||||||||||||||||
|
|
Member
Months
|
|
Premium Revenue
|
|
Medical Care Costs
|
|
MCR
|
|
Medical Margin
|
||||||||||||||||
|
|
|
Total
|
|
PMPM
|
|
Total
|
|
PMPM
|
|
|
|||||||||||||||
|
California
|
2.0
|
|
|
$
|
541
|
|
|
$
|
273.42
|
|
|
$
|
469
|
|
|
$
|
236.92
|
|
|
86.7
|
%
|
|
$
|
72
|
|
|
Florida
|
1.6
|
|
|
489
|
|
|
295.42
|
|
|
413
|
|
|
249.45
|
|
|
84.4
|
|
|
76
|
|
|||||
|
Illinois
|
0.6
|
|
|
149
|
|
|
267.10
|
|
|
132
|
|
|
236.76
|
|
|
88.6
|
|
|
17
|
|
|||||
|
Michigan
|
1.2
|
|
|
387
|
|
|
320.14
|
|
|
347
|
|
|
287.34
|
|
|
89.8
|
|
|
40
|
|
|||||
|
New Mexico
|
0.7
|
|
|
336
|
|
|
449.52
|
|
|
296
|
|
|
394.77
|
|
|
87.8
|
|
|
40
|
|
|||||
|
New York
(1)
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|||||
|
Ohio
|
1.0
|
|
|
488
|
|
|
489.14
|
|
|
449
|
|
|
450.11
|
|
|
92.0
|
|
|
39
|
|
|||||
|
Puerto Rico
|
1.0
|
|
|
181
|
|
|
176.85
|
|
|
174
|
|
|
170.43
|
|
|
96.4
|
|
|
7
|
|
|||||
|
South Carolina
|
0.3
|
|
|
84
|
|
|
275.97
|
|
|
67
|
|
|
220.78
|
|
|
80.0
|
|
|
17
|
|
|||||
|
Texas
|
1.1
|
|
|
620
|
|
|
580.81
|
|
|
575
|
|
|
538.91
|
|
|
92.8
|
|
|
45
|
|
|||||
|
Utah
|
0.4
|
|
|
114
|
|
|
264.62
|
|
|
102
|
|
|
235.88
|
|
|
89.1
|
|
|
12
|
|
|||||
|
Washington
|
2.0
|
|
|
506
|
|
|
255.41
|
|
|
458
|
|
|
231.18
|
|
|
90.5
|
|
|
48
|
|
|||||
|
Wisconsin
|
0.4
|
|
|
97
|
|
|
250.36
|
|
|
92
|
|
|
238.01
|
|
|
95.1
|
|
|
5
|
|
|||||
|
Other
(2)
|
—
|
|
|
3
|
|
|
—
|
|
|
14
|
|
|
—
|
|
|
—
|
|
|
(11
|
)
|
|||||
|
|
12.3
|
|
|
$
|
3,995
|
|
|
$
|
323.73
|
|
|
$
|
3,588
|
|
|
$
|
290.74
|
|
|
89.8
|
%
|
|
$
|
407
|
|
|
(1)
|
The New York health plan was acquired on August 1, 2016.
|
|
(2)
|
“Other” medical care costs include primarily medically related administrative costs of the parent company, and direct delivery costs.
|
|
|
Three Months Ended March 31,
|
||||||||||||||||||||
|
|
2017
|
|
2016
|
||||||||||||||||||
|
|
Amount
|
|
PMPM
|
|
% of Total
|
|
Amount
|
|
PMPM
|
|
% of Total
|
||||||||||
|
Fee for service
|
$
|
3,086
|
|
|
$
|
219.32
|
|
|
75.1
|
%
|
|
$
|
2,737
|
|
|
$
|
221.77
|
|
|
76.3
|
%
|
|
Pharmacy
|
616
|
|
|
43.76
|
|
|
15.0
|
|
|
525
|
|
|
42.53
|
|
|
14.6
|
|
||||
|
Capitation
|
324
|
|
|
23.06
|
|
|
7.9
|
|
|
295
|
|
|
23.87
|
|
|
8.2
|
|
||||
|
Direct delivery
|
22
|
|
|
1.58
|
|
|
0.5
|
|
|
16
|
|
|
1.34
|
|
|
0.5
|
|
||||
|
Other
|
63
|
|
|
4.48
|
|
|
1.5
|
|
|
15
|
|
|
1.23
|
|
|
0.4
|
|
||||
|
|
$
|
4,111
|
|
|
$
|
292.20
|
|
|
100.0
|
%
|
|
$
|
3,588
|
|
|
$
|
290.74
|
|
|
100.0
|
%
|
|
|
||||
|
|
||||
|
|
Three Months Ended March 31,
|
||||||||||
|
|
2017
|
|
2016
|
|
Change
|
||||||
|
|
(In millions)
|
||||||||||
|
Net cash provided by operating activities
|
$
|
719
|
|
|
$
|
139
|
|
|
$
|
580
|
|
|
Net cash used in investing activities
|
(339
|
)
|
|
(314
|
)
|
|
(25
|
)
|
|||
|
Net cash (used in) provided by financing activities
|
(1
|
)
|
|
2
|
|
|
(3
|
)
|
|||
|
Net increase (decrease) in cash and cash equivalents
|
$
|
379
|
|
|
$
|
(173
|
)
|
|
$
|
552
|
|
|
•
|
Health Plans segment medical claims and benefits payable
. Refer to Notes to Consolidated Financial Statements, Note
6
, “
Medical Claims and Benefits Payable
,” for a table that presents the components of the change in medical claims and benefits payable, and for additional information regarding the factors used to determine our changes in estimates for all periods presented in the accompanying consolidated financial statements. Other than the discussion as noted above, there have been no significant changes during the
three months ended March 31, 2017
, to our disclosure reported in “Critical Accounting Estimates” in our Annual Report on Form 10-K for the year ended
December 31, 2016
.
|
|
•
|
Health Plans segment contractual provisions that may adjust or limit revenue or profit
. For a discussion of this topic, including amounts recorded in our consolidated financial statements, refer to Notes to Consolidated Financial Statements, Note
2
, “
Significant Accounting Policies
.”
|
|
•
|
Health Plans segment quality incentives
. For a discussion of this topic, including amounts recorded in our consolidated financial statements, refer to Notes to Consolidated Financial Statements, Note
2
, “
Significant Accounting Policies
.”
|
|
•
|
Molina Medicaid Solutions segment revenue and cost recognition
. There have been no significant changes during the
three months ended March 31, 2017
, to our disclosure reported in “Critical Accounting Estimates” in our Annual Report on Form 10-K for the year ended
December 31, 2016
.
|
|
•
|
Goodwill and intangible assets, net.
There have been no significant changes during the
three months ended March 31, 2017
, to our disclosure reported in “Critical Accounting Estimates” in our Annual Report on Form 10-K for the year ended
December 31, 2016
.
|
|
|
Three Months Ended March 31,
|
||||||
|
2017
|
|
2016
|
|||||
|
|
(In millions)
|
||||||
|
Net income
|
$
|
77
|
|
|
$
|
24
|
|
|
Adjustments:
|
|
|
|
||||
|
Depreciation, and amortization of intangible assets and capitalized software
|
46
|
|
|
37
|
|
||
|
Interest expense
|
26
|
|
|
25
|
|
||
|
Income tax expense
|
54
|
|
|
40
|
|
||
|
EBITDA*
|
$
|
203
|
|
|
$
|
126
|
|
|
|
Three Months Ended March 31,
|
||||||||||||||
|
2017
|
|
2016
|
|||||||||||||
|
|
(In millions, except diluted per-share amounts)
|
||||||||||||||
|
Net income
|
$
|
77
|
|
|
$
|
1.37
|
|
|
$
|
24
|
|
|
$
|
0.43
|
|
|
Adjustment:
|
|
|
|
|
|
|
|
||||||||
|
Amortization of intangible assets
|
9
|
|
|
0.16
|
|
|
7
|
|
|
0.13
|
|
||||
|
Income tax effect
(1)
|
(3
|
)
|
|
(0.06
|
)
|
|
(2
|
)
|
|
(0.05
|
)
|
||||
|
Amortization of intangible assets, net of tax effect
|
6
|
|
|
0.10
|
|
|
5
|
|
|
0.08
|
|
||||
|
Adjusted net income*
|
$
|
83
|
|
|
$
|
1.47
|
|
|
$
|
29
|
|
|
$
|
0.51
|
|
|
(1)
|
Income tax effect of adjustments calculated at the blended federal and state statutory tax rate of 37%.
|
|
|
Total Number
of Shares
Purchased
(1)
|
|
Average Price
Paid per Share
|
|
Total Number of Shares
Purchased as Part of
Publicly
Announced
Plans or
Programs
|
|
Approximate
Dollar Value
of Shares Authorized to Be Purchased Under the Plans or Programs
|
||||||
|
January 1 - January 31
|
14,147
|
|
|
$
|
58.47
|
|
|
—
|
|
|
$
|
—
|
|
|
February 1 - February 28
|
511
|
|
|
$
|
57.42
|
|
|
—
|
|
|
$
|
—
|
|
|
March 1 - March 31
|
114,777
|
|
|
$
|
49.10
|
|
|
—
|
|
|
$
|
—
|
|
|
Total
|
129,435
|
|
|
$
|
50.16
|
|
|
—
|
|
|
|
||
|
(1)
|
During the
three months ended March 31, 2017
, we withheld
129,435
shares of common stock under our 2011 Equity Incentive Plan to settle employee income tax obligations.
|
|
Exhibit No.
|
|
Title
|
|
|
|
|
|
|
||
|
|
|
|
|
|
||
|
|
|
|
|
|
||
|
|
|
|
|
|
||
|
|
|
|
|
|
||
|
|
|
|
|
|
||
|
|
|
|
|
|
||
|
|
|
|
|
101.INS
|
|
XBRL Taxonomy Instance Document.
|
|
|
|
|
|
101.SCH
|
|
XBRL Taxonomy Extension Schema Document.
|
|
|
|
|
|
101.CAL
|
|
XBRL Taxonomy Extension Calculation Linkbase Document.
|
|
|
|
|
|
101.DEF
|
|
XBRL Taxonomy Extension Definition Linkbase Document.
|
|
|
|
|
|
101.LAB
|
|
XBRL Taxonomy Extension Label Linkbase Document.
|
|
|
|
|
|
101.PRE
|
|
XBRL Taxonomy Extension Presentation Linkbase Document.
|
|
|
|
|
MOLINA HEALTHCARE, INC.
|
|
|
|
|
(Registrant)
|
|
|
|
|
|
|
Dated:
|
May 4, 2017
|
|
/s/ JOSEPH W. WHITE
|
|
|
|
|
Joseph W. White
|
|
|
|
|
Interim Chief Executive Officer
|
|
|
|
|
(Principal Executive Officer)
|
|
|
|
|
|
|
Dated:
|
May 4, 2017
|
|
/s/ JOSEPH W. WHITE
|
|
|
|
|
Joseph W. White
|
|
|
|
|
Chief Financial Officer and Treasurer
|
|
|
|
|
(Principal Financial Officer)
|
No information found
* THE VALUE IS THE MARKET VALUE AS OF THE LAST DAY OF THE QUARTER FOR WHICH THE 13F WAS FILED.
| FUND | NUMBER OF SHARES | VALUE ($) | PUT OR CALL |
|---|
| DIRECTORS | AGE | BIO | OTHER DIRECTOR MEMBERSHIPS |
|---|
No information found
No Customers Found
No Suppliers Found
Price
Yield
| Owner | Position | Direct Shares | Indirect Shares |
|---|