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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
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FORM 10-K
FOR ANNUAL AND TRANSITION REPORTS PURSUANT TO SECTIONS 13 OR 15(d) OF THE
SECURITIES EXCHANGE ACT OF 1934
(MARK ONE)
[X] ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE
SECURITIES EXCHANGE ACT OF 1934
FOR THE FISCAL YEAR ENDED DECEMBER 31, 1999
OR
[ ] TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE
SECURITIES EXCHANGE ACT OF 1934
FOR THE TRANSITION PERIOD FROM ( TO )
COMMISSION FILE NUMBER: 333-2796
CERULEAN COMPANIES, INC.
(EXACT NAME OF REGISTRANT AS SPECIFIED IN ITS CHARTER)
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GEORGIA 58-2217138
(STATE OR OTHER JURISDICTION OF INCORPORATION
OR ORGANIZATION) (I.R.S. EMPLOYER IDENTIFICATION NO.)
3350 PEACHTREE ROAD, N.E., ATLANTA, GEORGIA 30326
(ADDRESS OF PRINCIPAL EXECUTIVE OFFICES) (ZIP CODE)
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(404) 842-8000
(REGISTRANT'S TELEPHONE NUMBER, INCLUDING AREA CODE)
Securities registered pursuant to Section 12(b) of the Act: None
Securities registered pursuant to Section 12(g) of the Act: Class A
Convertible Common Stock, no par value
Indicate by check mark whether the registrant (1) has filed all reports
required to be filed by Section 13 or 15(d) of the Securities Exchange Act of
1934 during the preceding 12 months (or for such shorter period that the
registrant was required to file such reports), and (2) has been subject to such
filing requirements for the past 90 days. Yes [X] No [ ]
Indicate by check mark if disclosure of delinquent filers pursuant to Item
405 of Regulation S-K is not contained herein, and will not be contained, to the
best of registrant's knowledge, in definitive proxy or information statements
incorporated by reference in Part III of this Form 10-K or any amendment to this
Form 10-K. [X]
The aggregate market value of the Class A Convertible Common Stock and Class
B Convertible Preferred Stock (voting stock) held by non-affiliates of the
registrant as of March 29, 2000: The Class A Convertible Common Stock and the
Class B Convertible Preferred Stock are not traded.
The number of shares of the registrant's Class A Convertible Common Stock,
no par value, $0.01 stated value, outstanding as of February 29, 2000 was
409,602.
DOCUMENTS INCORPORATED BY REFERENCE
Exhibits to Forms S-1, Registration No. 333-2796, effective May 14, 1996 and
subsequent amendments are incorporated by reference into Part IV -- Item 14 of
this Form 10-K.
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CERULEAN COMPANIES, INC.
TABLE OF CONTENTS
FOR THE YEAR ENDED DECEMBER 31, 1999
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PART I
Item 1 Business.................................................... 1
Item 2 Properties.................................................. 14
Item 3 Legal Proceedings........................................... 14
Item 4 Submission of Matters to a Vote of Security Holders......... 16
PART II
Item 5 Market for the Registrant's Common Equity and Related 17
Stockholder Matters.........................................
Item 6 Selected Financial Data..................................... 17
Item 7 Management's Discussion and Analysis of Financial Condition 19
and Results of Operations...................................
Item 7A Quantitative and Qualitative Disclosures About Market 24
Risk........................................................
Item 8 Financial Statements and Supplementary Data................. 25
Item 9 Changes In and Disagreements with Accountants on Accounting 25
and Financial Disclosure....................................
PART III
Item 10 Directors and Executive Officers of the Registrant.......... 26
Item 11 Executive Compensation...................................... 33
Item 12 Security Ownership of Certain Beneficial Owners and 42
Management..................................................
Item 13 Certain Relationships and Related Transactions.............. 43
PART IV
Item 14 Exhibits, Financial Statement Schedules and Reports on Form 44
8-K.........................................................
Signatures............................................................. 47
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Forward-Looking Statements
The matters discussed in this Form 10-K contain certain forward-looking
statements made pursuant to the safe harbor provisions of Section 27A of the
Securities Act, and Section 21E of the Exchange Act, that represent the
Company's expectations or beliefs including, without limitation, statements
concerning future revenue, future investment earnings and value and certain Year
2000 information. Such statements involve risk and uncertainties that may cause
actual results to differ materially from those implied in this Form 10-K. Among
other things, these risks and uncertainties include: the need to accurately
predict health care costs and the ability to control future health care costs
through product and benefit design, underwriting criteria, utilization
management and negotiation of favorable provider and hospital contracts; changes
in mandated benefits, utilization rates, demographic characteristics, health
care practices, inflation, new pharmaceuticals and technologies, clusters of
high-cost cases, response to the regulatory environment and numerous other
factors that are beyond the Company's control and may adversely affect is
ability to predict and control health care costs and claims; periodic
renegotiation of hospital and other provider contracts coupled with continued
consolidation of physician, hospital and other provider groups which may result
in increased health care costs, limit the Company's ability to negotiate
favorable rates and control costs and subject the Company to increased credit
risk or risks of network stability related to provider groups; competitive
pressure to contain premium prices; fiscal concerns regarding the continued
viability of government-sponsored programs such as Medicare and the potential of
decreasing reimbursement rates for these programs; and any other limitations on
the Company's ability to increase or maintain its premium levels, design
products, select underwriting criteria or negotiate competitive provider
contracts. Other risk factors are described in the Company's Security and
Exchange Commission reports and filings.
PART I
ITEM 1. BUSINESS
THE COMPANY
Cerulean Companies, Inc. (the "Company") was incorporated under the laws of
the State of Georgia on February 2, 1996 to act as the holding company for Blue
Cross and Blue Shield of Georgia, Inc. ("BCBSGA") and its subsidiaries and for
other lawful purposes. BCBSGA was established in 1937 and through a series of
business combinations and subsidiary operations had, by 1985, and has currently,
the largest health insurance company market share in Georgia. As of December 31,
1999, BCBSGA and HMO Georgia, Inc. ("HMO-Ga"), the Company's health maintenance
organization subsidiary, had 873,000 insurance and administrative service
contracts covering or administering benefits for approximately 1.7 million
members. This represents more than 22% of the total Georgia population and
includes approximately 46% of the over 3.7 million residents of the metropolitan
Atlanta area.
THE CONVERSION
On February 2, 1996, the Company acquired all of the outstanding capital
stock of BCBSGA, following BCBSGA's conversion from a not-for-profit corporation
to a for-profit corporation, pursuant to a Plan of Conversion approved by the
Commissioner of Insurance of the State of Georgia (the "Georgia Commissioner")
on December 27, 1995 (the "Conversion"). As a part of the Conversion, the
Company agreed to offer to each of BCBSGA's eligible subscribers five shares of
its Class A Convertible Common Stock, no par value (the "Class A Stock"), at no
cost. Upon completion of the offering, eligible subscribers accepted 351,545
shares of no par value Class A Stock. The registration of the Class A Stock
became effective under the Securities Act of 1933, as amended (the "Securities
Act") and under Section 12(g) of the Securities Exchange Act of 1934, as amended
(the "Exchange Act") on May 14, 1996 and June 30, 1997, respectively. As of
February 29, 2000, there were 409,602 shares of Class A Stock outstanding, held
by 70,268 holders. Currently, the Class A Stock is not publicly traded.
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Following the Conversion, the Company issued 49,900 shares of Class B
Convertible Preferred Stock (the "Preferred Stock") to raise $49.9 million in
capital. After deducting offering costs, the net proceeds to the Company were
$46.6 million.
PROPOSED MERGER
On July 9, 1998, the Company entered into an agreement and plan of merger
(the "Merger Agreement") with WellPoint Health Networks Inc. ("WellPoint") and a
subsidiary of WellPoint. As of July 9, 1999, the parties agreed upon an
extension of the Merger Agreement until October 15, 1999 and, under certain
circumstances, December 31, 1999. Effective October 15, 1999, the parties agreed
to extend the Merger Agreement through December 31, 1999. On December 30, 1999,
the parties agreed to further extend the Merger Agreement through December 31,
2000. Pursuant to the Merger Agreement, the Company will become a wholly-owned
subsidiary of WellPoint. On June 25, 1999, the shareholders of the Company
approved the transaction. Finalization of the transaction is subject to, among
other things, the approval of the Georgia Commissioner, the approval of the Blue
Cross and Blue Shield Association ("BCBSA") and certain approvals of the Health
Care Financing Administration ("HCFA"). Upon final disposition of the litigation
commenced by the Richmond County Plaintiffs described further in Item 3, Legal
Proceedings, the Company expects that the Commissioner will schedule a public
hearing. Upon closing the transaction, shareholders of the Company will exchange
their shares for WellPoint shares or cash in a transaction valued at $500
million.
INDUSTRY OVERVIEW
According to the HCFA, health care spending in the U.S. rose from $836.5
billion in 1992 to $1.1 trillion in 1998, an average annual increase of
approximately 5.0%. This rate was considerably more than the average annual
increase of the Consumer Price Index ("CPI") of approximately 2.6% for the same
period. Health care spending accounted for over 13% of the Gross Domestic
Product ("GDP") from 1992 through 1998. On an absolute dollar basis, as well as
on a percentage of GDP basis, the United States spends more on health care than
any other country in the world. Several factors have contributed to the dramatic
increase in health care expenditures, including the aging of the population,
increased use of high-technology treatments and tests, the rising cost of
malpractice insurance and higher operating costs for hospitals, physicians and
other health care providers. Prior to the development of managed health care,
most health insurers offered health care benefit plans known as indemnity, or
fee-for-service plans, which do not typically provide incentives to use
particular providers for the most cost effective care or include other
cost-containment features.
Due to the escalating cost of health care services, customers (both groups
and individuals) began to demand lower cost alternatives to traditional
indemnity insurance plans. Managed health care plans were developed to attempt
to provide access to appropriate health care services in an affordable manner.
Typically, health maintenance organization ("HMO") and preferred provider
organization ("PPO") plans develop networks of health care providers to deliver
health care at favorable rates while participating in quality initiatives
together with utilization management and other cost control measures. An
important factor in controlling costs is the number of members (i.e., enrolled
health care consumers) that a managed care benefit plan can direct to providers.
Under many managed care plans, providers are reimbursed based on either
capitation (a fixed monthly fee per member regardless of frequency of service,
generally used by HMOs for physicians and ancillary medical services such as
laboratory services), a negotiated per diem (daily rates, generally used for
hospitals) or limited fee schedules (generally used for specialty physicians).
Managed health care plans also feature a variety of methods of health care
utilization management. Utilization management programs are designed to
encourage providers to use health care resources effectively.
Different types of health care utilization management and cost control
methods differentiate managed health care plans. HMOs generally require members
to use network providers exclusively, except in emergency cases, and to consult
with a primary care physician prior to obtaining treatment from specialists. In
addition, HMOs generally include capitated payment arrangements with network
providers who charge members only modest copayments. A point of service network
plan ("POS") provides members with an HMO service option for network coverage
and also permits the member, at the time medical service is required, to choose
a provider that is not a member of the HMO network at additional cost. POS plans
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generally require the use of a primary care physician within the network to
coordinate health care services for the members, while PPO plans often do not.
PPO and POS plans also provide members with the option of using non-network
providers under indemnity-type coverage terms which require higher coinsurance
payments by members and higher deductibles. These member payments are generally
limited to an out-of-pocket maximum. Coinsurance and higher deductible
requirements for non-network care in POS and PPO plans are designed to encourage
greater utilization of the network care by members, thereby reducing costs. See
"Business -- Business Lines and Products".
According to a compilation of industry sources, in 1998 the total number of
HMO members nationwide grew by an estimated 15.4 million people, to 104.4
million. Since 1992, HMO enrollment nationally has more than doubled. The
Georgia marketplace is extremely diverse, ranging from the major metropolitan
area of Atlanta with a 1998 population in excess of 3.7 million to several
mid-sized cities to very rural areas. The southern half of the State of Georgia
is primarily rural and dominated by an agrarian economy. The State of Georgia
has an HMO market penetration of only 19%. Based on industry sources, the five
states with the highest HMO penetration in the country at the end of 1998 have
HMO market shares ranging from 55% to 64%. HMO membership in the State of
Georgia for 1998 increased approximately 250% over 1992, at a rate greater than
the rate of growth nationally, due in part to the state's low HMO market
penetration in the 1990s. HMO membership for 1998 in the metropolitan Atlanta
area, where the 1998 HMO market penetration was approximately 40%, increased
more than 231% over 1992, reflecting the increased consumer demand for managed
care plans in the Atlanta area.
The Company's rate of growth in HMO membership exceeded both the national
and state rates of growth, increasing over 1000% for the 1992-1998 period. The
higher rate of growth for the Company is attributable to its growth in HMO
membership specifically in the metropolitan Atlanta area. The Company
experienced a rate of growth in the Atlanta market of over 630% for the
1992-1998 period.
GENERAL
The Company, through its subsidiaries, has the largest health insurance
company market share in Georgia, with 873,000 insurance and administrative
service contracts covering or administering benefits for approximately 1.7
million members as of December 31, 1999 (including HMO, PPO and POS members).
This represents over 22% of the total Georgia population. BCBSGA has one of the
State's largest PPO memberships, serving approximately 417,000 members as of
December 31, 1999. HMO-Ga, a health maintenance organization which also offers
POS products, serves an additional 506,000 members. Greater Georgia Life
Insurance Company, Inc. ("GGL"), a subsidiary of BCBSGA, and GBG, an inactive
subsidiary of the Company, are also part of the consolidated group. GGL offers
group life, accident and disability insurance products that are sold in
conjunction with the Company's health products. GGL has an "A" rating from A.M.
Best and is licensed to offer its products in Alabama, Georgia, Mississippi,
North Carolina, South Carolina, Tennessee and Virginia.
The Company's core business products are its traditional indemnity products
and its HMO, POS and PPO products. The Company's current business strategy
centers around the belief that development of managed care products, with a
strong HMO at the core, represents the most prudent response to current
marketplace demands. In areas where there is no managed care, the Company's
strategy is to solidify market presence through PPO network expansion, favorable
changes in provider reimbursement and benefit design alterations that meet
employers' needs.
The Company offers its traditional indemnity products and its HMO, POS and
PPO products exclusively within the boundaries of the State of Georgia. The
Company and certain of its subsidiaries are licensed by BCBSA to use the Blue
Cross and Blue Shield names and logos only in the State of Georgia. While there
are only limited BCBSA restrictions on the conduct of business by the Company or
its subsidiaries outside the State of Georgia under a different name,
substantially all of the Company's revenue is currently associated with Georgia
business.
BCBSGA and HMO-Ga have a comprehensive quality management program which
focuses on assessment, management and monitoring of inpatient and ancillary
service costs. The quality management
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program monitors, collects data on and evaluates inpatient and outpatient
medical care, inclusive of preventive and mental health services, as well as the
level of customer service provided to members by physicians and other medical
providers. The Company has a disciplined credentialing function which monitors
the recruitment and retention of its provider panels throughout the state.
BCBSGA's PPO was the first preferred provider organization in Georgia to receive
full accreditation from the Utilization Review Accreditation Commission.
Additionally, in 1997, HMO-Ga was awarded a full, three year accreditation by
the National Committee for Quality Assurance ("NCQA"). The NCQA completed its
second accreditation review at the end of February 2000. The Company expects an
accreditation decision to follow within 120 days. The NCQA is a nationwide
organization which evaluates quality assurance programs for HMOs.
At present, HMO-Ga is licensed and operational as an HMO in eight markets
in Georgia representing more than 6.0 million residents, including Atlanta.
HMO-Ga's HMO and POS products are serviced through networks of primary care
physicians, specialist physicians and hospitals. Beginning in January 1995,
HMO-Ga also began supporting its products through Community Health Partnership
Networks ("CHPNs") which are currently operational in three of the eight HMO
market areas of the state.
ORGANIZATIONAL STRUCTURE
The Company's primary operating subsidiaries, BCBSGA and HMO-Ga, are
organized in a Business Unit, Support Unit and Governance Unit structure.
Business Units have responsibility to sell products, at appropriate prices, and
to manage the effective delivery of product benefits at acceptable levels.
Support Units manage the delivery of administrative services to individual or
multiple Business Units within defined cost parameters, while meeting customer
service expectations. The Governance Units establish policy, provide direction
for BCBSGA and HMO-Ga and monitor compliance.
Within the Individual Business Unit, health insurance products are sold to
individuals (or individual families) under age 65, or to persons over age 65 who
are Medicare eligible. Local Market Business Units offer a full line of health
insurance products for employer groups of less than 500 employees. The Major/
National Business Unit offers a full line of health benefit products to employer
groups with 500 or more covered employees and the National Par Business Unit
supports participating plan accounts of Georgia employees of national employers
sold through other Blue Cross and Blue Shield plans.
STRATEGIC INITIATIVES
CHPNs
As a result of concern with rising health care costs and changing trends in
the health care industry, the Company determined to develop its own integrated
delivery systems for managed health care products. The Company's CHPNs are the
cornerstone of this strategy. CHPNs have facilitated the introduction of the
Company's HMO and POS products into new markets which have provided alternatives
to group customer demand for lower cost health care. CHPNs are locally based
equity ventures between the Company and a local physician group and/or hospital,
which own the remaining equity interests in the CHPN. The Company owns at least
51% of the equity interests in each CHPN it has organized, and the local
physician group and/or hospital own the remaining equity interest. Clinical
services are provided by the physician or hospital partners as well as other
providers with which the CHPN maintains contracts, and BCBSGA provides sales,
management and administrative services, including information systems and data
management services through service contracts with the CHPNs. Premium and fee
revenues are received from subscribers by HMO-Ga which retains a flat percentage
for administration and as a contribution to surplus. After deduction for premium
taxes, the remaining premium revenue is used for payment of medical expenses and
for contribution to the CHPN's retained earnings.
The Company has taken several actions to support the CHPNs, including (i)
providing initial and additional capital, (ii) hiring experienced managers to
oversee sales, medical network management and financial performance in the local
markets, (iii) providing dedicated claims processing and membership services,
(iv) developing a strategic information systems plan that addresses the
information requirements, applications needs and systems architecture necessary
to support the CHPNs and (v) enhancing medical
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management activities and continued development of NCQA processes and Health
Plan Employer Data and Information Set ("HEDIS") reporting. Atlanta Healthcare
Partners, Inc. (which operates in the Atlanta metropolitan area and surrounding
counties) was the first CHPN to become operational. At the end of 1999
additional CHPNs, jointly owned by the Company and health care providers, were
also operational in the Augusta and Savannah markets. The Company and the health
care providers that were parties to the CHPNs in the Macon and Athens markets
entered into termination agreements during 1999. The medical cost outcomes under
these two joint venture arrangements were unsatisfactory for the partnership
during the first three years of operation.
Information Technology
The Company's comprehensive multi-year Strategic Information Systems Plan
("SISP") identified the capital, equipment, software and intellectual property
necessary to employ and support traditional kinds of systems effectively in an
evolving managed care and customer service environment. The software
applications and hardware architecture necessary to support the Company's
strategic CHPN business initiative were essential requirements of the SISP.
The Company believes that the information technology strategies employed in
the execution of the SISP have resulted in more efficient interrelated uses of
information both through systems targeted to specific uses and through the use
of networks to deploy solutions company-wide.
Historically, the Company used a mixture of systems and processing
platforms to meet its information requirements. Integral features of the SISP
include a principal software application, GTE's Q/Care product, as modified for
the Company, for claims processing and membership billing; a single hardware
platform for claims processing; client server technology; and an Enterprise Data
Warehouse ("EDW"). At the end of 1999, all of the Company's membership was
processed through the Q/Care system. Remaining predecessor systems were retired
during 1999. The EDW has been operational with medical management and claims
data since December 1997. During 1999, the EDW included membership and premium
revenue data, completing the initial phase of the evolution of the Company's
EDW. With the update to the EDW and the migration of all membership to Q/Care
during 1999, the Company has a technical infrastructure to provide highly
available, reliable and responsive business and clinical systems that will
position the Company to continue to excel in the dynamic health care
marketplace.
The Company also performs paperless claim clearinghouse/electronic data
interchange activities and provides on-line eligibility, claims status and
preauthorization/referral processing options to providers as well as on-line
access by some large employer groups to their eligibility and summary claims
information. Provider and employer on-line functionality has strengthened the
Company's position for health care electronic commerce.
IMPACT OF YEAR 2000
In prior years, the Company discussed the nature and progress of its plans
to become Year 2000 ready. In late 1999, the Company completed its remediation
and testing of systems. As a result of those planning and implementation
efforts, the Company experienced no disruptions in mission critical information
technology and non-information technology systems and believes those systems
successfully responded to the Year 2000 date change. The Company is not aware of
any material problems resulting from Year 2000 issues, either with its products,
its internal systems, or the products and services of third parties. The Company
will continue to monitor its mission critical computer applications and those of
its suppliers and vendors throughout the year 2000 to ensure that any latent
Year 2000 matters that may arise are addressed promptly. In the three years
ended December 31, 1999, the Company expended $19.6 million for Year 2000
readiness costs. Capital expenditures for new hardware and software totaled $8.3
million. Renovation expenses of $11.3 million were expensed when incurred, with
$4.6 million expensed in the 1999 period. These expenditures were funded from
cash flows from operations. See Item 7, "Management's Discussion and Analysis of
Financial Condition and Results of Operations -- Liquidity and Capital
Resources -- Year 2000 Computer Software Readiness."
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BUSINESS LINES AND PRODUCTS
Overview
The Company operates predominantly in one industry segment, health
insurance products and services. As a full service provider of health benefit
programs in the Georgia marketplace, the Company markets life, health and
disability insurance products to employer groups and individuals. The overall
product portfolio available includes standard indemnity insurance, PPO, HMO and
POS health benefits plans, life insurance products and ancillary products
including dental insurance, a vision affinity product, vision insurance and
specialty products for mental health and pharmacy benefits.
Various funding arrangements are available for each health benefit product.
These arrangements range from fully insured to administrative services only
("ASO/Cost Plus"). For example, under a fully insured indemnity arrangement,
BCBSGA assumes the full risk (subject to deductibles and other adjustments) with
direct payment by BCBSGA, generally to the provider. In an ASO/Cost Plus
indemnity arrangement, BCBSGA administers the health insurance program for its
customer and is compensated according to the terms of the contract for its
services by management services fees. The formula for compensation in ASO/Cost
Plus arrangements varies from contract to contract, but conceptually in such
arrangements, BCBSGA receives reimbursement for benefit payments processed and
related management services fees. ASO/Cost Plus funding is generally utilized by
employers with at least 500 covered enrollees. Some employers may choose
individual member or aggregate reinsurance to protect against catastrophic
losses. Additionally, the Company provides access to its provider networks and
other services to employer groups and other third parties under various
management services arrangements.
Shown below is certain information on each of the Company's major product
lines.
PERFORMANCE BY PRODUCT
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Year Ended
AT December 31, 1999
DECEMBER 31, 1999 ------------------------
MEMBERS(1) Premiums Loss Ratio
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($ in Thousands)
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INSURANCE PRODUCTS
Indemnity and PPO................................... 429,257 $ 810,598 88.9%
HMO and POS......................................... 409,426 658,352 86.8%
Life................................................ -- 17,344 50.5%
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Total..................................... 838,683 $1,486,294 87.5%
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MANAGEMENT SERVICES PRODUCTS(2)
Indemnity and PPO networks.......................... 753,592
HMO and POS networks................................ 96,873
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Total..................................... 850,465
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Total -- All Products..................... 1,689,148
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(1) Includes actual membership for HMO and POS products and indemnity and PPO
products with estimates for the FEP program and certain national
participating business.
(2) Revenues for these administrative services arrangements in 1999 totaled
$142.2 million.
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HMO and POS
The Company's HMO product has been offered by HMO-Ga since 1986. From 1986
through 1993, the product did not experience substantial growth. However, in
1993, new management and an increased emphasis on sales of managed care products
dramatically increased the market acceptance of HMO-Ga's products. HMO-Ga's HMO
and POS products are now the Company's fastest growing products. At present,
HMO-Ga is licensed and operational as an HMO in eight separate markets in
Georgia, including Athens, Atlanta, Augusta, Columbus, Gainesville, Macon, Rome
and Savannah, representing more than 6.0 million residents. HMO-Ga's HMO and POS
products are offered to group subscribers as "Blue Choice Healthcare Plan",
which is a prepaid coverage and preventive care product and as "Blue Choice
Option", which is a point-of-service product that allows members to choose
between HMO-Ga network providers and out-of-network providers. Premiums and
management services fees are collected on a monthly basis from employers. Some
employers allow members to elect, at annual enrollment, whether they wish to be
in the "Blue Choice Healthcare Plan" or the "Blue Choice Option".
Under the Company's HMO product, HMO members select a primary care
physician who provides basic medical care for the member pursuant to a contract
with HMO-Ga. The primary care physician coordinates all of the medical and
health care for each HMO member, including physical examinations, specialist
care and hospitalization. Each primary care provider is credentialed and
periodically re-credentialed by the Company to maintain physician network
standards. The primary care physician coordinates with the member and the
Company to assure that contract benefits are delivered in a cost-effective
manner. HMO benefit plans require varying copayments for health care services.
Coverage for non-emergency hospitalization services requires prior approval by
the member's primary care physician and must be provided in network facilities,
except for certain specified services. HMO benefit plans also provide coverage
for preventive treatment and wellness programs. Benefits such as dental
services, pharmacy services and vision care may be purchased as options to the
basic benefit plan with a variety of copayment levels.
Blue Choice Option members are required to use a primary care physician for
basic medical services and pre-certification of specialist services whether
performed by network or non-network providers. Network hospitalization is fully
covered. Non-network services and services obtained without primary care
physician approval are subject to deductibles and significant coinsurance
requirements.
BlueChoice Platinum
HMO-Ga's application to offer a Medicare Risk HMO product in nine counties
within the Atlanta metropolitan statistical area was approved by HCFA in
December 1996. This product, "BlueChoice Platinum" became operational in April
1997 and had over 16,000 members as of December 31, 1999. The individual
BlueChoice Platinum product has no member premium and includes all traditional
Medicare benefits plus preventive services, immunizations, annual vision
screening, annual hearing screening and limited outpatient prescription
coverage. The core benefits of the group BlueChoice Platinum product are those
of the BlueChoice Platinum individual product with additional benefits defined
by each employer.
PPO
The Company's PPO was first introduced in Georgia in the mid-1980's and
began being offered as "Blue Choice PPO" in 1995. The Company's PPO is one of
the three largest statewide provider networks in Georgia, serving approximately
417,000 members as of December 31, 1999.
The Company's PPO products are intended to deliver health care benefits to
employer groups at lower premium costs than traditional indemnity products due
to benefit design, favorable pricing arrangements with network providers and
utilization management and other cost control arrangements with network
providers. The Company introduced its first PPO product for the individual
market in February 1999. At December 31, 1999 there were 26,000 members served
in the PPO individual market. Typically, 80% to 90% of the cost of covered
health care services received by a subscriber through the PPO network is covered
by the Company's PPO benefit plans. Non-network services are generally covered
at 60% to 70%, subject to higher deductible and coinsurance requirements.
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Full coverage for covered services is provided after a member has paid a
specified annual out-of-pocket maximum (coinsurance). The Company offers a broad
range of PPO benefit plans which enables the employer to choose the mix of
benefits that is suited to its employees' needs. Higher deductibles, coinsurance
and out-of-pocket maximums and other financial incentives encourage subscribers
to use network provider services. The Company's PPO also offers preventive
health benefit coverage, such as health assessments, immunizations and prenatal
visits. Premiums and management services fees for the Company's PPO product are
collected monthly from employers.
Indemnity
The Company's traditional indemnity product line includes benefit options
for both the individual and group markets through products that reimburse for
covered health care services on a fee-for-service basis. Premiums and management
services fees are collected on a monthly basis. Traditional indemnity products
may utilize the statewide networks that the Company has established for
physicians, hospitals and pharmacies. The majority of new business opportunities
for traditional indemnity group business are in the rural markets where, the
Company believes, the flexibility of its indemnity products, in terms of
provider access, is an advantage.
The Company's indemnity products are offered to group subscribers as "New
CHIP", the traditional indemnity insurance product with certain managed care
features. Indemnity products are offered to individual subscribers as (i) "Flex
Plus", a comprehensive major medical product for people under age 65, that
provides a full range of benefits related to hospital, surgical, pharmacy and
other associated medical expenses with varying deductible and coinsurance
options, (ii) "hospital/surgical", a lower cost product than "Flex Plus" which
insures only catastrophic non-routine services associated with a more serious
medical condition related to a surgical procedure or inpatient hospital stay and
which is also offered to people under 65 and (iii) "65 PLUS", a guaranteed issue
plan that acts as a supplement to the federally insured Medicare program.
Life Insurance
GGL offers group life and disability products to employers of all sizes and
is licensed to do business in seven states throughout the Southeast although its
revenues are derived primarily from business in the State of Georgia. Term life
insurance is commonly offered with accidental death and dismemberment ("AD&D")
for all groups with less than 100 employees. For larger groups, the life product
may be offered with health insurance. In addition to the standard term life and
AD&D products, GGL also offers a contributory, voluntary life insurance product
as well as a dependent life insurance product. GGL offers a variety of plan
designs and coverage amounts. GGL also offers short-term and long-term
disability insurance.
Ancillary and Specialty Network Benefits
The Company offers a variety of ancillary and specialty network benefits to
enhance the Company's competitive position and is developing other such
products. Offering an array of ancillary products and specialty networks permits
the Company to capitalize on its name recognition and to appeal to employer
groups that are increasingly seeking a variety of benefit options. Currently,
these ancillary and specialty network benefits are offered in conjunction with
the Company's medical benefit plan designs.
The Company has offered dental insurance since 1982. Dental insurance is
typically offered as a benefit enhancement that may be purchased in conjunction
with group products. A number of major commercial carriers and other entities
are offering managed dental care products, although BCBSGA does not currently
offer such a product.
The Company offers vision, mental health/substance abuse and pharmacy
benefits as part of certain of its medical plan designs. These benefits have not
been designed as stand-alone products and are not sold separately from medical
products.
8
<PAGE> 11
MARKETING AND SALES
General
The Company's marketing operations vary depending upon the market at which
sales efforts are directed; individuals (i.e., direct pay), small employer
groups (defined as groups of two to 50 employees), large employer groups
(defined as groups of 50 or more employees) and major national groups (defined
as groups of 500 or more employees). The Company's marketing efforts are
coordinated by Local Market managers in each of the established local market
regions, as well as by an Assistant Vice-President of Major/National Accounts
and a Director of Individual Sales. Each of these individuals is supervised by
the Executive Vice-President of Local Market Operations.
From a competitive perspective, the Company addresses its market generally
by geography, product and customer group size. Significant competition exists in
the Atlanta, Macon, Columbus, Athens and Augusta markets for managed care
products. In other metropolitan areas, the majority of competition is generally
for indemnity or PPO products, although new market entrants with managed care
capabilities continue to enter these areas.
The Company has also been highly successful in developing Major and
National account business, especially for its HMO and POS products, because of
its unique position regarding statewide capabilities.
Internal Sales and Service Force
The Company employs an internal sales staff of account executives and group
sales representatives to sell and service all of the Company's group product
lines. The sales force works with other members of the distribution channel,
including independent agents and brokers. They also make direct calls on
selected target accounts and work with nationally recognized consulting firms.
Each geographic area has a local market manager and a sales manager directly
responsible for the results of the unit. In addition, a centralized
communications department develops direct mail advertising and promotional
material that targets specific audiences for potential distribution of products.
Service representatives are assigned specific accounts and work directly with
the internal sales force and independent agents and brokers. Service
representatives become the principal administrative contact for employers and
their benefit managers. Their duties include conducting on-site meetings,
providing health data reports and resolving potential service issues. The
Company also maintains an additional fully-commissioned staff of sales employees
who sell the Company's individual indemnity insurance products (other than the
Medicare supplement). The Medicare supplement is sold by a telemarketing staff.
Independent Insurance Agents and Brokers
The Company's group sales representatives also market health insurance and
managed care products through independent agents, brokers and consultants who
may be paid commissions from the premiums received by the Company. Brokers who
meet selected production and underwriting criteria are also eligible for a
"Preferred Producer" bonus. These independent agents and brokers are responsible
for a significant portion of the Company's enrollment growth over the past three
years. Any future growth in ensuing calendar years will also be dependent on the
Company's ability to continue productive relationships with these independent
agents and brokers. Independent agents and brokers are not salaried employees of
any insurance company or managed care company and are free to sell multiple
products from multiple insurance firms. Some agents and brokers are career
agents of other insurance companies whom they represent, and for whom they may
be required to maintain product exclusivity for a given type of product but are
able to sell group health insurance and managed care products from a number of
carriers, including the Company. The distribution channel for the majority of
sales opportunities in the Georgia market is dominated by independent agents and
brokers, particularly in rural areas, and most insurance companies utilize them
to distribute their products.
9
<PAGE> 12
UNDERWRITING
In determining whether to accept groups and to establish appropriate rates
for its plans, the Company uses specific underwriting criteria based on its
accumulated actuarial data, with adjustments for factors such as claims
experience, member mix and risk characteristic differences, to evaluate
anticipated health care costs. The risk selection criteria utilized by the
Company employ generally accepted risk characteristics and a flexible
underwriting formula to generate new business and renewal rates. Rates and the
rating process are monitored monthly with appropriate adjustments made
quarterly. New business ratings for all groups with 100 or fewer employees are
applied through the use of an automated proposal system, with rates and risk
selection criteria being implemented by field sales personnel. For employer
groups with 100 or more employees, all rates are determined by home office
underwriting personnel, who utilize the same screening of risk characteristics
that is conducted for employer groups of smaller size, but who attempt to blend
actual claim experience (utilizing a flexible credibility formula and
underwriting intervention) in order to establish an appropriate rate based on
the Company's desired competitive position. Rates for groups smaller than 51 are
regulated by Georgia law.
Customers
The Company has contracts with certain employer groups and government
agencies that account for a significant portion of the Company's total business.
One group accounted for 22% of the Company's total premium revenues and
management services revenues in 1999. The Company's next two largest customers
accounted for less than 9% of premium revenues and management services revenues
in 1999. The Company also serves as fiscal intermediary for the Medicare Part A
program. Claims processed for the Medicare Part A program, state agencies and
the National Blue Cross Blue Shield interplan system totaled $4.2 billion in
1999. The Company receives fees for performing these services.
The Company's contract with the State of Georgia, for self-funded benefits,
expires June 30, 2001. In February 2000 the State of Georgia awarded a contract
for the delivery of medical services for its new PPO program to a hospital
provider network system. BCBSGA will retain its role as sole administrator for
the State of Georgia's indemnity benefit plan and the new PPO program through
June 30, 2001.
The State of Georgia program accounts for over 25% of the Company's
membership. The Company cannot currently estimate the number of members that
will migrate from the State's indemnity plan to the new State PPO product, but
the Company's management services revenue will be unaffected by this migration.
The Company does expect an increase in HMO insured membership, for the State
account, as part of the benefit program change and the effect of the
contribution levels set by the State. A nominal decline in operating margin for
2000 for the aggregation of all products and services provided to the State is
anticipated. The Company does not anticipate any impact on hospital contracting
for its HMO, POS and PPO products as a result of the introduction of the new
State PPO product. The Company expects nominal impact on hospital contracting
arrangements for indemnity products this year as the Company's membership
continues to shift to lower benefit cost products such as HMO and PPO.
During the 1999 legislative session, the Georgia legislature created a new
agency, the Department of Community Health (the "DCH"), which, among other
things, will become the lead agency in coordinating and purchasing health care
benefit plans for state and public employees and their dependents, as well as
retirees. The Company expects the DCH to begin a bid process during the second
half of this year for the administration of the State's health benefit plans for
the periods beginning after July 1, 2001.
The non-renewal or termination of any of these contracts with major
employer groups could have a material adverse effect on the Company's business,
financial condition and results of operations. There can be no assurance that
the subscribers or providers will renew their contracts or enter into new
contracts with the Company, or, in the case of provider contracts, will not seek
terms that are less favorable to the Company in connection with any such
renewal.
10
<PAGE> 13
INVESTMENT PORTFOLIO
The Company's conservative management of the investment process has played
an integral role in creating and maintaining its financial strength. Earnings
from the investment portfolio have contributed significantly to the profits of
the Company. Over the five-year period from January 1, 1995 to December 31,
1999, investment income plus gains realized on sales of investments represented
123% of consolidated operating income. In 1999, such income and gains were $26.9
million compared to consolidated operating income of $40.9 million.
Investment discretion of the Company's insurance subsidiaries is governed
by investment guidelines which comply with the Georgia Insurance Code. The
Company has established a two-tiered investment portfolio. Liquidity needs are
met through an internally managed investment portfolio (the "Internal
Portfolio") which is invested primarily in institutional money market accounts
and short-term government agency notes. Those assets not required for liquidity
are transferred to external money managers for long-term investment in the fixed
income and equity markets (the "External Portfolio"). Applicable assets in both
portfolios are currently held in custody by Wachovia Bank. On April 1, 2000, the
assets held by Wachovia Bank will be transferred to State Street Bank due to a
sale by Wachovia of its custody services. All bonds in the investment portfolios
must have quality ratings of "A" or higher by Moody's Investors Service and
Standard & Poor's Ratings Group. The equity investments in the Company's
investment portfolios are highly diversified and limited to high quality,
dividend paying, domestic equity securities. There are no derivative securities
or instruments in the Company's investment portfolios. The Board of Directors of
each insurance subsidiary reviews and approves investment related activities at
least quarterly.
BCBSGA's investment portfolio represented 65% of the Company's consolidated
investment portfolio at December 31, 1999. BCBSGA's Internal Portfolio is
managed by management staff, who report to the Treasurer and Chief Financial
Officer ("CFO") of BCBSGA who in turn reports to the Treasurer of the Company.
BCBSGA's External Portfolio is managed by independent advisory firms and is
subject to the review of BCBSGA's CFO and the Finance Committee of BCBSGA's
Board of Directors. The CFO monitors the performance of BCBSGA's investment
managers and compares their performance on a monthly basis to predetermined
benchmarks. The Finance Committee of the BCBSGA Board of Directors formally
reviews performance of each investment manager on a quarterly basis. Performance
is also calculated quarterly by an outside consultant, ING Baring LLC, including
benchmarking to an extensive group of other professionally managed investment
portfolios. The investment process is dynamic and continually reviewed for
improvements and refinements.
Shown below are the Company's consolidated invested assets by category. The
following tables should be read in conjunction with the accompanying
Consolidated Financial Statements and the related Notes thereto at Item 8 of
this Form 10-K and with the discussion at Item 7A, "Quantitative and Qualitative
Disclosures About Market Risk" of this Form 10-K.
INVESTMENTS BY CATEGORY
<TABLE>
<CAPTION>
AS OF AS OF
DECEMBER 31, 1999 DECEMBER 31, 1998
-------------------- --------------------
% OF % OF
CARRYING CARRYING CARRYING CARRYING
VALUE VALUE VALUE VALUE
-------- -------- -------- --------
($ IN MILLIONS)
<S> <C> <C> <C> <C>
Fixed maturities...................................... $256.8 77.8% $239.5 73.6%
Equity securities..................................... 73.1 22.1 76.9 23.6
Short-term investments................................ 0.3 0.1 9.2 2.8
------ ----- ------ -----
Total investments........................... $330.2 100.0% $325.6 100.0%
====== ===== ====== =====
</TABLE>
The Company's consolidated portfolio is comprised primarily of highly
liquid investment securities. The Company's fixed maturities consist of United
States Government securities and corporate securities. At
11
<PAGE> 14
December 31, 1999, all of the Company's fixed maturities consisted of
instruments bearing fixed, rather than variable, rates of interest. The
following summarizes the Company's fixed maturities by category.
FIXED MATURITIES BY CATEGORY
<TABLE>
<CAPTION>
AS OF
DECEMBER 31, 1999
--------------------
% OF
CARRYING CARRYING
VALUE VALUE
-------- --------
($ IN MILLIONS)
<S> <C> <C>
U.S. Treasury securities and obligations of U.S. government
agencies.................................................. $162.1 63.1%
Corporate securities........................................ 72.3 28.2
Mortgage-backed securities.................................. 22.4 8.7
------ -----
Total fixed maturities............................ $256.8 100.0%
====== =====
</TABLE>
The following table summarizes the Company's fixed maturities by
contractual maturity. Expected maturities will differ from contractual
maturities because borrowers may have the right to call or prepay obligations
with or without a call or prepayment premium.
FIXED MATURITIES BY MATURITY CATEGORY
<TABLE>
<CAPTION>
AS OF
DECEMBER 31, 1999
--------------------
% OF
CARRYING CARRYING
VALUE VALUE
-------- --------
($ IN MILLIONS)
<S> <C> <C>
Due in one year or less..................................... $ 28.4 11.1%
Due after one year through five years....................... 109.8 42.8
Due after five years through ten years...................... 94.3 36.7
Due after ten years......................................... 1.9 0.7
Mortgage-backed securities.................................. 22.4 8.7
------ -----
Total fixed maturities............................ $256.8 100.0%
====== =====
</TABLE>
COMPETITION
The market for each of the Company's products in Georgia is highly
competitive on both a regional and statewide basis and has undergone significant
changes in recent years. From a competitive perspective, the market is generally
addressed by geography, product and employer group size. Significant competition
exists in the metropolitan Atlanta market for managed care products, while
outside of this area the majority of competition currently is for either
traditional indemnity or PPO products, although new market entrants with managed
care capabilities are beginning to penetrate this area. The Company has many
competitors in its indemnity, PPO and HMO operations, many of which have
substantially greater financial and other resources than the Company. However,
based upon current data available in publications circulated generally and
within the health care industry, no single competitor is dominant in any one of
the Company's eight geographic markets in the state.
Price competition among benefit plans in the Company's markets,
particularly the Atlanta metropolitan area, has intensified. According to public
information, as of September 1999, 88% of the Georgia HMO and POS market was
held by the Company and three national competitors: the HMO operations based in
Georgia for Aetna and Prudential; Kaiser Foundation Health Plan of Georgia,
Inc.; and United Health Care of Georgia, Inc. The Company's share was 34% and
the largest competitor's share, Aetna/Prudential, was 24%. Because the Company's
existing business operations are confined to markets within the State of
Georgia, the
12
<PAGE> 15
Company currently is unable to subsidize losses in these markets with profits
from other markets as national companies can. The Company believes that certain
larger, national competitors are able to subsidize losses in the Georgia market
with profits from other markets in which they operate and could pursue such a
strategy in the Company's markets in an effort to increase market share. The
national health care industry has recently seen a consolidation of companies
that offer health care insurance, including traditional indemnity and managed
care products. In addition to intensifying competition, this consolidation may
result in corporations with enhanced financial resources positioned to pursue a
strategy of subsidizing losses to increase their market position in Georgia.
Further, future legislation at the federal and state levels may also result
in increased competition in the Company's markets. Competition may also be
affected by independent agents and brokers who sell the Company's health care
benefit plans as well as the benefit plans of the Company's competitors.
Additionally, provider-sponsored initiatives, through which certain hospital and
physician alliances compete with traditional means of health care financing, are
developing in some market segments. No assurance can be given that the Company
will be able to compete effectively with such competition in the future.
EMPLOYEES
The Company had 2,635 employees at December 31, 1999. No Company employees
are represented by any union, and the Company believes that its relations with
its employees are satisfactory.
GOVERNMENT REGULATIONS
Holding Company Regulation
The Company is an insurance holding company and as such is subject to
regulation by the Georgia Insurance Department (the "Department"). Georgia
regulations require the filing of financial and other information concerning the
operations and interrelationships of entities within an insurance holding
company system. Such regulations extend to contracts, loans, dividends,
distributions, management agreements and other transactions between holding
company entities. Certain of these agreements must be submitted to the
Department for approval, based on concepts of fair and reasonable terms,
reasonable charges and fees, and the condition that following any such related
party transaction the insurer's surplus with regard to policyholders shall be
reasonable in relation to the insurer's outstanding liabilities and adequate to
meet its financial needs.
Regulation of Insurance Subsidiaries
BCBSGA, HMO-Ga and GGL are subject to comprehensive regulation. The
Department has broad authority to regulate, among other things: licenses to
transact the business of insurance; investment activity of insurers; premium
rates for certain insurance products; trade practices of insurers; agent
licensing; policy forms; insurance underwriting and claims practices; and
reserve adequacy and solvency. BCBSGA, HMO-Ga and GGL are required to file
detailed annual reports with the Department. BCBSGA, HMO-Ga and GGL's accounts
are subject to periodic examination by the Department. The regulation of
insurance holding company systems includes the acquisition and sales of licensed
entities, payment of dividends by regulated entities, the terms of affiliate
transactions and other related matters. HMO-Ga is a licensed HMO under Georgia
insurance law. Pursuant to Georgia law, HMOs are considered insurers and, except
as specifically provided to the contrary, are regulated by the same provisions
that apply with respect to BCBSGA and GGL.
Change or Acquisition of Control
Georgia insurance law requires the Georgia Commissioner's prior approval of
any transaction affecting change of control of, or other acquisition of, a
domestic insurer, or of any person or entity that controls a domestic insurer.
In general, a presumption of control exists if any person or entity beneficially
owns or controls 10% or more of the voting securities of a domestic insurer or
of a person that controls a domestic insurer. Any direct or indirect change in
control of a domestic insurer or an entity which controls a domestic insurer is
subject to the approval of the Georgia Commissioner, following a public hearing.
13
<PAGE> 16
Examinations
BCBSGA, HMO-Ga and GGL are each subject to examination of their affairs by
the Department. The Department conducts triennial examinations of insurance
companies domiciled in Georgia. During the last quarter of 1999, the Department
completed its financial examination and Market Conduct examination of BCBSGA,
HMO-Ga and GGL for the period January 1, 1995 through December 31, 1997. As a
result of those examinations, no matters were raised by the Department that
would have a material impact upon the statutory financial statements of either
BCBSGA, HMO-Ga or GGL.
TRADE NAMES, TRADE MARKS, SERVICE MARKS AND LICENSES
Pursuant to licenses from BCBSA, the Company has the exclusive right to
conduct business under the name "Blue Cross and Blue Shield of Georgia" and to
use the Blue Cross and Blue Shield names, trademarks and service marks for all
of the indemnity, life and managed health care products and services it offers
in all 159 counties in Georgia. The Company believes that the well-recognized
Blue Cross and Blue Shield names, trademarks and service marks will continue to
provide a significant marketing advantage in its licensed service area,
particularly as competitive pressures narrow differences among health care
benefit plans. The Company cannot do business using the Blue Cross and Blue
Shield names, trademarks and service marks outside of its licensed service area.
ITEM 2. PROPERTIES
The Company's corporate headquarters occupies approximately 265,000 square
feet of leased space in a 17-story building located in Atlanta, Georgia, and its
main claims operations center occupies approximately 176,000 square feet of
owned space in a four-story building located in Columbus, Georgia. Both
facilities are in desirable and accessible locations. The Company leases space
in 16 other buildings in communities throughout Georgia to support its
operations. If the current rate of the Company's business growth continues,
additional space may be required.
ITEM 3. LEGAL PROCEEDINGS
On September 18, 1998, Plaintiffs Allen Saravuth, Nga Nguyen, Chansamone
Sengsavath and Fatana Pirzad, individually and on behalf of all others similarly
situated (collectively, the "Richmond County Plaintiffs"), filed a lawsuit
against the Company, BCBSGA, James L. Laboon, Jr., Fred L. Tolbert, Jr., Richard
D. Shirk, James E. Albright, W. Daniel Barker, Elizabeth W. Camp, Louis H.
Felder, M.D., Edward M. Gillespie, Joseph D. Greene, Mel H. Gregory, Jr., Frank
J. Hanna, III, R. Pierce Head, Jr., Charles H. Keaton, James H. Leigh, Jr.,
M.D., Julia L. Mitchell-Ivey, Charles R. Underwood, M.D., W. Jerry Vereen, A.
Max Walker, Dan H. Willoughby, M.D., Joe M. Young, and John B. Zellars
(collectively, the "Defendant Directors") in the Superior Court of Richmond
County, State of Georgia, bearing Civil Action File No. 98-RCCV-806. In
addition, the Richmond County Plaintiffs filed a Motion for Temporary
Restraining Order and Interlocutory Injunctive Relief, which was heard and
denied by the Superior Court of Richmond County on September 21, 1998. The
Richmond County Plaintiffs identify themselves as four individuals who were
entitled to receive shares of the Company's stock in connection with the
conversion of BCBSGA from a non-profit corporation to a regular business
corporation (the "Conversion"). The Richmond County Plaintiffs assert claims for
specific performance, fraud, breach of provisions of the Insurance Code of
Georgia, breach of fiduciary duty, and request declaratory judgment and
certification of a class action consisting of all persons who were "eligible
subscribers" of BCBSGA as of February 1, 1996, and who did not become holders of
Class A Stock of the Company. The Richmond County Plaintiffs allege that they
and the members of the purported class are entitled to receive shares of Class A
Stock in the Company. The Richmond County Plaintiffs allege alternatively that
offering materials disseminated by BCBSGA during 1996 relating to Class A Stock
of the Company contained materially misleading and deceptive statements and
omissions and that the Richmond County Plaintiffs and the purported class
members are entitled to an award of damages in excess of $100 million. The
Richmond County Plaintiffs also asserted derivative causes of action against the
Defendant Directors alleging that the Defendant Directors breached fiduciary
duties by, among other things, approving the placement and issuance of Class B
Stock in
14
<PAGE> 17
the Company during 1996, the issuance of Class A Stock in the Company, the
settlement of the Let's Get Together, Inc. et al. v. Insurance Commissioner, et
al., Civil Action E-61714 (Superior Court of Fulton County, Georgia) lawsuit,
and certain management compensation. On November 9, 1998, Harrell Tiller,
Charlie Deal and Olean Lokey joined the case as additional named plaintiffs. On
December 9 and 10, 1998, a hearing was held on the plaintiffs' request for
declaratory ruling on the issue of whether plaintiffs are properly shareholders
of the Company and on December 17, 1998, the Superior Court ruled in favor of
the plaintiffs. The Company filed an appeal with the Georgia Supreme Court which
accepted jurisdiction and granted expedited treatment of the appeal. The
Company's Board of Directors appointed a Special Litigation Committee to review
the derivative claims. On April 14, 1999, the Special Litigation Committee
reported to the Board of Directors that it had concluded that the derivative
claims were without substance. On May 3, 1999, the Georgia Supreme Court
reversed the ruling of the Richmond County Superior Court, holding that the
Richmond County Superior Court erred in considering and ruling upon the
plaintiffs' claims. The Georgia Supreme Court found that the Georgia
Commissioner had broad power of review over the Conversion and that sufficient
administrative remedies with the Georgia Commissioner had been available to the
plaintiffs during and following the Conversion.
The Richmond County Plaintiffs did not file a motion for reconsideration of
the Georgia Supreme Court's decision. On May 5, 1999, BCBSGA and the Company
filed motions for summary judgment on the Richmond County Plaintiffs' fraud
claims. On May 20, 1999, the Company and BCBSGA filed a motion for entry of
judgment on all remaining counts of the Richmond County Plaintiffs' Complaint.
On July 29, 1999, the Superior Court of Richmond County entered an order
dismissing all claims against the Defendant Directors without prejudice. On
September 21, 1999, the Superior Court of Richmond County entered orders denying
the motions for summary judgment and the motion for entry of judgment. On
October 27, 1999, the Company and BCBSGA filed a motion for reconsideration of
the motion for entry of judgment. The case remains pending before the Superior
Court.
On May 17, 1999, Harrell Tiller, Charlie Deal and Olean Lokey, who were
among the Richmond County Plaintiffs, filed two separate Petitions for
Declaratory Ruling (the "Petitions") before the Georgia Commissioner, seeking a
declaration from the Georgia Commissioner that they, and others similarly
situated, should have been issued shares of Class A Stock. On June 22, 1999, the
Georgia Commissioner entered orders on the Petitions denying the relief sought.
On June 22, 1999, Harrell Tiller, Charlie Deal and Olean Lokey filed two
separate proceedings in the Superior Court of Richmond County. In these cases,
styled In Re: Harrell Tiller, individually and on behalf of all others similarly
situated v. Commissioner of Insurance of the State of Georgia, Civil Action No.
1999-RCCV-471 and In Re: Charlie Deal and Olean Lokey, individually and on
behalf of all others similarly situated v. Commissioner of Insurance of the
State of Georgia, Civil Action No. 1999-RCCV-470, the Petitioners sought
judicial review of the decisions of the Georgia Commissioner of June 22, 1999
(the "Judicial Review Proceedings"). On September 21, 1999, the Superior Court
of Richmond County entered orders reversing the Georgia Commissioner's orders.
On October 12, 1999, the Company and BCBSGA filed Applications for Discretionary
Appeal (the "Applications") with the Supreme Court of Georgia, seeking to have
that court reverse the Superior Court of Richmond County's decisions. These
Applications were transferred to the Court of Appeals of the State of Georgia on
November 12, 1999. On October 21, 1999, the Georgia Commissioner filed an
application for appellate relief from the Superior Court's decisions with the
Court of Appeals of the State of Georgia, seeking to have that court overturn
the Superior Court's decisions. On November 22, 1999, the Georgia Court of
Appeals granted the Applications for Discretionary Appeal of all parties. The
cases were docketed on December 15, 1999, and the parties are completing their
briefing of the cases. Oral arguments were presented to the Court of Appeals on
March 22, 2000. A decision from the Court of Appeals is expected to follow
within two to four months. Management of the Company believes the case to be
without merit and, in any event, believes that its impact, if any, on the assets
of the Company would not be material.
In the normal course of business, the Company is involved in and subject to
claims, contractual disputes and other uncertainties. Management, after
reviewing with legal counsel all of these actions and proceedings, believes that
the aggregate losses, if any, will not have a material effect on the Company's
financial position or results of operations.
15
<PAGE> 18
ITEM 4. SUBMISSION OF MATTERS TO A VOTE OF SECURITY HOLDERS
None.
16
<PAGE> 19
PART II
ITEM 5. MARKET FOR THE REGISTRANT'S COMMON EQUITY AND RELATED STOCKHOLDER
MATTERS
As of February 29, 2000, the Company had 70,268 Class A shareholders of
record. Presently, there is no market for the Class A Stock or any equity
securities of the Company. The Company does not anticipate that any dividends
will be paid on Class A Stock.
ITEM 6. SELECTED FINANCIAL DATA
The following is Selected Consolidated Financial and Operating Data of
BCBSGA, HMO-Ga and all subsidiaries for the periods described therein prior to
the Conversion and of the Company for the period following the Conversion. The
following data, prepared in accordance with generally accepted accounting
principles, should be read in conjunction with the accompanying Consolidated
Financial Statements, the related Notes thereto at Item 8 of this Form 10-K and
"Management's Discussion and Analysis of Financial Condition and Results of
Operations" at Item 7 of this Form 10-K.
<TABLE>
<CAPTION>
YEAR ENDED DECEMBER 31,
----------------------------------------------------------
1999 1998 1997 1996 1995
---------- ---------- ---------- -------- --------
($ IN THOUSANDS)
<S> <C> <C> <C> <C> <C>
STATEMENT OF INCOME DATA:
Revenues:
Premium revenue........................ $1,486,294 $1,189,665 $ 989,789 $818,351 $709,425
Management services revenue............ 142,186 117,963 96,470 87,262 74,297
Investment and other income............ 19,687 17,183 17,259 14,358 11,980
Realized gains......................... 7,214 9,254 11,300 4,113 15,265
---------- ---------- ---------- -------- --------
Total revenues...................... 1,655,381 1,334,065 1,114,818 924,084 810,967
Benefits expense......................... 1,300,923 1,032,520 881,554 702,234 613,031
Operating expenses....................... 313,603 279,218 233,651 202,072 176,387
---------- ---------- ---------- -------- --------
Operating income (loss).................. 40,855 22,327 (387) 19,778 21,549
Endowment of a non-profit
foundation(1).......................... -- (76,157) -- -- --
Non-operating income..................... 255 255 1,275 1,275 --
---------- ---------- ---------- -------- --------
Income (loss) before income taxes and
minority interests..................... 41,110 (53,575) 888 21,053 21,549
Income tax expense (benefit)(2).......... 9,061 2,073 (2,050) 3,159 3,857
Minority interests in (earnings) losses
of joint venture investments........... 794 (1,520) 1,460 (421) (282)
---------- ---------- ---------- -------- --------
Net income (loss)........................ $ 32,843 $ (57,168) $ 4,398 $ 17,473 $ 17,410
========== ========== ========== ======== ========
</TABLE>
- ---------------
(1) During 1998, the Company endowed a non-profit foundation (See Note 8 of the
accompanying Consolidated Financial Statements at Item 8 of this Form 10-K
and "Management's Discussion and Analysis of Financial Condition and Results
of Operations" at Item 7 of this Form 10-K).
(2) The Company pays taxes under the alternative minimum tax system as the
result of a special deduction available under Section 833(b) of the Internal
Revenue Code (See "Management's Discussion and Analysis of Financial
Condition and Results of Operations -- Overview" at Item 7 of this Form
10-K). If the deduction were no longer available, BCBSGA would be subject to
federal income taxes at the regular corporate tax rate, which is currently
35%. However, in 1997, the utilization of net operating loss carryforwards,
not the special deduction under Section 833(b), subjected the Company to
alternative minimum tax.
Earnings per share are omitted because such data is not meaningful at the
present time due to the likely dilutive events that will occur prior to or in
conjunction with the conversion of the Class A Stock or the Preferred Stock.
Currently there is no public trading market for the Company's Class A Stock or
any equity securities of the Company.
17
<PAGE> 20
<TABLE>
<CAPTION>
YEAR ENDED DECEMBER 31,
----------------------------------------------------------
1999 1998 1997 1996 1995
---------- ---------- ---------- -------- --------
($ IN THOUSANDS)
<S> <C> <C> <C> <C> <C>
OPERATING DATA BY PRODUCT GROUP:
Premium Revenue by Product Group:
HMO and POS........................... $ 658,352 $ 503,135 $ 331,393 $180,432 $ 89,943
Indemnity and PPO..................... 810,598 670,588 643,626 627,155 611,211
Life.................................. 17,344 15,942 14,770 10,764 8,271
---------- ---------- ---------- -------- --------
Total premium revenue.............. 1,486,294 1,189,665 989,789 818,351 709,425
Management services revenue............. 142,186 117,963 96,470 87,262 74,297
---------- ---------- ---------- -------- --------
Total premium revenue and
management services revenue...... $1,628,480 $1,307,628 $1,086,259 $905,613 $783,722
========== ========== ========== ======== ========
As a Percentage of Premium Revenue:
HMO and POS........................... 44.3% 42.3% 33.5% 22.1% 12.7%
Indemnity and PPO..................... 54.5% 56.4% 65.0% 76.6% 86.2%
Life.................................. 1.2% 1.3% 1.5% 1.3% 1.1%
---------- ---------- ---------- -------- --------
Total.............................. 100.0% 100.0% 100.0% 100.0% 100.0%
========== ========== ========== ======== ========
Loss Ratio (Benefits Expense as a
Percentage of Premium Revenue):
HMO and POS........................... 86.8% 85.6% 89.5% 84.7% 80.0%
Indemnity and PPO..................... 88.9% 88.5% 89.6% 86.7% 87.8%
Life.................................. 50.5% 52.6% 52.9% 53.9% 56.5%
---------- ---------- ---------- -------- --------
Total loss ratio................... 87.5% 86.8% 89.1% 85.8% 86.4%
========== ========== ========== ======== ========
Operating Expense Ratio (Operating
Expenses as a Percentage of Premium
Revenue and Management Services
Revenue).............................. 19.3% 21.4% 21.5% 22.3% 22.5%
---------- ---------- ---------- -------- --------
Effective Income Tax Rate(1)............ 22.0% -3.9% -230.9% 15.0% 17.9%
========== ========== ========== ======== ========
BALANCE SHEET DATA (AT PERIOD END):
Cash & investments...................... $ 388,729 $ 377,830 $ 315,323 $307,190 $223,994
Total assets............................ 612,083 587,342 496,532 459,131 353,468
Total estimated benefit liabilities..... 201,587 184,075 149,581 119,511 110,374
Total liabilities....................... 334,410 325,018 254,850 224,916 180,429
Mandatorily redeemable preferred
stock................................. 46,645 46,645 46,645 46,645 --
Common Stock............................ 4 4 4 4 --
Additional paid-in capital(2)........... 45,188 45,188 -- -- --
Stock warrants exercisable(2)........... 29,968 29,968 -- -- --
Shareholders' equity.................... 231,028 215,679 195,037 187,570 173,039
</TABLE>
- ---------------
(1) The Company pays taxes under the alternative minimum tax system as the
result of a special deduction available under Section 833(b) of the Internal
Revenue Code (See "Management's Discussion and Analysis of Financial
Condition and Results of Operations -- Overview" at Item 7 of this Form
10-K). If the deduction were no longer available, BCBSGA would be subject to
federal income taxes at the regular corporate tax rate, which is currently
35%. However, in 1997, the utilization of net operating loss carryforwards,
not the special deduction under Section 833(b), subjected the Company to
alternative minimum tax.
(2) During 1998, the Company endowed a non-profit foundation (See Note 8 of the
accompanying Consolidated Financial Statements at Item 8 of this Form 10-K
and "Management's Discussion and Analysis of Financial Condition and Results
of Operations" at Item 7 of this Form 10-K).
18
<PAGE> 21
ITEM 7. MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS
OF OPERATIONS
The following discussion should be read in conjunction with the
accompanying Consolidated Financial Statements and the related Notes thereto at
Item 8 of this Form 10-K. The Company's actual future results could differ
materially from its historical results, depending on, among other factors,
changing rates of utilization of medical services by its enrollees and changing
rates of medical service costs.
OVERVIEW
The Company was organized on February 2, 1996 to become a holding company
for BCBSGA and its subsidiaries upon the Conversion on February 2, 1996. During
1997, BCBSGA made a distribution of its investments in certain subsidiaries,
including HMO-Ga and GBG to the holding company. The discussions below relate to
the historical operations of BCBSGA, HMO-Ga and all subsidiaries prior to
February 2, 1996 and to the Company (including BCBSGA, HMO-Ga and all
subsidiaries on a consolidated basis) for the period following the Conversion.
Historically, substantially all of the Company's premium and management
services revenues were derived from its traditional indemnity and PPO business;
however, the growth of revenues and earnings in recent years is the result of a
strategic shift in focus that began in 1992. As a result of the change in
strategy, HMO and POS premiums have grown to 44% at the end of 1999 from 13% of
total premiums at the end of 1995. Membership for fully insured HMO and POS
products has grown to over 409,000 members at the end of 1999 from 81,000
members at the end of 1995. Additionally, HMO and POS membership under
management services agreements totaled 97,000 and 51,000 at the end of 1999 and
1995, respectively, bringing total HMO and POS membership served to over 506,000
and 132,000 for the same periods. The growth in the HMO and POS products is
attributable to new sales, in-group-growth and, to a lesser degree, migration of
business from other traditional indemnity products offered by the Company. Over
80% of total medical services for the Company's HMO and POS products sold were
provided through its CHPNs in 1999, compared to 59% in 1995.
Management services revenue consists of fees for administrative services
provided to commercial employer groups under self-funded arrangements, including
claims processing, access to provider networks and other services rendered to
third parties. Management services revenue also includes reimbursements for
administrative expenses incurred in performing services as agent for federal and
state government programs and for the national Blue Cross Blue Shield interplan
system. Membership in these administrative services contracts has declined to
850,000 members at the end of 1999 from 888,000 members at the end of 1995. The
decline in administrative services membership is due primarily to the migration
of a segment of the State of Georgia employees from traditional indemnity
benefit designs to HMO plans including the Company's HMO. Additionally, certain
self funded employer groups have shifted to the national Interplan
Teleprocessing System ("ITS") for Blue Cross Blue Shield plans.
Membership served under insurance products and management services
arrangements totaled 1,689,000 members at the end of 1999 compared to 1,333,000
members at the end of 1995.
Prudent management of the Company's investments has played a significant
role in developing and maintaining the Company's financial strength. Investment
earnings, including realized gains on sales of investments, have represented an
average of over 123% of operating income during the period January 1, 1995
through December 31, 1999.
Benefits expense consists primarily of health care claims and payments to
physicians, hospitals and other health care providers. The Company's
profitability largely depends on the ability to accurately predict and
effectively manage these health care costs. Accordingly, the Company continues
its efforts to improve contractual terms with providers for the delivery of
medical services, and effectively manage business mix changes from indemnity and
PPO products into HMO and POS products.
The Company's emphasis on managed care products, and the expenses
associated with the change in its infrastructure to support managed care
products and its investment in a Strategic Information Systems Plan, is
19
<PAGE> 22
reflected in its level of operating expenses as a percentage of premium and
management services revenues, an average of 21% over the last five years.
In the State of Georgia, insurers are required to pay a tax on insurance
premiums in lieu of a state income tax. Premium taxes are charged to operating
expenses as incurred.
The Company pays federal taxes under the alternative minimum tax system as
the result of a special deduction available under Section 833(b) of the Internal
Revenue Code. If the deduction were no longer available, BCBSGA would be subject
to federal income taxes at the regular corporate tax rate, which is currently
35%. However, in 1997, the utilization of net operating loss carryforwards, not
the special deduction under Section 833(b), subjected the Company to alternative
minimum tax.
Significant health care legislation has been, and continues to be, proposed
at both the federal and state levels. Any such legislation could have a material
impact on the Company's business. With or without legislation, consumers and
employer groups are expected to continue to exert pressure on pricing of health
care products. To meet these demands, more predictable, lower cost products will
be required.
Results of operations are directly affected by premium rate adequacy which
depends on pricing and underwriting decisions, the level of membership serviced
by and the performance of the Company's physician, hospital, pharmacy and
ancillary health care services networks (and since January 1995, by the
Company's CHPNs), estimates of medical benefits, health care utilization,
estimates of health care cost trends, effective administration of benefit
payments, operating efficiencies, investment returns and federal and state laws
and regulations.
RESULTS OF OPERATIONS
1999 Compared to 1998
Premium revenues increased $296.6 million to $1,486.3 million for the year
ended December 31, 1999 from $1,189.7 million for the year ended December 31,
1998. HMO and POS premiums increased 31% to $658.4 million for the 1999 period
from $503.1 million in 1998 primarily as a result of a 14% increase in
membership and rate increases in the 1999 period. HMO and POS insured membership
increased to 409,000 members at December 31, 1999 from 358,000 members at
December 31, 1998 due to new sales and in-group growth. Premium revenues for
indemnity and PPO products increased 21%, or $140.0 million, to $810.6 million
for the year ended December 31, 1999 as a result of rate increases in 1999 and a
10% growth in the members served.
Management services revenue increased $24.2 million to $142.2 million for
the year ended December 31, 1999 compared to $118.0 million for the year ended
December 31, 1998, as the Company has continued to experience increased
administrative fee revenue from services provided to self-funded employer groups
and other third parties and interplan network access fees from other Blue Cross
Blue Shield plans. Self-funded employer group membership of 850,000 at December
31, 1999 declined from 870,000 members at December 31, 1998 as certain
self-funded employer groups have shifted to the national ITS for Blue Cross Blue
Shield plans.
Membership served under insurance products and management services
arrangements totaled 1,689,000 members at December 31, 1999, an increase of 4%
over total membership of 1,620,000 at December 31, 1998.
Realized gains of $7.2 million on the sale of marketable securities for the
year ended December 31, 1999 were lower than gains realized of $9.3 million for
the prior year. The magnitude of realized gains in any period can fluctuate due
to fixed income and equity market performance, as well as timing of individual
sale transactions, which are subject to decisions made by the Finance Committee
of the Company's Board of Directors or by individual investment portfolio
managers. Results in one period are not necessarily indicative of results to be
expected in the future.
The Company's medical loss ratio (benefits expense as a percentage of
premium revenue) increased to 87.5% for the year ended December 31, 1999 up from
86.8% for the year ended December 31, 1998. Higher
20
<PAGE> 23
cost trends were identified resulting in higher loss ratios for all of the
Company's employer group products for 1999 incurred periods.
Operating expenses were $313.6 million for the year ended December 31,
1999, an increase of 12% over the same period a year ago, while premium revenue
and management services revenues increased 25%. Due to the positive impact from
premium increases in 1999 being realized at a rate higher than operating expense
increases, operating expenses as a percentage of premium revenue and management
services revenue continued to improve. Operating expenses were 19% of premium
revenue and management services revenue for the year ended December 31, 1999
compared to 21% for the year ended December 31, 1998. Year 2000 readiness costs
of $7.4 million for the years of 1999 and 1998, were included in operating
expenses. Additionally, the 1999 period includes approximately $7.6 million in
legal and other professional expenses related to the pending merger with
WellPoint and the litigation referred to in Note 8 of the Notes to Consolidated
Financial Statements, compared to $4.9 million incurred in the 1998 period.
On July 8, 1998, the Company entered into a stipulation and agreement of
settlement of a lawsuit concerning the conversion of the company to a for-profit
corporation. The Company endowed a new non-profit foundation and issued cash,
Class A Stock and Warrants pursuant to this settlement; in connection with this
transaction, the Company recorded a non-recurring charge of $76.2 million for
the year ended December 31, 1998. The Company recorded a tax benefit of $26.7
million related to this settlement, which was reduced to its expected realizable
value of $4.6 million.
The Company recorded tax expense of $9.1 million for the year ended
December 31, 1999 compared to a tax expense of $2.1 million for the year ended
December 31, 1998. The Company's effective tax rate in both periods (excluding
the effect of the 1998 endowment of a non-profit foundation) consists primarily
of federal alternative minimum tax and state income taxes, adjusted for the
effect of other permanent book to tax differences, including non-deductible
expenses and losses from CHPN subsidiaries that are not expected to generate a
tax benefit currently or in the foreseeable future.
As a result of the foregoing factors, operating income increased to $40.9
million for the year ended December 31, 1999 from $22.3 million for the year
ended December 31, 1998. The Company recognized net income of $32.8 million for
the year ended December 31, 1999 compared to net income of $14.4 million for the
year ended December 31, 1998, excluding the $76.2 million endowment of a
non-profit foundation, net of a tax benefit of $4.6 million.
1998 Compared to 1997
Premium revenue increased 20% to $1,189.7 million for the year ended
December 31, 1998 from $989.8 million for the year ended December 31, 1997. The
Company's membership in its indemnity and managed care insurance products
increased to 750,000 members as of December 31, 1998 compared to 649,000 members
as of December 31, 1997. HMO and POS premiums increased $171.7 million to $503.1
million for the year ended December 31, 1998 resulting from a 34% increase in
insured membership and rate increases in the 1998 period. New sales, in-group
growth, and to a lesser extent, migrations from traditional indemnity products
into HMO and POS products, continued to drive HMO and POS membership growth to
358,000 members at December 31, 1998 from 267,000 members at December 31, 1997.
Premium revenue for indemnity and PPO products increased $27.0 million to $670.6
million for the year ended December 31, 1998, primarily as a result of rate
increases during the 1998 period, offset in part by a shift in product mix as
consumers selected products with lower cost benefit design in the 1998 period.
Management services revenue increased to $118.0 million for the year ended
December 31, 1998 compared to $96.5 million for the year ended December 31,
1997, due primarily to increased administrative fee revenue from services
provided to self-funded employer groups, other third parties and interplan
network access fees from other Blue Cross Blue Shield plans in the 1998 period.
Membership in self-funded employer groups increased to 870,000 members at
December 31, 1998 from 863,000 members at December 31, 1997.
Investment and other income for the year ended December 31, 1998 was $17.2
million, slightly below investment and other income for the prior year. Although
the Company's average investment portfolio
21
<PAGE> 24
increased year over year, the investment yield (excluding realized gains and
losses) declined to 5.1% in 1998 due to lower interest rates compared to an
investment yield of 5.4% in 1997. Additionally, other income in 1997 included
$0.6 million related to non-recurring income.
Realized gains of $9.3 million on the sale of marketable securities for the
year ended December 31, 1998 were $2.0 million lower than gains realized in the
year ended December 31, 1997. The results in 1998 and 1997 are not necessarily
indicative of results to be expected in the future. The magnitude of realized
gains in any period can fluctuate due to fixed and equity market performance, as
well as timing of individual sale transactions, which are subject to decisions
made by individual investment portfolio managers or by the Finance Committee of
the Company's Board of Directors.
The Company's loss ratio (benefits expense as a percentage of premium
revenue) improved to 86.8% for the year ended December 31, 1998 from 89.1% for
the year ended December 31, 1997. This was primarily a result of rate increases
in the 1998 period, actions to control medical costs implemented in late 1997
and early 1998, and in part to an improvement in payment patterns and claims
trends from prior year's claims estimates, principally for the Company's HMO and
POS products. The loss ratio for HMO and POS products improved to 85.6% for 1998
from 89.5% for 1997. The loss ratio for indemnity and PPO products improved to
88.5% for the 1998 period from 89.6% for the same period in 1997.
Operating expenses increased 20% to $279.2 million for the year ended
December 31, 1998 from $233.7 million for the year ended December 31, 1997,
principally due to growth in the Company's infrastructure necessary to support
the increased HMO and POS membership base, information technology changes, Year
2000 readiness costs and Medicare Risk product development. Year 2000 readiness
costs were $4.6 million in 1998. Additionally, during the year ended December
31, 1998, the Company recognized increased operating expenses of $4.9 million
related to the settlement of the Lawsuit and the proposed Merger with WellPoint.
The operating expense ratio (operating expenses as a percentage of premium
revenue and management services revenue) was 21.4% for the year ended December
31, 1998, compared to 21.5% for the year ended December 31, 1997.
On July 8, 1998, the Company entered into a stipulation and agreement of
Settlement of the Lawsuit. The Company endowed the Foundation and issued cash,
Class A Stock and Warrants to the Foundation Shareholders pursuant to the
Settlement; in connection with this transaction, the Company recorded a
nonrecurring charge of $76.2 million for the year ended December 31, 1998.
In January 1998, a hospital purchased stock warrants exercisable for common
stock of one of the Company's CHPN subsidiaries in exchange for a note
receivable. In January 1997, a hospital purchased a 5% interest in one of the
Company's CHPN subsidiaries. These transactions were recorded as non-operating
income for the years ending December 31, 1998 and 1997.
The Company recorded tax expense of $2.1 million for the 1998 period
compared to a tax benefit of $2.1 million for the 1997 period. Net tax expense
in 1998 is from the alternative minimum tax, increased for CHPN losses that are
not expected to generate benefit in the foreseeable future, offset by tax
benefits related to the Lawsuit Settlement, and the difference in book and tax
bases in CHPN investments both reduced to expected realizable value. The net tax
benefit in 1997 included the utilization of loss carryforwards and tax benefits
from the Company's long-lived tax assets and the difference in book and tax
bases of its CHPN investments reduced to expected realizable value.
As a result of the foregoing factors, operating income increased to $22.3
million for the year ended December 31, 1998 from an operating loss of $0.4
million for the year ended December 31, 1997. After the endowment of a
non-profit foundation, non-operating income and minority interests in (earnings)
losses of joint venture investments, the Company recognized a net loss of $57.2
million for the year ended December 31, 1998 compared to net income of $4.4
million for the year ended December 31, 1997.
22
<PAGE> 25
LIQUIDITY AND CAPITAL RESOURCES
Liquidity
The Company has both short-term and long-term liquidity needs and has
structured its investment portfolios accordingly. Short-term liquidity needs to
fund operating costs, as well as payment obligations to its customers, are met
from funds invested primarily in institutional money market accounts and
short-term government agency notes.
Assets not required for short-term liquidity needs are transferred to a
portfolio of investments in the fixed income and equity markets. This portfolio,
which provides reserves for future payment obligations and funds for long-term
liquidity needs, is managed by several independent advisory firms. The Company's
investment policies are designed to provide liquidity to meet anticipated
payment obligations, to preserve capital and to maximize yield in conformance
with all regulatory requirements. Of the Company's total investment portfolio at
December 31, 1999, $321.0 million is held at its insurance subsidiaries and is
invested subject to limitations prescribed by Georgia insurance statutes.
Cash and investments were $388.7 million or 64% of total assets at December
31, 1999. The allocation of the Company's external investment portfolio has been
consistently maintained with approximately 70% in fixed maturities, all of which
are investment grade, and the balance in equity securities. Corporate and
government bonds are in issues with ratings of "A" or better by Moody's
Investors Service and Standard & Poor's Rating Group and investments in equity
securities are in domestic, dividend paying companies. The Company's portfolio
currently does not contain any derivative securities or instruments, or any real
estate investments or equity investments in corporations engaged solely in real
estate activities. Management believes that the Company's conservative
investment portfolio contributes to its financial stability.
The Company's balance sheet has improved steadily since 1995, with total
assets growing to $612.1 million at December 31, 1999, up from $353.5 million at
December 31, 1995. A substantial portion of the increase was a result of growth
in the Company's cash and investment portfolio as it invested excess cash
generated from operating activities and investment earnings.
The Company has historically satisfied its ordinary cash requirements from
operations. Net cash provided by operating activities amounted to $39.6 million
for 1999. Because of the nature of the Company's business, current cash flows
from operations are not necessarily expected to be indicative of future results;
however, the Company does believe its future cash resources will be adequate to
meet its operating requirements.
BCBSGA maintains a $55.0 million insolvency line of credit with a group of
banks. The insolvency line of credit may be drawn on solely in the event of any
insolvency of BCBSGA to pay authorized insurance policy claims. The insolvency
line of credit is designed to satisfy certain membership standards of the BCBSA
from which the Company and certain of its subsidiaries have the exclusive
license to do business in Georgia under the name "Blue Cross and Blue Shield",
and to use the Blue Cross and Blue Shield names, trademarks and service marks
with respect to the Company's indemnity, PPO, HMO, POS and life insurance
products. The Company does not anticipate making draws on the insolvency line of
credit.
BCBSGA, HMO-Ga and GGL are domiciled in the state of Georgia and prepare
their statutory statements in accordance with accounting principles and
practices prescribed by the Georgia Insurance Department. These entities may
distribute dividends only out of realized profits (undistributed, accumulated,
net earnings since organization). The amount of dividends distributable each
year is limited to the greater of the prior year's net income determined on a
statutory basis or 10% of prior year statutory surplus. In addition, dividends
distributable by BCBSGA are further limited by the Conversion order (approved by
the Georgia Commissioner of Insurance on December 27, 1995 related to BCBSGA's
conversion to a for-profit corporation). Dividend distributions by BCBSGA,
HMO-Ga and GGL above these defined limits require a filing with, and in some
cases special approval by, the Georgia Commissioner.
23
<PAGE> 26
Capital Resources
The Company anticipates that the principal elements of its future capital
requirements are information technology needs, product development, development
of potential medical access points, equity contributions to its CHPN joint
ventures and other subsidiaries and strategic acquisitions.
Medical access point development, including physician practice acquisition,
the establishment of urgent care, 24-hour, or primary care clinic facilities, or
physician recruitment or relocation costs, could occur if the CHPNs are not able
to adequately cover the geography or range of services desired. The capital cost
to develop a medical access point varies because of differing factors such as
available facilities and extent of existing infrastructure. The Company
anticipates that the development of a single medical access point could cost in
the range of $0.5 million to $2.0 million. To date, no CHPN has produced an
access need that has translated into additional capital requirements.
In prior years, the Company discussed the nature and progress of its plans
to become Year 2000 ready. In late 1999, the Company completed its remediation
and testing of systems. As a result of those planning and implementation
efforts, the company experienced no disruptions in mission critical information
technology and non-information technology systems and believes those systems
successfully responded to the Year 2000 date change. The Company is not aware of
any material problems resulting from Year 2000 issues, either with its products,
its internal systems, or the products and services of third parties. The Company
will continue to monitor its mission critical computer applications and those of
its suppliers and vendors throughout the year 2000 to ensure that any latent
Year 2000 matters that may arise are addressed promptly. In the three years
ended December 31, 1999, the Company expended $19.6 million for Year 2000
readiness costs. Capital expenditures for new hardware and software totaled $8.3
million. Renovation expenses of $11.3 million were expensed when incurred, with
$4.6 million expensed in the 1999 period. These expenditures were funded from
cash flows from operations.
The Company believes that future capital requirements can be met with a
combination of (i) the Company's current resources, (ii) cash flows from
operations, (iii) borrowings and (iv) potential debt or equity offerings.
Management believes that the consummation of the Merger will provide the Company
with significant additional capital alternatives.
Commitments and Contingencies
Refer to Item 3, "Legal Proceedings" of this Form 10-K which description is
incorporated herein by reference.
ITEM 7A. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
With a primary emphasis on protection of capital, the Board of
Directors-approved guidelines seek appropriate asset distribution,
diversification of risk, and use of professional external money managers to
manage levels of risk. The Company maintains two investment portfolios, one
internally managed for short-term liquidity and the other externally managed in
the fixed income and equity markets for long-term liquidity needs. The Company
does not hold derivative financial instruments or derivative commodity
instruments in either portfolio and has no foreign currency exposure. The
Company is subject to market risk exposure associated with changes in interest
rates and equity prices in its investment portfolios. A sensitivity analysis to
measure potential losses in the market value of the Company's fixed income and
equity investments in both portfolios (both portfolios are classified as other
than trading) indicates the following market risk exposures:
As of December 31, 1999, approximately 77.8% of the value ($256.8
million) of the consolidated portfolios was held in financial instruments
with fixed maturities, which are described above at Item 1,
"Business-Investment Portfolio". The primary market risk exposure is to
changes in interest rates. At December 31, 1999, an immediate one
percentage point decrease in interest rates would increase the net
aggregate market value of the fixed income portfolio by $9.0 million. An
immediate one percentage point increase in interest rates would decrease
the net aggregate market value of the fixed income portfolio by $9.1
million. Comparatively, at December 31, 1998, an immediate one percentage
point decrease in
24
<PAGE> 27
interest rates would increase the net aggregate market value of the fixed
income portfolio by $8.1 million. An immediate one percentage point
increase in interest rates would decrease the net aggregate market value of
the fixed income portfolio by $8.2 million. Corporate Treasury manages
interest rate exposure by maintaining a short duration. The modeling
technique used by the Company considers the net present value of cash flows
(including duration estimates). Short-term debt instruments, approximately
0.1% of the value ($0.3 million) of the consolidated portfolios, with a
fair value equal to their cost are excluded from the aggregate net market
value market risk exposure analysis.
The fair value of the common equity portfolio, excluding investments
in affiliated entities (0.1% of the common equity portfolio), was $72.3
million as of December 31, 1999. The equity portfolio is highly diversified
and limited to high quality domestic dividend paying stocks. The primary
market risk exposure is therefore an overall decline in market prices for
balanced portfolios composed of the equity securities of seasoned domestic
companies. At December 31, 1999, assuming an immediate 10% decrease in each
equity security price, the hypothetical pre-tax loss in fair value is $7.3
million. Likewise, assuming an immediate 10% increase in each equity
security price, the hypothetical pre-tax gain in fair value is $7.3
million. Comparatively, at December 31, 1998, assuming an immediate 10%
decrease in each equity security price, the hypothetical pre-tax loss in
fair value is $7.5 million. Likewise, assuming an immediate 10% increase in
each equity security price, the hypothetical pre-tax gain in fair value is
$7.5 million. The Company's unrealized net gains and losses are recorded
net of taxes as accumulated other comprehensive income in the Shareholders'
equity section of the accompanying Consolidated Financial Statements at
Item 8 of this Form 10-K.
While the first two months of 2000 have been unfavorable for equities (e.g.
the Standard & Poor's index declined 7.0%) due to rising short-term interest
rates, the Company does not anticipate any material change in primary market
risk exposure for the entire year 2000.
The portfolios and their management are also described and discussed above
at Item 1, "Business-Investment Portfolio" and Item 7, "Management's Discussion
and Analysis of Financial Condition and Results of Operations -- Liquidity and
Capital Resources -- Liquidity".
ITEM 8. FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA
The financial statements listed in Item 14(a)(1) are included in this
report beginning on page F-1.
ITEM 9. CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND
FINANCIAL DISCLOSURE
None.
25
<PAGE> 28
PART III
ITEM 10. DIRECTORS AND EXECUTIVE OFFICERS OF THE REGISTRANT
The following table sets forth certain information as of February 29, 2000
regarding each of the Directors of the Company and the executive officers of the
Company or BCBSGA. Each Director of the Company also serves as a Director of
BCBSGA.
<TABLE>
<CAPTION>
NAME AGE TITLE
- ---- --- -----
<S> <C> <C>
James L. LaBoon, Jr.................... 63 Chairman of the Board of Directors of the Company
and Blue Cross and Blue Shield of Georgia, Inc.
Fred L. Tolbert, Jr.................... 70 Vice Chairman of the Board of Directors of the
Company and Blue Cross and Blue Shield of Georgia,
Inc.
Richard D. Shirk....................... 54 Chief Executive Officer, President and Director of
the Company and Blue Cross and Blue Shield of
Georgia, Inc.
William A. Alias, Jr................... 58 Director
Elizabeth W. Camp...................... 48 Director
Edward M. Gillespie.................... 64 Director
Joseph D. Greene....................... 59 Director
Mel H. Gregory, Jr..................... 63 Director
Frank J. Hanna, III.................... 38 Director
Warren Y. Jobe......................... 59 Director
James H. Leigh, Jr., M.D............... 57 Director
James R. Lientz, Jr.................... 56 Director
Julia L. Mitchell-Ivey................. 66 Director
John W. Robinson, Jr................... 60 Director
Arnold M. Tenenbaum.................... 63 Director
W. Jerry Vereen........................ 59 Director
Joe M. Young........................... 71 Director
John A. Harris......................... 49 Treasurer of the Company, Executive Vice President
of Finance and Strategic Planning of Blue Cross and
Blue Shield of Georgia, Inc.
Hugh J. Stedman........................ 52 Secretary of the Company, Senior Vice President and
General Counsel of Blue Cross and Blue Shield of
Georgia, Inc.
Mark Kishel, M.D....................... 53 Executive Vice President, Chief Medical Officer of
Blue Cross and Blue Shield of Georgia, Inc.
Richard F. Rivers...................... 46 Executive Vice President, Chief Operating Officer of
Blue Cross and Blue Shield of Georgia, Inc.
Richard A. Steinhausen................. 56 Executive Vice President, Service Operations and
Information Systems of Blue Cross and Blue Shield of
Georgia, Inc.
R. Neil Vannoy......................... 53 Executive Vice President, Community Operations of
Blue Cross and Blue Shield of Georgia, Inc.
Robert A. Yungk........................ 43 Executive Vice President, Local Market Operations of
Blue Cross and Blue Shield of Georgia, Inc.
</TABLE>
James L. LaBoon, Jr., is the Chairman and President of Athens First Bank
and Trust Company, an affiliate of Synovus Financial Corporation, in Athens,
Georgia. Prior to joining Athens Bank and Trust, Mr. LaBoon was Vice President
of Finance and Chief Financial Officer of Wilkins Industries, Inc. He presently
serves as a Director of Athens First Bank and Trust Company, Synovus Mortgage
Corp., Athens Y.M.C.A. and Athens Symphony, Inc. Mr. LaBoon has been Chairman of
the Board of Directors of BCBSGA since 1994 and a Director since 1984. He has
also served as a Director of the Company since its
26
<PAGE> 29
organization in February 1996 and as its Chairman since March 22, 1996. He is
also a member of the Board of Directors of GBG.
Fred L. Tolbert, Jr., is retired as President of Albany First Federal
Savings and Loan in Albany, Georgia. He currently operates his own real estate
investment company in Albany, Georgia. Mr. Tolbert is a Trustee of the Darton
College Foundation. He has been a Director of BCBSGA since 1983 and Vice
Chairman of the Board since 1994. He has been Vice Chairman of the Board and a
Director of the Company since its organization in February 1996, and its Vice
Chairman since March 22, 1996. He also serves as Chairman of the Board of
Directors of GBG.
Richard D. Shirk joined BCBSGA as President and Chief Executive Officer on
April 1, 1992 and has been a Director of BCBSGA since that date. He has been
President, Chief Executive Officer and a Director of the Company since its
organization in February 1996. Mr. Shirk has been Chairman of GGL since 1992. He
is also a Director of HMO-Ga and GBG. Mr. Shirk has more than 25 years of
experience in employee benefits and managed care. He was a key senior officer of
Equicor in its formation in 1986, serving as President of the Southern Region.
When Equicor combined business operations with CIGNA in 1990, Mr. Shirk was
named Senior Vice President of the Central Region and coordinated the
integration of managed care operations of the companies. Mr. Shirk is a board
member of the Georgia Coalition for Health and the National Institute of Health
Care Management. He is a board member of Central Atlanta Progress and serves as
Chairman of the Georgia U.S.O.C. Steering Committee, as well as on the board of
directors of the Georgia Chamber of Commerce and the Board of SSgA Mutual Funds.
He is Director of the Buckhead Coalition and Metropolitan Atlanta Chapter of the
American Red Cross.
William A. Alias, Jr., is an entrepreneur holding various private
investments. Formerly, Mr. Alias was President of Rollins Protective Services, a
residential security company. Prior to joining Rollins, he was Executive Vice
President and Chief Operating Officer of Across the Street Restaurants of
America, Inc. He also held positions at Royal Crown Cola Company and the
National Icee Corporation. Mr. Alias is a former member of the Board of Trustees
of the Lovett School and is a Board Member of Security Check. He has been a
member of the Boards of Directors of the Company and BCBSGA since December 1996.
He is also a member of the Board of Directors of HMO-Ga.
Elizabeth W. Camp is President of Camp Oil Company in Rome, Georgia. Prior
to joining Camp Oil, Ms. Camp held positions as an attorney at Silver, Freedman
& Taff, attorneys in Washington, D.C. and as an accountant at Arthur Andersen,
LLP in Atlanta, Georgia. Ms. Camp is a member of the Boards of Directors of
Citizens First Bank in Rome, Camp Oil Company, Inc. and Sav-A-Ton Oil. She is a
member and past Chairman of the Board of Alumni Advisors for the Terry School of
Business at the University of Georgia. She is also a member of the Board of
Trustees of Darlington School in Rome. She has been a Director of BCBSGA since
1993 and a Director of the Company since its organization in February 1996.
Edward M. Gillespie is retired from University Hospital in Augusta,
Georgia, where he served as President and Executive Director until 1991. Prior
to joining University Hospital, Mr. Gillespie held various hospital
administrative positions including Hospital Administrator of Rochester Methodist
Hospital in Rochester, Minnesota. Mr. Gillespie serves on the advisory board of
South Trust and Brandon Wilde retirement community. He is also President of
Health Advance, a health care consulting organization. Mr. Gillespie has been a
Director of BCBSGA since 1980 and a Director of the Company since its
organization in February 1996.
Joseph D. Greene is a professor of Business Administration for the College
of Business at Augusta State University in Augusta, Georgia. Before joining
Augusta State University, Mr. Greene was employed by Pilgrim Health and Life
Insurance Company, where he retired as Executive Vice President after 32 years
of employment with the company. Mr. Greene is past Chairman of the Georgia Board
of Regents. He currently serves on the Boards of Directors of McDuffie Bank &
Trust of Thomson, the Greater Augusta Community Foundation, Morris Museum of
Arts, Southeastern Technology Center, the National Science Center Discovery and
the University of Georgia Terry College of Business. Mr. Greene has been a
Director of BCBSGA since 1993 and a Director of the Company since its
organization in February 1996. He is also Vice Chairman of the Board of
Directors of HMO-Ga.
27
<PAGE> 30
Mel H. Gregory, Jr., is retired, following a 35-year career in executive
insurance positions with The Equitable Companies. He held positions as Executive
Vice President, Agency Operations; President and Chief Operating Officer,
Equitable Variable Life Insurance Company; Chief Executive Officer, Equico
Securities; and as a member of The Equitable's Executive Committee. He is a
member of the Board of Directors of Stetson University School of Business. Mr.
Gregory has been a Director of the Company since its organization in February
1996 and a Director of BCBSGA since 1996. Mr. Gregory is also a Director of GGL.
Frank J. Hanna, III is, and has been since 1993, the Chief Executive
Officer of HBR Capital, Ltd., an investment firm based in Atlanta, Georgia. Mr.
Hanna began his career in Atlanta as a corporate attorney with the Atlanta law
firm of Troutman Sanders LLP. Mr. Hanna is also extensively involved in
education, including serving as a founding member of the Board of Directors of
the Archbishop Donnellan School and as a Director of Pinecrest Academy. Mr.
Hanna is a Director of CompuCredit Corporation. Mr. Hanna is a graduate of the
University of Georgia and the University of Georgia School of Law. Mr. Hanna
became a Director of the Company and BCBSGA in February 1996.
Warren Y. Jobe, is Senior Vice President of Southern Company responsible
for corporate development including customer relations and civic affairs. Mr.
Jobe is also Executive Vice President of Georgia Power Company and President of
the Georgia Power Foundation. Mr. Jobe is Chairman of the Board of Trustees of
Oglethorpe University. He is also currently a member of the Board of Directors
of the Atlanta Symphony Orchestra and the National Science Center, Inc. In the
past, Mr. Jobe has served on the Board of Regents of the University System of
Georgia and the Boards of Directors of the Georgia Chamber of Commerce, the
Visiting Nurse Health System of Atlanta, the Dekalb Regional Healthcare system
and various other civic and community organizations. Mr. Jobe became a Director
of BCBSGA and the Company in March 1999.
James H. Leigh, Jr., M.D., is a surgeon in Gainesville, Georgia, where he
has a private practice. He is a member of the Northeast Georgia Medical Center
staff and the Lanier Park Hospital consultant staff. Dr. Leigh is also past
Chief of Surgery and Chief of Staff at Northeast Georgia Medical Center. Dr.
Leigh served as an Assistant Professor of Surgery at the University of Tennessee
College of Medicine. Dr. Leigh was a member of the Board of Directors of the
Northeast Georgia Health Association and was previously an Alternate Director of
the Medical Association of Georgia. He has been a Director of BCBSGA since 1975
and a Director of the Company since its organization in February 1996. Dr. Leigh
is also a member of the Board of Directors of HMO-Ga.
James R. Lientz, Jr., is President of NationsBank, Mid-South Banking Group.
Prior to joining NationsBank, he was President and CEO of C&S National Bank of
South Carolina, a predecessor of NationsBank. Mr. Lientz is a member of the
Board of Directors of Georgia Power Company. He is a trustee of Rhodes College,
The Lovett School, the Georgia Research Alliance and the Georgia State
University Foundation. He serves as Chairman of the Georgia Chamber of Commerce
and the Georgia Council on Economic Education. He is also a member of the
Executive Committee of the Metropolitan Atlanta Chamber of Commerce. Mr. Lientz
has been a Director of BCBSGA and the Company since 1997.
Julia L. Mitchell-Ivey is a consultant and former Vice President and
Assistant Corporate Secretary at First Union National Bank of Georgia.
Previously, she held various positions at Decatur Federal Savings and Loan
Association including Corporate Treasurer, Corporate Secretary and Division Vice
President. Ms. Mitchell-Ivey is a past Chairperson of the Board of Directors of
Metropolitan Atlanta Rapid Transit Authority (MARTA) and Chairperson of the
Board of Directors of Private Colleges and Universities Authority and a member
of the Board of Directors of the Y.W.C.A. and the DeKalb Chamber of Commerce.
She has been a Director of BCBSGA since 1980 and a Director of the Company since
its organization in February 1996. She is Chairperson of the Board of Directors
of HMO-Ga.
John W. Robinson, Jr., is President of Southern Waistbands Incorporated.
Until June 1996, he was also a manufacturer's representative for Threads USA. He
has served as a member of the Board of Directors of the Bank of Bartow and Bank
South Corporation and is currently an Advisory Director to NationsBank Northeast
Georgia. He is a Trustee of The Georgia Baptist Foundation, serves on the
Executive Committee and is a past Chairman. Mr. Robinson has served on the
Georgia Board of Natural Resources and the Board of Regents of the University
System of Georgia and has been a Trustee of Athens Academy and a Director of the
Barrow
28
<PAGE> 31
County Chamber of Commerce. Mr. Robinson became a Director of BCBSGA and the
Company in March 1999.
Arnold M. Tenenbaum is President of Chatham Steel Corporation. He is a
member of the Boards of Directors of the Georgia Lottery Commission, First Union
National Bank of Savannah, First Union Bank of Georgia and Savannah Electric &
Power Company. Mr. Tenenbaum is a past President of the Telfair Academy of Arts
& Sciences, the Chairman of the Steel Service Center Institute and past Chairman
of the Georgia Chamber of Commerce. He has been a Director of BCBSGA and the
Company since 1997. He is also a member of the Board of Directors of HMO-Ga.
W. Jerry Vereen is President and Chief Executive Officer of Riverside
Manufacturing Company in Moultrie, Georgia and is acting Chairman of the Board
of Directors of Riverside Manufacturing Company and all of its subsidiary
corporations. Mr. Vereen serves on the Boards of Directors of Georgia Power
Company, Georgia Chamber of Commerce, Gerber Scientific, Inc., American Apparel
Manufacturers Association, and the Textile Clothing Technological Corporation,
the International Apparel Federation and the Georgia Research Alliance. He has
been a Director of BCBSGA since 1993 and a Director of the Company since its
organization in February 1996.
Joe M. Young is the General Manager of LOR, Inc. and Rollins Investment
Fund, two entities which manage the holdings of the family of the late O. Wayne
Rollins. His service with LOR, Inc. commenced in 1979 and with Rollins
Investment Fund at its inception in 1988. He also serves as an Officer and
Director of several other related entities and as a Trustee of several Rollins
Family Foundations and Trusts. Since 1992 he has been a Director of Valley
Systems, Inc., a public company traded on The NASDAQ Stock Market. Mr. Young
became a Director of BCBSGA and the Company in February 1996.
John A. Harris has served as BCBSGA's Executive Vice-President, Finance and
Strategic Planning since January 1993. He has served as Treasurer of the Company
since its organization in February 1996. Prior to joining BCBSGA, he worked in
the health care industry for 10 years, primarily in managed care companies, but
also with multi-line carriers. His positions included Chief Financial Officer,
Western Market Group, for the Employee Benefits Division of Lincoln National;
Assistant Corporate Controller for Financial Planning, Reporting and Analysis
for Equicor; President, VIP Health Plan (an IPA model HMO in California); and
Vice-President, Finance for CIGNA Health Plans for Southern California.
Hugh J. Stedman currently serves as Secretary of the Company and Senior
Vice President and General Counsel to BCBSGA. Mr. Stedman has been Counsel to
BCBSGA since 1985. Mr. Stedman obtained his J.D. from Rutgers University and is
admitted to practice law in Georgia and Pennsylvania. Prior to joining BCBSGA,
Mr. Stedman was Associate Counsel for Healthdyne, Inc., a manufacturer of
medical devices and supplier of home-health services. Mr. Stedman is a member of
the American, Georgia and Cobb County Bar Associations, the Cobb County Chamber
of Commerce and the National Health Lawyers' Association.
Mark Kishel, M.D., has been Executive Vice President and Chief Medical
Officer of BCBSGA since October 1993. Prior to joining BCBSGA, he developed
staff, group and IPA model HMOs, as well as PPOs, for major carriers and other
managed care organizations including Travelers, Lincoln National and Health
America. His management experience includes capitated Medicaid, managed workers
compensation, POS and HMO networks. Dr. Kishel has developed quality management
and utilization management programs for various start-up companies and consulted
in physician hospital organizations and university-sponsored health plan
development. As a practicing pediatrician and family physician for 11 years, Dr.
Kishel assisted in the development of a model primary care system that addressed
the needs of the indigent and uninsured in Arizona. He is a Director of the
Atlanta Boys and Girls Clubs, Inc.
Richard F. Rivers joined BCBSGA as Executive Vice President and Chief
Operating Officer in September 1997. Prior to joining BCBSGA, Mr. Rivers worked
for Prudential Insurance Company for 22 years. Most recently, he was Senior Vice
President of Health Plan Operations with Prudential Healthcare and was
responsible for the operations of 32 local health plans nationwide. Prior to
this, he was President of South Central Operations and had full responsibility
for operations in ten states.
29
<PAGE> 32
Richard A. Steinhausen joined BCBSGA in August 1995 as Executive Vice
President, Service Operations and Information Systems. Mr. Steinhausen has more
than 30 years of health care industry experience. Most recently, he served as
Vice President, Employee Benefits Division of Washington National. Previously,
he was a Senior Vice President of Equicor and President of its National Benefits
Sector. He also served as a Regional Vice President, Claims for Equitable Life
Assurance Society.
R. Neil Vannoy joined BCBSGA as Senior Vice President of Public Affairs and
Product Development in July 1992. In 1994, he was appointed Executive Vice
President of Community Operations of BCBSGA and is responsible for community
healthcare partnership developments and government programs. Prior to joining
BCBSGA, Mr. Vannoy served in management positions with Prudential Insurance
Company for 16 years, including Vice President, Group Corporate at Prudential's
New Jersey headquarters, Vice President in charge of the Company's Southern
Group Operations, Vice President of Florida Group Operations and Vice President
of Group Marketing and Sales at the New York City group office. Mr. Vannoy is a
member of the Boards of Directors of the Georgia Business Forum and the
Company's Community Health Partnership Network joint ventures in Atlanta and
Savannah. He serves on the Professional Advisory Council of Mission New Hope in
Atlanta, supported the development of the Georgia Coalition for Health as a
member of the formation steering committee and serves on the technical advisory
committee of the Georgia Health Policy Center. Mr. Vannoy holds a Chartered Life
Underwriter designation.
Robert A. Yungk joined BCBSGA on December 15, 1997 with 18 years experience
with national managed care companies. Mr. Yungk has extensive managed care
experience with staff, group, gatekeeper and open access IPA's, Point of
Service, Preferred Provider Organization and pre-paid Dental HMO's. Most
recently he served in a dual capacity as President and CEO of United Healthcare
of Alabama and Executive Vice President and COO of United Healthcare South, a
six-region managed care plan with 650,000 HMO members. During his 12 years at
Lincoln National Corporation he served in various senior roles in health plan
management, corporate and regional sales. He also holds a Chartered Life
Underwriter designation.
INFORMATION REGARDING THE BOARD OF DIRECTORS
The Company's Articles of Incorporation provide that the Board of Directors
shall consist of not more than 21 members with the actual number of Directors to
be fixed from time to time by the Board of Directors. The Articles of
Incorporation provide for the classification of the Company's Directors into
three classes, with each class containing approximately the same number of
Directors and the term of one class expiring each year. At each Annual Meeting
of Shareholders, the Directors of one class are elected by the shareholders
entitled to vote thereon, to hold office for a term of three years or until
their successors are elected and qualified. Set forth below is the name of each
Director, the class in which he or she serves and the year in which his or her
current term expires.
Class One -- Term Expires at the 2002 Annual Meeting of Shareholders
Elizabeth W. Camp(1)
Mel H. Gregory, Jr.
James L. LaBoon, Jr.
James H. Leigh, Jr., M.D.
Julia L. Mitchell-Ivey
John W. Robinson, Jr.(1)
Class Two -- Term Expires at the 2000 Annual Meeting of Shareholders
Edward M. Gillespie
Joseph D. Greene, CLU(1)
James R. Lientz, Jr.(1)
W. Jerry Vereen
Joe M. Young(2)
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<PAGE> 33
Class Three -- Term Expires at the 2001 Annual Meeting of Shareholders
William A. Alias, Jr.
Frank J. Hanna, III(2)
Warren Y. Jobe(1)
Richard D. Shirk
Arnold M. Tenenbaum(1)
Fred L. Tolbert, Jr.
- ---------------
(1) Ms. Camp and Messrs. Green, Jobe, Lientz, Robinson and Tenenbaum are Class A
Designated Directors
(2) Mr. Young is a Class Two, Preferred Designated Director. Mr. Hanna is a
Class Three, Preferred Designated Director.
Under the Articles of Incorporation, so long as shares of Preferred Stock
are issued, outstanding and entitled to vote and no shares of the Company's
common stock, no par value (the "Common Stock"), are outstanding, the holders of
outstanding shares of Class A Stock, voting separately as a single class (with
each share being entitled to one vote) and to the exclusion of all other classes
and series of capital stock of the Company, are entitled to elect two Directors
to each of the Company's three Classes of Directors ("Class A Designated
Directors"), for a total of six of the total number of members of the Board of
Directors following the third annual election.
On March 4, 1997 a special nominating committee composed of two Continuing
Directors and Ms. Camp and Mr. Greene, the then current Class A Designated
Directors, nominated Mr. Greene and James R. Lientz, Jr. as Class A Designated
Directors to serve as Class Two Directors until the 2000 Annual Meeting or until
their successors are duly elected and qualified and Arnold Tenenbaum as a Class
A Designated Director to serve as a Class Three Director until the 1998 Annual
Meeting to be voted on by all of the holders of the Class A Stock at the Annual
Meeting of Shareholders held on April 25, 1997 (the "1997 Annual Meeting"). The
three nominees were elected as Class A Designated Directors at the 1997 Annual
Meeting. Prior to the third meeting of the holders of Class A Stock scheduled
for December 30, 1998 at which Class A Designated Directors were to be elected
(the "1998 Annual Meeting"), a special nominating committee composed of two
Continuing Directors and the Class A Designated Directors nominated Arnold
Tenenbaum and Warren Y. Jobe as Class A designated Directors to serve as Class
Three Directors until the Annual Meeting of Shareholders held in 2001. As
described herein at Part I, Item 4, the 1998 Annual Meeting was adjourned until
an undetermined date. Following this adjournment, there existed two vacancies on
the Board of Directors for Class A Designated Directors. In order to comply with
the Plan of Conversion approved by the Georgia Commissioner in connection with
the Conversion, effective March 15, 1999 the Board of Directors unanimously
appointed John W. Robinson, Jr. and Warren Y. Jobe as Class A Designated
Directors in Class One and Class Three, respectively. These appointments were
ratified by the holders of Class A Stock at the 1999 Annual Meeting. Following
these Director appointments, at each annual meeting until the Class A Stock is
converted to Common Stock as provided in the Articles of Incorporation, a
special nominating committee composed of the six Class A Designated Directors
will nominate, and the holders of the Class A Stock will be entitled to elect,
two Class A Designated Directors each year to replace the Class A Designated
Directors whose terms expire during such year.
Notwithstanding any nomination by a special nominating committee, the
holders of the Class A Stock are entitled to nominate and elect any eligible
individual to fill the Class A Designated Director positions subject to election
each year.
The holders of shares of Preferred Stock, voting separately as a single
class (with each share being entitled to one vote) and to the exclusion of all
other classes and series of capital stock of the Company, are entitled to
nominate and elect two directors (the "Preferred Designated Directors") and all
of the remaining Directors of the Company other than the Class A Designated
Directors, who are elected exclusively by the holders of Class A Stock. However,
pursuant to the terms of a Shareholders' Agreement (the "Shareholders'
Agreement") among the holders of Preferred Stock, BCBSGA and the Company, so
long as no shares of the Company's Common Stock are issued and outstanding, the
holders of Preferred Stock will be obligated to vote their shares so that the
persons (other than the Preferred Designated Directors) nominated by the
Nominating Committee of the Company's Board of Directors and approved by
two-thirds of the Continuing
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<PAGE> 34
Directors of the Company are elected Directors of the Company. As a result, the
current Board of Directors will have the ability to designate a majority of the
Directors of the Company.
"Continuing Directors" are those individuals who: (i) were named as members
of the initial Board of Directors of the Company (other than the Preferred
Designated Directors), together with any new Directors whose election or
nomination to the Board of Directors was approved by a vote of two-thirds of the
Directors then still in office who were such Directors or whose election or
nomination was previously so approved; (ii) are not beneficial owners of more
than five percent of the total shares of any class of equity securities of the
Company outstanding; and (iii) were not nominated by such a beneficial owner
and, prior to such Director's election, did not have any agreement, arrangement,
or understanding with any such beneficial owner with respect to any action to be
taken by such person as a Director.
If no shares of Preferred Stock or Common Stock are issued, outstanding and
entitled to vote, all rights to vote in the election of Directors are vested in
the holders of outstanding Class A Stock and Blank Preferred Stock.
SECTION 16(A) OF THE SECURITIES EXCHANGE ACT
BENEFICIAL OWNERSHIP REPORTING
Section 16(a) of the Exchange Act and regulations of the Commission
thereunder require the Company's executive officers and Directors and persons
who own more than ten percent of the Company's Class A Stock, if any, as well as
certain affiliates of such persons, to file initial reports of ownership and
reports of changes in ownership with the Commission. Executive officers,
Directors and persons owning more than ten percent of the Company's Class A
Stock are required by Commission regulation to furnish the Company with copies
of all Section 16(a) forms they file. Based solely on its review of the copies
of such reports received by it and written representations from the reporting
persons that no other reports were required for those persons, to the Company's
knowledge, during and with respect to the fiscal year ended December 31, 1999,
all filing requirements applicable to its executive officers and Directors were
complied with in a timely manner. To the Company's knowledge, other than the
Foundation there is no person that owns more than ten percent of the Company's
Class A Stock.
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<PAGE> 35
ITEM 11. EXECUTIVE COMPENSATION
GENERAL
The following table summarizes by various categories, for the fiscal years
ended December 31, 1999, 1998 and 1997, the total compensation earned by (i) the
Chief Executive Officer of the Company, and (ii) each of the four most highly
compensated executive officers of the Company or BGBSGA who were serving as
executive officers at December 31, 1999 and whose salary and bonus for the
fiscal year ended December 31, 1999 exceeded $100,000 (collectively referred to
as the "Named Executive Officers").
TABLE 1: SUMMARY COMPENSATION TABLE
<TABLE>
<CAPTION>
LONG-TERM
ANNUAL COMPENSATION COMPENSATION ALL
---------------------------------- ------------ OTHER
OTHER ANNUAL LTIP COMPEN-
SALARY BONUS COMPENSATION PAYOUTS SATION
NAME AND PRINCIPAL POSITION YEAR ($)(1) ($)(2) ($)(3) ($)(4) ($)(5)
- --------------------------- ---- -------- -------- ------------ ------------ -------
<S> <C> <C> <C> <C> <C> <C>
Richard D. Shirk.............. 1999 $537,500 $379,923 -- -- 4,265
Chief Executive Officer, 1998 500,000 423,940 -- -- 4,505
President and Director of
the 1997 481,250 -- -- 281,437 4,030
Company and BCBSGA
Richard F. Rivers............. 1999 318,750 175,256 -- -- 3,604
Executive Vice President 1998 307,500 183,600 -- -- 2,376
and Chief Operating Officer 1997 77,299 -- -- -- 279
of BCBSGA(6)
John A. Harris................ 1999 273,500 139,553 -- -- 3,430
Treasurer of the Company, 1998 254,000 162,432 -- -- 3,460
Executive Vice President, 1997 225,750 -- -- 89,967 3,202
Finance and Strategic
Planning of BCBSGA
Mark Kishel, M.D.............. 1999 245,000 91,434 -- -- 3,325
Executive Vice President 1998 225,000 121,525 -- -- 3,276
and Chief Medical Officer 1997 208,750 -- -- 89,967 3,238
of BCBSGA
Stuart G. Wright.............. 1999 300,000 265,771 -- -- 3,569
Senior Vice President and 1998 300,000 91,800 -- -- 3,238
Chief Information Officer of 1997 199,000 -- -- 34,167 3,213
BCBSGA(7)
</TABLE>
- ---------------
(1) Includes amounts deferred at the election of the officers pursuant to the
Tax-Favored Savings Program and other deferred compensation plans.
(2) Threshold financial performance criteria pursuant to the Annual Incentive
Program was not achieved for 1997; no bonuses were earned for that period.
(3) Perquisites for Named Executive Officers were less than 10% of their total
salary for all periods presented.
(4) No payments were made in 1998 as threshold financial performance criteria
was not achieved for the 1995-1997 performance period. Includes payments in
1997 to the Named Executive Officers for long-term incentive payments for
the 1994-1996 performance period. The long-term incentive plan was replaced
by the performance unit plan during 1997.
(5) Reflects contributions to the Tax-Favored Savings Program in 1999, 1998 and
1997, respectively, of $2,525, $2,525 and $2,500 for Mr. Shirk, Mr. Harris
and Mr. Wright, $2,525, $2,444 and $2,500 for Dr. Kishel and $2,525, $1,188
and $-0- for Mr. Rivers, as well as the following premium payments on group
term life insurance in 1999, 1998 and 1997, respectively: Mr. Shirk, $1,740
$1,980 and $1,530; Mr. Rivers, $1,079, $1,188 and $279; Mr. Harris, $905,
$935 and $702; Dr. Kishel, $800, $832 and $738; and Mr. Wright, $1,044, $713
and $713.
(6) Mr. Rivers joined the Company in September 1997.
(7) 1999 bonus for Mr. Wright includes a nonrecurring bonus of $200,000 related
to the successful execution of the Company's Year 2000 Readiness Plan.
LONG-TERM INCENTIVE COMPENSATION
Prior to fiscal year 1997, BCBSGA maintained a Long-Term Incentive Plan
("LTIP"). The LTIP was designed to reward participants for their contributions
to the successful achievement of specific financial, market share and customer
service goals based on the Company's long-term business strategy. Goals were
established for three-year performance periods. Prior to 1997, long-term
incentive award opportunities had been established for four performance cycles,
the 1992-1994 performance period, the 1993-1995 performance
33
<PAGE> 36
period, the 1994-1996 performance period and the 1995-1997 performance period.
Named Executive Officers received payouts for the 1994-1996 performance cycle
which are reflected in the Summary Compensation Table. Minimum threshold levels
for financial performance were not achieved for the 1995-1997 cycle. No payouts
to Named Executive Officers were due for that performance period. The LTIP was
terminated as of December 31, 1997, and there are no remaining payments due
under the LTIP with respect to any period for which it was in effect.
In July 1997, the Company adopted the Performance Unit Plan (the "PUP")
effective February 2, 1996 to replace the LTIP and to reward key employees for
creating and increasing the value of the Company. The Compensation Committee of
the Board of Directors of the Company is responsible for the administration of
the PUP including designation of participants and granting of units. The PUP
provides that the Compensation Committee will award up to an aggregate of one
million (1,000,000) units to designated key employees. The terms of the PUP
established a beginning value of the Company of $221,000,000, as determined as
of February 2, 1996, with a beginning per unit value of $22.11. Under the PUP,
participants become vested in their units upon the occurrence of the earliest of
a "Change in Control" of the Company, the participant's death, disability or
retirement under the Company's tax-qualified retirement plan, the end of a
Measurement Period (as defined in the PUP) or December 31, 1999, so long as a
participant remains employed by the Company through the date of a shareholder
liquidity event, unless termination should occur by reason of death, disability
or retirement under the Company's defined benefit plan. The term "Measurement
Period" is defined in the PUP as the period beginning on February 2, 1996 and
ending on the date when the Company's value is first determinable, i.e., upon a
market event that creates a definite value and results in liquidity. The
Company's Board is granted authority to determine when such a market event has
occurred, until such time as the Company's Common Stock is listed or traded on a
recognized United States exchange. At the end of 1999, there was no
market/liquidity event as defined in the plan; therefore, units granted under
the plan did not have any assigned value.
Payments are to be made at the end of the Measurement Period; provided,
that if a Change in Control of the Company (as defined in the PUP) occurs first,
payment is to be made as soon as practicable thereafter. A "Change in Control"
is defined in the PUP to include (i) an acquisition of 50% or more of the
Company's voting stock; (ii) the termination of a majority of the members of the
Company's Board of Directors within a two-year period without certain approvals;
(iii) the approval by the Company's shareholders of any merger, consolidation or
share exchange of the voting stock, a liquidation of the Company or any sale of
50% of the Company's assets or earning power; or (iv) the approval by the
Company's shareholders of any merger, consolidation or share exchange which
would result in the persons who were shareholders immediately before such
transaction having beneficial ownership of less than 50% of the voting
securities. Under this definition, the shareholders' approval of the proposed
Merger would constitute a Change in Control for purposes of the PUP.
In order for any amount to be payable under the PUP, the per unit value of
the Company must have increased sufficiently from the beginning per unit value
to meet the performance hurdle established under the PUP, which is the average
yield of One-Year Treasury Bills (as specified in The Wall Street Journal on the
published date nearest to the end of each quarter for the preceding year),
compounded over the Measurement Period. Assuming that the value exceeds the
performance hurdle, payment is to be made in the amount of the difference
between the beginning per unit value of the Company and the per unit value of
the Company at the end of the Measurement Period multiplied by the number of
units awarded. Payment is to be made in cash, Company stock or any combination
of the two, subject to withholding for taxes. Payment is to be made as soon as
practicable after the end of the later of (i) when vesting occurs or (ii) the
end of a Measurement Period. The Merger establishes a value that satisfies the
performance hurdle.
At the end of February 2000, there were 964,000 performance units
outstanding which were granted to 259 employees during 1999 and 1998. Awards
under the performance unit plan were made to the Named Executive Officers during
1998. Awards to the Named Executive Officers and the amounts that become payable
to them under the PUP due to the Merger, assuming the purchase price of
$500,000,000 (and therefore an ending unit value of $50.00; $50.00 - $22.11 =
$27.89 per unit), are as follows: Richard D. Shirk,
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<PAGE> 37
138,000 units, $3,848,820; Richard F. Rivers, 30,000 units, $836,700; John A.
Harris, 67,000 units, $1,868,630; Mark Kishel, 55,000 units, $1,533,950; and
Stuart G. Wright, 25,000 units, $697,250.
DEFINED BENEFITS
Retirement Plan
The Non-Contributory Retirement Program for Certain Employees of BCBSGA
(the "Retirement Plan") is a tax-qualified defined benefit pension plan that
covers all employees of BCBSGA and its participating affiliated companies, who
have attained age 21 and have completed 1,000 hours of service in a 12-month
period after their date of hire or who complete 1,000 hours of service in any
calendar year thereafter. Benefits under the Retirement Plan are based upon
length of service with any Blue Cross/Blue Shield plan, with varying provisions
for employees who are terminated or take early, normal or deferred retirement.
The annual retirement benefit is calculated according to a specific formula. The
benefit is 60% of the participant's Final Average Earnings (i.e., the average of
the highest five consecutive years of annual salaries and annual incentive
payments out of the last ten years of credited service) reduced by 50% of the
participant's anticipated Social Security benefit. If the participant has less
than 30 years of service, the result is multiplied by a service fraction. The
fraction is the number of the participant's years of credited service up to 30
divided by 30. For purposes of the Retirement Plan, a participant's earnings
that may be considered may be limited by provisions of Section 401(a)(17) of the
Internal Revenue Code of 1986, as amended (the "Code"), and the annual additions
to his benefit may be limited by Code Section 415. A participant becomes fully
vested after five years of service. Generally, upon retirement, participants may
elect to receive their benefits in the form of a lump sum payment, lifetime
annuity, lifetime annuity with a guaranteed payout period (ten or 20 years), or
a joint and survivor annuity with 50%, 66 2/3% or 100% survivor benefits. The
Retirement Plan also provides, subject to certain conditions, for the payment of
vested benefits of a deceased employee to his or her spouse during such spouse's
lifetime.
The amount of contributions required by BCBSGA to fund benefits for its
employees is determined each year by actuaries. Participant contributions are
not permitted. Benefits under the Retirement Plan are insured by the Pension
Benefit Guaranty Corporation. The Retirement Plan is administered by BCBSA. All
contributions are held in a tax-qualified trust, and Bankers Trust Company
serves as Trustee to the Retirement Plan. BCBSGA made a contribution of $1.3
million to the Retirement Plan for the plan year ended December 31, 1999. The
amounts shown in the Summary Compensation Table above do not include BCBSGA's
contributions in connection with the Retirement Plan for the Named Executive
Officers. Such amounts are not and cannot be readily separated or individually
calculated.
In order to provide benefits to certain of its highly compensated or
management employees whose benefits under the Retirement Plan will be limited
due to requirements of the Code, BCBSGA maintains the Blue Cross and Blue Shield
of Georgia, Inc. Executive Benefit Restoration Plan (the "Restoration Plan"), in
which all of the Named Executive Officers participate. Generally, participants
are recommended by the Chief Executive Officer and approved by the Compensation
Committee. The Restoration Plan provides benefits to participants whose benefits
under the Retirement Plan are restricted by the compensation and annual addition
limitations described in Code Sections 401(a)(17) and 415. A participant becomes
vested in his benefit under the Restoration Plan upon retirement or disability
after attainment of age 55 and completion of five years of service (as defined
in the Retirement Plan). A participant whose employment is terminated within one
year following a change in control (as defined in the Restoration Plan) for
reasons other than death or disability will have a fully vested right to receive
all benefits accrued under the Restoration Plan as of the date of termination if
his employment is terminated without just cause (as defined in the Restoration
Plan) or if the participant terminates with good reason (as defined in the
Restoration Plan). The benefit payable under the Restoration Plan is equal to
the difference between (i) the benefit the participant would be entitled to
under the Retirement Plan, calculated without regard to the compensation and
annual addition limits in effect under the Code, and (ii) the sum of the benefit
payable under the Retirement Plan and any nonqualified defined benefit plan
sponsored by another Blue Cross/Blue Shield employer, that relates to a period
of service for which credit is given under the Restoration Plan. The benefits
provided by the Restoration Plan are generally an unfunded obligation of BCBSGA.
The accrued benefits payable under the Restoration Plan at the end of
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<PAGE> 38
1999 for the Named Executive Officers were $6,547 for Mr. Rivers; $19,586 for
Mr. Harris; $20,101 for Dr. Kishel; and $-0-for Mr. Wright. Mr. Shirk does not
participate in the Restoration Plan.
BCBSGA Supplemental Executive Retirement Plan
Effective as of July 1, 1996, BCBSGA adopted the Supplemental Executive
Retirement Plan (the "SERP") to provide additional, non-qualified retirement
benefits to a designated group of management employees. The SERP is administered
by BCBSGA's Compensation Committee and is designed as a supplement to the
Retirement Plan. Participants are recommended by the Chief Executive Officer of
BCBSGA and designated by the Compensation Committee. In general, each
participant in the SERP becomes entitled to receive a retirement benefit equal
to the difference between (A) and (B) where (A) equals the benefit that the
participant would be entitled to under the Retirement Plan calculated as if the
participant were credited with two years of service for each year of actual
service (up, to a maximum of 30 years) and without application of the
compensation or annual additions limitations imposed under Sections 401(a)(17)
and 415 of the Code, and (B) equals the sum of the participant's vested accrued
benefit under the Retirement Plan and his vested accrued benefit under the
Restoration Plan and any other non-qualified defined benefit plan sponsored by
BCBSGA or any affiliate which pertains to the same periods of service.
Benefits under the SERP generally become payable upon the participant's
termination of employment due to disability or retirement after reaching age 55
and completing five years of service. Payments may be made in a lump sum or any
form offered under the Retirement Plan. If payment commences before the
participant's attainment of age 65, the benefit amount will be subject to a
reduction of 0.25% for each month by which payment precedes the first day of the
month coinciding with or next following the participant's attainment of age 62.
The SERP provides that if a participant is terminated from employment
within one year following a Change in Control (as defined below) for reasons
other than death or disability, the participant becomes vested and entitled to
receive all benefits accrued under the SERP as of the date of such termination
if such termination arose from voluntary termination for "Good Reason" (as
defined below) or dismissal without "Just Cause" (as defined below). In this
instance, payment is to be made as of the later of the first day of the month
following the termination of employment or the first day of the month following
the participant's 55th birthday.
The SERP contains a definition of "Change in Control" that is similar to
that contained in the PUP. The term "Good Reason" is defined as the occurrence
after a Change in Control of either a reduction in the nature or status of the
participant's responsibilities or a reduction of the participant's base salary.
The term "Just Cause" is defined as (i) an act of fraud, embezzlement, theft or
other felonious criminal act; (ii) willful and continued failure to
substantially perform his duties; or (iii) willful engagement in conduct that is
demonstrably and materially injurious to BCBSGA and its affiliated companies.
The SERP is generally an unfunded obligation of BCBSGA. As of January 1,
1997, BCBSGA entered into a trust agreement with Wachovia Bank of North
Carolina, N.A., as Trustee, to establish the Blue Cross and Blue Shield of
Georgia, Inc. Non-qualified Retirement Trust (the "Trust"), to which BCBSGA
would contribute assets for the purpose of payment of the benefits under the
SERP and other non-qualified plans, subject to the claims of BCBSGA's creditors
in the event of its insolvency or bankruptcy.
Supplemental benefits accrued under the SERP at the end of 1999 for the
Named Executive Officers were $13,062 for Mr. Rivers; $39,172 for Mr. Harris;
$37,680 for Dr. Kishel; and $55,236 for Mr. Wright. Four other key management
employees participate in the SERP.
Agreement for Supplemental Executive Retirement Benefits between BCBSGA and
Richard D. Shirk
On December 1, 1996, BCBSGA entered into an agreement with Richard D. Shirk
to provide him a nonqualified retirement benefit to supplement the benefit
provided to him under the Retirement Plan (the "RDS SERP"), as amended by that
certain First Amendment to the RDS SERP, dated March 7, 1998 with
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<PAGE> 39
an effective date of January 1, 1998. Mr. Shirk becomes eligible for benefits
under the RDS SERP upon the termination of his employment for any reason other
than his voluntary termination without "Good Reason". The term "Good Reason" is
defined in Mr. Shirk's employment agreement with the Company and BCBSGA, dated
January 1, 1997, as amended by that certain First Amendment to the Employment
Agreement dated March 7, 1998, with an effective date of January 1, 1998 (the
"Employment Agreement"), as (i) any assignment of duties significantly different
from those contemplated by the Employment Agreement or any material limitation
in his authority, powers or responsibilities, (ii) failure to be elected or
removal as a member of the Board of Directors of either the Company or BCBSGA
unless required by a change in Georgia law, (iii) receipt of any notice limiting
the term of the Employment Agreement to two years, (iv) a material breach by
either the Company or BCBSGA of any of the material provisions of the Employment
Agreement which are not cured within 30 days after notice and (v) a Change in
Control. For purposes of the Employment Agreement and the RDS SERP, the term
"Change in Control" is defined as (i) the acquisition of ownership of stock or
securities of either the Company or BCBSGA representing 5% or more of the voting
power of any class of stock or securities of either the Company or BCBSGA
(except as may be acquired by institutional investors if the stock or securities
are traded on a recognized exchange or through The NASDAQ Stock Market); (ii)
the date on which a majority of the members of the board of either the Company
or BCBSGA are no longer Continuing Directors, as defined in the license
agreement between the Company and the BCBSA, originally dated February 2, 1996;
(iii) approval by the shareholders of the Company or BCBSGA of any merger,
consolidation or share exchange as a result of which the securities of the
Company or BCBSGA will be changed, converted or exchanged into the shares of
another corporation or the liquidation of the Company or BCBSGA or the sale or
disposition of 50% or more of the assets or earning power of either the Company
or BCBSGA; or (iv) approval by the shareholders of any plan of consolidation,
merger or share exchange which would result in the persons who were shareholders
immediately prior to such transaction retaining less than 50% of the voting
power to elect directors of the surviving corporation.
The benefits payable under the RDS SERP vary, depending on Mr. Shirk's age
at the time of his termination of employment. If he is less than age 55 at the
time of his termination, his monthly benefit shall equal 2% of his "Final
Average Earnings" times his years of credited service, minus 21% (which
represents a reduction of 3% per year for each year that the benefit begins
before age 62), minus the monthly annuity amount he would receive from the
Retirement Plan, and minus the actuarial equivalent value of the monthly benefit
he would receive from Social Security at age 62. If termination occurs after age
55 but before age 60, his monthly benefit would equal 2% of his Final Average
Earnings for each of his first 25 years of credited service, minus 0.25% for
each month that his termination precedes his 62nd birthday, plus 3% of his Final
Average Earnings for each of his next five years of credited service, minus the
monthly annuity amount he would receive from the Retirement Plan, and minus the
actuarial equivalent of the monthly benefit he would receive from Social
Security at age 62. If his employment is terminated after age 60, his monthly
benefit would equal 65% of his Final Average Earnings, minus the monthly annuity
amount he would receive from the Retirement Plan, minus the actuarial equivalent
value of the monthly benefit he would receive from Social Security at age 62.
For purposes of the RDS SERP, Mr. Shirk is deemed to have completed 25
years of credited service at age 55. For each year after age 55, he will earn an
additional year of service, up to a maximum of 30 years. Pursuant to the First
Amendment to the RDS SERP, dated December 1, 1996, the term "Final Average
Earnings" is defined to equal one-twelfth of the Final Average Earnings amount
determined under the Retirement Plan, with the following modifications: (i)
Final Average Earnings would not be limited to the Compensation limits imposed
by Section 401(a)(17) of the Code; (ii) cash incentive payments would be
included, regardless of whether they were received or deferred by Mr. Shirk,
(iii) if his market target rate for any given calendar year exceeds his base
salary rate, the market target rate is to be used in the calculation, and market
target rate is to equal the 50th percentile market rate as determined by the
Compensation Committee on an annual basis.
The RDS SERP provides that the benefit should be continuously funded by
BCBSGA through a grantor trust. BCBSGA has made contributions to the
aforementioned Trust for this purpose.
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<PAGE> 40
The amount of Mr. Shirk's benefit accrued at December 31, 1999 under the
RDS SERP was $427,351. The Trust held assets valued at $1,684,187 as of December
31, 1999. See "Interest of Certain Persons in the Merger -- Agreement for
Supplemental Executive Retirement Benefits between Blue Cross and Blue Shield of
Georgia, Inc., and Richard D. Shirk" in Form S-4, Registration No. 333-64995 of
WellPoint filed December 4, 1998, for the related funding obligation upon
consummation of the Merger.
If Mr. Shirk terminates employment following a Change in Control for any
reason other than voluntarily without Good Reason, the amount of his monthly
benefit is to be the greater of the normal calculation described above
(depending on his age at that time); or 60% of his Final Average Earnings,
without reduction for early commencement, but with reductions for benefits
payable under the Retirement Plan and Social Security. Benefits may be paid in a
lump sum payment or any optional form of payment permitted under the Retirement
Plan.
Because Mr. Shirk's Employment Agreement defines "Good Reason" to include a
Change in Control, he may voluntarily terminate his employment at any time
following a Change in Control of the Company or BCBSGA and be entitled to
immediate payment of the benefits under the RDS SERP. In addition, due to the
continuous funding requirement of the RDS SERP and the Change in Control funding
requirement of the Trust, it is anticipated that contributions will be required
to the Trust within 30 days of a Change in Control, to prefund Mr. Shirks'
entire benefit.
In addition, as of January 1, 1997, the Company amended Mr. Shirk's
Employment Agreement to state that the Company will provide Mr. Shirk an
additional cash payment sufficient to cover any excise tax imposed on him under
Sections 280G or 4999 of the Code on the total payments (made under the PUP, the
RDS SERP, the Employment Agreement and any other plan or arrangement) he
receives as a result of a Change in Control (the "Excise Tax Payment"), and an
additional payment to cover the state and Federal income taxes and employment
taxes on the Excise Tax Payment (the "Gross Up Payment").
The following Table 2 -- Pension Plan Table indicates an estimated annual
benefit payable after reductions for a portion of Social Security benefits to
participants in the Retirement Plan and the Restoration Plan, assuming continued
employment until retirement at age 65. The table indicates the estimated annual
benefit calculated on a straight-line annuity basis in persons in specified
Final Average Earnings and completed years of service categories. As of December
31, 1999, years of credited service under the Retirement Plan for the Named
Executive Officers were: Mr. Shirk -- 7 3/4 years; Mr. Harris -- 7 years; Dr.
Kishel -- 6 1/4 years; Mr. Wright -- 3 11/12 years; and Mr. Rivers -- 2 1/3
years. The compensation covered by the Retirement Plan generally includes the
base rate of annual earnings and annual incentive payments actually paid to a
participant by BCBSGA up to $160,000, the maximum amount of compensation that
may be recognized under qualified pension plans. For each Named Executive
Officer, the compensation in the Summary Compensation Table exceeds this maximum
amount.
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<PAGE> 41
TABLE 2: PENSION PLAN TABLE
<TABLE>
<CAPTION>
YEARS OF SERVICE
FINAL AVERAGE --------------------------------------------------------
EARNINGS 10 15 20 25 30
- ------------- -------- -------- -------- -------- --------
<S> <C> <C> <C> <C> <C>
$ 100,000........................... $ 17,132 $ 25,698 $ 34,264 $ 42,830 $ 51,396
150,000........................... 27,132 40,698 54,264 67,830 81,396
200,000........................... 37,132 55,698 74,264 92,830 111,396
250,000........................... 47,132 70,698 94,264 117,830 141,396
300,000........................... 57,132 85,698 114,264 142,830 171,396
350,000........................... 67,132 100,698 134,264 167,830 201,396
400,000........................... 77,132 115,698 154,264 192,830 231,396
500,000........................... 97,132 145,698 194,264 242,830 291,396
600,000........................... 117,132 175,698 234,264 292,830 351,396
700,000........................... 137,132 205,698 274,264 342,830 411,396
800,000........................... 157,132 235,698 314,264 392,830 471,396
900,000........................... 177,132 265,698 354,264 442,830 531,396
1,000,000.......................... 197,132 295,698 394,264 492,830 591,396
1,250,000.......................... 247,132 370,698 494,264 617,830 741,396
1,500,000.......................... 297,132 445,698 594,264 742,830 891,396
</TABLE>
Tax-Favored Savings Program
The Blue Cross and Blue Shield of Georgia, Inc. Tax-Favored Savings Program
is a tax-qualified retirement savings plan with a cash or deferred arrangement
under Code Section 401(k) (the "Savings Program"). The Savings Program is
designed to help participants build long-term savings for the future. Generally,
all employees are eligible to participate after they complete 30 days of service
and have attained age 21. A participant may contribute to the Savings Program on
a before-tax basis from 1% to 15% of pay up to the maximum dollar contribution
amount ($10,000 in 1999). The employer will match contributions up to 6%. The
first $500 contributed is matched at $.50 for every dollar contributed (maximum
$250). For the remaining contribution (up to 6%), the employer will contribute
$0.25 for each dollar the participant contributes. Participants become 25%
vested in all employer matching contributions after two years, 50% vested after
three years, 75% vested after four years, and 100% vested once they complete
five years of service. Lump sum distributions generally may be made from the
Savings Program upon termination of employment or attainment of age 59 1/2.
Participants also may obtain a hardship withdrawal or borrow money from their
account. All contributions to the Savings Program and investment earnings are
held in trust for the exclusive benefit of participants and their beneficiaries.
The name of the trust is Blue Cross and Blue Shield Association National 401(k)
Master Trust for the Tax-Favored Savings Program. The trustee is INVESCO Trust
Company. The Company's contributions to the Savings Program for the Named
Executive Officers for 1999, 1998 and 1997 are included in "All Other
Compensation" in Compensation Table.
Deferred Compensation Plans
The Company offers certain Directors and employees the opportunity to defer
income pursuant to the Company's "Deferred Compensation Plan for Select
Management". Qualified Directors and employees may elect to defer payment of all
or any portion of such person's compensation during any year for a period of
three years or more. At the election of the qualified Director or employee, such
deferred compensation may be paid in a lump sum or in monthly installments over
a period from 5 to 20 years. Approximately 43 Directors and employees
participate in these arrangements and become general creditors of the Company
thereunder. The Company's total obligation to these participants, which is
unsecured, was approximately $5.1 million as of December 31, 1999.
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<PAGE> 42
EXECUTIVE OR OTHER SEVERANCE AGREEMENTS
Chief Executive Officer
Pursuant to the Employment Agreement, each of the Company and BCBSGA
employs Mr. Shirk as President and Chief Executive Officer. The Employment
Agreement has a term of two years commencing on January 1, 1997, provided that
the term of the Employment Agreement automatically extends for an additional
month on the first day of each month so that the Employment Agreement always has
an unexpired term of two years unless the Board of Directors of either the
Company or BCBSGA affirmatively notifies Mr. Shirk to the contrary in writing,
in which event the monthly term extension ceases and the two year term becomes
fixed. The Employment Agreement provides Mr. Shirk with an annual base salary of
$425,000, which may be adjusted upward by the Boards of Directors or the
Compensation Committees of the Company and BCBSGA. The Employment Agreement
entitles Mr. Shirk to participate in all incentive compensation plans of the
Company and BCBSGA on a basis consistent with his position, but in no event less
than on an equal basis with any other executives of the Company and BCBSGA.
The Employment Agreement provides that if Mr. Shirk is terminated for any
reason other than "For Cause" or by Mr. Shirk for "Good Reason", then "all
payments" (broadly defined to include salary and certain other benefits under
the Employment Agreement) shall continue at the same rate for a period of two
years. If Mr. Shirk's employment is terminated "For Cause", or Mr. Shirk
voluntarily terminates his employment without "Good Reason", Mr. Shirk will not
be entitled to any compensation whatsoever after the effective date of
termination other than benefits as may be vested at such time. The Employment
Agreement defines "For Cause" as (i) the willful engagement by Mr. Shirk in
conduct, or the taking by him of any action, which is materially injurious to
the Company of BCBSGA, (ii) the willful and repeated failure by Mr. Shirk to
substantially perform his duties; or (iii) gross misconduct or conduct involving
moral turpitude. The Employment Agreement provides that "For Cause" shall first
be determined by the Governance Committees of the Boards of Directors of the
Company and BCBSGA and then approved by an absolute majority of the members of
the Boards of Directors of the Company and BCBSGA. The Employment Agreement
affirmatively provides that differences in management philosophy or the
structure of operations of the Company or BCBSGA shall not be deemed to be "For
Cause".
The Employment Agreement provides that in the event Mr. Shirk dies while
employed, three months of salary and all other compensation benefits are
payable, and thereafter all benefits shall terminate except benefits which are
vested on or prior to the date of death. In the event that Mr. Shirk becomes
physically or mentally disabled, he would become entitled to a continuation of
his salary for two years, and his benefit under the RDS SERP would immediately
become vested. The Employment Agreement entitles Mr. Shirk to six weeks of
vacation each year, an automobile allowance, and the right to reimbursement for
the cost of memberships in luncheon and civic clubs and for any costs and
expenses incurred in connection with the negotiation or renegotiation of the
Employment Agreement or the enforcement of any provision thereof.
The Employment Agreement provides Mr. Shirk with the RDS SERP. The
Employment Agreement also provides that if any portion of payments under the
Employment Agreement or any other agreement or plan of the Company or BCBSGA
qualifies as an "excess parachute payment" under Section 280G of the Code and is
thereby subject to excise tax as described in Section 4999 of the Code, the
Company and BCBSGA will provide Mr. Shirk with a cash Gross Up Payment equal to
Mr. Shirk's excise tax liability plus an additional amount to cover Mr. Shirk's
state and Federal income taxes on the Gross Up Payment.
Change in Control Severance Agreements
In January 1998, the Company entered into individual Change in Control
Severance Agreements with 38 key employees. Ten executives entered into Tier I
agreements, and 28 key employees entered into Tier II agreements. These
agreements each have an initial term that ends on December 31, 2001, which is
automatically extended for an additional year absent notice from either party or
upon a public announcement of an intended Change in Control of the Company.
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<PAGE> 43
The agreements provide that if, during the term of the agreement, the
employment of the employee is terminated by the Company without "Cause", by the
employee for "Good Reason" or due to disability following a public announcement
of an intended Change in Control of the Company, or if the Company fails to
renew the agreement within 90 days prior to the public announcement of an
intended Change in Control, then the employee becomes entitled to payment of
severance benefits in a lump sum no later than 30 days following termination of
employment. Shareholder approval of the Merger would constitute a Change in
Control.
The severance benefits for employees under the agreements include:
(i) all earned but unpaid base salary, earned and accrued vacation
pay, universal leave pay, unreimbursed business expenses and other amounts
owed;
(ii) an amount equal to two times (for Tier II, one times) the sum of
(a) and (b) where (a) equals the greater of annual base salary at the time
of termination or annual base salary prior to public announcement of
intended Change in Control, and (b) equals the average of the bonuses, if
any, received by the employee under the Company's Annual Incentive Plan and
the Company's Long-Term Incentive Plan during the two-year period that
ended immediately before the year in which the public announcement of the
intended Change in Control occurs;
(iii) if the employee is at least age 50 or has completed ten "years
of service" (as defined in the Retirement Plan) as of the date of
termination, for purposes of calculating his benefits under the Retirement
Plan, the SERP, the Restoration Plan or any other tax-qualified or
non-qualified defined benefit pension plan, he shall be considered to be
100% vested as of the date of his termination and he shall be considered to
have either three additional years of service or three additional years of
age, whichever produces the greater benefit payable to the employee (except
that the additional three years of service will not be eligible for the
double counting under the SERP);
(iv) an amount sufficient for the employee to purchase health and
dental insurance, life insurance and long-term disability insurance
coverage for himself and his dependents for 24 months, at the same cost and
level of coverage as the employee had at his date of termination (with the
COBRA continuation period beginning on date of termination); and
(v) up to $20,000 (for Tier II, up to $10,000) of outplacement
services from a nationally recognized outplacement firm chosen by the
employee.
The Change in Control Severance Agreements also provide that if a Change in
Control occurs during the term of the agreement, or if an intended Change in
Control is publicly announced within 90 days after the term of the agreement has
ended, certain benefits become payable regardless of whether the employee is
terminated from employment. These benefits include (i) the bonus, if any, which
would be earned under the Company's Annual Incentive Plan if the level of goal
achievement were annualized, then adjusted on a pro rata basis for the number of
days that the employee was actually employed during the year, and (ii) the
amount payable under the award to the employee under the PUP. These amounts are
required to be paid no later than 30 days following the Change in Control. In
addition, all stock options, restricted stock or performance shares that have
been granted to the employee during the term of the agreement become fully
vested upon a Change in Control.
Each of the Change in Control Severance Agreements contains provisions
requiring the Company to provide the employee an additional cash payment
sufficient to cover any Excise Tax Payment and an additional Gross Up Payment.
The Named Executive Officers who have entered into Tier I Change in Control
Severance Agreements are Richard F. Rivers, John A. Harris, Mark Kishel, M.D.
and Stuart G. Wright.
CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS
There were no transactions or relationships requiring disclosure under Item
404 of Regulation S-K for the fiscal year ended December 31, 1999.
41
<PAGE> 44
DIRECTORS' COMPENSATION
Non-employee Directors each receive aggregate annual retainers of $20,000
for service on the Board of Directors of the Company and BCBSGA plus meeting
fees for attendance at Board of Directors and Committee meetings of the Company
and of BCBSGA. The Chairman, the Vice Chairman and each Committee Chairman
receive additional aggregate retainers of $10,000, $5,000 and $3,000,
respectively. Each non-employee Director receives $1,000 for attendance at Board
of Directors meetings, $1,000 for attendance at Committee meetings and $500 for
participation in telephone meetings for each of the two companies. Each
non-employee Director may defer his or her Director fees pursuant to certain of
the Company's non-qualified, deferred compensation plans. Directors also are
reimbursed for reasonable expenses incurred in connection with the performance
of their duties.
COMPENSATION COMMITTEE; INTERLOCKS AND INSIDER PARTICIPATION
The Compensation Committee is comprised of Directors Vereen (Chair),
Gillespie, Gregory, Hanna and Tolbert. Mr. LaBoon sits with the Compensation
Committee ex officio. The Compensation Committee meets quarterly. The
Compensation Committee sets the compensation for the Chief Executive Officer and
the other Named Executive Officers at a meeting early in each fiscal year after
reviewing, in each case, the performance targets established for the prior year
in comparison to the prior year's actual performance. At this meeting the
Compensation Committee also sets performance targets for the new fiscal year as
well as any targets for additional compensation plans pursuant to which the
Chief Executive Officer and the other Named Executive Officers may earn
compensation with respect to that fiscal year and sets annual salaries in
accordance with the same considerations. None of the members of the Compensation
Committee is or has ever been an officer or employee of the Company. There were
no interlocking relationships between any executive officers of the Company and
any entity whose Directors or executive officers served on the Company's
Compensation Committee. None of the members of the Compensation Committee
engaged in transactions or had relationships requiring disclosure under Item 404
of Regulation S-K in the fiscal year ended December 31, 1999.
ITEM 12. SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT
Currently, no shares of Common Stock are outstanding or beneficially owned
by any person and no shares of Blank Preferred Stock are outstanding or
beneficially owned by any person.
The number of shares of Class A Stock outstanding as of February 29, 2000
was 409,602 held by 70,268 holders.
The Foundation owns 53,150 shares, or approximately 13% of the Class A
Stock outstanding. The address of the Foundation is: c/o Long Aldridge & Norman
LLP, 303 Peachtree Street, Suite 5300, Atlanta, Georgia 30308.
No directors or officers of the Company or of BCBSGA beneficially own any
shares of capital stock of the Company except Frank J. Hanna, III and John W.
Robinson, Jr. Mr. Robinson owns five shares, less than 1% of the Class A Stock
outstanding. Georgia Strategic Healthcare, LLC ("GSH") owns 40,000 shares,
approximately 80% of the Preferred Stock outstanding. Frank J. Hanna, III, Frank
J. Hanna, Jr. and David Hanna share voting and dispositive power with regard to
all of the shares of Preferred Stock owned by GSH. Frank J. Hanna, III, is,
therefore, deemed to be the indirect beneficial owner of the 40,000 shares held
by GSH. The address of GSH is: Suite 1750, Two Ravinia Drive, Atlanta, Georgia
30346.
42
<PAGE> 45
On July 9, 1998, the Company entered into an agreement and plan of merger
with WellPoint and a subsidiary of WellPoint. Pursuant to the Merger, the
Company will become a wholly-owned subsidiary of WellPoint. Finalization of the
transaction is subject to, among other things, the approval of the shareholders
of the Company, the Georgia Commissioner and BCBSA. Upon closing the
transaction, shareholders of the Company will exchange their shares for
WellPoint shares or cash in a transaction valued at $500 million.
ITEM 13. CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS
None.
43
<PAGE> 46
PART IV
ITEM 14. EXHIBITS, FINANCIAL STATEMENTS, FINANCIAL STATEMENT SCHEDULES AND
REPORTS ON FORM 8-K
(a) The following documents are filed as part of this Annual Report on Form
10-K.
1. The following financial statements are incorporated by reference into
Part II, Item 8 of this Form 10-K:
Report of Independent Auditors
Consolidated Balance Sheets -- December 31, 1999 and 1998
Consolidated Statements of Income -- Years Ended December 31, 1999, 1998
and 1997
Consolidated Statements of Comprehensive Income -- Years Ended December
31, 1999, 1998 and 1997
Consolidated Statements of Shareholders' Equity -- Years Ended December
31, 1999, 1998 and 1997
Consolidated Statements of Cash Flows -- Years Ended December 31, 1999,
1998 and 1997
Notes to Consolidated Financial Statements
2. Financial Statement Schedules
Schedule II Condensed Financial Information of Registrant
Schedule V Valuation and Qualifying Accounts
All other schedules are omitted because they are not applicable, not
required or the information is included elsewhere in the Consolidated Financial
Statements or Notes thereto. The financial statement schedules follow the
signature page.
3. Exhibits
<TABLE>
<CAPTION>
EXHIBIT
NUMBER DESCRIPTION
------- -----------
<S> <C>
2.1 Blue Cross and Blue Shield of Georgia, Inc. Plan of
Conversion, filed with the Insurance Department of the State
of Georgia, October 30, 1995.(1)
2.2 Form A Statement regarding the Acquisition of Control of or
Merger with a Domestic Insurer filed with respect to Blue
Cross and Blue Shield of Georgia, Inc. by Cerulean
Companies, Inc. on October 30, 1995, as amended and
supplemented.(1)
2.3 Conversion Order dated December 27, 1995 from Georgia
Insurance Commissioner.(1)
2.4 Agreement and Plan of Merger, dated July 9, 1998, by and
among Cerulean Companies, Inc., WellPoint Health Networks
Inc. and Water Polo Acquisition Corp.(2)
2.5 First Amendment to Agreement and Plan of Merger, dated July
9, 1999, by and among Cerulean Companies, Inc., WellPoint
Health Networks Inc., and Water Polo Acquisition Corp.(4)
2.6 Second Amendment to Agreement and Plan of Merger, dated
December 31, 1999, by and among Cerulean Companies, Inc.,
WellPoint Health Networks Inc., and Water Polo Acquisition
Corp.*
3.1 Amended Articles of Incorporation of Cerulean Companies,
Inc.(3)
3.2 Bylaws of Cerulean Companies, Inc.(1)
4.1 Stock Escrow Agreement among Cerulean Companies, Inc., Blue
Cross and Blue Shield of Georgia, Inc. and SunTrust Bank,
Atlanta.(1)
4.2 Specimen form of Class A Convertible Common Stock
certificate.(1)
4.3 Amended Articles of Incorporation of Cerulean Companies,
Inc. (included in Exhibit 3.1).(3)
</TABLE>
44
<PAGE> 47
<TABLE>
<CAPTION>
EXHIBIT
NUMBER DESCRIPTION
------- -----------
<S> <C>
10.1 Administrative Services Agreement between the State
Personnel Board and Blue Cross and Blue Shield of Georgia,
Inc., dated July 1, 1994.(1)
10.2 Plaza Lease Capital Plaza Associate ("Landlord") and Blue
Cross and Blue Shield of Georgia, Inc. ("Tenant") dated
December 23, 1986.(1)
10.3 Executive Compensation Plans and Arrangements.
(a) Deferred Compensation Plan.(1)
(b) Annual Executive Incentive Plan.(1)
(c) Long-Term Incentive Plan.(1)
(d) First Amendment, effective January 1, 1998, to the
Employment Agreement between Blue Cross and Blue Shield of
Georgia, Inc., Cerulean Companies, Inc., and Richard
D. Shirk, dated January 1, 1997.(2)
(e) Performance Unit Plan, effective February 2, 1996.(3)
(f) First Amendment, effective January 1, 1998, to the
Agreement for Supplemental Executive Retirement Benefits
between Blue Cross and Blue Shield of Georgia, Inc.
and Richard D. Shirk, dated December 1, 1996.(2)
(g) Blue Cross and Blue Shield of Georgia, Inc.
Supplemental Executive Retirement Plan effective July 1,
1996.(4)
(h) Blue Cross and Blue Shield of Georgia, Inc. Executive
Benefit Restoration Plan effective July 1, 1996.(4)
(i) Form of Change in Control Severance Protection
Agreement for Certain Employees of: Cerulean Companies,
Inc., Blue Cross and Blue Shield of Georgia, Inc., HMO
Georgia, Inc., Greater Georgia Life Insurance Company,
Inc., and Group Benefits of Georgia, Inc., effective
January 1, 1998, entered into by Cerulean Companies,
Inc., and each of Messrs. Raymond J. Colleran, John A.
Harris, Mark Kishel, M.D., Richard A. Steinhausen, R.
Neil Vannoy, Hugh J. Stedman, Richard F. Rivers,
Robert A. Yungk and two additional management
employees of Blue Cross and Blue Shield of Georgia,
Inc.(5)
(j) Form of Change in Control Severance Protection
Agreement for Certain Employees of: Cerulean Companies,
Inc., Blue Cross and Blue Shield of Georgia, Inc., HMO
Georgia, Inc., Greater Georgia Life Insurance Company,
Inc. and Group Benefits of Georgia, Inc., effective
January 1, 1998, entered into by Cerulean Companies,
Inc. and twenty-eight management employees in addition
to those listed in Exhibit 10.3(i).(5)
10.4 $55,000,000 Insolvency Credit Agreement dated as of April
18, 1996 among Blue Cross and Blue Shield of Georgia, Inc.,
the Banks Listed Herein and Wachovia Bank of Georgia, N.A.,
as agent.(1)
21 Subsidiaries of the registrant.(1)
</TABLE>
- ---------------
(1) This exhibit to Form S-1, Registration No. 333-2796, effective May 14,
1996 and subsequent amendments are incorporated herein by reference.
(2) This Appendix A of Form S-4, Registration No. 333-64955, filed by
WellPoint Health Networks, Inc. on September 30, 1998, is incorporated
herein by reference.
(3) This exhibit to Form 10-Q filed on November 13, 1998 is incorporated
herein by reference.
(4) This exhibit to Form 10-Q filed in August 16, 1999 is incorporated
herein by reference.
(5) This exhibit to Form 10-Q filed on August 14, 1998 is incorporated
herein by reference.
* This exhibit is filed herewith.
(b) Reports on Form 8-K
No reports on Form 8-K were filed with the Securities and Exchange
Commission during the last quarter of the period covered by this report.
45
<PAGE> 48
(c) Exhibits
The following additional exhibit is being filed concurrently with this
report.
<TABLE>
<CAPTION>
EXHIBIT
NUMBER DESCRIPTION
------- -----------
<S> <C>
27 Financial Data Schedule (for SEC use only)*
</TABLE>
- ---------------
* This exhibit is filed herewith.
46
<PAGE> 49
SIGNATURES
Pursuant to the requirements of Section 13 or 15(d) of the Securities
Exchange Act of 1934 as amended, the Registrant has duly caused this report to
be signed on its behalf by the undersigned, thereunto duly authorized in the
City of Atlanta, State of Georgia, on March 29, 2000.
CERULEAN COMPANIES, INC.
(Registrant)
By: /s/ RICHARD D. SHIRK
------------------------------------
Richard D. Shirk
President
Pursuant to the requirements of the Securities Exchange Act of 1934, this
report has been signed by the following persons on behalf of the Company and in
the capacities indicated on March 29, 1999.
<TABLE>
<CAPTION>
SIGNATURE TITLE
- --------- -----
<S> <C>
/s/ RICHARD D. SHIRK President
- -------------------------------------------- (Principal Executive Officer)
Richard D. Shirk and Director
/s/ JOHN A. HARRIS Treasurer
- -------------------------------------------- (Principal Financial and Accounting Officer)
John A. Harris
/s/ WILLIAM A. ALIAS, JR. Director
- --------------------------------------------
William A. Alias, Jr.
/s/ ELIZABETH W. CAMP Director
- --------------------------------------------
Elizabeth W. Camp
/s/ EDWARD M. GILLESPIE Director
- --------------------------------------------
Edward M. Gillespie
/s/ JOSEPH D. GREENE Director
- --------------------------------------------
Joseph D. Greene
/s/ MEL H. GREGORY, JR. Director
- --------------------------------------------
Mel H. Gregory, Jr.
/s/ FRANK J. HANNA, III Director
- --------------------------------------------
Frank J. Hanna, III
/s/ WARREN Y. JOBE Director
- --------------------------------------------
Warren Y. Jobe
/s/ JAMES L. LABOON, JR. Director
- --------------------------------------------
James L. LaBoon, Jr.
/s/ JAMES H. LEIGH, JR., M.D Director
- --------------------------------------------
James H. Leigh, Jr., M.D.
/s/ JAMES R. LIENTZ, JR. Director
- --------------------------------------------
James R. Lientz, Jr.
/s/ JULIA L. MITCHELL-IVEY Director
- --------------------------------------------
Julia L. Mitchell-Ivey
</TABLE>
47
<PAGE> 50
<TABLE>
<CAPTION>
SIGNATURE TITLE
- --------- -----
<S> <C>
/s/ JOHN W. ROBINSON, JR. Director
- --------------------------------------------
John W. Robinson, Jr.
/s/ ARNOLD M. TENENBAUM Director
- --------------------------------------------
Arnold M. Tenenbaum
/s/ FRED L. TOLBERT, JR. Director
- --------------------------------------------
Fred L. Tolbert, Jr.
/s/ W. JERRY VEREEN Director
- --------------------------------------------
W. Jerry Vereen
/s/ JOE M. YOUNG Director
- --------------------------------------------
Joe M. Young
</TABLE>
48
<PAGE> 51
SCHEDULE II
CERULEAN COMPANIES, INC. (PARENT ONLY)
CONDENSED BALANCE SHEETS
<TABLE>
<CAPTION>
DECEMBER 31,
----------------------------
1999 1998
------------ ------------
<S> <C> <C>
ASSETS
Investment in subsidiaries.................................. $255,373,777 $232,794,069
Investments in available-for-sale securities................ 2,999,169 10,841,198
Cash and cash equivalents................................... 11,463,772 12,957,346
Accrued interest and other assets........................... 12,837,420 11,461,886
------------ ------------
Total assets...................................... $282,674,138 $268,054,499
============ ============
LIABILITIES AND SHAREHOLDERS' EQUITY
Liabilities:
Accounts payable and accrued expenses..................... $ 5,000,192 $ 5,729,415
------------ ------------
Total liabilities................................. 5,000,192 5,729,415
Mandatorily redeemable preferred stock:
Class B Convertible Preferred Stock, no par value.
Authorized, issued and outstanding, 49,900 shares at
December 31, 1999 and 1998; aggregate liquidation
preference, $49,900,000; aggregate mandatory
redemption, $44,910,000.............................. 46,646,042 46,646,042
------------ ------------
Shareholders' equity:
Blank Preferred Stock, no par value.
Authorized and unissued 100,000,000 shares............. -- --
Series A Preferred Stock, no par value, $0.01 stated
value.
Authorized and unissued 64,000 shares.................. -- --
Class A Convertible Common Stock, no par value, $0.01
stated value.
Authorized 50,000,000 shares; issued and outstanding
409,597 and 409,392 shares at December 31, 1999 and
1998, respectively................................... 4,096 4,094
Additional paid-in capital................................ 45,188,422 45,188,422
Common Stock, no par value.
Authorized and unissued 100,000,000 shares............. -- --
Stock warrants exercisable................................ 29,968,000 29,968,000
Accumulated other comprehensive income (unrealized
appreciation on securities, net of taxes).............. 7,258,906 19,596,908
Retained earnings......................................... 148,608,480 120,921,618
------------ ------------
Total shareholders' equity........................ 231,027,904 215,679,042
------------ ------------
Total liabilities and shareholders' equity........ $282,674,138 $268,054,499
============ ============
</TABLE>
49
<PAGE> 52
SCHEDULE II -- (CONTINUED)
CERULEAN COMPANIES, INC. (PARENT ONLY)
CONDENSED STATEMENTS OF INCOME
<TABLE>
<CAPTION>
DECEMBER 31,
---------------------------
1999 1998
----------- ------------
<S> <C> <C>
Investment income........................................... $ 411,851 $ 1,653,771
Operating expenses.......................................... 6,274,106 7,718,546
----------- ------------
Operating loss.............................................. (5,862,255) (6,064,775)
Endowment of a non-profit foundation........................ -- (76,157,000)
Non-operating income........................................ 255,000 255,000
----------- ------------
Loss before income taxes.................................... (5,607,255) (81,966,775)
Income tax benefit.......................................... (3,731,321) (8,981,000)
----------- ------------
Loss before equity in earnings of subsidiaries.............. (1,875,934) (72,985,775)
Equity in earnings of subsidiaries.......................... 34,719,111 15,818,016
----------- ------------
Net income (loss)........................................... $32,843,177 $(57,167,759)
=========== ============
</TABLE>
50
<PAGE> 53
SCHEDULE II (CONTINUED)
CERULEAN COMPANIES, INC. (PARENT ONLY)
CONDENSED STATEMENTS OF CASH FLOWS
<TABLE>
<CAPTION>
YEAR ENDED DECEMBER 31,
----------------------------
1999 1998
------------ ------------
<S> <C> <C>
OPERATING ACTIVITIES
Net income (loss)........................................... $ 32,843,177 $(57,167,759)
Adjustments to reconcile net income (loss) to net cash used
in operating activities:
Non-cash and non-operating items:
Equity in earnings of subsidiaries..................... (34,719,111) (15,818,016)
Accretion.............................................. (765) (16,878)
Endowment of a non-profit foundation................... -- 75,157,000
Non-operating income................................... (255,000) (255,000)
Increase in accrued interest and other assets............. (1,374,209) (7,575,593)
(Decrease) increase in accounts payable and accrued
expenses............................................... (729,223) 3,777,992
Minority interest in sale of stock and stock warrants by a
subsidiary............................................. (245,000) (245,000)
------------ ------------
Net cash used in operating activities....................... (4,480,131) (2,143,254)
INVESTING ACTIVITIES
Investment in subsidiaries.................................. (16,032,163) (8,370,307)
Dividends received from subsidiaries........................ 15,567,000 --
Investments purchased....................................... (4,974,922) (36,699,079)
Investments sold or matured................................. 13,082,955 53,771,360
------------ ------------
Net cash provided by investing activities................... 7,642,870 8,701,974
FINANCING ACTIVITIES
Dividends paid and accrued.................................. (5,156,313) (2,994,000)
Sale of stock warrants by a subsidiary...................... 500,000 500,000
------------ ------------
Net cash used in financing activities....................... (4,656,313) (2,494,000)
------------ ------------
(Decrease) increase in cash and cash equivalents............ (1,493,574) 4,064,720
Cash and cash equivalents at beginning of year.............. 12,957,346 8,892,626
------------ ------------
Cash and cash equivalents at end of year.................... $ 11,463,772 $ 12,957,346
============ ============
</TABLE>
51
<PAGE> 54
SCHEDULE V
CERULEAN COMPANIES, INC.
VALUATION AND QUALIFYING ACCOUNTS
YEARS ENDED DECEMBER 31, 1999, 1998 AND 1997
<TABLE>
<CAPTION>
BALANCE AT CHARGED TO BALANCE
BEGINNING COSTS AND AT END
DESCRIPTION OF YEAR EXPENSES DEDUCTIONS OF YEAR
- ----------- ----------- ----------- ------------ -----------
<S> <C> <C> <C> <C>
Deferred Tax Asset
Valuation Allowance
1999............................... $89,750,000 $20,260,000 $(15,471,000) $94,359,000
=========== =========== ============ ===========
1998............................... $62,150,000 $28,764,000 $ (1,164,000) $89,750,000
=========== =========== ============ ===========
1997............................... $58,011,000 $10,169,000 $ (6,030,000) $62,150,000
=========== =========== ============ ===========
</TABLE>
52
<PAGE> 55
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549
FORM 10-K
CERULEAN COMPANIES, INC.
COMMISSION FILE NUMBER: 333-2796
CONSOLIDATED FINANCIAL STATEMENTS
YEARS ENDED DECEMBER 31, 1999, 1998 AND 1997
WITH REPORT OF INDEPENDENT AUDITORS
<PAGE> 56
CERULEAN COMPANIES, INC.
CONSOLIDATED FINANCIAL STATEMENTS
YEARS ENDED DECEMBER 31, 1999, 1998 AND 1997
CONTENTS
<TABLE>
<S> <C>
Report of Independent Auditors.............................. F-1
Audited Consolidated Financial Statements
Consolidated Balance Sheets................................. F-2
Consolidated Statements of Income........................... F-3
Consolidated Statements of Comprehensive Income............. F-3
Consolidated Statements of Shareholders' Equity............. F-4
Consolidated Statements of Cash Flows....................... F-5
Notes to Consolidated Financial Statements.................. F-6
</TABLE>
<PAGE> 57
REPORT OF INDEPENDENT AUDITORS
Board of Directors
Cerulean Companies, Inc.
We have audited the accompanying consolidated balance sheets of Cerulean
Companies, Inc. and subsidiaries as of December 31, 1999 and 1998, and the
related consolidated statements of income, comprehensive income, shareholders'
equity, and cash flows for each of the three years in the period ended December
31, 1999. Our audits also included the financial statement schedules listed in
the Index at Item 14(a). These financial statements and schedules are the
responsibility of the Company's management. Our responsibility is to express an
opinion on these financial statements and schedules based on our audits.
We conducted our audits in accordance with auditing standards generally
accepted in the United States. Those standards require that we plan and perform
the audit to obtain reasonable assurance about whether the financial statements
are free of material misstatement. An audit includes examining, on a test basis,
evidence supporting the amounts and disclosures in the financial statements. An
audit also includes assessing the accounting principles used and significant
estimates made by management, as well as evaluating the overall financial
statement presentation. We believe that our audits provide a reasonable basis
for our opinion.
In our opinion, the financial statements referred to above present fairly,
in all material respects, the consolidated financial position of Cerulean
Companies, Inc. and subsidiaries at December 31, 1999 and 1998, and the
consolidated results of their operations and their cash flows for each of the
three years in the period ended December 31, 1999, in conformity with accounting
principles generally accepted in the United States. Also, in our opinion, the
related financial statement schedules, when considered in relation to the basic
financial statements taken as a whole, present fairly in all material respects
the information set forth therein.
/s/ ERNST & YOUNG LLP
February 11, 2000
Atlanta, Georgia
F-1
<PAGE> 58
CERULEAN COMPANIES, INC.
CONSOLIDATED BALANCE SHEETS
<TABLE>
<CAPTION>
DECEMBER 31,
---------------------------
1999 1998
------------ ------------
<S> <C> <C>
ASSETS
Investments (Note 3):
Fixed maturities:
Available-for-sale, at fair value (amortized cost:
$265,875,467; $235,441,231)........................... $256,844,521 $239,548,185
Equity securities, at fair value (cost: $55,204,793;
$55,866,571)............................................ 73,036,645 76,906,525
Short-term investments, at fair value (cost: $325,000;
$9,215,878)............................................. 325,000 9,215,878
------------ ------------
Total investments.................................. 330,206,166 325,670,588
Cash and cash equivalents................................... 58,522,617 52,159,196
Accounts receivable (Note 4)................................ 76,429,351 61,777,995
Reimbursable portion of estimated benefit liabilities....... 47,002,000 47,816,000
FEP assets held by agent.................................... 26,749,038 38,786,536
Property and equipment (Note 5)............................. 40,063,725 36,898,538
Other assets................................................ 33,110,191 24,232,739
------------ ------------
Total assets....................................... $612,083,088 $587,341,592
============ ============
LIABILITIES AND SHAREHOLDERS' EQUITY
Liabilities:
Estimated benefit liabilities (Note 7).................... $201,587,264 $184,075,293
Unearned premiums......................................... 17,873,115 16,077,960
FEP stabilization reserve................................. 26,749,038 38,786,536
Accounts payable and accrued expenses..................... 50,723,056 43,893,056
Other liabilities......................................... 37,477,669 42,184,663
------------ ------------
Total liabilities.................................. 334,410,142 325,017,508
------------ ------------
Mandatorily redeemable preferred stock:
Class B Convertible Preferred Stock, no par value.
Authorized, issued and outstanding, 49,900 shares at
December 31, 1999 and 1998; aggregate liquidation
preference $49,900,000; aggregate mandatory
redemption, $44,910,000 (Note 10)..................... 46,645,042 46,645,042
------------ ------------
Shareholders' equity:
Blank Preferred Stock, no par value.
Authorized and unissued 100,000,000 shares (Note 10).... -- --
Series A Preferred Stock, no par value, $0.01 stated
value.
Authorized and unissued 64,000 shares (Note 10)......... -- --
Class A Convertible Common Stock, no par value, $0.01
stated value.
Authorized 50,000,000 shares; issued and outstanding
409,597 and 409,392 shares at December 31, 1999 and
1998, respectively (Note 10).......................... 4,096 4,094
Additional paid-in capital................................ 45,188,422 45,188,422
Common Stock, no par value.
Authorized and unissued 100,000,000 shares (Note 10).... -- --
Stock warrants exercisable (Note 10)...................... 29,968,000 29,968,000
Accumulated other comprehensive income (unrealized
appreciation on securities, net of taxes)............... 7,258,906 19,596,908
Retained earnings......................................... 148,608,480 120,921,618
------------ ------------
Total shareholders' equity......................... 231,027,904 215,679,042
Commitments and contingencies (Note 15)................... -- --
------------ ------------
Total liabilities and shareholders' equity......... $612,083,088 $587,341,592
============ ============
</TABLE>
See accompanying notes.
F-2
<PAGE> 59
CERULEAN COMPANIES, INC.
CONSOLIDATED STATEMENTS OF INCOME
<TABLE>
<CAPTION>
YEAR ENDED DECEMBER 31,
------------------------------------------------
1999 1998 1997
-------------- -------------- --------------
<S> <C> <C> <C>
Revenues (Note 2):
Premium revenue............................... $1,486,293,824 $1,189,665,302 $ 989,789,161
Management services revenue................... 142,186,145 117,962,641 96,470,348
Investment and other income................... 19,686,765 17,183,747 17,258,952
Realized gains................................ 7,214,467 9,253,506 11,299,757
-------------- -------------- --------------
Total revenues........................ 1,655,381,201 1,334,065,196 1,114,818,218
Benefits expense (Note 7)....................... 1,300,922,715 1,032,519,546 881,554,366
Operating expenses.............................. 313,602,633 279,218,246 233,650,574
-------------- -------------- --------------
Operating income (loss)......................... 40,855,853 22,327,404 (386,722)
Endowment of a non-profit foundation (Note 8)... -- (76,157,000) --
Non-operating income (Note 14).................. 255,000 255,000 1,275,000
-------------- -------------- --------------
Income (loss) before income taxes and minority
interests..................................... 41,110,853 (53,574,596) 888,278
Income tax expense (benefit) (Note 9)........... 9,061,000 2,073,000 (2,050,000)
Minority interests in losses (earnings) of joint
venture investments........................... 793,324 (1,520,163) 1,459,405
-------------- -------------- --------------
Net income (loss)..................... $ 32,843,177 $ (57,167,759) $ 4,397,683
============== ============== ==============
</TABLE>
See accompanying notes.
CERULEAN COMPANIES, INC.
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
<TABLE>
<CAPTION>
YEAR ENDED DECEMBER 31,
-----------------------------------------
1999 1998 1997
------------ ------------ -----------
<S> <C> <C> <C>
Net income (loss)..................................... $ 32,843,177 $(57,167,759) $ 4,397,683
Other comprehensive (loss) income, net of tax:
Unrealized holding (losses) gains arising during the
period, net of reclassification adjustment for
gains included in net income of $5,771,574,
$7,402,805 and $9,039,806, respectively.......... (12,338,002) 5,647,013 6,063,577
------------ ------------ -----------
Comprehensive income (loss)........................... $ 20,505,175 $(51,520,746) $10,461,260
============ ============ ===========
</TABLE>
See accompanying notes.
F-3
<PAGE> 60
CERULEAN COMPANIES, INC.
CONSOLIDATED STATEMENTS OF SHAREHOLDERS' EQUITY
<TABLE>
<CAPTION>
CLASS A ACCUMULATED
CONVERTIBLE ADDITIONAL STOCK OTHER
COMMON PAID-IN WARRANTS COMPREHENSIVE RETAINED
STOCK CAPITAL EXERCISABLE INCOME EARNINGS TOTAL
----------- ----------- ----------- ------------- ------------ ------------
<S> <C> <C> <C> <C> <C> <C>
Balance at December 31, 1996..... $3,506 $ -- $ -- $ 7,886,318 $179,679,704 $187,569,528
Issuance of Class A Common
Stock to eligible
subscribers.................. 9 -- -- -- (9) --
Net income..................... -- -- -- -- 4,397,683 4,397,683
Dividends paid and accrued..... -- -- -- -- (2,994,000) (2,994,000)
Accumulated other comprehensive
income (unrealized
appreciation on securities,
net of taxes of
$1,543,000).................. -- -- -- 6,063,577 -- 6,063,577
------ ----------- ----------- ------------ ------------ ------------
Balance at December 31, 1997..... 3,515 -- -- 13,949,895 181,083,378 195,036,788
Issuance of Class A
Common Stock to eligible
subscribers.................. 1 -- -- -- (1) --
Endowment of a non-profit
foundation (Note 8).......... 578 45,188,422 29,968,000 -- -- 75,157,000
Net income (loss).............. -- -- -- -- (57,167,759) (57,167,759)
Dividends paid and accrued..... -- -- -- -- (2,994,000) (2,994,000)
Accumulated other comprehensive
income (unrealized
appreciation on securities,
net of taxes of
$2,121,000).................. -- -- -- 5,647,013 -- 5,647,013
------ ----------- ----------- ------------ ------------ ------------
Balance at December 31, 1998..... 4,094 45,188,422 29,968,000 19,596,908 120,921,618 215,679,042
Issuance of Class A
Common Stock to eligible
subscribers.................. 2 -- -- -- (2) --
Net income..................... -- -- -- -- 32,843,177 32,843,177
Dividends paid and accrued..... -- -- -- -- (5,156,313) (5,156,313)
Accumulated other comprehensive
income (unrealized
appreciation on securities,
net of taxes of
$4,008,000).................. -- -- -- (12,338,002) -- (12,338,002)
------ ----------- ----------- ------------ ------------ ------------
Balance at December 31, 1999..... $4,096 $45,188,422 $29,968,000 $ 7,258,906 $148,608,480 $231,027,904
====== =========== =========== ============ ============ ============
</TABLE>
See accompanying notes.
F-4
<PAGE> 61
CERULEAN COMPANIES, INC.
CONSOLIDATED STATEMENTS OF CASH FLOWS
<TABLE>
<CAPTION>
YEAR ENDED DECEMBER 31,
---------------------------------------------
1999 1998 1997
------------- ------------- -------------
<S> <C> <C> <C>
OPERATING ACTIVITIES
Net income (loss)................................. $ 32,843,177 $ (57,167,759) $ 4,397,683
Adjustments to reconcile net income (loss) to net
cash provided by operating activities:
Non-cash and non-operating items:
Depreciation................................. 10,439,488 10,743,267 9,765,395
Amortization................................. 783,847 444,737 277,183
Uncollectible receivables.................... (2,269) 1,296,515 1,356,180
Gain on sale of investments.................. (7,214,467) (9,253,506) (11,299,757)
Loss (gain) on sale of property and
equipment.................................. 496,028 184,030 (13,419)
Endowment of a non-profit foundation......... -- 75,157,000 --
Non-operating income......................... (255,000) (255,000) (1,275,000)
(Increase) decrease in certain assets:
Accounts receivable.......................... (14,649,087) (3,449,611) (14,301,581)
Reimbursable portion of estimated benefit
liabilities................................ 814,000 (4,538,000) (3,840,000)
Other assets................................. (4,869,452) (7,336,540) (8,751,532)
Increase (decrease) in certain liabilities:
Estimated benefit liabilities................ 17,511,971 34,494,289 30,070,211
Unearned premiums............................ 1,795,155 7,776,763 (682,759)
Accounts payable and accrued expenses........ 6,830,000 12,682,968 (309,640)
Other liabilities............................ (4,706,994) 5,480,048 (1,947,055)
Minority interest in sale of stock and stock
warrants by a subsidiary................... (245,000) (245,000) (1,225,000)
------------- ------------- -------------
Net cash provided by operating activities......... 39,571,397 66,014,201 2,220,909
INVESTING ACTIVITIES
Investments available-for-sale:
Investments purchased........................... (166,642,785) (275,784,389) (211,187,305)
Investments sold or matured..................... 152,191,825 247,011,823 167,660,837
Property and equipment purchased.................. (14,738,523) (14,123,924) (12,434,970)
Property and equipment sold....................... 637,820 33,630 211,974
------------- ------------- -------------
Net cash used in investing activities............. (28,551,663) (42,862,860) (55,749,464)
FINANCING ACTIVITIES
Repayment of note payable......................... -- (3,500,000) --
Dividends paid and accrued........................ (5,156,313) (2,994,000) (2,994,000)
Sale of stock and stock warrants by a
subsidiary...................................... 500,000 500,000 2,500,000
------------- ------------- -------------
Net cash used in financing activities............. (4,656,313) (5,994,000) (494,000)
------------- ------------- -------------
Increase (decrease) in cash and cash
equivalents..................................... 6,363,421 17,157,341 (54,022,555)
Cash and cash equivalents at beginning of year.... 52,159,196 35,001,855 89,024,410
------------- ------------- -------------
Cash and cash equivalents at end of year.......... $ 58,522,617 $ 52,159,196 $ 35,001,855
============= ============= =============
</TABLE>
See accompanying notes.
F-5
<PAGE> 62
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
DECEMBER 31, 1999
1. ORGANIZATION AND PROPOSED MERGER
ORGANIZATION
Cerulean Companies, Inc. (the "Company") was incorporated under the laws of
the State of Georgia on February 2, 1996 to act as the holding company for Blue
Cross and Blue Shield of Georgia, Inc. ("BCBSGA") and its subsidiaries, and for
other lawful purposes. On February 2, 1996, the Company acquired all of the
outstanding capital stock of BCBSGA, following BCBSGA's conversion from a
not-for-profit corporation to a for-profit corporation pursuant to a Plan of
Conversion approved by the Georgia Commissioner of Insurance on December 27,
1995 (the "Conversion"). As part of the Conversion, the Company agreed to offer
to each of BCBSGA's approximately 141,000 eligible subscribers five shares of
Class A Convertible Common Stock, no par value (the "Class A Stock") at no cost.
Upon completion of the offering eligible subscribers accepted 351,545 shares of
no par value Class A Stock. The registration of the Class A Stock became
effective under the Securities Act of 1933 and under section 12(g) of the
Securities Exchange Act of 1934 on May 14, 1996 and June 30, 1997, respectively.
Currently, the Class A Stock is not publicly traded.
PROPOSED MERGER
On July 9, 1998, the Company entered into an agreement and plan of merger
(the "Merger Agreement") with WellPoint Health Networks Inc. ("WellPoint") and a
subsidiary of WellPoint. As of July 9, 1999, the parties agreed upon an
extension of the Merger Agreement until October 15, 1999 and, under certain
circumstances, December 31, 1999. Effective October 15, 1999, the parties agreed
to extend the Merger Agreement through December 31, 1999. On December 30, 1999,
the parties agreed to further extend the Merger Agreement through December 31,
2000. Pursuant to the Merger Agreement, the Company will become a wholly-owned
subsidiary of WellPoint. On June 25, 1999, the shareholders of the Company
approved the transaction. Finalization of the transaction is subject to, among
other things, the approval of the Commissioner of Insurance of the State of
Georgia (the "Georgia Commissioner"), the approval of the Blue Cross and Blue
Shield Association and certain approvals of the Health Care Financing
Administration. Upon final disposition of the litigation commenced by the
Richmond County Plaintiffs described further in Note 15 Legal Proceedings below,
the Company expects that the Commissioner will schedule a public hearing. Upon
closing the transaction, shareholders of the Company will exchange their shares
for WellPoint shares or cash in a transaction valued at $500 million.
2. SIGNIFICANT ACCOUNTING POLICIES
BASIS OF PRESENTATION
The Company's accompanying consolidated financial statements have been
prepared in conformity with generally accepted accounting principles ("GAAP")
and require the use of management's estimates. As to the Company's managed care,
health and life insurance operations, GAAP varies in some respects from
statutory accounting practices permitted or prescribed by insurance regulatory
authorities. The Company's health care plan subsidiary, its health maintenance
organization and its life insurance subsidiary are subject to regulation by the
Georgia Insurance Department including minimum capital and surplus requirements
and restrictions on payment of dividends. In the opinion of management, all
material adjustments necessary for a fair presentation of the financial position
and results of operations for the periods presented have been made. All such
adjustments are of a normal recurring nature.
F-6
<PAGE> 63
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
2. SIGNIFICANT ACCOUNTING POLICIES -- (CONTINUED)
PRINCIPLES OF CONSOLIDATION
The Company's accompanying consolidated financial statements include the
accounts of the Company, BCBSGA and its wholly-owned life insurance subsidiary,
a health maintenance subsidiary, a non-insurance subsidiary and community health
partnership network joint ventures ("CHPNs"). All significant intercompany
transactions and balances have been eliminated in consolidation.
The Company owns at least 51% of the voting shares of each CHPN. Under
certain circumstances defined in the CHPN shareholder agreements, supermajority
votes of shareholders are required for amendment of the CHPN articles of
incorporation; liquidation of the CHPN; and issuance and repurchase of CHPN
equity. The net effect of supermajority votes in these circumstances results in
consensus of the shareholders, providing minority shareholders protective
rights. Only the Company is required under the CHPN agreements to provide
required additional capital. Future capital requirements of minority
shareholders are limited or prescribed. Profits of CHPNs are allocated to
shareholders in accordance with their respective stock ownership percentages.
Losses are allocated in accordance with ownership interests up to previously
contributed capital; losses exceeding such amounts are absorbed entirely by the
Company.
ACCOUNTING FOR A SALE OF STOCK AND STOCK WARRANTS BY A SUBSIDIARY
Gains arising from a subsidiary issuing its own stock and stock warrants to
third parties are recorded as non-operating income and are presented as a
separate line item in the accompanying consolidated statements of income.
EARNINGS PER SHARE
Earnings per share are omitted because such data is not meaningful at the
present time due to the likely dilutive events that will occur prior to the
conversion of the Class A Stock or the Class B Convertible Preferred Stock.
Presently there is no market for Class A Stock or any equity securities of the
Company.
INVESTMENTS
The Company accounts for its investments in accordance with Financial
Accounting Standards Board ("FASB") Statement No. 115, Accounting for Certain
Investments in Debt and Equity Securities ("Statement No. 115"). Statement No.
115 requires that fixed maturity securities are to be classified as either
"held-to-maturity", "available-for-sale", or "trading".
Management determines the appropriate classification of its fixed maturity
securities at the time of purchase and reevaluates such designation as of each
balance sheet date. Fixed maturity securities are classified as held-to-maturity
when the Company has the positive intent and ability to hold them to maturity.
Held-to-maturity securities are stated at amortized cost, adjusted for
amortization of premiums and accretion of discounts to maturity. Such
amortization as well as interest earned is included in investment and other
income.
Fixed maturity and equity securities not classified as held-to-maturity are
classified as available-for-sale. Available-for-sale securities are carried at
fair value, with the unrealized gains and losses, net of tax, reported in a
separate component of shareholders' equity. The amortized cost of debt
securities in this category is adjusted for amortization of premiums and
accretion of discounts to maturity. Such amortization and interest earned is
included in investment and other income. The cost of securities sold is based on
the specific identification method. At December 31, 1999 and 1998, the Company
classified all of its fixed maturity and equity securities as
available-for-sale. The Company's investment portfolio is not significantly
concentrated in any particular industry or geographic region.
F-7
<PAGE> 64
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
2. SIGNIFICANT ACCOUNTING POLICIES -- (CONTINUED)
CASH AND CASH EQUIVALENTS
Cash equivalents are liquid, short-term investments with maturities of
three months or less at the time of purchase and are combined with cash account
balances. These investments are stated at cost, which approximates fair value.
PROPERTY AND EQUIPMENT
Property and equipment are stated at cost less accumulated depreciation.
The costs of developing software for internal use are capitalized when
technological feasibility has been established. Depreciation is computed using
the straight-line method over the estimated useful lives of the respective
assets, which are 15 years for buildings and 3-7 years for software, furniture
and equipment. Amortization of software developed for internal use begins when
the asset is placed in service.
ESTIMATED BENEFIT LIABILITIES
The Company provides for claims reported but unpaid and for claims incurred
but unreported and the cost of adjudicating claims based primarily on past
experience, membership demographics, claims run-off patterns and other current
medical trend information, using accepted actuarial methods. Estimates are
adjusted as changes in these factors occur and such adjustments are reported in
the year of determination. Portions of the Company's estimated benefit
liabilities are reimbursable due to the nature of certain rate stabilization
reserve programs. Offsetting receivables have been recorded in the accompanying
consolidated balance sheets.
PREMIUM REVENUE AND MANAGEMENT SERVICES REVENUE
The Company's premium revenues consist primarily of premiums for
traditional indemnity health insurance, managed care products and group life
insurance products. All of the Company's individual and employer group contracts
provide for the individual or the group to be fully insured. Premiums for these
contracts are billed in advance of the respective coverage periods and are
initially recorded as premium receivables and as unearned premiums. Unearned
premiums are recognized as earned in the period of coverage.
Management services revenue is earned as services are performed and
consists of administrative fees for services provided to commercial employer
groups under self-funded arrangements, including claims processing, management
of medical services, access to provider networks and other services rendered to
third parties. Related claims processed for commercial self-funded employer
groups were $515,909,000 in 1999, $499,618,000 in 1998 and $489,407,000 in 1997.
Management services revenue also includes reimbursements for administrative
expenses incurred in performing services as agent for federal and state
government programs and for the national Blue Cross Blue Shield interplan
system. Related claims processed for these programs were $4.2 billion in 1999,
$4.3 billion in 1998 and $3.9 billion in 1997.
RATE STABILIZATION RESERVES
The Company has fully insured arrangements with certain employer groups
whose premium revenues are based on experience rating. On each group's
anniversary date, the gain or loss resulting from its experience is determined.
Premium rates for these groups are based on the group's historical claims
experience plus a retention factor for an appropriate contribution to surplus.
Premium revenues include adjustments to employer groups under rate stabilization
contracts to the extent premiums billed exceed claims incurred plus retention.
F-8
<PAGE> 65
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
2. SIGNIFICANT ACCOUNTING POLICIES -- (CONTINUED)
RATE STABILIZATION RESERVES -- (CONTINUED)
Any accumulated excess of premium revenues over claims incurred and
retention is recorded as a rate stabilization reserve liability. Under the terms
of these agreements, groups may utilize these funds to reduce prospective rates,
leave the excess funds on deposit with the Company or receive a refund. An
accumulated excess of claims incurred over premiums billed is expensed by the
Company in the period incurred.
FEDERAL EMPLOYEE PROGRAM
The Company and other Blue Cross and Blue Shield plans participate in the
Federal Employee Program ("FEP") which underwrites a voluntary health insurance
contract for employees (and their dependents) of the federal government. The
Blue Cross and Blue Shield Association has been designated as the contract
agent. A premium stabilization reserve liability (FEP stabilization reserve) and
an offsetting asset (FEP assets held by agent) have been recorded in the
accompanying consolidated balance sheets, and premium revenues, investment
income and operating expenses, including FEP operations center expenses, have
been recorded in the accompanying consolidated statements of income to recognize
the Company's portion of the FEP's underwriting results.
ADVERTISING AND PROMOTION
All costs associated with advertising and promoting products are expensed
in the year incurred. Advertising and promotion expense was $3,608,037 in 1999,
$3,780,629 in 1998 and $5,012,557 in 1997.
3. INVESTMENTS
Investments at December 31, 1999 and 1998 are as follows:
<TABLE>
<CAPTION>
DECEMBER 31, 1999
AVAILABLE-FOR-SALE SECURITIES
-----------------------------------------------------------------------
COST OR GROSS GROSS
AMORTIZED UNREALIZED UNREALIZED FAIR CARRYING
COST GAINS LOSSES VALUE VALUE
------------ ----------- ------------ ------------ ------------
<S> <C> <C> <C> <C> <C>
Fixed Maturities:
U.S. Treasury securities and
obligations of U.S.
government agencies....... $168,468,947 $ 127,105 $ (6,491,695) $162,104,357 $162,104,357
Corporate securities........ 74,559,523 31,145 (2,244,622) 72,346,046 72,346,046
Mortgage-backed
securities................ 22,846,997 34,564 (487,443) 22,394,118 22,394,118
------------ ----------- ------------ ------------ ------------
Total fixed
maturities......... 265,875,467 192,814 (9,223,760) 256,844,521 256,844,521
Equity Securities:
Preferred stocks............ 448,000 -- -- 448,000 448,000
Common stocks............... 54,756,793 21,287,880 (3,456,028) 72,588,645 72,588,645
------------ ----------- ------------ ------------ ------------
Total equity
securities......... 55,204,793 21,287,880 (3,456,028) 73,036,645 73,036,645
Short-term investments........ 325,000 -- -- 325,000 325,000
------------ ----------- ------------ ------------ ------------
Total
available-for-sale
securities......... $321,405,260 $21,480,694 $(12,679,788) $330,206,166 $330,206,166
============ =========== ============ ============ ============
</TABLE>
F-9
<PAGE> 66
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
3. INVESTMENTS -- (CONTINUED)
<TABLE>
<CAPTION>
DECEMBER 31, 1998
AVAILABLE-FOR-SALE SECURITIES
----------------------------------------------------------------------
COST OR GROSS GROSS
AMORTIZED UNREALIZED UNREALIZED FAIR CARRYING
COST GAINS LOSSES VALUE VALUE
------------ ----------- ----------- ------------ ------------
<S> <C> <C> <C> <C> <C>
Fixed Maturities:
U.S. Treasury securities and
obligations of U.S. government
agencies........................... $160,529,318 $ 2,911,851 $ (414,659) $163,026,510 $163,026,510
Corporate securities................. 53,501,824 1,248,926 (41,695) 54,709,055 54,709,055
Mortgage-backed securities........... 21,410,089 441,500 (38,969) 21,812,620 21,812,620
------------ ----------- ----------- ------------ ------------
Total fixed maturities........ 235,441,231 4,602,277 (495,323) 239,548,185 239,548,185
Equity Securities:
Preferred stocks..................... 596,000 -- -- 596,000 596,000
Common stocks........................ 55,270,571 23,701,632 (2,661,678) 76,310,525 76,310,525
------------ ----------- ----------- ------------ ------------
Total equity securities....... 55,866,571 23,701,632 (2,661,678) 76,906,525 76,906,525
Short-term investments................. 9,215,878 -- -- 9,215,878 9,215,878
------------ ----------- ----------- ------------ ------------
Total available-for-sale
securities.................. $300,523,680 $28,303,909 $(3,157,001) $325,670,588 $325,670,588
============ =========== =========== ============ ============
</TABLE>
Fair values for fixed maturities and short-term investments are based on
quoted market prices, where available. For fixed maturities not actively traded,
fair values are estimated using values obtained from independent pricing
services. The fair values for common stocks are based on quoted market prices.
Substantially all of the Company's investments in equity securities at
December 31, 1999 and 1998 are comprised of stocks in industrial companies.
The amortized cost and fair values of fixed maturities at December 31,
1999, by contractual maturity, are shown below. Expected maturities will differ
from contractual maturities because borrowers may have the right to call or
prepay obligations with or without call or prepayment penalties.
<TABLE>
<CAPTION>
DECEMBER 31, 1999
AVAILABLE-FOR-SALE
SECURITIES
---------------------------
AMORTIZED FAIR
COST VALUE
------------ ------------
<S> <C> <C>
Due in one year or less..................................... $ 28,747,116 $ 28,451,929
Due after one year through five years....................... 112,519,094 109,800,004
Due after five years through ten years...................... 99,762,336 94,321,900
Due after ten years......................................... 1,999,924 1,876,570
Mortgage-backed securities.................................. 22,846,997 22,394,118
------------ ------------
Total fixed maturity securities............................. $265,875,467 $256,844,521
============ ============
</TABLE>
Bonds, certificates of deposit and money market funds carried at a value of
$1,004,422 were on deposit with insurance regulatory authorities at December 31,
1999 in accordance with statutory requirements.
F-10
<PAGE> 67
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
3. INVESTMENTS -- (CONTINUED)
Investment and other income for the years ended December 31, 1999, 1998 and
1997 is summarized as follows:
<TABLE>
<CAPTION>
YEAR ENDED DECEMBER 31,
---------------------------------------
1999 1998 1997
----------- ----------- -----------
<S> <C> <C> <C>
Fixed maturities................................ $14,114,469 $13,354,658 $11,464,768
Equity securities............................... 976,415 881,667 1,302,477
Short-term investments and cash equivalents..... 4,873,071 4,061,482 5,165,927
----------- ----------- -----------
Interest and dividend income.................... 19,963,955 18,297,807 17,933,172
Less: investment expenses....................... (1,008,599) (771,950) (947,913)
----------- ----------- -----------
Net investment income........................... 18,955,356 17,525,857 16,985,259
Other income (loss)............................. 731,409 (342,110) 273,693
----------- ----------- -----------
Investment and other income..................... $19,686,765 $17,183,747 $17,258,952
=========== =========== ===========
</TABLE>
Other income (loss) amounts are generally gains or losses on the disposal
of assets or other transactions that do not relate to the Company's primary
business operations.
Realized and unrealized investment gains and losses for the years ended
December 31, 1999, 1998 and 1997 were as follows:
<TABLE>
<CAPTION>
YEAR ENDED DECEMBER 31,
----------------------------------------
1999 1998 1997
------------ ----------- -----------
<S> <C> <C> <C>
Realized gains:
Fixed maturities............................. $ 709,622 $ 2,685,201 $ 248,942
Equity securities............................ 9,130,824 8,191,839 11,910,540
------------ ----------- -----------
Total gains.......................... 9,840,446 10,877,040 12,159,482
Realized losses:
Fixed maturities............................. (577,256) (7,778) (127,366)
Equity securities............................ (2,048,723) (1,615,756) (732,359)
------------ ----------- -----------
Total losses......................... (2,625,979) (1,623,534) (859,725)
------------ ----------- -----------
Net realized investment gains.................. 7,214,467 9,253,506 11,299,757
Changes in unrealized gains (losses):
Fixed maturities............................. (13,137,900) 1,553,093 1,936,513
Equity securities............................ (3,208,102) 6,214,920 5,618,852
Short-term investments....................... -- -- 51,212
------------ ----------- -----------
Net unrealized gains (losses).................. (16,346,002) 7,768,013 7,606,577
------------ ----------- -----------
Total realized and unrealized gains
(losses)........................... $ (9,131,535) $17,021,519 $18,906,334
============ =========== ===========
</TABLE>
F-11
<PAGE> 68
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
4. ACCOUNTS RECEIVABLE
Accounts receivable consists of the following:
<TABLE>
<CAPTION>
DECEMBER 31,
-------------------------
1999 1998
----------- -----------
<S> <C> <C>
Groups and subscribers...................................... $47,617,634 $37,132,624
Other....................................................... 35,115,414 30,951,367
Less: Allowance for doubtful accounts....................... (6,303,697) (6,305,996)
----------- -----------
$76,429,351 $61,777,995
=========== ===========
</TABLE>
5. PROPERTY AND EQUIPMENT
Property and equipment consists of the following:
<TABLE>
<CAPTION>
DECEMBER 31,
----------------------------
1999 1998
------------ ------------
<S> <C> <C>
Land.................................................... $ 1,046,773 $ 1,046,773
Building and improvements............................... 16,019,474 15,161,667
Furniture and equipment................................. 95,997,531 86,286,171
------------ ------------
113,063,778 102,494,611
Less: accumulated depreciation.......................... (73,000,053) (65,596,073)
------------ ------------
$ 40,063,725 $ 36,898,538
============ ============
</TABLE>
At December 31, 1999 and 1998, furniture and equipment includes $6,740,544
and $3,021,638, respectively, of capitalized costs related to the development of
internal use software. During 1999 and 1998, the Company recognized
approximately $564,073 and $90,000 of amortization expense related to costs
capitalized for the development of internal use software.
Depreciation expense was $10,439,488, $10,743,267 and, $9,765,395 for 1999,
1998 and 1997, respectively, including $697,594 in 1999, $1,187,550 in 1998 and
$1,063,318 in 1997 for building and improvements.
6. LINES OF CREDIT
The Company has available a $5,500,000 line of credit with a bank to
finance its working capital needs. Interest accrues on amounts advanced at the
prime rate. There were no borrowings on this line of credit during the three
years ended December 31, 1999.
The Company has a $55,000,000 insolvency line of credit with a group of
banks. The insolvency line of credit may be drawn on solely in the event of an
insolvency of BCBSGA to pay authorized insurance policy claims. The insolvency
line of credit is designed to satisfy certain membership standards of the Blue
Cross and Blue Shield Association, from which the Company and certain of its
subsidiaries have the exclusive right to do business in Georgia under the name
"Blue Cross and Blue Shield" and to use the Blue Cross and Blue Shield names,
trademarks and service marks with respect to the Company's indemnity, PPO, HMO
and POS products.
Under the terms of a revolving credit loan agreement with a group of banks
to finance the Company's community health partnership networks and other related
costs, the Company could borrow up to $9,000,000. During January 1998, the
Company terminated its $9,000,000 revolving credit agreement and paid in full
the $3,500,000 note payable outstanding at December 31, 1997. Interest accrued
on amounts advanced at 0.5% over the LIBOR rate in 1998 and 1997.
F-12
<PAGE> 69
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
7. ESTIMATED BENEFIT LIABILITIES
The following table provides a reconciliation of the beginning and ending
estimated benefit liabilities including claims adjudication expenses, net of
rate stabilization reimbursable reserves and life reserves, for 1999, 1998 and
1997:
<TABLE>
<CAPTION>
YEAR ENDED DECEMBER 31,
------------------------------------------
1999 1998 1997
------------ ------------ ------------
<S> <C> <C> <C>
Balance at January 1......................... $184,075,293 $149,581,004 $119,510,793
Less: Reimbursable reserves and life
reserves................................... 54,563,626 49,699,319 44,663,227
------------ ------------ ------------
Net balance at January 1..................... 129,511,667 99,881,685 74,847,566
Plus incurred related to:
Current year............................... 943,930,921 729,799,455 576,250,933
Prior year................................. (4,628,524) (13,801,953) 901,109
------------ ------------ ------------
Total incurred..................... 939,302,397 715,997,502 577,152,042
Less paid related to:
Current year............................... 801,587,915 603,369,042 478,159,277
Prior year................................. 119,857,216 82,998,478 73,958,646
------------ ------------ ------------
Total paid......................... 921,445,131 686,367,520 552,117,923
------------ ------------ ------------
Net balance at December 31................... 147,368,933 129,511,667 99,881,685
Plus: Reimbursable reserves and life
reserves................................... 54,218,331 54,563,626 49,699,319
------------ ------------ ------------
Balance at December 31....................... $201,587,264 $184,075,293 $149,581,004
============ ============ ============
</TABLE>
The Company uses paid claims and completion factors based on historical
payment patterns to estimate incurred claims. Changes in payment patterns and
claims trends can result in changes to prior year's claims estimates.
A reconciliation of the Company's incurred expense to total benefits
expense as shown in the accompanying consolidated statements of income is as
follows:
<TABLE>
<CAPTION>
YEAR ENDED DECEMBER 31,
----------------------------------------------
1999 1998 1997
-------------- -------------- ------------
<S> <C> <C> <C>
Incurred related to current and prior
year.................................... $ 939,302,397 $ 715,997,502 $577,152,042
Benefits expense related to life insurance
claims and claims reimbursed by certain
rate stabilization accounts............. 361,620,318 316,522,044 304,402,324
-------------- -------------- ------------
Total benefits expense.......... $1,300,922,715 $1,032,519,546 $881,554,366
============== ============== ============
</TABLE>
F-13
<PAGE> 70
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
8. ENDOWMENT OF NON-PROFIT FOUNDATION
On September 3, 1997, a lawsuit (the "Lawsuit") was filed in the Superior
Court of Fulton County by Plaintiffs Let's Get Together, Inc.; Statewide
Independent Living Council of Georgia, Inc.; Living Independence for Everybody,
Inc.; Aids Survival Project, Inc.; Women's Policy Education Fund, Inc.;
Disability Connections -- The Middle Georgia Center for Independent Living,
Inc.; Physicians for a National Health Program, Inc.; Campaign for a Prosperous
Georgia, Inc.; and Friends and Survivors Standing Together, Inc. (collectively,
the "Plaintiffs") on behalf of themselves and a class putatively composed of all
other 501(c)(3) organizations in Georgia seeking, among other things, to
invalidate a Georgia statute upon which certain aspects of the conversion of
Blue Cross and Blue Shield of Georgia, Inc. from a not-for-profit corporation to
a business corporation was based. The complaint named BCBSGA, the Company and
the Commissioner of Insurance of the State of Georgia as defendants. An
additional, similar request for declaratory ruling was filed with the Georgia
Insurance Department on September 3, 1997.
The Plaintiffs' claims related to the conversion of BCBSGA from a
non-profit entity to a for-profit entity which occurred as part of a Plan of
Conversion submitted to a public hearing November 21, 1995, and approved by the
Georgia Commissioner of Insurance in an order dated December 27, 1995. The
complaint sought to have the fair market value of the assets of BCBSGA as of
December 27, 1995, plus interest from December 27, 1995, placed in a public
trust for the use and benefit of a class of nonprofit charitable organizations.
On October 3, 1997, the Georgia Insurance Department denied the Plaintiffs'
request for declaratory ruling, which decision the Plaintiffs appealed. On
October 31, 1997, the Company and BCBSGA filed a motion to dismiss the Lawsuit.
Oral argument was held on January 12, 1998.
On July 8, 1998, the Company entered into a stipulation and agreement of
settlement of the Lawsuit (the "Settlement") subject to the approval of the
Superior Court of Fulton County, Georgia (the "Court"). On August 17, 1998, six
individuals, including two shareholders, filed a motion to intervene in the
lawsuit and an objection to the Settlement. A settlement hearing was held on
August 20, 1998 to determine, among other things, if the terms and conditions of
the Settlement were fair and reasonable and should be approved by the Court.
On August 21, 1998, the judge denied the motion to intervene and entered a
final order approving the Settlement. The effective date of the Settlement was
September 21, 1998, the date on which the appeal period expired after the entry
of the final order. Under the terms of the Settlement, the Company established a
new non-profit foundation for the advancement of health care for all Georgians
and paid to the foundation, as endowment, and to the Plaintiff's lawyers
(together, the "Foundation"), an aggregate of $1.0 million in cash, and
securities of Cerulean aggregating 20% of Cerulean's total equity upon their
issuance consisting of: (1) shares of Class A Stock approximating 9.5% of the
total equity of Cerulean and (2) warrants (the "Warrants") exercisable for
shares on non-voting Series A Preferred Stock (the "Series A Stock") in the
Company (which will approximate 10.5% of the total equity of the Company) upon
payment by the Foundation of an exercise price of $21 million. Additionally, the
Foundation entered into a shareholder's agreement to which it agreed not to vote
any larger number of its Class A Stock than would constitute 5% of the shares of
its Class A Stock.
In September 1998, the Company issued 57,772 shares of Class A Stock and
63,853 warrants exercisable for non-voting Series A Stock. Pursuant to the terms
of the Warrants, prior to consummation of a transaction such as the proposed
merger with WellPoint, the Warrants must be exercised in a defined "cash-less
exercise" which results in a reduction in the percentage participation by the
Foundation from a 20% portion of the total merger consideration of the Company
to approximately 16.7% of the total.
During 1998, the Company recorded a nonrecurring charge of $76.2 million
for the endowment of the Foundation, which, in management's judgment,
represented fair value as of the date of the Settlement.
F-14
<PAGE> 71
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
9. INCOME TAXES
Income tax expense (benefit) attributable to income before income taxes and
minority interests, substantially all of which is federal, consists of:
<TABLE>
<CAPTION>
YEAR ENDED DECEMBER 31,
---------------------------------------
1999 1998 1997
----------- ----------- -----------
<S> <C> <C> <C>
Current tax expense.......................... $12,155,000 $ 8,293,000 $ 3,330,000
Deferred tax benefit......................... (3,094,000) (6,220,000) (5,380,000)
----------- ----------- -----------
Total tax expense (benefit)........ $ 9,061,000 $ 2,073,000 $(2,050,000)
=========== =========== ===========
</TABLE>
The provision for income taxes is different than the amount computed using
the statutory federal income tax rate of 35% as follows:
<TABLE>
<CAPTION>
YEAR ENDED DECEMBER 31,
----------------------------------------
1999 1998 1997
----------- ------------ -----------
<S> <C> <C> <C>
Tax expense (benefit) at statutory rate........ $14,388,000 $(18,751,000) $ 311,000
Changes in valuation allowance related to:
Alternative minimum tax...................... (7,735,000) (3,282,000) --
Increase in loss carryforwards............... -- 22,085,000 --
Utilization of carryforwards................. -- -- (2,356,000)
CHPN losses with no benefit.................. 3,140,000 2,676,000 4,231,000
Long-lived tax assets........................ -- -- (2,119,000)
Other temporary differences.................. -- (542,000) (375,000)
CHPN investments............................... (1,872,000) (925,000) (2,132,000)
Other.......................................... 1,140,000 812,000 390,000
----------- ------------ -----------
$ 9,061,000 $ 2,073,000 $(2,050,000)
=========== ============ ===========
</TABLE>
The Company and its wholly-owned subsidiaries file a consolidated federal
income tax return. Income tax expense consisted primarily of federal alternative
minimum tax in 1999 and 1998. The Company's consolidated tax expense in 1997
calculated under the regular tax system was reduced by available net operating
loss carryforwards, which subjected the Company to alternative minimum tax.
CHPN subsidiaries do not join in the filing of the consolidated tax return
with the Company. Certain CHPNs generated tax losses that are not expected to
generate benefit currently or in the foreseeable future. The Company recorded a
benefit in 1999 for the difference in book and tax basis for its CHPN
investments reduced to its expected realizable value of $1,872,000. In 1998, the
Company recorded a benefit of $26,655,000 related to the Settlement, reduced to
its expected realizable value of $4,570,000. Other includes state taxes, net of
federal tax benefit, and permanent book to tax differences, including
non-deductible expenses.
Federal income taxes paid during 1999, 1998 and 1997 were $15,524,000,
$6,403,000 and $2,800,000, respectively.
F-15
<PAGE> 72
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
9. INCOME TAXES -- (CONTINUED)
Deferred income taxes reflect the net tax effects of temporary differences
between the carrying amounts of assets and liabilities for financial reporting
purposes and the amounts used for income tax purposes. The significant
components of the deferred tax asset, which is included in other assets in the
accompanying consolidated balance sheets, are as follows:
<TABLE>
<CAPTION>
DECEMBER 31,
---------------------------
1999 1998
------------ ------------
<S> <C> <C>
Deferred tax asset:
Regular tax operating loss carryforwards for the
consolidated tax group............................... $ 36,629,000 $ 40,400,000
Regular tax operating loss carryforwards for CHPNs...... 7,317,000 8,160,000
Alternative minimum tax credit.......................... 27,003,000 16,470,000
Long-lived tax assets................................... 23,621,000 23,900,000
Basis difference in CHPN investments.................... 3,670,000 5,350,000
Other temporary differences............................. 16,803,000 12,880,000
------------ ------------
Total deferred tax asset........................ 115,043,000 107,160,000
Valuation allowance for deferred tax asset.............. (94,539,000) (89,750,000)
------------ ------------
Deferred tax asset, net of valuation allowance.......... 20,504,000 17,410,000
------------ ------------
Deferred tax liability:
Unrealized investment gains............................. 1,542,000 5,550,000
------------ ------------
Total deferred tax liability.................... 1,542,000 5,550,000
------------ ------------
Net deferred tax asset.................................... $ 18,962,000 $ 11,860,000
============ ============
</TABLE>
Other temporary differences consist principally of differences between tax
and generally accepted accounting principles related to estimated benefit
liabilities and accounting accruals.
At December 31, 1999, the Company's consolidated tax group has net
operating loss carryforwards of $104,655,000 for regular income tax purposes
that expire in the years 2003 through 2018. Certain of the CHPN subsidiaries
which file separate tax returns have net operating loss carryforwards of
$19,276,000 that expire in 2011 through 2019.
The Company qualifies for a special deduction under the regular tax system
available to certain Blue Cross and Blue Shield plans under Section 833(b) of
the Internal Revenue Code. The effect of this deduction is to significantly
reduce regular taxable income and subjects the Company to alternative minimum
tax. The Company expects to be taxed under the alternative minimum tax system
into the foreseeable future and therefore principally all of the regular tax net
operating loss carryforwards of the consolidated tax group, the alternative
minimum tax credit and the long-lived tax assets which will not be deductible
until well into the future, will most likely not be utilized. For financial
reporting purposes, a valuation allowance has been recorded to reduce the
related deferred tax assets to the amount expected to be realized. The Company
reviewed the adequacy of the deferred tax valuation allowance and believes it is
appropriate.
During January 1999, the Internal Revenue Service completed its examination
of the Company's consolidated federal income tax returns for 1995 and 1994. The
Company does not believe that the ultimate resolution of the issues will have an
adverse effect on its operations or financial position.
F-16
<PAGE> 73
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
10. CAPITAL STOCK
MANDATORILY REDEEMABLE PREFERRED STOCK
The Class B Convertible Preferred Stock (the "Class B Stock") has a
liquidation preference of $1,000 per share and a mandatory redemption value of
$900 per share. Dividends on the Class B Stock are currently paid at the rate of
$100.00 per annum per share ($60.00 per annum per share prior to 1999), are
fully cumulative and accrue without interest. The preferred shares are
mandatorily redeemable on December 1, 2001 or may be redeemed prior to this date
upon the occurrence of certain events. Upon completion of a Stock Conversion,
each share of Class B Stock shall convert into the number of fully paid and
nonassessable shares of Common Stock equal to .0004446420631%. This rate may be
adjusted periodically upon the occurrence of certain events. The holders of the
Class B Stock vote separately as a single class with each share being entitled
to one vote.
BLANK PREFERRED STOCK
The Board of Directors (the "Board") of the Company may from time to time
issue shares of Blank Preferred Stock in such series or classes with such terms,
preferences and other provisions as the Board shall determine, provided that
such issuance is approved by the majority of the holders of the Preferred Stock
then issued, outstanding and entitled to vote. Presently, there is no Blank
Preferred Stock issued or outstanding.
SERIES A PREFERRED STOCK
The Series A Stock is a series of preferred stock created specifically for
the Settlement. The Series A Stock has all of the economic attributes of Class A
Stock, and each share of Series A Stock is the economic equivalent of one share
of Class A Stock. The Series A Stock, however, has no voting rights. In those
events in which there is a statutory voting right accorded to any class or
series of capital stock, each share of Series A Stock automatically converts
into one unit of the Company's Class A Common Stock Participation Rights (the
"Company's Rights"). Each of the Company's Rights is the economic equivalent of
one share of Class A Stock but has no voting rights.
The Series A Stock has been authorized by the Company's Board of Directors
and holders of a majority of the outstanding shares of Class B Stock, and an
amendment to the Company's Articles of Incorporation (the "Articles") creating
the Series A Stock was filed with the Georgia Secretary of State.
CLASS A CONVERTIBLE COMMON STOCK
Prior to December 1, 1998, shares of Class A Stock could not be sold,
transferred, encumbered, pledged or otherwise disposed of except upon the
occurrence of certain events. While there is no established market for the
Company's Class A Stock, following December 1, 1998, these shares became
transferable under certain defined criteria, with a right of first refusal by
the Company. As of December 31, 1999, no shares had been presented to the
Company for transfer that met the defined criteria. In the event of a Stock
Conversion, each share of Class A Stock will be converted into one share of
Common Stock. So long as any shares of the Company's Class B Stock are issued,
outstanding and entitled to vote, no dividends may be paid on the Class A Stock
without the approval of the Board and the holders of a majority of the shares of
Class B Stock. As long as no Common Stock is outstanding, the holders of the
Class A Stock vote separately as a single class with each share being entitled
to one vote. The Company's Articles do not contain any provisions protecting
holders of Class A Stock against dilution. In the event the Company issues
additional shares of Class A Stock, or issues shares of Common Stock or Blank
Preferred Stock convertible into Common Stock or effects a stock split, stock
dividend or other recapitalization of or on its Common Stock, the then existing
Class A Shareholders will be diluted.
F-17
<PAGE> 74
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
10. CAPITAL STOCK -- (CONTINUED)
During 1998, 57,772 shares of Class A Stock were issued as part of the
Settlement. These shares have all of the same terms and provisions as the other
shares of Class A Stock as provided in the Company's Articles, except that the
Foundation, which received shares of Class A Stock as part of the Settlement,
entered into a shareholders' agreement pursuant to which 37,305 shares of the
total 57,772 shares issued are not entitled to vote. Additionally, the
Foundation has the right to tender for redemption shares of Class A Stock for an
aggregate redemption price of $1.0 million. Under the Company's Articles, this
redemption right was required to be separately authorized by holders of a
majority of the shares of Class B Stock which authorization was granted at a
meeting of holders of Class B Stock held on September 15, 1998.
COMMON STOCK
Unless approved by two-thirds of the Directors, no person may directly or
indirectly acquire or hold more than the permissible ownership amount which is
currently 20% of the total shares of Common Stock outstanding. So long as any
shares of the Company's Class B Stock are issued, outstanding and entitled to
vote, no dividends may be paid on the Common Stock without the approval of the
Board and the holders of a majority of the shares of Class B Stock. In the event
no Class A Stock or Class B Stock is issued or outstanding at the time of a
liquidation, dissolution or winding up of the affairs of the Company, the entire
assets of the Company available for distribution to stockholders will be
distributed pro rata among the holders of the Common Stock. Each outstanding
share of Common Stock is entitled to one vote. Presently, there is no Common
Stock issued or outstanding.
STOCK WARRANTS EXERCISABLE
During 1998, Warrants were also issued as part of the Settlement. The
63,853 warrants are exercisable for shares of non-voting Series A Stock. There
are no circumstances under which the equity interest represented by the Warrants
has any voting rights. The Warrants also provide that upon the occasion of
certain defined "Major Events," the Warrants must be exercised in a cashless
exercise. The effect of this provision is that the Warrants will be
automatically converted into shares of Series A Stock according to a formula
provided in the Warrant Agreement.
11. OPERATING LEASES
The Company has an operating lease arrangement for its home office
facility. The term of the lease is ten years, with two five-year renewal
options. Annual rental includes base rental plus pro-rated real estate taxes and
operating expenses.
In addition, the Company leases other office space and data processing
equipment. Future minimum lease obligations (including estimated real estate
taxes and operating expenses) under all non-cancelable operating leases are as
follows:
<TABLE>
<S> <C>
2000........................................................ $17,735,926
2001........................................................ 5,130,170
2002........................................................ 2,336,903
2003........................................................ 1,192,762
2004........................................................ 1,135,079
Thereafter.................................................. --
-----------
$27,530,840
===========
</TABLE>
Rent expense amounted to approximately $21,911,000 in 1999, $18,413,000 in
1998 and $14,235,000 in 1997.
F-18
<PAGE> 75
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
12. EMPLOYEE BENEFITS
PENSION PLAN
The Company and its subsidiaries participate in a multi-employer
non-contributory defined benefit pension plan covering substantially all of its
employees. The benefits are based on years of service and the employee's
compensation during those years. The Company's funding policy is to contribute
amounts sufficient to meet the minimum funding requirements set forth in the
Employee Retirement Income Security Act of 1974. Contributions are intended to
provide not only for benefits attributed to service to date but also for those
expected to be earned in the future. The Projected Unit Credit Method is used to
determine funding requirements and pension expense.
SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN
During 1996, the Company and its subsidiaries established three defined
benefit pension plans (the "Plans") covering certain executives. The benefits
are based on years of service and the employee's compensation during those
years. The Plans are non-qualified and unfunded. The Projected Unit Credit
Method is used to determine pension expense. The Company will pay benefits to
eligible participants when due under terms of the individual plans.
POSTRETIREMENT PLAN
The Company sponsors a Defined Dollar Benefit Plan that provides
postretirement health, dental, vision and life insurance benefits to full-time
associates with at least ten years of service or part-time associates with the
equivalent of ten years full-time employment. These benefits are also available
to spouses. Credits based on length of service are provided to retirees annually
to be used towards the cost of postretirement benefits. Spouses of retirees
receive one half of the credits received by retirees. For those who retired
prior to January 1, 1995, insurance is provided by the Company at no cost to the
retiree. Additionally, a group of associates who meet the "rule of 80" (those
who were at least age 55 with ten years of service, and whose combined years of
service plus age equaled 80 or greater) by December 31, 1994 are grandfathered
and will receive postretirement benefits at no cost whenever they retire.
F-19
<PAGE> 76
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
12. EMPLOYEE BENEFITS -- (CONTINUED)
The following chart summarizes the change in the plans' benefit obligation,
assets and funded status:
<TABLE>
<CAPTION>
POSTRETIREMENT
PENSION PLANS BENEFIT PLANS
--------------------------- -----------------------------
1999 1998 1999 1998
------------ ------------ ------------- -------------
<S> <C> <C> <C> <C>
Change in benefit obligation
Benefit obligation at
beginning of year............ $ 84,889,734 $ 66,669,719 $ 17,551,400 $ 17,802,200
Service cost................. 6,300,720 5,153,127 649,000 581,500
Interest cost................ 5,646,635 5,029,628 1,126,100 1,140,700
Actuarial loss (gain)........ (13,002,983) 10,225,989 (2,899,600) (1,245,700)
Amendments................... 856,263 713,929 -- --
Benefits paid................ (3,801,774) (2,902,658) (792,500) (727,300)
------------ ------------ ------------- -------------
Benefit obligation at end of
year...................... 80,888,595 84,889,734 15,634,400 17,551,400
------------ ------------ ------------- -------------
Change in plan assets Fair
value of plan assets at
beginning of year............ 65,604,328 56,731,183 -- --
Actual return on plan
assets.................... 10,394,044 8,870,572 -- --
Employer contributions....... 1,282,570 2,905,231 -- --
Benefits paid................ (3,801,774) (2,902,658) -- --
------------ ------------ ------------- -------------
Fair value of plan assets at
end of year............... 73,479,168 65,604,328 -- --
------------ ------------ ------------- -------------
Reconciliation of funded status
Funded status................ $ (7,409,427) $(19,285,406) $ (15,634,400) $ (17,551,400)
Unrecognized actuarial loss
(gain).................... (10,783,205) 7,783,506 (5,644,400) (2,854,300)
Unrecognized prior service
cost...................... 4,983,476 4,676,823 -- --
Unrecognized transition
(asset) obligation........ (530,780) (665,153) 12,075,400 12,880,500
------------ ------------ ------------- -------------
Net amount recognized........ $(13,739,936) $ (7,490,230) $ (9,203,400) $ (7,525,200)
============ ============ ============= =============
Amounts recognized in the
accompanying consolidated
balance sheets consist of:
Accrued benefit liability.... $(13,753,953) $ (7,949,252) $ (9,203,400) $ (7,525,200)
Intangible asset............. 14,017 459,022 -- --
------------ ------------ ------------- -------------
Net amount recognized........ $(13,739,936) $ (7,490,230) $ (9,203,400) $ (7,525,200)
============ ============ ============= =============
Weighted-average assumptions as 6.75
of December 31, 7.75% 6.76% 7.75% %
Discount rate 9.00% 9.00% N/A N/A
Expected long-term rate of
return on plan assets
Rate of increase in future
compensation 3.0-6.5% 3.0-6.5% Varies by age Varies by age
</TABLE>
F-20
<PAGE> 77
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
12. EMPLOYEE BENEFITS -- (CONTINUED)
<TABLE>
<CAPTION>
POSTRETIREMENT
PENSION PLANS BENEFIT PLANS
--------------------------------------- ------------------------------------
1999 1998 1997 1999 1998 1997
----------- ----------- ----------- ---------- ---------- ----------
<S> <C> <C> <C> <C> <C> <C>
Components of net
periodic benefit
cost:
Service cost......... $ 6,300,720 $ 5,153,127 $ 3,731,909 $ 649,000 $ 581,500 $ 475,900
Interest cost........ 5,646,635 5,029,628 4,225,087 1,126,100 1,140,700 1,264,200
Expected return on
plan assets....... (5,220,276) (4,580,790) (3,817,799) -- -- --
Amortization of
actuarial loss
(gain)............ 389,961 236,924 67,886 (109,500) (114,900) (23,400)
Amortization of prior
service cost...... 549,609 549,609 462,788 -- -- --
Amortization of
transition
obligation
(asset)........... (134,373) (134,373) (134,373) 805,100 805,100 805,100
----------- ----------- ----------- ---------- ---------- ----------
Net periodic benefit
cost.............. $ 7,532,276 $ 6,254,125 $ 4,535,498 $2,470,700 $2,412,400 $2,521,800
=========== =========== =========== ========== ========== ==========
</TABLE>
The projected benefit obligation, accumulated benefit obligation and fair
value of plan assets for the supplemental executive retirement plan, which has
an accumulated benefit obligation in excess of plan assets, were $5,524,172,
$4,013,284 and $-0-, respectively as of December 31, 1999, and $5,185,428,
$3,055,356 and $-0-, respectively, as of December 31, 1998.
The postretirement benefit plan valuation is based on census information as
of January 1, 1999 and claims development based on the benefits provided. The
discount rate assumed is 7.75% and the salary increase rate assumed varies by
age. The health care cost trend rate is assumed to be 7.5% in 1999, decreasing
gradually to 5.25% in 2003 and after. The health care cost trend rate was
assumed to be 8.0% in 1998, decreasing 0.5% each year to an ultimate rate of
5.25%. The health care cost trend rate assumption has a significant effect on
the amounts reported. For example, increasing the assumed health care cost trend
rates by one percentage point each year would increase the accumulated
postretirement benefit obligation by $690,900 as of December 31, 1999, and the
aggregate of the estimated service and interest cost components of net periodic
postretirement benefit cost by $53,500 for 1999. Similarly, decreasing the
assumed health care cost trend rates by one percentage point each year would
decrease the accumulated postretirement benefit obligation by $598,000 as of
December 31, 1999, and the aggregate of the estimated service and interest cost
components of net periodic postretirement benefit cost by $46,300 for 1999.
DEFINED CONTRIBUTION PLAN
The Company offers a defined contribution plan ("401(k) plan") covering
substantially all employees. Under this plan, employees can contribute up to 15%
of their base compensation, subject to certain maximum limitations. The Company
matches 50% of the employee's first $500 contributed and 25% thereafter, up to a
maximum of 6% of the employee's annual compensation. The Company's matching
contributions vest 25% per year commencing at the end of the second year of
participation. Employee contributions vest immediately. The Company contributed
$1,201,000 to this 401(k) plan during 1999, $1,125,000 during 1998 and
$1,031,000 during 1997.
F-21
<PAGE> 78
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
13. BUSINESS SEGMENT, CUSTOMER AND PRODUCT INFORMATION
The Company operates predominantly in one industry segment, health
insurance products and services, and reports its operations as one business
segment. The Company's products and services are sold principally in the State
of Georgia. A significant portion of its customer base is concentrated with
companies that are located in the metropolitan Atlanta area. As a percentage of
total revenues (premium revenues and management services revenues), the
Company's largest customer represented 22% of total revenues in 1999, 23% of
total revenues in 1998 and 27% in 1997. The Company's next two largest customers
accounted for less than 9% of total revenues in 1999, 1998 and 1997.
The Company's total revenues (premium revenues and management services
revenues), by primary product groups are as follows:
<TABLE>
<CAPTION>
1999 1998 1997
-------------- -------------- --------------
<S> <C> <C> <C>
Indemnity and PPO insurance products and
services.............................. $ 933,807,941 $ 771,080,787 $ 727,786,073
HMO and POS insurance products and
services.............................. 677,047,014 520,317,074 343,613,408
Life insurance and other products and
services.............................. 17,625,014 16,230,082 14,860,028
-------------- -------------- --------------
Total......................... $1,628,479,969 $1,307,627,943 $1,086,259,509
============== ============== ==============
</TABLE>
14. NON-OPERATING INCOME
Community health partnership networks ("CHPNs") are locally based equity
joint ventures between the Company, which owns a 51% interest, and local
physician and/or hospital groups, which own the remaining equity interests in
the CHPNs. Clinical services are provided by the physician or hospital partners
as well as other providers with which the CHPNs maintain contracts, and BCBSGA
provides sales, management and administrative services, including information
systems and data management services through service contracts with the CHPNs.
In January 1998, a hospital purchased stock warrants exercisable for common
stock in one of the Company's CHPN subsidiaries in exchange for $1.0 million,
paid ratably over two years. The stock warrants expired on December 16, 1999. In
accordance with the CHPN formation agreement, the Company's 51% equity interest
was not diluted as a result of this transaction. The Company recorded
non-operating income of $255,000 in 1999 and in 1998 for its portion of this
transaction.
In 1997, a hospital purchased a 5% interest in one of the Company's CHPN
subsidiaries. In accordance with the CHPN formation agreement, the Company's 51%
equity interest was not diluted as a result of this transaction. The Company
recorded non-operating income of $1,275,000 in 1997 for its portion of this
transaction.
15. COMMITMENTS AND CONTINGENCIES
LEGAL PROCEEDINGS
On September 18, 1998, Plaintiffs Allen Saravuth, Nga Nguyen, Chansamone
Sengsavath and Fatana Pirzad, individually and on behalf of all others similarly
situated (collectively, the "Richmond County Plaintiffs"), filed a lawsuit
against the Company, BCBSGA, James L. Laboon, Jr., Fred L. Tolbert, Jr., Richard
D. Shirk, James E. Albright, W. Daniel Barker, Elizabeth W. Camp, Louis H.
Felder, M.D., Edward M. Gillespie, Joseph D. Greene, Mel H. Gregory, Jr., Frank
J. Hanna, III, R. Pierce Head, Jr., Charles H. Keaton, James H. Leigh, Jr.,
M.D., Julia L. Mitchell-Ivey, Charles R. Underwood, M.D., W. Jerry Vereen, A.
Max Walker, Dan H. Willoughby, M.D., Joe M. Young, and John B. Zellars
(collectively, the "Defendant
F-22
<PAGE> 79
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
15. COMMITMENTS AND CONTINGENCIES -- (CONTINUED)
Directors") in the Superior Court of Richmond County, State of Georgia, bearing
Civil Action File No. 98-RCCV-806. In addition, the Richmond County Plaintiffs
filed a Motion for Temporary Restraining Order and Interlocutory Injunctive
Relief, which was heard and denied by the Superior Court of Richmond County on
September 21, 1998. The Richmond County Plaintiffs identify themselves as four
individuals who were entitled to receive shares of the Company's stock in
connection with the conversion of BCBSGA from a non-profit corporation to a
regular business corporation (the "Conversion"). The Richmond County Plaintiffs
assert claims for specific performance, fraud, breach of provisions of the
Insurance Code of Georgia, breach of fiduciary duty, and request declaratory
judgment and certification of a class action consisting of all persons who were
"eligible subscribers" of BCBSGA as of February 1, 1996, and who did not become
holders of Class A Stock of the Company. The Richmond County Plaintiffs allege
that they and the members of the purported class are entitled to receive shares
of Class A Stock in the Company. The Richmond County Plaintiffs allege
alternatively that offering materials disseminated by BCBSGA during 1996
relating to Class A Stock of the Company contained materially misleading and
deceptive statements and omissions and that the Richmond County Plaintiffs and
the purported class members are entitled to an award of damages in excess of
$100 million. The Richmond County Plaintiffs also assert derivative causes of
action against the Defendant Directors alleging that the Defendant Directors
breached fiduciary duties by, among other things, approving the placement and
issuance of Class B Stock in the Company during 1996, the issuance of Class A
Stock in the Company, the settlement of the Let's Get Together, Inc. et al. v.
Insurance Commissioner, et al., Civil Action E-61714 (Superior Court of Fulton
County, Georgia) lawsuit, and certain management compensation. On November 9,
1998, Harrell Tiller, Charlie Deal and Olean Lokey joined the case as additional
named plaintiffs. On December 9 and 10, 1998, a hearing was held on the
plaintiffs' request for declaratory ruling on the issue of whether plaintiffs
are properly shareholders of the Company and on December 17, 1998, the Superior
Court ruled in favor of the plaintiffs. The Company filed an appeal with the
Georgia Supreme Court which accepted jurisdiction and granted expedited
treatment of the appeal. The Company's Board of Directors appointed a Special
Litigation Committee to review the derivative claims. On April 14, 1999, the
Special Litigation Committee reported to the Board of Directors that it had
concluded that the derivative claims were without substance. On May 3, 1999, the
Georgia Supreme Court reversed the ruling of the Richmond County Superior Court,
holding that the Richmond County Superior Court erred in considering and ruling
upon the plaintiffs' claims. The Georgia Supreme Court found that the Georgia
Commissioner had broad power of review over the Conversion and that sufficient
administrative remedies with the Georgia Commissioner had been available to the
plaintiffs during and following the Conversion.
The Richmond County Plaintiffs did not file a motion for reconsideration of
the Georgia Supreme Court's decision. On May 5, 1999, BCBSGA and the Company
filed motions for summary judgment on the Richmond County Plaintiffs' fraud
claims. On May 20, 1999, the Company and BCBSGA filed a motion for entry of
judgment on all remaining counts of the Richmond County Plaintiffs' Complaint.
On July 29, 1999, the Superior Court of Richmond County entered an order
dismissing all claims against the Defendant Directors without prejudice. On
September 21, 1999, the Superior Court of Richmond County entered orders denying
the motions for summary judgment and the motion for entry of judgment. On
October 27, 1999, the Company and BCBSGA filed a motion for reconsideration of
the motion for entry of judgment. The case remains pending before the Superior
Court.
LEGAL PROCEEDINGS
On May 17, 1999, Harrell Tiller, Charlie Deal and Olean Lokey, who were
among the Richmond County Plaintiffs, filed two separate Petitions for
Declaratory Ruling (the "Petitions") before the Georgia Commissioner, seeking a
declaration from the Georgia Commissioner that they, and others similarly
situated, should have been issued shares of Class A Stock. On June 22, 1999, the
Georgia Commissioner entered orders on the Petitions denying the relief sought.
On June 22, 1999, Harrell Tiller, Charlie Deal and Olean Lokey filed two
F-23
<PAGE> 80
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
15. COMMITMENTS AND CONTINGENCIES -- (CONTINUED)
separate proceedings in the Superior Court of Richmond County. In these cases,
styled In Re: Harrell Tiller, individually and on behalf of all others similarly
situated v. Commissioner of Insurance of the State of Georgia, Civil Action No.
1999-RCCV-471 and In Re: Charlie Deal and Olean Lokey, individually and on
behalf of all others similarly situated v. Commissioner of Insurance of the
State of Georgia, Civil Action No. 1999-RCCV-470, the Petitioners sought
judicial review of the decisions of the Georgia Commissioner of June 22, 1999
(the "Judicial Review Proceedings"). On September 21, 1999, the Superior Court
of Richmond County entered orders reversing the Commissioner's orders. On
October 12, 1999, the Company and BCBSGA filed Applications for Discretionary
Appeal (the "Applications") with the Supreme Court of Georgia, seeking to have
that court reverse the Superior Court of Richmond County's decisions. These
Applications were transferred to the Court of Appeals of the State of Georgia on
November 12, 1999. On October 21, 1999, the Commissioner filed an application
for appellate relief from the Superior Court's decisions with the Court of
Appeals of the State of Georgia, seeking to have that court overturn the
Superior Court's decisions. On November 22, 1999, the Georgia Court of Appeals
granted the Applications for Discretionary Appeal of all parties. The cases were
docketed on December 15, 1999, and the parties are completing their briefing of
the cases. Oral argument before the Court of Appeals is scheduled for March 23,
2000. Management of the Company believes the case to be without merit and, in
any event, believes that its impact, if any, on the assets of the Company would
not be material.
In the normal course of business, the Company is involved in and subject to
claims, contractual disputes and other uncertainties. Management, after
reviewing with legal counsel all of these actions and proceedings, believes that
the aggregate losses, if any, will not have a material effect on the Company's
financial position or results of operations.
16. STATUTORY FINANCIAL INFORMATION AND ACCOUNTING PRACTICES
BCBSGA, Greater Georgia Life Insurance Company, a life insurance
subsidiary, and HMO Georgia, Inc., a health maintenance organization are
domiciled in the State of Georgia and prepare their statutory financial
statements in accordance with accounting principles and practices prescribed or
permitted by the Georgia Insurance Department. Currently, prescribed statutory
accounting practices are interspersed throughout state insurance laws and
regulations, the National Association of Insurance Commissioners' ("NAIC")
"Accounting Practices and Procedures Manual" and a variety of other NAIC
publications. Permitted statutory accounting practices encompass all accounting
practices that are not prescribed; such practices may differ from state to
state, may differ from company to company within a state and may change in the
future.
In 1998, the NAIC adopted codified statutory accounting principles
("Codification") effective January 1, 2001. Codification will likely change, to
some extent, prescribed statutory accounting practices and may result in changes
to the accounting practices that the Company's subsidiaries use to prepare their
statutory financial statements. Codification will require adoption by the
various states before it becomes the prescribed statutory basis of accounting
for insurance companies domesticated within those states. Accordingly, before
Codification becomes effective for the Company's subsidiaries, the State of
Georgia must adopt Codification as the prescribed statutory basis of accounting
on which domestic insurers must report their statutory-basis results to the
Insurance Department. At this time it is anticipated that Georgia will adopt
codification. However, based on current guidance, management believes that the
impact of Codification will not be material to the statutory-basis financial
statements of the Company's subsidiaries. The Company's insurance subsidiaries
do not have permitted practices which would require authorization by the Georgia
Insurance Department.
The minimum amount of statutory capital and surplus necessary to satisfy
regulatory requirements of the Georgia Insurance Department is $1,000,000 for
BCBSGA and $3,000,000 each for HMO Georgia, Inc. and Greater Georgia Life
Insurance Company. The Company's insurance subsidiaries may distribute dividends
only out of realized profits (undistributed, accumulated, net earnings since
organization). The amount of
F-24
<PAGE> 81
CERULEAN COMPANIES, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS -- (CONTINUED)
16. STATUTORY FINANCIAL INFORMATION AND ACCOUNTING PRACTICES -- (CONTINUED)
dividends distributable each year is limited to the greater of the prior year's
net income determined on a statutory basis or 10% of prior year statutory
surplus. In addition, dividends distributable by BCBSGA are further limited by
the Conversion order (approved by the Georgia Commissioner of Insurance on
December 27, 1995 related to BCBSGA's conversion to a for-profit corporation).
Dividend distributions by BCBSGA, HMO Georgia, Inc. and Greater Georgia Life
Insurance Company above these defined limits require special approval by the
State of Georgia Insurance Commissioner.
The following table presents the amount of statutory capital and surplus
for the Company's insurance subsidiaries:
<TABLE>
<CAPTION>
DECEMBER 31,
----------------------------
1999 1998
------------ ------------
<S> <C> <C>
Blue Cross and Blue Shield of Georgia, Inc.............. $161,510,819 $155,721,970
HMO Georgia, Inc........................................ 45,481,883 26,017,636
Greater Georgia Life Insurance Company.................. 24,481,354 24,971,304
</TABLE>
The following table presents the amount of statutory net income for the
Company's insurance subsidiaries:
<TABLE>
<CAPTION>
YEAR ENDED DECEMBER 31,
--------------------------------------
1999 1998 1997
----------- ----------- ----------
<S> <C> <C> <C>
Blue Cross and Blue Shield of Georgia, Inc....... $33,158,697 $15,131,962 $1,936,150
HMO Georgia, Inc................................. 14,419,178 11,399,608 8,250,726
Greater Georgia Life Insurance Company........... 2,117,567 2,569,111 3,173,718
</TABLE>
F-25
<PAGE> 1
EXHIBIT 2.6
SECOND AMENDMENT TO
AGREEMENT AND PLAN OF MERGER
This Second Amendment (the "Amendment") to the Agreement and Plan of Merger
(the "Agreement") dated as of July 9, 1998, by and among Cerulean, Inc., a
Georgia corporation ("Cerulean"), WellPoint Health Networks Inc., a Delaware
corporation ("WellPoint") and Water Polo Acquisition Corp., a Delaware
corporation ("WPAC"), is dated as of December 31, 1999. Capitalized terms used
herein and not otherwise defined shall have the meaning set forth in the
Agreement.
WITNESSETH
WHEREAS, Cerulean, WellPoint and WPAC have previously entered into
the Agreement, pursuant to which Cerulean would merge with and into WPAC upon
the terms and conditions set forth therein; and
WHEREAS, Cerulean, WellPoint and WPAC entered into a First Amendment
to the Agreement dated July 9, 1999 ("First Amendment") amending Section 7.01(b)
of the Agreement to provide that the Agreement may be terminated and the Merger
contemplated thereby may be abandoned by either Cerulean or WellPoint if the
Merger shall not have been consummated on or before December 31, 1999 (which
date was elected by WellPoint and Cerulean pursuant to the First Amendment);
and
WHEREAS, Cerulean, WellPoint and WPAC desire further to amend the
Agreement as set forth in this Amendment.
AGREEMENT
NOW, THEREFORE, in consideration of the mutual agreements contained
herein, and upon and subject to the terms and conditions hereinafter set forth,
the parties do hereby agree as follows:
1. Section 7.01(b) of the Agreement, as it read prior to the First
Amendment, shall be amended by deleting the words "the one year
anniversary of this Agreement" and inserting in their place the
words "December 31, 2000." This Section 1 shall supersede
Section 1 of the First Amendment.
2. Except as set forth in this Amendment, the Agreement shall remain
unmodified and shall continue in full force and effect.
<PAGE> 2
IN WITNESS WHEREOF, each of the parties hereof have caused this Amendment to be
duly executed on its behalf as of the date indicated above.
CERULEAN COMPANIES, INC.
By: /s/ HUGH J. STEDMAN
------------------------------------
WELLPOINT HEALTH NETWORKS INC.
By: /s/ THOMAS C. GEISER
------------------------------------
WATER POLO ACQUISITION CORP.
By: /s/ THOMAS C. GEISER
------------------------------------
<TABLE> <S> <C>
<ARTICLE> 7
<LEGEND>
THIS SCHEDULE CONTAINS SUMMARY FINANCIAL INFORMATION EXTRACTED FROM THE
FINANCIAL STATEMENTS OF CERULEAN COMPANIES, INC. ON FORM 10-K FOR THE YEAR ENDED
DECEMBER 31, 1999 AND IS QUALIFIED IN ITS ENTIRETY BY REFERENCE TO SUCH
FINANCIAL STATEMENTS.
</LEGEND>
<MULTIPLIER> 1
<CURRENCY> U.S. DOLLARS
<S> <C>
<PERIOD-TYPE> YEAR
<FISCAL-YEAR-END> DEC-31-1999
<PERIOD-START> JAN-01-1999
<PERIOD-END> DEC-01-1999
<EXCHANGE-RATE> 1
<DEBT-HELD-FOR-SALE> 256,844,521
<DEBT-CARRYING-VALUE> 0
<DEBT-MARKET-VALUE> 0
<EQUITIES> 73,036,645
<MORTGAGE> 0
<REAL-ESTATE> 0
<TOTAL-INVEST> 330,206,166
<CASH> 58,522,617
<RECOVER-REINSURE> 0
<DEFERRED-ACQUISITION> 0
<TOTAL-ASSETS> 612,083,088
<POLICY-LOSSES> 201,587,264
<UNEARNED-PREMIUMS> 17,873,115
<POLICY-OTHER> 26,749,038
<POLICY-HOLDER-FUNDS> 0
<NOTES-PAYABLE> 0
46,645,042
0
<COMMON> 4,096
<OTHER-SE> 231,023,808
<TOTAL-LIABILITY-AND-EQUITY> 612,083,088
1,486,293,824
<INVESTMENT-INCOME> 19,686,765
<INVESTMENT-GAINS> 7,214,467
<OTHER-INCOME> 142,186,145
<BENEFITS> 1,300,922,715
<UNDERWRITING-AMORTIZATION> 0
<UNDERWRITING-OTHER> 0
<INCOME-PRETAX> 41,110,853
<INCOME-TAX> 9,061,000
<INCOME-CONTINUING> 32,843,177
<DISCONTINUED> 0
<EXTRAORDINARY> 0
<CHANGES> 0
<NET-INCOME> 32,843,177
<EPS-BASIC> 0
<EPS-DILUTED> 0
<RESERVE-OPEN> 0
<PROVISION-CURRENT> 0
<PROVISION-PRIOR> 0
<PAYMENTS-CURRENT> 0
<PAYMENTS-PRIOR> 0
<RESERVE-CLOSE> 0
<CUMULATIVE-DEFICIENCY> 0
</TABLE>
