|
Exhibit 13
FINANCIAL SECTION
23 | Selected Financial Data |
|
24 | Management's Discussion and Analysis of Financial Condition and Results of Operations | |
35 | Consolidated Balance Sheets | |
36 | Consolidated Statements of Operations | |
37 | Consolidated Statements of Stockholders' Equity | |
38 | Consolidated Statements of Cash Flows | |
39 | Notes to Consolidated Financial Statements | |
51 | Report of Independent Accountants | |
52 | Quarterly Financial Information (Unaudited) | |
53 | Board of Directors | |
54 | Senior Officers | |
55 | Additional Information |
SELECTED FINANCIAL DATA
(Dollars in millions, except
per share results)
For the years ended December 31, |
1999 (a) | 1998 (b) | 1997 (c) | 1996 (d) | 1995 (c) | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
|
||||||||||||
SUMMARY OF OPERATIONS | ||||||||||||
|
||||||||||||
Premiums | $ 9,959 | $ 9,597 | $ 7,880 | $ 6,677 | $ 4,605 | |||||||
Interest and other income | 154 | 184 | 156 | 111 | 97 | |||||||
|
||||||||||||
Total revenues | 10,113 | 9,781 | 8,036 | 6,788 | 4,702 | |||||||
|
||||||||||||
(Loss) income before income taxes | (404 | ) | 203 | 270 | 18 | 288 | ||||||
Net (loss) income | (382 | ) | 129 | 173 | 12 | 190 | ||||||
(Loss) earnings per common share | (2.28 | ) | 0.77 | 1.06 | 0.07 | 1.17 | ||||||
(Loss) earnings per common share assuming dilution | (2.28 | ) | 0.77 | 1.05 | 0.07 | 1.16 | ||||||
Net cash provided by operations | 217 | 55 | 279 | 341 | 150 | |||||||
FINANCIAL POSITION | ||||||||||||
|
||||||||||||
Cash and investments | $ 2,738 | $ 2,812 | $ 2,798 | $ 1,880 | $ 1,696 | |||||||
Total assets | 4,900 | 5,496 | 5,600 | 3,306 | 3,056 | |||||||
Medical and other expenses payable | 1,756 | 1,908 | 2,075 | 1,099 | 866 | |||||||
Debt and other long-term obligations | 830 | 977 | 1,057 | 361 | 399 | |||||||
Stockholdersequity | 1,268 | 1,688 | 1,501 | 1,292 | 1,287 | |||||||
OPERATING DATA | ||||||||||||
|
||||||||||||
Medical expense ratio | 85.7 | % | 83.8 | % | 82.8 | % | 84.3 | % | 81.7 | % | ||
Administrative expense ratio | 15.0 | % | 15.2 | % | 15.5 | % | 15.5 | % | 13.9 | % | ||
Medical membership by segment: | ||||||||||||
Health Plan: | ||||||||||||
Large group commercial | 1,420,500 | 1,559,700 | 1,661,900 | 1,435,000 | 1,502,500 | |||||||
Medicare HMO | 488,500 | 502,000 | 480,800 | 364,500 | 310,400 | |||||||
Medicaid and other | 661,100 | 700,400 | 704,000 | 152,900 | 164,000 | |||||||
TRICARE | 1,058,000 | 1,085,700 | 1,112,200 | 1,103,000 | ||||||||
Administrative services | 648,000 | 646,200 | 651,200 | 471,000 | 495,100 | |||||||
|
||||||||||||
Total Health Plan | 4,276,100 | 4,494,000 | 4,610,100 | 3,526,400 | 2,472,000 | |||||||
Small Group: | ||||||||||||
Small group commercial | 1,663,100 | 1,701,800 | 1,596,700 | 1,324,600 | 1,332,400 | |||||||
|
||||||||||||
Total medical membership | 5,939,200 | 6,195,800 | 6,206,800 | 4,851,000 | 3,804,400 | |||||||
|
||||||||||||
Specialty membership: | ||||||||||||
Dental | 1,628,200 | 1,375,500 | 936,400 | 844,800 | 797,000 | |||||||
Other | 1,333,100 | 1,257,800 | 1,504,200 | 1,039,400 | 1,063,000 | |||||||
|
||||||||||||
Total specialty membership | 2,961,300 | 2,633,300 | 2,440,600 | 1,884,200 | 1,860,000 | |||||||
|
(a) | Includes expenses of $585 million pretax ($499 million after tax, or $2.97 per diluted share) primarily related to goodwill write-down, losses on non-core asset sales, professional liability reserve strengthening, premium deficiency and medical reserve strengthening. |
(b) | Includes expenses of $132 million pretax ($84 million after tax, or $0.50 per diluted share) primarily related to the costs of certain market exits and product discontinuances, asset write-offs, premium deficiency and a one-time non-officer employee incentive. |
(c) | Includes the operations of Health Direct, Inc., Physician Corporation of America, ChoiceCare Corporation and EMPHESYS Financial Group, Inc. since their dates of acquisition, February 28, 1997, September 8, 1997, October 17, 1997 and October 11, 1995, respectively. |
(d) | Includes expenses of $215 million pretax ($140 million after tax, or $0.85 per diluted share) primarily related to the closing of the Washington, D.C. and certain other markets, severance and facility costs for workforce reductions, product discontinuance costs, premium deficiency, litigation and other costs. |
HUMANA INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
The consolidated financial statements of Humana Inc. (the "Company" or "Humana") in this Annual Report present the Company's financial position, results of operations and cash flows, and should be read in conjunction with the following discussion and analysis. This discussion and analysis contains both historical and forward-looking information. The forward-looking statements may be significantly impacted by risks and uncertainties, and are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. There can be no assurance that anticipated future results will be achieved because actual results may differ materially from those projected in the forward-looking statements. Readers are cautioned that a number of factors, which are described herein and in the Company's Annual Report on Form 10-K for the year ended December 31, 1999, could adversely affect the Company's ability to obtain these results. These include the effects of either federal or state health care reform or other legislation, including the Patients' Bill of Rights, any expanded right to sue managed care companies and alleged class action litigation directed against the managed care industry, changes in the Medicare reimbursement system, the ability of health care providers (including physician practice management companies) to comply with current contract terms, renewal of the Company's Medicare contracts with the federal government, renewal of the Company's contract with the federal government to administer the TRICARE program and renewal of the Company's Medicaid contracts with various state governments and the Health Insurance Administration in Puerto Rico. Such factors also include the effects of other general business conditions, including but not limited to, the success of the Company's improvement initiatives including its electronic business strategies, premium rate and yield changes, retrospective premium adjustments relating to federal government contracts, changes in commercial and Medicare HMO membership, medical and pharmacy cost trends, compliance with debt covenants, changes in the Company's debt rating and its ability to borrow under its commercial paper program, operating subsidiary capital requirements, competition, general economic conditions and the retention of key employees. In addition, past financial performance is not necessarily a reliable indicator of future performance and investors should not use historical performance to anticipate results or future period trends.
INTRODUCTION
Humana is one of the nation's largest publicly
traded health services companies that facilitates the delivery of health
care services through networks of providers to its approximately 5.9 million
medical members. The Company's products are marketed primarily through
health maintenance organizations ("HMOs") and preferred provider
organizations ("PPOs") that encourage or require the use of
contracted providers. HMOs and PPOs control health care costs by various
means, including pre- admission approval for hospital inpatient services,
pre-authorization of outpatient surgical procedures, and risk-sharing
arrangements with providers. These providers may share medical cost risk or
have other incentives to deliver quality medical services in a
cost-effective manner. The Company also offers various specialty products to
employers, including dental, group life and workers' compensation and
administrative services ("ASO") to those who self-insure their
employee health plans. The Company has entered into a definitive agreement
to sell its workers' compensation business. In total, the Company's products
are licensed in 49 states, the District of Columbia and Puerto Rico, with
approximately 20 percent of its membership in the state of
Florida.
During 1999, the Company realigned its organization to achieve greater accountability in its lines of business. As a result of this realignment, the Company organized into two business units: the Health Plan segment and the Small Group segment. The Health Plan segment includes the Company's large group commercial (100 employees and over), Medicare, Medicaid, ASO, workers' compensation and military or TRICARE business. The small group segment includes small group commercial (under 100 employees) and specialty benefit lines, including dental, life and short-term disability. Results of each segment are measured based upon results of operations before income taxes. The Company allocates administrative expenses, interest income and interest expense, but no assets, to the segments. Members served by the two segments generally utilize the same medical provider networks, enabling the Company to obtain more favorable contract terms with providers. As a result, the profitability of each segment is somewhat interdependent. In addition, premium revenue pricing to large group commercial employers has historically been more competitive than that to small group commercial employers, resulting in less favorable underwriting margins for the large group commercial line of business. Costs to distribute and administer products to small group commercial employers are higher compared to large group commercial employers resulting in small group's higher administrative expense ratio.
ACQUISITIONS AND DISPOSITIONS
Between December 30, 1999 and February 4, 2000, the
Company entered into definitive agreements to sell its
workers' compensation, Medicare supplement and North Florida Medicaid
businesses for proceeds of approximately $115 million. The Company recorded
a $118 million loss in 1999 related to these sale transactions.
On January 31, 2000, the Company acquired the Memorial Sisters of Charity Health Network ("MSCHN"), a Houston based health plan for approximately $50 million in cash.
On June 1, 1999, the Company reached an agreement with FPA Medical Management, Inc. ("FPA"), FPA's lenders and a federal bankruptcy court under which the Company acquired the operations of 50 medical centers from FPA for approximately $14 million in cash. The Company has subsequently reached agreements with 14 provider groups to assume operating responsibility for 38 of the 50 acquired FPA medical centers under long-term provider agreements with the Company.
On October 17, 1997, the Company acquired ChoiceCare Corporation ("ChoiceCare") for approximately $250 million in cash. The purchase was funded with borrowings under the Company's commercial paper program. ChoiceCare provided health services products to members in the Greater Cincinnati, Ohio, area.
On September 8, 1997, the Company acquired Physician Corporation of America ("PCA") for total consideration of $411 million in cash, consisting primarily of $7 per share for PCA's outstanding common stock and the assumption of $121 million in debt. The purchase was funded with borrowings under the Company's commercial paper program. PCA provided comprehensive health services through its HMOs in Florida, Texas and Puerto Rico. In addition, PCA provided workers' compensation third-party administrative management services. Prior to November 1996, PCA also was a direct writer of workers' compensation insurance in Florida. Long-term medical and other expenses payable in the accompanying Consolidated Balance Sheets includes the long-term portion of workers' compensation liabilities related to this business.
On February 28, 1997, the Company acquired Health Direct, Inc. ("Health Direct") from Advocate Health Care for approximately $23 million in cash.
The above acquisitions were accounted for under the purchase method of accounting. In connection with these acquisitions, the Company allocated the acquisition costs to net tangible and identifiable intangible assets based upon their fair values. Identifiable intangible assets, which are included in other long-term assets in the accompanying Consolidated Balance Sheets, primarily relate to subscriber and provider contracts. Any remaining value not assigned to net tangible or identifiable intangible assets was then allocated to cost in excess of net assets acquired, or goodwill. Goodwill and identifiable intangible assets acquired, recorded in connection with the acquisitions, was $17 million and $754 million in 1999 and 1997, respectively. Subscriber and provider contracts are amortized over their estimated useful lives (seven to 14 years), while goodwill has been amortized over periods from six to 40 years.
At December 31, 1999, goodwill and identifiable intangible assets represent 67% of total stockholders' equity. In accordance with the Company's policy, the carrying values of all long-lived assets including goodwill and identifiable intangible assets are periodically reviewed by management for impairment whenever adverse events or changes in circumstances occur. In addition, management periodically reviews the reasonableness of the estimated useful life assigned to goodwill and identifiable intangible assets. Impairment losses and/or changes in the estimated useful life related to these assets could have a material adverse impact on the Company's financial position and results of operations.
During 1999, the Company recorded an impairment loss and, effective January 1, 2000, adopted a 20 year amortization period from the date of acquisition for goodwill previously amortized over 40 years as discussed in the following section.
ASSET WRITE-DOWNS AND OPERATIONAL EXPENSES
The following table presents the components of the
asset write-downs and operational expenses and their respective
classifications in the 1999 and 1998 Consolidated Statements of
Operations:
(In millions)
|
Medical | Selling,
General and Administrative |
Asset
Write-Downs and Other |
Total | |||||
---|---|---|---|---|---|---|---|---|---|
|
|||||||||
1999: | |||||||||
FIRST QUARTER 1999: | |||||||||
|
|||||||||
Premium deficiency | $ 50 | $ 50 | |||||||
Reserve strengthening | 35 | 35 | |||||||
Provider costs | 5 | 5 | |||||||
|
|||||||||
Total first quarter 1999 | 90 | 90 | |||||||
|
|||||||||
FOURTH QUARTER 1999: | |||||||||
|
|||||||||
Long-lived asset impairment | $ 342 | 342 | |||||||
Losses on non-core asset sales | 118 | 118 | |||||||
Professional liability reserve strengthening and other costs | $ 35 | 35 | |||||||
|
|||||||||
Total fourth quarter 1999 | 35 | 460 | 495 | ||||||
|
|||||||||
Total 1999 | $ 90 | $ 35 | $ 460 | $585 | |||||
|
HUMANA INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
(In millions)
|
Medical |
Selling,
General and Administrative |
Asset
Write-Downs and Other |
Total |
|||||
---|---|---|---|---|---|---|---|---|---|
1998: | |||||||||
THIRD QUARTER 1998: | |||||||||
Premium deficiency | $ 46 | $ 46 | |||||||
Provider costs | 27 | 27 | |||||||
Market exit costs | $ 15 | 15 | |||||||
Losses on non-core asset sales | 12 | 12 | |||||||
Merger dissolution costs | 7 | 7 | |||||||
Non-officer employee incentive and other costs | $ 25 | 25 | |||||||
|
|||||||||
Total third quarter 1998 | $ 73 | $ 25 | $ 34 | $ 132 | |||||
|
1999 EXPENSES
Premium Deficiency, Reserve Strengthening and
Provider Costs
As a result of management's assessment of the
profitability of its contracts for providing health care services to its
members in certain markets, the Company recorded a provision for probable
future losses (premium deficiency) of $50 million during the first
quarter of 1999. Ineffective provider risk-sharing contracts and the
impact of the March 31, 1999 Columbia/HCA Healthcare Corporation (
"Columbia/HCA") hospital agreement in Florida on current and
projected future medical costs contributed to the premium deficiency. The
beneficial effect from losses charged to the premium deficiency liability
throughout 1999 was $50 million. Because the majority of the Company's
customers' contracts renew annually, the Company does not anticipate the
need for a premium deficiency in 2000, absent unanticipated adverse
events or changes in circumstances.
Prior period adverse claims development primarily in the Company's PPO and Medicare products initially identified during an analysis of February and March 1999 medical claims resulted in the $35 million reserve strengthening. The Company releases or strengthens medical claims reserves when favorable or adverse development in prior periods exceed actuarial margins existing in the reserves. In addition, the Company paid Columbia/HCA $5 million to settle certain contractual issues associated with the March 31, 1999 hospital agreement in Florida.
Long-Lived Asset Impairment
Historical and current period operating losses in
certain of the Company's markets prompted a review during the fourth
quarter of 1999 for the possible impairment of long-lived assets. This
review indicated that estimated future undiscounted cash flows were
insufficient to recover the carrying value of long-lived assets,
primarily goodwill, associated with the Company's Austin, Dallas and
Milwaukee markets. Accordingly, the Company adjusted the carrying value
of these long-lived assets to their estimated fair value resulting in a
non-cash impairment charge of $342 million. Estimated fair value was
based on discounted cash flows.
The long-lived assets associated with the Austin and Dallas markets primarily result from the Company's 1997 acquisition of PCA. Operating losses in Austin and Dallas were related to the deterioration of risk-sharing arrangements with providers and the failure to effectively convert the PCA operating model and computer platform to Humana's. The long-lived assets associated with the Milwaukee market primarily result from the Company's 1994 acquisition of CareNetwork, Inc. Operating losses in Milwaukee were the result of competitor pricing strategies resulting in lower premium levels to large employer groups as well as market dynamics dominated by limited provider groups causing higher than expected medical costs.
The Company also re-evaluated the amortization period of its goodwill and as a result, effective January 1, 2000, adopted a 20 year amortization period from the date of acquisition for goodwill previously amortized over 40 years.
The $342 million long-lived asset impairment will decrease depreciation and amortization expense $13 million annually ($13 million after tax, or $0.08 per diluted share), while the change in the amortization period of goodwill will increase amortization expense $25 million annually ($24 million after tax, or $0.15 per diluted share).
Losses on Non-Core Asset Sales
The Company has entered into definitive
agreements for the disposition of its workers' compensation, Medicare
supplement and North Florida Medicaid businesses, which are considered
non-core. As a result of the carrying value of the net assets of these
businesses exceeding the estimated sale proceeds, the Company has
recorded a loss of $118 million. Estimated fair value was established
based upon definitive sale agreements, net of expected transaction costs.
These transactions are expected to be completed in the first and second
quarters of 2000. Total assets of $725 million, primarily consisting of
marketable securities and reinsurance recoverables and total liabilities
of $490 million, primarily consisting of worker's compensation reserves
related to these businesses are included in the accompanying Consolidated
Balance Sheets. The accompanying Consolidated Statements of Operations
include 1999 revenues of $214 million and pretax operating income of $38
million from these businesses. Included in 1999 and 1998 pretax operating
(loss) income is $36 million and $5 million of workers' compensation
reserve releases resulting from favorable claim liability
development.
Professional Liability Reserve Strengthening and
Other Costs
The Company insures substantially all
professional liability risks through a wholly owned captive insurance
subsidiary (the "Subsidiary"). The Subsidiary recorded an
additional $25 million expense during the fourth quarter of 1999
primarily related to expected claim and legal costs to be incurred by the
Company.
In addition, other expenses of $10 million were recorded during the fourth quarter related to a claim payment dispute with a contracted provider and government audits.
Activity related to the 1999 expenses follows:
(In millions)
|
1999
Expenses |
1999 Activity |
Balance at
December 31, 1999 |
||||||
---|---|---|---|---|---|---|---|---|---|
Cash | Non-Cash | ||||||||
|
|||||||||
Premium deficiency | $ 50 | $ (50 | ) | | |||||
Reserve strengthening | 35 | (35 | ) | | |||||
Provider costs | 5 | (5 | ) | | |||||
Long-lived asset impairment | 342 | $ (342 | ) | | |||||
Losses on non-core asset sales | 118 | (28 | ) | $ 90 | |||||
Professional liability reserve | |||||||||
strengthening and other costs | 35 | 35 | |||||||
|
|||||||||
$ 585 | $ (90 | ) | $ (370 | ) | $ 125 | ||||
|
1998 EXPENSES
Market Exits, Non-Core Asset Sales and Merger
Dissolution Costs
On August 10, 1998, the Company and UnitedHealth
Group Company ("United") announced their mutual agreement to
terminate the previously announced Agreement and Plan of Merger, dated
May 27, 1998. The planned merger, among other things, was expected to
improve the operating results of the Company's products and markets due
to overlapping markets with United. Following the merger's termination,
the Company conducted a strategic evaluation, which included assessing
the Company's competitive market positions and profit potential. As a
result, the Company recognized expenses of $34 million during the third
quarter of 1998. The expenses included costs associated with exiting five
markets ($15 million), losses on disposals of non-core assets ($12
million) and merger dissolution costs ($7 million).
The costs associated with the market exits of $15 million included severance, lease termination costs as well as write-offs of equipment and uncollectible provider receivables. The planned market exits were Sarasota and Treasure Coast, Florida, Springfield and Jefferson City, Missouri and Puerto Rico. Severance costs were estimated based upon the provisions of the Company's employee benefit plans. The plan to exit these markets was expected to reduce the Company's market office workforce, primarily in Puerto Rico, by approximately 470 employees. In 1999, the Company reversed $2 million of the severance and lease discontinuance liabilities after the Company contractually agreed with the Health Insurance Administration in Puerto Rico to extend the Company's Medicaid contract, with more favorable terms. The Company estimated annual pretax savings of approximately $40 million, after all market exits were completed by June 30, 1999, primarily from a reduction in underwriting losses. Approximately 100 employees were ultimately terminated resulting in insignificant severance payments.
In accordance with the Company's policy on impairment of long-lived assets, equipment of $5 million in the exited markets was written down to its fair value after an evaluation of undiscounted cash flow in each of the markets. The fair value of equipment was based upon discounted cash flows for the same markets. Following the write-down, the equipment was fully depreciated.
Premium Deficiency and Provider
Costs
As a result of management's assessment of the
profitability of its contracts for providing health care services to its
members in certain markets, the Company recorded a provision for probable
future losses (premium deficiency) of $46 million during the third
quarter of 1998. The premium deficiency resulted from events prompted by
the terminated merger with United wherein the Company had expected to
realize improved operating results in those markets that overlapped with
United, including more favorable risk-sharing arrangements. The
beneficial effect from losses charged to the premium deficiency liability
in 1999 and 1998 was $23 million and $17 million, respectively. In 1999,
the Company reversed $6 million of premium deficiency liabilities after
the Company contractually agreed with the Health Insurance Administration
in Puerto Rico to extend the Company's Medicaid contract, with more
favorable terms.
The Company also recorded $27 million of expense related to receivables written-off from financially troubled physician groups, including certain bankrupt providers.
Non-Officer Employee Incentive and Other
Costs
During the third quarter of 1998, the Company
recorded a one-time incentive of $16 million paid to non-officer
employees and a $9 million settlement related to a third party pharmacy
processing contract.
Activity related to the 1998 expenses
follows:
(In millions)
|
1998
Expenses |
1998 Activity |
Balance at
December 31, 1998 |
1999 Activity |
Balance at
December 31, 1999 |
||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Cash | Non-cash | Cash | Adjustment | ||||||||||||
|
|||||||||||||||
Premium deficiency | $ 46 | $ (17 | ) | $ 29 | $ (23 | ) | $ (6 | ) | $ | ||||||
Provider costs | 27 | $ (27 | ) | ||||||||||||
Market exit costs | 15 | (10 | ) | 5 | (2 | ) | (2 | ) | 1 | ||||||
Losses from non-core asset sales | 12 | (5 | ) | (7 | ) | ||||||||||
Merger dissolution costs | 7 | (5 | ) | 2 | (2 | ) | | ||||||||
Non-officer employee incentive | |||||||||||||||
and other costs | 25 | (25 | ) | | |||||||||||
|
|||||||||||||||
$ 132 | $ (52 | ) | $ (44 | ) | $ 36 | $ (27 | ) | $ (8 | ) | $ 1 | |||||
|
Reported Results | Excluded Expenses | Adjusted Results | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
|||||||||||||
(In millions, except per
share results)
|
1999 | 1998 | 1999 (a) | 1998 (b) | 1999 | 1998 | |||||||
|
|||||||||||||
Consolidated Statements of Operations caption items that are adjusted: | |||||||||||||
Operating expenses: | |||||||||||||
Medical | $ 8,532 | $ 8,041 | $ (90 | ) | $ (73 | ) | $8,442 | $7,968 | |||||
Selling, general and administrative | 1,368 | 1,328 | (35 | ) | (25 | ) | 1,333 | 1,303 | |||||
Depreciation and amortization | 124 | 128 | 124 | 128 | |||||||||
Asset write-downs and other expenses | 460 | 34 | (460 | ) | (34 | ) | | | |||||
|
|||||||||||||
Total operating expenses | 10,484 | 9,531 | (585 | ) | (132 | ) | 9,899 | 9,399 | |||||
(Loss) income from operations | (371 | ) | 250 | 585 | 132 | 214 | 382 | ||||||
(Loss) income before income taxes | (404 | ) | 203 | 585 | 132 | 181 | 335 | ||||||
Net (loss) income | $ (382 | ) | $ 129 | $ 499 | $ 84 | $ 117 | $ 213 | ||||||
(Loss) earnings per common share | $ (2.28 | ) | $ 0.77 | $ 2.97 | $ 0.50 | $ 0.69 | $ 1.28 | ||||||
Diluted (loss) earnings per common share | $ (2.28 | ) | $ 0.77 | $ 2.97 | $ 0.50 | $ 0.69 | $ 1.27 |
Reported Ratios | Ratio Effect of Excluded Expenses | Adjusted Ratios | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
|||||||||||||
1999 | 1998 | 1999 (a) | 1998 (b) | 1999 | 1998 | ||||||||
|
|||||||||||||
Medical expense ratios: | |||||||||||||
Health Plan | 87 | .4% | 85 | .3% | (1 | .0)% | (0 | .9)% | 86 | .4% | 84 | .4% | |
Small Group | 81 | .9% | 80 | .2% | (0 | .7)% | (0 | .5)% | 81 | .2% | 79 | .7% | |
|
|||||||||||||
Total | 85 | .7% | 83 | .8% | (0 | .9)% | (0 | .8)% | 84 | .8% | 83 | .0% | |
|
|||||||||||||
Administrative expense ratios: | |||||||||||||
Health Plan | 12 | .5% | 12 | .8% | (0 | .4)% | (0 | .2)% | 12 | .1% | 12 | .6% | |
Small Group | 20 | .4% | 20 | .7% | (0 | .3)% | (0 | .4)% | 20 | .1% | 20 | .3% | |
|
|||||||||||||
Total | 15 | .0% | 15 | .2% | (0 | .4)% | (0 | .3)% | 14 | .6% | 14 | .9% | |
|
(a) | Reflects the previously discussed medical, administrative, asset write-downs and other expenses of $90 million, $35 million and $460 million, respectively. |
(b) | Reflects the previously discussed medical, administrative, asset write-downs and other expenses of $73 million, $25 million and $34 million, respectively. |
The Company's premium revenues increased 3.8 percent to a record $10.0 billion for 1999, compared to $9.6 billion for 1998. Higher premium revenues resulted from increased premium yields of 7.4 percent and 3.4 percent for the Company's commercial and Medicare HMO products, respectively. This increase was partially offset by a decline in commercial membership of 177,900, due to selling the Florida individual business line and the result of substantial premium increases delivered to large group and small group commercial customers. Membership levels are expected to decline in 2000 due to the sale of certain non-core businesses and substantial premium rate increases. The Company expects commercial and Medicare HMO premium yields to approximate 10 to 12 percent and 6 to 7 percent, respectively, in 2000, the result of commercial premium rate increases and newly introduced Medicare member premiums.
The Company's adjusted medical expense ratio for 1999 was 84.8 percent, compared to 83.0 percent for 1998. The increase was the result of medical cost increases in the Company's commercial products exceeding premium rate increases. Offsetting the impact of the increasing commercial medical costs was the continued favorable claim liability development in the Company's run-off workers' compensation business acquired in connection with its acquisition of PCA. After evaluating the workers' compensation claim liabilities against claim payments and file closings, the Company reduced these liabilities by $36 million ($23 million after tax, or $0.14 per diluted share) and $5 million ($3 million after tax, or $0.02 per diluted share) in 1999 and 1998, respectively.
The adjusted administrative expense ratio improved during 1999 to 14.6 percent from 14.9 percent in 1998. The year-over-year improvement in the administrative expense ratio reflects continued rationalization of staffing levels commensurate with membership levels. The administrative expense ratio is expected to increase slightly in 2000 from increased spending on information technology.
Interest income totaled $132 million for 1999 and $150 million for 1998. This decrease resulted from a decrease in realized investment gains, lower average invested balances and lower investment yields. The tax equivalent yield on invested assets approximated 7.1 percent for 1999 and 7.7 percent for 1998. Tax equivalent yield is the rate earned on invested assets, excluding unrealized gains and losses, adjusted for the benefit of nontaxable investment income. The weighted average investment life was 2.7 years at both December 31, 1999 and 1998. Other income declined $12 million during 1999, due to the reduction of income from ancillary businesses the Company sold in 1998 and a lower contribution from the Company's ASO business, partially offset by a $12 million gain from the sale of a tangible asset in 1999. Interest expense declined $14 million during 1999 as a result of lower average outstanding borrowings.
BUSINESS SEGMENT INFORMATION FOR THE YEARS ENDED DECEMBER 31, 1999 AND 1998The following table presents segment medical membership and activity for 1999 and 1998:
1999
|
1998
|
|||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
|
|||||||||||||
(In thousands) | Health Plan
|
Small Group
|
Total
|
Health
Plan
|
Small Group | Total
|
||||||||
|
||||||||||||||
Beginning medical membership | 4,494
|
1,702
|
6,196
|
4,610
|
1,597
|
6,207
|
||||||||
Sales | 588
|
436
|
1,024
|
610
|
571
|
1,181
|
||||||||
Cancellations | (778
|
) | (475
|
) | (1,253
|
) | (700
|
) | (466
|
) | (1,166
|
) | ||
TRICARE change | (28
|
) | (28
|
) | (26
|
) | (26
|
) | ||||||
|
||||||||||||||
Ending medical membership | 4,276
|
1,663
|
5,939
|
4,494
|
1,702
|
6,196
|
||||||||
|
||||||||||||||
Ending specialty membership | 477
|
2,484
|
2,961
|
444
|
2,189
|
2,633
|
||||||||
|
The following table presents certain financial data for the Company's two segments for the years ended December 31, 1999 and 1998:
(In millions)
|
1999 (a) | 1998 (b) | |||
---|---|---|---|---|---|
|
|||||
Premium revenues: | |||||
Health Plan | $ 6,827 | $ 6,734 | |||
Small Group | 3,132 | 2,863 | |||
|
|||||
$ 9,959 | $ 9,597 | ||||
|
|||||
Adjusted income (loss) before income taxes: | |||||
Health Plan | $ 184 | $ 304 | |||
Small Group | (3 | ) | 31 | ||
|
|||||
$ 181 | $ 335 | ||||
|
|||||
Adjusted medical expense ratios: | |||||
Health Plan | 86 | .4% | 84 | .4% | |
Small Group | 81 | .2% | 79 | .7% | |
|
|||||
84 | .8% | 83 | .0% | ||
|
|||||
Adjusted administrative expense ratios: | |||||
Health Plan | 12 | .1% | 12 | .6% | |
Small Group | 20 | .1% | 20 | .3% | |
|
|||||
14 | .6% | 14 | .9% | ||
|
(a) | Excludes the previously discussed medical expenses of $90 million ($66 million Health Plan and $24 million Small Group), administrative expenses of $35 million ($27 million Health Plan and $8 million Small Group) and asset write-downs and other expenses of $460 million ($460 million Health Plan). |
(b) | Excludes the previously discussed medical expenses of $73 million ($60 million Health Plan and $13 million Small Group), administrative expenses of $25 million ($13 million Health Plan and $12 million Small Group) and asset write-downs and other expenses of $34 million ($23 million Health Plan and $11 million Small Group). |
Health Plan
Adjusted income before income taxes totaled $184
million for 1999 compared to $304 million for 1998. The earnings decline
was attributable to higher medical cost trends which were not adequately
anticipated by the Company when it established premium rates for 1999.
These higher medical cost trends primarily resulted from ineffective
risk-sharing arrangements, pharmacy cost increases and the result of
unfavorable negotiations of the Florida Columbia/HCA provider contract.
Initiatives to mitigate the effect of these issues include significant
large group commercial rate increases, re-contracting with, or
eliminating certain risk-sharing providers, implementing three-tier
pharmacy benefit designs, instituting Medicare HMO member premium and
benefit changes and exiting various Medicare markets. These initiatives
began to improve operating results in the second half of 1999 but in
large part will be realized in January 2000 when the majority of the
Company's large group commercial customers renew and when the Company's
Medicare product offerings were adjusted.
The Health Plan segment's premium revenues increased 1.4 percent to $6.8 billion for 1999. Large group commercial and Medicare HMO premiums remained unchanged at $2.3 billion and $2.9 billion, respectively. Higher premium yields of 5.5 percent and 3.4 percent for the large group commercial and Medicare HMO lines, respectively, were offset by membership reductions. Large group commercial membership decreased 139,200 from 1998 reflecting the effects of the Company's commercial premium pricing actions intended to maintain profitability. Medicare HMO membership decreased 13,500 members from the exit of the Treasure Coast and Sarasota, Florida markets. The Medicare HMO membership reduction from market exits was somewhat mitigated by increased membership achieved through the redirecting of sales and marketing efforts focused on key Medicare markets like Chicago, Tampa and South Florida. The Company's Medicaid premiums increased 8.8 percent to $603 million for 1999 compared to $554 million in 1998. This increase resulted from the more favorable rates obtained from the renewal of the Company's contract with the Health Insurance Administration in Puerto Rico in the second quarter of 1999. TRICARE premium revenues increased 8.3 percent to $866 million in 1999, from $800 million in 1998, resulting from an annual contract rate increase and additional premiums recorded related to TRICARE's risk-sharing arrangement with the government.
The Health Plan segment's adjusted medical expense ratio for 1999 was 86.4 percent, increasing from 84.4 percent in 1998. The increase was the result of large group commercial and Medicare HMO medical costs exceeding premium increases. These higher medical cost trends were attributable to the inability of certain risk-sharing providers to effectively manage medical costs within their contractual arrangements, higher pharmacy utilization and generally higher medical cost trends across the industry. The Company expects to realize improvements in its medical cost trends in 2000 resulting from implementation of the three-tier pharmacy benefit designs, improvements in risk-sharing arrangements, the exit of unprofitable Medicare HMO counties and the sale of its Medicare supplement and North Florida Medicaid businesses.
The adjusted administrative expense ratio improved 50 basis points from 1998 to 12.1 percent, the result of the continued rationalization of staffing levels commensurate with membership levels.
Small Group
The Small Group segment's adjusted loss before
income taxes was $3 million for 1999 compared to adjusted income before
income taxes of $31 million for 1998. The decline in profitability is
attributable to higher medical costs which were not adequately
anticipated by the Company when it established premium rates for 1999. To
mitigate the effect of higher medical costs, the Small Group segment's
improvement initiatives include significant premium rate increases,
improving claim payment processes, provider re-contracting, rationalizing
markets and products and implementing three-tier pharmacy benefit
designs.
The Small Group segment's premium revenues increased 9.4 percent for 1999 to $3.1 billion from $2.9 billion for 1998. This premium increase was the result of increased premium yields, offset by a reduction of 38,700 members from the sale of the individual line of business in Florida.
The Small Group segment's adjusted medical expense ratio for 1999 was 81.2 percent, increasing from 79.7 percent for 1998. The medical expense ratio increase was the result of medical costs exceeding premium yields. These higher medical cost trends were the result of the rapid growth of the Company's more costly open access products, higher pharmacy utilization and the greater than expected impact of the Health Insurance Portability and Accountability Act or HIPAA and its guarantee issue requirements.
The adjusted administrative expense ratio improved during 1999 to 20.1 percent from 20.3 percent for 1998.
YEARS ENDED DECEMBER 31, 1998 AND 1997The Company's 1998 premium revenues increased 21.8 percent to $9.6 billion, from $7.9 billion for the year ended December 31, 1997. This increase was attributable to the current year effect of 1997 acquisitions, commercial and Medicare HMO same-plan membership growth and increased premium rates for the Company's commercial products. PCA and ChoiceCare premium revenues contributed approximately $1.6 billion, a $1.1 billion increase over 1997. Same-plan membership growth contributed $120 million and commercial premium rate increases added approximately $186 million, as same-plan commercial premium yields increased 4.8 percent. Changes in Medicare HMO premium yield had little effect on premium revenues as same-plan yields declined 0.4 percent in 1998. The Medicare 2 percent statutory rate increase for 1998 was offset by membership growth in geographic areas with lower reimbursement rates.
During 1998, the Company's adjusted medical expense ratio increased to 83.0 percent from 82.8 percent for the year ended December 31, 1997. The year to year increase was the result of the higher medical expense ratio of acquired plans being included for a full year during 1998. The same-plan medical expense ratio improved 20 basis points to 82.2 percent from 82.4 percent in 1997, the result of the aforementioned premium rate increases, provider risk-sharing initiatives and improved claim payment accuracy. These improvements were partially offset by increased year-over-year pharmacy costs of 16 percent and 9 percent for the Company's commercial and Medicare HMO products, respectively.
The Company's adjusted administrative expense ratio was 14.9 percent and 15.5 percent for the years ended December 31, 1998 and 1997, respectively. This improvement was the result of efforts to streamline the organization, as well as realized cost savings from the Company's 1997 acquisitions.
Interest income totaled $150 million for the year ended December 31, 1998, compared to $131 million for the year ended December 31, 1997. The increase was attributable to the full year impact of including PCA's and ChoiceCare's investment portfolios, as well as increased realized investment gains. The tax equivalent yield on invested assets approximated 7.7 percent and 7.5 percent for the years ended December 31, 1998 and 1997, respectively. Tax equivalent yield is the rate earned on invested assets, excluding unrealized gains and losses, adjusted for the benefit of nontaxable investment income. The weighted average investment life increased to 2.7 years at December 31, 1998, from 2.6 years at December 31, 1997. Interest expense increased $27 million during 1998 from funding the PCA and ChoiceCare acquisitions with additional borrowings.
BUSINESS SEGMENT INFORMATION FOR THE YEARS ENDED DECEMBER 31, 1998 AND 19971998 | 1997 | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
|
|||||||||||||
(In
thousands)
|
Health Plan | Small Group | Total | Health Plan | Small Group | Total | ||||||||
|
|
|||||||||||||
Beginning medical membership | 4,610 | 1,597 | 6,207 | 3,526 | 1,325 | 4,851 | ||||||||
Sales | 610 | 571 | 1,181 | 499 | 458 | 957 | ||||||||
Cancellations | (700 | ) | (466 | ) | (1,166 | ) | (465 | ) | (392 | ) | (857 | ) | ||
Acquisitions | 1,188 | 206 | 1,394 | |||||||||||
Dispositions | (147 | ) | (147 | ) | ||||||||||
TRICARE change | (26 | ) | (26 | ) | 9 | 9 | ||||||||
|
||||||||||||||
Ending medical membership | 4,494 | 1,702 | 6,196 | 4,610 | 1,597 | 6,207 | ||||||||
|
||||||||||||||
Ending specialty membership | 444 | 2,189 | 2,633 | 507 | 1,934 | 2,441 | ||||||||
|
The following table presents certain financial data for the Company's two segments for the years ended December 31, 1998 and 1997:
(In millions)
|
1998 (a) | 1997 | |||
---|---|---|---|---|---|
|
|||||
Premium revenues: | |||||
Health Plan | $ 6,734 | $ 5,487 | |||
Small Group | 2,863 | 2,393 | |||
|
|||||
$ 9,597 | $ 7,880 | ||||
|
|||||
Adjusted income before income taxes: | |||||
Health Plan | $ 304 | $ 244 | |||
Small Group | 31 | 26 | |||
|
|||||
$ 335 | $ 270 | ||||
|
|||||
Adjusted medical expense ratios: | |||||
Health Plan | 84.4 | % | 84.3 | % | |
Small Group | 79.7 | % | 79.4 | % | |
|
|||||
83.0 | % | 82.8 | % | ||
|
|||||
Adjusted administrative expense ratios: | |||||
Health Plan | 12.6 | % | 13.1 | % | |
Small Group | 20.3 | % | 21.0 | % | |
|
|||||
14.9 | % | 15.5 | % | ||
|
(a) | Excludes the previously discussed medical expenses of $73 million ($60 million Health Plan and $13 million Small Group), administrative expenses of $25 million ($13 million Health Plan and $12 million Small Group) and asset write-downs and other expenses of $34 million ($23 million Health Plan and $11 million Small Group). |
Health Plan
Adjusted income before income taxes totaled $304
million in 1998 compared to $244 million in 1997. The earnings increase
is attributable to the full year contribution from 1997 acquisitions of
PCA and ChoiceCare, improved claim payment accuracy and administrative
expense reductions.
The Health Plan segment's premium revenues increased 22.7 percent to $6.7 billion in 1998. This increase was attributable to the current year effect of the 1997 acquisitions, large group commercial and Medicare HMO same-plan membership growth and higher large group commercial premium yields.
The Health Plan segment's adjusted medical expense ratio increased 10 basis points to 84.4 percent. The increase was the result of the higher medical expense ratio of acquired plans being included for a full year during 1998 and higher pharmacy costs.
The adjusted administrative expense ratio improved during 1998 to 12.6 percent from 13.1 percent in 1997 in the Health Plan segment. This improvement reflects realized cost savings from integrating the PCA and ChoiceCare acquisitions into Humana's operating model.
Small Group
Adjusted income before income taxes was $31
million in 1998 compared to $26 million in 1997. The earnings increase is
primarily attributable to improved claims payment accuracy, increased
interest and other income and administrative expense reductions. These
favorable items were partially offset by higher interest expense and
increased pharmacy costs.
The Small Group segment's premium revenues increased 19.6 percent to $2.9 billion in 1998. This increase was primarily attributable to the current year effect of the 1997 acquisitions and small group commercial and specialty same-plan membership growth.
The Small Group segment's adjusted medical expense ratio increased 30 basis points to 79.7 percent. The year to year increase was the result of the higher medical expense ratio of acquired plans being included for a full year during 1998 and higher pharmacy costs.
The adjusted administrative expense ratio improved during 1998 to 20.3 percent from 21.0 percent in 1997 in the Small Group segment. This improvement reflects the continued rationalization of staffing levels commensurate with membership levels.
LIQUIDITYOperating cash flows improved to $217 million in 1999 from $55 million in 1998, due to increased premium receipts and reduced payments for accrued expenses, taxes, severance and professional liabilities. Partially offsetting these improvements were higher claim payments related to the Company's run-off workers' compensation business.
Cash provided by investing activities was $18 million in 1999, compared to $28 million in 1998. These amounts reflect the net effect of investment and capital expenditure transactions.
Cash used in financing activities totaled $170 million in 1999 compared to cash provided by financing activities of $51 million in 1998. This decrease primarily resulted from 1999 debt repayments and changes in book overdrafts.
The Company's subsidiaries operate in states that require minimum levels of equity and regulate the payment of dividends to the parent company. As a result, the Company's ability to use operating subsidiaries' cash flows is restricted to the extent of the subsidiaries' ability to obtain regulatory approval to pay dividends.
The National Association of Insurance Commissioners has recommended that states adopt a risk-based capital ( "RBC") formula for companies established as HMO entities, similar to the current requirement for insurance companies. The RBC provisions may require new minimum capital and surplus levels for some of the Company's HMO subsidiaries. Many states have not yet determined when they will adopt the RBC formula or if they will allow a phase-in to the required levels of capital and surplus.
The Company currently maintains approximately $768 million of capital and surplus in its health insurance and HMO entities, compared to the minimum statutory required capital and surplus levels of approximately $569 million. If the states in which the Company conducts business adopt the proposed RBC formula, without a phase-in provision, the Company estimates it would be required to fund additional capital into its various subsidiaries of approximately $45 million. After this capital infusion, the Company would have $138 million of capital and surplus above the required RBC level.
The Company maintains a revolving credit agreement ("Credit Agreement") which provides a line of credit of up to $1.0 billion and expires in August 2002. Principal amounts outstanding under the Credit Agreement bear interest at either a fixed rate or a floating rate, ranging from LIBOR plus 35 basis points to LIBOR plus 80 basis points, depending on the Company's credit ratings. The Credit Agreement, which was amended in 1999 to reduce the line of credit by $500 million from $1.5 billion and modify certain covenants, contains customary covenants and events of default including, but not limited to, financial tests for interest coverage and leverage. The Company is in compliance with all covenants. The Company also maintains and issues short-term debt securities under a commercial paper program.
Management believes that funds from planned divestitures, future operating cash flows and funds available under the existing Credit Agreement and commercial paper program are sufficient to meet future liquidity needs. Management also believes the aforementioned sources of funds are adequate to allow the Company to pursue selected acquisition and expansion opportunities, as well as to fund capital requirements.
RISK-SENSITIVE FINANCIAL INSTRUMENTS AND POSITIONSThe Company has evaluated the interest income and debt expense impact resulting from a hypothetical change in interest rates of 100, 200 and 300 basis points over the next twelve-month period, as reflected in the following table. In the past ten years, annual changes in commercial paper rates have never exceeded 300 basis points, changed between 200 and 300 basis points twice and changed between 100 and 200 basis points once. The modeling technique used to calculate the pro forma net change considered the cash flows related to fixed income investments and debt, which are subject to interest rate changes during a prospective twelve-month period.
(In millions)
|
Increase (decrease) in earnings given an interest rate
decrease of X basis points |
Increase (decrease) in earnings given an interest rate
increase of X basis points |
||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
(300) |
(200) |
(100) |
100 |
200 |
300 |
||||||||
1999 | ||||||||||||||
Fixed income portfolio | $ (10 | .1) | $ (6 | .7) | $ (3 | .4) | $ 3 | .4 | $ 6 | .8 | $ 10 | .2 | ||
Debt | 9 | .1 | 6 | .1 | 3 | .0 | (3 | .0) | (6 | .1) | (9 | .1) | ||
|
||||||||||||||
Total | $ (1 | .0) | $ (0 | .6) | $ (0 | .4) | $ 0 | .4 | $ 0 | .7 | $ 1 | .1 | ||
|
||||||||||||||
1998 | ||||||||||||||
Fixed income portfolio | $ (11 | .9) | $ (7 | .9) | $ (4 | .0) | $ 4 | .0 | $ 8 | .0 | $ 12 | .0 | ||
Debt | 5 | .7 | 3 | .8 | 1 | .9 | (1 | .9) | (3 | .8) | (5 | .7) | ||
|
||||||||||||||
Total | $ (6 | .2) | $ (4 | .1) | $ (2 | .1) | $ 2 | .1 | $ 4 | .2 | $ 6 | .3 | ||
|
The following table presents the hypothetical change in fair market values of common equity securities held by the Company at December 31, 1999 and 1998, which are sensitive to changes in stock market values. These common equity securities are held for purposes other than trading.
(In millions)
|
Decrease in valuation of securities
given an X% decrease in each equity securitys value |
Fair Value at
December 31, |
Increase in valuation of securities
given an X% increase in each equity securitys value |
||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
|||||||||||||||
(30%) | (20%) | (10%) | 10% | 20% | 30% | ||||||||||
|
|||||||||||||||
1999 | |||||||||||||||
Common equity securities | $ (5 | .6) | $ (3 | .7) | $ (1 | .9) | $ 18 | .6 | $ 1 | .9 | $ 3 | .7 | $ 5 | .6 | |
|
|||||||||||||||
1998 | |||||||||||||||
Common equity securities | $ (18 | .6) | $ (12 | .4) | $ (6 | .2) | $ 62 | .1 | $ 6 | .2 | $ 12 | .4 | $ 18 | .6 | |
|
Changes in equity valuations (based upon the Standard & Poor's 500 stock index) over the past ten years which were in excess of 30 percent occurred four times, between 20 percent and 30 percent occurred three times and between 10 percent and 20 percent also occurred three times.
CAPITAL RESOURCESExcluding acquisitions, planned capital spending in 2000 will approximate $130 million to $140 million for the funding of the Company's technology initiatives and expansion and improvement of its administrative facilities.
EFFECTS OF INFLATION AND CHANGING PRICESThe Company's 2000 average rate of statutory increase under the Medicare HMO contracts is approximately two percent. Over the last five years, annual increases have ranged from as low as the January 1999 increase of two percent to as high as nine percent in January 1996, with an average of approximately five percent. The Company's Medicare HMO contracts with the federal government are renewed for a one-year term each December 31 unless terminated 90 days prior thereto.
Legislative proposals are being considered which may revise the Medicare program's current support of the use of managed health care for Medicare beneficiaries and the future reimbursement rates thereunder. Management is unable to predict the outcome of these proposals or the impact they may have on the Company's financial position, results of operations or cash flows. The Company's Medicaid contracts are generally annual contracts with various states except for the two-year contract with the Health Insurance Administration in Puerto Rico. Additionally, the Company's TRICARE contract is a one-year contract renewable on July 1, 2000, for one additional year. The loss of these contracts or significant changes in these programs as a result of legislative action, including reductions in payments or increases in benefits without corresponding increases in payments, would have a material adverse effect on the revenues, profitability and business prospects of the Company.
In addition, the Company continually contracts and seeks to renew contracts with providers at rates designed to ensure adequate profitability. To the extent the Company is unable to obtain such rates, its financial position, results of operations and cash flows could be adversely impacted.
THE COMPANY'S YEAR 2000 DISCLOSURE STATEMENTTo date, the Company has experienced no outages or problems related to the Year 2000 date rollover. All business systems are functioning normally and the Company has not experienced any disruptions in service with third party organizations with which it interacts related to the century change.
The Company's application systems are largely developed and maintained in-house by a staff of 400 application programmers who are versed in the utilization of state-of-the-art technology. All application systems are fully integrated and automatically pass data through various system processes. The Company's primary data center and the majority of its programming and support staff are located at the Company's corporate offices in Louisville, Kentucky. In order to create the necessary internal focus surrounding the Year 2000 issue, the Company established a centralized Year 2000 Program Management Office ("PMO") which is charged with overall coordination of enterprise wide Year 2000 initiatives and regular progress reporting to the Company's senior management.
The Year 2000 project is currently estimated to have a minimum total cost of approximately $30 million of which approximately $10 million was spent during 1999. Year 2000 expenses represented less than ten percent of the Information Systems budget during 1999. Year 2000 costs are expensed as incurred and funded with cash flows from operations. The Company does not expect to incur significant Year 2000 project costs in the year 2000.
The extent and magnitude of the Year 2000 project, as it will affect the Company for some period after January 1, 2000, is difficult to predict or quantify. In order to mitigate these risks, the Company developed business continuity and contingency plans which were finalized in the second quarter of 1999. These plans would be enacted if Year 2000 problems were to occur within the Company, or if third party constituents have failures due to the millennium change. Contingency plans were developed for six major functional areas encompassing 22 operational subdivisions that require contingency plan development. The six major functional areas are: providers, service centers, suppliers and vendors, customers and brokers, banking and finance and legal services.
While the Company presently believes that the timely completion of its Year 2000 project limited the exposure, so that the Year 2000 issue has not posed material operational problems, the Company recognizes that it does not control third party constituents. If these third party organizations have failures related to the Year 2000 century change and/or fail to properly implement appropriate contingency plans, Year 2000 failures may result. These failures could potentially have a material adverse impact on the Company's financial position, results of operations and cash flows.
LEGAL PROCEEDINGSSince October 1999, the Company has received purported class action complaints alleging, among other things, that Humana intentionally concealed from its members information concerning the various ways Humana decides what claims will be paid, what procedures will be deemed medically necessary, and what criteria and procedures are used to determine the extent and type of their coverage. The complaints also allege that Humana concealed from members the existence of direct financial incentives to treating physicians and other health care providers to deny coverage. The complaints, generally, do not allege that any member was denied coverage for services that should have been covered but, instead, claim that Humana provided health insurance benefits of lesser value than promised. All seek money damages of unspecified amounts. The Company has requested to consolidate these complaints to a single court.
The Company believes the allegations in all of the above complaints are without merit and intends to pursue the defense of the actions vigorously.
On January 4, 2000, a jury in Palm Beach County, Florida, issued a verdict against Humana Health Insurance Company of Florida, Inc., awarding $79 million to Mark Chipps, an insured who had sued individually and on behalf of his minor daughter. The claim arose from the removal of the child from a case management program which had provided her with benefits in excess of those available under her policy. The award included $78 million for punitive damages, $1 million for emotional distress and $28,000 for contractual benefits. The Company is in the process of appealing the verdict.
During 1999, the Company reached an agreement in principle with the United States Department of Justice and the Department of Health and Human Services on a $15 million settlement relating to Medicare premium overpayments. The settlement is expected to be paid sometime during 2000. The Company had previously established adequate liabilities for the resolution of these issues and, therefore, the settlement did not have a material impact on the Company's financial position or results of operations.
Damages for claims for personal injuries and medical benefit denials are usual in the Company's business. Personal injury and medical benefit denial claims are covered by insurance from the Company's wholly owned captive insurance Subsidiary and excess carriers, except to the extent that claimants seek punitive damages, in states which prohibit insurable coverage for punitive damages. In connection with the Chipps case, the excess carriers have preliminarily indicated that they believe no coverage may be available for a punitive damages award.
During the ordinary course of its business, the Company is or may become subject to pending or threatened litigation or other legal actions. Management does not believe that any pending and threatened legal actions against the Company or audits by agencies will have a material adverse effect on the Company's financial position or results of operations.
RECENTLY ISSUED ACCOUNTING PRONOUNCEMENTSHUMANA INC.
CONSOLIDATED BALANCE SHEETS
(In millions, except share amounts)
December 31, |
1999
|
1998
|
|||
---|---|---|---|---|---|
|
|||||
ASSETS | |||||
|
|||||
Current assets: | |||||
Cash and cash equivalents | $ 978 | $ 913 | |||
Marketable securities | 1,507 | 1,594 | |||
Premiums receivable, less allowance for doubtful accounts | |||||
of $61 in 1999 and $62 in 1998 | 225 | 276 | |||
Deferred income taxes | 161 | 129 | |||
Other | 193 | 207 | |||
|
|||||
Total current assets | 3,064 | 3,119 | |||
|
|||||
Property and equipment, net | 418 | 433 | |||
Other assets: | |||||
Long-term marketable securities | 253 | 305 | |||
Cost in excess of net assets acquired | 806 | 1,188 | |||
Deferred income taxes | 54 | 64 | |||
Other | 305 | 387 | |||
|
|||||
Total other assets | 1,418 | 1,944 | |||
|
|||||
Total assets | $ 4,900 | $ 5,496 | |||
|
|||||
LIABILITIES AND STOCKHOLDERS EQUITY | |||||
|
|||||
Current liabilities: | |||||
Medical and other expenses payable | $ 1,432 | $ 1,470 | |||
Trade accounts payable and accrued expenses | 392 | 395 | |||
Book overdraft | 215 | 234 | |||
Unearned premium revenues | 349 | 294 | |||
Accrued losses on asset sales | 90 | ||||
Commercial paper | 686 | 730 | |||
|
|||||
Total current liabilities | 3,164 | 3,123 | |||
|
|||||
Long-term medical and other expenses payable | 324 | 438 | |||
Professional liability and other obligations | 144 | 154 | |||
Debt | 93 | ||||
|
|||||
Total liabilities | 3,632 | 3,808 | |||
|
|||||
Commitments and contingencies | |||||
Stockholders' equity: | |||||
Preferred stock, $1 par; authorized 10,000,000 shares; none issued | |||||
Common stock, $0.16 2/3 par; authorized 300,000,000 shares; issued and | |||||
outstanding 167,514,710 shares 1999 and 167,515,362 shares 1998 | 28 | 28 | |||
Capital in excess of par value | 899 | 903 | |||
Deferred compensation restricted stock | (2 | ) | (9 | ) | |
Retained earnings | 371 | 753 | |||
Accumulated other comprehensive (loss) income | (28 | ) | 13 | ||
|
|||||
Total stockholders equity | 1,268 | 1,688 | |||
|
|||||
Total liabilities and stockholders equity | $ 4,900 | $ 5,496 | |||
|
The accompanying notes are an integral part of the consolidated financial statements.
CONSOLIDATED STATEMENTS OF OPERATIONS
(In millions, except per share
results)
For the years ended December 31, |
1999 | 1998 | 1997 | ||||
---|---|---|---|---|---|---|---|
|
|||||||
Revenues: | |||||||
Premiums | $ 9,959 | $ 9,597 | $ 7,880 | ||||
Interest and other income | 154 | 184 | 156 | ||||
|
|||||||
Total revenues | 10,113 | 9,781 | 8,036 | ||||
|
|||||||
Operating expenses: | |||||||
Medical | 8,532 | 8,041 | 6,522 | ||||
Selling, general and administrative | 1,368 | 1,328 | 1,116 | ||||
Depreciation and amortization | 124 | 128 | 108 | ||||
Asset write-downs and other expenses | 460 | 34 | |||||
|
|||||||
Total operating expenses | 10,484 | 9,531 | 7,746 | ||||
|
|||||||
(Loss) income from operations | (371 | ) | 250 | 290 | |||
Interest expense | 33 | 47 | 20 | ||||
|
|||||||
(Loss) income before income taxes | (404 | ) | 203 | 270 | |||
(Benefit) provision for income taxes | (22 | ) | 74 | 97 | |||
|
|||||||
Net (loss) income | $ (382 | ) | $ 129 | $ 173 | |||
|
|||||||
(Loss) earnings per common share | $ (2.28 | ) | $ 0.77 | $ 1.06 | |||
|
|||||||
(Loss) earnings per common share assuming dilution | $ (2.28 | ) | $ 0.77 | $ 1.05 | |||
|
The accompanying notes are an integral part of the consolidated financial statements.
CONSOLIDATED STATEMENTS OF STOCKHOLDERS EQUITY
(In millions)
|
Capital
In Excess of Par Value |
Deferred
Compensation Restricted Stock |
Retained
Earnings |
Accumulated
Other Comprehensive (Loss) Income |
Total
Stockholders Equity |
||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Common Stock |
|||||||||||||||
Shares | Amount | ||||||||||||||
|
|||||||||||||||
Balances, January 1, 1997 | 163 | $ 27 | $ 824 | $ (2 | ) | $ 451 | $ (8 | ) | $ 1,292 | ||||||
Comprehensive income: | |||||||||||||||
Net income | 173 | 173 | |||||||||||||
Other comprehensive income: | |||||||||||||||
Net unrealized investment gains, | |||||||||||||||
net of $10 tax | 17 | 17 | |||||||||||||
|
|||||||||||||||
Comprehensive income | 190 | ||||||||||||||
Change in deferred compensation | 2 | (2 | ) | | |||||||||||
Restricted stock amortization | 1 | 1 | |||||||||||||
Stock option exercises | 1 | 11 | 11 | ||||||||||||
Stock option tax benefit | 7 | 7 | |||||||||||||
|
|||||||||||||||
Balances, December 31, 1997 | 164 | 27 | 844 | (3 | ) | 624 | 9 | 1,501 | |||||||
Comprehensive income: | |||||||||||||||
Net income | 129 | 129 | |||||||||||||
Other comprehensive income: | |||||||||||||||
Net unrealized investment gains, | |||||||||||||||
net of $2 tax | 4 | 4 | |||||||||||||
|
|||||||||||||||
Comprehensive income | 133 | ||||||||||||||
Change in deferred compensation | 8 | (8 | ) | | |||||||||||
Restricted stock amortization | 2 | 2 | |||||||||||||
Stock option exercises | 4 | 1 | 35 | 36 | |||||||||||
Stock option tax benefit | 16 | 16 | |||||||||||||
|
|||||||||||||||
Balances, December 31, 1998 | 168 | 28 | 903 | (9 | ) | 753 | 13 | 1,688 | |||||||
Comprehensive loss: | |||||||||||||||
Net loss | (382 | ) | (382 | ) | |||||||||||
Other comprehensive loss: | |||||||||||||||
Net unrealized investment losses, | |||||||||||||||
net of $27 tax | (41 | ) | (41 | ) | |||||||||||
|
|||||||||||||||
Comprehensive loss | (423 | ) | |||||||||||||
Change in deferred compensation | (5 | ) | 5 | | |||||||||||
Restricted stock amortization | 2 | 2 | |||||||||||||
Stock option exercises | 1 | 1 | |||||||||||||
|
|||||||||||||||
Balances, December 31, 1999 | 168 | $ 28 | $ 899 | $ (2 | ) | $ 371 | $ (28 | ) | $ 1,268 | ||||||
|
The accompanying notes are an integral part of the consolidated financial statements.
CONSOLIDATED STATEMENTS OF CASH FLOWS
(In millions)
For the years ended December 31, |
1999 | 1998 | 1997 | ||||
---|---|---|---|---|---|---|---|
|
|||||||
CASH FLOWS FROM OPERATING ACTIVITIES | |||||||
|
|||||||
Net (loss) income | $(382 | ) | $ 129 | $ 173 | |||
Adjustments to reconcile net (loss) income | |||||||
to net cash provided by operating activities: | |||||||
Asset write-downs and other expenses | 460 | 17 | |||||
Depreciation and amortization | 124 | 128 | 108 | ||||
Gain on sale of property and equipment | (12 | ) | |||||
Gain on sale of marketable securities | (11 | ) | (21 | ) | (10 | ) | |
Deferred income taxes | 5 | 26 | 40 | ||||
Provision for doubtful accounts | 12 | 11 | 10 | ||||
Changes in operating assets and liabilities: | |||||||
Premiums receivable | 39 | 34 | (112 | ) | |||
Other assets | 54 | 32 | (47 | ) | |||
Medical and other expenses payable | (23 | ) | (22 | ) | (118 | ) | |
Workers compensation liabilities | (150 | ) | (134 | ) | (31 | ) | |
Other liabilities | 45 | (135 | ) | 57 | |||
Unearned premium revenues | 56 | (10 | ) | 203 | |||
Other | 6 | ||||||
|
|||||||
Net cash provided by operating activities | 217 | 55 | 279 | ||||
|
|||||||
CASH FLOWS FROM INVESTING ACTIVITIES | |||||||
|
|||||||
Acquisitions of health plan assets, net of cash acquired | (14 | ) | (669 | ) | |||
Purchases of property and equipment | (89 | ) | (104 | ) | (73 | ) | |
Dispositions of property and equipment | 54 | 12 | 15 | ||||
Purchases of marketable securities | (781 | ) | (1,037 | ) | (608 | ) | |
Maturities of marketable securities | 391 | 380 | 341 | ||||
Proceeds from sales of marketable securities | 472 | 815 | 317 | ||||
Other | (15 | ) | (38 | ) | 23 | ||
|
|||||||
Net cash provided by (used in) investing activities | 18 | 28 | (654 | ) | |||
|
|||||||
CASH FLOWS FROM FINANCING ACTIVITIES | |||||||
|
|||||||
Issuance of long-term debt | 123 | 300 | |||||
Repayment of long-term debt | (93 | ) | (330 | ) | |||
Net commercial paper (repayments) borrowings | (44 | ) | 141 | 367 | |||
Change in book overdraft | (19 | ) | 82 | (1 | ) | ||
Other | (14 | ) | 35 | 13 | |||
|
|||||||
Net cash (used in) provided by financing activities | (170 | ) | 51 | 679 | |||
|
|||||||
Increase in cash and cash equivalents | 65 | 134 | 304 | ||||
Cash and cash equivalents at beginning of period | 913 | 779 | 475 | ||||
|
|||||||
Cash and cash equivalents at end of period | $ 978 | $ 913 | $ 779 | ||||
|
|||||||
Supplemental cash flow disclosures: | |||||||
Interest payments | $ 33 | $ 49 | $ 15 | ||||
Income tax (refunds) payments, net | (58 | ) | 69 | 8 | |||
Details of businesses acquired in purchase transactions: | |||||||
Fair value of assets acquired | $ 20 | $ 1,973 | |||||
Less: liabilities assumed | (6 | ) | (1,304 | ) | |||
|
|||||||
Cash paid for acquired businesses, net of cash acquired | $ 14 | $ 669 | |||||
|
The accompanying notes are an integral part of the consolidated financial statements.
HUMANA INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
1. REPORTING ENTITYDuring 1999, the Company realigned its organization to achieve greater accountability in its lines of business. As a result of this realignment, the Company organized into two business units: the Health Plan segment and the Small Group segment. The Health Plan segment includes the Company's large group commercial (100 employees and over), Medicare, Medicaid, ASO, workers' compensation and military or TRICARE business. The small group segment includes small group commercial (under 100 employees) and specialty benefit lines, including dental, life and short-term disability. Results of each segment are measured based upon results of operations before income taxes. The Company allocates administrative expenses, interest income and interest expense, but no assets, to the segments. Members served by the two segments generally utilize the same medical provider networks, enabling the Company to obtain more favorable contract terms with providers. As a result, the profitability of each segment is somewhat interdependent. In addition, premium revenue pricing to large group commercial employers has historically been more competitive than that to small group commercial employers, resulting in less favorable underwriting margins for the large group commercial line of business. Costs to distribute and administer products to small group commercial employers are higher compared to large group commercial employers resulting in small group's higher administrative expense ratio.
2. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIESUse of Estimates in Preparation of Financial
Statements
The preparation of financial statements in
accordance with generally accepted accounting principles requires
management to make estimates and assumptions that affect the amounts
reported in the financial statements and accompanying notes. Although
these estimates are based on knowledge of current events and anticipated
future events, actual results may ultimately differ from those
estimates.
Cash and Cash Equivalents
Cash and cash equivalents include cash, time
deposits, money market funds, commercial paper and certain U.S.
Government securities with an original maturity of three months or less.
Carrying value approximates fair value due to the short-term maturity of
the investments.
Marketable Securities
Marketable debt and equity securities have been
categorized as available for sale and, as a result, are stated at fair
value based generally on quoted market prices. Marketable debt and equity
securities available for current operations are classified as current
assets. Marketable securities available for the Company's capital
spending, professional liability, long-term insurance product
requirements and payment of long-term workers' compensation claims are
classified as long-term assets. Unrealized holding gains and losses, net
of applicable deferred taxes, are included as a component of
stockholders' equity until realized.
For the purpose of determining gross realized gains and losses, the cost of securities sold is based upon specific identification.
Long-Lived Assets
Property and equipment is carried at cost, and is
comprised of the following at December 31, 1999 and 1998:
(In millions)
|
1999 | 1998 | |||
---|---|---|---|---|---|
Land | $ 32 | $ 33 | |||
Buildings | 364 | 355 | |||
Equipment and computer software | 432 | 400 | |||
828 | 788 | ||||
Accumulated depreciation | (410 | ) | (355 | ) | |
$ 418 | $ 433 | ||||
Depreciation is computed using the straight-line method over estimated useful lives ranging from three to ten years for equipment, three to five years for computer software and twenty years for buildings. Depreciation expense was $79 million, $75 million and $66 million for the years ended December 31, 1999, 1998 and 1997, respectively.
Cost in excess of net assets acquired, or goodwill, represents the unamortized excess of cost over the fair value of net tangible and identifiable intangible assets acquired. Identifiable intangible assets, which are included in other long-term assets in the accompanying Consolidated Balance Sheets, primarily relate to subscriber and provider contracts. Goodwill and identifiable intangible assets are amortized on a straight-line method over their estimated useful lives. Goodwill has been amortized over periods ranging from six to 40 years and identifiable intangible assets are being amortized over periods ranging from seven to 14 years. After a re-evaluation, effective January 1, 2000, the Company adopted a 20 year amortization period from the date of acquisition for goodwill previously amortized over 40 years. Amortization expense was $45 million, $53 million and $42 million for the years ended December 31, 1999, 1998 and 1997, respectively.
The carrying values of all long-lived assets are periodically reviewed by management for impairment, based upon undiscounted market level cash flows, whenever adverse events or changes in circumstances occur. Losses are recognized when the carrying value of a long-lived asset may not be recoverable. See Note 3 for a discussion related to the Company's impairment review.
Revenue and Medical Cost Recognition
Premium revenues are recognized as income in the
period members are entitled to receive services. Premiums received prior
to such period are recorded as unearned premium revenues.
Medical costs include claim payments, capitation payments, physician salaries, allocations of certain centralized expenses and various other costs incurred to provide medical care to members, as well as estimates of future payments to hospitals and others for medical care provided prior to the balance sheet date. Capitation payments represent monthly prepaid fees disbursed to participating primary care physicians and other providers who are responsible for providing medical care to members. The estimates of future medical claim and other expense payments are developed using actuarial methods and assumptions based upon payment patterns, medical inflation, historical development and other relevant factors. Estimates of future payments relating to services incurred in the current and prior periods are continually reviewed by management and adjusted as necessary.
The Company assesses the profitability of its contracts for providing health care services to its members when current market operating results or forecasts indicate probable future losses. The Company records a premium deficiency in current operations to the extent that the sum of expected health care costs, claim adjustment expenses and maintenance costs exceeds related future premiums. Anticipated investment income is not considered for purposes of computing the premium deficiency. Because the majority of the Company's member contracts renew annually, the Company does not anticipate premium deficiencies, except when unanticipated adverse events or changes in circumstances indicate otherwise. See Note 3 for a discussion related to premium deficiencies.
Management believes the Company's medical and other expenses payable are adequate to cover future claims payments required, however, such estimates are based on knowledge of current events and anticipated future events, and, therefore, the actual liability could differ from amounts provided.
Book Overdraft
Under the Company's cash management system,
checks issued but not presented to banks frequently result in overdraft
balances for accounting purposes and are classified as a current
liability in the Consolidated Balance Sheets.
Stock Options
The Company has adopted the disclosure-only
provisions of Statement of Financial Accounting Standards No. 123,
"Accounting for Stock-Based Compensation" ("SFAS 123
") and uses Accounting Principles Board Opinion No. 25 and related
interpretations in the accounting for its stock option plans. No
compensation expense has been recognized in connection with the granting
of stock options. See Note 8 for discussion of stock options and the
disclosures required by SFAS 123.
(Loss) Earnings Per Common Share
Detail supporting the computation of (loss)
earnings per common share and (loss) earnings per common share-assuming
dilution follows:
(Dollars in millions, except per
share results)
|
Net (Loss) Income | Shares | Per Share Results | ||||
---|---|---|---|---|---|---|---|
|
|||||||
YEAR ENDED DECEMBER 31, 1999 | |||||||
|
|||||||
Loss per common share | $ (382 | ) | 167,555,917 | $ (2 | .28) | ||
Effect of dilutive stock options | |||||||
Loss per common share assuming dilution | $ (382 | ) | 167,555,917 | $ (2 | .28) | ||
|
|||||||
YEAR ENDED DECEMBER 31, 1998 | |||||||
|
|||||||
Earnings per common share | $ 129 | 166,471,824 | $ 0 | .77 | |||
Effect of dilutive stock options | 1,792,756 | ||||||
Earnings per common share assuming dilution | $ 129 | 168,264,580 | $ 0 | .77 | |||
|
|||||||
YEAR ENDED DECEMBER 31, 1997 | |||||||
|
|||||||
Earnings per common share | $ 173 | 163,406,460 | $ 1 | .06 | |||
Effect of dilutive stock options | 2,436,019 | (0 | .01) | ||||
Earnings per common share assuming dilution | $ 173 | 165,842,479 | $ 1 | .05 | |||
|
Options to purchase 9,427,060, 1,562,949 and 2,414,148 shares for the years ended December 31, 1999, 1998 and 1997, respectively, were not included in the computation of (loss) earnings per common share-assuming dilution due to the Company's loss in 1999 and because the options' exercise prices were greater than the average market price of the Company's common stock in 1998 and 1997.
Reclassifications
Certain reclassifications have been made to the
prior years' consolidated financial statements to conform with the
current year presentation.
Recently Issued Accounting
Pronouncements
In June 1998, the Financial Accounting Standards
Board issued Statement of Financial Accounting Standards No. 133,
"Accounting for Derivative Instruments and Hedging Activities" (
"SFAS No. 133"). In general, SFAS No. 133 requires that all
derivatives be recognized as either assets or liabilities in the balance
sheet at their fair value, and sets forth the manner in which gains or
losses thereon are to be recorded. The treatment of such gains or losses
is dependent upon the type of exposure, if any, for which the derivative
is designated as a hedge. This standard is effective for the Company's
financial statements beginning January 1, 2001, with early adoption
permitted. Management of the Company anticipates that the adoption of
SFAS No. 133 on January 1, 2001 will not have a material impact on the
Company's financial position, results of operations or cash
flows.
The following table presents the components of the asset write-downs and operational expenses and their respective classifications in the 1999 and 1998 Consolidated Statements of Operations:
(In millions)
|
Medical |
Selling,
General and Administrative |
Asset
Write-Downs and Other |
Total |
|||||
---|---|---|---|---|---|---|---|---|---|
1999: | |||||||||
FIRST QUARTER 1999: | |||||||||
|
|||||||||
Premium deficiency | $ 50 | $ 50 | |||||||
Reserve strengthening | 35 | 35 | |||||||
Provider costs | 5 | 5 | |||||||
|
|||||||||
Total first quarter 1999 | 90 | 90 | |||||||
|
|||||||||
FOURTH QUARTER 1999: | |||||||||
|
|||||||||
Long-lived asset impairment | $ 342 | 342 | |||||||
Losses on non-core asset sales | 118 | 118 | |||||||
Professional liability reserve strengthening and other costs | $ 35 | 35 | |||||||
|
|||||||||
Total fourth quarter 1999 | 35 | 460 | 495 | ||||||
|
|||||||||
Total 1999 | $ 90 | $ 35 | $ 460 | $ 585 | |||||
|
|||||||||
1998: | |||||||||
THIRD QUARTER 1998: | |||||||||
|
|||||||||
Premium deficiency | $ 46 | $ 46 | |||||||
Provider costs | 27 | 27 | |||||||
Market exit costs | $ 15 | 15 | |||||||
Losses on non-core asset sales | 12 | 12 | |||||||
Merger dissolution costs | 7 | 7 | |||||||
Non-officer employee incentive and other costs | $ 25 | 25 | |||||||
|
|||||||||
Total third quarter 1998 | $ 73 | $ 25 | $ 34 | $ 132 | |||||
|
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
1999 EXPENSESPrior period adverse claims development primarily in the Company's PPO and Medicare products initially identified during an analysis of February and March 1999 medical claims resulted in the $35 million reserve strengthening. The Company releases or strengthens medical claims reserves when favorable or adverse development in prior periods exceed actuarial margins existing in the reserves. In addition, the Company paid Columbia/HCA $5 million to settle certain contractual issues associated with the March 31, 1999 hospital agreement in Florida.
Long-Lived Asset Impairment
Historical and current period operating losses in
certain of the Company's markets prompted a review during the fourth
quarter of 1999 for the possible impairment of long-lived assets. This
review indicated that estimated future undiscounted cash flows were
insufficient to recover the carrying value of long-lived assets,
primarily goodwill, associated with the Company's Austin, Dallas and
Milwaukee markets. Accordingly, the Company adjusted the carrying value
of these long-lived assets to their estimated fair value resulting in a
non-cash impairment charge of $342 million. Estimated fair value was
based on discounted cash flows.
The long-lived assets associated with the Austin and Dallas markets primarily result from the Company's 1997 acquisition of Physician Corporation of America ("PCA"). Operating losses in Austin and Dallas were related to the deterioration of risk-sharing arrangements with providers and the failure to effectively convert the PCA operating model and computer platform to Humana's. The long-lived assets associated with the Milwaukee market primarily result from the Company's 1994 acquisition of CareNetwork, Inc. Operating losses in Milwaukee were the result of competitor pricing strategies resulting in lower premium levels to large employer groups as well as market dynamics dominated by limited provider groups causing higher than expected medical costs.
The Company also re-evaluated the amortization period of its goodwill and as a result, effective January 1, 2000, adopted a 20 year amortization period from the date of acquisition for goodwill previously amortized over 40 years.
The $342 million long-lived asset impairment will decrease depreciation and amortization expense $13 million annually ($13 million after tax, or $0.08 per diluted share), while the change in the amortization period of goodwill will increase amortization expense $25 million annually ($24 million after tax, or $0.15 per diluted share).
Losses on Non-Core Asset Sales
The Company has entered into definitive
agreements for the disposition of its workers' compensation, Medicare
supplement and North Florida Medicaid businesses, which are considered
non-core. As a result of the carrying value of the net assets of these
businesses exceeding the estimated sale proceeds, the Company has
recorded a loss of $118 million. Estimated fair value was established
based upon definitive sale agreements, net of expected transaction costs.
These transactions are expected to be completed in the first and second
quarters of 2000. Total assets of $725 million, primarily consisting of
marketable securities and reinsurance recoverables, and total liabilities
of $490 million, primarily consisting of workers' compensation reserves
related to these businesses are included in the accompanying Consolidated
Balance Sheets. The accompanying Consolidated Statements of Operations
include 1999 revenues of $214 million and pretax operating income of $38
million from these businesses. Included in 1999 and 1998 pretax operating
(loss) income is $36 million and $5 million of workers' compensation
reserve releases resulting from favorable claim liability
development.
Professional Liability Reserve Strengthening
and Other Costs
The Company insures substantially all
professional liability risks through a wholly owned captive insurance
subsidiary (the "Subsidiary"). The Subsidiary recorded an
additional $25 million expense during the fourth quarter of 1999
primarily related to expected claim and legal costs to be incurred by the
Company.
In addition, other expenses of $10 million were recorded during the fourth quarter related to a claim payment dispute with a contracted provider and government audits.
Activity related to the 1999 expenses follows:
1999 Activity | Balance at
December 31, 1999 |
||||||||
---|---|---|---|---|---|---|---|---|---|
(In millions)
|
1999
Expenses |
|
|||||||
Cash | Non-Cash | ||||||||
|
|||||||||
Premium deficiency | $ 50 | $ (50 | ) | | |||||
Reserve strengthening | 35 | (35 | ) | | |||||
Provider costs | 5 | (5 | ) | | |||||
Long-lived asset impairment | 342 | $ (342 | ) | | |||||
Losses on non-core asset sales | 118 | (28 | ) | $ 90 | |||||
Professional liability reserve | |||||||||
strengthening and other costs | 35 | 35 | |||||||
|
|||||||||
$ 585 | $ (90 | ) | $ (370 | ) | $ 125 | ||||
|
The costs associated with the market exits of $15 million included severance, lease termination costs as well as write-offs of equipment and uncollectible provider receivables. The planned market exits were Sarasota and Treasure Coast, Florida, Springfield and Jefferson City, Missouri and Puerto Rico. Severance costs were estimated based upon the provisions of the Company's employee benefit plans. The plan to exit these markets was expected to reduce the Company's market office workforce, primarily in Puerto Rico, by approximately 470 employees. In 1999, the Company reversed $2 million of the severance and lease discontinuance liabilities after the Company contractually agreed with the Health Insurance Administration in Puerto Rico to extend the Company's Medicaid contract, with more favorable terms. The Company estimated annual pretax savings of approximately $40 million, after all market exits were completed by June 30, 1999, primarily from a reduction in underwriting losses. Approximately 100 employees were ultimately terminated resulting in insignificant severance payments.
In accordance with the Company's policy on impairment of long-lived assets, equipment of $5 million in the exited markets was written down to its fair value after an evaluation of undiscounted cash flow in each of the markets. The fair value of equipment was based upon discounted cash flows for the same markets. Following the write-down, the equipment was fully depreciated.
Premium Deficiency and Provider
Costs
As a result of management's assessment of the
profitability of its contracts for providing health care services to its
members in certain markets, the Company recorded a provision for probable
future losses (premium deficiency) of $46 million during the third
quarter of 1998. The premium deficiency resulted from events prompted by
the terminated merger with United wherein the Company had expected to
realize improved operating results in those markets that overlapped with
United, including more favorable risk-sharing arrangements. The
beneficial effect from losses charged to the premium deficiency liability
in 1999 and 1998 was $23 million and $17 million, respectively. In 1999,
the Company reversed $6 million of premium deficiency liabilities after
the Company contractually agreed with the Health Insurance Administration
in Puerto Rico to extend the Company's Medicaid contract, with more
favorable terms.
The Company also recorded $27 million of expense related to receivables written-off from financially troubled physician groups, including certain bankrupt providers.
Non-Officer Employee Incentive and Other
Costs
During the third quarter of 1998, the Company
recorded a one-time incentive of $16 million paid to non-officer
employees and a $9 million settlement related to a third party pharmacy
processing contract.
Activity related to the 1998 expenses follows:
(In millions)
|
1998
Expenses |
1998 Activity | Balance at
December 31, 1998 |
1999 Activity | Balance at
December 31, 1999 |
|||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
|
|||||||||||||||||
Cash | Non-cash
|
Cash | Adjustment | |||||||||||||||
|
||||||||||||||||||
Premium deficiency
|
$ 46
|
$ (17)
|
$ 29
|
$ (23)
|
$ (6)
|
$
|
||||||||||||
Provider costs
|
27
|
$ (27)
|
|
|||||||||||||||
Market exit costs
|
15
|
(10)
|
5
|
(2)
|
(2)
|
1
|
||||||||||||
Losses from
non-core asset sales
|
12
|
(5)
|
(7)
|
|
||||||||||||||
Merger dissolution
costs
|
7
|
(5)
|
2
|
(2)
|
|
|||||||||||||
Non-officer employee incentive | ||||||||||||||||||
and other costs
|
25
|
(25)
|
|
|||||||||||||||
|
||||||||||||||||||
$ 132 | $ (52) | $ (44) | $ 36
|
$ (27)
|
$ (8)
|
$ 1
|
||||||||||||
|
1999 | 1998 | ||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
|
||||||||||||||||||||||||||||
(In millions)
|
Amortized
Cost |
Gross
Unrealized Gains |
Gross
Unrealized Losses |
Fair
Value |
Amortized
Cost |
Gross
Unrealized Gains |
Gross
Unrealized Losses |
Fair
Value |
|||||||||||||||||||||
|
|||||||||||||||||||||||||||||
U.S. Government obligations | $
|
178 | (3 | ) | $ | 175 | $ | 165 | $ | 4 | $ | 169 | |||||||||||||||||
Tax exempt municipal bonds | 889 | $ | (24 | ) | 865 | 845 | 6 | 851 | |||||||||||||||||||||
Corporate Bonds | 234 | (7 | ) | 227 | 250 | 8 | 258 | ||||||||||||||||||||||
Redeemable preferred stocks | 67 | (2 | ) | 65 | 124 | 1 | 125 | ||||||||||||||||||||||
Marketable equity securities | 96 | $ | 9
|
(6 | ) | 99 | 129 | 2 | $ | (2 | ) | 129 | |||||||||||||||||
Other | 77 | (1 | ) | 76 | 59 | 3 | 62 | ||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
$
|
1,541 | $ | 9
|
$ | (43 | ) | $ | 1,507 | $ | 1,572 | $ | 24 | $ | (2
|
) | $ | 1,594 | ||||||||||||
|
Marketable securities classified as long-term assets at December 31, 1999 and 1998 included the following:
1999 | 1998 | |||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
|
|||||||||||||||||||||||||||||
(In millions)
|
Amortized
Cost |
Gross
Unrealized Gains |
Gross
Unrealized Losses |
Fair
Value |
Amortized
Cost |
Gross
Unrealized Gains |
Gross
Unrealized Losses |
Fair
Value |
||||||||||||||||||||||
|
||||||||||||||||||||||||||||||
U.S. Government obligations | $ | 16 | $ | 16 | $ | 5 | $
|
5 | ||||||||||||||||||||||
Tax exempt municipal bonds | 180 | $ | (7 | ) | 173 | 234 | $ | 4 | $ | (1 | ) | 237 | ||||||||||||||||||
Redeemable preferred stocks | 27 | (1 | ) | 26 | 31 | 31 | ||||||||||||||||||||||||
Marketable equity securities | 10 | (1 | ) | 9 | 2 | 2 | ||||||||||||||||||||||||
Other | 29 | 29 | 30 | 30 | ||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||
$ | 262 | $ | (9 | ) | $ | 253 | $ | 302 | $ | 4 | $ | (1 | ) | $
|
305 | |||||||||||||||
|
The contractual maturities of debt securities available for sale at December 31, 1999, regardless of their balance sheet classification, are shown below. Expected maturities may differ from contractual maturities because borrowers may have the right to call or prepay obligations with or without call or prepayment penalties.
(In millions)
|
Amortized
Cost |
Fair
Value |
|||||
---|---|---|---|---|---|---|---|
|
|||||||
Due within one year | $ | 209 | $ | 207 | |||
Due after one year through five years | 499 | 490 | |||||
Due after five years through ten years | 384 | 370 | |||||
Due after ten years | 210 | 204 | |||||
Not due at a single maturity date | 395 | 381 | |||||
|
|||||||
$ | 1,697 | $ | 1,652 | ||||
|
Gross realized investment gains were $18 million, $30 million and $11 million and gross realized investment losses were $7 million, $9 million and $1 million in 1999, 1998 and 1997, respectively.
5. INCOME TAXESYears Ended December 31, | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
|||||||||||||
(In millions)
|
1999 | 1998 | 1997 | ||||||||||
|
|||||||||||||
Current (benefit) provision: | |||||||||||||
Federal | $ | (18 | ) | $ | 39 | $ | 51 | ||||||
State | (9 | ) | 9 | 6 | |||||||||
|
|||||||||||||
(27 | ) | 48 | 57 | ||||||||||
|
|||||||||||||
Deferred provision: | |||||||||||||
Federal | 4 | 24 | 36 | ||||||||||
State | 1 | 2 | 4 | ||||||||||
|
|||||||||||||
5 | 26 | 40 | |||||||||||
|
|||||||||||||
$ | (22 | ) | $ | 74 | $ | 97 | |||||||
|
The (benefit) provision for income taxes was different from the amount computed using the federal statutory rate due to the following:
Years Ended December 31, | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
|||||||||||||
(In millions)
|
1999 | 1998 | 1997 | ||||||||||
|
|||||||||||||
Income tax (benefit) provision at federal statutory rate | $ | (142 | ) | $ | 71 | $ | 95 | ||||||
State income taxes, net of federal benefit | (16 | ) | 8 | 10 | |||||||||
Tax exempt investment income | (19 | ) | (18 | ) | (13 | ) | |||||||
Amortization | 11 | 17 | 10 | ||||||||||
Long-lived asset impairment | 143 | ||||||||||||
Other | 1 | (4 | ) | (5 | ) | ||||||||
|
|||||||||||||
$ | (22 | ) | $ | 74 | $ | 97 | |||||||
|
Deferred income tax balances reflect the impact of temporary differences between the carrying amounts of assets and liabilities and their tax bases, and are stated at enacted tax rates expected to be in effect when taxes are actually paid or recovered. Principal components of the net deferred tax balances for the Company at December 31, 1999 and 1998 are as follows:
Assets (Liabilities) |
||||||||
---|---|---|---|---|---|---|---|---|
(In millions)
|
1999
|
1998
|
||||||
|
||||||||
Marketable securities | $ | 18 | $ | (8 | ) | |||
Long-term assets | (55 | ) | (46 | ) | ||||
Medical and other expenses payable | 95 | 95 | ||||||
Asset write-downs and operational expenses | 36 | 16 | ||||||
Professional liability risks | 9 | 7 | ||||||
Net operating loss carryforwards | 58 | 58 | ||||||
Workers compensation liabilities | 25 | 40 | ||||||
Compensation and other accruals | 29 | 31 | ||||||
|
||||||||
$ | 215 | $ | 193 | |||||
|
At December 31, 1999, the Company has available tax net operating loss carryforwards of approximately $150 million related to prior acquisitions. These loss carryforwards, if unused to offset future taxable income, will expire in 2000 through 2011.
Based on the Company's historical taxable income record and estimates of future profitability, management has concluded that operating income will more likely than not be sufficient to give rise to tax expense to recover all deferred tax assets.
6. DEBTBorrowings and the weighted average interest rate on those borrowings at December 31, 1999 and 1998 are as follows:
1999 | 1998 | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
|
||||||||||||
(In millions)
|
Amount | Weighted Average
Interest Rate |
Amount | Weighted Average
Interest Rate |
|||||||||
|
|
||||||||||||
Credit agreement | 5 | .7% | $ | 93 | 5 | .9% | |||||||
Commercial paper program | $ | 686 | 5 | .6% | 730 | 5 | .9% | ||||||
|
|||||||||||||
$ | 686 | $ | 823 | ||||||||||
|
7. PROFESSIONAL LIABILITY AND OTHER
OBLIGATIONS
The components of professional liability and
other obligations at December 31, 1999 and 1998 are as follows:
(in millions)
|
1999 | 1998 | |||
---|---|---|---|---|---|
|
|||||
Allowance for professional liabilities | $ 133 | $ 123 | |||
Liabilities for disability and other
long-term insurance products,
the Companys retirement and benefit plans and other |
44 | 53 | |||
Less: current portion of allowance for professional liabilities | (33 | ) | (22 | ) | |
|
|||||
$ 144 | $ 154 | ||||
|
The Company insures substantially all professional liability risks through a wholly owned subsidiary (the "Subsidiary"). Provisions for such risks, including expenses incident to claim settlements, were $57 million, $27 million and $32 million for the years ended December 31, 1999, 1998 and 1997, respectively. The amount for 1999 includes $25 million of professional liability reserve strengthening discussed in Note 3. The Subsidiary reinsures levels of coverage for losses in excess of its retained limits with unrelated insurance carriers. Reinsurance recoverables were $29 million and $40 million at December 31, 1999 and 1998, respectively. The current portion of allowance for professional liabilities is included with trade accounts payable and accrued expenses in the Consolidated Balance Sheets.
In 1998, the Subsidiary entered into a loss portfolio transfer agreement with unrelated insurance carriers for approximately $39 million, providing for the transfer of all professional and workers' compensation liabilities on claims incurred prior to December 31, 1997 limited to individual and maximum claim retention levels.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
8. EMPLOYEE BENEFIT PLANSStock Based Compensation
The Company has plans under which restricted
stock awards and options to purchase common stock have been granted to
officers, directors and key employees. In 1998, the Company awarded
400,000 shares of performance-based restricted stock to officers and key
employees. The shares had the potential to vest in equal one-third
installments beginning January 1, 2000, provided the Company met certain
earnings goals. As the goal was not met for 1999, and the awards are
cumulative, two-thirds has the potential to vest in 2000 and one-third in
2001. Unearned compensation under the restricted stock awards plan is
amortized over the vesting period. Compensation expense recognized
related to the restricted stock award plans was $2 million for each of
the years ended December 31, 1999 and 1998 and $1 million for the year
ended December 31, 1997.
Options are granted at the average market price on the date of grant. Exercise provisions vary, but most options vest in whole or in part one to five years after grant and expire ten years after grant. At December 31, 1999, there were 13,977,221 shares reserved for employee and director stock option plans. At December 31, 1999, there were 2,658,040 shares of common stock available for future grants.
On September 17, 1998, the Company repriced 5,503,491 of its stock options with original exercise prices ranging from $18.31 to $26.31 to the market price of the Company's common stock on that date of $15.59. Outstanding stock options with an exercise price in excess of $18.13 per share could be exchanged in return for a reduced number of options, with a deferred vesting date of one year after the exchange date. The repricing resulted in the cancellation of 5,503,491 options and the granting of 4,559,438 options.
The Company's option plan activity for the years ended December 31, 1999, 1998 and 1997 is summarized below:
Shares
Under Option |
Exercise Price
Per Share |
Weighted Average
Exercise Price |
||||||
|
||||||||
Balance, January 1, 1997 | 10,921,887
|
$ 4.32
|
to
|
$ 26.94
|
$ 13.71
|
|||
Granted | 2,819,000
|
|
18.31
|
to
|
23.69
|
19.79
|
||
Exercised | (1,247,793
|
)
|
4.32
|
to
|
23.06
|
8.67
|
||
Canceled or lapsed | (270,830
|
)
|
6.56
|
to
|
23.06
|
17.32
|
||
|
||||||||
Balance, December 31, 1997 | 12,222,264
|
|
5.80
|
to
|
26.94
|
15.54
|
||
Granted | 6,403,788
|
|
15.59
|
to
|
26.22
|
17.04
|
||
Exercised | (3,067,202
|
)
|
5.80
|
to
|
26.31
|
11.72
|
||
Canceled or lapsed | (6,753,198
|
)
|
6.56
|
to
|
26.31
|
20.03
|
||
|
||||||||
Balance, December 31, 1998 | 8,805,652
|
|
6.56
|
to
|
26.94
|
14.52
|
||
Granted | 3,966,750
|
|
6.88
|
to
|
19.25
|
14.16
|
||
Exercised | (105,232
|
)
|
6.56
|
to
|
8.91
|
16.75
|
||
Canceled or lapsed | (1,347,989
|
)
|
8.00
|
to
|
26.31
|
18.32
|
||
|
||||||||
Balance, December 31, 1999 | 11,319,181
|
$ 6.56
|
to
|
$ 26.94
|
$ 14.00
|
|||
|
A summary of stock options outstanding and exercisable at December 31, 1999 follows:
Stock Options
Outstanding
|
Stock Options
Exercisable
|
||||||||||||||
|
|
||||||||||||||
Range of Exercise
Prices
|
Shares
|
Weighted
Average
Remaining Contractual Life |
Weighted
Average
Exercise Price |
Shares
|
Weighted
Average
Exercise Price |
||||||||||
|
|||||||||||||||
$ | 6.56
|
to
|
$
|
9.64
|
3,820,428
|
6.5 years
|
$
|
8.05
|
1,914,178
|
$
|
6.95
|
||||
10.54
|
to
|
|
13.31
|
225,200
|
6.2 years
|
|
11.89
|
89,700
|
|
10.86
|
|||||
14.44
|
to
|
|
17.94
|
4,530,671
|
6.3 years
|
|
15.69
|
3,268,920
|
|
15.73
|
|||||
18.72
|
to
|
|
21.94
|
2,518,082
|
7.1 years
|
|
19.32
|
811,761
|
|
19.41
|
|||||
22.44
|
to
|
|
26.94
|
224,800
|
5.3 years
|
|
23.48
|
202,267
|
|
23.53
|
|||||
|
|||||||||||||||
$ | 6.56
|
to
|
$
|
26.94
|
11,319,181
|
6.5 years
|
$
|
14.00
|
6,286,826
|
$
|
13.71
|
||||
|
As of December 31, 1998 and 1997, there were 3,636,481 and 6,215,776 options exercisable, respectively. The weighted average exercise price of options exercisable during 1998 and 1997 was $12.32 and $13.32, respectively. If the Company had adopted the expense recognition provisions of SFAS 123 for purposes of determining compensation expense related to stock options granted during the years ended December 31, 1999, 1998 and 1997, net (loss) income and (loss) earnings per common share would have been changed to the pro forma amounts shown below:
The fair value of each option granted during 1999, 1998 and 1997 was estimated on the date of grant using the Black-Scholes pricing model with the following weighted average assumptions:
1999 | 1998 | 1997 | ||||||
---|---|---|---|---|---|---|---|---|
|
||||||||
Dividend yield | No | ne | No | ne | No | ne | ||
Expected volatility | 43 | .8% | 40 | .9% | 38 | .5% | ||
Risk-free interest rate | 5 | .6% | 4 | .9% | 6 | .1% | ||
Expected option life (years) | 8 | .3 | 6 | .8 | 5 | .4 | ||
Weighted average fair value at grant date | $
|
8 | .10 | $ | 8 | .59 | $ 8 | .88 |
|
The effects of applying SFAS 123 in the pro forma disclosures are not likely to be representative of the effects on pro forma net income for future years since variables such as option grants, exercises and stock price volatility included in the disclosures may not be indicative of future activity.
9. STOCKHOLDERS' EQUITYYears Ended December 31, | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
|
||||||||||
(In millions)
|
1999 | 1998 | 1997 | |||||||
|
||||||||||
Rent expense | $ 61 | $ 42 | $ 31 | |||||||
Sublease rental income | (25 | ) | (9 | ) | (3 | ) | ||||
|
||||||||||
Net rent expense | $ 36 | $ 33 | $ 28 | |||||||
|
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
Future annual minimum payments under all
noncancelable operating leases in excess of one year subsequent to
December 31, 1999 are as follows:
(In millions)
|
||||
---|---|---|---|---|
|
||||
2000 | $
|
54 | ||
2001 | 46 | |||
2002 | 31 | |||
2003 | 26 | |||
2004 | 22 | |||
Thereafter | 62 | |||
|
||||
Total minimum lease payments | $
|
241 | ||
Less: minimum sublease rental income | (112 | ) | ||
|
||||
Net minimum lease payments | $
|
129 | ||
|
Government and Other Contracts
The Company's Medicare HMO contracts with the
federal government are renewed for a one-year term each December 31,
unless terminated 90 days prior thereto. Legislative proposals are being
considered which may revise the Medicare program's current support of the
use of managed health care for Medicare beneficiaries and future
reimbursement rates thereunder. Management is unable to predict the
outcome of these proposals or the impact they may have on the Company's
financial position, results of operations or cash flows. The Company's
Medicaid contracts are generally annual contracts with various states
except for the two-year contract with the Health Insurance Administration
in Puerto Rico. Additionally, the Company's TRICARE contract is a
one-year contract renewable on July 1, 2000, for one additional year. The
loss of these contracts or significant changes in these programs as a
result of legislative action, including reductions in payments or
increases in benefits without corresponding increases in payments, would
have a material adverse effect on the revenues, profitability and
business prospects of the Company. In addition, the Company continually
contracts and seeks to renew contracts with providers at rates designed
to ensure adequate profitability. To the extent the Company is unable to
obtain such rates, its financial position, results of operations and cash
flows could be adversely impacted.
Legal Proceedings
During 1999, six purported class action
complaints have been filed against the Company and certain of its current
and former directors and officers claiming that the Company and the
individual defendants knowingly or recklessly made false or misleading
statements in press releases and public filings concerning the Company's
financial condition. All seek money damages of unspecified
amounts.
Since October 1999, the Company has received purported class action complaints alleging, among other things, that Humana intentionally concealed from its members information concerning the various ways Humana decides what claims will be paid, what procedures will be deemed medically necessary, and what criteria and procedures are used to determine the extent and type of their coverage. The complaints also allege that Humana concealed from members the existence of direct financial incentives to treating physicians and other health care providers to deny coverage. The complaints, generally, do not allege that any member was denied coverage for services that should have been covered but, instead, claim that Humana provided health insurance benefits of lesser value than promised. All seek money damages of unspecified amounts. The Company has requested to consolidate these complaints to a single court.
The Company believes the allegations in all of the above complaints are without merit and intends to pursue the defense of the actions vigorously.
On January 4, 2000, a jury in Palm Beach County, Florida, issued a verdict against Humana Health Insurance Company of Florida, Inc., awarding $79 million to Mark Chipps, an insured who had sued individually and on behalf of his minor daughter. The claim arose from the removal of the child from a case management program which had provided her with benefits in excess of those available under her policy. The award included $78 million for punitive damages, $1 million for emotional distress and $28,000 for contractual benefits. The Company is in the process of appealing the verdict.
During 1999, the Company reached an agreement in principle with the United States Department of Justice and the Department of Health and Human Services on a $15 million settlement relating to Medicare premium overpayments. The settlement is expected to be paid sometime during 2000. The Company had previously established adequate liabilities for the resolution of these issues and, therefore, the settlement did not have a material impact on the Company's financial position or results of operations.
Damages for claims for personal injuries and medical benefit denials are usual in the Company's business. Personal injury and medical benefit denial claims are covered by insurance from the Company's wholly owned captive insurance Subsidiary and excess carriers, except to the extent that claimants seek punitive damages, in states which prohibit insurable coverage for punitive damages. In connection with the Chipps case, the excess carriers have preliminarily indicated that they believe no coverage may be available for a punitive damages award.
During the ordinary course of its business, the Company is or may become subject to pending or threatened litigation or other legal actions. Management does not believe that any pending and threatened legal actions against the Company or audits by agencies will have a material adverse effect on the Company's financial position or results of operations.
11. ACQUISITIONS AND DISPOSITIONSOn January 31, 2000, the Company acquired the Memorial Sisters of Charity Health Network ("MSCHN"), a Houston based health plan for approximately $50 million in cash.
On June 1, 1999, the Company reached an agreement with FPA Medical Management, Inc. ("FPA"), FPA's lenders and a federal bankruptcy court under which the Company acquired the operations of 50 medical centers from FPA for approximately $14 million in cash. The Company has subsequently reached agreements with 14 provider groups to assume operating responsibility for 38 of the 50 acquired FPA medical centers under long-term provider agreements with the Company.
On October 17, 1997, the Company acquired ChoiceCare Corporation ("ChoiceCare") for approximately $250 million in cash. The purchase was funded with borrowings under the Company's commercial paper program. ChoiceCare provided health services products to members in the Greater Cincinnati, Ohio, area.
On September 8, 1997, the Company acquired PCA for total consideration of $411 million in cash, consisting primarily of $7 per share for PCA's outstanding common stock and the assumption of $121 million in debt. The purchase was funded with borrowings under the Company's commercial paper program. PCA provided comprehensive health services through its HMOs in Florida, Texas and Puerto Rico. In addition, PCA provided workers' compensation third-party administrative management services. Prior to November 1996, PCA also was a direct writer of workers' compensation insurance in Florida. Long-term medical and other expenses payable in the accompanying Consolidated Balance Sheets includes the long-term portion of workers' compensation liabilities related to this business.
On February 28, 1997, the Company acquired Health Direct, Inc. ("Health Direct") from Advocate Health Care for approximately $23 million in cash.
The above acquisitions were accounted for under the purchase method of accounting. In connection with these acquisitions, the Company allocated the acquisition costs to net tangible and identifiable intangible assets based upon their fair values. Identifiable intangible assets, which are included in other long-term assets in the accompanying Consolidated Balance Sheets, primarily relate to subscriber and provider contracts. Any remaining value not assigned to net tangible or identifiable intangible assets was then allocated to cost in excess of net assets acquired, or goodwill. Goodwill and identifiable intangible assets acquired, recorded in connection with the acquisitions, was $17 million and $754 million in 1999 and 1997, respectively. Subscriber and provider contracts are amortized over their estimated useful lives (seven to 14 years), while goodwill has been amortized over periods from six to 40 years. After a re-evaluation, effective January 1, 2000, the Company adopted a 20 year amortization period from the date of acquisition for goodwill previously amortized over 40 years.
The results of operations for the previously mentioned acquisitions have been included in the accompanying Consolidated Statements of Operations since the date of acquisition. The following unaudited pro forma data summarize the consolidated results of operations for the year ended December 31, 1997 as if the 1997 acquisitions referred to above had been completed as of the beginning of 1997:
(In millions, except per share
results)
|
|||
---|---|---|---|
|
|||
Revenues | $ 9,272 | ||
Net income | 64 | ||
Earnings per common share | $ 0.39 | ||
Earnings per common share assuming dilution | 0.39 |
The unaudited pro forma information above may not necessarily reflect future results of operations or what the results of operations would have been had the acquisitions actually been consummated at the beginning of 1997.
12. SEGMENT INFORMATIONDuring 1999, the Company realigned its organization to achieve greater accountability in its lines of business. As a result of this realignment, the Company organized into two business units: the Health Plan segment and the Small Group segment. The Health Plan segment includes the Company's large group commercial (100 employees and over), Medicare, Medicaid, ASO, workers' compensation and military or TRICARE business. The small group segment includes small group commercial (under 100 employees) and specialty benefit lines, including dental, life and short-term disability. Results of each segment are measured based upon results of operations before income taxes. The Company does not allocate assets to the segments, but allocates administrative expenses, interest income and interest expense to the segments. These allocations are based on systematic and rational methods which consider the nature of activities and volume of business associated with the segments' products. Members served by the two segments generally utilize the same medical provider networks, enabling the Company to obtain more favorable contract terms with providers. As a result, the profitability of each segment is somewhat interdependent. In addition, premium revenue pricing to large group commercial employers has historically been more competitive than that to small group commercial employers, resulting in less favorable underwriting margins for the large group commercial line of business. Costs to distribute and administer products to small group commercial employers are higher compared to large group commercial employers resulting in small group's higher administrative expense ratio. The accounting policies of each segment are similar and are described in Note 2.
The segment results for the years ended December 31, 1999, 1998 and 1997 are as follows:
(In millions)
|
Health Plan | Small Group | Total | ||||
---|---|---|---|---|---|---|---|
|
|||||||
1999 | |||||||
Revenues: | |||||||
Premiums | $ 6,827 | $ 3,132 | $ 9,959 | ||||
Interest and other income | 106 | 48 | 154 | ||||
|
|||||||
Total revenues | 6,933 | 3,180 | 10,113 | ||||
Underwriting margin | 861 | 566 | 1,427 | ||||
|
|||||||
Depreciation and amortization | 70 | 54 | 124 | ||||
|
|||||||
Loss before income taxes | (369 | ) | (35 | ) | (404 | ) | |
|
|||||||
(In millions)
|
Health Plan | Small Group | Total | ||||
|
|||||||
1998 | |||||||
Revenues: | |||||||
Premiums | $ 6,734 | $ 2,863 | $ 9,597 | ||||
Interest and other income | 140 | 44 | 184 | ||||
|
|||||||
Total revenues | 6,874 | 2,907 | 9,781 | ||||
Underwriting margin | 988 | 568 | 1,556 | ||||
|
|||||||
Depreciation and amortization | 76 | 52 | 128 | ||||
|
|||||||
Income (loss) before income taxes | 208 | (5 | ) | 203 | |||
|
|||||||
(In millions)
|
Health Plan | Small Group | Total | ||||
|
|||||||
1997 | |||||||
Revenues: | |||||||
Premiums | $ 5,487 | $ 2,393 | $ 7,880 | ||||
Interest and other income | 115 | 41 | 156 | ||||
|
|||||||
Total revenues | 5,602 | 2,434 | 8,036 | ||||
Underwriting margin | 864 | 494 | 1,358 | ||||
|
|||||||
Depreciation and amortization | 64 | 44 | 108 | ||||
|
|||||||
Income before income taxes | 244 | 26 | 270 | ||||
|
As previously discussed, during 1999 and 1998, the Company recorded pretax expenses of $585 million and $132 million, respectively. The following table details the reduction on operating results from these expenses for the Health Plan and Small Group segments for the years ended December 31, 1999 and 1998:
1999 | 1998 | ||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
|
||||||||||||||||||||||||
(In millions)
|
Health Plan | Small Group | Total | Health Plan | Small Group | Total | |||||||||||||||||||
|
|
||||||||||||||||||||||||
Underwriting margin | $ | 66 | $ | 24 | $ | 90 | $ | 60 | $ | 13 | $ | 73 | |||||||||||||
|
|||||||||||||||||||||||||
Income before income taxes | $ | 553 | $ | 32 | $ | 585 | $ | 96 | $ | 36 | $ | 132 | |||||||||||||
|
The Company's product offerings include managed health care products and specialty products. Managed health care product premiums were approximately $9.7 billion, $9.4 billion and $7.7 billion for the years ended December 31, 1999, 1998 and 1997, respectively. Specialty product premiums were approximately $277 million, $239 million, and $230 million for the years ended December 31, 1999, 1998 and 1997, respectively.
Premium revenues derived from contracts with the
federal government in 1999, 1998 and 1997 represent approximately 40
percent, 41 percent and 43 percent, respectively, of total premium
revenues.
HUMANA INC.
REPORT OF INDEPENDENT ACCOUNTANTS
To the Board of Directors and Stockholders
Humana Inc.
In our opinion, the accompanying consolidated balance sheets and the related consolidated statements of operations, stockholders' equity and cash flows present fairly, in all material respects, the consolidated financial position of Humana Inc. and its subsidiaries at December 31, 1999 and 1998, and the 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. These financial statements are the responsibility of the Company's management; our responsibility is to express an opinion on these financial statements based on our audits. We conducted our audits of these statements in accordance with auditing standards generally accepted in the United States, which 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, assessing the accounting principles used and significant estimates made by management, and evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for the opinion expressed above.
/s/ PricewaterhouseCoopers LLP
Louisville, Kentucky
February 9, 2000
HUMANA INC.
QUARTERLY FINANCIAL INFORMATION (UNAUDITED)
A summary of the Company's quarterly unaudited results of operations for the years ended December 31, 1999 and 1998 follows:
(In millions, except per share
results)
|
1999 | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
|
|||||||||||
First (a) | Second | Third | Fourth (b) | ||||||||
|
|||||||||||
Revenues | $ 2,477 | $2,505 | $ 2,557 | $ 2,574 | |||||||
(Loss) income before income taxes | (25 | ) | 44 | 34 | (457 | ) | |||||
Net (loss) income | (16 | ) | 28 | 22 | (416 | ) | |||||
(Loss) earnings per common share | (0.10 | ) | 0.17 | 0.13 | (2.48 | ) | |||||
(Loss) earnings per common share | |||||||||||
assuming dilution | (0.10 | ) | 0.17 | 0.13 | (2.48 | ) | |||||
(In millions, except per share
results)
|
1998
|
||||||||||
|
|||||||||||
First
|
Second
|
Third
(c)
|
Fourth
|
||||||||
|
|||||||||||
Revenues | $ 2,402 | $2,446 | $ 2,464 | $ 2,469 | |||||||
Income (loss) before income taxes | 79 | 82 | (47 | ) | 89 | ||||||
Net income (loss) | 50 | 52 | (30 | ) | 57 | ||||||
Earnings (loss) per common share | 0.30 | 0.31 | (0.18 | ) | 0.34 | ||||||
Earnings (loss) per common share | |||||||||||
assuming dilution | 0.30 | 0.31 | (0.18 | ) | 0.34 |
(a) | Includes expenses of $90 million pretax ($58 million after tax, or $0.34 per diluted share) primarily related to premium deficiency and medical reserve strengthening. |
(b) | Includes expenses of $495 million pretax ($441 after tax, or $2.63 per diluted share) primarily related to goodwill write-down, losses on non-core asset sales and professional liability reserve strengthening. |
(c) | Includes expenses of $132 million ($84 million after tax, or $0.50 per diluted share) primarily related to the costs of certain market exits and product discontinuances, asset write-downs, premium deficiency and a one-time non-officer employee incentive. |
HUMANA INC.
TRANSFER AGENT | CORPORATE HEADQUARTERS | ||
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National City Bank | Humana Inc. | ||
Stock Transfer Department | The Humana Building | ||
Post Office Box 92301 | 500 West Main Street | ||
Cleveland, Ohio 44193-0900 | Louisville, Kentucky 40202 | ||
(800) 622-6757 | (502) 580-1000 | ||
FORM 10-K | INDEPENDENT ACCOUNTANTS | ||
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Copies of the Company's Form 10-K filed with the | PricewaterhouseCoopers LLP | ||
Securities and Exchange Commission may be obtained, | Louisville, Kentucky | ||
without charge, by writing: | |||
Investor Relations | ANNUAL MEETING | ||
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Humana Inc.
Post Office Box 1438 Louisville, Kentucky 40201-1438 |
The Company's Annual Meeting of Stockholders will be held on Thursday, May 18, 2000, at 10:00 a.m. EDT in the Auditorium on the 25th floor of the Humana Building. | ||
Copies of the Company's Form 10-K and other
Company
information can also be obtained through the Internet at the following
address:
http://www.humana.com
1999 |
High |
Low |
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First Quarter |
20-3/4 |
16-15/16 |
Second Quarter |
16-7/16 |
11 |
Third Quarter |
13-1/8 |
6-7/8 |
Fourth Quarter |
8-1/4 |
5-7/8 |
1998 |
High |
Low |
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First Quarter |
26-3/8 |
19-1/2 |
Second Quarter |
31-11/16 |
24-15/16 |
Third Quarter |
31-7/8 |
12-7/8 |
Fourth Quarter |
21-9/16 |
14-3/8 |
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