Humana Inc. Reports First Quarter 2005 Financial Results of $0.67 Earnings per Share
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LOUISVILLE, Ky., May 2, 2005 /PRNewswire-FirstCall via COMTEX/ -- Humana Inc. (NYSE: HUM) today reported $0.67 diluted earnings per common share (EPS) for the quarter ended March 31, 2005 (1Q05) compared to $0.41 EPS for the quarter ended March 31, 2004 (1Q04). First quarter results exceeded the upper end of company expectations primarily due to quicker than anticipated response to the company's new Medicare products and markets.
Pretax income rose 18 percent to $121.7 million in 1Q05 due to significant growth in Humana's Medicare programs and improved Commercial segment margins. After-tax income for 1Q05 included a $0.14 per share benefit from the realization of a federal income tax gain contingency.
"Our Medicare team continually optimizes the performance of this business through the application of industry-leading capabilities, strategic planning, and expertise built over 20 years as a successful CMS contractor," said Michael B. McCallister, Humana's president and chief executive officer. "This quarter's results reflect senior consumers' early acceptance of both our new products and our entrance into new markets. Our 1Q05 results also reflect the continuation of our targeted shift to a mix of members in higher-margin individual, ASO, and consumer-choice products. More importantly, our progress this quarter positions Humana to achieve substantial earnings growth throughout 2005 and longer term."
The company now anticipates EPS for the year ending December 31, 2005 (FY 2005) of $2.23 to $2.25, up from the company's prior guidance of approximately $2.20 per share.
Commercial Segment Results
Commercial segment pretax earnings rose to $49.5 million in 1Q05 from $39.1 million in 1Q04, an increase of 27 percent, reflecting a more profitable business mix with significant increases in administrative services only (ASO), individual, and consumer-choice product members. Pretax margin for the Commercial segment increased 70 basis points year over year to 2.9 percent in 1Q05.
The company continues to expect FY 2005 Commercial segment pretax earnings to increase between 10 and 15 percent over those for the year ended December 31, 2004 (FY 2004).
Commercial Segment Enrollment
Commercial segment medical membership of 3,219,400 at March 31, 2005 decreased 3 percent from December 31, 2004, driven by the January 1 relinquishment of an 89,000-member unprofitable account. The company's ASO and individual membership grew sequentially by 16 percent and 6 percent, respectively, as the company continued to improve the risk profile of its commercial book.
The company's leadership in product innovation continues to be shown through growth in its consumer-choice plans. At March 31, 2005, 12 percent of the company's commercial medical membership was in these plans, up from 9 percent at December 31, 2004.
Commercial Segment Premiums and Medical Costs
Premiums and administrative services fees for the Commercial segment decreased 5 percent to $1.7 billion in 1Q05 compared to the prior year's quarter, driven by a 7 percent reduction in average organic membership for 1Q05 versus 1Q04 and a shift to a higher percentage of ASO business.
Commercial segment medical premiums for fully insured group membership increased approximately 8 percent on a per-member basis during 1Q05 compared to the same period in the prior year, including an approximately 50 basis point lowering effect from a higher mix of fully insured consumer-choice members. FY 2005 commercial premiums for fully insured group membership are projected to increase in the range of 8 to 10 percent on a per-member basis.
In 1Q05, the Commercial segment medical expense ratio (medical expenses divided by premium revenues) of 82.2 percent was 130 basis points lower than in 1Q04, reflecting the company's improving risk profile in its commercial portfolio.
Per-member medical costs for the commercial fully insured group business are forecast to rise in the range of 8 to 10 percent for FY 2005.
Government Segment Results
Government segment pretax earnings were $72.2 million in 1Q05 compared to $63.7 million in 1Q04, an increase of 13 percent, the result of significant growth in the company's Medicare membership along with an improved Medicare medical expense ratio.
For FY 2005, the company expects another year-over-year increase in earnings in its Government segment, driven by improvements in results from both Medicare and TRICARE operations.
Government Segment Enrollment
Organic growth in Medicare Advantage membership accelerated during 1Q05 due primarily to expanded participation in various Medicare programs combined with marketing and other investment spending in these programs by the company. Medicare membership of 449,900 at March 31, 2005 increased 72,700 members or 19 percent from the December 31, 2004 level of 377,200, including 50,400 members acquired through the company's acquisition of CarePlus Health Plans of Florida in mid-February 2005.
Medicare Advantage membership is anticipated to experience continued growth throughout FY 2005, with projected membership in the range of 480,000 to 500,000 by the end of the year.
As expected, TRICARE membership of 2,871,800 at March 31, 2005 was unchanged from December 31, 2004.
Government Segment Premiums and Medical Costs
Medicare Advantage premiums per member increased in the range of 10 to 12 percent year over year during 1Q05, including the partial-quarter impact of higher reimbursement associated with the acquired CarePlus membership.
For FY2005, the company anticipates Medicare per-member premiums to increase in the range of 11 to 13 percent. Medicare Advantage medical costs per member are projected to experience a corresponding increase of 11 to 13 percent for FY 2005.
TRICARE premiums and administrative services fees during 1Q05 of $574.0 million reflect the implementation of the new South Region contract with the Department of Defense, which included a reduction in the benefits and services provided under previous contracts, and thus, lower revenues. This accounted for the expected year-over-year decline in TRICARE premiums and administrative services fees of approximately 16 percent in 1Q05.
For 2005, the company anticipates TRICARE premiums and administrative services fees to approximate $2.5 billion as the company experiences a full year under the new South Region contract.
Selling, General & Administrative Expenses
The company's consolidated Selling, General, & Administrative (SG&A) expense ratio (SG&A expenses as a percent of premiums plus administrative services fees) was 14.1 percent for 1Q05, a 30 basis point improvement versus the prior year. The Commercial segment's SG&A expense ratio was 17.6 percent in 1Q05 versus 16.4 percent in 1Q04, primarily the result of a higher percentage of ASO business in 1Q05. The Government segment's SG&A expense ratio for 1Q05 of 10.8 percent was 130 basis points lower than that for 1Q04, as higher Medicare and TRICARE revenues outpaced the increases in related SG&A expenses during the quarter.
The company's 2005 consolidated SG&A expense ratio is projected to be in the range of 13.5 to 14.5 percent. The expected lower SG&A expense ratio should result from the beneficial effect of both growth in membership and revenues leveraging fixed costs and management's continued focus on streamlining administrative costs through process design and technology adoption.
Cash Flows from Operations
Cash flows provided by operations for 1Q05 of $99.2 million were in line with the company's expectations, and compared favorably to $40.1 million cash flows used in operations in 1Q04. The substantial increase in cash flows resulted from a difference in the timing of the January CMS premium payment receipt for 2005 versus 2004. The company also evaluates operating cash flows on a non-GAAP basis, as described below.
The company anticipates that cash flows from operations for FY 2005 will be in the range of $625 million to $675 million driven by expected higher earnings.
Non-GAAP Cash Flows from Operations
The following is a reconciliation of the most directly comparable historical and projected cash flows from operations prepared in accordance with Generally Accepted Accounting Principles (GAAP), to the historical and projected non-GAAP financial measures. When reviewing and analyzing Humana's operating cash flows, company management applies the CMS premium payment in each month to match the corresponding disbursements. To do otherwise distorts meaningful analysis of the company's operating cash flow. Therefore, decisions such as management's forecasting and business plans regarding cash flow use this non-GAAP financial measure.
($ in millions) 1Q04 1Q05 FY 2005 Actual Actual Expected GAAP cash flows (used in) provided by operations $(40.1) $99.2 $625 to $675 Timing of premium payment receipt from CMS 211.9 19.8 19.8 Non-GAAP cash flows provided by operations $171.8 $119.0 $625 to $675
Non-GAAP cash flows provided by operations during 1Q05 declined versus 1Q04 primarily as a result of the change in the company's commercial portfolio to a heavier mix of ASO customers on January 1, 2005 and the corresponding payment of runoff claims on fully-insured customers that either migrated to its ASO products or terminated their coverage with the company, including the large unprofitable, fully-insured account discussed during 2004.
Balance Sheet
At March 31, 2005, cash and investment securities comprised 49 percent of the company's total assets compared to 54 percent at December 31, 2004. Debt as a percent of total capitalization (debt plus stockholders' equity) increased to 28.7 percent from 23.3 percent at December 31, 2004. Changes in both of these metrics reflect the February 2005 closing of the accretive CarePlus transaction.
Acquisition of CarePlus
On February 16, 2005, the company completed its acquisition of CarePlus as well as its affiliated ten CAC-Florida Medical Centers, and PrescibIT Rx pharmacy company, adding 50,400 Medicare Advantage members in Miami-Dade, Broward and Palm Beach counties.
Conference Call & Virtual Slide Presentation
Humana will host a conference call, as well as a virtual slide presentation, at 9:00 a.m. eastern time today to discuss its financial results for the quarter and the company's expectations for future earnings.
A live virtual presentation (audio with slides) may be accessed via Humana's Investor Relations page at www.humana.com . The company suggests web participants sign on approximately 15 minutes in advance of the call. The company also suggests web participants visit the site well in advance of the call to run a system test and to download any free software needed to view the presentation.
All parties interested in the audio-only portion of the conference call are invited to dial 888-625-7430. No password is required. The company suggests participants dial in approximately ten minutes in advance of the call.
For those unable to participate in the live event, the virtual presentation archive will be available in the Presentations section of the Investor Relations page at www.humana.com , approximately two hours following the live web cast.
Cautionary Statement
This news release contains forward-looking statements. The forward- looking statements herein are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Forward-looking statements may be significantly impacted by certain risks and uncertainties described in the company's Form 10-K for the year ended December 31, 2004, as filed by Humana with the Securities and Exchange Commission.
About Humana
Humana Inc., headquartered in Louisville, Kentucky, is one of the nation's largest publicly traded health benefits companies, with approximately 7 million medical members located primarily in 15 states and Puerto Rico. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals.
Over its 44-year history, Humana has consistently seized opportunities to meet changing customer needs. Today, the company is a leader in consumer engagement, providing guidance that leads to lower costs and a better health plan experience throughout its diversified customer portfolio.
More information regarding Humana is available to investors via the Investor Relations page of the company's web site at http://www.humana.com , including copies of:
- Annual report to stockholders; - Securities and Exchange Commission filings; - Most recent investor conference presentation; - Quarterly earnings press releases; - Audio archive of most recent earnings release conference call; - Calendar of events (includes upcoming earnings conference call dates, times, and access number, as well as planned interaction with institutional investors); - Corporate Governance Information. Summary of Earnings Guidance Points 2005 Guidance Points FY 2005 EPS $2.23 to $2.25 2Q05 EPS $0.47 to $0.50 Consolidated revenues Approximately $14.5 billion Commercial segment pretax income Increase of 10% to 15% Commercial medical membership Slightly higher excluding loss of 89K member account on January 1, 2005 Increase in Commercial segment fully 6% to 8% overall; insured medical premiums on a per- 8% to 10% group only member basis Increase in Commercial segment fully 6% to 8% overall; insured medical costs on a per- 8% to 10% group only member basis TRICARE pretax margin Approximately 3% Medicare medical membership 480,000 to 500,000 by year end TRICARE medical membership No material change from 2004 ending membership Increase in Medicare medical 11% to 13% premiums on a per-member basis Increase in Medicare medical costs 11% to 13% on a per-member basis TRICARE revenues Approximately $2.5 billion Consolidated SG&A expense ratio 13.5% to 14.5% Cash flows from operations for full $625 million to $675 million year - GAAP and non-GAAP Capital expenditures Approximately $115 million Effective tax rate FY 2005 approximately 30 percent; 34% to 36% remainder of FY 2005 Shares used in computation of EPS FY 2005 approximately 166 million; 2Q05 approximately 165 million Humana Inc. In thousands March 31, Percent Ending Medical Membership 2005 2004 Difference Change Commercial: Fully insured 2,039.3 2,298.6 (259.3) (11.3) ASO 1,180.1 997.0 183.1 18.4 Total Commercial 3,219.4 3,295.6 (76.2) (2.3) Government: Medicare Advantage 449.9 333.2 116.7 35.0 Medicaid 477.2 468.2 9.0 1.9 TRICARE 1,723.4 1,860.1 (136.7) (7.3) TRICARE ASO 1,148.4 1,057.9 90.5 8.6 Total TRICARE 2,871.8 2,918.0 (46.2) (1.6) Total Government 3,798.9 3,719.4 79.5 2.1 Total ending medical membership 7,018.3 7,015.0 3.3 0.0 March 31, Percent Ending Specialty Membership 2005 2004 Difference Change Commercial: Dental-fully insured 874.6 781.6 93.0 11.9 Dental-ASO 488.0 408.2 79.8 19.5 Total Dental 1,362.6 1,189.8 172.8 14.5 Group life 444.9 495.7 (50.8) (10.2) Short-term disability 16.6 17.7 (1.1) (6.2) Total ending specialty membership 1,824.1 1,703.2 120.9 7.1 Three months ended March 31, Premiums 2005 2004 Commercial: Fully insured medical $1,517,394 $1,617,120 Specialty 93,538 85,971 Total Commercial 1,610,932 1,703,091 Government: Medicare Advantage 983,141 706,318 TRICARE 562,328 648,993 Medicaid 134,414 120,779 Total Government 1,679,883 1,476,090 Total premiums $3,290,815 $3,179,181 Three months ended March 31, Administrative services fees 2005 2004 Commercial $50,111 $41,696 Government 11,624 36,541 Total administrative services fees $61,735 $78,237 Humana Inc. Dollars in thousands, except per share results Three months ended March 31, Consolidated Statements of Income 2005 2004 Revenues: Premiums $3,290,815 $3,179,181 Administrative services fees 61,735 78,237 Investment income 30,211 27,454 Other income 4,464 2,077 Total revenues 3,387,225 3,286,949 Operating expenses: Medical 2,753,733 2,683,516 Selling, general and administrative 474,033 469,629 Depreciation 24,806 23,923 Other intangible amortization 4,443 2,389 Total operating expenses 3,257,015 3,179,457 Income from operations 130,210 107,492 Interest expense 8,523 4,719 Income before income taxes 121,687 102,773 Provision for income taxes 11,892 34,943 Net income $109,795 $67,830 Basic earnings per common share $0.68 $0.42 Diluted earnings per common share $0.67 $0.41 Shares used in computing basic earnings per common share (000's) 160,911 161,966 Shares used in computing diluted earnings per common share (000's) 164,179 164,357 Operating Results by Segment Pretax income Commercial $49,463 $39,086 Government 72,224 63,687 Consolidated $121,687 $102,773 Key Ratios Medical expense ratio Commercial 82.2% 83.5% Government 85.1% 85.4% Consolidated 83.7% 84.4% Selling, general, and administrative expense ratio Commercial 17.6% 16.4% Government 10.8% 12.1% Consolidated 14.1% 14.4% Humana Inc. Dollars in thousands, except per share results March 31, December 31, Consolidated Balance Sheets 2005 2004 Assets Current assets: Cash and cash equivalents $560,264 $580,079 Investment securities 2,136,841 2,145,645 Receivables, net: Premiums 568,184 554,661 Administrative services fees 20,145 24,954 Securities lending collateral 126,678 77,840 Other 226,339 212,958 Total current assets 3,638,451 3,596,137 Property and equipment, net 428,890 399,506 Other assets: Long-term investment securities 345,692 348,465 Goodwill 1,244,370 885,572 Other 492,190 427,937 Total other assets 2,082,252 1,661,974 Total assets $6,149,593 $5,657,617 Liabilities and Stockholders' Equity Current liabilities: Medical and other expenses payable $1,546,050 $1,422,010 Trade accounts payable and accrued expenses 395,498 488,332 Book overdraft 192,741 192,060 Securities lending payable 126,678 77,840 Unearned revenues 143,683 146,326 Total current liabilities 2,404,650 2,326,568 Long-term debt 885,271 636,696 Other long-term liabilities 659,867 604,229 Total liabilities 3,949,788 3,567,493 Commitments and contingencies Stockholders' equity: Preferred stock, $1 par; 10,000,000 shares authorized; none issued - - Common stock, $0.16 2/3 par; 300,000,000 shares authorized; 177,556,156 shares issued at March 31, 2005 29,592 29,340 Capital in excess of par value 1,055,491 1,017,156 Retained earnings 1,339,618 1,229,823 Accumulated other comprehensive income (5,648) 16,526 Unearned stock compensation (16,872) (1,721) Treasury stock, at cost, 15,824,092 shares at March 31, 2005 (202,376) (201,000) Total stockholders' equity 2,199,805 2,090,124 Total liabilities and stockholders' equity $6,149,593 $5,657,617 Debt to total capitalization ratio 28.7% 23.3% Humana Inc. Dollars in thousands Three months ended March 31, Consolidated Statements of Cash Flows 2005 2004 Cash flows from operating activities Net income $109,795 $67,830 Adjustments to reconcile net income to net cash provided by (used in) operating activities: Depreciation and amortization 29,249 26,312 Provision for deferred income taxes 7,255 12,223 Changes in operating assets and liabilities excluding the effects of acquisitions: Receivables (6,425) (20,546) Other assets (8,360) (15,472) Medical and other expenses payable 86,665 124,628 Other liabilities (97,548) (32,431) Unearned revenues (22,416) (201,699) Other 1,013 (900) Net cash provided by (used in) operating activities 99,228 (40,055) Cash flows from investing activities Acquisitions, net of cash acquired (348,099) - Purchases of property and equipment (36,193) (22,732) Proceeds from sales of property and equipment 8 19,385 Purchases of investment securities (714,371) (1,491,272) Proceeds from maturities of investment securities 261,665 246,845 Proceeds from sales of investment securities 434,506 786,868 Change in securities lending collateral (48,838) (15,222) Net cash used in investing activities (451,322) (476,128) Cash flows from financing activities Borrowings under credit agreement 294,000 - Repayments under credit agreement (25,000) - Change in book overdraft 681 (8,617) Change in securities lending payable 48,838 15,222 Common stock repurchases (1,376) (12,836) Proceeds from stock option exercises and other 15,136 8,657 Net cash provided by financing activities 332,279 2,426 Decrease in cash and cash equivalents (19,815) (513,757) Cash and cash equivalents at beginning of period 580,079 931,404 Cash and cash equivalents at end of period $560,264 $417,647 Humana Inc. Percentage of Ending Membership Under Capitation Arrangements Commercial Segment Fully Total Insured ASO Segment March 31, 2005 Capitated HMO hospital system based A 2.7% - 1.7% Capitated HMO physician group based A 2.5% - 1.6% Risk-sharing B 2.6% - 1.6% All other membership 92.2% 100.0% 95.1% Total 100.0% 100.0% 100.0% March 31, 2004 Capitated HMO hospital system based A 4.5% - 3.2% Capitated HMO physician group based A 3.4% - 2.4% Risk-sharing B 2.1% - 1.5% All other membership 90.0% 100.0% 92.9% Total 100.0% 100.0% 100.0% Government Segment Consol. Medicare TRICARE Total Total Advantage Medicaid TRICARE ASO Segment Medical March 31, 2005 Capitated HMO hospital system based A 8.1% 3.3% - - 1.4% 1.5% Capitated HMO physician group based A 0.9% 35.2% - - 4.5% 3.2% Risk-sharing B 52.5% 53.0% - - 12.9% 7.7% All other membership 38.5% 8.5% 100.0% 100.0% 81.2% 87.6% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% March 31, 2004 Capitated HMO hospital system based A 11.8% 3.3% - - 1.5% 2.3% Capitated HMO physician group based A 1.3% 43.9% - - 5.7% 4.1% Risk-sharing B 53.9% 45.5% - - 10.6% 6.3% All other membership 33.0% 7.3% 100.0% 100.0% 82.2% 87.3% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% A - In a limited number of circumstances, we contract with hospitals and physicians to accept financial risk for a defined set of HMO membership. In transferring this risk, we prepay these providers a monthly fixed-fee per member to coordinate substantially all of the medical care for their capitated HMO membership, including some health benefit administrative functions and claims processing. For these capitated HMO arrangements, we generally agree to reimbursement rates that target a medical expense ratio ranging from 82% to 89%. Providers participating in hospital-based capitated HMO arrangements generally receive a monthly payment for all of the services within their system for their HMO membership. Providers participating in physician-based capitated HMO arrangements generally have subcontracted specialist physicians and are responsible for reimbursing such hospitals and physicians for services rendered to their HMO membership. B - In some circumstances, we contract with physicians under risk-sharing arrangements whereby physicians have assumed some level of risk for all or a portion of the medical costs of their HMO membership. Although these arrangements do include capitation payments for services rendered, we process substantially all of the claims under these arrangements. Humana Inc. Dollars in thousands Medical Claim Reserves - Details and Statistics Change in medical and other expenses payable: The change in medical and other expenses payable is summarized as follows: For the Three For the Twelve Months Ended Months Ended March 31, 2005 December 31, 2004 Balances at January 1 $1,422,010 $1,272,156 Acquisition 37,375 71,063 Incurred related to: Current year 2,828,027 10,763,105 Prior years - non-TRICARE (62,800) (68,448) Prior years - TRICARE (1) (11,494) (25,010) Total incurred 2,753,733 10,669,647 Paid related to: Current year (1,660,838) (9,504,331) Prior years (1,006,230) (1,086,525) Total paid (2,667,068) (10,590,856) Balances at end of period $1,546,050 $1,422,010
The impact of any change in "incurred related to prior years" claims may be offset as we re-establish the "incurred related to current year". Our reserving practice is to consistently recognize the actuarial best estimate of our ultimate liability for our claims within a level of confidence required to meet actuarial standards. Thus, only when the release of a prior year reserve is not offset with the same level of conservatism in estimating the current year reserve will the redundancy reduce medical expense. We have consistently applied this methodology in determining our best estimate for unpaid claims liability in each period.
(1) Changes in estimates of TRICARE incurred claims for prior years recognized during 2004 and 2005 resulted primarily from claim costs and utilization levels developing favorably from the levels originally estimated for the second half of the prior year. As a result of substantial risk- sharing provisions with the Department of Defense and with subcontractors, any resulting impact on operations from the change in estimates of incurred related to prior years is substantially reduced, whether positive or negative.
Humana Inc. Dollars in thousands Medical Claim Reserves - Details and Statistics Medical and Other Expenses Payable Detail: March 31, December 31, 2005 2004 A IBNR and other medical expenses payable $962,681 $910,525 B TRICARE IBNR 328,920 284,647 C TRICARE other medical expenses payable 20,395 6,970 D Unprocessed claim inventories 111,200 115,300 E Processed claim inventories 92,030 97,801 F Payable to pharmacy benefit administrator 30,824 6,767 Total medical and other expenses payable $1,546,050 $1,422,010 A IBNR represents an estimate of medical expenses payable for claims incurred but not reported (IBNR) at the balance sheet date. The level of IBNR is primarily impacted by membership levels, medical claim trends and the receipt cycle time, which represents the length of time between when a claim is initially incurred and when the claim form is received (i.e. a shorter time span results in lower reserves for claims IBNR). B TRICARE IBNR has increased from higher medical expenses due to the transition to the new South region contract. C TRICARE other medical expense payable may include liabilities to subcontractors and/or risk share payables to the Department of Defense. The level of these balances may fluctuate from period to period due to the timing of payment (cutoff) and whether or not the balances are payables or receivables (receivables from the Department of Defense are classified as "receivables" in our balance sheet). D Unprocessed claim inventories represent the estimated valuation of claims received but not yet fully processed. TRICARE claim inventories are not included in this amount as an independent third party administrator processes all TRICARE medical claims on our behalf. Reserves for TRICARE claims inventory are included in TRICARE IBNR. E Processed claim inventories represent the estimated valuation of processed claims that are in the post claim adjudication process, which consists of administrative functions such as audit and check batching and handling. F The balance due to our pharmacy benefit administrator fluctuates due to bi-weekly payments and the month-end cutoff. Receipt Cycle Time: The receipt cycle time measures the average length of time between when a claim was initially incurred and when the claim form was received. Below is a summary: Average Number of Days from Incurred Date to Receipt Date (1) 2005 2004 Change % Change 1st Quarter Average 16.6 17.4 (0.8) -4.6% 2nd Quarter Average - 16.7 N/A N/A 3rd Quarter Average - 16.9 N/A N/A 4th Quarter Average - 16.4 N/A N/A Full Year Average 16.6 16.9 (0.3) -1.8% (1) Receipt cycle time data for our 3 largest claim processing platforms representing approximately 92% of our fully insured claims volume. Humana Inc. Medical Claim Reserves - Details and Statistics Unprocessed Claim Inventories: The estimated valuation and number of claims on hand that are yet to be processed are as follows: Estimated Number Valuation Claim Item of Days Date (000) Counts On Hand 3/31/2003 $99,000 421,700 4.4 6/30/2003 $92,100 446,600 4.7 9/30/2003 $106,800 528,400 5.8 12/31/2003 $109,700 443,000 4.9 3/31/2004 $94,800 400,900 3.9 6/30/2004 $98,100 387,000 3.7 9/30/2004 $122,300 453,300 4.4 12/31/2004 $115,300 394,400 3.7 3/31/2005 $111,200 393,200 3.6 Days in Claims Payable (Quarterly): A common metric for monitoring medical claim reserve levels relative to the medical claim expenses is days in claims payable, or DCP, which represents the medical claim liabilities at the end of the period divided by average medical expenses per day in the quarterly period. Since we have some providers under capitation payment arrangements (which do not require a medical claim IBNR reserve), we have also summarized this metric excluding capitation expenses. Days in Claims DCP Payable Annual Excluding Annual Quarter Ended (DCP) Change % Change Capitation Change % Change 3/31/2003 46.5 (0.7) -1.5% 54.7 (1.5) -2.7% 6/30/2003 47.9 1.1 2.4% 56.2 0.9 1.6% 9/30/2003 47.2 0.6 1.3% 54.5 (0.8) -1.4% 12/31/2003 46.2 1.0 2.2% 53.2 (0.1) -0.2% 3/31/2004 47.4 0.9 1.9% 54.3 (0.4) -0.7% 6/30/2004 47.4 (0.5) -1.0% 54.1 (2.1) -3.7% 9/30/2004 51.8 4.6 9.7% 59.1 4.6 8.4% 12/31/2004 49.5 3.3 7.1% 54.8 1.6 3.0% 3/31/2005 50.5 3.1 6.5% 56.1 1.8 3.3%
This metric fluctuates due to all of the issues reviewed above, including the change in the receipt cycle time, the change in medical claim inventories, the change in TRICARE liability balances, and the timing of our bi-weekly payment to our pharmacy benefits administrator. An annual recap follows:
2005 2004 4th quarter-prior year 49.5 46.2 Impact of change in claim receipt cycle time (0.3) (0.2) Impact of change in unprocessed claim inventories (0.1) 0.2 Impact of change in processed claim inventories (0.2) 0.9 Impact of changing TRICARE reserve balances 0.2 1.6 Impact of change in pharmacy payment cutoff 0.8 (0.4) All other 0.6 1.2 Year to date-current year 50.5 49.5
SOURCE Humana Inc.
Regina Nethery, Investor Relations, +1-502-580-3644, or Rnethery@humana.com , or Tom Noland, Corporate Communications, +1-502-580-3674, or Tnoland@humana.com , both of Humana Inc.
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