er8k5-06


UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549

 

FORM 8-K

 

CURRENT REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE
SECURITIES EXCHANGE ACT OF 1934

 

Date of report (Date of earliest event reported)    May 1, 2006

Humana Inc.
(Exact Name of Registrant as Specified in Its Charter)

Delaware
(State or Other Jurisdiction of Incorporation)

1-5975                                          61-0647538
(Commission File Number)                      (IRS Employer Identification No.)

 

500 West Main Street, Louisville, KY                          40202
(Address of Principal Executive Offices)                         (Zip Code)

502-580-1000
(Registrant's Telephone Number, Including Area Code)

 

(Former Name or Former Address, if Changed Since Last Report)

      Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions (see General Instruction A.2. below):


      o    Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
      o    Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
      o    Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
      o    Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))


Item 2.02   Results of Operations and Financial Condition.
Item 7.01   Regulation FD Disclosure.


                  An earnings release for the period ended March 31, 2006 and guidance for 2006 was issued by Humana Inc. this morning, a copy of which is attached hereto as Exhibit 99.1 and is incorporated herein by reference.

                  The information in this Current Report on Form 8-K, and the related Exhibit 99.1, is being furnished and shall not be deemed "filed" for the purposes of Section 18 of the Securities Exchange Act of 1934, as amended, or otherwise subject to the liabilities of that Section. The information in this Current Report and in Exhibit 99.1 shall not be incorporated by reference into any registration statement or other document pursuant to the Securities Act of 1933, as amended.

                  Conversely, Exhibit 99.2 shall be deemed "filed" and may be incorporated by reference into any registration statement or other document pursuant to the Securities Act of 1933, as amended.


Item 9.01   Financial Statements and Exhibits.

(c)   Exhibits:


Exhibit No.                                          Description                                                                  

       99.1              Earnings Release & Statistical Pages
       99.2              Stock Option Expensing 123R Statistical Pages

 

 

SIGNATURES

          Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this Report to be signed on its behalf by the undersigned hereunto duly authorized.

HUMANA INC.

BY: __/s/ Arthur P. Hipwell_____________
           Arthur P. Hipwell
           Senior Vice President
           and General Counsel

 

Dated:    May 1, 2006

 

 

INDEX TO EXHIBITS


Exhibit No.                                                  Description                                                                 

       99.1              Earnings Release & Statistical Pages
       99.2              Stock Option Expensing 123R Statistical Pages

500 West Main Street

n e w s r e l e a s e

Humana Inc.
500 West Main Street
P.O. Box 1438
Louisville, KY 40201-1438
www.humana.com

FOR MORE INFORMATION CONTACT:

Regina Nethery
Humana Investor Relations
(502) 580-3644
E-mail:   rnethery@humana.com

Tom Noland
Humana Corporate Communications
(502) 580-3674
E-mail:   tnoland@humana.com

 

Humana Inc. Reports First Quarter 2006 Financial Results

of $0.50 Earnings per Share

 

LOUISVILLE, KY (May 1, 2006) - Humana Inc. (NYSE: HUM) today reported $0.50 in diluted earnings per common share (EPS) for the quarter ended March 31, 2006 (1Q06), within the range of the company's guidance for 1Q06 EPS of $0.50 to $0.55. As expected, the change in the quarterly pattern of 2006 earnings resulting from the introduction of the company's stand-alone Medicare Prescription Drug Plans (PDPs), combined with higher Medicare sales, marketing, and service infrastructure costs versus a year ago, resulted in a year-over-year decline in 1Q06 EPS, while driving an increase in Medicare revenues of over $1.25 billion, or 127 percent. EPS for the quarter ended March 31, 2005 (1Q05) of $0.65 (a) was $0.15 higher than 1Q06 EPS.

The company estimates EPS for the year ending December 31, 2006 (FY06E) will be in the range of $2.82 to $2.88 versus $1.79 (a) for the year ended December 31, 2005 (FY05), a growth rate of approximately 60 percent.

"This is a transformative year for Humana, and we're on track to achieve the objectives that will produce 2006 growth in both earnings and revenues of more than 50 percent," said Michael B. McCallister, Humana's president and chief executive officer. "Better-than-expected Medicare membership growth and good progress in our Commercial business during the first quarter has led us to raise our guidance this morning for full-year earnings per share. By maximizing this year's opportunities, we're also establishing a strong foundation for robust growth in 2007 and beyond."

The company also evaluates its earnings performance on a non-GAAP basis. See management's explanation under item (b) of the "Footnotes" section of this news release. Below is a reconciliation of GAAP to non-GAAP results for 1Q06 and FY06E.

1Q06 Consolidated Results of Operations

($ in thousands except EPS)

Pretax Income

Pretax Margin

Net Income

EPS

Year-over-Year Change in EPS (a)

GAAP results

$131,208

2.8%

$83,715 

$0.50 

(23%)

Excess net realized capital gains (c)

(29,113)

(0.6%)

(18,167)

(0.11)

Non-GAAP results (b)

$102,095

2.2%

$65,548 

$0.39 

(24%)(e)

FY06E Consolidated Results of Operations

EPS

EPS Growth Rate (a)

GAAP results

$2.82 to $2.88

58% to 61%

Excess net realized capital gains (c)

(0.11)

Non-GAAP results (b)

$2.71 to $2.77

34% to 37%(f)

 

Revenues - 1Q06 consolidated revenues rose 39 percent to $4.70 billion from $3.39 billion in 1Q05, with total premium and administrative services fees up 37 percent compared to the prior year's quarter. These substantial increases are primarily the result of significantly higher enrollment in the company's Medicare Advantage plans and the implementation of stand-alone PDPs for Medicare beneficiaries on January 1, 2006.

Medical costs - The company's medical expense ratio (medical expenses as a percent of premium revenue or MER) of 83.7 percent in 1Q06 was unchanged from that for 1Q05 as significant year-over-year improvement in this metric for the Commercial Segment was offset by a higher Government Segment MER. The higher MER in the Government Segment results from the inclusion of stand-alone PDP results in the current period.

Selling, general, & administrative (SG&A) expenses - As expected, the company's consolidated SG&A expense ratio (SG&A expenses as a percent of premiums plus administrative services fees or SG&A expense ratio) increased to 16.1 percent for 1Q06 from 14.3 percent (a) in 1Q05 due to the increase in SG&A expenses associated with the Medicare expansion coupled with a substantial increase in the percentage of Commercial medical members in ASO accounts. The increase in SG&A related to Medicare results from the build out of infrastructure and support functions in advance of the anticipated escalation in enrollment and from sales and marketing costs associated with the more concentrated 2006 Medicare selling season.

Acquisition - Effective May 1, 2006, the company completed its acquisition of CHA Health, a Kentucky-based health plan, adding approximately 92,500 Commercial medical members for cash consideration of approximately $65.0 million.

Government Segment Results Summary

1Q06 Government Segment Results

($ in thousands)

Pretax Income

Pretax Margin

GAAP results

$21,572

0.7%

Excess net realized capital gains (c)

(1,872)

-

Non-GAAP results (b)

$19,700

0.7%

 

Pretax results:

Enrollment:

Revenues:

Medical Expenses:

SG&A Expenses:

Commercial Segment Results Summary

1Q06 Commercial Segment Results

($ in thousands)

Pretax Income

Pretax Margin

GAAP results

$109,636

6.4%

Excess net realized capital gains (c)

(27,241)

(1.5%)

Non-GAAP results (b)

$82,395

4.9%

 

Pretax results:

Enrollment:

Revenues:

Medical Expenses:

SG&A Expenses:

Cash Flows from Operations

Cash flows provided by operations for 1Q06 of $1.01 billion compared to $95.6 million (a) in 1Q05. The company also evaluates operating cash flows on a non-GAAP basis, as described in footnote (d) of the "Footnotes" section of this news release.

Cash flows from operations
($ in millions)

1Q06

1Q05(a)

GAAP cash flows provided by operations

$1,008.0

$95.6

Timing of premium payment from CMS (d)

(774.7)

19.8

Non-GAAP cash flows provided by operations (b) (d)

$233.3

$115.4

 

Non-GAAP cash flows provided by operations increased to $233.3 million in 1Q06 from $115.4 million (a) in 1Q05 driven by growth in the company's Medicare operations. The company continues to expect that cash flows from operations for 2006 will be in the range of $750 million to $850 million driven by expected higher earnings.

Footnotes

  1. In accordance with Generally Accepted Accounting Principles (GAAP), Humana adopted the retrospective method for implementing new stock option accounting rules on January 1, 2006. Consequently, prior period results in this news release reflect the restatement for the expensing of stock options.
  2. The Company has included certain financial measures that are not in accordance with GAAP in its summary of financial results and earnings projections within this news release. The company believes that these non-GAAP measures, when presented in conjunction with comparable GAAP measures, are useful to both management and its investors in analyzing the company's ongoing business and operating performance. Internally, management uses these non-GAAP financial measures as indicators of business performance, as well as for operational planning and decision making purposes. Non-GAAP financial measures should be considered in addition to, but not as a substitute for, or superior to, financial measures prepared in accordance with GAAP.
  3. During 1Q06 the company realized a gain on the sale of an investment totaling approximately $52 million (pretax) or $0.19 in EPS, which is $34 million (pretax) or $0.13 per share higher than the capital gains assumed in the company's 2006 non-GAAP EPS guidance and $34 million (pretax) higher than the capital gains realized in 2005. The company, in turn, donated $0.02 per share of the excess gains to the Humana Foundation.
  4. 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.
  5. Computed by comparing 1Q06 non-GAAP EPS to 1Q05 non-GAAP EPS of $0.51. 1Q05 GAAP EPS of $0.65 included the realization of a tax gain contingency of $0.14 per share.
  6. Computed by comparing FY06E non-GAAP EPS to FY05 non-GAAP EPS of $2.02. FY05 GAAP EPS of $1.79 included expenses associated with a class action litigation settlement of $0.27 per share, expenses related to Hurricane Katrina of $0.10 per share, and the benefit from the realization of a tax gain contingency of $0.14 per share.

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.

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, 2005, as filed by Humana with the Securities and Exchange Commission.

About Humana

Humana Inc., headquartered in Louisville, Ky., is one of the nation's largest publicly traded health benefits companies, with approximately 9.3 million medical members. 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 45-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:

 

Humana Inc.
GAAP Earnings Guidance Points
For the year ending December 31, 2006
As of May 1, 2006

Diluted earnings per common share

FY06: $2.82 to $2.88

2Q06: $0.31 to $0.36

Revenues

Consolidated: $21 billion to $22 billion

Medicare Advantage: $8.5 billion to $10.2 billion

Medicare stand-alone PDPs: $2.6 billion to $2.7 billion

TRICARE: $2.5 billion to $2.9 billion

Commercial: $6.5 billion to $7.0 billion

Year-end medical membership

Medicare Advantage: 900,000 to 1.1 million

Medicare stand-alone PDPs: 2.7 million to 2.9 million

TRICARE: No material change from prior year

Medicaid: Down approximately 40,000

Commercial: No material change from prior year

Medical costs

Medicare - stand-alone PDPs: MER in the range of 85% to 88%

Commercial: Medical cost trends in the range of 6% to 7%; premium yields at least in line with medical cost trends

Selling, general & administrative expenses

Consolidated SG&A expense ratio of 13% to 14%

Pretax results

(1)excluding allocation of investment and other income and interest expense

Medicare Advantage: 3% to 5% pretax margin(1)

Medicare stand-alone PDPs: 1% to 3% pretax margin(1)

TRICARE: Approximately 3% to 4% pretax margin(1)

Commercial Segment: $180 million to $220 million

Cash flows from operations

$750 million to $850 million

Capital expenditures

$125 million to $135 million

Effective tax rate

Approximately 35% to 37%

Weighted average shares outstanding used to compute diluted earnings per common share

Approximately 168 million

 

 

 

 

 

 

 

 

Humana Inc.

 

 

Statistical Schedules

 

 

And

 

 

Supplementary Information

 

 

1Q06 Earnings Release

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Humana Inc.

Statistical Schedules and Supplementary Information

1Q06 Earnings Release

Contents

Page

Description

S-3

Consolidated Statements of Income

S-4

Consolidated Balance Sheets

S-5

Consolidated Statements of Cash Flows

S-6

2005 Quarters Restated to Include Stock Options Expense

S-7

2003 Through 2005 Restated to Include Stock Options Expense

S-8

Key Income Statement Ratios and Segment Operating Results

S-9

Premiums and Administrative Services Fees Detail

S-10

Membership Detail

S-11

Percentage of Ending Membership under Capitation Arrangements

S-12

Detail of Medical and Other Expenses Payable Balance and Year-to-Date Changes

S-13-14

Medical Claims Reserves Statistics

S-15

Footnotes

 

 

 

 

 

 

 

 

 

 

 

 

Humana Inc.
Consolidated Statements of Income
In thousands, except per share results

Three Months Ended March 31,

Dollar

Percentage

2006

2005 (A)

Change

Change

Revenues:

Premiums

$4,521,486

$3,290,815

$1,230,671

37.4%

Administrative services fees

78,678

63,513

15,165

23.9%

Investment income

98,902

30,211

68,691

227.4%

Other income

5,299

2,686

2,613

97.3%

Total revenues

4,704,365

3,387,225

1,317,140

38.9%

Operating expenses:

Medical

3,783,926

2,753,733

1,030,193

37.4%

Selling, general and administrative

740,886

479,040

261,846

54.7%

Depreciation

29,852

24,806

5,046

20.3%

Other intangible amortization

5,054

4,443

611

13.8%

Total operating expenses

4,559,718

3,262,022

1,297,696

39.8%

Income from operations

144,647

125,203

19,444

15.5%

Interest expense

13,439

8,523

4,916

57.7%

Income before income taxes

131,208

116,680

14,528

12.5%

Provision for income taxes

47,493

9,945

37,548

377.6%

Net income

$83,715

$106,735

($23,020)

-21.6%

Basic earnings per common share

$0.51

$0.66

($0.15)

-22.7%

Diluted earnings per common share

$0.50

$0.65

($0.15)

-23.1%

Shares used in computing basic earnings per common share

163,116

160,911

Shares used in computing diluted earnings per common share

167,325

164,496

 

Humana Inc.
Consolidated Balance Sheets
Dollars in thousands, except par values

March 31,

December 31,

Dollar

Percentage

2006

2005 (A)

Change

Change

Assets

Current assets:

Cash and cash equivalents

$1,843,405

$732,016

Investment securities

2,623,009

2,354,904

Receivables, net:

Premiums

763,061

723,190

Administrative services fees

21,652

15,462

Securities lending collateral

250,322

47,610

Other

517,877

333,004

Total current assets

6,019,326

4,206,186

$1,813,140

43.1%

Property and equipment

498,267

484,412

Other assets:

Long-term investment securities

374,583

391,035

Goodwill

1,265,176

1,264,575

Other

540,668

523,406

Total other assets

2,180,427

2,179,016

Total assets

$8,698,020

$6,869,614

$1,828,406

26.6%

Liabilities and Stockholders' Equity

Current liabilities:

Medical and other expenses payable

$2,169,489

$1,909,682

Trade accounts payable and accrued expenses

871,231

560,550

Book overdraft

275,587

280,005

Securities lending payable

250,322

47,610

Unearned revenues

920,678

120,489

Current portion of long-term debt

300,231

301,254

Total current liabilities

4,787,538

3,219,590

$1,567,948

48.7%

Long-term debt

601,225

513,790

Other long-term liabilities

741,498

627,360

Total liabilities

6,130,261

4,360,740

$1,769,521

40.6%

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;

180,496,685 issued at March 31, 2006

30,085

29,843

Capital in excess of par value

1,264,161

1,235,888

Retained earnings

1,505,390

1,421,675

Accumulated other comprehensive (loss) income

(28,408)

24,832

Treasury stock, at cost, 15,848,413 shares at March 31, 2006

(203,469)

(203,364)

Total stockholders' equity

2,567,759

2,508,874

$58,885

2.3%

Total liabilities and stockholders' equity

$8,698,020

$6,869,614

$1,828,406

26.6%

Debt to total capitalization ratio

26.0%

24.5%

 

 

Humana Inc.
Consolidated Statements of Cash Flows
Dollars in thousands

 

 

Three Months Ended March 31,

 

Dollar

Percentage

 

 

 

2006

2005 (A)

 

Change

Change

 

Cash flows from operating activities

 

 

 

 

 

 

 

Net income

$83,715

$106,735

 

 

 

 

 

Adjustments to reconcile net income to net cash provided by operating activities:

 

 

 

 

 

 

 

Depreciation and amortization

34,906

29,249

 

 

 

 

 

Stock compensation

6,580

6,724

 

 

 

 

 

(Benefit) provision for deferred income taxes

(3,705)

8,062

 

 

 

 

 

Changes in operating assets and liabilities excluding

 

 

 

 

 

 

 

the effects of acquisitions:

 

 

 

 

 

 

 

Receivables

(46,061)

(6,425)

 

 

 

 

 

Other assets

(185,250)

(8,360)

 

 

 

 

 

Medical and other expenses payable

259,807

86,665

 

 

 

 

 

Other liabilities

114,752

(103,957)

 

 

 

 

 

Unearned revenues

800,189

(22,416)

 

 

 

 

 

Other

(56,960)

(704)

 

 

 

 

Net cash provided by operating activities

1,007,973

95,573

 

$912,400

954.7%

 

 

 

 

 

 

 

 

 

Cash flows from investing activities

 

 

 

 

 

 

 

Acquisitions, net of cash acquired

(113)

(348,099)

 

 

 

 

 

Purchases of property and equipment

(45,261)

(36,193)

 

 

 

 

 

Proceeds from sales of property and equipment

2,138

8

 

 

 

 

 

Purchases of investment securities

(1,663,658)

(714,371)

 

 

 

 

 

Proceeds from maturities of investment securities

910,108

261,665

 

 

 

 

 

Proceeds from sales of investment securities

559,830

434,506

 

 

 

 

 

Change in securities lending collateral

(202,712)

(48,838)

 

 

 

 

Net cash used in investing activities

(439,668)

(451,322)

 

$11,654

2.6%

 

 

 

 

 

 

 

 

 

Cash flows from financing activities

 

 

 

 

 

 

 

Receipts from CMS contract deposits

494,194

-

 

 

 

 

 

Withdrawals from CMS contract deposits

(273,444)

-

 

 

 

 

 

Borrowings under credit agreement

100,000

294,000

 

 

 

 

 

Repayments under credit agreement

-

(25,000)

 

 

 

 

 

Change in book overdraft

(4,418)

681

 

 

 

 

 

Change in securities lending payable

202,712

48,838

 

 

 

 

 

Common stock repurchases

(105)

(1,376)

 

 

 

 

 

Tax benefit from stock compensation

8,404

3,655

 

 

 

 

 

Proceeds from stock option exercises and other

15,741

15,136

 

 

 

 

Net cash provided by financing activities

543,084

335,934

 

$207,150

61.7%

 

 

 

 

 

 

 

 

 

Increase (decrease) in cash and cash equivalents

1,111,389

(19,815)

 

 

Cash and cash equivalents at beginning of period

732,016

580,079

 

 

 

 

 

 

 

 

Cash and cash equivalents at end of period

$1,843,405

$560,264

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Humana Inc.
2005 Quarters Restated to Include Stock Options Expense
In thousands, except per share results

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1Q05

 

2Q05

 

3Q05

 

4Q05

 

Reported

 

Restated (A)

 

Reported

 

Restated (A)

 

Reported

 

Restated (A)

 

Reported

 

Restated (A)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Revenues

$3,387,225

 

$3,387,225

 

$3,546,361

 

$3,546,361

 

$3,821,461

 

$3,821,461

 

$3,663,080

 

$3,663,080

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pretax income (loss):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Government

$72,224

 

$70,472

 

$104,092

 

$102,531

 

$89,557

 

$87,868

 

$57,395

 

$55,805

Commercial

49,463

 

46,208

 

25,215

 

22,317

 

(18,053)

 

(21,190)

 

41,821

 

38,869

Consolidated

$121,687

 

$116,680

 

$129,307

 

$124,848

 

$71,504

 

$66,678

 

$99,216

 

$94,674

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income

$109,795

 

$106,735

 

$84,137

 

$81,412

 

$49,944

 

$46,807

 

$64,607

 

$61,776

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Diluted earnings per common share

$0.67

 

$0.65

 

$0.51

 

$0.49

 

$0.30

 

$0.28

 

$0.39

 

$0.37

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shares used in computing diluted earnings per

164,179

 

164,496

 

164,908

 

165,149

 

166,037

 

166,076

 

166,371

 

166,521

common share

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SG&A expense ratio:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Government

10.8%

 

10.9%

 

10.6%

 

10.6%

 

13.1%

 

13.2%

 

15.5%

 

15.6%

Commercial

17.6%

 

17.8%

 

17.5%

 

17.7%

 

20.0%

 

20.2%

 

18.1%

 

18.3%

Consolidated

14.1%

 

14.3%

 

13.8%

 

14.0%

 

16.2%

 

16.3%

 

16.7%

 

16.9%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total assets

$6,149,593

 

$6,149,593

 

$6,277,907

 

$6,277,907

 

$6,832,421

 

$6,832,421

 

$6,869,614

 

$6,869,614

Total liabilities

$3,949,788

 

$3,916,471

 

$3,961,719

 

$3,927,862

 

$4,466,451

 

$4,432,166

 

$4,395,509

 

$4,360,740

Total stockholders' equity

$2,199,805

 

$2,233,122

 

$2,316,188

 

$2,350,045

 

$2,365,970

 

$2,400,255

 

$2,474,105

 

$2,508,874

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net cash provided by (used in) operating activities

$99,228

 

$95,573

 

$181,857

 

$179,287

 

$591,039

 

$586,006

 

($246,497)

 

($250,784)

Net cash used in investing activities

($451,322)

 

($451,322)

 

($59,909)

 

($59,909)

 

($96,395)

 

($96,395)

 

($159,650)

 

($159,650)

Net cash provided by (used in) financing activities

$332,279

 

$335,934

 

($78,422)

 

($75,852)

 

($119,498)

 

($114,465)

 

$159,227

 

$163,514

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Humana Inc.
2003 Through 2005 Restated to Include Stock Options Expense
 In thousands, except per share results

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For the year ended

 

For the year ended

 

For the year ended

 

 

 

December 31, 2005

 

December 31, 2004

 

December 31, 2003

 

 

 

Reported

 

Restated (A)

 

Reported

 

Restated (A)

 

Reported

 

Restated (A)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Revenues

 

$14,418,127

 

$14,418,127

 

$13,104,325

 

$13,104,325

 

$12,226,311

 

$12,226,311

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pretax income:

 

 

 

 

 

 

 

 

 

 

 

 

 

Government

 

$323,268

 

$316,676

 

$273,840

 

$269,063

 

$223,706

 

$221,240

 

Commercial

 

98,446

 

86,204

 

142,010

 

130,315

 

121,010

 

114,973

 

Consolidated

 

$421,714

 

$402,880

 

$415,850

 

$399,378

 

$344,716

 

$336,213

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income

 

$308,483

 

$296,730

 

$280,012

 

$269,947

 

$228,934

 

$223,739

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Diluted earnings per common share

 

$1.87

 

$1.79

 

$1.72

 

$1.66

 

$1.41

 

$1.38

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shares used in computing diluted earnings per common share

 

165,374

 

165,560

 

162,456

 

162,905

 

161,960

 

162,406

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SG&A expense ratio:

 

 

 

 

 

 

 

 

 

 

 

 

 

Government

 

12.6%

 

12.7%

 

12.2%

 

12.3%

 

13.4%

 

13.5%

 

Commercial

 

18.3%

 

18.5%

 

16.4%

 

16.5%

 

16.9%

 

17.0%

 

Consolidated

 

15.3%

 

15.4%

 

14.5%

 

14.6%

 

15.4%

 

15.4%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total assets

 

$6,869,614

 

$6,869,614

 

$5,657,617

 

$5,657,617

 

$5,379,814

 

$5,379,814

 

Total liabilities

 

$4,395,509

 

$4,360,740

 

$3,567,493

 

$3,533,369

 

$3,543,865

 

$3,510,842

 

Total stockholders' equity

 

$2,474,105

 

$2,508,874

 

$2,090,124

 

$2,124,248

 

$1,835,949

 

$1,868,972

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net cash provided by operating activities

 

$625,627

 

$610,082

 

$347,809

 

$344,061

 

$413,140

 

$397,921

 

Net cash used in investing activities

 

($767,276)

 

($767,276)

 

($624,081)

 

($624,081)

 

($382,837)

 

($382,837)

 

Net cash provided by (used in) financing activities

 

$293,586

 

$309,131

 

($75,053)

 

($71,305)

 

$179,744

 

$194,963

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Humana Inc.
Key Income Statement Ratios and Segment Operating Results
Dollars in thousands

 

 

 

 

 

 

 

 

 

 

Three Months Ended March 31,

 

 

 

 

 

 

 

 

 

 

 

 

Percentage

 

2006

2005 (A)

 

Difference

Change

 

Medical expense ratio

 

 

 

 

 

 

 

Government Segment

85.6%

85.1%

 

0.5%

 

 

 

Commercial Segment

80.1%

82.2%

 

-2.1%

 

 

 

Consolidated

83.7%

83.7%

 

0.0%

 

 

Selling, general, and administrative expense ratio

 

 

 

 

 

 

 

Government Segment

13.8%

10.9%

 

2.9%

 

 

 

Commercial Segment

20.4%

17.8%

 

2.6%

 

 

 

Consolidated

16.1%

14.3%

 

1.8%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Detail of Pretax Income

 

 

 

 

 

 

 

Government Segment

$21,572

$70,472

 

($48,900)

-69.4%

 

 

Commercial Segment

109,636

46,208

 

63,428

137.3%

 

 

Consolidated

$131,208

$116,680

 

$14,528

12.5%

 

 

 

 

 

 

 

 

 

 

 

Detail of Pretax Margins

 

 

 

 

 

 

 

Government Segment

0.7%

4.2%

 

-3.5%

 

 

 

Commercial Segment

6.4%

2.7%

 

3.7%

 

 

 

Consolidated

2.8%

3.4%

 

-0.6%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Humana Inc.
Premiums and Administrative Services Fees Detail
Dollars in thousands, except PMPM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Per Member per Month (B)

 

 

 

 

 

 

Three Months Ended March 31,

 

Dollar

Percentage

 

Three Months Ended March 31,

 

Dollar

Percentage

 

 

 

2006

2005

 

Change

Change

 

2006

2005

 

Change

Change

 

Premium revenues

 

 

 

 

 

 

 

 

 

 

 

 

Government Segment:

 

 

 

 

 

 

 

 

 

 

 

 

 

Medicare Advantage

$1,720,843

$983,141

 

$737,702

75.0%

 

$830

$786

 

$44

5.5%

 

 

Medicare - Stand-alone PDPs

515,157

-

 

515,157

100.0%

 

99

-

 

99

100.0%

 

 

Total Medicare

2,236,000

983,141

 

1,252,859

127.4%

 

308

786

 

(478)

-60.8%

 

 

TRICARE insured (C)

600,754

562,328

 

38,426

6.8%

 

116

106

 

9

8.9%

 

 

Medicaid

129,467

134,414

 

(4,947)

-3.7%

 

99

94

 

6

5.9%

 

 

Total Government Segment premiums

2,966,221

1,679,883

 

1,286,338

76.6%

 

216

210

 

5

2.5%

 

Commercial Segment:

 

 

 

 

 

 

 

 

 

 

 

 

 

Fully insured medical

1,453,932

1,517,394

 

(63,462)

-4.2%

 

259

245

 

13

5.5%

 

 

Specialty

101,333

93,538

 

7,795

8.3%

 

21

20

 

1

6.5%

 

 

Total Commercial Segment premiums

1,555,265

1,610,932

 

(55,667)

-3.5%

 

158

157

 

1

0.4%

 

Total premium revenues

$4,521,486

$3,290,815

 

$1,230,671

37.4%

 

$191

$180

 

$11

6.1%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Administrative services fees

 

 

 

 

 

 

 

 

 

 

 

 

 

Government segment (TRICARE-related) (C)

$11,191

$13,402

 

($2,211)

-16.5%

 

$3

$4

 

($1)

-19.5%

 

 

Commercial segment

67,487

50,111

 

17,376

34.7%

 

12

10

 

2

18.4%

 

Total administrative services fees

$78,678

$63,513

 

$15,165

23.9%

 

$9

$8

 

$1

13.0%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Humana Inc.
Membership Detail
In thousands

 

 

 

 

Year-over-year

 

 

 

Sequential

 

 

 

 

Ending

Ending

 

 

Percentage

 

Ending

 

 

Percentage

 

 

 

Average - 1Q06

March 31, 2006

March 31, 2005

 

Difference

Change

 

December 31, 2005

 

Difference

Change

 

Medical Membership:

 

 

 

 

 

 

 

 

 

 

 

 

Government Segment:

 

 

 

 

 

 

 

 

 

 

 

 

 

Medicare Advantage - HMO

439.2

443.7

412.4

 

31.3

7.6%

 

427.9

 

15.8

3.7%

 

 

Medicare Advantage - PPO

28.3

35.4

2.3

 

33.1

1439.1%

 

8.6

 

26.8

311.6%

 

 

Medicare Advantage - PFFS

223.7

262.1

35.2

 

226.9

644.6%

 

121.3

 

140.8

116.1%

 

 

Total Medicare Advantage

691.2

741.2

449.9

 

291.3

64.7%

 

557.8

 

183.4

32.9%

 

 

Medicare - PDP - Standard

1,193.6

1,289.2

-

 

1,289.2

100.0%

 

-

 

1,289.2

100.0%

 

 

Medicare - PDP - Enhanced

329.9

421.0

-

 

421.0

100.0%

 

-

 

421.0

100.0%

 

 

Medicare - PDP - Complete

203.8

248.8

-

 

248.8

100.0%

 

-

 

248.8

100.0%

 

 

Total Medicare - Stand-alone PDPs

1,727.3

1,959.0

-

 

1,959.0

100.0%

 

-

 

1,959.0

100.0%

 

 

Total Medicare

2,418.5

2,700.2

449.9

 

2,250.3

500.2%

 

557.8

 

2,142.4

384.1%

 

 

TRICARE insured

1,733.5

1,724.7

1,723.4

 

1.3

0.1%

 

1,750.9

 

(26.2)

-1.5%

 

 

TRICARE ASO

1,145.5

1,149.3

1,148.4

 

0.9

0.1%

 

1,138.2

 

11.1

1.0%

 

 

Total TRICARE

2,879.0

2,874.0

2,871.8

 

2.2

0.1%

 

2,889.1

 

(15.1)

-0.5%

 

 

Medicaid

434.3

427.0

477.2

 

(50.2)

-10.5%

 

457.9

 

(30.9)

-6.7%

 

 

Total Government Segment

5,731.8

6,001.2

3,798.9

 

2,202.3

58.0%

 

3,904.8

 

2,096.4

53.7%

 

Commercial Segment:

 

 

 

 

 

 

 

 

 

 

 

 

 

Fully insured medical:

 

 

 

 

 

 

 

 

 

 

 

 

 

Group

1,705.6

1,695.1

1,902.8

 

(207.7)

-10.9%

 

1,836.9

 

(141.8)

-7.7%

 

 

Individual

161.1

163.1

133.6

 

29.5

22.1%

 

158.1

 

5.0

3.2%

 

 

Medicare supplement

5.7

6.0

2.9

 

3.1

106.9%

 

4.8

 

1.2

25.0%

 

 

Total fully insured medical

1,872.4

1,864.2

2,039.3

 

(175.1)

-8.6%

 

1,999.8

 

(135.6)

-6.8%

 

 

ASO

1,399.2

1,395.2

1,180.1

 

215.1

18.2%

 

1,171.0

 

224.2

19.1%

 

 

Total Commercial Segment

3,271.6

3,259.4

3,219.4

 

40.0

1.2%

 

3,170.8

 

88.6

2.8%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total medical membership

9,003.4

9,260.6

7,018.3

 

2,242.3

31.9%

 

7,075.6

 

2,185.0

30.9%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Specialty Membership (all Commercial Segment)

 

 

 

 

 

 

 

 

 

 

 

 

Dental - fully insured

951.3

950.6

874.6

 

76.0

8.7%

 

960.5

 

(9.9)

-1.0%

 

 

Dental - ASO

494.0

494.7

488.0

 

6.7

1.4%

 

496.0

 

(1.3)

-0.3%

 

 

Total dental

1,445.3

1,445.3

1,362.6

 

82.7

6.1%

 

1,456.5

 

(11.2)

-0.8%

 

 

Group life

422.2

421.3

444.9

 

(23.6)

-5.3%

 

429.2

 

(7.9)

-1.8%

 

 

Short-term disability

15.9

15.7

16.6

 

(0.9)

-5.4%

 

16.4

 

(0.7)

-4.3%

 

Total specialty membership

1,883.4

1,882.3

1,824.1

 

58.2

3.2%

 

1,902.1

 

(19.8)

-1.0%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Humana Inc.
Percentage of Ending Membership under Capitation Arrangements

 

Government Segment

Commercial Segment

 

 

March 31, 2006

Medicare Advantage

Medicare - stand-alone PDPs

TRICARE

Medicaid

Total Govt. Segment

Fully insured

ASO

Total Comm. Segment

Total Medical Membership

 

 

 

 

 

 

 

 

 

 

 

 

Capitated HMO hospital system based (D)

4.5%

 -

 -

 -

0.6%

2.0%

 -

1.1%

0.8%

 

Capitated HMO physician group based (D)

3.2%

 -

 -

35.5%

2.9%

1.8%

 -

1.0%

2.2%

 

Risk-sharing (E)

31.9%

 -

 -

59.6%

8.2%

2.3%

 -

1.3%

5.8%

 

All other membership

60.4%

100.0%

100.0%

4.9%

88.3%

93.9%

100.0%

96.6%

91.2%

 

Total medical membership

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

 

 

 

 

 

 

 

 

 

 

 

 

March 31, 2005

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Capitated HMO hospital system based (D)

8.1%

 -

 -

3.3%

1.4%

2.7%

 -

1.7%

1.5%

 

Capitated HMO physician group based (D)

0.9%

 -

 -

35.2%

4.5%

2.5%

 -

1.6%

3.2%

 

Risk-sharing (E)

52.5%

 -

 -

53.0%

12.9%

2.6%

 -

1.6%

7.7%

 

All other membership

38.5%

 -

100.0%

8.5%

81.2%

92.2%

100.0%

95.1%

87.6%

 

Total medical membership

100.0%

-

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Humana Inc.
Detail of Medical and Other Expenses Payable Balance and Year-to-Date Changes
Dollars in thousands

 

 

 

 

 

 

 

 

 

 

March 31,

December 31,

 

 Dollar

Percentage

 

 

 

2006

2005

 

Change

Change

 

Detail of medical and other expenses payable

 

 

 

 

 

 

 

IBNR and other medical expenses payable (F)

$1,313,806

$1,125,205

 

$188,601

16.8%

 

 

TRICARE IBNR (G)

346,774

409,413

 

(62,639)

-15.3%

 

 

TRICARE other medical expenses payable (H)

90,073

88,443

 

1,630

1.8%

 

 

Unprocessed claim inventories (I)

185,300

148,200

 

37,100

25.0%

 

 

Processed claim inventories (J)

83,945

83,635

 

310

0.4%

 

 

Payable to pharmacy benefit administrator (K)

149,591

54,786

 

94,805

173.0%

 

Total medical and other expenses payable

$2,169,489

$1,909,682

 

$259,807

13.6%

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

Year Ended

 

 

 

 

 

 

March 31, 2006

December 31, 2005

 

 

 

 

Year-to-date changes in medical and other expenses payable

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Balances at January 1

$1,909,682

$1,422,010

 

 

 

 

 

 

 

 

 

 

 

 

 

Acquisitions

-

37,375

 

 

 

 

 

 

 

 

 

 

 

 

 

Incurred related to:

 

 

 

 

 

 

 

Current year

3,964,706

11,765,662

 

 

 

 

 

Prior years - non-TRICARE (L)

(125,469)

(72,868)

 

 

 

 

 

Prior years - TRICARE (L) (M)

(59,207)

(41,324)

 

 

 

 

 

Total incurred

3,780,030

11,651,470

 

 

 

 

 

 

 

 

 

 

 

 

 

Paid related to:

 

 

 

 

 

 

 

Current year

(2,640,214)

(9,979,449)

 

 

 

 

 

Prior years

(880,009)

(1,221,724)

 

 

 

 

 

Total paid

(3,520,223)

(11,201,173)

 

 

 

 

 

 

 

 

 

 

 

 

 

Balances at end of period

$2,169,489

$1,909,682

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Humana Inc.
Medical Claims Reserves Statistics

Receipt Cycle Time (N)

 

 

2006

2005

Change

Percentage Change

 

1st Quarter Average

16.1

16.6

(0.5)

-3.0%

 

2nd Quarter Average

 -

15.9

N/A

N/A

 

3rd Quarter Average

 -

16.7

N/A

N/A

 

4th Quarter Average

 -

16.9

N/A

N/A

 

Full Year Average

16.1

16.5

(0.4)

-2.4%

 

 

 

 

 

 

Unprocessed Claims Inventories

 

 

 

 

 

 

 

 

 

 

Date

Estimated Valuation (000's)

Claim Item Counts

Number of Days on Hand

 

 

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

 

 

6/30/2005

$119,500

443,600

4.0

 

 

9/30/2005

$136,700

512,800

4.7

 

 

12/31/2005

$148,200

498,400

4.6

 

 

3/31/2006

$185,300

683,900

5.6

 

 

 

 

 

 

 

 

 

 

 

Humana Inc.
Medical Claims Reserves Statistics (Continued)

Days in Claims Payable (O) (Q)

 

Quarter Ended

Days in Claims Payable (DCP)

Annual Change

Percentage Change

DCP Excluding Capitation

Annual Change

Percentage Change

 

 

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%

 

 

6/30/2005

52.8

5.4

11.4%

58.6

4.5

8.3%

 

 

9/30/2005

54.0

2.2

4.2%

60.8

1.7

2.9%

 

 

12/31/2005

60.3

10.8

21.8%

66.6

11.8

21.5%

 

 

3/31/2006

 59.1

8.6

17.0%

65.5

9.4

16.8%

 

 

 

 

 

 

 

 

 

 

Year-to-Date Change in Days in Claims Payable (P) (Q)

 

 

 

 

 

 

 

 

 

2006

2005

 

 

 

DCP - 4th quarter of prior year

 

 60.3

 49.5

 

 

 

 

Components of year-to-date change in DCP:

 

 

 

 

 

Change in claims receipt cycle time

 

 (1.3)

 0.2

 

 

 

 

Change in unprocessed claims inventories

 

 1.0

 1.0

 

 

 

 

Change in processed claims inventories

 

 -

 (0.4)

 

 

 

 

Change in TRICARE reserve balances

 

 (4.3)

 3.9

 

 

 

 

Change in pharmacy payment cutoff

 

 (0.2)

 1.5

 

 

 

 

Growth in Medicare PFFS membership

 

 3.4

 1.2

 

 

 

 

Growth in individual membership

 

 1.1

 0.9

 

 

 

 

Change in provider payables under risk arrangements

 0.7

 1.4

 

 

 

 

All other

 

 

 (1.6)

 1.1

 

 

 

DCP - current quarter

 

 

59.1

60.3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Humana Inc.
Footnotes to Statistical Schedules and Supplementary Information
1Q06 Earnings Release

 

 

Footnote

 

(A)

Restated to include stock-based compensation expense. Under SFAS 123R, which the company adopted effective January 1, 2006 using the modified retrospective method, stock-based compensation expense is recognized based on the grant date fair value over the vesting period.

 

(B)

Computed based on average membership for the period (i.e., monthly ending membership during the period divided by the number of months in the period).

 

(C)

TRICARE revenues are not contracted on a per member basis.

 

(D)

In a limited number of circumstances, the company contracts with hospitals and physicians to accept financial risk for a defined set of HMO membership. In transferring this risk, the company prepays 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, the company generally agrees 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.

 

(E)

In some circumstances, the company contracts 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, the company processes substantially all of the claims under these arrangements.

 

(F)

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). Other medical expenses payable includes amounts payable to providers under capitation arrangements.

 

(G)

TRICARE IBNR decreased due to favorable development as more fully discussed in Footnote M below.

 

(H)

TRICARE other medical expenses 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 the company's balance sheet).

 

(I)

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 the company's behalf. Reserves for TRICARE unprocessed claims inventory are included in TRICARE IBNR.

 

(J)

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.

 

(K)

The balance due to the company's pharmacy benefit administrator fluctuates due to bi-weekly payments made three times a month and the month-end cutoff.

 

(L)

The impact of any change in "incurred related to prior years" claims may be offset as the company re-establishes the "incurred related to current year". The company's 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.

 

(M)

Changes in estimates of TRICARE incurred claims for prior years recognized during 2006 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.

 

(N)

The receipt cycle time measures the average length of time between when a claim was initially incurred and when the claim form was received. Receipt cycle time data for our largest claim processing platforms representing approximately 87% of the company's fully insured claims volume. Pharmacy claims are excluded from this measurement.

 

(O)

A common metric for monitoring medical claim reserve levels relative to the medical claims expense 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 the company has some providers under capitation payment arrangements (which do not require a medical claim IBNR reserve), the company has also summarized this metric excluding capitation expense.

 

(P)

DCP fluctuates due to a number of issues, the more significant of which are detailed in the rollforward of DCP from the fourth quarter of the prior year. Growth in certain product lines can also impact DCP for the quarter since a provision for claims would not have been recorded for members that had not yet enrolled earlier in the quarter, yet those members would have a provision and corresponding reserve recorded upon enrollment later in the quarter.

 

(Q)

Excludes the impact of Medicare stand-alone PDPs.

 

Humana Inc

Humana Inc.
2005 Quarters Restated to Include Stock Options Expense
In thousands, except per share results

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1Q05

 

2Q05

 

3Q05

 

4Q05

 

Reported

 

Restated (A)

 

Reported

 

Restated (A)

 

Reported

 

Restated (A)

 

Reported

 

Restated (A)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Revenues

$3,387,225

 

$3,387,225

 

$3,546,361

 

$3,546,361

 

$3,821,461

 

$3,821,461

 

$3,663,080

 

$3,663,080

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pretax income (loss):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Government

$72,224

 

$70,472

 

$104,092

 

$102,531

 

$89,557

 

$87,868

 

$57,395

 

$55,805

Commercial

49,463

 

46,208

 

25,215

 

22,317

 

(18,053)

 

(21,190)

 

41,821

 

38,869

Consolidated

$121,687

 

$116,680

 

$129,307

 

$124,848

 

$71,504

 

$66,678

 

$99,216

 

$94,674

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income

$109,795

 

$106,735

 

$84,137

 

$81,412

 

$49,944

 

$46,807

 

$64,607

 

$61,776

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Diluted earnings per common share

$0.67

 

$0.65

 

$0.51

 

$0.49

 

$0.30

 

$0.28

 

$0.39

 

$0.37

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shares used in computing diluted earnings per

164,179

 

164,496

 

164,908

 

165,149

 

166,037

 

166,076

 

166,371

 

166,521

common share

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SG&A expense ratio:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Government

10.8%

 

10.9%

 

10.6%

 

10.6%

 

13.1%

 

13.2%

 

15.5%

 

15.6%

Commercial

17.6%

 

17.8%

 

17.5%

 

17.7%

 

20.0%

 

20.2%

 

18.1%

 

18.3%

Consolidated

14.1%

 

14.3%

 

13.8%

 

14.0%

 

16.2%

 

16.3%

 

16.7%

 

16.9%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total assets

$6,149,593

 

$6,149,593

 

$6,277,907

 

$6,277,907

 

$6,832,421

 

$6,832,421

 

$6,869,614

 

$6,869,614

Total liabilities

$3,949,788

 

$3,916,471

 

$3,961,719

 

$3,927,862

 

$4,466,451

 

$4,432,166

 

$4,395,509

 

$4,360,740

Total stockholders' equity

$2,199,805

 

$2,233,122

 

$2,316,188

 

$2,350,045

 

$2,365,970

 

$2,400,255

 

$2,474,105

 

$2,508,874

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net cash provided by (used in) operating activities

$99,228

 

$95,573

 

$181,857

 

$179,287

 

$591,039

 

$586,006

 

($246,497)

 

($250,784)

Net cash used in investing activities

($451,322)

 

($451,322)

 

($59,909)

 

($59,909)

 

($96,395)

 

($96,395)

 

($159,650)

 

($159,650)

Net cash provided by (used in) financing activities

$332,279

 

$335,934

 

($78,422)

 

($75,852)

 

($119,498)

 

($114,465)

 

$159,227

 

$163,514

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Humana Inc.
2003 Through 2005 Restated to Include Stock Options Expense
 In thousands, except per share results

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For the year ended

 

For the year ended

 

For the year ended

 

 

 

December 31, 2005

 

December 31, 2004

 

December 31, 2003

 

 

 

Reported

 

Restated (A)

 

Reported

 

Restated (A)

 

Reported

 

Restated (A)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Revenues

 

$14,418,127

 

$14,418,127

 

$13,104,325

 

$13,104,325

 

$12,226,311

 

$12,226,311

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pretax income:

 

 

 

 

 

 

 

 

 

 

 

 

 

Government

 

$323,268

 

$316,676

 

$273,840

 

$269,063

 

$223,706

 

$221,240

 

Commercial

 

98,446

 

86,204

 

142,010

 

130,315

 

121,010

 

114,973

 

Consolidated

 

$421,714

 

$402,880

 

$415,850

 

$399,378

 

$344,716

 

$336,213

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income

 

$308,483

 

$296,730

 

$280,012

 

$269,947

 

$228,934

 

$223,739

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Diluted earnings per common share

 

$1.87

 

$1.79

 

$1.72

 

$1.66

 

$1.41

 

$1.38

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shares used in computing diluted earnings per common share

 

165,374

 

165,560

 

162,456

 

162,905

 

161,960

 

162,406

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SG&A expense ratio:

 

 

 

 

 

 

 

 

 

 

 

 

 

Government

 

12.6%

 

12.7%

 

12.2%

 

12.3%

 

13.4%

 

13.5%

 

Commercial

 

18.3%

 

18.5%

 

16.4%

 

16.5%

 

16.9%

 

17.0%

 

Consolidated

 

15.3%

 

15.4%

 

14.5%

 

14.6%

 

15.4%

 

15.4%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total assets

 

$6,869,614

 

$6,869,614

 

$5,657,617

 

$5,657,617

 

$5,379,814

 

$5,379,814

 

Total liabilities

 

$4,395,509

 

$4,360,740

 

$3,567,493

 

$3,533,369

 

$3,543,865

 

$3,510,842

 

Total stockholders' equity

 

$2,474,105

 

$2,508,874

 

$2,090,124

 

$2,124,248

 

$1,835,949

 

$1,868,972

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net cash provided by operating activities

 

$625,627

 

$610,082

 

$347,809

 

$344,061

 

$413,140

 

$397,921

 

Net cash used in investing activities

 

($767,276)

 

($767,276)

 

($624,081)

 

($624,081)

 

($382,837)

 

($382,837)

 

Net cash provided by (used in) financing activities

 

$293,586

 

$309,131

 

($75,053)

 

($71,305)

 

$179,744

 

$194,963