Humana Reports 2012 2Q Financial Results, Up 4%

 

LOUISVILLE, Ky.--(BUSINESS WIRE)-- Humana Inc. (NYSE: HUM) today reported diluted earnings per common share (EPS) for the quarter ended June 30, 2012 (2Q12) of $2.16, compared to $2.71 per share for the quarter ended June 30, 2011 (2Q11). For the six months ended June 30, 2012 (1H12) the company reported $3.65 in EPS compared to $4.57 for the six months ended June 30, 2011 (1H11).

Results for 2Q12 and 1H12 included $0.18 per share in expenses related to the previously-disclosed settlement of a litigation matter. Prior-year favorable medical claims reserve development for 2Q12 of $0.15 per share compared to $0.12 per share in 2Q11. Results for 1H12 and 1H11 included $0.18 per share and $0.44 per share, respectively, of prior-year favorable medical claims reserve development.

The company lowered EPS guidance for the year ending December 31, 2012 (FY12) to a range of $6.90 to $7.10 versus its previous estimate of $7.38 to $7.58. This reduction in FY12 EPS guidance primarily reflects higher-than-previously expected individual Medicare Advantage benefit ratios associated with new members and increased utilization for both new and existing members.

"Our company's strategy is sound, though we are disappointed by the need to lower our full-year earnings guidance," said Michael B. McCallister, Humana's Chairman of the Board and Chief Executive Officer. "We believe the steps we are taking to address certain short-term operational challenges will put us back on the path for sustainable earnings growth moving forward."

Consolidated Highlights

Revenues – 2Q12 consolidated revenues were $9.70 billion, an increase of $415 million, or 4 percent from $9.28 billion in 2Q11, with total premiums and services revenue of $9.60 billion up $407 million, or 4 percent compared to $9.19 billion in the prior year's quarter. The increase in consolidated revenues was primarily due to related increases in the Retail and Employer Group segments driven by increases in average membership of the company's individual and group Medicare Advantage plans. These increases were partially offset by the company's new South Region TRICARE contract being accounted for as self-funded versus fully-insured for the previous contract. This new contract became effective on April 1, 2012.

1H12 consolidated revenues rose $1.44 billion, or 8 percent to $19.92 billion from $18.48 billion in 1H11 with total premiums and services revenue of $19.73 billion also up 8 percent, increasing $1.43 billion compared to $18.30 billion in the prior year's period, driven primarily by the same factors as the second quarter year-over-year increase.

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Benefit expenses – The 2Q12 consolidated benefit ratio (benefit expenses as a percent of premiums) of 83.5 percent increased 140 basis points from 82.1 percent for the prior year's quarter due primarily to higher year-over-year benefit ratios for the Retail and Employer Group segments. The consolidated benefit ratio for 1H12 of 84.5 percent increased by 150 basis points from the 1H11 consolidated benefit ratio of 83.0 percent primarily due to the same factors impacting the 2Q12 year-over-year comparison.

Operating costs – The consolidated operating cost ratio (operating costs as a percent of total revenues less investment income) of 14.4 percent increased 140 basis points for 2Q12 compared to 13.0 percent in 2Q11. The increased year-over-year ratio primarily reflects the impact of the accounting for the company's new South Region TRICARE contract discussed above.

The 1H12 consolidated operating cost ratio of 14.0 percent increased 60 basis points from 13.4 percent for 1H11 primarily due to the same factor impacting the second quarter year-over-year comparison.

Retail Segment Highlights

Pretax results:

  • Retail Segment pretax income of $367 million in 2Q12 decreased $136 million from $503 million in 2Q11. For 1H12, pretax earnings for the Retail Segment of $482 million decreased by $238 million versus 1H11 pretax earnings for the segment of $720 million. These decreases were primarily driven by year-over-year increases in both the segment's benefit ratio and its operating cost ratio during 2Q12 and 1H12.

Enrollment:

  • Individual Medicare Advantage membership was 1,895,800 at June 30, 2012, an increase of 293,300 members, or 18 percent, from 1,602,500 at June 30, 2011. Individual Medicare Advantage membership has increased 255,500 or 16 percent from 1,640,300 at December 31, 2011.
  • The company acquired 12,100 members with the acquisition of MD Care effective December 30, 2011 and 62,600 members from the acquisition of Arcadian Management Services, Inc. (Arcadian) effective March 31, 2012. As previously announced, the company expects to divest approximately 12,600 members acquired with Arcadian effective January 1, 2013 in accordance with the company's previously disclosed agreement with the United States Department of Justice.
  • Membership in the company's individual stand-alone Prescription Drug Plans (PDPs) of 2,896,800 at June 30, 2012 was up 488,100, or 20 percent compared to 2,408,700 at June 30, 2011 and up 356,400, or 14 percent, from 2,540,400 at December 31, 2011. These increases resulted primarily from growth in the company's Humana-Walmart plan offering.
  • HumanaOne® medical membership increased to 443,800 at June 30, 2012, an increase of 40,100 or 10 percent, from 403,700 at June 30, 2011 and an increase of 10,200, or 2 percent, from 433,600 at December 31, 2011.
  • Membership in individual specialty products(a) of 906,200 at June 30, 2012 increased 225,700, or 33 percent, from 680,500 at June 30, 2011 and increased 123,700, or 16 percent from 782,500 at December 31, 2011. Both the sequential and year-over-year increases were primarily driven by increased sales in dental offerings.

Premiums and services revenue:

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  • 2Q12 premiums and services revenue for the Retail Segment totaled $6.28 billion, an increase of $882 million, or 16 percent from $5.40 billion in 2Q11. The increase was primarily the result of year-over-year membership growth for individual Medicare Advantage plans.

Benefit expenses:

  • The 2Q12 benefit ratio for the Retail Segment was 84.1 percent, an increase of 270 basis points from 81.4 percent in 2Q11. The increase was primarily driven by the planned increase associated with positioning for Health Care Reform funding changes and minimum medical loss ratio requirements, a higher-than-previously expected Medicare Advantage benefit ratio associated with new members and increased utilization for both new and existing members as well as a year-over-year increase in clinicians and other health care quality expenditures given the continued growth in membership.
  • Retail Segment prior-year favorable medical claims reserve development for 2Q12 of $24 million compared to $32 million in 2Q11 lowered the related benefit ratio by 40 basis points in 2Q12 and 60 basis points in 2Q11.

Operating costs:

  • The Retail Segment's operating cost ratio of 10.0 percent in 2Q12 increased 90 basis points from 9.1 percent in 2Q11 reflecting higher year-over-year clinical, provider and technological infrastructure spending.

Employer Group Segment Highlights

Pretax results:

  • Employer Group Segment pretax income of $114 million in 2Q12 increased $6 million compared to $108 million in 2Q11 as the benefit of a lower operating cost ratio during 2Q12 more than offset the year-over-year impact of a higher benefit ratio. For 1H12, pretax earnings for the Employer Group Segment of $235 million decreased by $12 million versus 1H11 pretax earnings for the segment of $247 million primarily reflecting a year-over-year increase in this segment's benefit ratio partially offset by a lower operating cost ratio compared to 1H11.

Enrollment:

  • Group Medicare Advantage membership was 388,400 at June 30, 2012, an increase of 78,700 members, or 25 percent, from 309,700 at June 30, 2011, and an increase of 70,200, or 22 percent, from 318,200 at December 31, 2011. These increases primarily reflect the addition of a large group retiree account that became effective January 1, 2012.
  • Group fully-insured commercial medical membership of 1,196,900 at June 30, 2012, increased 10,700, or 1 percent from 1,186,200 at June 30, 2011 and 16,700, or 1 percent from 1,180,200 at December 31, 2011. Second quarter year-over-year and year-to-date changes primarily reflected growth in small group membership being partially offset by declines in large group business.
  • Group ASO commercial medical membership declined to 1,228,800 at June 30, 2012, a decrease of 84,800, or 6 percent, from 1,313,600 at June 30, 2011 and a decrease of 63,500, or 5 percent, from 1,292,300 at December 31, 2011. These declines reflected a continuation of pricing discipline in a highly competitive environment for self-funded accounts.
  • Membership in Employer Group specialty products(a) of 6,957,800 at June 30, 2012 increased 288,200, or 4 percent, from 6,669,600 at June 30, 2011 and increased 425,200, or 7 percent from 6,532,600 at December 31, 2011 primarily due to increased cross-sales of such products and growth in stand-alone specialty product sales.

Premiums and services revenue:

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  • 2Q12 premiums and services revenue for the Employer Group Segment totaled $2.62 billion, an increase of $309 million, or 13 percent from $2.31 billion in 2Q11 due primarily to the result of increased group Medicare Advantage membership year over year.

Benefit expenses:

  • The 2Q12 benefit ratio for the Employer Group Segment was 82.2 percent, an increase of 100 basis points from 81.2 percent in 2Q11 primarily due to higher average group Medicare membership year over year. Group Medicare benefit ratios generally carry a higher benefit ratio than commercial group medical products.
  • Employer Group Segment prior-year favorable medical claims reserve development for 2Q12 of $12 million compared to unfavorable development of $8 million in 2Q11. As a result, this segment's benefit ratio was lowered by 50 basis points in 2Q12 and increased by 40 basis points in 2Q11.

Operating costs:

  • The Employer Group Segment's operating cost ratio of 15.9 percent in 2Q12 decreased 90 basis points from 16.8 percent in 2Q11 reflecting increased year-over-year membership in the company's group Medicare Advantage products which generally carry a lower operating cost ratio than the company's fully-insured commercial group products, as well as savings associated with operating cost reduction initiatives.

Health and Well-Being Services Segment Highlights

Pretax results:

  • Health and Well-Being Services Segment pretax income of $131 million in 2Q12 rose $43 million compared to $88 million in 2Q11 reflecting growth in the company's pharmacy solutions business, including higher utilization of the company's RightSourceRx® mail-order pharmacy by the company's members. For 1H12, pretax earnings for the Health and Well-Being Services Segment of $263 million increased by $78 million versus 1H11 pretax earnings for the segment of $185 million.

Script volume:

  • Script volumes for the Retail and Employer Group Segments' membership increased to approximately 59 million in 2Q12, up 8 million, or 15 percent, versus 2Q11 scripts of approximately 51 million. The year-over-year increase primarily reflects growth associated with higher average medical membership for 2Q12 than in 2Q11.

Services revenue:

  • Services revenue of $3.22 billion in 2Q12 for the Health and Well-Being Services Segment increased $484 million, or 18 percent from $2.73 billion in 2Q11. This increase was primarily driven by growth in the company's Medicare Advantage membership, who use the company's pharmacy benefit management services under its health plan offerings, as well as increased utilization of RightSourceRx mail-order pharmacy by the company's membership across all product lines.

Operating costs:

  • The Health and Well-Being Services Segment's operating cost ratio of 95.2 percent in 2Q12 decreased 80 basis points from 96.0 percent in 2Q11 reflecting better administrative cost leverage and improved wholesale drug costs associated with higher script volumes in the company's RightSourceRx mail-order pharmacy.

Other Businesses Highlights

  • On April 1, 2012, the company's new South Region TRICARE contract became effective with the Department of Defense (DoD). The company's new contract is structured similar to self-funded products versus a fully-insured structure for the company's previous South RegionTRICARE contract with the DoD. This change resulted in significant volatility in year-over-year comparisons for the company's Other Businesses.
  • During 2Q12, the company incurred benefit expenses of approximately $46 million, or $0.18 per share, related to the resolution of certain previously-disclosed litigation involving Humana Military Healthcare Services, Inc.

Balance Sheet

  • At June 30, 2012, the company's cash, cash equivalents, and investment securities of $13.53 billion, increased $285 million, or 2 percent from $13.25 billion at March 31, 2012.
  • Parent company cash and investments of $1.28 billion at June 30, 2012 increased $1.06 billion from $225 million at March 31, 2012, primarily reflecting dividends to the parent company from the operating subsidiaries. These dividends were partially offset by share repurchases and the payment of a cash dividend to stockholders during the second quarter.
  • Days in claims payable were 51.0 at June 30, 2012, up 0.9 days from 50.1 at March 31, 2012.
  • Debt-to-total capitalization at June 30, 2012 was 16.1 percent, down 30 basis points compared to 16.4 percent at March 31, 2012 primarily driven by higher capitalization associated with second quarter earnings.

Cash Flows from Operations

Cash flows provided by operations for 2Q12 totaled $706 million compared to cash flows provided by operations of $161 million in 2Q11. For the first half of 2012, cash flows provided by operations totaled $3.05 billion versus $957 million in cash flows from operations during the first half of 2011. The company also evaluates operating cash flows on a non-GAAP(b) basis:

                 
Net cash provided by operating activities

(in millions)

  2Q12   2Q11   1H12   1H11
GAAP   $ 706     $ 161   $ 3,052     $ 957
CMS Medicare premium payment timing (c)     (118 )  

-

    (2,133 )  

-

Non-GAAP (b)   $ 588     $ 161   $ 919     $ 957
                             

The year over year decrease in the non-GAAP(b) cash flows from operations is due to the effect on cash flows of changes in working capital accounts.

Share Repurchase Program and Cash Dividend

  • During 2Q12, the company repurchased 1,579,000 of its outstanding shares at an average price per share of $79.94 in connection with a share repurchase authorization for up to $1 billion approved by the company's Board of Directors in April 2012. As of June 30, 2012, $874 million of the April 2012 share repurchase authorization was remaining, with an expiration date of June 30, 2014.
  • A cash dividend payment of approximately $42 million, or $0.26 per share, for stockholders of record as of June 29, 2012, was paid on July 27, 2012 as approved by the company's Board of Directors in accordance with its quarterly cash dividend policy.

Footnotes

(a)

The company provides a full range of insured specialty products including dental, vision and other supplemental products. Members included in these products may not be unique to each product since members have the ability to enroll in multiple products. Other supplemental benefits include life, disability, and fixed benefit products including cancer and critical illness policies.

   

(b)

The Company has included certain financial measures that are not in accordance with Generally Accepted Accounting Principles (GAAP) in its summary of financial results within this earnings press 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.

   

(c)

Generally, when the first day of a month falls on a weekend or holiday, with the exception of January 1 (New Year's Day), the company receives this payment at the end of the previous month. Therefore 1Q12 included four monthly Medicare payments compared to only three monthly Medicare payments in 1Q11. While 2Q12 included three monthly payments as did 2Q11 the three payments in 2Q12 were related to May, June and July versus April, May, and June in 2Q11.

Conference Call & Virtual Slide Presentation

Humana will host a conference call, as well as a virtual slide presentation, at 5:00 p.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 at least 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 at least ten minutes in advance of the call. For those unable to participate in the live event, the virtual presentation archive may be accessed via the Historical Webcasts & Presentations section of the Investor Relations page at www.humana.com.

Cautionary Statement

This news release includes forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. When used in investor presentations, press releases, Securities and Exchange Commission (SEC) filings, and in oral statements made by or with the approval of one of Humana's executive officers, the words or phrases like "expects," "anticipates," "intends," "likely will result," "estimates," "projects" or variations of such words and similar expressions are intended to identify such forward-looking statements. These forward-looking statements are not guarantees of future performance and are subject to risks, uncertainties, and assumptions, including, among other things, information set forth in the "Risk Factors" section of the company's SEC filings, a summary of which includes but is not limited to the following:

  • If Humana does not design and price its products properly and competitively, if the premiums Humana charges are insufficient to cover the cost of health care services delivered to its members, or if its estimates of benefit expenses are inadequate, Humana's profitability could be materially adversely affected. Humana estimates the costs of its benefit expense payments, and designs and prices its products accordingly, using actuarial methods and assumptions based upon, among other relevant factors, claim payment patterns, medical cost inflation, and historical developments such as claim inventory levels and claim receipt patterns. These estimates, however, involve extensive judgment, and have considerable inherent variability that is extremely sensitive to payment patterns and medical cost trends.
  • If Humana fails to effectively implement its operational and strategic initiatives, including its Medicare initiatives, the company's business may be materially adversely affected, which is of particular importance given the concentration of the company's revenues in the Medicare business.
  • If Humana fails to properly maintain the integrity of its data, to strategically implement new information systems, to protect Humana's proprietary rights to its systems, or to defend against cyber-security attacks, the company's business may be materially adversely affected.
  • Humana's business may be materially adversely impacted by CMS's adoption of a new coding set for diagnoses.
  • Humana is involved in various legal actions and governmental and internal investigations, including without limitation, an ongoing internal investigation and litigation and government requests for information related to certain aspects of its Florida subsidiary operations, any of which, if resolved unfavorably to the company, could result in substantial monetary damages. Increased litigation and negative publicity could increase the company's cost of doing business.
  • As a government contractor, Humana is exposed to risks that may materially adversely affect its business or its willingness or ability to participate in government health care programs.
  • Recently enacted health insurance reform, including The Patient Protection and Affordable Care Act and The Health Care and Education Reconciliation Act of 2010, could have a material adverse effect on Humana's results of operations, including restricting revenue, enrollment and premium growth in certain products and market segments, restricting the company's ability to expand into new markets, increasing the company's medical and operating costs by, among other things, requiring a minimum benefit ratio on insured products (and particularly how the ratio may apply to Medicare plans, including aggregation, credibility thresholds, and its possible application to prescription drug plans), lowering the company's Medicare payment rates and increasing the company's expenses associated with a non-deductible federal premium tax and other assessments; financial position, including the company's ability to maintain the value of its goodwill; and cash flows. In addition, if the new non-deductible federal premium tax and other assessments, including a three-year commercial reinsurance fee, were imposed as enacted, and if Humana is unable to adjust its business model to address these new taxes and assessments, such as through the reduction of the company's operating costs, there can be no assurance that the non-deductible federal premium tax and other assessments would not have a material adverse effect on the company's results of operations, financial position, and cash flows.
  • Humana's business activities are subject to substantial government regulation. New laws or regulations, or changes in existing laws or regulations or their manner of application could increase the company's cost of doing business and may adversely affect the company's business, profitability and cash flows.
  • Any failure to manage administrative costs could hamper Humana's profitability.
  • Any failure by Humana to manage acquisitions and other significant transactions successfully may have a material adverse effect on its results of operations, financial position, and cash flows.
  • If Humana fails to develop and maintain satisfactory relationships with the providers of care to its members, the company's business may be adversely affected.
  • Humana's pharmacy business is highly competitive and subjects it to regulations in addition to those the company faces with its core health benefits businesses.
  • Changes in the prescription drug industry pricing benchmarks may adversely affect Humana's financial performance.
  • If Humana does not continue to earn and retain purchase discounts and volume rebates from pharmaceutical manufacturers at current levels, Humana's gross margins may decline.
  • Humana's ability to obtain funds from its subsidiaries is restricted by state insurance regulations.
  • Downgrades in Humana's debt ratings, should they occur, may adversely affect its business, results of operations, and financial condition.
  • Changes in economic conditions could adversely affect Humana's business and results of operations.
  • The securities and credit markets may experience volatility and disruption, which may adversely affect Humana's business.
  • Given the current economic climate, Humana's stock and the stock of other companies in the insurance industry may be increasingly subject to stock price and trading volume volatility.

In making forward-looking statements, Humana is not undertaking to address or update them in future filings or communications regarding its business or results. In light of these risks, uncertainties, and assumptions, the forward-looking events discussed herein may or may not occur. There also may be other risks that the company is unable to predict at this time. Any of these risks and uncertainties may cause actual results to differ materially from the results discussed in the forward-looking statements.

Humana advises investors to read the following documents as filed by the company with the SEC for further discussion both of the risks it faces and its historical performance:

  • Form 10-K for the year ended December 31, 2011;
  • Form 10-Q for the quarter ending March 31, 2012;
  • Form 8-Ks filed during 2012.

About Humana

Humana Inc., headquartered in Louisville, Kentucky, is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

More information regarding Humana is available to investors via the Investor Relations page of the company's web site at www.humana.com, including copies of:

  • Annual reports to stockholders;
  • Securities and Exchange Commission filings;
  • Most recent investor conference presentations;
  • Quarterly earnings news releases;
  • Replays of most recent earnings release conference calls;
  • Calendar of events (including upcoming earnings conference call dates and times, as well as planned interaction with research analysts and institutional investors);
  • Corporate Governance information

Humana Inc. – Earnings Guidance Points as of July 30, 2012

     
(in accordance with For the year ending December 31, 2012 Comments
Generally Accepted    
Accounting Principles)    
Diluted earnings Full year 2012: $6.90 to $7.10 Projections exclude the impact of future share
per common share (EPS) Third quarter 2012: $2.00 to $2.10 repurchases
    Projections anticipate weighted average
    shares outstanding of 165 million
Revenues Consolidated revenues: $39.0 billion to $39.5 billion Includes expected investment income in the
    range of $375 million to $395 million
     
  Total revenues: Segment-level revenues include intersegment
  Retail Segment: $24.5 billion to $25.0 billion amounts that eliminate in consolidation
  Employer Group Segment: $10.5 billion to $11.0 billion  
  Health and Well-Being Services Segment: $13.1 billion to $13.3 billion  
  Other Businesses: $2.50 billion to $2.75 billion  
Ending medical Retail Segment:  
membership versus Medicare Advantage: Up 270,000 to 280,000  
prior year end Medicare stand-alone PDPs: Up 420,000 to 520,000  
 

HumanaOne: Up 25,000 to 35,000

 
  Medicare Supplement: Up 30,000 to 40,000  
  Employer Group Segment:  
  Medicare Advantage: Up approximately 80,000  
  Commercial Fully Insured: Up 35,000 to 45,000  
  Commercial ASO: Down 50,000 to 60,000  
Benefit ratios Retail Segment: 84.2% to 85.2% Benefit expenses as a percent of premiums
  Employer Group Segment: 84.0% to 85.0%  
Operating cost ratios Consolidated: 14.75% to 15.25% Consolidated operating costs as a percent of
  Health & Well-Being Services Segment: 95.25% to 95.75% total revenues excluding investment income
Consolidated depreciation $330 million to $345 million Approximately $40 million is expected to be
and amortization (cash   included in benefits expense on the income
flows)   statement
Consolidated interest Approximately $105 million  
expense    
Detailed pretax results Retail Segment: Segment-level pretax results and margins
  $1.0 billion to $1.1 billion; 4.2% to 4.4% pretax margin include the impact of net investment income
     
  Employer Group Segment:  
  $205 million to $215 million; Approximately 2% pretax margin  
  Health and Well-Being Services Segment:  
  $505 million to $515 million; 3.75% to 4.25% pretax margin  
Effective Tax Rate Approximately 36.7%  
Cash flows from $1.6 billion to $1.8 billion  
operations    
Capital expenditures Approximately $375 million  
 

Humana Inc.

Statistical Schedules

And

Supplementary Information

2Q12 Earnings Release

 
 
 

S-1

 

   
Humana Inc.
Statistical Schedules and Supplementary Information
2Q12 Earnings Release
   
Contents  
   

Page

Description

   
S-3-4 Consolidated Statements of Income
S-5-6 Quarterly Segment Financial Information
S-7-8 YTD Segment Financial Information
S-9 Consolidated Balance Sheets
S-10-11 Consolidated Statements of Cash Flows
S-12 Key Income Statement Ratios and Segment Operating Results
S-13 Pharmacy Statistics
S-14 Membership Detail
S-15-16 Premiums and Services Revenue Detail
S-17 Medicare Summary
S-18 Investments
S-19-21 Benefits Payable
S-22 Footnotes
   
   

S-2

 

                 
Humana Inc.
Consolidated Statements of Income
In millions, except per common share results
             
    Three Months Ended June 30,        
            Dollar   Percentage
    2012   2011   Change   Change
Revenues:                
Premiums   $ 9,166   $ 8,849   $ 317     3.6 %
Services     434     344     90     26.2 %
Investment income     99     91     8     8.8 %
Total revenues     9,699     9,284     415     4.5 %
Operating expenses:                
Benefits     7,652     7,269     383     5.3 %
Operating costs     1,384     1,193     191     16.0 %
Depreciation and amortization     73     68     5     7.4 %
Total operating expenses     9,109     8,530     579     6.8 %
Income from operations     590     754     (164 )   -21.8 %
Interest expense     26     28     (2 )   -7.1 %
Income before income taxes     564     726     (162 )   -22.3 %
Provision for income taxes     208     266     (58 )   -21.8 %
Net income   $ 356   $ 460   $ (104 )   -22.6 %
                 
Basic earnings per common share   $ 2.19   $ 2.76   $ (0.57 )   -20.7 %
Diluted earnings per common share   $ 2.16   $ 2.71   $ (0.55 )   -20.3 %
                 
Shares used in computing basic earnings per common share (000's)     162,816     167,021        
Shares used in computing diluted earnings per common share (000's)     164,639     169,560        
                 
   

 

 

 

       

S-3

                 
Humana Inc.
Consolidated Statements of Income
In millions, except per common share results
                 
    Six Months Ended June 30,        
            Dollar   Percentage
    2012   2011   Change   Change
Revenues:                
Premiums   $ 18,941   $ 17,616   $ 1,325     7.5 %
Services     784     679     105     15.5 %
Investment income     193     180     13     7.2 %
Total revenues     19,918     18,475     1,443     7.8 %
Operating expenses:                
Benefits     16,002     14,614     1,388     9.5 %
Operating costs     2,767     2,449     318     13.0 %
Depreciation and amortization     143     134     9     6.7 %
Total operating expenses     18,912     17,197     1,715     10.0 %
Income from operations     1,006     1,278     (272 )   -21.3 %
Interest expense     52     55     (3 )   -5.5 %
Income before income taxes     954     1,223     (269 )   -22.0 %
Provision for income taxes     350     448     (98 )   -21.9 %
Net income   $ 604   $ 775   $ (171 )   -22.1 %
                 
Basic earnings per common share   $ 3.70   $ 4.64   $ (0.94 )   -20.3 %
Diluted earnings per common share   $ 3.65   $ 4.57   $ (0.92 )   -20.1 %
                 
Shares used in computing basic earnings per common share (000's)     163,267     167,146        
Shares used in computing diluted earnings per common share (000's)     165,363     169,547        
                 
                 

S-4

 
Humana Inc.
2Q12 Segment Financial Information
In millions
            Health and            
        Employer   Well-Being   Other   Eliminations/    
 

 

Retail

  Group   Services   Businesses   Corporate   Consolidated
                         
Revenues - external customers                        
Premiums:                        
Medicare Advantage   $ 5,308     $ 1,011     $ -     $ -     $ -     $ 6,319  
Medicare stand-alone PDP     672       2       -       73       -       747  
Total Medicare     5,980       1,013       -       73       -       7,066  
Fully-insured     250       1,247       -       -       -       1,497  
Specialty     42       262       -       -       -       304  
Military services     -       -       -       44       -       44  
Medicaid and other (A)     -       -       -       255       -       255  
Total premiums     6,272       2,522       -       372       -       9,166  
Services revenue:                        
Provider     -       -       245       -       -       245  
ASO and other (B)     5       89       -       91       -       185  
Pharmacy     -       -       4       -       -       4  
Total services revenue     5       89       249       91       -       434  
Total revenues - external customers     6,277       2,611       249       463       -       9,600  
                         
Intersegment revenues                        
Services     1       4       2,377       -       (2,382 )     -  
Products     -       -       591       -       (591 )     -  
Total intersegment revenues     1       4       2,968       -       (2,973 )     -  
Investment income     20       10       -       15       54       99  
Total revenues     6,298       2,625       3,217       478       (2,919 )     9,699  
                         
Operating expenses:                        
Benefits     5,273       2,074       -       406       (101 )     7,652  
Operating costs     625       417       3,064       123       (2,845 )     1,384  
Depreciation and amortization     33       20       22       4       (6 )     73  
Total operating expenses     5,931       2,511       3,086       533       (2,952 )     9,109  
Income from operations     367       114       131       (55 )     33       590  
Interest expense     -       -       -       -       26       26  
Income (loss) before income taxes   $ 367     $ 114     $ 131     $ (55 )   $ 7     $ 564  
                         
Benefit ratio     84.1 %     82.2 %         109.1 %         83.5 %
Operating cost ratio (C)     10.0 %     15.9 %     95.2 %     26.6 %         14.4 %
                         
                         

S-5

                         
Humana Inc.
2Q11 Segment Financial Information
In millions
            Health and            
        Employer   Well-Being   Other   Eliminations/    
    Retail   Group   Services   Businesses   Corporate   Consolidated
                         
Revenues - external customers                        
Premiums:                        
Medicare Advantage   $ 4,555     $ 764     $ -     $ -     $ -     $ 5,319  
Medicare stand-alone PDP     601       2       -       77       -       680  
Total Medicare     5,156       766       -       77       -       5,999  
Fully-insured     206       1,217       -       -       -       1,423  
Specialty     30       233       -       -       -       263  
Military services     -       -       -       935       -       935  
Medicaid and other (A)     -       -       -       229       -       229  
Total premiums     5,392       2,216       -       1,241       -       8,849  
Services revenue:                        
Provider     -       -       222       -       -       222  
ASO and other (B)     4       87       -       28       -       119  
Pharmacy     -       -       3       -       -       3  
Total services revenue     4       87       225       28       -       344  
Total revenues - external customers     5,396       2,303       225       1,269       -       9,193  
                         
Intersegment revenues                        
Services     -       3       2,074       -       (2,077 )     -  
Products     -       -       434       -       (434 )     -  
Total intersegment revenues     -       3       2,508       -       (2,511 )     -  
Investment income     19       12       -       13       47       91  
Total revenues     5,415       2,318       2,733       1,282       (2,464 )     9,284  
                         
Operating expenses:                        
Benefits     4,390       1,800       -       1,149       (70 )     7,269  
Operating costs     490       387       2,625       111       (2,420 )     1,193  
Depreciation and amortization     32       23       20       3       (10 )     68  
Total operating expenses     4,912       2,210       2,645       1,263       (2,500 )     8,530  
Income from operations     503       108       88       19       36       754  
Interest expense     -       -       -       -       28       28  
Income before income taxes   $ 503     $ 108     $ 88     $ 19     $ 8     $ 726  
                         
Benefit ratio     81.4 %     81.2 %         92.6 %         82.1 %
Operating cost ratio (C)     9.1 %     16.8 %     96.0 %     8.7 %         13.0 %
                         
                         

S-6

                         
Humana Inc.
YTD12 Segment Financial Information
In millions
            Health and            
        Employer   Well-Being   Other   Eliminations/    
    Retail   Group   Services   Businesses   Corporate   Consolidated
                         
Revenues - external customers                        
Premiums:                        
Medicare Advantage   $ 10,401     $ 2,036     $ -     $ -     $ -     $ 12,437  
Medicare stand-alone PDP     1,332       4       -       139       -       1,475  
Total Medicare     11,733       2,040       -       139       -       13,912  
Fully-insured     494       2,489       -       -       -       2,983  
Specialty     80       522       -       -       -       602  
Military services     -       -       -       937       -       937  
Medicaid and other (A)     -       -       -       507       -       507  
Total premiums     12,307       5,051       -       1,583       -       18,941  
Services revenue:                        
Provider     -       -       478       -       -       478  
ASO and other (B)     11       178       -       109       -       298  
Pharmacy     -       -       8       -       -       8  
Total services revenue     11       178       486       109       -       784  
Total revenues - external customers     12,318       5,229       486       1,692       -       19,725  
                         
Intersegment revenues                        
Services     1       8       4,863       -       (4,872 )     -  
Products     -       -       1,175       -       (1,175 )     -  
Total intersegment revenues     1       8       6,038       -       (6,047 )     -  
Investment income     39       20       -       29       105       193  
Total revenues     12,358       5,257       6,524       1,721       (5,942 )     19,918  
                         
Operating expenses:                        
Benefits     10,560       4,138       -       1,512       (208 )     16,002  
Operating costs     1,253       844       6,218       239       (5,787 )     2,767  
Depreciation and amortization     63       40       43       8       (11 )     143  
Total operating expenses     11,876       5,022       6,261       1,759       (6,006 )     18,912  
Income from operations     482       235       263       (38 )     64       1,006  
Interest expense     -       -       -       -       52       52  
Income (loss) before income taxes   $ 482     $ 235     $ 263     $ (38 )   $ 12     $ 954  
                         
Benefit ratio     85.8 %     81.9 %         95.5 %         84.5 %
Operating cost ratio (C)     10.2 %     16.1 %     95.3 %     14.1 %         14.0 %
                         
                         

S-7

 
Humana Inc.
YTD11 Segment Financial Information
In millions
            Health and            
        Employer   Well-Being   Other   Eliminations/    
    Retail   Group   Services   Businesses   Corporate   Consolidated
                         
Revenues - external customers                        
Premiums:                        
Medicare Advantage   $ 9,080     $ 1,560     $ -     $ -     $ -     $ 10,640  
Medicare stand-alone PDP     1,158       4       -       153       -       1,315  
Total Medicare     10,238       1,564       -       153       -       11,955  
Fully-insured     407       2,416       -       -       -       2,823  
Specialty     56       463       -       -       -       519  
Military services     -       -       -       1,858       -       1,858  
Medicaid and other (A)     -       -       -       461       -       461  
Total premiums     10,701       4,443       -       2,472       -       17,616  
Services revenue:                        
Provider     -       -       437       -       -       437  
ASO and other (B)     7       180       -       50       -       237  
Pharmacy     -       -       5       -       -       5  
Total services revenue     7       180       442       50       -       679  
Total revenues - external customers     10,708       4,623       442       2,522       -       18,295  
                         
Intersegment revenues                        
Services     -       6       4,195       -       (4,201 )     -  
Products     -       -       869       -       (869 )     -  
Total intersegment revenues     -       6       5,064       -       (5,070 )     -  
Investment income     38       24       -       25       93       180  
Total revenues     10,746       4,653       5,506       2,547       (4,977 )     18,475  
                         
Operating expenses:                        
Benefits     8,944       3,552       -       2,258       (140 )     14,614  
Operating costs     1,023       811       5,281       230       (4,896 )     2,449  
Depreciation and amortization     59       43       40       5       (13 )     134  
Total operating expenses     10,026       4,406       5,321       2,493       (5,049 )     17,197  
Income from operations     720       247       185       54       72       1,278  
Interest expense     -       -       -       -       55       55  
Income before income taxes   $ 720     $ 247     $ 185     $ 54     $ 17     $ 1,223  
                         
Benefit ratio     83.6 %     79.9 %         91.3 %         83.0 %
Operating cost ratio (C)     9.6 %     17.5 %     95.9 %     9.1 %         13.4 %
                         
                         

S-8

                 
Humana Inc.
Consolidated Balance Sheets
Dollars in millions, except share amounts        
    June 30,   December 31,   Sequential Change
    2012   2011   Dollar   Percent
Assets                
Current assets:                
Cash and cash equivalents   $ 3,869     $ 1,377          
Investment securities     7,882       7,743          
Receivables, net     898       1,034          
Other     1,422       1,027          
Total current assets     14,071       11,181     $ 2,890   25.8 %
                 
Property and equipment, net     976       912          
Long-term investment securities     1,783       1,710          
Goodwill     2,792       2,740          
Other     1,233       1,165          
Total assets     20,855       17,708     $ 3,147   17.8 %
                 
Liabilities and Stockholders' Equity                
Current liabilities:                
Benefits payable     3,994       3,754          
Trade accounts payable and accrued expenses     2,081       1,783          
Book overdraft     260       306          
Unearned revenues     2,341       213          
Total current liabilities     8,676       6,056     $ 2,620   43.3 %
                 
Long-term debt     1,618       1,659          
Future policy benefits payable     1,785       1,663          
Other long-term liabilities     321       267          
Total liabilities     12,400       9,645     $ 2,755   28.6 %
                 
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; 194,250,130 issued at June 30, 2012

    32       32          
Capital in excess of par value     2,063       1,938          
Retained earnings     7,346       6,825          
Accumulated other comprehensive income     327       303          
Treasury stock, at cost, 32,537,691 shares at June 30, 2012     (1,313 )     (1,035 )        
Total stockholders' equity     8,455       8,063     $ 392   4.9 %
Total liabilities and stockholders' equity   $ 20,855     $ 17,708     $ 3,147   17.8 %
                 
Debt-to-total capitalization ratio     16.1 %     17.1 %        
                 
                 
                 

S-9

Humana Inc.
Consolidated Statements of Cash Flows
Dollars in millions                
    Three Months Ended June 30,        
            Dollar   Percentage
    2012   2011   Change   Change
Cash flows from operating activities                
Net income   $ 356     $ 460          

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

               
Depreciation and amortization     82       75          
Net realized capital gains     (10 )     (1 )        
Stock-based compensation     14       11          
(Benefit from) provision for deferred income taxes     -       (6 )        

Changes in operating assets and liabilities excluding the effects of acquisitions:

               
Receivables     432       (327 )        
Other assets     (112 )     (64 )        
Benefits payable     (114 )     13          
Other liabilities     (1 )     (2 )        
Unearned revenues     43       (14 )        
Other     16       16          
Net cash provided by operating activities     706       161     $ 545     338.5 %
                 
Cash flows from investing activities                
Acquisitions, net of cash acquired     (20 )     (6 )        
Purchases of property and equipment     (99 )     (58 )        
Purchases of investment securities     (650 )     (715 )        
Proceeds from maturities of investment securities     333       333          
Proceeds from sales of investment securities     287       278          
Net cash used in investing activities     (149 )     (168 )   $ 19     11.3 %
                 
Cash flows from financing activities                
Receipts (withdrawals) from contract deposits, net     (146 )     5          
Change in book overdraft     (34 )     (35 )        
Common stock repurchases     (127 )     (212 )        
Excess tax benefit from stock-based compensation     1       6          
Dividends paid     (41 )     -          
Proceeds from stock option exercises and other     3       55          
Net cash used in financing activities     (344 )     (181 )     ($163 )   -90.1 %
                 
Increase (decrease) in cash and cash equivalents     213       (188 )        
Cash and cash equivalents at beginning of period     3,656       1,756          
                 
Cash and cash equivalents at end of period   $ 3,869     $ 1,568          
                 
                 
                 

S-10

 
Humana Inc.
Consolidated Statements of Cash Flows
Dollars in millions                
    Six Months Ended June 30,        
            Dollar   Percentage
    2012   2011   Change   Change
Cash flows from operating activities                
Net income   $ 604     $ 775          

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

               
Depreciation and amortization     160       151          
Net realized capital gains     (14 )     (5 )        
Stock-based compensation     54       41          
(Benefit from) provision for deferred income taxes     (9 )     21          
Changes in operating assets and liabilities excluding                
the effects of acquisitions:                
Receivables     177       (587 )        
Other assets     (250 )     (175 )        
Benefits payable     170       484          
Other liabilities     51       202          
Unearned revenues     2,077       20          
Other     32       30          
Net cash provided by operating activities     3,052       957     $ 2,095     218.9 %
                 
Cash flows from investing activities                
Acquisitions, net of cash acquired     (76 )     (11 )        
Purchases of property and equipment     (185 )     (129 )        
Purchases of investment securities     (1,364 )     (1,902 )        
Proceeds from maturities of investment securities     757       751          
Proceeds from sales of investment securities     529       432          
Net cash used in investing activities     (339 )     (859 )   $ 520     60.5 %
                 
Cash flows from financing activities                
Receipts (withdrawals) from contract deposits, net     152       188          
Repayment of long-term debt     (36 )     -          
Change in book overdraft     (46 )     (192 )        
Common stock repurchases     (278 )     (301 )        
Excess tax benefit from stock-based compensation     21       11          
Dividends paid     (82 )     -          
Proceeds from stock option exercises and other     48       91          
Net cash used in financing activities     (221 )     (203 )     ($18 )   -8.9 %
                 
Increase (decrease) in cash and cash equivalents     2,492       (105 )        
Cash and cash equivalents at beginning of period     1,377       1,673          
                 
Cash and cash equivalents at end of period   $ 3,869     $ 1,568          
                 
                 
                 

S-11

                                   
Humana Inc.                                  
Key Income Statement Ratios and Segment Operating Results                          
Dollars in millions                                  
                                   
    Three Months Ended June 30,             Six Months Ended June 30,        
                Percentage                 Percentage
    2012   2011   Difference   Change     2012   2011   Difference   Change
Benefit ratio                                  
Retail   84.1 %   81.4 %   2.7 %         85.8 %   83.6 %   2.2 %    
Employer Group   82.2 %   81.2 %   1.0 %         81.9 %   79.9 %   2.0 %    
Other Businesses   109.1 %   92.6 %   16.5 %         95.5 %   91.3 %   4.2 %    
Consolidated   83.5 %   82.1 %   1.4 %         84.5 %   83.0 %   1.5 %    
                                   
Operating cost ratio (C)                                  
Retail   10.0 %   9.1 %   0.9 %         10.2 %   9.6 %   0.6 %    
Employer Group   15.9 %   16.8 %   -0.9 %         16.1 %   17.5 %   -1.4 %    
Health and Well-Being Services   95.2 %   96.0 %   -0.8 %         95.3 %   95.9 %   -0.6 %    
Other Businesses   26.6 %   8.7 %   17.9 %         14.1 %   9.1 %   5.0 %    
Consolidated   14.4 %   13.0 %   1.4 %         14.0 %   13.4 %   0.6 %    
                                   
Detail of pretax income (loss)                                  
Retail   $367     $503     ($136 )   -27.0 %     $482     $720     ($238 )   -33.1 %
Employer Group   $114     $108     $6     5.6 %     $235     $247     ($12 )   -4.9 %
Health and Well-Being Services   $131     $88     $43     48.9 %     $263     $185     $78     42.2 %
Other Businesses   ($55 )   $19     ($74 )   -389.5 %     ($38 )   $54     ($92 )   -170.4 %
Consolidated   $564     $726     ($162 )   -22.3 %     $954     $1,223     ($269 )   -22.0 %
                                   
                                   

S-12

                                   
Humana Inc.                                  
Pharmacy Metrics                                  
Script volume in thousands                                  
                                   
    Three Months Ended June 30,             Six Months Ended June 30,        
    2012   2011   Difference         2012   2011   Difference    
                                   
Generic Dispense Rate                                  
Retail                                  
Mail-Order   89.0 %   86.8 %   2.2 %         88.3 %   86.1 %   2.2 %    
90-Day Retail   86.6 %   83.2 %   3.4 %         86.2 %   83.0 %   3.2 %    
All Other   80.7 %   77.7 %   3.0 %         79.8 %   77.3 %   2.5 %    
Total   84.1 %   80.8 %   3.3 %         83.3 %   80.4 %   2.9 %    
Employer Group                                  
Mail-order   74.5 %   67.5 %   7.0 %         73.3 %   67.2 %   6.1 %    
90-Day Retail   81.8 %   76.1 %   5.7 %         81.2 %   76.0 %   5.2 %    
All Other   73.1 %   69.4 %   3.7 %         72.5 %   69.3 %   3.2 %    
Total Employer Group   75.5 %   70.7 %   4.8 %         74.8 %   70.4 %   4.4 %    
                                   
                Percentage                 Percentage
            Difference   Change             Difference   Change
Script volume                                  
Retail                                  
Mail-order   12,388     9,095     3,293     36.2 %     24,428     17,746     6,682     37.7 %
90-Day Retail   12,823     10,654     2,169     20.4 %     25,132     20,528     4,604     22.4 %
All Other   27,341     25,223     2,118     8.4 %     55,040     50,408     4,632     9.2 %
Total Retail   52,552     44,972     7,580     16.9 %     104,600     88,682     15,918     17.9 %
                                   
Employer Group                                  
Mail-order   1,012     969     43     4.4 %     1,995     1,927     68     3.5 %
90-Day Retail   1,565     1,443     122     8.5 %     3,047     2,740     307     11.2 %
All Other   3,752     3,892     (140 )   -3.6 %     7,555     7,817     (262 )   -3.4 %
Total Employer Group   6,329     6,304     25     0.4 %     12,597     12,484     113     0.9 %
                                   
Total Retail and Employer Group   58,881     51,276     7,605     14.8 %     117,197     101,166     16,031     15.8 %
                                   
                                   

S-13

                                     
Humana Inc.
Membership Detail
In thousands                            
   

Ending
June 30, 2012

 

Average
2Q12

 

Ending
June 30, 2011

    Year-over-year Change   Ending
December 31, 2011
    Sequential Change
            Amount   Percent       Amount   Percent
Medical Membership:                                    
Retail                                    
Medicare Advantage   1,895.8   1,891.3   1,602.5     293.3     18.3 %   1,640.3     255.5     15.6 %
Medicare stand-alone PDPs   2,896.8   2,884.5   2,408.7     488.1     20.3 %   2,540.4     356.4     14.0 %
Individual commercial   443.8   442.8   403.7     40.1     9.9 %   433.6     10.2     2.4 %
Medicare Supplement   70.5   69.3   52.9     17.6     33.3 %   59.6     10.9     18.3 %
Total Retail   5,306.9   5,287.9   4,467.8     839.1     18.8 %   4,673.9     633.0     13.5 %
                                     
Employer Group                                    
Medicare Advantage   360.5   359.4   282.0     78.5     27.8 %   290.6     69.9     24.1 %
Medicare Advantage ASO   27.9   27.9   27.7     0.2     0.7 %   27.6     0.3     1.1 %
Medicare stand-alone PDPs   4.4   4.4   4.1     0.3     7.3 %   4.2     0.2     4.8 %
Fully-insured medical commercial   1,196.9   1,191.2   1,186.2     10.7     0.9 %   1,180.2     16.7     1.4 %
ASO commercial   1,228.8   1,231.6   1,313.6     (84.8 )   -6.5 %   1,292.3     (63.5 )   -4.9 %
Total Employer Group   2,818.5   2,814.5   2,813.6     4.9     0.2 %   2,794.9     23.6     0.8 %
                                     
Other Businesses                                    
Military Services   3,133.5   3,102.4   3,015.2     118.3     3.9 %   3,028.1     105.4     3.5 %
Medicaid and other   607.1   606.4   619.2     (12.1 )   -2.0 %   614.2     (7.1 )   -1.2 %
LI-NET (D)   73.3   72.8   87.0     (13.7 )   -15.7 %   73.5     (0.2 )   -0.3 %
Total Other Businesses   3,813.9   3,781.6   3,721.4     92.5     2.5 %   3,715.8     98.1     2.6 %
                                     
Total Medical Membership   11,939.3   11,884.0   11,002.8     936.5     8.5 %   11,184.6     754.7     6.7 %
                                     
                                     
Specialty Membership:                                    
Retail                                    
Dental - fully-insured   662.7   650.3   512.5     150.2     29.3 %   579.6     83.1     14.3 %
Vision   103.8   99.8   70.8     33.0     46.6 %   83.8     20.0     23.9 %
Other supplemental benefits (E)   139.7   137.6   97.2     42.5     43.7 %   119.1     20.6     17.3 %
Total Retail   906.2   887.7   680.5     225.7     33.2 %   782.5     123.7     15.8 %
                                     
Employer Group                                    
Dental - fully-insured   2,416.4   2,407.5   2,250.3     166.1     7.4 %   2,283.9     132.5     5.8 %
Dental - ASO   849.4   851.3   1,220.7     (371.3 )   -30.4 %   869.9     (20.5 )   -2.4 %
Vision   2,456.3   2,442.0   2,227.0     229.3     10.3 %   2,329.6     126.7     5.4 %
Other supplemental benefits (E)   1,235.7   1,223.3   971.6     264.1     27.2 %   1,049.2     186.5     17.8 %
Total Employer Group   6,957.8   6,924.1   6,669.6     288.2     4.3 %   6,532.6     425.2     6.5 %
                                     
Total Specialty Membership   7,864.0   7,811.8   7,350.1     513.9     7.0 %   7,315.1     548.9     7.5 %
                                     
                                     
                                     

S-14

                         
Humana Inc.
Premiums and Services Revenue Detail
Dollars in millions, except per member per month
                     
                Per Member per Month (F)
    Three Months Ended June 30,           Three Months Ended June 30,
            Dollar   Percentage        
    2012   2011   Change   Change   2012   2011
                         
Premiums and Services Revenue                        
Retail:                        
Medicare Advantage   $ 5,308   $ 4,555   $ 753     16.5 %   $936   $949
Medicare stand-alone PDPs     672     601     71     11.8 %   $78   $84
Individual commercial     215     181     34     18.8 %   $162   $152
Medicare Supplemental     35     25     10     40.0 %   $168   $161
Specialty     42     30     12     40.0 %   $16   $15
ASO & other services (B)     6     4     2     50.0 %        
Total Retail     6,278     5,396     882     16.3 %        
                         
Employer Group:                        
Medicare Advantage     1,011     764     247     32.3 %   $938   $905
Medicare stand-alone PDPs     2     2     -     0.0 %        
Fully-insured medical commercial     1,247     1,217     30     2.5 %   $349   $342
Specialty     262     233     29     12.4 %   $14   $14
ASO & other services (B)     93     90     3     3.3 %        
Total Employer Group     2,615     2,306     309     13.4 %        
                         
Health and Well-Being Services:                        
Pharmacy solutions     2,833     2,406     427     17.7 %        
Primary care services     292     265     27     10.2 %        
Home care services     42     18     24     133.3 %        
Integrated wellness services     50     44     6     13.6 %        
Total Health and Well-Being Services     3,217     2,733     484     17.7 %        
                         
Other Businesses:                        
Military services (G)     130     959     (829 )   -86.4 %   $8   $179
LI-NET (D)     73     77     (4 )   -5.2 %   $334   $278
Medicaid and other (H)     260     233     27     11.6 %   $140   $123
Total Other Businesses     463     1,269     (806 )   -63.5 %        
                         
   

 

 

 

         

 

 

 

S-15

                         
Humana Inc.
Premiums and Services Revenue Detail
Dollars in millions, except per member per month
                     
                Per Member per Month (F)
    Six Months Ended June 30,           Six Months Ended June 30,
            Dollar   Percentage        
    2012   2011   Change   Change   2012   2011
                         
Premiums and Services Revenue                        
Retail:                        
Medicare Advantage   $ 10,401   $ 9,080   $ 1,321     14.5 %   $930   $948
Medicare stand-alone PDPs     1,332     1,158     174     15.0 %   $77   $82
Individual commercial     426     358     68     19.0 %   $161   $154
Medicare Supplemental     68     49     19     38.8 %   $167   $162
Specialty     80     56     24     42.9 %   $16   $15
ASO & other services (B)     12     7     5     71.4 %        
Total Retail     12,319     10,708     1,611     15.0 %        
                         
Employer Group:                        
Medicare Advantage     2,036     1,560     476     30.5 %   $947   $926
Medicare stand-alone PDPs     4     4     -     0.0 %        
Fully-insured medical commercial     2,489     2,416     73     3.0 %   $349   $341
Specialty     522     463     59     12.7 %   $14   $14
ASO & other services (B)     186     186     -     0.0 %        
Total Employer Group     5,237     4,629     608     13.1 %        
                         
Health and Well-Being Services:                        
Pharmacy solutions     5,766     4,863     903     18.6 %        
Primary care services     573     520     53     10.2 %        
Home care services     78     34     44     129.4 %        
Integrated wellness services     107     89     18     20.2 %        
Total Health and Well-Being Services     6,524     5,506     1,018     18.5 %        
                         
Other Businesses:                        
Military services (G)     1,036     1,901     (865 )   -45.5 %   $90   $177
LI-NET (D)     139     153     (14 )   -9.2 %   $313   $265
Medicaid and other (H)     517     468     49     10.5 %   $140   $124
Total Other Businesses     1,692     2,522     (830 )   -32.9 %        
                         
                         
                         

S-16

                                 
Humana Inc.
Medicare Summary
Premiums in millions
Membership in thousands                          
              Per Member per Month (F)
      Three Months Ended June 30,   Year-over-year Change   Three Months Ended June 30,
                                 
      2012     2011   Amount     Percent   2012     2011
Premiums                                
Medicare Advantage     $ 6,319     $ 5,319   $ 1,000     18.8 %   $936    

$942

Medicare stand-alone PDPs       747       680     67     9.9 %   $84    

$91

Total Medicare     $ 7,066     $ 5,999   $ 1,067     17.8 %          
                                 
                           
              Per Member per Month (F)
      Six Months Ended June 30,   Year-over-year Change   Six Months Ended June 30,
                                 
      2012     2011   Amount     Percent   2012     2011
Premiums                                
Medicare Advantage     $ 12,437     $ 10,640   $ 1,797     16.9 %   $932     $945
Medicare stand-alone PDPs       1,475       1,315     160     12.2 %   $84     $89
Total Medicare     $ 13,912     $ 11,955   $ 1,957     16.4 %          
                                 
                           
      Ending     Ending   Year-over-year Change          
      June 30, 2012     June 30, 2011   Amount     Percent          
Fully-Insured Membership                                
Medicare Advantage       2,256.3       1,884.5     371.8     19.7 %          
Medicare stand-alone PDPs       2,974.5       2,499.8     474.7     19.0 %          
Total Medicare       5,230.8       4,384.3     846.5     19.3 %          
                                 
                                 

S-17

                   
Humana Inc.     Fair value
Investments                  
Dollars in millions                  
      6/30/2012     3/31/2012     12/31/2011
Investment Portfolio:                  
Cash & cash equivalents     $3,869     $3,656     $1,377
Investment securities     7,882     7,889     7,743
Long-term investments     1,783     1,704     1,710
Total investment portfolio     $13,534     $13,249     $10,830
                   
Duration (I)     3.24     3.33     3.94
Average Credit Rating     AA-     AA-     AA-
                   
                   
Investment Portfolio Detail:                  
Cash and cash equivalents     $3,869     $3,656     $1,377
U.S. Government and agency obligations                  
U.S. Treasury and agency obligations     553     550     725
U.S. Government residential mortgage-backed     1,921     1,725     1,751
U.S. Government commercial mortgage-backed     34     33     33
Total U.S. Government and agency obligations     2,508     2,308     2,509
Tax-exempt municipal securities                  
Pre-refunded     294     304     332
Insured     631     645     634
Other     1,946     1,928     1,874
Auction rate securities     15     15     16
Total tax-exempt municipal securities     2,886     2,892     2,856
Residential mortgage-backed                  
Prime residential mortgages     36     38     41
Alt-A residential mortgages     1     2     2
Sub-prime residential mortgages     1     1     1
Total residential mortgage-backed     38     41     44
Commercial mortgage-backed     448     437     381
Asset-backed securities     44     74     83
Corporate securities                  
Financial services     818     867     692
Other     2,923     2,974     2,888
Total corporate securities     3,741     3,841     3,580
Redeemable preferred stocks     -     -     -
Total investment portfolio     $13,534     $13,249     $10,830
                   

S-18

                   
                   
Humana Inc.
Detail of Benefits Payable Balance and Year-to-Date Changes
Dollars in millions
                   
      June 30,     June 30,     December 31,
      2012     2011     2011
Detail of benefits payable                  
IBNR and other benefits payable (J)     $3,085       $2,795       $2,759  
Unprocessed claim inventories (K)     310       410       280  
Processed claim inventories (L)     359       274       209  
Payable to pharmacy benefit administrator (M)     163       142       167  
Benefits payable, excluding military services     3,917       3,621       3,415  
                   
Military services benefits payable (N)     77       332       339  
Total Benefits Payable     $3,994       $3,953       $3,754  
                   
                   
      Six Months Ended     Six Months Ended     Year Ended
      June 30, 2012     June 30, 2011     December 31, 2011

Year-to-date changes in benefits payable, excluding military services (O)

                 
                   
Balances at January 1     $3,415       $3,214       $3,214  
                   
Acquisitions     70             29  
                   
Incurred related to:                  
Current year     15,169       13,158       25,821  
Prior years (P)     (181 )     (284 )     (372 )
Total incurred     14,988       12,874       25,449  
                   
Paid related to:                  
Current year     (11,805 )     (10,083 )     (22,729 )
Prior years     (2,751 )     (2,384 )     (2,548 )
Total paid     (14,556 )     (12,467 )     (25,277 )
                   
Balances at end of period     $3,917       $3,621       $3,415  
                   
                   
      Six Months Ended     Six Months Ended     Year Ended
      June 30, 2012     June 30, 2011     December 31, 2011
Summary of Consolidated Benefit Expense:                  
Total benefit expense incurred, per above     $14,988       $12,874       $25,449  
Military services benefit expense     890       1,671       3,247  
Future policy benefit expense (Q)     124       69       127  
Consolidated Benefit Expense     $16,002       $14,614       $28,823  
                   

S-19

                   
                         
Humana Inc.
Benefits Payable Statistics (R)
                         
                         
Receipt Cycle Time (S)                        
      2012     2011     Change    

Percentage
Change

1st Quarter Average     13.0     13.8     (0.8 )     -5.8 %
2nd Quarter Average     13.7     13.8     (0.1 )     -0.7 %
3rd Quarter Average           13.6     n/a       n/a  
4th Quarter Average           14.0     n/a       n/a  
Full Year Average     13.4     13.8     (0.4 )     -2.9 %
                         
                         
                         
Unprocessed Claims Inventories
                         
Date    

Estimated Valuation
(millions)

   

Claim Item
Counts (000s)

   

Number of Days
on Hand

     
6/30/2010     $434     1,009     4.9        
9/30/2010     $429     1,064     5.2        
12/31/2010     $374     981     5.0        
3/31/2011     $482     1,197     6.0        
6/30/2011     $410     1,093     5.1        
9/30/2011     $419     1,272     5.7        
12/31/2011     $280     599     2.8        
3/31/2012     $376     1,028     4.2        
6/30/2012     $310     1,077     4.2        
                         

S-20

                         
                           
Humana Inc.
Benefits Payable Statistics (Continued) (R)
                           
                           
Days in Claims Payable (T)
 
Quarter Ended    

Days in Claims
Payable (DCP)

   

Change Last 4
Quarters

   

Percentage
Change

6/30/2010     57.0     0.9       1.6 %        
9/30/2010     57.8     1.6       2.8 %        
12/31/2010     53.5     (1.9 )     -3.4 %        
3/31/2011     55.5     1.3       2.4 %        
6/30/2011     56.0     (1.0 )     -1.8 %        
9/30/2011     54.2     (3.6 )     -6.2 %        
12/31/2011     52.5     (1.0 )     -1.9 %        
3/31/2012     50.1     (5.4 )     -9.7 %        
6/30/2012     51.0     (5.0 )     -8.9 %        
                           
Year-to-Date Change in Days in Claims Payable (U)
                  2012       2011
DCP - beginning of period     52.5         53.5  
Components of change in DCP:              
Change in unprocessed claims inventories     0.1         (2.3 )
Change in processed claims inventories     1.9         1.4  
Change in pharmacy payment cutoff     (0.2 )       0.6  
Change in capitation/provider settlements     (3.0 )       (0.7 )
All other     (0.3 )        
DCP - end of period     51.0         52.5  
                           

S-21

                           
 
Humana Inc.

Footnotes to Statistical Schedules and Supplementary Information

2Q12 Earnings Release

 

(A)

The Medicaid and other category includes the company's Medicaid business as well as the closed block of long-term care.

(B)

The ASO and other category is primarily comprised of ASO fees and other ancillary services fees.

(C)

The operating cost ratio is defined as operating costs as a percent of total revenues excluding investment income.

(D)

LI-NET is the CMS Limited Income Newly Eligible Transition program, operated by Humana, to provide Part D prescription drug coverage for all uncovered Full Duals and SSI-only

 

beneficiaries on a retroactive basis and all uncovered LIS eligible beneficiaries on a current basis.

(E)

Other supplemental benefits include life, disability, and fixed benefit products including cancer and critical illness policies.

(F)

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).

(G)

Military services revenues are generally not contracted on a per-member basis.

(H)

Includes premiums associated with Medicaid and the closed block of long-term care as well as services revenue.

(I)

Duration is the time-weighted average of the present value of the fixed income portfolio cash flows.

(J)

IBNR represents an estimate of benefit expenses payable for claims incurred but not reported (IBNR) at the balance sheet date. The level of IBNR is primarily impacted by membership

 

levels, benefit 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 benefits payable includes amounts payable to providers under capitation arrangements.

(K)

Unprocessed claim inventories represent the estimated valuation of claims received but not yet fully processed.

(L)

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.

(M)

The balance due to the company's pharmacy benefit administrator fluctuates as a result of the number of business days in the last payment cycle of the month. Payment cycles are every 8

 

days (8th, 16th, and 24th of month) and the last day of the month.

(N)

Military services benefits payable primarily consist of IBNR and to a lesser extent risk share payables to the Department of Defense and liabilities to subcontractors.

(O)

The table excludes activity associated with military services benefits payable because the federal government bears a substantial portion of the risk associated with financing the cost of

 

health benefits. More specifically, the risk-sharing provisions of the military services contracts with the federal government and with subcontractors effectively limit profits and losses when

 

actual claim experience varies from the targeted claim amount negotiated annually. As a result of these contract provisions, the impact of changes in estimates for prior year military

 

services benefits payable are substantially offset by the associated changes in estimates of revenue from health care services reimbursements. As such, any impact on the company's

 

results of operations is reduced substantially, whether positive or negative.

(P)

Amounts incurred related to prior years vary from previously estimated liabilities as the claims ultimately are settled. Negative amounts reported for incurred related to prior years result from

 

claims being ultimately settled for amounts less than originally estimated (favorable development). There were no changes in the approach used to determine the company's estimate of

 

claim reserves during the quarter.

(Q)

Future policy benefit expense has a related liability classified as a long-term liability on the balance sheet.

(R)

Benefits reserves statistics represents fully-insured medical claims data and excludes military services claims data and specialty benefits.

(S)

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 the company's

 

largest claim processing platforms represent approximately 95% of the company's fully-insured medical claims volume. Pharmacy and specialty claims, including dental, vision and other

 

supplemental benefits, are excluded from this measurement.

(T)

A common metric for monitoring benefits payable levels relative to the benefit expense is days in claims payable, or DCP, which represents the benefits payable at the end of the period

 

divided by average benefit expenses per day in the quarterly period.

(U)

DCP fluctuates due to a number of issues, the more significant of which are detailed in this rollforward. 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. This analysis excludes the impact of military services and Medicare stand-alone PDPs upon DCP.

   
 

S-22

   

 

Humana Investor Relations
Regina Nethery, 502-580-3644
Rnethery@humana.com
or
Humana Corporate Communications
Tom Noland, 502-580-3674
Tnoland@humana.com

Source: Humana Inc.

Copyright:  Copyright Business Wire 2012
Source:  Business Wire, Inc.
Wordcount:  11316

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