Molina Healthcare Reports Fourth Quarter and Year-End 2016 Results and Provides Fiscal Year 2017 Outlook and Guidance
- 2016 net income declines due to continued poor
Affordable Care Act (ACA) Marketplace performance - Strong enrollment growth generated approximately
$16.3 billion of premium revenue - General and administrative expenses ratio decreased to 7.9% in 2016
- 2017 guidance of
$1.72 net income per diluted share and$2.09 adjusted net income per diluted share
“While we experienced strong enrollment growth across our business and have made progress on our cost cutting efforts, today’s results highlight the continuing challenges we face in the
Analysis of Our Financial Results for the Year Ended
Net income per diluted share decreased to
Income before income taxes decreased by
Financial Impact of Variances between Actual Results and Our Pricing Model for the Marketplace Exchanges in 2016
We estimate that our loss before income taxes in 2016 from the Marketplace program amounted to approximately
- Risk transfer payments were approximately
$325 million higher than anticipated in our pricing. Risk transfer payments amounted to 24% of total premium in 2016, compared with a pricing expectation of 9%. - Although medical costs were
$120 million lower than anticipated by our pricing model, we nevertheless incurred$325 million in additional risk transfer payments noted above. - Other items increased income before income taxes by approximately
$35 million compared with pricing expectations.
The difference between our actual results and those anticipated by our pricing model was exacerbated by the federal government’s failure to pay amounts owed to our health plans under the Marketplace risk corridor program. We believe our health plans are owed approximately
The following table presents a summary of the variance in Marketplace performance to pricing expectations for 2016 (in millions, except per-share amounts):
Year Ended |
||||||||||
Amount |
Per Diluted |
|||||||||
Risk transfer payments | $ | (325 | ) | $ | (3.65 | ) | ||||
Lower than anticipated medical costs | 120 | 1.32 | ||||||||
Other revenue and operating expenses, net | 35 | 0.44 | ||||||||
Variance in Marketplace actual performance compared with pricing expectations | $ | (170 | ) | $ | (1.89 | ) |
________________________ | |
(1) |
Income tax effect calculated at the statutory tax rate of 37%. |
Revenue and Enrollment in 2016
Strong enrollment growth generated approximately
Medical Care Costs in 2016
The medical care ratio increased to 90.5% in 2016, from 89.1% in 2015, due to lower Marketplace margins. The medical care ratio of our Marketplace program increased to 93% in 2016 from 74% in 2015.
The medical care ratio of all of our programs excluding Marketplace increased by only 40 basis points between 2015 and 2016, as decreasing margins in Medicaid Expansion (where we saw a 500 basis point increase in our medical care ratio) were offset by improved margins in other programs. Consolidated medical care costs measured on a PMPM basis decreased approximately 3% in 2016 when compared with 2015.
General and Administrative Expense in 2016
General and administrative expenses as a percentage of total revenue (the “general and administrative expense ratio”) decreased to 7.9% in 2016, from 8.1% in 2015.
Analysis of our Financial Results for the Quarter Ended
Profitability declined in the fourth quarter of 2016. Net loss per diluted share was
The following discrete items had an adverse impact on our financial performance in the fourth quarter of 2016:
- Difficulties experienced by our Marketplace program, including a
$30 million premium deficiency reserve recorded in the fourth quarter of 2016 for anticipated losses in 2017. Including this reserve, our Marketplace program lost$130 million on a pre-tax basis in the fourth quarter of 2016. - Adjustments to premium revenue and medical costs of approximately
$25 million at our health plans that related to dates of service in 2015 or 2014. - Adjustments to premium revenue and medical costs of approximately
$37 million at our health plans that related to dates of service in the first three quarters of 2016. - Continued rate pressure in
Illinois ,Ohio andWashington . As discussed below, rate increases effectiveJanuary 1, 2017 , in all three of these states will provide margin relief in 2017.
Financial Impact of the Marketplace and Out-of-Period Items at Our Health Plans on our Fourth Quarter 2016 Results
The poor performance of our Marketplace program was very detrimental to our financial performance for both the quarter and the year ended
Quarter Ended |
||||||||||
Amount |
Per Diluted |
|||||||||
Marketplace losses before income tax expense | $ | (130 | ) | $ | (1.47 | ) | ||||
Premium and provider adjustments recorded in the Health Plans segment related to dates of service in 2015 or 2014 | (25 | ) | (0.29 | ) | ||||||
Premium and provider adjustments recorded in the Health Plans segment related to dates of service in the first three quarters of 2016 | (37 | ) | (0.41 | ) | ||||||
$ | (192 | ) | $ | (2.17 | ) |
________________________ | |
(1) |
Income tax effect calculated at the statutory tax rate of 37%. |
Income Taxes in 2016
The health insurer fee that we pay to the federal government is not deductible for purposes of determining our income tax expense. The decrease in income before taxes in 2016 compared with 2015, combined with the relatively large amount of reported expenses that are not deductible for tax purposes, has resulted in an effective tax rate in excess of 90% for the full year 2016, compared with 55.5% for 2015. Because non-deductible expenses for the year are fixed and do not decline relative to income or loss before income tax expense, the substantial change in income before income taxes in the fourth quarter is not matched by a proportional adjustment to income tax expense. Rather, the effective tax rate we reported in the fourth quarter of 2016 represents the cumulative adjustment to our year-to-date effective tax rate.
Molina’s 2017 Plan for Action
We have identified the following areas of focus and related actions to execute in 2017:
1. Stabilize Marketplace Performance:
We will continue to advocate for the immediate remediation of risk transfer methodologies that penalize comparatively efficient and affordable health plans like ours and, by extension, those individual consumers in need of affordable health insurance. In particular, we are recommending that the planned change to the Marketplace risk transfer methodology, which is currently scheduled to take effect on
In
2. Improve
Inadequate premium rates limited profitability in
3. Sustain the improvements achieved in
Results at our
Conference Call
Management will host a conference call and webcast to discuss Molina Healthcare’s fourth quarter and year-end results at
2017 Business Outlook and Investor Meeting
As has been our past practice, we will discuss our 2017 business outlook and strategy at our
About
Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995: This earnings release contains “forward-looking statements” regarding our plans, expectations, and anticipated future events. Actual results could differ materially due to numerous known and unknown risks and uncertainties. Those known risks and uncertainties include, but are not limited to, the following:
- the success of our profit improvement and cost-cutting initiatives;
- the numerous political and market-based uncertainties associated with the Affordable Care Act (the “ACA”) or “Obamacare,” including any potential repeal and replacement of the law, amendment of the law, or move to state block grants for
Medicaid ; - the market dynamics surrounding the ACA Marketplaces, including but not limited to uncertainties associated with risk transfer requirements, the potential for disproportionate enrollment of higher acuity members, the withdrawal of cost sharing subsidies and/or premium tax credits, the adequacy of agreed rates, and potential disruption associated with market withdrawal;
- subsequent adjustments to reported premium revenue based upon subsequent developments or new information, including changes to estimated amounts payable or receivable related to Marketplace risk adjustment/risk transfer, risk corridors, and reinsurance;
- management of our medical costs, including our ability to reduce over time the high medical costs commonly associated with new patient populations;
- our ability to predict with a reasonable degree of accuracy utilization rates, including utilization rates in new plans, geographies, and programs where we have less experience with patient and provider populations, and also including utilization rates associated with seasonal flu patterns or other newly emergent diseases;
- significant budget pressures on state governments and their potential inability to maintain current rates, to implement expected rate increases, or to maintain existing benefit packages or membership eligibility thresholds or criteria, including the resolution of the
Illinois budget impasse and continued payment of all amounts due to ourIllinois health plan; - the success of our efforts to retain existing government contracts, including those in
Illinois ,Washington ,Florida ,Texas , andNew Mexico , and to obtain new government contracts in connection with state requests for proposals (RFPs) in both existing and new states; - our ability to manage growth, including maintaining and creating adequate internal systems and controls relating to authorizations, approvals, provider payments, and the overall success of our care management initiatives;
- our ability to consummate and realize benefits from acquisitions, and to integrate acquisitions;
- our receipt of adequate premium rates to support increasing pharmacy costs, including costs associated with specialty drugs and costs resulting from formulary changes that allow the option of higher-priced non-generic drugs;
- our ability to operate profitably in an environment where the trend in premium rate increases lags behind the trend in increasing medical costs;
- the interpretation and implementation of federal or state medical cost expenditure floors, administrative cost and profit ceilings, premium stabilization programs, profit sharing arrangements, and risk adjustment provisions;
- our estimates of amounts owed for such cost expenditure floors, administrative cost and profit ceilings, premium stabilization programs, profit-sharing arrangements, and risk adjustment provisions;
- the
Medicaid expansion cost corridors inNew Mexico andWashington , and any other retroactive adjustment to revenue where methodologies and procedures are subject to interpretation or dependent upon information about the health status of participants other than Molina members; - the interpretation and implementation of at-risk premium rules and state contract performance requirements regarding the achievement of certain quality measures, and our ability to recognize revenue amounts associated therewith;
- cyber-attacks or other privacy or data security incidents resulting in an inadvertent unauthorized disclosure of protected health information;
- the success of our health plan in
Puerto Rico , including the resolution of thePuerto Rico debt crisis, payment of all amounts due under ourMedicaid contract, the effect of the PROMESA law, and our efforts to better manage the health care costs of ourPuerto Rico health plan; - the success and renewal of our duals demonstration programs in
California ,Illinois ,Michigan ,Ohio ,South Carolina , andTexas ; - the accurate estimation of incurred but not reported or paid medical costs across our health plans;
- efforts by states to recoup previously paid and recognized premium amounts;
- the continuation and renewal of the government contracts of our health plans, Molina Medicaid Solutions, and Pathways, and the terms under which such contracts are renewed;
- complications, member confusion, or enrollment backlogs related to the annual renewal of
Medicaid coverage; - government audits and reviews, or potential investigations, and any fine, sanction, enrollment freeze, monitoring program, or premium recovery that may result therefrom;
- changes with respect to our provider contracts and the loss of providers;
- approval by state regulators of dividends and distributions by our health plan subsidiaries;
- changes in funding under our contracts as a result of regulatory changes, programmatic adjustments, or other reforms;
- high dollar claims related to catastrophic illness;
- the favorable resolution of litigation, arbitration, or administrative proceedings;
- the relatively small number of states in which we operate health plans;
- the availability of adequate financing on acceptable terms to fund and capitalize our expansion and growth, repay our outstanding indebtedness at maturity and meet our liquidity needs, including the interest expense and other costs associated with such financing;
- our failure to comply with the financial or other covenants in our credit agreement or the indentures governing our outstanding notes;
- the sufficiency of our funds on hand to pay the amounts due upon conversion of our outstanding notes;
- the failure of a state in which we operate to renew its federal
Medicaid waiver; - changes generally affecting the managed care or
Medicaid management information systems industries; - increases in government surcharges, taxes, and assessments, including but not limited to the deductibility of certain compensation costs;
- newly emergent viruses or widespread epidemics, public catastrophes or terrorist attacks, and associated public alarm;
- increasing competition and consolidation in the
Medicaid industry;
and numerous other risk factors, including those discussed in our periodic reports and filings with the
UNAUDITED CONSOLIDATED STATEMENTS OF OPERATIONS |
||||||||||||||||||||
Three Months Ended |
Year Ended |
|||||||||||||||||||
2016 | 2015 | 2016 | 2015 | |||||||||||||||||
(Dollar amounts in millions, except per-share amounts) | ||||||||||||||||||||
Revenue: | ||||||||||||||||||||
Premium revenue | $ | 4,109 | $ | 3,589 | $ | 16,324 | $ | 13,241 | ||||||||||||
Service revenue | 131 | 107 | 539 | 253 | ||||||||||||||||
Premium tax revenue | 120 | 108 | 465 | 397 | ||||||||||||||||
Health insurer fee revenue | 94 | 61 | 345 | 264 | ||||||||||||||||
Investment income and other revenue | 9 | 6 | 38 | 23 | ||||||||||||||||
Total revenue | 4,463 | 3,871 | 17,711 | 14,178 | ||||||||||||||||
Operating expenses: | ||||||||||||||||||||
Medical care costs | 3,844 | 3,213 | 14,774 | 11,794 | ||||||||||||||||
Cost of service revenue | 123 | 90 | 485 | 193 | ||||||||||||||||
General and administrative expenses | 359 | 316 | 1,393 | 1,146 | ||||||||||||||||
Premium tax expenses | 120 | 108 | 465 | 397 | ||||||||||||||||
Health insurer fee expenses | 54 | 40 | 217 | 157 | ||||||||||||||||
Depreciation and amortization | 37 | 28 | 139 | 104 | ||||||||||||||||
Total operating expenses | 4,537 | 3,795 | 17,473 | 13,791 | ||||||||||||||||
Operating (loss) income | (74 | ) | 76 | 238 | 387 | |||||||||||||||
Other expenses, net: | ||||||||||||||||||||
Interest expense | 25 | 21 | 101 | 66 | ||||||||||||||||
Other income, net | — | (1 | ) | — | (1 | ) | ||||||||||||||
Total other expenses, net | 25 | 20 | 101 | 65 | ||||||||||||||||
(Loss) income before income tax expense | (99 | ) | 56 | 137 | 322 | |||||||||||||||
Income tax (benefit) expense | (8 | ) | 26 | 129 | 179 | |||||||||||||||
Net (loss) income | $ | (91 | ) | $ | 30 | $ | 8 | $ | 143 | |||||||||||
Diluted net (loss) income per share | $ | (1.64 | ) | $ | 0.52 | $ | 0.14 | $ | 2.58 | |||||||||||
Diluted weighted average shares outstanding | 55.6 | 57.7 | 56.3 | 55.6 | ||||||||||||||||
Operating Statistics: | ||||||||||||||||||||
Medical care ratio (1) | 93.6 | % | 89.5 | % | 90.5 | % | 89.1 | % | ||||||||||||
General and administrative expense ratio (2) | 8.0 | % | 8.2 | % | 7.9 | % | 8.1 | % | ||||||||||||
Premium tax ratio (1) | 2.8 | % | 2.9 | % | 2.8 | % | 2.9 | % | ||||||||||||
Effective tax rate | 7.9 | % | 46.9 | % | 94.1 | % | 55.5 | % | ||||||||||||
Net profit margin (2) | (2.0 | )% | 0.8 | % | — | % | 1.0 | % |
________________________ | |
(1) | Medical care ratio represents medical care costs as a percentage of premium revenue; premium tax ratio represents premium tax expenses as a percentage of premium revenue plus premium tax revenue. |
(2) | General and administrative expense ratio represents general and administrative expenses as a percentage of total revenue. Net profit margin represents net (loss) income as a percentage of total revenue. |
UNAUDITED CONSOLIDATED BALANCE SHEETS |
||||||||||
|
||||||||||
2016 | 2015 | |||||||||
(In millions, |
||||||||||
ASSETS | ||||||||||
Current assets: | ||||||||||
Cash and cash equivalents | $ | 2,819 | $ | 2,329 | ||||||
Investments | 1,758 | 1,801 | ||||||||
Receivables | 974 | 597 | ||||||||
Income taxes refundable | 63 | 13 | ||||||||
Prepaid expenses and other current assets | 131 | 192 | ||||||||
Derivative asset | 267 | 374 | ||||||||
Total current assets | 6,012 | 5,306 | ||||||||
Property, equipment, and capitalized software, net | 454 | 393 | ||||||||
Deferred contract costs | 86 | 81 | ||||||||
Intangible assets, net | 140 | 122 | ||||||||
|
620 | 519 | ||||||||
Restricted investments | 110 | 109 | ||||||||
Deferred income taxes | 10 | 18 | ||||||||
Other assets | 41 | 28 | ||||||||
$ | 7,473 | $ | 6,576 | |||||||
LIABILITIES AND STOCKHOLDERS’ EQUITY | ||||||||||
Current liabilities: | ||||||||||
Medical claims and benefits payable | $ | 1,929 | $ | 1,685 | ||||||
Amounts due government agencies | 1,273 | 729 | ||||||||
Accounts payable and accrued liabilities | 382 | 362 | ||||||||
Deferred revenue | 315 | 223 | ||||||||
Current portion of long-term debt | 472 | 449 | ||||||||
Derivative liability | 267 | 374 | ||||||||
Total current liabilities | 4,638 | 3,822 | ||||||||
Senior notes | 975 | 962 | ||||||||
Lease financing obligations | 198 | 198 | ||||||||
Deferred income taxes | 15 | — | ||||||||
Other long-term liabilities | 42 | 37 | ||||||||
Total liabilities | 5,868 | 5,019 | ||||||||
Stockholders’ equity: | ||||||||||
Common stock, |
— | — | ||||||||
Preferred stock, |
— | — | ||||||||
Additional paid-in capital | 841 | 803 | ||||||||
Accumulated other comprehensive loss | (2 | ) | (4 | ) | ||||||
Retained earnings | 766 | 758 | ||||||||
Total stockholders’ equity | 1,605 | 1,557 | ||||||||
$ | 7,473 | $ | 6,576 |
UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS |
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Three Months Ended |
Year Ended |
|||||||||||||||||||
2016 | 2015 | 2016 | 2015 | |||||||||||||||||
(In millions) | ||||||||||||||||||||
Operating activities: | ||||||||||||||||||||
Net (loss) income | $ | (91 | ) | $ | 30 | $ | 8 | $ | 143 | |||||||||||
Adjustments to reconcile net (loss) income to net cash provided by operating activities: | ||||||||||||||||||||
Depreciation and amortization | 47 | 33 | 182 | 126 | ||||||||||||||||
Deferred income taxes | 2 | 5 | 22 | (7 | ) | |||||||||||||||
Share-based compensation | 2 | 7 | 26 | 23 | ||||||||||||||||
Amortization of convertible senior notes and lease financing obligations | 8 | 8 | 31 | 30 | ||||||||||||||||
Other, net | 2 | 6 | 16 | 19 | ||||||||||||||||
Changes in operating assets and liabilities: | ||||||||||||||||||||
Receivables | 79 | 79 | (348 | ) | 56 | |||||||||||||||
Prepaid expenses and other assets | 47 | 28 | (69 | ) | (35 | ) | ||||||||||||||
Medical claims and benefits payable | 58 | 123 | 226 | 482 | ||||||||||||||||
Amounts due government agencies | 41 | (251 | ) | 544 | 202 | |||||||||||||||
Accounts payable and accrued liabilities | (8 | ) | 50 | (7 | ) | 84 | ||||||||||||||
Deferred revenue | (65 | ) | 153 | 92 | 24 | |||||||||||||||
Income taxes | (82 | ) | (52 | ) | (50 | ) | (22 | ) | ||||||||||||
Net cash provided by operating activities | 40 | 219 | 673 | 1,125 | ||||||||||||||||
Investing activities: | ||||||||||||||||||||
Purchases of investments | (485 | ) | (612 | ) | (1,929 | ) | (1,923 | ) | ||||||||||||
Proceeds from sales and maturities of investments | 454 | 263 | 1,966 | 1,126 | ||||||||||||||||
Purchases of property, equipment, and capitalized software | (33 | ) | (31 | ) | (176 | ) | (132 | ) | ||||||||||||
Change in restricted investments | — | (1 | ) | 4 | (6 | ) | ||||||||||||||
Net cash paid in business combinations | — | (373 | ) | (48 | ) | (450 | ) | |||||||||||||
Other, net | (7 | ) | (1 | ) | (19 | ) | (35 | ) | ||||||||||||
Net cash used in investing activities | (71 | ) | (755 | ) | (202 | ) | (1,420 | ) | ||||||||||||
Financing activities: | ||||||||||||||||||||
Proceeds from senior notes offerings, net of issuance costs | — | 689 | — | 689 | ||||||||||||||||
Proceeds from common stock offering, net of issuance costs | — | — | — | 373 | ||||||||||||||||
Proceeds from employee stock plans | 8 | 10 | 18 | 18 | ||||||||||||||||
Other, net | — | 2 | 1 | 5 | ||||||||||||||||
Net cash provided by financing activities | 8 | 701 | 19 | 1,085 | ||||||||||||||||
Net (decrease) increase in cash and cash equivalents | (23 | ) | 165 | 490 | 790 | |||||||||||||||
Cash and cash equivalents at beginning of period | 2,842 | 2,164 | 2,329 | 1,539 | ||||||||||||||||
Cash and cash equivalents at end of period | $ | 2,819 | $ | 2,329 | $ | 2,819 | $ | 2,329 |
UNAUDITED HEALTH PLANS SEGMENT MEMBERSHIP |
|||||||||||
As of |
|||||||||||
2016 | 2015 | 2014 | |||||||||
Ending Membership by Health Plan: | |||||||||||
|
683,000 | 620,000 | 531,000 | ||||||||
|
553,000 | 440,000 | 164,000 | ||||||||
|
195,000 | 98,000 | 100,000 | ||||||||
|
391,000 | 328,000 | 242,000 | ||||||||
|
254,000 | 231,000 | 212,000 | ||||||||
|
35,000 | — | — | ||||||||
|
332,000 | 327,000 | 347,000 | ||||||||
|
330,000 | 348,000 | — | ||||||||
|
109,000 | 99,000 | 118,000 | ||||||||
|
337,000 | 260,000 | 245,000 | ||||||||
|
146,000 | 102,000 | 83,000 | ||||||||
|
736,000 | 582,000 | 497,000 | ||||||||
|
126,000 | 98,000 | 84,000 | ||||||||
4,227,000 | 3,533,000 | 2,623,000 | |||||||||
Ending Membership by Program: | |||||||||||
Temporary Assistance for Needy Families (TANF) and Children’s Health Insurance Program (CHIP) | 2,536,000 | 2,312,000 | 1,809,000 | ||||||||
Medicaid Expansion | 673,000 | 557,000 | 385,000 | ||||||||
Marketplace | 526,000 | 205,000 | 15,000 | ||||||||
Aged, Blind or Disabled (ABD) | 396,000 | 366,000 | 347,000 | ||||||||
Medicare-Medicaid Plan (MMP) - Integrated | 51,000 | 51,000 | 18,000 | ||||||||
Medicare Special Needs Plans | 45,000 | 42,000 | 49,000 | ||||||||
4,227,000 | 3,533,000 | 2,623,000 |
________________________ | |
(1) |
The |
(2) |
The |
UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA (In millions, except percentages and per-member per-month amounts) |
|||||||||||||||||||||||||||||||||
Three Months Ended |
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Member
Months (1) |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
|
2.1 | $ | 595 | $ | 287.80 | $ | 544 | $ | 263.64 | 91.6 | % | $ | 51 | ||||||||||||||||||||
|
1.7 | 479 | 288.69 | 464 | 279.69 | 96.9 | 15 | ||||||||||||||||||||||||||
|
0.5 | 135 | 233.43 | 154 | 265.84 | 113.9 | (19 | ) | |||||||||||||||||||||||||
|
1.1 | 377 | 321.47 | 327 | 278.89 | 86.8 | 50 | ||||||||||||||||||||||||||
|
0.7 | 288 | 378.29 | 304 | 399.29 | 105.5 | (16 | ) | |||||||||||||||||||||||||
|
0.1 | 50 | 460.08 | 49 | 451.09 | 98.0 | 1 | ||||||||||||||||||||||||||
|
1.0 | 489 | 486.36 | 441 | 439.09 | 90.3 | 48 | ||||||||||||||||||||||||||
|
1.0 | 191 | 193.54 | 178 | 179.02 | 92.5 | 13 | ||||||||||||||||||||||||||
|
0.4 | 105 | 318.27 | 88 | 267.65 | 84.1 | 17 | ||||||||||||||||||||||||||
|
1.0 | 602 | 588.83 | 511 | 499.56 | 84.8 | 91 | ||||||||||||||||||||||||||
|
0.5 | 114 | 257.97 | 111 | 252.85 | 98.0 | 3 | ||||||||||||||||||||||||||
|
2.2 | 584 | 267.50 | 536 | 245.11 | 91.6 | 48 | ||||||||||||||||||||||||||
|
0.4 | 96 | 254.50 | 110 | 288.94 | 113.5 | (14 | ) | |||||||||||||||||||||||||
Other (4) | — | 4 | — | 27 | — | — | (23 | ) | |||||||||||||||||||||||||
12.7 | $ | 4,109 | $ | 323.54 | $ | 3,844 | $ | 302.68 | 93.6 | % | $ | 265 | |||||||||||||||||||||
Three Months Ended |
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Member
Months (1) |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
|
1.8 | $ | 662 | $ | 363.57 | $ | 577 | $ | 316.97 | 87.2 | % | $ | 85 | ||||||||||||||||||||
|
1.2 | 331 | 279.37 | 318 | 268.98 | 96.3 | 13 | ||||||||||||||||||||||||||
|
0.3 | 85 | 287.88 | 79 | 266.91 | 92.7 | 6 | ||||||||||||||||||||||||||
|
1.0 | 329 | 334.44 | 282 | 287.00 | 85.8 | 47 | ||||||||||||||||||||||||||
|
0.7 | 304 | 438.82 | 263 | 379.10 | 86.4 | 41 | ||||||||||||||||||||||||||
|
— | — | — | — | — | — | — | ||||||||||||||||||||||||||
|
1.0 | 500 | 501.11 | 437 | 436.77 | 87.2 | 63 | ||||||||||||||||||||||||||
|
1.1 | 192 | 184.79 | 159 | 153.04 | 82.8 | 33 | ||||||||||||||||||||||||||
|
0.3 | 78 | 261.07 | 69 | 229.48 | 87.9 | 9 | ||||||||||||||||||||||||||
|
0.7 | 543 | 693.55 | 496 | 633.77 | 91.4 | 47 | ||||||||||||||||||||||||||
|
0.4 | 89 | 290.05 | 77 | 251.55 | 86.7 | 12 | ||||||||||||||||||||||||||
|
1.7 | 416 | 241.28 | 376 | 217.77 | 90.3 | 40 | ||||||||||||||||||||||||||
|
0.3 | 55 | 186.57 | 53 | 182.41 | 97.8 | 2 | ||||||||||||||||||||||||||
Other (4) | — | 5 | — | 27 | — | — | (22 | ) | |||||||||||||||||||||||||
10.5 | $ | 3,589 | $ | 344.32 | $ | 3,213 | $ | 308.31 | 89.5 | % | $ | 376 |
________________________ | |
(1) |
A member month is defined as the aggregate of each month’s ending membership for the period presented. |
(2) |
The MCR represents medical costs as a percentage of premium revenue. |
(3) |
The |
(4) |
“Other” medical care costs include primarily medically related administrative costs at the parent company, and direct delivery costs. |
UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA (In millions, except percentages and per-member per-month amounts) |
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Year Ended |
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Member
Months (1) |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
|
8.2 | $ | 2,302 | $ | 282.14 | $ | 2,029 | $ | 248.70 | 88.1 | % | $ | 273 | ||||||||||||||||||||
|
6.7 | 1,926 | 288.73 | 1,765 | 264.60 | 91.6 | 161 | ||||||||||||||||||||||||||
|
2.3 | 601 | 257.99 | 568 | 243.71 | 94.5 | 33 | ||||||||||||||||||||||||||
|
4.7 | 1,520 | 321.93 | 1,345 | 284.82 | 88.5 | 175 | ||||||||||||||||||||||||||
|
3.0 | 1,304 | 429.81 | 1,209 | 398.49 | 92.7 | 95 | ||||||||||||||||||||||||||
|
0.2 | 82 | 446.72 | 79 | 431.73 | 96.6 | 3 | ||||||||||||||||||||||||||
|
4.0 | 1,961 | 485.20 | 1,747 | 432.36 | 89.1 | 214 | ||||||||||||||||||||||||||
|
4.0 | 726 | 180.65 | 694 | 172.57 | 95.5 | 32 | ||||||||||||||||||||||||||
|
1.3 | 378 | 296.54 | 320 | 250.97 | 84.6 | 58 | ||||||||||||||||||||||||||
|
4.3 | 2,454 | 575.01 | 2,110 | 494.41 | 86.0 | 344 | ||||||||||||||||||||||||||
|
1.8 | 444 | 249.56 | 423 | 238.03 | 95.4 | 21 | ||||||||||||||||||||||||||
|
8.4 | 2,218 | 263.36 | 2,015 | 239.21 | 90.8 | 203 | ||||||||||||||||||||||||||
|
1.6 | 395 | 252.94 | 388 | 248.28 | 98.2 | 7 | ||||||||||||||||||||||||||
Other (4) | — | 13 | — | 82 | — | — | (69 | ) | |||||||||||||||||||||||||
50.5 | $ | 16,324 | $ | 323.46 | $ | 14,774 | $ | 292.75 | 90.5 | % | $ | 1,550 | |||||||||||||||||||||
Year Ended |
|||||||||||||||||||||||||||||||||
Member
Months (1) |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
|
7.1 | $ | 2,200 | $ | 310.89 | $ | 1,926 | $ | 272.22 | 87.6 | % | $ | 274 | ||||||||||||||||||||
|
4.1 | 1,199 | 289.85 | 1,081 | 261.49 | 90.2 | 118 | ||||||||||||||||||||||||||
|
1.2 | 397 | 328.93 | 367 | 303.72 | 92.3 | 30 | ||||||||||||||||||||||||||
|
3.4 | 1,067 | 317.15 | 903 | 268.27 | 84.6 | 164 | ||||||||||||||||||||||||||
|
2.8 | 1,237 | 446.27 | 1,106 | 398.98 | 89.4 | 131 | ||||||||||||||||||||||||||
|
— | — | — | — | — | — | — | ||||||||||||||||||||||||||
|
4.1 | 2,034 | 499.34 | 1,718 | 421.61 | 84.4 | 316 | ||||||||||||||||||||||||||
|
3.2 | 567 | 178.31 | 505 | 158.80 | 89.1 | 62 | ||||||||||||||||||||||||||
|
1.3 | 348 | 267.25 | 278 | 213.30 | 79.8 | 70 | ||||||||||||||||||||||||||
|
3.1 | 1,961 | 621.37 | 1,809 | 573.32 | 92.3 | 152 | ||||||||||||||||||||||||||
|
1.2 | 331 | 286.22 | 300 | 259.32 | 90.6 | 31 | ||||||||||||||||||||||||||
|
6.6 | 1,602 | 242.36 | 1,470 | 222.36 | 91.7 | 132 | ||||||||||||||||||||||||||
|
1.2 | 261 | 213.48 | 215 | 176.01 | 82.4 | 46 | ||||||||||||||||||||||||||
Other (4) | — | 37 | — | 116 | — | — | (79 | ) | |||||||||||||||||||||||||
39.3 | $ | 13,241 | $ | 337.28 | $ | 11,794 | $ | 300.43 | 89.1 | % | $ | 1,447 |
________________________ | |
(1) |
A member month is defined as the aggregate of each month’s ending membership for the period presented. |
(2) |
The MCR represents medical costs as a percentage of premium revenue. |
(3) |
The |
(4) |
“Other” medical care costs include primarily medically related administrative costs at the parent company, and direct delivery costs. |
UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA (In millions, except percentages and per-member per-month amounts) |
|||||||||||||||||||||||||||||||||
Three Months Ended |
|||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
TANF and CHIP | 7.7 | $ | 1,404 | $ | 183.96 | $ | 1,304 | $ | 170.83 | 92.9 | % | $ | 100 | ||||||||||||||||||||
Medicaid Expansion | 2.0 | 700 | 349.12 | 625 | 311.57 | 89.2 | 75 | ||||||||||||||||||||||||||
Marketplace | 1.6 | 344 | 217.94 | 407 | 258.71 | 118.7 | (63 | ) | |||||||||||||||||||||||||
ABD | 1.2 | 1,200 | 1,003.09 | 1,104 | 921.69 | 91.9 | 96 | ||||||||||||||||||||||||||
MMP | 0.1 | 314 | 2,047.88 | 274 | 1,785.00 | 87.2 | 40 | ||||||||||||||||||||||||||
|
0.1 | 147 | 1,085.22 | 130 | 966.81 | 89.1 | 17 | ||||||||||||||||||||||||||
12.7 | $ | 4,109 | $ | 323.54 | $ | 3,844 | $ | 302.68 | 93.6 | % | $ | 265 | |||||||||||||||||||||
Three Months Ended |
|||||||||||||||||||||||||||||||||
Member
Months (1) |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
TANF and CHIP | 6.9 | $ | 1,203 | $ | 175.96 | $ | 1,092 | $ | 159.83 | 90.8 | % | $ | 111 | ||||||||||||||||||||
Medicaid Expansion | 1.7 | 735 | 446.24 | 606 | 367.76 | 82.4 | 129 | ||||||||||||||||||||||||||
Marketplace | 0.6 | 127 | 223.57 | 111 | 194.80 | 87.1 | 16 | ||||||||||||||||||||||||||
ABD | 1.1 | 1,061 | 969.51 | 995 | 910.11 | 93.9 | 66 | ||||||||||||||||||||||||||
MMP | 0.1 | 330 | 2,163.47 | 290 | 1,905.00 | 88.1 | 40 | ||||||||||||||||||||||||||
|
0.1 | 133 | 1,076.00 | 119 | 954.40 | 88.7 | 14 | ||||||||||||||||||||||||||
10.5 | $ | 3,589 | $ | 344.32 | $ | 3,213 | $ | 308.31 | 89.5 | % | $ | 376 | |||||||||||||||||||||
Year Ended |
|||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
TANF and CHIP | 30.2 | $ | 5,403 | $ | 179.21 | $ | 4,950 | $ | 164.18 | 91.6 | % | $ | 453 | ||||||||||||||||||||
Medicaid Expansion | 7.8 | 2,884 | 369.82 | 2,475 | 317.37 | 85.8 | 409 | ||||||||||||||||||||||||||
Marketplace | 6.7 | 1,525 | 228.44 | 1,416 | 212.17 | 92.9 | 109 | ||||||||||||||||||||||||||
ABD | 4.7 | 4,666 | 991.24 | 4,277 | 908.39 | 91.6 | 389 | ||||||||||||||||||||||||||
MMP | 0.6 | 1,303 | 2,131.97 | 1,141 | 1,866.93 | 87.6 | 162 | ||||||||||||||||||||||||||
|
0.5 | 543 | 1,033.15 | 515 | 981.36 | 95.0 | 28 | ||||||||||||||||||||||||||
50.5 | $ | 16,324 | $ | 323.46 | $ | 14,774 | $ | 292.75 | 90.5 | % | $ | 1,550 | |||||||||||||||||||||
Year Ended |
|||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
TANF and CHIP | 25.5 | $ | 4,483 | $ | 175.64 | $ | 4,122 | $ | 161.50 | 92.0 | % | $ | 361 | ||||||||||||||||||||
Medicaid Expansion | 5.9 | 2,389 | 408.51 | 1,931 | 330.18 | 80.8 | 458 | ||||||||||||||||||||||||||
Marketplace | 2.6 | 652 | 251.96 | 481 | 185.85 | 73.8 | 171 | ||||||||||||||||||||||||||
ABD | 4.3 | 4,124 | 966.83 | 3,784 | 887.27 | 91.8 | 340 | ||||||||||||||||||||||||||
MMP | 0.5 | 1,063 | 2,034.51 | 974 | 1,863.93 | 91.6 | 89 | ||||||||||||||||||||||||||
|
0.5 | 530 | 1,038.15 | 502 | 982.50 | 94.6 | 28 | ||||||||||||||||||||||||||
39.3 | $ | 13,241 | $ | 337.28 | $ | 11,794 | $ | 300.43 | 89.1 | % | $ | 1,447 |
________________________ | |
(1) |
A member month is defined as the aggregate of each month’s ending membership for the period presented. |
(2) |
The MCR represents medical costs as a percentage of premium revenue. |
|
|||||||||||||||||||||||||||||
UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA | |||||||||||||||||||||||||||||
(In millions, except percentages and per-member per-month amounts) | |||||||||||||||||||||||||||||
The following tables provide the details of our medical care costs for the periods indicated: | |||||||||||||||||||||||||||||
Three Months Ended |
|||||||||||||||||||||||||||||
2016 | 2015 | ||||||||||||||||||||||||||||
Amount | PMPM | % of
Total |
Amount | PMPM | % of
Total |
||||||||||||||||||||||||
Fee for service | $ | 2,837 | $ | 223.43 | 73.8 | % | $ | 2,297 | $ | 220.34 | 71.5 | % | |||||||||||||||||
Pharmacy | 592 | 46.57 | 15.4 | 449 | 43.08 | 14.0 | |||||||||||||||||||||||
Capitation | 317 | 24.93 | 8.2 | 257 | 24.69 | 8.0 | |||||||||||||||||||||||
Direct delivery | 23 | 1.80 | 0.6 | 43 | 4.14 | 1.3 | |||||||||||||||||||||||
Other | 75 | 5.95 | 2.0 | 167 | 16.06 | 5.2 | |||||||||||||||||||||||
$ | 3,844 | $ | 302.68 | 100.0 | % | $ | 3,213 | $ | 308.31 | 100.0 | % | ||||||||||||||||||
Year Ended |
|||||||||||||||||||||||||||||
2016 | 2015 | ||||||||||||||||||||||||||||
Amount | PMPM | % of
Total |
Amount | PMPM | % of
Total |
||||||||||||||||||||||||
Fee for service | $ | 10,993 | $ | 217.84 | 74.4 | % | $ | 8,572 | $ | 218.35 | 72.7 | % | |||||||||||||||||
Pharmacy | 2,213 | 43.84 | 15.0 | 1,610 | 41.01 | 13.7 | |||||||||||||||||||||||
Capitation | 1,218 | 24.13 | 8.2 | 982 | 25.02 | 8.3 | |||||||||||||||||||||||
Direct delivery | 78 | 1.55 | 0.5 | 128 | 3.26 | 1.1 | |||||||||||||||||||||||
Other | 272 | 5.39 | 1.9 | 502 | 12.79 | 4.2 | |||||||||||||||||||||||
$ | 14,774 | $ | 292.75 | 100.0 | % | $ | 11,794 | $ | 300.43 | 100.0 | % | ||||||||||||||||||
The following table provides the details of our medical claims and benefits payable as of the dates indicated: | |||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
2016 | 2015 | ||||||||||||||||||||||||||||
Fee-for-service claims incurred but not paid (IBNP) | $ | 1,352 | $ | 1,191 | |||||||||||||||||||||||||
Pharmacy payable | 112 | 88 | |||||||||||||||||||||||||||
Capitation payable | 37 | 140 | |||||||||||||||||||||||||||
Other (1) | 428 | 266 | |||||||||||||||||||||||||||
$ | 1,929 | $ | 1,685 |
________________________ | |
(1) |
“Other” medical claims and benefits payable include amounts payable to certain providers for which we act as an intermediary on behalf of various state agencies without assuming financial risk. Such receipts and payments do not impact our consolidated statements of income. As of |
UNAUDITED CHANGE IN MEDICAL CLAIMS AND BENEFITS PAYABLE
(Dollars in millions, except per-member amounts)
Our claims liability includes a provision for adverse claims deviation based on historical experience and other factors including, but not limited to, variations in claims payment patterns, changes in utilization and cost trends, known outbreaks of disease, and large claims. Our reserving methodology is consistently applied across all periods presented. The amounts displayed for “Components of medical care costs related to: Prior period” represent the amount by which our original estimate of claims and benefits payable at the beginning of the period were more than the actual amount of the liability based on information (principally the payment of claims) developed since that liability was first reported. The following table presents the components of the change in medical claims and benefits payable for the periods indicated:
Year Ended |
||||||||||
2016 | 2015 | |||||||||
Medical claims and benefits payable, beginning balance | $ | 1,685 | $ | 1,201 | ||||||
Components of medical care costs related to: | ||||||||||
Current period | 14,966 | 11,935 | ||||||||
Prior period | (192 | ) | (141 | ) | ||||||
Total medical care costs | 14,774 | 11,794 | ||||||||
Change in non-risk provider payables | 58 | 48 | ||||||||
Payments for medical care costs related to: | ||||||||||
Current period | 13,296 | 10,448 | ||||||||
Prior period | 1,292 | 910 | ||||||||
Total paid | 14,588 | 11,358 | ||||||||
Medical claims and benefits payable, ending balance | $ | 1,929 | $ | 1,685 | ||||||
Benefit from prior period as a percentage of: | ||||||||||
Balance at beginning of period | 11.4 | % | 11.8 | % | ||||||
Premium revenue, trailing twelve months | 1.2 | % | 1.1 | % | ||||||
Medical care costs, trailing twelve months | 1.3 | % | 1.2 | % | ||||||
Fee-For-Service Claims Data: (1) | ||||||||||
Days in claims payable, fee for service (2) | 47 | 48 | ||||||||
Number of members at end of year | 4,227,000 | 3,533,000 | ||||||||
Number of claims in inventory at end of year | 554,700 | 380,800 | ||||||||
Billed charges of claims in inventory at end of year | $ | 1,307 | $ | 816 | ||||||
Claims in inventory per member at end of year | 0.13 | 0.11 | ||||||||
Billed charges of claims in inventory per member at end of year | $ | 309.09 | $ | 230.91 | ||||||
Number of claims received during the year | 53,360,600 | 40,173,300 | ||||||||
Billed charges of claims received during the year | $ | 64,388 | $ | 46,211 |
________________________ | |
(1) |
Claims data includes inpatient and outpatient claims only. Pharmacy and other claims are not included. |
(2) |
Claims payable at |
UNAUDITED NON-GAAP FINANCIAL MEASURES
We use non-GAAP financial measures as supplemental metrics in evaluating our financial performance, making financing and business decisions, and forecasting and planning for future periods. For these reasons, management believes such measures are useful supplemental measures to investors in comparing our performance to the performance of other public companies in the health care industry. These non-GAAP financial measures should be considered as supplements to, and not as substitutes for or superior to, GAAP measures. See further information regarding non-GAAP measures below the tables.
Three Months Ended |
Year Ended |
||||||||||||||||||
2016 | 2015 | 2016 | 2015 | ||||||||||||||||
(In millions) | |||||||||||||||||||
Net (loss) income | $ | (91 | ) | $ | 30 | $ | 8 | $ | 143 | ||||||||||
Adjustments: | |||||||||||||||||||
Depreciation, and amortization of intangible assets and capitalized software | 43 | 33 | 161 | 120 | |||||||||||||||
Interest expense | 25 | 21 | 101 | 66 | |||||||||||||||
Income tax (benefit) expense | (8 | ) | 26 | 129 | 179 | ||||||||||||||
EBITDA | $ | (31 | ) | $ | 110 | $ | 399 | $ | 508 | ||||||||||
Three Months Ended |
Year Ended |
|||||||||||||||||||||||||||||||||||||||
2016 | 2015 | 2016 | 2015 | |||||||||||||||||||||||||||||||||||||
(In millions, except per diluted share amounts) | ||||||||||||||||||||||||||||||||||||||||
Amount |
Per |
Amount |
Per |
Amount |
Per |
Amount |
Per |
|||||||||||||||||||||||||||||||||
Net (loss) income | $ | (91 | ) | $ | (1.64 | ) | $ | 30 | $ | 0.52 | $ | 8 | $ | 0.14 | $ | 143 | $ | 2.58 | ||||||||||||||||||||||
Adjustment: | ||||||||||||||||||||||||||||||||||||||||
Amortization of intangible assets | 8 | 0.16 | 5 | 0.09 | 32 | 0.57 | 18 | 0.32 | ||||||||||||||||||||||||||||||||
Income tax effect (1) | (3 | ) | (0.06 | ) | (2 | ) | (0.03 | ) | (12 | ) | (0.21 | ) | (7 | ) | (0.12 | ) | ||||||||||||||||||||||||
Amortization of intangible assets, net of tax effect | 5 | 0.10 | 3 | 0.06 | 20 | 0.36 | 11 | 0.20 | ||||||||||||||||||||||||||||||||
Adjusted net (loss) income | $ | (86 | ) | $ | (1.54 | ) | $ | 33 | $ | 0.58 | $ | 28 | $ | 0.50 | $ | 154 | $ | 2.78 |
________________________ | |
(1) |
Income tax effect of adjustments calculated at the statutory tax rate of 37%. |
The following are descriptions of the adjustments made to GAAP measures used to calculate the non-GAAP measures used in this news release:
Earnings before interest, taxes, depreciation and amortization (EBITDA): Net income (GAAP) less depreciation, and amortization of intangible assets and capitalized software, interest expense and income tax expense. We believe that EBITDA is particularly helpful in assessing our ability to meet the cash demands of our operating units.
Adjusted net (loss) income: Net income (GAAP) less amortization of intangible assets, net of income tax effect calculated at the statutory tax rate of 37%. We believe that adjusted net income is very helpful in assessing our financial performance exclusive of the non-cash impact of the amortization of purchased intangibles.
Adjusted net (loss) income per diluted share: Adjusted net income divided by weighted average common shares outstanding on a fully diluted basis.
|
|||
2017 OUTLOOK AND GUIDANCE | |||
The following table presents the Company’s outlook for fiscal year 2017:(1) |
|||
Premium revenue | |
||
Premium tax revenue | |
||
Service revenue | |
||
Investment income and other revenue | |
||
Total revenue | |
||
Medical care costs | |
||
Medical care ratio (2) | 88.5% | ||
Cost of service revenue | |
||
General and administrative expenses | |
||
G&A ratio (3) | 9.0% | ||
Premium tax expenses | |
||
Depreciation and amortization | |
||
Interest expense and other income | |
||
Income before income taxes | |
||
Net income | |
||
EBITDA (4) | |
||
Effective tax rate | 44.0% | ||
Net profit margin (3) | 0.5% | ||
Diluted weighted average shares | 58.2M | ||
Net income per share | |
||
Adjusted net income per share (4) | |
________________________ | |
(1) |
All amounts are estimates; actual results may differ materially. Does not include |
(2) |
Medical care ratio represents medical care costs as a percentage of premium revenue. |
(3) |
G&A expense ratio represents general and administrative expenses as a percentage of total revenue. Net profit margin represents net income as a percentage of total revenue. |
(4) |
See below for a reconciliation of non-GAAP financial measures. |
Reconciliation of Non-GAAP Financial Measures – 2017 Outlook (in millions, except per-share amounts) |
||||||||||
Net income | $ | 100 | ||||||||
Adjustments: | ||||||||||
Depreciation, and amortization of intangible assets and capitalized software | 190 | |||||||||
Interest expense | 100 | |||||||||
Income tax expense | 75 | |||||||||
EBITDA | $ | 465 | ||||||||
Amount |
Per share (2) |
|||||||||
Net income | $ | 100 | $ | 1.72 | ||||||
Adjustments: | ||||||||||
Amortization of intangible assets | 34 | 0.59 | ||||||||
Income tax effect (1) | (12 | ) | (0.22 | ) | ||||||
Amortization of intangible assets, net of tax effect | 22 | 0.37 | ||||||||
Adjusted net income | $ | 122 | $ | 2.09 |
________________________ | |
(1) |
Income tax effect calculated at the statutory tax rate of 37%. |
(2) |
Computation assumes 58.2 million diluted weighted average shares outstanding. |
View source version on businesswire.com: http://www.businesswire.com/news/home/20170215006170/en/
Juan José Orellana, 562-435-3666, ext. 111143
Investor Relations
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