WellCare Reports First Quarter 2017 Results
"Our strong results in the first quarter of 2017 were fueled by growth across all three lines of business and reflect our continued focus on operational execution," said
Key Metrics |
1Q17 |
1Q16 |
Earnings per diluted share (EPS) (GAAP) |
|
|
Adjusted EPS(1) |
|
|
Net income margin (GAAP) |
1.7% |
1.1% |
Adjusted net income margin(1) |
1.8% |
1.4% |
Total Premium Revenue (GAAP) ($ millions) |
|
|
Adjusted Premium Revenue(1) ($ millions) |
|
|
Segment Premium Revenue ($ millions): |
||
Medicaid Health Plans (GAAP) |
|
|
Adjusted Medicaid Health Plans(1) |
|
|
Medicare Health Plans |
|
|
Medicare Prescription Drug Plans (PDP) |
|
|
Segment Medical Benefits Ratios (MBR): |
||
Medicaid Health Plans (GAAP) |
89.4% |
86.6% |
Adjusted Medicaid Health Plans(1) |
90.5% |
89.9% |
Medicare Health Plans |
83.0% |
84.6% |
Medicare Prescription Drug Plans (PDP) |
96.9% |
94.3% |
Selling, General and Administrative (SG&A) Ratio (GAAP) |
7.7% |
7.6% |
Adjusted SG&A Ratio(1) |
7.6% |
7.3% |
(1) Refer to the Basis of Presentation for a discussion of adjusted (non-GAAP) financial measures. |
Key Highlights
- GAAP and adjusted total premium revenue of
$3.9 billion for the first quarter of 2017 increased 11.6 percent and 13.5 percent, respectively, compared with the first quarter of 2016. - GAAP and adjusted Medicaid Health Plans premium revenue of
$2.6 billion for the first quarter of 2017 increased 11.8 percent and 14.7 percent, respectively, compared with the first quarter of 2016. - Medicare Health Plans premium revenue of
$1.1 billion for the first quarter of 2017 increased 12.4 percent compared with the first quarter of 2016. - Medicare Health Plans MBR for the first quarter of 2017 decreased 160 basis points compared with the first quarter of 2016.
- GAAP and adjusted net income margin for the first quarter of 2017 increased 60 basis points and 40 basis points, respectively, compared with the first quarter of 2016.
- On
January 1, 2017 , the company launched its Nebraska Medicaid business, and as ofMarch 31, 2017 , serves approximately 77,000Medicaid members inNebraska . - As previously announced on
April 28, 2017 , WellCare completed its acquisition of Universal American Corp. ("Universal American"). Universal American has approximately 119,000Medicare Advantage members inTexas ,New York andMaine as ofMarch 31, 2017 . - On
May 1, 2017 , WellCare completed its previously announced acquisition of certain Arizona Medicaid assets of Phoenix Health Plan ("PHP"). The transaction included the transfer of approximately 44,000Medicaid members toCare1st Arizona Health Plan, Inc. ("Care1stArizona "), a wholly owned subsidiary of WellCare. - On
May 1, 2017 , the company began services under its successfully retained Missouri Medicaid contract. The new contract expands the MO HealthNet Managed Care (Medicaid ) program statewide. As ofMarch 31, 2017 , the company served approximately 123,000Medicaid members inMissouri . - On
March 22, 2017 , WellCare issued 5.25% senior notes due 2025 (the "2025 notes") in the aggregate principal amount of$1.2 billion . The company used the net proceeds from the offering to repay in full$100 million outstanding under its senior unsecured revolving credit facility and to redeem in full the outstanding principal amount of$900 million of its 5.75% senior notes due 2020 (the "2020 notes") onApril 7, 2017 . WellCare also increased the amount available under its senior unsecured revolving credit facility from$850 million to$1.0 billion .
2017 Financial Outlook
WellCare is increasing its full-year 2017 adjusted EPS guidance to a range of
Consolidated Operations Results
GAAP net income for the first quarter of 2017 was
GAAP net income margin for the first quarter of 2017 was 1.7 percent compared with 1.1 percent for the first quarter of 2016. Adjusted net income margin for the first quarter of 2017 was 1.8 percent compared with 1.4 percent for the first quarter of 2016.
GAAP and adjusted total premium revenue of
GAAP SG&A expense was
The GAAP SG&A expense ratio was 7.7 percent in the first quarter of 2017 compared with 7.6 percent in the first quarter of 2016. The adjusted SG&A expense ratio was 7.6 percent in the first quarter of 2017 compared with 7.3 percent in the first quarter of 2016.
Medicaid Health Plans Segment Results
Membership in the company's Medicaid Health Plans segment increased by 244,000, or 10.3 percent, from
GAAP and adjusted Medicaid Health Plans premium revenue of
The GAAP Medicaid Health Plans MBR was 89.4 percent for the first quarter of 2017 compared with 86.6 percent for the first quarter of 2016. The year-over-year increase in the GAAP Medicaid Health Plans MBR was primarily due to the effect of the ACA industry fee moratorium and, as a result, the elimination of associated
The adjusted Medicaid Health Plans MBR was 90.5 percent for the first quarter of 2017 compared with 89.9 percent in the first quarter of 2016. The year-over-year increase in the adjusted Medicaid Health Plans MBR is primarily driven by the addition of the company's new
Medicare Health Plans Segment Results
Medicare Health Plans membership was 356,000 members at
Medicare Health Plans premium revenue of
The Medicare Health Plans MBR in the first quarter of 2017 was 83.0 percent compared with 84.6 percent in the first quarter of 2016. The 160 basis point decrease in the Medicare Health Plans MBR was primarily the result of continued operational execution and the company's 2017 bid strategy.
Medicare Prescription Drug Plans (PDP) Segment Results
Medicare PDP membership was 1.1 million as of
Medicare PDP premium revenue of
The Medicare PDP segment MBR in the first quarter of 2017 was 96.9 percent compared with 94.3 percent in the first quarter of 2016. The year-over-year increase was primarily the result of the company's 2017 bid strategy.
Operating Cash Flow and Financial Condition
Net cash provided by operating activities was
As of
Days in claims payable (DCP) was 46.2 days as of
Conference Call and Webcast
A discussion of WellCare's first quarter 2017 results will be available via a conference call and live webcast today at
The conference call will be webcast live from the company's website and will be available at the following link: http://services.choruscall.com/links/wcg170503.html. The webcast should be accessed 10 minutes prior to the conference call start time. A replay of the webcast will be available for one year following the conclusion of the live broadcast and will be accessible on the company's website at http://ir.wellcare.com/Event/.
The conference call can also be accessed by pre-registering using the following link: http://dpregister.com/10103817. Callers who pre-register will be given dial-in instructions and a unique PIN to gain immediate access to the call. Participants may pre-register now, or at any time prior to the call, and will receive simple instructions via email.
For those parties who do not have internet access or are unable to pre-register, the conference call may be accessed by calling:
Domestic participant dial in (toll free): |
1-844-492-3724 |
International participant dial in: |
1-412-542-4185 |
A telephonic replay will be available until
Domestic replay (toll free): |
1-877-344-7529 |
International replay: |
1-412-317-0088 |
About
Headquartered in
Basis of Presentation
In addition to results determined under GAAP, WellCare provides certain non-GAAP financial measures that management believes are useful in assessing the company's performance. 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. The company has provided a reconciliation of the historical non-GAAP financial measures with the most directly comparable financial measure calculated in accordance with GAAP.
Earnings per share, net income and, as noted below, other specific operating and financial measures have been adjusted for the effect of certain expenses, and as appropriate, the related tax effect, related to previously disclosed government investigations and related litigation and resolution costs ("investigation costs"); amortization expense associated with acquisitions ("acquisition-related amortization expenses"); certain one-time transaction costs related to the acquisition of Universal American ("Universal American-related transaction costs"); certain one-time costs associated with the integration of Universal American's operations expected to be incurred through 2019 ("Universal American-related integration costs"); and the costs associated with the redemption of the company's 2020 notes, including the early redemption premium, write-off of associated deferred financing costs and write-off of associated premiums paid on the 2020 notes ("loss on extinguishment of debt"). In addition, in 2016, these financial measures have been adjusted for the effect of transitory costs related to the company's decision to change its pharmacy benefit manager as of
In addition, because reimbursements for
The company is not able to project at the time of this news release the amount of expenses associated with investigation costs, acquisition-related amortization expenses and Universal American-related integration costs to be to be incurred during the remainder of 2017, and, therefore, cannot reconcile projected non-GAAP measures affected by these items to projected GAAP measures.
Following is a description of the adjustments made to GAAP measures used to calculate the non-GAAP measures used in this news release.
Adjusted premium revenue (non-GAAP) = Total premium revenue (GAAP) less
MBR (GAAP) = medical benefits expense divided by total premium revenue (GAAP).
Adjusted MBR (non-GAAP) = medical benefits expense divided by adjusted premium revenue. The company's adjusted Medicaid Health Plans segment MBR uses this non-GAAP definition of adjusted MBR.
SG&A expense ratio (GAAP) = SG&A expense (GAAP) divided by total premium revenue (GAAP).
Adjusted SG&A expense (non-GAAP) = SG&A expense (GAAP) less investigation costs, Universal American-related transaction and integration costs, PBM transitory costs, Sterling divestiture costs and Iowa SG&A costs.
Adjusted SG&A ratio (non-GAAP) = adjusted SG&A expense divided by adjusted premium revenue.
Adjusted depreciation & amortization = depreciation & amortization expense (GAAP) less acquisition-related amortization expenses.
Adjusted income before taxes (non-GAAP) = income before income taxes (GAAP) less investigation costs, acquisition-related amortization expenses, Universal American-related transaction and integration costs, PBM transitory costs, Sterling divestiture costs, loss on extinguishment of debt and Iowa SG&A costs.
Adjusted income tax expense (non-GAAP) = income tax associated with the applicable adjusted income before taxes, based on the applicable effective income tax rate.
Adjusted effective income tax rate (non-GAAP) = adjusted income tax expense divided by adjusted income before taxes.
Adjusted net income (non-GAAP) = adjusted income before taxes less adjusted income tax expense.
Net income margin (GAAP) = net income (GAAP) divided by total premium revenue (GAAP).
Adjusted net income margin (non-GAAP) = adjusted net income divided by adjusted premium revenue.
Adjusted earnings per diluted share (non-GAAP) = Adjusted net income divided by weighted average common shares outstanding on a fully diluted basis.
Cautionary Statement Regarding Forward-Looking Statements
This news release contains "forward-looking" statements that are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Statements that are predictive in nature, that depend upon or refer to future events or conditions, or that include words such as "expects," "anticipates," "intends," "plans," "believes," "estimates," and similar expressions are forward-looking statements. For example, statements regarding the company's financial outlook and the start date of new
Additional information concerning these and other important risks and uncertainties can be found in the company's filings with the
2017 Financial Outlook
WellCare is increasing its full-year 2017 adjusted EPS guidance to a range of
Guidance Metric |
2017 Guidance |
2017 Guidance as of |
Segment premium revenue: |
||
GAAP Medicaid Health Plans |
|
|
Adjusted Medicaid Health Plans(1) |
|
|
Medicare Health Plans |
|
|
Medicare PDP |
|
|
Total GAAP premium revenue |
|
|
Total adjusted premium revenue(1) |
|
|
Investment & other income* |
|
|
Segment MBR: |
||
GAAP Medicaid Health Plans |
88.6% to 89.6% |
88.60% to 89.60% |
Adjusted Medicaid Health Plans(1) |
89.5% to 90.5% |
89.50% to 90.50% |
Medicare Health Plans |
85.50% to 86.75% |
85.50% to 86.75% |
Medicare PDP |
80.5% to 82.5% |
80.50% to 82.50% |
Adjusted SG&A ratio(2)(7) |
7.95% to 8.20% |
7.7% to 7.9% |
GAAP depreciation & amortization(7) |
--- |
|
Adjusted depreciation & amortization(3) |
|
|
Interest expense |
|
|
Adjusted effective income tax rate(4)(7) |
37.5% to 38.5% |
37.5% to 39.0% |
Adjusted earnings per diluted share(5)(6)(7) |
|
|
* |
Investment & other income primarily includes investment income, specialty pharmacy business sold to nonmembers and equity from earnings in unconsolidated subsidiaries. The company will present equity from earnings in unconsolidated subsidiaries as a separate line item in its statement of comprehensive income as required under GAAP. |
(1) |
Excludes an estimated |
(2) |
Excludes estimated |
(3) |
Excludes acquisition-related amortization expenses. |
(4) |
Excludes the estimated income tax effect associated with the investigation costs, acquisition-related amortization expenses, Universal American-related transaction and integration costs, and loss on extinguishment of debt. |
(5) |
Excludes a one-time loss on extinguishment of debt of approximately |
(6) |
The company estimates adjusted earnings per diluted share guidance by adjusting net income for the estimated net-of-tax effect of investigation costs, acquisition-related amortization expense, Universal American-related transaction and integration costs and loss on extinguishment of debt. |
(7) |
WellCare is not able to estimate amounts associated with the investigation costs, acquisition-related amortization expenses associated with Universal American and Universal American-related integration costs expected to be incurred in 2017 and, therefore, cannot reconcile these metrics to total projected GAAP metrics. WellCare estimates that |
|
||||||||||||||||||
MEMBERSHIP INFORMATION |
||||||||||||||||||
(Unaudited) |
||||||||||||||||||
Change from |
||||||||||||||||||
|
|
|||||||||||||||||
|
|
|
Change |
% |
Change |
% |
||||||||||||
Medicaid Health Plans Membership by State: |
||||||||||||||||||
|
776,000 |
780,000 |
772,000 |
(4,000) |
(0.5) |
% |
4,000 |
0.5 |
% |
|||||||||
|
579,000 |
571,000 |
583,000 |
8,000 |
1.4 |
% |
(4,000) |
(0.7) |
% |
|||||||||
|
446,000 |
440,000 |
439,000 |
6,000 |
1.4 |
% |
7,000 |
1.6 |
% |
|||||||||
|
156,000 |
166,000 |
164,000 |
(10,000) |
(6.0) |
% |
(8,000) |
(4.9) |
% |
|||||||||
|
141,000 |
137,000 |
125,000 |
4,000 |
2.9 |
% |
16,000 |
12.8 |
% |
|||||||||
Other states |
525,000 |
450,000 |
296,000 |
75,000 |
16.7 |
% |
229,000 |
77.4 |
% |
|||||||||
Total Medicaid Health Plans Membership (1) |
2,623,000 |
2,544,000 |
2,379,000 |
79,000 |
3.1 |
% |
244,000 |
10.3 |
% |
|||||||||
Medicaid Health Plans Membership by Program: |
||||||||||||||||||
TANF |
2,176,000 |
2,119,000 |
1,983,000 |
57,000 |
2.7 |
% |
193,000 |
9.7 |
% |
|||||||||
SSI, ABD, Duals and LTC |
297,000 |
290,000 |
271,000 |
7,000 |
2.4 |
% |
26,000 |
9.6 |
% |
|||||||||
CHIP and other |
150,000 |
135,000 |
125,000 |
15,000 |
11.1 |
% |
25,000 |
20.0 |
% |
|||||||||
Total Medicaid Health Plans Membership (1) |
2,623,000 |
2,544,000 |
2,379,000 |
79,000 |
3.1 |
% |
244,000 |
10.3 |
% |
|||||||||
Medicare Health Plans: |
||||||||||||||||||
|
||||||||||||||||||
|
99,000 |
94,000 |
92,000 |
5,000 |
5.3 |
% |
7,000 |
7.6 |
% |
|||||||||
|
44,000 |
43,000 |
41,000 |
1,000 |
2.3 |
% |
3,000 |
7.3 |
% |
|||||||||
|
44,000 |
40,000 |
37,000 |
4,000 |
10.0 |
% |
7,000 |
18.9 |
% |
|||||||||
|
34,000 |
36,000 |
33,000 |
(2,000) |
(5.6) |
% |
1,000 |
3.0 |
% |
|||||||||
Other states |
135,000 |
132,000 |
123,000 |
3,000 |
2.3 |
% |
12,000 |
9.8 |
% |
|||||||||
Total Medicare Health Plans (1) |
356,000 |
345,000 |
326,000 |
11,000 |
3.2 |
% |
30,000 |
9.2 |
% |
|||||||||
Medicare Prescription Drug Plans |
1,099,000 |
1,009,000 |
1,025,000 |
90,000 |
8.9 |
% |
74,000 |
7.2 |
% |
|||||||||
Total Membership |
4,078,000 |
3,898,000 |
3,730,000 |
180,000 |
4.6 |
% |
348,000 |
9.3 |
% |
(1) |
|
|
||||||
Selected Data From Consolidated Statements of Comprehensive Income |
||||||
(Unaudited; dollars in millions except share and per share data) |
||||||
For the Three Months Ended
|
||||||
2017 |
2016 |
|||||
Revenues: |
||||||
Premium |
$ |
3,917.1 |
$ |
3,450.7 |
||
|
29.9 |
27.2 |
||||
ACA industry fee reimbursement |
— |
58.1 |
||||
Total premium |
3,947.0 |
3,536.0 |
||||
Investment and other income |
7.2 |
4.5 |
||||
Total revenues |
3,954.2 |
3,540.5 |
||||
Expenses: |
||||||
Medical benefits |
3,478.6 |
3,061.9 |
||||
Selling, general and administrative |
302.4 |
268.9 |
||||
ACA industry fee |
— |
57.0 |
||||
|
29.9 |
27.2 |
||||
Depreciation and amortization |
23.9 |
20.8 |
||||
Interest |
16.2 |
15.8 |
||||
Total expenses |
3,851.0 |
3,451.6 |
||||
Income before income taxes |
103.2 |
88.9 |
||||
Income tax expense |
35.9 |
51.1 |
||||
Net income |
$ |
67.3 |
$ |
37.8 |
||
Earnings per common share: |
||||||
Basic |
$ |
1.52 |
$ |
0.86 |
||
Diluted |
$ |
1.50 |
$ |
0.85 |
||
Weighted average common shares outstanding: |
||||||
Basic |
44,365,987 |
44,165,200 |
||||
Diluted |
44,826,663 |
44,493,755 |
|
|||||
Consolidated Balance Sheets |
|||||
(Unaudited; dollars in millions except share data) |
|||||
|
|
||||
Assets |
|||||
Current Assets: |
|||||
Cash and cash equivalents |
$ |
5,610.4 |
$ |
3,961.4 |
|
Short-term investments |
394.8 |
124.2 |
|||
Premiums receivable, net |
627.8 |
498.6 |
|||
Pharmacy rebates receivable, net |
272.4 |
278.0 |
|||
Receivables from government partners |
73.7 |
— |
|||
Funds receivable for the benefit of members |
24.7 |
32.6 |
|||
Prepaid expenses and other current assets, net |
264.7 |
224.8 |
|||
Total current assets |
7,268.5 |
5,119.6 |
|||
Property, equipment and capitalized software, net |
273.9 |
274.5 |
|||
|
377.5 |
392.5 |
|||
Other intangible assets, net |
94.9 |
74.1 |
|||
Long-term investments |
135.3 |
57.3 |
|||
Restricted investments |
192.1 |
234.3 |
|||
Other assets |
0.4 |
0.5 |
|||
Total Assets |
$ |
8,342.6 |
$ |
6,152.8 |
|
Liabilities and Stockholders' Equity |
|||||
Current Liabilities: |
|||||
Medical benefits payable |
$ |
1,787.6 |
$ |
1,690.5 |
|
Unearned premiums |
432.9 |
3.3 |
|||
Accounts payable and accrued expenses |
468.8 |
668.5 |
|||
Funds payable for the benefit of members |
1,058.8 |
390.3 |
|||
Current portion of long-term debt |
900.0 |
— |
|||
Other payables to government partners |
364.9 |
303.2 |
|||
Total current liabilities |
5,013.0 |
3,055.8 |
|||
Deferred income tax liability |
47.2 |
63.4 |
|||
Long-term debt |
1,180.1 |
997.6 |
|||
Other liabilities |
38.6 |
35.9 |
|||
Total liabilities |
6,278.9 |
4,152.7 |
|||
Commitments and contingencies |
— |
— |
|||
Stockholders' Equity: |
|||||
Preferred stock, |
— |
— |
|||
Common stock, |
0.4 |
0.4 |
|||
Paid-in capital |
543.1 |
546.9 |
|||
Retained earnings |
1,521.1 |
1,453.8 |
|||
Accumulated other comprehensive loss |
(0.9) |
(1.0) |
|||
Total Stockholders' Equity |
2,063.7 |
2,000.1 |
|||
Total Liabilities and Stockholders' Equity |
$ |
8,342.6 |
$ |
6,152.8 |
|
|||||
Consolidated Statements of Cash Flows |
|||||
(Unaudited; dollars in millions) |
|||||
For the Three Months Ended |
|||||
2017 |
2016 |
||||
Cash flows from operating activities: |
|||||
Net income |
$ |
67.3 |
$ |
37.8 |
|
Adjustments to reconcile net income to cash flows from operating activities: |
|||||
Depreciation and amortization |
23.9 |
20.8 |
|||
Stock-based compensation expense |
9.6 |
6.5 |
|||
Deferred taxes, net |
(25.8) |
15.4 |
|||
Other, net |
4.3 |
5.1 |
|||
Changes in operating accounts, net of effects from acquisitions: |
|||||
Premiums receivable, net |
(120.8) |
(146.1) |
|||
Pharmacy rebates receivable, net |
5.6 |
(144.4) |
|||
Medical benefits payable |
97.7 |
9.7 |
|||
Unearned premiums |
431.8 |
(17.0) |
|||
Other payables to government partners |
(12.0) |
21.1 |
|||
Accrued liabilities and other, net |
(87.1) |
79.7 |
|||
Net cash provided by (used in) operating activities |
394.5 |
(111.4) |
|||
Cash flow from investing activities: |
|||||
Purchases of investments |
(436.9) |
(20.5) |
|||
Proceeds from sales and maturities of investments |
97.2 |
45.7 |
|||
Additions to property, equipment and capitalized software, net |
(23.8) |
(16.8) |
|||
Net cash (used in) provided by investing activities |
(363.5) |
8.4 |
|||
Cash flows from financing activities: |
|||||
Proceeds from issuance of debt, net of financing costs paid |
1,182.2 |
196.9 |
|||
Payments on debt |
(100.0) |
(300.0) |
|||
Repurchase and retirement of shares to satisfy employee tax withholding requirements |
(13.4) |
(5.5) |
|||
Funds received for the benefit of members, net |
567.4 |
196.1 |
|||
Other, net |
(18.2) |
0.1 |
|||
Net cash provided by financing activities |
1,618.0 |
87.6 |
|||
Increase (decrease) in cash and cash equivalents |
1,649.0 |
(15.4) |
|||
Balance at beginning of period |
3,961.4 |
2,407.0 |
|||
Balance at end of period |
$ |
5,610.4 |
$ |
2,391.6 |
|
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION: |
|||||
Cash paid for taxes |
$ |
63.9 |
$ |
1.5 |
|
Cash paid for interest |
$ |
1.3 |
$ |
1.6 |
|
SUPPLEMENTAL DISCLOSURES OF NON-CASH TRANSACTIONS: |
|||||
Non-cash additions to property, equipment, and capitalized software |
$ |
3.3 |
$ |
7.5 |
|
|||||||
SUPPLEMENTAL INFORMATION |
|||||||
SELECTED SEGMENT INFORMATION |
|||||||
(Unaudited; dollars in millions) |
|||||||
For the Three Months Ended |
|||||||
2017 |
2016 |
||||||
Medicaid Health Plans Segment: |
|||||||
Adjusted premium revenue (a) |
$ |
2,554.3 |
$ |
2,226.4 |
|||
|
29.9 |
27.2 |
|||||
ACA industry fee reimbursement |
— |
58.1 |
|||||
Premium revenue (GAAP) |
2,584.2 |
2,311.7 |
|||||
Medical benefits expense |
2,310.6 |
2,001.9 |
|||||
Medical benefits ratio (GAAP) |
89.4 |
% |
86.6 |
% |
|||
Adjusted medical benefits ratio(a) |
90.5 |
% |
89.9 |
% |
|||
Medicare Health Plans Segment (GAAP): |
|||||||
Premium revenue |
$ |
1,094.7 |
$ |
974.1 |
|||
Medical benefits expense |
908.2 |
824.2 |
|||||
Medical benefits ratio |
83.0 |
% |
84.6 |
% |
|||
Prescription Drug Plans Segment (GAAP): |
|||||||
Premium revenue |
$ |
268.1 |
$ |
250.2 |
|||
Medical benefits expense |
259.8 |
235.8 |
|||||
Medical benefits ratio |
96.9 |
% |
94.3 |
% |
|||
|
|||||||
Adjusted premium revenue( a) |
$ |
3,917.1 |
$ |
3,450.7 |
|||
|
29.9 |
27.2 |
|||||
ACA industry fee reimbursement |
— |
58.1 |
|||||
Premium revenue (GAAP) |
3,947.0 |
3,536.0 |
|||||
Medical benefits expense |
3,478.6 |
3,061.9 |
|||||
Medical benefits ratio (GAAP) |
88.1 |
% |
86.6 |
% |
|||
Adjusted medical benefits ratio(a) |
88.8 |
% |
88.7 |
% |
|||
(a) Refer to the basis of presentation for a discussion of non-GAAP financial measures. |
|
|||||||
SUPPLEMENTAL INFORMATION (Continued) |
|||||||
Reconciliation of Selling, General and Administrative Expense Ratios |
|||||||
(Unaudited; dollars in millions) |
|||||||
The Company reports its selling, general and administrative ("SG&A") expense ratio on an adjusted or non-GAAP basis modified to exclude the |
|||||||
For the Three Months Ended |
|||||||
2017 |
2016 |
||||||
Company premium revenue: |
|||||||
As determined under GAAP |
$ |
3,947.0 |
$ |
3,536.0 |
|||
|
(29.9) |
(27.2) |
|||||
ACA industry fee reimbursement |
— |
(58.1) |
|||||
Adjusted premium revenue(a) |
$ |
3,917.1 |
$ |
3,450.7 |
|||
SG&A Expense: |
|||||||
As determined under GAAP |
$ |
302.4 |
$ |
268.9 |
|||
Adjustments: |
|||||||
Investigation costs |
(3.1) |
(6.5) |
|||||
Transaction and integration costs |
(1.1) |
— |
|||||
Sterling divestiture costs |
— |
0.3 |
|||||
PBM transitory costs |
— |
(4.9) |
|||||
Iowa SG&A costs |
— |
(5.2) |
|||||
Adjusted SG&A Expense(a) |
$ |
298.2 |
$ |
252.6 |
|||
SG&A expense ratio: |
|||||||
As determined under GAAP |
7.7 |
% |
7.6 |
% |
|||
Effect of |
0.1 |
% |
0.1 |
% |
|||
Effect of ACA industry fee reimbursement |
— |
% |
0.1 |
% |
|||
Effect of SG&A expense adjustments above(a) |
(0.2) |
% |
(0.5) |
% |
|||
Adjusted SG&A expense ratio(a) |
7.6 |
% |
7.3 |
% |
|||
(a) Refer to the basis of presentation for a discussion of non-GAAP financial measures. |
|||||||
|
||||||||||||||||||||||||
SUPPLEMENTAL INFORMATION (Continued) |
||||||||||||||||||||||||
Reconciliation of Certain GAAP Financial Information |
||||||||||||||||||||||||
(Unaudited; dollars in millions, except per share data) |
||||||||||||||||||||||||
The Company reports adjusted operating results on a non-GAAP basis to exclude certain expenses and other items that management believes are not indicative of longer-term |
||||||||||||||||||||||||
For the Three Months Ended |
For the Three Months Ended |
|||||||||||||||||||||||
GAAP |
Adjustments |
Adjusted |
GAAP |
Adjustments |
Adjusted |
|||||||||||||||||||
Selling, general, and administrative expense |
$ |
302.4 |
$ |
(4.2) |
(a) |
$ |
298.2 |
$ |
268.9 |
$ |
(16.3) |
(a) |
$ |
252.6 |
||||||||||
Depreciation and amortization |
$ |
23.9 |
$ |
(3.2) |
$ |
20.7 |
$ |
20.8 |
$ |
(2.5) |
$ |
18.3 |
||||||||||||
Income tax expense |
$ |
35.9 |
$ |
2.7 |
(b) |
$ |
38.6 |
$ |
51.1 |
$ |
8.9 |
(b) |
$ |
60.0 |
||||||||||
Effective tax rate |
34.8 |
% |
0.1 |
% |
(b) |
34.9 |
% |
57.5 |
% |
(1.8) |
% |
(b) |
55.7 |
% |
||||||||||
Net income |
$ |
67.3 |
$ |
4.7 |
$ |
72.0 |
$ |
37.8 |
$ |
9.9 |
$ |
47.7 |
||||||||||||
Net income margin |
1.7 |
% |
0.1 |
% |
1.8 |
% |
1.1 |
% |
0.3 |
% |
1.4 |
% |
||||||||||||
Earnings per share: |
||||||||||||||||||||||||
Basic |
$ |
1.52 |
$ |
0.10 |
$ |
1.62 |
$ |
0.86 |
$ |
0.22 |
$ |
1.08 |
||||||||||||
Diluted |
$ |
1.50 |
$ |
0.11 |
$ |
1.61 |
$ |
0.85 |
$ |
0.22 |
$ |
1.07 |
(a) |
Comprised of investigation costs and Universal American-related transaction and integration costs for 2017, and investigation, Sterling divestiture, PBM transitory and Iowa SG&A costs for 2016, as disclosed in the "Reconciliation of Selling, General and Administrative Expense Ratios" table. |
(b) |
Based on the effective income tax rates applicable to adjusted (non-GAAP) results, the company estimated the effect on income tax expense and the effective tax rate associated with the non-GAAP adjustments. Refer to the basis of presentation for a discussion of non-GAAP financial measures. |
To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/wellcare-reports-first-quarter-2017-results-300450201.html
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