
Contact: | Investor Relations Inquiries |
Edmund E. Kroll, Jr. | |
Senior Vice President, Finance & Investor Relations | |
(212) 759-0382 | |
Media Inquiries | |
Marcela Manjarrez-Hawn | |
Senior Vice President and Chief Communications Officer | |
(314) 445-0790 | |
Total revenues (in millions) | $ | 11,898 | ||
Health benefits ratio | 88.0 | % | ||
SG&A expense ratio | 9.0 | % | ||
GAAP diluted EPS | $ | 1.16 | ||
Adjusted Diluted EPS (1) | $ | 1.35 | ||
Total cash flow provided by operations (in millions) | $ | 97 | ||
(1) A full reconciliation of Adjusted Diluted EPS is shown on page six of this release. | ||||
• | September 30, 2017 managed care membership of 12.3 million, an increase of 874,900 members, or 8% compared to the third quarter of 2016. |
• | Total revenues for the third quarter of 2017 of $11.9 billion, representing 10% growth, compared to the third quarter of 2016. |
• | Health benefits ratio (HBR) of 88.0% for the third quarter of 2017, compared to 87.0% in the third quarter of 2016. |
• | Selling, general and administrative (SG&A) expense ratio of 9.0% for the third quarter of 2017, compared to 9.2% for the third quarter of 2016. |
• | Adjusted SG&A expense ratio of 8.9% for the third quarter of 2017, compared to 9.1% for the third quarter of 2016. |
• | Operating cash flow of $97 million for the third quarter of 2017 and $1,039 million for the nine months ended September 30, 2017. |
• | Diluted EPS for the third quarter of 2017 of $1.16, compared to $0.84 for the third quarter of 2016. |
• | Adjusted Diluted EPS for the third quarter of 2017 of $1.35, compared to $1.12 for the third quarter of 2016. |
• | In October 2017, the Company announced the early termination of the waiting period required under the Hart-Scott-Rodino Antitrust Improvements Act of 1976, as amended, for its Fidelis Care acquisition. In September 2017, the Company signed a definitive agreement under which Fidelis Care will become the Company's health plan in New York State. Under the terms of the agreement, the Company will acquire substantially all of the assets of Fidelis Care for $3.75 billion, subject to certain adjustments. The transaction is expected to close in the first quarter of 2018, subject to various closing conditions and receipt of New York regulatory approvals, including approvals under the New York Not-for-Profit Corporation Law. |
• | In October 2017, the Centers for Medicare and Medicaid Services (CMS) published updated Medicare Star quality ratings for the 2018 rating year. The 2018 rating year will affect quality bonus payments for Medicare Advantage plans in 2019. The results indicate that one of Health Net of California, Inc.'s Medicare Advantage plans (H0562) will move to a 3.5 Star rating from a 4.0 Star rating for the 2018 rating year. The effect of this Star rating change would lower the Company's parent Star rating for the 2018 rating year from 4.0 Stars to 3.5 Stars. The Company intends to appeal. |
• | In August 2017, our Illinois subsidiary, IlliniCare Health, was awarded the state-wide contract for the Medicaid Managed Care Program including children who are in need through the Department of Children and Family Services (DCFS)/Youth in Care by the Illinois Department of Healthcare and Family Services (HFS). The new agreement has a four-year term, with the option to renew the contract for up to an additional four years, and is expected to commence on January 1, 2018. |
• | In August 2017, Centurion was recommended for a contract award by the Tennessee Department of Correction to continue providing inmate health services. This contract is expected to commence in the first quarter of 2018. |
• | In September 2017, FORTUNE magazine announced Centene's position of #19 in its third-annual "Change the World" list of the top 50 companies that have made an important social or environmental impact through their profit-making strategy and operations. Companies are recognized for, and competitively ranked on, innovative strategies that positively impact the world. |
• | In September 2017, Health Net Federal Services, LLC, earned the Disease Management Accreditation from URAC. In August 2017, Envolve Dental, Inc., earned URAC accreditations for Dental Plan and Health Management. In addition, Buckeye Health Plan, Coordinated Care of Washington, Louisiana Healthcare Connections, CeltiCare Health, and New Hampshire Healthy Families earned Commendable Health Plan Accreditations from NCQA. |
• | In September 2017, FORTUNE magazine announced Centene's position of #27 on the Fortune 100 Fastest Growing Companies for 2017. |
• | In August 2017, Centene was named to the 2017 list of the Best Places to Work for People with Disabilities, presented by the American Association of People with Disabilities and the U.S. Business Leadership Network. |
September 30, | |||||
2017 | 2016 | ||||
Arizona | 659,500 | 601,500 | |||
Arkansas | 89,900 | 57,700 | |||
California | 2,928,600 | 3,004,500 | |||
Florida | 852,600 | 732,700 | |||
Georgia | 476,400 | 498,000 | |||
Illinois | 251,000 | 236,700 | |||
Indiana | 322,900 | 289,600 | |||
Kansas | 127,300 | 145,100 | |||
Louisiana | 483,300 | 455,600 | |||
Massachusetts | 48,300 | 45,300 | |||
Michigan | 2,400 | 2,100 | |||
Minnesota | 9,500 | 9,400 | |||
Mississippi | 335,600 | 313,900 | |||
Missouri | 272,100 | 104,700 | |||
Nebraska | 79,200 | — | |||
Nevada | 16,800 | — | |||
New Hampshire | 76,400 | 78,400 | |||
New Mexico | 7,100 | 7,100 | |||
Ohio | 336,500 | 319,500 | |||
Oregon | 209,700 | 218,400 | |||
South Carolina | 118,600 | 119,700 | |||
Tennessee | 22,100 | 21,600 | |||
Texas | 1,236,700 | 1,041,600 | |||
Vermont | 1,600 | 1,700 | |||
Washington | 239,600 | 240,500 | |||
Wisconsin | 70,200 | 75,100 | |||
Total at-risk membership | 9,273,900 | 8,620,400 | |||
TRICARE eligibles | 2,823,200 | 2,815,700 | |||
Non-risk membership | 213,900 | — | |||
Total | 12,311,000 | 11,436,100 | |||
September 30, | |||||
2017 | 2016 | ||||
Medicaid: | |||||
TANF, CHIP & Foster Care | 5,809,400 | 5,583,900 | |||
ABD & LTC | 850,300 | 754,900 | |||
Behavioral Health | 467,400 | 465,300 | |||
Commercial | 1,657,800 | 1,333,000 | |||
Medicare & Duals (1) | 331,000 | 333,500 | |||
Correctional | 158,000 | 149,800 | |||
Total at-risk membership | 9,273,900 | 8,620,400 | |||
TRICARE eligibles | 2,823,200 | 2,815,700 | |||
Non-risk membership | 213,900 | — | |||
Total | 12,311,000 | 11,436,100 | |||
(1) Membership includes Medicare Advantage, Medicare Supplement, Special Needs Plans, and Medicare-Medicaid Plans. | |||||
September 30, | |||||
2017 | 2016 | ||||
Dual-eligible (2) | 475,300 | 437,500 | |||
Health Insurance Marketplace | 1,024,000 | 582,600 | |||
Medicaid Expansion | 1,105,000 | 1,048,500 | |||
(2) Membership includes dual-eligible ABD & LTC and dual-eligible Medicare membership in the table above. | |||||
• | For the third quarter of 2017, total revenues increased 10% to $11.9 billion from $10.8 billion in the comparable period in 2016. The increase over prior year was primarily a result of growth in the Health Insurance Marketplace business in 2017 and expansions and new programs in many of our states in 2016 and 2017. This was partially offset by the moratorium of the Health Insurer Fee in 2017, lower membership in the commercial business in California as a result of margin improvement actions taken last year, and the addition of a competitor in Georgia. Sequentially, total revenues remained relatively consistent with the second quarter of 2017. |
• | HBR of 88.0% for the third quarter of 2017 represents an increase from 87.0% in the comparable period in 2016. The year-over-year increase is primarily a result of new or expanded health plans, which initially operate at a higher HBR, an increase in higher acuity members, and a premium rate reduction for California Medicaid Expansion effective July 1, 2017. |
• | HBR increased sequentially from 86.3% in the second quarter of 2017. The increase is primarily attributable to the favorable risk adjustment in our Health Insurance Marketplace business recorded in the second quarter of 2017, the previously mentioned California Medicaid Expansion premium rate reduction, and normal seasonality of the business. |
• | The SG&A expense ratio was 9.0% for the third quarter of 2017, compared to 9.2% for the third quarter of 2016 and 9.3% for the second quarter of 2017. The year-over-year decrease in the SG&A expense ratio reflects the leveraging of expenses over higher revenues in 2017. |
• | The Adjusted SG&A expense ratio was 8.9% for the third quarter of 2017, compared to 9.1% for the third quarter of 2016 and 9.3% for the second quarter of 2017. The year-over-year decrease in the Adjusted SG&A expense ratio reflects the leveraging of expenses over higher revenues in 2017. Sequentially, the Adjusted SG&A expense ratio decreased primarily due to higher variable compensation expense in the second quarter as a result of higher earnings. |
Days in claims payable, June 30, 2017 | 40 | ||
Timing of claims payments and the impact of new business | 2 | ||
Days in claims payable, September 30, 2017 | 42 | ||
• | The favorable performance in the third quarter of 2017. |
• | An increase in our business expansion cost range from $0.42 - $0.47 per diluted share to $0.46 - $0.51 per diluted share, reflecting additional Marketplace marketing and membership outreach efforts. |
• | An increase in acquisition related expenses from $5 million - $8 million to $20 million - $25 million. |
Full Year 2017 | |||||||||
Low | High | ||||||||
Total revenues (in billions) | $ | 47.4 | $ | 48.2 | |||||
GAAP diluted EPS | $ | 4.04 | $ | 4.18 | |||||
Adjusted Diluted EPS (1) | $ | 4.86 | $ | 5.04 | |||||
HBR | 87.0 | % | 87.4 | % | |||||
SG&A expense ratio | 9.4 | % | 9.8 | % | |||||
Adjusted SG&A expense ratio (2) | 9.3 | % | 9.7 | % | |||||
Effective tax rate | 39.0 | % | 41.0 | % | |||||
Diluted shares outstanding (in millions) | 176.3 | 177.3 | |||||||
(1) | Adjusted Diluted EPS excludes amortization of acquired intangible assets of $0.55 to $0.57 per diluted share, Health Net and Fidelis acquisition related expenses of $0.07 to $0.09 per diluted share, and Penn Treaty assessment expense of $0.20 per diluted share. |
(2) | Adjusted SG&A expense ratio excludes Health Net and Fidelis acquisition related expenses of $20 million to $25 million and the Penn Treaty assessment expense of $56 million. |
Three Months Ended September 30, | Nine Months Ended September 30, | ||||||||||||||
2017 | 2016 | 2017 | 2016 | ||||||||||||
GAAP net earnings from continuing operations | $ | 205 | $ | 148 | $ | 598 | $ | 304 | |||||||
Amortization of acquired intangible assets | 38 | 43 | 117 | 95 | |||||||||||
Acquisition related expenses | 7 | 10 | 13 | 224 | |||||||||||
Penn Treaty assessment expense (1) | 9 | — | 56 | — | |||||||||||
Income tax effects of adjustments (2) | (20 | ) | (5 | ) | (68 | ) | (106 | ) | |||||||
Adjusted net earnings from continuing operations | $ | 239 | $ | 196 | $ | 716 | $ | 517 | |||||||
(1) | Additional expense for the Company's estimated share of guaranty association assessment resulting from the liquidation of Penn Treaty. |
(2) | The income tax effects of adjustments are based on the effective income tax rates applicable to adjusted (non-GAAP) results. |
Three Months Ended September 30, | Nine Months Ended September 30, | Annual Guidance December 31, 2017 | |||||||||||||||
2017 | 2016 | 2017 | 2016 | ||||||||||||||
GAAP diluted earnings per share (EPS) | $ | 1.16 | $ | 0.84 | $ | 3.39 | $ | 1.90 | $4.04 - $4.18 | ||||||||
Amortization of acquired intangible assets (1) | 0.14 | 0.16 | 0.42 | 0.36 | $0.55 - $0.57 | ||||||||||||
Acquisition related expenses (2) | 0.02 | 0.12 | 0.05 | 0.97 | $0.07 - $0.09 | ||||||||||||
Penn Treaty assessment expense (3) | 0.03 | — | 0.20 | — | $0.20 | ||||||||||||
Adjusted Diluted EPS from continuing operations | $ | 1.35 | $ | 1.12 | $ | 4.06 | $ | 3.23 | $4.86 - $5.04 | ||||||||
(1) | The amortization of acquired intangible assets per diluted share presented above are net of an income tax benefit of $0.07 and $0.09 for the three months ended September 30, 2017 and 2016, respectively, and $0.24 and $0.23 for the nine months ended September 30, 2017 and 2016, respectively; and estimated $0.31 to $0.35 for the year ended December 31, 2017. |
(2) | The acquisition related expenses per diluted share presented above are net of an income tax benefit (expense) of $0.02 and $(0.06) for the three months ended September 30, 2017 and 2016, respectively, and $0.03 and $0.43 for the nine months ended September 30, 2017 and 2016, respectively; and estimated $0.04 to $0.06 for the year ended December 31, 2017. |
(3) | The Penn Treaty assessment expense per diluted share is net of an income tax benefit of $0.02 and $0.12 for the three and nine months ended September 30, 2017, respectively, and $0.12 estimated for the year ended December 31, 2017. |
Three Months Ended September 30, | Nine Months Ended September 30, | Three Months Ended June 30, | |||||||||||||||||
2017 | 2016 | 2017 | 2016 | 2017 | |||||||||||||||
GAAP SG&A expenses | $ | 1,030 | $ | 940 | $ | 3,186 | $ | 2,611 | $ | 1,065 | |||||||||
Acquisition related expenses | 7 | 10 | 13 | 224 | 1 | ||||||||||||||
Penn Treaty assessment expense | 9 | — | 56 | — | — | ||||||||||||||
Adjusted SG&A expenses | $ | 1,014 | $ | 930 | $ | 3,117 | $ | 2,387 | $ | 1,064 | |||||||||
September 30, 2017 | December 31, 2016 | ||||||
(Unaudited) | |||||||
ASSETS | |||||||
Current assets: | |||||||
Cash and cash equivalents | $ | 4,281 | $ | 3,930 | |||
Premium and related receivables | 3,955 | 3,098 | |||||
Short-term investments | 595 | 505 | |||||
Other current assets | 829 | 832 | |||||
Total current assets | 9,660 | 8,365 | |||||
Long-term investments | 4,927 | 4,545 | |||||
Restricted deposits | 138 | 138 | |||||
Property, software and equipment, net | 1,003 | 797 | |||||
Goodwill | 4,712 | 4,712 | |||||
Intangible assets, net | 1,428 | 1,545 | |||||
Other long-term assets | 132 | 95 | |||||
Total assets | $ | 22,000 | $ | 20,197 | |||
LIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND STOCKHOLDERS’ EQUITY | |||||||
Current liabilities: | |||||||
Medical claims liability | $ | 4,333 | $ | 3,929 | |||
Accounts payable and accrued expenses | 4,804 | 4,377 | |||||
Unearned revenue | 568 | 313 | |||||
Current portion of long-term debt | 4 | 4 | |||||
Total current liabilities | 9,709 | 8,623 | |||||
Long-term debt | 4,717 | 4,651 | |||||
Other long-term liabilities | 901 | 869 | |||||
Total liabilities | 15,327 | 14,143 | |||||
Commitments and contingencies | |||||||
Redeemable noncontrolling interests | 20 | 145 | |||||
Stockholders’ equity: | |||||||
Preferred stock, $0.001 par value; authorized 10,000 shares; no shares issued or outstanding at September 30, 2017 and December 31, 2016 | — | — | |||||
Common stock, $0.001 par value; authorized 400,000 shares; 179,033 issued and 172,566 outstanding at September 30, 2017, and 178,134 issued and 171,919 outstanding at December 31, 2016 | — | — | |||||
Additional paid-in capital | 4,310 | 4,190 | |||||
Accumulated other comprehensive earnings (loss) | 9 | (36 | ) | ||||
Retained earnings | 2,518 | 1,920 | |||||
Treasury stock, at cost (6,467 and 6,215 shares, respectively) | (197 | ) | (179 | ) | |||
Total Centene stockholders’ equity | 6,640 | 5,895 | |||||
Noncontrolling interest | 13 | 14 | |||||
Total stockholders’ equity | 6,653 | 5,909 | |||||
Total liabilities, redeemable noncontrolling interests and stockholders’ equity | $ | 22,000 | $ | 20,197 | |||
Three Months Ended September 30, | Nine Months Ended September 30, | ||||||||||||||
2017 | 2016 | 2017 | 2016 | ||||||||||||
Revenues: | |||||||||||||||
Premium | $ | 10,850 | $ | 9,625 | $ | 32,393 | $ | 25,299 | |||||||
Service | 571 | 590 | 1,634 | 1,603 | |||||||||||
Premium and service revenues | 11,421 | 10,215 | 34,027 | 26,902 | |||||||||||
Premium tax and health insurer fee | 477 | 631 | 1,549 | 1,794 | |||||||||||
Total revenues | 11,898 | 10,846 | 35,576 | 28,696 | |||||||||||
Expenses: | |||||||||||||||
Medical costs | 9,543 | 8,376 | 28,278 | 22,072 | |||||||||||
Cost of services | 437 | 504 | 1,334 | 1,386 | |||||||||||
Selling, general and administrative expenses | 1,030 | 940 | 3,186 | 2,611 | |||||||||||
Amortization of acquired intangible assets | 38 | 43 | 117 | 95 | |||||||||||
Premium tax expense | 510 | 512 | 1,643 | 1,460 | |||||||||||
Health insurer fee expense | — | 129 | — | 333 | |||||||||||
Total operating expenses | 11,558 | 10,504 | 34,558 | 27,957 | |||||||||||
Earnings from operations | 340 | 342 | 1,018 | 739 | |||||||||||
Other income (expense): | |||||||||||||||
Investment and other income | 51 | 33 | 137 | 80 | |||||||||||
Interest expense | (65 | ) | (57 | ) | (189 | ) | (142 | ) | |||||||
Earnings from continuing operations, before income tax expense | 326 | 318 | 966 | 677 | |||||||||||
Income tax expense | 125 | 169 | 381 | 372 | |||||||||||
Earnings from continuing operations, net of income tax expense | 201 | 149 | 585 | 305 | |||||||||||
Discontinued operations, net of income tax benefit | — | (1 | ) | — | (3 | ) | |||||||||
Net earnings | 201 | 148 | 585 | 302 | |||||||||||
(Earnings) loss attributable to noncontrolling interests | 4 | (1 | ) | 13 | (1 | ) | |||||||||
Net earnings attributable to Centene Corporation | $ | 205 | $ | 147 | $ | 598 | $ | 301 | |||||||
Amounts attributable to Centene Corporation common shareholders: | |||||||||||||||
Earnings from continuing operations, net of income tax expense | $ | 205 | $ | 148 | $ | 598 | $ | 304 | |||||||
Discontinued operations, net of income tax benefit | — | (1 | ) | — | (3 | ) | |||||||||
Net earnings | $ | 205 | $ | 147 | $ | 598 | $ | 301 | |||||||
Net earnings (loss) per common share attributable to Centene Corporation: | |||||||||||||||
Basic: | |||||||||||||||
Continuing operations | $ | 1.19 | $ | 0.87 | $ | 3.47 | $ | 1.95 | |||||||
Discontinued operations | — | (0.01 | ) | — | (0.02 | ) | |||||||||
Basic earnings per common share | $ | 1.19 | $ | 0.86 | $ | 3.47 | $ | 1.93 | |||||||
Diluted: | |||||||||||||||
Continuing operations | $ | 1.16 | $ | 0.84 | $ | 3.39 | $ | 1.90 | |||||||
Discontinued operations | — | — | — | (0.02 | ) | ||||||||||
Diluted earnings per common share | $ | 1.16 | $ | 0.84 | $ | 3.39 | $ | 1.88 | |||||||
Nine Months Ended September 30, | |||||||
2017 | 2016 | ||||||
Cash flows from operating activities: | |||||||
Net earnings | $ | 585 | $ | 302 | |||
Adjustments to reconcile net earnings to net cash provided by operating activities | |||||||
Depreciation and amortization | 264 | 189 | |||||
Stock compensation expense | 99 | 112 | |||||
Deferred income taxes | (32 | ) | (17 | ) | |||
Changes in assets and liabilities | |||||||
Premium and related receivables | (749 | ) | (906 | ) | |||
Other assets | (39 | ) | 7 | ||||
Medical claims liabilities | 406 | 15 | |||||
Unearned revenue | 255 | 301 | |||||
Accounts payable and accrued expenses | 205 | 99 | |||||
Other long-term liabilities | 45 | 156 | |||||
Other operating activities, net | — | 1 | |||||
Net cash provided by operating activities | 1,039 | 259 | |||||
Cash flows from investing activities: | |||||||
Capital expenditures | (301 | ) | (211 | ) | |||
Purchases of investments | (1,720 | ) | (1,528 | ) | |||
Sales and maturities of investments | 1,335 | 955 | |||||
Investments in acquisitions, net of cash acquired | — | (848 | ) | ||||
Net cash used in investing activities | (686 | ) | (1,632 | ) | |||
Cash flows from financing activities: | |||||||
Proceeds from long-term debt | 1,170 | 6,956 | |||||
Payments of long-term debt | (1,124 | ) | (4,257 | ) | |||
Common stock repurchases | (18 | ) | (29 | ) | |||
Purchase of noncontrolling interest | (33 | ) | (14 | ) | |||
Debt issuance costs | — | (59 | ) | ||||
Other financing activities, net | 2 | (3 | ) | ||||
Net cash (used in) provided by financing activities | (3 | ) | 2,594 | ||||
Effect of exchange rate changes on cash and cash equivalents | 1 | 1 | |||||
Net increase in cash and cash equivalents | 351 | 1,222 | |||||
Cash and cash equivalents, beginning of period | 3,930 | 1,760 | |||||
Cash and cash equivalents, end of period | $ | 4,281 | $ | 2,982 | |||
Supplemental disclosures of cash flow information: | |||||||
Interest paid | $ | 210 | $ | 113 | |||
Income taxes paid | $ | 358 | $ | 394 | |||
Equity issued in connection with acquisitions | $ | — | $ | 3,105 | |||
Q3 | Q2 | Q1 | Q4 | Q3 | |||||||||||
2017 | 2017 | 2017 | 2016 | 2016 | |||||||||||
MANAGED CARE MEMBERSHIP BY STATE | |||||||||||||||
Arizona | 659,500 | 669,500 | 684,300 | 598,300 | 601,500 | ||||||||||
Arkansas | 89,900 | 91,900 | 98,100 | 58,600 | 57,700 | ||||||||||
California | 2,928,600 | 2,925,800 | 2,980,100 | 2,973,500 | 3,004,500 | ||||||||||
Florida | 852,600 | 871,100 | 872,000 | 716,100 | 732,700 | ||||||||||
Georgia | 476,400 | 540,400 | 568,300 | 488,000 | 498,000 | ||||||||||
Illinois | 251,000 | 254,600 | 253,800 | 237,700 | 236,700 | ||||||||||
Indiana | 322,900 | 340,000 | 335,800 | 285,800 | 289,600 | ||||||||||
Kansas | 127,300 | 130,000 | 133,100 | 139,700 | 145,100 | ||||||||||
Louisiana | 483,300 | 484,600 | 484,100 | 472,800 | 455,600 | ||||||||||
Massachusetts | 48,300 | 54,100 | 44,200 | 48,300 | 45,300 | ||||||||||
Michigan | 2,400 | 2,300 | 2,100 | 2,000 | 2,100 | ||||||||||
Minnesota | 9,500 | 9,500 | 9,500 | 9,400 | 9,400 | ||||||||||
Mississippi | 335,600 | 343,600 | 349,500 | 310,200 | 313,900 | ||||||||||
Missouri | 272,100 | 278,300 | 106,100 | 105,700 | 104,700 | ||||||||||
Nebraska | 79,200 | 78,800 | 79,200 | — | — | ||||||||||
Nevada | 16,800 | — | — | — | — | ||||||||||
New Hampshire | 76,400 | 77,100 | 77,800 | 77,400 | 78,400 | ||||||||||
New Mexico | 7,100 | 7,100 | 7,100 | 7,100 | 7,100 | ||||||||||
Ohio | 336,500 | 332,700 | 328,900 | 316,000 | 319,500 | ||||||||||
Oregon | 209,700 | 213,600 | 211,900 | 217,800 | 218,400 | ||||||||||
South Carolina | 118,600 | 121,000 | 121,900 | 122,500 | 119,700 | ||||||||||
Tennessee | 22,100 | 22,200 | 21,900 | 21,700 | 21,600 | ||||||||||
Texas | 1,236,700 | 1,226,800 | 1,243,900 | 1,072,400 | 1,041,600 | ||||||||||
Vermont | 1,600 | 1,600 | 1,600 | 1,600 | 1,700 | ||||||||||
Washington | 239,600 | 248,500 | 254,400 | 238,400 | 240,500 | ||||||||||
Wisconsin | 70,200 | 70,800 | 71,700 | 73,800 | 75,100 | ||||||||||
Total at-risk membership | 9,273,900 | 9,395,900 | 9,341,300 | 8,594,800 | 8,620,400 | ||||||||||
TRICARE eligibles | 2,823,200 | 2,823,200 | 2,804,100 | 2,847,000 | 2,815,700 | ||||||||||
Non-risk membership | 213,900 | — | — | — | — | ||||||||||
Total | 12,311,000 | 12,219,100 | 12,145,400 | 11,441,800 | 11,436,100 | ||||||||||
Medicaid: | |||||||||||||||
TANF, CHIP & Foster Care | 5,809,400 | 5,854,400 | 5,714,100 | 5,630,000 | 5,583,900 | ||||||||||
ABD & LTC | 850,300 | 843,500 | 825,600 | 785,400 | 754,900 | ||||||||||
Behavioral Health | 467,400 | 466,500 | 466,900 | 466,600 | 465,300 | ||||||||||
Commercial | 1,657,800 | 1,743,600 | 1,864,700 | 1,239,100 | 1,333,000 | ||||||||||
Medicare & Duals (1) | 331,000 | 327,500 | 328,100 | 334,300 | 333,500 | ||||||||||
Correctional | 158,000 | 160,400 | 141,900 | 139,400 | 149,800 | ||||||||||
Total at-risk membership | 9,273,900 | 9,395,900 | 9,341,300 | 8,594,800 | 8,620,400 | ||||||||||
TRICARE eligibles | 2,823,200 | 2,823,200 | 2,804,100 | 2,847,000 | 2,815,700 | ||||||||||
Non-risk membership | 213,900 | — | — | — | — | ||||||||||
Total | 12,311,000 | 12,219,100 | 12,145,400 | 11,441,800 | 11,436,100 | ||||||||||
(1) Membership includes Medicare Advantage, Medicare Supplement, Special Needs Plans, and Medicare-Medicaid Plans. | |||||||||||||||
NUMBER OF EMPLOYEES | 32,400 | 31,500 | 30,900 | 30,500 | 29,400 | ||||||||||
Q3 | Q2 | Q1 | Q4 | Q3 | |||||||||||||||
2017 | 2017 | 2017 | 2016 | 2016 | |||||||||||||||
DAYS IN CLAIMS PAYABLE (a) | 42 | 40 | 41 | 42 | 41 | ||||||||||||||
(a) Days in claims payable is a calculation of medical claims liabilities at the end of the period divided by average claims expense per calendar day for such period. | |||||||||||||||||||
CASH, INVESTMENTS AND RESTRICTED DEPOSITS (in millions) | |||||||||||||||||||
Regulated | $ | 9,633 | $ | 9,673 | $ | 10,034 | $ | 8,854 | $ | 7,825 | |||||||||
Unregulated | 308 | 291 | 306 | 264 | 268 | ||||||||||||||
Total | $ | 9,941 | $ | 9,964 | $ | 10,340 | $ | 9,118 | $ | 8,093 | |||||||||
DEBT TO CAPITALIZATION | 41.5 | % | 42.5 | % | 43.3 | % | 44.1 | % | 44.5 | % | |||||||||
DEBT TO CAPITALIZATION EXCLUDING NON-RECOURSE DEBT (b) | 41.2 | % | 42.1 | % | 43.0 | % | 43.7 | % | 44.1 | % | |||||||||
(b) The non-recourse debt represents the Company's mortgage note payable ($62 million at September 30, 2017). | |||||||||||||||||||
Debt to capitalization is calculated as follows: total debt divided by (total debt + total equity). | |||||||||||||||||||
Three Months Ended September 30, | Nine Months Ended September 30, | ||||||||||
2017 | 2016 | 2017 | 2016 | ||||||||
HBR | 88.0 | % | 87.0 | % | 87.3 | % | 87.2 | % | |||
SG&A expense ratio | 9.0 | % | 9.2 | % | 9.4 | % | 9.7 | % | |||
Adjusted SG&A expense ratio | 8.9 | % | 9.1 | % | 9.2 | % | 8.9 | % | |||
Balance, September 30, 2016 | $ | 3,767 | ||
Incurred related to: | ||||
Current period | 37,321 | |||
Prior period | (479 | ) | ||
Total incurred | 36,842 | |||
Paid related to: | ||||
Current period | 33,250 | |||
Prior period | 3,043 | |||
Total paid | 36,293 | |||
Balance, September 30, 2017, net | 4,316 | |||
Plus: Reinsurance recoverable | 17 | |||
Balance, September 30, 2017 | $ | 4,333 | ||