Exhibit 99.1
            
centenelogoa02.jpg
N E W S R E L E A S E                                                                                
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

FOR IMMEDIATE RELEASE

CENTENE CORPORATION REPORTS 2018 SECOND QUARTER RESULTS AND UPDATES 2018 GUIDANCE
-- 2018 Second Quarter Diluted EPS of $1.50; Adjusted Diluted EPS of $1.80 --

ST. LOUIS, MISSOURI (July 24, 2018) -- Centene Corporation (NYSE: CNC) announced today its financial results for the second quarter ended June 30, 2018, reporting diluted earnings per share (EPS) of $1.50 and Adjusted Diluted EPS of $1.80.
 
In summary, the 2018 second quarter results were as follows:
Total revenues (in millions)
$
14,181

Health benefits ratio
85.7
%
SG&A expense ratio
9.6
%
GAAP diluted EPS
$
1.50

Adjusted Diluted EPS (1)
$
1.80

Total cash flow used in operations (in millions)
$
(526
)
 
 
(1) A full reconciliation of Adjusted Diluted EPS is shown on page six of this release.

Michael F. Neidorff, Centene's Chairman and Chief Executive Officer, stated, "Centene's strong fundamentals will be enhanced by the strategic and financial benefits of our recently closed Fidelis Care acquisition."

Second Quarter Highlights

•
June 30, 2018 managed care membership of 12.8 million, an increase of 584,700 members, or 5%, over June 30, 2017.

•
Total revenues for the second quarter of 2018 of $14.2 billion, representing 19% growth, compared to the second quarter of 2017.

•
Health benefits ratio (HBR) of 85.7% for the second quarter of 2018, compared to 86.3% in the second quarter of 2017.

•
Selling, general and administrative (SG&A) expense ratio and Adjusted SG&A expense ratio of 9.6% for the second quarter of 2018, compared to 9.3% for the second quarter of 2017.

•
Diluted EPS for the second quarter of 2018 of $1.50, compared to $1.44 for the second quarter of 2017.

•
Adjusted Diluted EPS for the second quarter of 2018 of $1.80, compared to $1.59 for the second quarter of 2017.

1



•
Operating cash flow of $(526) million for the second quarter of 2018, and $1.3 billion for the six months ended June 30, 2018. As expected and highlighted at our June Investor Day, the second quarter cash flow was negatively affected by the repayment of $630 million of Medicaid expansion rate overpayments in California, which was previously accrued.

Other Events

•
In July 2018, we completed the acquisition of substantially all of the assets of Fidelis Care for $3.75 billion. The acquisition was funded through approximately $2.8 billion of new equity and approximately $1.8 billion of new long-term debt. Both offerings were completed in May 2018.

•
In July 2018, our subsidiary, Health Net Federal Services, was awarded the next generation Military & Family Life Counseling Program contract. The awarded contract is up to ten years, including multiple one-year option periods.

•
In July 2018, Centurion began operating under a contract to provide healthcare services for correctional facilities in Pima County, Arizona. In addition, Centurion's contracts for correctional facilities were reprocured in Florida, New Hampshire and Tennessee.

•
In June 2018, our Kansas subsidiary, Sunflower Health Plan, was selected to continue providing managed care services to KanCare beneficiaries statewide. The new contract is expected to commence January 1, 2019.

•
In June 2018, we announced our partnership with the National Council on Independent Living for the "Barrier Removal Fund" program. This program is an initiative to increase the accessibility of provider medical offices and services for people with disabilities.

•
In May 2018, our Washington State subsidiary, Coordinated Care of Washington, was selected to provide expanded managed care services to Apple Health's Fully Integrated Managed Care (FIMC) Medicaid beneficiaries. This new contract integrates physical and behavioral health.

•
In May 2018, our Iowa subsidiary, Iowa Total Care, Inc., was selected to negotiate a new statewide contract for the IA Health Link Program. Pending regulatory approval, the contract is expected to commence on July 1, 2019.

•
In May 2018, our Florida subsidiary, Sunshine Health, was awarded a contract to provide physical and behavioral health care services in all 11 regions through Florida's Statewide Medicaid Managed Care Program, subject to regulatory approval and successful completion of readiness review. The five year contract is expected to begin December 1, 2018 and will be implemented by region through February 2019.

Accreditations & Awards

•
In July 2018, FORTUNE magazine announced Centene's position of #210 in its annual ranking of the largest companies globally by revenue.

•
In July 2018, Forbes announced Centene's position of #43 in its ranking of "Global 2000: Growth Champions."

•
In June 2018, Centene and several of its subsidiaries earned Accreditation from NCQA, including SilverSummit Healthplan and Envolve Pharmacy Solutions.

•
In May 2018, FORTUNE magazine announced Centene's position of #61 in its annual ranking of America's largest companies by revenue.

•
In May 2018, at Decision Health's Ninth Annual Case in Point Platinum Awards, Centene and six of its subsidiaries were honored for their innovative programs.


2


Membership

The following table sets forth our membership by line of business:
 
June 30
 
2018
 
2017
Medicaid:
 
 
 
TANF, CHIP & Foster Care
5,852,000

 
5,854,400

ABD & LTSS
874,200

 
843,500

Behavioral Health
454,600

 
466,500

Total Medicaid
7,180,800

 
7,164,400

Commercial
2,051,700

 
1,743,600

Medicare (1)
343,800

 
327,500

Correctional
157,900

 
160,400

Total at-risk membership
9,734,200

 
9,395,900

TRICARE eligibles
2,851,500

 
2,823,200

Non-risk membership
218,100

 
—

Total
12,803,800

 
12,219,100

 
 
 
 
(1) Membership includes Medicare Advantage, Medicare Supplement, Special Needs Plans, and Medicare-Medicaid Plans (MMP).
    
The following table sets forth additional membership statistics, which are included in the membership information above:
 
June 30
 
2018
 
2017
Dual-eligible (2)
489,500

 
467,500

Health Insurance Marketplace
1,503,100

 
1,084,600

Medicaid Expansion
1,079,700

 
1,101,900

 
 
 
 
(2) Membership includes dual-eligible ABD & LTSS and dual-eligible Medicare membership in the table above.

Revenues

The following table sets forth supplemental revenue information for the three months ended June 30, ($ in millions):
 
2018
 
2017
 
% Change 2017-2018
Medicaid
$
8,919

 
$
8,068

 
11
%
Commercial
3,143

 
2,122

 
48
%
Medicare (1)
1,203

 
1,134

 
6
%
Other
916

 
630

 
45
%
Total Revenues
$
14,181

 
$
11,954

 
19
%
 
 
 
 
 
 
(1) Medicare includes Medicare Advantage, Medicare Supplement, Special Needs Plans, and MMP.

3



Statement of Operations: Three Months Ended June 30, 2018

•
For the second quarter of 2018, total revenues increased 19% to $14.2 billion, from $12.0 billion in the comparable period in 2017. The increase over prior year was due to growth in the Health Insurance Marketplace business in 2018, acquisitions, expansions and new programs in many of our states in 2017 and 2018, and the reinstatement of the health insurer fee in 2018. Total revenues also increased by approximately $500 million associated with pass through payments from the State of California received in the second quarter that were recorded in premium tax revenue and premium tax expense. These increases were partially offset by the impact of the removal of the in-home support services (IHSS) program from California's Medicaid contract in January 2018.

•
Sequentially, total revenues increased 8% over the first quarter of 2018 primarily due to the pass through payments from the State of California noted above, the Illinois contract expansion and acquisitions.

•
HBR of 85.7% for the second quarter of 2018 represents a decrease from 86.3% in the comparable period in 2017. The year-over-year decrease was primarily a result of membership growth in the Health Insurance Marketplace business and the reinstatement of the health insurer fee in 2018. These decreases were partially offset by the impact of retroactive minimum medical loss ratio (MLR) changes under California's Medicaid expansion program.

•
HBR increased sequentially from 84.3% in the first quarter of 2018. The increase was primarily attributable to normal seasonality in the commercial business and the California minimum MLR changes noted above. These HBR increases were partially offset by the decrease in flu-related costs over the first quarter of 2018.

•
The SG&A expense ratio and Adjusted SG&A expense ratio were 9.6% for the second quarter of 2018, compared to 9.3% for the second quarter of 2017. The year-over-year increase was primarily a result of growth in the Health Insurance Marketplace business, which operates at a higher SG&A expense ratio.

Balance Sheet

At June 30, 2018, the Company had cash, investments and restricted deposits of $15.0 billion, including $3.5 billion held by unregulated entities. Medical claims liabilities totaled $5.0 billion, representing 44 days in claims payable, which is an increase of one day over the first quarter of 2018. Total debt was $6.3 billion, and there were no borrowings on our revolving credit facility. The Company had $1.5 billion available on the revolving credit facility at quarter-end. The debt to capitalization ratio was 36.7% at June 30, 2018, excluding the $85 million non-recourse mortgage note and construction loan.

Outlook

The Company's full updated annual guidance for 2018 is as follows:
 
 
Full Year 2018
 
 
 
Low
 
High 
 
Total revenues (in billions)
 
$
59.2

 
$
60.0

 
GAAP diluted EPS
 
$
4.25

 
$
4.57

 
Adjusted Diluted EPS (1)
 
$
6.80

 
$
7.16

 
HBR
 
85.9
%
 
86.4
%
 
SG&A expense ratio
 
10.2
%
 
10.7
%
 
Adjusted SG&A expense ratio (2)
 
9.4
%
 
9.9
%
 
Effective tax rate
 
34.0
%
 
36.0
%
 
Diluted shares outstanding (in millions)
 
198.7

 
199.7

 
 
 
 
 
 
 
(1)
Adjusted Diluted EPS excludes amortization of acquired intangible assets of $0.81 to $0.83 per diluted share, acquisition related expenses of $1.62 to $1.64 per diluted share and California minimum MLR changes of $0.12 per diluted share.

(2)
Adjusted SG&A expense ratio excludes acquisition related expenses of $422 million to $428 million, of which $400 million to $406 million will be incurred in the second half of 2018.

4



Conference Call

As previously announced, the Company will host a conference call Tuesday, July 24, 2018, at approximately 8:30 AM (Eastern Time) to review the financial results for the second quarter ended June 30, 2018. Michael Neidorff and Jeffrey Schwaneke will host the conference call. 

Investors and other interested parties are invited to listen to the conference call by dialing 1-877-883-0383 in the U.S. and Canada; +1-412-902-6506 from abroad, including the following Elite Entry Number: 7229256 to expedite caller registration; or via a live, audio webcast on the Company's website at www.centene.com, under the Investors section.

A webcast replay will be available for on-demand listening shortly after the completion of the call for the next twelve months or until 11:59 PM (Eastern Time) on Tuesday, July 23, 2019, at the aforementioned URL. In addition, a digital audio playback will be available until 9:00 AM (Eastern Time) on Tuesday, July 31, 2018, by dialing 1-877-344-7529 in the U.S. and Canada, or +1-412-317-0088 from abroad, and entering access code 10121638.

5


Non-GAAP Financial Presentation

The Company is providing certain non-GAAP financial measures in this release as the Company believes that these figures are helpful in allowing investors to more accurately assess the ongoing nature of the Company's operations and measure the Company's performance more consistently across periods. The Company uses the presented non-GAAP financial measures internally to allow management to focus on period-to-period changes in the Company's core business operations. Therefore, the Company believes that this information is meaningful in addition to the information contained in the GAAP presentation of financial information. The presentation of this additional non-GAAP financial information is not intended to be considered in isolation or as a substitute for the financial information prepared and presented in accordance with GAAP.

Specifically, the Company believes the presentation of non-GAAP financial information that excludes amortization of acquired intangible assets, acquisition related expenses, as well as other items, allows investors to develop a more meaningful understanding of the Company's performance over time. The tables below provide reconciliations of non-GAAP items ($ in millions, except per share data):
 
Three Months Ended June 30,
 
Six Months Ended June 30,
 
2018
 
2017
 
2018
 
2017
GAAP net earnings
$
300

 
$
254

 
$
640

 
$
393

Amortization of acquired intangible assets
45

 
39

 
84

 
79

Acquisition related expenses
1

 
1

 
22

 
6

California minimum medical loss ratio changes (1)
30

 
—

 
30

 
—

Penn Treaty assessment expense (2)
—

 
—

 
—

 
47

Income tax effects of adjustments (3)
(16
)
 
(14
)
 
(30
)
 
(48
)
Adjusted net earnings
$
360

 
$
280

 
$
746

 
$
477

(1)
The impact of retroactive minimum MLR changes under California’s Medicaid expansion program.

(2)
Additional expense for the Company's estimated share of guaranty association assessment resulting from the liquidation of Penn Treaty for the six months ended June 30, 2017.

(3)
The income tax effects of adjustments are based on the effective income tax rates applicable to adjusted (non-GAAP) results.

 
Three Months Ended June 30,
 
Six Months Ended June 30,
 
Annual Guidance
 December 31, 2018
 
2018
 
2017
 
2018
 
2017
 
GAAP diluted EPS
$
1.50

 
$
1.44

 
$
3.39

 
$
2.23

 
$4.25 - $4.57
Amortization of acquired intangible assets (1)
0.17

 
0.14

 
0.35

 
0.28

 
$0.81 - $0.83
Acquisition related expenses (2)
0.01

 
0.01

 
0.10

 
0.03

 
$1.62 - $1.64
California minimum medical loss ratio changes (3)
0.12

 
—

 
0.12

 
—

 
$0.12
Penn Treaty assessment expense (4)
—

 
—

 
—

 
0.17

 
—
Adjusted Diluted EPS
$
1.80

 
$
1.59

 
$
3.96

 
$
2.71

 
$6.80 - $7.16
(1)
The amortization of acquired intangible assets per diluted share presented above is net of an income tax benefit of $0.05 and $0.08 for the three months ended June 30, 2018 and 2017, respectively, and $0.10 and $0.17 for the six months ended June 30, 2018 and 2017, respectively; and an estimated $0.24 to $0.25 for the year ended December 31, 2018.

(2)
The acquisition related expenses per diluted share presented above are net of an income tax benefit of $0.00 for both the three months ended June 30, 2018 and 2017, and $0.02 and $0.01 for the six months ended June 30, 2018 and 2017, respectively; and an estimated $0.50 to $0.51 for the year ended December 31, 2018.


6


(3)
The impact of retroactive changes to the California minimum MLR is net of an income tax benefit of $0.03 and $0.04 for the three and six months ended June 30, 2018, respectively; and an estimated $0.03 to $0.04 for the year ended December 31, 2018.

(4)
The Penn Treaty assessment expense per diluted share presented above is net of an income tax benefit of $0.09 for the six months ended June 30, 2017.

 
Three Months Ended June 30,
 
Six Months Ended June 30,
 
Three Months Ended March 31,
 
2018
 
2017
 
2018
 
2017
 
2018
GAAP SG&A expenses
$
1,237

 
$
1,065

 
$
2,553

 
$
2,156

 
$
1,316

Acquisition related expenses
1

 
1

 
22

 
6

 
21

Penn Treaty assessment expense
—

 
—

 
—

 
47

 
—

Adjusted SG&A expenses
$
1,236

 
$
1,064

 
$
2,531

 
$
2,103

 
$
1,295


7


About Centene Corporation

Centene Corporation, a Fortune 100 company, is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government sponsored and commercial healthcare programs, focusing on under-insured and uninsured individuals. Many receive benefits provided under Medicaid, including the State Children’s Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long-Term Services and Supports (LTSS), in addition to other state-sponsored programs, Medicare (including the Medicare prescription drug benefit commonly known as “Part D”), dual eligible programs and programs with the U.S. Department of Defense and U.S. Department of Veterans Affairs. Centene also provides healthcare services to groups and individuals delivered through commercial health plans. Centene operates local health plans and offers a range of health insurance solutions. It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, correctional healthcare services, dental benefits management, commercial programs, home-based primary care services, life and health management, vision benefits management, pharmacy benefits management, specialty pharmacy and telehealth services.

Centene uses its investor relations website to publish important information about the Company, including information that may be deemed material to investors. Financial and other information about Centene is routinely posted and is accessible on Centene’s investor relations website, http://www.centene.com/investors.

Forward-Looking Statements

The company and its representatives may from time to time make written and oral forward-looking statements within the meaning of the Private Securities Litigation Reform Act ("PSLRA") of 1995, including statements in this and other press releases, in presentations, filings with the Securities and Exchange Commission ("SEC"), reports to stockholders and in meetings with investors and analysts. In particular, the information provided in this press release may contain certain forward-looking statements with respect to the financial condition, results of operations and business of Centene and certain plans and objectives of Centene with respect thereto, including but not limited to the expected benefits of the acquisition of Health Net, Inc. (Health Net) (Health Net Acquisition) and the acquisition of New York State Catholic Health Plan, Inc., d/b/a Fidelis Care New York (Fidelis Care) (Fidelis Care Acquisition). These forward-looking statements can be identified by the fact that they do not relate only to historical or current facts. Without limiting the foregoing, forward-looking statements often use words such as "believe", "anticipate", "plan", "expect", "estimate", "intend", "seek", "target", "goal", "may", "will", "would", "could", "should", "can", "continue" and other similar words and expressions (and the negative thereof). We intend such forward-looking statements to be covered by the safe-harbor provisions for forward-looking statements contained in PSLRA. A number of factors, variables or events could cause actual plans and results to differ materially from those expressed or implied in forward-looking statements. Such factors include, but are not limited to, Centene's ability to accurately predict and effectively manage health benefits and other operating expenses and reserves; competition; membership and revenue declines or unexpected trends; changes in healthcare practices, new technologies and advances in medicine; increased healthcare costs; changes in economic, political or market conditions; changes in federal or state laws or regulations, including changes with respect to income tax reform or government healthcare programs as well as changes with respect to the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act and any regulations enacted thereunder that may result from changing political conditions; rate cuts or other payment reductions or delays by governmental payors and other risks and uncertainties affecting Centene's government businesses; Centene's ability to adequately price products on federally facilitated and state-based Health Insurance Marketplaces; tax matters; disasters or major epidemics; the outcome of legal and regulatory proceedings; changes in expected contract start dates; provider, state, federal and other contract changes and timing of regulatory approval of contracts; the expiration, suspension or termination of Centene's contracts with federal or state governments (including but not limited to Medicaid, Medicare, TRICARE or other customers); the difficulty of predicting the timing or outcome of pending or future litigation or government investigations; challenges to Centene's contract awards; cyber-attacks or other privacy or data security incidents; the possibility that the expected synergies and value creation from acquired businesses, including, without limitation, the Health Net Acquisition and the Fidelis Care Acquisition, will not be realized, or will not be realized within the expected time period; the exertion of management's time and Centene's resources, and other expenses incurred and business changes required in connection with complying with the undertakings in connection with any regulatory, governmental or third party consents or approvals for the Health Net Acquisition or the Fidelis Care Acquisition; disruption caused by significant completed and pending acquisitions, including the Health Net Acquisition and the Fidelis Care Acquisition, making it more difficult to maintain business and operational relationships; the risk that unexpected costs will be incurred in connection with the completion and/or integration of acquisition transactions, including among others, the Health Net Acquisition and the Fidelis Care Acquisition; changes in expected closing dates, estimated purchase price and accretion for acquisitions; the risk that acquired businesses, including Health Net and Fidelis Care, will not be integrated successfully; the risk that, following the Fidelis Care Acquisition, Centene may not be able to effectively manage its expanded operations; restrictions and limitations in connection with Centene's indebtedness; Centene's ability to achieve improvement in the Centers for Medicare and Medicaid Services (CMS) Star ratings and maintain or achieve improvement in other quality scores

8


in each case that can impact revenue and future growth; availability of debt and equity financing, on terms that are favorable to Centene; inflation; foreign currency fluctuations; and risks and uncertainties discussed in the reports that Centene has filed with the SEC. These forward-looking statements reflect Centene's current views with respect to future events and are based on numerous assumptions and assessments made by Centene in light of its experience and perception of historical trends, current conditions, business strategies, operating environments, future developments and other factors it believes appropriate. By their nature, forward-looking statements involve known and unknown risks and uncertainties and are subject to change because they relate to events and depend on circumstances that will occur in the future. The factors described in the context of such forward-looking statements in this press release could cause Centene's plans with respect to the Health Net Acquisition, the Fidelis Care Acquisition, actual results, performance or achievements, industry results and developments to differ materially from those expressed in or implied by such forward-looking statements. Although it is currently believed that the expectations reflected in such forward-looking statements are reasonable, no assurance can be given that such expectations will prove to have been correct and persons reading this press release are therefore cautioned not to place undue reliance on these forward-looking statements which speak only as of the date of this press release. Centene does not assume any obligation to update the information contained in this press release (whether as a result of new information, future events or otherwise), except as required by applicable law. This list of important factors is not intended to be exhaustive. We discuss certain of these matters more fully, as well as certain other risk factors that may affect Centene's business operations, financial condition and results of operations, in Centene's filings with the SEC, including the annual report on Form 10-K, quarterly reports on Form 10-Q and current reports on Form 8-K.



[Tables Follow]


9


CENTENE CORPORATION AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
(In millions, except shares in thousands and per share data in dollars)
 
June 30, 2018
 
December 31, 2017

(Unaudited)
 

ASSETS
 
 
 
Current assets:
 
 
 
Cash and cash equivalents
$
6,707

 
$
4,072

Premium and trade receivables
4,067

 
3,413

Short-term investments
602

 
531

Other current assets
1,001

 
687

Total current assets
12,377

 
8,703

Long-term investments
5,746

 
5,312

Restricted deposits
1,943

 
135

Property, software and equipment, net
1,327

 
1,104

Goodwill
5,346

 
4,749

Intangible assets, net
1,501

 
1,398

Other long-term assets
503

 
454

Total assets
$
28,743

 
$
21,855




 


LIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND STOCKHOLDERS’ EQUITY

 
 

Current liabilities:
 

 
 

Medical claims liability
$
5,003

 
$
4,286

Accounts payable and accrued expenses
3,803

 
4,165

Return of premium payable
529

 
549

Unearned revenue
523

 
328

Current portion of long-term debt
4

 
4

Total current liabilities
9,862

 
9,332

Long-term debt
6,275

 
4,695

Other long-term liabilities
1,898

 
952

Total liabilities
18,035

 
14,979

Commitments and contingencies


 


Redeemable noncontrolling interests
11

 
12

Stockholders’ equity:
 

 
 

Preferred stock, $0.001 par value; authorized 10,000 shares; no shares issued or outstanding at June 30, 2018 and December 31, 2017
—

 
—

Common stock, $0.001 par value; authorized 400,000 shares; 207,413 issued and 205,247 outstanding at June 30, 2018, and 180,379 issued and 173,437 outstanding at December 31, 2017
—

 
—

Additional paid-in capital
7,355

 
4,349

Accumulated other comprehensive loss
(67
)
 
(3
)
Retained earnings
3,403

 
2,748

Treasury stock, at cost (2,166 and 6,942 shares, respectively)
(81
)
 
(244
)
Total Centene stockholders’ equity
10,610

 
6,850

Noncontrolling interest
87

 
14

Total stockholders’ equity
10,697

 
6,864

Total liabilities, redeemable noncontrolling interests and stockholders’ equity
$
28,743

 
$
21,855







10


CENTENE CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF OPERATIONS
(In millions, except per share data in dollars)
(Unaudited)
 
Three Months Ended June 30,
 
Six Months Ended June 30,
 
2018
 
2017
 
2018
 
2017
Revenues:

 

 

 

Premium
$
12,113

 
$
10,905

 
$
24,016

 
$
21,543

Service
762

 
536

 
1,415

 
1,063

Premium and service revenues
12,875

 
11,441

 
25,431

 
22,606

Premium tax and health insurer fee
1,306

 
513

 
1,944

 
1,072

Total revenues
14,181

 
11,954

 
27,375

 
23,678

Expenses:
 
 
 
 
 
 
 
Medical costs
10,380

 
9,413

 
20,419

 
18,735

Cost of services
658

 
456

 
1,201

 
897

Selling, general and administrative expenses
1,237

 
1,065

 
2,553

 
2,156

Amortization of acquired intangible assets
45

 
39

 
84

 
79

Premium tax expense
1,189

 
543

 
1,735

 
1,133

Health insurer fee expense
183

 
—

 
354

 
—

Total operating expenses
13,692

 
11,516

 
26,346

 
23,000

Earnings from operations
489

 
438

 
1,029

 
678

Other income (expense):

 

 
 
 
 
Investment and other income
65

 
45

 
106

 
86

Interest expense
(80
)
 
(62
)
 
(148
)
 
(124
)
Earnings from operations, before income tax expense
474

 
421

 
987

 
640

Income tax expense
175

 
169

 
350

 
256

Net earnings
299

 
252

 
637

 
384

Loss attributable to noncontrolling interests
1

 
2

 
3

 
9

Net earnings attributable to Centene Corporation
$
300

 
$
254

 
$
640

 
$
393



 

 

 

Net earnings per common share attributable to Centene Corporation:
Basic earnings per common share
$
1.53

 
$
1.47

 
$
3.46

 
$
2.28

Diluted earnings per common share
$
1.50

 
$
1.44

 
$
3.39

 
$
2.23



 

 

 




11


CENTENE CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
(In millions)
(Unaudited)
 
Six Months Ended June 30,
 
2018
 
2017
Cash flows from operating activities:
 
 
 
Net earnings
$
637

 
$
384

Adjustments to reconcile net earnings to net cash provided by operating activities
Depreciation and amortization
215

 
173

Stock compensation expense
67

 
62

Deferred income taxes
4

 
(58
)
Changes in assets and liabilities
 

 
 

Premium and trade receivables
(553
)
 
(696
)
Other assets
2

 
65

Medical claims liabilities
717

 
243

Unearned revenue
202

 
241

Accounts payable and accrued expenses
(865
)
 
(257
)
Other long-term liabilities
865

 
781

Other operating activities, net
29

 
4

Net cash provided by operating activities
1,320

 
942

Cash flows from investing activities:
 

 
 

Capital expenditures
(362
)
 
(181
)
Purchases of investments
(1,375
)
 
(1,317
)
Sales and maturities of investments
721

 
1,015

Acquisitions, net of cash acquired
(237
)
 
—

Other investing activities, net
—

 
(1
)
Net cash used in investing activities
(1,253
)
 
(484
)
Cash flows from financing activities:
 

 
 

Proceeds from the issuance of common stock
2,780

 
—

Proceeds from long-term debt
5,146

 
810

Payments of long-term debt
(3,471
)
 
(762
)
Common stock repurchases
(13
)
 
(15
)
Purchase of noncontrolling interest
(63
)
 
—

Other financing activities, net
(1
)
 
6

Net cash provided by financing activities
4,378

 
39

Net increase in cash, cash equivalents and restricted cash
4,445

 
497

Cash, cash equivalents, and restricted cash and cash equivalents, beginning of period
4,089

 
3,936

Cash, cash equivalents, and restricted cash and cash equivalents, end of period
$
8,534

 
$
4,433

Supplemental disclosures of cash flow information:
 

 
 

Interest paid
$
130

 
$
99

Income taxes paid
$
195

 
$
205

Equity issued in connection with acquisitions
$
507

 
$
—




12


CENTENE CORPORATION
SUPPLEMENTAL FINANCIAL DATA
 
Q2
 
Q1
 
Q4
 
Q3
 
Q2
 
2018
 
2018
 
2017
 
2017
 
2017
MANAGED CARE MEMBERSHIP BY LINE OF BUSINESS
Medicaid:
 
 
 
 
 
 
 
 
 
TANF, CHIP & Foster Care
5,852,000

 
5,776,600

 
5,807,300

 
5,809,400

 
5,854,400

ABD & LTSS
874,200

 
866,000

 
846,200

 
850,300

 
843,500

Behavioral Health
454,600

 
454,500

 
463,700

 
467,400

 
466,500

Total Medicaid
7,180,800

 
7,097,100

 
7,117,200

 
7,127,100

 
7,164,400

Commercial
2,051,700

 
2,161,200

 
1,558,300

 
1,657,800

 
1,743,600

Medicare (1)
343,800

 
343,400

 
333,700

 
331,000

 
327,500

Correctional
157,900

 
157,300

 
157,500

 
158,000

 
160,400

Total at-risk membership
9,734,200

 
9,759,000

 
9,166,700

 
9,273,900

 
9,395,900

TRICARE eligibles
2,851,500

 
2,851,500

 
2,824,100

 
2,823,200

 
2,823,200

Non-risk membership
218,100

 
218,900

 
216,300

 
213,900

 
—

Total
12,803,800

 
12,829,400

 
12,207,100

 
12,311,000

 
12,219,100

 
 
 
 
 
 
 
 
 
 
(1) Membership includes Medicare Advantage, Medicare Supplement, Special Needs Plans, and MMP.
 
 
 
 
 
 
 
 
 
 
NUMBER OF EMPLOYEES
41,200

 
34,800

 
33,700

 
32,400

 
31,500

 
 
 
 
 
 
 
 
 
 
DAYS IN CLAIMS PAYABLE (2)
44

 
43

 
41

 
42

 
40

(2) 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
$
11,455

 
$
11,398

 
$
9,740

 
$
9,633

 
$
9,673

Unregulated
3,543

 
452

 
310

 
308

 
291

Total
$
14,998

 
$
11,850

 
$
10,050

 
$
9,941

 
$
9,964

 
 
 
 
 
 
 
 
 
 
DEBT TO CAPITALIZATION
37.0
%
 
40.6
%
 
40.6
%
 
41.5
%
 
42.5
%
DEBT TO CAPITALIZATION EXCLUDING NON-RECOURSE DEBT (3)
36.7
%
 
40.3
%
 
40.3
%
 
41.2
%
 
42.1
%
(3) The non-recourse debt represents the Company's mortgage note payable ($59 million at June 30, 2018) and construction loan payable ($26 million at June 30, 2018).
Debt to capitalization is calculated as follows: total debt divided by (total debt + total equity).

OPERATING RATIOS
 
Three Months Ended June 30,
 
Six Months Ended June 30,
 
2018
 
2017
 
2018
 
2017
HBR
85.7
%
 
86.3
%
 
85.0
%
 
87.0
%
SG&A expense ratio
9.6
%
 
9.3
%
 
10.0
%
 
9.5
%
Adjusted SG&A expense ratio
9.6
%
 
9.3
%
 
10.0
%
 
9.3
%



13


MEDICAL CLAIMS LIABILITY

The changes in medical claims liability are summarized as follows (in millions):
Balance, June 30, 2017
 
$
4,170

Reinsurance recoverable
 
10

Balance, June 30, 2017, net
 
4,160

Incurred related to:
 
 
Current period
 
39,894

Prior period
 
(359
)
Total incurred
 
39,535

Paid related to:
 
 
Current period
 
35,184

Prior period
 
3,525

Total paid
 
38,709

Balance, June 30, 2018, net
 
4,986

Plus: Reinsurance recoverable
 
17

Balance, June 30, 2018
 
$
5,003


Centene's claims reserving process utilizes a consistent actuarial methodology to estimate Centene's ultimate liability. Any reduction in the “Incurred related to: Prior period” amount may be offset as Centene actuarially determines “Incurred related to: Current period.” As such, only in the absence of a consistent reserving methodology would favorable development of prior period claims liability estimates reduce medical costs. Centene believes it has consistently applied its claims reserving methodology. Additionally, approximately $5 million was recorded as an increase to premium revenues resulting from development within “Incurred related to: Prior period” due to minimum HBR and other return of premium programs.

The amount of the “Incurred related to: Prior period” above represents favorable development and includes the effects of reserving under moderately adverse conditions, new markets where we use a conservative approach in setting reserves during the initial periods of operations, receipts from other third party payors related to coordination of benefits and lower medical utilization and cost trends for dates of service June 30, 2017, and prior.

14