0001193125-19-200472.txt : 20190724 0001193125-19-200472.hdr.sgml : 20190724 20190724060503 ACCESSION NUMBER: 0001193125-19-200472 CONFORMED SUBMISSION TYPE: 8-K PUBLIC DOCUMENT COUNT: 3 CONFORMED PERIOD OF REPORT: 20190724 ITEM INFORMATION: Results of Operations and Financial Condition ITEM INFORMATION: Financial Statements and Exhibits FILED AS OF DATE: 20190724 DATE AS OF CHANGE: 20190724 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Anthem, Inc. CENTRAL INDEX KEY: 0001156039 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 352145715 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 8-K SEC ACT: 1934 Act SEC FILE NUMBER: 001-16751 FILM NUMBER: 19969134 BUSINESS ADDRESS: STREET 1: 220 VIRGINIA AVENUE CITY: INDIANAPOLIS STATE: IN ZIP: 46204 BUSINESS PHONE: 3174886000 MAIL ADDRESS: STREET 1: 220 VIRGINIA AVENUE CITY: INDIANAPOLIS STATE: IN ZIP: 46204 FORMER COMPANY: FORMER CONFORMED NAME: WELLPOINT, INC DATE OF NAME CHANGE: 20100105 FORMER COMPANY: FORMER CONFORMED NAME: WELLPOINT INC DATE OF NAME CHANGE: 20041130 FORMER COMPANY: FORMER CONFORMED NAME: ANTHEM INC DATE OF NAME CHANGE: 20010730 8-K 1 d764074d8k.htm 8-K 8-K

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

 

FORM 8-K

 

 

CURRENT REPORT

Pursuant to Section 13 or 15(d)

of the Securities Exchange Act of 1934

Date of Report (Date of earliest event reported): July 24, 2019

 

 

ANTHEM, INC.

(Exact name of registrant as specified in its charter)

 

 

 

Indiana   001-16751   35-2145715

(State or other jurisdiction

of incorporation)

 

(Commission

File Number)

 

(IRS Employer

Identification No.)

220 Virginia Ave

Indianapolis, IN 46204

(Address of principal executive offices) (Zip Code)

Registrant’s telephone number, including area code: (800) 331-1476

N/A

(Former name or former address, if changed since last report)

 

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions (see General Instruction A.2. below):

 

Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

 

Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

 

Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

 

Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

Securities registered pursuant to Section 12(b) of the Act:

 

Title of each class

 

Trading Symbol(s)

 

Name of each exchange on which registered

Common Stock   ANTM   NYSE

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).

Emerging growth company  ☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.  ☐

 

 

 


Item 2.02

Results of Operations and Financial Condition.

On July 24, 2019, Anthem, Inc. issued a press release reporting its financial results for its second quarter ended June 30, 2019. A copy of the press release is furnished as Exhibit 99.1 to this report and incorporated herein by reference.

None of the information furnished in Item 2.02 or Exhibit 99.1 hereto shall be deemed to be “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended. Unless expressly set forth by specific reference in such filings, none of the information furnished in this report shall be incorporated by reference in any filing under the Securities Act of 1933, as amended, whether made before or after the date hereof and regardless of any general incorporation language in such filings.

 

Item 9.01

Financial Statements and Exhibits.

 

  (d)

Exhibits.

The following exhibit is being furnished herewith:

 

Exhibit No.

  

Exhibit

99.1

   Press Release, dated July 24, 2019, reporting Anthem, Inc. financial results for its second quarter ended June 30, 2019.

FORWARD-LOOKING STATEMENTS

This document contains certain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements reflect our views about future events and financial performance and are generally not historical facts. Words such as “expect,” “feel,” “believe,” “will,” “may,” “should,” “anticipate,” “intend,” “estimate,” “project,” “forecast,” “plan” and similar expressions are intended to identify forward-looking statements. These statements include, but are not limited to: financial projections and estimates and their underlying assumptions; statements regarding plans, objectives and expectations with respect to future operations, products and services; and statements regarding future performance. Such statements are subject to certain risks and uncertainties, many of which are difficult to predict and generally beyond our control, that could cause actual results to differ materially from those expressed in, or implied or projected by, the forward-looking statements. You are cautioned not to place undue reliance on these forward-looking statements that speak only as of the date hereof. You are also urged to carefully review and consider the various risks and other disclosures discussed in our reports filed with the U.S. Securities and Exchange Commission from time to time, which attempt to advise interested parties of the factors that affect our business. Except to the extent otherwise required by federal securities laws, we do not undertake any obligation to republish revised forward-looking statements to reflect events or circumstances after the date hereof. These risks and uncertainties include, but are not limited to: the impact of federal and state regulation, including ongoing changes in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended, or collectively, the ACA, and the ultimate outcome of legal challenges to the ACA; trends in healthcare costs and utilization rates; our ability to contract with providers on cost-effective and competitive terms; our ability to secure sufficient premium rates, including regulatory approval for and implementation of such rates; competitive pressures and our ability to adapt to changes in the industry and develop and implement strategic growth opportunities; reduced enrollment; unauthorized disclosure of member or employee sensitive or confidential information, including the impact and outcome of any investigations, inquiries, claims and litigation related thereto; risks and uncertainties regarding Medicare and Medicaid programs, including those related to non-compliance with the complex regulations imposed thereon; our ability to maintain and achieve improvement in Centers for Medicare and Medicaid Services, or CMS, Star ratings and other quality scores and funding risks with respect to revenue received from participation therein; a negative change in our healthcare product mix; costs and other liabilities associated with litigation, government investigations, audits or reviews; the ultimate outcome of litigation between Cigna Corporation, or Cigna, and us related to the merger agreement between the parties, including our claim for damages against Cigna, Cigna’s claim for payment of a termination fee and other damages against us, and the potential for such litigation to cause us to incur substantial costs, materially distract management and negatively impact our reputation and financial condition; non-compliance by any party with the pharmacy benefit management services agreements between us and each of Express Scripts, Inc., or Express Scripts, and CaremarkPCS Health, L.L.C., or CVS Health, as well as any agreements governing the transition of pharmacy benefit management services provided to us from Express Scripts to CVS Health, which could result in financial penalties, our inability to meet customer demands, and sanctions imposed by governmental entities, including CMS; medical malpractice or professional liability claims or other risks related to healthcare services and pharmacy benefit management services provided by our subsidiaries; possible restrictions in the payment of dividends from our subsidiaries and increases in required minimum levels of capital; our ability to repurchase shares of our common stock and pay dividends on our common stock due to the adequacy of our cash flow and earnings and other considerations; the potential negative effect from our substantial amount of outstanding indebtedness; a downgrade in our financial strength ratings; the effects of any negative publicity related to the health benefits industry in general or us in particular; failure to effectively maintain and modernize our information systems; events that may negatively affect our licenses with the Blue Cross and Blue Shield Association; large-scale medical emergencies, such as future public health epidemics and catastrophes; general risks associated with mergers, acquisitions, joint ventures and strategic alliances; possible impairment of the value of our intangible assets if future results do not adequately support goodwill and other intangible assets; changes in economic and market conditions, as well as regulations that may negatively affect our liquidity and investment portfolios; changes in U.S. tax laws; intense competition to attract and retain employees; and various laws and provisions in our governing documents that may prevent or discourage takeovers and business combinations.


SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

Dated: July 24, 2019

 

ANTHEM, INC.
By:   /s/ Kathleen S. Kiefer
Name:   Kathleen S. Kiefer
Title:   Corporate Secretary
EX-99.1 2 d764074dex991.htm EX-99.1 EX-99.1

Exhibit 99.1

PRESS RELEASE

 

LOGO

ANTHEM REPORTS SECOND QUARTER 2019 RESULTS,

RAISES FULL YEAR OUTLOOK

 

   

Second quarter net income was $4.36 per share, including net negative adjustment items of $0.28 per share. Adjusted net income was $4.64* per share.

 

   

Operating revenue grew 10.8% over the prior year quarter to $25.2 billion.

 

   

Medical enrollment was 40.9 million members, representing an increase of 1.3 million members over the prior year quarter, driven by growth in the fully insured businesses.

 

   

The Company now expects the earnings contribution from IngenioRx to achieve the upper end of the $0.70—$0.90 range. As a result, full year net income is now expected to be greater than $18.34 per share and full year adjusted net income is now expected to be greater than $19.30* per share.

 

   

Third quarter 2019 dividend of $0.80 per share declared to shareholders.

Indianapolis, Ind. – July 24, 2019 – Anthem, Inc. (NYSE: ANTM) reported second quarter financial results driven by strong revenue growth and steady progress on the implementation of IngenioRx.

“Our second quarter results reflect solid top line growth across our businesses and reinforce our commitment to innovation and performance execution,” said Gail K. Boudreaux, President and CEO. “We began successfully migrating members to IngenioRx on May 1 and have received transition approvals from all of our 14 Blue states and the majority of our Medicaid states. We are tracking ahead of expectations, and as a result, we now expect IngenioRx to achieve the upper end of our $0.70 - $0.90 guidance.”

“Contributing to the momentum of IngenioRx, we are pleased to announce our first external pharmacy contract win with Blue Cross of Idaho beginning January 1, 2020, further demonstrating the strength of our pharmacy offering and our ability to deliver more affordable care with a simplified consumer experience. I am excited about our future growth opportunities as we continue to leverage our growing suite of integrated solutions, including our recently announced acquisition of Beacon Health Options, to create greater value for the customers, members and care providers that we are privileged to serve.”

 

*

Refer to the GAAP reconciliation tables on page 14.

 

1


CONSOLIDATED HIGHLIGHTS

Membership: Medical enrollment totaled approximately 40.9 million members at June 30, 2019, an increase of 1.3 million, or 3.3 percent, from June 30, 2018. Total fully insured enrollment grew by 1.1 million, or 7.7 percent, and self-funded enrollment increased by 188 thousand, or 0.7 percent. Government Business enrollment increased by 1.0 million, driven by growth in Medicaid and Medicare. Commercial & Specialty Business enrollment increased by 290 thousand, driven by growth in all lines of business.

Medical enrollment increased 9 thousand sequentially, reflecting growth in Medicaid and Medicare, partially offset by declines in Commercial & Specialty Business enrollment.

Operating Revenue: Operating revenue was $25.2 billion in the second quarter of 2019, an increase of $2.5 billion, or 10.8 percent, versus $22.7 billion in the prior year quarter. The increase in operating revenue reflected membership growth across our businesses and premium rate increases to cover overall cost trends. The increase was partially offset by the one year waiver of the health insurance tax in 2019.

Benefit Expense Ratio: The benefit expense ratio was 86.7 percent in the second quarter of 2019, an increase of 330 basis points from 83.4 percent in the prior year quarter. The increase, as expected, was primarily driven by the one year waiver of the health insurance tax in 2019 and medical cost experience in the Medicaid business.

Medical claims reserves established at December 31, 2018 developed moderately better than the Company’s expectation during the first six months of 2019.

Medical Cost Trend: For the full year 2019, the Company continues to expect underlying Local Group medical cost trend will be in the range of 6.0% +/- 50 basis points.

Days in Claims Payable: Days in Claims Payable was 39.1 days as of June 30, 2019, an increase of 0.6 days from 38.5 days as of March 31, 2019.

SG&A Expense Ratio: The SG&A expense ratio was 13.0 percent in the second quarter of 2019, a decrease of 210 basis points from 15.1 percent in the second quarter of 2018. The decrease, as expected, was primarily driven by the one year waiver of the health insurance tax in 2019 and growth in operating revenue.

Operating Cash Flow: Operating cash flow was $1.4 billion, or 1.3 times net income, and an increase of $895 million compared to the second quarter of 2018. Operating cash flow was $3.1 billion, or 1.1 times net income for the six months ending June 30, 2019.

Share Repurchase Program: During the second quarter of 2019, the Company repurchased 1.7 million shares of its common stock for $458 million, or a weighted average price of $272.95. As of June 30, 2019, the Company had approximately $4.7 billion of Board-approved share repurchase authorization remaining.

Cash Dividend: During the second quarter of 2019, the Company paid a quarterly dividend of $0.80 per share, representing a distribution of cash totaling $206 million.

On July 23, 2019, the Audit Committee declared a third quarter 2019 dividend to shareholders of $0.80 per share. On an annualized basis, this equates to a dividend of $3.20 per share. The third quarter dividend is payable on September 25, 2019 to shareholders of record at the close of business on September 10, 2019.

 

2


Investment Portfolio & Capital Position: During the second quarter of 2019, the Company recorded net realized gains on financial instruments totaling $11 million and other-than-temporary impairment losses totaling $7 million. During the second quarter of 2018, the Company recorded net realized gains of $4 million and other-than-temporary impairment losses totaling $4 million.

As of June 30, 2019, the Company’s net unrealized gain position in the investment portfolio was $561 million, consisting of fixed maturity securities. As of June 30, 2019 cash and investments at the parent company totaled approximately $1.4 billion.

 

3


REPORTABLE SEGMENTS

Anthem, Inc. has three reportable segments: Commercial & Specialty Business (comprised of the Local Group, National Accounts, Individual and Specialty businesses); Government Business (comprised of the Medicaid, Medicare, and Federal Health Products & Services businesses); and Other (comprised of IngenioRx, the Diversified Business Group, and corporate expenses not allocated to our other reportable segments).

Anthem, Inc.

Reportable Segment Highlights

(Unaudited)

 

(In millions)    Three Months Ended June 30     Six Months Ended June 30  
     2019     2018     Change     2019     2018     Change  

Operating Revenue

            

Commercial & Specialty Business

   $ 9,417     $ 9,055       4.0   $ 18,809     $ 18,006       4.5

Government Business

     15,538       13,619       14.1     30,464       26,972       12.9

Other

     794       350       126.9     1,342       710       89.0

Eliminations

     (572     (309     NM 2       (1,050     (631     NM 2 
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total Operating Revenue1

   $ 25,177     $ 22,715       10.8   $ 49,565     $ 45,057       10.0

Operating Gain / (Loss)

            

Commercial & Specialty Business

   $ 983     $ 1,048       (6.2 )%    $ 2,581     $ 2,450       5.3

Government Business

     478       532       (10.2 )%      855       1,021       (16.3 )% 

Other

     (28     (21     NM 2       (63     (44     NM 2 
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total Operating Gain1

   $ 1,433     $ 1,559       (8.1 )%    $ 3,373     $ 3,427       (1.6 )% 

Operating Margin

            

Commercial & Specialty Business

     10.4     11.6     (120 ) bp      13.7     13.6     10  bp 

Government Business

     3.1     3.9     (80 ) bp      2.8     3.8     (100 ) bp 

Total Operating Margin1

     5.7     6.9     (120 ) bp      6.8     7.6     (80 ) bp 

 

(1)

See “Basis of Presentation” on page 6 herein.

(2)

“NM” = calculation not meaningful.

Commercial & Specialty Business: Operating gain in the Commercial & Specialty Business segment totaled $983 million in the second quarter of 2019, a decrease of $65 million, or 6.2 percent, from $1,048 million in the second quarter of 2018. The decrease is primarily driven by the impact of higher favorable risk adjustor adjustments recognized in 2018. The decline is partially offset by higher administrative fee revenue in our self-funded businesses, driven by greater penetration of value-added services.

Government Business: Operating gain in the Government Business segment was $478 million in the second quarter of 2019, a decrease of $54 million, or 10.2 percent, from $532 million in the second quarter of 2018. The decrease is driven by continued elevated medical cost experience in Medicaid in select states and the one year waiver of the health insurance tax in 2019, partially offset by out of period revenue adjustments and Medicare membership growth.

Other: The Company reported an operating loss of $28 million in the Other segment for the second quarter of 2019, compared with an operating loss of $21 million in the prior year quarter.

 

4


OUTLOOK

Full Year 2019:

 

   

GAAP net income is now expected to be greater than $18.34 per share, including approximately $0.96 per share of net unfavorable items. Excluding these items, adjusted net income is now expected to be greater than $19.30* per share.

 

   

Medical membership is now expected to be in the range of 41,000,000 - 41,300,000. Fully-insured membership is expected to be in the range of 15,600,000 - 15,800,000 and self-funded membership is expected to be in the range of 25,400,000 - 25,500,000.

 

   

Operating revenue is now expected to be approximately $102.0 billion, including premium revenue of $93.0 billion - $94.0 billion.

 

   

Benefit expense ratio is now expected to be in the range of 86.2% - 86.5%.

 

   

SG&A ratio is now expected to be in the range of 13.2% - 13.5%.

 

   

Cost of products sold is expected to be $1.6 billion - $1.8 billion.

 

   

Operating cash flow is expected to be greater than $5.2 billion.

 

*

Refer to the GAAP reconciliation tables on page 14.

 

5


Basis of Presentation

 

1.

Operating revenue and operating gain are the key measures used by management to evaluate performance in each of its reporting segments, allocate resources, set incentive compensation targets and to forecast future operating performance. Operating gain is calculated as total operating revenue less benefit expense, cost of products sold and selling, general and administrative expense. It does not include net investment income, net realized gains/losses on financial instruments, other-than-temporary impairment losses recognized in income, interest expense, amortization of other intangible assets, gains/losses on extinguishment of debt or income taxes, as these items are managed in a corporate shared service environment and are not the responsibility of operating segment management. Refer to page 14 for the GAAP reconciliation tables.

 

2.

Operating margin is defined as operating gain divided by operating revenue.

Conference Call and Webcast

Management will host a conference call and webcast today at 8:30 a.m. Eastern Daylight Time (“EDT”) to discuss the company’s second quarter results and outlook. The conference call should be accessed at least 15 minutes prior to the start of the call with the following numbers:

 

800-553-0358 (Domestic)

   800-475-6701 (Domestic Replay)

612-332-0632 (International)

   320-365-3844 (International Replay)

An access code is not required for today’s conference call. The access code for the replay is 432045. The replay will be available from 11:00 a.m. EDT today, until the end of the day on August 7, 2019. The call will also be available through a live webcast at www.antheminc.com under the “Investors” link. A webcast replay will be available following the call.

 

Anthem Contacts:

     

Investor Relations

  

Media

    

Chris Rigg

  

Jill Becher, 414-234-1573

  

Chris.Rigg@anthem.com

  

Jill.Becher@anthem.com

  

 

6


About Anthem, Inc.

Anthem is a leading health benefits company dedicated to improving lives and communities, and making healthcare simpler. Through its affiliated companies, Anthem serves more than 78 million people, including over 40 million within its family of health plans. We aim to be the most innovative, valuable and inclusive partner. For more information, please visit www.antheminc.com or follow @AnthemInc on Twitter.

 

7


Anthem, Inc.

Membership Summary

(Unaudited and in Thousands)

 

                          Change from  

Medical Membership

   June 30,
2019
     June 30,
2018
     March 31,
2019
     June 30,
2018
    March 31,
2019
 

Customer Type

             

Local Group

     15,670        15,634        15,697        0.2     (0.2 )% 

Individual

     741        712        773        4.1     (4.1 )% 

National:

             

National Accounts

     7,693        7,658        7,757        0.5     (0.8 )% 

BlueCard®

     6,009        5,819        5,981        3.3     0.5
  

 

 

    

 

 

    

 

 

      

Total National

     13,702        13,477        13,738        1.7     (0.3 )% 

Medicare:

             

Medicare Advantage

     1,170        937        1,144        24.9     2.3

Medicare Supplement

     877        827        867        6.0     1.2
  

 

 

    

 

 

    

 

 

      

Total Medicare

     2,047        1,764        2,011        16.0     1.8

Medicaid

     7,099        6,414        7,033        10.7     0.9

Federal Health Products & Services

     1,593        1,560        1,591        2.1     0.1
  

 

 

    

 

 

    

 

 

      

Total Medical Membership

     40,852        39,561        40,843        3.3     —  
  

 

 

    

 

 

    

 

 

      

Funding Arrangement

             

Self-Funded

     25,433        25,245        25,495        0.7     (0.2 )% 

Fully-Insured

     15,419        14,316        15,348        7.7     0.5
  

 

 

    

 

 

    

 

 

      

Total Medical Membership

     40,852        39,561        40,843        3.3     —  
  

 

 

    

 

 

    

 

 

      

Reportable Segment

             

Commercial & Specialty Business

     30,113        29,823        30,208        1.0     (0.3 )% 

Government Business

     10,739        9,738        10,635        10.3     1.0
  

 

 

    

 

 

    

 

 

      

Total Medical Membership

     40,852        39,561        40,843        3.3     —  
  

 

 

    

 

 

    

 

 

      

Other Membership

             

Life and Disability Members

     4,906        4,673        4,849        5.0     1.2

Dental Members

     5,931        5,788        5,955        2.5     (0.4 )% 

Dental Administration Members

     5,523        5,384        5,491        2.6     0.6

Vision Members

     7,161        6,760        7,169        5.9     (0.1 )% 

Medicare Part D Standalone Members

     287        312        289        (8.0 )%      (0.7 )% 

 

8


Anthem, Inc.

Consolidated Statements of Income

(Unaudited)

 

(In millions, except per share data)    Three Months Ended
June 30
       
     2019     2018     Change  

Revenues

      

Premiums

   $ 23,501     $ 21,248       10.6

Administrative fees and other revenue

     1,676       1,467       14.2
  

 

 

   

 

 

   

Total operating revenue

     25,177       22,715       10.8

Net investment income

     285       229       24.5

Net realized gains on financial instruments

     11       4       175.0

Other-than-temporary impairment losses on investments:

      

Total other-than-temporary impairment losses on investments

     (9     (4     NM  

Portion of other-than-temporary impairment losses recognized in other comprehensive income

     2       —         NM  
  

 

 

   

 

 

   

Other-than-temporary impairment losses recognized in income

     (7     (4     NM  
  

 

 

   

 

 

   

Total revenues

     25,466       22,944       11.0

Expenses

      

Benefit expense

     20,368       17,728       14.9

Cost of products sold

     98       —         NM  

Selling, general and administrative expense

     3,278       3,428       (4.4 )% 

Interest expense

     184       192       (4.2 )% 

Amortization of other intangible assets

     85       93       (8.6 )% 

Gain on extinguishment of debt

     —         (1     NM  
  

 

 

   

 

 

   

Total expenses

     24,013       21,440       12.0
  

 

 

   

 

 

   

Income before income tax expense

     1,453       1,504       (3.4 )% 

Income tax expense

     314       450       (30.2 )% 
  

 

 

   

 

 

   

Net income

   $ 1,139     $ 1,054       8.1
  

 

 

   

 

 

   

Net income per diluted share

   $ 4.36     $ 3.98       9.5
  

 

 

   

 

 

   

Diluted shares

     261.0       264.5       (1.3 )% 

Benefit expense as a percentage of premiums

     86.7     83.4     330  bp 

Selling, general and administrative expense as a percentage of total operating revenue

     13.0     15.1     (210 ) bp 

Income before income taxes as a percentage of total revenue

     5.7     6.6     (90 ) bp 

“NM” = calculation not meaningful

 

9


Anthem, Inc.

Consolidated Statements of Income

(Unaudited)

 

(In millions, except per share data)    Six Months Ended
June 30
       
     2019     2018     Change  

Revenues

      

Premiums

   $ 46,344     $ 42,151       9.9

Administrative fees and other revenue

     3,221       2,906       10.8
  

 

 

   

 

 

   

Total operating revenue

     49,565       45,057       10.0

Net investment income

     495       458       8.1

Net realized gains (losses) on financial instruments

     89       (22     NM  

Other-than-temporary impairment losses on investments:

      

Total other-than-temporary impairment losses on investments

     (22     (12     NM  

Portion of other-than-temporary impairment losses recognized in other comprehensive income

     5       —         NM  
  

 

 

   

 

 

   

Other-than-temporary impairment losses recognized in income

     (17     (12     NM  
  

 

 

   

 

 

   

Total revenues

     50,132       45,481       10.2

Expenses

      

Benefit expense

     39,650       34,774       14.0

Cost of products sold

     98       —         NM  

Selling, general and administrative expense

     6,444       6,856       (6.0 )% 

Interest expense

     371       376       (1.3 )% 

Amortization of other intangible assets

     172       173       (0.6 )% 

(Gain) loss on extinguishment of debt

     (1     18       (105.6 )% 
  

 

 

   

 

 

   

Total expenses

     46,734       42,197       10.8
  

 

 

   

 

 

   

Income before income tax expense

     3,398       3,284       3.5

Income tax expense

     708       918       (22.9 )% 
  

 

 

   

 

 

   

Net income

   $ 2,690     $ 2,366       13.7
  

 

 

   

 

 

   

Net income per diluted share

   $ 10.28     $ 8.97       14.6
  

 

 

   

 

 

   

Diluted shares

     261.6       263.7       (0.8 )% 

Benefit expense as a percentage of premiums

     85.6     82.5     310  bp 

Selling, general and administrative expense as a percentage of total operating revenue

     13.0     15.2     (220 ) bp 

Income before income taxes as a percentage of total revenue

     6.8     7.2     (40 ) bp 

“NM” = calculation not meaningful

 

10


Anthem, Inc.

Consolidated Balance Sheets

 

     June 30,     December 31,  
(In millions)    2019     2018  
     (Unaudited)        

Assets

    

Current assets:

    

Cash and cash equivalents

   $ 4,078     $ 3,934  

Fixed maturity securities, current

     19,123       16,692  

Equity securities, current

     1,492       1,493  

Other invested assets, current

     14       21  

Accrued investment income

     168       162  

Premium receivables

     4,751       4,465  

Self-funded receivables

     2,534       2,278  

Other receivables

     2,633       2,558  

Income taxes receivable

     296       10  

Securities lending collateral

     565       604  

Other current assets

     2,151       2,104  
  

 

 

   

 

 

 

Total current assets

     37,805       34,321  

Long-term investments:

    

Fixed maturity securities

     509       487  

Equity securities

     33       33  

Other invested assets

     3,719       3,726  

Property and equipment, net

     2,837       2,735  

Goodwill

     20,500       20,504  

Other intangible assets

     8,840       9,007  

Other noncurrent assets

     1,608       758  
  

 

 

   

 

 

 

Total assets

   $ 75,851     $ 71,571  
  

 

 

   

 

 

 

Liabilities and shareholders’ equity

    

Liabilities

    

Current liabilities:

    

Policy liabilities:

    

Medical claims payable

   $ 8,758     $ 7,454  

Reserves for future policy benefits

     77       75  

Other policyholder liabilities

     2,586       2,590  
  

 

 

   

 

 

 

Total policy liabilities

     11,421       10,119  

Unearned income

     900       902  

Accounts payable and accrued expenses

     4,028       4,959  

Security trades pending payable

     382       197  

Securities lending payable

     564       604  

Short-term borrowings

     1,010       1,145  

Current portion of long-term debt

     850       849  

Other current liabilities

     3,935       3,190  
  

 

 

   

 

 

 

Total current liabilities

     23,090       21,965  

Long-term debt, less current portion

     17,436       17,217  

Reserves for future policy benefits, noncurrent

     655       706  

Deferred tax liabilities, net

     2,211       1,960  

Other noncurrent liabilities

     1,666       1,182  
  

 

 

   

 

 

 

Total liabilities

     45,058       43,030  
  

 

 

   

 

 

 

Shareholders’ equity

    

Common stock

     3       3  

Additional paid-in capital

     9,494       9,536  

Retained earnings

     21,679       19,988  

Accumulated other comprehensive loss

     (383     (986
  

 

 

   

 

 

 

Total shareholders’ equity

     30,793       28,541  
  

 

 

   

 

 

 

Total liabilities and shareholders’ equity

   $ 75,851     $ 71,571  
  

 

 

   

 

 

 

 

11


Anthem, Inc.

Consolidated Statements of Cash Flows

(Unaudited)

 

(In millions)    Six Months Ended June 30  
     2019     2018  

Operating activities

    

Net income

   $ 2,690     $ 2,366  

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

    

Net realized (gains) losses on financial instruments

     (89     22  

Other-than-temporary impairment losses recognized in income

     17       12  

(Gain) loss on extinguishment of debt

     (1     18  

Deferred income taxes

     79       2  

Amortization, net of accretion

     515       495  

Depreciation expense

     71       61  

Share-based compensation

     140       78  

Changes in operating assets and liabilities:

    

Receivables, net

     (589     (570

Other invested assets

     (28     (11

Other assets

     (258     (445

Policy liabilities

     1,251       (610

Unearned income

     (2     1,158  

Accounts payable and accrued expenses

     (1,015     29  

Other liabilities

     632       70  

Income taxes

     (286     187  

Other, net

     (60     (105
  

 

 

   

 

 

 

Net cash provided by operating activities

     3,067       2,757  

Investing activities

    

Purchases of fixed maturity securities

     (5,023     (4,886

Proceeds from sales and maturities of fixed maturity securities

     3,454       4,882  

Purchases of equity securities

     (5,974     (658

Proceeds from sales of equity securities

     6,059       1,777  

Purchases of other invested assets

     (116     (247

Proceeds from sales of other invested assets

     216       198  

Changes in securities lending collateral

     40       (170

Purchases of subsidiaries, net of cash acquired

     —         (1,722

Net purchases of property and equipment

     (455     (533

Other, net

     (18     15  
  

 

 

   

 

 

 

Net cash used in investing activities

     (1,817     (1,344

Financing activities

    

Net proceeds from (repayments of) commercial paper borrowings

     203       (704

Net repayments of short-term borrowings

     (135     (155

Net (repayments of) proceeds from long-term borrowings

     (73     172  

Changes in securities lending payable

     (40     170  

Changes in bank overdrafts

     84       69  

Premiums paid on equity call options

     (1     —    

Proceeds from issuance of common stock under Equity Units stock purchase contracts

     —         1,250  

Repurchase and retirement of common stock

     (752     (795

Change in collateral and settlements of debt-related derivatives

     —         22  

Cash dividends

     (412     (388

Proceeds from issuance of common stock under employee stock plans

     100       95  

Taxes paid through withholding of common stock under employee stock plans

     (80     (76
  

 

 

   

 

 

 

Net cash used in financing activities

     (1,106     (340

Change in cash and cash equivalents

     144       1,073  

Cash and cash equivalents at beginning of year

     3,934       3,609  
  

 

 

   

 

 

 

Cash and cash equivalents at end of period

   $ 4,078     $ 4,682  
  

 

 

   

 

 

 

 

12


Anthem, Inc.

Reconciliation of Medical Claims Payable

 

     Six Months Ended                    
     June 30     Years Ended December 31  
     2019     2018     2018     2017     2016  
(In millions)    (Unaudited)     (Unaudited)                    

Gross medical claims payable, beginning of period

   $ 7,266     $ 7,814     $ 7,814     $ 7,656     $ 7,360  

Ceded medical claims payable, beginning of period

     (34     (105     (105     (539     (646
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net medical claims payable, beginning of period

     7,232       7,709       7,709       7,117       6,714  
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Business combinations and purchase adjustments

     —         199       199       76       —    

Net incurred medical claims:

          

Current year

     38,237       33,922       69,581       70,377       64,868  

Prior years redundancies(1)

     (414     (795     (930     (1,133     (835
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total net incurred medical claims

     37,823       33,127       68,651       69,244       64,033  
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net payments attributable to:

          

Current year medical claims

     30,367       27,502       62,748       62,923       57,879  

Prior years medical claims

     6,182       6,208       6,579       5,805       5,751  
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total net payments

     36,549       33,710       69,327       68,728       63,630  
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net medical claims payable, end of period

     8,506       7,325       7,232       7,709       7,117  

Ceded medical claims payable, end of period

     43       35       34       105       539  
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Gross medical claims payable, end of period

   $ 8,549     $ 7,360     $ 7,266     $ 7,814     $ 7,656  
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Current year medical claims paid as a percentage of current year net incurred medical claims

     79.4     81.1     90.2     89.4     89.2

Prior year redundancies in the current year as a percentage of prior year net medical claims payable less prior year redundancies in the current year

     6.1     11.5     13.7     18.9     14.2

Prior year redundancies in the current year as a percentage of prior year net incurred medical claims

     0.6     1.2     1.3     1.8     1.4

 

(1) 

Negative amounts reported for net incurred medical claims related to prior years result from claims being settled for amounts less than originally estimated.

 

13


Anthem, Inc.

GAAP Reconciliation

(Unaudited)

Anthem, Inc. has referenced “Adjusted Net Income” and “Adjusted Net Income Per Share,” which are non-GAAP measures, in this document. These non-GAAP measures are not intended to be alternatives to any measure calculated in accordance with GAAP. In addition to these non-GAAP measures, references are made to the measures “Operating Revenue” and “Operating Gain.” Each of these measures is provided to further aid investors in understanding and analyzing the company’s core operating results and comparing Anthem, Inc.’s financial results. A reconciliation of Operating Revenue to Total Revenue is set forth in the Consolidated Statements of Income herein. A reconciliation of the non-GAAP measures to the most directly comparable measures calculated in accordance with GAAP, together with a reconciliation of reportable segments operating gain to income before income tax expense, is reported below. Prior amounts may be rounded differently to conform to current presentation.

 

     Three Months Ended           Six Months Ended        
     June 30           June 30        
(In millions, except per share data)    2019     2018     Change     2019     2018     Change  

Net income

   $ 1,139     $ 1,054       8.1   $ 2,690     $ 2,366       13.7

Add / (Subtract):

            

Net realized (gains) losses on financial instruments

     (11     (4       (89     22    

Amortization of other intangible assets

     85       93         172       173    

Other-than-temporary impairment losses recognized in income

     7       4         17       12    

(Gain) loss on extinguishment of debt

     —         (1       (1     18    

Litigation expenses for CI and ESI

     9       —           35       —      

Transaction related costs

     5       —           5       9    

Tax impact of non-GAAP adjustments

     (23     (21       (37     (55  
  

 

 

   

 

 

     

 

 

   

 

 

   

Net adjustment items

     72       71         102       179    
  

 

 

   

 

 

     

 

 

   

 

 

   

Adjusted net income

   $ 1,211     $ 1,125       7.6   $ 2,792     $ 2,545       9.7
  

 

 

   

 

 

     

 

 

   

 

 

   

Net income per diluted share

   $ 4.36     $ 3.98       9.5   $ 10.28     $ 8.97       14.6

Add / (Subtract):

            

Net realized (gains) losses on financial instruments

     (0.04     (0.02       (0.34     0.08    

Amortization of other intangible assets

     0.33       0.35         0.66       0.66    

Other-than-temporary impairment losses recognized in income

     0.03       0.02         0.06       0.05    

(Gain) loss on extinguishment of debt

     —         —           —         0.07    

Litigation expenses for CI and ESI

     0.03       —           0.13       —      

Transaction related costs

     0.02       —           0.02       0.03    

Tax impact of non-GAAP adjustments

     (0.09     (0.09       (0.14     (0.21  

Rounding Impact

     —         0.01         —         —      
  

 

 

   

 

 

     

 

 

   

 

 

   

Net adjustment items

     0.28       0.27         0.39       0.68    
  

 

 

   

 

 

     

 

 

   

 

 

   

Adjusted net income per diluted share

   $ 4.64     $ 4.25       9.2   $ 10.67     $ 9.65       10.6
  

 

 

   

 

 

     

 

 

   

 

 

   

 

     Full Year 2019 Outlook  

Net income per diluted share

     Greater than $18.34  

Add / (Subtract):

  

Net realized gains on financial instruments

     (0.34

Other-than-temporary impairment losses recognized in income

     0.06  

Litigation expenses for CI and ESI

     0.13  

Transaction related costs

     0.02  

Amortization of other intangible assets

     Approximately $1.37  

Tax impact of non-GAAP adjustments

     Approximately ($0.28
  

 

 

 

Net adjustment items

     Approximately $0.96  
  

 

 

 

Adjusted net income per diluted share

     Greater than $19.30  
  

 

 

 

 

     Three Months Ended           Six Months Ended        
     June 30           June 30        
(In millions)    2019     2018     Change     2019     2018     Change  

Reportable segments operating gain

   $ 1,433     $ 1,559       (8.1 )%    $ 3,373     $ 3,427       (1.6 )% 

Net investment income

     285       229         495       458    

Net realized gains (losses) on financial instruments

     11       4         89       (22  

Other-than-temporary impairment losses recognized in income

     (7     (4       (17     (12  

Interest expense

     (184     (192       (371     (376  

Amortization of other intangible assets

     (85     (93       (172     (173  

Gain (loss) on extinguishment of debt

     —         1         1       (18  
  

 

 

   

 

 

     

 

 

   

 

 

   

Income before income tax expense

   $ 1,453     $ 1,504       (3.4 )%    $ 3,398     $ 3,284       3.5
  

 

 

   

 

 

     

 

 

   

 

 

   

 

14


Anthem, Inc.

Reclassified Reportable Segment Highlights

(unaudited)

 

(In millions)    Three Months Ended  
     March 31, 2018     June 30, 2018     September 30, 2018     December 31, 2018  

Operating Revenue

        

Commercial & Specialty Business

   $ 8,951     $ 9,055     $ 8,933     $ 8,843  

Government Business

     13,353       13,619       13,979       14,397  

Other

     360       350       398       411  

Eliminations

     (322     (309     (330     (347
  

 

 

   

 

 

   

 

 

   

 

 

 

Total Operating Revenue1

   $ 22,342     $ 22,715     $ 22,980     $ 23,304  

Operating Gain / (Loss)

        

Commercial & Specialty Business

   $ 1,402     $ 1,048     $ 834     $ 316  

Government Business

     489       532       456       451  

Other

     (23     (21     (41     (17
  

 

 

   

 

 

   

 

 

   

 

 

 

Total Operating Gain1

   $ 1,868     $ 1,559     $ 1,249     $ 750  

 

(In millions)    Three Months Ended  
     March 31, 2019     June 30, 2019  

Operating Revenue

    

Commercial & Specialty Business

   $ 9,392     $ 9,417  

Government Business

     14,926       15,538  

Other

     548       794  

Eliminations

     (478     (572
  

 

 

   

 

 

 

Total Operating Revenue1

   $ 24,388     $ 25,177  

Operating Gain / (Loss)

    

Commercial & Specialty Business

   $ 1,598     $ 983  

Government Business

     377       478  

Other

     (35     (28
  

 

 

   

 

 

 

Total Operating Gain1

   $ 1,940     $ 1,433  

 

(1) 

See “Basis of Presentation” on page 6 herein.

 

15


Forward-Looking Statements

This document contains certain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements reflect our views about future events and financial performance and are generally not historical facts. Words such as “expect,” “feel,” “believe,” “will,” “may,” “should,” “anticipate,” “intend,” “estimate,” “project,” “forecast,” “plan” and similar expressions are intended to identify forward-looking statements. These statements include, but are not limited to: financial projections and estimates and their underlying assumptions; statements regarding plans, objectives and expectations with respect to future operations, products and services; and statements regarding future performance. Such statements are subject to certain risks and uncertainties, many of which are difficult to predict and generally beyond our control, that could cause actual results to differ materially from those expressed in, or implied or projected by, the forward-looking statements. You are cautioned not to place undue reliance on these forward-looking statements that speak only as of the date hereof. You are also urged to carefully review and consider the various risks and other disclosures discussed in our reports filed with the U.S. Securities and Exchange Commission from time to time, which attempt to advise interested parties of the factors that affect our business. Except to the extent otherwise required by federal securities laws, we do not undertake any obligation to republish revised forward-looking statements to reflect events or circumstances after the date hereof. These risks and uncertainties include, but are not limited to: the impact of federal and state regulation, including ongoing changes in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended, or collectively, the ACA, and the ultimate outcome of legal challenges to the ACA; trends in healthcare costs and utilization rates; our ability to contract with providers on cost-effective and competitive terms; our ability to secure sufficient premium rates, including regulatory approval for and implementation of such rates; competitive pressures and our ability to adapt to changes in the industry and develop and implement strategic growth opportunities; reduced enrollment; unauthorized disclosure of member or employee sensitive or confidential information, including the impact and outcome of any investigations, inquiries, claims and litigation related thereto; risks and uncertainties regarding Medicare and Medicaid programs, including those related to non-compliance with the complex regulations imposed thereon; our ability to maintain and achieve improvement in Centers for Medicare and Medicaid Services, or CMS, Star ratings and other quality scores and funding risks with respect to revenue received from participation therein; a negative change in our healthcare product mix; costs and other liabilities associated with litigation, government investigations, audits or reviews; the ultimate outcome of litigation between Cigna Corporation, or Cigna, and us related to the merger agreement between the parties, including our claim for damages against Cigna, Cigna’s claim for payment of a termination fee and other damages against us, and the potential for such litigation to cause us to incur substantial costs, materially distract management and negatively impact our reputation and financial condition; non-compliance by any party with the pharmacy benefit management services agreements between us and each of Express Scripts, Inc., or Express Scripts, and CaremarkPCS Health, L.L.C., or CVS Health, as well as any agreements governing the transition of pharmacy benefit management services provided to us from Express Scripts to CVS Health, which could result in financial penalties, our inability to meet customer demands, and sanctions imposed by governmental entities, including CMS; medical malpractice or professional liability claims or other risks related to healthcare services and pharmacy benefit management services provided by our subsidiaries; possible restrictions in the payment of dividends from our subsidiaries and increases in required minimum levels of capital; our ability to repurchase shares of our common stock and pay dividends on our common stock due to the adequacy of our cash flow and earnings and other considerations; the potential negative effect from our substantial amount of outstanding indebtedness; a downgrade in our financial strength ratings; the effects of any negative publicity related to the health benefits industry in general or us in particular; failure to effectively maintain and modernize our information systems; events that may negatively affect our licenses with the Blue Cross and Blue Shield Association; large-scale medical emergencies, such as future public health epidemics and catastrophes; general risks associated with mergers, acquisitions, joint ventures and strategic alliances; possible impairment of the value of our intangible assets if future results do not adequately support goodwill and other intangible assets; changes in economic and market conditions, as well as regulations that may negatively affect our liquidity and investment portfolios; changes in U.S. tax laws; intense competition to attract and retain employees; and various laws and provisions in our governing documents that may prevent or discourage takeovers and business combinations.

 

16

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