EX-99.1 2 dex991.htm PRESS RELEASE DATED NOVEMBER 3, 2006 Press Release dated November 3, 2006

Exhibit 99.1

 

LOGO   

Health Net, Inc.

21650 Oxnard Street

Woodland Hills, CA 91367

818.676.6000

800.291.6911

www.healthnet.com

News Release   

Contacts: David Olson

818.676.6978

david.w.olson@healthnet.com

Michael Engelhard

818.676.7620

michael.engelhard@healthnet.com

HEALTH NET REPORTS NET INCOME OF $91 MILLION

OR $.76 PER DILUTED SHARE

Days Claims Payable Rise Sequentially,

Cash Flow Affected by CMS Payment Timing

LOS ANGELES, November 3, 2006 – Health Net, Inc. (NYSE:HNT) today announced 2006 third quarter net income per diluted share of $.76 compared with net income per diluted share of $.67 in the third quarter of 2005, a 13.4 percent increase. The $.76 includes the effect of two items noted by the company in a press release it issued on October 16, 2006.

The first item is a $70,095,000 pretax charge for the refinancing of the company’s Senior Notes due 2011 that was completed on August 14, 2006. The second item is a tax benefit that resulted from a loss on the sale of a subsidiary and its affiliates in the third quarter of 2006. This tax benefit reduced the company’s effective tax rate in the third quarter of 2006 to 1.8 percent.


Absent this tax benefit, the company’s effective tax rate would have been 38.4 percent. The net effect of these two items reduced net income by $.08 per diluted share in the quarter.

Excluding these two items, third quarter earnings per diluted share would have been $.84, a 25.4 percent increase over the $.67 per diluted share earned in the third quarter of 2005. Management believes the earnings per diluted share figure of $.84 that excludes the $.08 effect of the two items in the third quarter of 2006 is more reflective of the company’s underlying operating performance and a more accurate representation of the change in the company’s performance between the two periods.

Effective as of the end of the third quarter ended September 30, 2006, Health Net is reporting certain revenue items, primarily from its Administrative Services Only (ASO) business and other like businesses, in a separate line item entitled “Administrative services fees and other income” on its Condensed Consolidated Statements of Operations. Such revenue items had previously been reported as part of Health plan services premiums (See Note (a) in the company’s Notes to Condensed Consolidated Financial Statements in the attached tables).

Other highlights of Health Net’s third quarter 2006 results included:

 

    Days claims payable (DCP) rose by 1.6 days to 42.5 days compared with the second quarter of 2006. When adjusted for capitation, provider settlements and Medicare Part D costs, DCP rose by 2.3 days sequentially to 55.1 days.

 

    Reported operating cash flow was a negative $50,283,000. This amount includes only two monthly payments from the Centers for Medicare & Medicaid Services (CMS) in the third quarter of 2006. Health Net received the third monthly payment for the third quarter on October 2, 2006. Had Health Net received all three monthly CMS payments during the third quarter, operating cash flow would have been approximately $170 million, or approximately 1.8 times reported net income in the quarter.

 

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    A 100 basis point sequential improvement in the company’s health plan services Medical Care Ratio (MCR) between the second and third quarters of 2006, consistent with historical seasonal utilization patterns. The health plan MCR improved by 70 basis points compared with the third quarter of 2005, as a result of higher premiums and moderating health care cost trends.

 

    The company’s pretax margin in the quarter was 2.9 percent. Excluding the pretax refinancing charge described above, the pretax margin would have been 5.0 percent, an 80 basis point improvement compared with the third quarter of 2005. Management believes the 5.0 percent figure, derived by excluding the impact of the $70,095,000 pretax refinancing charge, is more reflective of the company’s underlying operating performance and a more accurate representation of the changes in the company’s performance relative to the third quarter of 2005.

“We are pleased that the third quarter again demonstrated the inherent strength of our diverse government and commercial businesses,” said Jay Gellert, president and chief executive officer of Health Net. “We believe the earnings were of a high quality as margins expanded and both normalized operating cash flow and days claims payable improved sequentially, as we expected they would,” Gellert added.

Revenues

Health Net’s total revenues increased 6.2 percent in the third quarter of 2006 to $3,247,425,000 from $3,058,773,000 in the third quarter of 2005. Health plan revenues increased 9.9 percent to $2,622,065,000 in the third quarter of 2006 compared to $2,386,332,000 in the third quarter of 2005. In the third quarter of 2006, Health Net’s Government contracts revenue fell by 12.4 percent from the third quarter of 2005, as lower health care claims costs caused revenue to decline.

 

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“In health plans, we continue to see year-over-year revenue increases. In government contracts, the declines in costs and revenue demonstrate our success in keeping health care affordable for the families of our men and women in the military,” Gellert said.

Commercial premium yields per member per month (PMPM) increased 7.2 percent in the third quarter of 2006 compared to the third quarter of 2005. “Year-to-date commercial PMPM premiums are up around 8 percent, and that’s right on target for our plan, including the impact of our Universal Care acquisition,” noted Gellert.

Total health plan enrollment declined by approximately 31,000 members in the third quarter of 2006 compared to the second quarter of 2006.

Commercial enrollment, including both at-risk and ASO membership, declined by 18,000 members, or approximately 1 percent, in the third quarter of 2006 compared to the second quarter of 2006. Much of the decrease was attributable to expected enrollment declines resulting from the transition of members from Universal Care to Health Net. Health Net acquired Universal Care on March 31, 2006. The remaining 13,000-member decline was due to Medicaid attrition from ongoing enforcement of eligibility requirements.

“We expected to see a decline in the Universal enrollment as we moved through 2006,” said Gellert. “Overall commercial enrollment is very close to our expectations.”

Health Care Costs

The health plan MCR improvement in the third quarter resulted from ongoing moderating trends in physician, hospital and pharmacy expenses compared with 2005. Commercial health care costs rose by 8.0 percent PMPM between the third quarters of 2005 and 2006.

 

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“These cost trends are consistent with our 7.5 percent 2006 full year guidance,” Gellert stated. “Our sequential MCR is down by 100 basis points and our PMPM commercial gross margin expanded. The year-over-year health care cost comparison is inflated due to unusually low reported experience in 2005.”

The Government contracts cost ratio of 93.9 percent in the third quarter of 2006 represented a significant improvement compared with the third quarter of 2005.

“The improvement resulted from the good work done by everyone in containing cost increases in this program. We are very pleased that our efforts, in partnership with our customer, are saving the Federal government money while providing beneficiaries the care they need,” Gellert added.

Administrative Expenses

In the third quarter of 2006, total general, administrative and depreciation expenses increased by $53,825,000 to $299,679,000 compared to $245,854,000 in the third quarter of 2005. The increase is consistent with higher levels of such spending by the company throughout 2006.

“We continue to invest in our future through expanded product offerings, increased marketing and improved operations,” Gellert commented.

Debt Refinancing

On August 14, 2006, the company completed a series of transactions related to the redemption of all $400 million of its Senior Notes due 2011. The transaction costs incurred in connection with the redemption totaled $70,095,000 on a pretax basis and were recorded as a separate, non-recurring item in the third quarter of 2006.

 

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Balance Sheet Highlights and Interest Expense

Reserves for claims and other settlements increased by $59,576,000 to $1,035,958,000 at September 30, 2006, from $976,382,000 at June 30, 2006.

DCP increased by 1.6 days to 42.5 days in the third quarter of 2006, from 40.9 days in the second quarter of 2006. These amounts include the effects of provider settlements, capitation payments and Medicare Part D.

DCP, excluding provider settlements, capitation payments and the impact of Medicare Part D expenses, increased by 2.3 days to 55.1 days in the third quarter of 2006 compared to the second quarter of 2006 (see note (d) in the company’s Notes to Condensed Consolidated Financial Statements in the attached tables). The company employs an average claims reserves methodology in calculating DCP.

At the end of the third quarter of 2006, the company had $500 million in debt. Health Net’s debt-to-total capital ratio was 20.7 percent at September 30, 2006.

Interest expense increased in the third quarter of 2006 by $1,962,000 compared with the second quarter of 2006, as the company serviced higher average levels of debt associated with the redemption of its Senior Notes completed in the quarter.

“We expect to see a substantial reduction in interest expense in the fourth quarter as a result of the redemption of our Senior Notes,” Gellert added.

Cash Flow and Investment Income

Operating cash flow was negative $50,283,000 in the third quarter of 2006. As noted earlier, the company received only two of the three CMS payments it should have received in the third quarter.

 

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“Had we received all three payments in the third quarter, we would have had positive operating cash flow equal to approximately 1.8 times net income. We believe this result underscores the cash generating potential of Health Net going forward,” Gellert explained.

Investment income rose by $6,942,000 in the quarter compared with the second quarter of 2006. Health Net noted that the increase was the result of the fact that it maintained a high balance of treasury securities for approximately half the quarter in connection with the redemption of its Senior Notes and also recorded an investment gain on the sale of those securities.

Outlook

Health Net believes that its earnings per diluted share for the full year 2006 will be between $2.94 and $2.98, including the net $.08 per diluted share impact of the two items recorded in the third quarter of 2006. Excluding the impact of these two items, the company believes earnings per diluted share would be between $3.02 and $3.06. The company also is reaffirming prior guidance that its earnings per diluted share in the fourth quarter will be between $.88 and $.92. The company also issued specific guidance for 2007 earnings of $3.60 per diluted share based on a fully diluted share count of 117 million.

On October 16, 2006, Health Net announced that its board of directors approved a resumption of the company’s previously established stock repurchase program. The board also approved a $235 million increase in the repurchase authorization. As a result, Health Net’s current authorization under the stock repurchase program is an aggregate amount of up to $450 million.

The company is seeking to amend its bank credit agreements to obtain greater flexibility to engage in stock repurchases. The company’s credit agreements currently limit such purchases, other than purchases made with proceeds from a financing transaction undertaken specifically to fund stock repurchases, to $75 million (plus exercise proceeds and tax benefits from the exercise of employee stock options) in any consecutive four-quarter period, less other restricted payments made in such period.

 

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“We are very pleased that we will be resuming our stock repurchase program and that the board has demonstrated its confidence in our ability to generate cash flow that can be used for the stock repurchase program,” Gellert concluded.

Conference Call

As previously announced, Health Net will discuss the company’s third quarter results during a conference call scheduled on Friday, November 3, 2006, at approximately 11:00 a.m. Eastern Time. To listen to the call, please dial 800.811.7286, code 4578148. A live webcast and replay of the conference call also will be available at www.healthnet.com. The conference call webcast is open to all interested parties. A replay of the conference call will be available from November 3, 2006 through November 7, 2006, by dialing 888.203.1112, code 4578148. Anyone listening to the company’s conference call will be presumed to have read Health Net’s Annual Report on Form 10-K for the year ended December 31, 2005, Quarterly Reports on Form 10-Q for the quarters ended March 31, 2006 and June 30, 2006, and other reports filed by the company from time to time with the Securities and Exchange Commission.

About Health Net

Health Net, Inc. is among the nation’s largest publicly traded managed health care companies. Its mission is to help people be healthy, secure and comfortable. The company’s HMO, POS, insured PPO and government contracts subsidiaries provide health benefits to approximately 6.6 million individuals in 27 states and the District of Columbia through group, individual, Medicare, Medicaid and TRICARE and Veterans Affairs programs. Health Net’s behavioral health subsidiary, MHN, provides behavioral health, substance abuse and employee assistance programs (EAPs) to approximately 7.3 million individuals in various states. The

 

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company’s subsidiaries also offer managed health care products related to prescription drugs, and offer managed health care product coordination for multi-region employers and administrative services for medical groups and self-funded benefits programs.

For more information on Health Net, Inc., please visit the company’s Web site at www.healthnet.com.

Cautionary Statements

This release contains forward-looking statements within the meaning of Section 21E of the Securities Exchange Act of 1934, as amended, and Section 27A of the Securities Act of 1933, as amended, that involve a number of risks and uncertainties. All statements, other than statements of historical information provided herein, may be deemed to be forward-looking statements. These statements are based on management’s analysis, judgment, belief and expectation only as of the date hereof, and are subject to uncertainty and changes in circumstances. Without limiting the foregoing, the words “believes,” “anticipates,” “plans,” “expects,” “may,” “should,” “could,” “estimate,” “intend” and other similar expressions are intended to identify forward-looking statements. Actual results could differ materially due to, among other things, rising health care costs, negative prior period claims reserve developments, trends in medical care ratios, issues relating to provider contracts, litigation costs, operational issues, health care reform and general business conditions. Additional factors that could cause actual results to differ materially from those reflected in the forward-looking statements include, but are not limited to, the risks discussed in the “Risk Factors” section included within the company’s most recent Annual Report on Form 10-K and subsequent Quarterly Reports on Form 10-Q filed with the SEC. Readers are cautioned not to place undue reliance on these forward-looking statements. The company undertakes no obligation to publicly revise these

 

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forward-looking statements to reflect events or circumstances that arise after the date of this release.

#            #            #

 

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Health Net, Inc.

Condensed Consolidated Statements of Operations

(Amounts in thousands, except per share, per member and ratio data)

 

     Third Quarter
Ended
September 30,
2005
    Fourth Quarter
Ended
December 31,
2005
    First Quarter
Ended
March 31,
2006
    Second Quarter
Ended
June 30, 2006
    Third Quarter
Ended
September 30,
2006
 

REVENUES:

          

Health plan services premiums (a)

   $ 2,386,332     $ 2,354,722     $ 2,524,374     $ 2,599,079     $ 2,622,065  

Government contracts

     639,626       560,491       615,897       615,557       560,540  

Net investment income

     19,536       20,239       23,359       26,256       33,198  

Administrative services fees and other income (a)

     13,279       14,706       23,000       25,230       31,622  
                                        

Total revenues

     3,058,773       2,950,158       3,186,630       3,266,122       3,247,425  
                                        
          

EXPENSES:

          

Health plan services

     2,000,661       1,952,309       2,108,712       2,185,641       2,179,161  

Government contracts

     614,794       535,800       587,980       580,052       526,581  

General and administrative

     241,847       266,043       290,823       295,064       294,052  

Selling

     55,000       53,200       56,611       59,630       62,853  

Depreciation

     4,007       4,220       4,758       4,955       5,627  

Amortization

     861       861       591       1,275       1,092  

Interest

     11,789       11,690       12,226       13,449       15,411  
                                        
     2,928,959       2,824,123       3,061,701       3,140,066       3,084,777  

Debt refinancing (b)

     —         —         —         —         70,095  
                                        

Total expenses

     2,928,959       2,824,123       3,061,701       3,140,066       3,154,872  
                                        

Income from operations before income taxes

     129,814       126,035       124,929       126,056       92,553  

Income tax provision

     51,609       49,366       48,336       49,023       1,651 (c)
                                        

Net income

   $ 78,205     $ 76,669     $ 76,593     $ 77,033     $ 90,902  
                                        

Basic earnings per share

   $ 0.69     $ 0.67     $ 0.67     $ 0.67     $ 0.78  

Diluted earnings per share

   $ 0.67     $ 0.65     $ 0.65     $ 0.65     $ 0.76  

Weighted average shares outstanding:

          

Basic

     113,371       114,276       114,594       115,213       115,867  

Diluted

     116,543       117,902       118,398       118,305       118,830  

Pretax margin

          

(Income from operations before income taxes / Total revenues)

     4.2 %     4.3 %     3.9 %     3.9 %     2.9 %

Health plan services MCR (a)

     83.8 %     82.9 %     83.5 %     84.1 %     83.1 %

Government contracts cost ratio

     96.1 %     95.6 %     95.5 %     94.2 %     93.9 %

Administrative ratio

          

((G&A+Dep) / (HP serv prem + admin serv fees and other income))

     10.2 %     11.4 %     11.6 %     11.4 %     11.3 %

Selling costs ratio (Selling costs / HP serv prem) (a)

     2.3 %     2.3 %     2.2 %     2.3 %     2.4 %

Days claims payable (d)

     48.8       49.4       43.2       40.9       42.5  

Days claims payable - adjusted (d)

     61.1       63.5       58.1       52.8       55.1  

Effective tax rate

     39.8 %     39.2 %     38.7 %     38.9 %     1.8 % (c)

Health plan services premiums PMPM (a)

   $ 238.92     $ 239.88     $ 244.78     $ 241.75     $ 244.49  

Health plan services costs PMPM

   $ 200.31     $ 198.88     $ 204.48     $ 203.29     $ 203.19  

 

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Health Net, Inc.

Condensed Consolidated Balance Sheets

(Amounts in thousands, except ratio data)

 

     September 30,
2005
    December 31,
2005
    March 31,
2006
    June 30,
2006
    September 30,
2006
 

ASSETS

          

Current Assets

          

Cash and cash equivalents

   $ 1,027,848     $ 742,485     $ 870,224     $ 825,925     $ 825,369  

Investments - available for sale

     1,150,738       1,363,818       1,356,386       1,382,583       1,399,478  

Premiums receivable, net (a)

     127,020       132,019       163,237       214,173       235,267  

Amounts receivable under government contracts

     122,295       122,796       143,625       135,433       130,306  

Incurred but not reported (IBNR) health care costs receivable under TRICARE North contract

     263,329       265,517       295,800       318,827       299,878  

Other receivables (a)

     85,873       79,572       93,154       131,218       123,586  

Deferred taxes

     110,445       93,899       99,866       57,141       33,379  

Restricted assets for senior notes redemption

     —         —         —         499,557       —    

Other assets

     107,618       111,512       147,600       159,662       138,850  
                                        

Total current assets

     2,995,166       2,911,618       3,169,892       3,724,519       3,186,113  

Property and equipment, net

     112,218       125,773       136,727       144,436       155,395  

Goodwill, net

     723,595       723,595       751,949       751,949       751,949  

Other intangible assets, net

     19,271       18,409       47,062       45,532       44,183  

Deferred taxes

     29,527       31,060       46,560       48,574       51,557  

Other noncurrent assets

     143,555       130,267       137,645       132,186       101,719  
                                        

Total Assets

   $ 4,023,332     $ 3,940,722     $ 4,289,835     $ 4,847,196     $ 4,290,916  
                                        

LIABILITIES AND STOCKHOLDERS’ EQUITY

          

Current Liabilities

          

Reserves for claims and other settlements

   $ 1,057,848     $ 1,040,171     $ 986,525     $ 976,382     $ 1,035,958  

Health care and other costs payable under government contracts

     62,778       62,536       62,529       60,325       40,461  

IBNR health care costs payable under TRICARE North contract

     263,329       265,517       295,800       318,827       299,878  

Unearned premiums

     218,527       106,586       324,063       338,611       140,939  

Bridge loan

     —         —         —         200,000       200,000  

Senior notes payable

     —         —         —         376,052       —    

Accounts payable and other liabilities

     404,362       364,266       434,605       389,130       256,096  
                                        

Total current liabilities

     2,006,844       1,839,076       2,103,522       2,659,327       1,973,332  

Senior notes payable

     391,106       387,954       379,983       —         —    

Term loan

     —         —         —         300,000       300,000  

Other noncurrent liabilities

     123,376       124,617       129,507       108,222       106,897  
                                        

Total Liabilities

     2,521,326       2,351,647       2,613,012       3,067,549       2,380,229  
                                        

Stockholders’ Equity

          

Common stock and additional paid-in capital

     899,400       911,672       932,254       967,265       992,497  

Treasury common stock, at cost

     (633,153 )     (633,375 )     (636,252 )     (640,623 )     (640,623 )

Retained earnings

     1,247,496       1,324,165       1,400,758       1,477,791       1,568,693  

Accumulated other comprehensive loss

     (11,737 )     (13,387 )     (19,937 )     (24,786 )     (9,880 )
                                        

Total Stockholders’ Equity

     1,502,006       1,589,075       1,676,823       1,779,647       1,910,687  
                                        

Total Liabilities and Stockholders’ Equity

   $ 4,023,332     $ 3,940,722     $ 4,289,835     $ 4,847,196     $ 4,290,916  
                                        

Debt-to-Total Capital Ratio

     20.7 %     19.6 %     18.5 %     33.0 %     20.7 %

 

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Health Net, Inc.

Condensed Consolidated Statements of Cash Flows

(Amounts in thousands)

 

     Third Quarter
Ended
September 30,
2005
    Fourth Quarter
Ended
December 31,
2005
    First Quarter
Ended
March 31,
2006
    Second Quarter
Ended
June 30,
2006
    Third Quarter
Ended
September 30,
2006
 

CASH FLOWS FROM OPERATING ACTIVITIES:

          

Net income

   $ 78,205     $ 76,669     $ 76,593     $ 77,033     $ 90,902  

Adjustments to reconcile net income to net cash provided by (used in) operating activities:

          

Amortization and depreciation

     4,868       5,081       5,349       6,230       6,719  

Debt refinancing charge

     —         —         —         —         70,095  

Share-based compensation expense

     —         —         4,435       5,195       5,191  

Other changes

     3,229       3,032       4,344       4,002       3,680  

Changes in assets and liabilities, net of the effects of dispositions:

          

Premiums receivable and unearned premiums (a)

     114,245       (116,940 )     186,259       (36,388 )     (218,766 )

Other receivables, deferred taxes and other assets (a)

     4,901       18,476       (50,639 )     (6,327 )     39,109  

Amounts receivable/payable under government contracts

     (51,886 )     (743 )     (20,836 )     5,988       (14,737 )

Reserves for claims and other settlements

     (7,617 )     (17,677 )     (53,647 )     (10,143 )     59,576  

Accounts payable and other liabilities

     28,826       (35,706 )     34,046       (52,523 )     (92,052 )
                                        

Net cash provided by (used in) operating activities

     174,771       (67,808 )     185,904       (6,933 )     (50,283 )
                                        

CASH FLOWS FROM INVESTING ACTIVITIES:

          

Sales of investments

     13,283       179,102       228,995       44,374       47,397  

Maturities of investments

     20,215       41,037       15,770       30,248       29,683  

Purchases of investments

     (126,917 )     (437,250 )     (252,973 )     (110,683 )     (71,344 )

Proceeds from sale of property and equipment

     417       —         —         —         4,242  

Purchases of property and equipment

     (13,242 )     (17,738 )     (15,730 )     (12,679 )     (20,420 )

Cash paid/disposed for acquisition/sale of business

     —         —         (73,100 )     (494 )     (405 )

Sales and purchases of restricted investments and other

     (8,840 )     9,093       (9,027 )     (496,943 )     523,336  
                                        

Net cash (used in) provided by investing activities

     (115,084 )     (225,756 )     (106,065 )     (546,177 )     512,489  
                                        

CASH FLOWS FROM FINANCING ACTIVITIES:

          

Proceeds from exercise of stock options and employee stock purchases

     29,331       8,423       10,380       20,895       15,136  

Repurchases of common stock

     (227 )     (222 )     (1,724 )     (1,107 )     —    

Excess tax benefits from share-based compensation

     —         —         3,099       2,221       2,688  

Borrowings under term and bridge loan agreements

     —         —         —         497,334       —    

Senior notes redemption and interest rate swap settlement

     —         —         —         —         (465,045 )

Net Medicare Part D deposits (payments)

     —         —         36,145       (10,532 )     (15,541 )
                                        

Net cash provided by (used in) financing activities

     29,104       8,201       47,900       508,811       (462,762 )
                                        

Net increase (decrease) in cash and cash equivalents

     88,791       (285,363 )     127,739       (44,299 )     (556 )

Cash and cash equivalents, beginning of period

     939,057       1,027,848       742,485       870,224       825,925  
                                        

Cash and cash equivalents, end of period

   $ 1,027,848     $ 742,485     $ 870,224     $ 825,925     $ 825,369  
                                        

 

Page 13


Health Net, Inc.

Notes to Condensed Consolidated Financial Statements

Notes:

 

(a) Effective in the third quarter ended September 30, 2006, we have reported certain revenue items, primarily from our administrative services only (ASO) business and other like businesses, in a separate line item titled administrative services fees and other income on our condensed consolidated statements of operations. Historically, ASO and related revenue amounts were reported as part of health plan services premiums. In recent periods, the revenues from these businesses have increased to a level where we believe that reporting them separately would provide more insight on the nature of our operations. We have also reclassified the related receivables from premiums receivable to other receivables on our condensed consolidated balance sheets. All impacted prior period financial information reflect this reclassification change. This reclassification had no impact on net earnings, stockholders’ equity or cash flow from operating activities as previously reported.

 

(b) Reflects $59 million senior notes redemption and $11 million interest rate swap settlement costs.

 

(c) Reflects $32 million tax benefit from sale of Pennsylvania subsidiaries.

 

(d) Management believes that days claims payable (excluding capitation, provider settlements and Medicare Part D), a non-GAAP financial measure, provides useful information to investors because, in excluding those health care costs for which no or minimal reserves are maintained, it is a more accurate reflection of days claims payable calculated from claims-based reserves than is days claims payable, which does not exclude such costs. This non-GAAP financial information should be considered in addition to, not as a substitute for, financial information prepared in accordance with GAAP. The following table provides a reconciliation of the differences between days claims payable (excluding capitation, provider settlements and Medicare Part D) and days claims payable, the most directly comparable financial measure calculated and presented in accordance with GAAP:

 

     Q3 2005     Q4 2005     Q1 2006     Q2 2006     Q3 2006  
     (Dollars in millions)  

Reserve for Claims and Other Settlements

   $ 1,057.8     $ 1,040.2     $ 986.5     $ 976.4     $ 1,036.0  

Less: Capitation Payable, Provider Settlements and Medicare Part D

     (105.2 )     (95.4 )     (120.5 )     (110.3 )     (100.5 )
                                        

Adjusted Reserve for Claims and Other Settlements

     952.6       944.8       866.0       866.1       935.5  

(1) Average Reserve for Claims and Other Settlements

     1,061.7       1,049.0       1,013.3       981.5       1,006.2  

(2) Average Adjusted Reserve for Claims and Other Settlements

     942.7       948.7       905.4       866.1       900.8  

(3) Health Plan Services Cost

     2,000.7       1,952.3       2,108.7       2,185.6       2,179.2  

Less: Capitation Payments, Provider Settlements and Medicare Part D

     (580.8 )     (578.5 )     (705.9 )     (692.6 )     (674.1 )
                                        

(4) Adjusted Health Plan Services Cost

     1,419.9       1,373.8       1,402.8       1,493.0       1,505.1  

(5) Number of Days in Period

     92       92       90       91       92  

= (1) / (3) * (5) Days Claims Payable

     48.8       49.4       43.2       40.9       42.5  

= (2) / (4) * (5) Days Claims Payable (Excl. Capitation, Provider Settlements and Medicare Part D)

     61.1       63.5       58.1       52.8       55.1  
          

 

Page 14


HEALTH NET, INC.

Medical Covered Lives at September 30, 2006

(in Thousands)

 

     Commercial - Large
Group*
   Commercial -
Small Group &
Individual
   Commercial Risk
Subtotal
   ASO    Commercial Subtotal
     9/06    6/06   9/05    9/06    6/06   9/05    9/06    6/06   9/05    9/06    6/06   9/05    9/06    6/06   9/05

Arizona

   72    72   69    48    47   50    120    119   119    —      —     —      120    119   119

California

   1,053    1,063   1,088    419    422   391    1,472    1,485   1,478    6    5   7    1,478    1,490   1,485

Connecticut

   155    156   177    30    31   32    185    187   209    68    69   69    253    256   278

New Jersey

   44    47   61    57    58   83    101    105   145    19    20   18    120    125   163

New York

   121    120   116    96    96   103    217    216   218    17    17   21    234    233   239

Oregon

   99    99   102    37    37   36    136    136   138    —      —     —      136    136   138
                                                                     

Total

   1,544    1,557   1,612    687    691   695    2,231    2,248   2,307    110    111   115    2,341    2,359   2,422
                                                                     

Year over Year

      (4)%         (1)%         (3)%         (4)%         (3)%  

Sequential

      (1)%         (1)%         (1)%         (1)%         (1)%  

 

     Medicare Risk    Medicaid    Health Plan Total
     9/06    6/06   9/05    9/06    6/06   9/05    9/06    6/06   9/05

Arizona

   34    35   31    —      —     —      154    154   150

California

   104    104   94    717    726   703    2,299    2,320   2,282

Connecticut

   33    32   26    83    87   90    369    375   394

New Jersey

   —      —     —      47    47   40    167    172   203

New York

   7    7   6    —      —     —      241    240   245

Oregon

   19    19   15    —      —     —      155    155   153
                                         

Total

   197    197   172    847    860   833    3,385    3,416   3,427
                                         

Year over Year

      15%         2%         (1)%  

Sequential

      (0)%         (2)%         (1)%  
     9/06    6/06   9/05                            

Medicare PDP (Stand-Alone)

   294    288   —                  
     9/06    6/06   9/05                            

TRICARE

                       

North Contract **

   2,944    2,932   2,962                

 

* Commercial Large Group includes Medicare Supplement

 

** Includes Tricare eligible for which we have health care risk, and those for which we provide Administrative Services Only (ASO), primarily active duty

 

Page 15


Health Net, Inc.

Reconciliation of Reserves for Claims and Other Settlements

(In millions)

 

     Health Plan Services
     YTD 9/2006     Year 2005     Year 2004

Reserve for claims (a), beginning of period

   $ 768.7     $ 794.6     $ 777.1

Incurred claims related to:

      

Current Year

     3,926.9       5,130.4       5,048.3

Prior Years (c)

     (75.9 )     (114.5 )     8.7
                      

Total Incurred (b)

     3,851.0       5,015.9       5,057.0

Paid claims related to:

      

Current Year

     3,197.0       4,401.3       4,286.9

Prior Years

     666.4       640.5       752.6
                      

Total Paid (b)

     3,863.4       5,041.8       5,039.5

Reserve for claims (a), end of period

     756.3       768.7       794.6

Add:

      

Claims Payable

     179.9       177.2       288.3

Other (d)

     99.8       94.3       86.4
                      

Reserves for claims and other settlements, end of period

   $ 1,036.0     $ 1,040.2     $ 1,169.3
                      

 

(a) Consists of incurred but not reported claims and received but unprocessed claims and reserves for loss adjustment expenses.

 

(b) Includes medical claims only. Capitation, pharmacy and other payments including provider settlements are not included.

 

(c) This line represents the change in reserves attributable to the difference between the original estimate of incurred claims for prior years and the revised estimate. In developing the revised estimate, there have been no changes in the approach used to determine the key actuarial assumptions, which are the completion factor and medical cost trend. Claims liabilities are estimated under actuarial standards of practice and generally accepted accounting principles. The majority of the reserve balance held at each quarter-end is associated with the most recent months’ incurred services because these are the services for which the fewest claims have been paid. The majority of the adjustments to reserves relate to variables and uncertainties associated with actuarial assumptions. The degree of uncertainty in the estimates of incurred claims is greater for the most recent months’ incurred services. Revised estimates for prior years are determined in each quarter based on the most recent updates of paid claims for prior years.

 

(d) Includes accrued capitation, shared risk settlements, provider incentives and other reserve items.

 

Page 16