04.08.2010 20:00:00

Molina Healthcare Reports Second Quarter 2010 Results

Molina Healthcare, Inc. (NYSE: MOH):

  • Quarterly premium revenues of $977 million, up 6% over 2009
  • Quarterly operating income of $21 million, up 9% over 2009
  • Earnings per diluted share for second quarter 2010 of $0.41
  • Quarterly cash provided by operating activities of $52 million
  • Includes May and June results for Molina Medicaid Solutions
  • 130,000 new members enrolled since the second quarter 2009

Molina Healthcare, Inc. (NYSE: MOH) today reported its financial results for the second quarter and six months ended June 30, 2010.

Net income for the quarter was $10.6 million, or $0.41 per diluted share, compared with net income of $14.6 million, or $0.56 per diluted share, for the quarter ended June 30, 2009.

"Our second quarter results reflect improvement across our business despite a very difficult premium rate environment. Although a few states have provided rate increases, most states remain burdened by their budget shortfalls. Our diversified revenue growth, increasing scale, and disciplined cost management have contributed to our success in the quarter,” said J. Mario Molina, M.D., chief executive officer of Molina Healthcare, Inc. "Through the first half of the year, we have made progress in strengthening our core operations while continuing to build a strong portfolio in the industry. As a result, our earnings today reflect the benefits of lower medical costs and our expanded offering in the Medicaid management information systems space.”

Overview of Financial Results

Second Quarter 2010 Compared with First Quarter 2010

Net income for the second quarter of 2010 was consistent with the first quarter of 2010 as $5.0 million in operating income earned by the Molina Medicaid Solutions segment was offset by the following factors:

  • $5.5 million in premium reductions retroactive to October 1, 2009, that were imposed by the state of Michigan;
  • $1.7 million in acquisition costs related to the purchase of Molina Medicaid Solutions; and
  • $0.6 million in incremental interest costs incurred to finance the acquisition.

Health Plans

Second Quarter 2010 Compared with Second Quarter 2009

Premium revenue grew 6% in the second quarter of 2010 compared with the second quarter of 2009 due to a membership increase of nearly 10% as of June 30, 2010, compared with membership as of June 30, 2009. Premium revenue was reduced during the second quarter of 2010 by $5.5 million due to rate reductions in Michigan that were retroactive to October 1, 2009. The related reduction to medical expense was only $0.5 million. On a PMPM basis, consolidated premium revenue decreased 4% because of declines in premium rates at several of the Company’s health plans. The most significant declines in premium rates were in Ohio and Missouri, due to the transfer of pharmacy risk back to the states, and in Washington. Washington premiums PMPM were lower during the second quarter of 2010 compared with second quarter of 2009 as result of reductions made to both Medicaid premiums and fee schedules during the third quarter of 2009. Medicare enrollment exceeded 20,000 members at June 30, 2010, and Medicare premium revenue for the quarter was $67.6 million compared with $35.2 million in the second quarter of 2009.

Medical care costs, in the aggregate, decreased 5% on a PMPM basis in the second quarter of 2010 compared with the second quarter of 2009, primarily due to the following:

  • The transfer of pharmacy risk back to the states of Ohio and Missouri;
  • A less severe flu season in 2010;
  • Reductions in Medicaid fee schedules subsequent to June 30, 2009; and
  • The implementation of various contracting and medical management initiatives.

Excluding pharmacy costs, medical care costs decreased 2% on a PMPM basis in the second quarter of 2010 compared with the second quarter of 2009. Medical care costs as a percentage of premium revenue (the medical care ratio) were 86.0% for the second quarter of 2010 compared with 86.8% for the second quarter of 2009.

Physician and outpatient costs increased 2% on a PMPM basis compared with the second quarter of 2009. Although the Company continued to observe hospitals billing for more intensive levels of care for the second quarter of 2010 compared with the second quarter of 2009, emergency room costs PMPM were stable as both utilization and cost per visit remained essentially unchanged. The Company attributes stable emergency room costs to, among other things, a less severe flu season when compared with 2009, changes in provider contracts and fee schedules, and its efforts to reduce inappropriate utilization.

Inpatient facility costs increased 6% on a PMPM basis compared with the second quarter of 2009. Both utilization and unit costs increased slightly compared with the second quarter of 2009.

Pharmacy costs (including the benefit of rebates) decreased 31% on a PMPM basis for the second quarter of 2010, including the Company’s Missouri and Ohio health plans. The pharmacy benefit was transferred to the state of Missouri effective October 1, 2009, and was transferred to the state of Ohio effective February 1, 2010. Excluding these health plans, pharmacy costs increased 6% on a PMPM basis compared with the second quarter of 2009 as a result of increases in unit costs that more than offset decreases in utilization.

Capitated costs decreased 20% on a PMPM basis compared with the second quarter of 2009 as a result of the recognition, in the second quarter of 2009, of $22 million in retroactive capitation expense at the New Mexico health plan that related to 2009 and 2008. The retroactive capitation expense at the New Mexico health plan was directly related to the receipt of $25.3 million in retroactive premium revenue in the second quarter of 2009. There was no corresponding retroactive adjustment in the second quarter of 2010.

Days in medical claims and benefits payable – Beginning January 1, 2010, and for all prior periods presented, the Company is reporting days in medical claims and benefits payable relating to fee-for-service medical claims only. This new computation includes only fee-for-service medical care costs and related liabilities and, therefore, calculates the extent of reserves for those liabilities that are most subject to estimation risk.

The days in medical claims and benefits payable amount previously reported included all medical care costs (fee-for-service, capitation, pharmacy, and administrative), and all medical claims liabilities, including those liabilities that are typically paid concurrently, or shortly after the costs are incurred, such as capitation cost and pharmacy costs. Medical claims liabilities used in this calculation do not include accrued costs – such as salaries – associated with the administrative portion of medical costs.

By including only fee-for-service medical costs and liabilities in this computation, the Company’s days in claims payable metric will be more indicative of the adequacy of the Company’s reserves for liabilities subject to a substantial degree of estimation. The days in medical claims and benefits payable computed under each method were as follows:

(dollars in thousands)   June 30,

2010

 

March 31,

2010

 

June 30,

2009

Days in claims payable – fee-for-service only 44 days 44 days 47 days
Days in claims payable – all medical costs 39 days 37 days 39 days
Number of claims in inventory at end of period 106,300 153,700 117,100
Billed charges of claims in inventory at end of period $ 146,600 $ 194,000 $ 173,400
 

Molina Medicaid Solutions (acquired May 1, 2010)

Molina Medicaid Solutions contributed $5.0 million to operating income during the second quarter of 2010, resulting in an operating profit margin of approximately 24%. The Company expects the operating profit for this segment to decline once the contracts in Idaho and Maine enter the operations stage and costs currently deferred for those contracts begin to amortize.

Performance of Molina Medicaid Solutions for the two months ended June 30, 2010, was as follows:

  (In thousands)
Service revenue $ 22,645
Amortization of purchased intangibles recorded as contra-service revenue   (1,591 )
Net service revenue 21,054
 
Cost of service revenue 14,254
General and administrative costs 966
Amortization of purchased intangibles recorded as amortization expense   829  
Operating income $ 5,005  
 

Consolidated Expenses

General and administrative expenses, or G&A, were $78.1 million, or 7.8% of total revenue, for the second quarter of 2010 compared with $65.0 million, or 7.0% of total revenue, for the second quarter of 2009. The increase in the G&A ratio was the result of higher administrative expenses for the Health Plan segment, driven in part by the cost of the Company’s Medicare expansion and the acquisition of Molina Medicaid Solutions.

  Three Months Ended June 30,
2010   2009

Amount

  % of Total

Revenue

Amount

  % of Total

Revenue

(Dollar amounts in millions)
Medicare-related administrative costs $ 6.6 0.7 % $ 3.9 0.4 %
Non Medicare-related administrative costs:
Molina Medicaid Solutions segment administrative costs 1.0 0.1
Molina Medicaid Solutions acquisition costs 1.7 0.2
Health Plans segment administrative payroll, including employee incentive compensation 53.7 5.4 49.3 5.3
All other Health Plans segment administrative expense   15.1 1.4     11.8 1.3  
$ 78.1 7.8 % $ 65.0 7.0 %
 

Premium tax expense increased to 3.6% of premium revenue in the second quarter of 2010 from 3.3% in the second quarter of 2009, primarily due to the imposition of a higher premium tax rate in Ohio effective October 1, 2009.

Depreciation and amortization expense specifically identified as such in the Company’s consolidated statements of income increased $1.6 million in the second quarter of 2010 compared with the second quarter of 2009, primarily due to depreciation of investments in infrastructure and the amortization of certain purchased intangibles associated with the acquisition of Molina Medicaid Solutions. Beginning in the second quarter of 2010, the amortization of a portion of the purchased intangibles associated with the acquisition of Molina Medicaid Solutions is recorded as contra-service revenue, rather than as part of depreciation and amortization expense. Additionally, most of the depreciation expense associated with Molina Medicaid Solutions is recorded as cost of service revenue. The following table presents all depreciation and amortization expense recorded in the Company’s consolidated financial statements:

  Three Months Ended June 30,
2010   2009
Amount  

% of Total

Revenue

Amount  

% of Total

Revenue

(Dollar amounts in millions)
Depreciation and amortization $ 11.2 1.1 % $ 9.6 1.0 %
Amortization expense recorded as contra-service revenue 1.6 0.2
Depreciation expense recorded as cost of service revenue   1.0 0.1      

Depreciation and amortization reported in the condensed consolidated statements of cash flows

$ 13.8 1.4 % $ 9.6 1.0 %
 

Interest expense increased to $4.1 million for the second quarter of 2010 compared with $3.2 million for the second quarter of 2009. The Company incurred higher interest expense relating to the $105 million draw on its credit facility (beginning May 1, 2010) to fund the acquisition.

Income tax expense was recorded at an effective rate of 38.1% in the second quarter of 2010 compared with 10.5% in the second quarter of 2009. The lower rate in 2009 was primarily due to discrete tax benefits of $4.4 million recorded in the second quarter of 2009 as a result of settling tax examinations and the voluntary filing of certain accounting method changes.

Effective January 1, 2008 through December 31, 2009, the Company’s income tax expense included both the Michigan business income tax, or BIT, and the Michigan modified gross receipts tax, or MGRT. Effective January 1, 2010, the Company has recorded the MGRT as a premium tax and not as an income tax. The Company will continue to record the BIT as an income tax. For the second quarter and first half of 2009, premium tax expense and income tax expense have been reclassified to conform to this presentation.

First Half of 2010 Compared with First Half of 2009

Health Plans

Premium revenue grew 9% between the first half of 2009 and the first half of 2010 due to a membership increase of nearly 10% as of June 30, 2010, compared with membership as of June 30, 2009. Premium revenue was reduced during the first half of 2010 by $8.7 million due to rate reductions in Michigan that were retroactive to October 1, 2009. The related reduction to medical expense was only $0.5 million. On a PMPM basis, consolidated premium revenue decreased 3% because of declines in premium rates at several of the Company’s health plans. The most significant declines in premium rates were in Ohio and Missouri, due to the transfer of pharmacy risk back to the states, and in Washington. Washington premiums PMPM were lower during the first half of 2010 compared with the first half of 2009 as result of reductions made to both Medicaid premiums and fee schedules during the third quarter of 2009. Medicare enrollment exceeded 20,000 members at June 30, 2010, and Medicare premium revenue for the first half of 2010 was $117.9 million compared with $62.2 million for the same period in 2009.

Medical care costs, in the aggregate, decreased 4% on a PMPM basis in the first half of 2010 compared with the first half of 2009, due to the same factors described for the decrease in medical care costs in the second quarter of 2010 compared with the second quarter of 2009. Excluding pharmacy costs, medical care costs were flat in the first half of 2010 compared with the second half of 2009. Medical care costs as a percentage of premium revenue (the medical care ratio) were 85.6% for the first half of 2010 compared with 86.4% for the first half of 2009.

Physician and outpatient costs increased 3% on a PMPM basis compared with the first half of 2009. Although the Company continued to observe hospitals billing for more intensive levels of care for the first half of 2010 compared with the first half of 2009, emergency room costs PMPM were stable as both utilization and cost per visit remained essentially unchanged. The Company attributes stable emergency room costs to, among other things, a less severe flu season when compared with 2009, changes in provider contracts and fee schedules, and its efforts to reduce inappropriate utilization.

Inpatient facility costs increased 3% on a PMPM basis compared with the first half of 2009. Both utilization and unit costs increased slightly compared with the first half of 2009.

Pharmacy costs (including the benefit of rebates) decreased 27% on a PMPM basis for the first half of 2010, including the Company’s Missouri and Ohio health plans. The pharmacy benefit was transferred to the state of Missouri effective October 1, 2009, and was transferred to the state of Ohio effective February 1, 2010. Excluding these health plans, pharmacy costs increased 4% on a PMPM basis compared with the first half of 2009 as a result of flat utilization and a moderate increase in unit costs.

Capitated costs decreased 10% on a PMPM basis compared with the first half of 2009, primarily as a result of the recognition of retroactive capitation expense in the second quarter of 2009, as described above.

Consolidated Expenses

General and administrative expenses were $157.0 million, or 8.0% of total revenue, for the first half of 2010 compared with $130.4 million, or 7.3% of total revenue, for the first half of 2009. The increase in the G&A ratio was the result of higher administrative expenses for the Health Plan segment, driven in part by the cost of the Company’s Medicare expansion and the acquisition of Molina Medicaid Solutions.

  Six Months Ended June 30,
2010   2009

 

Amount

  % of Total

Revenue

Amount

  % of Total

Revenue

(Dollar amounts in millions)
Medicare-related administrative costs $ 14.5 0.7 % $ 8.8 0.5 %
Non Medicare-related administrative costs:
Molina Medicaid Solutions segment administrative costs 1.0 0.1
Molina Medicaid Solutions acquisition costs 2.3 0.1
Health Plans segment administrative payroll, including employee incentive compensation 109.9 5.6 98.3 5.5
All other Health Plans segment administrative expense   29.3 1.5     23.3 1.3  
$ 157.0 8.0 % $ 130.4 7.3 %
 

Premium tax expense increased to 3.6% of revenue in the first half of 2010 from 3.2% in the first half of 2009, primarily due to the imposition of a higher premium tax rate in Ohio effective October 1, 2009.

Depreciation and amortization expense specifically identified as such in the Company’s consolidated statements of income increased $2.6 million in the first half of 2010 compared with the first half of 2009, primarily due to depreciation of investments in infrastructure and the amortization of certain purchased intangibles associated with the acquisition of Molina Medicaid Solutions. Beginning in the second quarter of 2010, a portion of amortization expense has been recorded as contra-service revenue, rather than as part of depreciation and amortization expense. Additionally, most of the depreciation expense associated with Molina Medicaid Solutions is recorded as cost of service revenue. The following table presents all depreciation and amortization expense recorded in the Company’s financial statements:

  Six Months Ended June 30,
2010   2009
Amount  

% of Total

Revenue

Amount  

% of Total

Revenue

(Dollar amounts in millions)
Depreciation and amortization $ 21.3 1.1 % $ 18.6 1.0 %
Amortization expense recorded as contra-service revenue 1.6 0.1
Depreciation expense recorded as cost of service revenue   1.0      

Depreciation and amortization reported in the condensed consolidated statements of cash flows

$ 23.9 1.2 % $ 18.6 1.0 %
 

Interest expense increased to $7.5 million for the first half of 2010 compared with $6.6 million for the first half of 2009. As described previously, the increase was due to additional interest expense relating to the $105 million draw on the Company’s credit facility to fund the acquisition of Molina Medicaid Solutions on May 1, 2010.

Income tax expense was recorded at an effective rate of 38.0% in the first half of 2010 compared with 25.6% in the first half of 2009. The lower rate in 2009 was primarily due to discrete tax benefits of $4.4 million recorded in the second quarter of 2009 as a result of settling tax examinations and the voluntary filing of certain accounting method changes.

Cash Flow

Cash provided by operating activities for the first half of 2010 was $25 million compared with $95 million for the first half of 2009, a decrease of $70 million. This decrease was primarily due to the timing of the Ohio health plan’s receipt of premium payments from the state of Ohio. In 2009, the state of Ohio typically paid premiums in advance of the month the premium was earned. Beginning in January 2010, the state of Ohio has delayed its premium payments to mid-month for the month premium is earned. The Company does not anticipate any advance payments for the Ohio plan’s premiums during 2010.

Cash used in investing activities increased significantly in the first half of 2010 compared with the first half of 2009, due chiefly to the acquisition of Molina Medicaid Solutions, which totaled $131 million. This acquisition was funded primarily by a $105 million draw on the Company’s credit facility.

At June 30, 2010, the Company had cash and investments (not including restricted investments) of $673 million, including non-current auction rate securities with a fair value of $37 million. At June 30, 2010, the parent company had unrestricted cash and investments of $47 million, including auction rate securities with a fair value of $8 million.

Investment income decreased to $3.1 million in the first half of 2010 compared with $5.6 million in the first half of 2009. This decline was due primarily to lower interest rates.

EBITDA (1)

   
 

Three Months Ended

June 30,

Six Months Ended

June 30,

2010   2009 2010   2009
(In millions)
Operating income $ 21.2 $ 19.5 $ 41.6 $ 42.7
Add back:
Depreciation and amortization expense 11.2 9.6 21.3 18.6
Amortization expense recorded as contra-service revenue 1.6 1.6
Depreciation expense recorded as cost of service revenue   1.0     1.0  
EBITDA $ 35.0 $ 29.1 $ 65.5 $ 61.3
 

(1)

The Company calculates EBITDA by adding back depreciation and amortization expense to operating income, including $1.6 million amortization expense recorded as contra-service revenue, and $1.0 million depreciation expense recorded as cost of service revenue for both the three months and six months ended June 30, 2010. EBITDA is not prepared in conformity with GAAP because it excludes depreciation and amortization expense, as well as interest expense, and the provision for income taxes. This non-GAAP financial measure should not be considered as an alternative to net income, operating income, operating margin, or cash provided by operating activities. Management uses EBITDA as a supplemental metric in evaluating the Company’s financial performance, in evaluating financing and business development decisions, and in forecasting and analyzing future periods. For these reasons, management believes that EBITDA is a useful supplemental measure to investors in evaluating the Company’s performance and the performance of other companies in its industry.

 

Wisconsin Health Plan Acquisition

On July 12, 2010, the Company announced a definitive agreement to acquire Abri Health Plan, a provider of Medicaid managed care services to BadgerCare Plus and SSI Managed Care enrollees in Wisconsin. Abri Health Plan currently serves Medicaid beneficiaries in 23 counties in Wisconsin. The purchase price for the acquisition is expected to be approximately $16 million, subject to adjustments, and will be funded with available cash and/or a draw under our credit facility. Subject to regulatory approvals and the satisfaction of other conditions, the closing of the transaction is expected to occur by August 31, 2010.

Conference Call

The Company’s management will host a conference call and webcast to discuss its second quarter results at 5:00 p.m. Eastern time on Wednesday, August 4, 2010. The number to call for the interactive teleconference is (212) 271-4651. A live webcast of the call can be accessed on the Company’s website at www.molinahealthcare.com, or at www.earnings.com. An online replay will be available beginning about one hour following the conclusion of the call and webcast. A telephonic replay of the conference call will be available from 7:00 p.m. Eastern time on Wednesday, August 4, 2010, through 6:00 p.m. on Thursday, August 5, 2010, by dialing (800) 633-8284 and entering confirmation number 21473695.

About Molina Healthcare

Molina Healthcare, Inc. provides quality and cost-effective Medicaid-related solutions to meet the health care needs of low-income families and individuals and to assist state agencies in their administration of the Medicaid program. Our licensed health plans in California, Florida, Michigan, Missouri, New Mexico, Ohio, Texas, Utah, and Washington currently serve approximately 1.5 million members, and our subsidiary, Molina Medicaid Solutions, provides business processing and information technology administrative services to Medicaid agencies in Idaho, Louisiana, Maine, New Jersey, and West Virginia, and drug rebate administration services in Florida. More information about Molina Healthcare is available at www.molinahealthcare.com.

Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995: This earnings release contains "forward-looking statements” regarding the Company’s plans, expectations, and anticipated future events. Actual results could differ materially due to numerous known and unknown risks and uncertainties, including, without limitation, risk factors related to the following:

  • budgetary pressures on the federal and state governments and their resulting inability to fully fund Medicaid, Medicare, or CHIP, or to maintain current payment rates, benefit packages, or membership eligibility thresholds and criteria;
  • uncertainties regarding the impact of the recently enacted Patient Protection and Affordable Care Act, including the funding provisions related to health plans, and uncertainties regarding the likely impact of other federal or state health care and insurance reform measures;
  • management of our medical costs, including rates of utilization that are consistent with our expectations;
  • the accurate estimation of incurred but not reported medical costs across our health plans;
  • the continuation and renewal of the government contracts of our health plans;
  • the integration of Molina Medicaid Solutions, including its employees, systems, and operations;
  • the retention and renewal of the Molina Medicaid Solutions’ state government contracts on terms consistent with our expectations;
  • the accuracy of our operating cost and capital outlay projections for Molina Medicaid Solutions;
  • the timing of receipt and recognition of revenue under our various state contracts held by Molina Medicaid Solutions, including any changes to the anticipated start date of operation at our Maine location;
  • cost recovery efforts by the state of Michigan from Michigan health plans with respect to allegedly incorrect statewide rates and enrollment errors;
  • government audits and reviews
  • the establishment of a federal or state medical cost expenditure floor as a percentage of the premiums we receive;
  • up-coding by providers or billing in a manner at material variance with historic patterns;
  • approval by state regulators of dividends and distributions by our subsidiaries;
  • changes in funding under our contracts as a result of regulatory changes, programmatic adjustments, or other reforms;
  • high dollar claims related to catastrophic illness;
  • the favorable resolution of litigation or arbitration matters;
  • restrictions and covenants in our credit facility;
  • the success of our efforts to leverage our administrative costs to address the needs associated with increased enrollment;
  • the relatively small number of states in which we operate health plans and the impact on the consolidated entity of adverse developments in any single health plan;
  • the availability of financing to fund and capitalize our acquisitions and start-up activities and to meet our liquidity needs;
  • retroactive adjustments to premium revenue or accounting estimates which require adjustment based upon subsequent developments;
  • a state’s failure to renew its federal Medicaid waiver;
  • an unauthorized disclosure of confidential member information;
  • changes generally affecting the managed care or Medicaid management information systems industries;
  • general economic conditions, including unemployment rates;

and numerous other risk factors, including those discussed in our periodic reports and filings with the Securities and Exchange Commission. These reports can be accessed under the investor relations tab of our Company website or on the SEC’s website at www.sec.gov. Given these risks and uncertainties, we can give no assurances that our forward-looking statements will prove to be accurate, or that any other results or events projected or contemplated by our forward-looking statements will in fact occur, and we caution investors not to place undue reliance on these statements. All forward-looking statements in this release represent our judgment as of August 4, 2010, and we disclaim any obligation to update any forward-looking statements to conform the statement to actual results or changes in our expectations.

   
MOLINA HEALTHCARE, INC.
UNAUDITED CONSOLIDATED STATEMENTS OF INCOME

(Amounts in thousands, except per-share data)

 
Three Months Ended

June 30,

Six Months Ended

June 30,

2010   2009 2010   2009
Revenue:
Premium revenue $ 976,685 $ 925,507 $ 1,941,905 $ 1,782,991
Service revenue 21,054 - 21,054 -
Investment income   1,599     2,082     3,120     5,629  
Total operating revenue   999,338     927,589     1,966,079     1,788,620  
 
Expenses:
Medical care costs 839,613 803,206 1,662,429 1,541,094
Cost of service revenue 14,254 - 14,254 -
General and administrative expenses 78,079 65,011 156,959 130,418
Premium tax expenses (1) 34,995 30,300 69,541 57,355
Depreciation and amortization   11,219     9,584     21,280     18,636  
Total expenses   978,160     908,101     1,924,463     1,747,503  
Gain on purchase of convertible senior notes   -     -     -     1,532  
Operating income 21,178 19,488 41,616 42,649
Interest expense   (4,099 )   (3,223 )   (7,456 )   (6,638 )
 
Income before income taxes 17,079 16,265 34,160 36,011
Income tax expense (1)   6,500     1,700     12,991     9,235  
Net income $ 10,579   $ 14,565   $ 21,169   $ 26,776  
 
Net income per share:
Basic $ 0.41   $ 0.56   $ 0.82   $ 1.02  
Diluted $ 0.41   $ 0.56   $ 0.82   $ 1.02  
 
Weighted average number of common shares and potentially dilutive common shares outstanding   25,951     25,870     25,952     26,241  
 
Operating Statistics:
Ratio of medical care costs paid directly to providers to premium revenue 83.8 % 84.8 % 83.5 % 84.4 %
Ratio of medical care costs not paid directly to providers to premium revenue   2.2 %   2.0 %   2.1 %   2.0 %

Medical care ratio (2)

  86.0 %   86.8 %   85.6 %   86.4 %
General and administrative expense ratio (3) 7.8 % 7.0 % 8.0 % 7.3 %

Premium tax ratio (1), (3)

3.6 % 3.3 % 3.6 % 3.2 %
Effective tax rate (1) 38.1 % 10.5 % 38.0 % 25.6 %
 

(1)

Effective January 1, 2010, the Company has recorded the MGRT as a premium tax and not as an income tax. For the three months and six months ended June 30, 2009, premium tax expense and income tax expense have been reclassified to conform to this presentation.

(2)

Medical care ratio represents medical care costs as a percentage of premium revenue; premium tax ratio represents premium taxes as a percentage of premium revenue.

(3)

Computed as a percentage of total operating revenue.

 
MOLINA HEALTHCARE, INC.
UNAUDITED CONSOLIDATED BALANCE SHEETS

(Amounts in thousands, except per-share data)

   
June 30,

2010

Dec. 31,

2009

 
ASSETS
Current assets:
Cash and cash equivalents $ 460,985 $ 469,501
Investments 175,212 174,844
Receivables 155,380 136,654
Income and related taxes refundable 1,157 6,067
Deferred income taxes 4,726 8,757
Prepaid expenses and other current assets   23,843     15,583  
Total current assets 821,303 811,406
Property and equipment, net 83,562 78,171
Deferred contract costs 8,018 -
Intangible assets, net 120,480 80,846
Goodwill and indefinite-lived intangible assets 205,749 133,408
Investments 36,745 59,687
Restricted investments 41,028 36,274
Receivable for ceded life and annuity contracts 25,277 25,455
Other assets   19,242     19,988  
$ 1,361,404   $ 1,245,235  
 
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Medical claims and benefits payable $ 345,600 $ 316,516
Accounts payable and accrued liabilities 111,022 71,732
Deferred revenue   19,305     101,985  
Total current liabilities 475,927 490,233
Long-term debt 266,409 158,900
Deferred income taxes 9,075 12,506
Liability for ceded life and annuity contracts 25,277 25,455
Other long-term liabilities   16,862     15,403  
Total liabilities   793,550     702,497  
 
Stockholders’ equity:
Common stock, $0.001 par value; 80,000 shares authorized, outstanding 25,811 shares at June 30, 2010, and 25,607 shares at December 31, 2009 26 26

Preferred stock, $0.001 par value; 20,000 shares authorized, no shares outstanding

- -
Additional paid-in capital 134,076 129,902
Accumulated other comprehensive loss (2,039 ) (1,812 )
Retained earnings   435,791     414,622  
Total stockholders’ equity   567,854     542,738  
$ 1,361,404   $ 1,245,235  
 
MOLINA HEALTHCARE, INC.

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(In thousands)

   
Three Months Ended

June 30,

Six Months Ended

June 30,

2010   2009 2010   2009
Operating activities:
Net income $ 10,579 $ 14,565 $ 21,169 $ 26,776
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization 13,851 9,584 23,912 18,636
Unrealized (gain) loss on trading securities (2,320 ) 29 (2,860 ) (3,610 )
Loss (gain) on rights agreement 2,118 (27 ) 2,611 3,296
Deferred income taxes (2,470 ) (1,743 ) 624 3,245
Stock-based compensation 2,372 2,024 4,508 3,458
Non-cash interest on convertible senior notes 1,266 1,172 2,509 2,366
Gain on purchase of convertible senior notes - - - (1,532 )
Amortization of deferred financing costs 343 344 687 696
Tax deficiency from employee stock compensation (30 ) (14 ) (383 ) (547 )
Changes in operating assets and liabilities:
Receivables (9,652 ) 6,735 (1,598 ) (22,878 )
Prepaid expenses and other current assets (5,680 ) 3,644 (5,148 ) 732
Medical claims and benefits payable 18,627 (2,920 ) 29,084 16,265
Accounts payable and accrued liabilities 12,824 (12,804 ) 27,958 (15,726 )
Deferred revenue 7,984 1,670 (82,680 ) 54,638
Income taxes   1,975     5,666     4,910     9,025  
Net cash provided by operating activities   51,787     27,925     25,303     94,840  
 
Investing activities:
Purchases of property and equipment (11,547 ) (9,557 ) (17,523 ) (19,924 )
Purchases of investments (42,329 ) (24,055 ) (91,768 ) (72,182 )
Sales and maturities of investments 63,610 46,665 116,836 82,292
Cash paid in business purchase transactions (131,970 ) - (134,400 ) -
Increase in deferred contract costs (8,018 ) - (8,018 ) -
Increase in restricted investments (4,098 ) (6,979 ) (4,754 ) (6,534 )
Increase in other assets (88 ) (1,053 ) (332 ) (2,761 )
Increase (decrease) in other long-term liabilities   419     (8,641 )   1,089     (8,772 )
Net cash used in investing activities   (134,021 )   (3,620 )   (138,870 )   (27,881 )
 
Financing activities:
Borrowings under credit facility 105,000 - 105,000 -
Treasury stock purchases - (12,736 ) - (27,712 )
Purchase of convertible senior notes - - - (9,653 )
Payment of credit facility fees (1,671 ) - (1,671 ) -
Excess tax benefits from employee stock compensation 66 - 179 -
Proceeds from employee stock plans   1,543     1,081     1,543     1,081  
Net cash provided by (used in) financing activities   104,938     (11,655 )   105,051     (36,284 )
Net increase (decrease) in cash and cash equivalents 22,704 12,650 (8,516 ) 30,675
Cash and cash equivalents at beginning of period   438,281     405,187     469,501     387,162  
Cash and cash equivalents at end of period $ 460,985   $ 417,837   $ 460,985   $ 417,837  
 
MOLINA HEALTHCARE, INC.
UNAUDITED MEMBERSHIP DATA
       
Total Ending Membership By Health Plan:

June 30,

2010

March 31,

2010

Dec. 31,

2009

June 30,

2009

California 348,000 353,000 351,000 349,000
Florida 54,000 52,000 50,000 29,000
Michigan 226,000 226,000 223,000 207,000
Missouri 78,000 78,000 78,000 78,000
New Mexico 93,000 92,000 94,000 85,000
Ohio 234,000 228,000 216,000 203,000
Texas 42,000 40,000 40,000 30,000
Utah 77,000 75,000 69,000 64,000
Washington 346,000 338,000 334,000 323,000
1,498,000 1,482,000 1,455,000 1,368,000
 
Total Ending Membership By State

for the Medicare Advantage Plans:

California 3,600 2,700 2,100 1,600
Florida 500 300
Michigan 5,000 4,200 3,300 2,100
New Mexico 600 600 400 400
Texas 600 500 500 400
Utah 8,100 7,100 4,000 3,100
Washington 1,900 1,600 1,300 1,000
20,300 17,000 11,600 8,600
 
Total Ending Membership By State

for the Aged, Blind or Disabled Population:

California 13,600 13,400 13,900 13,100
Florida 9,300 8,900 8,800 6,000
Michigan 31,600 32,700 32,200 29,900
New Mexico 5,800 5,800 5,700 5,700
Ohio 27,400 26,700 22,600 19,700
Texas 18,500 18,100 17,600 17,000
Utah 7,600 7,900 7,500 7,600
Washington 3,700 3,500 3,200 3,000
117,500 117,000 111,500 102,000
 
  Three Months Ended   Six Months Ended

Total Member Months (1) by Health Plan:

June 30,

2010

 

March 31,

2010

 

June 30,

2009

June 30,

2010

 

June 30,

2009

California 1,050,000 1,062,000 1,031,000 2,112,000 2,011,000
Florida 160,000 154,000 75,000 314,000 136,000
Michigan 679,000 675,000 623,000 1,354,000 1,243,000
Missouri 234,000 234,000 232,000 468,000 463,000
New Mexico 280,000 280,000 251,000 560,000 499,000
Ohio 695,000 673,000 596,000 1,368,000 1,156,000
Texas 125,000 121,000 92,000 246,000 190,000
Utah 230,000 221,000 200,000 451,000 384,000
Washington 1,022,000 1,007,000 952,000 2,029,000 1,871,000
4,475,000 4,427,000 4,052,000 8,902,000 7,953,000
 

(1)

A total member month is defined as the aggregate of each month’s ending membership for the period presented.

 
MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED FINANCIAL DATA BY HEALTH PLAN

(Dollars in thousands except per member per month amounts)

 
Three Months Ended June 30, 2010
Premium Revenue   Medical Care Costs  

Medical Care

Ratio

 

Premium Tax

Expense (1)

Total   PMPM Total   PMPM
California $ 124,551 $ 118.57 $ 106,006 $ 100.92 85.1 % $ 1,637
Florida 41,462 260.32 39,134 245.70 94.4 6
Michigan (1) 156,769 230.76 135,763 199.84 86.6 9,711
Missouri 51,779 220.86 46,320 197.58 89.5
New Mexico 91,949 328.48 73,210 261.54 79.6 2,987
Ohio 212,669 306.34 174,275 251.03 82.0 16,512
Texas 43,493 348.45 39,133 313.52 90.0 705
Utah 64,934 281.44 60,975 264.28 93.9
Washington 186,204 182.23 154,792 151.49 83.1 3,394
Other (2)   2,875   10,005   43
$ 976,685 $ 218.25 $ 839,613 $ 187.62 86.0 % $ 34,995
 
Three Months Ended June 30, 2009
Premium Revenue Medical Care Costs

Medical Care

Ratio

Premium Tax

Expense (1)

Total PMPM Total PMPM
California $ 121,918 $ 118.23 $ 111,750 $ 108.37 91.7 % $ 3,395
Florida 19,339 257.22 17,355 230.83 89.7
Michigan (1) 136,549 219.44 112,402 180.64 82.3 9,538
Missouri 58,141 251.06 48,582 209.78 83.6
New Mexico 114,408 456.80 100,255 400.30 87.6 2,989
Ohio 194,885 327.02 168,639 282.98 86.5 10,731
Texas 34,345 372.13 24,851 269.26 72.4 572
Utah 57,918 288.99 53,182 265.35 91.8
Washington 183,720 192.96 156,981 164.88 85.5 3,064
Other (2)   4,284   9,209   11
$ 925,507 $ 228.38 $ 803,206 $ 198.20 86.8 % $ 30,300
 

(1)

Effective January 1, 2010, the Company has recorded the Michigan gross receipts tax, or MGRT, as a premium tax and not as an income tax. The 2009 amounts have been reclassified to conform to this presentation.

(2)

"Other” medical care costs primarily include medically related administrative costs at the parent company.

 
MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED FINANCIAL DATA BY HEALTH PLAN

(Dollars in thousands except per member per month amounts)

 
Six Months Ended June 30, 2010
Premium Revenue   Medical Care Costs  

Medical Care

Ratio

 

Premium Tax

Expense (1)

Total   PMPM Total   PMPM
California $ 248,461 $ 117.62 $ 213,567 $ 101.10 86.0 % $ 3,265
Florida 80,550 256.94 73,821 235.47 91.7 12
Michigan (1) 312,114 230.45 261,212 192.87 83.7 19,650
Missouri 103,922 221.93 89,836 191.85 86.5
New Mexico 187,547 334.75 147,225 262.78 78.5 4,991
Ohio 431,032 315.20 346,900 253.68 80.5 33,517
Texas 82,693 336.46 71,464 290.77 86.4 1,386
Utah 123,474 273.66 122,435 271.36 99.2
Washington 367,258 181.05 318,302 156.91 86.7 6,656
Other (2)   4,854   17,667   64  
$ 1,941,905 $ 218.15 $ 1,662,429 $ 186.75 85.6 % $ 69,541  
 
Six Months Ended June 30, 2009
Premium Revenue Medical Care Costs

Medical Care

Ratio

Premium Tax

Expense (1)

Total PMPM Total PMPM
California $ 231,953 $ 115.34 $ 215,723 $ 107.27 93.0 % $ 6,711
Florida 39,030 287.03 35,123 258.29 90.0
Michigan (1) 269,314 216.71 222,397 178.96 82.6 17,376
Missouri 116,848 252.53 95,556 206.51 81.8
New Mexico 196,226 393.53 172,276 345.50 87.8 5,082
Ohio 382,107 330.46 326,419 282.30 85.4 20,923
Texas 67,356 354.66 52,257 275.15 77.6 1,256
Utah 108,536 282.34 97,445 253.49 89.8
Washington 364,424 194.78 306,526 163.83 84.1 6,011
Other (2)   7,197   17,372   (4 )
$ 1,782,991 $ 224.14 $ 1,541,094 $ 193.73 86.4 % $ 57,355  
 

(1)

Effective January 1, 2010, the Company has recorded the Michigan gross receipts tax, or MGRT, as a premium tax and not as an income tax. The 2009 amounts have been reclassified to conform to this presentation.

(2)

"Other” medical care costs primarily include medically related administrative costs at the parent company.

 
MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED FINANCIAL DATA

(Dollars in thousands except per member per month amounts)

   
 

The following tables provide the details of the Company’s medical care costs for the periods indicated:

 
Three Months Ended

June 30, 2010

Three Months Ended

June 30, 2009

Amount   PMPM  

% of Total

Medical

Care Costs

Amount   PMPM  

% of Total

Medical

Care Costs

Fee-for-service $ 594,960 $ 132.95 70.9 % $ 517,066 $ 127.59 64.4 %
Capitation 136,764 30.56 16.3 154,386 38.10 19.2
Pharmacy 75,170 16.80 8.9 99,256 24.49 12.4
Other   32,719   7.31 3.9     32,498   8.02   4.0  
$ 839,613 $ 187.62 100.0 % $ 803,206 $ 198.20   100.0 %
 

Six Months Ended

June 30, 2010

Six Months Ended

June 30, 2009

Amount PMPM

% of Total

Medical

Care Costs

Amount PMPM

% of Total

Medical

Care Costs

Fee-for-service $ 1,161,839 $ 130.52 69.9 % $ 1,006,207 $ 126.49 65.3 %
Capitation 273,896 30.77 16.5 272,800 34.29 17.7
Pharmacy 165,241 18.56 9.9 201,894 25.38 13.1
Other   61,453   6.90 3.7     60,193   7.57   3.9  
$ 1,662,429 $ 186.75 100.0 % $ 1,541,094 $ 193.73   100.0 %
 
 

The following table provides the details of the Company’s medical claims and benefits payable as of the dates indicated:

 

June 30,

2010

March 31,

2010

June 30,

2009

Fee-for-service claims incurred but not paid (IBNP) $ 268,652 $ 260,456 $ 244,987
Capitation payable 49,101 42,461 34,657
Pharmacy payable 13,385 16,196 22,367
Other   14,462   7,860   6,696  
$ 345,600 $ 326,973 $ 308,707  
 
MOLINA HEALTHCARE, INC.
CHANGE IN MEDICAL CLAIMS AND BENEFITS PAYABLE

(Dollars in thousands, except per-member amounts)

(Unaudited)

     

The Company’s claims liability includes an allowance for adverse claims development based on historical experience and other factors including, but not limited to, variation in claims payment patterns, changes in utilization and cost trends, known outbreaks of disease, and large claims. The Company’s reserving methodology is consistently applied across all periods presented. The negative amounts displayed for "Components of medical care costs related to: Prior periods” represent the amount by which the Company’s original estimate of claims and benefits payable at the beginning of the period exceeded the actual amount of the liability based on information (principally the payment of claims) developed since that liability was first reported. The following table shows the components of the change in medical claims and benefits payable as of the periods indicated:

 
 
Six Months Ended Quarter Ended Year Ended
June 30,

2010

  June 30,

2009

March 31,

2010

Dec. 31,

2009

Balances at beginning of period $ 316,516   $ 292,442   $ 316,516   $ 292,442  
Components of medical care costs related to:
Current period 1,705,411 1,587,469 861,271 3,227,794
Prior periods   (42,982 )   (46,375 )   (38,455 )   (51,558 )
Total medical care costs   1,662,429     1,541,094     822,816     3,176,236  
Payments for medical care costs related to:
Current period 1,389,307 1,297,946 581,389 2,919,240
Prior periods   244,038     226,883     230,970     232,922  
Total paid   1,633,345     1,524,829     812,359     3,152,162  
Balances at end of period $ 345,600   $ 308,707   $ 326,973   $ 316,516  
 
Benefit from prior period as a percentage of:
Balance at beginning of period 13.6 % 15.9 % 12.1 % 17.6 %
Premium revenue 2.2 % 2.6 % 4.0 % 1.4 %
Total medical care costs 2.6 % 3.0 % 4.7 % 1.6 %
 
Days in claims payable, fee for service only 44 47 44 44
Number of members at end of period 1,498,000 1,368,000 1,482,000 1,455,000
Number of claims in inventory at end of period 106,300 117,100 153,700 93,100
Billed charges of claims in inventory

at end of period

$ 146,600 $ 173,400 $ 194,000 $ 131,400
Claims in inventory per member at end of period 0.07 0.09 0.10 0.06
Billed charges of claims in inventory

per member at end of period

$ 97.86 $ 126.75 $ 130.90 $ 90.31
Number of claims received during the period 7,029,600 6,287,300 3,493,300 12,930,100
Billed charges of claims received

during the period

$ 5,580,400 $ 4,707,200 $ 2,760,500 $ 9,769,000

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