Earnings Labs

Elevance Health Inc. (ELV)

Q2 2011 Earnings Call· Wed, Jul 27, 2011

$373.56

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Transcript

Executives

Management

Brian Sassi - Executive Vice President of Strategy and Marketing, Chief Executive Officer of Consumer Business Unit and President of Consumer Business Unit Michael Kleinman - Vice President of Investor Relations and Acting Vice President of Internal Audit, Ethics & Compliance Ken Goulet - Executive Vice President, Chief Executive Officer of Commercial Business Unit and President of Commercial Business Unit Wayne Deveydt - Chief Financial Officer and Executive Vice President Angela Braly - Chairman, Chief Executive Officer, President and Chairman of Executive Committee

Analysts

Management

Joshua Raskin - Barclays Capital Michael Baker - Raymond James & Associates, Inc. Justin Lake - UBS Investment Bank Carl McDonald - Citigroup Inc Matthew Borsch - Goldman Sachs Group Inc. Scott Fidel - Deutsche Bank AG David Windley - Jefferies & Company, Inc. Thomas Carroll - Stifel, Nicolaus & Co., Inc. John Rex - JP Morgan Chase & Co Kevin Fischbeck - BofA Merrill Lynch Christine Arnold - Cowen and Company, LLC Doug Simpson - Morgan Stanley

Operator

Operator

Ladies and gentlemen, thank you for standing by, and welcome to the WellPoint conference call. [Operator Instructions] As a reminder, this conference is being recorded. I would now like to turn the conference over to company's management.

Michael Kleinman

Analyst

Good morning, and welcome to WellPoint's Second Quarter Earnings Conference Call. I'm Michael Kleinman, Vice President of Investor Relations. With me this morning are Angela Braly, our Chair, President and Chief Executive Officer; and Wayne Deveydt, Executive Vice President and Chief Financial Officer. Angela will begin this morning's call with an overview of our second quarter results, actions and accomplishments. Wayne will then offer a detailed review of our financial performance, capital management and current guidance, which will be followed by a question-and-answer session. Ken Goulet, Executive Vice President and President of our Commercial Business; and Brian Sassi, Executive Vice President of Strategy and Marketing and President of our Consumer Business are available to participate in the Q&A session. During this call, we will reference certain non-GAAP measures. A reconciliation of these non-GAAP measures to the most directly comparable measures calculated in accordance with GAAP is available on our company website at www.wellpoint.com. We will also be making some forward-looking statements on this call. Listeners are cautioned that these statements are subject to certain risks and uncertainties, many of which are difficult to predict and generally beyond the control of WellPoint. These risks and uncertainties can cause actual results to differ materially from our current expectations. We advise listeners to review the risk factors discussed in our press release this morning and in our quarterly and annual filings with the SEC. I will now turn the call over to Angela.

Angela Braly

Analyst · UBS

Thank you, Michael, and good morning. Today, we are pleased to report second quarter 2011 earnings per share of $1.89, which included net investment gains of $0.06 per share. Earnings per share in the second quarter of 2010 totaled $1.71 per share and included net investment gains of $0.04 per share. Excluding the net investment gains in each period, our adjusted EPS was $1.83 for the second quarter of 2011, an increase of 9.6% compared with adjusted EPS of $1.67 in the same period of last year. Our second quarter results exceeded our forecast and reflected the significant administrative cost savings that we've been able to achieve through our continuous improvement and efficiency initiative. Our performance continues to be strong in our Commercial segment and in the capital management areas of the company, while we are experiencing lower than expected results in our Senior business this year. Based on our second quarter results, today, we are raising our full year 2011 earnings per share guidance to a range of $6.90 to $7.10 on a GAAP basis, which includes $0.15 per share of net investment gains realized during the first half of the year. On an adjusted basis or excluding the net investment gain, our full year EPS guidance equates to a range of $6.75 to $6.95. Our medical enrollment totaled nearly 34.2 million members as of June 30, 2011. Membership was stable on a sequential basis in the quarter as we've achieved organic membership gains in our State Sponsored and Senior programs, which were substantially offset by in-group membership attrition in the Commercial segment. While we have experienced negative and group change during 2011, it has been much lower than the in-group losses we experienced in 2010. Unfortunately, the economy remains challenging and we expect to continue experiencing modest attrition…

Wayne Deveydt

Analyst · UBS

Thank you, Angela, and good morning. Premium income was $13.9 billion in the second quarter, an increase of $657 million or 5% from the prior year quarter. This reflected premium increases designed to cover overall cost trend and membership growth in the Senior and FEP businesses, partially offset by a decline in fully insured Commercial membership. Administrative fees were $958 million in the quarter, an increase of $35 million or 4% from the second quarter of last year, driven by growth in self-funded membership. As of June 30, 2011, approximately 60% of our medical enrollment was self-funded and 40% was fully insured compared with 58% and 42%, respectively, as of June 30, 2010. Overall membership was slightly higher than we expected at June 30, 2011, although we expect modest in-group attrition to continue over the last 6 months of the year. We currently anticipate that we'll end 2011 with 33.9 million members and that full year operating revenue will be just under $60 billion. The benefit expense ratio for the second quarter of 2011 was 85.7%, an increase of 280 basis points from the same period of 2010. As Angela described, this increase was driven by higher benefit expense in the Senior business and lower prior period reserve development. We now expect the benefit expense ratio to be in the range of 85.1% to 85.3% for the full year of 2011, which is an increase from our prior guidance, primarily due to the Senior business. We continue to anticipate the underlying Local Group medical cost trend will be at the lower end of our 7.5%, plus or minus 50 basis points range, for the full year of 2011. For the rolling 12 months ended June 30, 2011, medical trend continued at lower than expected levels. Inpatient trend is currently in…

Angela Braly

Analyst · UBS

Operator, please open the queue for questions.

Operator

Operator

[Operator Instructions] And our first question comes from the line of Justin Lake from UBS.

Justin Lake - UBS Investment Bank

Analyst · UBS

My first question is on the Medicare side. Can you talk about the full year impact of what the Medicare mispricing resulted in? And can you give us some additional color on what type of product or geographies the issues might have been seen in? And then, if we take -- once we've identified that impact to run rate earnings, can you tell us whether or not you caught the issue in time to reflect the higher costs fully in your bids? And if so, can we assume the full impact gets fixed for '12?

Angela Braly

Analyst · UBS

Justin, let me speak to that. First, we're obviously disappointed with our performance in Senior. If you look at all the other areas of the company, we feel like we're really executing things, disciplined there and our continuous improvement, efficiency initiatives are getting the right results and great customer service, but we're disappointed about the performance in Senior. Let me address a couple of your questions then I'll turn it over to Brian to give more detail. The full year impact is $0.30 on an EPS basis. Yes, we did see this before the bids were due. Unfortunately, we can't speak in detail about the bid process for 2012 as the CMS regulations don’t allow us to do that. But we did see this performance deteriorate prior to the bidding process. We think we have clarity around it. So I'll turn it over to Brian, who can get specific about the products where we saw this.

Brian Sassi

Analyst · UBS

Okay. Thanks, Angela. Justin, let me just add a little more color and frame the issue. Beginning at the end of Q1, we started to see some increased morbidity in our Medicare advantage program. Specifically, we've isolated the vast majority of the issue, and in Northern California, it impacts our regional PPO product. And looking at kind of April results and doing deep dives into it, we further isolated our issue to the new member cohort versus existing members. And further looking at all of our new business that we've received in 2011, further isolated the issue to really being directed at switchers. Some of our membership growth in the RPPO has been agents, but that appears to be performing as expected. So it's really the switcher cohort primarily in Northern California. As Angela mentioned, we did see this emerging in early Q2. We followed it very closely. We have adjusted and really bid appropriately based on the emerging experience, and do expect that we will resolve this through the bidding process in 2012.

Angela Braly

Analyst · UBS

And Wayne, do you want to speak to that as well?

Wayne Deveydt

Analyst · UBS

Yes. So Justin, relative to 2012, then we would expect that this $0.30 headwind we have for the current year impacting our current earnings would be resolved. And we would expect that our previous assumptions regarding run rate and execution, other lines of business, would remain consistent with our previous expectations. So relative to our growth, while we're not giving guidance for next year at this point in time, we view this as an incremental benefit to our run rate because it was obviously not anticipated to be an incremental detriment to our run rate this year.

Operator

Operator

Our next question is from the line of Josh Raskin from Barclays Capital.

Joshua Raskin - Barclays Capital

Analyst · Josh Raskin from Barclays Capital

I want to stay with the Medicare business obviously here. So it sounds like, Brian, you guys feel like – you mentioned you saw this at the end of the first quarter, but we didn't hear anything about that when you reported last quarter. So is it that things deteriorated significantly after the end of April and before the beginning of June? And then, as I look at the California landscape, in terms of switchers and movers, I guess, the CIGNA exit was about 15,000 lives. There's no one else that even lost 10,000 lives. So you guys are up about 43,000 lives in California, I'm just sort of doing the rough math, if you got 40 basis points or something in that ballpark of MLR, I’m coming up with like 220 million. It just seems like the MLR would be off the charts for this California cohort. So maybe just a little more color as to what exactly is happening and how come you didn't see your product being sort of mispriced versus the others?

Angela Braly

Analyst · Josh Raskin from Barclays Capital

Josh, let me have Wayne answer the question about the timing, and then Brian to add the specifics.

Wayne Deveydt

Analyst · Josh Raskin from Barclays Capital

Josh, I think the primary thing in the timing I want to keep in mind is that where we're seeing the issue is on the switchers, not on the agents. And so for new individuals that switched over to us in January, we really don't start getting any visibility on claims until really early March. Ultimately they start seeing the doctors in mid-late January, doctor starts sending in claims in later February. But you really don't have a lot of real good data at that point for the switchers. So in March, I would say it wasn't really a huge outlier. I mean, it was a small blip at that point but nothing of concern. When we got April results in, we were more concerned about what we saw being more elevated claims, and that's when we did our deep dive to identify where this was being driven from, and that's where we identified that it was in the Northern California location, and it was really the switchers. We then went ahead and estimated the bid process that would reflect as if that was more run rate, under the hope that that wouldn't be the case. And when we say May, in fact, that was the case. So we know that now having April, May and June versus what we've spent as part of the process, that we've always considered that activity and then feel comfortable with that. To your question about size and scale, $0.30 for us, if you look at the number of shares outstanding, that equates to close to $170 million, so I think if you're looking at numbers, you're looking at closer to $170 million, put that in perspective. And keep in mind that the MLR on this is greater than 100% on this group of cohorts. And we are talking about a small number of members in between 40,000 and 50,000 that are basically this entire group that's impacting us, while the PPO has over 110,000 in it, it's the northern portion that we're focused on.

Brian Sassi

Analyst · Josh Raskin from Barclays Capital

Yes, and just to add a little more color. I think your numbers are directionally right as we've looked at kind of all the new members, we have the ability to look at kind of where they come from. Certainly, the CIGNA exit in Northern California, we did pick up a large chunk of that membership. This is a regional PPO, so some of the membership growth, probably about half, occurred in Southern California. Historically, as we look at the performance of the RPPO, that has been a possible program for us, more so in Southern California and that does continue, but the Northern California cohort, particularly the new membership from some of the competitor exits is where the problem lies.

Operator

Operator

And our next question is from John Rex from JPMorgan. John Rex - JP Morgan Chase & Co: A couple of things. I guess first, I want to focus on during the course of the quarter, you've often talked to how we should consider quarterly progression here in earnings, and 3Q being higher than the 2Q is what you’d typically expect. The guide you have out today would indicate that's not the case, I guess, unless we should be expecting a dramatically lower 4Q, and I just want to get your sense for the 2H progression here, and if it's changed from the pattern you were indicating?

Angela Braly

Analyst · JPMorgan

Wayne, why don't you address the quarterly pattern question for John?

Wayne Deveydt

Analyst · JPMorgan

Yes, John, on a quarterly progression basis now, we do expect 3Q now to be slightly lower than 2Q at this point in time. So primarily because of some of the tax benefits we received, and we did take a cautious view on the back half of the year regarding Senior. Obviously, we hope to do a number of medical managements to potentially alleviate it. We took a cautious view on commercial trends, if those would potentially rebound in the back half of the year. And we also took a view around some of the regulatory environment changes we're seeing out there, in particular an AB 97, if that could have some potential impacts as well. So for that reason, I wouldn't call it down substantially, I'd say it's slightly lower than what we finished 2Q on an adjusted diluted basis right now. John Rex - JP Morgan Chase & Co: Okay. And then, just the other thing just that you'd mentioned, I think very early in the quarter, in the 2Q you noted you were seeing some signs, I think in your script data, that would indicate that maybe utilization was edging up, but I want to know if focus is more on your Commercial book rather than your Medicare book? Was that borne out over the course of the -- it doesn't seem like that you saw broad utilization coming, edging up in the Commercial book, however. Is that a fair characterization?

Angela Braly

Analyst · JPMorgan

Yes, John, let me let Ken speak to the Commercial book, the performance has been good there. And so I'll let Ken talk about the Commercial trend.

Ken Goulet

Analyst · JPMorgan

John, the second quarter did develop slightly better than we expected, and we've had good performance as you can see. I would say the utilization has been stable to declining in all categories, except pharmacy, which is modestly higher. However, we are expecting an uptick to occur in the second half of the year and we priced accordingly.

Operator

Operator

Your next question is from the line of Doug Simpson from Morgan Stanley.

Doug Simpson - Morgan Stanley

Analyst · Doug Simpson from Morgan Stanley

I guess just you guys have a history of conservatism on your guidance, so just to come at that question maybe a little bit differently, how would you characterize your confidence in the $6.75 to $6.95 that you've laid out? Wayne, you mentioned you took a cautious view of the second half of 2011. The seasonality would imply then, really, sort of a number in the Q4 that's closer I guess to around $1, so just how would you characterize your level of confidence in the range you've laid out?

Angela Braly

Analyst · Doug Simpson from Morgan Stanley

We believe our guidance reflects our expectations. We've always been cautious about trend in the second half of this year. We're pricing, as Ken said, for it. We continue to be very focused in our medical management areas and working on cost of care very intently. And so we do think the guidance range reflects our best estimate. Wayne can speak to how we looked at it for the overall year and below the line.

Wayne Deveydt

Analyst · Doug Simpson from Morgan Stanley

Yes. I mean, Doug, the one thing I would say is, this is a unique industry that we continue to see many state budget deficits, a regulatory environment that evolves by the day, and I think it's fair to say that for those reasons that both from an operating perspective, we generally try to err on the side that many things will come to light in, sometimes, a less than optimal level of expectation. Whether that occurs or not will remain to be seen, but we would rather not have shareholders surprised by things that we see out there that are evolving that could occur. Below the line, we have a very, very solid confidence in those numbers, those updated guidance numbers and where that's at. So I think to Angela's point, the $6.75 to $6.95, we wouldn't have guided to that range if we didn't have a level of confidence that we would be able to achieve it, and we do believe that it contemplates a number of potential downsides for the back half of the year.

Operator

Operator

Our next question is from Scott Fidel from Deutsche Bank.

Scott Fidel - Deutsche Bank AG

Analyst · Deutsche Bank

I just want to follow up on the change in the Medicaid view that you discussed in, maybe if you can frame what the operating margins look like for Medicaid in the first half and what you're assuming for the back half of the year? Or maybe what the deterioration is that you're building in? And then, give us an update on what your composite rate expectation is for Medicaid for the full year and for the back half of the year?

Angela Braly

Analyst · Deutsche Bank

Yes. Let me speak a little bit to that, and then I'm going to turn it over to Brian. Because State Sponsored, our Medicaid managed care business, has performed in line with our expectations for the first half of the year. But as we look out at the states and their budgetary pressures and some of the issues specifically in California, we're expecting pressure on the reimbursement levels and tougher program requirements. So Brian, do you want to speak more specifically?

Brian Sassi

Analyst · Deutsche Bank

Yes, so as we looked at the second half of the year, particularly given some AB 97 in California, we did establish a reserve for potential adverse impacts of that. Certainly, while AB 97 is a law that has been passed in California, subject to CMS approval. That has not occurred yet. We do know that there are a number of potential challenges to that legislation. But to be prudent, we felt that in our analysis of the law, in all the different components of it and our ability to kind of react to it, we felt that it was necessary to put up a reserve in the last half of the year, which we feel will adequately cover us. Looking ahead, in terms of, as Angela talked about, many of the states are being pressured with state budgets, a lot of which since Medicaid is either #1 or #2 in terms of expenditures. We do see a tightening in potential reimbursement levels and are expecting compression in the level of increase, down into potentially the low single digits for next year.

Angela Braly

Analyst · Deutsche Bank

Let me say, longer term, this business is one we do think there are opportunities. We think scale -- the scale that we can bring to this is important. But we are committed to staying disciplined in how we do this. So we'll continue to focus on the opportunities but we’ll only take them where we think it's appropriate.

Operator

Operator

And our next question is from Christine Arnold from Cowen and Company.

Christine Arnold - Cowen and Company, LLC

Analyst · Cowen and Company

I'd like to just talk about the starting point on the Medicare MLR. I'm thinking around 95% this quarter and that your guidance assumes you rise to 96%, 97%, kind of in that range. Am I ballpark in kind of my starting point and where you're going on that?

Angela Braly

Analyst · Cowen and Company

Wayne, can you address that?

Wayne Deveydt

Analyst · Cowen and Company

Yes. I mean, Christine, we obviously don't give MLRs by lines of business. We want to be careful at this point, as we're still in the bidding process, there's certain things we're allowed to discuss and not discuss, as we're still working with CMS. That being said, what I am confident in telling you is that we had obviously significant deterioration in the quarter due to the California, there's over 100%. We expect that to continue into the back half of the year, although we are putting mitigation strategies, but we've taken a more cautious view on that. And we do expect to get to a normal run rate for next year on our MLRs.

Operator

Operator

Our next question is from Matthew Borsch from Goldman Sachs.

Matthew Borsch - Goldman Sachs Group Inc.

Analyst · Goldman Sachs

Can I just -- I just wanted to try to better understand the issue in the Medicare Advantage product. In Northern California, are these members where the issue is primarily their acute health status and the fact that the CMS risk adjusters don't adequately correct for those? And therefore, with those types of members, they need to be spread across several plans to be able to absorb the impact, rather than concentrated in the way that you found yourselves with the exit of a competitor? Or is it more the product premiums and the product offering?

Angela Braly

Analyst · Goldman Sachs

Brian, you want to address that?

Brian Sassi

Analyst · Goldman Sachs

Yes. I think it's more the former than the latter. If you look at the competitiveness of the RPPO product, it's generally not an overly rich product. It's better than traditional Medicare, but it's not super rich when compared to other offerings around the country. And I think your characterization in the front of your statement is accurate. We've had the RPPO for a number of years. The new membership that we've received essentially doubled our Northern California membership because most of our membership had historically been in Southern California. So the combination of the increased morbidity and the unique situation with competitors exiting, and potentially not gathering or knowing that in advance, maybe not gathering, the optimal risk data that would impact risk course in 2011 have created kind of a unique situation for us. Of course, some of which, it's a calendar year issue. As we see it, increased morbidity over a population, it's difficult to correct that in the current calendar year, but certainly that increased morbidity and our ability to provide the data to CMS could have a positive impact into next year's final settlement that we receive in 2012 based on 2011 data.

Operator

Operator

Your next question is from Kevin Fischbeck from Bank of America.

Kevin Fischbeck - BofA Merrill Lynch

Analyst · Bank of America

I wanted to talk a little bit about the CareMore deal. I guess, Wayne, the company hasn't been talking very strongly about how -- when you think about capital deployment, it's always being evaluated against share repurchase, and it sounds like I guess maybe we can get there over time. But I just wanted to hear your thoughts about that transaction accretion and what do you think you're going to be getting from that? And how you think about deploying capital outside of share repurchase going forward?

Angela Braly

Analyst · Bank of America

Let me speak to CareMore. We're obviously really pleased about the announcement of our acquisition of CareMore, and it does a number of things for us that I think will be important. Of course, we hope that the transaction is going to close by the end of the year, hopefully sooner. We have gotten through the antitrust regulatory process and we have more steps in the regulatory process to go on the state but are optimistic about that. A couple of things that this transaction brings to us, obviously, they have a unique model that both addresses the need for the seniors in terms of health outcomes, both on the front end, in terms of the way that they bring in membership. They encourage and have a very large percentage of their members come in for a healthy start visit, which really helps them gather the information that's relevant to the risk adjustment process, as well as the star rating process. And then in the most chronic care cases they have an extensive list model that really addresses the needs of the seniors who are the most ill and have the greatest needs and do so in a really cost-efficient and effective way. Our commitment with respect to CareMore, is it can bring immediate value, obviously, to us, bringing on its membership, as well as its capability to address the membership that we have ourselves in WellPoint and can grow together. We do believe that part of our model with CareMore is to invest, given the ability to expand the care center model that they have. And that through their earnings and the earnings we generate, together, we can reinvest for those, that expansion plan, so that we can double the number of care centers we have over the next, hopefully, couple of years, bringing this model out throughout our other states and serve a bigger footprint for senior members there. Wayne, do you want to speak to the efficiency question?

Wayne Deveydt

Analyst · Bank of America

Yes. Thanks, Kevin, for the question. We continue to be committed as our board is to deploy capital at the most optimal use for our shareholders. And one of those things that we continue to evaluate in any transaction is whether this transaction is more optimal than other alternatives, whether that be a buyback program, dividends or other investments in the business. In the case of the CareMore situation, we believe that this is a better long-term return for our shareholders and it will help support our broader expansion strategy into Senior. It is very challenging to have anything in day 1 be better than a buyback. I mean, the reality is, you can buy the share, there's no execution risk and we get immediate lift. But when we evaluate our transactions, we have to look over not just the immediate term but the longer-term impact of both the buyback as well as the accretion from these investments. I want to reiterate on CareMore for 2012, we expect to be neutral, but the neutral in CareMore is not due to CareMore by itself. It's due to the fact that we want to expand and more than double the number of locations over the next 2 to 3 years. These locations have about an 18-month breakeven period, and then the IRR is substantially higher than anything a buyback could return. Clearly, we could choose an option of not doing anything and have this be very accretive next year, in similar accretion what you may see in a buyback, but we think the longer-term investment is really the better play here. So I do want you to know, Kevin, and other investors, that our focus has not changed around deployment, and we will continue to evaluate all transactions with that same lens.

Operator

Operator

Our next question is from Thomas Carroll from Stifel, Nicolaus. Thomas Carroll - Stifel, Nicolaus & Co., Inc.: A question for you on -- and I realize you're not talking about 2012 just yet, but wanting to -- starting to think about the pricing process into next year, in particular for the Commercial business. So maybe give us a sense of how you're thinking about pricing your Commercial fully insured book into next year, given lower utilization we've seen and given the fact that states are going to be better prepared to perhaps oversee a bit more than in the past, what insurers are doing with their Commercial price increases? And also, understanding that sometimes the Blues tend to be a regulatory target. So let me stop there and maybe just let you chat about that a little bit.

Angela Braly

Analyst · Stifel, Nicolaus

Tom, let’s let Ken speak to the pricing environment. Obviously, we're staying disciplined. We're also looking at trends and have expectations about it growing for a number of reasons. So that discipline is important. But Ken, do you want to speak to your hopes there?

Ken Goulet

Analyst · Stifel, Nicolaus

Yes. Tom, let me just say, we always price to what we believe forward cost will be. And we are assuming an uptick in the trends, and therefore, pricing to it. And when I look at the market overall, I would say the market's competitive but very rational and seems to be pricing in the same way right now. We're ensuring that our pricing is consistent with our historical pattern of being disciplined, but using our advantage to win customers in the market. So I would just say it's disciplined. It's covering forward-looking costs, and our forward-looking costs assume that there will be an uptick in trend.

Operator

Operator

And our next question is from David Windley from Jefferies. David Windley - Jefferies & Company, Inc.: I wanted to have you comment on SG&A and the gains that you've made so far. I'm wondering how sustainable those are. How much lower -- how much more cost and how much lower you think your SG&A ratio can go? And then if you'd also please comment on what triggered the lower tax rate in the quarter and where you expect the tax rate to be for the full year, that would be great.

Angela Braly

Analyst · Jefferies

Yes. Let me speak to the SG&A piece, and then Wayne can answer as well. Importantly, I think the key for us has been giving the SG&A expense in the right way, and we're doing that through initiatives that we've described as Building a Better WellPoint, there are continuous improvement. We're training all of our managers. We're delivering these savings because, frankly, because of the history of having so much variation from coming together as 14 separate companies over time, and so we can get this SG&A in the right way and continue to improve services to our members. So we're executing well on our continuous improvement efforts. We're executing well on systems migration that we have accomplished over the last 2 or 3 years in particular, and we're confident about our ability to do that. Now we do think there is run rate with respect to SG&A expense declining, but we also need to balance that with the investments that we are making for future growth for the company. So Wayne, do you want to speak to how that question is?

Wayne Deveydt

Analyst · Jefferies

Yes. So just one last comment, and to Angela's comment about the SG&A, I mean, as an organization, we are committed, though, on a per member per month to continue to be more efficient. And so while we believe absolute dollars will continue to come down this year, as you know, we have committed to taking out almost $400 million this year, we believe we're well on pace to achieving that. And we expect much of that to run rate with some incremental benefits to next year. That being said, we balance that with investments. But on a total basis, we expect it to be leveraged off our existing membership growth, so in theory, PMPM should continue to be flat-to-down year-over-year, not just for the near term but we believe the long term, as we build the longer term operating model. Relative to the tax rate, we as you know, we continue to take a cautious conservative posture regarding tax exposures that may exist. And we have generally had favorable outcomes regarding those exposures, of which we had some favorable outcomes this quarter as well. That being said, we expect our full year tax rate to be just below 34%. Some of that, of course, is the release and the benefit of what we received this quarter. Some of that is run rate, but it's not run rate I hope that we will not have repeat next year, specifically that when you're not making money in a particular state, in Individual or in Senior, which is a higher state tax rate, you're not paying taxes in that state, which in general drives your rate down. So ultimately, we expect some of that to actually pop back up next year as we improve in those markets.

Operator

Operator

Our next question is from Carl McDonald from Citigroup.

Carl McDonald - Citigroup Inc

Analyst · Citigroup

Can you talk about your outlook for the rate review bill in California, likelihood for amendments over the next couple of months, likelihood of passage, and if it did get passed in the current form, how that would change the view for 2012, given the relatively strong profit margins that you've historically had in Small Group in the state?

Angela Braly

Analyst · Citigroup

Well, obviously, in California and other states where we are working on either rate filings or the potential for rate regulation, the level of transparency that we now have in terms of the rate review and regulation process is so significant and the fact that the minimum medical loss ratio exists, creates a number of protections for members and for protecting to make sure that the industry is very transparent about what our opportunities are there. So like in California, we bring the view of what does this mean for our customers in the end, because ultimately, this is about the customers. So it's too early to say what exactly will happen in California. There are amendments being discussed. What that means in terms of the ultimate end results for AB 52, we can't yet say. We obviously are believing it's in the best interest of California and all other states, for there to be a sustainable market for consumers to buy products in both the Individual market as well as in the group employer market so we're going to continue to advocate in that way.

Operator

Operator

And that question will come from the line of Michael Baker from Raymond James. Michael Baker - Raymond James & Associates, Inc.: I was wondering if you could comment on the expected benefits that you would anticipate, particularly from a capability standpoint, with the pending merger of Express Scripts and Medco assuming that goes through. And then if you could just comment in general from your perspective, how important is Walgreens as part of the network as you move into the selling season for seniors?

Angela Braly

Analyst · Raymond James

Well, let me say that our partner, Express Scripts, brings us a significant benefit in the PBM process. Scale is obviously important, so if they come together, hopefully, with Medco, that we'll benefit from that enhanced scale. And the capabilities of the 2 together, we think will be important for our customers. And so we’ll look forward to that. In terms of Walgreens, I think it's early, and the negotiation process there gives them plenty of time to work that out, and I think that's how the market is viewing it overall. So with that question, I want to thank everyone for the questions that you've had today. Let me say in closing, I want to reiterate that we're pleased to have exceeded our plans through the first 6 months of 2011. We're now forecasting higher earnings for the full year and we expect continued growth and success in the years to come. We're successfully executing on our strategy to reduce general and administrative costs, while adding new customers and improving our service. I'd like to recognize our more than 37,000 associates for their discipline and their dedication. We are achieving our goals by keeping our customers first and committing to our continuous improvement culture. I want to thank everybody for participating on our call this morning. Operator, would you please provide the call replay instructions?

Operator

Operator

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