James H. Bloem
Analyst · Goldman Sachs
Thanks, Bruce, and good morning everyone. Looking at the first quarter, we were pleased with earnings per share of $1.49, which exceeded the midpoint of our previous guidance of $1.40 by $0.09. As indicated on the slide, there were 2 principal items that drove this over performance: first, greater-than-anticipated prior period development of medical claims reserves added $0.03 per share to the quarter's results. This amount was lower than the $0.31 of favorable development experienced during last year's first quarter, a difference that I will discuss when I review each segment's results in the next few minutes. Second, we lowered our estimate of the 2011 Medical Loss Ratio rebates payable for our Employer Group and individual commercial business lines by approximately $15 million, which added $0.06 per share to the results for the first quarter. $13 million of this $15 million was driven by our Commercial Group business while the remaining $2 million was attributable to our individual commercial business. Looking ahead to the full year, these same 2 principles apply as indicated on the slide. In addition, we now have included the recent Arcadian acquisition in our full year 2012 guidance. We estimate that Arcadian will be $0.05 per share dilutive due to transaction and integration costs. Arcadian is expected to become accretive once we switch the business to our platform on January 1, 2013. So in summary, we now expect full year 2012 earnings per share of $7.55 to $7.75, an increase of $0.05 per share over our previous guidance midpoint. In this morning's press release, we also included EPS guidance of $2.15 to $2.25 for the second quarter. Based upon our 2012 full year guidance of $7.55 to $7.75 per share, we expect to earn slightly more than 1/2 of our full year EPS in the second half of the year. In contrast, we earned 54% of our 2011 EPS in the first half of the year. This 2012 difference in our earnings pattern of the first half versus the second half of the year primarily is attributable to the following 3 factors: first, our 2002 year-over-year -- our 2012 year-over-year quarterly administrative expense growth for the rest of this year is expected to be progressively lower versus 2011. As in prior years, we expect to incur a higher run rate of marketing and enrollment costs for our Medicare business during the final 4 months of 2012. However, in 2011, we also were investing increasing amounts in our clinical and provider infrastructure throughout the year. Accordingly, the 2012 year-over-year quarterly change in this investment spend is expected to decrease as we progress through this year. Thus, even though our Retail Segment operating expense ratio was 40 basis points higher in the first quarter of 2012 than it was in the first quarter of '11, we expect that, ultimately, it will come in around 50 basis points lower for the full year 2012 versus 2011. Second, the expected growth rate in our PDP membership by 550,000 members at the midpoint results in a further shift of our earnings toward the second half of the year. As we've discussed on numerous occasions, the annual benefit change of the PDP product results in a declining medical expense ratio as the year progresses. And finally, leap day this year had the impact of moving more expense into the first half of the year relative to the second half. Accordingly, after including the impact of these 3 items, we remain comfortable with our second half 2012 forecasts. Turning now in more detail to the first quarter Retail Segment results. Pretax earnings of $115 million were in line with our expectations. They included the $33 million impact of favorable prior period development versus $40 million in last year's first quarter. It is also important to note that leap day resulted in an extra $40 million of medical expense compared to last year's first quarter. Looking at the full year. As I mentioned previously, we now have included the impact of the Arcadian acquisition in our forecast, which results in approximately $0.05 per share dilution, a $14 million pretax loss. Again, the 2012 Arcadian dilution reflects both transaction costs, as well as the full cost of the integration to prepare this business to fully transition to our Medicare platform on January 1, 2013. Thus, in evaluating our full year 2012 Retail Segment pretax margin guidance range of 5.2% to 5.4%, it should be noted that the inclusion of Arcadian reduced our anticipated pretax margin by 20 basis points. However, on a same-store basis with our previous Retail margin guidance range of 5.3% to 5.5%, the revised pretax margin outlook for our Retail book of business, excluding Arcadian, actually is anticipated to increase by 10 basis points to a range of 5.4% to 5.6%, again primarily due to the favorable prior period development I discussed earlier. Finally, as you review the Retail Segment for the full year, please remember the 3 things that I mentioned earlier: first, the operating expense ratio will improve relative to last year as we go through this year; second, the addition of 550,000 at the midpoint PDP members, which, as usual, primarily benefits the second half pretax income; and third, also as usual, we do not include any future benefit from any additional prior period development in our full year forecast. Turning now to the Employer Group segment. Our pretax income of $121 million included 2 items that were not considered in our previous forecast as indicated on the slide. First, the results included the impact of $30 million in unfavorable prior period development, which I will elaborate on in just a minute. Second, we lowered our estimate of the 2011 minimum Medical Loss Ratio rebate payable by $13 million during the first quarter, which benefited our first quarter results. This amount was primarily attributable to the refinement of state-level calculations based on the first quarter runout of claims. With respect to the unfavorable prior period development, the $30 million consist primarily of the following 2 nontrend-related events: first, the timing of claims processing changes primarily at some of our claims clearinghouses as a result of their implementation of the HIPAA 5010 requirements caused us to slightly underestimate our IBNR at the end of the year. We are confident that this was a disruption around year end that is fully behind us since we are now processing over 98% of all claims in the new 5010 format. This change accounted for more than 1/2 of the $30 million. Second, a onetime plan design change for one medium-sized Group Medicare Advantage account resulted in a slight underestimation of the related fourth quarter claims for this group and this accounted for most of the remainder of the $30 million. So to summarize with the respect to medical claims reserve development, we had $8 million or $0.03 per share in the aggregate of greater-than-anticipated favorable development. And we anticipate there should be additional favorable development throughout the remaining 3 quarters of the year just as there has been in prior years since we continue to use the same actuarially based consistent reserving methodology from period-to-period as in the prior years. With respect to 2012 commercial medical cost trends, although we continue to expect a gradual uptick in utilization at some point, we did not experience an increase in the first quarter. In fact, we saw lower levels of inpatient hospitalization than we had expected. Although we have not changed our trend outlook for the full year, our trend forecast has now moved toward the lower end of the range of 6% to 6.5% that we have been planning for the full year and have discussed during the last 2 earnings conference calls. And finally, as also shown on the slide, leap-day negatively impacted the first quarter of this year by $15 million compared to 2011. Thus, with respect to the Employer Group segment, we're pleased with our overall pretax income of $121 million for the first quarter after giving consideration to the nontrend-related unfavorable development and the other factors listed on the slide. We remain confident of our full year Employer Group pretax outlook. Turning next to our Health and Well-Being Services Segment. As shown on this slide, both pretax and revenue earnings are showing significant growth over 2011. This is primarily due to the increase in volumes for our PBM and mail order operations, which are a result of increased Medicare Advantage and Medicare PDP membership, as well as increasing same-store mail order penetration levels. Also in this morning's press release, we've added statistical Page 9, which shows pharmacy metrics that provide further detail regarding our generic dispense rates and our script volumes. This final slide updates our current financial resources and 2012 capital deployment plans. But first, I want to comment on the first quarter 2012 cash flows, which were affected by an early CMS payment of 2 point -- $2,020,000,000 on March 30 related to the premiums for the month of April. Excluding the early payment from CMS, first quarter operating cash flows were $465 million lower than in the first quarter of '11 due both to lower net income and working capital timing differences. The approximately $400 million of working capital timing differences primarily were due to roughly equal changes in both benefits payable and other liabilities. The majority of the benefits payable portion included the timing of payments to our pharmacy benefit administrator while the other liabilities primarily included lower Part D risk share accruals and an additional associate payroll cycle. Accordingly, we remain confident in our full year 2012 operating cash flows guidance range of $1.8 billion to $2.0 billion. From the standpoint of available financial resources, we are pleased to report that after consultations with the various state departments of insurance and the credit rating agencies, we expect to receive $1,022,000,000 in 2012 dividends from our operating subsidiaries during the next 90 days. This amount compares with $1,077,000,000 of 2011 dividends and will increase the March 31, 2012, parent cash and investments balance of $225 million. With respect to our 2012 capital deployment plans, we continue our consistent and constant review of strategically important potential acquisitions and investments, as well as capital projects while concurrently returning capital to shareholders through our quarterly cash dividends and a strong repurchase program. As noted in the press release, the board recently increased our quarterly cash dividend initiated last year to $0.26 per share. At the same time, the board also refreshed our share repurchase program to up to $1 billion through June 30, 2014. Like the previous authorization, the new authorization permits shares to be repurchased from time-to-time at prices in the open market by block purchases or in privately negotiated transactions. And with that, we'll open up the phone lines for questions. [Operator Instructions] Operator, will you please introduce the first caller?