Earnings Labs

Cigna Corporation (CI)

Q4 2009 Earnings Call· Thu, Feb 4, 2010

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Transcript

Operator

Operator

Ladies and gentlemen, thank you for standing by for CIGNA’s fourth quarter 2009 results review. At this time, all callers are in a listen-only mode. We’ll conduct the question-and-answer session later during the conference and review procedures on how to enter the queue to ask questions at that time. (Operator Instructions) As a reminder ladies and gentlemen, this conference, including Q&A session, is being recorded. We’ll begin by turning the conference over to Mr. Ted Detrick. Mr. Detrick, please go ahead, sir.

Ted Detrick

Management

Good morning, everyone, and thank you for joining today’s call. I’m Ted Detrick, Vice President of Investor Relations. And with me this morning are David Cordani, our President and Chief Executive Officer; and, Annmarie Hagan, CIGNA’s Chief Financial Officer. In our remarks today, David will begin by discussing the highlights of CIGNA’s 2009 results. He will also provide his perspective on the marketplace as we head into 2010. He will also comment briefly on healthcare reforms. Then Annmarie will provide a detailed review of the financial results for the year and discuss the 2010 financial outlook. She will also provide an update on our achievements and expectations related to our expense reductions and capital management goals. And lastly, she will share some early indications on how our January 1st business is developing. David will then conclude with a discussion of CIGNA’s growth strategy before we open the lines for your questions. As noted in our earnings release this morning, CIGNA uses certain non-GAAP financial measures when describing its financial results. A reconciliation of these measures to the most directly comparable GAAP measure is contained in today’s earnings release, which was filed this morning on Form 8-K with the Securities and Exchange Commission, and is posted in the Investor Relations section of cigna.com. In our remarks today, we will be making some forward-looking comments. We would remind you that there are risk factors that could cause actual results to differ materially from our current expectations. And those risk factors are discussed in today’s earnings release. Now before turning the call over to David, I will cover a few items pertaining to our fourth quarter results. Regarding our results, I would note that in the quarter, we recorded an after tax charge of $13 million related to CIGNA’s previously announced cost reduction plan, which we reported to the special item. I would remind you that special items are excluded from adjusted income from operations in today’s discussion of both our 2009 results and our 2010 outlook. Relative to our runoff reinsurance operations, our fourth quarter shareholders net income included after tax income of $60 million or $0.22 per share related to the guaranteed minimum income benefits business, otherwise known as GMIB. I would remind you that the impact of FASB’s fair value disclosure and measurement guidance on our GMIB results is for GAAP accounting purposes only. We continue to believe that the application of this guidance does not represent management’s expectations of the ultimate liability payout. And because of the application of this accounting guidance, CIGNA’s future results for the GMIB business will be volatile as any future change and the exit value of GMIB’s assets and liabilities will be recorded in shareholders net income. CIGNA’s 2010 earnings outlook, which we will discuss in a few moments, excludes the results for the GMIB business, and therefore, any potential volatility related to the perspective applications of this accounting guidance. And with that, I will turn it over to David.

Dave Cordani

Management

Thanks, Ted, and good morning, everyone. Before Annmarie reviews our result and outlook, I'm going to give you a brief update and overview of 2009, and why, despite economic turbulence, we’ve delivered very good results. I’ll cover market highlights, our point of focus and why we’re winning in the market, and I’ll share some brief comments on healthcare reform. And later in my closing comments, I’ll discuss highlights of our strategy and related actions. Let’s get started with the results from last year. As we reflect in 2009, it is clear that the global economic decline, the competitive environment as well as the uncertain political landscape combined to make it a very challenging year for our company and the industry overall. With that as a backdrop, we believe our 2009 results represented good outcome both in absolute terms as well as from a competitive perspective. For full year 2009, we delivered earnings per share of $3.98, an adjusted income from operations of approximately $1.1 billion, which represents year-over-year earnings growth of 16%. This result reflects solid earnings in each of our ongoing businesses, our healthcare, (inaudible) life, and international operations. In addition, our runoff reinsurance results improved significantly due to stabilization of the capital markets. In 2009, we delivered on our capital management goals by restoring our subsidiary capital to targeted levels, significantly building our parent company cash, and as expected, making a meaningful contribution to our pension plans. Relative to operating expenses, we made good progress in 2009 by driving $100 million in reductions in our healthcare operating expenses. Remember, as I said before, reducing expenses is an integral part of our growth strategy, not a one-time initiative. To underscore this, looking to 2010 and beyond, we’ve already identified actions to further drive operating efficiencies. So how are we…

Annmarie Hagan

Management

Thanks, David. Good morning, everyone. In my remarks today, I will review CIGNA’s 2009 results. I will also discuss our outlook for full year 2010, including some early insights into our January one membership. In my review of consolidated and segment results, I will comment on adjusted income from operations. This is, shareholders income from continuing operations, excluding realized investment results, CMIB results, and special items. This is outside the basis on which I will provide our earnings outlook. Our full year consolidated earnings were $1.1 billion or $3.98 per share, compared to $946 million or $3.39 per share in 20008. Full year consolidated results increased 16% versus 2008, primarily due to improved results in our runoff reinsurance businesses. Full year earnings for our three ongoing businesses were modestly above 2008 and represent a solid result in the challenging economic, political, and competitive environment. I will now review each and of the segment results beginning with healthcare. Full year 2009 healthcare earnings were $729 million. This result primarily reflects favorable operating expenses and continued solid contributions from our specialty businesses, partially offset by a higher reported guarantee cost loss ratio and medical membership declines primarily related to dis-enrollment. For full year 2009, healthcare membership declined 5.5% versus year-end 2008. This result was primarily due to lower enrollment from existing customers and lower covered lives on new business sales both resulting from elevated unemployment level. Our full year guaranteed cost medical care ratio or our MLR was 85.5% excluding our voluntary business. This result was in line with our expectations as of the third quarter. On a fully developed basis, the 2009 MLR represents a flat year-over-year result reflecting rate increases offset by higher flu-related claims, including H1N1. For the full year, the impact of flu-related claims, including H1N1, contributed approximately…

David Cordani

President

Thanks, Annmarie. It's just (inaudible), our 2009 results reflect solid contributions from our ongoing businesses, with fourth quarter results positioning as well for 2010, our 2010 is aligned with our strategy and early indicators relative to execution are positive. And the 2010 capital outlook is strong. Now I'll briefly highlight some of the key actions and points of focus for we're driving to deliver these results and position CIGNA for 2011 and beyond. As a backdrop, let me remind you of our mission and destination. Our mission remains unchanged. We are focused on helping the people we serve, improve their health, well being, and sense of security. Every decision, product, and service supports this mission. Our destination over the next three to five years is to be a global health service company that wins based on knowledge of our customers and distribution partners, differentiated service and products, and distribution excellence. As we've discussed in length at our investor day in November, our growth strategy is to play to our strengths, deliver differentiated value for our customers, and as a result, attractive and comfortable growth. It's best described by, "Go deep, go global, and go individual." "Go deep" refers to our focus geographically on products and on certain segments. Our goal is to build a leading position in targeted geographies, products, and segments. There are four main areas of focus for us in the US, first is the middle market segment. This represents employers with 250 to 5,000 employees across large single-sized business. This is our largest market segment consisting of approximately 6 million individuals, and has been a consistent area of strength for us. We have achieved strong organic growth in this market segment for the past few years. And as Annmarie indicated, our early January enrollment data confirms that…

Operator

Operator

Thank you, sir. (Operator Instructions) And we will first go to Matthew Borsch with Goldman Sachs. Matthew Borsch – Goldman Sachs: Yes. Hi. Good morning. Could you just talk a little bit about your strategy with Private Fee-for-Service? And I guess the context that I'm thinking of is the products on set at the end of this year, at least in most geographies as I understand it. And yet, your guidance seems conservative with the breakeven expectation, so. I guess the question must be, what are you really achieving with this growth? And what do you intend to take it to next year?

David Cordani

President

Good morning, Matthew. It's David. Relative to Private Fee-for-Service, first off, for senior solutions more broadly, our strategy has been to ensure that we have the right portfolio of solutions for employer-sponsored customers. A part of that is employer-sponsored Private Fee-for-Service as well as our day – the broad wrap program, et cetera. As Annmarie referenced in her prepared remarks, we've leveraged that on a fixed cost infrastructure to have the employer solutions to grow on a targeted basis in specific geographies and some individual Private Fee-for-Service business. In addition, a part of or strategy is to make sure we have the right learnings and capabilities in the US around the individual market. A part of that obviously is seniors, a part of that is non-seniors individual. I think underlying your question is what's our strategy and what's our intent as we step into 2011 and beyond with this product. As you indicated, the marketplace is going to change with the regulations. And we're evaluating the alternatives of what we would do with the employer-sponsored lives versus the individual lives that are in the Private Fee-for-Service business. Lastly, the note around the conservatism, again, this was never intended to be a fundamental driver of our earnings growth stepping into 2010. As Annmarie referenced, both at (inaudible) day with a smaller book of business that we anticipated as well as today, we've continued to project it at a breakeven rate, although we've priced for margin in the product. Matthew Borsch – Goldman Sachs: Okay, okay. As a follow-up, do you – are you potentially looking to migrate that enrollment to a network-based product in some geographies or across the board for 2011?

David Cordani

President

Matthew, again it's David. That is one of the options we're evaluating. Matthew Borsch – Goldman Sachs: Okay. All right. Thank you.

Operator

Operator

Thank you, Mr. Borsch. We go next to John Rex with J.P. Morgan. John Rex – J.P. Morgan: Thanks. So more on that, on the (inaudible) books, I guess a couple of things I was interested in. First, obviously the members game came in far ahead of what you've been expecting, so maybe double. And as you do the hindsight on that, what do you attribute that to? And particularly, as you compare the products that those members are coming from, what kind of alternatives do they have, so how your benefits stacked up in those regions where you were picking up the business? And then if you mapped in that membership, do you get – you have right now to where you have existing networks that you can transition into a network-based product in 2011, what would be the penetration rate you could – that you're getting out of that?

David Cordani

President

Good morning, John. I'll start, and I'll ask Annmarie to add in some of the color in terms of the migration, where the business has come from, what we know about it. Just a little bit of a backdrop here, first is it's quite early. You get the CMS polls in phases. We know we're – a good amount of the individual rights are, but there's a final poll that comes from that acquired data. Our strategy was to put price – well-priced products, lean products, in about 1,500 counties. Our enrollees came in, in about 600 of those counties. One thing's that's changed here, I think you're very well aware of, but it's important to call out, is that there were several companies that exited this space, which resulted in about 600,000 additional lives coming into the pool. So there's a lot more activity in the marketplace where individuals were, if you will, forced to make an additional decision because they're incumbent carrier was no longer a choice. And what we saw was there was an additional – about 600,000 lives that were brought to bear in the marketplace. My final point before I hand it over to Annmarie is our early look is within those 600 counties, we don't have any more than 4% of our enrollees in any individual county. If you look at the top 200 counties we're in, we have about 12% share. If you look at all the counties we're in, we have about 8% share. So from a concentration standpoint, our early look at the enrollment is that our concentration of membership is not there. It's actually quite diverse, and only a subset of the counties that we put our lean products in, did we (inaudible). I'll let Annmarie expand in terms of where the lives came from and some of the information we know about the risk profile.

Annmarie Hagan

Management

Sure, David. Relative to where the lives came from, there're still some uncertainty as we're pulling in the information from CMS. And I do want to remind, it is early in the cycle and this inherently volatile in uncertain products. But where we see some of the lives coming from are from those competitors who had gone out of the market. And as David mentioned they are very geographically dispersed. When we look at what we’ve seen to date from a profiling perspective as it relates to the enrollees that we have priority on, there’s about 85% of the new enrollment, its coming from what we’ve previously Medicare advantaged products, so not previous Medicare coming from Medicare advantaged products. And that's a positive sign, a couple of things there. We have more information around the risk profiles as it relates to those enrollees who come from Medicare advantaged. And typically because they come from another Med-advantaged product, they have lower commissions. In addition, I would highlight a couple of other key factors about the population as we know it today. We have an average risk score on those products – on these enrollees today, John, that’s currently at about what I think 0.86%. I’m sure you know that anything under 1% would indicate that we have healthier individuals, anything over 1% would say that we have less healthy individuals. So 0.86% is in line with what we would have expected when we priced it and slightly better than we’ve had in the past. And also, these enrollees are in our leaner – the leanest benefit products that we offer. We have less low income people. We have less disabled individuals. And overall, the population that we’ve attracted this year appears to be on the younger side. John Rex – J.P. Morgan: Okay. Have you done the retrospective – compare to what the other offerings were in that market and how your benefit design stacked up against some of their offerings?

David Cordani

President

John, we had and we continue to. A big part of our strategy, again, was to have, as Annmarie has referenced and I did, a leaner benefit offering. So the retrospective review, if you will, what we see and can confirm is that our pharmacy benefit on a couple of funds is leaner. And broadly speaking, some of the costs here on the core medical, if you will, the hospital benefit is also leaner. It correlates back to the risk score that Annmarie made reference to. John Rex – J.P. Morgan: Okay. And this is one last, you said you did target a margin on this business even though you’re not assuming that in your guidance. We've heard you say you targeted something like a 5% pre-tax?

Annmarie Hagan

Management

John, it’s Annmarie. The target was in the 2% to 3% range for our margins. And as I’ve said, given the inherent volatility around these products, we thought it was appropriate to project it at about breakeven. John Rex – J.P. Morgan: Again, Annmarie, that was 2% to 3% pre-tax, is that correct?

Annmarie Hagan

Management

That’s correct. John Rex – J.P. Morgan: Great. Thank you.

Operator

Operator

Thank you, Mr. Rex. We’ll go next to Christine Arnold with Cowen and Company. Christine Arnold – Cowen and Company: Hi. Switching gears, what one of your competitors indicated that they were seeing a lot of pressure on in ASO fees, not a lot of take up of the specialty, the disease management, employee assistance, and potentially some pressure with trend guarantees. So could you talk about your outlook for 2010 for your ASO book in light of those issues and what portion of your ASO fees are subject to trend guarantee?

Annmarie Hagan

Management

Hi, Christine. It’s Annmarie. First of all, you know we have historically offered performance guarantees to our ASO customers. Over time that changed from the traditional service guarantee to some accounts, management-type guarantees, clinical discounts, and trends. That’s the way the market has been evolving. Relative to our position exclusively on trend guarantees, we have ASO fees of about $2.7 billion and our trend guarantees would be roughly 1%. So we’ll do the math for you, approximately $25 million of ASO fees at risk relative to trend guarantees. Christine Arnold – Cowen and Company: And then what about the up-tick on specialty and ASO fees being pressured year-over-year, can you speak to those issues?

David Cordani

President

Good morning, Christine. It’s David. Relative to specialty up-tick, we certainly have seen certain instances where clients decided to delay purchasing given the challenging economic environment they’re facing. I would say though net-net on an overall basis, we’re not seeing any material change in demand when we look at what the penetration rates we expected to have stepping into 2010 as part of our planning and what our early look at the penetration rates are. We’re seeing that net-net, it’s about where our expectations are. I would highlight, it puts a little bit more pressure on the consultative selling to make sure that you’re pinpointing the right programs for that employer and using account-based information to pinpoint the right maybe two or three disease management or chronic care management programs as opposed to a general approach. The net-net on an overall basis, we're not seeing a material change. Christine Arnold – Cowen and Company: Okay. So no change versus expectations or not a change year-over-year in specialty earnings?

David Cordani

President

:

Annmarie Hagan

Management

The only thing I wanted to add there, Christine, was that, as I’ve noted in my prepared remarks, we did see strong one-one particularly in the mid market with ASO penetrated with specialty. So we are continuing to see good demand for these products on a penetrative basis. And as you recall, at Investor Day, when we rolled forward our earnings from 2009 to 2010, one of the uplift is the continued strong contribution from our specialty businesses. Christine Arnold – Cowen and Company: Okay. And on the SOP fees, are they down more in 2010 than they were in ’09?

Annmarie Hagan

Management

No, we don’t expect that. Overall we expect the growth fees, yields, et cetera, to be on the positive side. Christine Arnold – Cowen and Company: Great. Thank you.

Operator

Operator

Thank you, Ms. Arnold. We’ll go next to Carl McDonald with Oppenheimer. Carl McDonald – Oppenheimer: Thanks. Can you give us breakdown of how you think risk ASO and experience rated enrollment will look for 2010?

Annmarie Hagan

Management

Sure, Carl. It’s Annmarie. There has not been any significant change since those indications that we highlighted in Investor Day relative to our membership. So on the risk side ,we have low single digit growth. In the shared return side we have bit of an up-tick there growing probably from unstable to mid single digit growth. and on the ASO side, we have in a stable range. Carl McDonald – Oppenheimer: Okay. And on the risk enrollment growth, how do you feel about the fact that you’re expecting some growth in the risk product relative to most of the competitors that are polling for some still fairly significant declines?

Annmarie Hagan

Management

Carl, it’s Annmarie. I feel good about the risk growth as we’ve indicated in some of our prepared remarks where we’re seeing some of the growth is in our select segment, which is one of our targeted segments, part of our strategy. And last year, we did rollout our leaner benefit designs. So we are seeing good traction with leaner benefit design. Also in the – with membership, you’ll have some of the growth related to our strategy around individual. So relative to the individual and some of the targeted markets where David mentioned, we were using to learn into – drive the strategy as we go individual, we’ve seen some good growth there as well. So I feel good about the risk profile there, and should our pricing posture on the renewal and new business continue to be the price set about trends. David, did you want to add something?

David Cordani

President

Hey, Carl. Good morning. It’s David. I would just reinforce one point, which is within the risk part of business. Our retention rates are strong. So when you go back to retention rates, you have strong service delivery. And an important comment today we made in a prepared remarks is of the consistency around the pricing and underwriting result from a little bit last we saw ph and the market are playing in. So we’re very pleased to see that retention rate move up coupled with the sales moving up in the targeted geographies. Carl McDonald – Oppenheimer: And regarding the comments you made on the capital, with no change to the expected dividends given all the medical growth that you’re seeing, does that mean you’re willing to let the risk-based capital ratios come down a little bit in subs?

Annmarie Hagan

Management

Carl, no. That’s not what we’re implying there. In fact, the year ended with a stronger result in our capital position in our subsidiaries. We did come in with earnings, quite with ph better than our expectations. The fourth quarter S&P was stronger than we had expected when we talked to the group the other ph day. And as a matter of fact, that strength in our operating subsidiary capacity allowed us to cover the capital required for privacy for service business, and still allow us to end with the result in the parent company that were stronger than we have thought before as well.

Operator

Operator

Thank you, Mr. McDonald. As a reminder to our participants, please limit yourself to one question and one follow-up question. We go next to Ana Gupte with Sanford Bernstein. Ana Gupte – Sanford Bernstein: Thanks. Good morning. About your commercial full range above (inaudible), you said that you’re pricing above trends and growing in individual and possibly involuntary where the loss ratio should help you make suggest that fully insured the MLRs. So what is your guidance right now on the outlook for the all-in commercial fully insured loss ratio to guarantee cost with the voluntary and everything fixed in there?

Annmarie Hagan

Management

Hi Ana, just to correct the record there, I indicated that we were pricing at trends, not above. So I indicated that we were pricing at trends, which was consistent with their pricing posture and our expectations. Relative to the all-in voluntary individual set our guaranteed cost MLR that was projected to be 83.5% to 84.5%, which is consistent with the 83.9% that we reported through to 2009. Ana Gupte – Sanford Bernstein: And what are the trend assumptions you’re making on that MLR with regard to the flu season COBRA, and then any network contracting that you’ve seen completed January of this year?

Annmarie Hagan

Management

Sure Ana. Our overall book of business trend is – continues to be in 89% range, and relative to the flu, we had talked earlier about the fact that in the guarantee cost area particularly, you’d expected about 60 basis points of flu in 2009, actually seem as but we’re better than that. Having said that, we maintain that 60 basis point assumption relative to flu in the 83.5% to 84.5%. And to remind you that COBRA for us was very insignificant. Any COBRA that we typically had has been on the ASO account where there’s very little exposure unless that it hits the stop loss , which I think we talked previously. That for the full year of 2010, I’m sorry, it’s 2009, we had about $2 million relative to COBRA. So no explicit assumption as we move forward into 2010 on that. Ana Gupte – Sanford Bernstein: And then finally, the 8 9% you’re pricing in line with the 89% on a buy down in mixed adjusted basis, do you see that trending somewhat close to that or will there be pressure downward on the top line year-over-year growth?

Annmarie Hagan

Management

Yes. I’d see it in line with trend. The only thing I would add there is that as we write more leaner benefits, hence more individual business, the overall revenue yield and the related trends will actually start to decrease. But we don't expect there to be a significant difference between the two. But overall those numbers, as we drive more into that select segment with leaner benefits in individual, that overall yield and trends should decrease a little bit. Ana Gupte – Sanford Bernstein: Okay. Thank you.

Operator

Operator

Thank you, Ms. Gupta. We will go next to Josh Raskin with Barclays Capital. Josh Raskin – Barclays Capital: All right. Thanks. Good morning. Just a couple of questions quickly on the pension I guess, it sounded like you made $410 million of contributions net of tax into the pension of the past year. And yet your under-funded status is only down by $350 million. So I’m just curious, was it that your planned asset growth didn't keep up with your project benefit obligation growth or was there a change in the returns, a change in the discount rate? And then, how shall we think about the actual pension expense in 2010 versus 2009?

Annmarie Hagan

Management

Josh, its Annmarie. Actually, our assets performed much stronger than our underlying assumption. The issue we’re dealing with in the roll forward of the pension liability was the change in discount rate. So order of magnitude, that cost us about $225 million given the discount – the interest rate environment, so assets performing better than expected. And as a matter of fact, I noted in my prepared remarks we expected the unfunded liability to be a little worse. We came in better than we’ve expected for year-end. And then as you think about the expense for 2010, I’d remind you that we froze our pension plan effective July 1st and the expense for 2009 relative to the amortization of the actuarial losses, so service costs this way, you just have that would be probably around half of what we experienced in 2009. Josh Raskin – Barclays Capital: And looking at the dollars, what would have happened?

Annmarie Hagan

Management

I’m going to ask Ted to get back to you on that, Josh. Josh Raskin – Barclays Capital: Okay. I can grab it from the last queue. And then also, just I understand the discount rate you’re saying, that was changed for 2009 and that was spread related I think?

Annmarie Hagan

Management

Yes. That would change. We do our complete valuation of the pension plan at 12/31/09, and we update all of our assumptions, our growth rate, our discount rate, et cetera. And that would change the events – the interest rate environment. Josh Raskin – Barclays Capital: But no change in the asset return rate?

Annmarie Hagan

Management

Yes. We continue to maintain the asset return assumption around 8% consistent with what you would have read in the 10-K previously. Josh Raskin – Barclays Capital: Thank you.

Operator

Operator

Thank you, Mr. Raskin. We will go next to Charles Boorady with Citi. Charles Boorady – Citi: Thanks, good morning. These two questions, one on M&A priorities, and if we would be consistent with your desire to grow faster internationally or you think M&A would be more domestically based? And then secondly, my question will be of a big picture one. In light of the economy around affordability, you talked about more leaner benefits, which we’ve seen a trend to over the last almost decade. But once you get to a point where that can no longer effect the cost there, what are some other things you’re doing to addresses the affordability and, are we seeing a return to more networks or each move these products for prior authorization or gate keeping, and any examples you can give us about the effect that it’s having on cost trend?

David Cordani

President

Charles, good morning. It’s David. First one, as to the M&A question. Annmarie went through the sources in use of the capital. And M&A is currently our second priority once we take care of the appropriate needed capital for the ongoing operations. We continue to expect actually that our industry will consolidate over time. Although, the view, at least in the US is that the administration views that the maintenance is a twist in the industry is rather important. Specific to your question, we would look at them in two ways. One is capability based, second is skill based. And as to whether or not we have a biased word, non-US or US asset, I would say, we’re open to either as we look at it. So we will evaluate capabilities to further enhance, be they help advocacy, engagements, information of care delivery support, or produce capabilities. Secondary to that, we look at targeted scale opportunities that make sense both strategically and financially to us. As relates to your second question, I think your point is quite important in terms of it's the pattern of benefit buy downs, if you will, or ultimately miss a product gets to a tipping point, what’s next? I would say about to – from the prepared remarks we had relative to a choice fund fourth-year study, what we feel in the marketplace is now an increasing pattern of demand and interest in what we recall engagement and incentive-based program. So how do you incent individuals to become a bit more active in terms of the management of that both health risk as well as healthcare consumptions, in terms of the services that they utilize, pursuit of more value-based or higher-performing outcomes. Pursuit of more generic outcomes et cetera. And finally we give you a little bit of tip of the iceberg. We have some employers out there now that are – that we’re working with around the value-based benefit alternatives, outside the pharmacy. And that might mean as pegging a benefit design to wherever the clinical asset could see threshold exist, providing information back to their employees and customers and having the individual take more physical responsibility beyond that. So back to recap, if the use of information, the use of incentives and supporting people to both lower the health risks, and then consume the healthcare services where the highest quality and therefore, best value unfolds, that’s where we see the most activity right now, national middle and emerging in the select segment as well. Charles Boorady – Citi: Dave, does that include, the potentially excluding facilities from networks more aggressively than you have recently or excluding other providers to the networks?

David Cordani

President

Yes. I would say, last so in the traditional way that you referenced from 10 years ago, or 15 years ago, so the network within a network or the sub-so-last network. Last of that, and more actually going the opposite direction in providing choice and information to the individuals, so a more important customers wanting to have the same breath of network, or potentially differentiating the coverage and providing more information in terms of the overall quality or the centers of excellence within the program. We do have examples where kind of outliers will more indeed be called, and employers are more interested in that. But often the use of information as opposed to just looking at a cost indicator that use of information for the total episodic care. So the headline there is still maintaining choice, using information, providing incentives for individuals to pursue the right service at the right venue at the right time, but last of the 15-year goal model were just laughing a third of a network off and constricting access. Charles Boorady – Citi: And the prior also, David? Or are gate keeping coming back or not?

David Cordani

President

Sure. So keep it as a fact. You sense of less than 1% of services that are going through if you’ll gate it or prior off , and that’s back to the use of information? So I would say no, not in the historical sense, but on a very targeted basis, yes. So it’s sorting the force for the trees and identify the finite services where there are high variabilities in clinical quality delivery. Therefore, high variability in cost, and that’s where the activity is. And you’re dealing with small number of services that have high variability. And that’s we are dealing with single digit percentages there.

Operator

Operator

Thank you, Mr. Boorady. We go next to Justin Lake with UBS. Justin Lake – UBS: Thanks. My first question is just around 2011 and 2012. You've done a great job of detailing the SG&A savings opportunity over the next several years. And I'll just be curious to hear you talk on how much of that you would expect to reinvest in the business to fund future growth initiatives, and maybe what areas of the business you want to invest in.

David Cordani

President

Good morning, Justin. It's David. I appreciate your comment. Specific to your comment, as you recall for 2010 and just using that as a transitional comment, you find that I and Annmarie made reference to the gross savings and then some of the targeted reinvests we will make. Our expectation is that we will continue to reinvest back in the business. The savings rate that Annmarie made reference to for '11 and '12, as we can best estimate right now, represent essentially a net number as opposed to a gross number because we are actually investing in our business today. Annmarie made reference to target investments within the group insurance operations. We have a rather robust level of investments within our healthcare business. And we're investing in the international business. And that's all quantified within our current guidance. So outside of large step function M&A capital deployment, we would intend to maintain our current investment level and see those expenses as being an additive step function of reduction beyond that. Justin Lake – UBS: Great. That's helpful. And just a quick follow-up in regards to the cash flow, what is the expected of dividends to the parent year? And when would you expect to begin being able to deploy some of that free cash in 2010?

Annmarie Hagan

Management

Yes. It's Annmarie. The timing of dividends are a little bit more backend loaded than front end loaded. So I think, consistently, we said that given our capital position, any normal capital deployment – and I'll remind you of the priority. First, make sure our businesses are well capitalized and we're funding growth; second, M&A; and then, finally, repo of shares. So if any types of capital deployment would be more towards the latter part of 2010. Justin Lake – UBS: Great. Thank you.

Operator

Operator

Thank you, Mr. Lake. We will go next to Scott Fidel with Deutsche Bank. Scott Fidel – Deutsche Bank: Thanks. First question, just if you can provide us with an update on the experience rate of business just in terms of the percentage of accounts that ended the year in deficit. And also, are you seeing any change just in the pace of deficit recoveries over the course of the last year? I know at the end of last year, there were some economically related dynamics there, just an update on that.

Annmarie Hagan

Management

Hi. It's Annmarie. Relative to the experience rate and deficit, Scott, it's pretty much consistent. We have about 54% surplus and 36% in deficit. We continue to have strong rate executions on our accounts in deficit, and actually, good results during 2009 relative to our margins, flat to slightly better in 2009 and expected in '10, which inherently implies we are making good progress on the deficit side to half. Scott Fidel – Deutsche Bank: Okay. And I just – I have a follow-up, just if you could provide enough data on the stop loss book in the fourth quarter and if you saw any improvement or deterioration, and just some of the emerging costs – pressures that you have tied to the third quarter.

Annmarie Hagan

Management

Sure, Scott. The stop loss book came in about as we expected. There was not any indication that what happened in the third quarter was redone in a new jump off plate. So we had as expected stop loss results. And as I noted in my prepared remarks, as we jump into 2010, stop loss continues to be a very important contributor to our earnings trajectory. And the only other thing I'll note is that we continue to feel the good leverage from the re-contracting effort relative to our Great-West book of business. Scott Fidel – Deutsche Bank: If I could just sneak one quick one, and just on part D, just an update on your enrollment and margin expectations for 2010.

Annmarie Hagan

Management

I don't have the exact numbers on enrollment at my fingertips, Scott, but it's up. So we have gross in part D, and the earnings is expected to be up as well. Just like I noted earlier, when you think about the progression of our earnings in 2010, given the way part D comes through with losses in the first quarter and improving as we go along, that might be a little bit different because we have expectation for modestly higher earnings from part D. Scott Fidel – Deutsche Bank: Thanks.

Operator

Operator

Thank you, Mr. Fidel. We go next to Kevin Fischbeck with Bank of America/Merrill Lynch. Kevin Fischbeck – Bank of America/Merrill Lynch: Okay. Great. Thanks. Just in the quarter versus your guidance, it seems like the other operations runoff was better than expected for the year – for the quarter. But now you're looking for it to go back to that 135-type run rate the next year. Can you talk about what happened this year and what's going to happen next year?

Annmarie Hagan

Management

Sure. It's Annmarie. Relative to the runoff reinsurance operations on an annual basis, we evaluate our different reserve positions. Remember, we stopped writing this business in 2000. So this continues to runoff in the reserve positions there, continues to get smaller. As we evaluate that, there is some opportunity for reserve favorability. So as we do the reserve reviews and execute very strongly on the claims education, et cetera, we typically would see, all things going well, some upside at the end of the year. In addition, we continue to focus on resolving reinsurance recoverables. Remember, this is – this business has a risk associated with that collection of reinsurance from third parties. We've done a very good job at actually resolving those in a positive way, which also results in earnings for us. And I would say as we move ahead, as this book continues to decline in runoff, you could have a quarterly good news, but would not expect the level of the fourth quarter good news to be run ratable. Kevin Fischbeck – Bank of America/Merrill Lynch: Okay. And then, you mentioned that the international business had a $4 million impact for the tax rate in South Korea. Was that a one-time issue or is that going to be an ongoing $4 million drag to that business?

Annmarie Hagan

Management

Relative to the fourth quarter, we did have a $4 million – that was a full year true up of the effective tax rate. So having said that, it is a higher effective tax rate as we move forward into 2010. All things being equal though, you might recall back in the second quarter, we talked about the fact that we employed a capital management strategy, which allowed us to effectively reduce the overall tax rate for Korea and expect that for some other countries as we jump in 2010. So as we jump off into 2010, actually, the full year impact of having an overall lower effective tax rate will be an upside for us in international. Kevin Fischbeck – Bank of America/Merrill Lynch: Okay. So that's upside versus what was reported in 2009 or upside (inaudible) extra $4 million.

Annmarie Hagan

Management

It's upside related to 2009 all in. Kevin Fischbeck – Bank of America/Merrill Lynch: All in, okay. Great. Thanks.

Operator

Operator

Thank you, Mr. Fischbeck. We will go next to our final question from Doug Simpson with Morgan Stanley. Doug Simpson – Morgan Stanley: Thanks. Can you just remind us in the real estate business, I think at the end of last year, you had something like $470 million of future purchase obligations? Do we need the fact to send the sources and (inaudible)? Can you just give us a sense for the timing and if there's an updated number there?

Annmarie Hagan

Management

It's Annmarie. I don't have that number, to be honest with you. But I think it's probably around the same amount. That'll be in our 10-K as we file that at the end of the month. And that does not close repair in company cash of that actual purchase of any of our investors are funding at a – are funded at our operating subsidiary level. So whether it be signatory, be a real estate commitment, whatever turn we have on our investment portfolio is imbedded in our operating subsidiaries and does not impact parent cash. Doug Simpson – Morgan Stanley: Okay. And then, the recoverables dipped down about $90 million in the quarter. As we're looking at year or two, how should we be thinking about that in the model? Does that just continue to chip away at that clip or maybe if you could just remind us the triggers there?

Annmarie Hagan

Management

Yes. The warranted components of the reinsurance recoverables continue to be some of the divestitures we've had in the past relative to the individual business, the retirement business, and then the runoff reinsurance that I talked to you about. So it does continue to clip down over time. There's not any major acceleration, if anything at all, probably decline more slowly. Doug Simpson – Morgan Stanley: Okay. Thanks.

Operator

Operator

Thank you, Mr. Simpson. At this time, I'd like to turn the call back to Mr. David Cordani for any additional or closing comments.

David Cordani

President

Thank you. In closing, I just want to emphasize five key points to quickly wrap up. First, 2009 results represented a good outcome, both in absolute terms as well as from a competitive perspective. Second, our capital position and balance sheet are strong, and our investment portfolio continues to produce good results. Third, we believe our capabilities and our focused growth strategy match up very well with the current market needs regardless of the outcome of healthcare reform. Fourth, our 2010 earnings outlook reflects competitively attractive earnings growth in a tough economic environment, which is driven by the strength of our diversified portfolio of businesses. And finally, emerging indicators for January 1st validate early progress that we are making with our growth strategy. We want to thank you for joining today's call and have a great day.