Thomas A. McCarthy
Analyst · Deutsche Bank
Thanks, David. Good morning, everyone. In my remarks today, I will review Cigna's first quarter 2014 results and discuss our outlook for the full year. We've had a very strong start to the year, driven by continued effective execution of our strategy, with significant contributions from each of our business segments. Some key highlights from the quarter include consolidated revenues grew to $8.5 billion, driven by continued growth in our targeted markets. Consolidated earnings were $501 million. Quarterly earnings per share were $1.83, representing growth of 6% over the first quarter of 2013. And free cash flow was strong, and we returned $650 million to shareholders through share repurchases on a year-to-date basis. Overall, the strength of our first quarter performance provides us with solid momentum for the year. Regarding the segments, I will first comment on our Global Health Care segment. Global Health Care results were strong in both our Commercial and Seniors books of business. First quarter premium and fees for Global Health Care grew 3% to $6 billion. This reflects continued good growth in our Commercial business, partially offset by the expected reimbursement reduction in our Seniors business and our exit from the Limited Benefits business. We ended first quarter 2014 with 14.2 million global medical customers, growing by 90,000 customers. First quarter earnings grew 3% to $439 million and were driven by revenue growth and specialty contributions, as well as favorable medical costs across both our Commercial Employer and Seniors businesses. Turning now to medical costs. As David indicated, we continued to improve health outcomes for the benefit of our customers, driven by engagement with physicians and value-based solutions for our customers and clients. Our commercial medical cost trend continues to be among the lowest in the industry. And given that 85% of our U.S. Commercial customers are in transparent ASO funding arrangements, our clients directly benefit from these favorable medical costs. Regarding medical care ratios, in our U.S. Commercial Guaranteed Cost business, our first quarter 2014 medical care ratio, or MCR, was 76.1% on a reported basis or 78% excluding prior year reserve development. Our Guaranteed Cost results reflect continued favorable medical costs within our Employer business. Overall, we are pleased with the results of our commercial risk businesses, which continued to reflect strong pricing, disciplined underwriting and continued effective medical management and physician engagement. In our Seniors business, our first quarter MCR for Medicare Advantage was 82.7% on a reported basis or 84.1% excluding prior year reserve development. First quarter Medicare Advantage results were better than expected, with good early progress on the network and medical management actions we discussed last quarter to improve medical costs for our Seniors business. Across our Commercial and Seniors risk books of business, our first quarter earnings included favorable prior year reserve development of $30 million after tax compared to $48 million after tax in the first quarter of 2013. Moving to operating expenses. For the first quarter of 2014, the total Global Health Care operating expense ratio was 21.9%, which reflects the impact of the industry fee, which added 110 basis points to the expense ratio in the quarter, as well as efficiency gains and some favorable timing impacts. To recap, we've had a strong start to 2014 in our Global Health Care business. Now I will discuss the results of our Global Supplemental Benefits business, which continues to deliver attractive growth and profitability. Premiums and fees grew 13% quarter-over-quarter for Global Supplemental. First quarter earnings were $53 million, reflecting strong customer retention, business growth and effective operating expense management with some modest claim pressure in South Korea. For Group Disability and Life, first quarter results were strong, with premium and fee increases of 7% over first quarter 2014. First quarter earnings in our group business increased to $67 million, driven by business growth as well as lower benefit and operating expense ratios. For our Corporate and Other Operations, results totaled to an after-tax loss of $58 million for the first quarter of 2014. Overall, as a result of the continued effective execution of our strategy, our first quarter results reflect strong revenue and earnings contributions from each of our business segments, as well as continued significant free cash flow. Turning to our investment portfolio. In the first quarter, we recognized net realized investment gains of $27 million after tax, coupled with a strong net investment income result. We continue to be pleased with the quality and diversification of our investment portfolio. Now I will discuss our outlook for 2014. We expect to continue to deliver differentiated value for our customers and clients and strong financial performance for our shareholders in 2014. We continue to expect consolidated revenues to grow in the range of 4% to 7% over 2013. Our outlook for full year 2014 consolidated adjusted income from operations is now in the range of approximately $1.93 billion to $2 billion or $7.05 to $7.35 per share. This represents an increase of $0.20 per share at the midpoint over our previous expectations. Consistent with past practice, our outlook excludes any contribution from additional capital deployment and any additional prior year reserve development. I will now discuss the components of our 2014 outlook, starting with Global Health Care. We now expect full year Global Health Care earnings in the range of approximately $1.61 billion to $1.64 billion, an increase over our prior expectations. This increased outlook for Global Health Care primarily reflects first quarter favorable prior year reserve development, strong execution in both our Commercial Employer and Seniors businesses, with some offsets from the current outlook for our U.S. Individual business and the spending pattern of operating expenses for the remainder of the year. I'll now summarize some of the key assumptions reflected on our Global Health Care earnings outlook for 2014, starting with our customer base. Regarding global medical customers, we continue to expect 2014 customer growth of approximately 1% to 2%. Turning to medical costs. Our 2014 outlook continues to assume some increase in medical utilization versus current levels. For our total U.S. Commercial book of business, we continue to expect full year medical cost trend to be in the range of 5% to 6%. This strong medical cost trend result delivers value for our customers and clients across our broad array of funding types. Turning now to our medical care ratio outlook. We are pleased with the performance of our overall Commercial Guaranteed Cost book of business, particularly the Commercial Employer component of our Guaranteed Cost book. As a result, the MCR outlook for the -- our employer book remains unchanged. We are, however, increasing our outlook for our U.S. Individual book of business MCR based on our early view of results. Taken together, the 2014 medical care ratio for our U.S. Commercial Guaranteed Cost book of business is now in the range of 81% to 82.5%. For context, while our U.S. Individual business is growing in 2014, it will approximate 3% of enterprise revenues. As a result, we continue to expect the impact of the -- of this business will be manageable within our overall diversified portfolio. For our Seniors business, our Medicare Advantage MCR for 2014 continues to be in the range of 84% to 85%. Regarding operating expenses for 2014, we continue to expect our total Global Health Care operating expense ratio to be in the range of 22.5% to 23.5%. We expect the operating expense favorability that we saw in the first quarter to be offset over the balance of the year by increased spending on strategic investments and some expense timing impact. Overall, we expect full year 2014 Global Health Care earnings to be approximately $1.61 billion to $1.64 billion. The other components of our outlook are unchanged. For our Global Supplemental Benefits business, we continue to expect strong top line growth and earnings in the range of $195 million to $215 million. Regarding the Group Disability and Life business, we continue to expect full year 2014 earnings in the range of $305 million to $325 million. Regarding our remaining operations, that is, Corporate and Other Operations, we continue to expect a loss of $175 million for 2014. So all in, for full year 2014, we have increased our outlook for consolidated adjusted income from operations to a range of approximately $1.93 billion to $2 billion or $7.05 to $7.35 per share. This represents an increase of $0.20 per share at the midpoint, building on a strong 2013. Now moving to our 2014 capital management position and outlook. Overall, we continue to have good financial flexibility. Our subsidiaries remain well capitalized and are generating significant free cash flow to the parent, with a strong return on capital [indiscernible] of our business segments. Our capital deployment strategy and priorities have not changed. These priorities are: providing the capital to support the growth of our ongoing operations; pursuing M&A activity with a focus on acquiring capabilities and scale to further grow in our targeted areas of focus; and after considering these first 2 items, we would return capital to shareholders, primarily through share repurchase. Regarding free cash flow, we ended the quarter with parent company cash of approximately $475 million. During the period February 7 through April 30, we repurchased 5.4 million shares of Cigna common stock for $425 million, bringing our total year-to-date share repurchase to 8 million shares for $650 million. After considering all sources and uses of parent company cash, we now expect to have approximately $1.25 billion available for deployment during the balance of the year. This represents a $100 million increase compared to our previous capital outlook. Overall, our financial position and capital outlook remains strong. The high returns on capital from our businesses, coupled with our strong balance sheet, means that we will continue to generate significant free cash flow to deploy for the benefit of the shareholders. Now to recap, our first quarter 2014 consolidated results reflect the strength of our diversified portfolio of global businesses and continued effective execution of our focused strategy. The fundamentals in our businesses remains strong, as evidenced by our first quarter results, which reflected attractive growth and revenue earnings, favorable medical costs that directly benefit our customers and clients and continued strong free cash flow. Based on the strength of these results, we are confident in our ability to achieve our increased full year 2014 earnings outlook. With that, we will turn it over to the operator for the Q&A portion of the call.