Good morning. My name is Jackie and I will be your conference operator today. At this time, I would like to welcome everyone to the CNC Q1 2009 financial results conference call. All lines have been placed on mute to prevent any background noise. After the speakers’ remarks, there will be a question-and-answer session. (Operator Instructions) I will now turn the call over to Ed Kroll, Senior Vice President of Finance and Investor Relations for Centene Corporation. You may begin your conference.

Thank you and good morning everyone. It is Ed Kroll, Senior Vice President of Finance and Investor Relations at Centene Corporation. Thank you for joining us on today’s conference call for our first quarter earnings. Michael Neidorff, our Chairman, President and Chief Executive Officer; and Eric Slusser, Executive Vice President and Chief Financial Officer, will host this morning’s call. The call is expected to last about 45 minutes and may also be accessed through our website at www.centene.com. A replay will be available shortly after the call’s completion, also on our website at centene.com or by dialing 800-642-1687 in the US and Canada or 706-645-9291 from all other countries and the access code for those calls is 93132567. Any remarks that Centene may make about future expectations, plans and prospects constitute forward-looking statements for purposes of the Safe Harbor Provision under the Private Securities Litigation Reform Act of 1995. Actual results may differ materially from those indicated by these forward-looking statements, as a result of various important factors, including those discussed in Centene’s Form 10-Q dated today, April 28, 2009, and other public SEC filings. Centene anticipates that subsequent events and developments will cause its estimates to change. While the Company may elect to update these forward-looking statements at some point in the future, we specifically disclaim any obligation to do so. With that, I would like to turn the call over to our Chairman and CEO, Michael Neidorff.

Thank you, Ed. Good morning everyone and thank you for joining Centene’s first quarter earnings call. I will briefly review some of the highlights of the first quarter and then turn the call over to Eric, who will walk you through the financial results in greater detail. Before I discuss another solid quarter for Centene, I would like to take a moment to briefly comment on three important and timely topics. One, our first swine flu and its possible impact. Secondly, Centene’s position as a Medicaid Managed Care organization in the current economic environment, and thirdly, the impact on our business from possible federal healthcare reform. While the recently ended regular flu season was significantly lighter than last year, the very recent outbreak of so called swine flu has become the main topic of healthcare news around the world. Swine flu is a respiratory disease of pigs caused by the Type A flu virus. People do not normally get swine flu but human infections can and do happen. Swine flu virus has been reported to spread from person-to-person and is contagious. The symptoms of swine flu in people are similar to the symptoms of regular human flu and include high fever, cough, sore throat, body aches, headaches, chills, fatigue, and gastrointestinal tract related issues. Centene has a detailed response plan in place that was developed in 2006 during the bird flu pandemic scare to manage major disease outbreaks which allows us to be proactive rather than reactive in our actions. We communicate and coordinate with providers, state and local agencies and our members as we continuously monitor the disease incidents in our markets. Our NurseWise call centers are in invaluable resource in disseminating useful information on symptoms, treatment, and prevention, while there is no flu vaccine for swine flu. Antiviral…

Thank you Michael and good morning everyone. Before I discuss the first quarter financial highlights, I would like to remind everyone of two important facts from 2008. First, the 2008 first quarter results include the benefit of the July 1 through December 31st, 2007 rate increase for Georgia of $20.8 million of premium revenue or approximately $0.28 per diluted share. Second, beginning with the fourth quarter of 2008, the results of operations for University Health Plans, our New Jersey Health Plan were classified in the financial statements as a discontinued operation as a result of our intent to sell the business. The financial results discuss throughout this call will be in the context of continuing operations unless noted otherwise. In addition, beginning January 1, 2009, we have presented our investment in Access as a consolidated subsidiary in our financial statements. Access was previously in equity method investment and the earnings were recorded in other income in prior periods. For the quarter ended March 31, 2009, revenue net of premium taxes grew to $908.9 million which represents 20% growth compared to the first quarter of 2008. Excluding the Georgia rate increase recorded in 2008 the growth was 23%. The revenue increase in 2009 was driven by the following items: Organic full-risk membership growth in each of our states; the acquisition of certain assets of AMERIGROUP Community Care of South Carolina on March 1st, 2009; third, the consolidation of Access as a subsidiary as well as the conversion of non-risk Florida Access members to the full-risk Sunshine State Health Plan model starting on February 1, 2009; fourth, the commencement of the Arizona Acute Care contract in October 2008; number five would be acquisition of Celtic in July 2008; six, the commencement of the Texas Foster Care Contract in April 2008; and finally,…

(Operator Instructions) Your first question comes from the line Joshua Raskin - Barclays Capital.

First question, if you can help us out in terms of the cash flow. Seasonally, you mentioned weakest but still obviously well about net income this quarter. I was curious if there were any timing issues there specifically around the unearned premium. It is looks like that might have been affected maybe by state payment. Will that reverse in the second quarter?

Yes. The month of March, we had a couple of states that actually held payments. You will see an increase from the balance sheet on the asset side related to that. So we had two that held their payments to a month later. We had one that prepaid which is causing the change in unearned income. The other thing you will note in the cash flow is in the payables line that significant change and driver of the lower amount and that was driven mostly by the estimated federal income tax payment we made in the month of March related our finalization of ’08 earnings and taxable income.

I guess just in terms of as expectations for the second quarter then would you expect the second quarter to be slightly lower on a year-over-year basis than previously expected?

Well, we would expect our second quarter trend to be consistent with prior years and moving upwards in the range of 1.5 times to 2 times net income.

Okay, perfect. And then, second question, just do you have for New Jersey the contribution? I know you guys broke it out in terms of just continuing at last quarter but do you have a number of what the contribution was in the first quarter of ’08?

Hang on just a second. Yes, it looked surround almost a penny positive contribution.

Okay, okay. And then just last question, there is a ton of moving parts and the top line of over 20% obviously is a big number, but just trying to figure out if it is possible to strip out sort of Foster Care and Arizona and maybe South Carolina acquisition, do you guys have what you think sort of the organic? What is the organic rate of growth on revenues in the quarter?

We sometime ago said it is very difficult to comment on organic because of what is true organic if we add a new product in an existing state, is that organic? And one that we acquired, it gets too complicated. So we indicated sometime ago in the concern to not mislead but do not do something we can do comparable period-to-period. We just will not comment on that.

Yes, I guess I understand. I mean it is sort of impossible to even classify it. Maybe if I ask you a different way, it sounds like you saw low single digit rate increases. In your existing state, what would you say the membership growth was in states were you saying population year-over-year?

I think we showed you what the membership is in the tables in the news release. I cannot comment beyond that.

Your next question comes from the line of Gregg Genova - Deutsche Bank.

Looking at the MLRs a little bit, it looks like the ABD and the Medicare MLR came in pretty low in the quarter while the Medicaid and SCHIP came in a little higher. Was there any negative or favorable development in either one? And can you talk a little bit about how those kinds of work through the quarter?

Eric, do you want to comment on that?

Yes. As I comment a little bit in my comments, the ABD is driven by improvement as I talk about we saw a decline in upper respiratory disease this year in the first quarter compared the last year particularly in Ohio. There has been significant medical management efforts as I talked about, and really in all of our plans around that program as you have seen in our press release about ABD HBR was downed approximately 81%. We do not expect that that trend is going to continue with that level, but through management and efforts to improve that and again the change year-over-year in the upper respiratory disease which particularly impacts that group. We saw favorability. We typically do not comment about positive or negative prior period development. We tend to manage that process and as I indicated we serve conservatively but we show the table year-over-year development on press release and we do not comment about our quarterly over quarter development. But again, there has been significant management both network management and member management around that population and an attempt to improve it over that prior year where it was upwards of 97% HBR for the ABD.

Okay, thanks. I guess shifting over to investment income and other, obviously that is lower because the reclassification of Access but still just the core investment income is if you annualize that it comes out more towards $50 million versus I think you guys have talked about lower to 20 and you talked about the lower interest rates. So, is that being off so I would assume does that come down a little bit and has been offset by things there were in other direction? I guess you have at $0.08 a benefit from the tax rate offset by the cost from Massachusetts around $0.06 or so. So, if you talk maybe just a little bit more about around the moving parts to the guidance now.

Yes. Well, let me talk about the tax rate first. As we indicated in the first quarter that was about $0.02 of benefit which as I also indicated with the reason we took up the lower into the range. We expect the tax favorability will continue at approximately the same level of $0.02 per quarter. So, but we are also estimating that the cost of Massachusetts both start-up and the early operations until it gets to a breakeven and accretive stage will offset that for the last three quarters of this year. So, net-net, the positive from taxes will be offset by the cost of Massachusetts netting no estimated change in our run rates around those two items and in guidance for the rest of the year.

And on the investment come then, is that…?

Yes, investment income as the feds of continued to lower the rates in the first quarter, we have seen a decline in investment income. If I look at the rest of the year assuming all thing is being equal no more changes by them, looking at that line for the most part investment income and interest expense will just about net each other out to zero, and again, I will remind you that last year there was Access earnings in that other income there will be nothing in there this year related Access as we consolidate that entity.

I would add also, we have to be cautious on that tax rate going forward and that if we move from some of the municipal tax rate investments we have and others that we move that around based on what we see in the current political economic environment, that too for change. So, we manage that very carefully, recognizing or attempting to minimize risks in any investment that we have.

Yes. And there was also an element of favorability driven in that tax rate through a job’s tax credit we are getting for growth and new employee additions. So, certainly that also will be subject to our new job addition as we continue to the remainder this year.

Your next question comes from the line of Greg Nersessian - Credit Suisse.

Just a couple of questions, first is on Florida. I see you converted about 21,000 lives this quarter. Actually, we think about that ramping in over the rest of the year. There is sort of a monthly conversion figure we should expect or help us in modeling that out.

Jesse will respond that. Jesse?

Yes. The way that the Florida conversation any state version is county specific, so we are working through that conversion process right now, building out networks and in other regulatory approvals in terms of readiness, etc on a county-by-county basis. So, we have been approved in four counties. That was what converted in the fourth quarter. We have submitted additional counties to the state for approval so we expect those to come up obviously through the second half of the year. We do not expect based on the timing right now to do any conversions in the second quarter of 2009. But we obviously expect throughout to continue to work through county-by-county conversions in the second of the year.

If your penetration amongst that, it looks like this is about 90,000 non-risk lives. Is there penetration rate there that you expect or conversion rate that you can help us? About what percent is that you expect to hold on through the year?

Yes. We cannot really get into some of the specificity around that and obviously our objective can make the retention rate as high as you can and obviously to grow the business through both member choice and auto-assignment on an ongoing basis.

Okay. And then next question on Massachusetts, it sounds like you have got the start-up cost built in the business or you have not changed the revenue, so assuming no revenue impact this year from next. Can you just give us a sense of how the economics work there with your joint venture?

I think if you look at the revenue line we have a range of revenues for the year so which within that range is we see it this year.

Okay.

Okay. And we have a joint venture with the hospital and a contract within. We are managing the plan for them and we will share on equal basis as appropriate and some adjustments in there because of the nature at the hospital.

When do you expect this start generating revenue in Massachusetts?

We are hoping to start and grow slowly in July 1.

Okay. And then just last quick question and you said you added about $20 million of short term then in the quarters are attempted to repay that in the second quarter?

Well, some of that was driven by timing of the items I indicated earlier in the period. We would expect to continue to keep that balance at a moderated level but at this point there is no intention to take it downwards significantly in the second quarter.

Your next question comes from the line of Daryn Miller - Goldman Sachs.

Question on the accounts receivable or previous receive that increased during the quarter, what states was that related to?

Wisconsin and Indiana.

I got you, and that will be also had a similar situation was like third quarter of last year?

Yes. We have had actually each quarter. I do not have the specifics but each quarter we have had instances most of the time it has just been one state where they lag over the month in and into the next month. So you will see that volatility and we expect in some cases that would likely continue. It is a timing issue but there are some states in this case that held them over to the first week of the following month and then the other side of that is like Ohio where it was essentially a fully paid in this time. So, net-net, they did not quite offset the two states versus the one but there was some offset in pure cash flow because of the prepayment and postpayment.

Great and then can you comment on what you are seeing in terms of behavioral health utilization?

Bill, would you like to comment on that?

I think. It is just pretty steady between years. We have added Foster Care overall which we classified by the Medicaid segment and we are here into that program and I do not think there is anything out of the ordinary at this point.

Okay. And then one last one, the services revenue line increased $6 million. I am sorry if I missed your comments on what was driving that.

That is the consolidation of Access.

Okay.

The Access is the non-risk membership, ASO membership and that gets recorded in the service line.

I got you, and that is what about $2 million-ish?

About $6 million-ish.

Is that what was running about last year too? Because it was all of that in the other line of investment and other in revenue last year?

On the investment line, the other income is just the net earnings impact.

I got you.

Percentage that is only our portion of the earnings, we now consolidated and under consolidation you show 100% and then you net out the minority interest impact.

(Operators Instructions) There are no more questions in queue.

Well, we thank everyone and look forward to call again at the end of Q2, and we would remind you that we have our Investor Day coming up so look forward to seeing you there as well on June 2nd. Thank you.

This concludes today’s conference call. You may now disconnect.