Gary L. Lauer
Analyst · William Blair
Good afternoon. Thanks, everyone, for joining us today as we report our second quarter 2014 results. The health insurance industry continues to undergo significant changes related to the Affordable Care Act and we continue to see the impact of these changes on our Individual & Family Plan business. Recent conflicting federal court decisions have done little to allay the uncertainty, confusion and turmoil in the health insurance markets. Our second quarter results reflect the changing health insurance industry environment. One of the factors that includes our second quarter financial results was what appeared to be a changing market landscape and participation of carriers in the individual market. We believe that as a result, the overall mix of Individual & Family Plan products selected by our paying members in the first quarter of 2014 changed compared to prior years. Given that our commission rates vary by carrier and state, the change resulted in lower second quarter individual and family health insurance commission revenue than we anticipated. Secondly, we have not received a first commission payment on a large number of applications obligations that were submitted in the first and second quarters and that were approved by carriers, which adversely impacted our second quarter membership and revenue. Additionally, due to the technology and implementation challenges of healthcare.gov and state exchanges, we were unable to address the significant demand that we generated from subsidy-qualified individuals during the open enrollment period that ended March 31, 2014, which would have translated into membership in commission revenue in the second quarter and throughout the year. Somewhat offsetting this impact during the second quarter, we saw a significant increase in applications for short-term products. A continuation of strong demand in revenues in our Medicare business and continued year-over-year growth in demand and revenue in our ancillary products business. And I'll provide more color on these points later during the call. Our financial results for the second quarter were as follows: second quarter revenues were $42.6 million and GAAP earnings per share were $0.15; EBITDA was $9.6 million and cash flow from operations was $300,000. Although second quarter Individual & Family Plan revenues were less than we have expected, at the same time, our operating expenses declined meaningfully compared to the first quarter levels driven in part by careful expense management and reduced Individual & Family Plan marketing expenses. Our balance sheet remains strong at the end of the second quarter with no debt and $70 million in cash, reflecting some of our share repurchases under our $50 million share buyback program authorized by our Board of Directors in March of this year. We began to repurchase shares in June and completed the program earlier this month. Not surprisingly, second quarter submitted applications for Individual & Family Plans were down substantially year-over-year. This decline reflects the new seasonality inherent in the Individual Health Insurance business. As a reminder, following the completion of the open enrollment period, only a small subset of consumers with qualifying life events can transact and buy major medical plans until the next open enrollment period starts on November 15. Accordingly, we expect to see another year-over-year decline in submits during the third quarter followed by a strong spike in demand in the fourth quarter. While Individual and Family health insurance application volumes declined, we generated significant demand for short-term health insurance products, with submitted applications growing 130% compared to the second quarter a year ago, and the number of approved short-term members growing in excess of 100%. We believe that much of this demand was driven by consumers buying short-term plans to bridge themselves to the next open enrollment period. Our goal is to transition many of these members to major medical policies after the open enrollment period begins this November. As I mentioned, an important factor that impacted our revenue performance this past quarter was the mix of plans selected by new Individual & Family Plan members. Going into the year, we estimated that our Individual & Family Plan commissions per member would be flat to slightly up in 2014 compared to 2013, assuming a constant product carrier mix. However, what we are finding is that the products that are paying members selected during the open enrollment period and especially in the first quarter of 2014, represented a change from our historic product in carrier mix. Some of the carriers that have been, in the past, been part of our top revenue contributors in the Individual & Family Plan business, deemphasize their participation in the individual market during the first quarter following the affordable care launch. At the same time, other carriers pursue their Individual & Family Plan business more aggressively in the marketplace. These dynamics resulted in the change in the concentration of our paying members with certain carriers, which after incorporating the positive impact of premium inflation has slightly reduced our commissions per member. Stuart will provide more color on our carrier and product mix during this call. Although the shift in mix adversely impacted our revenue, it illustrates that the eHealth Marketing and Sales process for consumers is unbiased and objective. Total membership was 1.25 million, up 14% year-over-year and down slightly sequentially. Our estimated Individual & Family Plan membership was 751,000, up slightly year-over-year and down sequentially from 800,000 we had at the end of the first quarter. The sequential decline in our estimated Individual & Family Plan membership occurred despite record submitted application volumes that we generated in the fourth quarter of 2013 and the first quarter of this year. The number of Individual & Family Plan members approved during the second quarter exceeded the number of members on submitted Individual & Family Plan applications during the same time period by more than 50,000 due to a large number of applications which had been submitted in the first quarter of 2014 but not approved until this past second quarter. While the approval rates for applications submitted during the open enrollment period were higher than what we've seen historically, we did see a decline in the percentage of approved members for which we've received a first commission payment compared to our historical experience. We believe that this step-down is driven by processing backlogs and other issues at some of our carrier partners and by members not paying for their policies at historical rates. This impacts not only our commission revenues but also our ability to record new paying members. It is difficult at this point to parse out how much of the membership shortfall was due to changing patterns of consumer behavior during the first open enrollment period versus a delay in receiving commission checks from carriers. Our Medicare business continue to grow at a fast pace outside of the Medicare annual enrollment period. Second quarter submitted applications for all Medicare products grew 52% compared to the second quarter last year. And our submitted applications for Medicare Advantage products grew 43%. We are seeing an increased contribution for Medicare Supplement products with Medicare Supplement applications growing in excess of 80% year-over-year, and contributing 17% of our total Medicare-submitted applications during the quarter. We are also beginning to ramp our sales of special needs plans for Medicare beneficiaries who were duly eligible for Medicare and Medicaid. About 9 million people in the United States are currently covered by both Medicare and Medicaid, and carriers are interested in this market. We began selling dual-eligible special needs plans this year and currently offer products from Humana, Cigna, HealthSpring and Coventry. Dual-eligible consumers can buy Medicare plans throughout the year and are not constrained by the annual enrollment period which, over time, can help increase Medicare business transacted outside of the annual enrollment period. The broker economics for dual-eligible Special Needs Plans are generally the same as the broker economics for Medicare Advantage product. In addition to our continued success with our existing Medicare carrier, such as Humana, we're also seeing an increased diversification in carrier mix with strong growth of submitted applications from recently added carriers, including United, WellCare and Coventry. The estimated number of our paying Medicare members grew 41% compared to the end of the second quarter of 2013, and we have 44% year-over-year growth of Medicare commission revenue. Total medical revenue was up 32% year-over-year. We're pleased with these results and are optimistic about growth opportunities in our Medicare business. As we continue to scale our Medicare business, we expect to see margin expansion in this business resulting from an increased member base which generates a recurring revenue stream for us. As a reminder, the retention rates and lifetime values we project are considerably higher for our Medicare Advantage and Medicare Supplement members compared to our Individual & Family Plan members. In conclusion, the challenges that we face during this transitional period under healthcare reform are far outweighed, in our opinion, by the significant opportunities related to the individual health insurance market expansion as a result of the Affordable Care Act. The record Individual & Family Plan application volumes that we generated in the first open enrollment period are a good testament to that. Over 480,000 individuals applied for Individual & Family Plans through eHealth during the open enrollment period, and the vast majority of those were not subsidy-eligible. For comparison purposes, approximately 1.2 million non-subsidy-eligible individuals applied for Individual and Family Plans through all of the government changes during the same period. We learned a lot in this past open enrollment period and the next open enrollment period in the individual market starts on November 15 of this year. We believe that we have developed an effective solution for which subsidy-eligible individuals can enroll in qualified health plans at eHealth, which could considerably expand our addressable Individual & Family Plan market compared to this past selling season. We're operating under the assumption that we are not going to get any additional functionality from the government exchanges to help us enroll individuals and subsidy-eligible health insurance through the exchanges. What they have provided to date is far from ideal, but we believe that working through different access points provided by the exchanges and also by leveraging our call center and in-house technology, we can transact large volumes of subsidy-eligible individuals in the upcoming open enrollment period. If we have had these processes in place during the last open enrollment period, we believe we could've generated significantly higher application volume based on the demand that we observed but could not address. In our Medicare business, we are preparing for the Medicare Annual Enrollment Period, which starts on October 15. We are optimistic about the opportunities in the upcoming enrollment period, given the brand name carriers and products we have on our platform, our technological capabilities, the recent acquisition of Medicare.com and the strength of demand for Medicare products that we have observed so far this year outside of the annual enrollment period. And now I'll turn the call over to Stuart.