John C. Molina
Analyst · Wedbush
Thank you, Mario, and hello, everyone. As Mario noted, this year we faced some challenges, but have made great progress, which is reflected in our fourth quarter results. Today, we reported earnings of $26 million or $0.54 per diluted share for the fourth quarter of 2012, a substantial improvement over the earnings of just $0.07 per diluted share that we reported in the third quarter, and the loss of $0.72 per diluted share for the same period last year. There was a lot of ebb and flow in this quarter: a $12 million benefit from a retroactive rate increase in California, a $30 million benefit from a prior period claims development in Texas, and a $14 million expense for potential settlements. Had we not incurred these items, earnings per share would have been about $0.26 for the quarter. But the real story of this quarter is that we have demonstrated an ability to work with our state partners to get rates right as we increase value by encouraging members and providers to access and provide care in a more cost-effective manner. That's a reassuring message as we prepare for 2013 and 2014. In the interest of time, I'm going to focus on Texas and California, but I want to point out to everyone that 7 of our 9 health plans reported a decrease in their medical care ratios from the third quarter of this year to the fourth quarter of this year. As we've discussed in the past, we usually see an increase in medical care ratios from the third to the fourth quarters. But Texas is, of course, the big story. When we reported results in the third quarter, we felt that Texas was on the right track, but we didn't yet have enough information to be certain. Today, we have that information. With the benefit of the last 3 months of the year, we are now able to review the Texas health plan's performance over the entire 10 months that have passed since the expansion took place effective March 1, 2012. In the fourth quarter, we were able to reap the benefits of our approach to patient care and provider contracting. We also recognized more revenue due to increased premium rates that more closely matched the high costs of our ABD members. The result is that our Texas health plan reported a medical care ratio of $0.78 -- 78% for the fourth quarter, with a benefit of about $30 million of lower medical cost that related primarily to the second and third quarters of 2012. However, to understand the Texas performance in the proper context, we have to assign all revenues and medical costs to their proper periods. When we do that, we can see that the medical care ratio of the Texas health plan declined from 99% in the first and second quarters of 2012 to 90% in the third quarter and 89% in the fourth quarter. This represents solid improvement that gives our shareholders a fair return, while also providing value and quality to the state of Texas. For the fourth quarter, again adjusting for a favorable out of period claims development, the Texas health plan reported pre-tax income up $4 million. We have made good on our commitment to reach breakeven by the end of 2012. While we are proud of our accomplishments in Texas, I want to be clear that we are not going to maintain a 78% medical care ratio you see reported in this fourth quarter. The adjusted medical care ratio of 89% for the fourth quarter that I mentioned a minute ago is a good starting point for 2013. California is another example of where our perseverance has paid off. You will recall that on our third quarter call, we talked about our efforts to demonstrate to the state that higher premiums for ABD members were appropriate. In the fourth quarter, we received a cumulative retroactive rate increase of approximately $12 million for our ABD members. About $4 million of this rate increase related to 2011, while about $8 million related to 2012. So just like with Texas, the medical care ratio of 89% that we reported in the fourth quarter is not indicative of where we are on a run-rate basis. When we push back the retroactive rate increase to the proper time periods, we have an adjusted medical care ratio of 94.5% for the fourth quarter. The situation in California is analogous to our situation in Texas. Our greatest challenge is among our ABD members. After adjusting for a retroactive rate increase in California, we still had a 103% medical care ratio for the ABD members in the fourth quarter of 2012. We did achieve a 10% decline in inpatient utilization between the third and fourth quarters of 2012. This activity, coupled with the rate increase, shows we are making good progress towards improved financial performance. General and administrative expenses grew to 9.7% of total revenue in the fourth quarter of 2012 from 8.3% in the third quarter. Absent $14 million of expense recognized for potential settlements in the fourth quarter, our administrative expense ratio was 8.8%. We will also continue to make the infrastructure investments necessary to support the growth opportunities we've previously identified. As of December 31, 2012, the company had cash and investments of approximately $1.2 billion. The parent company had free cash and investments of approximately $45 million. Moving on to guidance, a more comprehensive list of guidance components for our 2013 guidance can be found in today's press release. The following are some highlights, and as a reminder, all numbers are approximations: total revenue, $7 billion; medical care ratio, 88%; G&A ratio, 8.6%; income before tax, $128 million; net income, $74 million; earnings before interest, taxes, depreciation and amortization or EBITDA, $245 million; diluted EPS, $1.55; and effective tax rate, 42%. Let me speak about our tax rate for a moment. Although we have historically experienced and guided to a tax rate of about 38%, we expect that limits in compensation deductions for health insurers as a result of the Affordable Care Act will increase our tax rate. These changes to the Internal Revenue Code apply to all health insurers beginning in 2013. For our 2013 guidance, we estimate that the impact of a change in our effective tax rate from 38% to 42% results in a reduction to earnings per share of about $0.10. I also want to point out to everyone that we are now calculating our medical care ratio by dividing medical cost into revenue exclusive of premium tax. We made this change to allow for better comparability of the medical care ratio between periods for health plans operating in states where premium taxes have changed. Michigan and California reduced or eliminated their premium taxes during 2012. A complete discussion of our assumptions and risk factors associated with our guidance will be discussed at our upcoming Investor Day on February 21. So I would ask that you defer your guidance questions until then. This concludes our prepared remarks. David, we're now ready to take questions.