Douglas Sharp
Analyst · Jim MacDonald from First Analysis. Your lines open
Thanks Paul. Now, let me begin by discussing further details of our third quarter results. Average paid worksite employees increased 12% over Q3 of 2018 with a sequential increase of 4% over Q2 of this year. Higher than expected benefit cost resulted in just a 3% increase in gross profit over the third quarter of 2018. These higher benefit costs of approximately $18 million were slightly offset by favorable results in other areas of gross profit and operating costs, but drove the decline in adjusted EBITDA to $51 million and adjust EPS to $0.75. Now upon receipt of our third quarter healthcare claims data in October and our subsequent analysis of this data, we determined that these higher benefit costs were primarily driven by elevated large claim activity, which declined from Q2, but did not return to historical levels. Two consecutive quarters of large healthcare claim payments at these elevated levels is a historical anomaly for us. Additionally, we have historically had a strong track record in predicting our total claim costs on an annual basis. It appears that 2019 will be an exception due to this recent spike in large claims. In light of this, we have spent an extensive amount of time drilling into the details of claims data with the assistance of our insurance carrier, in order to determine the root cause of the elevated claims, and whether anything systemic has changed in our plans. Based upon our review of the detailed data we have determined the following. First, it's clear that only a relatively small number of claimants rather than something pervasive over our entire participant face negatively impacted our healthcare costs in Q2 in Q3. An analysis of large claims over the past two years indicated a recent spike in activity related to participant with claims exceeding $250,000 a year. These jumbo claims from a very small number of participants were the primary driver behind our claim dollars exceeding expectations by approximately $27 million over the past two quarters. As a second finding our insurance carrier confirm that there is an element of randomness in the recent elevated large claim activity, and there is an expectation that it will revert back to a normal level. The recent increase in the frequency of claimants with jumbo claims is above the level of our insurance carriers fully insured book of business whereas prior to this activity, we have historically been in line or below their book. Thirdly, an analysis of claims over $100,000 over the course of the two quarters shows that the claims were largely from different participants, as opposed to ongoing claims from the same group of participants. The fact that the two consecutive quarters of large claim activity were driven by two largely different groups of participants, further points to the randomness of these two isolated events. Fourthly, a review of the clients associated with these large claims did not indicate a concentration associated with new clients. And therefore would indicate that this was not driven by adverse client selection. And finally, our comprehensive review of overall plan participant demographics such as age, gender, geographic mix, overall inpatient hospital stays, and plan migration continues to point that to favorable trends of our health plan as a whole. Accordingly, based upon our detailed review, our best estimate is that the spike in large claim activity during 2019 is a historical anomaly and we expect the large claim activity to normalize. Now, even though the claims data doesn't appear to point to an ongoing issue with our health plan, we believe it is prudent to take a more conservative approach to estimating benefit costs for the fourth quarter by not assuming a further reduction in large claim levels for the remainder of 2019. And when taking a look at the full year, you may recall that we began 2019 estimating an expected benefit cost trend of 2% to 3% over 2018. Year-to-date results combined with our revised Q4 forecast yields a cost trend of approximately 3.7% which is still favorable to trend seen in the marketplace. The elevated large claim activity fully accounts for the incremental trend over the midpoint of our initial budget. As we look forward to 2020 and enter a new plan year. Our detailed claims data does not indicate the level of large claim activity will compound by increasing over the recent elevated rate. Under this scenario, we would expect 2020 to return to a more normalized benefit cost trend over 2019 costs. And we are pricing our new and renewing business accordingly. Considerable pricing strength throughout 2019 in other areas of gross profit combined with favorable calls trends in our other direct cost areas, and the traction we are gaining in workforce acceleration contributes to our outlook for gross profit improvement in 2020. And any reversion of large claim activity back to our lower levels would reduce our 2020 benefit cost trend and further improve our gross profit. Now shifting to our balance sheet and cash flow, we ended the second quarter with $131 million of adjusted cash and $239 million of debt outstanding on our recently expanded $500 million credit line. We have now repurchased one and a half million shares in 2019, including 1.2 million shares in Q3. When combined with dividend payments totaling $37 million, we have returned just over $190 million to shareholders thus far in 2019 as we continue to invest in the long-term growth of the business. Now before we open up the call for request for questions, I'd like to provide an update to our full year 2019 forecast. As Paul just mentioned, we are now forecasting 13% growth in average paid worksite employees for the full year 2019. Our updated 2019 earnings guidance takes into account this revised growth forecast, the recent elevated large claim activity and our conservative approach to estimating Q4 benefit costs. With this in mind, we're now forecasting full year 2019 adjusted EPS in a range of $4.08 to $4.20, and adjusted EBITDA in a range of $247 million to $253 million. While we are obviously disappointed in the effect of elevated healthcare costs in our 2019 results, we still plan on completing the year with both in industry leading worksite employee growth rate and profitability for worksite employee. We're currently going through our normal budgeting process for 2020. And we'll provide our detailed guidance on our next earnings call. Based upon our current outlook, including our earlier comments in the areas of worksite employee growth and gross profit, we expect 2020 earnings growth to be improved, and not indicative of the latter half of 2019. Now at this time, I'd like to open up the call for questions.