© 2017 MOLINA HEALTHCARE, INC.
February 16, 2017
New York, New York
Investor Day
2017A
© 2017 MOLINA HEALTHCARE, INC.
2
Cautionary Statement
Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995: This slide presentation and our accompanying
oral remarks contain numerous “forward-looking statements” regarding, without limitation: our 2017 financial outlook and business
expectations for 2017; expected rate changes in 2017; potential efforts to repeal and replace the Affordable Care Act; potential changes
in the Medicaid program, including changes in funding mechanisms or the switch to state block grants; Marketplace product and
performance issues, including rate adequacy, the Marketplace risk transfer methodology in 2017, cost sharing reductions and premium
subsidies, the individual mandate, the special enrollment period, potential effects of announced market exits, and pending Marketplace
risk corridor litigation; our expected operational improvements and profit improvement initiatives; general changes in the health care
industry; the continued growth of the Company, including continued expansion into Medicare Advantage and Long Term Services and
Supports; our quality improvement initiatives; medical expense seasonality; our success in securing reprocurements of existing contracts
in Illinois, Washington, Florida, Texas, and New Mexico; projected improvements in our medical care ratio and administrative costs;
expected revenues from investment income; our projected effective tax rate; and various other matters. All of our forward-looking
statements are subject to numerous risks, uncertainties, and other factors that could cause our actual results to differ materially from
those projected in each forward-looking statement. Anyone viewing or listening to this presentation is urged to read the risk factors and
cautionary statements found under Item 1A in our Annual Report on Form 10-K, as well as the risk factors and cautionary statements in
our Quarterly Reports on Form 10-Q, in our Current Reports on Form 8-K, and in our other filings with the Securities and Exchange
Commission and available for viewing on our website at sec.gov. Except to the extent required by federal securities laws, we do not
undertake to address or update forward-looking statements in future filings or communications regarding our business or operating
results.
© 2017 MOLINA HEALTHCARE, INC.
3
Investor day 2017A
Approx. Time Topic Speaker
12:30pm-12:35pm Opening Remarks Juan José Orellana, SVP Investor Relations
12:35pm-1:20pm Business Overview
J. Mario Molina, MD, Chief Executive Officer;
Terry Bayer, Chief Operating Officer
1:20pm-1:35pm Q&A
1:35pm-1:40pm Break
1:40pm-2:10pm Marketplace Joseph White, Chief Accounting Officer
2:15pm-3:00pm 2017 Outlook
John Molina, Chief Financial Officer;
Joseph White, Chief Accounting Officer
3:00pm-3:30pm Q&A
3:30pm End of Program
Agenda
© 2017 MOLINA HEALTHCARE, INC.
February 16, 2017
New York, New York
Investor Day
J. Mario Molina, MD
President & Chief Executive Officer
2017A
© 2017 MOLINA HEALTHCARE, INC.
5
Our mission
To provide quality health care to people receiving government assistance
© 2017 MOLINA HEALTHCARE, INC.
6
Our footprint today
Health plan footprint includes the 5 largest Medicaid markets
Total enrollment relates to membership as of December 31, 2016
Member Mix
4.2M
Members
Puerto Rico
USVI
Molina Health plans
Molina Medicaid Solutions
Primary Care Direct delivery
Pathways by Molina
1% Medicare
60%
TANF &
CHIP
16%
Expansion
9%
ABD
13%
Marketplace
1% Duals
© 2017 MOLINA HEALTHCARE, INC.
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Strong topline growth amidst Marketplace headwinds
2016 Marketplace loss significantly impacted EBITDA
Membership
1.8M
1.9M
2.6M
3.5M
4.2M
1M
2M
3M
4M
5M
2012 2013 2014 2015 2016
5.9B
6.6B
9.7B
14.2B
17.7B
$0B
$4B
$8B
$12B
$16B
$20B
2012 2013 2014 2015 2016
Total Revenue
$115M
$225M
$305M
$508M
$399M
$0M
$100M
$200M
$300M
$400M
$500M
$600M
2012 2013 2014 2015 2016
EBITDA
Marketplace
Impact
© 2017 MOLINA HEALTHCARE, INC.
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Driving profitability
Marketplace risk transfer payments
Premium rate increases in Illinois, Ohio and Washington
Need for ongoing operational improvements
Redirection, reduce hospitalization, leverage technology, integrate
behavioral health, care coordination
© 2017 MOLINA HEALTHCARE, INC.
9
Marketplace
Dramatic year over year growth in enrollment
Government must address these key elements that are
needed to stabilize the program long term:
1. Address issues around the special enrollment period (SEP)
2. Improve the risk transfer methodology
3. Cost sharing reductions (CSRs) and premium subsidies
must continue
4. The purchase of health insurance must continue to be a
requirement
1Q14 1Q15 1Q16 1Q17E
266K
630K
1.0MMolina Marketplace
Enrollment Growth
8K
© 2017 MOLINA HEALTHCARE, INC.
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Decisive actions with Marketplace
Our approach may affect Marketplace sales, but will also reduce our business risk
Increased premiums approximately 15% across all
markets (range +6% to +37%)
Premium deficiency reserve recorded in 4Q for 2017
Evaluate 2018 Marketplace participation based on:
State by state performance
Policy and program developments
Federal government risk corridor litigation
~ $52M for 2015
~$90M in 2016
Molina Marketplace
Avg. Premium Increase
-6.5%
-1.5%
+15.0%
2015 2016
2017
© 2017 MOLINA HEALTHCARE, INC.
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Proposed Marketplace Rules
New regulations are helpful, comments due back March 7th
Source: https://federalregister.gov/d/2017-03027
Guaranteed Availability
Closes loophole that allows consumers who do not pay premiums then re-enroll in next open enrollment
Open Enrollment
November 1 – December 15
Simplifies things for consumers and plans
Special Enrollment Period
Tightens pre-enrollment verification to 100%
Begins June 2017
Limits ability to change metal tiers
Broader Actuarial Ranges
Gold 76% – 82%
Silver 66% – 72%
Bronze 56 %– 65%
No change to silver CSR
© 2017 MOLINA HEALTHCARE, INC.
12
We are improving the strength of our core business
Strengthen operational performance
1.5%-2.0% margin target now a longer term goal in light
of 4Q results and political uncertainty
Appropriate documentation of medical conditions
Continue to lower hospital utilization
Continue to improve quality scores Risk-based health plan
outsourcing for Medicaid,
Medicare, and other
government programs.
Government
Health Plans
© 2017 MOLINA HEALTHCARE, INC.
13
Aligning the organization for better results
Our mission driven team continues to be a major strength
Reviewing how to best evolve our operating model in
response to:
Company scale and maturity
Dynamic industry context
Identification of team strength, development areas, and
talent
Identifying implementation priorities
© 2017 MOLINA HEALTHCARE, INC.
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An industry in transition
The government health care space is complex and changing rapidly
ProvidersMembers State & Federal GovernmentCost Trends & Public Health
People aged >65 years will
make up 20% of the nation’s
population by 2030; driving
growth in Medicare
enrollment.
61% of Long Term Services &
Support paid by Medicaid.
Mental Health Parity.
National prescription drug
spending is expected to
continue growing at 7% per
year for the next decade.
U.S. becoming more
vulnerable to diseases not
seen in the U.S. (e.g. Zika).
ACA revisited
Spending on government
healthcare rising faster than
spending on social security and
other programs.
Medicaid program expected to
experience enrollment and
spending increases across most
eligibility groups.
Greater consolidation among
providers seeking additional
scale.
Greater vertical integration
health plan & direct delivery.
© 2017 MOLINA HEALTHCARE, INC.
151. MAC Stats Data Book December 2016, US Census, CMS office of the Actuary
Johnson
1965
Established
Medicaid &
Medicare
Programs
Clinton
1997
State
Children’s
Health
Insurance
Program
(SCHIP)
Bush
2003
Medicare
Modernization
Act
Obama
2010
Affordable
Care Act
Trump
2017
…
Molina responds and adapts
Molina has a proven track record in responding to changes in government programs
C. David Molina
1969
Obtains MPH at
UCLA
1980
Medicaid focused primary care
clinics founded in California
2000
Awarded first SCHIP contract
2005
Awarded Medicare Advantage
Special Needs Plan contracts
2013
Medicaid Expansion,
Marketplace, Dual Eligible
Demonstration Programs
1984
Awarded first Medicaid
HMO contract
Molina Healthcare
Response
123 Million
Currently enrolled
Medicaid & Medicare
beneficiaries1
4.2 Million
Medicaid & Medicare
Beneficiaries enrolled
with Molina
© 2017 MOLINA HEALTHCARE, INC.
16
Our toolkit for responding to industry changes & customer needs
Product portfolios
Risk-based health plan
outsourcing for Medicaid,
Medicare, and other
government programs.
Company owned and operated
primary care clinics.
Medical Services
Primary Care
Provider network of outcome
based behavioral/mental
health and social services.
Medical Services
Behavioral Health
Government
Health Plans
Medicaid non-risk fee based
fiscal agent services, business
process outsourcing, and care
and utilization management.
Medicaid Health
Information Management
© 2017 MOLINA HEALTHCARE, INC.
17
Demand for low-cost health insurance will continue
States that have expanded Medicaid1
1. http://kkf.org/health-reform
2. http://www.cnbc.com/2016/06/13/obamacare-repeal-would-lead-to-24-million-more-people-without-health-insurance.html
Puerto Rico
USVI Number of Americans that currently receive their
care through Medicaid Expansion and Marketplace
products
24 Million2
Democratic States that
have expanded Medicaid
Republican States that have
expanded Medicaid
Healthcare is a growing
portion of federal and state
budgets
Long term care needs of baby
boomers
Growing cost of drugs
(specialty and generic)
Current and emerging public
health threats (e.g. Zika, etc.)
© 2017 MOLINA HEALTHCARE, INC.
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Positions on Approaches for ACA Replacement
Maintain Coverage for Low-Income Populations
Medicaid is a more affordable way to provide insurance
Move high-cost fee for service Medicaid services to
managed care to reduce cost (e.g. long term care)
Leverage expertise & experience of MCOs in replacement
planning
Advantages of Managed Care
Budget certainty (capitation)
Patients with complex needs drive public healthcare
spending
MCOs deliver high-quality, cost-effective care and provide a
source of fiscal stability
© 2017 MOLINA HEALTHCARE, INC.
19
The Washington debate on healthcare
How do we fund government sponsored health care?
Government
contributes to health
care coverage;
sometimes
beneficiary also
contributes.
Defined Benefit VS Defined Contribution
Beneficiary
contributes to
health care
coverage;
sometimes
Government
also contributes
Beneficiary
generally chooses
how health care is
consumed.
Federal/State
Governments generally
choose how health
care is consumed.
(Entitlement Program)
© 2017 MOLINA HEALTHCARE, INC.
20
Proposed funding mechanisms for Medicaid
Under current law eligible individuals have an entitlement to coverage and states are guaranteed federal
matching dollars with no pre-set limit
BLOCK GRANTS VS ‘PER CAPITA CAPS’
COVERAGE No Guarantee
FUNDING Capped; fixed amount not based on enrollment, costs or program needs
BASELINE
Fixed with pre-set growth rate
Trend factor used to determine growth rate is
critical
CONSIDERATIONS
Cannot adjust for enrollment during economic
down-turns
Constrained to respond to cost shocks (e.g.
Sovaldi, Zika)
MARKET COMPS Puerto Rico’s Medicaid program pre-ACA funded by a block grant
May be Guaranteed
Fixed with pre-set growth per enrollee
Baseline (fast vs. slow growing states) & future
growth rate critical
Capped; fixed amount per enrollee; not based
on health care costs and needs
Can expand/contract with number of enrollees
Constrained to respond to cost shocks (e.g.
Sovaldi, Zika)
Similar to current health plan PMPM funding but
for States; cost control very important
© 2017 MOLINA HEALTHCARE, INC.
21
Proposed funding mechanisms for Medicaid
Other plans
Cassidy Collins
Price Plan
Ryan Plan
Molina Plan
© 2017 MOLINA HEALTHCARE, INC.
22
But we are having the wrong debate
Medicaid Fee-for-Service expenditures remain high…
Sources:
1. CMS Medicaid Managed care Enrollment and Program Characteristics, 2014 – Published spring 2016
2. MAC Stats Data Book December 2015
62%
of Medicaid spending
remains in Fee-for-Service
$468B72M
24%
76%
62%
38%
55M
17M
$177B
$291B
Medicaid Enrollment 2014 Medicaid Benefit Spending 2014
Fee-for-Service
Managed Care
Managed care organizations and Fee-for-Service FY 2014
© 2017 MOLINA HEALTHCARE, INC.
23
Continued growth in Medicaid Managed Long Term Services & Support
MLTSS provides community-based services, in-home support, senior services and long-term nursing home care.
1. Medicaid Expenditures for Long-Term Services and Supports (LTSS) in FY 2014, April 15, 2016. https://www.medicaid.gov/medicaid/ltss/downloads/ltss-expenditures-2014.pdf
Puerto Rico
USVI Molina MLTSS Footprint
$6.6B $7.3B
$8.2B
$10.0B
$14.5B
$22.5B
2009 2010 2011 2012 2013 2014
Spending Growth in MLTSS1
$19 Billion is still in Fee-For-Service
© 2017 MOLINA HEALTHCARE, INC.
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Molina Medicare-Medicaid Plan (MMP) footprint
Puerto Rico
USVI
Molina Medicare-Medicaid Plans
…and per capita Medicare-Medicaid spending for the dual eligible is more than 4X per capita spending for
other Medicare beneficiaries.1
Sources:
1. The Diversity of Dual Eligible Beneficiaries, Kaiser Family Foundation April 2012.
© 2017 MOLINA HEALTHCARE, INC.
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Strategic foundation driving execution
1
2
3
4
our strategic foundation
Sticking to our knitting
Government programs (Medicaid,
Medicare, Marketplace, LTTSS)
Focus on care
management
Administrative
efficiency
Care model, social
determinants of health
Leverage scale & lower costs
Augment brand
development
Government program toolkit,
greater member and provider
connection, customer experience
© 2017 MOLINA HEALTHCARE, INC.
2017A: Molina Healthcare Investor Day
February 16, 2017
New York, New York
Business Review
Terry Bayer
Chief Operating Officer
© 2017 MOLINA HEALTHCARE, INC.
27
Our toolkit for responding to industry changes & customer needs
Product portfolios
Risk-based health plan
outsourcing for Medicaid,
Medicare, and other
government programs.
Company owned and operated
primary care clinics.
Medical Services
Primary Care
Provider network of outcome
based behavioral/mental
health and social services.
Medical Services
Behavioral Health
Government
Health Plans
Medicaid non-risk fee based
fiscal agent services, business
process outsourcing, and care
and utilization management.
Medicaid Health
Information Management
© 2017 MOLINA HEALTHCARE, INC.
28
Diverse $16 billion premium revenue base
1. Premium revenue as reported for the Year ending December 31, 2016
2. The Total Care transaction in New York, closed on August 1, 2016
Washington 14%
Utah 3%
Texas 15%
Ohio 12%
New Mexico 8%
Illinois 4%
Florida 12%
California 14%
Wisconsin 2%
New York 1%2
Puerto Rico 4%
South Carolina 2% Michigan 9%
Risk-based health plan
outsourcing for Medicaid,
Medicare, and other
government programs.
Government
Health Plans
Premium Contribution by State1
© 2017 MOLINA HEALTHCARE, INC.
Premium
Revenue
29
Revenue diversification through expansion into new products
Effect of Molina’s changing patient mix on revenue, by product
1. TANF includes CHIP membership, and starting in 2014, Medicaid Expansion membership
$9.0B $13.2B$3.1B
2015A2014A2008A
52%
Marketplace 5%
TANF131%
ABD
Medicare 4%
Duals 8%
ABD
$16.3B
2016A
TANF1
79%
TANF
18%
Medicare 3%
51%
Marketplace
Duals
8%
9%
29%
ABD
Medicare 3%
TANF1
ABD
54%
Marketplace 1%
TANF136%
ABD
Medicare 7%
Duals 2%
© 2017 MOLINA HEALTHCARE, INC.
30
Strategic foundation driving execution
1
2
3
4
1
2
3
4
our strategic foundation our tactical execution
Sticking to our Knitting
Government programs (Medicaid,
Medicare, Marketplace, LTTSS)
Focus on care
management
Administrative
efficiency
Care model, social
determinants of health
Leverage scale & lower costs
Augment brand
development
Government program toolkit,
greater member and provider
connection, customer experience
Lower medical costs
Grow higher margin
business
Leverage our skills from
Marketplace for Medicare
Quality
© 2017 MOLINA HEALTHCARE, INC.
31
Lowering medical costs
1
2
3
4
our tactical execution
Lower medical costs
Grow higher margin
business
Leverage our skills from
Marketplace for Medicare
Quality
$288.84
$300.43
$292.75
2014A 2015A 2016A
PMPM Medical Costs Per member per month medical costs are about 3%
lower year over year by:
Directing members to high performing
networks
Reducing hospitalizations
Leveraging technology
Integrated behavioral and physical health
solutions
Overall care coordination
Contributing to higher margins
© 2017 MOLINA HEALTHCARE, INC.
32
Leveraging our skills for Marketplace to Medicare
1
2
3
4
our tactical execution
Lower medical costs
Grow higher margin
business
Leverage our skills from
Marketplace for Medicare
Quality
Learning from our Marketplace product is
transferable to our MA market entry initiatives
Dir ct marketing and sales
Distribution/Broker channel management
Brand awareness & development
1 out of 3 adult individuals <250% of FPL in
our markets know the Molina brand name
1Q14 1Q15 1Q16 1Q17E
266K
630K
1.0M
8K
Molina Marketplace
Enrollment Growth
© 2017 MOLINA HEALTHCARE, INC.
2006 2007 2008 2009 2010 2012 2013 2014 2015 2016 2017 2018
33
Medicare
Disciplined history of expansion
1. Additionally tested Medicare Advantage in a certain existing markets
2010 D-SNP
Florida, Ohio
2006 D-SNP Start up:
California, Michigan, Utah,
Washington
2008 D-SNP1
New Mexico, Texas
2014: D-SNP and Duals
D-SNP:
Wisconsin
Duals:
California, Illinois, and Ohio
2015 Duals
Michigan, South Carolina,
Texas
2018: D-SNP and Medicare
Advantage
D-SNP:
Idaho, South Carolina
Medicare Advantage:
California, Idaho, New Mexico,
Virginia, and Washington
© 2017 MOLINA HEALTHCARE, INC.
34
Our Medicare business continues to grow
1. Kaiser Family Foundation, Medicare Advantage Fact Sheet, May 2016. http://kff.org/medicare/fact-sheet/medicare-advantage/
2. http://kff.org/medicare/issue-brief/income-and-assets-of-medicare-beneficiaries-2014-2030/
$0.4B $0.5B
$0.5B
$0.8B
$1.6B
$1.8B
2011 2012 2013 2014 2015 2016
As Medicare revenues continue to grow…
69% 31%
Traditional
Medicare
Medicare
Advantage
HMO 64%
Local PPO 23%
Regional PPO 7%
PFFS 1%
Other 4%
Distribution of Enrollment in Medicare Private Plans,
by Plan Type, 2016
50% of all Medicare beneficiaries in the U.S. had incomes below $24,1502
… the opportunity remains large
Medicare Revenue
18 Million1
Number of Americans enrolled in Medicare
Advantage.
© 2017 MOLINA HEALTHCARE, INC.
35
Pursuing higher margin business
1
2
3
4
our tactical execution
Lower medical costs
Grow higher margin
business
Leverage our skills from
Marketplace for Medicare
Quality
Expanding Medicare where 2% of our members drive 22% of our medical margin
Puerto Rico
USVI
Special Needs Plan
Medicare-Medicaid Plan
SNP + MMP
3 year Medicare expansion roadmap
2018 targeting 4 existing states and
1 new entry for MAPD
Focus on high-performing networks
and value-based contracts
Up to 250% of the FPL
Current Footprint includes 7 of the 10 largest Medicare Advantage markets1
1. Source: CMS January 2017 Medicare eligibles
© 2017 MOLINA HEALTHCARE, INC.
36
Pursuing higher margin business
1
2
3
4
our tactical execution
Lower medical costs
Grow higher margin
business
Leverage our skills from
Marketplace for Medicare
Quality
Continuing to pursue organic LTSS opportunities
$124B
$131B
$139B $140B $141B
$146B
$54B $59B
$67B $68B $70B
$75B
$70B $72B $73B $72B $72B
$71B
2008 2009 2010 2011 2012 2013
U.S. Medicaid Expenditures for LTSS1
2008-2013
1. Truven Health Analytics, Medicaid Expenditures for Long-Term Services and Supports (LTSS) in FY 2013, June 30, 2015
Total (HCBS + Institutional)
HCBS
Institutional
What are Managed Long Term Services and Support?
Enables an individual to remain in their home or a community based setting,
provides services and addresses barriers to social determinants of health.
Provides long term care (residential) when needed.
© 2017 MOLINA HEALTHCARE, INC.
37
Continued growth in Medicaid Managed Long Term Services & Support
MLTSS provides community-based services, in-home support, senior services and long-term nursing home care.
1. Medicaid Expenditures for Long-Term Services and Supports (LTSS) in FY 2014, April 15, 2016. https://www.medicaid.gov/medicaid/ltss/downloads/ltss-expenditures-2014.pdf
Puerto Rico
USVI Molina MLTSS Footprint
$6.6B $7.3B
$8.2B
$10.0B
$14.5B
$22.5B
2009 2010 2011 2012 2013 2014
Spending Growth in MLTSS1
$19 Billion is still in Fee-for-Service
© 2017 MOLINA HEALTHCARE, INC.
38
Augmenting brand development through quality
1
2
3
4
our tactical execution
Lower medical costs
Grow higher margin
business
Leverage our skills from
Marketplace for Medicare
Quality
States link reimbursement and patient assignment
to quality scores
Medicare links quality scores to our premium rates
STAR ratings
HEDIS scores
Why does quality matter?
MI, UT
NM, OH, TX, WA
CA, FL, SC, WI
2016 – 2017
NCQA Overall Medicaid Quality Rankings1
NM
CA
FL, MI, TX, UT, WA
2017
Medicare Star Ratings
1. http://healthinsuranceratings.ncqa.org/2016/Default.aspx
2. http://healthaffairs.org/blog/2014/09/22/medicare-advantage-stars-systems-disproportionate-impact-on-ma-plans-focusing-on-low-income-populations/
NCQA Commendable Accreditation – Medicaid and Marketplace
NCQA Multicultural Healthcare Distinction
NCQA Commendable Accreditation – Medicaid
NCQA Multicultural Healthcare Distinction
NCQA Commendable Accreditation – Medicaid
NCQA Accredited Accreditation – Marketplace
NCQA Multicultural Healthcare Distinction
NCQA Accredited Accreditation – Medicaid
NCQA Multicultural Healthcare Distinction
© 2017 MOLINA HEALTHCARE, INC.
39
Q&A
© 2017 MOLINA HEALTHCARE, INC.
2017A: Molina Healthcare Investor Day
February 16, 2017
New York, New York
Marketplace
Joseph White
Chief Accounting Officer
© 2017 MOLINA HEALTHCARE, INC.
41
Cautionary Statement
Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995: This slide presentation and our accompanying
oral remarks contain numerous “forward-looking statements” regarding, without limitation: our 2017 financial outlook and business
expectations for 2017; expected rate changes in 2017; potential efforts to repeal and replace the Affordable Care Act; potential changes
in the Medicaid program, including changes in funding mechanisms or the switch to state block grants; Marketplace product and
performance issues, including rate adequacy, the Marketplace risk transfer methodology in 2017, cost sharing reductions and premium
subsidies, the individual mandate, the special enrollment period, potential effects of announced market exits, and pending Marketplace
risk corridor litigation; our expected operational improvements and profit improvement initiatives; general changes in the health care
industry; the continued growth of the Company, including continued expansion into Medicare Advantage and Long Term Services and
Supports; our quality improvement initiatives; medical expense seasonality; our success in securing reprocurements of existing contracts
in Illinois, Washington, Florida, Texas, and New Mexico; projected improvements in our medical care ratio and administrative costs;
expected revenues from investment income; our projected effective tax rate; and various other matters. All of our forward-looking
statements are subject to numerous risks, uncertainties, and other factors that could cause our actual results to differ materially from
those projected in each forward-looking statement. Anyone viewing or listening to this presentation is urged to read the risk factors and
cautionary statements found under Item 1A in our Annual Report on Form 10-K, as well as the risk factors and cautionary statements in
our Quarterly Reports on Form 10-Q, in our Current Reports on Form 8-K, and in our other filings with the Securities and Exchange
Commission and available for viewing on our website at sec.gov. Except to the extent required by federal securities laws, we do not
undertake to address or update forward-looking statements in future filings or communications regarding our business or operating
results.
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
42
Marketplace pretax bridge 2016 pricing to reported
Note: Other includes out of periods adjustments, premium deficiency reserve and administrative costs
(60.3)
$60M
($110M)
($325M)
$35M
Risk Transfer
Payments
Other items
including premium
deficiency reserveLower than
anticipated
medical costs
2016 Pricing
Expected pre-tax
$35M
$120M
2016 Reported
pre-tax
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
43
Marketplace profitability
Marketplace MCR including broker and exchange fees
84%
74%
93% 86%
4%
12%
11%
9%88% 86%
104%
95%
2014 2015 2016 2017 Outlook
MarketPlace MCR Broker Commissions & Exchange Fees as a % of Premium Revenue
Pure period MCR ~87%
MCR without PDR
reversal ~87%
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
Plan Year 2015 2016 2017
California 2% -8% 6%
Florida -9% 0% 17%
Michigan -22% -9% 3%
New Mexico -11% -3% 24%
Ohio -22% -6% 2%
Texas -14% -7% 10%
Utah -11% 0% 37%
Washington -10% -12% 8%
Wisconsin -11% 0% 27%
44
Marketplace rate changes
In 2017 we priced 15% higher
-7%
-1%
15%
2015 2016 2017
© 2017 MOLINA HEALTHCARE, INC.
Marketplace medical cost trend
4%
11%
19%2017 Outlook
2017 Pricing
2016 Actual
45
Please refer to the Company’s cautionary statement
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
Marketplace risk transfer
% of Gross Revenue (pure period)
O = Outlook
$2M
($254M)
($522M
)
($708M)
29%
2014 2015 2016 2017 Pricing 2017O
Risk Transfer ($2M) $254M $522M $710M $980M
Net Revenue $59M $630M $1,620M $2,970M $2,660M
71%
27%
73%
81%
76%
19%
24%
29%
46
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
Scenario 1 - risk transfer calculated on premium
Industry MOH Competition
Premium 100 90 110
Medical Cost 80 64 96
Risk Transfer -20 20
Gross Margin 20 6 34
Relative Risk 1 -0.2 0.2
MCR before RT 80% 71% 87%
MCR including RT 80% 93% 69%
Difference 0% 22% -18%
Percentage transferred 4%
Scenario 2 - risk transfer calculated on medical cost
Industry MOH Competition
Premium 100 90 110
Medical Cost 80 64 96
Risk Transfer -16 16
Gross Margin 20 10 30
Relative Risk 1 -0.2 0.2
MCR before RT 80% 71% 87%
MCR including RT 80% 89% 73%
Difference 0% 18% -15%
Percentage transferred 3%
47
Risk transfer methodology
The risk transfer (RT) payment methodology encourages higher premiums
RT = risk transfer
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
Marketplace risk transfer
Impact of 2018 methodology
RT= Risk Transfer
P = Pricing
O - Outlook
$2M
State wide average
premium multiplied by
86%
Changes to the MarketPlace
risk transfer methodology1
1. https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-
30433.pdf
2014 2015 2016 2017P 2017O
RT Savings ($0.2M) $36M $73M $99M $137M
RT '18 Methodology ($1M) $219M $449M $609M $843M
$980M
$708M
$522M
$255M
($1M)
48
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
49
Marketplace risk corridor
$52M
$90M
$(5M) $(2M) $(1M)
2014 2015 2016
Due from Fed Paid by Molina
$ -
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
50
Higher acuity equals higher margins
The risk model overcompensates for high acuity
Every cohort with at least one HCC
shows an MCR <=71%
People with claims but no HCCs were the least
profitable members
M
e
m
b
e
r
s
h
i
p
%
MCR by HCC and Year
0 HCC Has
Claims
1 HCC 2 HCC 3 HCC 4 HCC 5+ HCC Total
2016 Membership 42% 11% 2% 1% 0% 0%
2016 MCR 193% 64% 64% 70% 69% 71% 78%
2016 Average 78% 78% 78% 78% 78% 78% 78%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
0%
20%
40%
60%
80%
100%
120%
140%
M
C
R
20
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
Pent up demand
Partial year duration
risk scores
Q3 2016
Measure Continuous Lapse New Total
Risk Score 1.27 1.09 1.01 1.25
Direct MCR 87% 61% 144% 88%
Q4 2016
Measure Continuous Lapse New Total
Risk Score 1.25 1.39 0.80 1.23
Direct MCR 92% 78% 185% 95%
51
Why SEP is more expensive
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
Marketplace
Non Marketplace
Quarter 1 Quarter 2 Quarter 3 Quarter 4
Marketplace 0.89 0.92 1.05 1.14
Non Marketplace 1.00 0.99 0.99 1.01
0.80
0.85
0.90
0.95
1.00
1.05
1.10
1.15
1.20
Marketplace
Utilization increases during the year:
Special enrollment
Attrition of healthy members
Members understanding
benefits
Member cost sharing
52
Seasonality of medical expenses
Seasonality calculated as the average cost of each day (specific to day of week and holiday).
Adjustments were made for distribution of days and holidays in month/ year.
© 2017 MOLINA HEALTHCARE, INC.
53
Marketplace
Dramatic year over year growth in enrollment
Government must address these key elements that are
needed to stabilize the program long term:
1. Address issues around the special enrollment period (SEP)
2. Improve the risk transfer methodology
3. Cost sharing reductions (CSRs) and premium subsidies
must continue
4. The purchase of health insurance must continue to be a
requirement
1Q14 1Q15 1Q16 1Q17E
266K
630K
1.0MMolina Marketplace
Enrollment Growth
8K
© 2017 MOLINA HEALTHCARE, INC.
2017A: Molina Healthcare Investor Day
February 16, 2017
New York, New York
2017 Outlook
John C. Molina
Chief Financial Officer
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
55
Keys to 2017 outlook
Secure re-procurements
Marketplace profitability
Profit improvement initiatives
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
56
2016 vs. 2017 outlook
Includes $30 million (approximately $0.34 per share) impact of PDR in 2016 and 2017 outlook
Notes:
1. Subtotals, totals, and other amounts may differ due to rounding.
2. All amounts are estimates; actual results may differ materially. Does not include Aetna/Humana Medicare transaction break-up fee. See our risk factors as discussed in our Form 10-K and other filings.
3. Medical care ratio represents medical care costs as a percentage of premium revenue.
4. G&A expense ratio represents general and administrative expenses as a percentage of total revenue. Net profit margin represents net income as a percentage of total revenue.
5. See following reconciliations of GAAP financial measures to non-GAAP financial measures
2016
Actual1
2017
Outlook1
$ Variance
Fav/(UnFav)
% Change
Fav/(UnFav)
Premium Revenue $16.3B $18.4B $2.1B 13%
Health Insurer Fee Revenue $345M - $ (345M) (100%)
Premium Tax Revenue $465M $460M $ (5M) (1%)
Service Revenue $539M $570M $31M 6%
Investment Income and Other Revenue $38M $40M $2M 5%
Total Revenue $17.7B $19.5B $1.8B 10%
Total Medical Care Cost $14.8B $16.3B $ (1.5B) (10%)
Medical Care Ratio3 90.5% 88.5% 2.0% n/a
Total Cost of Service Revenue $485M $520M $ (35M) (7%)
General & Administrative Expenses $1.4B $1.8B $ (0.4B) (29%)
G&A Ratio4 7.9% 9.0% (1.1%) n/a
Premium Tax Expense $465M $460M $5M 1%
Health Insurer Fee Expense $217M - $217M 100%
Depreciation and Amortization $139M $160M $ (21M) (15%)
Interest and Other Expense $101M $100M $1M 1%
Income Before Taxes $137M $175M $38M 28%
EBITDA5 $399M $465M $66M 17%
Effective Tax Rate 94% 44% 50% n/a
Net Income $8M $100M $92M Not meaningful
Net Profit Margin - % 0.5% 0.5% n/a
Diluted EPS $0.14 $1.72 $1.58 Not meaningful
Adjusted EPS5 $0.50 $2.09 $1.59 318%
Weighted Diluted Shares Outstanding 56.3M 58.2M 1.9M 3%
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
57
2017 outlook – Marketplace and non-Marketplace
Outlook
4Q2017
Normalize
Seasonality
Run rate
4Q2017
Outlook
If we normalize the non-marketplace fourth quarter
for seasonality we expect to be at a 1.4% by the end
of 2017
Non Marketplace 4Q Net Profit Margin
1.1%
1.4%
0.3%
Non MP Marketplace
2017
Guidance
Premium Revenue $15.7B $2.7B $18.4B
Health Insurer Fee Revenue - - -
Premium Tax Revenue $423M $37M $460M
Service Revenue $570M - $570M
Investment Income and Other Revenue $40M - $40M
Total Revenue $16.8B $2.7B $19.5B
Total Medical Care Cost $14.0B $2.3B $16.3B
Medical Care Ratio 89.0% 86.0% 88.5%
Total Cost of Service Revenue $520M - $520M
General & Administrative Expenses $1.3B $0.5B $1.8B
G&A Ratio 7.8% 18.0% 9.0%
Premium Tax Expense $423M $37M $460M
Health Insurer Fee Expense - - -
Depreciation and Amortization $160M - $160M
Interest and Other Expense $100M - $100M
Income Before Taxes $290M ($115M) $175M
Effective Tax Rate 44% 44% 44%
Net Income $164M ($64M) $100M
Net Profit Margin 1.0% (2.3%) 0.5%
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
58
Bridge 2016 actuals to 2017 outlook
Net profit margin
Notes:
Numbers may not add due to rounding.
0.0% 0.5%
(0.5%)
0.4%
0.4%
(0.1%)
1.5%
Marketplace
Enrollment
Growth
Marketplace
Rates Net of
Trend
2017 Outlook
Admin
Non Marketplace
Medical Cost Trends
and Initiatives
Non
Marketplace
Rates
Other
(1.1%)
(0.6%)
2016
Actual
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
59
Marketplace 2016 actuals to 2017 outlook
Medical cost ratio percent
Note: Numbers may not add up due to rounding
93%
0% 0% 0% 0% 0%
86%
0.1%
16%
1.6%
2.5%
3.1%
4.5%
7%
(8%)
(3%)
(19%)
Other
Medical Cost
Trend 19%
Risk Transfer
27% of premium
Out of
Period
Rate Increase
15%
2016
Actual
MCR
2017
Outlook
MCR
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
92.9%
86.0%
2016 2017 Outlook
Marketplace
90.3%
89.0%
2016 2017 Outlook
Non Marketplace
90.5%
88.5%
2016 2017 Outlook
Consolidated
60
MCR year over year change
Notes:
Numbers may not add up due rounding
Rate increases
Profit improvement
initiatives
Increased pricing
HIF moratorium
PDR
2016 Prior period
adjustments
Pure period MCR ~87%
MCR
without
PDR
reversal
~87%
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
61
Medicaid rate changes
Notes::
Rate changes are net
Excludes risk adjustments
Eff. Date Effective Rate Change Status
CA Jul-17 (4.0%) Estimate
FL Oct-17 3.0% Estimate
IL Jan-17 5.0% Draft
MI Jan-17 (0.4%) Final
NM Jan-17 (1.0%) Final
NY Apr-17 1.0% Estimate
OH Jan-17 4.0% Final
PR Jan-17 2.0% Draft
SC Jul-17 1.0% Estimate
TX Sep-17 1.0% Estimate
UT Jan-17 4.5% Final
WA Jan-17 4.0% Final
WI Jan-17 3.0% Draft
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
Quarter 1 Quarter 2 Quarter 3 Quarter 4
Marketplace 0.89 0.92 1.05 1.14
Non Marketplace 1.00 0.99 0.99 1.01
0.80
0.85
0.90
0.95
1.00
1.05
1.10
1.15
1.20
Marketplace
Non Marketplace
62
Seasonality
Seasonality calculated as the average cost of each day (specific to day of week and holiday).
Adjustments were made for distribution of days and holidays in month/ year.
Seasonality of medical costs
30%
50%
20%
0%
1Q 2017
Outlook
2Q 2017
Outlook
3Q 2017
Outlook
4Q 2017
Outlook
Seasonality of earnings
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
63
G&A ratio – Marketplace impact
Exchange fees and broker commissions
7.9% 8.1% 7.9%
9.0%
7.9% 7.5% 6.9%
8.0%
2014 Actual 2015 Actual 2016 Actual 2017 Outlook
Impact of Marketplace Exchange Fees and Broker Commissions
G&A Ratio Net of Marketplace Exchange Fees and Broker Commissions
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
64
G&A bridge - actual to outlook
7.9%
0 0 0 0
9.0%
0.1%
(2.2%) 1.6%
2.5%
3.1%
0.2%
0.4%
0.3%
0.2%
G&A Guidance
2017
Marketplace
G&A
Bonus not
recorded
2016
Systems and
Infrastructure
Investment
Impact of HIF
Moratorium
G&A Reported
2016
© 2017 MOLINA HEALTHCARE, INC.
65
Investment income
Investment income is projected at $37M, $4.3M or 12% up from 2016 Actual, $4.6M is due to rate increase offset by ($0.3M) due to
lower cash balance.
Note: Numbers may be off due to rounding
$33M
$37M
2016 Actual 2017 Outlook
Outlook Assumptions:
(1) Fed rate increase 25 bps in December 2016
(2) Fed rate increase 25 bps in September 2017
Investment income increases $5M for every 25bps fed
rate increment effective 1/1/17.
$37M
$42M
$47M
$52M
0.25% 0.50% 0.75% 1.00%
Investment Income Sensitivity
Please refer to the Company’s cautionary statement
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
66
Tax rate update
Tax Rate Bridge
94%
0 0
44%
2016 Actual HIF Moratorium Other 2017 Outlook
(55%)
5%
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
67
Financial Policy
Long term focused:
No planned share repurchase or dividends
$500M revolving credit facility
Disciplined strategic approach to acquisitions
© 2017 MOLINA HEALTHCARE, INC.
68
Q&A
© 2017 MOLINA HEALTHCARE, INC.
69
Supplemental
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
Re-procurement and new business
Subject to change
February
2017
June
2017
August
2017
September
2017
November
2017
State WA TX IL FL TX PR NM
Program
Type
North Central
Region
CHIP Medicaid Medicaid/LTC Star+ PLUS TANF, CHIP Medicaid
Upcoming Bids – New Business
Re-procurement of Existing Market
January
2017
February
2017
May
2017
December
2017
State TX MS VA NC
Program
Type
IDD Medicaid
Medicaid/
TANF
Medicaid/
TANF
70
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
53.0M
54.0M
55.0M
56.0M
57.0M
58.0M
59.0M
60.0M
61.0M
62.0M
63.0M
50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80
Share Dilution Based on Stock Price
Denominator for BASIC EPS Dilutive effect of employee stock options & stock grants Shares dilution due to Convert and Warrant
71
Share count sensitivity
For every $1 changed in share price, our diluted shares changes by approximately 250K
Note:
Share counts are the same if stock price drops below $53/share
Outlook assumes $60 share price and 58.2M weighted average shares outstanding
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
72
Revenue by line of program
Notes:
Numbers may not add due to rounding.
$16.3B
$5.4B
$4.7B
$2.9B
$1.5B $1.3B
$0.5B
$18.4B
$5.7B
$5.0B
$3.2B
$2.7B
$1.3B
$0.6B
CON TANF ABD Medicaid Expansion Marketplace MMP Integrated
Dual
Medicare
2016 Actual 2017 Outlook
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
73
Medical care ratio by program
Notes:
Numbers may not add due to rounding.
91% 92% 92%
86%
93%
88%
95%
89% 89% 91%
83%
86%
91% 93%
CON TANF ABD Medicaid Expansion Marketplace MMP Integrated
Dual
Medicare
2016 Actual 2017 Outlook
© 2017 MOLINA HEALTHCARE, INC.
Please refer to the Company’s cautionary statement
74
Reconciliation of non-GAAP financial measures
Note:
1. Computation based on 56.3M and 58.2M diluted weighted average shares outstanding for 2016 and 2017 respectively.
2. Income tax effect calculated at the statutory tax rate of 37%.
Per share 1 2016 Actual 2017 Outlook
Net Income $0.14 $1.72
Adjustments:
Amortization of intangible assets $0.57 $0.59
Income tax effect 2 ($0.21) ($0.22)
Amortization of intangible assets, net of tax effect $0.36 $0.37
Adjusted net income $0.50 $2.09
2016 Actual 2017 Outlook
Net Income $8M $100M
Adjustments:
Depreciation, and amortization of intangibles assets and capitalized software $161M $190M
Interest expense $101M $100M
Income tax expense $129M $75M
EBITDA $399M $465M