UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
______________
FORM 8-K
______________
Current Report
Pursuant to Section 13 OR 15(d) of the Securities Exchange Act of 1934
Date of Report (Date of earliest event reported): October 27, 2021 (October 27, 2021 )
______________
(Exact name of registrant as specified in its charter)
| (State or other jurisdiction of incorporation) | (Commission File Number) | (IRS Employer Identification No.) | ||||||
______________
| (Address of principal executive offices) | (Zip Code) | ||||||||||
Registrant’s telephone number, including area code: (562 ) 435-3666
Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:
Securities registered pursuant to Section 12(b) of the Act:
| Title of each class | Trading Symbol(s) | Name of each exchange on which registered | ||||||
Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).
Emerging growth company | |||||
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section13(a) of the Exchange Act. | |||||
☐ | |||||
Item 2.02. Results of Operations and Financial Condition.
On October 27, 2021, Molina Healthcare, Inc. (the “Company”) issued a press release reporting its financial results for the third quarter ended September 30, 2021, and the Company’s reaffirmed full year 2021 earnings guidance. The full text of the press release is included as Exhibit 99.1 to this report. The information contained in the website cited in the press release is not part of this report.
Note: The information in this Form 8-K and the exhibit attached hereto shall not be deemed to be “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), or otherwise subject to the liabilities of that section, nor shall it be deemed incorporated by reference in any filing under the Securities Act of 1933, as amended, or the Exchange Act, except as expressly set forth by specific reference in such a filing.
Item 9.01. Financial Statements and Exhibits.
(d) Exhibits:
| Exhibit No. | Description | ||||
| 99.1 | |||||
| 104 | Cover Page information from Molina Healthcare, Inc.’s Current Report on Form 8-K filed on October 27, 2021 formatted in iXBRL (Inline Extensible Business Reporting Language). | ||||
SIGNATURE
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.
MOLINA HEALTHCARE, INC. | |||||||||||
Date: | October 27, 2021 | By: | /s/ Jeff D. Barlow | ||||||||
| Jeff D. Barlow | |||||||||||
| Chief Legal Officer and Secretary | |||||||||||
News Release
Investor Contact: Joseph Krocheski, Joseph.Krocheski@molinahealthcare.com, 562-951-8382
Media Contact: Caroline Zubieta, Caroline.Zubieta@molinahealthcare.com, 562-951-1588
Molina Healthcare Reports Third Quarter 2021 Financial Results
Reaffirms Full Year 2021 Earnings Guidance
Long Beach, Calif, October 27, 2021 – Molina Healthcare, Inc. (NYSE: MOH) (the “Company”) today reported third quarter of 2021 GAAP earnings per diluted share of $2.46 and adjusted earnings per diluted share of $2.83. Financial results are summarized below:
| Quarter ended | Nine months ended | ||||||||||||||||||||||
September 30, | September 30, | ||||||||||||||||||||||
| 2021 | 2020 | 2021 | 2020 | ||||||||||||||||||||
| (In millions, except per-share results) | |||||||||||||||||||||||
| Premium Revenue | $6,800 | $4,768 | $19,689 | $13,444 | |||||||||||||||||||
| Total Revenue | $7,040 | $5,021 | $20,362 | $14,188 | |||||||||||||||||||
| GAAP: | |||||||||||||||||||||||
| Net Income | $143 | $185 | $556 | $639 | |||||||||||||||||||
| EPS – Diluted | $2.46 | $3.10 | $9.51 | $10.65 | |||||||||||||||||||
| Medical Care Ratio (MCR) | 88.9% | 85.9% | 88.1% | 84.9% | |||||||||||||||||||
| G&A Ratio | 7.5% | 7.3% | 7.3% | 7.3% | |||||||||||||||||||
| After-tax Margin | 2.0% | 3.7% | 2.7% | 4.5% | |||||||||||||||||||
| Adjusted: | |||||||||||||||||||||||
| Net Income | $164 | $201 | $623 | $670 | |||||||||||||||||||
| EPS – Diluted | $2.83 | $3.36 | $10.66 | $11.15 | |||||||||||||||||||
| G&A Ratio | 7.3% | 7.3% | 7.1% | 7.2% | |||||||||||||||||||
| After-tax Margin | 2.3% | 4.0% | 3.1% | 4.7% | |||||||||||||||||||
| See the Reconciliation of Unaudited Non-GAAP Financial Measures at the end of this release. | |||||||||||||||||||||||
Quarter Highlights
•GAAP net income for the third quarter of 2021 was $143 million, or $2.46 per diluted share.
•Adjusted net income for the third quarter of 2021 was $164 million, or $2.83 per diluted share.
•As of September 30, 2021, the Company served approximately 4.8 million members, an increase of 805,000 members, or 20%, compared to September 30, 2020.
•Premium revenue was approximately $6.8 billion for the third quarter of 2021, an increase of 43% compared to the third quarter of 2020.
•The net effect of COVID decreased net income by approximately $1.00 per diluted share in the third quarter of 2021.
•The Company increased its full year 2021 premium revenue guidance to no less than $26.5 billion.
•The Company reaffirmed its full year 2021 adjusted earnings guidance of no less than $13.25 per diluted share.
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Molina Healthcare, Inc. Announces Third Quarter 2021 Results
Page 2
October 27, 2021
“We are pleased with our third quarter and year-to-date performance. With the backdrop of a continuing pandemic, we executed well, delivered solid operating earnings, and continued to drive our growth strategy,” said Joseph Zubretsky, president and CEO of Molina Healthcare. “The Nevada contract award and the AgeWell acquisition reflect that the components of our growth engine are well established and working.”
New York Acquisitions
On October 7, 2021, the Company announced that it has entered into a definitive agreement to acquire the Medicaid Managed Long Term Care business of AgeWell New York. As of August 31, 2021, AgeWell served approximately 13,000 managed long-term services and supports members, with full-year 2020 premium revenue of approximately $700 million.
On October 25, 2021, the Company announced the closing of its acquisition of Affinity Health Plan.
Premium Revenue
Premium revenue was approximately $6.8 billion for the third quarter of 2021, an increase of 43% compared to the third quarter of 2020. The higher premium revenue reflects increased organic membership in all lines of business, along with the impact of acquisitions.
Net Income
Net income for the third quarter was $143 million, or $2.46 per diluted share, compared to $185 million, or $3.10 per diluted share, in the third quarter of 2020. Adjusted net income for the third quarter was $164 million, or $2.83 per diluted share, compared to $201 million, or $3.36 per diluted share, in the third quarter of 2020.
The year-over-year comparison reflects the negative impact from the net effect of COVID in the third quarter of 2021. In contrast, the prior year third quarter was positively impacted by the net effect of COVID.
Net income for the nine months ended September 30, 2021 was $556 million, or $9.51 per diluted share, compared to $639 million, or $10.65 per diluted share, in the nine months ended September 30, 2020. Adjusted net income for the nine months ended September 30, 2021 was $623 million, or $10.66 per diluted share, compared to $670 million, or $11.15 per diluted share, in the nine months ended September 30, 2020.
Medical Care Ratio
The consolidated MCR for the third quarter was 88.9%, compared to 85.9% in the third quarter of 2020. The net effect of COVID increased the consolidated MCR by approximately 110 basis points and impacted all three lines of business. In the prior year, the net effect of COVID was negligible to slightly positive.
A year-over-year comparison is less meaningful than it would be in a typical year due to pandemic related effects. Due to those anomalous effects, a sequential comparison of MCR is more relevant.
On a sequential basis, the consolidated MCR for the third quarter was 88.9%, compared to 88.4% in the second quarter of 2021. The net effect of COVID increased the consolidated MCR by approximately 110 basis points in the second and third quarters of 2021 and was negligible in the first quarter of 2021.
•The Medicaid MCR increased to 89.6% in the third quarter of 2021 compared to 89.0% in the second quarter of 2021. The increase in the MCR was primarily due to an increase in the net effect of COVID.
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Molina Healthcare, Inc. Announces Third Quarter 2021 Results
Page 3
October 27, 2021
•The Medicare MCR decreased to 82.8% in the third quarter of 2021 compared to 87.6% in the second quarter of 2021. The decrease in the MCR was primarily due to the lower negative net effect of COVID among our Medicare members.
•The Marketplace MCR increased to 91.3% in the third quarter of 2021 compared to 84.8% in the second quarter of 2021. The increase in the MCR was primarily due to the higher net effect of COVID, normal seasonality, and non-COVID utilization by Special Enrollment Period members.
General and Administrative Expense Ratio
The G&A ratio for the third quarter was 7.5%, compared to 7.3% for the third quarter of 2020. The adjusted G&A ratio for the third quarter was 7.3% and was consistent with the third quarter of 2020 reflecting disciplined cost management, and growth investments.
Balance Sheet
Cash and investments at the parent company amounted to $703 million as of September 30, 2021, compared to $644 million as of December 31, 2020. The increase was due to dividends received from the regulated health plan subsidiaries in the quarter.
In September 2021, the Company’s Board of Directors authorized a stock repurchase program of up to $500 million and continuing through December 31, 2022. This program supersedes the stock repurchase program approved by our Board in September 2020. As of October 27, 2021, no shares have been purchased under this program.
Cash Flow
Operating cash flow for the nine months ended September 30, 2021 amounted to $1.5 billion, and was higher compared to the nine months ended September 30, 2020, primarily due to growth in operations and the net impact of timing differences in governmental receivables and payables.
2021 Guidance
The Company expects its full year 2021 total revenue to be no less than $27.5 billion, an increase of approximately 42% from its full year 2020.
Premium revenue for the full year 2021 is expected to be no less than $26.5 billion, an increase of approximately 45% from the full year 2020.
The Company reaffirmed its full year 2021 adjusted earnings per share guidance to be no less than $13.25 per share.
Guidance reflects:
•The continuation of the Public Health Emergency period, through mid-January, 2022 and the associated pause on Medicaid membership redeterminations;
•Underlying outperformance;
•An offset caused by the estimated net effect of COVID which is expected to be approximately $3.00 per share for the full year 2021; and
•Continued caution in forecasting utilization trends for the remaining three months of the year due to the COVID pandemic.
The impact of the Cigna Texas membership acquisition is not included in guidance. The Cigna Texas membership acquisition is expected to close in January of 2022.
See the Reconciliation of Unaudited Non-GAAP Financial Measures at the end of this release.
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Molina Healthcare, Inc. Announces Third Quarter 2021 Results
Page 4
October 27, 2021
Conference Call
Management is hosting a conference call and webcast to discuss Molina Healthcare’s third quarter 2021 results at 8:00 a.m. Eastern Time on Thursday, October 28, 2021. The number to call for the interactive teleconference is (877) 883-0383 and the confirmation number is 5108692. A telephonic replay of the conference call will be available through Thursday, November 11, 2021, by dialing (877) 344-7529 and entering confirmation number 10160042. A live audio broadcast of this conference call will be available on Molina Healthcare’s website, molinahealthcare.com. A 30-day online replay will be available approximately an hour following the conclusion of the live broadcast.
About Molina Healthcare
Molina Healthcare, Inc., a FORTUNE 500 company, provides managed healthcare services under the Medicaid and Medicare programs and through the state insurance marketplaces. Through its locally operated health plans, Molina Healthcare served approximately 4.8 million members as of September 30, 2021. For more information about Molina Healthcare, please visit molinahealthcare.com.
Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995
This earnings release and the Company’s accompanying oral remarks contain forward-looking statements regarding its 2021 guidance, as well as its plans and expectations regarding future developments. Actual results could differ materially due to numerous known and unknown risks and uncertainties. These risks and uncertainties are discussed under the headings “Forward-Looking Statements,” and “Risk Factors,” in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020, which is on file with the SEC, and also in its Quarterly Report on Form 10-Q for the period ended September 30, 2021, which the Company expects to file on or about October 28, 2021.
These reports can be accessed under the investor relations tab of the Company’s website or on the SEC’s website at sec.gov. Given these risks and uncertainties, the Company can give no assurances that its forward-looking statements will prove to be accurate, or that any other results or developments projected or contemplated by its forward-looking statements will in fact occur, and the Company cautions investors not to place undue reliance on these statements. All forward-looking statements in this release represent the Company’s judgment as of October 27, 2021, and, except as otherwise required by law, the Company disclaims any obligation to update any forward-looking statement to conform the statement to actual results or changes in its expectations.
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Molina Healthcare, Inc. Announces Third Quarter 2021 Results
Page 5
October 27, 2021
MOLINA HEALTHCARE, INC.
UNAUDITED CONSOLIDATED STATEMENTS OF INCOME
| Three Months Ended | Nine Months Ended | ||||||||||||||||||||||
| September 30, | September 30, | ||||||||||||||||||||||
| 2021 | 2020 | 2021 | 2020 | ||||||||||||||||||||
| (In millions, except per-share amounts) | |||||||||||||||||||||||
| Revenue: | |||||||||||||||||||||||
| Premium revenue | $ | 6,800 | $ | 4,768 | $ | 19,689 | $ | 13,444 | |||||||||||||||
| Premium tax revenue | 204 | 170 | 576 | 477 | |||||||||||||||||||
| Health insurer fees reimbursed | — | 69 | — | 206 | |||||||||||||||||||
| Investment income | 20 | 10 | 39 | 48 | |||||||||||||||||||
| Other revenue | 16 | 4 | 58 | 13 | |||||||||||||||||||
| Total revenue | 7,040 | 5,021 | 20,362 | 14,188 | |||||||||||||||||||
| Operating expenses: | |||||||||||||||||||||||
| Medical care costs | 6,049 | 4,098 | 17,342 | 11,412 | |||||||||||||||||||
| General and administrative expenses | 532 | 368 | 1,489 | 1,030 | |||||||||||||||||||
| Premium tax expenses | 204 | 170 | 576 | 477 | |||||||||||||||||||
| Health insurer fees | — | 70 | — | 209 | |||||||||||||||||||
| Depreciation and amortization | 32 | 23 | 96 | 64 | |||||||||||||||||||
| Other | 2 | 3 | 30 | 9 | |||||||||||||||||||
| Total operating expenses | 6,819 | 4,732 | 19,533 | 13,201 | |||||||||||||||||||
| Operating income | 221 | 289 | 829 | 987 | |||||||||||||||||||
| Other expenses, net: | |||||||||||||||||||||||
| Interest expense | 30 | 27 | 90 | 72 | |||||||||||||||||||
| Other expense, net | — | — | — | 5 | |||||||||||||||||||
| Total other expenses, net | 30 | 27 | 90 | 77 | |||||||||||||||||||
Income before income tax expense | 191 | 262 | 739 | 910 | |||||||||||||||||||
| Income tax expense | 48 | 77 | 183 | 271 | |||||||||||||||||||
| Net income | $ | 143 | $ | 185 | $ | 556 | $ | 639 | |||||||||||||||
| Net income per share – Diluted | $ | 2.46 | $ | 3.10 | $ | 9.51 | $ | 10.65 | |||||||||||||||
Diluted weighted average shares outstanding | 58.5 | 59.6 | 58.5 | 60.0 | |||||||||||||||||||
| Operating Statistics: | |||||||||||||||||||||||
| Medical care ratio | 88.9 | % | 85.9 | % | 88.1 | % | 84.9 | % | |||||||||||||||
| G&A ratio | 7.5 | % | 7.3 | % | 7.3 | % | 7.3 | % | |||||||||||||||
| Premium tax ratio | 2.9 | % | 3.4 | % | 2.8 | % | 3.4 | % | |||||||||||||||
| Effective income tax rate | 24.8 | % | 29.5 | % | 24.7 | % | 29.8 | % | |||||||||||||||
| After-tax margin | 2.0 | % | 3.7 | % | 2.7 | % | 4.5 | % | |||||||||||||||
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Molina Healthcare, Inc. Announces Third Quarter 2021 Results
Page 6
October 27, 2021
MOLINA HEALTHCARE, INC.
CONSOLIDATED BALANCE SHEETS
| September 30, | December 31, | ||||||||||
| 2021 | 2020 | ||||||||||
| Unaudited | |||||||||||
| (Dollars in millions, except per-share amounts) | |||||||||||
| ASSETS | |||||||||||
| Current assets: | |||||||||||
| Cash and cash equivalents | $ | 4,357 | $ | 4,154 | |||||||
| Investments | 2,900 | 1,875 | |||||||||
| Receivables | 1,912 | 1,672 | |||||||||
| Prepaid expenses and other current assets | 197 | 175 | |||||||||
| Total current assets | 9,366 | 7,876 | |||||||||
| Property, equipment, and capitalized software, net | 385 | 391 | |||||||||
| Goodwill and intangible assets, net | 915 | 941 | |||||||||
| Restricted investments | 156 | 136 | |||||||||
| Deferred income taxes | 83 | 69 | |||||||||
| Other assets | 128 | 119 | |||||||||
| Total assets | $ | 11,033 | $ | 9,532 | |||||||
| LIABILITIES AND STOCKHOLDERS’ EQUITY | |||||||||||
| Current liabilities: | |||||||||||
| Medical claims and benefits payable | $ | 3,191 | $ | 2,696 | |||||||
| Amounts due government agencies | 2,081 | 1,253 | |||||||||
| Accounts payable, accrued liabilities and other | 797 | 641 | |||||||||
| Deferred revenue | 1 | 375 | |||||||||
| Total current liabilities | 6,070 | 4,965 | |||||||||
| Long-term debt | 2,130 | 2,127 | |||||||||
| Finance lease liabilities | 220 | 225 | |||||||||
| Other long-term liabilities | 95 | 119 | |||||||||
| Total liabilities | 8,515 | 7,436 | |||||||||
| Stockholders’ equity: | |||||||||||
Common stock, $0.001 par value, 150 million shares authorized; outstanding: 58 million shares at September 30, 2021, and 59 million shares at December 31, 2020 | — | — | |||||||||
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding | — | — | |||||||||
| Additional paid-in capital | 205 | 199 | |||||||||
| Accumulated other comprehensive income | 17 | 37 | |||||||||
| Retained earnings | 2,296 | 1,860 | |||||||||
| Total stockholders’ equity | 2,518 | 2,096 | |||||||||
| Total liabilities and stockholders’ equity | $ | 11,033 | $ | 9,532 | |||||||
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Molina Healthcare, Inc. Announces Third Quarter 2021 Results
Page 7
October 27, 2021
MOLINA HEALTHCARE, INC.
UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
Nine Months Ended | |||||||||||
| September 30, | |||||||||||
| 2021 | 2020 | ||||||||||
| (in millions) | |||||||||||
| Operating activities: | |||||||||||
| Net income | $ | 556 | $ | 639 | |||||||
Adjustments to reconcile net income to net cash provided by operating activities: | |||||||||||
| Depreciation and amortization | 96 | 64 | |||||||||
| Deferred income taxes | (8) | (3) | |||||||||
Share-based compensation | 49 | 43 | |||||||||
| Loss on debt repayment | — | 5 | |||||||||
Other, net | 9 | 2 | |||||||||
| Changes in operating assets and liabilities: | |||||||||||
| Receivables | (247) | (369) | |||||||||
| Prepaid expenses and other current assets | (43) | (98) | |||||||||
| Medical claims and benefits payable | 522 | 431 | |||||||||
| Amounts due government agencies | 810 | (24) | |||||||||
| Accounts payable, accrued liabilities and other | 129 | 63 | |||||||||
| Deferred revenue | (374) | (188) | |||||||||
| Income taxes | 23 | 34 | |||||||||
Net cash provided by operating activities | 1,522 | 599 | |||||||||
| Investing activities: | |||||||||||
| Purchases of investments | (2,018) | (670) | |||||||||
Proceeds from sales and maturities of investments | 965 | 891 | |||||||||
Purchases of property, equipment, and capitalized software | (56) | (64) | |||||||||
| Net cash paid in business combinations | — | (62) | |||||||||
| Other, net | 3 | 3 | |||||||||
| Net cash (used in) provided by investing activities | (1,106) | 98 | |||||||||
| Financing activities: | |||||||||||
Common stock purchases | (128) | (453) | |||||||||
| Common stock withheld to settle employee tax obligations | (52) | (8) | |||||||||
| Contingent consideration liabilities settled | (20) | — | |||||||||
| Proceeds from senior notes offering, net of issuance costs | — | 789 | |||||||||
| Repayment of term loan facility | — | (600) | |||||||||
| Proceeds from borrowings under term loan facility | — | 380 | |||||||||
| Other, net | (4) | (47) | |||||||||
| Net cash (used in) provided by financing activities | (204) | 61 | |||||||||
| Net increase in cash, cash equivalents, and restricted cash and cash equivalents | 212 | 758 | |||||||||
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period | 4,223 | 2,508 | |||||||||
Cash, cash equivalents, and restricted cash and cash equivalents at end of period | $ | 4,435 | $ | 3,266 | |||||||
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Molina Healthcare, Inc. Announces Third Quarter 2021 Results
Page 8
October 27, 2021
MOLINA HEALTHCARE, INC.
UNAUDITED SEGMENT DATA
(Dollars in millions)
| September 30, | December 31, | September 30, | ||||||||||||||||||
2021 (1) | 2020 | 2020 | ||||||||||||||||||
| Ending Membership by Segment: | ||||||||||||||||||||
| Medicaid | 3,981,000 | 3,599,000 | 3,595,000 | |||||||||||||||||
| Medicare | 138,000 | 115,000 | 113,000 | |||||||||||||||||
| Marketplace | 719,000 | 318,000 | 325,000 | |||||||||||||||||
| Total | 4,838,000 | 4,032,000 | 4,033,000 | |||||||||||||||||
(1)Approximately 200,000 members, from the Magellan Complete Care acquisition that closed on December 31, 2020, are included in the totals as of September 30, 2021, but not in prior periods. | ||||||||||||||||||||
Three Months Ended June 30, | |||||||||||||||||||||||||||||||||||
| 2021 | 2020 | ||||||||||||||||||||||||||||||||||
| Premium Revenue | Medical Margin | MCR (1) | Premium Revenue | Medical Margin | MCR (1) | ||||||||||||||||||||||||||||||
| Medicaid | $ | 5,034 | $ | 551 | 89.0 | % | $ | 3,375 | $ | 553 | 83.6 | % | |||||||||||||||||||||||
| Medicare | 814 | 101 | 87.6 | 630 | 125 | 80.0 | |||||||||||||||||||||||||||||
| Marketplace | 735 | 112 | 84.8 | 367 | 96 | 74.0 | |||||||||||||||||||||||||||||
| Consolidated | $ | 6,583 | $ | 764 | 88.4 | % | $ | 4,372 | $ | 774 | 82.3 | % | |||||||||||||||||||||||
Three Months Ended September 30, | |||||||||||||||||||||||||||||||||||
| 2021 | 2020 | ||||||||||||||||||||||||||||||||||
| Premium Revenue | Medical Margin | MCR (1) | Premium Revenue | Medical Margin | MCR (1) | ||||||||||||||||||||||||||||||
| Medicaid | $ | 5,146 | $ | 532 | 89.6 | % | $ | 3,754 | $ | 509 | 86.4 | % | |||||||||||||||||||||||
| Medicare | 875 | 151 | 82.8 | 632 | 91 | 85.6 | |||||||||||||||||||||||||||||
| Marketplace | 779 | 68 | 91.3 | 382 | 70 | 81.6 | |||||||||||||||||||||||||||||
| Consolidated | $ | 6,800 | $ | 751 | 88.9 | % | $ | 4,768 | $ | 670 | 85.9 | % | |||||||||||||||||||||||
| Nine Months Ended September 30, | |||||||||||||||||||||||||||||||||||
| 2021 | 2020 | ||||||||||||||||||||||||||||||||||
| Premium Revenue | Medical Margin | MCR (1) | Premium Revenue | Medical Margin | MCR (1) | ||||||||||||||||||||||||||||||
| Medicaid | $ | 15,020 | $ | 1,687 | 88.8 | % | $ | 10,415 | $ | 1,427 | 86.3 | % | |||||||||||||||||||||||
| Medicare | 2,488 | 329 | 86.8 | 1,896 | 333 | 82.4 | |||||||||||||||||||||||||||||
| Marketplace | 2,181 | 331 | 84.8 | 1,133 | 272 | 76.0 | |||||||||||||||||||||||||||||
| Consolidated | $ | 19,689 | $ | 2,347 | 88.1 | % | $ | 13,444 | $ | 2,032 | 84.9 | % | |||||||||||||||||||||||
(1)The MCR represents medical costs as a percentage of premium revenue. | |||||||||||||||||||||||||||||||||||
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Molina Healthcare, Inc. Announces Third Quarter 2021 Results
Page 9
October 27, 2021
MOLINA HEALTHCARE, INC.
CHANGE IN MEDICAL CLAIMS AND BENEFITS PAYABLE
(Dollars in millions)
The Company’s claims liabilities include additional reserves to account for moderately adverse conditions based on historical experience and other factors including, but not limited to, variations in claims payment patterns, changes in utilization and cost trends, known outbreaks of disease, and large claims. The Company’s reserving methodology is consistently applied across all periods presented. The amounts displayed for “Components of medical care costs related to: Prior year” represent the amounts by which the original estimates of claims and benefits payable at the beginning of the year were more than the actual liabilities based on information (principally the payment of claims) developed since those liabilities were first reported. The following table presents the components of the change in medical claims and benefits payable for the periods indicated:
| Nine Months Ended | |||||||||||
| September 30, | |||||||||||
| 2021 | 2020 | ||||||||||
| Unaudited | |||||||||||
Medical claims and benefits payable, beginning balance | $ | 2,696 | $ | 1,854 | |||||||
| Components of medical care costs related to: | |||||||||||
| Current year | 17,558 | 11,478 | |||||||||
| Prior year | (216) | (66) | |||||||||
| Total medical care costs | 17,342 | 11,412 | |||||||||
| Payments for medical care costs related to: | |||||||||||
| Current year | 14,880 | 9,500 | |||||||||
| Prior year | 2,008 | 1,527 | |||||||||
| Total paid | 16,888 | 11,027 | |||||||||
| Change in acquired balances | (27) | — | |||||||||
| Change in non-risk and other provider payables | 68 | 50 | |||||||||
Medical claims and benefits payable, ending balance | $ | 3,191 | $ | 2,289 | |||||||
Days in claims payable, fee for service (1) | 49 | 52 | |||||||||
__________________
(1)Claims payable includes primarily claims incurred but not paid, or IBNP. It also includes certain fee-for-service payables reported in medical claims and benefits payable amounting to $148 million and $79 million, as of September 30, 2021, and 2020, respectively.
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Molina Healthcare, Inc. Announces Third Quarter 2021 Results
Page 10
October 27, 2021
MOLINA HEALTHCARE, INC.
RECONCILIATION OF UNAUDITED NON-GAAP FINANCIAL MEASURES
(In millions, except per diluted share amounts)
The Company believes that certain non-GAAP (generally accepted accounting principles) financial measures are useful supplemental measures to investors in comparing the Company’s performance to the performance of other public companies in the health care industry. The non-GAAP financial measures are also used internally to enable management to assess the Company’s performance consistently over time. These non-GAAP financial measures, presented below, should be considered as supplements to, and not as substitutes for or superior to, GAAP measures.
Adjustments represent additions and deductions to GAAP net income as indicated in the table below, which include the non-cash impact of amortization of acquired intangible assets, acquisition-related expenses, and the impact of certain expenses and other items that management believes are not indicative of longer-term business trends and operations.
Adjusted G&A Ratio represents the GAAP G&A ratio, recognizing adjustments.
Adjusted net income represents GAAP net income recognizing the adjustments, net of tax. The Company believes that adjusted net income is helpful to investors in assessing the Company’s financial performance.
Adjusted net income per diluted share represents adjusted net income divided by weighted average common shares outstanding on a fully diluted basis.
Adjusted after-tax margin represents adjusted net income, divided by total revenue.
| Three Months Ended September 30, | Nine Months Ended September 30, | ||||||||||||||||||||||||||||||||||||||||||||||
| 2021 | 2020 | 2021 | 2020 | ||||||||||||||||||||||||||||||||||||||||||||
| Amount | Per Diluted Share | Amount | Per Diluted Share | Amount | Per Diluted Share | Amount | Per Diluted Share | ||||||||||||||||||||||||||||||||||||||||
Net income | $ | 143 | $ | 2.46 | $ | 185 | $ | 3.10 | $ | 556 | $ | 9.51 | $ | 639 | $ | 10.65 | |||||||||||||||||||||||||||||||
Adjustments: | |||||||||||||||||||||||||||||||||||||||||||||||
Acquisition-related expenses (1) | 17 | 0.28 | 4 | 0.07 | 44 | 0.75 | 4 | 0.06 | |||||||||||||||||||||||||||||||||||||||
Amortization of intangible assets | 11 | 0.20 | 4 | 0.06 | 35 | 0.60 | 12 | 0.19 | |||||||||||||||||||||||||||||||||||||||
| Loss on debt repayment | — | — | — | — | — | — | 5 | 0.08 | |||||||||||||||||||||||||||||||||||||||
Other (2) | — | — | 13 | 0.21 | 9 | 0.16 | 19 | 0.32 | |||||||||||||||||||||||||||||||||||||||
Subtotal, adjustments | 28 | 0.48 | 21 | 0.34 | 88 | 1.51 | 40 | 0.65 | |||||||||||||||||||||||||||||||||||||||
Income tax effect | (7) | (0.11) | (5) | (0.08) | (21) | (0.36) | (9) | (0.15) | |||||||||||||||||||||||||||||||||||||||
Adjustments, net of tax | 21 | 0.37 | 16 | 0.26 | 67 | 1.15 | 31 | 0.50 | |||||||||||||||||||||||||||||||||||||||
Adjusted net income | $ | 164 | $ | 2.83 | $ | 201 | $ | 3.36 | $ | 623 | $ | 10.66 | $ | 670 | $ | 11.15 | |||||||||||||||||||||||||||||||
__________________
(1)Beginning in the third quarter of 2020, reflects non-recurring costs associated with acquisitions, including various transaction and integration costs.
(2)The nine months ended September 30, 2021 includes change in premium deficiency reserves, loss on sale of property, and restructuring costs. The nine months ended September 30, 2020 includes premium deficiency reserves, and restructuring costs.
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Molina Healthcare, Inc. Announces Third Quarter 2021 Results
Page 11
October 27, 2021
MOLINA HEALTHCARE, INC.
RECONCILIATION OF UNAUDITED NON-GAAP FINANCIAL MEASURES (CONTINUED)
2021 GUIDANCE
Net income per diluted share (1) | $ | 11.61 | |||
Adjustments: | |||||
Acquisition-related expenses | 1.18 | ||||
Amortization of intangible assets | 0.81 | ||||
| Other | 0.16 | ||||
Subtotal, adjustments | 2.15 | ||||
Income tax effect (2) | (0.51) | ||||
Adjustments, net of tax | 1.64 | ||||
Adjusted net income per diluted share | $ | 13.25 | |||
__________________
(1)Computations assume approximately 58.6 million diluted weighted average shares outstanding.
(2)Income tax effect calculated at the statutory tax rate of 23.8%.
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