a5534434.htm

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): November 1, 2007
 

 
MOLINA HEALTHCARE, INC.
(Exact name of registrant as specified in its charter)
 
Delaware
 
1-31719
 
13-4204626
(State of incorporation)
 
(Commission File Number)
 
(I.R.S. Employer Identification Number)
 

 
200 Oceangate, Suite 100, Long Beach, California 90802
(Address of principal executive offices)
 
 
Registrant’s telephone number, including area code: (562) 435-3666
 
 
One Golden Shore Drive, Long Beach, California 90802
(Former name or former address, if changed since last report)
 
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:
 
o
Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
o
Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
o
Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
o
Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))
 
 


 

 
 Item 2.02.      Results of Operations and Financial Condition.
 
On November 1, 2007, Molina Healthcare, Inc. issued a press release announcing its financial results for the third quarter and nine months ended September 30, 2007.  The full text of the press release is included as Exhibit 99.1 to this report.  The information contained in the websites cited in the press release is not part of this report.

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 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 or the Securities Exchange Act of 1934, 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
Press release of Molina Healthcare, Inc. issued November 1, 2007, as to financial results for the third quarter and nine months ended September 30, 2007.
   


 
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: November 1, 2007
 
By:    /s/ Mark L. Andrews
 
 
Mark L. Andrews
Chief Legal Officer, General Counsel,
   and Corporate Secretary
 

 
EXHIBIT INDEX
 
Exhibit
No.  
Description
   
99.1
Press release of Molina Healthcare, Inc. issued November 1, 2007, as to financial results for the third quarter and nine months ended September 30, 2007.

 

a5534434ex99_1.htm


News Release

Contact:
Juan José Orellana
Investor Relations
Molina Healthcare, Inc.
562-435-3666, ext. 111143


MOLINA HEALTHCARE REPORTS
THIRD QUARTER 2007 RESULTS


Long Beach, California (November 1, 2007) – Molina Healthcare, Inc. (NYSE: MOH) today announced its financial results for the third quarter and nine months ended September 30, 2007.

Net income for the quarter ended September 30, 2007, increased to $17.5 million, or $0.62 per diluted share, compared with net income of $12.3 million, or $0.44 per diluted share, for the quarter ended September 30, 2006.

Net income for the nine months ended September 30, 2007, increased to $40.4 million, or $1.43 per diluted share, compared with net income of $34.1 million, or $1.21 per diluted share, for the same nine months of 2006.

Commenting on the results, J. Mario Molina, M.D., president and chief executive officer of Molina Healthcare, Inc., said, “Higher enrollment at our Ohio and Texas HMOs, modest rate increases and improvements to our medical care costs have all contributed to our strong third quarter financial results.  We are pleased that these results confirm our philosophy that quality health care and cost-effectiveness are not mutually exclusive aims.  We believe this philosophy was also validated when Molina’s subsidiary Medicaid health plans in New Mexico and Utah were recently ranked by U.S. News & World Report as among “America’s Best Health Plans,” which was compiled in collaboration with the National Committee for Quality Assurance.”

Earnings Per Share Guidance

The Company also announced that it is increasing its previously issued earnings per diluted share guidance for fiscal year 2007 to between $1.90 and $2.00.  The Company had most recently issued guidance for fiscal year 2007 in the range of $1.85 to $1.95 per diluted share.

Although many factors affect its financial results, the Company believes that the following factors have been the most influential in changing its earnings outlook since guidance was last issued on September 12, 2007:

·  
The increased revenue resulting from rate increases for San Bernardino and Riverside counties effective October 1, 2007;

·  
Better-than-anticipated medical cost performance in Washington, New Mexico, and Texas;

 
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MOH Reports Third Quarter Results
Page 2
November 1, 2007
 
·  
The November 1st closing of the Company’s acquisition of Mercy CarePlus in Missouri. Previously issued guidance did not include any benefit from the acquisition of Mercy CarePlus;

·  
The impact on investment income and interest expense of the Company’s recent issuance of $200 million in convertible senior notes, as well as the impact on investment income of declining interest rates; and

·  
Uncertainty surrounding any rate increase in Michigan as a result of state budget issues.

The revised guidance does not take into account the increase to the Company’s interest expense that would result if the Financial Accounting Standards Board adopts the proposed FASB Staff Position 14-a, “Accounting for Convertible Debt Instruments That May Be Settled in Cash upon Conversion (Including Partial Cash Settlement).”

Financial Results – Comparison of Quarters Ended September 30, 2007 and 2006

Premium revenue for the third quarter of 2007 was $628.4 million, an increase of $116.3 million, or 22.7%, over premium revenue of $512.1 million for the third quarter of 2006.  Among the factors increasing premium revenue between the third quarter of 2007 and the third quarter of 2006 were:

·  
Increased enrollment at the Ohio and Texas health plans.  The Ohio health plan contributed $125.5 million in premium revenue in the third quarter of 2007, an increase of $104.5 million from a year ago.  The Texas health plan, which commenced operations in September 2006, contributed $25.0 million in premium revenue in the third quarter of 2007 and less than $0.3 million in September 2006.

·  
Increased revenue of approximately $14.0 million at the New Mexico health plan due to:

§  
A rate increase of approximately 5% effective July 1, 2007;

§  
Increased enrollment; and

§  
A one time out-of-period increase to revenue of approximately $2.2 million.  This adjustment was made to reduce the amount the Company estimated was owed back to the state for the two-year period ending June 30, 2007, based upon direct medical costs incurred during that period.

The following items served to decrease premium revenue for the third quarter of 2007 compared with the third quarter of 2006:

·  
Termination of operations at the Company’s Indiana health plan effective January 1, 2007.  The Indiana health plan contributed no premium revenue in the third quarter of 2007 compared with $24.6 million in premium revenue in the third quarter of 2006.

·  
Reduced revenue of approximately $11.8 million at the Utah health plan due to:

§  
Lower enrollment;

§  
Lower medical costs, which reduced revenue under the Utah health plan’s cost-plus reimbursement contract; and

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MOH Reports Third Quarter Results
Page 3
November 1, 2007
 
§  
An out-of-period reduction of approximately $1.7 million to the amount receivable under a savings sharing agreement with the state.  The amount of the receivable for this item has been reduced from approximately $4.7 million at June 30, 2007, to $3.0 million at September 30, 2007.  The Utah health plan continues to work with the state in an effort to assure an appropriate determination of amounts due under the savings sharing agreement.

Medical care costs as a percentage of premium revenue (the medical care ratio) decreased to 83.7% in the third quarter of 2007 from 84.1% in the third quarter of 2006, an improvement of 40 basis points year-over-year.  Sequentially, the medical care ratio decreased from 85.1% for the quarter ended June 30, 2007, an improvement of 140 basis points.  The Company believes that its medical care ratio is normally at its lowest during the third quarter of any given fiscal year as a result of seasonality in medical care utilization.

The most significant developments regarding medical care costs in the third quarter of 2007 were:

·  
An improvement in the medical care ratios of the Ohio and Texas health plans.  The medical care ratio of the Ohio health plan declined to 88.8% in the third quarter of 2007 from 97.6% in the third quarter of 2006 and 91.1% in the second quarter of 2007.  The medical care ratio of the Texas health plan declined to 76.2% in the third quarter of 2007 from 91.3% in the second quarter of 2007.  The Texas health plan did not have significant premium revenue or medical expense in the third quarter of 2006.  The Company believes that the medical care costs of its Ohio and Texas health plans are developing as anticipated, although the medical care costs of its Texas plan have been somewhat better than anticipated.  Nevertheless, the limited claims payment experience for the many members who have been added during 2007 adds a degree of uncertainty to the medical care cost estimates in both Ohio and Texas that is not found with the Company’s more mature health plans.

·  
An improvement in the medical care ratio of the New Mexico health plan as a result of a 1.5% increase to per member per month medical care costs compared with the third quarter of 2006 and the increases to premium revenue discussed above.

·  
An improvement in the medical care ratio of the California health plan as a result of a 5% decrease to per member per month medical care costs compared with the third quarter of 2006, and increases to premium revenue that took effect during the first half of 2007, particularly in San Diego County.

·  
Increases in the medical care ratios of the Washington and Michigan health plans when compared with the third quarter of 2006.  The Company believes that the medical care ratios experienced by the Washington and Michigan health plans in the third quarter of 2006 were not reasonably sustainable on a long-term basis.

·  
The termination of operations in Indiana.  The Indiana health plan had a medical care ratio of 103.1% in the third quarter of 2006.

The Company’s days in claims payable were 54 days at September 30, 2007, June 30, 2007, and September 30, 2006.

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MOH Reports Third Quarter Results
Page 4
November 1, 2007
 
General and administrative expenses were $74.2 million, or 11.7% of total revenue, for the third quarter of 2007 as compared with $60.5 million, or 11.7% of total revenue, for the third quarter of 2006.

Core G&A expenses (defined as G&A expenses less premium taxes) decreased to 8.4% of revenue in the third quarter of 2007 compared with 8.6% in the third quarter of 2006, but increased from 7.7% in the second quarter of 2007.

The increase in Core G&A in comparison with the second quarter of 2007 is primarily the result of increases to bonus accruals as a result of the Company’s improved financial performance in 2007 as well as the Company’s continued investment in the administrative infrastructure necessary to support its Medicare product line.  Absent the additional bonus expense recorded in the third quarter of 2007, the Core G&A Ratio would have been 7.8% compared with 7.7% in the second quarter of 2007.

Financial Results – Comparison of Nine Months Ended September 30, 2007 and 2006

Premium revenue for the nine months ended September 30, 2007, was $1,791.8 million, an increase of $350.6 million, or 24.3%, over premium revenue of $1,441.2 million for the nine months ended September 30, 2006.  The increase in premium revenue for the nine months ended September 30, 2007, was driven by increased membership in the Company’s Ohio and Texas health plans and by the acquisition of Cape Health Plan in Michigan effective May 15, 2006.

Medical care costs as a percentage of premium revenue (the medical care ratio) increased to 84.8% in the nine months ended September 30, 2007, from 84.4% in the same nine-month period of 2006, a deterioration of 40 basis points, principally as a result of the higher medical care costs of the Company’s Ohio and Texas health plans.

General and administrative expenses were $204.8 million, or 11.3% of total revenue, for the nine months ended September 30, 2007, as compared with $168.0 million, or 11.5% of total revenue, for the same nine-month period of 2006.

Core G&A expenses decreased to 8.0% of total revenue for the nine months ended September 30, 2007, compared with 8.5% in the same nine-month period of 2006.

Cash Flow

Cash provided by operating activities for the nine months ended September 30, 2007, was $113.3 million, as compared with $67.2 million for the same period in 2006, an increase of $46.1 million.  The primary sources of cash provided by operating activities were increased net income, increased deferred revenue at the Ohio health plan, the timing of payments for medical claims and benefits payable, and an increase in accounts payable and accrued liabilities.

On a consolidated basis, at September 30, 2007, the Company had cash and investments (exclusive of restricted investments) of approximately $555.8 million.  The parent company had cash and investments of approximately $24.0 million.   Subsequent to quarter end, the Company issued $200 million in senior convertible notes.  A portion of the net proceeds from the issuance of the notes was used to pay off the $20.0 million owed on the Company’s credit facility at September 30, 2007.  The Company also used $80.0 million of the net proceeds in connection with its acquisition of Mercy CarePlus in Missouri.

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MOH Reports Third Quarter Results
Page 5
November 1, 2007
 
Conference Call

The Company’s management will host a conference call and webcast to discuss its third quarter results at 5:00 p.m. Eastern Time on Thursday, November 1, 2007.  The telephone number for this interactive conference call is 212-231-2920, and the live webcast of the call can be accessed on the Company’s website at www.molinahealthcare.com, or at www.earnings.com.  An online replay will be available beginning approximately one hour following the conclusion of the call and webcast.

Molina Healthcare, Inc. is a multi-state managed care organization that arranges for the delivery of healthcare services to persons eligible for Medicaid and other government-sponsored programs for low-income families and individuals.  Molina Healthcare, Inc. currently operates health plans in California, Michigan, Missouri, Nevada, New Mexico, Ohio, Texas, Utah, and Washington.  More information about Molina Healthcare, Inc. can be obtained at www.molinahealthcare.com.

Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995: This press release contains “forward-looking statements” identified by words such as “will,” “believes,” “expects” or ”expectations,” “anticipates,” “plans,” “projects,” “estimates,” “intends,” and similar words and expressions.  In addition, any statements that explicitly or implicitly refer to earnings guidance, expectations, projections, or their underlying assumptions, or other characterizations of future events or circumstances, are forward-looking statements.  All of our forward-looking statements are based on our current expectations and assumptions which are subject to numerous known and unknown risks, uncertainties, and other factors that could cause actual results to differ materially.  Such factors include, without limitation, risks related to: the continuing achievement of a decrease in the medical care ratio of our health plans in Ohio and Texas; the continuing achievement of projected savings from a decrease in the overall medical care ratio of all of our health plans; an increase in enrollment in our Ohio and California health plans and in our dual eligible population consistent with our expectations; our ability to reduce administrative costs in the event enrollment or revenue is lower than expected for the remainder of the year; increased administrative costs in support of the Company's efforts to expand Medicare membership; risks related to our minimal experience with Ohio, Texas, and dual eligible members and attendant claims estimation difficulties; our ability to accurately estimate incurred but not reported medical costs across all health plans; the securing of expected premium rate increases, particularly in the state of Michigan; the effect of the DRG rate rebasing in Washington being greater than expected; the payment of savings sharing income by the state of Utah to our Utah health plan consistent with our expectations; the successful renewal and continuation of the government contracts of all of our health plans; the availability of adequate financing to fund and/or capitalize our acquisitions and start-up activities, and applicable interest rates that are consistent with our expectations; the successful and cost-effective integration of our acquisitions, including Mercy CarePlus; membership eligibility processes and methodologies; unexpected changes in member utilization patterns, healthcare practices, or healthcare technologies; high dollar claims related to catastrophic illness; changes in federal or state laws or regulations or in their interpretation; failure to maintain effective and efficient information systems and claims processing technology; funding decreases in the Medicaid, SCHIP, or Medicare programs or the failure to timely renew the SCHIP program; the favorable resolution of pending litigation or arbitration; competition; epidemics such as the avian flu; and other risks and uncertainties as detailed in our reports and filings with the Securities and Exchange Commission and available on its website at www.sec.gov.  All forward-looking statements in this release represent our judgment as of November 1, 2007.  We disclaim any obligation to update any forward-looking statement to conform the statement to actual results or changes in our expectations.
 
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MOH Reports Third Quarter Results
Page 6
November 1, 2007
MOLINA HEALTHCARE, INC.
CONDENSED CONSOLIDATED STATEMENTS OF INCOME
(Dollars in thousands, except for per share data)
(Unaudited)
 

     
Three Months Ended   
   
Nine Months Ended   
 
     
September 30,   
   
September 30,
 
     
2007
   
2006
   
2007
   
2006
 
Revenue: 
                       
 
Premium revenue
   $
628,402
     $
512,080
     $
1,791,764
     $
1,441,197
 
 
Investment income
   
7,632
     
5,385
     
21,061
     
14,278
 
 
Total revenue
   
636,034
     
517,465
     
1,812,825
     
1,455,475
 
                                   
Expenses: 
                               
 
Medical care costs
   
525,902
     
430,870
     
1,519,244
     
1,215,832
 
 
General and administrative expenses
   
74,235
     
60,504
     
204,831
     
168,025
 
 
Depreciation and amortization
   
7,082
     
5,633
     
20,274
     
15,265
 
 
Impairment charge on purchased software (1)
   
     
     
782
     
 
 
Total expenses
   
607,219
     
497,007
     
1,745,131
     
1,399,122
 
 
Operating income
   
28,815
     
20,458
     
67,694
     
56,353
 
                                   
Other expense: 
                               
 
Interest expense
    (530 )     (645 )     (2,380 )     (1,636 )
 
Total other expense
    (530 )     (645 )     (2,380 )     (1,636 )
 
Income before income taxes
   
28,285
     
19,813
     
65,314
     
54,717
 
 
Income tax expense
   
10,772
     
7,472
     
24,895
     
20,634
 
 
Net income
   $
17,513
     $
12,341
     $
40,419
     $
34,083
 
                                   
Net income per share: 
                               
 
Basic
   $
0.62
     $
0.44
     $
1.43
     $
1.22
 
 
Diluted
   $
0.62
     $
0.44
     $
1.43
     $
1.21
 
                                   
Weighted average number of common shares and 
                               
 
potential dilutive common shares outstanding
   
28,441,000
     
28,346,000
     
28,356,000
     
28,253,000
 
                                   
Operating Statistics: 
                               
 
Medical care ratio (2)
    83.7%       84.1%       84.8%       84.4%  
 
General and administrative expense ratio (3),
                               
 
excluding premium taxes
    8.4%       8.6%       8.0%       8.5%  
 
Premium taxes included in general and
                               
 
administrative expenses
    3.3%       3.1%       3.3%       3.0%  
 
   Total general and administrative expense ratio
    11.7%       11.7%       11.3%       11.5%  
 
Depreciation and amortization expense ratio (4)
    1.1%       1.1%       1.1%       1.0%  
 
Effective tax rate
    38.1%       37.7%       38.1%       37.7%  
 
(1)
Amounts represent an impairment charge related to commercial software no longer used for operations.
(2)
Medical care ratio represents medical care costs as a percentage of premium revenue.
(3)
General and administrative expense ratio represents such expenses as a percentage of total revenue.
(4)
Depreciation and amortization expense ratio represents such expenses as a percentage of total revenue.
 
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MOH Reports Third Quarter Results
Page 7
November 1, 2007
 
MOLINA HEALTHCARE, INC.
 
CONDENSED CONSOLIDATED BALANCE SHEETS
 
(Dollars in thousands, except per share data)
 
               
 
 
 
Sept. 30,
   
Dec. 31,
 
     
2007
   
2006
 
 
 
 
(Unaudited)
       
ASSETS
 
               
Current assets:
             
Cash and cash equivalents
    $
447,594
    $
403,650
 
Investments
     
108,161
     
81,481
 
Receivables
     
124,145
     
110,835
 
Income tax receivable
     
     
7,960
 
Deferred income taxes
     
577
     
313
 
Prepaid expenses and other current assets
     
11,424
     
9,263
 
Total current assets
     
691,901
     
613,502
 
Property and equipment, net
     
47,431
     
41,903
 
Goodwill and intangible assets, net
     
133,502
     
143,139
 
Restricted investments
     
27,762
     
20,154
 
Receivable for ceded life and annuity contracts
     
30,929
     
32,923
 
Other assets
     
14,492
     
12,854
 
Total assets
 
  $
946,017
    $
864,475
 
                   
LIABILITIES AND STOCKHOLDERS’ EQUITY
 
                   
Current liabilities:
                 
Medical claims and benefits payable
    $
308,722
    $
290,048
 
Deferred revenue
     
42,043
     
18,120
 
Income tax payable
     
1,242
     
 
Accounts payable and accrued liabilities
     
61,778
     
46,725
 
Total current liabilities
     
413,785
     
354,893
 
Long-term debt
     
20,000
     
45,000
 
Deferred income taxes
     
1,056
     
6,700
 
Liability for ceded life and annuity contracts
     
30,929
     
32,923
 
Other long-term liabilities
     
11,808
     
4,793
 
Total liabilities
     
477,578
     
444,309
 
                   
Stockholders’ equity:
                 
Common stock, $0.001 par value; 80,000,000 shares authorized;
issued and outstanding: 28,346,685 shares at September 30, 2007,
and 28,119,026 shares at December 31, 2006
      28       28  
Preferred stock, $0.001 par value; 20,000,000 shares authorized,
no shares issued and outstanding
      -       -  
Additional paid-in capital
     
181,841
     
173,990
 
Accumulated other comprehensive gain (loss)
     
111
     
(337
Retained earnings
     
306,849
     
266,875
 
Treasury stock (1,201,174 shares, at cost)
     
(20,390
)    
(20,390
Total stockholders’ equity
     
468,439
     
420,166
 
Total liabilities and stockholders’ equity
    $
946,017
   
864,475
 
 
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MOH Reports Third Quarter Results
Page 8
November 1, 2007
 
MOLINA HEALTHCARE, INC.
 
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
 
(Dollars in thousands)
 
(Unaudited)
 
             
   
Nine Months Ended
 
   
September 30,
 
   
2007
   
2006
 
Operating activities:
           
Net income
  $
40,419
    $
34,083
 
Adjustments to reconcile net income to net cash provided by operating activities:
               
Depreciation and amortization
   
20,274
     
15,265
 
Amortization of capitalized credit facility fees
   
646
     
646
 
Deferred income taxes
    (4,139 )     (2,510 )
Stock-based compensation
   
5,238
     
4,331
 
Changes in operating assets and liabilities:
               
Receivables
    (13,310 )     (13,099 )
Prepaid expenses and other current assets
    (2,161 )    
2,068
 
Medical claims and benefits payable
   
18,674
     
17,036
 
Deferred revenue
   
23,923
     
 
Accounts payable and accrued liabilities
   
14,763
     
7,411
 
Income taxes
   
8,989
     
1,955
 
Net cash provided by operating activities
   
113,316
     
67,186
 
                 
Investing activities:
               
Purchases of property and equipment
    (16,5140 )     (13,285 )
Purchases of investments
    (85,252 )     (103,702 )
Sales and maturities of investments
   
59,292
     
115,866
 
Net cash acquired in purchase transactions
   
     
5,820
 
Increase in restricted cash
    (7,608 )     (738 )
Increase in other long-term liabilities
   
6,569
     
42
 
Increase in other assets
    (2,921 )     (1,218 )
Net cash (used in) provided by investing activities
    (46,434 )    
2,785
 
                 
Financing activities:
               
Borrowings under credit facility
   
     
20,000
 
Repayment of amounts borrowed under credit facility
    (25,000 )     (5,000 )
Repayment of credit facility fees
    (551 )    
 
Repurchase and retirement of common stock
    (480 )    
 
Tax benefit from exercise of employee stock options
               
   recorded as additional paid-in capital
   
554
     
1,094
 
Proceeds from exercise of stock options and employee stock purchases
   
2,539
     
1,816
 
Net cash (used in) provided by financing activities
    (22,938 )    
17,910
 
Net increase in cash and cash equivalents
   
43,944
     
87,881
 
Cash and cash equivalents at beginning of period
   
403,650
     
249,203
 
Cash and cash equivalents at end of period
  $
447,594
    $
337,084
 
 
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MOH Reports Third Quarter Results
Page 9
November 1, 2007
 
MOLINA HEALTHCARE, INC.
MEMBERSHIP DATA
(Unaudited)
               
   
Sept. 30,
 
June 30,
 
Sept. 30,
 
Total Ending Membership by Health Plan:
 
2007
 
2007
 
2006
 
California
 
288,000
 
291,000
 
302,000
 
Michigan
 
211,000
 
217,000
 
227,000
 
New Mexico
 
69,000
 
66,000
 
62,000
 
Ohio
 
138,000
 
138,000
 
33,000
 
Texas
 
30,000
 
30,000
 
3,000
(2)
Utah
 
50,000
 
47,000
 
54,000
 
Washington
 
284,000
 
287,000
 
280,000
 
   Subtotal
 
1,070,000
 
1,076,000
 
961,000
 
Indiana
 
N/A
(1)
N/A
(1)
54,000
 
   Total
 
1,070,000
 
1,076,000
 
1,015,000
 
               
(1)  The Company’s Indiana health plan ceased serving members effective January 1, 2007. 
(2)  The Company’s Texas health plan commenced operations in September 2006. 
               
Total Ending Membership by State for the Company’s
 
Sept. 30,
 
June 30,
 
Sept. 30,
 
Medicare Advantage Special Needs Plans:
 
2007
 
2007
 
2006
 
California
 
875
 
724
 
455
 
Michigan
 
814
 
459
 
138
 
Nevada
 
178
 
9
 
 
Utah
 
1,802
 
1,646
 
1,426
 
Washington
 
446
 
413
 
153
 
   Total
 
4,115
 
3,251
 
2,172
 
               
Total Ending Membership by State for the Company’s
 
Sept. 30,
 
June 30,
 
Sept. 30,
 
   Aged, Blind and Disabled (“ABD”) Population:
 
2007
 
2007
 
2006
 
California
 
10,912
 
10,728
 
10,368
 
Michigan
 
31,488
 
31,940
 
22,553
 
New Mexico
 
6,844
 
6,822
 
6,674
 
Ohio
 
14,965
 
15,117
 
 
Texas
 
16,515
 
16,603
 
 
Utah
 
7,056
 
6,876
 
6,763
 
Washington
 
2,715
 
2,693
 
2,727
 
   Total
 
90,495
 
90,779
 
49,085
 

                         
   
Quarter Ended
   
Nine Months Ended
 
Total Member Months (1)
 
Sept. 30,
 
June 30,
 
Sept. 30,
   
Sept. 30,
 
Sept. 30,
 
   by Health Plan:
 
2007
 
2007
 
2006
   
2007
 
2006
 
California
 
859,000
 
874,000
 
911,000
   
2,619,000
 
2,785,000
 
Michigan
 
640,000
 
658,000
 
681,000
   
1,967,000
 
1,677,000
 
New Mexico
 
200,000
 
197,000
 
181,000
   
589,000
 
535,000
 
Ohio
 
416,000
 
399,000
 
95,000
   
1,155,000
 
229,000
 
Texas
 
90,000
 
91,000
 
3,000
(3)
 
247,000
 
3,000
(3)
Utah
 
142,000
 
145,000
 
167,000
   
438,000
 
527,000
 
Washington
 
854,000
 
860,000
 
846,000
   
2,570,000
 
2,572,000
 
  Subtotal
 
3,201,000
 
3,224,000
 
2,884,000
   
9,585,000
 
8,328,000
 
Indiana
 
N/A
(2)
N/A
(2)
150,000
   
N/A
(2)
328,000
 
  Total
 
3,201,000
 
3,224,000
 
3,034,000
   
9,585,000
 
8,656,000
 
                         
(1) Total member months is defined as the aggregate of each month’s ending membership for the period.  
(2) The Company’s Indiana health plan ceased serving members effective January 1, 2007.  
(3) The Company’s Texas health plan commenced operations in September 2006.  
 
-MORE-

MOH Reports Third Quarter Results
Page 10
November 1, 2007
 
MOLINA HEALTHCARE, INC.
SELECTED FINANCIAL DATA BY HEALTH PLAN
(Dollars in thousands except PMPM amounts)
(Unaudited)
 
 
 
Three Months Ended September 30, 2007
 
     
Premium Revenue
   
Medical Care Costs
   
Medical
   
Premium Tax
 
     
Total
   
PMPM
   
Total
   
PMPM
   
Care Ratio
   
Expense
 
California
    $
93,154
    $
108.39
    $
76,443
    $
88.95
      82.1%     $
2,382
 
Michigan
     
119,752
     
187.19
     
100,378
     
156.90
      83.8%      
7,069
 
New Mexico
     
72,543
     
361.23
     
56,984
     
283.76
      78.6%      
2,828
 
Ohio
     
125,452
     
302.02
     
111,387
     
268.16
      88.8%      
5,645
 
Texas
     
24,997
     
279.39
     
19,041
     
212.82
      76.2%      
450
 
Utah
     
27,513
     
193.52
     
26,534
     
186.63
      96.4%      
 
Washington
     
164,367
     
192.43
     
130,216
     
152.45
      79.2%      
2,748
 
Other
     
624
     
     
4,919
     
     
     
7
 
  Consolidated
    $
628,402
    $
196.29
    $
525,902
    $
164.27
      83.7%     $
21,129
 
 
   
Three Months Ended September 30, 2006
 
   
Premium Revenue
   
Medical Care Costs
   
Medical
   
Premium Tax
 
   
Total
   
PMPM
   
Total
   
PMPM
   
Care Ratio
   
Expense
 
California
  $
93,590
    $
102.71
    $
85,283
    $
93.59
      91.1%     $
2,934
 
Indiana
   
24,626
     
164.15
     
25,384
     
169.20
      103.1%      
 
Michigan
   
122,209
     
179.25
     
95,049
     
139.42
      77.8%      
7,505
 
New Mexico
   
58,648
     
324.51
     
50,533
     
279.61
      86.2%      
2,164
 
Ohio
   
20,977
     
219.76
     
20,466
     
214.41
      97.6%      
968
 
Texas
   
280
     
108.86
     
361
     
140.69
      129.2%      
24
 
Utah
   
39,268
     
234.81
     
35,961
     
215.03
      91.6%      
 
Washington
   
152,481
     
180.40
     
112,372
     
132.95
      73.7%      
2,587
 
Other
   
1
     
     
5,461
     
     
     
2
 
  Consolidated
  $
512,080
    $
168.77
    $
430,870
    $
142.00
      84.1%     $
16,184
 
 
   
Nine Months Ended September 30, 2007
 
   
Premium Revenue
   
Medical Care Costs
   
Medical
   
Premium Tax
 
   
Total
   
PMPM
   
Total
   
PMPM
   
Care Ratio
   
Expense
 
California
  $
280,796
    $
107.22
    $
228,952
    $
87.42
      81.5%     $
8,614
 
Michigan
   
364,945
     
185.54
     
306,163
     
155.66
      83.9%      
21,942
 
New Mexico
   
191,073
     
324.23
     
159,152
     
270.07
      83.3%      
6,438
 
Ohio
   
311,853
     
270.08
     
282,164
     
244.37
      90.5%      
14,033
 
Texas
   
64,406
     
260.88
     
55,163
     
223.44
      85.6%      
1,140
 
Utah
   
88,473
     
201.87
     
81,535
     
186.04
      92.2%      
 
Washington
   
489,254
     
190.36
     
392,201
     
152.60
      80.2%      
8,117
 
Other
   
964
     
     
13,914
     
     
     
21
 
  Consolidated
  $
1,791,764
    $
186.93
    $
1,519,244
    $
158.50
      84.8%     $
60,305
 
 
   
Nine Months Ended September 30, 2006
 
   
Premium Revenue
   
Medical Care Costs
   
Medical
   
Premium Tax
 
   
Total
   
PMPM
   
Total
   
PMPM
   
Care Ratio
   
Expense
 
California
  $
279,161
    $
100.23
    $
245,599
    $
88.18
      88.0%     $
8,918
 
Indiana
   
54,873
     
167.16
     
52,980
     
161.40
      96.6%      
 
Michigan
   
301,739
     
179.88
     
234,950
     
140.06
      77.9%      
18,259
 
New Mexico
   
168,088
     
314.30
     
141,657
     
264.88
      84.3%      
6,039
 
Ohio
   
49,555
     
216.18
     
46,199
     
201.54
      93.2%      
2,237
 
Texas
   
280
     
108.86
     
381
     
148.47
      136.4%      
24
 
Utah
   
126,741
     
240.30
     
115,828
     
219.61
      91.4%      
 
Washington
   
460,733
     
179.17
     
362,800
     
141.08
      78.7%      
7,937
 
Other
   
27
     
     
15,438
     
     
     
2
 
  Consolidated
  $
1,441,197
    $
166.49
    $
1,215,832
    $
140.45
      84.4%     $
43,416
 
 
-MORE-

MOH Reports Third Quarter Results
Page 11
November 1, 2007
 MOLINA HEALTHCARE, INC.
DETAIL OF MEDICAL CARE COSTS
(Dollars in thousands, except PMPM amounts)
(Unaudited)

The following table provides detail of the Company’s medical care costs:
 
     
Three Months Ended
   
Three Months Ended
 
     
September 30, 2007
   
September 30, 2006
 
                 
% of Total
               
% of Total
 
                 
Medical
               
Medical
 
     
Amount
   
PMPM
   
Care Costs
   
Amount
   
PMPM
   
Care Costs
 
Medical care costs:
                                     
 Fee for service costs
  $
339,841
    $
106.15
      64.6%     $
284,648
    $
93.81
      66.1%  
 Capitation
   
95,879
     
29.95
      18.2%      
68,144
     
22.46
      15.8%  
 Pharmacy
   
67,844
     
21.19
      12.9%      
51,697
     
17.04
      12.0%  
 Other
   
22,338
     
6.98
      4.3%      
26,381
     
8.69
      6.1%  
 Total medical
                                               
    care costs
  $
525,902
    $
164.27
      100.0%     $
430,870
    $
142.00
      100.0%  
 
     
Nine Months Ended
   
Nine Months Ended
 
     
September 30, 2007
   
September 30, 2006
 
                 
% of Total
               
% of Total
 
                 
Medical
               
Medical
 
     
Amount
   
PMPM
   
Care Costs
   
Amount
   
PMPM
   
Care Costs
 
Medical care costs:
                                     
 Fee for service costs
  $
984,375
    $
102.70
      64.8%     $
814,928
    $
94.14
      67.0%  
 Capitation
   
276,742
     
28.87
      18.2%      
187,997
     
21.72
      15.5%  
 Pharmacy
   
194,354
     
20.28
      12.8%      
148,858
     
17.19
      12.2%  
 Other
   
63,773
     
6.65
      4.2%      
64,049
     
7.40
      5.3%  
 Total medical
                                               
    care costs
  $
1,519,244
    $
158.50
      100.0%     $
1,215,832
    $
140.45
      100.0%  
 
-MORE-

MOH Reports Third Quarter Results
Page 12
November 1, 2007
MOLINA HEALTHCARE, INC.
CHANGE IN MEDICAL CLAIMS AND BENEFITS PAYABLE
(Dollars in thousands)
(Unaudited)

The following table shows the components of the change in medical claims and benefits payable for the nine months ended September 30, 2007 and 2006:

   
Nine Months Ended
 
   
September 30,
 
   
2007
   
2006
 
Balances at beginning of period
  $
290,048
    $
217,354
 
Medical claims and benefits payable from business acquired during the period
   
     
22,536
 
Components of medical care costs related to:
               
Current year
   
1,568,949
     
1,254,174
 
Prior years
    (49,705 )     (38,342 )
Total medical care costs
   
1,519,244
     
1,215,832
 
Payments for medical care costs related to:
               
Current year
   
1,278,321
     
1,017,923
 
Prior years
   
222,249
     
180,872
 
Total paid
   
1,500,570
     
1,198,795
 
Balances at end of period
  $
308,722
    $
256,927
 
 
The Company’s claims liability includes an allowance for adverse claims development based on historical experience and other factors including, but not limited to, variation 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.  Accordingly, any benefit recognized in medical care costs resulting from favorable development of an estimated liability at the start of the period (captured as a component of “medical care costs related to prior years”) may be offset by the addition of an allowance for adverse claims development when estimating the liability at the end of the period (captured as a component of “medical care costs related to current year”).  During the second quarter of 2006, the Company recognized a net benefit in medical care costs of approximately $5.0 million due to favorable development of its medical claims liability at December 31, 2005.
 
   
Nine Months Ended
 
   
September 30,
 
   
2007
   
2006
 
Days in claims payable
   
54
     
54
 
                 
Number of members at end of period
   
1,070,000
     
1,015,000
 
Number of claims in inventory at end of period (1)
   
179,186
     
246,435
 
Billed charges of claims in inventory at end of period (in thousands) (1)
  $
231,753
    $
234,494
 
Claims in inventory per member at end of period (1)
   
0.17
     
0.26
 
                 
(1)  2006 claims data excludes information for Cape Health Plan membership of approximately 85,000 members.  Cape membership was processed on a separate claims platform through December 31, 2006.       
 
 
-END-