Molina Healthcare, Inc.
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
Form 8-K/A
Current Report
Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934
Date of Report (Date of earliest event reported): 11/01/2007
MOLINA HEALTHCARE, INC.
(Exact name of registrant as specified in its charter)
Commission
File Number: 001-31719
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134204626 |
(State or other jurisdiction of
incorporation)
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(IRS Employer
Identification No.) |
200 Oceangate, Suite 100
Long Beach, CA 90802
(Address of principal executive offices, including zip code)
562 435 3666
(Registrants telephone number, including area code)
One Golden Shore Drive
Long Beach, CA 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:
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Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425) |
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Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12) |
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Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR
240.14d-2(b)) |
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Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR
240.13e-4(c)) |
TABLE OF CONTENTS
Item 2.01. Completion of Acquisition or Disposition of Assets
This
Current Report on Form 8-K/A amends the Current Report on Form 8-K
filed on November 1, 2007, to include the required Item 9.01
financial statements of the business acquired and pro forma financial
information.
Item 9.01. Financial Statements and Exhibits
(a) Financial statements of businesses acquired.
The
required financial statements for Mercy CarePlus are attached as Exhibits 99.1 and 99.2
hereto and are hereby incorporated by reference.
(b) Pro forma
financial information.
The unaudited pro forma condensed financial
statements give pro forma effect to our acquisition of Mercy
CarePlus as of September 30, 2007 for balance sheet purposes and
as of January 1, 2006, for statement of income purposes, and are filed as
Exhibit 99.3 hereto and are hereby
incorporated by reference.
(c) Shell company transactions.
Not applicable.
(d) Exhibits
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Exhibit No. |
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Description |
23.1
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Consent of Brown Smith Wallace, LLC |
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99.1
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Audited financial statements of
Alliance for Community Health LLC d/b/a Mercy CarePlus for the fiscal year ended December 31, 2006. |
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99.2
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Unaudited condensed financial statements of
Alliance for Community Health LLC d/b/a Mercy CarePlus for the nine month periods ended September
30, 2007 and 2006. |
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99.3
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Unaudited pro forma
financial information. |
Signature(s)
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.
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Date: January 17, 2008 |
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MOLINA HEALTHCARE, INC.
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By: |
/s/ Mark L. Andrews |
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Mark L. Andrews |
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Chief Legal Officer and General Counsel |
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Exhibit Index
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Exhibit No. |
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Description |
23.1
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Consent of Brown Smith Wallace, LLC |
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99.1
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Audited financial statements of
Alliance for Community Health LLC d/b/a Mercy CarePlus for the fiscal year ended December 31, 2006. |
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99.2
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Unaudited condensed financial statements of
Alliance for Community Health LLC d/b/a Mercy CarePlus for the nine month periods ended September
30, 2007 and 2006. |
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99.3
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Unaudited pro forma
financial information. |
Exhibit 23.1
Exhibit 23.1
Consent of Independent Registered Public Accounting Firm
We consent to the incorporation by reference in the registration statements (Forms S-8, No.
333-108317 and No. 333-138552) pertaining to the Molina Healthcare, Inc. 2000 Omnibus Stock and
Incentive Plan, 2002 Equity Incentive Plan, and 2002 Employee Stock Purchase Plan, and to the
registration statement (Form S-3/A, No. 333-123783) and
related Prospectus Supplement of Molina Healthcare,
Inc., of our report dated December 20, 2007, with respect to the consolidated balance sheet of
Alliance For Community Health LLC, d/b/a Mercy CarePlus, as of December 31, 2006, and the related
statements of income, members equity, and cash flows for the year then ended, which report appears
in the Form 8-K/A of Molina Healthcare, Inc. dated January 17, 2008.
Brown Smith Wallace, LLC
St. Louis, Missouri
January 16, 2008
Exhibit 99.1
Exhibit 99.1
Alliance For Community Health LLC
d/b/a
Mercy CarePlus
Financial Statements
with
Independent Auditors Report
December
31, 2006
TABLE OF CONTENTS
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Page |
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Independent Auditors Report |
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1 |
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Financial Statements |
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Balance Sheet |
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2 |
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Statement of Income |
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3 |
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Statement of Members Equity |
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4 |
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Statement of Cash Flows |
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5 |
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Notes to Financial Statements |
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6 |
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1050 N. LINDBERGH BOULEVARD ST. LOUIS, MO 63132
PH 314.983.1200 FX 314.983.1300 WWW.BSWLLC.COM |
A
MEASURABLE DIFFERENCETM
Independent Auditors Report
Board of Managers
Alliance For Community Health LLC
d/b/a Mercy CarePlus
St. Louis, Missouri
We have audited the accompanying balance sheet of Alliance For Community Health LLC, d/b/a Mercy
CarePlus (Company) as of December 31, 2006, and the related statements of income, members equity,
and cash flows for the year then ended. These financial statements are the responsibility of the
Companys management. Our responsibility is to express an opinion on these financial statements
based on our audit.
We conducted our audit in accordance with auditing standards generally accepted in the United
States of America. Those standards require that we plan and perform the audit to obtain reasonable
assurance about whether the financial statements are free of material misstatement. An audit
includes consideration of internal control over financial reporting as a basis for designing audit
procedures that are appropriate in the circumstances, but not for the purpose of expressing an
opinion on the effectiveness of the Companys internal control over financial reporting.
Accordingly, we express no such opinion. An audit also includes examining, on a test basis,
evidence supporting the amounts and disclosures in the financial statements. An audit also includes
assessing the accounting principles used and significant estimates made by management, as well as
evaluating the overall financial statement presentation. We believe that our audit provides a
reasonable basis for our opinion.
In our opinion, the financial statements referred to above present fairly, in all material
respects, the financial position of the Company as of December 31, 2006, and the results of its
operations and its cash flows for the year then ended, in conformity with accounting principles
generally accepted in the United States of America.
/s/ Brown
Smith Wallace, LLC
December 20, 2007
MEMBER
AMERICAN INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS AND MOORE STEPHENS NORTH AMERICA, INC
KNOWN INTERNATIONALLY AS MOORE STEPHENS BROWN SMITH WALLACE, LLC
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Balance Sheet
December 31, 2006
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ASSETS |
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Current Assets |
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Cash and cash equivalents |
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$ |
14,193,020 |
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Certificates of deposit |
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6,051,860 |
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Prepaid assets |
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219,601 |
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Deferred taxes |
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388,095 |
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Accounts Receivable: |
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Premiums |
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17,140,378 |
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Health care |
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84,093 |
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Interest |
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64,777 |
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Total Current Assets |
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38,141,824 |
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Furniture and Equipment, net |
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261,905 |
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Goodwill |
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19,375,796 |
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Non-Current Investments
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Restricted investments |
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496,187 |
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Long-term investments |
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1,645,000 |
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Deposits |
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19,672 |
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TOTAL ASSETS |
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$ |
59,940,384 |
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LIABILITIES AND MEMBERS EQUITY |
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Current Liabilities
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Accounts payable |
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$ |
550,919 |
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Claims payable |
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12,742,654 |
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Accrued expenses and other current liabilities |
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1,108,874 |
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Income taxes payable |
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1,584,292 |
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Deferred taxes |
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20,891 |
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Total Current Liabilities |
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16,007,630 |
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Long-Term Deferred Taxes |
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251,885 |
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Members Equity |
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43,680,869 |
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TOTAL LIABILITIES AND MEMBERS EQUITY |
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$ |
59,940,384 |
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The accompanying notes are an integral part of these financial statements.
-2-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Statement of Income
Year ended December 31, 2006
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Revenues |
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Premium revenue |
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$ |
124,454,390 |
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Interest and other revenue |
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1,179,015 |
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Total Revenues |
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125,633,405 |
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Expenses |
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Medical and hospital |
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100,624,556 |
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Reinsurance |
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217,074 |
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Administration |
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Compensation and benefits |
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3,937,860 |
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Purchased services |
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4,606,735 |
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Marketing |
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429,135 |
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Bad debt recovery, net |
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(281,040 |
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Occupancy and depreciation |
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324,854 |
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General and administrative |
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967,709 |
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Total Expenses |
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110,826,883 |
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Income before income taxes |
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14,806,522 |
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Income taxes |
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Current |
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4,787,337 |
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Deferred |
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385,692 |
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NET INCOME |
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$ |
9,633,493 |
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The accompanying notes are an integral part of these financial statements.
-3-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Statement of Changes to Members Equity
Year ended December 31, 2006
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Balance at December 31, 2005 |
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$ |
10,878,564 |
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Contributed capital |
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32,719,847 |
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Distributions to Members |
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(9,551,035 |
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Net income |
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9,633,493 |
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Balance at December 31, 2006 |
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$ |
43,680,869 |
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The accompanying notes are an integral part of these financial statements.
-4-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Statement of Cash Flows
Year ended December 31, 2006
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Cash from operating activities |
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Net income |
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$ |
9,633,493 |
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Adjustments to reconcile net income to net cash
provided by operating activities: |
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Realized losses on disposal of furniture and equipment |
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2,609 |
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Depreciation and amortization |
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87,144 |
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Deferred income taxes |
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(115,319 |
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Amortization of discount on restricted assets |
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2,563 |
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(Increase) decrease in operating assets: |
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Prepaid assets |
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(123,121 |
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Premiums receivable |
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(9,847,773 |
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Reinsurance receivable |
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111,252 |
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Health care receivable |
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470,332 |
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Deposits |
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(1,152 |
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Increase (decrease) in operating liabilities: |
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Accounts payable |
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233,873 |
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Claims payable |
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5,458,076 |
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Accrued expenses and other current liabilities |
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(100,036 |
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Accrued interest receivable |
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4,403 |
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Income taxes payable |
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1,226,626 |
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Net cash provided by operating activities |
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7,042,970 |
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Cash from investing activities |
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Purchases of furniture and equipment |
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(150,425 |
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Proceeds from maturity of certificates of deposit |
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2,000,000 |
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Purchases of certificates of deposit |
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(6,051,860 |
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Proceeds from maturity or sale of investments |
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4,848,617 |
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Proceeds from maturity or sale of long-term investments |
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1,505,000 |
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Net cash provided by investing activities |
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2,151,332 |
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Cash from financing activities |
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Additions to contributed capital, net |
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13,344,051 |
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Distributions to Members |
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(9,551,035 |
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Net cash provided by financing activities |
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3,793,016 |
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Net increase in cash and cash equivalents |
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12,987,318 |
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Cash and cash equivalents, at beginning of year |
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1,205,702 |
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Cash and cash equivalents, at year end |
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$ |
14,193,020 |
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The accompanying notes are an integral part of these financial statements.
-5-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Notes to Financial Statements
December 31, 2006
Note A Summary of Significant Accounting Policies
Organization and Operations
Alliance For Community Health LLC, d/b/a Mercy CarePlus (the Company) is a prepaid
health maintenance organization (HMO) providing health insurance to certain State of
Missouri Medicaid and Childrens Health Insurance Program (CHIP) managed care participants
in St. Louis, Missouri and certain surrounding counties and expanded into the Central and
Western regions of Missouri on July 1, 2006. The Company was originally incorporated as a
not-for-profit entity, Alliance for Community Health, Inc., on March 5, 1986; received a
license to operate as an HMO in the State of Missouri on June 17, 1987; began operations
as an HMO on September 1, 1995; and converted to a limited liability company (LLC) on
August 16, 1996.
On May 28, 2004, ownership of the Company changed pursuant to a Definitive Agreement
approved by the Department of Insurance of the State of Missouri. In accordance with the
Agreement, the Companys former Class A and Class B members transferred their ownership
rights to CCP Acquisition Limited (CAL) and three executive members of management. Upon
transfer, CAL became the sole Class A Member of the Company and the three executive
members of management became Class B Members.
On May 17, 2006 CAL transferred its ownership interest in the Company to CCP Holdings,
LLC (CH), an affiliate of CAL by common ownership.
On June 30, 2006, Mercy Health Plans, Inc. (MHP), contributed cash in the amount of
$13,344,051 and goodwill in the amount of $19,375,796 to purchase a newly issued member
interest in the Company. The goodwill was established to record the new members interest
of the Company at the fair market value. The goodwill was calculated as the difference
between the newly established fair market value of the Company and the value of the cash
contributed by the new member. The Company obtained an independent qualified appraisal
for the determinable market value before the merger was completed. As a result of the
contribution, MHP obtained 50% ownership of the Company. The ownership percentages of the
existing owners, CH and certain members of management (collectively), were reduced to
40.05% and 9.95%, respectively. CH remained the sole Class A Member, the three executive
members of management remained the sole Class B Members and MHP become the sole Class C
Member of Alliance for Community Health, LLC. Simultaneously, the Companys doing
business as changed from Community CarePlus to Mercy CarePlus.
-6-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Notes to Financial Statements Continued
December 31, 2006
Note A Summary of Significant Accounting Policies (Continued)
Organization and Operations (Continued)
As a result of the June 30, 2006, change in ownership, the Company has three classes of
members: Classes A, B, and C. Voting rights are reserved for only Classes A and C. Class A
receives priority in distributions over other classes.
On September 29, 2006, the Class C ownership interest of MHP was transferred to Sisters
of Mercy Health System (SMHS), an affiliate of MHP.
At December 31, 2006, the Company had insured members of approximately 70,000.
The Company is structured as a network model HMO. As such, the Company has contracts with
networks for physician and hospital services. Each member chooses a primary care
physician (PCP) who is under contract with the Company. The Company has also negotiated
contracts with hospitals, physician specialists, and other health care providers to
satisfy the necessary medical care needs of its eligible members that extend beyond the
level of care provided by the PCP. The Company has subcapitation agreements with some of
its PCPs under the Medicaid program that are structured so that the PCP receives monthly
payments based upon the number, age, and sex of members associated with the PCP. The
Company also has subcapitation agreements with its network providers for mental health,
transportation, dental, and vision services that are structured so that the respective
providers receive monthly payments based upon the number of members enrolled with the
Company.
The Company contracts with NovaSys Health Network, LLC (NovaSys) to provide third-party
administrative services under a service agreement which provides for the Company to pay
NovaSys a per member per month (PMPM) processing fee. Services provided by NovaSys
include, but are not limited to claims and revenue processing, information systems, and
management reporting systems. The initial term of the contract was from September 1, 1998
through August 31, 2001. The term of the current contract is October 1, 2005 through
September 30, 2008.
Basis of Presentation
The Companys financial statements are presented on the accrual basis of accounting in
conformity with accounting standards generally accepted in the United States of America
(GAAP).
-7-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Notes to Financial Statements Continued
December 31,2006
Note A Summary of Significant Accounting Policies (Continued)
Use of Estimates
The preparation of financial statements in conformity with accounting practices generally
accepted in the United States requires management to make estimates and assumptions that
affect the reported amounts of assets and liabilities and disclosure of contingent assets
and liabilities at the date of the financial statements and the reported amounts of
revenues and expenses during the reporting period. Actual results could differ from those
estimates.
The Companys most significant estimates relate to medical costs payable, revenues,
contingent liabilities and asset valuations, allowances and impairments. These estimates
are adjusted each period, as more current information becomes available. The impact of
any changes in estimates is included in the determination of earnings in the period in
which the estimate is adjusted. The following describes significant changes in estimates
and their impact on 2006 net income and members equity:
Claims Payable:
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1. |
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The actuarial assumption of the margin of error was 6% for the year
ended December 31, 2006, based on historical experience. |
Risks and Uncertainties
Investment securities are exposed to various risks, such as interest rate, market and
credit. Due to the level of risk associated with investment securities and the level of
uncertainty related to changes in the value of investment securities, it is at least
reasonably possible that changes in risk in the near term could materially affect the
amounts reported in the financial statements.
Cash and Cash Equivalents
Cash and cash equivalents consists of cash on deposit with financial institutions,
certificates of deposit with original or remaining maturities at purchase of three months
or less, and overnight repurchase agreements, excluding amounts classified as restricted
assets. The carrying amount approximates fair value because of the short maturities of
these investments.
-8-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Notes to Financial Statements Continued
December 31, 2006
Note A Summary of Significant Accounting Policies (Continued)
Premiums Receivable
Premiums receivable are amounts due from the State of Missouri pursuant to the terms of
the Medicaid Managed Care Contract. In addition, the Company is entitled to receive
amounts from the Missouri Department of Social Services, Division of Medical Services,
under the Supplemental Omnibus Budget Reconciliation Act (SOBRA), for reimbursement of the
costs related to deliveries by eligible Medicaid and CHIP mothers. SOBRA reimbursements
for Medicaid and CHIP deliveries were $3,503 and $3,894, respectively, for each delivery
during the period from January 1, 2006 through June 30, 2006. The Company records the
SOBRA reimbursement due as a premium receivable and recognizes the corresponding premium
revenue in the period that the delivery occurs.
Included in premiums receivable are $34,919 related to SOBRA at December 31, 2006. As of
December 31, 2006, SOBRA receivables are recorded net of related allowances of $0. The
State of Missouri eliminated separate SOBRA payments for member births effective July 1,
2006.
Health Care Receivables
Health care receivables represent amounts owed to the Company for pharmaceutical rebates,
as well as claim overpayment receivables. In April 2006, the Company entered into an
agreement with the pharmacy benefit manager (PBM) whereby the PBM reduces direct
pharmacy costs by an amount equal to a minimum guaranteed rebate amount. Therefore, as of
December 31, 2006, there were no outstanding pharmaceutical rebate receivables.
Restricted Assets
Restricted assets consist of U.S. Treasury notes at December 31, 2006. Restricted assets
are held on deposit with a financial institution to comply with applicable federal and
state HMO regulations. The U.S. Treasury notes at December 31, 2006 are classified as
held to maturity and carried at amortized cost, which approximates market value.
-9-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Notes to Financial Statements Continued
December 31, 2006
Note A Summary of Significant Accounting Policies (Continued)
Furniture and Equipment
Furniture and equipment are stated at cost less accumulated depreciation. Repairs and
maintenance are expensed in the period incurred. Depreciation is calculated using the
straight-line method over the estimated useful lives of the assets as follows: furniture
and office equipment five years, and computer hardware and software three years to
five years. Furniture and equipment consists of the following:
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Cost |
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Furniture and office equipment |
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$ |
319,222 |
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Computer hardware |
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170,949 |
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Computer software |
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124,947 |
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Total cost |
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615,118 |
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Accumulated depreciation |
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(353,213 |
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Furniture and equipment, net |
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$ |
261,905 |
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Depreciation expense for the year ended December 31, 2006 was $87,144.
Impairment of Long Lived Assets
The Company evaluates whether events and circumstances have occurred that indicate the
remaining estimated useful life of long lived assets may warrant revision or that the
remaining balance of an asset may not be recoverable. The measurement of possible
impairment is based on the ability to recover the balance of assets from expected future
operating cash flows on an undiscounted basis. In the opinion of management, no such
impairment existed at December 31, 2006.
Goodwill
As part of the capital transaction that occurred on June 30, 2006 (see Organization and
Operations above), the Company has recorded Goodwill. In accordance with Statements of
Financial Accounting Standards No. 142, goodwill is not amortized since it has an
indefinite life. Instead, it is tested annually for impairment. During the year ended
December 31, 2006, no impairment was identified.
-10-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Notes to Financial Statements Continued
December 31, 2006
Note A Summary of Significant Accounting Policies (Continued)
Claims Payable
Claims payable consists of case reserves for claims received and estimates of losses
incurred but not reported on unpaid benefits. Estimates of losses incurred but not
reported are actuarially determined based on prior experience modified for current trends
as well as industry data to aid in this estimation process.
The following table sets forth an analysis of claims payable and provides a reconciliation
of beginning and ending reserves as follows:
|
|
|
|
|
Net balance at beginning of year |
|
$ |
7,284,578 |
|
Incurred related to: |
|
|
|
|
Prior year |
|
|
(882,945 |
) |
Current year |
|
|
101,507,498 |
|
Paid related to: |
|
|
|
|
Prior year |
|
|
(3,931,480 |
) |
Current year |
|
|
(91,234,997 |
) |
|
|
|
|
|
|
|
|
|
Net balance at end of year |
|
$ |
12,742,654 |
|
|
|
|
|
Long-Term Investments
Long-term investments consist of municipal preferred bonds with maturities of greater
than one year. These investments are recorded at cost, which approximates their market
value at December 31, 2006.
Revenue Recognition
The Company recognizes premiums from the State of Missouri as income in the period to
which health care coverage relates.
Medical and Hospital Expenses
Medical and hospital expenses represent amounts paid and payable to physicians,
specialists, hospitals, and other health care providers for individual claims on which
services have been performed. Such amounts include paid and pending claims and estimates
of claims for services performed during the year which have not, as of the balance sheet
date, been reported to the Company. The estimated cost of claims incurred but not
reported is actuarially determined based on current membership statistics, current
utilization, industry, and historical data.
-11-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Notes to Financial Statements Continued
December 31, 2006
Note A Summary of Significant Accounting Policies (Continued)
Medical and Hospital Expenses (Continued)
The Company contracts with certain PCPs and other providers to provide health, dental, and
ancillary services to its members at contracted monthly PMPM capitation rates. Monthly
capitation is paid currently in the month of service. As such, there is no capitation
payable at December 31, 2006.
Advertising and Public Relations Expenses
The Company utilizes various types of nondirect-response advertising and methods. The
costs related to advertising and public relations are expensed as incurred. As such there
are no capitalized advertising or public relations costs as December 31, 2006. Related
expenses incurred during the year ended December 31, 2006 were, $297,221.
Income Taxes
The Company qualifies as an insurance entity for federal and state income tax purposes.
As an insurance entity, the Company is subject to corporate income taxes. Deferred tax
assets and liabilities are recognized for temporary differences between the financial
statement carrying amounts of existing admitted assets and liabilities, and their
respective tax bases and operating loss and tax credit carryforwards. Deferred tax assets
and liabilities are measured using enacted tax rates in effect for the year in which
those differences are expected to be recovered or settled.
To account for historic differences between deferred taxes on the Companys books, which
are kept on a basis of accounting other than generally accepted accounting principles (US
GAAP), and an adjustment of $114,611 was made to reduce the opening balance of members
equity.
-12-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Notes
to Financial Statements Continued
December 31, 2006
Note A - Summary of Significant Accounting Policies (Continued)
Recently Issued Accounting Standards
In September 2006, the FASB issued No. 157, Fair Value Measurements (SFAS No. 157), to
clarify the definition of fair value, establish a framework for measuring fair value and
expand the disclosures on fair value measurements. SFAS No. 157 defines fair value as the
price that would be received to sell an asset or the price paid to transfer a liability in
an orderly transaction between market participants at measurement date (i.e., an exit
price). SFAS No. 157 also stipulates that, as a market-based measurement, fair value
measurement should be determined based on the assumptions that market participants would
use in pricing the asset or liability, and establishes a fair value hierarchy that
distinguishes between (a) market participant assumptions developed based on market data
obtained from sources independent of the reporting entity (i.e., observable inputs) and
(b) the reporting of the entitys own assumptions about market participant assumptions
developed based on the best information available in the circumstances (i.e., unobservable
inputs). SFAS No. 157 becomes effective for the Company in its year ending December 31,
2008. The Company is currently evaluating the impact of the provisions of SFAS No. 157 on
its financial statements.
Note B - Business and Credit Concentration
The Companys financial instruments that are exposed to concentrations of credit risk
consist primarily of cash and cash equivalents, short-term investments, and premiums
receivable. The Company places its cash and cash equivalents with what management
believes to be high credit quality institutions. At times such investments may be in
excess of the FDIC insurance limit. At December 31, 2006, the Company does not anticipate
nonperformance by its financial institutions.
With respect to premiums receivable, the Company conducts its business primarily under
the Medicaid and CHIP managed care contracts with the related State of Missouri
governmental agencies, and virtually all of the Companys revenues are attributable to
this contract. The Companys cash flow is subject to the receipt of sufficient funding
and timely payment by the applicable government entities. If the appropriate government
agency does not receive sufficient appropriations to cover its contractual obligations,
the Medicaid managed care contract may be terminated or the Companys compensation may be
deferred or reduced. Any deferral or reduction in payment could have a material adverse
effect on the Companys financial position, results of operations, or cash flows. In
addition, the Company is dependent on a sufficient number of individuals to enroll in the
Companys plan.
-13-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Notes
to Financial Statements Continued
December 31, 2006
Note B - Business and Credit Concentration (Continued)
The failure of the Company to receive a sufficient number of such enrollees may also have
a material adverse effect on the Companys business, financial position, results of
operations, and cash flows.
The Companys Medicaid and CHIP managed care contracts are subject to renewal every
three years. The Companys current contract, which was effective July 1, 2006, is due
for renewal on July 1, 2009. The renewal and financial terms of the contract are
dependent upon many factors, including the quality and type of service provided,
governmental budget constraints, changes in government or agency personnel, and
priorities or philosophies of government agencies with respect to provision of services
to various at-risk populations.
Government contracts generally are subject to audits, reviews, and investigations. These
audits, reviews, and investigations typically involve a review of the contractors
performance under the contract, its reported costs, and its compliance with applicable
laws and regulations. In addition, the contract is subject to competitive bidding, and
the State of Missouri may terminate its contract with the Company for cause and upon
certain other specified conditions. The loss, or renewal on less favorable terms, of the
State of Missouri Medicaid managed care contract could have a material adverse effect on
the Companys business, financial position, results of operations, and cash flows.
Note C - Reinsurance
The Company purchases, on a premium basis, reinsurance coverage from a commercial
carrier, which limits the Companys exposure on large dollar claims for medical services.
The deductible under the reinsurance policy in force at December 31, 2006 includes a
stop-loss provision for 90% of claimed eligible expenses in excess of $1,000,000 per
member per year, based on the lesser of the Companys contracted payments and billed
charges.
Note D - Members Contributed Capital
As described in Note A: Organization and Operations, on June 30, 2006, Mercy Health
Plans, Inc. (MHP), contributed cash in the amount of $13,344,051 and goodwill in the
amount of $19 375,796 to purchase a newly issued member interest in the Company. These
contributions were treated as additions to the Companys contributed capital.
-14-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Notes to Financial Statements Continued
December 31, 2006
Note D - Members Contributed Capital (Continued)
On May 1, 2006, the Company made a dividend distribution to its members in the amount of
$421,754. A second distribution of $6,129,281 was made on June 30, 2006 as part of the
closing of the capital transaction with MHP. A portion of this distribution in the amount
of $2,828,424 was considered a return of capital and was charged against contributed
capital, while the remaining balance of $3,300,857 was reported as a dividend
distribution. On December 5, 2006, a third dividend distribution was made in the amount
of $3,000,000.
Note E - Lease Commitments
The Company leases office space and equipment under noncancelable operating lease
agreements which expire at various dates through 2009. Future minimum payments under
noncancelable operating leases that have initial or remaining lease terms in excess of
one year are as follows:
|
|
|
|
|
Years ending |
|
|
|
|
December 31, |
|
|
|
|
2007 |
|
$ |
282,167 |
|
2008 |
|
|
280,501 |
|
2009 |
|
|
254,471 |
|
|
|
|
|
|
|
|
|
|
Total |
|
$ |
817,139 |
|
|
|
|
|
Rent expense during 2006 was $237,710.
Note F - Statutory Financial Information
Mercy CarePlus is subject to regulation by the Department of Insurance of the State of
Missouri. Those regulations, in part, prescribe certain accounting methods for statutory
purposes, which differ from GAAP. For statutory purposes, the Company follows National
Association of Insurance Commissioners Statements of Statutory Accounting Principles
(NAIC SSAP) as the basis of its accounting principles, as long as they do not contradict
the statutes or regulations of the State of Missouri.
-15-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Notes to Financial Statements Continued
December 31, 2006
Note F - Statutory Financial Information (Continued)
As of December 31, 2006, Mercy CarePlus statutory assets, statutory surplus, and
statutory net income were as follows:
|
|
|
|
|
Statutory assets |
|
$ |
41,600,350 |
|
|
|
|
|
Statutory surplus |
|
$ |
4,143,669 |
|
|
|
|
|
Statutory net income |
|
$ |
9,400,622 |
|
|
|
|
|
The maximum amount of dividends which can be paid by Mercy CarePlus to its shareholders
without prior approval of the Department of Insurance of the State of Missouri is equal to
the lesser of 10% of statutory surplus as of the preceding calendar year-end or Mercy
CarePlus net investment income from the previous year. All dividends must be paid from
earned surplus.
As a condition for licensure by the Department of Insurance of the State of Missouri, the
Company is required to maintain a minimum surplus of 2% of its prior fiscal years
premium revenue, as defined by state statutes and regulations. The Company met the
minimum surplus requirements of approximately $1,710,000 for the year ended December 31,
2006.
The most significant differences resulting from the financial statements under statutory
accounting practices with GAAP, are as follows:
|
1. |
|
Revenue is recorded net of amounts ceded to reinsurers rather than being
presented on a gross basis for GAAP. |
|
|
2. |
|
Certain assets designated as nonadmitted assets (principally, prepaid
expenses, deferred tax assets, furniture, equipment, and certain receivables) are
charged directly to accumulated surplus. |
|
|
3. |
|
Deferred federal income taxes are provided for the tax effects of certain
income and expense items recognized for income tax purposes in different years than
for financial reporting purposes. The change in deferred tax asset or liability is
reflected in surplus. GAAP requires the change to be reported in income. Admittance
testing may result in a charge to capital and surplus for nonadmitted portions of
the deferred tax asset. For GAAP reporting, a valuation allowance may be recorded
against the deferred tax asset. |
-16-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Notes to Financial Statements Continued
December 31, 2006
Note F - Statutory Financial Information (Continued)
|
4. |
|
The statutory statements of cash flow do not classify consistently with
GAAP and a reconciliation of net income to net cash provided by operating activities
is not provided. |
|
|
5. |
|
The statutory financial statements do not include a statement of
comprehensive income. |
|
|
6. |
|
Cash and cash equivalents include cash and certificates of deposit in
banks with maturity dates of one year or less from the acquisition date, as well as
overnight repurchase agreements. Short-term investments include money market
accounts and repurchase agreements with remaining maturities of one year or less at
the time of acquisition. GAAP considers cash on hand and highly liquid investments
with original maturities of three months or less, including money market accounts,
to be cash and cash equivalents. GAAP considers investments with original maturities
in excess of three months but less than one year to be temporary investments. |
|
|
7. |
|
If a reporting entity has multiple cash accounts, the net amount of all
accounts shall be reported jointly. Cash accounts with positive balances shall not
be reported separately from cash accounts with negative balances. GAAP permits
reporting the net cash amount only if the legal right of offset exists. |
The following tables set forth the differences between the Companys net worth and net
income as determined on a GAAP versus a statutory basis. The intangible asset component
of the differences noted below was not audited in conjunction with these statutory
financial statements.
|
|
|
|
|
Statutory net worth |
|
$ |
25,613,610 |
|
Assets non-admitted for statutory purposes |
|
|
7,006,022 |
|
Intangible asset |
|
|
18,200,271 |
|
Cumulative statutory amortization of
intangible asset |
|
|
117,552 |
|
Decrease in deferred tax asset for GAAP
purposes |
|
|
(7,371,905 |
) |
Increase in income tax expense net |
|
|
115,319 |
|
|
|
|
|
GAAP net worth |
|
$ |
43,680,869 |
|
|
|
|
|
-17-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Notes to Financial Statements Continued
December 31, 2006
Note F - Statutory Financial Information (Continued)
|
|
|
|
|
Statutory net income |
|
$ |
9,400,622 |
|
Amortization of intangible asset |
|
|
117,552 |
|
Increase in income tax expense net |
|
|
115,319 |
|
|
|
|
|
GAAP net income |
|
$ |
9,633,493 |
|
|
|
|
|
The NAIC has established certain minimum risk-based capital (RBC) requirements for
insurance enterprises. The NAICs RBC Model serves as a benchmark for the regulation of
insurance companies by state insurance regulators. RBC provides for targeted surplus
levels based on formulas which specify various weighting factors that are applied to
financial balances or various levels of activity based on the perceived degree of risk,
and are set forth in the RBC requirements. The amount determined under such formulas is
called the Authorized Control Level RBC (ACL). The NAIC RBC requirements have not been
adopted by the Department of Insurance of the State of Missouri (state within which the
Company is domiciled). At December 31, 2006, the Companys total adjusted capital was 634%
of its ACL.
Note G - Income Taxes
Total income tax expense (benefit) was allocated as follows:
|
|
|
|
|
Current |
|
$ |
4,787,337 |
|
Deferred |
|
|
385,692 |
|
|
|
|
|
|
|
|
|
|
Total |
|
$ |
5,173,029 |
|
|
|
|
|
Income tax expense (benefit) from continuing operations differed from the amounts
computed by applying the U.S. federal income tax rate of 35% as a result of the
following:
|
|
|
|
|
Federal tax computed at a statutory rate |
|
$ |
5,182,283 |
|
Meals and entertainment |
|
|
13,026 |
|
State income taxes |
|
|
479,720 |
|
Other |
|
|
(502,000 |
) |
|
|
|
|
|
|
|
|
|
|
|
$ |
5,173,029 |
|
|
|
|
|
-18-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Notes to Financial Statements Continued
December 31, 2006
Note G - Income Taxes (Continued)
The tax effects of temporary differences that give rise to significant portions of the deferred tax
assets and deferred tax liabilities are presented below:
|
|
|
|
|
Deferred tax asset |
|
|
|
|
Unpaid losses and LAE |
|
$ |
96,038 |
|
Accrued vacation pay |
|
|
44,478 |
|
Allowance for uncollectible receivables |
|
|
11,626 |
|
Accrued professional fees |
|
|
52,879 |
|
Accrued bonuses |
|
|
27,072 |
|
Other |
|
|
156,002 |
|
|
|
|
|
|
|
|
|
|
Total gross deferred tax assets |
|
|
388,095 |
|
|
|
|
|
|
Deferred tax liability |
|
|
|
|
Depreciation |
|
|
20,891 |
|
Intangible asset |
|
|
251,885 |
|
|
|
|
|
|
|
|
|
|
Total gross deferred tax liability |
|
|
272,776 |
|
|
|
|
|
|
|
|
|
|
Net deferred tax asset |
|
$ |
115,319 |
|
|
|
|
|
Note H
- - Related Party Transactions
Total medical and hospital claim payments made by the Company to the current Members and their
affiliates during 2006 were $9,058,079.
Note I
- - Contingencies
The Company maintains insurance coverage for property, casualty, fidelity, directors and
officers liability, and general and medical liability in amounts deemed adequate by its Board of
Managers. The Company is subject to various claims and legal actions arising in the ordinary course
of business. In the opinion of management, the ultimate disposition of these matters would not have
a material adverse effect on the Companys financial position or liquidity.
-19-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Notes to Financial Statements Continued
December 31, 2006
Note J - 401(k) Savings Plan
Mercy CarePlus sponsors a 401(k) Retirement Savings Plan (RSP) for employees. All active full-time
employees who are age twenty-one or over and have completed three months of service are eligible
for the RSP. Employees are able to contribute from 1% to 75% of their wages to the plan. In
addition to employee contributions to the RSP, the Company matches the first 5% of the employees
contribution. The Companys matching contribution was $99,983 for the year ended December 31, 2006.
Note K - Non-Cash Transactions
During the year ended December 31, 2006, the following non-cash transaction occurred:
|
|
|
The merger described in Note A generated Goodwill in the amount
of $19,375,796. |
Note L - Supplemental Disclosure of Cash Flow Information
Cash paid during the year ended December 31, 2006:
Income taxes paid $ 4,064,796
Note M - Subsequent Events
On February 27, 2007, the Company received Amendment #003 to contract #C306118003, Medicaid Managed
Care Central, Eastern and Western regions, with the State of Missouri. The amended contract is
for the period of July 1, 2006 through June 30, 2007, and calls for an increase in the fixed prices
of the contract for performing the required services in accordance with the terms, conditions, and
provisions of the contract. The contractors firm, fixed PMPM Net Capitation Rate for each Category
of Aid (COA) Rate subgroup must not exceed the States Maximum Net Capitation Rate as listed in the
contract. All other terms, conditions and provisions of the contract, including all prices, shall
remain the same and apply hereto.
The contract amendment is retroactive to July 1, 2006 and, as a result of Amendment #003, the
Company has recorded premiums receivable and corresponding revenue in the amount of $2,907,722 at
December 31, 2006.
-20-
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
Notes to Financial Statements Continued
December 31, 2006
Note M - Subsequent Events (Continued)
On October 31, 2007, all of the ownership interests in the Company were sold to Molina Healthcare,
Inc., a publicly traded corporation which operates government-sponsored health insurance plans in
eight states. The sale was subject to the terms of a purchase agreement executed by the parties on
September 6, 2007 and approved by the Missouri Department of Insurance, Financial Institutions and
Professional Registration on October 22, 2007.
As part of this change in ownership of the Company, $3,840,382 was expensed during 2007.
Approximately $3,500,000 of this amount was related to Class B Members employment agreements,
which were terminated as part of the change in ownership.
-21-
Exhibit 99.2
Exhibit 99.2
Alliance for Community Health LLC
d/b/a
Mercy Care Plus
Unaudited Condensed Financial Statements
Nine Months Ended September 30, 2007 and 2006
Exhibit 99.2
ALLIANCE FOR COMMUNITY HEALTH LLC
D/B/A MERCY CAREPLUS
CONDENSED BALANCE SHEET
SEPTEMBER 30, 2007
(amounts in thousands)
(unaudited)
|
|
|
|
|
ASSETS |
|
|
|
|
Current assets: |
|
|
|
|
Cash and cash equivalents |
|
$ |
9,046 |
|
Investments certificate of deposit |
|
|
8,000 |
|
Receivables |
|
|
15,861 |
|
Prepaid and other current assets |
|
|
213 |
|
Current deferred taxes |
|
|
366 |
|
|
|
|
|
Total current assets |
|
|
33,486 |
|
|
|
|
|
|
Property and equipment, net |
|
|
242 |
|
Goodwill & intangible assets |
|
|
19,598 |
|
Restricted investments |
|
|
501 |
|
Long-term investments |
|
|
1,645 |
|
Other assets |
|
|
36 |
|
|
|
|
|
|
|
|
|
|
Total assets |
|
$ |
55,508 |
|
|
|
|
|
|
|
|
|
|
LIABILITIES AND STOCKHOLDERS EQUITY |
|
|
|
|
Current liabilities |
|
|
|
|
Medical claims and benefits payable |
|
$ |
12,609 |
|
Income taxes payable |
|
|
326 |
|
Accounts payable and accrued liabilities |
|
|
1,818 |
|
|
|
|
|
Total current liabilities |
|
|
14,753 |
|
|
|
|
|
|
Long-term deferred income taxes |
|
|
252 |
|
|
|
|
|
Total Liabilities |
|
|
15,005 |
|
|
|
|
|
|
Commitments and contingencies |
|
|
|
|
|
|
|
|
|
Members equity |
|
|
40,503 |
|
|
|
|
|
Total liabilities and members equity |
|
$ |
55,508 |
|
|
|
|
|
See accompanying notes.
Exhibit 99.2
ALLIANCE FOR COMMUNITY HEALTH LLC
D/B/A MERCY CAREPLUS
CONDENSED STATEMENTS OF INCOME
(amounts in thousands)
(unaudited)
|
|
|
|
|
|
|
|
|
|
|
Nine months ended September
30, |
|
|
|
|
|
|
2007 |
|
|
2006 |
|
Revenues |
|
|
|
|
|
|
|
|
Premium revenue |
|
$ |
126,906 |
|
|
$ |
80,750 |
|
Interest and other revenue |
|
|
1,059 |
|
|
|
717 |
|
|
|
|
|
|
|
|
Total Revenues |
|
|
127,965 |
|
|
|
81,467 |
|
|
|
|
|
|
|
|
|
|
Expenses |
|
|
|
|
|
|
|
|
Medical and hospital |
|
|
103,953 |
|
|
|
66,175 |
|
Administrative expense: |
|
|
|
|
|
|
|
|
Compensation and benefits |
|
|
3,580 |
|
|
|
2,802 |
|
Marketing |
|
|
455 |
|
|
|
605 |
|
Other general and administrative exp |
|
|
4,851 |
|
|
|
3,836 |
|
Depreciation and amortization |
|
|
157 |
|
|
|
60 |
|
|
|
|
|
|
|
|
Total Expenses |
|
|
112,996 |
|
|
|
73,478 |
|
|
|
|
|
|
|
|
|
|
Income before income taxes |
|
|
14,969 |
|
|
|
7,989 |
|
|
|
|
|
|
|
|
|
|
Income taxes |
|
|
5,147 |
|
|
|
2,939 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
NET INCOME |
|
$ |
9,822 |
|
|
$ |
5,050 |
|
|
|
|
|
|
|
|
See accompanying notes.
Exhibit 99.2
ALLIANCE FOR COMMUNITY HEALTH LLC
D/B/A MERCY CAREPLUS
CONDENSED STATEMENTS OF CASH FLOWS
(amounts in thousands)
(unaudited)
|
|
|
|
|
|
|
|
|
|
|
Nine Months Ended September 30, |
|
|
|
2007 |
|
|
2006 |
|
Operating activities |
|
|
|
|
|
|
|
|
Net income |
|
$ |
9,822 |
|
|
$ |
5,050 |
|
Adjustments to reconcile net income to net cash provided by operating activities: |
|
|
|
|
|
|
|
|
Depreciation and amortization |
|
|
157 |
|
|
|
60 |
|
(Increase) decrease in operating assets |
|
|
|
|
|
|
|
|
Prepaid & other current assets |
|
|
60 |
|
|
|
(98 |
) |
Receivables |
|
|
1,363 |
|
|
|
(5,556 |
) |
|
|
|
|
|
|
|
|
|
Increase (decrease) in operating liabilities: |
|
|
|
|
|
|
|
|
Medical claims and benefits payable |
|
|
(133 |
) |
|
|
6,296 |
|
Accounts payable and accrued liabilities |
|
|
155 |
|
|
|
185 |
|
Income taxes payable |
|
|
(1,259 |
) |
|
|
1,006 |
|
|
|
|
|
|
|
|
Net cash provided by operating activities |
|
|
10,165 |
|
|
|
6,943 |
|
|
|
|
|
|
|
|
|
|
Investing activities |
|
|
|
|
|
|
|
|
Purchases of furniture and equipment |
|
|
(60 |
) |
|
|
(141 |
) |
Proceeds from maturity of certificates of deposit |
|
|
3,091 |
|
|
|
3,960 |
|
Purchases of certificates of deposit |
|
|
(5,039 |
) |
|
|
(5,054 |
) |
Proceeds from maturity or sale of long-term investments |
|
|
|
|
|
|
1,505 |
|
Increased in restricted investments |
|
|
(4 |
) |
|
|
4 |
|
Purchase of intangible assets |
|
|
(300 |
) |
|
|
|
|
|
|
|
|
|
|
|
Net cash provided by investing activities |
|
|
(2,312 |
) |
|
|
274 |
|
|
|
|
|
|
|
|
|
|
Financing activities |
|
|
|
|
|
|
|
|
Additions to contributed capital |
|
|
|
|
|
|
13,344 |
|
Distributions to Members |
|
|
(13,000 |
) |
|
|
(6,551 |
) |
|
|
|
|
|
|
|
Net cash provided by financing activities |
|
|
(13,000 |
) |
|
|
6,793 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net increase in cash and cash equivalents |
|
|
(5,147 |
) |
|
|
14,010 |
|
|
|
|
|
|
|
|
|
|
Cash and cash equivalents at beginning of year |
|
|
14,193 |
|
|
|
1,206 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Cash and cash equivalents at end of year |
|
$ |
9,046 |
|
|
$ |
15,216 |
|
|
|
|
|
|
|
|
Supplemental
cash flow information: |
|
|
|
|
|
|
|
|
Cash paid during
the period for income taxes |
|
$ |
6,405 |
|
|
$ |
2,054 |
|
See accompanying notes.
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
NOTES
TO CONDENSED UNAUDITED FINANCIAL STATEMENTS
(Dollar amounts in thousands)
(Unaudited)
September 30, 2007
Note A Summary of Significant Accounting Policies
Organization and Operations
Alliance For Community Health LLC, d/b/a Mercy CarePlus (the Company) is a prepaid health
maintenance organization (HMO) providing health insurance to certain State of Missouri Medicaid
and Childrens Health Insurance Program (CHIP) managed care participants in St. Louis, Missouri and
certain surrounding counties. The Company expanded operations into the Central and Western regions
of Missouri on July 1, 2006. The Company was originally incorporated as a not-for-profit entity,
Alliance for Community Health, Inc., on March 5, 1986; received a license to operate as an HMO in
the State of Missouri on June 17, 1987; began operations as an HMO on September 1, 1995; and
converted to a limited liability company (LLC) on August 16, 1996.
On May 28, 2004, ownership of the Company changed pursuant to a Definitive Agreement approved by
the Department of Insurance of the State of Missouri. In accordance with the Agreement, the
Companys former Class A and Class B members transferred their ownership rights to CCP Acquisition
Limited (CAL) and three executive members of management. Upon transfer, CAL became the sole Class
A Member of the Company and the three executive members of management became Class B Members.
On May 17, 2006, CAL transferred its ownership interest in the Company to CCP Holdings, LLC (CH),
an affiliate of CAL by common ownership.
On June 30, 2006, Mercy Health Plans, Inc. (MHP) purchased a newly issued member interest in the Company.
As a result, MHP obtained 50% ownership of the Company. The
ownership percentages of the existing owners, CH and certain members of management (collectively),
were reduced to 40.05% and 9.95%, respectively. CH remained the sole Class A Member, the three
executive members of management remained the sole Class B Members and MHP became the sole Class C
Member of Alliance for Community Health, LLC. Simultaneously, the Companys doing business as
changed from Community CarePlus to Mercy CarePlus.
As a result of the June 30, 2006 change in ownership, the Company has three classes of members:
Classes A, B and C. Voting rights are reserved for only Classes A and C. Class A receives
priority in distributions over other classes.
On September 29, 2006, the Class C ownership interest of MHP was transferred to Sisters of Mercy
Health System (SMHS), an affiliate of MHP.
At September 30, 2007, the Company had membership of approximately 68,000.
The Company is structured as a network model HMO. As such, the Company has contracts with networks
for physician and hospital services. Each member chooses a primary care physician (PCP) who is
under contract with the Company. The Company has also negotiated contracts with hospitals,
physician specialists, and other health care providers to satisfy the necessary medical care needs
of its eligible members that extend beyond the level of care provided by the PCP. The Company has
sub-capitation agreements with some of its PCPs under the Medicaid program that are structured so
that the PCP receives monthly payments based upon the number, age and sex of members associated
with the PCP. The Company also has sub-capitation agreements with its network providers for
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
NOTES TO CONDENSED UNAUDITED FINANCIAL STATEMENTS
mental health, transportation, dental and vision services that are structured so that the
respective providers receive monthly payments based upon the number of members enrolled with the
Company.
The Company contracts with NovaSys Health Network, LLC (NovaSys) to provide third-party
administrative services under a service agreement which provides for the Company to pay NovaSys a
per member per month (PMPM) processing fee. Services provided by NovaSys include, but are not
limited to, claims and revenue processing, information systems, and management reporting systems.
The initial term of the contract was from September 1, 1998 through August 31, 2001. The term of
the current contract is October 1, 2005 through September 30, 2008.
Basis of Presentation
The Companys unaudited condensed interim financial statements are presented on the accrual basis
of accounting in conformity with accounting practices generally accepted in the United States of
America (GAAP).
The financial statements have been prepared under the assumption that users of the interim
financial data have either read or have access to our audited financial statements for the fiscal
year ended December 31, 2006. Accordingly, certain disclosures that would substantially duplicate
the disclosures contained in the December 31, 2006 audited financial statements have been omitted.
These unaudited condensed interim financial statements should be read in conjunction with our
December 31, 2006 audited financial statements.
In the opinion of management, all adjustments considered necessary for a fair presentation of the
results as of the date and for the interim periods presented, which consist solely of normal
recurring adjustments, have been included. The condensed results of income for the current interim
period are not necessarily indicative of the results for the entire year ending December 31, 2007.
Use of Estimates
The preparation of financial statements in conformity with accounting practices generally accepted
in the United States requires management to make estimates and assumptions that affected the
reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at
the date of the financial statements and the reported amounts of revenues and expenses during the
reporting period. Actual results could differ from those estimates.
The Companys most significant estimates relate to medical costs payable, revenues, contingent
liabilities and asset valuations, allowances and impairments. These estimates are adjusted each
period, as more current information becomes available. The impact of any changes in estimates is
included in the determination of earnings in the period in which the estimate is adjusted. The
following describes significant changes in estimates and their impact on net income and members
equity for the nine months ended September 30, 2007 and 2006:
|
|
|
Claims Payable: |
|
|
1. |
|
During 2007 the Company changed certain actuarial assumptions, which affect the
calculation of claims payable. Specifically, the Company changed its assumptions regarding
the timing of the recognition of inpatient charges. Additionally, the actuarial margin of
error was increased from 6% to 10%, primarily due to reclassification of loss adjustment
expense from the accrued expenses category. These changes increased medical and hospital
expenses by approximately $2,000 for the nine month period ended
September 30, 2007. |
Premiums Receivable
Premiums receivables are amounts due from the State of Missouri pursuant to the terms of the
Medicaid Managed Care Contract.
ALLIANCE FOR COMMUNITY HEALTH LLC
d/b/a MERCY CAREPLUS
NOTES TO CONDENSED UNAUDITED FINANCIAL STATEMENTS
Claims Payable
Claim payable consists of case reserves for claims received and estimates of losses incurred but
not reported on unpaid benefits. Estimates of losses incurred but not reported are actuarially
determined based on prior experience modified for current trends as well as industry data to aid in
this estimation process.
Revenue Recognition
The Company recognizes premiums from the State of Missouri as income in the period to which health
care coverage relates.
Note B Related Party Transactions
Total medical and hospital claim payments made by the Company to the current Members and their
affiliates during nine months ended September 30, 2007 and 2006 were $12,170 and $5,020.
Note C Subsequent Events
On October 31, 2007, all of the ownership interests in the Company were sold to Molina Healthcare,
Inc., a publicly traded corporation which operates government-sponsored health insurance plans in
eight states. The sale was subject to the terms of a purchase agreement executed by the parties on
September 6, 2007 and approved by the Missouri Department of Insurance, Financial Institutions and
Professional Registration on October 22, 2007.
Exhibit 99.3
Exhibit 99.3
UNAUDITED PRO FORMA FINANCIAL INFORMATION
The unaudited pro forma combined financial information presented below gives effect to the
purchase of Mercy CarePlus (Mercy CarePlus) by Molina Healthcare, Inc. (the Company) and the
issuance of the portion of the senior convertible notes that the Company used to fund the
acquisition as if the acquisition had occurred and the senior convertible notes had been issued on
September 30, 2007 for purposes of the unaudited pro forma combined balance sheet, and as of
January 1, 2006 for purposes of the unaudited pro forma combined statements of income for the nine
months ended September 30, 2007 and the year ended December 31, 2006. The unaudited pro forma
combined balance sheet and statements of income include the historical amounts of the Company and
Mercy CarePlus, adjusted to reflect the impact of acquisition.
On November 1, 2007, the Company completed its acquisition of the Alliance for Community
Health, L.L.C., a Missouri limited liability company doing business as Mercy CarePlus (Mercy
CarePlus). Under the terms of the transaction, the Company acquired all of the outstanding
limited liability company ownership interests of Mercy CarePlus from Sisters of Mercy Health
System, a Missouri nonprofit corporation; CCP Holdings, LLC, a Missouri limited liability company;
and certain Mercy CarePlus executives in consideration for a base purchase price of $80 million
subject to adjustments.
In accordance with FAS 141, the purchase price has been allocated to the estimated fair value
of Mercy CarePlus assets acquired and liabilities assumed. The excess of purchase price over the
fair value of net tangible assets acquired has been primarily allocated to certain identifiable
intangible assets and goodwill. The purchase price allocation may be adjusted upon completion of
the final valuation of the assets and liabilities of Mercy CarePlus and certain earn-out
provisions. The effect of any such adjustments cannot be determined at this time.
The Unaudited Pro Forma Condensed Consolidated Financial Statements do not give effect to any
synergies that may be realized as a result of the acquisition, nor do they give effect to any
nonrecurring/unusual restructuring charges that may be incurred as a result of the integration of
Mercy CarePlus. The amount of such charges cannot be reasonably determined at this time.
The Unaudited Pro Forma Condensed Consolidated Financial Statements are provided for
informational purposes only and do not purport to present the combined financial position or
results of operations of Molina Healthcare, Inc. and Mercy CarePlus had the acquisition occurred on
the dates specified, nor are they necessarily indicative of the results of operations that may be
expected in the future.
The pro forma information should be read in conjunction with the historical consolidated
financial statements of Molina Healthcare, Inc., which have been filed with the Securities and
Exchange Commission. The audited financial statements of Mercy CarePlus for the year ended
December 31, 2006 and the unaudited financial statements for the nine-month period ended September
30, 2007, are filed as part of this Current Report on Form 8-K/A. The Unaudited Pro Forma
Condensed Consolidated Financial Statements should be read in conjunction with each companys
historical financial statements and the notes thereto. Certain accounts of Mercy CarePlus have been
reclassified to be consistent with Molina Healthcare, Inc.s presentation.
1
Exhibit
99.3
Unaudited Pro Forma Combined Balance Sheet
September 30, 2007
(amounts in thousands)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Molina |
|
|
Mercy |
|
|
Pro Forma |
|
|
|
|
|
|
|
|
|
Historical |
|
|
Historical |
|
|
Adjustments |
|
|
(a) |
|
|
Pro Forma |
|
|
|
|
|
|
|
|
|
|
|
ASSETS |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Current assets: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Cash and cash equivalents |
|
$ |
447,594 |
|
|
$ |
9,046 |
|
|
$ |
(7,557 |
) |
|
|
(b |
) |
|
$ |
449,083 |
|
Investments |
|
|
108,161 |
|
|
|
8,000 |
|
|
|
|
|
|
|
|
|
|
|
116,161 |
|
Receivables |
|
|
124,145 |
|
|
|
15,861 |
|
|
|
|
|
|
|
|
|
|
|
140,006 |
|
Deferred income taxes |
|
|
577 |
|
|
|
366 |
|
|
|
|
|
|
|
|
|
|
|
943 |
|
Prepaid and other current assets |
|
|
11,424 |
|
|
|
213 |
|
|
|
|
|
|
|
|
|
|
|
11,637 |
|
|
|
|
|
|
|
|
|
|
|
Total current assets |
|
|
691,901 |
|
|
|
33,486 |
|
|
|
(7,557 |
) |
|
|
|
|
|
|
717,830 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Property and equipment, net |
|
|
47,431 |
|
|
|
242 |
|
|
|
|
|
|
|
|
|
|
|
47,673 |
|
Goodwill & intangible assets |
|
|
133,502 |
|
|
|
19,598 |
|
|
|
57,329 |
|
|
|
(c |
) |
|
|
210,429 |
|
Restricted investments |
|
|
27,762 |
|
|
|
501 |
|
|
|
|
|
|
|
|
|
|
|
28,263 |
|
Long-term investments |
|
|
|
|
|
|
1,645 |
|
|
|
|
|
|
|
|
|
|
|
1,645 |
|
Receivable for ceded life and annuity contracts |
|
|
30,929 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
30,929 |
|
Other assets |
|
|
14,492 |
|
|
|
36 |
|
|
|
|
|
|
|
|
|
|
|
14,528 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total assets |
|
$ |
946,017 |
|
|
$ |
55,508 |
|
|
$ |
49,772 |
|
|
|
|
|
|
$ |
1,051,297 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
LIABILITIES AND STOCKHOLDERS EQUITY |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Current liabilities |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Medical claims and benefits payable |
|
$ |
308,722 |
|
|
$ |
12,609 |
|
|
|
|
|
|
|
|
|
|
$ |
321,331 |
|
Deferred revenue |
|
|
42,043 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
42,043 |
|
Income taxes payable |
|
|
1,242 |
|
|
|
326 |
|
|
|
|
|
|
|
|
|
|
|
1,568 |
|
Accounts payable & accrued liabilities |
|
|
61,778 |
|
|
|
1,818 |
|
|
|
4,283 |
|
|
|
(d |
) |
|
|
67,879 |
|
|
|
|
|
|
|
|
|
|
|
Total current liabilities |
|
|
413,785 |
|
|
|
14,753 |
|
|
|
4,283 |
|
|
|
|
|
|
|
432,821 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Long-term debt, less current maturities |
|
|
20,000 |
|
|
|
|
|
|
|
80,000 |
|
|
|
(e |
) |
|
|
100,000 |
|
Deferred income taxes |
|
|
1,056 |
|
|
|
252 |
|
|
|
5,992 |
|
|
|
(f |
) |
|
|
7,300 |
|
Liability for ceded life and annuity contracts |
|
|
30,929 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
30,929 |
|
Other long-term liabilities |
|
|
11,808 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
11,808 |
|
|
|
|
|
|
|
|
|
|
|
Total Liabilities |
|
|
477,578 |
|
|
|
15,005 |
|
|
|
90,275 |
|
|
|
|
|
|
|
582,858 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Commitments and contingencies |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Stockholders equity: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Common stock |
|
|
28 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
28 |
|
Paid in Capital |
|
|
181,841 |
|
|
|
40,503 |
|
|
|
(40,503 |
) |
|
|
(g |
) |
|
|
181,841 |
|
Comprehensive Income |
|
|
111 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
111 |
|
Retained earnings |
|
|
306,849 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
306,849 |
|
Treasury stock |
|
|
(20,390 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(20,390 |
) |
|
|
|
|
|
|
|
|
|
|
Total stockholders equity |
|
|
468,439 |
|
|
|
40,503 |
|
|
|
(40,503 |
) |
|
|
|
|
|
|
468,439 |
|
|
|
|
|
|
|
|
|
|
|
Total liabilities and stockholders equity |
|
$ |
946,017 |
|
|
$ |
55,508 |
|
|
$ |
49,772 |
|
|
|
|
|
|
$ |
1,051,297 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
See accompanying notes.
2
Exhibit
99.3
Unaudited Pro Forma Combined Statements of Income
Nine Months Ended September 30, 2007
(amounts in thousands)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
MOH |
|
|
Mercy |
|
|
Pro Forma |
|
|
|
|
|
|
|
|
|
Historical |
|
|
Historical |
|
|
Adjustments |
|
|
(a) |
|
|
Pro Forma |
|
|
|
|
|
|
|
|
|
|
|
Revenue: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Premium revenue |
|
$ |
1,791,764 |
|
|
$ |
126,906 |
|
|
$ |
|
|
|
|
|
|
|
$ |
1,918,670 |
|
Investment income |
|
|
21,061 |
|
|
|
1,059 |
|
|
|
|
|
|
|
|
|
|
|
22,120 |
|
|
|
|
|
|
|
|
|
|
|
Total revenue |
|
|
1,812,825 |
|
|
|
127,965 |
|
|
|
|
|
|
|
|
|
|
|
1,940,790 |
|
Expenses: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
|
Medical care costs |
|
|
1,519,244 |
|
|
|
103,953 |
|
|
|
|
|
|
|
|
|
|
|
1,623,197 |
|
|
Marketing, general and administration expense |
|
|
204,831 |
|
|
|
8,886 |
|
|
|
|
|
|
|
|
|
|
|
213,717 |
|
Depreciation and amortization |
|
|
20,274 |
|
|
|
157 |
|
|
|
1,842 |
|
|
|
(h |
) |
|
|
22,273 |
|
Impairment charge on purchased software |
|
|
782 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
782 |
|
|
|
|
|
|
|
|
|
|
|
Total expenses |
|
|
1,745,131 |
|
|
|
112,996 |
|
|
|
1,842 |
|
|
|
|
|
|
|
1,859,969 |
|
|
|
|
|
|
|
|
|
|
|
Operating income |
|
|
67,694 |
|
|
|
14,969 |
|
|
|
(1,842 |
) |
|
|
|
|
|
|
80,821 |
|
Other expense: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
0 |
|
Interest expense |
|
|
(2,380 |
) |
|
|
|
|
|
|
(2,527 |
) |
|
|
(i |
) |
|
|
(4,907 |
) |
|
|
|
|
|
|
|
|
|
|
Total other expense |
|
|
(2,380 |
) |
|
|
|
|
|
|
(2,527 |
) |
|
|
|
|
|
|
(4,907 |
) |
|
|
|
|
|
|
|
|
|
|
Income (loss) before income taxes |
|
|
65,314 |
|
|
|
14,969 |
|
|
|
(4,369 |
) |
|
|
|
|
|
|
75,914 |
|
Income tax expense (benefit) |
|
|
24,895 |
|
|
|
5,147 |
|
|
|
(1,661 |
) |
|
|
(j |
) |
|
|
28,381 |
|
|
|
|
|
|
|
|
|
|
|
Net income (loss) |
|
$ |
40,419 |
|
|
$ |
9,822 |
|
|
$ |
(2,708 |
) |
|
|
|
|
|
$ |
47,533 |
|
|
|
|
|
|
|
|
|
|
|
See accompanying notes.
3
Exhibit
99.3
MOLINA HEALTHCARE, INC.
NOTES TO UNAUDITED PRO FORMA CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(dollars in thousands, except per share data)
September 30, 2007
a. |
|
Purchase accounting. The Mercy CarePlus acquisition is accounted for under the purchase
method of accounting. Accordingly, the amount of the consideration paid is allocated to
assets acquired and liabilities assumed based on their estimated fair values, The excess of
consideration paid over the estimated fair value of the tangible assets acquired and
liabilities assumed has been preliminarily allocated to certain identifiable intangible assets
and goodwill. The purchase price allocation may be adjusted upon completion of the final
valuation of the assets and liabilities of Mercy CarePlus and settlement of contingent
payments to sellers, as discussed in more detail below. The effect of any such adjustments
cannot be determined at this time. |
b. |
|
Purchase consideration. Purchase price consideration of $80,000 was paid on October 30, 2007
and the acquisition was fully funded through issuance of the senior convertible debt.
Immediately prior to closing of the purchase transaction, with the approval by the Missouri
Department of Insurance, a dividend of $7,335 was declared and paid to the sellers in
accordance with the Purchase Agreement. This dividend payment represented Mercy CarePlus
capital as of October 31, 2007 less 300% of its risk-based capital (RBC) authorized control
level (ACL). A final RBC calculation will be made within 120 days following the closing
date. Based upon the final RBC calculation an additional dividend payout will be made to
reduce the multiplier of ACL from 300% to 200%. The estimated amount of this additional
dividend is estimated to be approximately $4,283. Furthermore, an additional contingent
payment of $5,000 will be paid to the sellers if certain financial targets are met by Mercy
CarePlus for the twelve month period ending June 30, 2008. These adjustments may increase or
decrease the purchase price consideration. Any contingent consideration, when finally
determined, will be reported as an adjustment to goodwill. The Mercy CarePlus Purchase also
required $222 of direct transaction costs. |
|
|
|
The net reduction in cash and cash equivalents of $7,557 comprises the following estimated items: |
|
|
|
|
|
Purchase price consideration |
|
$ |
(80,000 |
) |
Direct transaction costs (see below) |
|
|
(222 |
) |
|
|
|
|
Subtotal |
|
|
(80,222 |
) |
Borrowings to fund the acquisition |
|
|
80,000 |
|
Pre-closing dividends (based on 300% of RBC) |
|
|
(7,335 |
) |
|
|
|
|
Net reduction in cash and cash equivalents |
|
$ |
(7,557 |
) |
|
|
|
|
c. |
|
Goodwill and intangible assets. We intend to determine the fair value of net assets of Mercy
CarePlus as of October 31, 2007. The purchase price will be allocated to the fair value of
Mercy CarePlus net assets, including identified intangible assets, such as the provider
network and enrolled member list. The following is a preliminary analysis of goodwill and
intangible assets recognized in connection with the acquisition: |
|
|
|
|
|
Purchase price consideration |
|
$ |
80,000 |
|
Direct transaction costs |
|
|
222 |
|
|
|
|
|
Assumed total purchase price |
|
|
80,222 |
|
Deferred tax liability on identifiable intangible assets (@ 38% tax rate) |
|
|
5,992 |
|
Pre-closing dividends (based on 300% of RBC) |
|
|
7,335 |
|
Dividends to be paid out on 2/28/08 (see above) |
|
|
4,283 |
|
Mercys historical net assets as of September 30, 2007 |
|
|
(40,503 |
) |
|
|
|
|
Acquisition cost in excess of net assets acquired |
|
$ |
57,329 |
|
|
|
|
|
|
|
Allocation of acquisition cost in excess of net assets acquired: |
|
|
|
|
|
Allocation to identifiable intangible assets |
|
|
|
|
Provider network |
|
$ |
5,926 |
|
Enrolled member list |
|
|
9,840 |
|
|
|
|
|
Total identifiable intangible assets |
|
|
15,766 |
|
Goodwill |
|
|
41,563 |
|
|
|
|
|
Total goodwill and other intangible assets: |
|
$ |
57,329 |
|
|
|
|
|
4
Exhibit
99.3
d. |
|
Accounts payable and accrued liabilities. Pro forma adjustment represents future
dividends to be paid out to sellers upon final determination of Mercy CarePlus RBC
calculation (see Note b). |
e. |
|
Long-term debt. On October 11, 2007, we issued $200,000 of senior convertible debt at
an interest rate of 3.75%. Part of the proceeds was used to fund the Mercy CarePlus
acquisition. |
f. |
|
Deferred income taxes. Pro forma adjustment to increase deferred tax liabilities
related to the estimated identifiable intangible assets of $15,766 as described in Note c
above. Upon finalization of purchase accounting, the amount of deferred tax liability will
change as final purchase price allocations are made to the fair values of Mercy CarePlus
assets. For purposes of calculating the pro forma adjustments an effective tax rate of 38%
was used. |
g. |
|
Paid in capital is reduced by the equity of Mercy CarePlus at
September 30, 2007 ($40,503). |
h. |
|
Amortization of intangibles. Pro forma adjustment reflects the amortization of the
Medicaid medical provider network in the state of Missouri valued at approximately $5,926
arising from the acquisition that is classified as an identifiable
intangible asset. This identifiable intangible asset is being amortized on a straight-line basis over 10 years.
Pro forma adjustment also reflects the amortization of enrolled member list in the state of
Missouri valued at approximately $9,840 arising from the acquisition that is classified as
an identifiable intangible asset. The value of member list is being amortized on a
straight-line basis over 5 years. The pro forma amortization expense is partially offset
by elimination of the amortization of Mercy CarePlus historical intangibles assets of $78
and $0 for the nine months ended September 30, 2007 and year ended December 31, 2006. |
i. |
|
Interest expense. Pro forma adjustment to reflect an increase in interest expense
resulting from the issuance of senior convertible debt of which a portion was used to fund
the acquisition. Interest rate used for pro forma purposes is 3.75% per annum.
Additionally, approximately $6,471 of underwriting discount and fees are being capitalized
and amortized over the term of the debt. The portion used for this acquisition is 40% of
the entire debt issuance and as such, 40% of the underwriting discount and fees is being
amortized for pro forma purposes. |
j. |
|
Provision for income taxes. Pro forma adjustments reflect the tax effect of the
acquisition at statutory rates in effect during nine months ended September 30, 2007 and
the fiscal year ended December 31, 2006. For purposes of calculating the pro forma
adjustments a consolidated as adjusted effective tax rate of 38.0% was used for both
periods. |
5