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): February 10, 2021 (February 10, 2021)
______________
(Exact name of registrant as specified in its charter)
| (State or other jurisdiction of incorporation) | (Commission File Number) | (IRS Employer Identification No.) | ||||||
______________
| (Address of principal executive offices) | (Zip Code) | ||||||||||
Registrant’s telephone number, including area code: (562 ) 435-3666
Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:
Securities registered pursuant to Section 12(b) of the Act:
| Title of each class | Trading Symbol(s) | Name of each exchange on which registered | ||||||
Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).
Emerging growth company | |||||
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section13(a) of the Exchange Act. | |||||
☐ | |||||
Item 2.02. Results of Operations and Financial Condition.
On February 10, 2021, Molina Healthcare, Inc. (the “Company”) issued a press release reporting its financial results for the fourth quarter and year ended December 31, 2020, and the Company’s full year 2021 earnings guidance. The Company has also posted a slide presentation entitled “4Q20 Earnings Supplement,” dated February 10, 2021, on the Company’s website, www.molinahealthcare.com. The full text of the press release and the slide presentation are included as Exhibit 99.1 and Exhibit 99.2, respectively, to this report. The information contained in the website cited in the press release is not part of this report.
Note: The information in this Form 8-K and the exhibit attached hereto shall not be deemed to be “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), or otherwise subject to the liabilities of that section, nor shall it be deemed incorporated by reference in any filing under the Securities Act of 1933, as amended, or the Exchange Act, except as expressly set forth by specific reference in such a filing.
Item 9.01. Financial Statements and Exhibits.
(d) Exhibits:
| Exhibit No. | Description | ||||
| 104 | Cover Page information from Molina Healthcare, Inc.’s Current Report on Form 8-K filed on February 10, 2021 formatted in iXBRL (Inline Extensible Business Reporting Language). | ||||
SIGNATURE
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.
MOLINA HEALTHCARE, INC. | |||||||||||
Date: | February 10, 2021 | By: | /s/ Jeff D. Barlow | ||||||||
| Jeff D. Barlow | |||||||||||
| Chief Legal Officer and Secretary | |||||||||||
News Release
Investor Contact: Julie Trudell, Julie.Trudell@molinahealthcare.com, 562-912-6720
Media Contact: Caroline Zubieta, Caroline.Zubieta@molinahealthcare.com, 562-951-1588
____________________________________________________________________________
Molina Healthcare Reports Fourth Quarter and Year-End 2020 Financial Results
Introduces Full Year 2021 Earnings Guidance
Long Beach, Calif, February 10, 2021 – Molina Healthcare, Inc. (NYSE: MOH) today reported net income for the fourth quarter of 2020 of $34 million, or $0.56 per diluted share, and $673 million, or $11.23 per diluted share, for the full year 2020. Financial results are summarized below:
| Three Months Ended | Year Ended | ||||||||||||||||||||||
| December 31, | December 31, | ||||||||||||||||||||||
| 2020 | 2019 | 2020 | 2019 | ||||||||||||||||||||
| (In millions, except per share results) | |||||||||||||||||||||||
| Premium Revenue | $4,855 | $4,123 | $18,299 | $16,208 | |||||||||||||||||||
| Total Revenue | $5,235 | $4,274 | $19,423 | $16,829 | |||||||||||||||||||
| Pre-Tax Income | $51 | $222 | $961 | $972 | |||||||||||||||||||
| Net Income | $34 | $168 | $673 | $737 | |||||||||||||||||||
GAAP EPS – Diluted | $0.56 | $2.67 | $11.23 | $11.47 | |||||||||||||||||||
Adjusted EPS – Diluted (1) | ($0.51) | $2.73 | $10.67 | $11.57 | |||||||||||||||||||
Normalized EPS - Diluted (1) | $3.29 | — | $12.97 | — | |||||||||||||||||||
| GAAP Ratios: | |||||||||||||||||||||||
| MCR | 90.8 | % | 86.0 | % | 86.5 | % | 85.8 | % | |||||||||||||||
| G&A Ratio | 8.6 | % | 8.0 | % | 7.6 | % | 7.7 | % | |||||||||||||||
| Effective Tax Rate | 33.8 | % | 24.3 | % | 30.0 | % | 24.2 | % | |||||||||||||||
| After-Tax Margin | 0.6 | % | 3.9 | % | 3.5 | % | 4.4 | % | |||||||||||||||
(1) Description and reconciliation of non-GAAP financial measures on pages 11-12 of this release. | ||
Full Year Highlights
•Total revenue increased 15% to $19.4 billion for the full year 2020 compared to 2019.
•For the full year 2020, net income was $673 million, or $11.23 per diluted share, compared to net income of $737 million, or $11.47 per diluted share, for the full year 2019.
•Results were positively impacted by adjustments of $0.56 per diluted share for the full year 2020.
•The net effect of COVID decreased net income for the full year 2020 by $2.30 per diluted share.
•Full year 2020 normalized EPS, representing adjusted EPS and excluding the net effect of COVID, was $12.97 per diluted share.
•The Company issued its full year 2021 earnings guidance, with premium revenue growth expected to be over 25% and adjusted EPS expected to be in the range of $12.50 - $13.00.
•Included in the Company’s guidance is the effect of the overhang from COVID and Medicare risk scores expected to soon abate. When combined with the attainment of targeted margins on recent acquisitions, the Company expects an increase of several dollars in EPS in future periods.
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Molina Healthcare, Inc. Announces Fourth Quarter and Year-End 2020 Results
Page 2
February 10, 2021
“2020 presented an unprecedented environment, and I am proud of our performance as we focused on delivering for all of our stakeholders. We ensured our members had access to high quality care, we implemented innumerable special protocols for providers and our state customers, and we delivered growth and excellent financial results,” said Joseph Zubretsky, president and CEO of Molina Healthcare. “As the pandemic continues into 2021, we are determined to do the same. We are pleased with the significant revenue growth we expect to achieve in 2021, and look forward to another successful year.”
Total Revenue
For the year ended December 31, 2020, total revenue increased 15% to $19.4 billion, compared to $16.8 billion for the comparable period in 2019. The higher total revenue reflects increased membership, primarily in Medicaid, and includes the impact from the YourCare and Passport acquisitions.
Net Income
For the year ended December 31, 2020, net income was $673 million, or $11.23 per diluted share, compared to net income of $737 million, or $11.47 per diluted share, for the full year 2019.
For the full year 2020, the Company’s normalized EPS was $12.97 and normalized after-tax margin was 3.9%. The Company’s results were positively impacted by adjustments of $0.56 per diluted share for the full year 2020. The Company estimates the net effect of COVID decreased full year 2020 GAAP EPS by $2.30 per diluted share.
Medical Care Ratio
The consolidated MCR for the year ended December 31, 2020, was 86.5%, compared to 85.8% for 2019. The full year 2020 normalized MCR, which excludes adjustments and the net effect of COVID, was 85.9%. Medicaid and Medicare performed in line with expectations, while Marketplace performance was below expectations.
General and Administrative Expense Ratio
For the year ended December 31, 2020, the G&A ratio was 7.6% compared to 7.7% in 2019. The full year 2020 normalized G&A ratio, which excludes adjustments and the net effect of COVID, was 7.3%. This improvement reflects disciplined cost management and the benefits of scale produced by the Company’s growth.
Balance Sheet
Cash and investments at the parent company amounted to $644 million as of December 31, 2020, compared to $997 million as of December 31, 2019. In November 2020, the Company closed on its private offering of $650 million aggregate principal amount of 3.875% senior notes due November 15, 2030. The Company used a portion of the proceeds to repay $330 million principal amount outstanding of its 4.875% senior notes.
In September 2020, the Company’s Board of Directors authorized a share repurchase program of up to $500 million. Through December 31, 2020, the Company purchased an aggregate of approximately 766,000 shares for $159 million, at an average cost of $208.37 per share.
Cash Flow
Operating cash flow for the year ended December 31, 2020, amounted to $1,890 million, and was higher compared to the year ended December 31, 2019, primarily due to strong operating results, cash flow timing benefits from the growth in membership in 2020, and the net impact of timing differences in governmental receivables and payables.
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Molina Healthcare, Inc. Announces Fourth Quarter and Year-End 2020 Results
Page 3
February 10, 2021
2021 Guidance
The Company issued its full year 2021 earnings guidance, with premium revenue growth expected to be over 25% and adjusted EPS expected to be in the range of $12.50 - $13.00. Given its recent M&A activity and the associated non-cash impact from amortization of intangible assets, the Company believes that adjusted EPS has become a more relevant measure of earnings going forward.
Full year guidance reflects the following expected positive drivers:
•Continued strong performance in Medicaid and Medicare;
•Margin recovery and growth in the Marketplace business;
•Accretion from the Magellan Complete Care businesses and the Kentucky and Passport installation; and,
•The elimination of the Health Insurer Fee.
Full year guidance considers the following industry-wide and economic environment challenges that are expected to be mostly temporary, including:
•A negative net effect of COVID due to a continuation of many of the risk-sharing corridors that existed in 2020 and the direct costs of COVID-related patient care;
•Medicare risk scores; and,
•Net pharmacy benefit carve-outs.
Full year guidance does not include:
•The Affinity acquisition, as the transaction has not yet closed; and,
•The impact of potential Public Health Emergency extensions beyond mid-April 2021.
Included in the Company’s guidance is the effect of the overhang from COVID and Medicare risk scores expected to soon abate. When combined with the attainment of targeted margins on recent acquisitions, the Company expects an increase of several dollars in EPS in future periods.
The Company has posted a presentation entitled “4Q20 Earnings Supplement,” dated February 10, 2021, on the Company’s website, molinahealthcare.com.
Full Year 2021 Guidance (1) | |||||
| Premium Revenue | >$23.0B | ||||
| Total Revenue | >$24.0B | ||||
| GAAP Net Income | $649M - $678M | ||||
Adjusted Net Income (2) | $730M - $759M | ||||
| GAAP EPS – Diluted | $11.10 - $11.60 | ||||
Adjusted EPS – Diluted (2) | $12.50 - $13.00 | ||||
| Diluted weighted average shares | ~58.5M | ||||
| Year End Total Membership | ~3.9M | ||||
| Medicaid and Medicare | ~3.5M | ||||
| Marketplace | ~400K | ||||
| MCR | ~88.0% | ||||
| GAAP G&A Ratio | ~7.3% | ||||
Adjusted G&A Ratio (2) | ~7.0% | ||||
| Effective Tax Rate | ~25.6% | ||||
| GAAP After-tax Margin | ~2.7% | ||||
Adjusted After-tax Margin (2) | ~3.0% | ||||
| ______________ | |||||
(1)All amounts are rounded and approximations. | |||||
| (2) Reconciliations of non-GAAP financial measures on page 13 of this release. | |||||
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Molina Healthcare, Inc. Announces Fourth Quarter and Year-End 2020 Results
Page 4
February 10, 2021
Conference Call
Management will host a conference call and webcast to discuss Molina Healthcare’s fourth quarter and year-end 2020 results at 8:00 a.m. Eastern Time on Thursday, February 11, 2021. The number to call for the interactive teleconference is (877) 883-0383 and the confirmation number is 9566162. A telephonic replay of the conference call will be available through Thursday, February 18, 2021, by dialing (877) 344-7529 and entering confirmation number 10150614. A live audio broadcast of this conference call will be available on Molina Healthcare’s website, molinahealthcare.com. A 30-day online replay will be available approximately an hour following the conclusion of the live broadcast.
About Molina Healthcare
Molina Healthcare, Inc., a FORTUNE 500 company, provides managed healthcare services under the Medicaid and Medicare programs and through the state insurance marketplaces. Through its locally operated health plans, Molina Healthcare served approximately 4.0 million members as of December 31, 2020. For more information about Molina Healthcare, please visit molinahealthcare.com.
Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995
This earnings release and the Company’s accompanying oral remarks contain forward-looking statements regarding its 2021 guidance, as well as its plans, expectations, and the Company’s expectations regarding future developments. Actual results could differ materially due to numerous known and unknown risks and uncertainties. These risks and uncertainties are discussed under the headings “Forward-Looking Statements,” and “Risk Factors,” in the Company’s Annual Report on Form 10-K for the year ended December 31, 2019, and also in its Quarterly Reports on Form 10-Q for the periods ended March 31, 2020, June 30, 2020, and September 30, 2020, which are on file with the SEC. Additional information will also be set forth in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020, which the Company expects to file on or about February 12, 2021.
These reports can be accessed under the investor relations tab of the Company’s website or on the SEC’s website at sec.gov. Given these risks and uncertainties, the Company can give no assurances that its forward-looking statements will prove to be accurate, or that any other results or developments projected or contemplated by its forward-looking statements will in fact occur, and the Company cautions investors not to place undue reliance on these statements. All forward-looking statements in this release represent the Company’s judgment as of February 10, 2021, and, except as otherwise required by law, the Company disclaims any obligation to update any forward-looking statement to conform the statement to actual results or changes in its expectations.
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Molina Healthcare, Inc. Announces Fourth Quarter and Year-End 2020 Results
Page 5
February 10, 2021
MOLINA HEALTHCARE, INC.
UNAUDITED CONSOLIDATED STATEMENTS OF INCOME
| Three Months Ended | Year Ended | ||||||||||||||||||||||
| December 31, | December 31, | ||||||||||||||||||||||
| 2020 | 2019 | 2020 | 2019 | ||||||||||||||||||||
| (In millions, except per-share amounts) | |||||||||||||||||||||||
| Revenue: | |||||||||||||||||||||||
| Premium revenue | $ | 4,855 | $ | 4,123 | $ | 18,299 | $ | 16,208 | |||||||||||||||
| Premium tax revenue | 172 | 122 | 649 | 489 | |||||||||||||||||||
| Health insurer fees reimbursed | 65 | — | 271 | — | |||||||||||||||||||
| Marketplace risk corridor judgment | 128 | — | 128 | — | |||||||||||||||||||
| Investment income and other revenue | 15 | 29 | 76 | 132 | |||||||||||||||||||
| Total revenue | 5,235 | 4,274 | 19,423 | 16,829 | |||||||||||||||||||
| Operating expenses: | |||||||||||||||||||||||
| Medical care costs | 4,408 | 3,545 | 15,820 | 13,905 | |||||||||||||||||||
| General and administrative expenses | 450 | 343 | 1,480 | 1,296 | |||||||||||||||||||
| Premium tax expenses | 172 | 122 | 649 | 489 | |||||||||||||||||||
| Health insurer fees | 68 | — | 277 | — | |||||||||||||||||||
| Depreciation and amortization | 24 | 21 | 88 | 89 | |||||||||||||||||||
| Other | 22 | 1 | 31 | 6 | |||||||||||||||||||
| Total operating expenses | 5,144 | 4,032 | 18,345 | 15,785 | |||||||||||||||||||
| Operating income | 91 | 242 | 1,078 | 1,044 | |||||||||||||||||||
| Other expenses, net: | |||||||||||||||||||||||
| Interest expense | 30 | 20 | 102 | 87 | |||||||||||||||||||
| Other expense (income), net | 10 | — | 15 | (15) | |||||||||||||||||||
| Total other expenses, net | 40 | 20 | 117 | 72 | |||||||||||||||||||
Income before income tax expense | 51 | 222 | 961 | 972 | |||||||||||||||||||
| Income tax expense | 17 | 54 | 288 | 235 | |||||||||||||||||||
| Net income | $ | 34 | $ | 168 | $ | 673 | $ | 737 | |||||||||||||||
| Net income per share - Diluted | $ | 0.56 | $ | 2.67 | $ | 11.23 | $ | 11.47 | |||||||||||||||
Diluted weighted average shares outstanding | 59.4 | 63.0 | 59.9 | 64.2 | |||||||||||||||||||
| Operating Statistics: | |||||||||||||||||||||||
| Medical care ratio | 90.8 | % | 86.0 | % | 86.5 | % | 85.8 | % | |||||||||||||||
| G&A ratio | 8.6 | % | 8.0 | % | 7.6 | % | 7.7 | % | |||||||||||||||
| Premium tax ratio | 3.4 | % | 2.9 | % | 3.4 | % | 2.9 | % | |||||||||||||||
| Effective income tax rate | 33.8 | % | 24.3 | % | 30.0 | % | 24.2 | % | |||||||||||||||
| After-tax margin | 0.6 | % | 3.9 | % | 3.5 | % | 4.4 | % | |||||||||||||||
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Molina Healthcare, Inc. Announces Fourth Quarter and Year-End 2020 Results
Page 6
February 10, 2021
MOLINA HEALTHCARE, INC.
CONSOLIDATED BALANCE SHEETS
| December 31, | |||||||||||
| 2020 | 2019 | ||||||||||
| Unaudited | |||||||||||
| (Dollars in millions, except per-share amounts) | |||||||||||
| ASSETS | |||||||||||
| Current assets: | |||||||||||
| Cash and cash equivalents | $ | 4,154 | $ | 2,452 | |||||||
| Investments | 1,875 | 1,946 | |||||||||
| Receivables | 1,672 | 1,406 | |||||||||
| Prepaid expenses and other current assets | 175 | 163 | |||||||||
| Total current assets | 7,876 | 5,967 | |||||||||
| Property, equipment, and capitalized software, net | 391 | 385 | |||||||||
| Goodwill and intangible assets, net | 941 | 172 | |||||||||
| Restricted investments | 136 | 79 | |||||||||
| Deferred income taxes | 69 | 79 | |||||||||
| Other assets | 119 | 105 | |||||||||
| Total assets | $ | 9,532 | $ | 6,787 | |||||||
| LIABILITIES AND STOCKHOLDERS’ EQUITY | |||||||||||
| Current liabilities: | |||||||||||
| Medical claims and benefits payable | $ | 2,696 | $ | 1,854 | |||||||
| Amounts due government agencies | 1,253 | 664 | |||||||||
| Accounts payable, accrued liabilities and other | 641 | 502 | |||||||||
| Deferred revenue | 375 | 249 | |||||||||
| Total current liabilities | 4,965 | 3,269 | |||||||||
| Long-term debt | 2,127 | 1,237 | |||||||||
| Finance lease liabilities | 225 | 231 | |||||||||
| Other long-term liabilities | 119 | 90 | |||||||||
| Total liabilities | 7,436 | 4,827 | |||||||||
| Stockholders’ equity: | |||||||||||
Common stock, $0.001 par value, 150 million shares authorized; outstanding: 59 million shares at December 31, 2020, and 62 million shares at December 31, 2019 | — | — | |||||||||
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding | — | — | |||||||||
| Additional paid-in capital | 199 | 175 | |||||||||
| Accumulated other comprehensive income | 37 | 4 | |||||||||
| Retained earnings | 1,860 | 1,781 | |||||||||
| Total stockholders’ equity | 2,096 | 1,960 | |||||||||
| Total liabilities and stockholders’ equity | $ | 9,532 | $ | 6,787 | |||||||
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Molina Healthcare, Inc. Announces Fourth Quarter and Year-End 2020 Results
Page 7
February 10, 2021
MOLINA HEALTHCARE, INC.
UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
Year Ended | |||||||||||
| December 31, | |||||||||||
| 2020 | 2019 | ||||||||||
| (In millions) | |||||||||||
| Operating activities: | |||||||||||
| Net income | $ | 673 | $ | 737 | |||||||
Adjustments to reconcile net income to net cash provided by operating activities: | |||||||||||
| Depreciation and amortization | 88 | 89 | |||||||||
| Deferred income taxes | (19) | 10 | |||||||||
Share-based compensation | 57 | 39 | |||||||||
Loss (gain) on debt repayment | 15 | (15) | |||||||||
Other, net | 12 | — | |||||||||
| Changes in operating assets and liabilities: | |||||||||||
| Receivables | (100) | (76) | |||||||||
| Prepaid expenses and other current assets | (16) | 28 | |||||||||
| Medical claims and benefits payable | 544 | (107) | |||||||||
| Amounts due government agencies | 446 | (303) | |||||||||
| Accounts payable, accrued liabilities and other | 78 | 2 | |||||||||
| Deferred revenue | 126 | 38 | |||||||||
| Income taxes | (14) | (15) | |||||||||
Net cash provided by operating activities | 1,890 | 427 | |||||||||
| Investing activities: | |||||||||||
| Purchases of investments | (670) | (2,536) | |||||||||
Proceeds from sales and maturities of investments | 1,097 | 2,302 | |||||||||
| Net cash paid in business combinations | (755) | — | |||||||||
Purchases of property, equipment, and capitalized software | (74) | (57) | |||||||||
| Other, net | 2 | (2) | |||||||||
| Net cash used in investing activities | (400) | (293) | |||||||||
| Financing activities: | |||||||||||
| Proceeds from senior notes offerings, net of issuance costs | 1,429 | — | |||||||||
Common stock purchases | (606) | (47) | |||||||||
| Repayment of term loan facility | (600) | — | |||||||||
| Proceeds from borrowings under term loan facility | 380 | 220 | |||||||||
| Repayment of senior notes | (338) | — | |||||||||
Cash paid for partial termination of warrants | (30) | (514) | |||||||||
Cash paid for partial settlement of conversion option | (27) | (578) | |||||||||
Cash received for partial settlement of call option | 27 | 578 | |||||||||
Repayment of principal amount of convertible senior notes | (12) | (240) | |||||||||
| Other, net | 2 | 29 | |||||||||
Net cash provided by (used in) financing activities | 225 | (552) | |||||||||
Net increase (decrease) in cash, cash equivalents, and restricted cash and cash equivalents | 1,715 | (418) | |||||||||
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period | 2,508 | 2,926 | |||||||||
Cash, cash equivalents, and restricted cash and cash equivalents at end of period | $ | 4,223 | $ | 2,508 | |||||||
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Molina Healthcare, Inc. Announces Fourth Quarter and Year-End 2020 Results
Page 8
February 10, 2021
MOLINA HEALTHCARE, INC.
UNAUDITED HEALTH PLANS SEGMENT DATA
(Dollars in millions)
| As of December 31, | |||||||||||
| 2020 | 2019 | ||||||||||
Ending Membership(1) by Government Program: | |||||||||||
| Medicaid | 3,599,000 | 2,956,000 | |||||||||
| Medicare | 115,000 | 101,000 | |||||||||
| Marketplace | 318,000 | 274,000 | |||||||||
| Total | 4,032,000 | 3,331,000 | |||||||||
Ending Membership(1) by Health Plan: | |||||||||||
| California | 593,000 | 565,000 | |||||||||
| Florida | 140,000 | 132,000 | |||||||||
| Illinois | 302,000 | 224,000 | |||||||||
| Kentucky | 337,000 | — | |||||||||
| Michigan | 400,000 | 362,000 | |||||||||
| Ohio | 352,000 | 288,000 | |||||||||
| Texas | 357,000 | 341,000 | |||||||||
| Washington | 977,000 | 832,000 | |||||||||
Other (2) | 574,000 | 587,000 | |||||||||
| Total | 4,032,000 | 3,331,000 | |||||||||
__________________
(1)Does not include approximately 200,000 Magellan Complete Care members from the acquisition closed on December 31, 2020.
(2)“Other” includes the Idaho, Mississippi, New Mexico, New York, Puerto Rico, South Carolina, Utah, and Wisconsin health plans, which were not individually significant to the Company’s consolidated operating results for the periods presented.
| Three Months Ended December 31, | |||||||||||||||||||||||||||||||||||
| 2020 | 2019 | ||||||||||||||||||||||||||||||||||
| Premium Revenue | Medical Care Costs | MCR (1) | Premium Revenue | Medical Care Costs | MCR (1) | ||||||||||||||||||||||||||||||
| Medicaid | $ | 3,850 | $ | 3,473 | 90.2 | % | $ | 3,227 | $ | 2,818 | 87.3 | % | |||||||||||||||||||||||
| Medicare | 616 | 598 | 97.1 | 561 | 480 | 85.5 | |||||||||||||||||||||||||||||
| Marketplace | 389 | 337 | 86.6 | 335 | 247 | 73.5 | |||||||||||||||||||||||||||||
| Consolidated | $ | 4,855 | $ | 4,408 | 90.8 | % | $ | 4,123 | $ | 3,545 | 86.0 | % | |||||||||||||||||||||||
| Year Ended December 31, | |||||||||||||||||||||||||||||||||||
| 2020 | 2019 | ||||||||||||||||||||||||||||||||||
| Premium Revenue | Medical Care Costs | MCR (1) | Premium Revenue | Medical Care Costs | MCR (1) | ||||||||||||||||||||||||||||||
| Medicaid | $ | 14,265 | $ | 12,461 | 87.4 | % | $ | 12,466 | $ | 10,969 | 88.0 | % | |||||||||||||||||||||||
| Medicare | 2,512 | 2,161 | 86.0 | 2,243 | 1,913 | 85.3 | |||||||||||||||||||||||||||||
| Marketplace | 1,522 | 1,198 | 78.7 | 1,499 | 1,023 | 68.2 | |||||||||||||||||||||||||||||
| Consolidated | $ | 18,299 | $ | 15,820 | 86.5 | % | $ | 16,208 | $ | 13,905 | 85.8 | % | |||||||||||||||||||||||
__________________
(1)The MCR represents medical costs as a percentage of premium revenue.
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Molina Healthcare, Inc. Announces Fourth Quarter and Year-End 2020 Results
Page 9
February 10, 2021
MOLINA HEALTHCARE, INC.
CHANGE IN MEDICAL CLAIMS AND BENEFITS PAYABLE
(Dollars in millions)
The Company’s claims liabilities include additional reserves to account for moderately adverse conditions based on historical experience and other factors including, but not limited to, variations in claims payment patterns, changes in utilization and cost trends, known outbreaks of disease, and large claims. The Company’s reserving methodology is consistently applied across all periods presented. The amounts displayed for “Components of medical care costs related to: Prior year” represent the amounts by which the original estimates of claims and benefits payable at the beginning of the year were more than the actual liabilities based on information (principally the payment of claims) developed since those liabilities were first reported. The following table presents the components of the change in medical claims and benefits payable for the periods indicated:
| Year Ended | |||||||||||
| December 31, | |||||||||||
| 2020 | 2019 | ||||||||||
| Unaudited | |||||||||||
Medical claims and benefits payable, beginning balance | $ | 1,854 | $ | 1,961 | |||||||
| Components of medical care costs related to: | |||||||||||
| Current year | 15,939 | 14,176 | |||||||||
| Prior year | (119) | (271) | |||||||||
| Total medical care costs | 15,820 | 13,905 | |||||||||
| Payments for medical care costs related to: | |||||||||||
| Current year | 13,871 | 12,554 | |||||||||
| Prior year | 1,507 | 1,482 | |||||||||
| Total paid | 15,378 | 14,036 | |||||||||
| Acquisition - Magellan Complete Care | 294 | — | |||||||||
| Change in non-risk and other provider payables | 106 | 24 | |||||||||
Medical claims and benefits payable, ending balance | $ | 2,696 | $ | 1,854 | |||||||
Days in claims payable, fee for service (1) | 50 | 50 | |||||||||
______________________
(1)Claims payable includes primarily claims incurred but not paid, or IBNP. It also includes certain fee-for-service payables reported in medical claims and benefits payable amounting to $78 million and $50 million, as of December 31, 2020, and 2019, respectively.
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Molina Healthcare, Inc. Announces Fourth Quarter and Year-End 2020 Results
Page 10
February 10, 2021
MOLINA HEALTHCARE, INC.
RECONCILIATION OF UNAUDITED NON-GAAP FINANCIAL MEASURES
(In millions)
The Company believes that certain non-generally accepted accounting principles, or non-GAAP, financial measures are useful supplemental measures to investors in comparing the Company’s performance to the performance of other public companies in the health care industry. These non-GAAP financial measures, presented below, should be considered as supplements to, and not as substitutes for or superior to, GAAP measures.
Earnings before interest, taxes, depreciation and amortization (“EBITDA”) represents GAAP net income less depreciation and amortization, interest expense and income tax expense. The Company believes that EBITDA is helpful to investors in assessing the Company’s ability to meet the cash demands of its operating units.
| Three Months Ended | Year Ended | ||||||||||||||||||||||
| December 31, | December 31, | ||||||||||||||||||||||
| 2020 | 2019 | 2020 | 2019 | ||||||||||||||||||||
Net income | $ | 34 | $ | 168 | $ | 673 | $ | 737 | |||||||||||||||
Adjustments: | |||||||||||||||||||||||
Depreciation and amortization | 24 | 21 | 88 | 89 | |||||||||||||||||||
Interest expense | 30 | 20 | 102 | 87 | |||||||||||||||||||
| Income tax expense | 17 | 54 | 288 | 235 | |||||||||||||||||||
EBITDA | $ | 105 | $ | 263 | $ | 1,151 | $ | 1,148 | |||||||||||||||
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Molina Healthcare, Inc. Announces Fourth Quarter and Year-End 2020 Results
Page 11
February 10, 2021
MOLINA HEALTHCARE, INC.
RECONCILIATION OF UNAUDITED NON-GAAP FINANCIAL MEASURES CONTINUED
(In millions, except per diluted share amounts)
Adjustments represent additions and deductions to GAAP net income as indicated in the table below, which include the non-cash impact of amortization of purchased intangibles and the impact of certain expenses and other items that management believes are not indicative of longer-term business trends and operations.
Adjusted net income (loss) represents GAAP net income recognizing the adjustments, net of tax. The Company believes that adjusted net income is helpful to investors in assessing the Company’s financial performance.
Adjusted net income (loss) per diluted share represents adjusted net income (loss) divided by weighted average common shares outstanding on a fully diluted basis.
| Three Months Ended December 31, | Year Ended December 31, | ||||||||||||||||||||||||||||||||||||||||||||||
| 2020 | 2019 | 2020 | 2019 | ||||||||||||||||||||||||||||||||||||||||||||
| Amount | Per Diluted Share | Amount | Per Diluted Share | Amount | Per Diluted Share | Amount | Per Diluted Share | ||||||||||||||||||||||||||||||||||||||||
Net income | $ | 34 | $ | 0.56 | $ | 168 | $ | 2.67 | $ | 673 | $ | 11.23 | $ | 737 | $ | 11.47 | |||||||||||||||||||||||||||||||
Adjustments: | |||||||||||||||||||||||||||||||||||||||||||||||
Marketplace risk corridor judgment | (128) | (2.15) | — | — | (128) | (2.14) | — | — | |||||||||||||||||||||||||||||||||||||||
Acquisition-related expenses (1) | 18 | 0.31 | — | — | 22 | 0.37 | — | — | |||||||||||||||||||||||||||||||||||||||
Amortization of intangible assets | 4 | 0.07 | 4 | 0.06 | 16 | 0.26 | 17 | 0.27 | |||||||||||||||||||||||||||||||||||||||
Loss (gain) on debt repayment | 10 | 0.18 | — | — | 15 | 0.26 | (15) | (0.24) | |||||||||||||||||||||||||||||||||||||||
| Charitable contribution | 15 | 0.25 | — | — | 15 | 0.25 | — | — | |||||||||||||||||||||||||||||||||||||||
Restructuring costs | 1 | 0.01 | 1 | 0.02 | 10 | 0.16 | 6 | 0.10 | |||||||||||||||||||||||||||||||||||||||
Premium deficiency reserve - Puerto Rico | (4) | (0.07) | — | — | 6 | 0.10 | — | — | |||||||||||||||||||||||||||||||||||||||
Subtotal, adjustments | (84) | (1.40) | 5 | 0.08 | (44) | (0.74) | 8 | 0.13 | |||||||||||||||||||||||||||||||||||||||
Income tax effect | 20 | 0.33 | (1) | (0.02) | 11 | 0.18 | (2) | (0.03) | |||||||||||||||||||||||||||||||||||||||
Adjustments, net of tax | (64) | (1.07) | 4 | 0.06 | (33) | (0.56) | 6 | 0.10 | |||||||||||||||||||||||||||||||||||||||
Adjusted net (loss) income | $ | (30) | $ | (0.51) | $ | 172 | $ | 2.73 | $ | 640 | $ | 10.67 | $ | 743 | $ | 11.57 | |||||||||||||||||||||||||||||||
__________________
(1)Beginning in the third quarter of 2020, reflects non-recurring costs associated with acquisitions, including various transaction and integration costs.
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Molina Healthcare, Inc. Announces Fourth Quarter and Year-End 2020 Results
Page 12
February 10, 2021
MOLINA HEALTHCARE, INC.
RECONCILIATION OF UNAUDITED NON-GAAP FINANCIAL MEASURES CONTINUED
Normalized EPS represents adjusted EPS, as shown in the reconciliation of GAAP EPS to non-GAAP adjusted EPS, excluding the net effect of COVID. The net effect of COVID consists of discrete premium refunds, reduced demand for medical services, and the cost of COVID-related care. This non-GAAP financial measure should be considered a supplement to, and not a substitute for, GAAP earnings per diluted share. The Company believes this metric, which is used by management in the operation of the business, is helpful to investors in assessing the Company’s 2020 financial performance and operations without the temporary distortion caused by the COVID pandemic.
Normalized after-tax margin represents adjusted net income, excluding the net effect of COVID, divided by total revenue.
| Three Months Ended | Year Ended | ||||||||||
| December 31, 2020 | |||||||||||
| (Per diluted share) | |||||||||||
| GAAP EPS – Diluted | $ | 0.56 | $ | 11.23 | |||||||
| Less: Adjustments, net of tax | (1.07) | (0.56) | |||||||||
| Adjusted EPS – Diluted | (0.51) | 10.67 | |||||||||
| Add: Net effect of COVID | 3.80 | 2.30 | |||||||||
| Normalized EPS – Diluted | $ | 3.29 | $ | 12.97 | |||||||
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Molina Healthcare, Inc. Announces Fourth Quarter and Year-End 2020 Results
Page 13
February 10, 2021
MOLINA HEALTHCARE, INC.
2021 GUIDANCE
RECONCILIATION OF UNAUDITED NON-GAAP FINANCIAL MEASURES
(In millions, except per diluted share amounts)
| Low End | High End | ||||||||||||||||||||||
| Amount | Per Diluted Share (2) | Amount | Per Diluted Share (2) | ||||||||||||||||||||
Net income | $ | 649 | $ | 11.10 | $ | 678 | $ | 11.60 | |||||||||||||||
Adjustments: | |||||||||||||||||||||||
Acquisition-related expenses | 62 | 1.06 | 62 | 1.06 | |||||||||||||||||||
Amortization of intangible assets | 45 | 0.77 | 45 | 0.77 | |||||||||||||||||||
Subtotal, adjustments | 107 | 1.83 | 107 | 1.83 | |||||||||||||||||||
Income tax effect (1) | (26) | (0.43) | (26) | (0.43) | |||||||||||||||||||
Adjustments, net of tax | 81 | 1.40 | 81 | 1.40 | |||||||||||||||||||
Adjusted net income | $ | 730 | $ | 12.50 | $ | 759 | $ | 13.00 | |||||||||||||||
| $ | — | $ | — | $ | — | $ | — | ||||||||||||||||
__________________
(1)Income tax effect calculated at the statutory tax rate of 23.9%.
(2)Computation assumes approximately 58.5 million diluted weighted average shares outstanding.
Adjusted G&A Ratio represents the GAAP G&A ratio, recognizing adjustments.
Adjusted after-tax margin represents adjusted net income, divided by total revenue.
-END-
4Q20 Earnings Supplement February 10, 2021 This 4Q20 Earnings Supplement should be read together and in conjunction with the Company’s earnings release dated February 10, 2021.
2 Cautionary Statement Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995 This presentation and the accompanying oral remarks include forward-looking statements regarding, without limitation, the Company’s strategic position, its projected 2021 financial guidance and future revenue growth prospects, political and judicial developments, the continuing net effect of COVID during 2021, Medicaid rates and risk corridor provisions, our 2021 Marketplace business and membership, and our Medicare risk scores. The Company intends such forward-looking statements to be covered by the safe harbor provisions for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995. The Company cannot guarantee that it will actually achieve the plans, outlook, or expectations disclosed in its forward-looking statements and, accordingly, you should not place undue reliance on the Company’s forward-looking statements. Those risks and uncertainties are discussed under Item 1A in the sec tion entitled “Risk Factors” in the Company’s Annual Report on Form 10-K and also in the Company’s quarterly reports and other reports and filings with the Securities and Exchange Commission, or SEC. These reports can be accessed under the investor relations tab o f the Company’s website or on the SEC’s website at www.sec.gov. Given these risks and uncertainties, the Company can give no assurances that its forward-looking statements will prove to be accurate, or that the results or events projected or contemplated by its forward-looking statements will in fact occur. All forward-looking statements in this presentation represent management’s judgment as of February 10, 2021, and, except as otherwise required by law, the Company disclaims any obligation to update any forward-looking statements to conform the statement to actual results or changes in its expectations.
3 4Q20 GAAP EPS Net Effect of COVID 4Q20 Normalized EPS Adjustments 4Q20 Adjusted EPS $3.29$3.80 $0.56 ($1.07) ($0.51) Normalized 4Q20 earnings continue strong performance and in line with expectations 4Q20 Earnings Summary
4 Net Effect of COVID Adjustments2020 GAAP EPS 2020 Normalized EPS 2020 Adjusted EPS Normalized earnings exceeded guidance of $11.20 - $11.70 per share 2020 Earnings Summary $12.97$2.30 $10.67 $11.23 ($0.56)
5 $18.3B $3.5B >$23.0B Continued execution of our growth strategy leads to 2021 premium revenue of over $23 billion, or 25% growth over 2020 2021 Premium Revenue Net Acquisitions Organic Regulatory Actions $0.8B $0.5B ~4% ~3% ~19% 2020 GAAP Premium Revenue 2021 GAAP Premium Revenue >25%
6 Growth strategy has similar impacts on all lines of business 2021 Premium Revenue MarketplaceMedicaid2020 GAAP Premium Revenue 2021 GAAP Premium Revenue Medicare $18.3B $3.5B $0.8B $0.4B >$23.0B ~25% ~30% ~25% >25%
7 2021 Adjusted EPS (~$2.50) (~20%) Temporary Items ~$2.25 ~20% Sustaining Growth 2020 Normalized EPS Core Performance Acquisitions and Share Repurchases Net Effect of COVID Medicare Risk Scores 2021 Adjusted EPS $12.97 $1.25 $1.00 ($1.00) ($1.50) $12.75 Core performance and acquisitions are primary drivers of growth offset by temporary COVID and Medicare risk score impacts