WellCare Reports Second Quarter 2019 Results

TAMPA, Fla., July 30, 2019 /PRNewswire/ -- WellCare Health Plans, Inc. WCG ("WellCare") today reported results for the quarter ended June 30, 2019. As determined under generally accepted accounting principles (GAAP), net income for the second quarter of 2019 was $182.8 million, or $3.60 per diluted share. Adjusted net income for the second quarter of 2019 was $219.0 million, or $4.31 per diluted share.

"Our strong revenue and earnings growth in the quarter was the result of continued strong operational and financial execution by our WellCare associates," said Ken Burdick, WellCare's chief executive officer. "We remain focused on delivering on our commitments to our government partners on behalf of our 6.3 million members, while we pursue regulatory approvals for our previously announced merger with Centene."                        

Key Highlights

• GAAP and adjusted total revenue of $7.0 billion and $7.0 billion, respectively, for the second quarter of 2019 increased 51.1 percent and 53.5 percent, respectively, compared with the second quarter of 2018.
• GAAP and adjusted Medicaid Health Plans revenue of $4.7 billion and $4.7 billion, respectively, for the second quarter of 2019 increased 64.1 and 68.5 percent, respectively, compared with the second quarter of 2018.
• Medicare Health Plans revenue of $1.9 billion for the second quarter of 2019 increased 21.1 percent compared with the second quarter of 2018.
• Medicare PDP revenue of $259.3 million for the second quarter of 2019 increased 29.7 percent compared with the second quarter of 2018.
• Medicare PDP membership was approximately 1.6 million as of June 30, 2019, and increased by approximately 592,000 members, or 56.1 percent, compared with June 30, 2018.
• GAAP and adjusted SG&A ratios for the second quarter of 2019 decreased approximately 120 basis points and 130 basis points, respectively, compared with the second quarter of 2018.
• In the second quarter of 2019, WellCare incurred $2.9 million pre-tax, or ($0.04) per adjusted diluted share, in startup costs associated with the North Carolina statewide Medicaid contract implementation.  These startup costs are included in adjusted EPS.

2019 Financial Outlook

Due to the pending merger with Centene, WellCare is not currently providing updated financial guidance.

Consolidated Operations Results

GAAP net income for the second quarter of 2019 was $182.8 million, or $3.60 per diluted share, compared with GAAP net income of $151.6 million, or $3.35 per diluted share, for the second quarter of 2018. Adjusted net income for the second quarter of 2019 was $219.0 million, or $4.31 per diluted share, compared with adjusted net income of $166.9 million, or $3.69 per diluted share, for the second quarter of 2018. The year-over-year increase in GAAP and adjusted net income primarily reflects growth across all business segments and continued operational execution.

GAAP net income margin for the second quarter of 2019 was 2.6 percent compared with 3.3 percent for the second quarter of 2018. Adjusted net income margin for the second quarter of 2019 was 3.1 percent compared with 3.7 percent for the second quarter of 2018.

GAAP and adjusted total revenue of $7.0 billion and $7.0 billion, respectively, for the second quarter of 2019 increased 51.1 percent and 53.5 percent, respectively, compared with the second quarter of 2018. The year-over-year increases in GAAP and adjusted total revenue were primarily the result of the company's 2018 acquisition of Meridian and net organic growth across all business segments, partially offset by the effect of the 2019 ACA Health Insurer Fee (HIF) moratorium.

GAAP SG&A expense was $486.8 million for the second quarter of 2019 compared with $377.9 million for the second quarter of 2018. Adjusted SG&A expense was $473.6 million for the second quarter of 2019 compared with $368.1 million for the second quarter of 2018. The year-over-year increases in GAAP and adjusted SG&A expense primarily reflect staffing and infrastructure to support growth across all business segments. 

The GAAP SG&A expense ratio was 6.9 percent in the second quarter of 2019 compared with 8.1 percent in the second quarter of 2018. The adjusted SG&A expense ratio was 6.8 percent in the second quarter of 2019 compared with 8.1 percent in the second quarter of 2018.  The decreases in GAAP and adjusted SG&A expense ratios reflect continued operating leverage as a result of the company's growth.

Medicaid Health Plans Segment Results

Medicaid Health Plans membership was 4.1 million as of June 30, 2019 and increased by approximately 1.3 million members, or 45.5 percent, compared with June 30, 2018. The increase was primarily due to the company's 2018 acquisition of Meridian as well as net organic growth, including additional members in our Florida Medical health plan.

GAAP and adjusted Medicaid Health Plans revenue was $4.7 billion and $4.7 billion, respectively, for the second quarter of 2019, an increase of 64.1 percent and 68.5 percent, respectively, compared with the second quarter of 2018. The increases in GAAP and adjusted premium revenue were primarily the result of the company's 2018 acquisition of Meridian and net organic growth, including additional members in our Florida and Arizona Medical health plans.  The increase in GAAP Medicaid Health Plans revenue was partially offset by the effect of the 2019 ACA HIF moratorium.

The GAAP Medicaid Health Plans MBR was 90.7 percent for the second quarter of 2019 compared with 85.1 percent for the second quarter of 2018. The increase in the GAAP Medicaid Health Plans MBR was primarily due to the company's 2018 acquisition of Meridian, primarily our Illinois health plan, net organic growth, including our health plan in Florida, where newer products typically have a higher MBR, and the effect of the 2019 ACA HIF moratorium, partially offset by continued operational execution.  The adjusted Medicaid Health Plans MBR was 91.3 percent for the second quarter of 2019 compared with 88.0 percent for the second quarter of 2018, primarily as a result of the company's 2018 acquisition of Meridian, primarily our Illinois health plan, and net organic growth, including our health plan in Florida, where newer products typically have a higher MBR, partially offset by continued operational execution.

Medicare Health Plans Segment Results

Medicare Health Plans membership was approximately 560,000 as of June 30, 2019 and increased by approximately 50,000 members, or 9.8 percent, compared with June 30, 2018. The increase was due to the company's 2018 acquisition of Meridian and organic growth.

Medicare Health Plans revenue was $1.9 billion for the second quarter of 2019 and increased by 21.1 percent compared with the second quarter of 2018. The increase was due to organic growth and the company's 2018 acquisition of Meridian.

The Medicare Health Plans MBR for the second quarter of 2019 was 82.5 percent compared with 82.9 percent in the second quarter of 2018.  The decrease primarily resulted from our 2019 bid positioning and continued operational execution.

Medicare Prescription Drug Plans (PDP) Segment Results

Medicare PDP membership was approximately 1.6 million as of June 30, 2019, and increased by approximately 592,000 members, or 56.1 percent, compared with June 30, 2018. The increase was primarily a result of organic growth through a new enhanced product offering in 2019.

Medicare PDP revenue of $259.3 million for the second quarter of 2019 increased by 29.7 percent compared with the second quarter of 2018. The increase was primarily a result of organic membership growth through a new enhanced product offering in 2019.

The Medicare PDP segment MBR for the second quarter of 2019 was 81.2 percent, compared with 72.7 percent for the second quarter of 2018. The increase was primarily a result of the company's 2019 bid strategy partially offset by the performance of the company's new enhanced product offering in 2019 and continued operational execution.

Operating Cash Flow and Financial Condition

Net cash provided by operating activities was $536.5 million for the three months ended June 30, 2019, compared with $330.9 million for the three months ended June 30, 2018.  The year-over-year increase in operating cash flow is primarily due to the timing of pharmacy rebate payments and higher earnings in the second quarter of 2019.

As of June 30, 2019, unregulated cash and investments were approximately $249.4 million, compared with $514.8 million as of June 30, 2018.

Days in claims payable (DCP) was 48.8 days as of June 30, 2019, compared with 49.5 days as of March 31, 2019 and 55.2 days as of June 30, 2018.

Conference Call and Webcast

A discussion of WellCare's second quarter 2019 results will be available via a conference call and webcast today at 9:00 a.m. ET.  The company will not be taking questions during the conference call.

The conference call will be webcast from the company's website and will be available at the following link: https://services.choruscall.com/links/wcg190730.html. The webcast should be accessed a few minutes prior to the conference call start time. A replay of the webcast will be available for 90 days following the conclusion of the broadcast and will be accessible on the company's website at http://ir.wellcare.com/Event.

The conference call can also be accessed by pre-registering using the following link: http://dpregister.com/10132137. Callers who pre-register will be given dial-in instructions and a unique PIN to gain immediate access to the call. Participants may pre-register now, or at any time prior to the call, and will receive simple instructions via email.

For those parties who do not have internet access or are unable to pre-register, the conference call may be accessed by calling:

Domestic participant dial-in number (toll-free):     1-844-492-3724
International participant dial-in number:                1-412-542-4185

A telephonic replay will be available until midnight ET on Friday, August 30, 2019. This replay may be accessed by dialing either of the numbers below and entering the replay access code 10132137:

Domestic replay number (toll-free):  1-877-344-7529
International replay number:             1-412-317-0088

About WellCare Health Plans, Inc.

Headquartered in Tampa, Fla., WellCare Health Plans, Inc. WCG focuses primarily on providing government-sponsored managed care services to families, children, seniors and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, as well as individuals in the Health Insurance Marketplace. WellCare serves approximately 6.3 million members nationwide as of June 30, 2019. For more information about WellCare, please visit the company's website at www.wellcare.com.

Basis of Presentation

Discontinued Operations

In 2016, Universal American, a subsidiary of WellCare, completed the sale of its life insurance business while retaining ownership of the life insurance subsidiary. Universal American entered into a 100% quota-share reinsurance treaty with the buyer, which, among other treaties, resulted in the reinsurance of all of the life insurance policies underwritten by the retained subsidiary. Accordingly, the discontinued business has not materially affected WellCare's results of operations for the periods presented in this news release. For additional information, refer to Note 17–Discontinued Operations within the Consolidated Financial Statements included in the company's Annual Report on Form 10-K for the period ended December 31, 2018.

Non-GAAP Financial Measures

In addition to results determined under GAAP, WellCare provides certain non-GAAP financial measures that management believes are useful in assessing the company's performance. Non-GAAP financial measures should be considered in addition to, but not as a substitute for, or superior to, financial measures prepared in accordance with GAAP. The company has provided a reconciliation of the historical non-GAAP financial measures with the most directly comparable financial measure calculated in accordance with GAAP.

Earnings per share, net income and, as noted below, other specific operating and financial measures have been adjusted for the effect of certain expenses, and as appropriate, the related tax effect, related to previously disclosed government investigations and related litigation and resolution costs ("investigation costs") in 2018; amortization expense associated with acquisitions ("acquisition-related amortization expenses"); and certain one-time transaction and integration costs related to the proposed acquisition by Centene and  acquisitions of Universal American, Meridian and Aetna Part D membership ("transaction and integration costs").

Although the excluded items may recur, WellCare believes that by providing non-GAAP measures exclusive of these items, it facilitates period-over-period comparisons and provides additional clarity about events and trends affecting its core operating performance, as well as providing comparability to competitor results. The investigation costs are related to a discrete incident which management does not expect to reoccur. WellCare has adjusted for acquisition-related amortization expenses as these transactions do not directly relate to the servicing of products for our customers and are not directly related to the core performance of its business operations. The other costs mentioned above are related to specific events, which do not reflect the underlying ongoing performance of the business.

In addition, because reimbursements for Medicaid premium tax and the 2018 Medicaid-associated ACA industry fee are both included in the premium rates or reimbursement established in certain Medicaid contracts and also recognized separately as a component of expense, the company excludes these reimbursements from premium revenue and total revenue when calculating key ratios as the company believes that these components are not indicative of operating performance.

Following is a description of the adjustments made to GAAP measures used to calculate the non-GAAP measures used in this news release.

Adjusted total revenue (non-GAAP) = total revenue (GAAP) less Medicaid premium taxes revenue and 2018 ACA industry fee reimbursement.

Adjusted premium revenue (non-GAAP) = premium revenue (GAAP) less Medicaid premium taxes revenue and 2018 ACA industry fee reimbursement. The company's adjusted Medicaid Health Plans segment premium revenue uses this non-GAAP definition of adjusted premium revenue.

MBR (GAAP) = medical benefits expense divided by premium revenue (GAAP).

Adjusted MBR (non-GAAP) = medical benefits expense divided by adjusted premium revenue. The company's adjusted Medicaid Health Plans segment MBR uses this non-GAAP definition of adjusted MBR.

SG&A expense ratio (GAAP) = SG&A expense (GAAP) divided by total revenue (GAAP).

Adjusted SG&A expense (non-GAAP) = SG&A expense (GAAP) less 2018 investigation costs and transaction and integration costs.

Adjusted SG&A ratio (non-GAAP) = adjusted SG&A expense divided by adjusted total revenue.

Adjusted depreciation & amortization (non-GAAP) = depreciation & amortization expense (GAAP) less acquisition-related amortization expenses.

Adjusted income before taxes (non-GAAP) = income before income taxes (GAAP) less 2018 investigation costs, acquisition-related amortization expenses, and transaction and integration costs.

Adjusted income tax expense (non-GAAP) = income tax associated with the applicable adjusted income before taxes, based on the applicable effective income tax rate.

Adjusted effective income tax rate (non-GAAP) = adjusted income tax expense divided by adjusted income before taxes.

Adjusted net income (non-GAAP) = adjusted income before taxes less adjusted income tax expense.

Net income margin (GAAP) = net income (GAAP) divided by total revenue (GAAP).

Adjusted net income margin (non-GAAP) = adjusted net income divided by adjusted total revenue.

Adjusted earnings per diluted share (non-GAAP) = adjusted net income divided by weighted average common shares outstanding on a fully diluted basis.

Cautionary Statement on Forward-Looking Statements

All statements, other than statements of current or historical fact, contained in this communication are forward-looking statements. Without limiting the foregoing, forward-looking statements often use words such as "believe," "anticipate," "plan," "expect," "estimate," "intend," "seek," "target," "goal," "may," "will," "would," "could," "should," "can," "continue" and other similar words or expressions (and the negative thereof). We intend 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, and we are including this statement for purposes of complying with these safe-harbor provisions. In particular, these statements include, without limitation, statements about our future operating or financial performance, market opportunity, growth strategy, competition, expected activities in completed and future acquisitions, including statements about the impact of Centene Corporation's ("Centene") proposed acquisition of WellCare Health Plans, Inc. ("WellCare") (the "Centene Transaction"), investments and the adequacy of our available cash resources.

These forward-looking statements reflect our current views with respect to future events and are based on numerous assumptions and assessments made by us in light of our experience and perception of historical trends, current conditions, business strategies, operating environments, future developments and other factors we believe appropriate. By their nature, forward-looking statements involve known and unknown risks and uncertainties and are subject to change because they relate to events and depend on circumstances that will occur in the future, including economic, regulatory, competitive and other factors that may cause our or our industry's actual results, levels of activity, performance or achievements to be materially different from any future results, levels of activity, performance or achievements expressed or implied by these forward-looking statements. These statements are not guarantees of future performance and are subject to risks, uncertainties and assumptions.

All forward-looking statements included in this filing are based on information available to us on the date of this communication. Except as may be otherwise required by law, we undertake no obligation to update or revise the forward-looking statements included in this communication, whether as a result of new information, future events or otherwise, after the date of this filing. You should not place undue reliance on any forward-looking statements, as actual results may differ materially from projections, estimates, or other forward-looking statements due to a variety of important factors, variables and events including, but not limited to, the following: (i) the risk that regulatory or other approvals required for the Centene Transaction may be delayed or not obtained or are obtained subject to conditions that are not anticipated that could require the exertion of management's time and our resources or otherwise have an adverse effect on WellCare; (ii) the possibility that certain conditions to the consummation of the Centene Transaction will not be satisfied or completed on a timely basis and accordingly the Centene Transaction may not be consummated on a timely basis or at all; (iii) uncertainty as to the expected financial performance of the combined company following completion of the Centene Transaction; (iv) the possibility that the expected synergies and value creation from the Centene Transaction will not be realized, or will not be realized within the expected time period; (v) the exertion of management's time and our resources, and other expenses incurred and business changes required, in connection with complying with the undertakings in connection with any regulatory, governmental or third party consents or approvals for the Centene Transaction; (vi) the risk that unexpected costs will be incurred in connection with the completion and/or integration of the Centene Transaction or that the integration of WellCare will be more difficult or time consuming than expected; (vii) the risk that potential litigation in connection with the Centene Transaction may affect the timing or occurrence of the Centene Transaction or result in significant costs of defense, indemnification and liability; (viii) a downgrade of the credit rating of WellCare's indebtedness, which could give rise to an obligation to redeem existing indebtedness; (ix) unexpected costs, charges or expenses resulting from the Centene Transaction; (x) the inability to retain key personnel; (xi) disruption from the announcement, pendency and/or completion of the Centene Transaction, including potential adverse reactions or changes to business relationships with customers, employees, suppliers or regulators, making it more difficult to maintain business and operational relationships; and (xii) the risk that, following the Centene Transaction, the combined company may not be able to effectively manage its expanded operations.

Additional factors that may cause actual results to differ materially from projections, estimates, or other forward-looking statements include, but are not limited to, the following: (i) WellCare's progress on top priorities such as integrating care management, advocating for our members, building advanced relationships with providers and government partners, ensuring a competitive cost position, and delivering prudent, profitable growth, (ii) WellCare's ability to effectively identify, estimate and manage growth, (iii) the ability to achieve accretion to WellCare's earnings, revenues or other benefits expected, (iv) disruption to business relationships, operating results, and business generally of WellCare, (v) potential reductions in Medicaid and Medicare revenue, (vi) WellCare's ability to estimate and manage medical benefits expense effectively, including through its vendors, (vii) WellCare's ability to negotiate actuarially sound rates, especially in new programs with limited experience, (viii) WellCare's ability to improve healthcare quality and access, (ix) the appropriation and payment by state governments of Medicaid premiums receivable, (x) the outcome of any protests and litigation related to Medicaid awards, (xi) the approval of Medicaid contracts by the Centers for Medicare & Medicaid Services, (xii) any changes to the programs or contracts, (xiii) WellCare's ability to address operational challenges related to new business and (xiv) WellCare's ability to meet the requirements of readiness reviews.

This list of important factors is not intended to be exhaustive. We discuss certain of these matters more fully, as well as certain other factors that may affect our business operations, financial condition and results of operations, in our filings with the Securities and Exchange Commission (the "SEC"), including our Annual Report on Form 10-K, quarterly reports on Form 10-Q and current reports on Form 8-K.  Due to these important factors and risks, we cannot give assurances with respect to our future performance, including without limitation our ability to maintain adequate premium levels or our ability to control our future medical and selling, general and administrative costs.