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Executives

Doug Simpson - Vice President, Investor Relations

Joe Swedish - Chief Executive Officer

Wayne DeVeydt - Executive Vice President and CFO

Analysts

Justin Lake - JP Morgan

Tom Carroll - Stifel

A.J. Rice - UBS

Christine Arnold - Cowen

Kevin Fischbeck - Bank of America

Josh Raskin - Barclays

Ralph Giacobbe - Credit Suisse

Matthew Borsch - Goldman Sachs

Dave Windley - Jefferies

Chris Rigg - Susquehanna

Scott Fidel - Deutsche Bank

Ana Gupte - Leerink

Claire Diesen - Morgan Stanley

WellPoint Inc. (WLP) Q1 2014 Results Earnings Conference Call April 30, 2014 8:30 AM ET

Operator

Ladies and gentlemen, thank you for standing by. Welcome to the WellPoint Conference Call. At this time, all participants are in a listen-only mode. Later, we will conduct a question-and-answer session. Instructions will be given at that time. (Operator Instructions)

As a reminder, this conference is being recorded. I would now like to turn the conference over to the company's management. Please go ahead.

Doug Simpson

Welcome to WellPoint's First Quarter 2014 Earnings Call. This is Doug Simpson, Vice President of Investor Relations. Presenting today are Joe Swedish, Chief Executive Officer; Wayne DeVeydt, Executive Vice President and CFO.

Joe will start this morning with an overview of our first quarter 2014 financial results and the broader backdrop, and then Wayne will review the quarterly financial highlights in detail and provide an update on the 2014 outlook. Q&A will follow Wayne's remarks.

During the call this morning, we will reference certain non-GAAP measures. Reconciliations of these non-GAAP measures to the most directly comparable GAAP measures are available on our website at wellpoint.com.

We will also be making some forward-looking statements on this call. Listeners are cautioned that these statements are subject to certain risks and uncertainties, many of which are difficult to predict and generally beyond the control of WellPoint.

These risks and uncertainties can cause actual results to differ materially from our current expectations. We advise listeners to review the risk factors discussed in today's press release and in our quarterly and annual filings with the SEC.

I will now turn the call over to Joe.

Joe Swedish

Thank you, Doug, and good morning. It was great to see many of you at our Investor Day last month and I look forward to building on the dialogue today and into the future. Let me begin by stating, we are pleased with our performance in the first quarter and continuing our focus on execution and fostering a culture of discipline, consistency and accountability to drive value for our customers and shareholders.

Before I get into the review of the quarter, I want to frame the discussion this morning around our goals of driving affordability and better health outcomes for our members, which we laid out in detail last month and which are key to our capitalizing on our future opportunities.

The overarching goal of our 48,000 associates is to provide the most attractive product in the market to serve the healthcare needs of our customers. Our view is that the complexity of the healthcare industry combined with growth in national health expenditures that consistently outpaces GDP creates a need to our health plan leadership with creative solutions to drive better cost and quality outcomes.

We believe our broad-based engagement with providers, employers and policymakers will continue to benefit our members and their families. As we address the goal of achieving affordability and improving outcomes.

This is a time for creativity not festivity. To that end, we continue to invest for success in the evolving marketplace, focusing on areas such as provider collaboration, information technology and process improvements to improve customer experience.

Over the last two years we have invested approximately $550 million in our health insurance exchange build-out, improve analytics and predictive model. These investments are foundational to leveraging our assets against the growth opportunities across our segments. These investments are clearly creating better solutions that are valued by our 37 million members, representing roughly one in nine Americans.

We're pleased to share that in the first quarter 2014 our products have been chosen by 1.3 million new consumers across both our Commercial and Government segments. Importantly, these new consumers represent a broad mix of customers, including individuals and their families, employers and government programs.

We believe our enrollment success demonstrates the strength of our product design and our prudent pricing strategy. I would also note that we are a leader in the new markets being created under the Affordable Care Act.

Newly created public exchanges in marketplace, which was specifically intended to enhance price transparency and drive affordability, we committed to participate by making the needed investments to be successful.

Applications especially near the end of the quarter were robust. Our March 31 membership includes applications through February 15th and we have enrolled over 400,000 members. Through the entire open enrollment period which officially ended April 15th, we now expect to add more than 600,000 members from public exchanges.

We are also serving approximately 100,000 members in private exchanges, which represent a new option for employers and their employees to obtain health coverage. Taken together, our overall enrollment growth and our positioning in the exchanges represent tangible examples of how our commitment to driving value for our customers is resonating with employers, individuals and their families on a daily basis.

Now focusing on first quarter results, I'm happy to report a solid quarter during a very dynamic period for our industry. We believe this serves as an indicator about our continuing improvement in execution, as well as the benefits we are capturing from our investments across both Commercial and Government segments.

Specifically in the first quarter, we reported earnings per share of $2.40 on the GAAP basis and $2.30 on an adjusted basis. Our GAAP EPS and adjusted EPS decreased from first quarter 2013, but the change in the mix of our product portfolio and the implementation of the Affordable Care Act has changed the quarterly earnings patterns of our core business results. Both of these results compare favorably to our initial expectations for the first quarter of 2014.

We also generated higher than expected operating cash flow of approximately $1.4 billion, which has allowed us to continue executing on our share repurchase and dividend programs. We repurchased 14.3 million shares or nearly 5% of the shares outstanding at the start of the quarter for approximately $1.3 billion and paid $123 million of dividends.

Turning to our business segment performance, our Commercial business had another strong quarter. Our product portfolio and leading cost structure drove Commercial membership growth of 1.2 million lives in the quarter and first quarter operating revenues of $9.7 billion.

Investments made in recent years are translating into profitable market share capture, as evidenced by our 648,000 new lives national and our strong growth on the health insurance exchanges, which is expected to exceed 600,000 new lives by the end of the open enrollment.

Commercial operating margins declined as expected from 12.8% a year ago to 9.1% in the first quarter of 2014, due to our SG&A investment spending and the changing quarterly earnings pattern of our business, which we discussed with you previously.

The implementation of our public exchange strategy is progressing well, based on our read of available data and provides a foundation for future commercial risk growth opportunities over the coming years.

To update you on the various metrics that support our position, let me say that our enrollment is tracking well, individual membership in total stood at roughly 1.85 million at the end of the first quarter 2014, consistent with our expectations and up 95,000 lives during the quarter.

For exchanges, the general characteristics of applicants, including average age are tracking well versus our expectations. We anticipated that exchange enrollees would generally be older than our legacy individual customers and our pricing assumptions for both on and off exchange products reflected this view. We did notice the average age of applicants decreased and further we got into the open enrollment period, indicating that younger age applicants signed up later in the period.

Product selection has also been consistent with expectations as silver and bronze have been the two most popular metal levels by a wide margin. The actuarial value of the products selected by new applicants is also in line with our projections to date and we will continue to monitor product mix on a state-by-state basis.

We're continued to see signs at our brand name and network quality are carrying more of an advantage in the market than we had expected. For example, there are geographies where we believe we are gaining share despite lower priced competition, which points to the value of our local market depth, knowledge, brand, reputation and networks.

Finally with respect to our small group business, we continue to be mindful of the potential for employer coverage changes in light of the exchanges and we did see Q1 small group member declines above our expectations. However, this was offset by stronger large group membership trends in the quarter. These dynamics are reflected in our outlook.

Turning to the Government Business segment, our Government Business division added 75,000 lives in the quarter, driven by strong growth in Medicaid and generated revenues of $7.9 billion, up approximately 4.9% year-over-year. Government Business represented 45% of operating revenues in the quarter as our business continues to evolve and diversify.

Medicaid enrollment is off to a strong start in 2014, growing by 121,000 lives in the quarter and it’s expected to continue growing throughout the year, driven by our recent RFP wins in Florida, Kentucky, Georgia and California, as well as the ACA-driven expansion.

Medicare enrollment declined by 62,000 in the quarter in line with our expectations, as we work to reposition our individual Medicare advantage portfolio of products to preserve affordability and benefits for our members and improve our performance.

Government operating margins improved 160 basis points to 3%, reflecting continued medical cost management efforts and an improvement in expense efficiency, as well as receiving actuarial sound rates in certain states.

We are updating our 2014 financial outlook this morning and now expect adjusted earnings per share of greater than $8.40 for full year 2014. This outlook reflects stronger than expected Q1 results while also incorporating an incremental $100 million in Hep C spending over the balance of the year to reflect the potential for higher than expected utilization of new drugs in that area.

Wayne will discuss these elements in more detail. We believe this is a prudent outlook in light of the dynamic nature of our markets and the potential for future changes in the regulatory framework.

As we articulated at our Investor Day last month, we believe we have a clear strategy to deliver more affordable products to more people across the commercial and government markets. This includes a differentiated approach provider collaboration.

The site one specific relationship, our new partnership with Emory Healthcare System in Atlanta integrates the CareMore clinical model into their delivery system. The goal is migrating to full-risk contracts and leveraging CareMore capabilities to drive performance under those arrangements. More broadly, we note our momentum in the market with 87 ACOs currently in place and over 70 in the pipeline come online between now and the end of 2015.

So wrapping up, we're very pleased with our Q1 performance. We believe that by focusing on improving health care cost and quality and leveraging our understanding of consumer trends and preferences, we have delivered on our commitment and will continue to demonstrate market leading solutions for our growing number of customers.

With that, I will turn it over to Wayne.

Wayne DeVeydt

Thank you Joe and good morning. My comments today will focus on the key financial highlights from the first quarter of 2014. I’ll also provide an update on our 2014 outlook.

On a GAAP basis, we reported earnings per share of $2.40 for the first quarter of 2014. These results included net benefits of $0.10 per share, reflecting net investment gains of $0.07 per share and approximately $0.04 per share of income from 1-800 CONTACTS which we sold January 31, 2014, partially offset by $0.01 per share of debt extinguishment expense recorded in the quarter.

Excluding these items, our adjusted EPS totaled $2.30 for the quarter. These results were favorable to our expectations. And as Joe noted we are pleased with how our 2014 has progressed so far.

To anticipate the question, roughly one-third of the outperformance versus our previous expectations in the quarter from stronger operating gain and about two-thirds came from below-the-items and while positives, we’ll not necessarily repeat. Operating outperformance in the quarter reflected high enrollment, modestly favorable medical cost experience and G&A expense control.

March results supported some of the early positive trends we have seen in January and February. Below-the-line, our tax rate, while increasing from last year, was lower-than-expected due primarily to favorable state tax developments.

Medical enrollment grew by 1.3 million or 3.6% sequentially to approximately 36.9 million medical members as of March 31. This reflected membership gains in our national and local group ASO, individual and Medicaid businesses.

Operating revenue exceeded $17.6 billion in the quarter, an increase of approximately $210 million or 1.2% versus the first quarter of 2013, driven by higher overall enrollment and growth in the government business. These increases were partially offset by decline in commercial resulting from the previously discussed impact of transition of the State of New York account from fully insured to self funded on January 1st.

The benefit expense ratio was 82.7% in the first quarter of 2014, a decrease of 100 basis points from the prior year quarter and favorable to our expectations. The decline reflected continued strong medical management and the impact of the premium revenue designed to help cover new healthcare reformed fees, partially offset by changes in our quarterly earnings pattern Joe discussed previously.

For the full year 2014, we continue to expect underlying local group medical cost trend to be in the range of 6.5% plus or minus 50 basis points. Our SG&A expense ratio increased by 280 basis points from the first quarter of 2013. As expected, due to the inclusion of various healthcare reform fees in 2014, continued investment spending in preparation for ACA driven market changes and higher administrative cost as a result of strong commercial membership growth during the first quarter of 2014.

Moving onto the balance sheet. Days and claims payable was 44.2 days as of March 31st, up 5.5 days from 38.7 days as of December 31st. We continue to maintain mid to upper single-digit margin for adverse deviation and believe our reserve balance remains strong and consistently conservative as of March 31, 2014.

Our debt-to-capital ratio was 38.2% as of March 31, 2014, up from 36.9% from December 31st, down from 38.6% from year end 2012. We ended the first quarter with approximately $2 billion of cash and investments for the parent company and our investment portfolio was in an unrealized gain position of $995 million as of March 31st.

We generated stronger than expected operating cash flow of $1.4 billion in the first quarter or two times net income. We continue to expect cash flow timing to remain volatile, partially reflecting the timing of exchange-based enrollment this year and the timing of payments related to health insurer fee and the 3Rs.

That said cash flow trends in the first quarter been encouraging and we remain comfortable on outlook of greater than $2.4 billion for the full year. We repurchased nearly 14.3 million shares for nearly $1.3 billion during the quarter. This is a weighted average price at $88.14.

As of March 31st, we had approximately $2.4 billion, a board approved repurchase authorization remaining which we intent to utilize over a multiyear period, subject to market conditions. We used $123 million during the quarter for our cash dividend and yesterday the audit committee declared our second quarter dividend to shareholders.

Turning to our 2014 outlook. As Joe noted, we currently expect adjusted EPS to be greater than $8.40 for 2014. The increase in our full year outlook reflects a balanced contribution from higher operating income and below-the-line items.

Above-the-line, improvement reflects stronger enrollment, strong medical management and expense controls and some recapture of the non-deductibility of the health insurer tax. Above-the-line, our outlook includes a slightly lower tax rate than we originally expected due to favorable state tax developments.

These positives are partially offset by roughly $100 million in incremental Hep C cost we now factored into the remainder of 2014. So logical question is, could this prove to be conservative in light of the Q1 results. It is fair to say that at the level of our performance in Q1 were to persist, or if Hep C cost failed to increase as currently factored into our forecast then our current outlook could prove conservative.

In addition, while our outlook factors in some recapture the non-deductibility of the health insurer tax in our Medicaid block of business based on signed contracts thus far. Incremental contributions from this block could add modestly to results all else being equal. That said it remains early in the year, in which the industry is undergoing substantial change and our biases to maintain a prudent stance in this dynamic environment.

I would also note that our outlook continues to reflect approximately $210 million of intangible asset amortization expense in 2014 related to prior acquisitions including the Amerigroup. There are also investment in our business that we do not expect to repeat in 2015 including at least $30 million of cost associated with implementing the first year of public exchanges and nearly $20 million of the startup associated with two eligible programs.

With that, I'll turn the call back over to Joe.

Joe Swedish

Thanks, Wayne. Before we move to the Q&A section of the call, I do want to update you on our few senior leadership changes. Dick Zoretic who heads our government business division has recently informed us of his decision to retire for personal reasons at the end of May.

I first want to express our sincere thanks to Dick for everything he has done to position our government business division with a continued growth opportunities we see in that area over the coming years. The success of the Amerigroup integration and our success in accelerating growth in our government business under his leadership are the result of the reinvigorated organization leveraging its key assets more fully.

In addition to Dick’s leadership, a key driver of this improvement has been the level and the depth of leadership and talent throughout division. As such, I'm very pleased to announce that Pete Haytaian, President of our Medicaid business will be taking over Dick’s roll next month.

Pete joined Amerigroup in 2005. Many of you have met Pete over the years. But for those that have not, Pete has been a key factor behind sustained growth and execution track record at Amerigroup and has been absolutely instrumental in the successful integration over the last year and the improved performance of legacy WellPoint Medicaid business.

Pete bring substantial operating experience across both Medicaid and Medicare markets and a track record of operating execution and discipline to the role. I have every confidence that Pete will lead our government business to further success across our markets.

I'm also pleased to announce that Tom Zielinski has agreed to join us as Executive Vice President and General Counsel. I've known Tom for many years. He is a fantastic addition to our team, bringing extensive legal and industry experience having previously served as General Counsel at Coventry. I believe both of these appointments strengthen our company and strengthen our prospects going forward.

With that, operator, please open the queue for questions.

Question-and-Answer Session

Operator

Thank you. (Operator Instructions) Your first question comes from the line of Justin Lake from JP Morgan. Please go ahead.

Justin Lake - JP Morgan

Thanks. Good morning. First, on the exchanges, can you tell us what margins or booking for these exchange revenues at this point. And then just a quick question on the 3Rs, the government is now looking for risk orders to be budget neutral. So I’m curious if you are running a negative margin in a specific state for instance, would you comfortable, would your auditors be comfortable with booking a receivable in that risk order or given the budget neutrality?

Joe Swedish

Hey, Justin. Good morning. Let me first start by saying that relative to margins, we are very pleased with the mix of business and probably more importantly the affirmation of the strategy we laid out around the design of our products and formulary. So our margins within our markets varied but they are still within our targeted range in total of 3% to 5% category.

Relative to the 3Rs, it’s a little bit of a hard question for us to answer because we do not believe we will be in receivable position on the corridors. From our perspective, we believe we are in situation where we are within the sweet spot of maintaining the appropriate margins. So, I couldn’t respond to what the auditors may or may not say. If anything, we have evaluated a few markets where we may be booking payable, in fact in the quarter while deminimis, have booked a small payable towards the corridor.

Justin Lake - JP Morgan

Okay. And just a quick follow-up on Hep C. You talked about a $100 million of costs, is that -- I just wanted to confirm that’s incremental to what you already expected and then can you share with me, would you really expected for Hep C and what that implies for an overall kind of U.S. spend in your mind?

Joe Swedish

So, Justin, for Hep C, we are actually pricing our book for Hep C cost to double over what those costs were for last year. In the first quarter, we were just shy of $50 million in costs. So we are still well within our pricing that we laid out for the year. But we thought it would be prudent to at least incrementally increase by additional $100 million in our outlook in the event that we would see a continued ramp up in utilizations. As I mentioned in my comments, if that proves to be conservative in our outlook and that would provide upsides to our guidance.

Justin Lake - JP Morgan

Sorry, what was that number last year?

Joe Swedish

We doubled it from last year. So last year was at a level comparable to what you saw in the first quarter. So we had in excess of $100 plus million in pricing for this year.

Justin Lake - JP Morgan

Great. Thank you.

Operator

Your next question comes from the line of Tom Carroll from Stifel. Please go ahead.

Tom Carroll - Stifel

Hey, guys. Good morning. So with government accounting for like 45% of your operating revenue, I think is what you said, so basically half. How do you see this trending going forward and it’s certainly should increase I would think a bit, given the dual programs coming on and the growth in Medicaid? But I guess, are you comfortable with the current level or do you see, do you have a particular target in mind in terms of how much explicit government business you are contributing to the total revenue number?

Wayne DeVeydt

Tom, let me start by first saying that I won’t say that we have a targeted goal as a percentage of our book. What we have is a goal to really maintain and as Joe said at IR Day, a number one or number two market position in every segment, whether it would be government or not government. And then ultimately how that plays out will be very dependent on how the commercial book shifts over time. But that being said, we are bullish on our outlook for Medicaid and duals and longer-term for Medicare. We expected the government Medicaid to ramp up as the year goes on in terms of numbers shifts. So we are actually pleased with what we have in first quarter relative to expectations and expect that to continue to ramp up as the year progresses. And as you know, our dual revenue really doesn’t start coming on until mid and late this year. So the full run rate impacts of that will really start to ramp up beginning next year.

Tom Carroll - Stifel

And you see greater efforts on Medicare or Medicaid and maybe which one?

Wayne DeVeydt

I’d say from a Medicaid, we really like expanding our key pipeline, not just on the tenant population but as Dick highlighted a month ago, there was over 40 billion of our key pipeline in the next 18 to 24 months. So we plan to actually participate. But I will tell you that Joe has made it clear to his leadership team that on the Medicare front, we are going to get our shopping order and we are getting close to that and then we expect to start expanding in there much more aggressively beginning 2016.

Tom Carroll - Stifel

Great. Thank you.

Joe Swedish

This is Joe. Good morning.

Tom Carroll - Stifel

Thanks, Joe.

Joe Swedish

Just to add some color commentary, I think we are very solidly positioned for continued growth in the space. We believe and I just maybe affirm what Wayne just shared with you on that and we are actively pursuing duals. We are repositioning in Medicare, leaving that there will be an inflection point sometime in the not-too-distant future that would call us backend but we certainly want do that with a stable portfolio.

And we have other government initiatives in terms of expectations with respect to Medicaid number growth. So all-in, we see the horizon. We believe that building a team as well as an infrastructure to support that growth is absolutely essential for success going forward. We are well on our way. And I think we're perfectly positioned for continued growth in the space.

Tom Carroll - Stifel

Great. Thank you.

Operator

The next question comes from the line of A.J. Rice from UBS. Please go ahead.

A.J. Rice - UBS

Hello everybody. Thanks. Well, maybe first I will go back to the public exchanges. Can you expand in anyway? I know you said the demographics are consistent with your expectations. Do you have any data at this point about legacy WellPoint, previous, understand to whether they are previously uninsured, any commentary about the enrollees that sort of a big push at the end in February and March, with a materially different than what we were seeing earlier in the sign-up period, any color along those lines?

Joe Swedish

Good morning, A.J. I will give you a little bit of background on what we saw. First of all, just as reminder, the membership you see in our current 1.3 member, a million number growth only reflects open enrollment due February 15th. So clearly applications received post that date, have a much more meaningful lift beginning in April and May. Relative to our expectations, the volume we saw is specifically in the last two weeks of March and that actually continued into the first two weeks of April for the extended enrollment period, not only was substantial versus our expectations.

But I would tell you that we saw in each day’s applications, the average age coming down in a meaningful fashion. And from our perspective, again, only time will tell but relative to the average age we've seen in that, we have hit the sweet spot. Relative to the claims activity, we have pushed over 90% of the claims we received in the first quarter through our predictive analytics and modeling we’ve done. As we were building out whether we thought we hit the sweet spot or not and at least as of today, everything continues to be in the green status meaning positive status for now. We’ve maintained a cautious outlook though until we can get through second quarter at this point because so much volume comes in, in April and May.

A.J. Rice - UBS

Okay. And maybe just -- I'm sorry.

Joe Swedish

One other wrinkle might be helpful because we are still tallying related to the post-February 15th and we are witnessing about a 90% premium pay relative to the enrollment capture, which I think is very strong and I think we've settled out on that number at the moment. So, I think that might help you in terms of envisioning where enrollment might land regarding April 15th.

A.J. Rice - UBS

Yeah. That’s great. And maybe just one follow-up, Joe, WellPoint is often in the press, you talked about various potential scenarios, acquisition wise and otherwise you guys seem to be doing well under the integration of the Amerigroup at this point, obviously you got a complex year. What's your view on looking at transactions to help build up some of the areas you’ve identified that you want to build up?

Joe Swedish

Yeah. Good question. At IR day, I emphasized that last year’s effort certainly going into this is all about stabilization of the company. And I underscored the belief that going forward, we're really keening on transformation of the enterprise, reaching out to some initiatives and strengthening some long-standing commitments we’ve made to the market.

Our sense is that we've got a very strong base to work off of and obviously we're now going forward, observing about possibilities, no specifics obviously but we certainly are observant and we believe we can continue to grow our position with what we've got and we may look at further opportunities going into the future.

A.J. Rice - UBS

All right. Thanks a lot.

Operator

Your next question comes from the line of Christine Arnold from Cowen. Please go ahead.

Christine Arnold - Cowen

Good morning. In your assumptions now, you were assuming that the non-deductibility of the health insurance fee will be collected in Medicaid and how much did you collect in health insurance, C&A and revenue this quarter and how might that change going forward?

Joe Swedish

So, Christine, first, in terms of the non-deductibility of the fee relative to Medicaid, the vast majority of the states have now, either in writing or verbally committed to covering that fee. However, as we've said previously, we believe that it is prudent to not recognize that fee and so you can see the all-in rates because we think ultimately rates are fungible and fees are fungible.

So while we've included some of this in our first quarter, in our outlook, I will tell you it is less than a nickel at this point in time. So, I think we saw the reasonable amount of modest upside as we see the all-in rates that they imply that would point to trend and a true gross up.

Christine Arnold - Cowen

And $0.25 to $0.35 would probably be the gross ups to less than a nickel of $0.25 to $0.35, is that what you think about it?

Joe Swedish

It’s a reasonable proxy.

Christine Arnold - Cowen

And then in small group, you said that you have less than expected enrollment. You had more lapses but it was offset by some other factors. Could you just highlight that and I miss that? Thank you.

Joe Swedish

Yeah, what was interesting is for all the areas that I performed on membership, the one that was a little surprising was the level of small group membership that actually no longer provided coverage post-January 1. So our early renewals were successful but for those, post that day, once the exchanges got up and running, we saw really -- we missed our expectations in some of the small group in the quarter. From our perspective, we expected that to occur at some point in time. In fact, it occurred sooner was a little surprising but nonetheless we like the fact that our positioning on the exchanges is what is. It was more than offset though by a large group in and of itself in the exchanges.

Christine Arnold - Cowen

Thank you.

Operator

Your next question comes from the line of Kevin Fischbeck from Bank of America. Please go ahead.

Kevin Fischbeck - Bank of America

Hey. Just -- maybe want to follow-up on the small group point there. One of your competitors talked a lot about how they were seeing disruptions in the city of New York and I guess, maybe it’s where the pockets as well. Just wanted to hear your thoughts about your expectations for small group margins and I know you’ve already talked about $200 million plus of margin compression this year. Wanted to understand whether that was focused in a couple of states specifically or whether that was a broad-based trend?

Joe Swedish

Kevin, good morning. In terms of the small group margin compression either through moving to the exchanges or no longer purchasing with us, we have that pretty much of the broad-based trend across all of our states and in fact that’s what we are seeing. Relative to the State of New York, I don’t think it’s any secret that the past, several years prior to this year we’ve indicated we felt that was a challenging market for anybody to get actuarial sound rates and make a profitable return.

So the comments about an aggressive market there are nothing new to that particular market. We play very small in that market and we have only around 25,000 small group members in total there so. And that’s about half of what we finish the year at. So clearly the membership there is moving, but we are okay with that because until it actually improves, we really don’t want to be an active participant.

Wayne DeVeydt

Wayne, we exited in New York to a degree in 2012 and I guess we are holding firm where we are in a very deminimis position.

Kevin Fischbeck - Bank of America

Okay. And just one quick follow-up. I think you mentioned PBT was modest in the quarter, do you have an actual number there?

Joe Swedish

Yes. I would tell you while modest I don’t think it actually benefited the quarter at all. What I mean by that is, we exited our high-single-digit margin for adverse deviation that we typically record. It came in modestly better than that. But we believe we’ve reestablished it all as of March 31, and so we can see further development on the underlying book. And I think that’s evidenced in the DCP being up over 5.5 days. So we think the quarter did not benefit from any development.

Kevin Fischbeck - Bank of America

Okay. Great. Thanks.

Operator

Your next question comes from the line of Josh Raskin from Barclays. Please go ahead.

Josh Raskin - Barclays

Hi, thanks. Good morning. So I wanted to follow up on the individual bookings, just sort of help to understand the churn there. I know sort of a 95,000 lives sequentially increased, but I don’t believe that tells much of a story. So I am just curious what new sales were versus what lapses were. It sounds like obviously 400,000 in the exchanges, but that seems like a relatively low number. I think you’re saying 600 total. We have you guys at almost 400,000 California alone. So I just want to make I understand all the moving pieces in the individual book.

Wayne DeVeydt

Hey, Josh, good morning. Let me first state that I think we’ve taken a prudently cautious outlook on the exchange membership that hopefully will prove to be more of a low bar when we talk about the 600,000 members. Recognize that a lot of the volume that we got came in, in the last two weeks of March and a lot of it came in, in the first two weeks of April. Note that membership does not have an effective date till May 1 though. So from our standpoint until we can see that each of those members that we got an application on actually converts to a paying member. We are going to go ahead and maintain maybe a lower bar in their outlook.

Now if it converts at the rate that Joe has said that we’ve started to see which is closer to 90%, we will outperform that greater than 600,000 exchange base numbers. So I think all-in, when you look at the mix, we are off exchange, but metal products were quite strong as well in the roughly 400,000 plus range. So you are looking at almost 1 million what I call metal based members and then the delta represents that which was grandfathered in existing products. Unfortunately we cannot tell you if a member was previously uninsured or not. We just know that we are winning a lot of new members and whether they had coverage previously as this point we do not know.

Josh Raskin - Barclays

You know how many were previously WellPoint members?

Wayne DeVeydt

Well, we clearly know who was or wasn’t a member, but until we see all these applications we recently received push back, it’s hard for us to give you a definitive figure at this point.

Josh Raskin - Barclays

Okay, got. And maybe a quick follow-up on the exchanges, have you guys thought about 2015 and what you are going to do from rate? It doesn’t sound like you are going to have all your information before you have to get the rate. So I am curious if you think there will be significant rates increases or it really sounds like maybe pricing is where you thought it should be.

Wayne DeVeydt

Again, we are really pleased with our strategy and the affirmation of our pricing strategy relative to what we built. We actually feel like we have more data to go into ’15 pricing than we did going into ’14 and we’ve got validation. And we see the areas where we need to tweak on the fringes now based on getting into the market early and with the market share we have. So I think if you were to talk to our actuarial team Josh, they would tell you that we feel really good about moving into new market. What we can’t control is what competitors do, but we really like our chances. And we think because we get the sweet spots, there will be less volatility in pricing for our members than there would be for others.

Josh Raskin - Barclays

We should think about commercials at 6% cost trend you guys or 6.5% we should think about that as representative of exchange trend as well?

Wayne DeVeydt

Yes, I mean, it’s a reasonable proxy for medical trend in general.

Josh Raskin - Barclays

Okay, perfect. Thanks.

Operator

Your next question comes from the line of Ralph Giacobbe from Credit Suisse. Please go ahead.

Ralph Giacobbe - Credit Suisse

Thanks. Good morning. You talked about change to seasonal earnings pattern a few times in your prepared remarks. And I think when you updated guidance about a month ago, you said you expected fairly even distribution each quarter and that was sort of implied closer to 9.20 EPS number for the year just based on the 1Q results. So, is that fair, or is there some sort of pull forward in 1Q that’s changed how you are thinking about the quarterly progression?

Wayne DeVeydt

First of all, I think it’s important to recognize that the reason for some of the smoothing now relates to ACA related products where you were forced to move up what the actuarial valuation would be for the products offer. So you have in some cases smaller deductible or smaller copay in the first quarter than you would have seen in historical products, which allowed you to earn more in the first quarter historically versus now you earn less but more straight line.

Additionally, keep in mind the reinsurance does not kick in until 45,000, and so you are bearing most of the cost early in the quarter this year, but towards the end of the year you will bear less of those costs for those that exceed reinsurance thresholds. So that just a simple factor of why we think it’s more smooth. That being said, that outlook hasn’t changed for us. The one reason I wouldn’t run rate first quarter though is keep in mind that we know that storms had to play some positive factor right and we can do a variety of model giving us a variety of outcomes, but we definitely don’t believe that all of that would necessarily run rate, but we are encouraged with our underlying results. As we said at IR Day, if we can get through 2Q and this trend continues, then I think our guidance would prove to be conservative.

Ralph Giacobbe - Credit Suisse

Okay, fair enough. And then just the follow-up, are you seeing any acceleration in script trends. I guess just overall or within the exchange or Medicaid expansion population at this point, any specific categories worth highlighting? And again maybe how comfortable you are on the pricing side relative to your exchange premiums and/or the Medicaid expansion rates that you are seeing within your territories? Thanks.

Wayne DeVeydt

We’ve seen modest acceleration in script trends, but I think it’s important to recognize too for example on exchanges we expected acceleration in script trends, and in some ways the exchanges are so early but coming in slightly better than the acceleration we expected. Really have to see you guys is the biggest issue right now, and I think it’s the watch item for the industry. We think we’ve provided adequate coverage by including an incremental $100 million in our outlook and it’s the one area that we feel we have a responsibility as an industry to help control cost for the consumer and we plan to be very focused on that.

And the other thing I would simply say is the unit price as a pass-through fee for us. So as other industries are getting their taxes and from the ACA those taxes relatively being passed on to us, which ultimately get passed on to the consumers. And so while we are seeing rising prices there, I do not think we expected much there to occur.

Ralph Giacobbe - Credit Suisse

Okay, thank you.

Operator

Your next question comes from the line of Matthew Borsch from Goldman Sachs. Please go ahead.

Matthew Borsch - Goldman Sachs

Yes. If I could just circle back to the recovery of the tax impact of the insurer fee, am I correct going back to regional guidance that you had none of that impact baked in for the commercial side of the business, nor Medicaid? I know you discussed Medicaid, but on the commercial side that seemed to be worth something upwards of $0.65. Is that something that you don’t expect to realize this year, or is that potential upside?

Wayne DeVeydt

Hi, Matt. I think the best way to answer this on the commercial front was to the extent that our membership can exceed our expectations that additional member incrementally begins the recovery of that non deductibility of the tax. We’re out of the gate strong. We are raising our membership outlook. We hope that proves to be conservative. And if it does, in theory, we will begin to cut into the nondeductible tax, which would also be upside.

Matthew Borsch - Goldman Sachs

And just a related question if I could. You touched on the attrition in small group and the growth in large group. On the large group side, is that primarily reflecting account wins, are you little bit question I am getting at, are you seeing increased uptake of coverage by employees that you might attribute to the ACA?

Wayne DeVeydt

I think what I would highlight in that right now more in large group is retention solid, sales have been solid with expectations, probably the more beneficial items has been the inflection point we talked about in Investor Day about four or five weeks ago around the level of in group change has really moderated. And so while we had been assuming that we will continue to see negative netting group change, we didn’t really see that in the first quarter. Now we are going to continue to maintain an outlook that’s cautious for that to occur, but I think what we are finding is we got good retention, we got good sales and it appears that the layoffs have substantially declined a large group employers.

Matthew Borsch - Goldman Sachs

Great. Thank you.

Operator

Your next question comes from the line of Dave Windley from Jefferies. Please go ahead.

Dave Windley - Jefferies

Hi, thanks for taking the question. I wanted to follow up on Josh’s question around exchange and price for next year. I just wanted to make sure I understand that Wayne you are basically saying that you don’t think that there will be an inflationary impact from things like uptake in insurer fee, lower support from 3Rs, broader network requirements, those types of things. I guess I was interested in what you think the impact of those things will be on top of what underlying trend might influence price increase?

Wayne DeVeydt

Dave, yes, thanks for the question. Let me please clarify. There will clearly be an uptick for each of those items. The response to Josh simply to say that you’re starting point is just what underlying trend will most likely in like and today we are at 6.5% plus or minus 50 basis points. There is no reason to believe that wouldn’t continue. Items that I think would obviously impact pricing further are going to be the fact that the ACA fee increases next year for us and for other industries and those become ultimately pass-throughs. Clearly have seen if it continues based on our new outlook at the level that it is at that would be something that would have to be adding in as well. But we do think with the size of our book and the positive younger age as we’ve seen coming in that that could be a muted utilization and folks are expecting going into next year, but there are many other factors beyond just trend that we think are going to meaningfully impact rate increases.

Dave Windley - Jefferies

So as your expectations then likely to be into the double digits and what were your thoughts relative to rate review? And I guess President Obama is meaningless, insurance commissioners lately to encourage them to scrutinize the rates pretty aggressively.

Wayne DeVeydt

Yes. I would say it’s not an easy one to answer because it’s going to vary by market, by product. I think that every commissioner has an obligation to ensure that the rates are reasonable and appropriate and we have an obligation to ensure we are driving the most affordable product for the member. So the pricing will ultimately be reflective of what require to cover and if we require to cover more and require to bear more cost, then the rates will reflect that.

Dave Windley - Jefferies

Okay. Thank you.

Operator

Your next question comes from the line of Chris Rigg from Susquehanna. Please go ahead.

Chris Rigg - Susquehanna

Good morning. Thanks for taking my questions. Just on hepatitis C again, can you give us a sense for how the expenses were allocated by business segment, commercial, Medicaid, Medicare in the quarter? And when you think about them going forward, is there one area where you are most concerned over the balance of the year? Thanks.

Joe Swedish

Thank you. Good morning again. March pattern for fully insured claims was roughly 40% Commercial, 35% Medicaid and 25% Medicare and this does match our revenue mix. So on expense basis, the distribution is about, maybe a half commercial, half government and then when we adjusted from Medicare portion paid by CMS. So it’s within government Medicaid having a largest share of that both.

Chris Rigg - Susquehanna

Okay. And then just one quick follow-up here. On the Medicaid membership growth of about 121,000 in the quarter? Do you know how much of that was sort of ACA expansion-related growth versus just sort of what I would call core growth? Thanks.

Joe Swedish

Yeah. Chris, the majority of that was some early expansion, obviously, there are some of the new markets such as Kentucky and that we expected to come a little slower. The item that we can’t gauge right now, although we’re getting very positive feedbacks is that the ACA expansion growth that is in the pipeline with the space right now is quite substantial.

And so, we are going to see much more that coming through and then a lot of the other expansion growth that we did this year actually kind of phases and as the year go. So in Medicaid, we actually expect our membership to ramp up from the current level of 122,000 roughly sequential growth to get much closer to that 400,000 to 500,000 level we’ve talked about previously.

Chris Rigg - Susquehanna

Great. Thanks a lot.

Operator

Your next question comes from the line of Scott Fidel from Deutsche Bank. Please go ahead.

Scott Fidel - Deutsche Bank

Thanks. First question, just wondering if you had a breakdown just within your silver members, what percentage of those are eligible for cost sharing subsidies at less than 250% of FPL as compare to those that are above?

And just whether you’ve made some assumptions around whether you expect to see different utilization patterns amongst that cohort of members as compared to those that aren’t eligible for our cost sharing subsidies?

Joe Swedish

Yeah. So relative to that about 80% of the members were eligible to some degree of the subsidy, is what we’ve saw. I would say Scott that our pricing was assumed not just by metal level but as you know in the metals we do have, we saw rating bands and age bands and so. It varies very much by segment.

But, again, I would say, all in, as we try to carve the data down by market into the different segments that we looked at and we did evaluate whether subsidy eligibility would have different outcome. But I think probably the most optimistic thing I can say is the risk pool and the product selection seems to be coming in in the manner that we had hoped it would.

And again, I really want to see second quarter because of the volume of applications that will affect 2Q and make sure that converts before we officially say that we've got it all right, but it's very encouraging right now.

Scott Fidel - Deutsche Bank

Okay. Then just I had a follow-up question, just interest in your thoughts on how the co-ops have been pricing in the market and just interested from your perspective, since you are expecting WellPoint could have the 3% to 5% positive margins and are actually booking payables in some of your markets, if the co-ops ended up taking a big [bath] (ph) in the exchanges in terms of their profitability? How would that affect their consumption of the 3R’s and would that be an issue in terms of potentially increase in the payable that WellPoint after actually put in to the risk quarters?

Joe Swedish

Scott, it’s a good question. Unfortunately, has a lot of hypothetical. So, I’ll talk about what I can say or know at this point. We’re following the law and the way the calculation play out in the 3R’s. I will tell you the amount we had to accrue the payable is so de minimis that will pay nobody out. We are within our 3% to 5% targeted range, slightly over the few markets which is why we put the very small payable.

Relative to co-op pricing in the market, not, when we see one co-Operator, we only see once, so this is not meant to be broad speaking, but I think it's fair to say there are some co-ops that we do not understand the pricing and we don’t know how economically it will work for them as time progresses.

And so from our perspective, it's important to recognize that because of revenue neutrality and we think the market get smarter as each year passes by the data that the probability of money being paid in the pool actually gets less and non-enhance over the next several years.

And so, I'm not sure there’s going to be much in the kitty to begin with this year if anything when it said and done. And I would be -- I would personally be cautious against believing there will be anything in the kitty in the out years.

Scott Fidel - Deutsche Bank

Okay. Thanks.

Operator

Your next question comes from the line of Ana Gupte from Leerink. Please go ahead.

Ana Gupte - Leerink

Yeah. Thanks. Good morning. Just wanted to follow-up again on the membership that you’ve offered for the quarter, if you could just elaborate on the $1.1 million loss since the fully insured? How much of that is coming from that New York State account that shifted to self insured and what does that mean for your small group membership at this point? I think you had $1.85 million and you’d mentioned potentially booking or including $200 million of EBIT loss in your guidance for the year. I just want to understand how other pieces are fitting together?

Joe Swedish

Yeah. Good morning Ana. The fully insured $1.1 million loss that I saw is all due to the conversion of New York ASO. So from out perspective, we have had very strong growth in maintaining our book and then growing.

In terms of the small group margin loss or EBIT loss that we expected in the year, it is more than the $200 million that we talked about it at IR Day that we expected. It’s actually going a little bit higher than that, but as I said early, we recapturing the vast majority of that back in exchanges and other area.

I would say that, a big portion of the headwind we expect in that business. We anticipated they will incur this year and in fact is incurring this year and a more they continues to incur will actually create less of the headwind in future years for us . So we’re actually not discouraged by it.

Ana Gupte - Leerink

That’s helpful. Thanks. So would it means that you’ve already booked it in the first quarter and it would minimize the headwind for ’15. And just another follow-up is, if I’m understanding this right, you have I think a pretty small increase in the individual book right now 100,000. Does that include your off-exchange and on-exchanges, and if so, even if you’re only booking 600,000 in public exchanges, why is your net increase only about a 100k. The blues seem to be pretty positive about the off-exchange growth of that, if I look correctly?

Joe Swedish

Thanks. A couple of things to keep in mind, while we’ve grown by what is only a 100,000 net in individual, keep in mind that’s essentially retaining the vast majority of our existing book, plus adding to that book. More importantly, it does not include membership enrollment post February 15. So you should see a 150,000 plus more members coming in, if not 200,000 plus more members in the next two months that would get added to that number.

And then finally, the one thing it's very hard to model right now is what will happen with small group attrition throughout the year or even the broader economy and if layoff start to pick up again or small group of trips faster than we expected, those lives end up having what we call a life changing event, which allows them then to still go back and enroll in the exchanges. So the one piece I can’t answer for you is how much more of a net additive will be in this year. We’ve taken a cautious view of that for now, but if that actually picks up, I can still see the membership really start tracking well above the 2 million plus lives for the year on individual.

Ana Gupte - Leerink

Okay. Got it. So basically what you’re saying is the 1.3 million to 1.4 million membership increases contributor in your guidance.

Joe Swedish

Yes.

Ana Gupte - Leerink

Okay. Got it. Thank you.

Operator

And your final question today comes from the line of Andrew Schenker from Morgan Stanley. Please go ahead.

Claire Diesen - Morgan Stanley

Hi, this is Claire in for Andy. Thanks for the question. Just a quick one here on the commercial and specialty MLR commentary in the release. You mentioned it was stable year-to-year. I thought we would have seen some improvement given the inclusion of the industry fee and potentially some benefit from weather. Is there anything going on in that space that is worth highlighting and how do that ramp versus your expectations? Thanks.

Joe Swedish

Thanks Claire. I appreciate the question. First thing, it was actually better than our expectations in the quarter. The biggest thing I can point to though to why you’re not seeing as much improvement, as we thought it wasn’t a prudent thing to maintain a stronger balance sheet in this quarter until we give the second quarter. As we said at IR Day, it’s important to get to 2Q for you really start understanding the results. And we think we can show that to our investors as you can see the DCP is up 5.5 days and the underlying cash flow is quite strong related to that DCP.

Okay. Well, thank you for your questions. In closing, let me reiterate a few key messages I like you to take away from this call. A better than expected first quarter results reflect our strong position in the managed care industry, benefits we are seeing from our strategic investments and our intense focus on execution. We made substantial investments to enhance the depth and breadth of our experience, as well as to improve our responsiveness to the needs of our customers.

The addition of Marty Silverstein which was previously announced as Chief Strategy Officer and today's appointments of Pete Haytaian and Tom Zielinski continue that momentum. Recall the IR Day thing. You don't know what you don't know about us because we’ve not told you. With that backdrop, let me summarize. We’re off to a strong start in 2014, supporting an increase in our earnings guidance for the year.

Perhaps most important though is that we have executed on our commitments. We told you we would make operational improvements and we have. We told you we would manage capital prudently and we have. We said we’d be a winner on the exchanges and we are. I hope you see them when this management team tells you they will do something we follow through.

I want to thank everybody for dissipating on our call this morning. Operator, please provide the call replay instructions.

Operator

Thank you. Ladies and gentlemen, this conference will be available for replay after 11 AM Eastern Time today through May 14. You may access the AT&T Teleconference Replay System at any time by dialing 1800-475-6701 and entering the access code 310061. International participants dial 320-265-3844. Those numbers once again our 1800-475-6701 or 320-265-3844, with the access code, 310061. That does conclude your conference for today. Thank you for your participation and for using AT&T Executive Teleconference. You may now disconnect.

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