10-Q 1 form10q_06302011.htm FORM 10Q form10q_06302011.htm
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D. C. 20549
FORM 10-Q
 
x QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d)
OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period June 30, 2011
 
OR
 
o TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d)
OF THE SECURITIES EXCHANGE ACT OF 1934
 
For the transition period from ______________ to _________________
 
COMMISSION FILE NUMBER 1-16477
 
Coventry Logo
 
COVENTRY HEALTH CARE, INC.
(Exact name of registrant as specified in its charter)
 
Delaware
 
52-2073000
(State or other jurisdiction of
 
(I.R.S. Employer
incorporation or organization)
 
Identification Number)
 
6705 Rockledge Drive, Suite 900, Bethesda, Maryland 20817
(Address of principal executive offices) (Zip Code)
 
Registrant’s telephone number, including area code: (301) 581-0600
 
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.           Yes x No o
 
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).           Yes  x No o
 
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See the definitions of “large accelerated filer,” “accelerated filer,” and “smaller reporting company” in Rule 12b-2 of the Exchange Act.
 
Large accelerated filer x                                                                                                           Accelerated filer o
Non-accelerated filer o (Do not check if a smaller reporting company)                            Smaller reporting company o
 
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).
Yes o No x
 
       Indicate the number of shares outstanding of each of the issuer’s classes of common stock, as of the latest practicable date.
 
Class
 
Outstanding at July 29, 2011
     
Common Stock $.01 Par Value
 
148,557,269

COVENTRY HEALTH CARE, INC.
FORM 10-Q
 
PART I. FINANCIAL INFORMATION
 
 
ITEM 1:  Financial Statements
   
   
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4
       
   
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6
       
 
20
     
 
28
     
 
28
     
PART II:  OTHER INFORMATION
 
   
 
29
     
 
29
     
 
29
     
 
29
     
 
29
     
 
29
     
 
30
     
 
31
     
 
32
 
 
PART I.  FINANCIAL INFORMATION
 
ITEM 1: Financial Statements
 
COVENTRY HEALTH CARE, INC. AND SUBSIDIARIES
(in thousands)
 
   
June 30, 2011
   
December 31, 2010
 
   
(unaudited)
       
ASSETS
           
Current assets:
           
Cash and cash equivalents
  $ 1,645,616     $ 1,853,988  
Restricted cash - litigation escrow
    150,500        
Short-term investments
    254,166       16,849  
Accounts receivable, net
    264,846       276,694  
Other receivables, net
    588,653       515,882  
Other current assets
    268,389       371,528  
Total current assets
    3,172,170       3,034,941  
                 
Long-term investments
    2,461,548       2,184,606  
Property and equipment, net
    260,462       262,282  
Goodwill
    2,552,348       2,550,570  
Other intangible assets, net
    399,641       431,886  
Other long-term assets
    37,824       31,300  
Total assets
  $ 8,883,993     $ 8,495,585  
                 
LIABILITIES AND STOCKHOLDERS’ EQUITY
               
Current liabilities:
               
Medical liabilities
  $ 1,278,647     $ 1,237,690  
Accounts payable and other accrued liabilities
    702,973       942,226  
Deferred revenue
    158,185       103,082  
Current portion of long-term debt
    233,903        
Total current liabilities
    2,373,708       2,282,998  
                 
Long-term debt
    1,584,456       1,599,396  
Other long-term liabilities
    431,007       414,025  
Total liabilities
    4,389,171       4,296,419  
                 
Stockholders’ equity:
               
Common stock, $.01 par value; 570,000 authorized
    1,932       1,915  
193,169 issued and 148,451 outstanding in 2011
               
191,512 issued and 149,427 outstanding in 2010
               
Treasury stock, at cost; 44,718 in 2011; 42,085 in 2010
    (1,354,677 )     (1,268,456 )
Additional paid-in capital
    1,825,777       1,784,826  
Accumulated other comprehensive income, net
    47,262       41,081  
Retained earnings
    3,974,528       3,639,800  
Total stockholders’ equity
    4,494,822       4,199,166  
Total liabilities and stockholders’ equity
  $ 8,883,993     $ 8,495,585  
 
See accompanying notes to the condensed consolidated financial statements.
 
 
COVENTRY HEALTH CARE, INC. AND SUBSIDIARIES
(in thousands, except per share data)
(unaudited)
 
   
Quarters Ended June 30,
   
Six Months Ended June 30,
 
   
2011
   
2010
   
2011
   
2010
 
Operating revenues:
                       
Managed care premiums
  $ 2,737,594     $ 2,570,508     $ 5,492,930     $ 5,141,083  
Management services
    295,452       297,633       589,054       586,036  
Total operating revenues
    3,033,046       2,868,141       6,081,984       5,727,119  
                                 
Operating expenses:
                               
Medical costs
    2,248,793       2,032,556       4,523,953       4,146,898  
Cost of sales
    70,194       64,116       138,092       123,262  
Selling, general and administrative
    484,879       454,254       983,470       949,159  
Provider class action
    (159,300 )     278,000       (159,300 )     278,000  
Depreciation and amortization
    33,379       33,985       69,195       69,504  
Total operating expenses
    2,677,945       2,862,911       5,555,410       5,566,823  
                                 
Operating earnings
    355,101       5,230       526,574       160,296  
                                 
Interest expense
    22,579       20,195       42,616       40,325  
Other income, net
    23,819       18,207       43,287       38,494  
                                 
Earnings before income taxes
    356,341       3,242       527,245       158,465  
                                 
Provision for income taxes
    131,846       2,221       192,517       60,119  
                                 
Net earnings
  $ 224,495     $ 1,021     $ 334,728     $ 98,346  
                                 
Net earnings per share:
                               
Basic earnings per share
  $ 1.53     $ 0.01     $ 2.28     $ 0.67  
                                 
Diluted earnings per share
  $ 1.51     $ 0.01     $ 2.25     $ 0.67  
                                 
Weighted average common shares outstanding:
                               
Basic
    146,342       145,943       146,778       145,863  
Effect of dilutive options and restricted stock
    2,362       1,357       2,164       1,428  
Diluted
    148,704       147,300       148,942       147,291  
 
See accompanying notes to the condensed consolidated financial statements.
 
 
COVENTRY HEALTH CARE, INC. AND SUBSIDIARIES
(in thousands)
(unaudited)
 
   
Six Months Ended June 30,
 
   
2011
   
2010
 
Cash flows from operating activities:
           
Net earnings
  $ 334,728     $ 98,346  
Adjustments to earnings:
               
Depreciation and amortization
    69,195       69,504  
Amortization of stock compensation
    18,515       21,258  
Provider class action
    (159,300 )     278,000  
Provider class action – deferred tax adjustment
    58,145       (103,385 )
Changes in assets and liabilities:
               
Restricted cash – litigation escrow
    (150,500 )      
Accounts receivable, net
    12,704       (2,915 )
Other receivables
    (70,824 )     4,050  
Medical liabilities
    40,704       (291,330 )
Accounts payable and other accrued liabilities
    (15,392 )     (136,770 )
Deferred revenue
    55,185       (2,743 )
Other operating activities
    (6,654 )     (43 )
Net cash from operating activities
    186,506       (66,028 )
                 
Cash flows from investing activities:
               
Capital expenditures, net
    (34,995 )     (22,920 )
Proceeds from sales of investments
    934,657       410,972  
Proceeds from maturities of investments
    55,215       477,123  
Purchases of investments
    (1,494,113 )     (653,880 )
Payments for acquisitions, net of cash acquired
    (4,000 )     (66,894 )
Net cash from investing activities
    (543,236 )     144,401  
                 
Cash flows from financing activities:
               
Proceeds from issuance of stock
    37,514       1,128  
Payments for repurchase of stock
    (106,824 )     (3,628 )
Proceeds from issuance of debt, net
    590,305        
Repayment of debt
    (380,029 )      
Excess tax benefit from stock compensation
    7,392       987  
Net cash from financing activities
    148,358       (1,513 )
                 
Net change in cash and cash equivalents
    (208,372 )     76,860  
                 
Cash and cash equivalents at beginning of period
    1,853,988       1,418,554  
                 
Cash and cash equivalents at end of period
  $ 1,645,616     $ 1,495,414  
 
See accompanying notes to the condensed consolidated financial statements.
 

COVENTRY HEALTH CARE, INC. AND SUBSIDIARIES
(unaudited)
 
A.
BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES
 
Basis of Presentation
 
The condensed consolidated financial statements of Coventry Health Care, Inc. and its subsidiaries (“Coventry” or the “Company”) contained in this report are unaudited but reflect all normal recurring adjustments which, in the opinion of management, are necessary for the fair presentation of the results of the interim periods reflected. Certain information and footnote disclosures normally included in the consolidated financial statements prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) have been omitted pursuant to applicable rules and regulations of the Securities and Exchange Commission (“SEC”). Therefore, it is suggested that these condensed consolidated financial statements be read in conjunction with the consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10–K for the year ended December 31, 2010. The results of operations for the interim periods reported herein are not necessarily indicative of results to be expected for the full year. The year-end balance sheet data included in this report was derived from audited financial statements.
 
Significant Accounting Policies
 
Beginning January 1, 2011, the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively, “PPACA”), mandates minimum medical loss ratios for health plans such that the percentage of health coverage premium revenue spent on health care medical costs and other allowable administrative expenses, including quality improvement and taxes, as defined by PPACA, equals or exceeds such minimum medical loss ratios with rebates to policyholders if the actual loss ratios fall below these minimums.
 
The Company has a detailed projection process to estimate full year medical loss ratio results. Based on these current full year estimates, the Company has accrued a liability for a proportional amount of the projected annual estimate in the current quarter.  These projections will be updated every quarter with resulting changes in accrued liabilities recorded on a pro rata year-to-date basis.  The potential rebate liabilities are recorded in the “accounts payable and other accrued liabilities” line in the accompanying balance sheets and as contra-revenue in “managed care premiums” in the accompanying statement of operations.
 
B.
NEW ACCOUNTING STANDARDS
 
In January 2010, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2010-06, “Improving Disclosures about Fair Value Measurements.” ASU 2010-06 requires, among other things, the separate presentation (gross basis) of information about purchases, sales, issuances, and settlements of financial instruments in the roll forward of activity in fair value measurements using significant unobservable inputs (Level 3).  The Company adopted this provision on January 1, 2011, as required.  The adoption of ASU 2010-06 did not affect the Company’s financial position or results of operations.
 
In May 2011, the FASB issued ASU No. 2011-04, “Fair Value Measurement (Topic 820): Amendments to Achieve Common Fair Value Measurement and Disclosure Requirements in U.S. GAAP and International Financial Reporting Standards (“IFRS”).” ASU 2011-04 requires additional fair value measurement disclosures, including: (a) quantitative information about the significant unobservable inputs used for Level 3 fair value measurements, a qualitative discussion about the sensitivity of the measurements to changes in the unobservable inputs, and a description of the company’s valuation process, (b) any transfers between Level 1 and 2, (c) information about when the current use of a non-financial asset measured at fair value differs from its highest and best use, and (d) the hierarchy classification for items whose fair value is not recorded on the balance sheet but is disclosed in the notes. ASU 2011-04 is effective for fiscal periods beginning after December 15, 2011.  The Company will adopt the disclosure requirements beginning in fiscal year 2012 and is currently evaluating the effects of the provisions of ASU 2011-04.
 
In June 2011, the FASB issued ASU No. 2011-05, “Comprehensive Income (Topic 220): Presentation of Comprehensive Income.” ASU 2011-05 allows an entity the option to present the total of comprehensive income, the components of net income, and the components of other comprehensive income either in one continuous statement of comprehensive income or in two separate but consecutive statements.  ASU 2011-05 eliminates the option to present the components of other comprehensive income as part of the statement of changes in stockholders’ equity. Also, reclassification adjustments between comprehensive income and net income must be presented on the face of the financial statements. ASU 2011-05 is effective for fiscal years and interim periods beginning after December 15, 2011, with early adoption permitted. The Company is currently evaluating the effects of the provisions of ASU 2011-05.
 
 
C.
SEGMENT INFORMATION
 
The Company has the following three reportable segments:  Health Plan and Medical Services, Specialized Managed Care and Workers’ Compensation.  Each of these reportable segments, which the Company also refers to as “Divisions,” is separately managed and provides separate operating results that are evaluated by the Company’s chief operating decision maker.
 
The Health Plan and Medical Services Division is primarily comprised of the Company’s traditional health plan Commercial Risk, Medicare Advantage and Medicaid businesses and products.  Additionally, through this Division the Company contracts with various federal employee organizations to provide health insurance benefits under the Federal Employees Health Benefits Program (“FEHBP”) and offers managed care and administrative products to businesses that self-insure the health care benefits of their employees.  This Division also contains the dental services business.
 
The Specialized Managed Care Division includes the Company’s Medicare Part D, network rental and behavioral health benefits businesses.
 
The Workers’ Compensation Division is comprised of fee-based, managed care services such as provider network access, bill review, care management services and pharmacy benefit management to underwriters and administrators of workers’ compensation insurance.
 
The tables below summarize the operating results of the Company’s reportable segments through the gross margin level, as that is the measure of profitability used by the chief operating decision maker to assess segment performance and make decisions regarding the allocation of resources.  A reconciliation of gross margin to operating earnings at a consolidated level is also provided.  Total assets by reportable segment are not disclosed as these assets are not reviewed separately by the Company’s chief operating decision maker.  The dollar amounts in the segment tables are presented in thousands.
 
   
Quarter Ended June 30, 2011
 
   
Health Plan
and Medical
Services
   
Specialized
Managed
Care
   
Workers’
Comp.
   
Elim.
   
Total
 
Operating revenues
                             
Managed care premiums
  $ 2,417,877     $ 342,905     $     $ (23,188 )   $ 2,737,594  
Management services
    74,016       23,833       200,059       (2,456 )     295,452  
Total operating revenues
    2,491,893       366,738       200,059       (25,644 )     3,033,046  
Medical costs
    1,974,512       297,470             (23,189 )     2,248,793  
Cost of sales
                70,194             70,194  
Gross margin
  $ 517,381     $ 69,268     $ 129,865     $ (2,455 )   $ 714,059  
                                         
Selling, general and administrative
                                    484,879  
Provider class action
                                    (159,300 )
Depreciation and amortization
                                    33,379  
Operating earnings
                                  $ 355,101  
 
   
Quarter Ended June 30, 2010
 
   
Health Plan
and Medical
Services
   
Specialized
Managed
Care
   
Workers’
Comp.
   
Elim.
   
Total
 
Operating revenues
                             
Managed care premiums
  $ 2,141,001     $ 448,865     $     $ (19,358 )   $ 2,570,508  
Management services
    82,395       25,960       191,746       (2,468 )     297,633  
Total operating revenues
    2,223,396       474,825       191,746       (21,826 )     2,868,141  
Medical costs
    1,653,957       397,956             (19,357 )     2,032,556  
Cost of sales
                64,116             64,116  
Gross margin
  $ 569,439     $ 76,869     $ 127,630     $ (2,469 )   $ 771,469  
                                         
Selling, general and administrative
                                    454,254  
Provider class action
                                    278,000  
Depreciation and amortization
                                    33,985  
Operating earnings
                                  $ 5,230  
 
 
   
Six Months Ended June 30, 2011
 
   
Health Plan
and Medical
Services
   
Specialized
Managed
Care
   
Workers’
Comp.
   
Elim.
   
Total
 
Operating revenues
                             
Managed care premiums
  $ 4,811,284     $ 727,765     $     $ (46,119 )   $ 5,492,930  
Management services
    151,858       50,411       391,622       (4,837 )     589,054  
Total operating revenues
    4,963,142       778,176       391,622       (50,956 )     6,081,984  
Medical costs
    3,913,618       656,455             (46,120 )     4,523,953  
Cost of sales
                138,092             138,092  
Gross margin
  $ 1,049,524     $ 121,721     $ 253,530     $ (4,836 )   $ 1,419,939  
                                         
Selling, general and administrative
                                    983,470  
Provider class action
                                    (159,300 )
Depreciation and Amortization
                                    69,195  
Operating earnings
                                  $ 526,574  

   
Six Months Ended June 30, 2010
 
   
Health Plan
and Medical
Services
   
Specialized
Managed
Care
   
Workers’
Comp.
   
Elim.
   
Total
 
Operating revenues
                             
Managed care premiums
  $ 4,231,584     $ 947,779     $     $ (38,280 )   $ 5,141,083  
Management services
    165,353       49,458       376,151       (4,926 )     586,036  
Total operating revenues
    4,396,937       997,237       376,151       (43,206 )     5,727,119  
Medical costs
    3,314,999       870,180             (38,281 )     4,146,898  
Cost of sales
                123,262             123,262  
Gross margin
  $ 1,081,938     $ 127,057     $ 252,889     $ (4,925 )   $ 1,456,959  
                                         
Selling, general and administrative
                                    949,159  
Provider class action
                                    278,000  
Depreciation and Amortization
                                    69,504  
Operating earnings
                                  $ 160,296  
 
D.
DEBT
 
The Company’s outstanding debt consisted of the following (in thousands):
 
 
June 30, 2011
 
December 31, 2010
 
         
5.875% Senior notes due 1/15/12, net of repurchases
$ 233,903   $ 233,903  
6.300% Senior notes due 8/15/14, net of unamortized discount
           
of $721 at June 30, 2011
  374,377     374,264  
6.125% Senior notes due 1/15/15, net of repurchases
  228,845     228,845  
5.950% Senior notes due 3/15/17, net of repurchases and
           
unamortized discount of $809 at June 30, 2011
  382,426     382,355  
5.450% Senior notes due 6/7/21, net of unamortized discount
           
of $1,192 at June 30, 2011
  598,808      
Revolving Credit Facility due 7/11/12, 0.77% weighted
           
average interest rate for the period ended June 30, 2011
      380,029  
Total debt, including current portion
  1,818,359     1,599,396  
Less current portion of total debt
  233,903      
Total long-term debt
$ 1,584,456   $ 1,599,396  

 
On June 7, 2011, the Company completed the sale of $600.0 million aggregate principal amount of its 5.45% Senior Notes due 2021 (the “2021 Notes”) at the issue price of 99.800% per note.  The 2021 Notes are senior unsecured obligations of Coventry and rank equally with all of its other senior unsecured indebtedness.
 
During the quarter ended June 30, 2011, the Company repaid in full the $380.0 million outstanding balance of the revolving credit facility due July 11, 2012 and the associated credit agreement was terminated on June 22, 2011.
 
On June 22, 2011, the Company entered into a new Credit Agreement (the “Credit Facility”).  The Credit Facility provides for a five-year revolving credit facility in the principal amount of $750.0 million, with the Company having the ability to request an increase in the facility amount up to an aggregate principal amount not to exceed $1.0 billion.  The Company pays commitment fees on the Credit Facility ranging from 0.200% to 0.400% per annum. The obligations under the Credit Facility are general unsecured obligations of the Company.  As of June 30, 2011, there were no amounts outstanding under the Credit Facility. 
 
The Company’s senior notes and Credit Facility contain certain covenants and restrictions regarding, among other things, additional debt, dividends or other restricted payments, transactions with affiliates, asset dispositions and consolidations or mergers.  Additionally, the Company’s Credit Facility requires compliance with a leverage ratio of 3 to 1.  The Company’s Credit Facility and certain of its senior notes also include, as an event of default, the entry of a judgment against the Company or a subsidiary in excess of a specified amount ($50 million in the case of the Credit Facility and $20 million in the case of the applicable senior notes) if enforcement proceedings are commenced or if enforcement is not stayed for a period of 30 consecutive days. No enforcement proceedings have commenced against the Company. As of June 30, 2011, the Company was in compliance with the applicable covenants and restrictions under its senior notes and Credit Facility.
 
E.
CONTINGENCIES
 
Legal Proceedings
 
As described in the Company’s Annual Report on Form 10-K for the year ended December 31, 2010, the Company received a subpoena from the U.S. Attorney for the District of Maryland, Northern Division, requesting information regarding the operational process for confirming Medicare eligibility for its Workers’ Compensation set-aside product. The Company is fully cooperating and is providing the requested information. The Company cannot predict what, if any, actions may be taken by the U.S. Attorney. However, based on the information known to date, the Company does not believe that the outcome of this investigation will have a material adverse effect on its financial position or results of operations.
 
First Health Group Corporation (“FHGC”), a subsidiary of the Company, is a party to various lawsuits filed in the state and federal courts of Louisiana involving disputes between providers and workers’ compensation payors who access FHGC’s contracts with these providers to reimburse them for services rendered to injured workers. FHGC has written contracts with providers in Louisiana which expressly state that the provider agrees to accept a specified discount off their billed charges for services rendered to injured workers. The discounted rate set forth in the FHGC provider contract is less than the reimbursement amount set forth in the Louisiana Workers’ Compensation Fee Schedule. For this reason, workers’ compensation insurers and third-party administrators (“TPAs”) for employers who self insure workers’ compensation benefits contract with FHGC to access the FHGC provider contracts. Thus, when a FHGC contracted provider renders services to an injured worker, the workers’ compensation insurer or the TPA reimburses the provider for those services in accordance with the discounted rate in the provider’s contract with FHGC. These workers’ compensation insurers and TPAs are referred to as “payors” in the FHGC provider contract and the contract expressly states that the discounted rate will apply to those payors who access the FHGC contract. Thus, the providers enter into these contracts with FHGC knowing that they will be paid the discounted rate by every payor who chooses to access the FHGC contract. So that its contracted providers know which payors are accessing their contract, FHGC sends regular written notices to its contracted providers and maintains a provider website which lists each and every payor who is accessing the FHGC contract.
 
 
Four providers who have contracts with FHGC filed a state court class action lawsuit against FHGC and certain payors alleging that FHGC violated Louisiana’s Any Willing Provider Act (the “Act”), which requires a payor accessing a preferred provider network contract to give a one time notice 30 days before that payor uses the discounted rate in the preferred provider network contract to pay the provider for services rendered to a member insured under that payor’s health benefit plan. These provider plaintiffs allege that the Act applies to medical bills for treatment rendered to injured workers and that the Act requires point of service written notice in the form of a benefit identification card. If a payor is found to have violated the Act’s notice provision, the court may assess up to $2,000 in damages for each instance when the provider was not given proper notice that a discounted rate would be used to pay for the services rendered. In response to the state court class action, FHGC and certain payors filed a suit in federal court against the same four provider plaintiffs in the state court class action seeking a declaratory judgment that FHGC’s contracts are valid and enforceable, that its contracts are not subject to the Act since the Act does not apply to medical services rendered to injured workers and that FHGC is exempt from the notice requirements of the Act because it has contracted directly with each provider in its network. The federal district court ruled in favor of FHGC and declared that its contracts are not subject to the Act, that FHGC was exempt from the Act’s notice provision because it contracted directly with the providers and that FHGC’s contracts were valid and enforceable, i.e., the four provider plaintiffs were required to accept the discounted rate in accordance with the terms of their written contracts with FHGC.
 
Despite the federal court’s decision, the provider plaintiffs continued to pursue their state court class action against FHGC and filed a motion for partial summary judgment seeking damages of $2,000 for each provider visit where the provider was not given a benefit identification card at the time the service was performed. In response to the motion for partial summary judgment filed in the state court action, FHGC obtained an order from the federal court which enjoined, barred and prevented any of the four provider plaintiffs or their counsel from pursuing any claim against FHGC before any court or tribunal arising under the Act. Despite the issuance of this federal court injunction, the provider plaintiffs and their counsel pursued their motion for partial summary judgment in the state court action. Before the state court held a hearing on the motion for partial summary judgment, FHGC moved to decertify the class on the basis that the four named provider plaintiffs had been enjoined by the federal court from pursuing their claims against FHGC. The state court denied the motion to decertify the class but did enter an order permitting FHGC to file an immediate appeal of the state court’s denial of the motion. Even though FHGC had filed its appeal and there were no class representatives since all four named plaintiffs had been enjoined from pursuing their claims against FHGC, the state court held a hearing and granted the plaintiffs’ motion for partial summary judgment.  The amount of the partial summary judgment was $262 million. FHGC appealed both the partial summary judgment order and the denial of class decertification order to the state’s intermediate appellate court. Both appeals were denied by the intermediate appellate court.  FHGC has filed an application for a writ of appeal with the Louisiana Supreme Court with respect to the class decertification order and the partial summary judgment order. The decision to grant or deny the application for a writ of appeal is at the discretion of the Louisiana Supreme Court. The Louisiana Supreme Court has not yet issued a decision on either of these applications.  FHGC also filed a motion with the federal court to enforce the federal court’s prior judgments and for sanctions against the provider plaintiffs for violating those judgments which barred and enjoined them from pursuing their claims against FHGC in the state courts. That motion also sought to enjoin the state courts from proceeding in order to protect and effectuate the federal court’s judgments.  FHGC’s motion was denied by the federal court.
 
As a result of the Louisiana appellate court’s decision on July 1, 2010 to affirm the state trial court’s summary judgment order, the Company recorded a $278 million pre-tax charge to earnings and a corresponding accrued liability during the quarter ended June 30, 2010.  This amount represented the $262 million judgment amount plus post judgment interest and is included in “accounts payable and other accrued liabilities” in the accompanying balance sheet at December 31, 2010.  The Company accrued for legal fees expected to be incurred related to this case as well as post judgment interest subsequent to the second quarter charge, which are included in “accounts payable and other accrued liabilities” in the accompanying balance sheet at December 31, 2010.
 
On December 6, 2010, FHGC entered into a Memorandum of Understanding with attorneys representing the four plaintiffs and the class setting forth the settlement terms of the $262 million partial summary judgment entered in the class action lawsuit.  The Memorandum of Understanding provided that, subject to the execution of a settlement agreement acceptable to FHGC and final non-appealable approval of such settlement by the Louisiana state court, FHGC would pay $150.5 million to satisfy in full the amount of the partial summary judgment and to resolve and settle all claims of the class, including claims for pre- and post-judgment interest, attorneys fees and costs.  In addition, Coventry would assign to the class certain rights it has to the proceeds of FHGC’s insurance policies relating to the claims asserted by the class. Pursuant to the Memorandum of Understanding, the parties also agreed to request that the appropriate courts stay all related proceedings and consideration of any pending appellate writ applications, and to stay the effect of any outstanding judgments until the settlement agreement was prepared, executed and received final court approval.
 
 
In exchange for the settlement payment by FHGC, class members would release FHGC and all of its affiliates and clients for any claims relating in any way to re-pricing, payment for, or reimbursement of a workers’ compensation bill, including but not limited to claims under the Act. Plaintiffs also agreed to a notice procedure that FHGC may follow in the future to comply with the Act. As noted, the Memorandum of Understanding was contingent upon the execution of a definitive settlement agreement acceptable to FHGC.  Under Louisiana law, once the parties have executed such a settlement agreement, they must apply to the court for approval of the settlement following a court-supervised process of notice to the class and an opportunity for the class to be heard about the fairness of the settlement or exclude themselves from the settlement.
 
On February 2, 2011, FHGC, counsel for the class representatives and the class representatives executed a definitive settlement agreement which was acceptable to FHGC. The settlement agreement contained the same terms and conditions as were set forth in the Memorandum of Understanding. Accordingly, the Company made a $150.5 million cash payment into escrow. As noted above and as set forth in the settlement agreement, certain contingencies such as preliminary court approval; resolutions of objections filed by class members challenging the fairness of the settlement; class members excluded from the settlement not exceeding a materiality threshold; and final court approval, were required to be satisfied before the settlement became final. On May 27, 2011, the court entered an order of final approval of the settlement and thus all contingencies in the definitive settlement agreement were satisfied.  As a result of the resolution of the settlement agreement contingencies, including final court approval, the Company recorded a non-recurring pre-tax adjustment to earnings of $159.3 million, or $0.68 per diluted share after tax, in the second quarter of 2011. The $150.5 million deposited in escrow and included in the accompanying balance sheet, at June 30, 2011, will be released to the settlement class on the settlement effective date, which is expected in August 2011.
 
In a related matter, FHGC has filed another lawsuit in Louisiana federal district court against 85 Louisiana providers seeking a declaratory judgment that its contracts are valid and enforceable, its contracts are not subject to the Louisiana’s Any Willing Provider Act because its contracts pertain to payment for services rendered to injured workers, and FHGC is exempt from the notice provision of the Any Willing Provider Act because it has contracted directly with the providers. As a result of the Memorandum of Understanding and the settlement agreement executed in connection with the provider class action lawsuit in Louisiana referenced above, this lawsuit has been stayed and will now be dismissed since the settlement agreement of the class action lawsuit has become final.
 
On September 3, 2009, a shareholder, who owned less than 5,000 shares, filed a putative securities class action against the Company and three of its current and former officers in the federal district court of Maryland. Subsequent to the filing of the complaint, three other shareholders and/or investor groups filed motions with the court for appointment as lead plaintiff and approval of selection of lead and liaison counsel. By agreement, the four shareholders submitted a stipulation to the court regarding appointment of lead plaintiff and approval of selection of lead and liaison counsel. In December 2009, the court approved the stipulation and ordered the lead plaintiff to file a consolidated and amended complaint. To date, no consolidated and amended complaint has been filed. The purported class period is February 9, 2007 to October 22, 2008. The complaint alleges that the Company’s public statements contained false, misleading and incomplete information regarding the Company’s profitability, particularly the profit margins for its Medicare Private-Fee-For-Service (“Medicare PFFS”) products.  The Company filed a motion to dismiss the complaint. By Order, dated March 31, 2011, the court granted in part, and denied in part, the Company’s motion to dismiss the complaint.  The Company has filed a motion for reconsideration of that part of the court’s March 31, 2011 Order which denied the Company’s motion to dismiss the complaint. The Company will vigorously defend against the allegations in the lawsuit.  Although it cannot predict the outcome, the Company believes this lawsuit will not have a material adverse effect on its financial position or results of operations.
 
On October 13, 2009, two former employees and participants in the Coventry Health Care Retirement Savings Plan filed a putative ERISA class action lawsuit against the Company and several of its current and former officers, directors and employees in the U.S. District Court for the District of Maryland. Plaintiffs allege that defendants breached their fiduciary duties under ERISA by offering and maintaining Company stock in the Plan after it allegedly became imprudent to do so and by allegedly failing to provide complete and accurate information about the Company’s financial condition to plan participants in SEC filings and public statements. Three similar actions by different plaintiffs were later filed in the same court and were consolidated on December 9, 2009. An amended consolidated complaint has been filed.  The Company filed a motion to dismiss the complaint. By Order, dated March 31, 2011, the court denied the Company’s motion to dismiss the amended complaint.  The Company has filed a motion for reconsideration of the court’s March 31, 2011 Order and has filed an Alternative Motion to Certify the Court’s March 31, 2011 Order For Interlocutory Appeal to the Fourth Circuit Court of Appeals. The Company will vigorously defend against the allegations in the consolidated lawsuit.  Although it cannot predict the outcome, the Company believes this lawsuit will not have a material adverse effect on its financial position or results of operations.
 
 
Guaranty Fund Assessments
 
The Company operates in a regulatory environment that may require the Company to participate in assessments under state insurance guaranty association laws. The Company’s exposure to guaranty fund assessments is based on its share of business it writes in the relevant jurisdictions for certain obligations of insolvent insurance companies to policyholders and claimants.
 
The Pennsylvania Insurance Commissioner has placed Penn Treaty Network America Insurance Company and its subsidiary (collectively, “Penn Treaty”), neither of which is affiliated with the Company, in rehabilitation (an intermediate action before insolvency) and has petitioned a Pennsylvania state court for liquidation. If Penn Treaty is liquidated, the Company’s health plans and other insurers may be required to pay a portion of Penn Treaty’s policyholder claims through guaranty association assessments in future periods from various states in which Penn Treaty policyholders reside and in which the Company’s health plans and insurance subsidiaries write premiums.
 
The Company is unable to estimate losses or ranges of losses because the Company cannot predict when the Pennsylvania state court will render a decision, the amount of the insolvency, if any, the amount and timing of any associated guaranty fund assessments or the availability and amount of any potential offsets, such as an offset of any premium taxes otherwise payable by the Company. Based on information known to date, the Company cannot predict the outcome of this matter.  However, an assessment could have a material adverse effect on the Company’s financial position and results of operations.
 
F.
COMPREHENSIVE INCOME
 
Comprehensive income was as follows (in thousands):
 
   
Quarters Ended June 30,
   
Six Months Ended June 30,
 
   
2011
   
2010
   
2011
   
2010
 
Net earnings
  $ 224,495     $ 1,021     $ 334,728     $ 98,346  
Other comprehensive income:
                               
Unrealized holding gains
    24,886       25,311       15,859       27,308  
Reclassification adjustments, net
    (4,130 )     (1,881 )     (5,724 )     (5,739 )
Other comprehensive income, before income taxes
    20,756       23,430       10,135       21,569  
 Income tax provision
    (8,095 )     (9,139 )     (3,953 )     (8,412 )
Other comprehensive income, net of income taxes
    12,661       14,291       6,182       13,157  
Comprehensive income
  $ 237,156     $ 15,312     $ 340,910     $ 111,503  
 
G.
INVESTMENTS
 
The Company considers all of its investments as available-for-sale securities. For debt securities, if the Company either intends to sell or determines that it will more-likely-than-not be required to sell a debt security before recovery of the entire amortized cost basis or maturity of the debt security, the Company recognizes the impairment in earnings.  If the Company does not intend to sell the debt security and the Company determines that it will not more-likely-than-not be required to sell the debt security but it does not expect to recover the entire amortized cost basis, the impairment is bifurcated into the amount attributed to the credit loss, which is recognized in earnings, and all other cases, which are recognized in other comprehensive income. Realized gains and losses on the sale of investments are determined on a specific identification basis.
 
 
The amortized cost, gross unrealized gain or loss and estimated fair value of short-term and long-term investments by security type were as follows as of June 30, 2011 and December 31, 2010 (in thousands):
 
   
Amortized
   
Unrealized
   
Unrealized
   
Fair
 
   
Cost
   
Gain
   
Loss
   
Value
 
As of June 30, 2011
                       
State and municipal bonds
  $ 858,760     $ 39,379     $ (636 )   $ 897,503  
U.S. Treasury securities
    76,706       3,117             79,823  
Government-sponsored enterprise securities (1)
    282,900       5,760       (7 )     288,653  
Residential mortgage-backed securities (2)
    311,803       10,558       (641 )     321,720  
Commercial mortgage-backed securities
    14,939       1,006             15,945  
Asset-backed securities (3)
    16,953       887             17,840  
Corporate debt and other securities
    1,051,115       19,051       (992 )     1,069,174  
    $ 2,613,176     $ 79,758     $ (2,276 )   $ 2,690,658  
Equity method investments (4)
                            25,056  
                            $ 2,715,714  
 
   
Amortized
   
Unrealized
   
Unrealized
   
Fair
 
   
Cost
   
Gain
   
Loss
   
Value
 
As of December 31, 2010
                               
State and municipal bonds
  $ 856,838     $ 29,886     $ (3,068 )   $ 883,656  
U.S. Treasury securities
    84,739       3,667       (7 )     88,399  
Government-sponsored enterprise securities (1)
    332,421       7,477       (318 )     339,580  
Residential mortgage-backed securities (2)
    308,250       10,421       (1,270 )     317,401  
Commercial mortgage-backed securities
    22,025       952             22,977  
Asset-backed securities (3)
    29,143       1,192             30,335  
Corporate debt and other securities
    473,982       17,123       (588 )     490,517  
    $ 2,107,398     $ 70,718     $ (5,251 )   $ 2,172,865  
Equity method investments (4)
                            28,590  
                            $ 2,201,455  
 
 
(1)
Includes FDIC-insured Temporary Liquidity Guarantee Program securities.
 
(2)
Agency pass-through, with the timely payment of principal and interest guaranteed.
 
(3)
Includes auto loans, credit card debt, and rate reduction bonds.
 
(4)
Includes investments in entities accounted for under the equity method of accounting and therefore are presented at their carrying value.
 
The amortized cost and estimated fair value of available-for-sale debt securities by contractual maturity were as follows as of June 30, 2011 and December 31, 2010 (in thousands):
 
   
As of June 30, 2011
   
As of December 31, 2010
 
   
Amortized
   
Fair
   
Amortized
   
Fair
 
   
Cost
   
Value
   
Cost
   
Value
 
Maturities:
                       
Within 1 year
  $ 500,826     $ 503,426     $ 174,639     $ 176,400  
1 to 5 years
    1,087,934       1,120,696       889,990       922,696  
5 to 10 years
    478,867       504,304       499,632       519,296  
Over 10 years
    545,549       562,232       543,137       554,473  
Total
  $ 2,613,176     $ 2,690,658     $ 2,107,398     $ 2,172,865  
 
Investments with long-term option adjusted maturities, such as residential and commercial mortgage-backed securities, are included in the “Over 10 years” category.  Actual maturities may differ due to call or prepayment rights.
 
Gross investment gains of $5.8 million and gross investment losses of $0.1 million were realized on sales of investments for the six months ended June 30, 2011. This compares to gross investment gains of $11.7 million and gross investment losses of $4.3 million realized on sales of investments for the six months ended June 30, 2010.  All realized gains and losses are recorded in Other income, net in the Company’s consolidated statement of operations.
 
 
The following table shows the Company’s investments’ gross unrealized losses and fair value at June 30, 2011 and December 31, 2010, aggregated by investment category and length of time that individual securities have been in a continuous unrealized loss position (in thousands):
 
At June 30, 2011
Less than 12 months
   
12 months or more
   
Total
 
Description of Securities
Fair Value
   
Unrealized Losses
   
Fair Value
   
Unrealized Losses
   
Fair Value
 
Unrealized Losses
 
State and municipal bonds
$ 59,079     $ (636 )   $     $     $ 59,079   $ (636 )
U.S. Treasury securities
                               
Government sponsored enterprises
  17,878       (7 )                 17,878     (7 )
Residential mortgage-backed  securities
  66,170       (640 )     46       (1 )     66,216     (641 )
Commercial  mortgage-backed securities
  3                         3      
Asset-backed securities
                               
Corporate debt and other securities
  162,430       (992 )                 162,430     (992 )
Total
$ 305,560     $ (2,275 )   $ 46     $ (1 )   $ 305,606   $ (2,276 )
 
At December 31, 2010
Less than 12 months
   
12 months or more
   
Total
 
Description of Securities
Fair Value
   
Unrealized Losses
   
Fair Value
   
Unrealized Losses
   
Fair Value
 
Unrealized Losses
 
State and municipal bonds
$ 156,894     $ (3,068 )   $     $     $ 156,894   $ (3,068 )
U.S. Treasury securities
  5,890       (7 )                 5,890     (7 )
Government sponsored enterprises
  19,551       (318 )                 19,551     (318 )
Residential mortgage-backed securities
  59,738       (1,269 )     17       (1 )     59,755     (1,270 )
Commercial  mortgage-backed securities
                               
Asset-backed securities
                               
Corporate debt and other securities
  34,405       (588 )                 34,405     (588 )
Total
$ 276,478     $ (5,250 )   $ 17     $ (1 )   $ 276,495   $ (5,251 )
 
The unrealized losses presented in this table do not meet the criteria for treatment as an other-than-temporary impairment.  The unrealized losses are the result of interest rate movements.  The Company has not decided to sell, and it is not more-likely-than-not that the Company will be required to sell before a recovery of the amortized cost basis of these securities.
 
The Company continues to review its investment portfolios under its impairment review policy. Given the current market conditions and the significant judgments involved, there is a continuing risk that declines in fair value may occur and that other-than-temporary impairments may be recorded in future periods.
 
H.
FAIR VALUE MEASUREMENTS
 
Accounting Standards Codification (“ASC”) Topic 820, “Fair Value Measurements and Disclosures,” defines fair value and requires a three-tier fair value hierarchy, which prioritizes the inputs used in measuring fair value based on the quality and reliability of the inputs or assumptions used in fair value measurements.
 
The Company’s Level 1 securities primarily consist of U.S. Treasury securities and cash. The Company determines the estimated fair value for its Level 1 securities using quoted (unadjusted) prices for identical assets or liabilities in active markets.
 
The Company’s Level 2 securities primarily consist of government-sponsored enterprise securities, state and municipal bonds, mortgage-backed securities, asset-backed securities, corporate debt and money market funds. The Company determines the estimated fair value for its Level 2 securities using the following methods: quoted prices for similar assets/liabilities in active markets, quoted prices for identical or similar assets in non-active markets (few transactions, limited information, non-current prices and high variability over time), inputs other than quoted prices that are observable for the asset/liability (e.g., interest rates, yield curves volatilities and default rates, among others), and inputs that are derived principally from or corroborated by other observable market data.
 
For the Company’s Level 2 assets, the following inputs and valuation techniques were utilized in determining the fair value of our financial instruments:
 
Cash Equivalents: Level 2 cash equivalents are valued using inputs that are principally from, or corroborated by, observable market data, primarily quoted prices for like or similar assets.
 
Government-Sponsored Enterprises:  These securities primarily consist of bonds issued by government-sponsored enterprises, such as the Federal Home Loan Bank, the Federal National Mortgage Association and the Federal Home Loan Mortgage Corporation.  The fair value of government-sponsored enterprises is based upon observable market inputs such as quoted prices for like or similar assets, benchmark yields, reported trades and credit spreads.
 
State and Municipal Bonds, Corporate Debt and Other Securities:  The fair value of our debt securities is determined by observable market inputs which include quoted prices for identical or similar assets that are traded in an active market, benchmark yields, new issuances, issuer ratings, reported trades of comparable securities and credit spreads.
 
Residential and Commercial Mortgage-Backed Securities and Asset-Backed Securities:  The fair value of these securities is determined by a cash flow model which utilizes the following inputs: quoted prices for identical or similar assets, benchmark yields, prepayment speeds, collateral performance, credit spreads and default rates that are observable at commonly quoted intervals.
 
The Company’s Level 3 securities primarily consisted of corporate financial holdings and mortgage-backed and asset-backed securities that were thinly traded due to market volatility and lack of liquidity. The Company determined the estimated fair value for its Level 3 securities using unobservable inputs that cannot be corroborated by observable market data including, but not limited to, broker quotes, default rates, benchmark yields, credit spreads and prepayment speeds.
 
The Company obtains one price for each security from an independent third-party valuation service provider, which uses quoted or other observable inputs for the determination of fair value as noted above.  As the Company is responsible for the determination of fair value, the Company performs quarterly analyses on the prices received from the third-party provider to determine whether the prices are reasonable estimates of fair value.
 
The following table presents the fair value hierarchy for the Company’s financial assets measured at fair value on a recurring basis at June 30, 2011 and December 31, 2010 (in thousands):
 
     
Quoted Prices in Active Markets for Identical Assets
 
Significant Other Observable Inputs
 
Significant Unobservable Inputs
 
At June 30, 2011
Total
 
Level 1
 
Level 2
 
Level 3
 
                 
Cash and cash equivalents
$ 1,645,616   $ 1,366,369   $ 279,247   $  
State and municipal bonds
  897,503         897,503      
U.S. Treasury securities
  79,823     79,823          
Government-sponsored enterprise securities
  288,653         288,653      
Residential mortgage-backed securities
  321,720         321,720      
Commercial mortgage-backed securities
  15,945         15,945      
Asset-backed securities
  17,840         17,840      
Corporate debt and other securities
  1,069,174     28,576     1,040,598      
Total
$ 4,336,274   $ 1,474,768   $ 2,861,506   $  
 
 
     
Quoted Prices in Active Markets for Identical Assets
 
Significant Other Observable Inputs
 
Significant Unobservable Inputs
 
At December 31, 2010
Total
 
Level 1
 
Level 2
 
Level 3
 
                 
Cash and cash equivalents
$ 1,853,988   $ 326,258   $ 1,527,730   $  
State and municipal bonds
  883,656         883,656      
U.S. Treasury securities
  88,399     88,399          
Government-sponsored enterprise securities
  339,580         339,580      
Residential mortgage-backed securities
  317,401         317,181     220  
Commercial mortgage-backed securities
  22,977         22,977      
Asset-backed securities
  30,335         30,208     127  
Corporate debt and other securities
  490,517         489,787     730  
Total
$ 4,026,853   $ 414,657   $ 3,611,119   $ 1,077  
 
Transfers between levels, if any, are recorded as of the end of the reporting period. During the quarter and six months ended June 30, 2011, there were no transfers between Level 1 and Level 2. As described in the tables below, the Company transferred all securities from Level 3 to Level 2 during the quarter ended March 31, 2011. The following tables provide a summary of changes in the fair value of the Company’s Level 3 financial assets for the quarter ended June 30, 2010 and six months ended June 30, 2011 and 2010 (in thousands):
 
Quarter Ended June 30, 2010
   
Total Level 3
   
Mortgage-backed securities
   
Asset-backed securities
   
Corporate and other
 
Beginning Balance, April 1, 2010
  $ 14,476     $ 2,119     $ 5,005     $ 7,352  
Transfers to (from) Level 3
                       
Total gains or losses (realized / unrealized)
                               
Included in earnings
    2,986       80       2,908       (2 )
Included in other comprehensive  income
    (3,101 )     2       (3,044 )     (59 )
Purchases, issuances, sales and settlements
                               
Purchases
                       
Issuances
                       
Sales
    (4,842 )     (133 )     (4,709 )      
Settlements
                       
Ending Balance, June 30, 2010
  $ 9,519     $ 2,068     $ 160     $ 7,291  
 
 
Six Months Ended June 30, 2011
   
Total Level 3
   
Mortgage-backed securities
   
Asset-backed securities
   
Corporate and other
 
Beginning Balance, January 1, 2011
  $ 1,077     $ 220     $ 127     $ 730  
Transfers to (from) Level 3 (1)
    (856 )     (258 )     (119 )     (479 )
Total gains or losses (realized / unrealized)
                               
Included in earnings
    107       16       7       84  
Included in other comprehensive  income
    (55 )     38       (8 )     (85 )
Purchases, issuances, sales and settlements
                               
Purchases
                       
Issuances
                       
Sales
    (273 )     (16 )     (7 )     (250 )
Settlements
                       
Ending Balance, June 30, 2011
  $     $     $     $  
 
(1) The Company no longer relies upon broker quotes or other models involving unobservable inputs to value these securities, as there are sufficient observable inputs (e.g., trading activity) to validate the reported fair value.  As a result, the Company transferred all securities from Level 3 to Level 2 during the quarter ended March 31, 2011.
 
Six Months Ended June 30, 2010
   
Total Level 3
   
Mortgage-backed securities
   
Asset-backed securities
   
Corporate and other
 
Beginning Balance, January 1, 2010
  $ 16,164     $ 3,100     $ 4,438     $ 8,626  
Transfers to (from) Level 3
          (470 )     470        
Total gains or losses (realized / unrealized)
                               
Included in earnings
    5,140       200       3,109       1,831  
Included in other comprehensive  income
    (4,861 )     (453 )     (2,910 )     (1,498 )
Purchases, issuances, sales and settlements
                               
Purchases
    1,950       1,745             205  
Issuances
                       
Sales
    (8,874 )     (2,054 )     (4,947 )     (1,873 )
Settlements
                       
Ending Balance, June 30, 2010
  $ 9,519     $ 2,068     $ 160     $ 7,291  
 
I.
STOCK-BASED COMPENSATION
 
Stock Options
 
The Company recorded compensation expense related to stock options of $3.9 million and $5.9 million for the quarters ended June 30, 2011 and 2010, respectively, and $7.4 million and $11.5 million for the six months ended June 30, 2011 and 2010, respectively. The total intrinsic value of options exercised was $13.9 million and $0.1 million for the quarters ended June 30, 2011 and 2010, respectively, and $17.9 million and $0.4 million for the six months ended June 30, 2011 and 2010, respectively. As of June 30, 2011, there was $28.1 million of total unrecognized compensation cost (net of expected forfeitures) related to non-vested stock option grants, which is expected to be recognized over a weighted average period of 2.2 years.
 
The following table summarizes stock option activity for the six months ended June 30, 2011:
 
       
Weighted-
   
Aggregate
   
Weighted Average
 
 
Shares
   
Average
   
Intrinsic Value
   
Remaining
 
 
(in thousands)
   
Exercise Price
   
(in thousands)
   
Contractual Life
 
                       
Outstanding at January 1, 2011
  12,260     $ 34.88              
Granted
  1,453     $ 35.34              
Exercised
  (1,657 )   $ 22.64              
Cancelled and expired
  (716 )   $ 44.66              
Outstanding at June 30, 2011
  11,340     $ 36.11     $ 69,773       5.70  
Exercisable at June 30, 2011
  7,869     $ 39.61     $ 38,076       4.37  
 
 
The Company continues to use the Black-Scholes-Merton option pricing model and amortizes compensation expense over the requisite service period of the grant. The methodology used in 2011 to derive the assumptions used in the valuation model is consistent with that used in 2010. The following average values and weighted-average assumptions for the quarters and six months ended June 30, 2011 and 2010 were used for option grants.
 
   
Quarters Ended June 30,
   
Six Months Ended June 30,
 
   
2011
   
2010
   
2011
   
2010
 
                         
Black-Scholes-Merton Value
  $ 11.31     $ 7.38     $ 11.09     $ 7.43  
Dividend yield
    0.0 %     0.0 %     0.0 %     0.0 %
Risk-free interest rate
    0.9 %     1.5 %     0.9 %     1.5 %
Expected volatility
    41.5 %     47.8 %     41.6 %     47.7 %
Expected life (in years)
    3.5       3.5       3.5       3.5  
 
Restricted Stock Awards
 
The value of the restricted shares is amortized over various vesting periods through 2015. The Company recorded compensation expense related to restricted stock grants, including restricted stock granted in prior periods, of $6.4 million and $4.8 million for the quarters ended June 30, 2011 and 2010, respectively, and $11.2 million and $9.8 million for the six months ended June 30, 2011 and 2010, respectively. The total unrecognized compensation cost (net of expected forfeitures) related to the restricted stock was $44.4 million at June 30, 2011, and is expected to be recognized over a weighted average period of 2.1 years. The total fair value of shares vested during the six months ended June 30, 2011 and 2010 was $19.6 million and $10.4 million, respectively.
 
The following table summarizes restricted stock award activity for the six months ended June 30, 2011:
 
   
Shares
(in thousands)
   
Weighted-Average
Grant-Date Fair
Value Per Share
 
             
Nonvested, January 1, 2011
    2,173     $ 22.01  
Awarded
    721     $ 35.04  
Vested
    (574 )   $ 24.72  
Forfeited
    (41 )   $ 27.15  
Nonvested, June 30, 2011
    2,279     $ 26.89  
 
Performance Share Units
 
Performance share units (“PSUs”) represent hypothetical shares of the Company’s common stock and vest based upon the achievement of certain performance goals and other criteria as of December 31, 2011. The Company recorded compensation expense related to the PSUs of $8.2 million and $1.2 million for the quarters ended June 30, 2011 and 2010, respectively, and $14.9 million and $4.4 million for the six months ended June 30, 2011 and 2010, respectively. The related liability on the Company’s balance sheets at June 30, 2011 and December 31, 2010 was $19.8 million and $23.1 million, respectively. During the six months ended June 30, 2011, the Company paid $18.2 million with respect to PSUs that vested December 31, 2010.
 
The following table summarizes PSU activity for the six months ended June 30, 2011:
 
   
Units
 
   
(in thousands)
 
Nonvested, January 1, 2011
    585  
Granted
    393  
Vested
     
Forfeited
    (30 )
Nonvested, June 30, 2011
    948  
 
 
J.
SHARE REPURCHASE PROGRAM
 
The Company’s Board of Directors has approved a program to repurchase its outstanding common shares.  Share repurchases may be made from time to time at prevailing prices on the open market or in private transactions. In March 2011, the Company’s Board of Directors approved an increase to the share repurchase program in an amount equal to 5% of the Company’s then outstanding common stock, thus increasing the Company’s repurchase authorization by 7.5 million shares. Under the share repurchase program, the Company purchased 1.5 million shares and 3.1 million shares of its common stock during the three and six months ended June 30, 2011, respectively, at an aggregate cost of $50.0 million and $100.2 million, respectively. As of June 30, 2011, the total remaining number of common shares the Company is authorized to repurchase under this program is 9.6 million. Excluded from these amounts are shares purchased in connection with vesting of restricted stock awards to satisfy employees’ minimum statutory tax withholding obligations, as these purchases are not part of the program.
 
K.
OTHER DISCLOSURES
 
Earnings Per Share
 
Basic earnings per share is calculated using the weighted average number of common shares outstanding during the period. Diluted earnings per share assumes the exercise of all options and the vesting of all restricted stock using the treasury stock method. Potential common stock equivalents to purchase 4.9 million and 10.3 million shares for the quarters ended June 30, 2011 and 2010, respectively, and 6.4 million and 9.9 million shares for the six months ended June 30, 2011 and 2010, respectively, were excluded from the computation of diluted earnings per share because the potential common stock equivalents were anti-dilutive.
 
Other Income, net
 
Other income, net includes interest income of $19.0 million and $18.1 million for the quarters ended June 30, 2011 and 2010, respectively, and $36.0 and $35.4 million for the six months ended June 30, 2011 and 2010, respectively.
 
Concentration of Credit Risk
 
The Company is a provider of health insurance coverage to State of Illinois employees and their dependents.  In August 2009, the State of Illinois notified the Company of the State’s significant budget deficit. The State of Illinois subsequently limited payments to the Company based on its available cash.
 
As of June 30, 2011, the Company has an outstanding premium receivable balance from the State of Illinois of approximately $60.5 million, which represents five months of health insurance premiums. As the receivable is from a governmental entity which has been making payments, the Company believes that the full receivable balance will ultimately be realized and therefore has not reserved against the outstanding balance. The Company’s regulated subsidiaries are required to submit statutory-basis financial statements to state regulatory agencies. For those financial statements, in accordance with state regulations, this receivable is being treated as an admitted asset in its entirety.
 
The Company believes its allowance for doubtful accounts adequately provides for estimated losses as of June 30, 2011.  The Company has a risk of incurring losses if such allowances are not adequate.
 
The Company contracts with a pharmacy benefit management (“PBM”) vendor to manage pharmacy benefits for its members and to provide rebate administration services on behalf of the Company.  The Company had pharmacy rebate receivables of $275.1 million and $310.7 million as of June 30, 2011 and December 31, 2010, respectively, due from the PBM vendor resulting from the normal cycle of rebate processing, data submission and collection of rebates.  The Company has credit risk due to the concentration of receivables with this single vendor although the Company does not consider the associated credit risk to be significant.  The Company only records the pharmacy rebate receivables to the extent that the amounts are deemed probable of collection.
 

 
General Information
 
This Form 10-Q contains forward–looking statements which are subject to risks and uncertainties in accordance with the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Forward-looking statements typically include assumptions, estimates or descriptions of our future plans, strategies and expectations, and are generally identifiable by the use of the words “anticipate,” “will,” “believe,” “estimate,” “expect,” “intend,” “seek,” or other similar expressions. Examples of these include discussions regarding our operating and growth strategy, projections of revenue, income or loss and future operations. Unless this Form 10-Q indicates otherwise or the context otherwise requires, the terms “we,” “our,” “our Company,” “the Company” or “us” as used in this Form 10-Q refer to Coventry Health Care, Inc. and its subsidiaries.
 
These forward–looking statements may be affected by a number of factors, including, but not limited to, the “Risk Factors” contained in Part I, Item 1A, “Risk Factors,” of our Annual Report on Form 10-K for the year ended December 31, 2010 and contained in Part II, Item 1A, “Risk Factors,” of our quarterly report on Form 10-Q for the quarter ended March 31, 2011, and as may be further updated from time to time in our  subsequent quarterly reports on Form 10-Q.  Actual operations and results may differ materially from those forward-looking statements expressed in this Form 10-Q.
 
 The following discussion and analysis relates to our financial condition and results of operations for the quarters and six months ended June 30, 2011 and 2010. This discussion should be read in conjunction with our condensed consolidated financial statements and other information presented herein as well as “Management’s Discussion and Analysis of Financial Condition and Results of Operations” contained in our Annual Report on Form 10-K for the year ended December 31, 2010, including the critical accounting policies discussed therein.
 
Summary of Second Quarter 2011 Performance
 
 
Operating revenues of $3.0 billion, up 5.7% from the prior year quarter.
 
Diluted earnings per share were $1.51.
 
Includes $159.3 million adjustment related to the provider class action litigation in Louisiana state court.
 
Commercial risk membership of 1,648,000, an increase of 126,000 members from the prior year quarter.
 
Cash flow from operations of $186.5 million.
 
Completed $600 million public offering of 5.450% Senior Notes due 2021. Repaid $380 million outstanding balance on previous credit facility and terminated agreement.
 
Entered into a new $750 million, five-year unsecured credit facility.
 
Repurchased 1.5 million shares for $50 million during the quarter. Total year-to-date share repurchase of 3.1 million shares for $100 million.
 
New Accounting Standards
 
See Note B, New Accounting Standards, to the condensed consolidated financial statements for information and disclosures related to the new accounting standards which is incorporated herein by reference.
 
 
Membership
 
The following table presents our membership (in thousands):
 
     As of June 30,      Increase  
Membership by Product
 
2011
   
2010
   
(Decrease)
 
Health Plan Commercial Risk
    1,648       1,522       126  
Health Plan Commercial ASO
    689       657       32  
Medicare Advantage CCP
    219       192       27  
Medicaid Risk
    467       413       54  
Health Plan Total
    3,023       2,784       239  
                         
Other National ASO
    379       466       (87 )
Total Medical Membership
    3,402       3,250       152  
                         
Medicare Part D
    1,150       1,631       (481 )
                         
Total Membership
    4,552       4,881       (329 )
 
Total Health Plan membership increased 239,000 from the prior year quarter, primarily reflecting an increase from our acquisition of MHP, Inc. (“MHP”) in the fourth quarter of 2010 and an increase in Medicaid Risk as we began enrolling Medicaid members in the State of Nebraska and the Commonwealth of Pennsylvania starting in 2010. Other National ASO membership decreased 87,000 primarily due to a decline of our Federal Employees Health Benefit Program (“FEHBP”) membership and the attrition of membership associated with the runout of our National Accounts business. The decrease in Medicare Part D membership of 481,000 was a result of the loss of auto assign regions as well as a reduction in product offerings from five in 2010 to two in 2011.
 
Results of Operations
 
The following table is provided to facilitate a discussion regarding the comparison of our consolidated results of continuing operations for the quarters and six months ended June 30, 2011 and 2010 (dollars in thousands, except diluted earnings per share amounts):
 
   
Quarters Ended June 30,
   
Six Months Ended June 30,
 
   
2011
   
2010
   
2011
   
2010
 
                                 
Total operating revenues
  $ 3,033,046     $ 2,868,141     $ 6,081,984     $ 5,727,119  
Provider class action (release)/charge
  $ (159,300 )   $ 278,000     $ (159,300 )   $ 278,000  
Operating earnings
  $ 355,101     $ 5,230     $ 526,574     $ 160,296  
Operating earnings as a percentage of revenues
    11.7 %     0.2 %     8.7 %     2.8 %
Net Earnings
  $ 224,495     $ 1,021     $ 334,728     $ 98,346  
Diluted earnings per share
  $ 1.51     $ 0.01     $ 2.25     $ 0.67  
Selling, general and administrative as a percentage of revenue
    16.0 %     15.8 %     16.2 %     16.6 %
 
Comparison of Quarters Ended June 30, 2011 and 2010
 
Managed care premium revenue increased primarily as a result of the acquisition of MHP in 2010, as well as an increase in Medicaid Risk revenue primarily due to new markets entered during 2010 in the State of Nebraska and the Commonwealth of Pennsylvania.  Revenue also increased as a result of organic membership growth and an increase in the average realized premium per member per month. This was partially offset by a decrease in Medicare Part D revenue as a result of the loss of membership resulting from the aforementioned reduction in auto assign regions and product offerings from five in 2010 to two in 2011.

 
The increases mentioned above were partially offset by an accrual for the minimum medical loss ratio rebate for our Commercial business required by the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively, “PPACA”).  As a result of the PPACA minimum medical loss ratio mandates, rebates are required to be issued to policyholders if the actual loss ratios fall below these minimums.  Accordingly, in the current quarter, the Company has recorded a rebate estimate based on a proportional amount of the projected annual estimate in the “accounts payable and other accrued liabilities” line in the accompanying balance sheet, at June 30, 2011, and as contra-revenue in “managed care premiums” in the accompanying statement of operations for the periods ended June 30, 2011.
 
Medical costs increased primarily as a result of the acquisition of MHP, new Medicaid Risk markets entered during 2010 in the State of Nebraska and the Commonwealth of Pennsylvania, and as a result of organic membership growth and medical trend.  This was partially offset by the decrease in Medicare Part D membership, as noted above. Total medical costs, as a percentage of premium revenue (“medical loss ratio” or “MLR”) increased 3.0% over the prior year to 82.1% from 79.1% primarily as a result of the minimum MLR mandates previously mentioned, as well as the MLR increases during the current year quarter for the Medicaid Risk and Medicare Advantage products, as described in the segment results of operations discussion that follows.
 
Cost of sales increased due to the growth of our pharmacy benefit management program in the Workers’ Compensation Division.
 
Selling, general and administrative expense increased primarily due to normal operating costs associated with MHP including, but not limited to, salaries and benefits, professional fees, broker commissions and premium taxes.  Additionally, the increase is attributable to additional stock-based compensation expense primarily as a result of changes in the Company’s stock price.  For more information, refer to Note I, Stock-Based Compensation, to the condensed consolidated financial statements, which is incorporated herein by reference.
 
During the second quarter of 2010, a $278.0 million charge for a provider class action was recorded resulting from the Court of Appeal, Third Circuit for the State of Louisiana decision to affirm the trial court’s decision to grant summary judgment against a wholly-owned subsidiary of Coventry in provider class action litigation in Louisiana state court. On May 27, 2011, the court entered an order of final approval of a settlement and, accordingly, the Company recorded a non-recurring pre-tax adjustment to earnings of $159.3 million in the second quarter of 2011. For additional information regarding the provider class action, refer to Note E, Contingencies, to the condensed consolidated financial statements, which is incorporated herein by reference.
 
Interest expense increased due to the issuance of $600.0 million aggregate principal amount of our 5.450% Senior Notes due 2021 (the “2021 Notes”) in the second quarter of 2011.  This increase was partially offset by reduced interest expense on the Company’s revolving credit facility due to the repayment of the outstanding balance in the second quarter of 2011.
 
Other Income, net increased as income in the current quarter included larger gains on the sales of investments.
 
The provision for income taxes increased from the prior year due to the increase in earnings.  The effective tax rate on operations decreased to 37.0% as compared to 68.4% for the prior year.  This decrease is primarily due to effects that the provider class action litigation charge in 2010 had on the prior year rate.
 
Comparison of Six Months Ended June 30, 2011 and 2010
 
Managed care premium revenue increased from the prior year six-month period primarily as a result of the acquisition of MHP in 2010, as well as an increase in Medicaid Risk revenue primarily due to new markets entered during 2010 in the State of Nebraska and the Commonwealth of Pennsylvania.  Revenue also increased as a result of organic membership growth and an increase in the average realized premium per member per month. This was partially offset by a decrease in Medicare Part D revenue as a result of the loss of membership resulting from the aforementioned reduction in auto assign regions and product offerings from five in 2010 to two in 2011.
 
The increases mentioned above were partially offset by an accrual for the minimum MLR rebate for our Commercial business, as discussed above.
 
Medical costs increased from the prior year six-month period primarily as a result of the acquisition of MHP, new Medicaid Risk markets entered during 2010 in the State of Nebraska and the Commonwealth of Pennsylvania, and as a result of organic membership growth and medical trend.  This was partially offset by the decrease in Medicare Part D membership, as noted above.  The overall MLR increased 1.7% over the prior year six-month period to 82.4% from 80.7%.

 
Medical costs for the six months ended June 30, 2011 included approximately $98.9 million of favorable medical cost development related to prior calendar years, of which $7.1 million related to the non-renewal of our Medicare PFFS product.  On a full year basis we expect favorable development related to prior calendar years for the remainder of 2011 to be minimal. Comparatively, medical costs for the six months ended June 30, 2010, included approximately $205.0 million of favorable medical cost development related to prior calendar years, of which $84.0 million related to the non-renewal of the Medicare PFFS product. For the full year of 2010, we experienced favorable medical cost development of $241.5 million, of which $103.1 million related to the non-renewal of our Medicare PFFS product.
 
The favorable development during the six-month period of 2010 was higher as a result of the higher effect of Medicare PFFS runout from the non-renewal of that product.  Additionally, the higher favorable development during the six-month period of 2010, excluding Medicare PFFS, was primarily due to lower than expected medical cost increases as well as lower than expected utilization as compared to the six-month period in 2011.
 
Cost of sales increased due to the growth of our pharmacy benefit management program in the Workers’ Compensation Division.
 
Selling, general and administrative expense increased primarily due to operating costs associated with the acquisition of MHP in 2010 including, but not limited to, salaries and benefits, professional fees, broker commissions and premium taxes.  Additionally, the increase is attributable to additional stock-based compensation expense primarily as a result of an increase in the Company’s stock price.  For more information, refer to Note I, Stock-Based Compensation, to the condensed consolidated financial statements, which is incorporated herein by reference. These increases were partially offset by a decrease in salaries and benefits costs primarily from a general reduction in the number of full-time employees.
 
Interest expense increased due to the issuance of the 2021 Notes in the second quarter of 2011.  This increase was partially offset by reduced interest expense on the Company’s revolving credit facility due to the repayment of the outstanding balance in the second quarter of 2011.
 
Other income, net is higher in the current year six-month period as the prior year six-month period included an impairment charge on one of our equity method investments.
 
The provision for income taxes increased from the prior year due to the increase in earnings.  The effective tax rate on operations decreased to 36.5% as compared to 37.9% for the prior year.  This decrease is primarily due to the proportion of our earnings in states with lower tax rates.
 
 
Segment Results
 
   
Quarters Ended June 30,
   
Increase
   
Six Months Ended June 30,
   
Increase
 
   
2011
   
2010
   
(Decrease)
   
2011
   
2010
   
(Decrease)
 
Operating Revenues (in thousands)
                         
                                     
Commercial Risk
  $ 1,510,849     $ 1,367,457     $ 143,392     $ 3,001,948     $ 2,684,678      $ 317,270  
Commercial Management Services
    74,016       82,395       (8,379 )     151,858       165,353       (13,495 )
Medicare Advantage
    601,240       505,084       96,156       1,192,482       1,012,675       179,807  
Medicaid Risk
    305,788       268,460       37,328       616,854       534,231       82,623  
Health Plan and Medical Services
    2,491,893       2,223,396       268,497       4,963,142       4,396,937       566,205  
Medicare Part D
    316,196       423,664       (107,468 )     674,641       897,473       (222,832 )
Other Premiums
    26,709       25,201       1,508       53,124       50,306       2,818  
Other Management Services
    23,833       25,960       (2,127 )     50,411       49,458       953  
Specialized Managed Care
    366,738       474,825       (108,087 )     778,176       997,237       (219,061 )
Workers’ Compensation
    200,059       191,746       8,313       391,622       376,151       15,471  
Other/Eliminations
    (25,644 )     (21,826 )     (3,818 )     (50,956 )     (43,206 )     (7,750 )
Total Operating Revenues
  $ 3,033,046     $ 2,868,141     $ 164,905     $ 6,081,984     $ 5,727,119      $ 354,865  
                                                 
Gross Margin (in thousands)
                                               
                                                 
Health Plan and Medical Services
  $ 517,381     $ 569,439     $ (52,058 )   $ 1,049,524     $ 1,081,938     $ (32,414 )
Specialized Managed Care
    69,268       76,869       (7,601 )     121,721       127,057       (5,336 )
Workers’ Compensation
    129,865       127,630       2,235       253,530       252,889       641  
Other/Eliminations
    (2,455 )     (2,469 )     14       (4,836 )     (4,925 )     89  
Total Gross Margin
  $ 714,059     $ 771,469     $ (57,410 )   $ 1,419,939     $ 1,456,959     $ (37,020 )
 
Revenue and Medical Cost Statistics
                             
Managed Care Premium Yields (per member per month):
                   
Health plan commercial group risk
  $ 322.83     $ 313.92       2.8 %   $ 321.90     $ 313.00       2.8 %
Medicare Advantage risk (1)
  $ 909.10     $ 867.43       4.8 %   $ 896.08     $ 876.28       2.3 %
Medicare Part D (2)
  $ 93.72     $ 90.49       3.6 %   $ 92.29     $ 89.28       3.4 %
Medicaid risk
  $ 218.28     $ 217.77       0.2 %   $ 219.72     $ 218.26       0.7 %
                                                 
Medical Loss Ratios:
                                               
Health plan commercial group risk
    81.1 %     78.3 %     2.8 %     80.7 %     79.3 %     1.4 %
Medicare Advantage risk (1)
    82.9 %     81.2 %     1.7 %     83.6 %     83.5 %     0.1 %
Medicare Part D
    88.8 %     90.7 %     (1.9 %)     92.5 %     93.1 %     (0.6 %)
Medicaid risk
    86.9 %     84.2 %     2.7 %     86.4 %     84.1 %     2.3 %
Total MLR
    82.1 %     79.1 %     3.0 %     82.4 %     80.7 %     1.7 %
 
  (1)  Beginning Q1 2010 excludes the PFFS product, which was not renewed effective January 1, 2010.
  (2) 
Revenue per member per month excludes the effect of the Centers for Medicare and Medicaid Services (“CMS”) risk-share premium adjustments and revenue ceded to external parties.
 

 
Health Plan and Medical Services Division
 
Quarters and Six Months Ended June 30, 2011 and 2010
 
Health Plan and Medical Services division revenue increased for the quarter and six months ended June 30, 2011 as compared to the quarters and six months ended June 30, 2010, primarily due to the acquisitions of Preferred Health Systems (“PHS”) and MHP in 2010 as well as entry into two new Medicaid markets during 2010 in the State of Nebraska and the Commonwealth of Pennsylvania.  Partially offsetting this increase in revenue was a decrease in Commercial Management Services revenue due to a decline of our FEHBP membership. The increase in Commercial Risk revenue was primarily due to the acquisition of PHS and MHP, as well as organic membership growth, and was partially offset by the accruals for the minimum MLR rebates, discussed above.  There was an increase in the average realized premium per member per month for the Commercial Risk business due to renewal rate increases.  Medicare Advantage revenues increased primarily due to the acquisition of MHP, as well as a general increase in premiums per member per month.  The increase in Medicaid Risk revenue is primarily due to the two new markets entered during 2010, as discussed above. The Medicaid Risk premiums per member per month were largely consistent with the prior year quarter and six-month periods.
 
The gross margin for this Division decreased for the quarter and six months ended June 30, 2011 as compared to the quarter and six months ended June 30, 2010, primarily due to the accrual for the minimum MLR rebate for our Commercial business, discussed above, and a decrease in the Medicare PFFS gross margin. The Medicare PFFS decrease was a result of lower favorable IBNR reserve development for the Medicare PFFS product experienced in the current year six-month period, compared to the prior year six-month period, due to our non-renewal of the product line on January 1, 2010. These decreases were offset by the acquisitions of PHS and MHP, as well as organic growth in existing markets.  The Medicare Advantage MLR is consistent with the prior year six-month period. The Medicaid Risk MLR increase primarily resulted from higher utilization rates in Missouri, our largest Medicaid market.
 
Specialized Managed Care Division
 
Quarters and Six Months Ended June 30, 2011 and 2010
 
Specialized Managed Care division revenue decreased from the quarter and six months ended June 30, 2011 as compared to the quarter and six months ended June 30, 2010, primarily due to lower Medicare Part D membership as a result of the loss of auto assign regions as well as a reduction in product offerings from five in 2010 to two in 2011.  Including the effect of the CMS risk sharing premium adjustments as well as ceded revenue, the premium per member per month was $97.21 in 2011 compared to $93.16 in 2010.  Excluding the effect of CMS risk sharing premium adjustments and revenue ceded to external parties, Medicare Part D premium per member per month for 2011 increased to $92.29 compared to $89.28 in 2010, primarily due to pharmacy cost trends.
 
When reviewing the premium yield for the Medicare Part D business, we believe that adjusting for the ceded revenue is useful for comparisons to competitors that may not have similar ceding arrangements. When reviewing the Medicare Part D business, adjusting for the risk sharing amounts is useful to understand the results of the Part D business because of our expectation that the risk sharing revenue will eventually be insignificant on a full year basis.
 
The decrease in gross margin was primarily driven by the Medicare Part D membership losses.  This is partially offset by improved performance in our Mental Health and Network Rental products.  The Medicare Part D MLR was generally consistent with the prior year period as a result of improved performance in our low income product, which makes up the majority of our Medicare Part D business in 2011, offset by the loss of the majority of our mainstream membership.
 
Workers’ Compensation Division
 
Quarters and Six Months Ended June 30, 2011 and 2010
 
Workers’ Compensation division revenue increased for the quarter and six months ended June 30, 2011 as compared to the quarter and six months ended June 30, 2010 primarily due to the growth of our pharmacy benefit management program, which was partially offset by a decline in volume and rates in our network products and a decline in volume in our clinical programs.
 
Workers’ Compensation gross margin increased slightly for the quarter and six months ended June 30, 2011 as compared to the quarter and six months ended June 30, 2010.  The increase is due to the growth of our pharmacy benefit management program, which operates at a lower margin.  The increase was partially offset by a decline in volume and rates in our network products and a decline in volume in our clinical programs, both of which operate at a higher margin.

Liquidity and Capital Resources
 
Liquidity
 
Our investment guidelines require our fixed income securities to be investment grade in order to provide liquidity to meet future payment obligations and minimize the risk to principal. The fixed income portfolio includes government and corporate securities with an average quality rating of “AA” and an effective duration of 3.03 years as of June 30, 2011. Typically, the amount and duration of our short-term assets are more than sufficient to pay for our short-term liabilities, and we do not anticipate that sales of our long-term investment portfolio will be necessary to fund our claims liabilities.
 
Our cash and investments, consisting of cash and cash equivalents and short-term and long-term investments, but excluding restricted cash associated with the litigation escrow of $150.5 million and deposits of $75.1 million at June 30, 2011 and $79.9 million at December 31, 2010 that are restricted under state regulations, increased by $310.7 million to $4.3 billion at June 30, 2011 from $4.0 billion at December 31, 2010.
 
On February 2, 2011, in relation to a class action lawsuit filed by providers in Louisiana, the Company entered into a definitive settlement agreement with plaintiffs’ counsel and attorneys representing the provider class setting forth the settlement terms for an amount payable of $150.5 million.  The $150.5 million paid into the escrow account was recorded as “restricted cash – litigation escrow” in the accompanying balance sheet, at June 30, 2011, and will be released on the settlement effective date which is expected in August 2011. For additional information regarding this matter, refer to Note E, Contingencies, to the condensed consolidated financial statements, which is incorporated herein by reference.
 
We have classified all of our investments as available-for-sale securities. Contractual maturities of the securities are disclosed in Note G, Investments, to the condensed consolidated financial statements, which are incorporated herein by reference.
 
The demand for our products and services is subject to many economic fluctuations, risks, and uncertainties that could materially affect the way we do business.  Management believes that the combination of our ability to generate cash flows from operations, our cash and investments on hand, and the excess funds held in certain of our regulated subsidiaries will be sufficient to fund continuing operations, capital expenditures, debt interest costs, debt principal repayments, and any other reasonably likely future cash requirements.  In addition, our long-term investment portfolio is available for further liquidity needs, including satisfaction of policy holder benefits.  Please refer to Part II, Item 1A, “Risk Factors,” of this Form 10-Q, as well as Part II, Item 1A, “Risk Factors,” of our Quarterly Report on Form 10-Q for the quarter ended March 31, 2011, and to Part I, Item 1A, “Risk Factors,” of our Annual Report on Form 10-K for the year ended December 31, 2010, for more information about how risks and uncertainties could materially affect our business.
 
Cash Flows
 
Net cash from operating activities for the six months ended June 30, 2011 was an inflow as a result of net earnings, net of adjustments, and an increase in medical liabilities and deferred revenue.  A significant offset to these inflows was $150.5 million paid into escrow, related to the provider class action litigation in Louisiana state court.  For additional information regarding this matter, refer to Note E, Contingencies, to the condensed consolidated financial statements, which is incorporated herein by reference. Also offsetting this inflow was an increase in Medicare receivables.
 
Our net cash from operating activities for the six months ended June 30, 2011 increased by $252.5 million from the corresponding 2010 period.   Prior year’s cash flow was negative due to payments of medical claims liabilities associated with the non-renewal of the Medicare PFFS product, effective January 1, 2010.  The nature of our business is such that premium revenues are generally received in advance of the expected cash payment for the related medical costs.  This results in strong cash inflows upon the implementation of a benefit program and cash outflows upon the termination.  Also contributing to the increase was a decrease in other accrued liabilities outflows as a result of lower tax payments during the current six-month period compared to the prior year. The lower tax payments in 2011 were a result of recognizing the deduction in 2011 for the escrow paid related to the provider class action.
 
Net cash from investing activities was an outflow for the six months ended June 30, 2011, primarily due to investment purchases during the period. This outflow was partially offset by the proceeds received from the sales and maturities of investments.
 
Projected capital expenditures for fiscal year 2011 are estimated at $70 to $80 million and consist primarily of computer hardware, software and other equipment.
 
Net cash from financing activities was an inflow, primarily due to the proceeds from the issuance of the 2021 Notes, net of discount and issuance costs, partially offset by the repayment of the $380.0 million outstanding balance of the previous revolving credit facility and share repurchases during the six months ended June 30, 2011.
 
 
On June 22, 2011, we entered into a five-year revolving credit facility agreement in the principal amount of $750.0 million.  As of June 30, 2011, there were no amounts outstanding under this credit facility. For more information, refer to Note D, Debt, to the condensed consolidated financial statements, which is incorporated herein by reference.
 
Under the share repurchase program, we purchased 1.5 million shares and 3.1 million shares of our common stock during the quarter and six months ended June 30, 2011 at an aggregate cost of $50.0 million and $100.2 million, respectively.  As of June 30, 2011, the total remaining number of common shares we are authorized to repurchase under this program is 9.6 million.
 
Health Plans
 
Our regulated Health Maintenance Organization (“HMO”) and insurance company subsidiaries are required by state regulatory agencies to maintain minimum surplus balances, thereby limiting the dividends our parent company may receive from our regulated subsidiaries. During the quarter ended June 30, 2011, we received $466.4 million in dividends from our regulated subsidiaries and did not make any capital contributions to them.  We had approximately $1.6 billion of regulated capital and surplus at June 30, 2011.
 
We believe that all of our subsidiaries that incur medical claims maintain more than adequate liquidity and capital resources to meet these short-term obligations as a matter of both our policy and state insurance regulations.
 
Excluding funds held by entities subject to regulation and excluding our equity method investments, we had cash and investments of approximately $1.7 billion and $1.1 billion at June 30, 2011 and December 31, 2010, respectively.  The increase primarily resulted from the issuance of the 2021 Notes discussed previously, dividends received from our regulated subsidiaries, and earnings generated from our non-regulated entities partially offset by repayment of debt, share repurchases and a cash payment into escrow related to the provider class action litigation in Louisiana.
 
Outlook
 
Health Plan and Medical Services Division – We expect our Commercial Risk membership will be flat to slightly down for 2011 as compared to the 2010 ending membership of approximately 1.6 million.  The forecasted Commercial group MLR is expected to be in the range of 80.5% to 81.5%, an increase from the 2010 MLR of 79.2%, largely driven by compliance with new healthcare reform regulations.  The forecasted Commercial Individual MLR is expected to be in the range of 75.0% to 77.0%, an increase from the 2010 MLR of 66.1%, largely driven by compliance with new healthcare reform regulations.
 
For our Health Plan based Medicare Advantage Coordinated Care Plans (“Medicare Advantage CCP”) product, we are forecasting membership to be slightly down for 2011 as compared to 2010. We expect the 2011 Medicare Advantage MLR to be consistent with our Medicare bid estimates in the mid 80%s, an increase from the 2010 MLR of 82.0%.
 
For our Health Plan based Medicaid business, we are forecasting a 2011 MLR in the high 80%s.
 
Specialized Managed Care Division – We anticipate year-end membership in our Medicare Part D product to be down by approximately 500,000 members in 2011 from the 2010 ending membership of approximately 1.6 million. This decrease reflects the loss of auto assign regions as well as membership losses driven by a reduction in product offerings from five in 2010 to two in 2011. Our MLR for 2011 is expected to be approximately consistent with the 2010 MLR.
 
Workers’ Compensation Division – We believe our Workers’ Compensation Division will grow slightly compared to 2010 with continued focus on streamlining the supporting administrative cost structure.
 
Regarding our balance sheet and liquidity, we ended the second quarter with approximately $1.3 billion in free cash at the parent level.  After supporting the regulatory capital needs of our subsidiaries and maintaining overall liquidity, our first priority for deployment of our free cash is acquisitions.
 
Regarding our effective tax rate, we expect it will range from 36% to 37% for the full year of 2011.
 
Legal Proceedings
 
See Note E, Contingencies, to the condensed consolidated financial statements for information and disclosures related to contingencies, which is incorporated herein by reference.
 

 
These disclosures should be read in conjunction with the condensed consolidated financial statements, Management’s Discussion and Analysis of Financial Condition and Results of Operations, and other information presented herein as well as in the Quantitative and Qualitative Disclosures About Market Risk section contained in our Annual Report on Form 10–K for the year ended December 31, 2010.
 
No material changes have occurred in our exposure to market risk since the date of our Annual Report on Form 10–K for the year ended December 31, 2010.
 
 
We have performed an evaluation as of the end of the period covered by this report of the effectiveness of our “disclosure controls and procedures” (as defined in Rule 13a-15(e) promulgated under the Securities Exchange Act of 1934), under the supervision and with the participation of our Chief Executive Officer and our Chief Financial Officer.  Based upon our evaluation, our Chief Executive Officer and Chief Financial Officer concluded that our disclosure controls and procedures are effective.
 
There have been no significant changes in our internal control over financial reporting (as defined in Rule 13a–15(f) promulgated under the Securities and Exchange Act of 1934) during the quarter ended June 30, 2011 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
 

PART II.  OTHER INFORMATION
 
 
See Note E, Contingencies, to the condensed consolidated financial statements for information and disclosures related to contingencies which is incorporated herein by reference.
 
 
There have been no material changes with respect to the risk factors disclosed in our Annual Report on Form 10-K for the year ended December 31, 2010 as updated in our quarterly report on Form 10-Q for the quarter ended March 31, 2011.
 
 
The following table presents information about our purchases of our common shares during the quarter ended June 30, 2011 (in thousands, except average price paid per share information):
 
   
Total Number of Shares Purchased (1)
   
Average Price Paid per Share
   
Total Number of Shares Purchased as Part of Publicly Announced Plans
   
Maximum Number of Shares That May Yet Be Purchased Under The Plan or Program (2)
 
                         
April 1-30, 2011
        $             11,048  
May 1-31, 2011
    76     $ 34.26             11,048  
June 1-30, 2011
    1,529     $ 34.28       1,462       9,586  
 Totals
    1,605     $ 34.28       1,462          
 
(1)  Includes shares purchased in connection with the vesting of restricted stock awards to satisfy employees’ minimum statutory tax withholding obligations.
(2) These shares are under a stock repurchase program previously announced on December 20, 1999, as amended. In March 2011, our Board of Directors approved an increase to the share repurchase program in an amount equal to 5% of our then outstanding common stock, thus increasing our repurchase authorization by 7.5 million shares.
 
 
Not Applicable.
 
 
 
Not Applicable.
 

 
Exhibit
 
No.
 
Description of Exhibit
     
31.1
 
Certification pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 made by Allen F. Wise, Chief Executive Officer and Chairman.
     
31.2
 
Certification pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 made by Randy P. Giles, Executive Vice President, Chief Financial Officer and Treasurer.
     
32
 
Certification pursuant to 18 U.S.C. Section 1350 as adopted pursuant to section 906 of the Sarbanes-Oxley Act of 2002 made by Allen F. Wise, Chief Executive Officer and Chairman and Randy P. Giles, Executive Vice President, Chief Financial Officer and Treasurer.
     
101
 
The following financial statements from Coventry Health Care, Inc.’s Quarterly Report on Form 10-Q for the quarter ended June 30, 2011, formatted in eXtensible Business Reporting Language (XBRL): (i) Consolidated Balance Sheets, (ii) Consolidated Statements of Operations,  (iii) Condensed Consolidated Statements of Cash Flows, and (iv) Notes to Condensed Consolidated Financial Statements, tagged as blocks of text.
 
 
 
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 thereunto duly authorized.
         
     
COVENTRY HEALTH CARE, INC.
 
     
(Registrant)
 
 
Date:
 
 August 5, 2011
 
 
/s/ Allen F. Wise
 
     
Allen F. Wise
 
     
Chief Executive Officer and Chairman
 
         
Date:
 August 5, 2011
 
/s/ Randy P. Giles
 
     
Randy P. Giles
 
     
Executive Vice President, Chief Financial Officer and Treasurer
 
         
         
Date:
 August 5, 2011
 
/s/ John J. Ruhlmann
 
     
John J. Ruhlmann
 
     
Senior Vice President and Corporate Controller
 
 

 
Exhibit
 
No.
 
Description of Exhibit
     
31.1
 
Certification pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 made by Allen F. Wise, Chief Executive Officer and Chairman.
     
31.2
 
Certification pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 made by Randy P. Giles, Executive Vice President, Chief Financial Officer and Treasurer.
     
32
 
Certification pursuant to 18 U.S.C. Section 1350 as adopted pursuant to section 906 of the Sarbanes-Oxley Act of 2002 made by Allen F. Wise, Chief Executive Officer and Chairman and Randy P. Giles, Executive Vice President, Chief Financial Officer and Treasurer.
     
101
 
The following financial statements from Coventry Health Care, Inc.’s Quarterly Report on Form 10-Q for the quarter ended June 30, 2011, formatted in eXtensible Business Reporting Language (XBRL): (i) Consolidated Balance Sheets, (ii) Consolidated Statements of Operations,  (iii) Condensed Consolidated Statements of Cash Flows, and (iv) Notes to Condensed Consolidated Financial Statements, tagged as blocks of text.
 
32