Two of the region’s three dominant health insurers reported full-year profits for 2012 on Monday, but the trends went in opposite directions.
HealthNow New York, the region’s largest health insurer, said Monday that its profits for last year soared nearly eightfold, as a jump in revenues and slightly lower administrative expenses offset an increase in medical costs for members.
The Buffalo-based parent of BlueCross BlueShield of Western New York reported net income of $31.5 million, up sharply from $3.94 million for 2011, when the insurer incurred a big increase in medical costs.
That’s still well below the previous two years, when it earned $52.69 million and $62 million, respectively, in 2010 and 2009, but it’s 24 percent higher than the $25.41 million in 2008.
“There will always be cycles in businesses, and ours is no different,” said Stephen T. Swift, the company’s executive vice president and chief financial officer. “2011 was an anomaly. … But when you look at the history of the organization over the last five years, our performance in 2012 was comparable to our performance in the recent past.”
Total revenues rose by 2.6 percent to a record $2.46 billion.
“The financials reflect rigor and discipline, particularly in the midst of an environment with heavy regulation and the mandates from health care reform,” Swift said.
Meanwhile, Excellus BlueCross BlueShield of Rochester, parent of Univera Healthcare, said that it earned $106 million last year, for a profit margin of 1.8 percent. That’s down by 53 percent from $223.3 million in 2011, when it experienced an unusual surge in revenues that outpaced normal trends and expenses.
The latest results are higher than the figures for each of the previous four years, when it reported profits of $44.45 million, $46.57 million, a loss of $54.1 million and a profit of $84.26 million. On average, over the last five years, it posted a 1.3 percent margin, compared with a statewide average of 3.5 percent for all insurers, the company said.
Total revenues last year rose by 6 percent, to $6 billion.
As nonprofits, the insurers reinvest revenues in the companies and add to reserves – their capital and surplus that is used to cushion unexpected expenses and ensure the ability to pay claims. HealthNow’s reserves rose by 6.9 percent, to $565.3 million, and Excellus’ by 1.6 percent, to $1.28 billion.
The weak performance in 2011 was reflected in HealthNow’s compensation for its top executives, especially President and CEO Alphonso O’Neil-White. His total pay fell by 32 percent, to $1.1 million, as his bonus and other compensation were slashed by 70 percent, from $759,673 to $224,807. His base salary, which is contractual, rose by 2.9 percent, to $872,000.
O’Neil-White last month announced his intention to retire after a new CEO is chosen. He joined HealthNow in 1996 and has been president and CEO since 2003.
A profit breakdown for Univera was not available.
Under New York State law, health insurers must report their year-end financial results and executive compensation by March 31. Independent Health Association spokesman Frank J. Sava said the Amherst-based insurer, the region’s No. 2 carrier, will not report until then.
HealthNow said its net underwriting gain, or profit after medical and operating costs, swung back to a profit of $25.58 million, from a loss in 2011 of $17.62 million. That’s a 1 percent profit margin. But that’s still lower than in the previous three years, when the underwriting gain totaled $26.4 million, $38 million and $47.78 million, respectively. “Those margins are very, very low, and extremely responsible, given the profile of our business and the constituents we serve,” Swift said.
Total medical and hospital expenses for members rose by just under 1 percent last year, to $2.19 billion, as the company spent 89.1 cents of every premium dollar on member costs. Claims adjustment expenses rose by 9 percent, to $51.3 million. Administrative expenses fell by less than 1 percent, to $190.98 million. The net investment gain fell by 3.7 percent, to $32.98 million.
Total insured membership continued to fall, as it has done for each of the last five years, as the company has seen a “steady increase” in self-funded employers who pay for their own claims. HealthNow reported 473,249 members at the end of 2012, down by 2.8 percent from 486,675 in 2011, and down by 14 percent from 553,149 in 2008. Self-funded group members, and individual members, are not included in the membership totals, but the company said they number 300,000.
As for Excellus, it reported $44 million in operating income, for a 0.7 percent operating or net underwriting gain, compared with 2.9 percent statewide. Medical spending rose by 8.4 percent, to $5.279 billion, indicating that the company spent 88 cents of every premium dollar on medical costs, compared with an average of 86 percent for other plans in the state and 80 percent nationally.
Former Excellus CEO David H. Klein received $3.8 million last year, down from $5.2 million in 2011, while current CEO Christopher C. Booth, who was chief operating officer until his promotion, received $1.6 million, up from $1.22 million.