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Cigna is Short on Cash |
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Cigna is Short on Cash![]() |
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cannot survive Obama |
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cannot survive Obama![]() |
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CIGNA Corporation (CI) is a health insurance company - sort of. For one, three-quarters of Cigna's health insurance business isn't really insurance - Cigna manages health plans for companies who self-insure, agreeing to pay employee's health care costs. Employees get Cigna cards and access to Cigna's negotiated rates with doctors, and Cigna handles billing, but the employer bears the risk of paying for care when employees get sick. This arrangement means less risk for Cigna, but also smaller premiums. Over 75% of CIGNA's 2007 enrollment consisted of self-funded administrative-only plans.
Cigna also differs from its competitors in that over 68% of the company's pretax operating income came from investment income in 2007 - 50% higher than its next most-invested competitor, Aetna, and almost four times that of other large national health account providers.[1] [2] This reliance on investment income makes the company much more vulnerable to market conditions than most other health insurance companies. For example, an 18% decrease in investment income from 2005 to 2007 caused the company’s operating income to decrease by 12% over this same period.
The company’s Medicare membership comprises only 0.3% of its total coverage, shielding CIGNA from legislation like the 2006 Deficit Reduction Act, which aims to cut Medicare funding by over $4.8 billion before 2011 and threatens competitors’ profit margins.
CIGNA operates in five major business segments:
| Source: CI 10-K[8] | 2005 | 2006 | 2007 | |
|---|---|---|---|---|
| Total Revenue ($M) | 16,684 | 16,547 | 17,623 | |
| Operating Income ($M) | 1,276 | 1,159 | 1,120 | |
| Source: CI 10-K[9] | 'Health Care | Disability and Life | International | Run-Off Reinsurance | Other Operations | Corporate Expenses | Total | |
|---|---|---|---|---|---|---|---|---|
| 2007 Total Revenue ($M) | 12,236 | 2,781 | 1,884 | 106 | 627 | (11) | 17,623 | |
| 2007 Operating Income ($M) | 697 | 254 | 176 | (11) | 109 | (97) | 1,120 | |
CIGNA’s revenue stream has increased by approximately 5% from $16.68 billion in 2005 to $17.62 billion in 2007. This is due primarily to a 12% increase in overall membership during this time, which increased total revenue from premium payments by over 6%. This increase was partially offset by a decrease in net investment income.[10]
Operating income has decreased by over 12% from 2005 to 2007, dropping from $1.276 billion in 2005 to $1.120 billion in 2007. This decrease is largely attributed to an 18% decrease in investment income (which dropped from $1.359 billion in 2005 to $1.114 billion in 2007).[11] CIGNA's investment income represents the largest proportion of pretax operating income for any health insurance company (75.4% in the first half of 2007, to Aetna’s 49.4%), and is thus unusually susceptible to market volatility.
CIGNA invests the highest proportion of their pretax income for any comparable health insurance company. In the first half of 2007, the company generated 75.4% of its pretax income in securities including short-term investments, equity, and issuance of short and long-term debt. The next most-invested competitor, Aetna (AET), generated 49.4% of its pretax income from investments, and UnitedHealth Group (UNH) only 16.5% of its income. According to CIGNA’s 2007 10-K, a 100 basis point (bps) (1 percentage point) increase in the market interest rate would result in an $800 million fair value loss for the company’s securities, and a 10% decrease in market equity prices would result in a $60 million loss for the company.[12] Thus, CIGNA’s operating income is much more dependent on interest rates and the market than other health insurance companies, and their stock price has mirrored this fact. Since 1990 (with only 2 years of exception), the change in growth of CIGNA’s stock price has moved in the opposite direction of the change to the average Fed Funds rate.[13] Now, with the Fed foreshadowing a stop to rate decreases and the market predicting rate increases over the next year, the value of CIGNA’s investments are threatened in the short term.
Under Medicare and Medicaid plans, a health insurance company takes on medical cost risk for a customer in exchange for monthly premiums paid by the government. The 2006 Deficit Reduction Act, however, included a plan to cut Medicaid funding by $4.8 billion before 2011.[14] This bill, along with any additional legislation of this form, would lead to decreased profit margin for any customer under a Medicaid or Medicare plan. As this funding is cut, CIGNA increasingly low exposure to government payments offers it a competitive advantage over competitors providing a large proportion of Medicare plans. In 2007, Medicare customers represented only 0.3% of CIGNA’s coverage, down from only 0.4% in 2005.[15]
Under self-funded accounts, customers pay a smaller premium in exchange for administrative services, but incur their own medical costs up to a given "stop-loss" amount. In March 2008, self-funded accounts represented 75% of CIGNA's enrollment, compared to only 14% risk-based "guaranteed cost" enrollment, and 1% experience-rated accounts[16] While this prevalence of self-funded accounts eliminates some inherent risks of medical costs, it dampens revenue growth by generating smaller premiums per member. For example, Medical Membership in CIGNA's Health Care Segment grew by over 8% in 2007, but the total premiums generated by this segment grew only 7% in this same time period.[17]
CIGNA’s Health Care services face a highly competitive industry that competes on the prices and comprehensiveness of benefits, location and choice of health care providers, quality of customer service, and reputation of financial strength. Its greatest competition comes from other national account companies such as Aetna (AET), UnitedHealth Group (UNH), and WellPoint Health Networks (WLP).
| CIGNA[18] | Aetna (AET)[19] | UnitedHealth Group (UNH)[20] | WellPoint Health Networks (WLP)[21] | ||
|---|---|---|---|---|---|
| 2007 Total Revenue ($B) | 16.72 | 27.60 | 75.43 | 61.13 | |
| 2007 Operating Income ($B) | 1.12 | 1.83 | 7.85 | 3.35 | |
| First 2Q 2007 Proportion of Pretax Income as Investment Income (%) | 75.4 | 49.4 | 16.5 | 19.5 | |
| 2007 Proportion of Medicare/Medicaid Enrollment (%) | 0.3 | 0.3 | 17.7 | 6.2 | |
| 2007 Medical Loss Ratio (%) | Not Avail. | 80.4 | 80.6 | 82.4 | |
Note: If not explicitly given, MLR is calculated as Medical Cost/Premiums. CIGNA's is unavailable given the way information is presented to their stockholders, largely due to variety and assortment of services that they provide.
As an insurer of national and regional accounts, CIGNA’s market share is best considered as an average of its regional markets. In 2006, CIGNA’s average market share across all 50 states was only 5.3%, and its average market position in those markets was just 6.4. Its market share is better in its larger markets (as would be expected), but it still falls below its 3 major competitors.
| Source: Credit Suisse[22] | CIGNA | Aetna (AET) | UnitedHealth Group (UNH) | WellPoint Health Networks (WLP) | |
|---|---|---|---|---|---|
| Average Market Share (%) | 9.7 | 9.8 | 16.2 | 32.9 | |
| Average Position | 5.1 | 3.9 | 2.5 | 1.7 | |
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