Centene Corporation Reports 2010 Fourth Quarter and Full Year Earnings

ST. LOUIS, Feb. 8, 2011 /PRNewswire/ -- Centene Corporation (NYSE: CNC) today announced its financial results for the quarter and year ended December 31, 2010.  The discussions below, with the exception of cash flow information, are in the context of continuing operations and all financial ratios exclude premium taxes.






 2010 Highlights

                                            Q4           Full Year

 Premium and Service Revenues (in millions) $ 1,129.5    $ 4,283.8

 Consolidated HBR                             83.3    %    83.8    %

 General & Administrative expense ratio       13.0    %    12.8    %

 Diluted EPS                                $ 0.50       $ 1.80

 Cash flow from operations (in millions)    $ 194.6      $ 168.9









Fourth Quarter Highlights

    --  Quarter-end managed care at-risk membership of 1,533,500, an increase of
        75,300 members, or 5.2% year over year.
    --  Premium and Service Revenues of $1,129.5 million, representing 7.5% year
        over year growth.
    --  Health Benefits Ratio of 83.3%, compared to 83.9% in the prior year.
    --  General and Administrative expense ratio of 13.0%, compared to 12.7% in
        the prior year.
    --  Cash flow from operations of $194.6 million.
    --  Days in claims payable of 45.6.
    --  Diluted earnings per share from continuing operations of $0.50 (which
        includes the dilution from the stock offering in early 2010), compared
        to $0.53 in the prior year.
    --  Debt to capitalization of 29.3%, or 23.9% excluding the $80.0 million
        non-recourse mortgage note.


Other Events

    --  During the fourth quarter of 2010, we completed the conversion of
        approximately 22,500 Florida members from Access Health Solutions LLC to
        our subsidiary, Sunshine State Health Plan, on an at-risk basis.
        Additionally, in December 2010, we completed the acquisition of Citrus
        Health Care, Inc., a Florida Medicaid and Long-term Care health plan. We
        served 194,900 at-risk members in Florida as of December 31, 2010.
    --  In December 2010, we refinanced the construction loan related to our
        corporate headquarters development with an $80 million non-recourse
        mortgage loan. In January 2011, we refinanced our $300 million Revolving
        Credit Facility with a new $350 million unsecured Revolving Credit
        Facility.
    --  In December 2010, Cenpatico Behavioral Health of Arizona began operating
        under an expanded contract to manage behavioral healthcare services in
        an additional four counties.
    --  In December 2010, one of our highly regarded health programs, Start
        Smart for Your Baby, was the recipient of the URAC/GKEN International
        Health Promotion Award for Community Health. Start Smart for Your Baby
        also received a gold award at the 2010 Web Health Awards for its audio
        book and a merit award for its podcasts.
    --  In January 2011, Magnolia Health Plan began operating under a new
        contract in Mississippi to provide managed care services to Medicaid
        recipients through the Mississippi Coordinated Access Network
        (MississippiCAN) Program.
    --  In January 2011, we entered into an agreement with Pima Health Systems
        in Arizona to administer their long-term care program on a non-risk
        basis.
    --  In February 2011, Superior HealthPlan began operating under an
        additional STAR+PLUS ABD contract in Texas in the Dallas service area.


Michael F. Neidorff, Centene's Chairman and Chief Executive Officer, stated, "Our team's coordinated and consistent efforts produced solid financial and operational performance in 2010, setting the stage for continued success in 2011."

The following table depicts membership in Centene's managed care organizations, by state, at December 31, 2010 and 2009:




                          December 31,

                          2010       2009

Arizona                   22,400     20,700

Florida                   194,900    102,600

Georgia                   305,800    309,700

Indiana                   215,800    208,100

Massachusetts             36,200     27,800

Ohio                      160,100    150,800

South Carolina            90,300     48,600

Texas                     433,100    455,100

Wisconsin                 74,900     134,800

Total at-risk membership  1,533,500  1,458,200

Non-risk membership       4,200      63,700

Total                     1,537,700  1,521,900









The following table depicts membership in Centene's managed care organizations, by member category, at December 31, 2010 and 2009:




                          December 31,

                          2010       2009

Medicaid                  1,177,100  1,081,400

CHIP & Foster Care        210,500    263,600

ABD & Medicare            104,600    82,800

Hybrid Programs           36,200     27,800

Long-term Care            5,100      2,600

Total at-risk membership  1,533,500  1,458,200

Non-risk membership       4,200      63,700

Total                     1,537,700  1,521,900







Statement of Operations: Three Months Ended December 31, 2010

    --  For the fourth quarter of 2010, Premium and Service Revenues increased
        7.5% to $1,129.5 million from $1,050.8 million in the fourth quarter of
        2009. The increase was primarily driven by membership growth resulting
        from acquisitions in Florida and South Carolina, conversion of
        membership in Florida from Access to at-risk under Sunshine State Health
        Plan, as well as premium rate increases in 2010. This increase was
        moderated by the removal of pharmacy service in two states in 2010.
        These pharmacy carve outs had the effect of reducing 2010 fourth quarter
        revenue by approximately $52 million.
    --  Consolidated HBR of 83.3% for the fourth quarter of 2010 represents a
        decrease of 0.6% from the comparable period in 2009. The year over year
        improvement in HBR is due to rate increases, decreased costs associated
        with the flu and better performance in our Florida health plan.
        Consolidated HBR decreased 0.9% sequentially from the third quarter of
        2010. The improvement in HBR was due to the impact of rate increases in
        several markets and improvements in our Florida health plan.
    --  Consolidated G&A expense as a percent of premium and service revenues
        was 13.0% in the fourth quarter of 2010, an increase from 12.7% in the
        fourth quarter of 2009. The increase in the G&A ratio between years
        reflects increased business expansion costs, including Mississippi,
        Dallas STAR+PLUS and Illinois.
    --  Earnings from continuing operations increased to $45.5 million in 2010
        from $37.8 million in 2009, or 20.4% year over year. Net earnings from
        continuing operations were $25.5 million, or $0.50 per diluted share in
        2010 (which includes the dilution from the stock offering in early
        2010), compared to $23.7 million, or $0.53 per diluted share in the
        fourth quarter of 2009.


Statement of Operations: Year Ended December 31, 2010

    --  For the year ended December 31, 2010, Premium and Service Revenues
        increased 10.5% to $4.3 billion in 2010 from $3.9 billion in 2009. This
        reflects a 13.6% increase in member months, offset by reduced revenue of
        $185 million as a result of pharmacy carve outs in 2010. The increase
        was primarily driven by membership growth resulting from acquisitions in
        Florida and South Carolina, conversion of membership in Florida from
        Access to at-risk under Sunshine State Health Plan, as well as premium
        rate increases in 2010.
    --  The consolidated HBR of 83.8% for 2010 represented a 0.3% increase from
        the 2009 consolidated HBR of 83.5%. The increase is primarily due to the
        growth in our Florida health plan where we have experienced a higher
        HBR.
    --  G&A expenses as a percent of Premium and Service Revenues decreased to
        12.8% in 2010, compared to 13.3% in 2009. The decrease primarily
        reflects the leveraging of our expenses over higher revenues, partially
        offset by increased business expansion costs.
    --  Earnings from continuing operations increased to $157.1 million in 2010
        from $138.1 million in 2009, or 13.7% year over year. Net earnings from
        continuing operations were $90.9 million, or $1.80 per diluted share in
        2010 (which includes the dilution from the stock offering in early
        2010), compared to $86.1 million, or $1.94 per diluted share in 2009.


Balance Sheet and Cash Flow

At December 31, 2010, the Company had cash and investments of $1,073.9 million, including $1,043.0 million held by its regulated entities and $30.9 million held by its unregulated entities.  Medical claims liabilities totaled $456.8 million, representing 45.6 days in claims payable.  Total debt was $330.6 million and debt to capitalization was 29.3%.  Excluding the $80.0 million non-recourse mortgage note, our debt to capital ratio is 23.9%.  Full year 2010 cash flow from operations was $168.9 million, or 1.7 times net earnings.

A reconciliation of the Company's change in days in claims payable from the immediately preceding quarter-end is presented below:




Days in claims payable, September 30, 2010    47.1

Reduced time of claims processing and payment (1.4)

Other                                         (0.1)

Days in claims payable, December 31, 2010     45.6









During the fourth quarter of 2010, we experienced increased electronic claims submissions and auto-adjudication of claims which reduced the average time from claims incurred to claims paid by 1.4 days, which is reflected in the decrease in period end claims inventory from the third quarter as presented in Supplemental Financial Data included in this release.  We expect our days in claims payable to be within our targeted range of 43 to 48 days in 2011.  This may be higher from time to time as we have new plans begin operations.  

Outlook

The table below depicts the Company's annual guidance from continuing operations for 2011:




                                            Full Year 2011

                                            Low      High

Premium and Service Revenues (in millions)  $ 4,900  $ 5,100

Diluted EPS                                 $ 2.00   $ 2.10

Consolidated HBR                            84.0%    85.0%

General & Administrative expense ratio      12.0%    12.5%



Diluted Shares Outstanding (in thousands)   51,500









Conference Call

As previously announced, the Company will host a conference call Tuesday, February 8, 2011, at 8:30 A.M. (Eastern Time) to review the financial results for the fourth quarter ended December 31, 2010, and to discuss its business outlook.  Michael F. Neidorff and William N. Scheffel will host the conference call.  Investors and other interested parties are invited to listen to the conference call by dialing 1-877-887-1134 in the U.S. and Canada; 1-412-317-0794 from abroad, or via a live, audio webcast on the Company's website at www.centene.com, under the Investors section.  A webcast replay will be available for on-demand listening shortly after the completion of the call for the next twelve months until 11:59 PM (Eastern Time) on Tuesday, February 7, 2012, at the aforementioned URL. In addition, a digital audio playback will be available until 9:00 AM Eastern Time on Wednesday, February 16, 2011, by dialing 1-877-344-7529 the U.S. and Canada, or 1-412-317-0088 from abroad, and entering access code 447292.

About Centene Corporation

Centene Corporation, a Fortune 500 company, is a leading multi-line healthcare enterprise that provides programs and related services to the rising number of under-insured and uninsured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and long-term care, in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans). Centene's CeltiCare subsidiary offers states unique, "exchange based" and other cost-effective coverage solutions for low-income populations. The Company operates local health plans and offers a range of health insurance solutions. It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health, life and health management, managed vision, telehealth services, and pharmacy benefits management.

The information provided in this press release contains forward-looking statements that relate to future events and future financial performance of Centene.  Subsequent events and developments may cause the Company's estimates to change.  The Company disclaims any obligation to update this forward-looking financial information in the future.  Readers are cautioned that matters subject to forward-looking statements involve known and unknown risks and uncertainties, including economic, regulatory, competitive and other factors that may cause Centene's or its industry's actual results, levels of activity, performance or achievements to be materially different from any future results, levels of activity, performance or achievements expressed or implied by these forward-looking statements.  Actual results may differ from projections or estimates due to a variety of important factors, including Centene's ability to accurately predict and effectively manage health benefits and other operating expenses, competition, changes in healthcare practices, changes in federal or state laws or regulations, inflation, provider contract changes, new technologies, reduction in provider payments by governmental payors, major epidemics, disasters and numerous other factors affecting the delivery and cost of healthcare.  The expiration, cancellation or suspension of Centene's Medicaid Managed Care contracts by state governments would also negatively affect Centene.  


(Tables Follow)







CENTENE CORPORATION AND SUBSIDIARIES



CONSOLIDATED BALANCE SHEETS

(In thousands, except share data)



                                                   December 31,   December 31,

                                                   2010           2009

ASSETS

Current assets:

Cash and cash equivalents of continuing
operations                                         $ 433,914    $ 400,951

Cash and cash equivalents of discontinued
operations                                           252          2,801

Total cash and cash equivalents                      434,166      403,752

Premium and related receivables, net of allowance
for uncollectible accounts of $17 and $1,338,
respectively                                         136,243      103,456

Short-term investments, at fair value (amortized
cost $21,141 and $39,230, respectively)              21,346       39,554

Other current assets                                 64,154       64,866

Current assets of discontinued operations other
than cash                                            912          4,506

Total current assets                                 656,821      616,134

Long-term investments, at fair value (amortized
cost $585,862 and $514,256, respectively)            595,879      525,497

Restricted deposits, at fair value (amortized
cost $22,755 and $20,048, respectively)              22,758       20,132

Property, software and equipment, net of
accumulated depreciation of $138,629 and
$103,883, respectively                               326,341      230,421

Goodwill                                             278,051      224,587

Intangible assets, net                               29,109       22,479

Other long-term assets                               30,057       36,829

Long-term assets of discontinued operations          4,866        26,285

Total assets                                       $ 1,943,882  $ 1,702,364



LIABILITIES AND STOCKHOLDERS' EQUITY

Current liabilities:

Medical claims liability                           $ 456,765    $ 470,932

Accounts payable and accrued expenses                185,218      132,001

Unearned revenue                                     117,344      91,644

Current portion of long-term debt                    2,817        646

Current liabilities of discontinued operations       3,102        20,685

Total current liabilities                            765,246      715,908

Long-term debt                                       327,824      307,085

Other long-term liabilities                          53,378       59,561

Long-term liabilities of discontinued operations     379          383

Total liabilities                                    1,146,827    1,082,937



Commitments and contingencies



Stockholders' equity:

Common stock, $.001 par value; authorized
100,000,000 shares; and 52,172,037 issued and
49,616,824 outstanding at December 31, 2010, and
45,593,383 issued and 43,179,373 outstanding
shares at December 31, 2009                          52           46

Additional paid-in capital                           384,206      281,806

Accumulated other comprehensive income:

Unrealized gain on investments, net of tax           6,424        7,348

Retained earnings                                    453,743      358,907

Treasury stock, at cost (2,555,213 and 2,414,010
shares, respectively)                                (50,486)     (47,262)

Total Centene stockholders' equity                   793,939      600,845

Noncontrolling interest                              3,116        18,582

Total stockholders' equity                           797,055      619,427

Total liabilities and stockholders' equity         $ 1,943,882  $ 1,702,364












CENTENE CORPORATION AND SUBSIDIARIES



CONSOLIDATED STATEMENTS OF OPERATIONS

(In thousands, except share data)

(Unaudited)



                      Three Months Ended           Year Ended

                      December 31,                 December 31,

                      2010           2009          2010           2009

Revenues:

Premium               $ 1,106,370    $ 1,031,812   $ 4,192,172    $ 3,786,525

Service                 23,118         19,018        91,661         91,758

Premium and service
revenues                1,129,488      1,050,830     4,283,833      3,878,283

Premium tax             51,481         41,896        164,490        224,581

Total revenues          1,180,969      1,092,726     4,448,323      4,102,864

Expenses:

Medical costs           922,070        865,415       3,514,394      3,163,523

Cost of services        16,414         14,425        63,919         60,789

General and
administrative
expenses                146,751        133,005       547,823        514,529

Premium tax             50,233         42,103        165,118        225,888

Total operating
expenses                1,135,468      1,054,948     4,291,254      3,964,729

Earnings from
operations              45,501         37,778        157,069        138,135

Other income
(expense):

Investment and other
income                  3,293          3,910         15,205         15,691

Interest expense        (5,452)        (4,108)       (17,992)       (16,318)

Earnings from
continuing
operations, before
income tax expense      43,342         37,580        154,282        137,508

Income tax expense      16,958         13,781        59,900         48,841

Earnings from
continuing
operations, net of
income tax expense      26,384         23,799        94,382         88,667

Discontinued
operations, net of
income tax expense
(benefit) of $12, $
(56), $4,388 and $
(1,204), respectively   (65)           (28)          3,889          (2,422)

Net earnings            26,319         23,771        98,271         86,245

Noncontrolling
interest                920            56            3,435          2,574

Net earnings
attributable to
Centene Corporation   $ 25,399       $ 23,715      $ 94,836       $ 83,671



Amounts attributable
to Centene
Corporation common
shareholders:

Earnings from
continuing
operations, net of
income tax expense    $ 25,464       $ 23,743      $ 90,947       $ 86,093

Discontinued
operations, net of
income tax (benefit)
expense                 (65)           (28)          3,889          (2,422)

Net earnings          $ 25,399       $ 23,715      $ 94,836       $ 83,671



Net earnings (loss)
per share
attributable to
Centene Corporation:

Basic:

Continuing operations $ 0.52         $ 0.55        $ 1.87         $ 2.00

Discontinued
operations              —            —           0.08           (0.06)

Earnings per common
share                 $ 0.52         $ 0.55        $ 1.95         $ 1.94

Diluted:

Continuing operations $ 0.50         $ 0.53        $ 1.80         $ 1.94

Discontinued
operations              —            —           0.08           (0.05)

Earnings per common
share                 $ 0.50         $ 0.53        $ 1.88         $ 1.89



Weighted average
number of shares
outstanding:

Basic                   49,356,768     43,068,502    48,754,947     43,034,791

Diluted                 51,205,720     44,513,679    50,447,888     44,316,467












CENTENE CORPORATION AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS

(In thousands, unaudited)



                                                    Year Ended December 31,

                                                    2010          2009

Cash flows from operating activities:

Net earnings                                        $ 98,271      $ 86,245

Adjustments to reconcile net earnings to net cash
provided by operating activities:

Depreciation and amortization                         52,000        44,004

Stock compensation expense                            13,874        14,634

(Gain) loss on sale of investments, net               (6,337)       (141)

(Gain) on sale of UHP                                 (8,201)       —

Impairment loss                                       5,531         —

Deferred income taxes                                 10,317        3,696

Changes in assets and liabilities:

Premium and related receivables                       (23,359)      2,379

Other current assets                                  (3,240)       (1,263)

Other assets                                          (2,028)       9

Medical claims liability                              (30,421)      79,000

Unearned revenue                                      25,700        78,345

Accounts payable and accrued expenses                 37,398        (60,915)

Other operating activities                            (573)         2,202

Net cash provided by operating activities             168,932       248,195

Cash flows from investing activities:

Capital expenditures                                  (63,304)      (23,721)

Capital expenditures of Centene Center LLC            (55,252)      (59,392)

Purchase of investments                               (615,506)     (791,194)

Sales and maturities of investments                   570,423       642,783

Proceeds from asset sales                             13,420        —

Investments in acquisitions, net of cash acquired,
and investment in equity method investee              (60,388)      (38,563)

Net cash used in investing activities                 (210,607)     (270,087)

Cash flows from financing activities:

Proceeds from exercise of stock options               3,419         2,365

Proceeds from borrowings                              218,538       659,059

Proceeds from stock offering                          104,534       —

Payment of long-term debt                             (195,728)     (616,219)

Purchase of noncontrolling interest                   (48,257)      —

Distributions (to) from noncontrolling interest       (7,387)       8,049

Excess tax benefits from stock compensation           963           53

Common stock repurchases                              (3,224)       (6,304)

Debt issue costs                                      (769)         (458)

Net cash provided by financing activities             72,089        46,545

Net increase in cash and cash equivalents             30,414        24,653

Cash and cash equivalents, beginning of period        403,752       379,099

Cash and cash equivalents, end of period            $ 434,166     $ 403,752



Supplemental disclosures of cash flow information:

Interest paid                                       $ 17,296      $ 15,428

Income taxes paid                                   $ 53,938      $ 52,928



Supplemental disclosure of non-cash investing and
financing activities:

Contribution from noncontrolling interest           $ 306         $ 5,875

Capital expenditures                                $ 8,720       $ (1,476)












CENTENE CORPORATION



CONTINUING OPERATIONS SUPPLEMENTAL FINANCIAL DATA



                        Q4         Q3         Q2         Q1           Q4

                        2010       2010       2010       2010         2009

MEMBERSHIP

Managed Care:

Arizona                 22,400     22,300     22,100     21,700       20,700

Florida                 194,900    116,300    113,100    105,900      102,600

Georgia                 305,800    300,900    295,600    301,000      309,700

Indiana                 215,800    213,300    212,700    211,400      208,100

Massachusetts           36,200     34,400     30,100     26,900       27,800

Ohio                    160,100    161,800    159,300    156,000      150,800

South Carolina          90,300     90,600     92,600     53,900       48,600

Texas                   433,100    428,100    475,500    459,600      455,100

Wisconsin               74,900     106,100    133,600    134,900      134,800

Total at-risk
membership              1,533,500  1,473,800  1,534,600  1,471,300    1,458,200

Non-risk membership     4,200      35,900     50,900     62,200       63,700

TOTAL                   1,537,700  1,509,700  1,585,500  1,533,500    1,521,900



Medicaid                1,177,100  1,122,800  1,135,500  1,088,300    1,081,400

CHIP & Foster Care      210,500    219,100    272,400    266,300      263,600

ABD & Medicare          104,600    94,500     93,800     87,100       82,800

Hybrid Programs         36,200     34,400     30,100     26,900       27,800

Long-term Care          5,100      3,000      2,800      2,700        2,600

Total at-risk
membership              1,533,500  1,473,800  1,534,600  1,471,300    1,458,200

Non-risk membership     4,200      35,900     50,900     62,200       63,700

TOTAL                   1,537,700  1,509,700  1,585,500  1,533,500    1,521,900



Specialty Services (a):

Cenpatico Behavioral
Health

Arizona                 174,600    121,300    119,700    119,300      120,100

Kansas                  39,200     39,800     39,100     39,800       41,400

TOTAL                   213,800    161,100    158,800    159,100      161,500



(a) Includes external membership
only.



REVENUE PER MEMBER PER
MONTH (b)               $ 239.66   $ 224.62   $ 218.40   $ 219.90(c)  $ 233.66



CLAIMS(b)

Period-end inventory    434,900    469,000    480,400    341,400      423,400

Average inventory       304,700    307,500    306,900    283,900      279,000

Period-end inventory
per member              0.28       0.32       0.31       0.23         0.29

(b) Revenue per member and claims information are presented for the Managed
Care at-risk members.

(c) Reduction in revenue per member per month is a result of the pharmacy
carve-outs in 2010.














                                 Q4         Q3       Q2       Q1       Q4

                                 2010       2010     2010     2010     2009



DAYS IN CLAIMS PAYABLE

Medical                          44.5       46.0     47.2     46.6     48.1

Pharmacy                         1.1        1.1      1.0      1.1      2.0

TOTAL                            45.6       47.1     48.2     47.7     50.1

Days in Claims Payable is a calculation of Medical Claims Liabilities at the
end of the period divided by average claims expense per calendar day for such
period.



CASH AND INVESTMENTS (in millions)

Regulated                        $ 1,043.0  $ 895.4  $ 813.0  $ 917.9  $ 949.9

Unregulated                        30.9       32.7     39.4     51.3     36.2

TOTAL                            $ 1,073.9  $ 928.1  $ 852.4  $ 969.2  $ 986.1



DEBT TO CAPITALIZATION           29.3%      24.7%    24.5%    23.7%    33.2%

DEBT TO CAPITALIZATION EXCLUDING
NON-RECOURSE DEBT (d)            23.9%

Debt to Capitalization is calculated as follows: total debt divided by (total
debt + total equity).

(d) The non-recourse debt represents our mortgage note payable of $80.0
million at December 31, 2010.












Operating Ratios:



                                       Three Months Ended  Year Ended

                                       December 31,        December 31,

                                       2010     2009       2010     2009

Health Benefits Ratios:

Medicaid and CHIP                      82.4 %   85.3 %     83.6 %   84.6 %

ABD and Medicare                       86.8     79.9       85.0     81.1

Specialty Services                     83.4     81.8       83.4     80.2

Total                                  83.3     83.9       83.8     83.5



Total General & Administrative Expense
Ratio                                  13.0 %   12.7 %     12.8 %   13.3 %












MEDICAL CLAIMS LIABILITY (In thousands)

The changes in medical claims liability are summarized as follows:



Balance, December 31, 2009 $ 470,932

Incurred related to:

Current period               3,582,463

Prior period                 (68,069)

Total incurred               3,514,394

Paid related to:

Current period               3,133,527

Prior period                 395,034

Total paid                   3,528,561

Balance, December 31, 2010 $ 456,765









Centene's claims reserving process utilizes a consistent actuarial methodology to estimate Centene's ultimate liability.  Any reduction in the "Incurred related to:  Prior period" amount may be offset as Centene actuarially determines "Incurred related to: Current period."  As such, only in the absence of a consistent reserving methodology would favorable development of prior period claims liability estimates reduce medical costs.  Centene believes it has consistently applied its claims reserving methodology in each of the periods presented.

The amount of the "Incurred related to: Prior period" above includes the effects of reserving under moderately adverse conditions, new markets where we use a conservative approach in setting reserves during the initial periods of operations, increased receipts from other third party payors related to coordination of benefits and lower medical utilization and cost trends for dates of service prior to December 31, 2009.

SOURCE Centene Corporation