WellPoint Inc., the second-biggest U.S. health insurer, reported fourth-quarter profit that beat analyst estimates on lower-than-expected medical costs and an enrollment boost from its Amerigroup Corp. acquisition.

Earnings excluding a tax settlement and investment gains were $1.03 a share, nine cents higher than the average of 16 analyst estimates compiled by Bloomberg. Medical-plan membership increased to 36.1 million with last year’s $4.9 billion Amerigroup purchase, Indianapolis-based WellPoint said in a statement Wednesday.

WellPoint forecast 2013 profit will rise to at least $7.60 a share, less than the average analyst estimate of $7.93. The company is being cautious in its outlook while looking for a new chief executive officer, said Chris Rigg, a Susquehanna Financial Group analyst in New York.

“It’s rational to offer a conservative outlook,” Rigg said in a phone interview. “You wouldn’t want to back the new CEO, whoever she or he may be, into the corner with a high bar.”

WellPoint is seeking a new leader to replace former CEO Angela Braly, who resigned in August amid complaints about the company’s performance. Interim CEO John Cannon said at a Jan. 8 investor conference that the search may be completed by the end of this quarter.

President’s overhaul

The 2013 forecast reflects “uncertainties” that include a flu outbreak, U.S. budget negotiations and implementation of President Barack Obama’s health-care overhaul, said Kristin Binns, a WellPoint spokeswoman, in an e-mail. It also includes integration costs for the Amerigroup purchase.

The company is taking “an appropriately prudent stance in our outlook, in light of what we expect to be a fluid and dynamic market over the next 18 to 24 months,” Chief Financial Officer Wayne DeVeydt said in the statement.

Fourth-quarter net income surged 38% to $464.2 million, or $1.51 a share, from $335.3 million, or 96 cents, a year earlier, according to WellPoint’s statement. Revenue climbed to $15.3 billion from $15.2 billion a year earlier.

The results were buoyed by WellPoint’s purchase last month of Amerigroup, the largest insurer specializing in the government-sponsored Medicaid plans for the poor. Adding Amerigroup’s 2.7 million members, total enrollment increased about 5 percent.

Medical costs for WellPoint’s employer-sponsored plans also came in below expectations, helping earnings. That followed a Jan. 17 report by Minnetonka, Minn.-based UnitedHealth Group Inc., the largest U.S. medical insurer, that Americans hadn’t used medical services as much as expected last year.

“In terms of an uptick in utilization, we haven’t seen that at all,” Thomas Carroll, a Stifel Nicolaus & Co. analyst in Baltimore, said in a telephone interview before the announcement.

To contact the reporter on this story: Alex Nussbaum in New York at anussbaum1@bloomberg.net

To contact the editor responsible for this story: Reg Gale at rgale5@bloomberg.net

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