May 14,
2004 12:08:00 PM ET
NORTH RICHLAND HILLS, Texas,
May 14 -- UICI (the "Company") today announced
that, without acknowledging any fault, liability or
wrongdoing of any kind and subject to satisfaction of
certain conditions, it has agreed to settle a
substantial number of its pending "association group"
lawsuits.
In particular, UICI, The MEGA Life and
Health Insurance Company and Mid- West National Life
Insurance Company of Tennessee (UICI's principal
insurance subsidiaries), together with the National
Association for the Self Employed, Inc., Alliance for
Affordable Services and Americans for Financial
Security, Inc. (the principal membership associations
that make available to their members the Company's
health insurance products), have executed and expect to
shortly file in U.S. District Court for the Northern
District of Texas a definitive Stipulation of Settlement
and Release agreement contemplating, among other things,
the full and final settlement of a class action case
originally filed in Mississippi and a representative
action originally filed in California challenging the
relationship between UICI's insurance companies and the
membership associations.
Pursuant to the terms of the
settlement, MEGA and Mid-West have agreed to include
enhanced disclosures in their marketing and sales
materials with respect to the contractual relationships
between UICI and the insurance companies, on the one
hand, and the associations, on the other hand, and MEGA
and Mid-West have also agreed to enter into an
injunction with respect to certain business practices.
In addition, members of a to-be-certified nationwide
class of current and former MEGA and Mid-West insureds
and current and former members of the associations will
be entitled to relief in the form of free insurance
coverage for a period of months under a personal
accident policy to be issued by a UICI subsidiary
(covering, among other things, accidental death and
out-patient and hospital costs incurred as a result of
specified accidents) and discounts on association
membership fees. The settlement also contemplates the
payment of attorneys' fees to counsel for the plaintiff
class. The proposed settlement does not contemplate a
release of specific claims by individuals for insurance
coverage benefits.
The Company believes that the terms of
the settlement as contemplated by the Stipulation of
Settlement and Release will not have a material adverse
effect upon the financial condition or results of
operations of the Company. As previously disclosed, in
the year ended December 31, 2003, the Company recorded a
$25.0 million charge associated with the reassessment of
loss accruals established for the lawsuits that are
governed by the settlement and for all other pending
"association group" cases to which the Company and its
insurance companies are currently a party.
The settlement of the to-be-certified
class action litigation is subject to preliminary
approval of the terms of the settlement and
certification of a nationwide plaintiff class by the
U.S. District Court for the Northern District of Texas;
mailing notice of the settlement to members of the
plaintiff class; and final approval of, and granting of
a final judgment by, the Court. There can be no
assurance that these conditions to effectiveness of the
settlement will in fact be satisfied.
Separately, the Company has also
agreed, without acknowledging any fault, liability or
wrongdoing of any kind, to settle an association group
case pending in state court in Texas and an association
group case pending in Federal court in California. As
the Company has previously disclosed, the Company has
also recently executed agreements fully and finally
resolving, without admitting liability, all of the
Company's association group litigation brought on behalf
of individual claimants in the state of Mississippi. All
of these cases have been resolved on terms that will not
have a material adverse effect on the Company's
financial condition or results of operations.
UICI, MEGA and Mid-West continue to be
parties to certain other pending "association group"
cases in other states, and the Company continues its
ongoing efforts to bring such cases to a successful
resolution. The Company currently believes that
resolution of those cases will not have a material
adverse effect on the Company's financial condition or
results of operations.
CORPORATE PROFILE:
UICI (headquartered in North Richland
Hills, Texas) through its subsidiaries offers insurance
(primarily health and life) to niche consumer and
institutional markets. Through its Self Employed Agency
Division, UICI provides to the self-employed market
health insurance and related insurance products, which
are distributed primarily through the Company's
dedicated agency field forces, UGA-Association Field
Services and Cornerstone America. Through its Group
Insurance Division, UICI provides tailored health
insurance programs for students enrolled in
universities, colleges and kindergarten through grade
twelve and markets, administers and underwrites limited
benefit insurance plans for entry level, high turnover,
hourly employees. Through its Life Insurance Division,
UICI offers life insurance products to selected markets.
UICI's stock is included in the Standard & Poor's Small
Cap 600 Index. For more information, visit www.uici.net
.
SAFE HARBOR STATEMENT UNDER THE
PRIVATE SECURITIES LITIGATION REFORM ACT OF 1995:
Certain statements set forth herein or
incorporated by reference herein from the Company's
filings that are not historical facts are
forward-looking statements within the meaning of the
Private Securities Litigation Reform Act. Actual results
may differ materially from those included in the
forward- looking statements. These forward-looking
statements involve risks and uncertainties including,
but not limited to, the Company's ability to maintain
adequate liquidity to satisfy its obligations; changes
in general economic conditions, including the
performance of financial markets, and interest rates;
competitive, regulatory or tax changes that affect the
cost of or demand for the Company's products; health
care reform; the ability to predict and effectively
manage claims related to health care costs; and reliance
on key management and adequacy of claim liabilities.
The Company's future results will
depend in large part on accurately predicting health
care costs incurred on existing business and upon the
Company's ability to control future health care costs
through product and benefit design, underwriting
criteria, utilization management and negotiation of
favorable provider contracts. Changes in mandated
benefits, utilization rates, demographic
characteristics, health care practices, provider
consolidation, inflation, new
pharmaceuticals/technologies, clusters of high- cost
cases, the regulatory environment and numerous other
factors are beyond the control of any health plan
provider and may adversely affect the Company's ability
to predict and control health care costs and claims, as
well as the Company's financial condition, results of
operations or cash flows. Periodic renegotiations of
hospital and other provider contracts coupled with
continued consolidation of physician, hospital and other
provider groups may result in increased health care
costs and limit the Company's ability to negotiate
favorable rates. In addition, the Company faces
competitive and regulatory pressure to contain premium
prices. Fiscal concerns regarding the continued
viability of government-sponsored programs such as
Medicare and Medicaid may cause decreasing reimbursement
rates for these programs. Any limitation on the
Company's ability to increase or maintain its premium
levels, design products, implement underwriting criteria
or negotiate competitive provider contracts may
adversely affect the Company's financial condition or
results of operations.
The Company's insurance subsidiaries
are subject to extensive regulation in their states of
domicile and the other states in which they do business
under statutes that typically delegate broad regulatory,
supervisory and administrative powers to state insurance
departments and agencies. State insurance departments
have also periodically conducted and continue to conduct
financial and market conduct examinations and other
inquiries of UICI's insurance subsidiaries. State
insurance regulatory agencies have authority to levy
monetary fines and penalties resulting from findings
made during the course of such examinations and
inquiries. Historically, the Company's insurance
subsidiaries have from time to time been subject to such
regulatory fines and penalties. While none of such fines
or penalties individually or in the aggregate have to
date had a material adverse effect on the results of
operations or financial condition of the Company, the
Company could be adversely affected by increases in
regulatory fines or penalties an/or changes in the
scope, nature and/or intensity of regulatory scrutiny
and review.
The Company provides health insurance
products to consumers in the self- employed market in 44
states. A substantial portion of such products is issued
to members of various independent membership
associations that act as the master policyholder for
such products. The two principal membership associations
in the self-employed market for which the Company
underwrites insurance are the National Association for
the Self-Employed ("NASE") and the Alliance for
Affordable Services ("AAS"). The associations provide
their membership with a number of benefits and products,
including health insurance underwritten by the Company.
Subject to applicable state law, individuals generally
may not obtain insurance under an association's master
policy unless they are also members of the associations.
UGA agents and Cornerstone agents also act as field
service representatives on behalf of the associations,
in which capacity the agents act as enrollers of new
members for the associations and provide field support
services, for which the agents receive compensation.
Specialized Association Services, Inc. (a company
controlled by the adult children of the Chairman of the
Company) provides administrative and benefit procurement
services to the associations. A subsidiary of the
Company generates new membership sales prospect leads
for both UGA and Cornerstone for use by the enrollers
and agents and provides video and print services to the
associations and to Specialized Association Services,
Inc. In addition to health insurance premiums derived
from the sale of health insurance, the Company receives
fee income from the associations, including fees
associated with the enrollment of new members, fees for
association membership marketing and administrative
services and fees for certain association member
benefits. The agreements with these associations
requiring the associations to continue as the master
policyholder and to make the Company's insurance
products available to their respective members are
terminable by the Company and the associations upon not
less than one year's advance notice to the other party.
Articles in the press have been
critical of association group coverage. In December
2002, the National Association of Insurance
Commissioners (NAIC) convened a special task force to
review association group coverage, and the Company is
aware that selected states are reviewing the laws and
regulations under which association group policies are
issued. The Company and its insurance companies are also
subject to several lawsuits challenging the nature of
the relationship between the Company's insurance
companies and the associations that have made available
to their members the insurance companies' health
insurance products. While the Company believes it is
providing association group coverage in full compliance
with applicable law, changes in the relationship between
the Company and the membership associations and/or
changes in the laws and regulations governing so-called
"association group" insurance (particularly changes that
would subject the issuance of policies to prior premium
rate approval and/or require the issuance of policies on
a "guaranteed issue" basis) could have a material
adverse impact on the financial condition, results of
operations and/or business of the Company.
UICI press releases and other company
information are available at UICI's website located at
www.uici.net .